Compose the last question on the template reflection in a Word document and be sure to address, at a minimum, the following questions:Why do you feel the way you do about the issue presented?Of the four responses (attached) offered in the scenario, which do you think is the most ethical and why?Which ethical theory would you use to support your stance? Why does this theory work?4. Support your conclusions with evidence and specific examples from the textbook, including a minimum of one theory of ethics to defend your stance.5. Your reflection must be 1-2 pages (250 words) in length and follow APA formatting and citation guidelines as appropriate, making sure to cite at least two sources.I attached the template, which provides context on what the reflection needs to be about. The final question on the template is the reflection instructions, including discussing an ethical theory and the pros & cons of the topic, which applies to HIV/AIDS Prevention. I also attached one of the responses from the scenario that you must include in the reflection. Thanks!
Unformatted Attachment Preview
Reflective Journal Template – Topic Reflection
Topic
Public Health and HIV-AIDS
What are the key points of contention on this topic?
The keys points of this topic is how to slow the spread of HIV and AIDS in
Africa. One side believes that condoms should be available to everyone to stop
the spread and the other side believes that everyone should do mandatory HIV
tests every so often.
What side of the argument (stance) do you take on this topic?
My stance on this topic is a mixture of both. I believe that condoms and HIV
testing should be available for everyone and should be easy to access. I don’t
think it is right to force someone into doing a test, considering it is their body
and that decision should be voluntary. But, if you have test available and easily
accessible, it will bring the likeliness of an individual going to get tested.
What strong points does the other side of this topic have?
Although it is not right to force someone into taking an HIV test, it would
definitely bring the numbers down considering everyone who has it would be
aware and getting treatment immediately. Logically, it is a good option but
ethically it is not right to force someone into taking a test.
What were the three most important things you took away from the topic?
1. I was not aware that more than 6,300 new HIV infections are discovered
every day. That number is crazy and needs to go down.
2. The average life expectancy in Zambia is 33 years which is the lowest in
the world and AIDs plays a big part in that. That is horrible considering
33 is so young.
3. Confidentiality of your medical records is huge, you shouldn’t be forced
into taking tests and should only be with your own will.
Which ethical theory (of the 6 approved ones ONLY – Kant; Act Utilitarianism;
Rule Utilitarianism; Care Ethics; Virtue Ethics; and Social Contract) would you
apply to this topic to defend your stance? Explain fully. 250 words.
A) In this reflection you must first define the key terms of the debate (for
example, define what Euthanasia/Abortion/Stem Cell/Public
Health/PreNatal Testing/Animal Research/Health Care, etc. means and
what are the different types depending on which topic you are
discussing)
B) Define and explain the ethical theory you chose (show me you know
exactly what the theory is and does – in your own words)
C) Present the evidence both pro and con and follow up how using your
ethical theory is the best way to determine whether or not your stance is
really ethical
D) Conclusion – any final thoughts and opinions would go here
E) 2 to 3 resources as support for your evidence (text book counts as 1)
Assessment 3: Public Health Data AnalysisGenerative AI tools are restricted for certain functions in this assessment task
In this assessment, you can use generative artificial intelligence (AI) in order to produce
summaries of topics that provide a basis for further non-AI-assisted enquiry only. Any use of
generative AI must be appropriately acknowledged (see Learn HQ)
Weighting: 30 %
Details of task:
This assignment involves the presentation and interpretation of descriptive statistics and statistical
test results.
You have been randomly allocated to 1 of a large number of different datasets from the
Roberton Data Set on Moodle.
This task will take approximately 10 – 12 hrs to complete.
On completion of this assessment task, you will be able to:
● Demonstrate an ability to present data clearly and interpret its results
● Conduct and show workings where appropriate for various statistical tests
● Describe the epidemiological foundations for obtaining the data
● Ability to generate an interpret results based on various statistical tests and public health
tasks
Word limit: This assessment is 2,500 word equivalent with a focus on calculations and reporting.
Format: Your results will be submitted in a question and answer format using a quiz mode on
Moodle. This report requires extensive data analysis and interpretation skills.
Submission is final and your attempt can NOT be reopened.
Criteria for marking: Question set and marking guide are available on the unit’s Moodle site.
Attempts allowed: 1Due date: 11:55 pm, Tuesday 10 October 2023
Unformatted Attachment Preview
BMS1042: Public Health & Preventive Medicine
Assessment 3 – Public Health Data Analysis
The Roberton Report
MONASH PUBLIC HEALTH & PREVENTIVE MEDICINE
Public Health Data Analysis (30%)
Assessment 3
The Council of Roberton needs our help. They are investigating the impact of car accidents and
reaction time in their population and want to ensure that they make informed decisions.
Therefore, they need you to analyse the data and provide recommendations.
What you need to know:
• Assessment questions available on Moodle in Week 2
• You will have covered all content for this assessment in Week 8
• An Assessment 3 help session will be run in Week 9
• More information in the weekly live lectures
•
•
•
•
You will be randomly allocated to a dataset
Analyse the data to complete the online report in your own time
Learn all the skills in the weekly tutorials
Use the e-books as a resource and for more practice
Assessment 3 – What’s on Moodle
In the “Assessment” tab
PDF of question set
Assessment 3 – What’s on Moodle
Where to access quiz & dataset:
Navigation bar on left hand side:
Assessment 3 section is underneath the Week-by-Week sections
Available from 10:00 am, Tues 1 August 2023.
Assessment 3 mark distribution
Section
Questions
Topic
Marks
Section A: Understanding the context
1 to 4
Reaction time & stopping distance
8 marks
Section B: Describing & Summarising Data
5 to 13
Sampling, Types of data, Reaction time
20.5 marks
Section C: Graphs and %
14 to 19
Gender and Reaction time: slow vs quick
11 marks
Section D: Conducting statistical tests
20 to 35
Do males and females differ in their reaction times?
Section E: Interpreting statistical tests
36 to 43
Handedness and Reaction time: slow vs quick
13 marks
Section F: Using statistical packages
44 to 49
Reaction time and physical activity
12 marks
Section G: Putting it all together
50
Conclusion
10 marks
TOTAL
25.5 marks
100 marks
Quiz navigation bar in The Roberton Report quiz
Each Section of the quiz is a series of questions on a research question
(see previous slide)
“Description” questions with info are highlighted.
Make sure to watch the embedded video at the start of each section.
For navigating the quiz:
•
DO: Use the “Previous page” and “Next page” buttons at the
bottom of each page of the quiz.
•
DON’T: Use the browser navigation “arrows”.
Important things to be aware of…
• You can go into the quiz as many times as you like to view
the questions / enter answers while the quiz is open.
There is no timer.
• Once Finish attempt… and Submit all and finish have
been clicked, your quiz submission is final.
Don’t submit until you’ve entered all your answers.
• At the Assessment 3 deadline, all open quizzes will
automatically submit.
• Make sure you press the submit button!
• Need an extension or special consideration?
Make sure you apply with enough time to get the outcome
before the deadline, so the quiz stays open!
Have a question?
•
•
•
•
Read the info in the “Assessment Detailed Information” Book.
Watch the “Assessment 3 video” and FAQ for Assessment 3
Download the PDF of the question set
Browse / Search the forum
– has your question has already been asked?
If you’ve done all of the above – post your question on the Forum.
BMS1042 – Assessment 3 – Public Health Data Analysis
Assessment 3: Public Health Data Analysis
Generative AI tools are restricted for certain functions in this assessment task
In this assessment, you can use generative artificial intelligence (AI) in order to produce
summaries of topics that provide a basis for further non-AI-assisted enquiry only. Any use of
generative AI must be appropriately acknowledged (see Learn HQ)
Weighting: 30 %
Details of task:
This assignment involves the presentation and interpretation of descriptive statistics and statistical
test results.
You have been randomly allocated to 1 of a large number of different datasets from the
Roberton Data Set on Moodle.
2. This task will take approximately 10 – 12 hrs to complete.
1.
On completion of this assessment task, you will be able to:
●
●
●
●
Demonstrate an ability to present data clearly and interpret its results
Conduct and show workings where appropriate for various statistical tests
Describe the epidemiological foundations for obtaining the data
Ability to generate an interpret results based on various statistical tests and public health
tasks
Word limit: This assessment is 2,500 word equivalent with a focus on calculations and reporting.
Format: Your results will be submitted in a question and answer format using a quiz mode on
Moodle. This report requires extensive data analysis and interpretation skills.
Submission is final and your attempt can NOT be reopened.
Criteria for marking: Question set and marking guide are available on the unit’s Moodle site.
Attempts allowed: 1
Release date: 10:00 am, Tuesday 1 August 2023
Due date:
11:55 pm, Tuesday 10 October 2023
1
BMS1042 – Assessment 3 – Public Health Data Analysis
Assessment 3: Public Health Data Analysis
The slogan for World Health Day 2004 – Road Safety Is No Accident – suggests that road safety does not
happen accidentally, but requires a deliberate effort by governments and their many partners.
The WHO strategy for road traffic injury prevention has three objectives:
To build better systems for gathering and reporting data on traffic injuries;
To make prevention of road traffic injuries a public health priority in all countries;
To advocate for prevention and promote appropriate prevention strategies for road traffic injuries.
In Australia, on average, five peoples die every day in road crashes. In a 2018 report by the ABC using
national data found that:
48,592 people have died on the Australia’s road since 1989
Traffic injury is the biggest killer of children under 15
Traffic injury is the 2nd biggest killer of Australians aged between 15-24
The yearly death toll has decreased from 3798 (1970) to 1225 (2017)
According to the AIHW Injury in Australia: transport accidents report (updated 9 Dec 2021), in 2018-19,
transport injuries resulted in:
63,900 hospitalisations (255 per 100,000 population) – 10 % of injury hospitalisations
1,400 deaths (5.6 per 100,000 population) – 10 % of injury deaths
This is despite Australia’s strong legislative approach to road safety. Public health experts know:
Road deaths are predictable and preventable
Road safety is no accident
Links:
http://www.emro.who.int/violence-injuries-disabilities/violence-events/whd2004.html
https://www.abc.net.au/news/2018-01-25/every-road-death-in-australia-since-1989/9353794
https://www.aihw.gov.au/reports/injury/transport-accidents
Dataset: The Council of Roberton
The Council of Roberton is interested in investigating risk factors that can lead to road accidents in their
population. They have sent out a tender for the brightest researchers to inform their future public health
policies and health promotion interventions. They are interested in the association between physical activity
in terms of reaction time for stopping a car and preventing an accident.
The good news is that they have existing historical data. The data was collected from a census index from
the Council of Roberton which has 17,935 residents aged between 6 years to 80 years. Each individual’s
data were identified by a six-letter identification code. From the records given on Moodle in the Excel
file “Roberton Dataset.xlsx”, the age group and gender of each person in this population are known.
Gender was only collected as a binary variable: Male and Female. This data is a snapshot in time and
there is no historical or post-research data available.
The Council wanted to examine the association between reaction time and physical activity. Therefore, they
have conducted a one-off test as part of their health assessments and collected the reaction time of the
individuals. A quick reaction time on the test is considered an indicator of a good ability when to stop a car.
2
BMS1042 – Assessment 3 – Public Health Data Analysis
A stratified random sample of 100 Roberton residents has been obtained. The stratification was based on
the age groups and the sample size from each stratum was in proportion to that in the population:
Age Group
6-20
21-35
36-50
51-65
65-80
%
22
23
25
19
11
Variable
Descriptor
Age
Years (recorded as the date of birth)
Gender
Male (M) and Female (F)
Handedness
Left-Handed (LH) and Right Handed (RH)
Physical activity
Hours per week
Reaction time to test
Seconds
Reaction time: Slow and Quick
Slow (>= 0.31 sec) & Quick ( 0.05, the p-value is not significant. Therefore, in this sample we can not justify
rejecting the null hypothesis.”
33. What is the 95% Confidence Interval? (3 decimal places) [1 mark]
_____ to _____
34. The correct description and interpretation of your 95% Confidence Interval is: [3 marks]
35. Write a conclusion paragraph about your statistical conclusions for Section D.
[4 points, 1 mark each = 4 marks]
9
BMS1042 – Assessment 3 – Public Health Data Analysis
Section E: Interpreting statistical test results (13 marks)
Now, let’s look at the relationship between handedness and reaction time: slow vs quick.
Watch the embedded in the quiz
Hint: For this question, you’ll need your data summarised in the table below.
Slow
Quick
Total
Left
Right
Total
36. For the relationship between Handedness (left) and Reaction time (slow) calculate the Odds Ratio
(2 decimal places). [1 mark]
37. For the relationship between Handedness (left) and Reaction time (slow): interpret the results of the
odds ratio from the previous question [2 marks]
Next, you will calculate the SE and 95% CI of the Odds Ratio, and interpret the 95% CI.
You will need your odds ratio (handedness (left) and reaction time (slow)) from the earlier question
to 6 decimal places.
38. Calculate the standard error of the odds ratio: (4 decimal places) [1 mark]
39. Calculate 95% CI of the Odds Ratio. (3 decimal places) [1 mark]
Hint: Write your answer as x.xxx to y.yyy. e.g. 0.123 to 1.234.
40. Interpret your 95 % CI from the previous question, by filling in the gaps to the sentence below. [3
marks]
This interval the value of , so it statistically significant
A: includes; excludes
B: 0; 1
C: is; is not
10
BMS1042 – Assessment 3 – Public Health Data Analysis
41. Calculate the Z-statistic (2 decimal places) [1 mark]
42. Calculate the p-value (3 decimal places) [1 mark]
43. Interpret the p-value from the previous question [3 marks]
As the p-value is than 0.05, the null hypothesis is .
The odds of having a slow reaction time is left and right handed people.
A: greater than ; less than
B: not rejected ; rejected
C: the same among ; different between
(Section F follows on the next page…)
11
BMS1042 – Assessment 3 – Public Health Data Analysis
Section F: Using statistical packages (12 marks)
Watch the embedded in the quiz.
The Council of Roberton has contacted you and is really interested in the association between physical
activity and how this impacts on your reaction time in the test.
Is there a correlation between the physical activity reported and their reaction times?
You are going to need to justify your answer using appropriate graphs, interpreting correlation coefficients
and appropriate summary conclusions.
44. Draw a graph for the variables: physical activity and reaction time.
Please attach the graph as a file below.
In the text box, type the file name only.
[5 marks]
45. What is your line of best fit? (All numbers to 4 decimal places) [1 mark]
46. What is the predicted reaction time for someone with 3 hours of physical activity per week?
(3 decimal places) [1 mark]
47. State your r (correlation) value (4 decimal places) [1 mark]
48. State your R2 (coefficient of determination) value (4 decimal places) [1 mark]
49. Using your results from this section interpret your data by completing this sentence. [3 marks]
“Overall, there was a [X] correlation between reaction times and physical activity. [Y] in physical
activity were correlated with [Z] reaction times of individuals.”
[X] = strong negative;
weak negative;
weak positive;
strong positive
[Y] = increases ; decreases
[Z] = increased; decreased
12
BMS1042 – Assessment 3 – Public Health Data Analysis
Section G: Putting it all together (10 marks)
Congratulations! This is the end of your investigation.
Now it is time to finalise those conclusions and submit your recommendations to the Council.
Watch the embedded in the quiz.
50. Describe your results and conclusions. Based on these, suggest recommendations in the form of a
public health response that the Council of Roberton could implement to help improve this situation
(max 300 words)
[10 marks]
Key points required:
Your results (numbers and interpretation)
i. Gender (Section D)
ii. Handedness (Section E)
iii. Physical activity (Section F)
A health promotion approach response and recommendation to the council
Your overall conclusion
13
Formula Sheet & Statistical Tables
BMS1042 Public Health and Preventive Medicine – 2023
Formula Sheet
Z – score
Observed Value – True Mean
True Standard Deviation
Z score
Sample mean – True Mean
Standard Error
T score
Sample mean – True Mean
Standard Error
where df n 1
2
Larger SD
Ratio
Smaller SD2
df
SE
Equal SD
Unequal SD
Paired
df = n1 + n2 – 2
df not taught
df = n – 1 (pairs)
SDp2
(n1 1) SD12 (n2 1) SD22
n1 n2 2
SD p2
SE
t-Statistic
t stat
95% CI
n1
SE
SDd
n
SD p2
n2
x1 x2
SE
x x T SE
*
1
SD12 SD22
n1
n2
SE
2
t stat
x1 x2
SE
x x T SE
*
1
2
t stat
xd
SE
xd T * SE
Where:
n1 and n2 are the sample size
x1 & x2 are the sample means. x d is the mean of the differences.
SD1 and SD2 are the sample standard deviation
SDp is the pooled standard deviation. SDd is the standard deviation of the differences.
SE is the standard error
T* is the t multiplier
Page 1 of 6
Relative Risk
Odds Ratio
Statistic
RR
a /(a b) a (c d )
c /(c d ) c (a b)
OR
ad
bc
Standard Error
SE
1
1
1
1
a ab c cd
SE
1 1 1 1
a b c d
Z-statistic
Z
95% Confidence Interval
exp lnRR Z * SE
Expected Cell Frequency
2
lnRR
SE
Z
lnOR
SE
exp lnOR Z * SE
Row Total Column Total
Grand Total
Observed – Expected2
Expected
Correlation coefficient: t
Linear regression:
t
r ( n 2)
(1 r 2 )
coefficient
SE
Page 2 of 6
Statistical tables from Essential Medical Statistics
Page 3 of 6
Page 4 of 6
Page 5 of 6
END OF FORMULA SHEETS & TABLES
Page 6 of 6
Hi, there are some questions to give answers. If you are expert in this area so no doubt you can accept the bid other don’t need to accept. No references are required no similarity problem.
1.
Identify changes in the legal, political and social frameworks within the disability sector.
The suggested response is approximately 50 – 100 words and/or 5 – 8 detailed bullet points
2.Identify ways society can affect the level of impairment experienced by a person with disability.
The suggested response is approximately 30 – 50 words and/or 3 – 5 detailed bullet points
3. Consider personal values and attitudes regarding disability and explain their potential impact when working in disability contexts.
The suggested response is approximately 30 – 50 words and/or 3 – 5 detailed bullet points
4. Explain how you would develop and adjust your own approaches to facilitate empowerment. Provide four (4) examples.
The required response is four (4) examples, approximately 15 – 30 words per response
5. Explain the social versus medical model of service.
The suggested response is approximately 20 – 50 words and/or 2 – 4 detailed bullet points
6. Consider the institutionalised versus person-centred, self-directed model of support and explain the differences.
The suggested response is approximately 20 – 50 words
a. Provide two (2) examples of the Institutionalised Model of Support
b. Provide two (2) examples of Self-Directed Support
The patient visits the office with a headache and fatigue issues. She reports feeling tired and having difficulty getting sleep. She wakes up early and has a dull, aching, and generalized headache. She admits that these symptoms began 21 days ago and have worsened. She has lost interest in the activities she previously enjoyed (Jakobsen et al., 2020). She will not work due to fatigue and a challenge in focusing. She has no appetite and lost weight of 10 pounds last month.
The List of the Client’s Issues
There is a challenge in getting sufficient sleep; she has lost interest in previous activities, lost focus, missed work because of fatigue, is more concerned about her children and fears they might get lost, and have a headache.
Diagnosis to be Considered and Reasons
The potential condition is a major depressive disorder. She presents with six symptoms which have lasted for three weeks. The DSM-5 diagnosis of major depressive disorder requires at least five of the nine symptoms (Westhoff-Bleck et al., 2020). There must be the presence of depressed moods or lost interest in activities. Based on the scenario, the patient has lost interest in an activity, experienced changes in her weight and is not dieting, fatigue, decreased focus, retardation of the psychomotor, and insomnia.
Differential Diagnosis
The potential differential diagnoses are anxiety, bipolar disorder, borderline personality disorder, and adjustment disorder characterized by depressed mood.
Test or the Screening tool to Apply
The Beck Depression Inventory (BID) can screen depression conditions (Westhoff-Beck et al., 2020). It helps measure the behavioral manifestation and the severity of the condition.
Treatment to Propose
The suitable drug for treatment is escitalopram which is an SSRI. It has fewer side effects, well tolerated by the patient with no other medical issues.
The Standard Guideline for the Assessment or Treatment of the Patient
The standard guideline for the assessment and treatment involves the consideration of scientific proof, considering the benefits compared to harms, and the values and preferences of the clients (Jakobsen et al., 2020). There is also a need to consider the applicability of the evidence across demographic groupings and settings.
References
Jakobsen, J. C., Gluud, C., & Kirsch, I. (2020). Should antidepressants be used for major depressive disorder? BMJ Evidence-Based Medicine, 25(4), 130-130.
Westhoff-Bleck, M., Winter, L., Aguirre Davila, L., Herrmann-Lingen, C., Treptau, J., Bauersachs, J., … & Kahl, K. G. (2020). Diagnostic evaluation of the hospital depression scale (HADS) and the Beck depression inventory II (BDI-II) in adults with congenital heart disease using a structured clinical interview: Impact of depression severity. European journal of preventive cardiology, 27(4), 381-390.
Select one of the case studies below for your assignment. In your discussion, be sure to discuss developing collaborative relationships with clients when teaching concepts concerning pathological states to individuals and families.
Case Study Assignment Requirements
Make sure all of the topics in the case study have been addressed.
Cite at least three references in your case study paper; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
All reference sources must be within 5 years.
Do not use sources such as Wikipedia or UpToDate as a reference.
Assignments must have at least four full pages of analytic content, double-spaced (the cover and reference pages do not count in the page count, but must be included with the assignment), and follow APA 7th edition format.
Case Study 1: Disorders of Hepatobiliary and Exocrine Pancreas Function
Robert is a 68-year-old who has dealt with alcoholism for over 30 years. He has cirrhosis and is anemic. His appetite has declined, and he regularly complains of abdominal pain. Recently, while preparing himself a sandwich, he cut his finger deeply with a knife. The wound bled profusely, and he used a kitchen towel to stop the flow. Refusing to go and seek medical assistance, he put ice on his finger and wrapped the towel around it. He sat down in his recliner with his hand over his head and fell asleep.
Anemia and clotting disorders are common features of alcoholic liver disease. What are the mechanisms that cause these hematologic disorders?
What gastrointestinal bleed is associated with a high mortality rate in those with advanced cirrhosis? What is the pathophysiology of this condition?
Acute pancreatitis is sometimes seen in alcoholics, particularly after binge drinking. Why are tachycardia and hypotension indications of this condition?
Why are women more predisposed to alcoholic liver disease than men?
Case Study 2: Somatosensory Function, Pain, Headache, and Temperature Regulation
Ramandeep is an active 23-year-old. She works as a part-time nurse during the day and is studying for a postgraduate certificate in the evening. Ramandeep started to wear a bite plate at night after she began to experience jaw pain and headaches. Sometimes the pain radiated to her ear, and she would apply a hot water bottle to it to ease the discomfort. It was not until her husband mentioned to her that he heard her grinding her teeth at night while she was sleeping. She knew then that her headaches might be from temporomandibular joint syndrome, and she went to her dentist to confirm her thoughts. In addition to the bite plate, the dentist also recommended she should continue with the application of heat, use NSAIDs when needed, and incorporate regular relaxation exercises throughout her stressful days.
What effect does heat have on nociceptors so that it makes a good nonpharmacologic treatment for pain?
Heat and cold treatment are both hypothesized to have an effect on the release of endogenous opioids. What are these chemicals, and why are they hypothesized to be beneficial in the body?
Using your knowledge of physiology, how do NSAID analgesics function in the management of pain?
Case Study 3: Disorders of Visual Function
Phil is a 54-year-old with type 2 diabetes. After he was initially diagnosed with the condition, his physician referred him to an ophthalmologist for a comprehensive eye examination. Phil had been struggling with the lifestyle changes he was required to make. He was able to return to a healthy weight with physical exercise and dietary changes, but he worked long hours and ate poorly when on business trips. Phil missed his second annual checkup with his ophthalmologist because of such a trip. When he finally made it in, she examined him and stated there was no evidence of small retinal hemorrhages and cotton-wool exudates. She emphasized his need to reduce his hypertension and hyperlipidemia and wrote up a report for his physician.
How do visual disturbances arise from background and proliferative retinopathy?
How might blindness occur with a prolonged detached retina? Explain using your knowledge of pathophysiology.
What are the similarities and differences between traction retinal detachment and rhegmatogenous detachment?
Case Study 4: Mechanisms of Endocrine Control
Leda is a 38-year-old woman who began to experience weight gain, mood swings, and weakness. When her periods became irregular, she went to her physician. Leda’s physician heard the symptoms Leda was concerned about and then ordered a 24-hour free cortisol urine test and an overnight dexamethasone suppression test and measured her serum ACTH levels. The results indicated that Leda had Cushing disease, a condition caused by the hypersecretion of ACTH by the anterior pituitary and resulting in elevated cortisol levels. To confirm the diagnosis, Leda’s physician ordered a cranial MRI to identify the presence of a pituitary tumor.
The dexamethasone test involves the administration of a synthetic glucocorticoid (e., cortisol). Knowing what you do about negative feedback mechanisms, how might this test be used to assess pituitary function?
Describe how the steroid hormones, like cortisol, are metabolized in the body. What are the advantages of using a 24-hour urine test to measure this hormone?
Protein-based and steroid-based hormones trigger cellular responses in different ways. What are the differences between the mechanism of action of ACTH and cortisol on target cells?
Case Study 5: Disorders of Endocrine Control of Growth and Metabolism
Bertha is a 71-year-old woman who takes daily medication for Hashimoto thyroiditis. Last winter, she developed pneumonia. Although she did her best to run errands for her husband, she became tired easily and needed to rest frequently. One day, after shoveling the snow outside, her husband came inside to find Bertha lying on the sofa covered in blankets. Her face appeared puffy and her eyelids hung. When he spoke to her, Bertha’s voice was hoarse and her words did not make sense to him. Her respirations were also shallow and slow. Suspecting low thyroid hormone levels were causing the signs, her husband called for an ambulance.
When testing for hypothyroidism, why is the free T4 level an important measurement? What would the TSH and T4 test results indicate in someone with primary hypothyroidism?
Using your knowledge of the function of thyroid hormone in the body, explain why Bertha’s respiratory rate was decreased? Why might pleural effusion be present in someone with hypothyroidism?
What factors in Bertha’s history leave her susceptible to myxedematous coma? What are the physiologic aspects involved in myxedematous coma?
Before finalizing your work, it is important to:
Review Case Study Assignment Requirements (described above) and the Case Study Assignment Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
Make sure to review your chosen case study carefully to make sure you have effectively answered all questions asked.
Utilize spelling and grammar checks to minimize errors.
Follow the conventions of Standard American English (correct grammar, punctuation, etc.).
Make sure your assignment is original, insightful, and utilizes your logic and critical thinking skills; that your assignment is well-organized, with superior content, style, and mechanics.
Utilize APA 7th Edition format.
Be diligent about APA formatting including paraphrasing and direct quotations, utilizing appropriate in-text citations, and referencing your sources.
You complete a chart review, take note of current orders and enter the patient’s room to
introduce yourself and complete a full assessment.
You note that Mr. Burmond is awake, but lethargic when you enter his room. He knew the
time, but not the day of the week. His speech is clear and easy to understand. Pupillary
response was reactive to light. His wristband is in place and he responds correctly to his
name and date of birth. Both side rails are up and his bed is at the lowest position. You note
shortness of breath, especially with readjustment in the bed. Crackles are auscultated in the
lower lobes, but note no evidence of stridor or wheezing. Respirations are 19 per
minute. Saturation is 92% on 2L oxygen therapy. Temperature is 99.9 F. His heart sounds
are present, with no abnormal beats upon auscultation. His BP is 142/89 and heart rate is
92. Pulses are all present, 2+ in upper extremities and 1+ in the pedal region. Capillary refill
is less than 2 seconds. No edema noted in lower extremities. Bowels sounds present in all
quadrants. No pain disclosed. Active ROM and muscle strength is 1+ in all extremities. No
skin breakdown noted. Needs minor assistance, but has bathroom privileges. IV line in right
forearm flushed with no issues. IV fluid therapy infusing..
CHIEF COMPLAINT: “I have had trouble breathing for the past 3 weeks”
HISTORY OF PRESENT ILLNESS: 65-year-old Caucasian male complaining of shortness of
breath and productive cough with yellow sputum for 3 weeks. He also states that he has
been coughing accompanying with low-grade type fever. He also admits to having
intermittent headaches and bilateral chest pain that does not radiate to upper extremities
and jaws but worse with coughing. Patient initially had this type of episodes about 10
months ago but has intermittently getting worse since.
PMH: Asthma, Bronchitis PSH: none FH: Non-contributory SOCH: Married and lives with wife,
Mary, retired postal worker, has 3 children, 7 grandchildren. 100 packs/years and is a social
drinker. He denies any illicit drug use.
TRAVEL HISTORY: Denies any recent travel overseas
ALLERGIES: Sulfa
HOME MEDICATIONS: Albuterol 2 puffs bid prn.
REVIEW OF SYSTEMS REVEALS: Same as above
PHYSICAL EXAM: Vital signs are: Temp. 98 F / BP 126/82, Resp. 26, P 88
General: Patient is cachectic, anxious in mild acute respiratory distress. Lips are cyanotic.
He denies fever, night sweats
HEENT: Head: Atraumatic, normocephalic, Eyes: Conjunctiva clear; pupils 3 mm in size,
EOMI, PERLLA Ears: Tympanic membranes are pearly gray; no TM inflammation or
perforation. Nose: Nasal congestion with thick yellow rhinorrhea; swollen, erythematous
nasal turbinates; septum midline Throat: Pharyngeal erythema; post-nasal drainage; tonsils
mildly enlarged; there are no pustules, ulcers or exudate.
Face: Symmetrical; no maxillary or frontal sinus tenderness
Neck: Supple, no anterior or posterior cervical lymphadenopathy; thyroid is not palpable;
trachea is midline; no JVD
Heart: regular rhythm; normal S1 and S2; no S3 or S4; no murmurs, gallops or rubs.
Lungs: with rapid respirations, marked supraclavicular and intercostal retractions, using his
accessory muscles to breath.Bi-basilar crackles left > right, diffuse wheezes.
Chest exam revealed limited expansion, increased A-P diameter, hyperresonance and a
fixed diaphragm on percussion, marked inspiratory and expiratory wheezing, and a
prolonged expiratory phase.
Abdomen: No distention; no tenderness to palpation; no masses or organomegaly; bowel
sounds present in four quadrants; no bruits auscultated; no inguinal adenopathy.
Extremities: Warm, +1 pedal pulses. +clubbing. No edema.
Neuro: Moving all extremities well, 2+/4 reflexes throughout.
OSTEOPATHIC STRUCTURAL EXAM: He has bilateral paravertebral spasm, greater on the
right, T10-L5. The spine is flattened T10-L2. Generalized restriction of the lumbar to spring
towards rotation and sidebending both directions. Restriction to extension (restriction to
anterior spring) T10-L3. Articular restriction is greatest T10-12. T4 ESrRr, T2 FSlRl. Twelfth
ribs held in exhalation at an extremely acute angle static with respiration. Ribs 8-10 are held
in inhalation bilaterally. 1st and 2nd ribs are elevated on the right with right clavicle
elevated. The left 2nd rib is held in exhalation and there is bogginess to the tissues in the
area of the second ribs. The thorax has general restriction to exhalation. The diaphragm
was extremely tense and depressed with virtually no discernable movement during
respiration.
ASSESSMENT: Exacerbation of COPD related to respiratory infections.
PLAN: Treat with antibiotics and observe for improvement in status. Discharge home when
stable.
Chest X-ray
Imaging Results
Chest X-ray
COPD – Hyperexpansion In normal subjects the diaphragm is intersected by the 5th to 7th anterior ribs in t
with COPD as they are osteopenic due to long term steroid use – as in this patient In this image, the 7th ribs
level with the mid-clavicular line – so are the lungs hyperexpanded? Patient positioning and use of accessor
of the ribs on a chest X-ray Flattening of the diaphragm (red lines) is often a more reliable feature of lung hy
normal diaphragm shape and position
Diagnostic Study Results
Pulmonary Function Test
COMPLETE PULMONARY FUNCTION TESTING AND INTERPRETATION DATE OF TEST: REASON FOR THE TEST:
amount of deterioration over time. Spirometry showed forced vital capacity severely reduced to 49 percent
The ratio of FEV1 to forced vital capacity is reduced to 66 percent predicted. FEF 25-75 percent is severely re
reduced to 6 percent. Response to bronchodilators showed modest improvement with the maximum impro
Also there is marked improvement in the small airway, FEF 25-75 percent ratio that has improved to 20 per
change considering that small airway disease is still small. Total vital capacity was 63 percent predicted, whi
severe air trapping. Diffusion was decreased to 37 percent predicted with adjusted diffusion to hyperventila
showed severe obstructive defect with mild response to bronchodilators and evidence of obstructive sleep
defect. 2. Mild response to bronchodilators. 3. Severe air trapping. 4. Severe diffusion impairment. 5. Possib
Medication administration record : Approving Provider: John Mack, MD
Scheduled
FLUTICASONE PROPIONATE; SALMETEROL XINAFOATE
Details: , 2x Daily, Inhaled
(LEVAQUIN) LEVOFLOXACIN IN DEXTROSE 5% IVPB/DRIP
Details: 500 mg at 100 mL/hour, Daily, IVPB
prednisone
Details: 50 mg , Daily, Oral
PRN
ALBUTEROL
Details: 2 puffs , Every 6 Hours PRN, Inhaled
CONTINUOUS INFUSIONS
0.9% SODIUM CHLORIDE (NACL)
Details: at 50 mL/hour, Continuous, IV
Student Name
Clinical Judgement Plan
Professor Name
Date
SK/DW 2/22 pg. 1
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
Patient Information
(1)
History of Present Illness (HPI)
WHAT BROUGHT THE PT TO THE HOSPITAL? WHAT EVENTS LEAD UP TO THIS? WHAT HAPPENED WHEN THEY
GOT TO THE HOSPITAL- UNTIL NOW WHEN YOU ARE PROVIDING CARE? (USE SEPARATE ATTACHED WORD DOC → WHEN
NEEDED) (SEE RUBRIC REQUIREMENTS)
Patient Initials:
Age & Gender: Age in years/not DOB
Height/Weight:
Code Status:
Medical History: (SEE RUBRIC REQUIREMENTS)
PAST DIAGNOSED MEDICAL PROBLEMS
For each disease identified, define, it, describe pathophysiology, and cite source
Living Will/ DPOA:
Chief Complaint
Ex: SUBJECTIVE (Abnormal – Bullet Points)
What is the cause of the patients problem
now describing i.e., Pt is having SOB 8/10
with exertion?
Surgical History: (SEE RUBRIC REQUIREMENTS)
PAST DIAGNOSED SURGICAL PROBLEMS
For each procedure identified, define & describe it; include year of procedure & cite source
Social History:
SMOKING/ CIGARETTE/ TOBACCO/ E-CIGARETTE /MARIJUANA USE ALCOHOL/ ELICIT DRUG USE
Admitting Diagnosis & Admission
Date
Cultural considerations, ethnicity, occupation, religion, family support, insurance.
(1) (14) Socioeconomic/Cultural/Spiritual Orientation & Psychosocial
Considerations/Concerns: include the following Social Determinants of Health
(SDOH) (SEE RUBRIC REQUIREMENTS)
Erickson’s Developmental Stage Related to pt. & Cite References (1)
*List and Discuss specific stage (based on objective assessment)
(SEE RUBRIC REQUIREMENTS)
❋Economic Stability
❋ Education
❋Social and Community Context
❋ Health and Health Care
❋ Neighborhood and Built Environment
Final Version 3/10/22 DW/ss & MS Team
Clinical Judgement Plan
Medical Management and Collaborative Plan
(From MD, PT, OT notes…. etc.) *Consider past 24 – 48 hours
(SEE RUBRIC REQUIREMENTS)
Instructor:
DATE Care Provided and UNIT:
TIME OUT!!! Student instructions:
Include Relevant Diagnostic Procedures/Results & Pertinent Lab tests/ Values
(With normal ranges), include dates and rationales supported with Evidence Based Citations
Include 2-3 nursing interventions for abnormal labs and for all diagnostic procedures
ANTICIPATED TRANSFER/ DISCHARGE PLANNING:
DISCUSS: PRIORITY GOALS TO BE ACHIEVED to TRANSFER or DISCHARGE
EQUIPMENT
Lab Tests or
Diagnostic Scan
Normal
Ranges
Admission
Lab Values
Current Lab
Values
Explain Abnormal Labs R/T
Your Pt & NI
(USE SEPARATE ATTACHED
WORD DOC → WHEN
NEEDED)
MEDS
TREATMENT
TIME OUT!!! Student instructions:
(SEE RUBRIC REQUIREMENTS)
Patient Education (In Pt.) for Referrals/ Discharge Planning
REFERRALS NEEDED/CASE Management
ASSESS LEARNING STYLE:
LEARNING PREFERENCE: WRITTEN, VIDEO, etc.
LEARNING BARRIER(S): LANGUAGE, EDUCATION LEVEL
ASSISTIVE DEVICES: GLASSES, HEARING AIDES, etc.
TIME OUT!!! Student instructions:
Pathophysiology of Primary Medical Dx (reason for
hospitalization) Support with Evidence Based Citations
Pathophysiology of Primary Medical Dx (reason for
TIME OUT!!! Student
instructions:
INCLUDE:
Appropriate Diagnostic
Tests/ ProceduresDATEs and RESULTS
(Can add → See
attached Word Doc)
Ex: The primary pathophysiologic process in COPD is
persistent but variable inflammation of the airways
(SEE RUBRIC REQUIREMENTS)
hospitalization)
Final Version 3/10/22 DW/ss & MS Team
Clinical Judgement Plan
Instructor:
TIME OUT!!! Student instructions:
DATE Care Provided and UNIT:
Medication Name
Include BOTH Generic
AND Trade names for
RX; include OTC,
herbal (nonpharmacological items)
Dose
Medications & Allergies (2)
Route
Freq.
Indications
Mechanism of Action
NOTE:
PRN
‘alone’
≠ Freq
(PRN meds must
include MD
ordered Indication)
Final Version 3/10/22 DW/ss & MS Team
Side Effects/
Adverse Reactions
Nursing Considerations specific to this
patient with citations
What cues will you observe for?
What will you monitor (labs, vitals, etc?)
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
ASSESSMENT/History of Present Illness /REVIEW OF SYTEMS
TIME OUT!!! Student instructions:
Physical Assessment Findings including presenting signs and symptoms that you will complete for this patient supported with Evidence Based Citations
Vital Signs (4)
Neurological (5)
Cardiovascular (6)
Respiratory (7)
Musculoskeletal (8)
GI/Hydration/Nutrition (9)
GU (10)
Rest/ Exercise (11)
Integumentary (12)
Endocrine (13)
Psychosocial (14)
BP:
HR: (Rhythm)
RR:
Temp:
O2 (any supplemental)
Pain (0/10)
Ht (cm)
Wt. (Kg)
BMI:
Final Version 3/10/22 DW/ss & MS Team
MISC:
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
TIME OUT!!! Student instructions:
To be sure your clinical judgement statements written below are accurate. You need to review the defining characteristics and related factors associated with and see how your patient data match.
Do you have an accurate match or are additional data required, or does another cue from abnormal assessment findings need to be investigated?
Observation
Assessment
Recognize Cues
Obtain information from
different sources (e.g., the
environment, the pt., the
family, another nurse,
EHR) in different formats
(e.g., visual observation,
audio perception, lab
results, text description,
etc.).
Interpreting
Responding
Analysis
Analyze Cues
Interprets cues from their
existing knowledge base and
nursing perspective, evaluate
cues in terms of relevancy,
importance, and
interrelationship among other
cues, organize cues in the
mental representation of the
scenario (e.g., organize cues
in clusters), and then
develops a group of probable
client needs/concerns and
problems
Prioritize Hypotheses
Evaluates the probable client
needs/concerns and problems
generated previously in
various dimensions and
organize them into an ordered
list where the priority
hypotheses are on the top.
(ABCs, Maslow, safety, acute
v chronic, unstable v stable,
urgent v non-urgent)
Planning
Implement
Generate Solutions
Develops a list of actions to
address the hypotheses.
Give rationales for each
solution.
Take Action
Sorts the actions (based on
their evaluation in various
dimensions) and carries
out the action(s) to address
the hypothesis/hypotheses
with highest priority first.
Clinical Judgement (The expected/anticipated outcomes or SMART GOALS)
These should be written in a SMART format for patient goals.
For examples:
The patient will have decreased pain by verbalizing pain score 3/10 or below by the end of the shift.
The patient will maintain clear airway by effectively coughing by the end of the shift.
Reflecting
Evaluate
Evaluation
Compare and contrast what happened with your plan of care against what was expected/anticipated (disease progression, unique client
response) and decide whether additional clinical decisions are needed.
Final Version 3/10/22 DW/ss & MS Team
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
References
Use APA format and hanging indents for all references.
If you have any questions, please consult the APA 7th Edition.
Final Version 3/10/22 DW/ss & MS Team
ASSIGNMENT COVER SHEET
Course name:
Concepts of Health Education & Health Promotion
Course number:
PHC 212
CRN:
11679
Paper Assignment
Assignment title or task:
(You can write a question)
Choose a health issue in KSA, explore the determinants
causing that issue, and justify your understanding with
evidence from the literature.
Student Name:
Student ID:
Submission Date:
7/10/2023
Instructor name:
Grade:
Dr. Naif Alanazi
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Your response should be a minimum of 250 words but should not exceed 500
words (Excluding references).
• Support your answer with examples.
• Font size should be 12
• Font type should be Times New Roman
• Heading should be Bold
• Colour should be Black
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style
• AVOID PLAGIARISM
• Due date; 7/10/2023 11:59 PM
Best of Luck
Each student is required to complete and turn in the evolution of the course prior to sitting for the final exam. This is a portfolio requirement that must be completed at the end of each course. You will not be allowed to sit for the final without having completed the evolution for this course.
Rubric
NURS_307 – Nursing Evolution Rubric
NURS_307 – Nursing Evolution Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeReflects on current theory and clinical class with concepts and theories using the Program Learning Outcomes and BSN Essentials listed in the syllabus
3.3 pts
Meets Expectations
1. Reflects on current theory class and clinical and how courses support each other (transfer of knowledge to apply to clinical)- Focused to Current Term. 2. Synthesizes theories and concepts from liberal education to build an understanding of the human experience. 3. Uses skills of inquiry and analysis to address practice issues 4. Applies knowledge of social and cultural factors in the care of populations encountered in this course.
2.51 pts
Approaches Expectations
1. Limited reflection on current theory class and clinical and how courses support each other (transfer of knowledge to apply to clinical)- Focused to Current Term. 2. Limited synthesis of theories and concepts from liberal education to build an understanding of the human experience 3. Use limited skills of inquiry and analysis to address practice issues 4. Applies limited knowledge of social and cultural factors in the care of populations encountered in this course.
1.65 pts
Does Not Meet Expectations
1.No reflection on current theory class and clinical and how courses support each other 2. Does not synthesize theories and concepts from liberal education to build an understanding of the human experience 3. Does not use skills of inquiry and analysis to address practice issues 4. Does not apply knowledge of social and cultural factors in the care of populations encountered in this course.
3.3 pts
This criterion is linked to a Learning OutcomeDevelops an effective communication style for interacting with current patients, families, and the interdisciplinary health team when providing holistic, patient centered nursing care to populations encountered in this course.
3.4 pts
Meets Expectations
1. Reflects on providing holistic patient care to populations encountered in this course. 2. Describes inter-collaborative involvement (i.e. Interprofessional rounds; consultations and interaction with PT/OT; Respiratory Therapy, Pharmacist consultation—describe their role/ contribution.)
2.58 pts
Approaches Expectations
1. A limited reflection on providing holistic patient care to populations encountered in this course. 2. Describes limited inter-collaborative involvement
1.7 pts
Does Not Meet Expectations
1. No reflection on providing holistic patient care to populations encountered in this course. 2. Does not describes inter-collaborative involvement
3.4 pts
This criterion is linked to a Learning OutcomeModels leadership when providing safe, quality nursing care; coordinating the healthcare team; and when tasked with oversight and accountability for care delivery.
3.3 pts
Meets Expectations
1. Describe an event that demonstrates: • application of leadership concepts, skills and decision making in the provision of high quality nursing care, • healthcare team coordination • the oversight and accountability for care delivery 2. Describe an event that demonstrates leadership, appropriate teambuilding and collaborative strategies to effectively implement patient safety and quality improvement initiatives within the context of the interprofessional team
2.51 pts
Approaches Expectations
1. Describes limited leadership concepts, skills and decision making in the provision of high quality nursing care, healthcare team coordination and the oversight and accountability for care delivery 2. Limited description of an event that demonstrates leadership, appropriate teambuilding and collaborative strategies to effectively implement patient safety and quality improvement initiatives within the context of the interprofessional team
1.65 pts
Does Not Meet Expectations
1. Gives no examples of leadership concepts, skills and decision making in the provision of high quality nursing care, healthcare team coordination and the oversight and accountability for care delivery in a variety of settings 2. Does not describe an event that demonstrates leadership, appropriate teambuilding and collaborative strategies to effectively implement patient safety and quality improvement initiatives within the context of the interprofessional team
How is PDSA utilized in quality improvement? What are the different stages, and what stakeholders should be involved? How does technology support quality improvement processes?
What to Submit
Write an initial post (ideally 1 to 2 paragraphs) and reply to at least two posts during the week outside of your initial post thread.
Discussion Rubric
Criteria Evident (100%) Not Evident (0%) Value
Clarity of Communication Initial post clearly communicates key ideas and thoughts related to the prompt Does not clearly communicate key ideas and thoughts in an initial posting related to the prompt 45
Timeliness Submits initial post on time Initial post is not submitted or is submitted late 25
Response Engagement Posts responses building off the initial post and incorporating course concepts Response posts are missing, or do not build from initial posts and incorporate course concepts 30
Total: 100%
Read the SAMHSA data note attached. After reading the data note, please answer the following questions (copy the question then provide answer underneath, to clarify what question is being answered):What does the article suggest is our primary policy problem?Do the options seem adequate?What additional data or information do you need to strengthen the tie between the problem and the options?What other public health issues similarly face significant challenges due to a lack of understanding (about the science or data), options, or political will?
Students are required to submit weekly journal entries throughout the course. These reflective narratives help students identify important learning events that happen throughout the course and the practicum. In each week’s entry, students should reflect on the personal knowledge and skills gained.
Write a reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing.
Topic Focus: Health care delivery and clinical systems
While APA style is not required for the body of this assignment, solid academic writing is expected.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Topic Focus: Ethical Considerations in Health Care
Assessment Description
Students are required to submit weekly journal entries throughout the course. These reflective narratives help students identify important learning events that happen throughout the course and the practicum. In each week’s entry, students should reflect on the personal knowledge and skills gained.
Write a reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing.
Topic Focus: Ethical Considerations in Health Care
While APA style is not required for the body of this assignment, solid academic writing is expected.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Many of us can think of leaders we have come to admire, be they historical figures, pillars of the industry we work in, or leaders we know personally. The leadership of individuals such as Abraham Lincoln and Margaret Thatcher has been studied and discussed repeatedly. However, you may have interacted with leaders you feel demonstrated equally competent leadership without ever having a book written about their approaches.
What makes great leaders great? Every leader is different, of course, but one area of commonality is the leadership philosophy that great leaders develop and practice. A leadership philosophy is basically an attitude held by leaders that acts as a guiding principle for their behavior. While formal theories on leadership continue to evolve over time, great leaders seem to adhere to an overarching philosophy that steers their actions.
What is your leadership philosophy? In this Assignment, you will explore what guides your own leadership.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
Reflect on the leadership behaviors presented in the three resources that you selected for review.
Reflect on your results of the CliftonStrengths Assessment*, and consider how the results relate to your leadership traits.
*not required to submit CliftonStrengths Assessment
The Assignment (2-3 pages):
Personal Leadership Philosophies
Develop and submit a personal leadership philosophy that reflects what you think are characteristics of a good leader. Use the scholarly resources on leadership you selected to support your philosophy statement. Your personal leadership philosophy should include the following:
A description of your core values.
A personal mission and vision statement.
An analysis of your CliftonStrengths Assessment summarizing the results of your profile
A description of two key behaviors that you wish to strengthen.
A development plan that explains how you plan to improve upon the two key behaviors you selected and an explanation of how you plan to achieve your personal vision. Be specific and provide examples.
Be sure to incorporate your colleagues’ feedback on your CliftonStrengths Assessment from this Module’s Discussion 2.
BY DAY 7 OF WEEK 6
Submit your personal leadership philosophy.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK6Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_6053_Module03_Week06_Assignment_Rubric
NURS_6053_Module03_Week06_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeDevelop and submit a personal leadership philosophy that reflects what you think are characteristics of a good leader. Use the scholarly resources on leadership you selected to support your philosophy statement. Your personal leadership philosophy should include the following:· A description of your core values.· A personal mission statement, AND· a personal vision statement.
15 to >13.0 pts
Excellent
The response accurately and thoroughly describes a set of core values. …The response clearly and thoroughly describes a personal mission statement and a personal vision statement.
13 to >11.0 pts
Good
The response describes a set of core values. …The response describes a personal mission statement and a personal vision statement.
11 to >10.0 pts
Fair
The response describes a set of core values that is vague or inaccurate. …The response describes a personal mission statement and vision statement that are vague or inaccurate.
10 to >0 pts
Poor
The response describes a set of core values that is vague and inaccurate or is missing. …The response describes a personal mission/vision statement that is vague and inaccurate, or is missing.
15 pts
This criterion is linked to a Learning Outcome· Analysis of your CliftonStrengths Assessment summarizing the results of your profile. · A description of two key behaviors you wish to strengthen. *not required to submit CliftonStrengths Assessment.
15 to >13.0 pts
Excellent
The response accurately and completely provides an analysis and detailed summary of the CliftonStrengths Assessment. (Not required to submit Clifton Strengths Assessment.) …The response clearly and thoroughly describes two key behaviors to strengthen.
13 to >11.0 pts
Good
The response accurately provides an analysis and summary of the CliftonStrengths Assessment. (Not required to submit Clifton Strengths Assessment.) …The response describes two key behaviors to strengthen.
11 to >10.0 pts
Fair
The response provides an analysis and summary of the CliftonStrengths Assessment that is vague or inaccurate. (Not required to submit Clifton Strengths Assessment.) …The response describes two key behaviors to strengthen that is vague or inaccurate.
10 to >0 pts
Poor
The response provides an analysis and summary of the CliftonStrengths Assessment that is vague and inaccurate or is missing. (Not required to submit Clifton Strengths Assessment.) …The response describes two key behaviors to strengthen that is vague and inaccurate or is missing.
15 pts
This criterion is linked to a Learning Outcome· A development plan that explains how you plan to improve upon the two key behaviors you selected · An explanation of how you plan to achieve your personal vision. Be specific and provide examples.
50 to >44.0 pts
Excellent
An accurate, complete, and detailed development plan is provided that thoroughly explains plans to improve upon the two key behaviors selected. … The response accurately and thoroughly includes plans on how to achieve a personal vision with specific examples.
44 to >39.0 pts
Good
An accurate development plan is provided that explains plans to improve upon the two key behaviors selected. … The response includes plans on how to achieve a personal vision with specific examples.
39 to >34.0 pts
Fair
A development plan is provided that explains plans to improve upon the two key behaviors selected that is vague or inaccurate. … The response includes vague or inaccurate plans on how to achieve a personal vision and may include some examples or examples are vague.
34 to >0 pts
Poor
A vague and inaccurate development plan is provided that explains plans to improve upon the two key behaviors selected or development plan is missing. … The response vaguely and inaccurately explains plans on how to achieve a personal vision, does not include any examples, or response is missing.
50 pts
This criterion is linked to a Learning OutcomeResource Synthesis
5 to >4.0 pts
Excellent
Using proper in-text citations, the response fully integrates at least 2 outside resources and 2 or 3 course-specific resources.
4 to >3.0 pts
Good
Using proper in-text citations, the response fully integrates at least 2 outside resources and 1 course-specific resource.
3 to >2.0 pts
Fair
Using proper in-text citations, the response minimally integrates outside and course-specific resources.
2 to >0 pts
Poor
The response does not integrate outside and course-specific resources or no in-text citations are used.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and Organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided, which delineates all required criteria.
5 to >4.0 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. … A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria.
4 to >3.0 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. …Purpose, introduction, and conclusion of the assignment are stated but are brief and not descriptive.
3 to >2.0 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. … Purpose, introduction, and conclusion of the assignment is vague or off topic.
2 to >0 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. … No purpose statement, introduction, or conclusion is provided.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—English Writing Standards:Correct grammar, mechanics, and proper punctuation.
5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.0 pts
Good
Contains a few (one or two) grammar, spelling, and punctuation errors.
3 to >2.0 pts
Fair
Contains several (three or four) grammar, spelling, and punctuation errors.
2 to >0 pts
Poor
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting:The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
5 to >4.0 pts
Excellent
Uses correct APA format with no errors.
4 to >3.0 pts
Good
Contains a few (one or two) APA format errors.
3 to >2.0 pts
Fair
Contains several (three or four) APA format errors.
Discussion Board: Summarize the case and include your most significant finding and elaborate on what you learned from this assignment. I will provide you the PDF to very brifly summerize.respond to one classmate: after reading the discussion from a classmate, provide a response to their summary and include additional terminology or a law or regulation that could align but may have been missed. For full points, response must be constructive and reference details from the Code of Ethics or the DHBC Law and Regulationsplease respond to this:Article Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88605…In this article, the legal case “United States et al. ex red. Simpson v. HQRC et al., No.2017-cv-02823” talks about how a management company by the name of HQRC was found to be doing fraudulent insurance claims. This management company was providing their services for various dental clinics and during the years of 2011-2021, these false insurance claims were being made. The company did a fraud amount of about $754 million and were made to pay the amount of fraud done plus interest on the fee’s. Something I found significant in this was the amount of deception the providers have done. They have not only lied to the insurance company, but also the patients and themselves (as they are doing this unethically). I think the managing company of these dental providers also had to have know about this as they can see what is being charged out and connect it to the patients records. With this assignment I learned how even the smallest things that one may consider “errors” can build up and become something big. In this legal case they claimed to have accidentally sent out the treatment provided under wrong codes, however even if this was the case, the amount of little mistakes they claimed to have had built up to something so big that it ended up doing a lot of damage. Not only were they accused of fraud but they have also misled their patients and even created a burden to those with Medical as the office is no longer able to accept this insurance!
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Legal Case
1
Carr v. Dickey
[Civ. No. 17766. First Dist., Div. One. Sept. 11, 1958.]
ARLINE CARR, Appellant, v. LLOYD W. DICKEY, Respondent.
Issue
The case was between Arline Carr (the plaintiff) and Lloyd Dickey (the defendant). Carr filed
charges against Dickey, a dentist, for malpractice, assault, and battery. The case also involved the
extraction of the plaintiff’s tooth by the defendant. According to the case, the lower left wisdom
tooth is designated number 17.
The defendant extracted the tooth before an event came up. The case also states that the defendant
extracted the molar next to the wisdom teeth, the second lower left molar, and the back tooth after
the wisdom tooth was extracted, designated as number 18. The next tooth, designated as number
19, was also extracted after that.
The plaintiff complains about the defendant’s alleged malpractice where he negligently removed
the first lower molar, tooth number 19, which appeared sound and perfect. The plaintiff also
complained that the defendant failed to extract tooth number 18 (the second lower left molar), a
decayed and diseased tooth. The assault and battery, as stated by the court, are accounts of charges
for the defendant. He was asked to extract a designated tooth but a different one without cause and
the plaintiff’s consent.
According to the case, the trial court granted a nonsuit to both accounts. The court claimed no
evidence of negligence in extracting the tooth. Similarly, the court stated that it could not find
Legal Case
2
evidence of negligence in the proof presented. Similarly, the court ruled that the assault and battery
could not be sustained because the action of tooth extraction was taken with her consent. In that
case, the plaintiff consented to removing the tooth.
The record showed that the ruling was correct according to the standards applicable to nonsuit.
Dickey was a dentist and an oral surgeon. Dickey stated that he first treated the plaintiff in 1953.
During treatment, the defendant took a full-mouth x-ray and tooth the patient’s dental history. He
also clinically examined her mouth and then filled three of her teeth.
Facts
When the plaintiff later visited the defendant, she complained of pain in the lower left molar area.
After examining the area, the defendant found no emergency that could need immediate tooth
extraction. He then took another x-ray of the two lower left molars, where he discovered a cavity
in the back molar (number 18). The defendant thought the cavity could be filled. Continuing with
the X-ray, the defendant discovered a radiolucent area in the first molar (number 19).
The defendant claimed that the plaintiff complained that both teeth were hurt and requested
extraction. The defendant asked the plaintiff to go home to see if the pain could be localized. The
defendant stated that he knew the plaintiff was a chronic pain complainer. Still, he did not want to
extract the teeth until he was sure the pain was so severe that it required tooth extraction.
The plaintiff returned to the defendant complaining about the pain the two molars conflict. After
reviewing the X-ray, the defendant concluded that tooth number 18 could be saved by filling the
cavity and tooth number 19 should be removed. He also discovered that none of the teeth were
abscessed but were diseased. The radiolucent also indicated that tooth number 19 was decayed.
Legal Case
3
The defendant stated that the condition of tooth number 19 was just about to reach the tooth’s
nerve.
After the defendant re-examined the X-ray, he concluded that the plaintiff’s pain came from tooth
number 19. The plaintiff stated that he made the conclusions considering the X-ray results. First,
the radiolucent area was on the back surface of the tooth, below the gum line in the tooth’s root.
He also stated that extraction remains the remedy when decay reaches the tooth’s nerve. He also
considered the plaintiff’s statement that she feels pain due to nerve sensitivity when she takes hot
or cold substances.
Under these circumstances, the defendant told the plaintiff that he could refill tooth number 18 and
save the tooth while he extracted tooth number 19. The defendant showed the plaintiff the X-ray
and even showed her the radiolucent area in tooth number 19 and how close it was to the pulp.
Upon seeing that, the plaintiff accepted the procedure. Since the plaintiff consented, the defendant
filled tooth number 18 and extracted tooth number 19. The defendant extracted the tooth,
considering the X-ray’s outcome and the plaintiff’s symptoms.
The statements given by the defendant have no substantial difference from those of the plaintiff.
The plaintiff also stated that he visited the defendant in 1954. She complained of tooth pain. The
defendant performed an x-ray and told her that it was not tooth number 18 that was hurting but
tooth number 19.
The plaintiff also explained to the doctor that if she ate, chewed gum, or opened her mouth so that
air got in, she felt tooth pain. When the court asked the defendant if she consented to the extraction,
she stated that she told the defendant that he should know what to do. In that case, the defendant
Legal Case
4
extracted tooth number 19. The plaintiff then asked the defendant for the extracted tooth. The
defendant gave it to her and took it home. The tooth was also used as evidence in the court.
Court’s ruling
The problem arose when the pain and sensitivity continued after the tooth was extracted. The
plaintiff visited the doctor again and told him she still felt pain. She accused the defendant of
extracting the wrong tooth; thus, she refused to allow him to work on tooth number 18. The
plaintiff visited another doctor, Dr. Brady, who advised her to extract tooth number 18. The
plaintiff took Dr. Brady as her witness. Still, the court granted a nonsuit, considering the evidence
provided.
https://law.justia.com/cases/california/court-of-appeal/2d/163/416.html
Need a discussion post in reply to both posts below
Length: A minimum of 150 words each post, not including references
Citations: At least one high-level scholarly reference in APA 7th edition from within the last 5 years
Post #1
Cultural competency, according to Saha et al. (2018), is a key feature of healthcare, particularly when treating patients from varied cultural origins who have beliefs that may influence their acceptance of evidence-based therapies. This discussion highlights the importance of cultural competency in healthcare. It offers techniques for advanced practice nurses (APNs) to handle scenarios involving patients who have cultural beliefs that influence their acceptance of evidence-based treatments. It emphasizes the significance of reconciling cultural diversity with excellent treatment, going beyond the “do no harm” ethic in order to create patient-centered care that respects cultural variety.
Firstly, a full cultural assessment is required. This assessment gives important information about a patient’s cultural background, beliefs, values, and habits, allowing APNs to modify their approach to care accordingly. It is also critical to establish trust and rapport with the patient. Active listening and empathy, together with effective communication, create an environment in which patients feel respected and appreciated. APNs should prioritize patient education and explanation when cultural beliefs appear to contradict evidence-based treatments (Saha et al., 2018). It is critical to provide accurate and culturally sensitive information about the illness and treatment alternatives. By emphasizing the benefits of evidence-based treatments while aligning them with the patient’s values and beliefs, patients can be empowered to make educated decisions that respect their cultural perspectives (Saha et al., 2018).
On the other hand, shared decision-making is critical for honoring cultural beliefs while providing great treatment. When appropriate, encouraging patients to participate in treatment decisions actively protects their autonomy and allows them to select therapies that correspond with their cultural beliefs. In the presence of linguistic or cultural hurdles, using cultural mediators or interpreters can also improve effective communication (Saha et al., 2018). Exploring alternative treatments or complementary therapies in partnership with the patient is another way to respect cultural beliefs while providing appropriate care. APNs should carefully weigh the possible benefits and hazards of these alternatives, taking into account their safety and efficacy in the context of the patient’s condition. APNs can also improve their cultural competency by receiving training and working with cultural specialists or community leaders. In difficult circumstances, when cultural beliefs directly contradict evidence-based therapies and create ethical quandaries, obtaining ethical consultation may be required to make informed decisions that prioritize the patient’s well-being (Swihart & Martin, 2023).
Ultimately, cultural competency is required in healthcare to honor patients’ different cultural beliefs and requirements. To balance cultural diversity with high-quality treatment, advanced practice nurses (APNs) should use a comprehensive strategy that includes cultural assessment, education, shared decision-making, and teamwork. These tactics go beyond the “do no harm” approach and enable APNs to provide patient-centered care that embraces and respects cultural diversity. This fusion of cultural awareness and healthcare competence is critical for providing complete and successful patient care.
Post#2
Cultural competence is the capacity of systems to treat patients with various values, beliefs, and behaviors, including the customization of healthcare delivery to meet patients’ cultural, social, and linguistic needs. A culturally competent healthcare system recognizes the value of culture, includes the evaluation of cross-cultural relationships, recognizes the potential effects of cultural differences, broadens cultural knowledge, and modifies treatments to meet culturally specific requirements. Ultimately, cultural competency is acknowledged as a crucial strategy for minimizing racial and ethnic inequities in healthcare. (AHA, 2023).
Some methods for enhancing individual and organizational cultural competency include encouraging family members to take part in making healthcare decisions, promoting health while taking cultural values into account, conducting cultural competency education, fostering a setting where traditional healers can practice, offering interpreter services, and hiring minority staffs. (Swihart & Martin, 2023)
Betancourt et al. (2023) mentioned the idea of “negotiation” in the article The Patient’s Culture and Effective Communication, where negotiation is not about persuading people who refuse medical treatment to believe what we say. It requires eliminating the idea that what we, as medical professionals, believe applies to everyone. The negotiation process involves essential steps such as:
1. Examining the patient’s viewpoint.
2. Explicitly stating your position.
3. Recognizing differences of opinion.
4. Establishing common ground.
5. Choosing a mutually agreeable plan.
For the question relating to what ways can the nurse do more than “do no harm?” I believe anybody can generate an exhaustive list of ways for a nurse to intervene rather than “do no harm.” Still, the main idea of culturally competent care is the healthcare provider’s cultural awareness of the patient’s culture and self. Most of the time, this involves modifying the treatment plan to fit into the patient’s culture. A good example based on experience is managing fasting diabetic patients during Ramadan. According to Ahmad et al. (2015), diabetes patients are at significant risk for developing a wide range of potential fasting-related problems, including dehydration, hypoglycemia, hyperglycemia, and diabetic ketoacidosis (DKA), because diabetes is a metabolic disease that affects several organs. However, it should not be disregarded that for some diabetes patients who strictly follow evidence-based recommendations and religious physician’s advice, fasting can be beneficial.
EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH
In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.
RESOURCES
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
Chapter 6, “Critically Appraising Quantitative Evidence for Clinical Decision Making” (pp. 189–228)
Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. American Journal of NursingLinks to an external site., 110(7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c
Fineout-Overhold, E., Melnyk, B.M., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: Critical appraisal of the evidence: Part II. American Journal of NursingLinks to an external site., 110(7), 47-52
Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical appraisal of the evidence: Part III the process of synthesis: Seeing similarities and differences across the body of evidence.American Journal of NursingLinks to an external site., 110(11), 43-51. doi:10.1097/01.NAJ.0000390523.99066.b5
Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric Nurses AssociationLinks to an external site., 15(3), 202–207. doi:10.1177/1078390309338733
To Prepare:
Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)
Part 3A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
Assignment_Rubric
Criteria
This criterion is linked to a Learning OutcomePart 3A: Critical Appraisal of ResearchCritical Appraisal of Research Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tool Worksheet Template. Be sure to include: An Evaluation Table
Ans
The critical appraisal accurately and clearly provides a detailed evaluation table. …The responses provide a detailed, specific, and accurate evaluation of each of the peer-reviewed articles selected.
Criteria
Part 3B: Evidence-Based Best PracticesEvidence-Based Best Practices Based on your appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with the selected resources.
Ans.
The responses accurately and clearly suggest a detailed best practice that is fully aligned to the research reviewed. …The responses accurately and clearly explain in detail the best practice, with sufficient justification of why this represents a best practice in the field. …The responses provide a complete, detailed, and specific synthesis of the four peer reviewed articles.
Criteria
Resource Synthesis
Ans.
The response fully integrates at least two outside resources and two or three course-specific resources that fully support the responses provided.
Criteria
Written Expression and Formatting—Paragraph Development and Organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided, which delineates all required criteria.
Ans.
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. …A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria.
Criteria
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—English Writing Standards: Correct grammar, mechanics, and proper punctuation.
Ans.
Uses correct grammar, spelling, and punctuation with no errors.
Criteria
Written Expression and Formatting:The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
The attached file contains an article. Simply make the article as a presentation and copy the information from the article. There is another attached file that contains the presentation requirements for the Journal Club.
Unformatted Attachment Preview
T h e n e w e ng l a n d j o u r na l o f m e dic i n e
original article
Oral Rivaroxaban for Symptomatic Venous
Thromboembolism
The EINSTEIN Investigators*
A BS T R AC T
Background
Rivaroxaban, an oral factor Xa inhibitor, may provide a simple, fixed-dose regimen
for treating acute deep-vein thrombosis (DVT) and for continued treatment, without the need for laboratory monitoring.
Methods
We conducted an open-label, randomized, event-driven, noninferiority study that
compared oral rivaroxaban alone (15 mg twice daily for 3 weeks, followed by 20 mg
once daily) with subcutaneous enoxaparin followed by a vitamin K antagonist (either warfarin or acenocoumarol) for 3, 6, or 12 months in patients with acute, symptomatic DVT. In parallel, we carried out a double-blind, randomized, event-driven
superiority study that compared rivaroxaban alone (20 mg once daily) with placebo
for an additional 6 or 12 months in patients who had completed 6 to 12 months of
treatment for venous thromboembolism. The primary efficacy outcome for both
studies was recurrent venous thromboembolism. The principal safety outcome was
major bleeding or clinically relevant nonmajor bleeding in the initial-treatment
study and major bleeding in the continued-treatment study.
Results
The study of rivaroxaban for acute DVT included 3449 patients: 1731 given rivaroxaban and 1718 given enoxaparin plus a vitamin K antagonist. Rivaroxaban had noninferior efficacy with respect to the primary outcome (36 events [2.1%], vs. 51 events
with enoxaparin–vitamin K antagonist [3.0%]; hazard ratio, 0.68; 95% confidence
interval [CI], 0.44 to 1.04; P100 kg
245 (14.2)‡
246 (14.3)‡
85 (14.1)‡
87 (14.6)‡
6 (0.3)
1 (
Purchase answer to see full
attachment
Do 3 critical points based off of the given topics from ati for nurs 420 leadership for online practice proctor Bdo it based off of the given topics example is provided from another classadd references no plagirsim
Unformatted Attachment Preview
“3 Critical Concepts – Remediation Document”
Upon completion of the required Practice Assessment, conduct a focused review by downloading the “ATI Individual Performance Profile” Report.
Complete the “3 Critical Concepts – Remediation Document” by using each NCLEX Client Need Category, listed under the “Topics to Review
Section” in the report to identify 3 Critical Concepts learned and or understand better about the concept. Use reliable evidence-based resources
to remediate each topic (ATI Focused Review, ATI eBook, Course textbook per Syllabus). Cite your sources (APA formatting not required).
8 NCLEX Client Need Categories
1) Management of Care, 2) Safety and Infection Control, 3) Basic Care and comfort, 4) Health Promotion and Maintenance, 5) Psychosocial Integrity, 6)
Pharmacological and Parenteral Therapies, 7) Reduction of Risk Potential, and 8) Physiological Adaptation
Reflection Section – include one of the 6 Cognitive Functions
•
Reflect on how the 3 critical concepts you learned, helped you gain a better understanding of the 6 Cognitive Functions of the National Council for State
Boards of Nursing (NCSBN) – Clinical Judgement Measurement Model (NCJMM) – which follows the Nursing Process:
o Recognize Cues (Assessment) – Filter information from different sources (i.e., signs, symptoms, health history, environment).
o Analyze Cues (Analysis) – Link recognized cues to a client’s clinical presentation and establishing probable client needs, concerns, or problems.
o Prioritize Hypotheses (Analysis) – Establish priorities of care based on the client’s health problems (i.e. environmental factors, risk assessment,
urgency, signs/ symptoms, diagnostic test, lab values, etc.)
o Generate Solutions (Planning) – Identify expected outcomes and related nursing interventions to ensure clients’ needs are met.
o Take Actions (Implementation) – Implement appropriate interventions based on nursing knowledge, priorities of care, and planned outcomes to
promote, maintain, or restore a client’s health.
o Evaluate Outcomes (Evaluation) – Evaluate a client’s response to nursing interventions and reach a nursing judgment regarding the extent to which
outcomes have been met.
Topics To Review – F y h t y r om y o u r j oj g o 5 j o r j o t r6 5 h y 5 oj 5 o6
List the NCLEX Client Need Categories, Topics, and Concepts to review from your report here – as shown in the example provided.
NCLEX Client Need Category Topic Concept
Safety and Infection Control (1 item)
Reporting of Incident/Event/Irregular Occurrence/Variance (1 item)
Safe Medication Administration and Error Reduction: Priority Action Following a Medication Error
Remove the 5 lines above, add information from your report before submission.
Date
Student Name
Instructor Name
Assessment Name
# of Topics to Review
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
Reflection – Address 1 of the 6 Cognitive
understand better about this topic)
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
References:
Include your references here. Below is an example – delete this line and the examples below and add the references you used.
Halter, M. J. (2022). Varcarolis’ Foundations of Psychiatric Mental Health Nursing 9th ed. Publisher: Saunders/Elsevier. St. Louis, Missouri.
ATI Content Mastery Series Review Module: RN Mental Health 11.0 ed.
McCuistion, L.E., DiMaggio, K., Winton, M.B., & Yeager (2023). Pharmacology: A Patient-Centered Nursing Process Approach. 11th. Ed. Publisher: Elsevier.
ATI Content Mastery Series Review Module: RN Pharmacology 11.0 ed.
“3 Critical Concepts – Remediation Document”
Upon completion of the required Practice Assessment, conduct a focused review, by downloading the “ATI Individual Performance Profile” Report.
Complete the “3 Critical Concepts – Remediation Document” by using each NCLEX Client Need Category, listed under the “Topics to Review
Section” in the report to identify 3 Critical Concepts learned and or understand better about the missed concept. Use reliable evidence-based
resources to remediate each topic (ATI Focused Review, ATI eBook, Course textbook per Syllabus). Cite your sources (APA formatting not required).
8 NCLEX Client Need Categories
1) Management of Care, 2) Safety and Infection Control, 3) Basic Care and comfort, 4) Health Promotion and Maintenance, 5) Psychosocial Integrity, 6)
Pharmacological and Parenteral Therapies, 7) Reduction of Risk Potential, and 8) Physiological Adaptation
Reflection Section – Include one of the 6 Cognitive Functions
Reflect on how the 3 critical concepts you learned, helped you gain a better understanding of the 6 Cognitive Functions of the National Council for State
Boards of Nursing (NCSBN) – Clinical Judgement Measurement Model (NCJMM) – which follows the Nursing Process:
o Recognize Cues (Assessment) – Filter information from different sources (i.e., signs, symptoms, health history, environment).
o Analyze Cues (Analysis) – Link recognized cues to a client’s clinical presentation and establishing probable client needs, concerns, or problems.
o Prioritize Hypotheses (Analysis) – Establish priorities of care based on the client’s health problems (i.e. environmental factors, risk assessment,
urgency, signs/ symptoms, diagnostic test, lab values, etc.)
o Generate Solutions (Planning) – Identify expected outcomes and related nursing interventions to ensure clients’ needs are met.
o Take Actions (Implementation) – Implement appropriate interventions based on nursing knowledge, priorities of care, and planned outcomes to
promote, maintain, or restore a client’s health.
o Evaluate Outcomes (Evaluation) – Evaluate a client’s response to nursing interventions and reach a nursing judgment regarding the extent to which
outcomes have been met.
Topics To Review Safety and Infection Control (1 item)
Reporting of Incident/Event/Irregular Occurrence/Variance (1 item)
Safe Medication Administration and Error Reduction: Priority Action Following a Medication Error
Pharmacological and Parenteral Therapies (7 items)
Adverse Effects/Contraindications/Side Effects/Interactions (5 items)
Dermatitis and Acne: Required Tests for Isotretinoin Prescription Refill
Gastrointestinal Disorders: Monitoring for Adverse Effects of a Metoclopramide
Medications Affecting Coagulation: Adverse Effects of Heparin
Neurocognitive Disorders: Monitoring for Adverse Effects of Donepezil
Urinary Tract Infections: Contraindications to Ciprofloxacin
Medication Administration (2 items)
Miscellaneous Central Nervous System Medications: Teaching About Cyclobenzaprine
Opioid Agonists and Antagonists: Teaching About Hydrocodone
Physiological Adaptation (2 items)
Fluid and Electrolyte Imbalances (2 items)
Medications Affecting Urinary Output: Identifying ECG Manifestations of Hypokalemia for a Client Who Is Taking Furosemide
Vitamins and Minerals: Interventions for a Client Who Is Taking Sodium Polystyrene Sulfonate
Date
Student Name
Instructor Name
Assessment Name
# of Topics to Review
12/13/2022
JadaRose Johnson
Dr. Candace James-Marrast
RN Pharmacology Online Practice Assessment 2019 A
10
NCLEX Client Need Category
Safety and Infection Control (1 item)
Topic
Concept
3 Critical Concepts (I learned, and/or
understand better about this topic)
Reflection – Address 1 of the 6
Cognitive Functions
Reporting of
Incident/Event/Irregular
Occurrence/Variance
(1 item)
Safe Medication
Administration and
Error Reduction:
Priority Action
Following a
Medication Error
1. Giving a medication 1 hour the scheduled
time is too late.
2. When this occurs, I must complete an
incident report
3. Every facility have a different timeframe
for when medication can be given with
causing a medication error.
Take Actions (Implementation)
The answer choices had both 30 minutes
and 1 hour after the scheduled time. In
class, we learned that safe medication
administered can be given either 30 minutes
or 1 hour before or after the schedule. I will
review the ATI book and my facility policy
and procedure to determine the allowed
timeframe of when I should give a
medication without making a medication
error.
Pharmacological and Parenteral Therapies (7 items)
Topic
Concept
3 Critical Concepts (I learned, and/or
understand better about this topic)
Reflection – Address 1 of the 6
Cognitive Functions
Adverse
Effects/Contraindications/Side
Effects/Interactions (5 items)
Dermatitis and Acne:
Required Tests for
Isotretinoin
Prescription Refill
1. Isotretinoin is used to treat nodulocystic
acne vulgaris and is a category X medication,
which causes teratogenic effects to the fetus.
2. A pregnancy test should be done and ruled
out before the client can obtain a refill.
3. Client must provide two negative
pregnancy tests for the initial prescription and
one negative test before monthly refills.
1. Multiple CNS adverse effects can occur
with this medication
2. Some of the adverse effects include
dizziness, fatigue, and sedation
3. I need to teach the client to report the
adverse effect or conduct frequent hourly
rounding to allow for appropriate
intervention.
1. SQ heparin can be inject in the abdomen
above the iliac crest and at least 5 cm (2 in)
away from the umbilicus
2. When administering IV heparin, the platelet
count should be closely monitored.
3. Platelet count less than 100,000/mm3 can
indicate heparin-induced thrombocytopenia, a
potentially fatal condition that requires
stopping the infusion.
4. ADR of IV heparin includes blood in the
urine, bruising, hematomas, hypotension, and
tachycardia. The nurse should report these
findings to the provider because these can
indicate manifestations of heparin toxicity.
Prioritize Hypotheses (Analysis)
I did not know much about this medication.
I will review the section on dermatitis, the
medications that can be used, and the
nursing role when managing care for a
client receiving isotretinoin.
1. Donepezil causes bronchoconstriction by
the increase in acetylcholine levels, which is a
primary effect of donepezil.
2. Some ADR of donepezil include dyspepsia,
diarrhea, dyspnea, and dizziness.
Evaluate Outcomes (Evaluation)
I understood what the question was asking
but could decide on which ADR was the
priority. I need more practice on
prioritization. I will review the ATI Nurse
Gastrointestinal
Disorders: Monitoring
for Adverse Effects of
a Metoclopramide
Medications Affecting
Coagulation: Adverse
Effects of Heparin
Neurocognitive
Disorders: Monitoring
for Adverse Effects of
Donepezil
Evaluate Outcomes (Evaluation)
I did not know much about this medication.
I will review the section on gastrointestinal
disorders especially metoclopramide.
Reviewing this medication will provide me
with the information to report and my
assessment for any of the related adverse
effects.
Evaluate Outcomes (Evaluation)
Client safety is very important and this
medication is a high alert medication that
causing bleeding and possible death of the
client. I would be sure to review the chapter
on heparin – especially the S/Es, ADR. So,
when managing care for the client, I will
monitor the client closely for any ADRs,
monitor the platelet count, and report any
concerns to the health care provider.
3. Although all these are ADR, it is very most
important to report dyspnea to the provider
first – using the airway, breathing, circulation
(ABC) approach to client care.
Logic Tutorial on Priority Setting
Frameworks.
1. ciprofloxin has not be given to a client with
tendonitis. If ciprofloxin is given to a client
with tendonitis, it can cause risk of tendon
rupture.
2. ciprofloxin can cause photosensitivity
resulting in severe sunburns even with
sunscreen use.
3. ciprofloxin can cause a superinfection such
as thrush and vaginal yeast infection.
1. cyclobenzaprine can cause seizure, so it is
important to monitor the client and report any
seizure activity to the provider.
2. cyclobenzaprine can cause chronic
dependence from chronic use
3. cyclobenzaprine can cause taper off before
discontinuing to prevent abstinence syndrome
or rebound insomnia. So, I must teach my
client to not stop the drug abruptly.
Evaluate Outcomes (Evaluation)
I missed re-read the question. I thought the
question was asking for complications of
ciprofloxacin. Professor, I will pay closer
attention when reading the questions and
use my test-taking skill more often.
Opioid Agonists and
Antagonists: Teaching
About Hydrocodone
1. Hydrocodone cause a few CNS effects such
as dizziness, lightheadedness, drowsiness, and
respiratory depression
2. Because of the CNS effects I must teach
my client to change position slowly and avoid
activities that requires alertness like driving
and operating heavy machinery
3. Hydrocodone cause a few GI effects such
as nausea, vomiting, and constipation, so I
must teach my client to increase fluids and
dietary fiber and take with food.
Take Actions (Implementation)
Although I understood the question was
asking about teaching, I was not focusing on
complications and the related teaching. I
now understanding that teaching also
includes teaching the client about the
possible complications of taking the
hydrocodone especially with
acetaminophen. I will consider that in the
future.
Concept
3 Critical Concepts (I learned, and/or
understand better about this topic)
Reflection – Address 1 of the 6
Cognitive Functions
Urinary Tract
Infections:
Contraindications to
Ciprofloxacin
Medication Administration
(2 items)
Miscellaneous Central
Nervous System
Medications:
Teaching About
Cyclobenzaprine
Take Actions (Implementation)
I thought I knew a lot about this drug, such
as – it causes anticholinergic effect such as
constipation and urinary retention.
However, I did not remember this drug
needed to be tapered and should be included
in my teaching plan. I will review this
section on my ATI and textbook.
Physiological Adaptation (2 items)
Topic
Fluid and Electrolyte Imbalances (2
items)
Medications Affecting
Urinary Output:
Identifying ECG
Manifestations of
Hypokalemia for a
Client Who Is Taking
Furosemide
Vitamins and
Minerals:
Interventions for a
Client Who Is Taking
Sodium Polystyrene
Sulfonate
1. One diagnostic test to confirm hypokalemia
from furosemide is to perform an EKG on the
client.
2. With the hypokalemia, the EKG will show
flatten or inverted T waves, prominent or
elevated U waves, ST depression, and
prolonged PR interval.
3. Other expected findings because of
hypokalemia from furosemide use include:
Vital signs changes – decreased BP, thready
pulse, orthostatic hypotension.
Respiratory changes – shallow breathing.
Muscular involvement – weakness, deep
tendon reflexed could be reduced.
GI involvement – Hypoactive bowel sounds,
nausea, vomiting, constipation.
Neurologic changes – altered mental status,
anxiety, and lethargy that progresses to acute
confusion and coma.
1. Polystyrene sulfonate replaces sodium with
potassium in the intestinal tract to promote
potassium excretion.
2. Polystyrene sulfonate can cause the ADR
of constipation, which can lead to fecal
impaction.
3. I must monitor the client for constipation
and report it to the provider.
Evaluate Outcomes (Evaluation)
From this practice assessment, I learned
additional information to what I learned in
class. Having this knowledge, I now
understanding hypokalemia is not just
decreased potassium levels of less than 3.5.
Hypokalemia can potentially cause serious
complications. I know have more
information to include in my plan of care
when managing care for a client who may
be experiencing hypokalemia.
Take Actions (Implementation)
I knew polystyrene sulfonate is used to treat
hyperkalemia and can cause frequent
diarrhea. I do not remember that polystyrene
sulfonate could also cause the opposite
effect of constipation. I would be sure to go
over my notes and review that section in
both my ATI and textbook.
References:
McCuistion, L.E., DiMaggio, K., Winton, M.B., & Yeager (2023). Pharmacology: A Patient-Centered Nursing Process Approach. 11th. Ed. Publisher: Elsevier.
ATI Content Mastery Series Review Module: RN Pharmacology 11.0 ed.
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3 critical points leadership practice B
Leadership (West Coast University)
Studocu is not sponsored or endorsed by any college or university
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“3 Critical Points”
Identify the 3 critical (Most Important) points for every NCLEX Client Need Category below 76%. Use whatever reliable evidence-based resources
necessary to remediate each topic (ATI Focused Review, ATI eBook, Course textbook per syllabus). Cite your sources (APA formatting not required).
Include the following reflection with each of your topics
How do the 3 critical (Most Important) points that you learned help you understand the following 6 Cognitive Functions (which follows the Nursing Process):
o Recognize Cues (Assessment) – Filter information from different sources (i.e., signs, symptoms, health history, environment).
o Analyze Cues (Analysis) – Link recognized cues to a client’s clinical presentation and establishing probable client needs, concerns, or problems.
o Prioritize Hypotheses (Analysis) – Establish priorities of care based on the client’s health problems (i.e. environmental factors, risk assessment, urgency,
signs/ symptoms, diagnostic test, lab values, etc.)
o Generate Solutions (Planning) – Identify expected outcomes and related nursing interventions to ensure clients’ needs are met.
o Take Actions (Implementation) – Implement appropriate interventions based on nursing knowledge, priorities of care, and planned outcomes to
promote, maintain, or restore a client’s health.
o Evaluate Outcomes (Evaluation) – Evaluate a client’s response to nursing interventions and reach a nursing judgment regarding the extent to which
outcomes have been met.
o
Date
Student Name
Instructor Name
Assessment Name
# of incorrect topics
NCLEX Client Need
Category
Managing Client
Care: Delegating
Tasks to Assistive
Personnel
Topic
3 critical points
To APActivities of daily
living
1. Identify what tasks are
appropriate to delegate for
each specific client.
2. A right task is repetitive,
requires little supervision, and
is relatively noninvasive for
the client.
3. Delegate tasks to appropriate
levels of team members (PN,
AP) based on standards of
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Reflection on critical points using the 6
Cognitive Functions
Nurses can only delegate tasks
appropriate for the skill and
education level of the health care
team member who is receiving the
assignment
lOMoARcPSD|13444472
Managing Client
Care: Delegating
Tasks to Assistive
Personnel
To APActivities of daily
living
practice, legal and facility
guidelines, and available
resources
1. Assess the health status and
complexity of care required by
the client
2. Match the complexity of care
demands to the skill level of
the health care team member
3. Consider the workload of the
team member
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The task must have the necessary
competence/training. Continually
review the performance of the team
member and determine care
competency
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Case study: The NCAA, Penn State, and Quality LeadershipIdentify the actions taken against PSU immediately after the Jerry Sandusky sexual abuse verdict and explain how the NCAA leadership justified these actions.Identify the actions taken by the NCAA in the several years following the initial sanctions and explain how the NCAA leadership justified these actions.Explain whether the NCAA membership should work to include bylaws that would afford the Association to discipline schools in future cases of felonious behavior on the part of coaches and administrators.Explain whether Emmert’s actions on the issue would qualify him as a “quality” leader.
Discussion Board: Summarize the case and include your most significant finding and elaborate on what you learned from this assignment. i will attach the one page for you to summerize.Respond to one classmate: after reading the discussion from a classmate, provide a response to their summary and include additional terminology or a law or regulation that could align but may have been missed. For full points, response must be constructive and reference details from the Code of Ethics or the DHBC Law and Regulationsplease respond to this post.Article Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88605…In this article, the legal case “United States et al. ex red. Simpson v. HQRC et al., No.2017-cv-02823” talks about how a management company by the name of HQRC was found to be doing fraudulent insurance claims. This management company was providing their services for various dental clinics and during the years of 2011-2021, these false insurance claims were being made. The company did a fraud amount of about $754 million and were made to pay the amount of fraud done plus interest on the fee’s. Something I found significant in this was the amount of deception the providers have done. They have not only lied to the insurance company, but also the patients and themselves (as they are doing this unethically). I think the managing company of these dental providers also had to have know about this as they can see what is being charged out and connect it to the patients records. With this assignment I learned how even the smallest things that one may consider “errors” can build up and become something big. In this legal case they claimed to have accidentally sent out the treatment provided under wrong codes, however even if this was the case, the amount of little mistakes they claimed to have had built up to something so big that it ended up doing a lot of damage. Not only were they accused of fraud but they have also misled their patients and even created a burden to those with Medical as the office is no longer able to accept this insurance!
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1. Describe the law case and the violation accusations (include the article link)
The case was between Arline Carr (the plaintiff) and Lloyd Dickey (the defendant). Carr filed
charges against Dickey, a dentist, for malpractice, assault, and battery. The case also involved the
extraction of the plaintiff’s tooth by the defendant. According to the case, the lower left wisdom
tooth is designated number 17. The plaintiff had accused the defendant of extracting the wrong
tooth. Even after the defendant extracted tooth number 19, the plaintiff continued feeling pain.
The defendant had done an X-ray and even showed it to the plaintiff. They agreed that tooth
number 18 was to be filled and tooth number 19 be extracted. The defendant even showed the
plaintiff the radiolucent, indicating tooth Number 19 was decayed. https://law.justia.com/cases/
california/court-of-appeal/2d/163/416.html
2. Use terminology from the CDA or CDHA Code of Ethics document (a minimum of
four terms and definitions) that align with the violation. Include the definitions.
Competence- the competent dentist can diagnose and treat the patient’s oral health needs and
work according to the patient’s interests. It also entails continuing self-assessment about the
outcome of patient care.
Autonomy: Patient has the right to choose what should be done with their own bodies. They are
capable of autonomous decision-making. The defendant should have done what the plaintiff
asked. Still, the dentist must weigh the benefits and harm and inform the patient of contemporary
standards of oral health.
Professionalism- dental hygienists should be committed to promoting oral healthcare initiatives.
That means the defendant should practice in a way that does not ruin community trust.
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Informed consent: It reflects on the patient’s right to self-decision. A dental hygienist must
obtain the fully informed consent of the patient. That means the doctor should have obtained full
consent before removing teeth number 19.
3. Affix the violations to the DHBC laws and regulations and reference how they link.
Section 1683. (a) Every dentist, dental health professional, or other licensed health professional
who performs a service on a patient in a dental office shall identify himself or herself in the
patient record by signing his or her name or an identification number and initials next to the
service performed and shall date those treatment entries in the record. Any person licensed under
this chapter who owns, operates, or manages a dental office shall ensure compliance with this
requirement.
The regulation links with the violation; according to the case, the defendant performed an X-ray
and told the patient that tooth number 19 was to be extracted. The plaintiff then told the
defendant to do what he felt was correct. The defendant claims that the plaintiff consented, while
the plaintiff states that she did not consent to the extraction of tooth number 19. There was no
record by signing, which makes it a violation of DHBC laws and regulations.
This assignment will allow students to utilize the basic tools of public health inquiry to identify and describe the distribution of diseases and/or health-related outcomes.
CEPH CONTENT COMPETENCIES
Explain the role of quantitative and qualitative methods and sciences in describing and assessing a population’s health (3)
List major causes and trends of morbidity and mortality in the US or other community relevant to the school or program (4)
Instructions
Purpose
This assignment will allow students to utilize the basic tools of public health inquiry to identify and describe the distribution of diseases and/or health-related outcomes.
CEPH Content Competencies
Explain the role of quantitative and qualitative methods and sciences in describing and assessing a population’s health (3)
List major causes and trends of morbidity and mortality in the US or other community relevant to the school or program (4)
Instructions
You have already completed an Exercise where you learned about the quantitative (numerical) information that is available from the Center for Disease Control and Prevention’s, Behavioral Risk Factor Surveillance System (BRFSS). That site is not working so we have found another similar site for you to use to complete this assignment, the CDC’s United Cancer Statistics Data VisualizationLinks to an external site.s site. You will explore the distribution of mortality from one type of cancer by sex and race/ethnicity across two states.
From this “Cancer Statistics at a Glance” page, make selections from the drop-down menus as follows:
Area: Choose any state; you will do a second state afterwards to compare.
New Cases (Incidence) or Deaths (Mortality): Choose “Rate of Cancer Deaths”.
Sex: Start with male or female; you will come back to the other.
Cancer Type: Choose one cancer that occurs in both women and men (not corpus and uterus, cervix, ovary, prostate, breast, testis).
Year: Choose 2016-2020.
Race and Ethnicity: Start with ALL Races and Ethnicities. You will come back for the others.
Using this “Cancer Statistics at a Glance” site (and other reputable internet sources), write a 2-page essay that addresses the following:
Explain why you selected the states you chose. Use internet sources to find information that allows you to briefly describe the states you selected, including demographics and other important features.
Explain why you selected the cancer you chose. Use internet sources to write one paragraph about this cancer including risk factors, prevention strategies, treatments, how common it is, how deadly it is and/or any other information you think is valuable.
Use the drop down menu options to find the mortality rates (not the number of cases) for your selected cancer in each of the two states for each race/ethnicity for males and females. Hover your mouse over the state to see the rates. Organize this information in a table you create and put in after your references as an Appendix.
Discuss the distribution of this disease/health indicator by state, sex, and race/ethnicity. Who is most at risk of death from this cancer? Who is least at risk? Did anything surprise you?
Discuss why it is important to have this evidence and suggest how a public health expert might use this numerical information.
Course Outcomes: This assignment enables the student to meet the following course outcomes.
1. Explain the pathophysiologic processes of select health conditions.
2. Predict clinical manifestations and complications of select disease processes.
3. Correlate lifestyle, environmental, and other influence with changes in levels of wellness.
Requirements:
NOTE: Students should NOT provide any medical/nursing advice or education to
interviewees. This assignment is for educational purposes only. Refer interviewee questions
to their physician.
1. Each student is to choose a chronic medical disorder that they would like to learn more
about from a list provided (find list below).
2. It is the responsibility of the student to research the topic using current literature (at least 2
current professional resources), become familiar with the pathophysiology, causes, risk
factors, common clinical manifestations and common complications for the disorder.
3. Once the student has become familiar with the disorder, it is their responsibility to locate
an individual to interview (interviewee). You may find the individual with approved
disorder first but should not perform the interview until you have completed research on
the topic. 10 points will be deducted for not completing interview
The interviewee must be at least 18 years old and able to answer questions by
themselves
The interviewee must currently have a chronic disease/disorder. If an interviewee
has been diagnosed with a disease/disorder but has NO manifestations or
complications related to the disorder they DO NOT qualify for the assignment.
Acute infections/diseases DO NOT qualify (pneumonia, urinary tract infection, flu,
colds).
The interviewee cannot be a patient from the clinical setting or a patient from your
work environment (hospitals, doctor’s office, LTC facility, home health, etc…)
The interviewee may be a relative, friend, colleague, or stranger.
Please use the individual’s own words in relation to their experience with the
disease/disorder.
4. Questions to be answered (Found in resources/references):
Introduction (20 points)
o 1 paragraph – Approximately 200 words
o Identify and introduce the chosen disorder
o Disease description
o Epidemiology of the disease
Incidence/prevalence (new cases per year/how many people are
affected total)
Age group most affected
Gender most affected
Prognosis
Causes and Risk Factors (20 points)
o Common causes of the disease/condition
o Risk factors for the disease/condition (impact of age, gender, influence of the
environment, genetic basis, lifestyle influences)
Pathophysiology (20 points)
o Describe in detail the pathophysiology of the disorder. (Do NOT just copy
this section from a resource-use your own words and understanding with
reference)
o Describe changes occurring at the cellular, tissue, and organ level that
contribute to the disease process.
o Describe adaptation of the cells and body in response to the disease.
o Relates the disease process to manifested signs and symptoms.
Clinical Manifestations (10 points)
o What are the common clinical manifestations of the disease/disorder
according to your resources?
o Describe the rationale for each manifestation. Using the pathophysiology,
explain why we see the manifestations presented in the disorder.
Complications (10 points)
o Describe the common complications of this disorder/disease according to your
resources.
o Describe the rationale for each complication. Using the pathophysiology,
explain why we see the complications presented in the disorder.
o Discuss the implications to the patient when complications are left untreated.
Diagnostics (10 points)
o List of laboratory and diagnostic tests used to determine the presence of the
disease.
o Discuss what the results will show in the presence of the chosen disease.
5. References/Citations
Minimum of 2 professional references-within 5 years
Your textbook
Professional website (.com is not professional-can use either .org, .gov, or .edu)
Scholarly journals
Reference page and in-text citations must be in APA format.
Turnitin score must be 24% or less.
You must use in-text citations for all information that you use in the slides after
each entry/sentence.
One missing citation will result in a 5-point deduction
Two missing citations will result in a 10-point deduction and an academic
integrity violation
6. APA Style and Organization (10 points)
a. Reference list submitted – at least two professional references
b. APA format – 7th Edition
c. Grammar and mechanics free of error
7. Answered during Interview: 10 points will be deducted for not completing interview
What is the age of the individual being interviewed? What is the relationship of the
individual to you? How long have they had the disorder?
What clinical manifestations of this disorder did the individual experience? How
does it compare to what you discovered in your resources?
What complications of this disorder did your individual experience? How does this
compare to what you discovered in your resources?
What other medical conditions/disorders has your individual been diagnosed with?
Do their other medical conditions have any effect on the chosen disorder?
How does the disease affect the individual’s daily living/activities? (repeat
hospitalizations, has to take a lot of meds, any activity restrictions, a lot of
appointments)
How does the disease/disorder affect the individual’s outlook on life? (Feel like a
burden to family, do they have good family support, feel hopeless, optimistic,
good coping mechanisms?)
8. PowerPoint Structure
Please use the power point template loaded on the class shell.
Headings with included questions have already been provided for you
Disease/Disorder Examples
Genetic Diseases-any type
Cancer-any type
Hematologic-blood disorders
ITP, TTP, HIT
Anemia-any type
Leukemia
Lymphoma
Multiple Myeloma
HIV
Cardiac System
Hypertension
Heart Failure
Chronic venous insufficiency
Cardiomyopathy-any type
Pulmonary System
Asthma
COPD-chronic bronchitis, emphysema
Cystic Fibrosis
Cancer
Neurologic System
Stroke
Parkinson’s
Alzheimer’s-early onset-still cognitively intact and can answer interview questions
Huntington’s
Multiple Sclerosis
Myasthenia Gravis
ALS
Cancer
Reproductive System
Polycystic ovarian syndrome
Endometriosis
Cancer
Digestive System
Crohns
Ulcerative Colitis
Ulcer-which type
Pancreatitis-chronic
Hepatitis-B or C only
Cirrhosis
Cancer
Endocrine System
DM I or II
Graves
Hashimoto
Cushing’s
Addison’s
Gigantism
Cancer
Integumentary System
Psoriasis
Lupus
Pressure Ulcer
Melanoma
Scleroderma
Cancer
Musculoskeletal System
Rheumatoid Arthritis
Osteoarthritis
Fibromyalgia
Gout
Ankylosing spondylitis
Osteoporosis
Osteomalacia
Cancer
Renal System
Renal failure
Cancer
Polycystic renal disease
This week you are to develop a PowerPoint presentation summarizing your Public Health Analysis paper. The presentation should analyze the public health issue in terms of the justice, legal, regulatory, data and advanced practice issues related to it. Be sure to identify how your discussion relates to the objectives of Healthy People 2020.What strategies or policies have been used to address the issue?Are they working? Why or why not?What strategies do you propose to improve the situation? Is legislative change needed?What are the implications of this issue for advanced practice nursing and/or public health? In other words where do we go with this policy issue in the future?Your PowerPoint presentation should be 20-25 slides, in APA format, with details included. Be creative.
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Comprehensive Review of the Literature: Enhancing Vaccination Rates through
Advanced Practice Nursing Interventions
Sabina Thomas, MSN, APRN, FNP-C
South University
NSG 7005
Dr. Alejandro
9/18/2023
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Comprehensive Review of the Literature: Enhancing Vaccination Rates through
Advanced Practice Nursing Interventions
In order to develop a robust evidence-based Public Health Analysis Paper on
enhancing vaccination rates through advanced practice nursing (APN) interventions, it is
essential to conduct a comprehensive review of the existing literature. This literature review
will serve as the foundation for understanding the current state of vaccination rates, the role
of APNs, and the effectiveness of APN interventions in addressing this critical public health
issue. Additionally, this review endeavors to extend our understanding by delving into
primary sources that offer valuable insights into the challenging task of bolstering vaccination
rates through public policy interventions. Primary sources, including research studies, clinical
trials, government reports, and authoritative documents, serve as the bedrock for shaping
sound vaccination policies and are thus instrumental in this exploration.
Current State of Vaccination Rates
It is imperative to understand the current state of vaccination rates in the United
States. The literature suggests that despite the availability of safe and effective vaccines,
vaccination rates for certain diseases have fallen below the desired thresholds, leading to
outbreaks and public health concerns (Orestein & Ahmed, 2017). Studies and reports from
organizations like the Centers for Disease Control and Prevention (CDC) provide valuable
statistics and trends related to vaccination coverage across various age groups and vaccines
(CDC, 2020).
The Role of Advanced Practice Nurses in Vaccination
Advanced practice nurses play a crucial role in healthcare delivery and preventive
care. They are often at the forefront of primary care and are well-positioned to address
vaccination-related issues (American Association of Nurse Practitioners, 2022). Several
studies highlight the importance of APNs in vaccination advocacy, education, and
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administration. These professionals are not only skilled in providing vaccinations but also in
counseling patients and families about vaccine safety and efficacy (Limaye et al., 2021).
Research indicates that patients are more likely to accept vaccines when recommended by
their APN, underscoring the influential role APNs can play in improving vaccination rates
(Siddiqui et al., 2022).
Effectiveness of APN Interventions
The effectiveness of APN interventions in enhancing vaccination rates is a critical
aspect of this literature review. Research studies evaluating the impact of APN-led initiatives
on vaccination rates provide valuable insights. These interventions may include communitybased immunization clinics, educational campaigns, and collaborations with schools and local
health departments. It is crucial to explore the strategies employed by APNs to address
vaccine hesitancy and improve vaccine acceptance among diverse populations. Tailoring
interventions to specific communities, taking into account cultural and socioeconomic
factors, has been shown to be effective in increasing vaccination rates (Rodrigues & Plotkin,
2020). Examining successful case studies and evidence-based practices can provide valuable
guidance for APNs seeking to implement interventions in their practice settings (Ismail et al.,
2022; NICE, 2022).
Alignment with Healthy People 2020 Objectives
An integral part of this literature review involves assessing how the proposed APN
interventions align with the objectives of Healthy People 2020, specifically those related to
immunization and infectious diseases (Office of Disease Prevention and Health Promotion,
2021). Healthy People 2020 aims to increase vaccination rates, reduce vaccine-preventable
diseases, and eliminate health disparities in immunization coverage (CDC, 2020). The
literature should be scrutinized to identify examples where APN-led interventions have
contributed to achieving these objectives. Research demonstrating the impact of such
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interventions on improving vaccination rates at the population level can underscore their
significance in public health efforts.
Relating Data to the Capstone Project
The integration of findings from the literature review into the capstone project, which
focuses on community health promotion, is a critical step in ensuring that evidence-based
strategies are applied effectively. The literature review will identify specific best practices
and interventions that can directly inform the design and implementation of the capstone
project. For example, if the review highlights that community-based vaccination clinics led
by advanced practice nurses (APNs) have significantly increased vaccination rates, these
clinics can be used as a model for the capstone project. The capstone project could involve
establishing similar clinics within the targeted community to provide convenient access to
vaccinations. Furthermore, the literature review will guide the selection of vaccines to
prioritize based on the unique needs of the community. For instance, if the review reveals that
a specific vaccine-preventable disease is more prevalent in the community, the capstone
project can focus on increasing vaccination coverage for that particular disease.
Primary Sources on Vaccination Policies
Clinical Trials and Vaccine Efficacy Studies
Primary research studies and clinical trials assume a pivotal role in assessing the
safety and efficacy of vaccines. These meticulously conducted experiments, often
orchestrated by esteemed entities like the National Institutes of Health (NIH) and
pharmaceutical firms, provide fundamental data pertaining to vaccine development, testing
processes, and outcomes. The information gleaned from these primary sources is
indispensable in the formulation of vaccination policies. It offers concrete evidence of a
vaccine’s effectiveness and safety, contributing to informed decision-making in public health
(Langford, 2020; Robinson et al., 2022).
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In these trials, the effectiveness and safety of vaccines are laid bare, subjected to
intense scrutiny, and evaluated with exacting precision. The data derived from these primary
sources constitute a treasure trove of evidence that forms the bedrock upon which vaccination
policies are constructed. They furnish policymakers with concrete and unassailable proof of a
vaccine’s performance. Such empirical grounding is paramount in guiding the direction of
public health strategies, ensuring that decisions are based on scientific certainties rather than
conjecture or speculation.
As individuals navigate the complex landscape of vaccination policies, these primary
sources offer an unimpeachable foundation upon which their understanding is built. They
empower policymakers with the confidence to make decisions that directly impact the health
and well-being of communities, grounded in the evidence painstakingly gathered in these
trials. The value of clinical trials and vaccine efficacy studies cannot be overstated; they are
the vanguards of public health, forging a path towards safer and more effective vaccination
practices.
Government Reports and Surveillance Data
Government agencies, including the Centers for Disease Control and Prevention
(CDC) and the World Health Organization (WHO), assume an unwavering role as steadfast
sources of primary reports and surveillance data. These publications represent a
comprehensive repository of meticulously collected and curated data concerning vaccination
rates, the prevalence of vaccine-preventable diseases, and the monitoring of adverse events
following vaccination. As guardians of public health, these agencies offer an exhaustive
panorama of the complex and ever-evolving public health landscape.
Within the pages of these reports lie invaluable insights into the impact of vaccination
policies. They provide policymakers and researchers with a data-rich canvas on which to
paint a vivid picture of vaccination efficacy and its broader consequences. The ability to
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monitor disease outbreaks, gauge vaccination campaign efficacy, and assess the safety and
effectiveness of vaccines is crucial for evidence-based policy formulation. In essence, these
primary sources, emanating from the authoritative agencies like the CDC and WHO, are the
keystones that support the arch of informed decision-making in public health (CDC, 2022;
WHO, 2023).
As individuals delve into the labyrinthine world of vaccination policies, these
government reports and surveillance data serve as a guiding light. They offer an unparalleled
vantage point from which to navigate the intricacies of public health initiatives. Armed with
the insights garnered from these sources, policymakers and researchers are better equipped to
design and implement vaccination strategies that safeguard public well-being. In an era where
data-driven decisions are paramount, these primary sources serve as the bedrock upon which
the foundations of effective vaccination policies are built.
Policy Evaluations and Impact Assessments
Policy evaluations and impact assessments, often conducted by universities, research
institutions, and government entities, stand as pivotal endeavors in critically scrutinizing the
effectiveness of vaccination policies. These primary research undertakings delve deep into
the ramifications of policy alterations on crucial aspects such as vaccination rates, the
prevalence of vaccine-preventable diseases, and the economic dimensions of healthcare. They
provide policymakers with a granular understanding of the tangible impacts of policies,
arming them with the essential information required to iteratively craft and refine vaccination
strategies.
By meticulously examining the consequences of policy changes, these primary
sources become the crucible in which the efficacy of vaccination policies is tested and
refined. Through rigorous research methodologies, they unearth invaluable insights into the
real-world outcomes of policy shifts, offering a comprehensive view of their influence on
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public health outcomes. Policymakers can draw upon the evidence generated by these
assessments to make informed decisions, adapt policies as necessary, and continually
enhance vaccination strategies to address evolving challenges (Rodrigues & Plotkin, 2020).
In the complex landscape of vaccination policy, policy evaluations and impact
assessments serve as beacons of evidence, guiding the formulation of strategies that have a
meaningful impact on public health. They bridge the gap between theory and practice,
ensuring that policy changes translate into tangible benefits for communities. As such, they
are instrumental in the iterative process of crafting effective vaccination policies that
safeguard public well-being.
Vaccine Hesitancy and Communication Research
In the quest to understand the complexities surrounding vaccine acceptance, primary
research on vaccine hesitancy and communication strategies offers profound insights. These
investigations dissect public perceptions, attitudes, and beliefs regarding vaccines,
illuminating the socio-psychological underpinnings of vaccine hesitancy. Furthermore,
primary sources delve into the efficacy of diverse communication interventions, providing
data-backed strategies for crafting effective communication policies. Such research is pivotal
in aligning vaccination policies with the multifaceted dynamics of public opinion (de
Figueiredo et al., 2020; Nuwarda et al., 2022).
Health Equity and Access Research
The pursuit of health equity and equitable access to vaccines demands rigorous
research. Primary sources scrutinizing barriers to access, socioeconomic determinants, and
strategies for bridging healthcare disparities in vaccination rates are essential. These sources
shed light on the uneven distribution of vaccines, the role of socioeconomic factors, and
interventions required to ensure equitable vaccine distribution. They are a moral compass that
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directs policy initiatives towards addressing disparities and ensuring that no community is left
behind in vaccination efforts (Ali et al., 2022).
Methodologies in Primary Studies
Understanding the methodologies employed in primary studies is imperative for
critically evaluating their findings and relevance to public policy analysis. Primary research
in the field of vaccines embraces a diverse set of methodologies, each tailored to specific
objectives:
Randomized Controlled Trials (RCTs)
Randomized controlled trials stand as the gold standard for assessing vaccine safety
and efficacy. These meticulously designed experiments randomly assign participants to
receive either the vaccine or a placebo, ensuring rigorous evaluation of vaccine outcomes.
RCTs furnish policymakers with unequivocal data on vaccine performance, serving as the
foundation for vaccine licensure and policy recommendations (Smith et al., 2008).
Surveillance and Epidemiological Studies
Epidemiological studies cast a wide net over disease occurrence and distribution.
These primary investigations, often leveraging extensive datasets and robust statistical
analyses, unearth trends, unearth risk factors, and gauge the effectiveness of vaccination
programs. Such studies are invaluable in identifying the real-world impact of vaccination
policies on populations (Hansen et al., 2019).
Qualitative Research
Qualitative research methods, encompassing interviews and focus groups, provide a
nuanced understanding of the motivations, attitudes, and beliefs that underpin vaccination
behavior. By delving into the human aspect of vaccine acceptance and hesitancy, qualitative
studies contribute rich, context-dependent data that enrich policy decisions. They bridge the
gap between raw data and actionable insights (Erchick et al., 2022).
9
Policy Analysis
The domain of policy analysis research entails a holistic appraisal of vaccination
policies. Researchers in this arena delve into policy documents, engage in stakeholder
interviews, and scrutinize policy implementation. By dissecting the lifecycle of vaccination
policies, from conception to execution, policy analysis research illuminates the nuances of
policy formulation and the impacts of policy changes (Attwell & Navin, 2019; Rodrigues &
Plotkin, 2020).
Conclusion
This comprehensive review of the literature is essential for building a strong
evidence-based foundation for the Public Health Analysis Paper. It will provide a thorough
understanding of the current state of vaccination rates, the role of APNs, the effectiveness of
APN interventions, alignment with Healthy People 2020 objectives, and practical insights for
application in the capstone project. By synthesizing and critically analyzing existing research,
this literature review will contribute to the development of a well-informed and impactful
analysis of the public health issue at hand. Primary sources, as gleaned from clinical trials,
government reports, policy evaluations, vaccine hesitancy studies, and health equity research,
are the pillars upon which evidence-based public policies are erected. These sources bring
forth the empirical foundation for crafting sound vaccination policies. Understanding the
methodologies harnessed in these primary studies is a prerequisite for scrutinizing their
findings and discerning their applicability to the realm of public policy analysis. With
primary sources as our compass, we embark on a journey towards bolstering vaccination
rates, mitigating vaccine-preventable diseases, and optimizing public health outcomes. The
imperative for policymakers and researchers is to maintain an unwavering commitment to
evidence-driven policy formulation, ensuring the vitality of our communities’ well-being.
10
References
Ali, H. A., Hartner, A.-M., Echeverria-Londono, S., Roth, J., Li, X., Abbas, K., . . .
Gaythorpe, K. A. (2022). Vaccine equity in low and middle income countries: a
systematic review and meta-analysis. International Journal for Equity in Health, 82.
American Association of Nurse Practitioners. (2022, October). State Practice Environment.
Retrieved from American Association of Nurse Practitioners:
https://www.aanp.org/advocacy/state/state-practice-environment
Attwell, K., & Navin, M. C. (2019). Childhood Vaccination Mandates: Scope, Sanctions,
Severity, Selectivity, and Salience. Milbank Quarterly, 97(4), 978-1014.
CDC. (2020, December 14). Healthy People 2020. Retrieved from Centers for Disease
Control and Prevention: https://www.cdc.gov/nchs/healthy_people/hp2020.htm
CDC. (2022, February 17). Vaccination Coverage among Adults in the United States,
National Health Interview Survey, 2019–2020. Retrieved from Centers for Disease
Control and Prevention: https://www.cdc.gov/vaccines/imzmanagers/coverage/adultvaxview/pubs-resources/vaccination-coverage-adults-20192020.html
de Figueiredo, A., Simas, C., Karafillakis, E., Paterson, P., & Larson, H. J. (2020). Mapping
global trends in vaccine confidence and investigating barriers to vaccine uptake: a
large-scale retrospective temporal modelling study. The Lancet, 396(10255), 898-908.
Erchick, D. J., Gupta, M., Blunt, M., Bansal, A., Sauer, M., Gerste, A., . . . Limaye, R. J.
(2022). Understanding determinants of vaccine hesitancy and acceptance in India: A
qualitative study of government officials and civil society stakeholders. PLoS One.
Hansen, N. D., Molbak, K., Cox, I. J., & Lioma, C. (2019). Relationship Between Media
Coverage and Measles-Mumps-Rubella (MMR) Vaccination Uptake in Denmark:
Retrospective Study. JMIR, 5(1), e9544.
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Hinman, A. R., Orenstein, W. A., & Schuchat, A. (2011). Vaccine-preventable diseases,
immunizations, and MMWR–1961-2011. MMWR Supplements, 60(4), 49-57.
Ismail, S. A., Lam, S. T., Bell, S., Fouad, F. M., Blanchet, K., & Borghi, J. (2022).
Strengthening vaccination delivery system resilience in the context of protracted
humanitarian crisis: a realist-informed systematic review. BMC Health Services
Research.
Langford, A. T. (2020). Health communication and decision making about vaccine clinical
trials during a pandemic. Journal of Health Communication, 25(10), 780-789.
Limaye, R. J., Opel, D. J., Dempsey, A., Ellingson, M., Spina, C., Omer, S. B., . . . O’Leary,
S. T. (2021). Communicating With Vaccine-Hesitant Parents: A Narrative Review.
Academic Pediatrics, 21(4), S24-S29.
NICE. (2022). Evidence review for interventions to increase the uptake of routine vaccines by
improving access: Vaccie Uptake in the General Population. National Institute for
Health and Care Excellence (NICE).
Nuwarda, R. F., Ramzan, I., Weekes, L., & Kayser, V. (2022). Vaccine Hesitancy:
Contemporary Issues and Historical Background. Vaccines, 10(10), 1595.
Office of Disease Prevention and Health Promotion. (2021, October 27). Immunization and
Infectious Diseases. Retrieved from Office of Disease Prevention and Health
Promotion: HealthyPeople 2020: https://wayback.archiveit.org/5774/20211119191447/https://www.healthypeople.gov/2020/topicsobjectives/topic/Immunization-and-Infectious-Diseases/objectives
Orestein, W. A., & Ahmed, R. (2017). Simply put: Vaccination saves lives. Proceedings of
the National Academy of Sciences of the United States of America, 114(16), 40314033.
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Robinson, R., Nguyen, E., Wright, M., Holmes, J., Oliphant, C., Cleveland, K., & Nies, M.
A. (2022). Factors contributing to vaccine hesitancy and reduced vaccine confidence
in rural underserved populations. Humanities and Social Sciences Communications,
9(1), 416.
Rodrigues, C. M., & Plotkin, S. A. (2020). Impact of Vaccines; Health, Economic and Social
Perspectives. Frontiers in Microbiology, 11.
Siddiqui, F. A., Padhani, Z. A., Salam, R. A., Aliani, R., Lassi, Z. S., Das, J. K., & Bhutta, Z.
A. (2022). Interventions to Improve Immunization Coverage Among Children and
Adolescents: A Meta-analysis. Pediatrics, 149(6).
Smith, M. J., Ellenberg, S. S., Bell, L. M., & Rubin, D. M. (2008). Media coverage of the
measles-mumps-rubella vaccine and autism controversy and its relationship to MMR
immunization rates in the United States. Pediatrics, 121(4), e836-e843.
WHO. (2023, July 18). Immunization coverage. Retrieved from World Health Organization:
https://www.who.int/news-room/fact-sheets/detail/immunization-coverage
Review the interactive media decision tree exercise about the patient with “Complex Regional Pain Disorder” Walden University, LLC. (Producer). (2019e). Complex regional pain disorder. [Interactive media file]. Baltimore, MD: Author please watch this link . https://cdn-media.waldenu.edu/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_07/index.html the first choice will be (Amitriptyline 25 mg po QHS and titrate upward weekly by 25 mg to a max dose of 200 mg per day). second choice (Continue current medication and increase dose to 125 mg at BEDTIME this week continuing towards the goal dose of 200 mg daily. Instruct the client to take the medication an hour earlier than normal starting tonight and call the office in 3 days to report how his function is in the morning).third choice (Continue the current dose of Elavil of 125 mg per day, refer the client to a life coach who can counsel him on good dietary habits and exercise). Write a 2 to 3-page summary paper that addresses the following:Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources (at least 5) for the last 5 years.Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples. it has an introduction with a brief explanation of the case study and includes the purpose statement
Select a health problem that primarily affects the pediatric population: Osteomyelitis in children
Provide information about the incidence, prevalence, and pathophysiology of the disease/disorder to the cellular level.
Differential Diagnosis
Educate advanced practice nurses on
assessment and diagnostic exams (Remember, APRN are the primary care providers)
care/treatment including genetics/genomics—specific for this disorder
Provide patient education for management, cultural, and spiritual considerations for care must also be addressed.
Submission Instructions:
Presentation is original work and logically organized.
Followed current APA format for PowerPoint slides, including citation of references.
PowerPoint presentation with 10-15 slides were clear and easy to read. Speaker notes expanded upon and clarified content on the slides.
Incorporate a minimum of 4 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
ASSIGNMENT COVER SHEET
Course name:
Concepts of Health Education & Health Promotion
Course number:
PHC 212
CRN:
Paper Assignment
Assignment title or task:
(You can write a question)
Choose a health issue in KSA and explore the
determinants causing that issue and justify your
understanding with evidence from the literature.
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Your response should be a minimum of 250 words but should not exceed 500
words (Excluding references).
• Support your answer with examples.
• Font size should be 12
• Font type should be Times New Roman
• Heading should be Bold
• Colour should be Black
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style and include in text citation.
• AVOID PLAGIARISM
• Due date; 07/10/2023 11:59 PM
Best of Luck
In this assignment you will apply the the first six steps of the seven-step process of ethical decision-making process to a case and write an essay. This refers to the decision-making process covered in the online lecture and in the assigned viewing. Please note that we expect you to incorporate concepts from this and previous week’s required reading into your analysis. You can only do the first six steps because you do not know the outcome to reflect upon.
For this assignment you will analyze one of the following cases from the required textbook
Case 8: Learning Experience, or
Case 10: Policy
You will analyze your selected case though the first six step of the decision-making process decribed in the readings:
Identify one ethical issue in the case (the rest of the steps should be related to this issue)
Reflect on personal bias and assumptions
Gather relevant information
Consider differing stakeholder values and interests
Explore practical alternatives
Make your choice and justify it using ethical theories, principles, and approaches explored in the class.
Your responses should be in essay format and follow the following formatting conventions:
The essay should be between 1000 and 1250 words, excluding references.
The essay should be double spaced.
The essay should include section headings.
Works cited page and citations in APA Style: http://owl.english.purdue.edu/owl/resource/717/01/. At least three (3) sources should be used in completing this assignment–the assigned readings can be among them.
Discuss the purpose and importance of conducting a workflow analysis prior to the implementation of a patient portal. Include in your discussion the steps you would take to: map the current processwho should be involvedwhat will be made availablepotential problems that can occur if a facility does not map and evaluate its workflow prior to implementation.
PLEASE MAKE SURE TO READ THE INSTRUCTIONS. PLEAGERISM MUST BE LESS THAN 20%. ALSO, PAY ATTENTION “formatting errors and all paragraphs must be indented. FOR THIS THE PROFESSOR HAS DEDUCTED MANY POINTS. ATTACHED YOU CAN FIND ALL THE PREVIOUS PAPERS SO THAT YOU KNOW WHAT YOU SHOULD WRITE ABOUT. THANK YOU.
The theoretical framework is a critical element of your work. A theoretical framework is the general representation of relationships in your problem and is based on existing theory. The conceptual framework is your idea on how the problem should be explored, and it is generally based on a theory. The difference between the two is the scope. Theory is broad; concept is narrow.
In most research studies, your framework can be either theoretical or conceptual in nature. For the purposes of this project, you will most likely follow a conceptual framework, which is your idea on how the research problem will be explored (although you could have both).
For example:
Theoretical framework: Stimulus is applied to elicit a response
Conceptual framework: A new teaching method is applied to elicit improvement in midterm test scores.
In this section of your change project paper, state the perspective through which the problem and/or phenomenon may be explored, and include the following:
Select a minimum of two theories.
Identify the process and logic in selecting these theoretical frameworks or conceptual frameworks for your study.
Discuss how each theory or model applies to the individual project.
Present the framework guiding your study.
Describe the assumptions of the framework.
Describe each key component of the framework.
Discuss how each element of the phenomenon applies to the framework.
Apply each element of the theory to the elements of the phenomenon under study.
Develop the rationale for the sample selection criteria.
Discuss, analyze, and critique pertinent research that uses the framework.
Remember that research never proves theory. Your research project can only support or refute the theoretical propositions you are using as your framework. But if you do not use theory or conceptual frameworks in your research, you may not be able to put your findings in a context that could strengthen the nursing education profession!
This section should be 3 Pages in length, not including the cover or reference page. You must reference a minimum of 3 scholarly articles.
Use current APA format to style your paper and to cite your sources. Review the rubric for more information on how the assignment will be graded.
Points: 75
Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
60 to >49.2 pts
Meets Expectations
Identifies independent theories or conceptual models that relate to the change project topic and describes how they will be applied to the change project. Thoroughly discusses how each element of the phenomenon applies to the framework. Clearly applies each element of the theory to the elements of the phenomenon under study. Develops the rationale for the sample selection criteria, and expertly discusses, analyzes, and critiques pertinent research that uses the framework.
49.2 to >45.0 pts
Approaches Expectations
Identifies independent theories or conceptual models that relate to the change project topic and describes how they will be applied to the change project. Discusses how most elements of the phenomenon apply to the framework, but may be lacking specific details. Attempts to apply each element of the theory to the elements of the phenomenon under study but may not make clear connections. Develops the rationale for the sample selection criteria, and briefly discusses pertinent research that uses the framework, but may be somewhat lacking in analysis and/or critique.
45 to >35.4 pts
Falls Below Expectations
Identifies independent theories or conceptual models but they may only indirectly relate to the change project topic. May not discuss how elements of the phenomenon apply to the framework. Connections to each element of the theory to the elements of the phenomenon are vague and unclear. The rationale for the sample selection criteria and pertinent research that uses the framework may be missing or severely lacking in analysis and/or critique.
35.4 to >0 pts
Does Not Meet Expectations
Fails to identify a theory or conceptual model or it is written in such a way that no relationships can be identified.
60 pts
This criterion is linked to a Learning OutcomeOrganization
7.5 to >6.15 pts
Meets Expectations
Content is well written throughout. Information is well organized and clearly communicated.
6.15 to >5.63 pts
Approaches Expectations
Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.
5.63 to >4.43 pts
Falls Below Expectations
Content is disorganized in many places and it lacks clarity.
4.43 to >0 pts
Does Not Meet Expectations
Content lacks clarity and information is disorganized, or may be an outline or a list.
7.5 pts
This criterion is linked to a Learning OutcomeAPA Format/Mechanics
7.5 to >6.15 pts
Meets Expectations
Follows all the requirements related to format, length, source citations, and layout. Assignment is free of spelling and grammatical errors.
6.15 to >5.63 pts
Approaches Expectations
Follows length requirement and most of the requirements related to format, source citations, and layout. Assignment is mostly free of spelling and grammatical errors.
5.63 to >4.43 pts
Falls Below Expectations
Follows most of the requirements related to format, length, source citations, and layout. Assignment contains some spelling and grammatical errors.
4.43 to >0 pts
Does Not Meet Expectations
Does not follow format, length, source citations, and layout requirements. Assignment contains many spelling and grammatical errors.
7.5 pts
Total Points: 75
Unformatted Attachment Preview
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Problem Identification and Description
September 17, 2023
Problem Identification and Description
Prevention and control of Sexually transmitted diseases (STDs) and related conditions are
significant public health concerns and priorities. Sexually transmitted infections (STIs) are
mainly caused by parasites, viruses, and bacteria passed from one person to another through
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semen, blood, or bodily fluids. However, apart from sexual intercourse, STIs can be transmitted
to infants during childbirth, pregnancy, shared needles, and blood transfusion. It is impossible to
know if someone has STIs in the early stages of the illness, even if they seem healthy. STDs and
unwanted pregnancies are common in nearly every society, affecting adults and adolescents.
Teenage pregnancy and unwanted pregnancy are increasingly affecting the livelihood of many
women, forcing young adults to become mothers earlier than desired. The clinically identified
problem in this paper is the unwanted pregnancies and contraction of STDs due to unprotected
sexual activity. This paper describes the clinical problem, target population, and significance of
the clinical intervention and health promotion.
PICOT Question
Among adolescents (P), can best sexual health education and promotion (I) compared
with no interventions (C) prevent STIs and unwanted pregnancy (O) within one year (T)?
Clinical Setting
In the United States, sexual health education is inconsistent with varying methods and
information nationwide. Education is vital in empowering young people to develop safe sex
practices. However, despite sexual health promotion activities, rates of STIs in the United States
are on the rise. The best clinical setting to address and promote sexual health and unwanted
pregnancy is the primary care unit, which is the first point of contact for millions of Americans
seeking healthcare services. The intervention initiative will be in a primary care facility with an
obstetrician-gynecologist (OBGYN) unit that deals with women and mothers. The unit provides
services related to reproductive health and women’s well-being. It encompasses health clinics
that serve pregnant women, young adolescent girls, and boys needing urgent clinical
3
interventions and emergencies. Thus, the OBGYN unit in primary care is the perfect clinical
setting to promote sexual health and reach both males and females seeking reproductive health.
OBGYN Service and Population Group
OBGYN unit offers various services for women planning pregnancy, including prenatal
care, pregnancy services, and postpartum care. It also provides services to young mothers,
monitoring baby’s health, delivery, and postpartum care. Likewise, OBGYN offers patients
services outside pregnancy, including fertility issues, preventive maintenance, gynecologic
procedures, and bleeding complications. With varied clinical specialties, adolescents can access
solutions to address female reproductive organs, both pregnant and non-pregnant women. Even
though people visit primary care with issues unrelated to health problems, unwanted pregnancy
can create more significant problems for young mothers, including psychological issues. Many
adolescent girls and young women visit the clinic seeking alternative solutions to unwanted
pregnancies, including abortion. Even though other medical conditions or complications can lead
to the termination of the pregnancies, young mothers visiting the clinic have other worrying
concerns related to STIs, particularly herpes, HPV, syphilis, gonorrhea, and chlamydia.
Statement Of The Problem and Target Population
In the United States, sexual health education is inconsistent, with varying methods and
information nationwide. Education is vital in empowering young people to develop safe sex
practices (Walchonski, 2020). However, despite sexual health promotion activities, rates of STIs
in the United States are on the rise. Multiple interventions have been implemented to promote
women’s health in various settings, including promoting adolescent education to enhance sexual
health. These interventions include comprehensive sexual education, cognitive behavioral
interventions, abstinence-only education, and dyad education for parents and teenagers.
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However, sexual behaviors among adolescents are influenced by various factors,
including peer pressure, individual environment, parental involvement, policy, and social
situations. Many schools promote abstinence-only, while others offer HIV education with a
choice of content and nuanced values. Despite the education enshrined in school and education
policy, STI rates are on the uptrend, disproportionately among teens. There is an urgent need to
successfully promote awareness to enhance understanding of the risks associated with sex and
adolescents’ reckless practices. This may require state and federal government policy to enforce
teenage reproductive health promotion. Assessing the problem’s dimension and planning
effective efforts to address it is challenging, given the magnitude of social media influence on
today’s teenagers.
Clinical Significance of the EBP Approach
According to the CDC (2021), STIs are rising, compromising national health, with over
2.5 million cases reported in 2021 for syphilis, gonorrhea, and chlamydia. WHO statistics
indicate that over 1 million new cases are reported daily worldwide. The majority are young
people between 15-34 years. Even though most STIs are treatable with antibiotics, they increase
risks for adverse events, including infertility, stillbirth, inflammatory disease, neonatal death, and
HIV infections. Increased over-the-counter prescription of antibiotics has increased resistance
from STI strains that are becoming difficult to treat (WHO, 2023). Research has shown that STIs
among college student is mainly due to a lack of knowledge and awareness of STDs
(Amirkhanzadeh et al., 2019).
Therefore, the best approach is required to overcome teenage and unwanted pregnancies.
Another research in India offers insight into misinformed young people on emergency
contraception that can resolve unwanted pregnancies (Davis et al., 2020). Evidence-Based
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Practice (EBP) provides valuable information that guides interventions and policy development
for influential women’s reproductive health development. It is crucial to understand the
effectiveness of the best sexual education approach to inform policymakers, particularly in
resource allocation and funding of school-based education. This project’s clinical significance is
applying EBP to find the best reproductive health interventions to close the knowledge gap
among young girls to reduce high cases of STIs and unwanted pregnancies.
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References
Amirkhanzadeh Barandouzi, Z., & Cong, X. (2019). Knowledge of sexually transmitted diseases
among college students in the USA. Journal of Client-Centered Nursing Care, 5(2), 7380. http://dx.doi.org/10.32598/JCCNC.5.2.73
CDC (2021). Sexually Transmitted Disease Surveillance 2021.
https://www.cdc.gov/std/statistics/2021/default.htm
Davis, P., Sarasveni, M., Krishnan, J., Bhat, L. D., & Kodali, N. K. (2020). Knowledge and
attitudes about the use of emergency contraception among college students in Tamil
Nadu, India. Journal of the Egyptian Public Health Association, 95, 1-11.
https://doi.org/10.1186/s42506-019-0030-9
Walchonski, C. F. (2020). Best Youth Education Methods for Sexually Transmitted Infection
Prevention.
https://cornerstone.lib.mnsu.edu/cgi/viewcontent.cgi?article=1974&context=etds
WHO (2023). Sexually transmitted infections (STIs). https://www.who.int/news-room/factsheets/detail/sexually-transmitted-infections-(stis)
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The Integrative Literature Review
September 23, 2023
The Integrative Literature Review
Sexual health education has a significant role in preventing STIs and unplanned
pregnancies among young adults. Effective reproductive health plans can offer adolescents the
proper knowledge and insights to base on when making informed decisions concerning their
2
reproductive health. Opening an intervention center like the OBGYN will help provide a wide
range of reproductive topics that will be age-appropriate. Moreover, the intervention aims to
bridge the existing gap in sexual health to increase abstinence and reduce incidences of unwanted
pregnancy. Various scholars have indulged in the topic to prove the effectiveness of quality
sexual health education.
Mantula et al. (2023) did their study to prove the effectiveness of inclusive sexual health
education. According to the authors, sexual well-being is a state of wholeness in aspects relating
to reproduction. Therefore, sexual health entails effective counseling and providing people with
the proper knowledge, explaining available resources related to sexuality, and addressing any
barriers that compromise knowledge acquisition. The scholars further prove that adolescents
have long been engaging in risky sexual conduct due to the unavailability of effective sexual
education.
Although youths have been accessing details related to sexuality in schools, churches, or
within their families, education has not been enough to induce the correct behavioral change.
Comprehensive sexual education entails emphasizing behold information but providing support
that motivates young adults to attain the right life skills and have appropriate attitudes.
Moreover, practical education should also focus on growth and development, appropriate sexual
behaviors, pregnancy, and health issues related to unethical sexual conduct.
Basically, according to Mantula et al. (2023), effective sexual education is necessary for
addressing adolescents’ well-being. Therefore, tailored education programs that offer age-related
and continuous reproductive health updates are appropriate in the contemporary adolescent
world. The education should cover broad aspects related to relationships, contraceptives, the
effects of pregnancy, the necessity of abstinence, and the responsibility of a teen to lead a moral
3
life. Lastly, ensuring that the education programs are related and friendly is essential while
considering these topics.
Mbizvo et al. (2023) explain that adolescents’ health education, especially about sexuality
and reproduction, is essential to development. The study’s outcomes indicate that early and
unintentional pregnancies are becoming a hot topic among adolescents. The increasing
pregnancy rates indicate that youths have been engaging in risky sex behaviors, increasing their
chances of acquiring HIV and STIs. That implies that adolescents have a high probability of
unhealthy abortions and childbirth health issues. The central contributing aspect is the lack of
comprehensive sexual education to increase their knowledge about sexual health.
The research topic entails identifying if comprehensive sexual education can reduce the
chances of these instances. The researchers imply that effective sexual education significantly
offers young adults the appropriate details about their sexual health. Moreover, education
minimizes assumptions and life skills that help adolescents enhance their decision-making
abilities to choose a proper sex life. That can help reduce the increasing rates of HIV and
unwanted pregnancies. Such an outcome supports the research topic since it helps evaluate if
effective education can reduce incidences of STDs.
Aguirre & Carrión-Yaguana (2023) comprehensively evaluated the impact of
comprehensive sex education in Ecuador. Adolescents have a promising future in the society.
However, many challenges, like early pregnancies and risky sexual behaviors, have been
significant among youths. The main reason is adolescents lack the necessary and timely
information about sexuality. Effective sexual and reproductive education motivates individuals
to make competent decisions about their sex lives. Poor knowledge of sexuality is one of the
significant reasons why STIs and unwanted pregnancies have become common among teens.
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Adolescents do not have the correct information about contraceptives and the risks and impact of
engaging in early sexual activities.
Therefore, as the study indicates, integrating comprehensive sex education in school
programs helped reduce unwanted pregnancies in Ecuador. The unlimited benefits of sexual
education are evident, supporting the research topic. A reproduction health program that
addresses diverse aspects of sexual life to provide youths with the correct information about their
growth and the effects of early sexual activities is the best solution. That is because thorough
education provides insights on abstinence and preventing STIs.
However, providing abstinence-related education and comprehensive sex education
appears to be the best remedy. Informing adolescents about sexual engagement and
contraceptives has an unpromising future since it can be compromised. However, diverse
education provides teens with the correct information about the dangers of engaging in sexual
behaviors. Teens have the chance to identify how early pregnancies can affect their education,
parents, and career dreams. They also get to understand STIs’ effects on their reproductive
health. That helps create a knowledge base that allows adolescents to make the right decisions
about their sexual lives.
Mark & Wu (2022) indicates that sex education in America has been a major topic
among researchers and legislators. The primary reason is that teen birth has been increasing
recently. Most of these births are unwanted and unplanned. The necessity of comprehensive sex
education is evident even with the federal government funding programs like abstinence-only sex
education to provide teens with the right tips about immoral behaviors and the value of
abstaining till marriage. Based on the study outcomes, emphasizing sex education has helped
reduce teen pregnancy by more than 2%. That implies that focusing on more individualized
5
education strategies can be promising. Tailoring education programs to address the diverse
causes of early pregnancy and STIs can significantly save American teens. Moreover, these
education programs can support addressing societal barriers that hinder teens from accessing the
proper and comprehensive information about sexuality.
Mohamed et al. (2023) provide an analysis of the significant causes of unwanted
pregnancies among teens. Early pregnancy has high risks of premature births or delivering
unhealthy kids. Moreover, early pregnancy increases the economic burden on parents and
introduces mental complications to adolescent mothers. Therefore, finding a remedy to this issue,
as the article implies, can help reduce the impacts and complications of early sexual engagement.
Comprehensive sexual education is the primary solution to increasing unwanted pregnancies.
According to the article, effective sexual education should provide detailed sessions about
contraceptives and making competent decisions about sexual life. Such an analysis supports the
idea that a comprehensive reproduction education would effectively address the increasing rate
of adolescents.
Agbor et al. (2021) evaluate how introducing sex education to youths at an early stage
can help reduce cases of early pregnancy. As the researcher indicates, many teens engage in
unethical behaviors due to societal and economic conditions. Moreover, these young adults lack
the knowledge to avoid STIs and unintended pregnancies. Little engagement between families
and children has also increased STDs and unwanted pregnancies. Therefore, comprehensive sex
education has become relevant and supportive for teens despite the challenges they are currently
experiencing. The topic of sexual education has for a long time been considered for married
people. However, these assumptions have proven ineffective, and introducing comprehensive
sexual education has indicated its necessity amongst teens. This education aims to minimize the
6
chances of adverse effects and STIs. The education provides awareness on enhancing life quality
and enjoying sexuality.
However, as the authors signify, a well-planned and structured education plan is the best
way to address these challenges. Many education programs have failed due to their inconsistency
and shallowness of the topic. They lack the details to inform teens about generating essential life
skills like abstinence and living a moral life. Therefore, cooperating with the correct information
in education would have a promising future for teens.
Lastly, Pires et al. (2021) explain that adolescent pregnancy is a worldwide medical issue.
The main contributing factors include poor female education and lack of knowledge. Lower
perceptions of the topic have been a significant reason why unwanted pregnancies have become
dominant today. Also, teens lack the appropriate expertise on contraceptives and engage in risky
sexual behaviors. Therefore, finding the right interventions, such as comprehensive sex
education, would limit these barriers. The research also provides insights into why adolescents
engage in sexual behavior at an early stage. The primary aspect is having older partners
introduce them to sexual activities before maturity. This information forms the foundation for an
effective education system where adolescents gain the correct information about their sexual
lives.
Summary of literature review
All articles in the literature review prove that early pregnancies and STIs among teens
have become a significant healthcare issue today. Many teens face major challenges due to their
7
introduction to sexual behaviors by their peers and older partners. Moreover, knowledge
inadequacy and a lack of a support system have contributed to these issues. Many teens lack the
proper sexual life knowledge, compromising their ability to make informed decisions. Without
the appropriate expertise, it is hard to make the right choices. Therefore, introducing a
comprehensive education system proves to be an effective remedy for addressing this challenge.
Moreover, introducing the education mechanism will reduce the burden on the advanced
practice nurse. There will be a limited burden of addressing STIs and treating premature births.
Also, the identified gaps, including the causes of significant unwanted pregnancies and why
available programs fail, provide a baseline for the nurse to develop comprehensive education
plans that help address unintended teen pregnancies. Also, the nurse will be able to advocate for
the right resources that connect adolescents with the right support system.
References
8
Agbor, P. E., Chile, O., & Ogu, E. N. (2021). Influence of Sex Education on Early Pregnancy
among Adolescent Female Students in Port Harcourt Metropolis: Implication for Students
Academic Performance. https://seahipaj.org/journals-ci/sept-2021/IJIHCR/full/IJIHCR-S2-2021.pdf
Aguirre, K., & Carrión-Yaguana, V. D. (2023). Empowering youth: the impact of comprehensive
sex education on teenage pregnancy in Ecuador (No. wp-2023-107). World Institute for
Development Economic Research (UNU-WIDER).
https://www.wider.unu.edu/sites/default/files/Publications/Working-paper/PDF/wp2023107-empowering-youth-impact-sex-education-teenage-pregnancy-Ecuador.pdf
Mantula, F., Chauraya, Y., Danda, G., Chaibva, C. N., Ngwenya, T., Gwatiringa, C., & Chamisa,
J. A. (2023). Perspective Chapter: Sexual Health Interventions for Adolescents. In Sexual
Education Around the World-Past, Present and Future Issues. IntechOpen.
https://www.intechopen.com/chapters/1137866
Mark, N. D., & Wu, L. L. (2022). More comprehensive sex education reduced teen births: Quasiexperimental evidence. Proceedings of the National Academy of Sciences, 119(8),
e2113144119.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872707/#:~:text=A%20consistent%20fi
nding%20from%20observational,use%20(29%E2%80%9331).
Mbizvo, M. T., Kasonda, K., Muntalima, N. C., Rosen, J. G., Inambwae, S., Namukonda, E. S.,
… & Kangale, C. (2023). Comprehensive sexuality education linked to sexual and
reproductive health services reduces early and unintended pregnancies among in-school
adolescent girls in Zambia. BMC public health, 23(1), 1-13.
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15023-0
9
Mohamed, S., Chipeta, M., Kamninga, T., Nthakomwa, L., Chifungo, C., Mzembe, T., … &
Madise, N. (2023). Interventions to prevent unintended pregnancies among adolescents:
A rapid overview of systematic reviews. https://assets.researchsquare.com/files/rs2568862/v1/050a2163-7cde-4133-8f4d-608a5ac40908.pdf?c=1679000290
Paton, D., Bullivant, S., & Soto, J. (2020). The impact of sex education mandates on teenage
pregnancy: International evidence. Health economics, 29(7), 790-807.
https://onlinelibrary.wiley.com/doi/full/10.1002/hec.4021
Pires, R., Araújo-Pedrosa, A., Pereira, J., & Canavarro, M. C. (2021). How Can Unintended
Pregnancies Be Prevented among Adolescents Who Engaged in Sexual Intercourse at
Earlier Ages? The Role of Female Education and Partner Age Difference. International
Journal of Environmental Research and Public Health, 18(20), 10631.
https://www.mdpi.com/1660-4601/18/20/10631
1
Project Aims, Values, and Desired Outcomes
2
Benefits
The project’s goal is to address the pressing issue of unwanted pregnancies and the spread of sexually
transmitted diseases (STDs) in our community, especially among young adults and adolescents (Albertson
et al., 2018). We hope to promote sexual health, improve access to reproductive healthcare, and ultimately
improve the well-being of individuals in our community by implementing a comprehensive intervention
in primary care facilities with obstetrician-gynecologist (OBGYN) units.
The project reduces the need for significant capital investment by leveraging existing primary care
infrastructure. This cost-effective approach allows resources to be reallocated to critical interventions and
programs. For millions of people, primary care facilities are their first point of contact for healthcare
services (Widman et al., 2018). By leveraging these existing structures, reproductive health services can
be delivered more efficiently, ensuring timely access for those in need. Individuals receive high-quality,
comprehensive reproductive healthcare services thanks to the specialized expertise of OBGYN units
within primary care facilities (Marcell et al., 2017). This targeted approach results in more effective
outcomes and improved community health.
The project to improve reproductive health in primary care settings will have a wide-ranging impact on
individuals, programs, and institutions. Individuals will experience fewer unwanted pregnancies and a
lower risk of contracting STDs as access to comprehensive reproductive healthcare services improves
(Widman et al., 2018). This will result in improved overall health and well-being. Individuals, particularly
young adults and adolescents, will be empowered to make informed decisions about their sexual health
through educational programs and access to contraception, resulting in greater autonomy and control over
their futures (Widman et al., 2018). Individuals will experience improved mental, emotional, and physical
well-being as the risks of unintended pregnancies and STDs are reduced, leading to an overall higher
quality of life (Albertson et al., 2018).
3
The project will increase the use of reproductive health services in primary care settings (Albertson et al.,
2018). To meet the needs of the community, this increased demand will necessitate the expansion and
improvement of existing programs. Participation in sexual health education programs will increase,
resulting in a more informed and aware population (Widman et al., 2018). This will almost certainly result
in the creation of more effective and targeted educational resources.
Primary care facilities with OBGYN units will improve their ability to provide comprehensive
reproductive healthcare services (Marcell et al., 2017). This could result in a general improvement in the
reputation and trustworthiness of these institutions in the community. The community will likely view
institutions involved in this project favorably because of their dedication to addressing a critical public
health issue (Albertson et al., 2018). This favorable perception may entice additional support and resources
for future initiatives. With fewer unwanted pregnancies and STD cases, the strain on the broader healthcare
system will be reduced. This includes the possibility of a decrease in the demand for emergency services
and specialized care for pregnancy-related complications.
Goals, Objectives, and Variables
The project’s goal is to reduce unwanted pregnancies and STD transmission among adolescents and young
adults by 30% in two years. This will be accomplished by implementing the strategies outlined below.
Increasing contraception use among sexually active individuals aged 15-24 by 20% will help reduce the
number of unwanted pregnancies. Increasing the percentage of people who get regular STD screenings by
25% will result in earlier diagnosis and treatment, as well as less transmission to others. Providing
comprehensive sexual education to 65% of the community’s adolescents aged 15-19 will help raise
awareness of STD prevention and treatment, as well as unwanted pregnancies.
To track the project’s success, measurable indicators such as contraceptive use rates, STD screening rates,
and the percentage of adolescents receiving sexual education will be used. Measurable indicators will
4
include contraception use rates, STD screening rates, and the proportion of adolescents who receive sexual
education. Surveys and medical records are being used to collect quantitative data on contraceptive use,
STD screening rates, and attendance at sexual education programs.
Research Impact, Desired Outcomes, and Timeline
Research Impact and Social Change:
This research initiative will make a significant contribution to our community’s overall well-being. We
hope to empower individuals with knowledge and access to essential reproductive healthcare services by
addressing the root causes of unwanted pregnancies and STD transmission. As a result, families will be
healthier, educational opportunities will be improved, and the community will be more prosperous (De
Vasconcelos et al., 2018).
Desired Outcomes
The goal of this project is to develop a comprehensive, accessible, and effective reproductive healthcare
system within primary care facilities, with the goal of lowering the number of unwanted pregnancies and
STD transmission among adolescents and young adults (Widman et al., 2018). The project focuses on
providing targeted reproductive health services to a vulnerable population, with the goal of improving
overall health outcomes. The project takes a community-centric approach, recognizing that individual
health and well-being are inextricably linked to the prosperity of the larger community.
Timeline
Months 1-3: Assess needs and form partnerships with key stakeholders.
4-6 months: Create and improve intervention protocols and educational materials.
5
Months 7-9: Implement the intervention in primary care settings and launch public awareness
campaigns.
Months 10-12: Begin data collection and analysis to track progress toward goals.
Year 2: Based on feedback and results, continuously refine and expand the program.
6
References
Albertson, K., Crouch, J. M., Udell, W., Schimmel-Bristow, A., Serrano, J., & Ahrens, K. R. (2018).
Caregiver perceived barriers to preventing unintended pregnancies and sexually transmitted infections
among youth in foster care. Children and Youth Services Review, 94, 82-87.
https://www.sciencedirect.com/science/article/abs/pii/S0190740918303220
Widman, L., Nesi, J., Kamke, K., Choukas-Bradley, S., & Stewart, J. L. (2018). Technology-based
interventions to reduce sexually transmitted infections and unintended pregnancy among youth. Journal
of Adolescent Health, 62(6), 651-660.
https://www.sciencedirect.com/science/article/abs/pii/S1054139X18300892
Marcell, A. V., Burstein, G. R., Braverman, P., Adelman, W., Alderman, E., Breuner, C., … & Levine, D.
(2017). Sexual and reproductive health care services in the pediatric setting. Pediatrics, 140(5).
https://publications.aap.org/pediatrics/article/140/5/e20172858/37895/Sexual-and-Reproductive-HealthCare-Services-in
De Vasconcelos, S., Toskin, I., Cooper, B., Chollier, M., Stephenson, R., Blondeel, K., … & Kiarie, J.
(2018). Behaviour change techniques in brief interventions to prevent HIV, STI and unintended
pregnancies: A systematic review. PloS one, 13(9), e0204088.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204088
this assignment has two part. First part is you do a reflection over my day how it went and what i had during my clinical in kids side at psychiatric unit. second part of the assignment is you do prep sheet on my patient. I will provide the info.
Unformatted Attachment Preview
Student Name _______________________________________
Client’s Initials:
Age:
Room Number:
Ethnicity:
Facility:
Legal
Status:
DSM V:
Date ________________________
Gender
M
F
Admission Date: _______________
Unit:
Minor
Vol.
Invol.
Checks/Precautions:
MEDICATIONS (Include generic/trade name, classification/use, dose, schedule, common side effects)
Generic Name Trade Name Classification/Use Dose Schedule Side Effects
LABS/DIAGNOSTIC TESTS:
(Only those not WNL, Tox Screen, and medication lab levels)
Presenting Problem:
Physical, sexual abuse history:
Medical History:
Family History:
Substance Abuse History:
Recent Stressors/Losses:
Education:
Legal:
Marital History:
Support Systems (with whom does the client live with):
Occupational:
Mental Status Assessment (Include general appearance and behavior,
mood/affect, other):
Appearance:
Physical handicaps _______________________________________________________
Dress/Grooming: Appropriate
Inappropriate Sloppy Poor Hygiene
Gait & Motor coordination (awkward, stagers, shuffling, rigid, steady) ______________
_______________________________________________________________________
Relationship between appearance and age _____________________________________
Behavior
Agitated
Calm
Lethargic
Restless
Anxious
Angry
Tearful
Distractible Evasive Cooperative Follows commands
Negative Fearful
Alert
Movements: Excessive Reduced WNL
Peculiar body movements (e.g., scanning of the environment, odd or repetitive gestures, level of
consciousness, balance and gait) _____________________________________
Abnormal movements (e.g., tardive dyskinesia, tics, tremors) _____________________
Level of eye contact (keep cultural differences in mind) _________________________
Speech
Rate: Rapid Slow
Normal
Volume: Loud Soft
Normal
Clear
Mumbling
Pressured Slurring Stuttering
Constant Mute or silent
Disorganized
Tongue-tied speech
Barriers to communication
Specify (e.g., client has delusions or is confused, withdrawn, or verbose) ____________
_______________________________________________________________________
Mood
What mood does the client convey? __________________________________________
_______________________________________________________________________
Affect
Is the client’s affect bland, apathetic, flat, dramatic, bizarre, or appropriate? Describe.
_______________________________________________________________________
Thought process
1. Characteristics: Flight of ideas Looseness of association Blocking
Concrete thinking Confabulation Disorganized Neologisms
Circumstantiality Coherent
Describe the characteristics of the client’s responses ___________________________
______________________________________________________________________
2. Cognitive ability:
Proverbs: Concrete
Abstract
Serial sevens: How far does the client go? _____________________
Can the client do simple math? Yes No
What seems to be the reason for poor concentration? ___________________________
Orientation to Time
Place
Person
Situation
Thought content
1. Central theme: What is important to the client? ______________________________
Describe. ____________________________________________________________
2. Self-concept: How does the client view him/herself? __________________________
____________________________________________________________________
What does the client want to change about him/herself? _______________________
____________________________________________________________________
3. Insight: Does the client realistically assess his/her symptoms? Yes No
Describe. ____________________________________________________________
Realistically appraise his/her situation? Yes No
Describe. ____________________________________________________________
4. Is the client a Reliable historian? _______________Describe:__________________
_____________________________________________________________________
5. Suicidal or homicidal ideation? Yes
No Suicide potential? ______________
Family history of suicide or homicide attempt or successful completion? Yes No
Explain. _____________________________________________________________
6. Preoccupations: Does the client have
Hallucinations Type: Auditory Visual Tactile Olfactory
Delusions Type: Grandiosity Jealous Persecutory Somatic
Obsessions
Rituals Phobias Religiosity Worthlessness Illusions
Describe. ____________________________________________________________
make a critique for 2 reasearch papers a qualtiatative and a quantitative research each critique has to be within 5 pages using APA style for references . The attached files has the questions for critique
Complete the Fall Risk and Cognition Assessments Case Study, including the Hendrich II Fall Risk Assessment available in the Resources folder.Complete the Mini-Cog screening (see Borson, n.d., in the Resources section) and the Pittsburgh Sleep Quality Index (PSQI; see Buysse, Reynolds, Monk, Berman, & Kupfer, 1989, in the Resources section) to develop a comprehensive assessment for Mrs. L.’s risk of falling.Develop a one-paragraph summary describing Mrs. L.’s risk for falls.Create one goal for each category.Review the rubric for more information on how your assignment will be graded.Submit the three fall risk assessment tools and your summary as attachments to the assignment area.
College of Health Sciences
Department of Public Health
Assignment Cover Sheet
Course name:
GLOBAL HEALTH
Course number:
PHC 311
CRN
Assignment title or task:
What are the different types of Aids which are delivered by
wealthy countries to poor countries? (10 marks)
Student Name:
Students ID Number:
Submission Date:
Instructor name:
Grade:
Out of 10
College of Health Sciences
Department of Public Health
Assignment Instructions (Week 5):
Dear Students,
The Assignment is available in Course materials and activities under Week 5 by name Week 5 –
Assignment.
This activity will comprise for 10 marks in the Total course work.
The Assignment is available from Release date 24/04/2023.
Assignment guidelines:
•
•
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, Submission date)
in word document, Pdf is not accepted.
It must Avoid plagiarism. It is not acceptable. Marks will cut if plagiarism available.
Word count- Maximum 500 words for each answer.
Font should be 12 Time New Roman.
Color should be black.
Line spacing should be 1.5.
Don’t use bold or Italic or underline in your answer.
References should be in APA style format only.
This criterion is linked to a Learning OutcomeHistory of present illness (HPI) and comprehensive clinical examination/review of systems (ROS)
8 pts
Proficient
Explains HPI and ROS in detail with clear and accurate understanding of chief complaint. Evidence-based rationales clearly and accurately support the HPI and ROS.
6.08 pts
Acceptable
Explains HPI and ROS in some detail with adequate understanding of chief complaint. Evidence-based rationales adequately support the HPI and ROS.
4.8 pts
Needs Improvement
Explains HPI and ROS in limited detail with limited understanding of chief complaint. Evidence-based rationales vaguely support the HPI and ROS or are not present.
0 pts
Unsatisfactory
Fails to explain HPI and ROS with poor understanding of chief complaint. Evidence-based rationales do not support the HPI and ROS or are not present.
8 pts
This criterion is linked to a Learning OutcomePathophysiology of admitting diagnosis and past medical/surgical histories
8 pts
Proficient
Clearly and accurately explains the pathophysiology for each admitting diagnosis and past medical/surgical history. Clearly and accurately associates specific details related to the client’s history and signs/symptoms with evidence-based citations.
6.08 pts
Acceptable
Adequately explains the pathophysiology for each admitting diagnosis and past medical/surgical history. Adequately associates specific details related to the client’s history and signs/symptoms with evidence-based citations.
4.8 pts
Needs Improvement
Vaguely explains the pathophysiology for each admitting diagnosis and past medical/surgical history. Vaguely associates specific details related to the client’s history and signs/symptoms with limited to no evidence- based citations.
0 pts
Unsatisfactory
Fails to provide pathophysiology of admitting diagnosis and past medical/surgical history. Does not associate specific details related to the client’s history and signs/symptoms with limited to no evidence- based citations.
8 pts
This criterion is linked to a Learning OutcomeSocioeconomic/psychosocial assessment
4 pts
Proficient
Clearly and accurately describes socioeconomic and psychosocial background in detail with evidence-based citations. Identifies at least 3 or more psychosocial concerns.
3.04 pts
Acceptable
Adequately describes socioeconomic and psychosocial background in detail with evidence-based citations. Identifies at least 2 psychosocial concerns.
2.4 pts
Needs Improvement
Vaguely describes socioeconomic and psychosocial background in detail with limited to no evidence-based citations. Identifies at least 1 psychosocial concern.
0 pts
Unsatisfactory
Fails to describe socioeconomic and psychosocial background with limited to no evidence- based citations. Identified no psychosocial concerns.
4 pts
This criterion is linked to a Learning OutcomeTeaching assessment & client education
4 pts
Proficient
Clearly and accurately identifies areas of instructional needs, learning preference, and learning barriers. Provided clear and concise client education that will aid in health promotion, health maintenance and self-care activities.
3.04 pts
Acceptable
Adequately identifies areas of instructional needs, learning preference and learning barriers. Provided some and adequate client education that aids in health promotion, health maintenance and self-care activities.
2.4 pts
Needs Improvement
Vaguely identifies areas of instructional needs, learning preference and learning barriers. Provided minimal and vague client education that will aid in health promotion, health maintenance and self-care activities.
0 pts
Unsatisfactory
Fails to identify areas of instructional needs, learning preference and learning barriers. Did not provide client education that will aid in health promotion, health maintenance and self-care activities.
4 pts
This criterion is linked to a Learning OutcomeInterprofessional consults and collaborative plan
4 pts
Proficient
Lists at least 3 appropriate collaborative issues/concerns. Evidence- based rationales demonstrate clear and accurate understanding of consults and interventions.
3.04 pts
Acceptable
Lists at least 2 appropriate collaborative issues/concerns. Evidence- based rationales demonstrate adequate understanding of consults and interventions.
2.4 pts
Needs Improvement
Lists at least 1 appropriate collaborative issue/concern. Evidence-based rationales demonstrate vague understanding of consults and interventions or may be missing.
0 pts
Unsatisfactory
Fails to list collaborative issues/concerns or lists issues/concerns that are inappropriate. Evidence- based rationales demonstrate unsatisfactory understanding of consults and interventions or may be missing.
4 pts
This criterion is linked to a Learning OutcomeMultidisciplinary client outcome and discharge planning/referrals
4 pts
Proficient
Clearly and accurately describes issues/concerns related to multidisciplinary discharge planning with evidence-based rationales.
3.04 pts
Acceptable
Adequately describes issues/concerns related to multidisciplinary discharge planning with evidence- based rationales.
2.4 pts
Needs Improvement
Vaguely describes issues/concerns related to multidisciplinary discharge planning with limited to no evidence-based rationales.
0 pts
Unsatisfactory
Fails to describe issues/concerns related to multidisciplinary discharge planning with limited to no evidence-based rationales.
4 pts
This criterion is linked to a Learning OutcomeLabs
4 pts
Proficient
Clearly and accurately identifies pertinent laboratory tests with applicable indications, addresses abnormal values, and recognizes trends related to a client’s disease process with evidence- based rationales.
3.04 pts
Acceptable
Adequately identifies pertinent laboratory tests with applicable indications, addresses abnormal values, and recognizes trends related to a client’s disease process with evidence- based rationales.
2.4 pts
Needs Improvement
Vaguely identifies pertinent laboratory tests with applicable indications, addresses abnormal values, and recognizes trends related to a client’s disease process with limited to evidence-based rationales.
0 pts
Unsatisfactory
Fails to identify pertinent laboratory tests with applicable indications, address abnormal values, or recognize trends related to a client’s disease process with limited to no evidence-based rationales.
4 pts
This criterion is linked to a Learning OutcomeDiagnostics/procedures
4 pts
Proficient
Clearly and accurately describes the client’s diagnostic criteria and indications with evidence- based rationales that clearly support the chief complaint and presenting signs/symptoms.
3.04 pts
Acceptable
Adequately describes the client’s diagnostic criteria and indications with evidence-based rationales that adequately support the chief complaint and presenting signs/symptoms.
2.4 pts
Needs Improvement
Vaguely describes the client’s diagnostic criteria and indications with limited to no rationales which vaguely support the identified chief complaint and presenting signs/symptoms.
0 pts
Unsatisfactory
Fails to describe the client’s diagnostic criteria and indications with limited to no rationales and does not support the identified chief complaint and presenting signs/symptoms.
4 pts
This criterion is linked to a Learning OutcomeMedications
8 pts
Proficient
Clearly and accurately identifies all components of the medication list with evidence-based citations, including name, class, route, dose, frequency, mechanism of action, applicable indication(s), side and adverse effects, interactions, and nursing considerations relevant to the client.
6.08 pts
Acceptable
Adequately identifies some components of the medication list with evidence-based citations, including name, class, route, dose, frequency, mechanism of action, applicable indication(s), side and adverse effects, interactions, and nursing considerations relevant to the client.
4.8 pts
Needs Improvement
Vaguely identifies few components of the medication list with limited to no evidence-based citations, including name, class, route, dose, frequency, mechanism of action, applicable indication(s), side and adverse effects, interactions, and nursing considerations relevant to the client.
0 pts
Unsatisfactory
Fails to identify all components of the medication list with limited to no evidence-based citations, including name, class, route, dose, frequency, mechanism of action, applicable indication(s), side and adverse effects, interactions, and nursing considerations relevant to the client.
8 pts
This criterion is linked to a Learning OutcomeRecognition of cues
8 pts
Proficient
Identifies at least 4 or more imperative assessment cues. All cues are relevant. Evidence-based citations clearly and accurately support the cues.
6.08 pts
Acceptable
Identifies at least 2 imperative assessment cues. Some cues are relevant. Evidence-based citations adequately support the cues.
4.8 pts
Needs Improvement
Identifies at least 1 imperative assessment cue. Few cues are relevant. Evidence-based citations vaguely support the cues or are missing.
0 pts
Unsatisfactory
Fails to identify imperative assessment cues. Cues are not relevant. Evidence- based citations are limited or are missing.
8 pts
This criterion is linked to a Learning OutcomeAnalysis of cues
8 pts
Proficient
The analysis of cues clearly and accurately supports the prioritized client needs and plan of care. Clearly and accurately links cues to a patient’s clinical presentation in establishing probable patient needs, concerns, or problems. All cues are analyzed with evidence- based citations.
6.08 pts
Acceptable
The analysis of cues adequately supports the prioritized client needs and plan of care. Adequately links cues to a patient’s clinical presentation in establishing probable patient needs, concerns, or problems. Some cues are analyzed with evidence- based citations.
4.8 pts
Needs Improvement
The analysis of cues vaguely supports the prioritized client needs and plan of care. Vaguely links cues to a patient’s clinical presentation in establishing probable patient needs, concerns, or problems. Few cues are analyzed with limited to no evidence-based citations.
0 pts
Unsatisfactory
Fails to analyze cues or does not support the prioritized client needs and plan of care. Fails to link cues to a patient’s clinical presentation in establishing probable patient needs, concerns, or problems. No cues are analyzed or do not have evidenced-based citations.
8 pts
This criterion is linked to a Learning OutcomePrioritization of hypotheses (clinical judgments)
8 pts
Proficient
Identifies at least 4 nursing clinical judgements that are clear, accurate, and prioritized with clear etiology and data to support rationale. The clinical decision is clear, accurate, and presents correlation from the recognized cues based on priority-setting frameworks.
6.08 pts
Acceptable
Identifies at least 4 nursing clinical judgments that are adequate and prioritized with sufficient etiology and data to support rationale. The clinical decision is adequate and presents correlation from the recognized cues based on priority-setting frameworks.
4.8 pts
Needs Improvement
Identifies less than or equal to 4 nursing clinical judgments that are vague and not prioritized with insufficient etiology and data to support rationale. The clinical decision is vague and may or may not have correlation from the recognized cues based on priority-setting frameworks or is missing.
0 pts
Unsatisfactory
Fails to identify nursing clinical judgments or is not prioritized with insufficient etiology and data to support rationale. Fails to identify clinical decisions with no correlation from the recognized cues based on priority-setting frameworks.
8 pts
This criterion is linked to a Learning OutcomeGeneration of solutions (S.M.A.R.T goals/outcomes)
8 pts
Proficient
Clearly and accurately establishes client’s goal/outcome criteria that can be achieved with nursing assistance. The goal/outcomes clearly and accurately support the clinical judgments and plan of care. All goals/outcomes are time-limited to the date/time of care and are specific, measurable, attainable, and relevant.
6.08 pts
Acceptable
Adequately establishes client’s goal/outcome criteria that can be achieved with nursing assistance. The goal/outcomes adequately support the clinical judgments and plan of care. Some goals/outcomes are time-limited to the date/time of care and are specific, measurable, attainable, and relevant.
4.8 pts
Needs Improvement
Vaguely establishes client’s goal/outcome criteria that may be achieved with nursing assistance. The goal/outcomes vaguely support the clinical decisions and plan of care. Few goals/outcomes are time- limited to the date/time of care and may or may not be specific, measurable, attainable, and relevant.
0 pts
Unsatisfactory
Fails to establish client’s goal/outcome criteria that may be achieved with nursing assistance. The goal/outcome does not support the clinical decisions and plan of care. Goals/outcomes are not time-limited to the date/time of care and are not specific, measurable, attainable, or relevant.
8 pts
This criterion is linked to a Learning OutcomeImplementation of actions (interventions)
8 pts
Proficient
Clearly and accurately identifies at least 16 actions that are independent nursing interventions supported by scientific rationale and evidence-based practice. All interventions are individualized, prioritized, specific, and with timed frequencies. Nursing actions are always aimed at the client’s goals and directed at the stated health deviation based on the nursing assessment and Erikson’s stages of development.
6.08 pts
Acceptable
Adequately identifies at least 14 to 16 actions that are independent nursing interventions supported by scientific rationale and evidence-based practice. Some interventions are individualized, prioritized, specific, and with timed frequencies. Nursing actions are adequately aimed at the client’s goals and sometimes directed at the stated health deviation based on the nursing assessment and Erikson’s stages of development.
4.8 pts
Needs Improvement
Vaguely identifies at least 12 to 14 actions that are independent nursing interventions that may or may not be supported by scientific rationale and evidence-based practice. Few interventions are individualized, prioritized, specific, and may or may not notate timed frequencies. Nursing actions are vaguely aimed at the client’s goals and may or may not be directed at the stated health deviation based on the nursing assessment and Erikson’s stages of development.
0 pts
Unsatisfactory
Fails to identify at least 12 actions that are independent nursing interventions supported by scientific rationale and evidence-based practice. Interventions are not individualized, prioritized, specific, or do not have timed frequencies. Nursing actions are not aimed at the client’s goals and are not directed at the stated health deviation based on the nursing assessment and Erikson’s stages of development.
8 pts
This criterion is linked to a Learning OutcomeEvaluation
8 pts
Proficient
Clearly and accurately identifies criteria for evaluation, effectiveness of interventions, and measurement of goal completion. Evaluation is clearly and accurately linked to the generated solutions and overall plan of care. Modifies, revises, and recommends alternative intervention(s) with evidence-based citations as applicable.
6.08 pts
Acceptable
Adequately identifies criteria for evaluation, effectiveness of interventions, and measurement of goal completion. Evaluation is adequately linked to the generated solutions and overall plan of care. Modifies, revises, and recommends alternative intervention(s) with evidence-based citations as applicable.
4.8 pts
Needs Improvement
Vaguely identifies criteria for evaluation, effectiveness of interventions, and measurement of goal completion. Evaluation is vaguely linked with generated solutions and overall plan of care. May or may not modify, revise, or recommend alternative intervention(s) with limited to no evidence-based citations as applicable.
0 pts
Unsatisfactory
Fails to identify criteria for evaluation, effectiveness of interventions, and measurement of goal completion. Evaluation is not linked with generated solutions and overall plan of care. Does not modify, revise, or recommend alternative intervention(s) with limited to no evidence- based citations as applicable.
8 pts
This criterion is linked to a Learning OutcomeGeneral Organization
4 pts
Proficient
Clear and accurate APA format. Concisely appropriate citations and references. No spelling or grammar errors.
3.04 pts
Acceptable
Adequate APA format. Adequate appropriate citations and references, Few spelling or grammar errors.
2.4 pts
Needs Improvement
Inadequate APA format. Inappropriate citations and references. Some spelling or grammar errors.
0 pts
Unsatisfactory
Fails to utilize APA format. No appropriate citations and references. Many spelling or grammar errors.
Module 8 – Coding Guidelines and Validation
Module 8 Objectives:
After completing this module, you should be able to:
1.
2.
3.
4.
Assess the necessity for using ICD-10-CM coding guidelines.
Apply coding guidelines to clinical cases for assigning ICD-10-CM codes.
Examine the validation process for confirming the ICD-10-CM code assignment.
Evaluate coding compliance and audit requirements of ICD-10-CM coding.
Module 8 Readings
1. Health Information Management Technology: An Applied Approach Chapter 5 –
Clinical Vocabularies and Classification Systems, pgs. 212- 221.
2. ICD-10-CM Official Guidelines for Coding and Reporting
3. Top 10 Must-Follow Coding Guidelines to Become perfect in ICD 10 Coding
4. How to select ICD-10 codes
5. Medical Coding ICD-10-CM Guidelines
6. Updates to the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2023
7. General ICD-10-CM Coding Guidelines April 2022 Coding Updates
8. ICD-10-CM: New Guidelines for 2023
9. History of ICD-10 Coding
Assignment
MedCoding Inaccuracies
Part 1
Medical Coding and Documentation inaccuracies result in missed revenue and reduced cash
flow for healthcare organizations and to avert such situations Auditing and Compliance
specialists regularly conduct validation reviews.
What these specialists look for in the medical documents? How they ensure synergism
between the medical documents and ICD/CPT codes? How many medical documents they
review as a sample? Why is that so? How do they resolve coding mismatch situations? What
could be the consequences of lack of the validation programs on the healthcare facility’s
financial health? Would it have impact on the facility’s accreditation status also?
Part 2
Watch the YouTube video on https://www.youtube.com/watch?v=rKnj0OrZnSA ICD-10-CM
Guidelines and conduct the following activities individually for self-check. After that offer a
reflection on the experience on the learning activity in the discussion. Do you think the job of
Auditing and Compliance Specialist is boring? Exciting? Stressful? Other?
1. What do the ICD codes represent?
2. What is the purpose of ICD-10-CM?
3. What are various ICD-10-CM sections and how are they labeled?
4. What is meant by “Conventions” for the ICD-10-CM?
5. Where would you start looking for the ICD-10-CM code?
6. What are the “format” and “structure” of the ICD codes?
7. Where is a placeholder (X) used with the ICD codes?
8. What do the “NEC” and “NOS” abbreviations represent in ICD-10-CM?
9. What is “punctuation” and its “types” in ICD-10-CM and where are they used?
10. What do “Include” and “Exclude” explain in ICD-10-CM?
11. Which condition should be coded “first” if multiple medical conditions exist?
12. What do the “AND” and “WITH” indicate in ICD-10-CM?
13. What do “See” and “See Also” mean in ICD-10CM?
14. What are “Default Codes” in ICD-10CM and what do they represent?
15. Which statement of the provider documentation determines the code assignment?
Offer a reflection on the experience on the learning activity. Do you think the job of Auditing
and Compliance Specialist is boring? Exciting? Stressful? Other
Response to Discussions
POST 1
Audit and compliance specialists carefully examine medical documentation,
such as physician notes, lab results, imaging reports, etc., to ensure that they
support the diagnosis and procedure codes assigned (The Centers for
Medicare and Medicaid Services (CMS), 2021). This is done to confirm that
the codes billed accurately represent the services rendered.
To ensure synergy and accuracy, the specialists cross-reference the medical
documentation with the codes submitted for reimbursement (HCRS, 2021).
They examine the documentation to ensure it supports the codes built
following guidelines set by the World Health Organization for ICD codes and
the American Medical Association for CPT codes.
The number of documents that need to be reviewed during an audit can vary
based on the size of the practice or hospital, the scope of the audit, and the
specific risk areas being addressed. It is essential that the sample size is large
enough to represent the coding and billing practices accurately but not so
large that it becomes unmanageable. Auditors use statistical sampling
methods to determine the appropriate sample size (HCRS, 2021).
If an auditor identifies a mismatch between the documentation and the billed
codes, they bring it to the healthcare provider’s attention. They provide
education and training to correct any misunderstandings or errors, and the
incorrect claim may need to be adjusted or resubmitted (HCRS, 2021).
Regular validation is crucial for maintaining financial health, ensuring
accurate data collection, and compliance with legal and accreditation
requirements. With regular validation, healthcare organizations can avoid
revenue loss due to undercoating or denied claims, potential fines and
penalties from overcoating or fraudulent billing, and incorrect data for quality
and outcome measurements, which could negatively affect the organization’s
reputation and patient care (The Centers for Medicare and Medicaid Services
(CMS), 2021).
In addition, inaccurate coding can impact the facility’s accreditation status.
Many accreditation bodies, such as the Joint Commission or the National
Committee for Quality Assurance, require healthcare organizations to comply
with coding and billing regulations (The Centers for Medicare and Medicaid
Services (CMS), 2021). Non-compliance could jeopardize an organization’s
accreditation status and its ability to participate in specific insurance or
government programs.
Therefore, regular audits and compliance checks are essential for maintaining
financial health, ensuring accurate data collection, and compliance with legal
and accreditation requirements.
Part two:
After completing steps 1-15 as instructed, and watching the linked video, I
have concluded that the job of an auditing and compliance specialist would be
too monotonous and unexciting for me. Although I have some experience in
billing and coding, I know that it is not something I could enjoy working with
for eight hours a day. While each circumstance may be different, the process
of determining the correct coding is more or less repetitive. I can anticipate
that even with experience, I could become very frustrated with repeated errors
and ongoing updates leading to more mistakes. I also believe it is only a
matter of time before these processes become automated.
References
HCRS (2021, November 16). Benefits of medical coding Audits & Why You
need one. Healthcare Resolution
Services. https://healthcareresolutionservices.com/blog/benefits-of-medicalcoding-audits-why-you-need-one/
The Centers for Medicare and Medicaid Services (CMS). (2021). ICD-10-CM
Official Guidelines for Coding and
Reporting. CMS.gov. https://www.cms.gov/files/document/2021-codingguidelines-updated-12162020.pdf
POST 2
Medical coding and documentation inaccuracies have a tremendous impact on the finances of
healthcare organizations, leading to missed revenue and reduced cash flow. Auditing and
compliance specialists are crucial in conducting validation reviews to prevent such situations.
When reviewing records, coders look for reliability, validity, completeness, and timeliness
using other coding systems, including CPT, HCPCS, and ICD10. They pay close attention to
how the documents align with the regulated codes, such as the ICD and CPT codes, and crossreference the codes used in the documentation. They verify that the assigned codes accurately
reflect the documented medical services.
A baseline audit is performed with a review of a large sample of the coding completed. That
audit includes a sample of records coded by the coders for all types of services. It should
represent all types of cases treated by all physicians within the organization. The audit helps
to ensure that the medical records and codes are in accordance and compliant with the coding
practices within the organization.
In mismatched situations, specialists must investigate by consulting with the physicians
involved in the patient’s care and request additional information. This helps solve discrepan cy
and ensure accuracy in the coding.
As mentioned, a lack of validation programs can impact the facility’s financial health. Any
errors can lead to a loss in revenue, compliance and regulation issues, penalties, and
reputational damage.
Therefore, implementing robust validation programs conducted by skilled auditing and
compliance specialists is crucial for healthcare facilities. These programs ensure accurate
coding, enhance revenue capture, mitigate compliance risks, and safeguard the financial
health and reputation of the organization.
References
Sayles, N. B., & American Health Information Management Association. (2013). Health
Information Management Technology : An Applied Approach: Vol. Fourth edition. AHIMA
Press.
PART II
I can see how the job of Auditing and Compliance Specialist can be exciting and stressful.
The changing regulations and the complexity of the laws make it a challenging position. This
role requires a strong understanding of the laws and regulations and analytical skills to
interpret and apply them to the organization’s operations. This role requires strong attention to
detail because any error may lead to financial implication. However, with continuous
education and staying current on industry changes to develop the relevant and appropriate
skills, this job could be rewarding.
REFERENCES
Contempo Coding. (2020, September 3). MEDICAL CODING ICD-10-CM GUIDELINES
LESSON – 1.A – Coder explanation and examples for 2021 [Video]. YouTube.
ICD-10-CM Official Guidelines for Coding and Reporting FY 2018. (2017). In American
Academy of Pediatrics eBooks (pp. xi–xx). https://doi.org/10.1542/9781610021074-icd
Introduction to Healthcare Financial Management
READ:
•
•
•
Week 8 Overview
Office of Inspector General – Compliance:
Compliance Program Policy and Guidance:
DO:
•
•
Discussions
Assignment 4: Analyzing Healthcare Finance Fraud Case White Paper – Due NLT
11:59 on Day 7
ADDITIONAL RESOURCES:
•
New complexities require a new approach to budgeting and forecasting, available
at: https://www.healthcarefinancenews.com/blog/new-complexities-require-newapproach-budgeting-and-forecasting
Discussion With a minimum of 250 words
Many of the regulations you have read about this week were developed from prior actions
within the medical community that warranted changes to be made to protect patients,
individuals, investors, and other stakeholders. The Sarbanes-Oxley (SOX) Act of 2002 was
born out of several accounting scandals at the time. One of these accounting scandals was
HealthSouth Corp., the nation’s largest provider of outpatient surgery, diagnostic and
rehabilitative healthcare services at the time (Sec.gov, 2003). Discuss the importance of fair
and accurate financial reporting in the healthcare industry in a few paragraphs and post this
discussion to the discussion forum. Be sure to support your statements through research. Once
you have completed your post, review the link of at least two of your peers.
ASSIGNMENT
Compliance is a comprehensive program that helps institutions and their
employees conduct operations and activities ethically; with the highest level
of integrity, and in compliance with legal and regulatory requirements. To
have an effective compliance program, an organization must establish and
maintain an organizational culture that “encourages ethical conduct and a
commitment to compliance with the law.” U.S. Federal Sentencing Guidelines
§8B2.1(a)(2).
•
•
Using the OIG website (https://oig.hhs.gov/) or another of your
choosing, select a real-time healthcare fraud news report from your
local area to feature
Develop a 3-5 page white paper using the case as the point of
application for the financial compliance process and that provides a
succinct overview of the healthcare finance fraud committed applied to
the chosen case.
o The potential criminal and monetary fines that can be imposed on
the individual and/or organization from the case.
o Explain what financial compliance processes could have
prevented the occurrence of this case.
o What loopholes in the applicable law or the system the
perpetrators used to commit the fraud.
*At least one (1) cited source is required.
Please respond to the following Post with a minimum of 150 words
POST 1
The Sarbanes-Oxley Act of 2002 (SOX) is a U.S. federal law enacted in response to corporate
accounting scandals. It aims to improve corporate governance, strengthen financial reporti ng,
enhance auditor independence, increase accountability for executives, protect whistleblowers,
and establish the Public Company Accounting Oversight Board (PCAOB) to regulate auditing
firms. SOX seeks to restore investor confidence by imposing strict regulations on publicly
traded companies, promoting transparency, and preventing financial fraud (Amadeo, 2022). In
early 2000, massive fraud and accounting scandals at significant companies occurred and
shook the financial market, which led to calling on Congress to enhance investor protection.
Enron was one of the high-profile firms involved in accounting scandals, destroying over $6
trillion of household wealth over two years (SOXlaw.com, n.d.).
The Sarbanes-Oxley Act of 2002 was undoubtedly a response to several high-profile
accounting scandals, including the one involving HealthSouth Corp. HealthSouth, a
significant healthcare services provider in the United States, was involved in a massive
accounting scandal where the company’s executives were found to have inflated earnings by
nearly $2.7 billion.
Furthermore, its scandal involved accounting fraud and manipulation of financial statements
to overstate earnings and assets. This and other corporate scandals highlighted the need for
stronger regulations and oversight in corporate governance and financial reporting, leading to
the enactment of SOX to prevent similar misconduct in the future (Sec.gov., 2003). The
disclosure of such fraudulent activities at HealthSouth and other high-profile cases like Enron
and WorldCom contributed to losing investor confidence and trust in financial markets
(SOXlaw.com, n.d.).
Fair and accurate financial reporting holds immense importance in the healthcare industry for
various reasons. Firstly, healthcare organizations are vital for societal well-being, and reliable
reporting ensures they have the resources needed for high-quality care, efficient resource
allocation, and investment in medical technology. This, in turn, contributes to better patient
outcomes. Secondly, the healthcare sector is heavily regulated, and accurate financial
reporting is crucial for compliance with laws to protect patients, prevent fraud, and maintain
system integrity. Noncompliance can lead to legal consequences and damage an organization’s
reputation. Moreover, investors, including government agencies, rely on accurate financial
information to make informed decisions about funding, research, and healthcare initiatives.
Transparent reporting attracts essential investments for innovation in medical treat ments and
technology. Fair and accurate reporting also fosters trust among stakeholders, including
patients and insurers. In an industry where trust is crucial, any hint of financial impropriety
can lead to a loss of confidence that is challenging to rebuild (Rosario, 2021).
In conclusion, fair and accurate financial reporting is vital for resource allocation, legal
compliance, and patient care. Transparency is crucial for stakeholders, including patients and
investors, as it ensures informed decision-making and accountability. Failure to comply, as
seen in the HealthSouth Corp. case, illustrates the risks of lax reporting. Accurate financial
information attracts essential investments for medical innovation, and noncompliance with
laws like SOX can have legal consequences. Healthcare professionals must understand
regulations, employ third-party auditors, and foster a culture of transparency to protect patient
well-being and maintain trust in the industry.
Reference
Amadeo, K. (2022). Sarbanes-Oxley summary: Four ways Sarbanes-Oxley stops corporate
fraud. The balance.https://www.thebalancemoney.com/sarbanes-oxley-act-of-2002-3306254
Lane, L. (2021). Healthcare organization financial statements: Understanding best
practices. Richter. https://blog.richterhc.com/health-care-organization-financial-statementsunderstanding-best-practices
Rosario, C. (2021). How important is financial & clinical reporting for healthcare? Advanced
Data System Corporation.https://www.adsc.com/blog/how-important-is-financial-andclinical-reporting-for-healthcare
Sec.gov. (2003). SEC charges HealthSouth Corp. CEO Richard Scrushy with $1.4 billion
accounting fraud. https://www.sec.gov/news/press/2003-34.htm
SOXlaw.com. (n.d.). Understanding and complying with the Sarbanes-Oxley
Act. https://www.soxlaw.com
POST 2
Hospitals face multiple challenges in managing their financial statement, especially manually.
These financial statements show information and outcomes of various operations within the
organization. The Sarbanes-Oxley Act emphasizes the importance of fairness and accuracy in
financial reporting in the healthcare industry. A fair and accurate financial report can assist an
organization in assessing its financial health, identifying inefficiencies, and expanding
revenue streams and cost-saving strategies. Transparency in financial reporting can also
increase the accountability of operational leaders, auditors, and accounts and reduce financial
fraud. Additionally, fair and accurate reporting can assist organizations in raising capital,
determining the effectiveness of billing and collection staff (predicting and optimizing cash
flow), providing accurate information regarding future performance and viability to potential
investors, and satisfying compliance requirement. Financial statements need proper analysis
and reporting to ensure the smooth functioning of hospitals. It also helps providers identify
the loopholes in operations and improve their efficiency (Shah, n.d). A fair and accurate
financial report can help in maintaining the quality of healthcare system and this will promote
the health of people in the community and leads to the development of our country. Financial
Transparency helps keep track of a company’s financial status as it is vital to its success
(Business Advice, 2021). Assets depreciate, cash flow sources vary. Figures like Profit before
Tax, Profit after Tax, and Profit after Interest, Depreciation, and Tax are all important
numbers in these reports that provide valuable information to shareholders and mana gement.
Building trust is very important in financial reporting. Investors, lenders, and bankers all look
for accurate financial statements and reports from companies they do business with.
Government regulations on compliance with mandatory reporting have become more stringent
due to problems in the past from larger companies hiding, misreporting, or fudging numbers.
There are many plans and insurance policies present in the medical care system. The financial
reports also include those details too.
Reference:
Business Advice. (2021, March 01).Understanding the Need for Accurate Financial
Statementsfor a Business. Retrieved from Orcutt &
Company:https://www.orcuttfinancial.com/understanding-the-need-for-accurate-financialstatements-for-a-business/
Shah, R. (n.d.). 7 Tips to Follow While Developing Financial Information System in
Healthcare. Retrieved from OSP: https://www.osplabs.com/insights/7-tips-to-follow-whiledeveloping-financial-information-system-in-healthcare/
HCAD 640 – Financial Management for Healthcare I
Week #8: Financial Compliance & Ethical Decision Making
WEEK #8 OVERVIEW
“Medicare is an ocean of money surrounded by people who want some.” – Wall St. Journal, June 8, 2009
Compliance promotes adherence to applicable Federal and State law and regulations. Legal compliance
promotes compliance with Federal and State laws; regulatory compliance promotes compliance with
Federal and State statutes and regulations. In this week’s content, we review the primary legal and
regulatory guidelines that are pertinent to the health care industry along with the most common
reporting requirements.
Ultimately, the goal of all compliance programs is to prevent fraud and abuse.
Fraud = intentional deception or misrepresentation of facts for gain.
Abuse = unintentional actions that are inconsistent with accepted, sound medical, business, or
fiscal practices.
Fraud and abuse typically involve false claims (e.g., billing the government for something that shouldn’t
be paid). During the civil war, unscrupulous contractors sold the Union Army decrepit horses and mules
in ill health, faulty rifles and ammunition, and rancid rations and provisions, among other actions. In
response, Congress passed the False Claims Act of 1863. Under the Act, citizens can sue on behalf of the
government and be paid a percentage of the recovery (‘whistleblower’ provision).
Since then, numerous other legal and regulatory acts have been enacted to address various other health
care related issues, which provide precedent to many of the leadership and management actions that
must be followed in the modern health care operational environment. In the sections that follow, we
review several of the most commonly encountered compliance-related acts that bear some financial
implications for individuals and organizations that operate in the health care environment. Note: this is
not an exhaustive list.
Laws Applicable to Healthcare
•
False Claims Act (1863): The False Claims Act makes it illegal for any individual or facility to
submit claims to the federal government for payment when the submitting individual/entity
knows, or should know, that the claims are false or fraudulent. The False Claims Act also created
‘whistleblower’ (aka Qui Tam) provisions. The qui tam provision in the federal False Claims Act
contributes greatly the statutes widespread prevalence because it allows any individual who
possesses knowledge of a false claim to bring a civil action on behalf of the United States against
a violator.
The False Claims Act: A Primer:
https://www.justice.gov/sites/default/files/civil/legacy/2011/04/22/C-FRAUDS_FCA_Primer.pdf
•
Social Security Act (1965): Title XVIII = Health insurance for the Aged and Disabled (Medicare);
Title XIX = Grants to States for Medical Assistance Programs (Medicaid and CHIP); Title V =
Maternal and Child Health Services block grants (Medicaid).
The Social Security Act Amendments (1965):
https://www.ourdocuments.gov/doc.php?flash=true&doc=99
•
ERISA (1974): ERISA protects the interests of employee benefit plan participants and their
beneficiaries. It requires plan sponsors to provide plan information to participants. It establishes
standards of conduct for plan managers and other fiduciaries. It establishes enforcement
provisions to ensure that plan funds are protected and that qualifying participants receive their
benefits, even if a company goes bankrupt.
Health Plans & Benefits: ERISA: https://www.dol.gov/general/topic/health-plans/erisa
•
Anti-Kickback Statute (1987): The federal Anti-Kickback Statute is a healthcare fraud and
abuse statute that prohibits the exchange of remuneration—which the statute defines broadly
as anything of value—for referrals for services that are payable by a federal program, which, in
the context of healthcare providers, is Medicare. Makes it a criminal offense to knowingly and
willfully offer to pay, solicit, or receive any remuneration to induce or reward referrals of items
or services reimbursable by a Federal health care program. Where remuneration is paid
purposefully to induce or reward referrals of item or services payable by a Federal health care
program, the anti-kickback statute is violated. By its terms, the statute ascribes criminal liability
to parties on both sides of an impermissible ‘kickback’ transaction. For the purposes of this
statute, ‘remuneration’ includes transfer of anything of value, directly or indirectly, overtly or
covertly, in cash or in kind. The statute has numerous ‘safe harbors’, if met, insulate individuals
and entities from prosecution for conduct which would otherwise violate the Anti-Kickback
Statute.
Federal Anti-Kickback Law and Regulatory Safe Harbors:
https://www.oig.hhs.gov/fraud/docs/safeharborregulations/safefs.htm
•
EMTALA (1986): Emergency Medical Treatment & Labor Act (EMTALA) ensures public access to
emergency services regardless of a patient’s ability to pay. Section 1867 of the Social Security
Act imposes specific obligations on Medicare-participating hospitals that offer emergency
services to provide a medical screening examination (MSE) when a request is made for
examination or treatment for an emergency medical condition (EMC), including active labor,
regardless of an individual’s ability to pay. Hospitals are then required to provide stabilizing
treatment for patients with EMCs. If a hospital is unable to stabilize a patient within its
capability, or if the patient requests, an appropriate transfer should be implemented.
EMTALA Fact Sheet: https://www.acep.org/life-as-a-physician/ethics–legal/emtala/emtala-factsheet/
•
Stark I and II (1989 and 1993): Stark Law prohibits physician self-referral, specifically a referral
by a physician of a Medicare or Medicaid patient to an entity providing designated health
services (“DHS”) if the physician (or an immediate family member) has a financial relationship
with that entity.
Stark Law – Information on Penalties, Legal Practices, Latest News and Advice:
http://starklaw.org/
•
•
Tax Laws
o
1982: TEFRA – The Tax Equity and Fiscal Responsibility Act (TEFRA) is a Medicaid
program that can help families with children younger than 19 years old who have a
disability receive care in their homes rather than an institution. The TEFRA program can
help pay for the cost of those services for eligible children.
o
1986: COBRA – The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a health
insurance program that allows an eligible employee and his or her dependents the
continued benefits of health insurance coverage in case that employee loses his or her
job or experiences a reduction of work hours.
o
1993: OBRA – The Omnibus Budget Reconciliation Act (OBRA), also known as the
Nursing Home Reform Act of 1987, has dramatically improved the quality of care in the
nursing home over the last twenty years by setting forth federal standards of how care
should be provided to residents.
o
2017: TCJA – The Tax Cuts and Jobs Act (TCJA) contained provisions which effectively
repealed the ACA’s individual mandate.
HIPAA (1996) – The Health Insurance Portability and Accountability Act (HIPAA) provides security
provisions and data privacy, in order to keep patients’ medical information safe.
o
HIPAA Title I – aims to protect coverage of health insurance for those who have changed
or lost their jobs. It prevents group health plans from refusing to cover individuals who
have pre-existing diseases or conditions, and prohibits them from setting limits for
lifetime coverage.
o
HIPAA Title II – aims to direct the United States Department Of Human Services and
Health in order to standardize the processing of electronic healthcare transactions
nation-wide. It requires the organizations to implement safe electronic access to the
patients’ health data, remaining in compliance with the privacy regulations which were
set by the HHS.
o
HIPAA Title III – is related to provisions which are tax-related, as well as general medical
care guidelines.
o
HIPAA Title IV – defines a further reform in health insurance, including provisions for
those who have pre-existing diseases or conditions, and individuals who are seeking
continued coverage.
o
HIPAA Title V – includes provisions associated with company-owned insurance, and
treatment of those who lost their citizenship for income tax reasons.
HIPAA Basics: https://www.healthit.gov/topic/privacy-security-and-hipaa/hipaa-basics
•
Sarbanes-Oxley (2002): The Sarbanes-Oxley (SOX) Act of 2002 is a federal law that established
sweeping auditing and financial regulations for public companies. Lawmakers created the
legislation to help protect shareholders, employees and the public from accounting errors and
fraudulent financial practices. Three of its key provisions are commonly referred to by their
section numbers: Section 302, Section 404, and Section 802.
o
Section 302 of the SOX Act of 2002 mandates that senior corporate officers personally
certify in writing that the company’s financial statements “comply with SEC disclosure
requirements and fairly present in all material aspects the operations and financial
condition of the issuer.” Officers who sign off on financial statements that they know to
be inaccurate are subject to criminal penalties, including prison terms.
o
Section 404 of the SOX Act of 2002 requires that management and auditors
establish internal controls and reporting methods to ensure the adequacy of those
controls. Some critics of the law have complained that the requirements in Section 404
can have a negative impact on publicly traded companies because it’s often expensive to
establish and maintain the necessary internal controls.
o
Section 802 of the SOX Act of 2002 contains the three rules that affect recordkeeping.
The first deals with destruction and falsification of records. The second strictly defines
the retention period for storing records. The third rule outlines the specific business
records that companies need to store, which includes electronic communications.
A Guide to the Sarbanes-Oxley Act: http://www.soxlaw.com/
•
HITECH Act (2009): The Health Information Technology for Economic and Clinical Health Act
(HITECH) is part of the American Recovery and Reinvestment Act of 2009 (ARRA). ARRA contains
incentives related to health care information technology in general (e.g. creation of a national
health care infrastructure) and contains specific incentives designed to accelerate the adoption
of electronic health record (EHR) systems among providers.
The HITECH Act: An Overview: https://journalofethics.ama-assn.org/article/hitech-actoverview/2011-03
•
Patient Protection and Affordable Care Act (2010): The PPACA (aka ACA or Obamacare)
extends health care coverage to millions of Americans who were previously uninsured and
greatly improve patients’ rights. The laws also invest billions of dollars in prevention and
wellness programs, boost education opportunities for physicians and allied health workers, and
increase the government’s capacity to fight fraud and abuse.
A notable feature of the PPACA is it made compliance programs mandatory. The mandatory
compliance plans must contain 8 ‘core elements’:
1. Written standards and procedures
2. High-level oversight
3. Non-delegation of authority to those with a propensity to criminal acts (sanctioned
individuals)
4. Effective communication of standards to employees and agents
5. Reasonable monitoring and auditing activities
6. Consistent enforcement
7. Appropriate responses to violations
8. Periodic assessment of the program
Summary of the Affordable Care Act: https://www.kff.org/health-reform/fact-sheet/summaryof-the-affordable-care-act/
Unique IRS Regulations pertaining to Not-For-Profit Healthcare
For-profit health care organizations must comply with standard reporting requirements mandated of
any for-profit business in any industry. However, as of 2017, only ~21% of hospitals in the United States
are operated as for-profit organizations, ~59% are not-for-profit, and the remainder are government
owned and operated. This implies a large segment of the industry has alternative tax reporting
requirements. We cover a few of the unique requirements below.
50 Things to Know About the Hospital Industry | 2017:
https://www.beckershospitalreview.com/hospital-management-administration/50-things-toknow-about-the-hospital-industry-2017.html
Tax Information for Business: https://www.irs.gov/businesses
Section 501 tax exemption – A 501(c) organization is a nonprofit organization in the federal law of the
United States according to 26 U.S.C. § 501 and is one of 29 types of nonprofit organizations exempt from
some federal income taxes. Sections 503 through 505 set out the requirements for attaining
such exemptions. Not-for-profit health care institutions fall under 501(c)(3), which encompasses
organizations that are, “…organized and operated exclusively for charitable, religious, educational,
scientific, or other social welfare purposes”.
•
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Introduction to Public health
Course number:
PHC101
CRN
10074
Discuss the organization of public health services in KSA
Assignment title or task:
Your answer should includes :
• How public health services are organized in Saudi
Arabia
• How the government supervise performance of public
and private health providers
• What are the possible challenges facing the public
health in KSA
Student Name:
XXXX
Students ID:
XXXX
Submission date:
XXXX
Instructor name:
Dr. Abdallah Ahmed A. Belal
Grade:
…..out of 10
College of Health Sciences
Department of Public Health
Release Date: Sunday, 1st October 2023 (12:00 Noon)
Due Date: Sunday, 15th October 2023 (11:59 pm)
Instructions for submission:
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
Modules
Collaborations
Chat
BigBlueButton
Grades7
People
Office 365
Secure Exam Proctor (Proctorio)
WoltersKluwer LTI 1.3
Unit 5: Assignment Theory Chart
Start Assignment
Due Sunday by 11:59pm
Points 50
Submitting a text entry box or a file upload
Unit 5Theory Chart
Unit 5: Introduction (1 of 4)
Unit 5: Reading and Activities (2 of 4)
Current Assignment: Unit 5: Assignment Theory Chart (3 of 4)
Unit 5: Discussion Attachment Theories (4 of 4)
Instructions
Use the chart attached below each week to document theories covered in the class readings and films. You may copy and paste main points, definitions, and the theorist names from the readings. Do not copy information from your peers. The Application to practice section should be in your own words so you can demonstrate integration of theory to practice. The spaces in the chart will expand as needed. You will submit this chart each week throughout the semester. By the end of the semester, you will have a complete study guide of relevant theories and their application to Social Work practice. Each week is worth up to 50 points for a total of 700 points for the course.
In the chart, please address the following theories:
Attachment theory – John Bowlby
Psychosocial development theory Erik Erikson
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.
Estimated time to complete 2 hours
Assignment Resources
MSW600 Theory ChartDownload MSW600 Theory Chart
Rubric
Unit 5 Theory Chart Rubric
Unit 5 Theory Chart Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeCompetency 6.7.8Main points of the theory
20 pts
Exceptional Demonstration
Listed or summarized the main points of the theories in exceptional detail. Described how the theory contributed to understanding people. Described in exceptional detail how the theories considers human differences and is culturally informed. Described the limitations of the theory in detail.
18 pts
Proficient Demonstration
Listed or summarized the main points of the theory in exceptional detail. Described how the theories contributed to understanding people. Described in profecient detail how the theory considers human differences and is culturally informed. Described the limitations of the theory in detail.
16 pts
Competent Demonstration
Listed or summarized the main points of the theories in exceptional detail. Described how the theories contributed to understanding people. Described in detail how the theory considers human differences and is culturally informed. Described the limitations of theories.
12 pts
Emerging Demonstration
Listed some of the main points of the theories. Described how the theory contributed to understanding people. Attempted to describe how the theories considers human differences and is culturally informed. Described the limitations of the theory. Or, only provided information on partial theories this week.
8 pts
Attempted Demonstration
Listed limited points of the theories. Described how the theories contributed to understanding people. Attempted to describe how applied to human differences. Described some limitations of the theories. Or only provided information on one theory this week.
0 pts
Not Competent
Did not complete
20 pts
This criterion is linked to a Learning OutcomeVocabulary
10 pts
Exceptional Demonstration
Clearly provided key words and exceptional definitions from each theory
8 pts
Proficient Demonstration
Clearly provided key words and definitions from each theory
7 pts
Competent Demonstration
Provided key words and definitions for each theory
5 pts
Emerging Demonstration
Provided key words and definitions for some theories this week.
3 pts
Attempted Demonstration
Attempted to provide some definitions for some theories this week.
0 pts
Not Competent
Did not complete
10 pts
This criterion is linked to a Learning OutcomeCompetency 6.7.8Application to practice
20 pts
Exceptional Demonstration
Exceptionally linked all theories to practice. Provided many examples of who theories apply to working with clients. Included information on how all theories will help prepare them to engage, assess, and intervene with clients.
18 pts
Proficient Demonstration
Clearly linked the theories to practice. Provided several examples of how theories apply to working with clients. Included information on how theory will help prepare them to engage, assess, and intervene with clients.
16 pts
Competent Demonstration
Provided links to practice. Provided examples of how theories apply to working with clients. Included information on how theories will help prepare them to engage, assess, and intervene with clients.
12 pts
Emerging Demonstration
Provided links to practice. Provided examples of how theories apply to working with clients. Included information on how theories will help prepare them to engage, assess, and intervene with clients. Only completed partial assigned theories this week.
8 pts
Attempted Demonstration
Provided superficial view of how theories apply to working with clients. No specifics or not all theories covered.
Observation is an important data collection method in qualitative research. It may include observation of the movement and behavior of people or the physical environment where they live or work or play. It may draw attention to previously unidentified cultural factors that influence behaviors compounding a public health problem.
In this Assignment, you will conduct a set of direct observations using a windshield survey. A windshield survey is a good way to get an overview of physical conditions or the behaviors that influence health. Consider the information you could gather when observing from a vehicle, while sitting in a parking lot of a church, neighborhood, or farmers market. Windshield surveys can also be conducted on foot or even indoors in a smaller environment where you are sitting in a chair. In addition to the built environment, you should observe and record cultural factors (i.e., directly related to religion, family make-up, or patriarchy/matriarchy), or other themes that are related to a public health problem.
TO PREPARE
Select a community to observe and conduct a windshield survey with a community member.
Spend 40–60 minutes observing and keeping detailed notes.
Summarize your findings from the observation.
ASSIGNMENT
Your two- to three-page summary should include:
A summary description of the physical environment you observed.
The main themes resulting from your observations of behaviors and other factors that influence public health.
Provide examples from your observations that exemplify the themes.
Examples should be thorough and detailed descriptions for each theme you identified.
An interpretation of your findings and their relationship to the health problem.
Walden University, LLC. (2017). Needs assessment: Conducting a windshield survey [Video]. Walden University Blackboard. https://waldenu.instructure.com
Community Tool Box. (n.d.). Section 21. Windshield and walking surveys, University of Kansas, Center for Community Health and Development. https://ctb.ku.edu/en/table-of-contents/assessment…
Bonello, M., & Meehan, B. (2019). Transparency and coherence in a doctoral study case analysis: Reflecting on the use of NVivo within a ‘framework’ approach, The Qualitative Report, 24(3), 483–498.
Namey, E. E., & Trotter, R. T. (2015). Chapter 15 | Qualitative research methods, In G. Guest & E. E. Namey (Eds.), Public health research methods (pp. 442–482) SAGE Publications. https://doi.org/10.4135/9781483398839.n15
Patton, M. Q. (2015). Designing qualitative studies. In Qualitative research & evaluation methods: Integrating theory and practice (4th ed., pp. 244–326) SAGE Publications.
Note: Read Module 29, “Data collection decisions.”
Patton, M. Q. (2015). Fieldwork strategies and observation methods. In Qualitative research & evaluation methods: Integrating theory and practice (4th ed., pp. 327–420) SAGE Publications.
Note: Read Module 43, “The power of direct observations” and Module 48, “Integrating what to observe with how to observe.”
Patton, M.Q. (2015). Qualitative analysis and interpretation. In Qualitative research & evaluation methods: Integrating theory and practice (4th ed., pp. 520–651) SAGE Publications.
Note: Read Module 65, “Establishing a strong foundation for qualitative analysis” and Module 70, “Interpreting findings.”
Soriano, F. I. (2013). Chapter eight: Qualitative data preparation and analyses. In Conducting needs assessment: A multidisciplinary approach (2nd ed., pp. 137–152). SAGE Publications. https://doi.org/10.4135/9781506335780.n8
Soriano, F. I. (2013). Chapter nine: Recruiting and collecting data from participants. In Conducting needs assessment: A multidisciplinary approach (2nd ed., pp. 155–167). SAGE Publications. https://doi.org/10.4135/9781506335780.n9
Tomaszewski, L. E., Zarestky, J., & Gonzalez, E. (2020). Planning qualitative research: Design and decision making for new researchers , International Journal of Qualitative Methods, 19, 1–7 https://doi.org/10.1177/1609406920967174
Document: Qualitative Coding Data Example
PUBH_8248_Module4_Assignment _Rubric
PUBH_8248_Module4_Assignment _Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomePhysical EnvironmentSummary includes a description of the physical environment you observed.
20 to >17.0 ptsOutstandingFully developed and supported, insightful, credible, and scholarly description of the physical environment observed. 17 to >15.0 ptsVery GoodThorough, well-organized, and supported description of the physical environment observed. 15 to >13.0 ptsMeets ExpectationsAdequate description of the physical environment observed. 13 to >0 ptsDoes Not Meet ExpectationsMissing, unoriginal, or does not adequately describe the physical environment observed.
20 pts
This criterion is linked to a Learning OutcomeThemesSummary includes the main themes resulting from your observations of behaviors and other factors that influence public health.
20 to >17.0 ptsOutstandingFully developed and supported, insightful, credible, and scholarly identification of the main themes resulting from observations of behaviors and other factors that influence public health.Thorough, well-organized, and supported identification of the main themes resulting from observations of behaviors and other factors that influence public health. 17 to >15.0 ptsVery GoodThorough, well-organized, and supported identification of the main themes resulting from observations of behaviors and other factors that influence public health. 15 to >13.0 ptsMeets ExpectationsAdequate identification of the main themes resulting from observations of behaviors and other factors that influence public health. 13 to >0 ptsDoes Not Meet ExpectationsMissing, unoriginal, or does not adequately identify the main themes resulting from observations of behaviors and other factors that influence public health.
20 pts
This criterion is linked to a Learning OutcomeExamplesSummary includes examples from your observations that exemplify the themes. Examples should be thorough and detailed descriptions for each theme identified.
20 to >17.0 ptsOutstandingFully developed and supported, insightful, credible, and scholarly identification of examples from observations that exemplify the themes previously identified. Examples are thorough, and detailed descriptions are included for each theme identified. 17 to >15.0 ptsVery GoodThorough, well-organized, and supported identification of examples from observations that exemplify the themes previously identified. Examples are thorough, and detailed descriptions are included for each theme identified. 15 to >13.0 ptsMeets ExpectationsAdequate identification of examples from observations that exemplify the themes previously identified. Examples are adequate descriptions and have been included for each theme. 13 to >0 ptsDoes Not Meet ExpectationsMissing, unoriginal, or does not adequately provide examples from observations that exemplify the themes previously identified. Examples are not thorough and detailed descriptions or are not included for each theme identified.
20 pts
This criterion is linked to a Learning OutcomeInterpretationSummary includes an interpretation of your findings and their relationship to the health problem.
20 to >17.0 ptsOutstandingFully developed and supported, insightful, credible, and scholarly interpretation of the findings of the windshield survey and the relationship to a health problem. 17 to >15.0 ptsVery GoodThorough, well-organized, and supported interpretation of the findings of the windshield survey and the relationship to a health problem. 15 to >13.0 ptsMeets ExpectationsAdequately interprets the findings of the windshield survey and adequately interprets the relationship to a health problem. 13 to >0 ptsDoes Not Meet ExpectationsMissing, unoriginal, or does not adequately interpret the findings of the windshield survey or their relationship to a health problem.
20 pts
This criterion is linked to a Learning OutcomeWritten Communication: Extent to which Discussion communication demonstrates doctoral-level writing in APA format with proper grammar, mechanics, tone, vocabulary, and spelling as well as proper paragraph structure with a clear central idea. In addition, sources are identified to support responses and referenced properly.
20 to >17.0 ptsOutstandingDiscussion communication is fully developed and demonstrates complete understanding of doctoral writing and APA expectations as well as the rules of proper grammar, mechanics, tone, and vocabulary; includes no spelling errors; contains cohesive paragraphs with a clear central idea; and identifies proper sources to support the post. 17 to >15.0 ptsVery GoodDiscussion communication is generally thorough and grammatically and mechanically correct with proper tone and vocabulary and minor or no spelling errors. Post demonstrates proper doctoral and APA writing and contains mostly cohesive paragraphs with a generally clear central idea and identifies proper sources to support the post. 15 to >13.0 ptsMeets ExpectationsDiscussion communication adequately meets expectations for doctoral and APA writing with infrequent and minor errors in grammar, mechanics, tone, and vocabulary, and minor to moderate spelling errors. Post contains some cohesive paragraphs with an adequately clear central idea and identifies adequate sources to support the post. 13 to >0 ptsDoes Not Meet ExpectationsDiscussion communication does not meet basic expectations for doctoral or APA writing or in grammar, mechanics, tone, or vocabulary; includes several spelling errors; has non-cohesive paragraphs with an unclear central idea; or does not identify proper sources to support the post.
20 pts
Research a community mental health program or organization in your local city or county. 1. Give the name and brief description of the community program or organization you selected. Make sure to cite the source of the information and have a full reference at the end of the post 2. What types of patients would benefit from this program or organization? What resources are available within this program?3. a.What are potential or actual barriers to patients receiving treatment from this type of program or organization? b.What can you do as a nurse to eliminate these barriers? There needs to be a minimum of 400 words total
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.Chapter 4, “Government Response: Regulation” (pp. 57–84)American Nurses Association. (n.d.). ANA enterpriseLinks to an external site.. Retrieved September 20, 2018, from http://www.nursingworld.orgBosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary careLinks to an external site.. Nursing Outlook, 65(6), 761–765.Halm, M. A. (2018). Evaluating the impact of EBP education: Development of a modified Fresno test for acute care nursingDownload Evaluating the impact of EBP education: Development of a modified Fresno test for acute care nursing. Worldviews on Evidence-Based Nursing, 15(4), 272–280. doi:10.1111/wvn.12291National Council of State Boards of Nursing (NCSBN)Links to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.ncsbn.org/index.htmNeff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman J. S. (2018). The impact of nurse practitioner regulations on population access to careLinks to an external site.. Nursing Outlook, 66(4), 379–385.Peterson, C., Adams, S. A., & DeMuro, P. R. (2015). mHealth: Don’t forget all the stakeholders in the business caseLinks to an external site.. Medicine 2.0, 4(2), e4.
Throughout this course, you will be developing a resource guide. This guide will serve as a resource for you while working with individuals with mental health challenges .
For this unit you will identify a minimum of 5 childhood mental health disorders or challenges, at least one evidence-based treatment to treat each of those challenges, and a resource to support individuals experiencing the challenge or disorder.
Please use the template provided in the Assignment Resources below for all of the Resource Guide assignments throughout this course. You will download this document one time and continue to add to the same document for all Resource Guide assignments.
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.
Estimated time to complete: 3 hours
Assignment Resources
Mental Health Resource GuideDownload Mental Health Resource Guide
Rubric
MSW628 Resource Guide Part I Rubric
MSW628 Resource Guide Part I Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIdentify mental health disorders or challenge
15 pts
Mastered
Clearly identifies five childhood challenges or disorders
13.5 pts
Excels
Clearly identifies four childhood challenges or disorders
12 pts
Competent
Clearly identifies three childhood challenges or disorders
10.5 pts
Low-Level Competency
Clearly identifies two childhood challenges or disorders
9 pts
Needs Improvement
Clearly identifies one childhood challenge or disorders
0 pts
Not Attempted
Does not identify challenges
15 pts
This criterion is linked to a Learning OutcomeEvidence-Based Practice
20 pts
Mastered
Identifies at least one evidence-based intervention that is clearly connected to each challenge or disorder and provides citation/ reference
18 pts
Excels
Identifies at least one evidence-based intervention that are somewhat connected to each challenge or disorder and provides citation/ reference
16 pts
Competent
Identifies at least one evidence-based intervention that is somewhat clearly connected to most of the challenges or disorders and provides citation/ reference
14 pts
Low-Level Competency
Identifies at least one evidence-based intervention that are somewhat connected to each challenge or disorder with limited or no citations
12 pts
Needs Improvement
Identifies at least one intervention that is connected to each challenge or disorder
0 pts
Not Attempted
Does not identify evidence-based intervention
20 pts
This criterion is linked to a Learning OutcomeResources
15 pts
Mastered
Identifies at least one resource that is clearly connected to the identified issue to support individuals or communities that struggle with the identified challenge or disorder, including a website
13.5 pts
Excels
Identifies at least one resource that is somewhat connected to the identified issue to support individuals or communities that struggle with the identified challenge or disorder, including website
12 pts
Competent
Identifies at least one resource that is somewhat connected to the identified issue to support individuals or communities that struggle with the identified challenge or disorder, including website to some of the issues identified
10.5 pts
Low-Level Competency
Identifies at least one resource that is somewhat connected to the identified issue to support individuals or communities that struggle with the identified challenge or disorder
9 pts
Needs Improvement
Identifies some resources that don’t have a clear connection to the challenge
You were asked to create the initial steps of an Evidence-Based Practice (EBP) project using your chosen topic from Week 3 and the articles your instructor approved in Week 4. After gathering your approved articles, you completed appraisals on a quantitative or qualitative review and systematic review in Week 6.This week, you will be using your two approved sources to complete your EBP project poster.Your poster should include:Explanation of the nursing issue significance with three statementsDescription of your position on the issue and three statements on how a nurse can impact this issueInclude only the two approved journal sources used in your Week 6 appraisals to support your position.After you submit your poster, you will be automatically assigned one peer review. You will review one of your classmate’s posters using the grading rubric. Please fill out the rubric and provide substantive feedback on your
Reflecting on an ethical issue that you experienced either directly or indirectly (as a healthcare student or clinician), answer the following questions:
Summarize the salient points of the scenario including:
The Situation,
Context
Stakeholders
Why is this an ethical dilemma?
What occurred to bring this situation to light?
How did it become an issue? What was the outcome of the ethical dilemma?
Were there any legal issues that arose? Why or why not?
Did you feel that your contribution was valued by other stakeholders? Why or why not?
If you were in a position of authority (or were in a position of authority in this scenario) describe:
what you would have done differently, and
what would you have done the same.
Are there any take-away lessons to be learned from this case?
Submission Instructions:
Your paper should be 3 pages in length + references using proper APA referencing style, double spaced.
Times Roman or Calibri (Body) 12 font.
Submit to this assignment submission folder.
Select one of the case studies below for your assignment. In your discussion, be sure to discuss developing collaborative relationships with clients when teaching concepts concerning pathological states to individuals and families.
Case Study Assignment Requirements
Make sure all of the topics in the case study have been addressed.
Cite at least three references in your case study paper; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
All reference sources must be within 5 years.
Do not use sources such as Wikipedia or UpToDate as a reference.
Assignments must have at least four full pages of analytic content, double-spaced (the cover and reference pages do not count in the page count, but must be included with the assignment), and follow APA 7th edition format.
Case Study 1: Disorders of Hepatobiliary and Exocrine Pancreas Function
Robert is a 68-year-old who has dealt with alcoholism for over 30 years. He has cirrhosis and is anemic. His appetite has declined, and he regularly complains of abdominal pain. Recently, while preparing himself a sandwich, he cut his finger deeply with a knife. The wound bled profusely, and he used a kitchen towel to stop the flow. Refusing to go and seek medical assistance, he put ice on his finger and wrapped the towel around it. He sat down in his recliner with his hand over his head and fell asleep.
Anemia and clotting disorders are common features of alcoholic liver disease. What are the mechanisms that cause these hematologic disorders?
What gastrointestinal bleed is associated with a high mortality rate in those with advanced cirrhosis? What is the pathophysiology of this condition?
Acute pancreatitis is sometimes seen in alcoholics, particularly after binge drinking. Why are tachycardia and hypotension indications of this condition?
Why are women more predisposed to alcoholic liver disease than men?
Case Study 2: Somatosensory Function, Pain, Headache, and Temperature Regulation
Ramandeep is an active 23-year-old. She works as a part-time nurse during the day and is studying for a postgraduate certificate in the evening. Ramandeep started to wear a bite plate at night after she began to experience jaw pain and headaches. Sometimes the pain radiated to her ear, and she would apply a hot water bottle to it to ease the discomfort. It was not until her husband mentioned to her that he heard her grinding her teeth at night while she was sleeping. She knew then that her headaches might be from temporomandibular joint syndrome, and she went to her dentist to confirm her thoughts. In addition to the bite plate, the dentist also recommended she should continue with the application of heat, use NSAIDs when needed, and incorporate regular relaxation exercises throughout her stressful days.
What effect does heat have on nociceptors so that it makes a good nonpharmacologic treatment for pain?
Heat and cold treatment are both hypothesized to have an effect on the release of endogenous opioids. What are these chemicals, and why are they hypothesized to be beneficial in the body?
Using your knowledge of physiology, how do NSAID analgesics function in the management of pain?
Case Study 3: Disorders of Visual Function
Phil is a 54-year-old with type 2 diabetes. After he was initially diagnosed with the condition, his physician referred him to an ophthalmologist for a comprehensive eye examination. Phil had been struggling with the lifestyle changes he was required to make. He was able to return to a healthy weight with physical exercise and dietary changes, but he worked long hours and ate poorly when on business trips. Phil missed his second annual checkup with his ophthalmologist because of such a trip. When he finally made it in, she examined him and stated there was no evidence of small retinal hemorrhages and cotton-wool exudates. She emphasized his need to reduce his hypertension and hyperlipidemia and wrote up a report for his physician.
How do visual disturbances arise from background and proliferative retinopathy?
How might blindness occur with a prolonged detached retina? Explain using your knowledge of pathophysiology.
What are the similarities and differences between traction retinal detachment and rhegmatogenous detachment?
Case Study 4: Mechanisms of Endocrine Control
Leda is a 38-year-old woman who began to experience weight gain, mood swings, and weakness. When her periods became irregular, she went to her physician. Leda’s physician heard the symptoms Leda was concerned about and then ordered a 24-hour free cortisol urine test and an overnight dexamethasone suppression test and measured her serum ACTH levels. The results indicated that Leda had Cushing disease, a condition caused by the hypersecretion of ACTH by the anterior pituitary and resulting in elevated cortisol levels. To confirm the diagnosis, Leda’s physician ordered a cranial MRI to identify the presence of a pituitary tumor.
The dexamethasone test involves the administration of a synthetic glucocorticoid (e., cortisol). Knowing what you do about negative feedback mechanisms, how might this test be used to assess pituitary function?
Describe how the steroid hormones, like cortisol, are metabolized in the body. What are the advantages of using a 24-hour urine test to measure this hormone?
Protein-based and steroid-based hormones trigger cellular responses in different ways. What are the differences between the mechanism of action of ACTH and cortisol on target cells?
Case Study 5: Disorders of Endocrine Control of Growth and Metabolism
Bertha is a 71-year-old woman who takes daily medication for Hashimoto thyroiditis. Last winter, she developed pneumonia. Although she did her best to run errands for her husband, she became tired easily and needed to rest frequently. One day, after shoveling the snow outside, her husband came inside to find Bertha lying on the sofa covered in blankets. Her face appeared puffy and her eyelids hung. When he spoke to her, Bertha’s voice was hoarse and her words did not make sense to him. Her respirations were also shallow and slow. Suspecting low thyroid hormone levels were causing the signs, her husband called for an ambulance.
When testing for hypothyroidism, why is the free T4 level an important measurement? What would the TSH and T4 test results indicate in someone with primary hypothyroidism?
Using your knowledge of the function of thyroid hormone in the body, explain why Bertha’s respiratory rate was decreased? Why might pleural effusion be present in someone with hypothyroidism?
What factors in Bertha’s history leave her susceptible to myxedematous coma? What are the physiologic aspects involved in myxedematous coma?
Before finalizing your work, it is important to:
Review Case Study Assignment Requirements (described above) and the Case Study Assignment Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
Make sure to review your chosen case study carefully to make sure you have effectively answered all questions asked.
Utilize spelling and grammar checks to minimize errors.
Follow the conventions of Standard American English (correct grammar, punctuation, etc.).
Make sure your assignment is original, insightful, and utilizes your logic and critical thinking skills; that your assignment is well-organized, with superior content, style, and mechanics.
Utilize APA 7th Edition format.
Be diligent about APA formatting including paraphrasing and direct quotations, utilizing appropriate in-text citations, and referencing your sources.
In a 5–7 page written assessment, assess the effect of the patient, family, or population problem you’ve previously defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you’ve chosen to work with and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Report on your experiences during your first two practicum hours.
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Introduction
Organizational data, such as readmission rates, hospital-acquired infections, falls, medication errors, staff satisfaction, serious safety events, and patient experience can be used to prioritize time, resources, and finances. Health care organizations and government agencies use benchmark data to compare the quality of organizational services and report the status of patient safety. Professional nurses are key to comprehensive data collection, reporting, and monitoring of metrics to improve quality and patient safety.
Preparation
In this assessment, you’ll assess the effect of the health problem you’ve defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.
To prepare for the assessment:
Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
Conduct research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence.
Review the Practicum Focus Sheet: Assessment 2 [PDF] Download Practicum Focus Sheet: Assessment 2 [PDF], which provides guidance for conducting this portion of your practicum.
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.
Instructions
Complete this assessment in two parts.
Part 1
Assess the effect of the patient, family, or population problem you defined in the previous assessment on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Use the Practicum Focus Sheet: Assessment 2 [PDF] Download Practicum Focus Sheet: Assessment 2 [PDF]provided for this assessment to guide your work and interpersonal interactions.
Part 2
Report on your experiences during your first 2 practicum hours, including how you presented your ideas about the health problem to the patient, family, or group.
Whom did you meet with?
What did you learn from them?
Comment on the evidence-based practice (EBP) documents or websites you reviewed.
What did you learn from that review?
Share the process and experience of exploring the influence of leadership, collaboration, communication, change management, and policy on the problem.
What barriers, if any, did you encounter when presenting the problem to the patient, family, or group?
Did the patient, family, or group agree with you about the presence of the problem and its significance and relevance?
What leadership, communication, collaboration, or change management skills did you employ during your interactions to overcome these barriers or change the patient’s, family’s, or group’s thinking about the problem (for example, creating a sense of urgency based on data or policy requirements)?
What changes, if any, did you make to your definition of the problem, based on your discussions?
What might you have done differently?
Requirements
The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.
Explain how the patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
Cite evidence that supports the stated impact.
Note whether the supporting evidence is consistent with what you see in your nursing practice.
Explain how state board nursing practice standards and/or organizational or governmental policies can affect the problem’s impact on the quality of care, patient safety, and costs to the system and individual.
Describe research that has tested the effectiveness of these standards and/or policies in addressing care quality, patient safety, and costs to the system and individual.
Explain how these standards and/or policies will guide your actions in addressing care quality, patient safety, and costs to the system and individual.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of care quality, patient safety, and cost to the system and individual.
Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
Discuss research on the effectiveness of these strategies in addressing care quality, patient safety, and costs to the system and individual.
Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Use paraphrasing and summarization to represent ideas from external sources.
Apply APA style and formatting to scholarly writing.
Additional Requirements
Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
A title page and reference page. An abstract is not required.
Appropriate section headings.
Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
Supporting evidence: Cite at least 5 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.
Capella Academic Portal
Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in Capella Academic Portal.
The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the BSN Practicum Campus page for more information and instructions on how to log your hours.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
Explain how a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Explain how state board nursing practice standards and/or organizational or governmental policies can affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual.
Competency 8: Integrate professional standards and values into practice.
Use paraphrasing and summarization to represent ideas from external sources.
Apply APA style and formatting to scholarly writing.
Assessing the Problem: Quality, Safety, and Cost Considerations Scoring Guide
CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Explain how a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual. Does not describe the impact of a patient, family, or population problem on the quality of care, patient safety, and costs to the system and individual. Attempts to describe the impact of a patient, family, or population problem on the quality of care, patient safety, and costs to the system and individual. Explains how a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual. Provides a convincing explanation of how a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual by providing specific individual, family, or population examples of such impacts.
Explain how state board nursing practice standards and/or organizational or governmental policies can affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual. Does not identify state board nursing practice standards and/or organizational or governmental policies that could affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual. Attempts to explain state board nursing practice standards and/or organizational or governmental policies that could affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual. Explains how state board nursing practice standards and/or organizational or governmental policies can affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual. Provides an explanation—based on a perceptive and coherent synthesis of current literature—of how state board nursing practice standards and/or organizational or governmental policies can affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual. Provides clear insight into how policy affects nursing scope of practice and will inform and guide an intervention.
Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Does not propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual, and does not document practicum hours in the Capella Academic Portal Volunteer Experience Form. Proposes leadership strategies that are not clearly related to care quality, patient safety, or cost reduction, or which are unlikely to significantly improve outcomes, and/or does not document practicum hours in the Capella Academic Portal Volunteer Experience Form. Proposes strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual and documents the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Proposes strategies, supported by examples, to improve the quality of care, enhance patient safety, and reduce costs to the system and individual. Exhibits clear insight into the effectiveness of the strategies and available sources of relevant benchmark data. Documents the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form
Use paraphrasing and summarization to represent ideas from external sources. Incorporates plagiarized information. Paraphrasing or summarization is awkward, inaccurate, or borders on plagiarism. Uses paraphrasing and summarization to represent ideas from external sources. Uses concise paraphrasing or summarization to accurately represent ideas from external sources. Exhibits an insightful interpretation and synthesis of credible sources.
Apply APA style and formatting to scholarly writing. Does not apply APA style and formatting to scholarly writing. Applies APA style and formatting to scholarly writing incorrectly and/or inconsistently, detracting noticeably from good scholarship. Applies APA style and formatting to scholarly writing. Applies APA style and formatting to scholarly writing. Exhibits strict and nearly flawless adherence to stylistic conventions, document structure, and source attributions.
Youssef, Thank you for assessment #2 submission. However, there should be more discussion with prevent complications from CKD for your patients and promote health and wellness. My recommendation is to review the assessment’s instructions and requirements in each rubric’s section more carefully. Please be sure to highlight all the revision sections. TIPS for Assessment 2: There should be the actual research data with the cost to the system and individual. Please see the “distinguished” requirements from the rubric. You will also need to provide a clear insight into how different policies affects nursing scope of practice, will inform and guide an intervention that is more specific to your patient’s health problem (DM). You will need to discuss on how the health polic(ies) or BON impact the quality of care as well as cost of care for your health concern conditions. You will need to gather your statistical data for analysis to measure the effectiveness of the EBP strategies in your discussion. Dr Swanson-Tracey SwansonScoring GuideTransform processes to improve quality, enhance patient safety, and reduce the cost of care.Explain how a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.Does not describe the impact of a patient, family, or population problem on the quality of care, patient safety, and costs to the system and individual.Faculty Comments:You did not describe the impact of a patient, family, or population problem on the quality of care, patient safety, and costs to the system and individual. (For higher scores, I would have wanted to read more about the actual research data with the cost to the system and individual. Please see the “distinguished” requirements from the rubric.) There should be discussing on how this health concern impact patients. You are discussing something that is not relating to your patient’s CKD.Show all Performance RatingsPropose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.Does not propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual, and does not document practicum hours in the Capella Academic Portal Volunteer Experience Form.Faculty Comments:You did not propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual, and does not document practicum hours in the Capella Academic Portal Volunteer Experience Form. need to exhibit a clear insight into effectiveness of strategies and available sources of relevant benchmark data. You will need to gather your statistical data for analysis to measure the effectiveness of the EBP strategies to improve your patient’s CKD conditions.Show all Performance RatingsCompetency 5Analyze the impact of health policy on quality and cost of care.Explain how state board nursing practice standards and/or organizational or governmental policies can affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual.Does not identify state board nursing practice standards and/or organizational or governmental policies that could affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual.Faculty Comments:You did not identify state board nursing practice standards and/or organizational or governmental policies that could affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual. For higher scores, you will also need to provide a clear insight into how policy affects nursing scope of practice, will inform and guide an intervention that is more specific to your patient’s health problem (DM). You will need discuss on how the health policy or BON impact the quality of care as well as cost of care for your health concern conditions.Show all Performance RatingsCompetency 8Integrate professional standards and values into practice.Use paraphrasing and summarization to represent ideas from external sources.Uses concise paraphrasing or summarization to accurately represent ideas from external sources. Exhibits an insightful interpretation and synthesis of credible sources.Faculty Comments:You use concise paraphrasing or summarization to accurately represent ideas from external sources. You exhibited an insightful interpretation and synthesis of credible sources.Show all Performance RatingsApply APA style and formatting to scholarly writing.Applies APA style and formatting to scholarly writing. Exhibits strict and nearly flawless adherence to stylistic conventions, document structure, and source attributions.Faculty Comments:You applied APA style and formatting to scholarly writing. You exhibited strict and nearly flawless adherence to stylistic conventions, document structure and source attributions.
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Effect of Chronic Kidney Disease on Quality of Care, Patient Safety, and Care Costs
Youssef Tawfik
Capella University
Professor Tracey Swanson
NURS-FPX4900 Capstone Project for Nursing
Sep 25th, 2023
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Effect of Chronic Kidney Disease on Quality of Care, Patient Safety, and Care Costs
How chronic kidney disease (CKD) impacts the quality of care, patient safety, and costs to
the system and individual
CKD is associated with a considerable risk of medication errors, which hinders patient
safety. New et al. (2021) note that since CKD patients have a higher hospitalization rate than the
healthy population, they face a higher risk of medical errors. The American Heart Association
(AHA) reports that older adults with CKD should be considered to be at high risk for medication
errors (Milani et al., 2011). In collaboration with the Institute for Healthcare Improvement (IHI)
and the Institute for Safe Medication Practices, AHA concurs that antithrombotic drugs in CKD
are high-risk pharmacological agents (Milani et al., 2011). Should a CKD patient misuse these
high-risk agents, they face a profound risk of injury. CKD management demands a coordinated
intervention because of the risk to patient safety caused by pharmacological agents that are
otherwise well tolerated in healthy persons. Medications such as enoxaparin and eptifibatide,
well-tolerated and appropriately cleared in healthy persons, expose CKD patients to considerable
risks of bleeding complications (Milani et al., 2011). Collaboration among healthcare
practitioners is paramount in diminishing the risk to patient safety when managing a CKD
patient.
The prevalence of adverse drug events (ADRs) is higher in CKD patients than in their
healthy counterparts. Roux-Marson et al. (2020) report that CKD increases the risk of ADRs by
3-10 times compared to a healthy cohort. The incidence and severity of ADRs are compounded
in elderly CKD patients than in a younger population. CKD also increases the number of
potentially inappropriate-for-the-elderly medications (PIMs). A French study reported a PIM rate
of 66% among elderly patients, while a US-based study observed a rate of 13% in 100 patients
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above 70 years (Roux-Marson et al., 2020). The longer the list of PIMs, the higher the risk of
ADRs, which compromises patient safety.
CKD often requires dose adjustment for most pharmacological agents. Dose adjustment
is a complicated process plagued with considerable risk of dosing errors. Roux-Marson et al.
(2020) report that at least one medication requiring dose adjustment or is contraindicated is
prescribed to over 77% of patients with advanced CKD. According to Hassan et al. (2021), dose
adjustment in CKD patients is often performed incorrectly. The prevalence of incorrect dose
adjustment varies from 25% to 77% (Hassan et al., 2021). The risk of incorrect dose adjustment
in CKD is prevalent in developed and developing countries (Hassan et al., 2021). Some
practitioners overlook dose adjustment, often at considerable risk to patient safety. Hassan et al.
(2021) established that 30.99% of medication administered to CKD patients require dose
adjustment. Of those requiring adjustment, 40.42% are adjusted accurately, while 59.58% are not
adjusted (Hassan et al., 2021). Incorrect dose adjustment and failure to adjust the dose for CKD
patients pose a risk to their safety and the cost of care to the individual and the system. In my
nursing practice, I have witnessed the full range of possibilities, from correct dose adjustment to
incorrect adjustment. By my estimation, correct dose adjustment accounts for 50% of
prescriptions in CKD, while the remaining 50% is split between incorrect adjustment and failure
to adjust.
How state board nursing practice standards and/or organizational or governmental policies
can affect the CKD’s impact on the quality of care, patient safety, and costs to the system
and individual
CKD patients require frequent hospitalization. During hospitalization, these patients
require health practitioners to leverage their safe patient handling and mobility (SPHM)
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knowledge and techniques to limit their risk of injury. In 2020, there were over 806,200 private
industry injuries in the healthcare and social assistance sector (HCSA), at least half of which
precipitated one lost day due to injury (CDC, 2020). SPHM entails using assistive devices in
patient handling and mobility to avoid exposing healthcare practitioners to manual, high-risk
patient-handling exercises (VA, n.d.). The American Nursing Association (ANA) reports that a
single bad lift during patient handling and mobility tasks is enough to end a nurse’s career and
adversely affect their quality of life (ANA, 2021). The New York State Nursing Association
(NYSNA) encourages healthcare facilities to adopt the stipulated SPHM protocols in developing
their programs (NYSNA, n.d.). SPHM reduces injuries to healthcare practitioners by 60-95%,
indemnity costs by 92%, workers’ compensation costs by 95%, and lost work days due to injury
by 100% (NYSNA, n.d.). SPHM policies safeguard the welfare of healthcare practitioners,
NYSA limits the scope of nursing practice to activities within the nurse’s scope of
competence. The board prohibits nurses within the state from offering services for which they
are incompetent, even if they are legal under New York law (NYSA, n.d.). CKD management is
an intensive process requiring competent practitioners across the board. Collaboration among
practitioners ensures that each person only provides the services they are licensed and competent
to offer. NYSA promotes patient safety and quality of care by limiting nurses’ scope of practice
to their competence. Limiting nursing activities to areas within one’s competence minimizes the
risk of errors and promotes EBP, thereby ensuring safe, high-quality care. High-quality care is
instrumental in managing care costs to the individual and the system.
Strategies to improve the quality of care, enhance patient safety, and reduce costs to the
system and individual
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Drug dose adjustment has far-reaching ramifications on patient safety, quality of care,
and costs to the individual and the system. CKD patients require dose adjustment at various
stages of disease progression, exposing them to incremental risk of incorrect dose adjustment or
failure to adjust (Stefani et al., 2019). Adopting an EBP-based dose adjustment protocol would
provide a standard operating procedure, significantly diminishing the risk of incorrect dose
adjustments. Some practitioners presumably overlook dose adjustment because it risks patient
safety. A tried and proven dose adjustment formula with precisely defined parameters would
minimize this risk, resulting in a comparatively high success rate and diminishing the risk of
toxicity. Several dose adjustment protocols, including the Cockcroft-Gault and Serum Cystatin
C-based formulas, have been developed to adjust the dose in CKD patients correctly. The
Cockcroft-Gault formula is less effective than the Serum Cystatin C-based formula in estimating
the GFR and adjusting the dose (Delanaye et al., 2021). A more effective formula for estimating
GFR is necessary to improve the accuracy of drug dose adjustment for CKD patients.
CKD is a progressive condition. Despite the quality of care and strict compliance with the
prescribed regimen, disease progression can only be retarded but not averted. CKD patients are
also at increased risk of hospitalization, exposing practitioners to situations requiring safe patient
handling and safety. Adopting SPHM protocols is essential to protect practitioners from injuries
related to patient handling and mobility. According to the CDC (2020), Dr. Thomas Waters
adapted the revised NIOSH Lifting Equation (RNLE) for determining the maximum weight that
health practitioners can lift without injuries by increasing the minimum distance between them
and the patient to 14.5 inches. Subsequent to the modification, the maximum weight limit that a
healthcare practitioner can handle safely is 35 lbs. (CDC, 2020). Estimating the effectiveness of
lifting-related solutions is not straightforward because the risk of injury when different
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individuals are exposed to the same weight varies from person to person (Fox et al., 2019).
However, implementing an effective SPHM protocol reduces the risk of injury by at least one
lifting index (LI) (Fox et al., 2019). An effective SPHM program for healthcare practitioners in
CKD management would be instrumental in promoting patient safety and quality of care while
minimizing costs to the individual and the system.
Sources of benchmark data on care quality, patient safety, and costs to the system and
individual
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is the
go-to reference for the recommended best practices for CKD management. NIDDK provides
reliable, EBP-based guidelines on CKD management from the definition, diagnostic criteria,
management, and prevention. The platform also contains information on available clinical trials
and other resources that may benefit CKD patients, families, and healthcare practitioners.
NIDDK also provides data sources from the US Renal Data System (USRDS), a surveillance
program that tracks the prevalence of CKD, quality of care, and patient safety parameters. The
Center for Disease Prevention and Control (CDC) is also an invaluable resource for benchmark
data on care quality, patient safety, and the associated costs to the individual and the system. The
CDC also has a CKD surveillance program that provides accurate data on quality of care, patient
safety, and care costs to individuals and the system. The National Kidney Foundation may also
provide valuable insight into CDK management that could inform management practices.
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References
ANA. (2021). Safe Patient Handling and Mobility: Interprofessional National Standards Across
the Care Continuum (2nd ed.). American Nurses Association (ANA).
Delanaye, P., Björk, J., Courbebaisse, M., Couzi, L., Ebert, N., Eriksen, B. O., Dalton, R. N.,
Dubourg, L., Gaillard, F., Garrouste, C., Grubb, A., Jacquemont, L., Hansson, M.,
Kamar, N., Lamb, E. J., Legendre, C., Littmann, K., Mariat, C., Melsom, T., …
Nyman, U. (2021). Performance of creatinine‐based equations to estimate glomerular
filtration rate with a methodology adapted to the context of drug dosage
adjustment. British Journal of Clinical Pharmacology, 88(5), 21182127. https://doi.org/10.1111/bcp.15132
Fox, R. R., Lu, M., Occhipinti, E., & Jaeger, M. (2019). Understanding outcome metrics of the
revised NIOSH lifting equation. Applied Ergonomics, 81,
102897. https://doi.org/10.1016/j.apergo.2019.102897
Hassan, Z., Ali, I., Ullah, A. R., Ahmed, R., Rehman, S., & Khan, A. (2021). Assessment of
medication dosage adjustment in hospitalized patients with chronic kidney
disease. Cureus, 13(2). https://doi.org/10.1101/2020.05.04.20090787
Milani, R. V., Oleck, S. A., & Lavie, C. J. (2011). Medication errors in patients with severe
chronic kidney disease and acute coronary syndrome: The impact of computer-assisted
decision support. Mayo Clinic Proceedings, 86(12), 11611164. https://doi.org/10.4065/mcp.2011.0290
New, L., Goodridge, D., Kappel, J., Lawson, J., Dobson, R., Penz, E., Groot, G., & Gjevre, J.
(2021). Improving hospital safety for patients with chronic kidney disease: A mixed
methods study. BMC Nephrology, 22(1). https://doi.org/10.1186/s12882-021-02499-4
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Roux-Marson, C., Baranski, J., Fafin, C., Extermann, G., Vigneau, C., Couchoud, C., &
Moranne, O. (2020). Medication burden and inappropriate prescription risk among
elderly with advanced chronic kidney disease. https://doi.org/10.21203/rs.2.10876/v4
Safe patient handling and mobility (SPHM). (2020, June 24). Centers for Disease Control and
Prevention (CDC). https://www.cdc.gov/niosh/topics/safepatient/default.html
Safe patient handling and mobility. (n.d.). New York State Nurses Association
(NYSNA). https://www.nysna.org/safe-patient-handling-and-mobility
Scope of practice. (n.d.). New York State Nurses Association
(NYSNA). https://www.nysna.org/nursing-practice/practice-resources/scope-practice
Stefani, M., Singer, R. F., & Roberts, D. M. (2019). How to adjust drug doses in chronic kidney
disease. Australian Prescriber, 42(5), 163. https://doi.org/10.18773/austprescr.2019.054
VA.gov | Veterans affairs. (n.d.). Public Health
Home. https://www.publichealth.va.gov/employeehealth/patient-handling/
The purpose of the Disaster Preparedness Shelter Project is to provide a learning opportunity that illustrates the impact of a shelter in place during a hurricane on communities and vulnerable populations. The student will design and implement a coordinated plan of shelter in place. The coordinated plan should demonstrate your knowledge of disaster preparation, the needs of the community, resources and efforts of the interproffesional team involved.
Objectives
Identify the guiding principles from FEMA, CDC etc.. during the Hurricane
Explore the principles of an Incident Command Centers during a disaster
Understanding Policies and Procedures during a disaster
Identify a vulnerable population at risk during a disaster and identify appropriate resources for that vulnerable population
Reflect on your personal and professional experiences during crisis management and include any biases and implicit assumptions that they have of the population that are serving
Instructions
This is an Individual assignment. The student will create a power point presentation that identifies the four (4) parts of each element of a Disaster Shelter. Be creative ex: voice over, a recorded zoom (must upload link to Blackboard) that discusses each element of your power point.
To prepare for this project:
References used must be cited within the powerpoint presentation.
Part 1: Location: Needs Assessment of Logan Elementary School (consider the following):
Space
Air flow
Safety
Security
Supplies
Electricity/Water/Food/Sanitation
Part 2: Interprofessional Team: Identifying roles of teams within shelter (consider the following):
Nurses role
Social Worker
Red Cross
Volunteer organizations
Spiritual
Part 3: Triage – Placement of the community (people) within the shelter (consider the following):
Men/women/children/elderly/injured/families/pets
Population at risk
Home – do they have a place to return to?
Financial support
Resiliency
Part 4: Discharge considerations from shelter (consider the following):
Reflect and consider your Admission Ticket pre-work, simulation, nursing articles listed below and other crediable/scholarly resources as you research.
To have an idea of the interior and exterior space of Logan Elementary School, photos of the outdoor area of the school are on Blackboard and also a document of the schools informal interior space.
You will apply this knowledge and information into your power point to build your Shelter and submit in Blackboard for grading.
Be prepared to discuss your powerpoint in debriefing.
References: Websites/Youtube:
Ready.gov shelter
OSHA.gov
CDC.gov
DisasterAssistance.gov
American Red Cross
Evacuees seeking shelter Superdome video (2.04 minutes)
Inside the Superdome (2.39 minutes)
Superdome after Hurricane Katrina (4.30 minutes)
See Blackboard for grading rubric.
POST-GLOBAL REFLECTION
Reflect upon your personal practicum experience using the following key components: Please see rubric for grading to meet satisfactory requirements for this assignment.
Submit a two-page reflection, written in a scholarly tone answering the below questions (double spaced). Students must meet satisfactory requirements for this assignment. Please see rubric for grading.
1. Noticing: Provide some important background information you served. What is the story? What did you observe? What did you see & hear? What kind of people did you meet? What were their concerns and problems/situations did you see?
2. Interpreting: What solutions to the problems did you witness as a result of the issues you noticed? What resources were in place to support this vulnerable population?
3. Responding: What did you learn about the issues, challenges, and needs of this vulnerable population? What gifts did you offer?
4. Reflecting: How has this practicum experience affected your values as a nursing student? How has this practicum experience affected your personal/academic life? Were your expectations met or not met?
CC: Back pain after helping transfer a patient, difficulty walking
HPI: Recent back injury while assisting a patient transfer, exacerbating an old coccyx fracture, severe pain hindering mobility
Mary:
CC: Backache and right knee pain, worsened by stairs
HPI: Chronic back and knee pain due to osteoarthritis and osteoporosis, exacerbated knee pain affecting daily activities
Linda:
CC: Lower back pain, radiation to right buttock and thigh, numbness
HPI: Chronic lower back pain exacerbated by a recent fall, radiating pain and numbness down the right thigh, disrupting sleep and daily activities
OBJECTIVE
General:
VS: Blood Pressure, Heart Rate, Respiratory Rate, Weight, Height, BMI
Physical Exam Elements: Musculoskeletal examination focusing on the back, lower back, hips, and thighs
ASSESSMENT
Susan:
Working Diagnosis: Acute exacerbation of chronic lower back pain with potential lumbar strain (ICD-10: M54.5)
Differential Diagnosis: Lumbar herniated disc, coccyx fracture complications
Mary:
Working Diagnosis: Osteoarthritis-induced chronic back and knee pain (ICD-10: M15.9, M17.9)
Differential Diagnosis: Degenerative joint disease, exacerbation of osteoporosis-induced fractures
Linda:
Working Diagnosis: Lumbar radiculopathy, likely due to a lumbar disc herniation (ICD-10: M51.16)
Differential Diagnosis: Sciatica, lumbar sprain/strain
PLAN
Susan:
Diagnostic Studies: X-ray of the lumbar spine, if symptoms persist or worsen
Treatment: NSAIDs for pain management (e.g., ibuprofen 800 mg TID), muscle relaxants (e.g., cyclobenzaprine 10 mg TID), physical therapy for rehabilitation
Referrals: Orthopedic specialist for further evaluation if symptoms persist
Education: Proper lifting techniques, importance of calcium intake, smoking cessation strategies
Health Maintenance: Encourage regular exercise and calcium supplementation
RTC: Follow-up in 2 weeks to assess progress and adjust treatment if needed
Mary:
Diagnostic Studies: X-ray of the knee, if pain continues
Treatment: Acetaminophen for pain management (e.g., 650 mg TID), glucosamine/chondroitin supplement continuation, gentle knee exercises, referral to a rheumatologist for further evaluation if pain worsens
Education: Proper joint care, importance of regular exercise, managing acid reflux symptoms
Health Maintenance: Routine bone density scans and Reclast infusions
RTC: Follow-up in 4 weeks to assess progress and adjust treatment if needed
Linda:
Diagnostic Studies: MRI of the lumbar spine for detailed evaluation
Treatment: Consultation with a spine specialist for further evaluation, pain management with NSAIDs (e.g., ibuprofen 800 mg TID), neuropathic pain medication (e.g., gabapentin 300 mg TID), physical therapy for rehabilitation
Referrals: Spine specialist for evaluation and possible intervention
Education: Proper posture and back care, importance of regular exercise
Health Maintenance: Routine back and spine checks
RTC: Follow-up in 2 weeks to assess progress and adjust treatment if needed
American Academy of Orthopaedic Surgeons. (2014). Orthopaedic knowledge update 11. Rosemont, IL: American Academy of Orthopaedic Surgeons.
Chou, R., Qaseem, A., Snow, V., Casey, D., Cross Jr, J. T., Shekelle, P., … & Owens, D. K. (2007). Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine, 147(7), 478-491.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2021). Osteoarthritis. Retrieved from https://www.niams.nih.gov/health-topics/osteoarthritisLinks to an external site.
Gold standard for injuries to cartilage, meniscus, tendons and ligaments
No metal, pacemakers, aneurysm clips
CT
Views structures like masses, trauma, fractures, bleeding. Forms 3-D picture
More cost-effective than MRI
2. Case Study 1: Susan is a 30-year-old registered nurse who works in transitional care. She presents to employee health stating, “My back is killing me. I was helping to transfer a patient and he moved. I thought he was going to fall, so I twisted around to grab onto him and wrenched my back. The pain is terrible, and I can barely walk.” Susan is a healthy young adult, married with a 5-year old. daughter. She has no significant family history. Susan has a past medical history of fractured coccyx as a teenager when she fell during cheerleading practice; no sequelae. She has smoked one-half pack of cigarettes a day since age 15 but is trying to quit. Current medicines include medroxyprogesterone acetate (Depo Provera) injection for birth control every 13 weeks. She is supposed to take calcium, but states that she “always forgets, and it constipates me anyway.” Susan denies any change in bowel/bladder habits.
Demographics: 30 year old Female
Subjective
CC: Back pain
History of Present Illness (HPI): 30 year old female patient presents with severe back pain after transferring a patient during work. She reports the pain began when she twisted her body to prevent the patient from falling. Patient describes the pain as “terrible” and states she can barely walk.
Past Medical History: Fractured coccyx; no sequelae due to cheerleading fall in teen years. Patient has smoked 1/2 packs of cigarettes everyday for the last 15 years.
Family History: no significant family history
Current Medications: medroxyprogesterone acetate (Depo Provera) injection every 13 weeks. Prescribed calcium but patient states she “always forgets, and it constipates” her
Allergies:
Do you have any allergies to food or medications?
Immunization History:
Are your immunizations up to date? Are you missing any shots?
Social History: Patient is a registered nurse with a husband and a 5 year old daughter
Review of System:
General: Do you have any weakness, fever or chill?
Cardiovascular: Do you have any chest discomfort, heaviness or tightness? Do you feel any abnormal heartbeats or palpitations?
Respiratory: Any shortness of breath? Any coughing or phlegm from your history of smoking?
Gastrointestinal/Genitourinary: Denies any bowel or bladder habit changes
Musculoskeletal: positive for severe back pain making it very difficult to walk. What location do you feel the pain? Does the pain radiate anywhere? How long have you had the pain? On a scale of 0-10 how bad is the pain? Do you have any aggravating or relieving factors: Do you have any associated symptoms such as numbness or tingling? Have you taken any pain relievers?
Objective
Vitals example: BP 118/72, HR 86, RR 16, Spo2 98% on room air, temp 97.1 F Height 5’4 Weight 146 lb, BMI 25.1
Constitutional/general appearance: Vitals stable, Alert, well developed
Respiratory/chest: Unlabored. Chest rise is equal and symmetric. Lungs are CTA bilaterally with no adventitious breath sounds
Cardiovascular: S1,S2 without murmurs, rubs or gallops
GI: bowel sounds present in 4 quadrants. No masses or hernias
Musculoskeletal: positive for tenderness in back and reduced range of motion
Assessment
Working Diagnosis: Acute low back pain (ICD-10: M54.5)
It is estimated that 85% of adults experience lower back pain at some point in their lives. Causes may include strain, sprains, nerve impingement and nerve compression. Acute low back pain was considered the working diagnosis based on the positive reported symptoms of pain after abrupt twisting motion and inability to walk or have full range of motion (See et al., 2021).
Differential Diagnosis:
Sciatica (ICD-10:M54.30)
Patient shows positive signs of Sciatica such as pain in the back that has occurred after injury however she does not report other positive signs such as pain radiating down the back of the leg. Sciatica also typically affects only one side of the body.
Ankylosing Spondylitis (ICD-10: M45.9)
Patient shows positive signs of ankylosing spondylitis such as back pain. The patient’s history of a prior fractured coccyx may cause suspicion of spondylitis however she did not mention if this pain was primarily early morning stiffness or resulted in a stooped posture. Other positive symptoms may include weight loss, fatigue, fever and anemia (Symons, 2012).
Plan
Diagnostic Studies: X-ray
Treatment/ Education
Encourage rest and application of heat to affected area
Avoid heavy lifting or strenuous activity
Education on importance of implementing proper body mechanics in the work environment to prevent future injuries
Start ibuprofen 400 mg every 6 hours as needed for pain x 7 days
Education on the importance of taking calcium supplements. Encourage increase in fluid intake as well as daily fiber intake to prevent constipation.
Education on importance of smoking cessation and offer resources such as nicotine patch (Cho et al., 2021).
Pls see attached doc requirements for reflection journal
Unformatted Attachment Preview
Start Assignment
Due Sunday by 11:59pm
Points 40
Submitting a text entry box or a file upload
Unit 5
Journal Reflection
Instructions
You will create 5 entries for your Reflective Journal about a patient encounter. In the 5th entry,
you will review the previous 4 entries and evaluate your progress in reflective practice over the
course of the term. Each journal should be a minimum of 250 words.
The purpose of this reflective journal is self-reflection regarding the role in the process of selfreflection as a PMHNP provider. Through reflective practice, the student will evaluate their own
emotional health and recognize one’s own feelings as well as one’s ability to monitor and
manage those feelings. The point of the exercise is to learn yourself, your triggers, the types of
cases you end up getting overly involved with, and those you’d rather refer to someone else. The
idea is to be able to personally reflect on your behaviors/thoughts/decisions and how those
impact you in the role of PMHNP.
Discuss a patient interaction in which there was transference, countertransference,
prejudice/biases, or judgments that you may be making about the patients or that they are
verbalizing about you.
Have you encountered this before?
From where does this originate?
Would it appropriate for you to continue to provide care to the patient and if so, how will you
prevent these issues from affecting the care you are able to provide the patient?
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.
Estimated time to complete: 2 hours
NU673 Unit 5 Assignment – Clinical: Journal Reflection
Criteria
Content
Reflection
Ratings
Pts
14 pts
10 pts
6 pts
0 pts
Level 5
Level 3
Level 1
Level 0
Reflection
demonstrates a high
Reflection
demonstrates some
Reflection
demonstrates
Reflection lacks
critical thinking.
degree of critical
thinking in applying,
analyzing, and
degree of critical
thinking in applying,
analyzing, and/or
limited critical
thinking in applying,
analyzing, and/or
Superficial
connections are
made with key
evaluating key
course concepts and
evaluating key
course concepts
evaluating key
course concepts
course concepts
and course
theories from
readings, lectures,
media, discussions
and theories from
readings, lectures,
media, discussions
and theories from
readings, lectures,
media, discussions,
materials,
activities, and/or
assignments.
activities, and/or
assignments.
Insightful and
activities, and/or
assignments.
Connections made
activities, and/or
assignments
Minimal
relevant connections
made through
through
explanations,
connections made
through
contextual
explanations,
inferences, and
inferences, and/or
examples.
explanations,
inferences, and/or
examples.
14 pts
examples.
Personal
Growth
13 pts
9 pts
5 pts
0 pts
Level 5
Level 3
Level 1
Level 0
Conveys strong
evidence of
Conveys evidence
of reflection on
Conveys limited
evidence of
Conveys
inadequate
reflection on own
work with a
personal response
own work with a
personal response
to the self-
reflection on own
work in response to
the self-
evidence of
reflection on own
work in response to
to the selfassessment
assessment
questions posed.
assessment
questions posed.
the selfassessment
questions posed.
Demonstrates
significant personal
Demonstrates
satisfactory
personal growth
Demonstrates less
than adequate
personal growth
questions posed.
Personal growth
and awareness are
growth and
awareness of
deeper meaning
and awareness
through some
inferences made,
and awareness
through few or
simplistic
not evident and/or
demonstrates a
neutral experience
through inferences
made, examples,
examples, insights,
and challenges.
inferences made,
examples, insights,
with negligible
personal impact.
well developed
Some thought of
and/or challenges
Lacks enough
13 pts
Criteria
Ratings
insights, and
substantial depth in
perceptions and
the future
implications of
current experience.
challenges.
Synthesizes current
experience into
Pts
that are not well
developed. Minimal
thought of the
inferences,
examples, personal
insights and
future implications
of current
experience.
challenges, and/or
future implications
are overlooked.
future implications.
Quality
13 pts
9 pts
5 pts
0 pts
Level 5
Level 3
Level 1
Level 0
Excellent
Above average
Reflection is poorly
The reflection is
presentation.
Reflection is well
written and does
presentation.
Reflection contains
minor errors in
written or contains
multiple errors in
grammar and
poorly written,
missing
significant
not contain any
errors in grammar
grammar and
punctuation that do
punctuation that
interfere with the
information, or
contains multiple
or punctuation.
Professionalism
present.
not interfere with the
readability of the
reflection.
readability of the
reflection.
Professionalism
errors in
grammar and
punctuation
Professionalism
present.
needs improvement.
severely affecting
the readability or
13 pts
there is no
reflection
present.
Total Points: 40
Read Case Study 6, “St. John’s Reengineering.” In 1,000-1,250 words, include the following:Process of organizational change.The change needed in the case study.Strategies you would have used to motivate stakeholders to support the change. Include how you would have gotten political support for the change.The model you would have applied to the change needed for this case. Include your rationale for why the model was chosen.Use three to five scholarly resources in addition to information from your textbook.Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Baldwin, A., Capper, T., Harvey, C., Willis, E., Ferguson, B., & Browning, N. (2022). Promoting nurses’ and midwives’ ethical responsibilities towards vulnerable people: An alignment of research and clinical practice. Journal of Nursing Management, 30(7), 2442–2447. https://doi.org/10.1111/jonm.13764Links to an external site.
Do you think it is possible to protect this vulnerable population during a research study? How do the authors apply the four ethical principles when dealing with a vulnerable population such as incarcerated pregnant women? 2 discussions comments after assignment
books
Evidence-Based Nursing: The Research Practice Connection
Author: Brown, S.
Publisher: Jones & Bartlett Learning
Edition: 4th
Publication Manual of the American Psychological Association
Author: American Psychological Association
Publisher: American Psychological Association
Edition: 7th
Optional
Instructions: Submit a problem-focused SOAP note for grading. You must use an actual patient from your clinical practicum who presents with one or more chief complaints.
( 35 y/o female coming in for her annual physical exam.)
Use the format below for your SOAP note.
Use the current APA format to style your paper and cite your sources. Review the rubric for more information on how your assignment will be graded.
Problem-Focused SOAP Note Format
Demographic Data
Age and gender (must be HIPAA compliant)
Subjective
Chief Complaint (CC): A short statement about why they are there
History of Present Illness (HPI): Write your HPI in paragraph form. Start with the age, gender, and why they are there (example: 23-year-old female here for…). Elaborate using the acronym OLDCART: Onset, Location, Duration, Characteristics, Aggravating/Alleviating Factors, Relieving Factors, Treatment
Past Med. Hx (PMH): Medical or surgical problems, hospitalizations, medications, allergies, immunizations, and preventative health maintenance
Family Hx: any history of CA, DM, HTN, MI, CVA?
Social Hx: Including nutrition, exercise, substance use, sexual hx, occupation, school, etc.
Review of Systems (ROS) as appropriate: Include health maintenance (e.g., eye, dental, pap, vaccines, colonoscopy)
Objective
Vital Signs
Physical findings listed by body systems, not paragraph form- Highlight abnormal findings
Assessment (the diagnosis)
At least Two (2) differential diagnoses (if applicable) with rationale and pertinent positives and negatives for each
Final diagnosis with rationale, pertinent positives and negatives, and pathophysiological explanation
Plan
Dx Plan (lab, x-ray)
Tx Plan (meds): including medication(s) prescribed (if any), dosage, frequency, duration, and refill(s) (if any)
Pt. Education, including specific medication teaching points
Referral/Follow-up
Health maintenance: including when screenings eye, dental, pap, vaccines, immunizations, etc. are next due
Reference
Compare care given to the patient with the National Standards of Care/National Guidelines. Cite accordingly.
Points: 50
Problem-focused SOAP Note Format
Rubric
Problem-focused SOAP Note Rubric
Problem-focused SOAP Note Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeSubject
12.5 to >11.5 pts
Accomplished
Symptom analysis is well organized, with C/C, OLDCART, pertinent negatives, and pertinent positives. All data needed to support the diagnosis & differential are present. Is complete, concise, and relevant with no extraneous data.
11.5 to >10.25 pts
Satisfactory
Symptom analysis well organized with C/C, OLDCART, pertinent negatives, and pertinent positives. Some extraneous data present and/or one minor data point missing.
10.25 to >8.64 pts
Needs Improvement
Symptom analysis is not well organized. Data is missing. There is too much extraneous data and/or 2-3 minor data points missing.
8.64 to >0 pts
Unsatisfactory
Symptom analysis is inadequate, is not organized. Objective or other data is mixed into the subjective data. Important data is missing.
12.5 pts
This criterion is linked to a Learning OutcomeObject
12.5 to >11.5 pts
Accomplished
Complete, concise, well organized, and well written and includes pertinent positive and pertinent negative physical findings. Organized by body system in list format. No extraneous data.
11.5 to >10.25 pts
Satisfactory
All relevant exams were done thoroughly but extraneous exams were also done. Somewhat organized in list format.
10.25 to >8.64 pts
Needs Improvement
Omitted important relevant exams and/or not in list format.
8.64 to >0 pts
Unsatisfactory
Omitted important relevant exams and/or subjective data are included. Lacking organization.
12.5 pts
This criterion is linked to a Learning OutcomeAssessment
12.5 to >11.5 pts
Accomplished
Diagnosis and differential dx are correct with ICD code and supported by subjective and objective data.
11.5 to >10.25 pts
Satisfactory
Diagnosis is correct with ICD codes and is supported by subjective and objective data, however, the most accurate differential diagnosis is not listed according to subjective and objective data.
10.25 to >8.64 pts
Needs Improvement
Diagnosis is correct but either does not include ICD code or is missing two or more important differential diagnoses according to the subjective and objective data provided.
8.64 to >0 pts
Unsatisfactory
Diagnosis is not correct, is not provided, or is not reflective of the subjective and objective data provided.
12.5 pts
This criterion is linked to a Learning OutcomePlan
12.5 to >11.5 pts
Accomplished
Plan is organized, complete, and evidence-based according to the National Standards of Care. Addresses each diagnosis and is individualized to the specific patient and includes medication teaching and all 5 components: (Dx plan, Tx plan, patient education, referral/follow-up, health maintenance).
11.5 to >10.25 pts
Satisfactory
Plan is organized, complete, and evidence-based according to the National Standards of Care. Addresses each diagnosis and is individualized to the specific patient and includes medication teaching but may be missing 1-2 minor points.
10.25 to >8.64 pts
Needs Improvement
Plan is less organized and not based on evidence according to the National Standards of Care. Does not address each diagnosis or may not be individualized to the specific patient. Missing medication teaching or one of the 5 components.
8.64 to >0 pts
Unsatisfactory
No Plan is provided or is not organized. Does not address all diagnoses identified and/or does not include all 5 components of plan, including medication teaching.
Hello, I have attached a document with instructions on how to do the assignment attached below.
Unformatted Attachment Preview
Every discussion post should be approximately 250-300 words with APA 7 in text citations
and references included.
Replies should be no less than 100 words, along with APA 7 in text citations and references
included.
Module 3 Discussion:
•
•
What concepts discussed in this module and during our course are represented in the
video?
Identify 3 and discuss how they relate to existing health disparities for that ethnic
group.
Please watch the video and write about it.
Now make a “Reply” which is basically writing 100 words minimum replying to a classmate
with the instructions below.
1. Read Posts from Peers
o Navigate to the assignment and click on posts from your peers.
2. Reply to One of Your Peers Initial Postings with a comment that should include
questions or provide additional angles to the classmates’ posting.
o Replies should be a minimum of 100 words and include reference to
research materials utilized to support your findings as necessary.
Below is my classmate’s discussion, please “Reply” to it with a minimum of 100 words.
Classmate’s discussion:
The video “Drezus – Warpath,” directed by Stuey Kubrick, offers a visual and auditory
exploration of several concepts related to diversity in healthcare, focusing on indigenous
communities. Here are three critical images from the video and their relevance to existing health
disparities for indigenous ethnic groups.
Cultural Identity and Healing
In the video, we see a strong emphasis on indigenous cultural identity, traditions, and healing
practices. This concept is crucial in addressing health disparities among indigenous populations.
Many indigenous communities deeply connect to traditional healing methods, including herbal
remedies, spiritual practices, and cultural ceremonies. These practices can play a significant role
in holistic healthcare but are often overlooked or marginalized by Western healthcare systems.
Recognizing and respecting indigenous cultural identity and incorporating it into healthcare can
lead to better health outcomes for these communities.
Historical Trauma and Resilience
The video also hints at the historical trauma endured by indigenous communities, including the
impacts of colonization, forced displacement, and cultural suppression. This historical trauma
has contributed to ongoing health disparities, such as higher rates of chronic diseases, mental
health issues, and substance abuse among indigenous populations. However, the video also
portrays resilience and strength within these communities, highlighting the importance of
acknowledging historical trauma while celebrating indigenous resilience and the capacity for
healing.
Access to Quality Healthcare
Throughout the video, we see glimpses of indigenous communities’ contemporary challenges,
including limited access to quality healthcare. Health disparities in healthcare access,
affordability, and availability persist among indigenous groups, often due to geographic
isolation, underfunded healthcare facilities, and cultural barriers. Recognizing the need for
improved access to healthcare services, culturally competent healthcare providers, and increased
funding for indigenous healthcare initiatives is vital to addressing these disparities.
In summary, “Drezus – Warpath” touches on critical concepts related to diversity in healthcare
for indigenous populations, emphasizing the importance of cultural identity, acknowledging
historical trauma, and addressing healthcare access issues. By embracing these concepts and
working collaboratively with indigenous communities, healthcare systems can significantly
reduce health disparities and promote equitable health outcomes for these ethnic groups.
———————————————————————————————————————
Module 4 Discussion:
A children’s hospital in the United States has a contract to serve families from a small Arabspeaking nation who will fly in their children for specialty care when needed. The marketing
director of the hospital advises his staff to develop a brochure in English for the incoming
patients. One of the staff members objects, suggesting that the patients will not understand the
brochure because they do not speak English. The marketing director responds, “If a patient wants
to receive care here and read our informational materials, they better learn English and fast”.
1. Is there a problem with this director’s perspective regarding the patients to be served?
Describe the cultural competence or linguistic competence training approaches he should
receive? (Chapter 15, case 5, p.230).
Watch the video below as a guide to answer this discussion.
Instructions for the reply:
1. Read Posts from Peers
o Navigate to the assignment and click on posts from your peers.
2. Reply to One of Your Peers Initial Postings with a comment that should include
questions or provide additional angles to the classmates’ posting.
o Replies should be a minimum of 100 words and include reference to
research materials utilized to support your findings as necessary.
o Click “Reply” and write your message in the reply box.
o Click “Post Reply” button to submit.
Below is my classmate’s discussion, please “Reply” to it with a minimum of 100 words.
1. There is a significant problem with the marketing director’s perspective. The director’s
approach must be more culturally sensitive and disregard patient-centered care principles and
equitable access to healthcare services. Several issues can be identified.
Cultural Insensitivity
The director’s statement displays a need for more cultural competence and sensitivity. Expecting
patients from a small Arab-speaking nation to learn English quickly places an undue burden on
them. It fails to recognize that patients may already be dealing with the stress of having a child
needing specialized medical care and may need more time or resources to become proficient in
English.
Language Access
Language barriers can have profound implications for patient care. Effective communication
between healthcare providers and patients is essential for informed consent, understanding
medical instructions, and providing emotional support. By insisting on English-only materials,
the hospital is potentially jeopardizing patient safety and the quality of care.
Equity in Healthcare
The director’s perspective ignores the principle of equity in healthcare. Regardless of their
language proficiency, every patient should have equal access to information about their care.
Providing materials in a language patients understand is essential for equitable healthcare
services.
2. The marketing director should undergo cultural and linguistic competence training to address
this issue.
Cultural Competence Training
The director should receive training that helps develop an understanding of cultural differences,
biases, and stereotypes. This training should emphasize respecting and valuing cultural diversity
in healthcare.
Linguistic Competence Training
Training should focus on the significance of effective communication in healthcare and the
potential consequences of language barriers. The director should learn about language access
laws and regulations, such as Title VI of the Civil Rights Act, which requires healthcare facilities
receiving federal funds to provide language assistance services.
Patient-Centered Care
The director should be educated on the principles of patient-centered care, which emphasize
tailoring healthcare services to meet each patient’s unique needs and preferences. This includes
the provision of information in a language patients can understand.
Cross-Cultural Communication Skills
Training should include strategies for effective cross-cultural communication, such as using
trained medical interpreters, translated materials, and culturally competent approaches to engage
with patients and their families.
By undergoing these training approaches, the marketing director can develop a more culturally
competent and patient-centered perspective, ensuring that the hospital provides equitable
healthcare services to all patients, regardless of their language or cultural background.
Post your answers to the 6 questions corresponding to this week’s content on primary care medication management. Provide your responses and rationales. Support your rationales with high-level evidence. (See Post Expectations)
A 12-year-old boy has occasional episodes of mild asthma while playing soccer with his friends.
Q1. What treatment should this patient receive to relieve symptoms during an asthma attack?
Q2. If the patient’s asthma attacks occur more frequently, what changes in therapy might be appropriate?
A 19-year-old college student is asking for contraceptives.
Q3. What will you assess to determine if this patient is a good candidate for contraceptives, and what will you prescribe? (Include brand and generic name, route, frequency, and dose). What is the mechanism of action of the contraceptive you prescribed and the adverse effects?
Q4. The patient states she heard a pill can help her acne. What would you prescribe and what is your rationale? (Include brand and generic name, dose, route, and frequency).
Q5. The patient is concerned because her mother and sister developed fractures in their legs and vertebra after menopause. She wants to know what medication and other advice will prevent osteoporosis. You discuss bisphosphonates. How are they used in the prevention and treatment of osteoporosis?
A 48-year-old man has occasional episodes of gout that are painful and debilitating. He requires drugs to treat the symptoms of acute gout attacks and prevent recurrent attacks.
Q6. How would you treat this patient’s acute gout attack? Please list the trade and generic name and the dose of therapy. What is the mechanism of action of your choice of prescription?
Expectations
Length: A minimum of 500 words, not including references
Citations: At least two high-level scholarly references in APA from within the last 5 years
Post your answers to the 6 questions corresponding to this week’s content on primary care medication management. Provide your responses and rationales. Support your rationales with high-level evidence. (See Post Expectations)
A 12-year-old boy has occasional episodes of mild asthma while playing soccer with his friends.
Q1. What treatment should this patient receive to relieve symptoms during an asthma attack?
Q2. If the patient’s asthma attacks occur more frequently, what changes in therapy might be appropriate?
A 19-year-old college student is asking for contraceptives.
Q3. What will you assess to determine if this patient is a good candidate for contraceptives, and what will you prescribe? (Include brand and generic name, route, frequency, and dose). What is the mechanism of action of the contraceptive you prescribed and the adverse effects?
Q4. The patient states she heard a pill can help her acne. What would you prescribe and what is your rationale? (Include brand and generic name, dose, route, and frequency).
Q5. The patient is concerned because her mother and sister developed fractures in their legs and vertebra after menopause. She wants to know what medication and other advice will prevent osteoporosis. You discuss bisphosphonates. How are they used in the prevention and treatment of osteoporosis?
A 48-year-old man has occasional episodes of gout that are painful and debilitating. He requires drugs to treat the symptoms of acute gout attacks and prevent recurrent attacks.
Q6. How would you treat this patient’s acute gout attack? Please list the trade and generic name and the dose of therapy. What is the mechanism of action of your choice of prescription?
Expectations
Length: A minimum of 500 words, not including references
Citations: At least two high-level scholarly references in APA from within the last 5 years
Poverty porn” is defined as the practice of using highly disturbing, sad images of poor people for the purposes of eliciting an emotional response in order to generate more charitable donations. Some justify this approach because the use of depressing images of poor children has been proven to lead to increased donations, which are needed to do impactful global health work. Others say it exploits poor people’s conditions and uses their suffering for financial gain.For example, the photo below generated $23 million between 1980-1984 for famine relief in Ethiopia, and was heralded as a huge marketing success:What do you think about this controversy? What are the benefits of this approach? Is this practice unethical? What could be done to encourage more responsible marketing in global health?
Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.
Mental health care is often initiated in the primary care setting. Screenings are a critical part of identifying clients who may require psychiatric care. Carefully read the questions below and address each in your initial post.
Application of Course Knowledge
Identify your clinical practicum setting (primary care office, urgent care, etc.) and a population that you typically see (i.e., adolescents, women, older adults).
Discuss mental health screening tools used at your clinical site. If no screening tools are currently used, which ones would you recommend?
Describe the quality of the mental health care you have observed. Discuss disparities or biases, if any, in the care provided to different members of the population.
Screening opportunities are often missed in vulnerable populations and those with limited access to care. Describe at least TWO changes you recommend in your practice setting and community to increase the frequency of mental health screenings within vulnerable populations.
Integration of Evidence: Integrate relevant scholarly sources as defined by program expectations.Links to an external site.
Cite a scholarly source in the initial post.
Cite a scholarly source in one faculty response post.
Cite a scholarly source in one peer post.
Accurately analyze, synthesize, and/or apply principles from evidence with no more than one short quote (15 words or less) for the week.
Include a minimum of two different scholarly sources per week. Cite all references and provide references for all citations.
Engagement in Meaningful Dialogue: Engage peers and faculty by asking questions, and offering new insights, applications, perspectives, information, or implications for practice.
Peer Response: Respond to at least one peer.
Faculty Response: Respond to at least one faculty post.
Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice.
Professionalism in Communication: Communicate with minimal errors in English grammar, spelling, syntax, and punctuation.
Reference Citation: Use current APA format to format citations and references and is free of errors.
Wednesday Participation Requirement: Provide a substantive response to the graded discussion topic (not a response to a peer or faculty), by Wednesday, 11:59 p.m. MT of each week.
Total Participation Requirement: Provide at least three substantive posts (one to the initial question or topic, one to a student peer, and one to a faculty question) on two different days during the week.
Describe the importance and implications of health and fitness in terms of maintaining an optimal cerebral environment for cognitive function. Provide examples and justify your answer.
Your initial answer should be 280 words minimum. Reference and cite (AMA or APA) two current peer reviewed research articles. Make your initial post by the 10th of the month so others have time to respond. Next, comment and provide feedback on at least three of your classmate’s posts (280 words minimum/post). Please see the syllabus and grading rubric for more information.
Classmate Respones
Emma Stevenson
As one ages, the functioning of the cerebral cortex declines as the brain itself changes and deteriorates. While some decline in cognitive functioning may be inevitable, there are ways for one to slow down and minimize this degradation of brain matter. One of the most efficient ways to preserve one’s memory, intelligence, and executive functioning is choosing a healthy lifestyle pattern. A healthy lifestyle pattern consists of eating nutritious food, abstaining from dangerous practices like smoking, and exercising. Exercise in particular is especially beneficial in helping the cerebral environment stay healthy throughout one’s life, as it helps strengthen the brain’s plasticity, and improve memory and spatial learning skills.
Exercise can help improve memory and spatial discrimination skills by keeping the hippocampus at a decent size and less inflamed. According to Cassilhas et al. the neurons within the hippocampus, specifically within the dentate gyrus region of the hippocampus, are capable of regenerating in response to exercise. Through a study comparing active to sedentary mice, it was concluded that the generation of new neurons, neurogenesis, in the active mice was what helped these mice have better performances on spatial differentiation tasks (Cassilhas et al. 2016). Since links between larger hippocampuses and those who are more active have been found, one can conclude that exercise can positively influence one’s ability to form and recall memory, as well as determine spatial differences.
Additionally, exercise and healthy lifestyle patterns are important in keeping the brain plastic. Plasticity refers to the brain’s ability to form, reform, and change the wiring and connections internally. This plasticity is extremely useful if one were to have brain damage due to an accident or disease, but it is also useful to maintain just to help keep the brain efficient in the face of typical degeneration of neurons with age. In the research of Cotman et al. it is determined that exercise helps maintain the upkeep of the underlying systems that help facilitate the brain’s plasticity. Exercise helps improve the vasculature system by decreasing the demand on the heart and improving blood flow. Having a better blood flow to the brain can improve the functioning of the neurons and their ability to form new connections, which is an especially vital skill for being able to learn new things. So since exercise helps improve cardiovascular health, it subsequently improves the cerebral environment and the plasticity of the aging brain.
References
Cotman, C. W., Berchtold, N. C., & Christie, L. A. (2007). Exercise builds brain health: key roles of growth factor cascades and inflammation. Trends in neurosciences, 30(9), 464–472. https://doi.org/10.1016/j.tins.2007.06.011Links to an external site.
Cassilhas, R. C., Tufik, S., & de Mello, M. T. (2016). Physical exercise, neuroplasticity, spatial learning and memory. Cellular and molecular life sciences : CMLS, 73(5), 975–983. https://doi.org/10.1007/s00018-015-2102-0Karen Hanna
STUDENT #2 Oct 5 7:25pmManage Discussion by Karen HannaReply from Karen Hanna
Yes, physical activity is very important because it is good for the cardiovascular system, skeletal muscles, and bones. Although physical activity is healthy for everyone’s body, it is also very good for the brain. According to the Centers for Disease Control and Prevention, physical activity is known to help a person think, learn, problem solve, and enjoy an emotional balance. Regular physical activity is very important to the brain and cognitive functioning and thinking. Exercising regularly can reduce one’s risk of cognitive decline, including dementia, memory loss, Alzheimer’s, and many more. A study has shown that those who exercise regularly are at a reduced risk of developing a cognitive decline as they get older. Those who do not exercise or are inactive are twice as more likely to develop cognitive decline early on as they age. Any type of physical activity is helpful and useful for one’s body and their cognitive function. Physical activity helps maintain optimal cerebral environment for cognitive function. Physical activity allows a person to be able to sleep more freely and feel better about themselves. It can also reduce the risk of some common cancers among some people. Believe it or not, regularly performing physical activity can add years to your life. One does not have to be the best at exercising or go to the gym everyday, but any amount of physical activity can help someone improve their health no matter their age or level of fitness. Walking can also be a simple physical activity that is helpful.
Centers for Disease Control and Prevention. (2023, February 24). Physical activity boosts brain health. Centers for Disease Control and Prevention. https://www.cdc.gov/nccdphp/dnpao/features/physica… to an external site..
Kirk-Sanchez, N. J., & McGough, E. L. (2014). Physical exercise and cognitive performance in the elderly: Current perspectives. Clinical interventions in aging. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC38720… to an external site.
Discussion Board 2 – Maintaining Sexual Health and Fitness in Older Age –
How would you suggest that individuals adjust their sexual activities, expectations, attitudes, and meanings as they age? What physiological processes must they consider? Health problems? Reference at least two sites you visited on this topic (AMA or APA citation).
Your initial post should be a minimum of 280 words and posted by the 10th of the month. In addition, make three additional posts to your classmate’s comments (280 word minimum) for a minimum total of four posts.
Classmate Respones
Alejandro Alvarado
Reply from Alejandro Alvarado
As individuals age, there are several factors, including physiological processes and health problems, that can influence their sexual activities, expectations, and attitudes. It is also important to note that sexual health is a complex and multifaceted aspect of overall well-being. So here are a few suggestions on how individuals can adjust their sexual activities and expectations as they age: it is important to understand the physiological changes like hormonal changes and chronic illnesses. With age, there is a decline in hormone levels, including testosterone and estrogen, which can affect libido and sexual response (DeLamater, 2012). Understanding these changes and the patterns can help individuals manage the expectations they have from their partners. Next chronic illnesses like diabetes and heart disease, can limit the physicality that individuals can handle (DeLamater, 2012). In addition, their body does not function at the same metabolic rate that it once did thus their energy levels may be reduced along with their sex drive (DeLamater, 2012). So, a good solution or rather option to maneuver such hindrance will be to incorporate and maintain an exercise regiment that puts healthy stress on the musculoskeletal system. This won’t cure the illness, but it will help manage the symptoms and maintain or improve sexual desire.
When aging is mentioned almost everyone’s first thought jumps straight into the physical aspects. However, it is also important to consider the sociological aspects and mentality of individuals (Kontula, 2009). Maintaining open communication and emotional intimacy will help support a healthy sexual life. Open and honest communication with partners is essential in order to know or learn what desires, limitations, and concerns they may have (Kontula, 2009). In turn discussing such needs can lead to a satisfying sexual experience by having all parties involved happy. Finally, emotional intimacy is an aspect that is consistently overlooked and discarded, especially in long-term relationships that have accumulated years together (Kontula, 2009). Building emotional connections and intimacy can compensate for any physical limitations that may be present between partners. Emotional bonding and imprinting create trust which is a necessary foundation aging relationships that can withstand the test of time.
Citations:
DeLamater, J. (2012). Sexual Expression in Later Life: A Review and Synthesis. The Journal of Sex Research, 49(2/3), 125–141. http://www.jstor.org/stable/23249140
Kontula, O., & Haavio-Mannila, E. (2009). The Impact of Aging on Human Sexual Activity and Sexual Desire. The Journal of Sex Research, 46(1), 46–56. http://www.jstor.org/stable/20620398
Lauren Nicole Tennis
Manage Di
Reply from Lauren Nicole Tennis
Every person’s body changes as they age, but what is not discussed as openly is the sexual change that people go through as they get older. This is in part because our society sees these topics as more of a taboo, but it is important to be knowledgeable of the changes coming in our lives and how we can counteract them. Big ones that are know are things like poor blood circulation, erectile disfunction, menopause symptoms, vaginal thinning, reshaping, reduction in lubrication, and a harder time to become aroused along with climaxing. Other issues that men can run into is Peyronie’s disease, where scare tissue develops under the penis and pulls on the surrounding tissue causing it to curve, and making arousal painful. Other factors that affect their health along with sexual health are diabetes, chronic pain, alcohol, depression, arthritis, heart diseases, incontinence, and medications. These issues need to be approached with care and open conversations. A lot of these are helped with partners finding new positions to try and finding new things to help the process. One issue that was studied in women was menopause and pelvic organ prolapse which is when the pelvic organs drop and push on other organs making things very uncomfortable down there. Research was done to see what helped women the most in these scenarios. It was found that aerobic exercises were the most effective in helping women have more functionality and comfort. For others, yoga was more beneficial. There was also a study that proved aerobic exercises greatly helped men with erectile disfunction as well. This is also just beneficial in other problem areas. Exercising helps blood circulation, muscle retention, blood pressure, diabetes levels, mental health, heart health, and reduction of medication intake. Now it is not the end all, be all. People still need to be wary of what they eat and other ‘normal’ health maintenances. Older adults still need to be mindful in their sexual health as their aging bodies will not be able to perform the same way it did years prior, but if they take in all the tools to help them perform and enjoy the experience better they will have a healthier life and partner relationship.
Carcelén-Fraile, María Del Carmen, et al. “Effects of Physical Exercise on Sexual Function and Quality of Sexual Life Related to Menopausal Symptoms in Peri- and Postmenopausal Women: A Systematic Review.” International Journal of Environmental Research and Public Health, U.S. National Library of Medicine, 14 Apr. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7215442/Links to an external site..
Gerbild, Helle, et al. “Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies.” Sexual Medicine, U.S. National Library of Medicine, June 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5960035/.
“Sexuality and Intimacy in Older Adults.” National Institute on Aging, U.S. Department of Health and Human Services, www.nia.nih.gov/health/sexuality-and-intimacy-older-adults. Accessed 6 Oct. 2023.
Article Title: Regulating the international surrogacy market: the ethics of commercial surrogacy in the Netherlands and India
Q1. Compare and contrast the ethical considerations relevant to altruistic and commercial surrogacy, with specific attention to how the principles of beneficence, respect for persons (autonomy), and justice might be upheld or violated in each case. Why do you believe most nations only allow altruistic surrogacy? Based on your evaluation above, should legalization of commercial surrogacy be embraced internationally?
Q2. Consider the discussions on the coercive effect of high pay and inequities in bargaining power as well as arguments that commercial surrogacy reduces reproductive labor, women and children to mere commodities that can be bought and sold. Do you believe that exploitation and commodification are inherent to commercial surrogacy? Within your reasoning, please reflect on one of these quotations from the reading:
“It then becomes clear that the exploitation issue arises not because of the nature of commercial surrogacy, but because of the nature of an unequal society.” (Blazier & Janssens, 2020, p.624).
“It is well-established that human beings themselves are degraded if they are commodified. This rests on the Kantian argument that humans have an inherent dignity which must be respected, and in order to respect it, humans must be treated as ends in themselves, never as a means only.” (Blazier & Janssens, 2020, p.624).
Q3. Alongside recommendations to increase state and international regulations governing commercial and cross-border surrogacy (CBS), Blazier & Janssens (2020) proposes that surrogacy payment systems in many low- and middle-income countries (LMIC) should operate under Fair Trade mechanisms. Is this option more ethically justified than paying the minimum-wage of that country or setting a universal standard based on minimum-wages in high-income countries (HIC)? Why?
Reference:
Blazier, J., & Janssens, R. (2020). Regulating the international surrogacy market:the ethics of commercial surrogacy in the Netherlands and India. Medicine, Health Care and Philosophy, 23(4), 621–630. https://doi.org/10.1007/s11019-020-09976-x
You will keep a 3-day food log, where you will record the meals and snacks, along with their nutrients, that you ate throughout each day. You can choose to track this using Cronometer or the provided Word document.
Actions
This week’s focus: water, sodium, potassium, Vitamin A, Vitamin C, Vitamin D, calcium, and iron.
You may record carbohydrates, fat, and protein; however, they are not required for this week.
Please see the Everything You Need to Know About- DIETARY ANALYSIS ASSIGNMENTS page for more specific details on this process.
TASK 2- ANALYSIS
Please answer the following questions in complete sentences:
In regard to last week’s ‘challenge’-
Did you try your protein/fat swaps or additions? If so, how did it go?
In regard to water-
Did you meet the recommendations for water intake? What are considerations that a person needs to make when determining water needs?
What drinks do you mainly drink to meet fluid needs? Do you think that those are healthy choices (caffeine, alcohol, sugar)?
In regard to micronutrients-
What is your fruit and vegetable consumption like? Are you meeting recommendations? What are ways that you can increase your consumption?
What were your averages for salt, potassium, Vitamin A, Vitamin C, Vitamin D, calcium, and iron? Were these values above, below, or at the recommended values? Did these averages surprise you?
Were you taking a multivitamin prior to this course? After seeing these values, do you think you will continue taking the multivitamin or will you start taking a multivitamin? Why or why not?
Looking forward-
What are foods that you can start eating in order to increase the above micronutrients (except salt!) in your diet?
What are ways that you can cut back on salt in your diet?
Submission and Grading
This assignment is due on Saturday, October 7th by 11:59 PM. Task 1 needs to be submitted as a pages document, Word document, or PDF file. Task 2 can be submitted as a text entry or file upload. This assignment is worth a total of 40 points. Each task is worth 20 points, and will be assessed based on the level of completeness. Submissions are graded anonymously.
Purpose
In short, the purpose of these assignments is to practically apply what you are learning in your day-to-day life.
Assignment Components
ASSIGNMENTS 1 AND 6
The only task for you in these two assignments is to answer a series of questions. Assignment 1 will assess your current understanding of nutritional topics, and will allow you to examine your current dietary practices. Assignment 6 will involve a reflection of what you learned via the course and the dietary analysis assignments.
Please complete both of these assignments using complete sentences. More specific instructions can be found in the assignment pages.
ASSIGNMENTS 2-5
In assignments 2-5 you will have two tasks and a “challenge”:
TASK 1- FOOD LOG
You will complete a 3-day food log during Weeks 2-5 of the course. We are doing 3 days in order to get a basic understanding of our eating trends, although you are welcome to track for more days in order to have more robust data.. You can choose which consecutive days you complete the log; however, I would strongly encourage you to do the log between Monday and Friday since we are generally more consistent in our eating habits during these days (example- parties and other celebrations are more likely to occur on weekends).
You will be responsible for recording a list of the foods/beverages from each meal/snack, as well as their serving sizes and nutrients. Students have several options for accomplishing this:
Using the Word document provided for the week 2-5 assignments.
I have created a space for you to record your meals, and specify which nutrients you need to track for that particular week.
Pros of this option- This option is best for students who are less comfortable using technology, and would prefer a simpler form of tracking. This also provides students the opportunity to print the document for easy recording access throughout the day.
Cons of this option- Nutrition analysis is done manually. In other words, it requires an understanding on reading a food label. Also, you will need to type everything up at the end of the week should you choose to print and record manually.
One tool that can help in obtaining nutrient values for fresh foods is the FoodData CentralLinks to an external site. from the USDA.
Using the website CronometerLinks to an external site..
You also have the option of utilizing an online tracking tool. For this class we will be using Cronometer, since it provides more information compared to other free nutrient trackers. If you already have a paid subscription to a service like MyFitnessPal then you are welcome to use that.
This is similar to using the Word document; however, you will track your nutrition using their database. I provide step-by-step instructions for how to use Cronometer on the following page.
Pros of this option- This is best for students who are more comfortable using technology. Also, you can save meals that you commonly eat, which makes the tracking process faster in the long run. The biggest pro of this option is that the nutrition analysis is done for you, as opposed to manually logging each nutrient,
Cons of this option- There is a slight learning curve when it comes to how the tracking process works. Also, you will need to keep in mind that the food selections and nutrient information are based on the site’s users, which means that they might not be 100% accurate and they might not have certain brands…this will require you to use your best judgment. Finally, you will need to remember to take screenshots or download a file for assignment submission.
Using a combination of both
Finally, for some of you it might be easiest to utilize both the Word document and Cronometer.
Pros of this option- This allows for the greatest flexibility. During the week you can simply write down the foods that you ate in the Word document (printed or online). Then you can use Cronometer at the end of the 3 days so that you don’t have to figure out the nutrients on the food label.
Cons of this option- This option will require the most work, since you are essentially recording your food twice.
TASK 2- ANALYSIS
This is similar to Assignments 1 and 6 in that you will be answering a series of questions in complete sentences. Questions will be based on the specific nutrients that I am asking you to focus on for that week. Here are examples of what some questions will look like:
What was your average [nutrient(s) for the week] this week? Is this within the daily intake range? Were you surprised?
What foods contributed to these values?
What type of [subcategory of nutrient] did you consume the most of? Did this affect how you felt physically?
THE WEEKLY “CHALLENGE”
In Task 2 I will ask you to think of 2 food swaps that relate to the nutrient focus for that week. I then present you with the challenge of actually implementing those swaps during the next week’s food log. You aren’t required to participate in the challenge; however, I will ask you about it in the following week’s Task 2 questions.
Unformatted Attachment Preview
Food Log- Week 4 of Tracking
Task 1
This week, please log the meal, food/drink, # of servings, serving size, sodium (Na), potassium
(K), Vitamin A (Vit A), Vitamin C (Vit C), Vitamin D (Vit D), calcium (Ca), and iron (Fe).
DAY 1
MEAL
FOOD/DRINK
SERVING
SIZE
# OF
SERVINGS
Na
K
VIT A
VIT C VIT
D
Ca
Fe
FOOD/DRINK
SERVING
SIZE
# OF
SERVINGS
Na
K
VIT A
VIT C VIT
D
Ca
Fe
TOTAL
DAY 2
MEAL
TOTAL
DAY 3
MEAL
FOOD/DRINK
SERVING
SIZE
# OF
SERVINGS
Na
K
TOTAL
[Analysis Questions on Next Page]
VIT A
VIT C VIT
D
Ca
Fe
Task 2- Analysis
Please answer the following questions in complete sentences:
1. In regard to last week’s ‘challenge’1. Did you try your protein swaps? If so, how did it go?
2. In regard to water1. Did you meet the recommendations for water intake? What are considerations that a person
needs to make when determining water needs?
2. What drinks do you mainly drink to meet fluid needs? Do you think that those are healthy
choices (caffeine, alcohol, sugar)?
3. In regard to micronutrients1. What is your fruit and vegetable consumption like? Are you meeting recommendations? What
are ways that you can increase your consumption?
2. What were your averages for salt, potassium, Vitamin A, Vitamin C, Vitamin D, calcium, and
iron? Were these values above, below, or at the recommended values? Did these averages
surprise you?
3. Were you taking a multivitamin prior to this course? After seeing these values, do you think you
will continue taking the multivitamin or will you start taking a multivitamin? Why or why not?
4. Looking forward1. What are foods that you can start eating in order to increase the above micronutrients (except
salt!) in your diet?
2. What are ways that you can cut back on salt in your diet?
Nursing’s primary focus is on the promotion of wellness and disease prevention. In this assignment you will develop and implement a patient educational brochure to educate your patient on the nutritional considerations of a specific disease process. Use any type of publisher software you choose to create your brochure. Information must be in the form of a patient educational brochure.
Need help? Here’s a YouTube video on creating a trifold brochure:Links to an external site.
Develop a trifold instructional brochure on the nutritional aspects of one of the disorders below:
Type 2 Diabetes
Hypertension
Coronary Artery Disease
Chronic Kidney Disease
Cancer
HIV/AIDS
Include in your brochure all points below:
Explanation of the pathophysiology of the disorder. Provide 4 risk factors OR 4 symptoms of the disorder.
Two common, specific medications (not classifications of medications) used for the disorder. Explain how medications work to treat the disorder. Include 3 nutritional considerations for each medication. (Example: food interactions, foods to avoid, foods to take with medication).
Identify an evidence-based diet to prevent or reduce the incidence of the disorder.
Include at least 3 specific foods that should be included in the diet, provide rational for why foods should be included in the diet for this disease process.
Include at least 3 specific foods that should be avoided in the diet, provide rational for why the foods should be excluded from the diet for disease process.
Examples of Evidence-based diets:
Dash diet
Mediterranean diet
Low carb diet
Low sodium diet
Low fat diet
Modified fiber and bland diet
Protein restricted
High protein diet
Include the information for at least 2 patient resources. One resource on the evidence-based diet and 1 resource on the disorder. Include name of organization and URL for the citation.
Include images or clipart to support your information. Trifold brochure should look professional.
Include at least 2 evidence-based references (less than 5 years old) included in your brochure to support your information. Proper use of in-text citations and references in APA Style. References must be on brochure.
Double check that you have submitted the correct file. You will not be able to resubmit after grading. Only PDF or Word files will be accepted.
The theoretical framework is a critical element of your work. A theoretical framework is the general representation of relationships in your problem and is based on existing theory. The conceptual framework is your idea on how the problem should be explored, and it is generally based on a theory. The difference between the two is the scope. Theory is broad; concept is narrow. In most research studies, your framework can be either theoretical or conceptual in nature. For the purposes of this project, you will most likely follow a conceptual framework, which is your idea on how the research problem will be explored (although you could have both).
For example:
Theoretical framework: Stimulus is applied to elicit a response
Conceptual framework: A new teaching method is applied to elicit improvement in midterm test scores.
In this section of your change project paper, state the perspective through which the problem and/or phenomenon may be explored, and include the following:
Select a minimum of two theories.
Identify the process and logic in selecting these theoretical frameworks or conceptual frameworks for your study.
Discuss how each theory or model applies to the individual project.
Present the framework guiding your study.
Describe the assumptions of the framework.
Describe each key component of the framework.
Discuss how each element of the phenomenon applies to the framework.
Apply each element of the theory to the elements of the phenomenon under study.
Develop the rationale for the sample selection criteria.
Discuss, analyze, and critique pertinent research that uses the framework.
Remember that research never proves theory. Your research project can only support or refute the theoretical propositions you are using as your framework. But if you do not use theory or conceptual frameworks in your research, you may not be able to put your findings in a context that could strengthen the nursing education profession!
This section should be 3–4 pages in length, not including the cover or reference page. You must reference a minimum of 3 scholarly articles. APA format. TOPIC: ADOLESCENT UNPLANNED PREGNANCY/ STDS
Unformatted Attachment Preview
1
Adolescents and Unplanned Pregnancies: An Integrative Literature Review
Suzanna Changulyan
NURS 619A
Professor Fuson
September 24, 2023
2
Introduction
Unintended pregnancies and sexually transmitted diseases (STDs) are represented as
an important problem in the public health sector not only in the high-income countries but also
in the lower and middle-income earning countries. Numerous preventive measures are often
implemented by not only healthcare institutions but also the general community. Some of the
common measures include; the integration of sex education in learning centers and enhancing
the distribution and the accessibility of contraceptives. To fully address this problem, there is
a need to understand not only the challenges caused by the problem but also the differences in
the level of prevalence of the healthcare problem in demographics such as; race and the socioeconomic status in the community. This paper presents an integrated research review on the
various challenges of unplanned pregnancies and the variation in teen births in various
demographics including; race, socio-economic status, and geography.
The impact of unplanned pregnancies on adolescents
According to research conducted by the World Bank in 2022, there were more than 12
million girls, aged between 15 and 19, who gave birth. The World Bank (2022), noted various
challenges encountered by teenage mothers including; social stigma, health risks, and possible
adverse economic impacts for the rest of their adult lives. Gurung, et al. (2020), in their
research, also attempted to explore the various consequences associated with teenage
pregnancy. Through an observational study, Gurung, et al. (2020) noted that pregnant
adolescents are at risk of prolonged labor compared to adult mothers. Besides, this research
3
identified that the risk of malfunction is more than two-fold in the case of adolescent mothers
in comparison to adult mothers. The World Bank (2022) further improves on this comparison
by stating that pregnant adolescent girls experience more birth complications such as low baby
weight and severe neonatal conditions compared to pregnant mothers aged between 20 and 24.
Chakole, Akre, Sharma, Wasnik, & Wanjari (2022), in their research, also conducted
a narrative literature review to explore the impact of teenage pregnancy. According to this
study, teenage pregnancy can result in a high mortality rate because of delivery challenges or
even illegal and botched abortions. According to a study conducted by The World Bank
(2022), more than half of the abortions that occur among adolescent girls across the globe are
unsafe. Besides, the World Bank (2022) also reported on the risk of the high rate of mortality
in pregnant adolescents compared to older pregnant women.
Adolescent pregnancy is also more likely to undermine the economic potential of
teenage mothers. According to The World Bank (2022), teenage mothers are less likely to
proceed with education, which can prevent them from not only realizing but also reaching their
true potential. The inability to proceed with education can undermine the future earnings of the
teenage mother and even contribute to the intergenerational cycles of poverty. Moreover,
pregnancy among adolescents is likely to contribute to psychological impact on the individuals.
According to Chakole, Akre, Sharma, Wasnik, & Wanjari (2022), the physical and financial
stress associated with teenage pregnancy can undermine the emotional stability of an
individual. E, R, & HS, (2023) further expand on the connection of mental health to unplanned
pregnancies among teenagers by indicating that adolescent mothers are likely to get less rest
and sleep, be introverted, and even into anxiety and depression compared to the older pregnant
mothers. The research presented in this study can be used to understand the various problems
that can be encountered by pregnant adolescents and young mothers. Ideally, the information
4
from these articles can offer a proper framework for not only addressing any existing research
gaps but also formulating a basis for implementing the proper interventions to help address the
problem in the various communities across the globe.
Racial and ethnic disparities on adolescents’ unplanned pregnancies
The assessment of the racial and ethnic differences in prevalence of the unplanned
pregnancies among adolescents is another important component that can be used in
understanding the foundation of implementing the proper interventions to address the problem.
According to past research studies, demographic factors such as age, race, social economic
factors, and geographic factors can impact the rate of teen births. Ideally, understanding the
differences in the racial and ethnic teen birth rates can help foster a plan, which can be used to
mitigate the problem.
Among the researchers who have examined the racial and ethnic differences in teen
births is Cox (2020), who explored the differences in the pregnancy rates among black and
white teens in the United States. In 2018, there were more than twice the birth rates of black
and Hispanic teens as that of white teens (Cox, 2020). Dumas, Chu, & Horswell (2020) also
affirm that black teens in the United States have an overall high pregnancy and birth rates
compared to white teens. The racial differences in teen birth rates among various ethnicities
can be due to the different perceptions of access to reproductive healthcare and contraception.
According to Galloway, Duffy, Dixon, & Fuller (2017), the disparities in access to
sexual reproductive services and sexual healthcare among African-American and Hispanic
teens are heavily influenced by inaccurate perceptions and beliefs regarding the reliability of
contraceptives. Besides, this study reported concerns about the side effects of birth control as
5
a major contributor to the adoption of contraceptives among black and Hispanic teens.
Sychareun, et al. (2018), in their qualitative research also noted the negative perceptions of the
reliance on contraceptives as a major contributor to teenage pregnancy. While this study only
focuses on rural Lao, the findings presented in the research can play an essential role in
understanding the differences in teenage birth rates among various races and ethnicities.
Social-economic differences in the adolescents’ unplanned pregnancies
Socioeconomic status is another area of exploration that can be examined to identify the
differences in unplanned pregnancies among adolescents. Ideally, the differences in socioeconomic status can help further identify the distribution of interventions and ultimately
address the problem. Gurung, et al. (2020), in their study, identified that two-thirds of their
research participants, who were adolescent mothers, were from disadvantaged ethnic groups.
Besides, the research noted that individuals who lacked formal education were more likely to
be teenage mothers compared to those with formal education.
Chirwa, et al. (2019), in their research, explored the socio-economic differences in
teenage pregnancies in Malawi. The findings of this research suggested that teenage bearing
and childbearing were more prevalent in the communities with the lower socio-economic status
in the country. Ideally, this study noted wealth status in the families was an important
contributor to teenage pregnancies. Cox (2020) further explored the aspect of socioeconomic
status about the difference in teen birth rates. According to the study, the comparison of the
teens in the black and white communities of equally lower socio-economic status suggested a
reduction in the racial differences in the teen birth rates.
The findings of Dumas, Chu, & Horswell (2020) also support the conclusions presented
by Cox (2020), as the research mentions the lack of significant differences in teen births
between black and white communities. Individuals of lower socioeconomic status, irrespective
6
of age and race, were more likely to encounter teenage pregnancy compared to those of higher
socioeconomic status (Cox, 2020). Okoli, Hajizadeh, Rahman, Velayutham, & Khanam
(2022), in their study, also identified teenagers from lower socio-economic communities were
more likely to encounter unplanned pregnancies. This article noted that the existence of social
economic inequality limited access to information, which in turn contributes to higher birth
rates among adolescents.
Geographic Differences
Moreover, geographic differences can also play a part in the assessment of the
differences in teen births. Ideally, the findings from the exploration of this component can be
used to understand the various gaps and the possible solutions that can be implemented to help
further address the problem. According to the study conducted by Cox (2020), there is a higher
teen birth rate among the communities residing in Arkansas compared to those residing in
Massachusetts. Byonanebye, Brazauskas, Tumwesigye, Young, & Cassidy (2020), also
conducted a geographic variation on teenage pregnancies in Uganda. The findings of this study
indicate that there are higher birth rates among the communities in the Eastern central region
compared to the other regions in the country. The findings of these two studies offer an
informative view regarding the component of geographic variation and its importance in
understanding and noting the differences in teenage birth rates in a country.
Conclusion
Unplanned pregnancies and sexually transmitted diseases form part of important public
health problems not only in the high-income countries but also in the middle income and the
low-income earning countries. The integrated research review reveals unplanned pregnancies
have a significant impact not only on the physical and mental health of an individual but also
on the economic stability and potential. Besides, the review uncovers that teenage pregnancies
7
are more prevalent in the less advantaged racial and ethnic groups and communities in socioeconomic status. Geographical variation also plays a part as a factor that determines the
differences in teen births in various countries. Understanding the challenges caused by teenage
pregnancies and differences in teen births in various communities can help formulate a proper
plan for investment in the proper interventions.
8
References
Byonanebye, J., Brazauskas, R., Tumwesigye, N., Young, S. M., & Cassidy, L. (2020).
Geographic variation and risk factors for teenage pregnancy in Uganda. African
Health Sciences, 20(4), 1898-907.
Chakole, S., Akre, S., Sharma, K., Wasnik, P., & Wanjari, M. B. (2022). Unwanted Teenage
Pregnancy and Its Complications: A Narrative Review. Cureus 14(12): e32662.
doi:10.7759/cureus.32662.
Chirwa, G. C., Mazalale, J., Likupe, G., Nkhoma, D., Chiwaula, L., & Chintsanya, J. (2019).
An evolution of socioeconomic related inequality in teenage pregnancy and
childbearing in Malawi. PloS one, 14(11), e0225374.
Cox, J. E. (2020). Understanding the Differences in Pregnancy and Birth Rates for Black and
White Teens. Journal of Adolescent Health .
Dumas, S. A., Chu, S., & Horswell, R. (2020). Analysis of pregnancy and birth rates among
black and white medicaid-enrolled teens. Journal of Adolescent Health, 67(3), 409415.
E, E., R, W., & HS, M. (2023). The Impact of Unwanted Pregnancy in Adolescents toward
Pregnancy Care: A Systematic Review. . Open Access Maced J Med Sci [Internet].
2022 Feb. 5 [cited 2023 Sep. 22];10(F):7-14. Available from:
https://oamjms.eu/index.php.
Galloway, C. T., Duffy, J. L., Dixon, R. P., & Fuller, T. R. (2017). Exploring AfricanAmerican and Latino Teens’ Perceptions of Contraception and Access to
Reproductive Health Care Services. National Library of Medicine .
9
Gurung, R., Målqvist, M., Hong, Z., Poudel, P., Sunny, A., Sharma, S., & Kc, A. (2020). The
burden of adolescent motherhood and health consequences in Nepal. BMC pregnancy
and childbirth , 20 , 1-7.
Okoli, C. I., Hajizadeh, M., Rahman, M. M., Velayutham, E., & Khanam, R. (2022).
Socioeconomic inequalities in teenage pregnancy in Nigeria: evidence from
Demographic Health Survey. BMC Public Health, 22(1), 1-11.
Sychareun, V., Vongxay, V., Houaboun, S., Thammavongsa, V., Phummavongsa, P.,
Chaleunvong, K., & Durham, J. (2018). Determinants of adolescent pregnancy and
access to reproductive and sexual health services for married and unmarried
adolescents in rural Lao. BMC pregnancy and childbirth , 18 , 1-12.
The World Bank . (2022). The Social and Educational Consequences of Adolescent
Childbearing. From: https://genderdata.worldbank.org/data-stories/adolescentfertility/.

1
Adolescent Unwanted Pregnancy and STDS
Suzanna Changulyan
West Coast University
Professor Fuson
NURS 619A
October 1, 2023

2
The Impact of the Project
This project on the impacts and prevalence of unintended pregnancies and STDs plays a
significant role in improving the public health sector’s understanding and approach to this
significant issue (Vaina & Perdikaris, 2022). The exploration of variations in teen births across
different demographics offers crucial insights that have wide-ranging benefits in terms of cost,
time, and quality for people, programs, institutions, and communities.
Cost Benefits
The first benefit is economical resource allocation. Identifying the areas with high
prevalence rates and understanding demographic variations allows resources to be allocated
more efficiently, potentially reducing the economic burden associated with unintended
pregnancies and STDs. Implementing tailored preventive measures can potentially reduce the
future economic costs associated with healthcare, social services, and educational support that
teenage parents and their children require (Vaina & Perdikaris, 2022). Also, reducing unplanned
pregnancies can lead to long-term savings for healthcare systems by averting costs related to
pregnancy complications and long-term health implications for young mothers and their children.
Time Benefits
The project’s insights into demographic variations enable the development of targeted
interventions, thus maximizing efficiency and minimizing the time taken to address high-risk
populations. The research helps quickly identify the needs and modifications in the policies

3
addressing unintended pregnancies and STDs, allowing for swift amendments and
implementations. According to Javidi et al. (2021), understanding the prevalent demographics
helps in prioritizing and streamlining educational interventions, saving time in curriculum
development and implementation.
Quality Benefits
Insights drawn from this project aid in developing high-quality, culturally sensitive
interventions that address different demographics’ specific needs and circumstances. This
research facilitates improvements in the quality of healthcare services by offering a nuanced
understanding of the varying needs and challenges associated with different demographics facing
unintended pregnancies. Knowledge from this research supports the enhancement of sex
education quality by addressing the diverse needs and concerns of varied demographics, making
it more impactful and relevant.
Addressing Needs or Changes
This project provides communities, particularly those marginalized or underrepresented,
with the information and resources to effectively address and prevent unintended pregnancies
and STDs. The rich, demographic-specific insights ensure that interventions and policies are
adaptable and responsive to the evolving community needs and changes (Javidi et al., 2021).
This research is crucial in heightening awareness about the socio-economic and racial disparities
in unintended pregnancies and contributes to a more informed dialogue and action.
Impacts and Consequences

4
This project helps in reducing disparities. It highlights disparities in teen births across
various demographics, which acts as a catalyst for change, promoting equitable access to
resources and services (Harris et al., 2023). The comprehensive insights derived from this study
empower individuals, communities, and policymakers to make more informed decisions
regarding reproductive health. The overall improvements in the efficiency, effectiveness, and
relevance of interventions lead to a holistic enhancement in the well-being and quality of life of
individuals and communities affected by unintended pregnancies.
Therefore, this project is not just an academic endeavor but a transformative initiative
with far-reaching implications. It addresses the diverse impacts of unplanned pregnancies and
explores demographic-specific challenges, fostering a better, more equitable, and informed
approach to reproductive health. This has the potential to revolutionize public health policies,
community interventions, and individual choices.
Goals and objectives
To create measurable, shared, and hypothetically agreed-upon goals and objectives for the
project addressing unintended pregnancies and sexually transmitted diseases (STDs), I aligned
them with the project’s success factors. The first goal is to reduce the incidence of unintended
pregnancies and STDs among teenagers in both high-income and lower or middle-income
countries. The objectives of these goals are to decrease the teenage pregnancy rate by 40% over
the next five years and to lower the incidence of STDs among teenagers by 45% in targeted
regions within five years.

5
Another goal is to enhance the accessibility and effectiveness of preventive measures for
unintended pregnancies and STDs. The objectives of this goal are to increase the distribution of
contraceptives to teenagers in prone regions by 30% within the next two years and to improve
sex education in learning centers by introducing comprehensive and evidence-based sex
education programs in 60% of schools within three years. The third goal is to understand and
address demographic disparities in the prevalence of unintended pregnancies and teen births. The
objective is to conduct comprehensive research on the factors contributing to demographic
disparities in unintended pregnancies and teen births, with a focus on race, socio-economic
status, and geography, to publish findings within two years.
Variables to Consider
The first variable to be considered is budget. Budget is a critical variable in this project if
I implement a clinic-wide practice change. In this project, I will need to secure funding.
Consequently, it is crucial to develop a budget plan for prospective financing avenues
(Gusmartina et al., 2021). I will seek grants, partnerships, and fundraising opportunities if
necessary. The second variable is the staff. I will determine the staff and expertise required for
the project to ensure that I have the necessary human resources, whether hiring new staff,
training existing ones, or collaborating with external experts. Another important variable in this
project is regulations and compliance. I will maneuver this by understanding and complying with
relevant regulations and ethical considerations, especially in healthcare research.
Research Method

6
Due to the complex nature of this project, I intend to deploy both qualitative and
quantitative research methods. Quantitative methods will provide statistical insights into the
prevalence of unintended pregnancies and STDs. In contrast, qualitative methods will help
understand the affected population’s underlying causes, experiences, and attitudes, especially
teenage mothers.
Research Contribution to the Community or Social Change
This project aims to foster communal well-being while cultivating meaningful reform
through engaged cooperation by empowering members and inspiring collective progress. The
research will empower policymakers and healthcare professionals to make informed
interventions and resource allocation decisions. The project will reduce health inequalities,
ensuring healthcare services are more equitable across different groups. According to Parida et
al. (2021), a well-rounded education that holistically addresses relationships, health, and
sexuality could cultivate adolescents’ capacities for discovering their own interests while
respecting others’, empowering youth to navigate intimacy with care, responsibility, and mutual
understanding.
Project Purpose, Focus, and Expected Accomplishments
The project aims to curb unintended pregnancies and the spread of STDs by addressing
the challenges faced disproportionately by teenage mothers and certain demographics through
focused interventions and awareness campaigns. The primary focus is on reducing unintended
pregnancies and STDs among teenagers, especially those of disadvantaged demographics. The
project takes a public health perspective, viewing the reduction of unintended pregnancies and

7
STDs as a vital aspect of community well-being. The project expects to significantly reduce
teenage pregnancies and STD rates, with a particular focus on closing demographic disparities.
Timeline
The project will take about six years. The 1st and 2nd years shall be dedicated to
acquiring financing, forming a collaborative group of specialists, and drafting a strategic research
plan. The researchers will use their third and fourth years to collect data and scrutinize results to
gain insights. The 5th and 6th years will be for developing and implementing interventions and
monitoring the progress.

8
References
Harris, B., McCredie, M. N., Truong, T., Regan, T., Thompson, C. G., Leach, W., & Fields, S. A.
(2023). Relations between adolescent sensation seeking and risky sexual behaviors across
sex, race, and age: A meta-analysis. Archives of Sexual Behavior, 52(1), 191-204.
Gusmartina, S., Azlina, N., & Julita, J. (2021). The Effect of Budget Planning, Budget
Implementation, Procurement of Goods and Services, Competence of Human Resources
and Budget Politics on Budget Absorption (Empirical Study on Opd Pelalawan
District). AFEBI Accounting Review, 6(1), 1-9.
Javidi, H., Widman, L., Lipsey, N., Brasileiro, J., Javidi, F., & Jhala, A. (2021). Redeveloping a
digital sexual health intervention for adolescents to allow for broader dissemination:
Implications for HIV and STD prevention. AIDS Education and Prevention, 33(2),
89-102.
Parida, S. P., Gajjala, A., & Giri, P. P. (2021). Empowering adolescent girls, is sexual and
reproductive health education a solution? Journal of Family Medicine and Primary
Care, 10(1), 66.
Vaina, A., & Perdikaris, P. (2022). School-based sex education among adolescents worldwide:
Interventions for the prevention of STIs and unintended pregnancies. British Journal of
Child Health, 3(5), 229-242.
Please see the attached study materials and complete the assignment using the template. Thank you
Unformatted Attachment Preview
Name:
CASE B: CARDIOVASCULAR DISEASE TEMPLATE
Please erase ?, …, and ___ – Please use a different color that black for your answers!!!!!!!
1. Descriptive epidemiology involves …
2. A population is …
3. Measures of frequency include …
Measures of association report …
Measures of impact assess …
4. A ratio represents …
The proportion…
The rate … The rate is generally expressed as …
5. Ratio of heart attacks – ?/? = ?, or men have _______ times the number of heart attacks
in this population;
Proportion of heart attacks in men ?/? = ? or = ?%, or ___ percent of the heart attacks in
this sample occur among men;
Heart attack rate ?/? × ? = ? per ?. Therefore, the rate of heart attacks among men is ? per
?.
6. Ratio white to black of females – There are ? / ? = ? times as many white women age 20
years and older with diabetes compared with black women in the same age group.
It tells you …
It doesn’t tell you …
7. Proportion – ?/? = ?,
It tells you …
It does not tell / allow you …
8. White women have a rate of (?/?) × ? = ? per ? and black women have a rate of (?/?) × ? =
? per ?.
Comparison – ?/? = ?. Black women have ___ times the rate of diabetes as white women.
9. Ratio of hypertension among Whites vs Blacks – ?/? = ? times as much hypertension in
whites versus blacks,
The proportion of Hypertension in White males – ?/? = ? of the white males have
hypertension.
Rates are (?/?) × ? = ? per ? among whites, and ?/? × ? = ? per ? among blacks
relative risk of ?/? = ?, or blacks have ____ times the prevalence rate of hypertension as
whites.
10. Incidence measures …
Prevalence measures …
The difference between point prevalence and period prevalence is …
11. Incidence rates can be used for …
Prevalence rates can be used for …
12. See Exhibit B.3. – Fill in values for highlighted portion of the table
Exhibit B.3 Number of US Residents (in thousands) with Five Cardiovascular Risk Factors
Prevalence (in thousands)
Prevalence rate (per 100)
White
White
Black
Black
White
White
Black
Males
Females Males
Females Males
Females
Males
18,847
16,998
2,956
2,118
Smoking
prevalence1
Obesity (>=30
27,422
27,522
BMI)2
Cholesterol
32,858
38,785
>200mg/d2
High blood
27,098
25,998
pressure2
Diabetes mellitus2
6,247
5,250
1: age 19 and older; 2: age 20 and older
Source: Go et al. (2013).
4,723
7,560
4,810
5,709
5,309
6,592
1,682
2,160
13. Cumulative incidence refers to …
Incidence rate refers to …
Incidence density refers to ….
14. Please read Page 554 – Cumulative five-year incidence rate of Heart Disease among
coffee drinkers (Group 1)- (? / ?) × ? = ? cases per ? persons
15. Please read Page 554 – Cumulative five-year incidence rate of Heart Disease among noncoffee drinkers (Group 2) – (? / ?) × ? = ? per ? persons
16. 90 persons, each at risk for all 5 years and didn’t get HD, so 90 × 5 = 450 patient-years
? persons, each at risk for 3 years before developing HD, so ? × ? = ? patient-years
? persons, each at risk for 4 years before developing HD, so ? × ? = ? patient-years
? persons, each at risk for 2 years before leaving study, so ? × ? = ? patient-years
? persons, each at risk for 4 years before dying so ? × ? = ? patient-years
Total person years = 450 + ? + ? + ? + ? = ? patient-years
Black
Females
17. 100 persons, each at risk for all 5 years and didn’t get HD, so 100 × 5 = 500 patient-years
? persons, each at risk for 1 year before developing HD, so ? × ? = ? patient-years
? persons, each at risk for 2 years before developing HD, so ? × ? = ? patient-years
? persons, each at risk for 4 years before leaving study, so ? × ? = ? patient-years
? persons, each at risk for 3 years before dying, so ? × ? = ? patient-years
Total person years = 500 + ? + ? +? + ? = ? person-years
18. Incidence Density Rate for Coffee Drinkers – (? /?) × ? = ? cases per ? person-years
19. Incidence Density Rate for Coffee Drinkers – (? /?) × ? = ? cases per ? person-years
20. Cumulative Incidence – Incidence of HD in coffee drinkers / Incidence of Heart Disease
(HD) in non–coffee drinkers = ? / ? = ? so coffee drinkers are ? times more likely to get
HD than non–coffee drinkers
21. Cumulative Incidence Density – Incidence density of HD in coffee drinkers / Incidence
density of HD in non–coffee drinkers = ? / ? = ? so coffee drinkers are ? times more likely
to get HD than non–coffee drinkers
22. See Exhibit B.5
Prevalence rates:
white males ? /? × ? = ? per ?;
white females: ? /? × ? = ? per ?;
black males: ? / ? × ? = ? per ?;
black females: ? /? × ? = ? per ?.
Incidence rates:
white males; ? /? × ? = ? per ?;
white females: ? / ? × ? = ? per ?;
black males: ? /? × ? = ? per ?;
black females: ? / ? × ? = ? per ?.
If we reorganize the formula prevalence (P) = incidence (I) × duration, we demonstrate
that the ratio of prevalence to incidence equals duration. This gives us some idea of the
average duration with the disease assuming a steady state system:
white males: ? years;
white females: ? years;
black males: ? years;
black females: ? years.
Fill in values for highlighted portion of the table using calculations from above
Exhibit B.5 Number of US Residents (in Thousands) with Prevalent or Incident Congestive
Heart Failure (CHF), Age 45 and Older, 2010
Number of US Residents (in
Rate (per 1,000)
Thousands)
White White
Black Black
White
White
Black
Black
Males Females Males Females Males
Females Males
Females
Prevalent
1,783
1,439
CHF
Incident
253
232
CHF
Source: Go et al. (2013)
511
421
44
40
23. New Incidence Rates:
White males: ? / (? – ?) × ? = ? per ?;
white females: ? / (? – ?) × ? = ? per ?;
black males: ? / (? – ?) × ? = ? per ?;
black females: ? / (? – ?) × ? = ? per ?.
The rates …
24. Prevalence denominator: ? million + ? million (44-year-olds) – ? million (deaths) = ?
million estimated for 2011;
incidence denominator: ? million – ? million (existing cases) + ? million (44-year-olds) –
2.5 million (deaths) = ? million;
prevalence rate: ? / ? × ? = ? per ?;
incidence: ? / ? × ? = ? per ?
25. Numerator issues include …
Denominator issues include …
The time period must be …
26. Read 556 – 557
Relative Risk:
Men: ? / ? = ?
women ? / ? = ?
The results were ____________ the meta analysis
_____ have a higher relative risk than ___, which means that ____ is a somewhat
stronger risk factor for _____ among ____.
_____with MS are _____ times as likely to develop cardiovascular disease as those
without MS.
_______ with MS are _____ times as likely to develop cardiovascular disease as those
without MS.
27. Men: ? – ? = ? per ?, this means that ? per ? cases of CVD among men can be attributed
to MS; .
Women: ? – ? = ? per ?, this means that ? per ? cases of CVD among women can be
attributed to MS.
Complete your Focused Exam using the Brian Foster Cough DCE Assignment in Shadow Health. Complete your documentation using the documentation template provided.
Topic: 1) Drug overdose deaths; 2) Household food insecurity and hunger; 3) Employment among the working-age population in West Virginia
2 Things to complete:
Strategic Plan includes:
1. Financial analysis to produce baseline budget for program
2. External assessment (existing outside the organization) of opportunities and threats
3. Stakeholder/Systems Thinking for collaboration/coordination of community partners
Scenario:
Your State Health Department (team chooses a state) received $25 million in federal funding to
establish a program to reduce health disparities among vulnerable populations. The funding
guidance is not specific in which disparities to address. The program should address a minimum
of three (3) Healthy People 2030 Leading Health Indicators (indicator list attached). Your team
is responsible for choosing which Leading Health Indicators to address by identifying which
indicators have significant outcome disparities.
Your team is tasked with creating a comprehensive 5-year strategic plan for the program. The
Strategic plan should include a timeline for deliverables and program impacts
Unformatted Attachment Preview
HPO 689 – ILE (Fall 2023)
TEAM PROJECT –Instructions/Rubric
Project Overview
Objective: To design a strategic plan and presentation for a state health
department that includes a strategic plan, a budget plan, and a policy/evaluation
plan to address leading health indicators prioritized by Healthy People 2030.
Related Competencies: The Strategic Plan/Program/Budget, System
Thinking/Stakeholder Analysis, Policy Analysis/Evaluation Brief, and Presentation
competencies listed in the syllabus are met through this assignment.
Process: Students will work individually and collaboratively in groups to produce
each component of the final Capstone Project. There will be an opportunity to
evaluate your group members as part of the final grade.
Product: The Final written product includes a 5-year Strategic Plan, a 5-year
Program/Budget Plan, and a Policy/Evaluation Brief, which culminates in a voiceover PowerPoint presentation of the combined product. The instructor will grade
by the below rubrics.
Submission of the assigned individual components is required of all group
members involving their portion of the Team assignment.
Your Role: Your State Health Department (team chooses a state) received $25 million
in federal funding to establish a program to reduce health disparities among vulnerable
populations. The funding guidance is not specific in which disparities to address. The
program should address a minimum of three (3) Healthy People 2030 Leading Health
Indicators (indicator list provided). Your team is responsible for choosing which Leading
Health Indicators to address by identifying which indicators have significant outcome
disparities.
Assignment Instructions – TEAM PROJECT
Part I—Strategic Plan
At this point, your team should have a clear understanding of the state’s health
needs or strengths based on the Healthy People 2030 Leading Health Indicators
(LHIs).
Step 1. As a group, determine which LHIs will be addressed in the overall 5-year
strategic plan. What weaknesses are critical for improvement? In your strategic
plan, prioritize three (3) selected LHIs that will be your focus for improvement.
Step 2. After making your LHI selections, develop three to four strategic goals for
Department and 2 SMART objectives of how these goals might be achieved.
(Tips for Writing SMART objectives)
Step 3. Identify how you will gauge fulfillment of goals and objectives. This
process will reveal how well you succeeded based on measurements used and data
produced.
Evaluation methodology must include following components (see table below):
1)
2)
Define success criterion or criterions for each goal (i.e., one or more specific
and measurable factors that indicate a goal has been reached)
Identify data to be collected for measuring each goal’s fulfillment
Example. Assume that you have identified access to dental care among immigrant
populations as an issue based on profiles and other external information.
Goal #
SMART Objective Specific & Measurable Data Collection
factors indicating
success
To increase Increase the number
# of new providers in
Data on dental
access to
of new dental
areas where immigrant providers in
dental care
providers in Region 1 populations reside
Region 1
within
of the state from 4 to
through
immigrant
8 by Year 4 (in your
provider
populations assessment, you
registry (already
noted that the
in existence or
immigrant population
could be
is higher in this
developed as
region)
part of this
goal)
Step 4. External Environmental Analysis
State Department of Health must understand and respond to external (outside
Department of Health) opportunities and threats. These represent fundamental
issues that will determine success or failure of organization and its activities. A
key element in developing strategy for State Department of Health is to gain a
formal understanding of its external environment. Specific objectives for Team
Project in conducting External Environmental Analysis are:
•
•
•
•
•
•
Classify and order information generated and available outside of Department
Identify and analyze current important issues that will affect Department
Detect and analyze weak signals of emerging issues that will affect Department
Speculate on likely future issues that will have significant impact on Department
Provide organized information for development of Department’s vision, mission,
objectives, and strategy and
Foster strategic and long-term thinking throughout Department
Step 4a. You are expected to identify important characteristics, descriptive statistics, events,
trends, and other relevant information that will assist with addressing these LHI Public Health
needs within the state. Below are a list of external environment dimensions and factors within
the dimensions. List of factors provided is not exhaustive. Include additional information as
necessary. For this step, you should research each factor. Teams are advised to divide
factors among team members.
Dimension External Environment
Economic
Demographic/Geographic
Health Status
Competitive/Health Care Infrastructure
Social/Psychographics
Examples of Factors to Included in Analysis*
Income distribution
Employment trends
Types of businesses
Growth rate
Families living below poverty level
Age profile
Income distribution/trends
Ethnic/Racial diversity/distribution
Occupation mix
Residence locations
Major causes of death
Cancer rates
Stroke/heart disease rates
Homicides rates
Infant injury/deaths
Number of physicians and health care workers
Number of hospitals/medical centers
Number of long-term care facilities
Distances to health care facilities
Health insurance statistics
Life style characteristics
Tobacco/alcohol/substance abuse trends
Population mobility
Single heads of households
Violence/child abuse/rape statistics/trends
Step 4b. After researching each factor, prioritize the external environmental factors that may
have the most influence on the leading health indicators (LHIs) chosen. The prioritized external
environmental factors should be documented in the form of a table as shown below.
The table has three columns and as many rows as you need to include all of your prioritized
factors. The first column should identify the dimensions of the external environment dimensions
related to LHIs your group chose. The second column identifies the factor. The third column
contains a brief statement explaining your rationale (meaning the impact of the factor on
public health and your LHIs) for including the factor in your analysis.
EXAMPLE. Table contains dimensions of economic external environment.
External
Environment
Dimension
Economic
Factor
Rationale
Income disparity of
urban and rural areas
Household income data: Urban
average $27,000 vs. rural $12,000.
Low incomes prevalent in Northwest
and Western areas. Evidence suggests
need for additional public health
infrastructure in impoverished areas.
Excellent
Clear, concise,
well-stated; above
expectation
Part I. Strategic Plan
Department information
obtained from external sources
for classification (5 points)
Based on external analysis,
identify current and emerging
issues (10 points)
Discussion of future impacting
issues (10 points)
Development of 3-4 strategic
goals (20 points)
Development of 1-2 SMART
objectives for each of these
goals (15 points)
Evaluation strategies for
success are well-defined and
measurable (10 points)
Good
Generally covered
topics, yet areas
lacking
Fair
Minimal, did
just enough
to submit
Poor
Did not
adequately
cover issues
Total
Points
70
Part II—Policy Analysis
Step 1: Identification and description of policy options: before writing this section, you will
research possible options relevant to problem you identified and described. Identify at least one
policy solution for each LHI and answer questions about public health impact, feasibility, and
economic impacts. In this section, you will summarize answers to following questions for each
of three policy solutions.
A. Public Health Impact: Potential for policy to impact risk factors, quality of life,
disparities, morbidity, and mortality.
•
How does policy address problem or issue (e.g., increase access, protect from
exposure)?
•
What is magnitude, reach, and distribution of benefit and burden (including impact on
risk factor, quality of life, morbidity, and mortality)?
•
What population(s) will benefit? How much? When?
•
What population(s) will be negatively impacted? How much? When?
•
Will policy impact health disparities/health equity? How?
•
Are there gaps in data/evidence-base?
B. Feasibility: Likelihood that policy can be successfully adopted and
implemented. Consider both Political and Operational perspectives.
•
Political: What are current political forces, including political history, environment,
and policy debate?
•
Political: Who are stakeholders, including supporters and opponents? What are their
interests and values?
•
Political: What are potential social, educational, and cultural perspectives associated
with policy option (e.g., lack of knowledge, fear of change, force of habit)?
•
Political: What are potential impacts of policy on other sectors and high priority
issues (e.g., sustainability, economic impact)?
•
Operational: What are resource, capacity, and technical needs for developing,
enacting, and implementing policy?
•
Operational: What is timeline for policy to be enacted, implemented, and enforced.
•
Operational: How scalable, flexible, and transferable is policy?
C. Economic and budgetary impacts: Comparison of the costs to enact, implement,
and enforce the policy with the value of the benefits. (Think about budgets and the
financial impact hypothetically)
•
Budget: What are the costs and benefits associated with the policy, from a budgetary
perspective?
o e.g., for the public (federal, state, local) and private entities to enact, implement,
and enforce the policy?
•
Economic: How do costs compare to benefits (e.g., cost-savings, costs averted, ROI,
cost-effectiveness, cost-benefit analysis, etc.)?
o How are costs and benefits distributed (e.g., for individuals, businesses,
government)?
o What is the timeline for costs and benefits? Economic: Where are there gaps in
the data/evidence-base?
Step 2: Assessing policy option – Assess each option independently against the criteria.
•
Based on the ratings assigned from your assessment using the policy analysis
worksheet, evaluate the policy alternatives against each other, and prioritize the
policy options. Criteria are not intended to be examined in isolation. Which policy(s)
you prioritize will depend on the weight you place on the three criteria and the overall
analysis.
•
In this section of your paper, describe the results of your evaluation and which policy
options are prioritized.
Excellent
Clear, concise,
well-stated; above
expectations
Part II. Policy Analysis
Identification and
description of policy
options (20 points)
Discussion of Public
Health Impact from
options (20 points)
Feasibility of Policy
options implanted from
political & operational
views (20 points)
Policy options assessed
and prioritized (10 points)
Good
Generally
covered topics,
but areas lacking
Fair
Minimal, did
just enough
to submit
Poor
Did not
adequately
cover issues
Total
Points
70
Part III—Program/Budget Plan
Budget reflects the State Department of Health’s additional resources ($25 million
over a 5-year period) to address 3 LHIs chosen by the group. Your task is to
provide each LHI item with an annual dollar amount. Each of the LHIs should be
identified separately with corresponding funding amount for each fiscal year
planned for use. Following table provides a template for budget needs:
Category
Yr 1
LHI – #1
Category-#1a
Category-#1b
Category-#1c
LHI – #2
Category-#2a
Category-#2b
Category-#2c
LHI – #3
Category-#3a
Category-#3b
Category-#3c
Total
|
|
|
|
|
|
|
|
|
|
|
|
|
Budget Expenditure ($000)
Yr 2
Yr 3
Yr 4
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Amount
Yr 5
|
|
|
|
|
|
|
|
|
|
|
|
|
Grand Total
You will include this table as part of your presentation. The rationale for inclusion
of activities in one of the four categories should be briefly discussed in the final
presentation. Also, include a brief discussion of how this breakdown helps in
understanding the priorities of the organization. In addition, discuss challenges
you encountered in the categorization (rationale) process.
Excellent
Clear, concise,
well-stated;
above
expectations
Part III. Budget Plan
Budget table completed
(20 points)
Rationale for allocating
funds each LHIs (20 points)
Budget analysis related to
LHI priorities of the
organization (20 points)
Challenges encountered in
the categorization process
(10 points)
Good
Generally
covered topic,
but areas
lacking
Fair
Minimal, did
just enough
to submit
Poor
Did not
adequately
cover issues
Total
Points
70
Part IV–Presentation
Each group is to prepare a PowerPoint with voice-over narrations. Each group is
allotted 20 minutes. Time allocation for the 20-minute presentation is 10 minutes
for revealing your critical LHI factors and needs analysis and 10 minutes for your
strategic objectives and goals; The time constraint will be enforced. PowerPoints
are to be uploaded to Canvas by the deadline.
Excellent
Clear, concise, wellstated; above
expectations
Part IV. Presentation
Well-organized
slides (30 points)
Speaker(s) were
prepared (30
points)
Presentation
properly timed (10
points)
Good
Generally, topics
addressed but
areas lacking
Fair
Minimal, did
just enough to
submit
Poor
Did not adequately
cover issues
Part V–Group Evaluation (separate evaluation in Canvas)
Format for Team Project
Title page (Title, Group Number and Names)
Section Headers
Each Section Page length (15-25 pages)
Times New Roman 12 Font, Double-Spaced, 1-inch Margins
Use APA for references (minimum 10 references)
Total
Points
70
70 Points
Assignment Instructions – INDIVIDUAL COMPONENT
The Individual Component requirements are based on each group member’s assigned portion of
the Team Project. For instance, if your Team assigns to you the Program/Budget plan
development as your contribution to the overall Team Project, then this will serve as your
Individual Component submission. The Individual Component submission should contain all
elements previously identified for that specific area. In addition, your written narrative should
address the basis for your recommended actions, analysis of actions recommended, and
anticipated outcome for proposed actions.
The Individual Component submission is divided into 2 portions. The first submission is your
progress to date of your assigned Team portion and will serve as your Draft Submission. The
second submission is your completed assignment and will serve as your Final Submission. Be
sure to follow all APA style guidance and appropriate margin, font, and letter size when
completing your submissions.
Format for Individual Component
Title page (Title, Group Number and Name)
Section
Section Page length (15-20 pages)
Times New Roman 12 Font, Double-Spaced, 1-inch Margins
Use APA for references (minimum 3 references)
HPO 689 – ILE (Fall 2023)
TEAM PROJECT –Instructions/Rubric
Project Overview
Objective: To design a strategic plan and presentation for a state health
department that includes a strategic plan, a budget plan, and a policy/evaluation
plan to address leading health indicators prioritized by Healthy People 2030.
Related Competencies: The Strategic Plan/Program/Budget, System
Thinking/Stakeholder Analysis, Policy Analysis/Evaluation Brief, and Presentation
competencies listed in the syllabus are met through this assignment.
Process: Students will work individually and collaboratively in groups to produce
each component of the final Capstone Project. There will be an opportunity to
evaluate your group members as part of the final grade.
Product: The Final written product includes a 5-year Strategic Plan, a 5-year
Program/Budget Plan, and a Policy/Evaluation Brief, which culminates in a voiceover PowerPoint presentation of the combined product. The instructor will grade
by the below rubrics.
Submission of the assigned individual components is required of all group
members involving their portion of the Team assignment.
Your Role: Your State Health Department (team chooses a state) received $25 million
in federal funding to establish a program to reduce health disparities among vulnerable
populations. The funding guidance is not specific in which disparities to address. The
program should address a minimum of three (3) Healthy People 2030 Leading Health
Indicators (indicator list provided). Your team is responsible for choosing which Leading
Health Indicators to address by identifying which indicators have significant outcome
disparities.
Assignment Instructions – TEAM PROJECT
Part I—Strategic Plan
At this point, your team should have a clear understanding of the state’s health
needs or strengths based on the Healthy People 2030 Leading Health Indicators
(LHIs).
Step 1. As a group, determine which LHIs will be addressed in the overall 5-year
strategic plan. What weaknesses are critical for improvement? In your strategic
plan, prioritize three (3) selected LHIs that will be your focus for improvement.
Step 2. After making your LHI selections, develop three to four strategic goals for
Department and 2 SMART objectives of how these goals might be achieved.
(Tips for Writing SMART objectives)
Step 3. Identify how you will gauge fulfillment of goals and objectives. This
process will reveal how well you succeeded based on measurements used and data
produced.
Evaluation methodology must include following components (see table below):
1)
2)
Define success criterion or criterions for each goal (i.e., one or more specific
and measurable factors that indicate a goal has been reached)
Identify data to be collected for measuring each goal’s fulfillment
Example. Assume that you have identified access to dental care among immigrant
populations as an issue based on profiles and other external information.
Goal #
SMART Objective Specific & Measurable Data Collection
factors indicating
success
To increase Increase the number
# of new providers in
Data on dental
access to
of new dental
areas where immigrant providers in
dental care
providers in Region 1 populations reside
Region 1
within
of the state from 4 to
through
immigrant
8 by Year 4 (in your
provider
populations assessment, you
registry (already
noted that the
in existence or
immigrant population
could be
is higher in this
developed as
region)
part of this
goal)
Step 4. External Environmental Analysis
State Department of Health must understand and respond to external (outside
Department of Health) opportunities and threats. These represent fundamental
issues that will determine success or failure of organization and its activities. A
key element in developing strategy for State Department of Health is to gain a
formal understanding of its external environment. Specific objectives for Team
Project in conducting External Environmental Analysis are:
•
•
•
•
•
•
Classify and order information generated and available outside of Department
Identify and analyze current important issues that will affect Department
Detect and analyze weak signals of emerging issues that will affect Department
Speculate on likely future issues that will have significant impact on Department
Provide organized information for development of Department’s vision, mission,
objectives, and strategy and
Foster strategic and long-term thinking throughout Department
Step 4a. You are expected to identify important characteristics, descriptive statistics, events,
trends, and other relevant information that will assist with addressing these LHI Public Health
needs within the state. Below are a list of external environment dimensions and factors within
the dimensions. List of factors provided is not exhaustive. Include additional information as
necessary. For this step, you should research each factor. Teams are advised to divide
factors among team members.
Dimension External Environment
Economic
Demographic/Geographic
Health Status
Competitive/Health Care Infrastructure
Social/Psychographics
Examples of Factors to Included in Analysis*
Income distribution
Employment trends
Types of businesses
Growth rate
Families living below poverty level
Age profile
Income distribution/trends
Ethnic/Racial diversity/distribution
Occupation mix
Residence locations
Major causes of death
Cancer rates
Stroke/heart disease rates
Homicides rates
Infant injury/deaths
Number of physicians and health care workers
Number of hospitals/medical centers
Number of long-term care facilities
Distances to health care facilities
Health insurance statistics
Life style characteristics
Tobacco/alcohol/substance abuse trends
Population mobility
Single heads of households
Violence/child abuse/rape statistics/trends
Step 4b. After researching each factor, prioritize the external environmental factors that may
have the most influence on the leading health indicators (LHIs) chosen. The prioritized external
environmental factors should be documented in the form of a table as shown below.
The table has three columns and as many rows as you need to include all of your prioritized
factors. The first column should identify the dimensions of the external environment dimensions
related to LHIs your group chose. The second column identifies the factor. The third column
contains a brief statement explaining your rationale (meaning the impact of the factor on
public health and your LHIs) for including the factor in your analysis.
EXAMPLE. Table contains dimensions of economic external environment.
External
Environment
Dimension
Economic
Factor
Rationale
Income disparity of
urban and rural areas
Household income data: Urban
average $27,000 vs. rural $12,000.
Low incomes prevalent in Northwest
and Western areas. Evidence suggests
need for additional public health
infrastructure in impoverished areas.
Excellent
Clear, concise,
well-stated; above
expectation
Part I. Strategic Plan
Department information
obtained from external sources
for classification (5 points)
Based on external analysis,
identify current and emerging
issues (10 points)
Discussion of future impacting
issues (10 points)
Development of 3-4 strategic
goals (20 points)
Development of 1-2 SMART
objectives for each of these
goals (15 points)
Evaluation strategies for
success are well-defined and
measurable (10 points)
Good
Generally covered
topics, yet areas
lacking
Fair
Minimal, did
just enough
to submit
Poor
Did not
adequately
cover issues
Total
Points
70
Part II—Policy Analysis
Step 1: Identification and description of policy options: before writing this section, you will
research possible options relevant to problem you identified and described. Identify at least one
policy solution for each LHI and answer questions about public health impact, feasibility, and
economic impacts. In this section, you will summarize answers to following questions for each
of three policy solutions.
A. Public Health Impact: Potential for policy to impact risk factors, quality of life,
disparities, morbidity, and mortality.
•
How does policy address problem or issue (e.g., increase access, protect from
exposure)?
•
What is magnitude, reach, and distribution of benefit and burden (including impact on
risk factor, quality of life, morbidity, and mortality)?
•
What population(s) will benefit? How much? When?
•
What population(s) will be negatively impacted? How much? When?
•
Will policy impact health disparities/health equity? How?
•
Are there gaps in data/evidence-base?
B. Feasibility: Likelihood that policy can be successfully adopted and
implemented. Consider both Political and Operational perspectives.
•
Political: What are current political forces, including political history, environment,
and policy debate?
•
Political: Who are stakeholders, including supporters and opponents? What are their
interests and values?
•
Political: What are potential social, educational, and cultural perspectives associated
with policy option (e.g., lack of knowledge, fear of change, force of habit)?
•
Political: What are potential impacts of policy on other sectors and high priority
issues (e.g., sustainability, economic impact)?
•
Operational: What are resource, capacity, and technical needs for developing,
enacting, and implementing policy?
•
Operational: What is timeline for policy to be enacted, implemented, and enforced.
•
Operational: How scalable, flexible, and transferable is policy?
C. Economic and budgetary impacts: Comparison of the costs to enact, implement,
and enforce the policy with the value of the benefits. (Think about budgets and the
financial impact hypothetically)
•
Budget: What are the costs and benefits associated with the policy, from a budgetary
perspective?
o e.g., for the public (federal, state, local) and private entities to enact, implement,
and enforce the policy?
•
Economic: How do costs compare to benefits (e.g., cost-savings, costs averted, ROI,
cost-effectiveness, cost-benefit analysis, etc.)?
o How are costs and benefits distributed (e.g., for individuals, businesses,
government)?
o What is the timeline for costs and benefits? Economic: Where are there gaps in
the data/evidence-base?
Step 2: Assessing policy option – Assess each option independently against the criteria.
•
Based on the ratings assigned from your assessment using the policy analysis
worksheet, evaluate the policy alternatives against each other, and prioritize the
policy options. Criteria are not intended to be examined in isolation. Which policy(s)
you prioritize will depend on the weight you place on the three criteria and the overall
analysis.
•
In this section of your paper, describe the results of your evaluation and which policy
options are prioritized.
Excellent
Clear, concise,
well-stated; above
expectations
Part II. Policy Analysis
Identification and
description of policy
options (20 points)
Discussion of Public
Health Impact from
options (20 points)
Feasibility of Policy
options implanted from
political & operational
views (20 points)
Policy options assessed
and prioritized (10 points)
Good
Generally
covered topics,
but areas lacking
Fair
Minimal, did
just enough
to submit
Poor
Did not
adequately
cover issues
Total
Points
70
Part III—Program/Budget Plan
Budget reflects the State Department of Health’s additional resources ($25 million
over a 5-year period) to address 3 LHIs chosen by the group. Your task is to
provide each LHI item with an annual dollar amount. Each of the LHIs should be
identified separately with corresponding funding amount for each fiscal year
planned for use. Following table provides a template for budget needs:
Category
Yr 1
LHI – #1
Category-#1a
Category-#1b
Category-#1c
LHI – #2
Category-#2a
Category-#2b
Category-#2c
LHI – #3
Category-#3a
Category-#3b
Category-#3c
Total
|
|
|
|
|
|
|
|
|
|
|
|
|
Budget Expenditure ($000)
Yr 2
Yr 3
Yr 4
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Amount
Yr 5
|
|
|
|
|
|
|
|
|
|
|
|
|
Grand Total
You will include this table as part of your presentation. The rationale for inclusion
of activities in one of the four categories should be briefly discussed in the final
presentation. Also, include a brief discussion of how this breakdown helps in
understanding the priorities of the organization. In addition, discuss challenges
you encountered in the categorization (rationale) process.
Excellent
Clear, concise,
well-stated;
above
expectations
Part III. Budget Plan
Budget table completed
(20 points)
Rationale for allocating
funds each LHIs (20 points)
Budget analysis related to
LHI priorities of the
organization (20 points)
Challenges encountered in
the categorization process
(10 points)
Good
Generally
covered topic,
but areas
lacking
Fair
Minimal, did
just enough
to submit
Poor
Did not
adequately
cover issues
Total
Points
70
Part IV–Presentation
Each group is to prepare a PowerPoint with voice-over narrations. Each group is
allotted 20 minutes. Time allocation for the 20-minute presentation is 10 minutes
for revealing your critical LHI factors and needs analysis and 10 minutes for your
strategic objectives and goals; The time constraint will be enforced. PowerPoints
are to be uploaded to Canvas by the deadline.
Excellent
Clear, concise, wellstated; above
expectations
Part IV. Presentation
Well-organized
slides (30 points)
Speaker(s) were
prepared (30
points)
Presentation
properly timed (10
points)
Good
Generally, topics
addressed but
areas lacking
Fair
Minimal, did
just enough to
submit
Poor
Did not adequately
cover issues
Part V–Group Evaluation (separate evaluation in Canvas)
Format for Team Project
Title page (Title, Group Number and Names)
Section Headers
Each Section Page length (15-25 pages)
Times New Roman 12 Font, Double-Spaced, 1-inch Margins
Use APA for references (minimum 10 references)
Total
Points
70
70 Points
Assignment Instructions – INDIVIDUAL COMPONENT
The Individual Component requirements are based on each group member’s assigned portion of
the Team Project. For instance, if your Team assigns to you the Program/Budget plan
development as your contribution to the overall Team Project, then this will serve as your
Individual Component submission. The Individual Component submission should contain all
elements previously identified for that specific area. In addition, your written narrative should
address the basis for your recommended actions, analysis of actions recommended, and
anticipated outcome for proposed actions.
The Individual Component submission is divided into 2 portions. The first submission is your
progress to date of your assigned Team portion and will serve as your Draft Submission. The
second submission is your completed assignment and will serve as your Final Submission. Be
sure to follow all APA style guidance and appropriate margin, font, and letter size when
completing your submissions.
Format for Individual Component
Title page (Title, Group Number and Name)
Section
Section Page length (15-20 pages)
Times New Roman 12 Font, Double-Spaced, 1-inch Margins
Use APA for references (minimum 3 references)
In this discussion board, you will compare healthcare reimbursement methodologies in Saudi Arabia with the United States. Research and evaluate the need for more public and private funding of healthcare in Saudi Arabia.
Your response should address the following:
Description of current reimbursement formats in Saudi Arabia and the United States.
Pros and cons of the current reimbursement model in Saudi Arabia and the United States.
515
Review the following article for this week’s discussion:
Sama’a, H. A., Alfayez, A. S., Alanazi, A. T., Alwuhaimed, L. A., & Hamed, S. S. B. (2021).Autonomy, accountability, and competition: the privatisation of the Saudi health care system. Journal of Taibah
Discuss the various governmental entities involved in the privatization of healthcare in the Kingdom of Saudi Arabia. How are these entities helping meet the needs of healthcare in the Kingdom? Include anything you found surprising in the article.
520
Select a healthcare organization in KSA and review the organization’s mission and vision statements.
State what organization you selected to review and briefly summarize the organization’s mission and vision statements.
Discuss the difference between a vision and mission statement.
Analyze the selected organization’s mission and vision statement.
Describe how the vision statement aligns with Saudi Vision 2030.
yes like the ppt moer detalis in wordPrepare the allotted case study for the assignment. • Download five articles related to the case study and prepare the assignment using these articles. ■ Mention your view of the evidence from the articlesthe ppt is very good bout she need in ppt and word more ditaelis i will pay for you
Unformatted Attachment Preview
Clinical Practice Guidelines
for Lateral Epicondylitis: An
Evidence-Based Approach
Presented by:
Date:
Introduction
Meaning:
It is a prevalent musculoskeletal condition affecting the elbow’s outer part, causing pain and
discomfort.
Other name:
Tennis elbow
Importance of Evidence-Based Guidelines:
They integrate the best available evidence to inform clinical decisions, ensuring optimal
patient care.
Objective:
The presentation will examine a case study of lateral epicondylitis and outline evidencebased conclusions that came from a thorough examination of five pertinent studies,
highlighting a sound treatment strategy.
Case Study Overview
Patient Profile:
To provide context for understanding lateral epicondylitis, our case study involves a patient
with unique demographics, symptoms, and pertinent medical history.
Impact of Lateral Epicondylitis:
The presentation will illustrate how the patient’s daily activities are affected by lateral
epicondylitis, emphasizing the need for successful treatment interventions.
Treatment Approaches:
The presentation will explore the conditions’ treatment methods in detail, shining light on the
techniques used to reduce the patient’s symptom burden and improve their quality of life.
Presentation Structure:
The presentation will use a systematic format in order to preserve clarity, with a particular
emphasis on fact-based conclusions drawn from both the case study and chosen
publications.
Article Selection
Criteria for the 5 Article Selection:
Relevance to the case study
Recent publications in the last 15 years
The credibility of the sources
Importance of Diverse Perspectives:
Since lateral epicondylitis has several facets, our selection of publications ensures a
variety of viewpoints, enhancing our comprehension and analysis.
The rationale for Selection:
The publications were chosen for their methodological rigor and ability to add
significant knowledge to the evidence-based framework we are developing.
Demonstration of Rigor:
The evidence-based approach is strengthened by a thorough evaluation of the
chosen papers to ensure methodological soundness.
Evidence-Based Findings – Article 1
Article title:
“Conservative treatment of lateral epicondylitis: comparison of two different orthotic devices.”
The study assessed the effectiveness of various conservative treatments like:
Physiotherapy
Bracing
Non-steroidal anti-inflammatory drugs (NSAIDs).
Findings indicated that a combination of physiotherapy and bracing demonstrated significant
improvement in:
Pain reduction
Functional outcomes
Relevance to Case Study:
Aligns with the case study’s conservative treatment approach.
Provides evidence supporting the efficacy of specific interventions used in the case study.
Methodological Rigor:
Used an RCT (randomized controlled trial) design.
Used pain and function outcome metrics that had been approved.
Diverse Perspectives:
Contrasts with studies that prioritize pharmacological interventions.
Offers insights into non-pharmacological approaches for lateral epicondylitis
Evidence-Based Findings – Article 2
Article Title:
“Management of lateral epicondylitis: a narrative literature review”.
Various methods of management:
Nonoperative Treatment:
Physiotherapy
activity modification
Counterforce Braces
Anti-Inflammatory Medications
Autologous Blood Injection (ABI) etc.
Operative Treatment
Percutaneous Surgery
Open Surgery
Arthroscopic Surgery
Findings:
Nonoperative treatment remains the priority with 90% success rate
In case nonoperative treatment fails, surgical interventions will be recommended for the patients.
Evidence-Based Findings – Article 3
Title:
“Clinical effectiveness of shockwave therapy in lateral elbow tendinopathy: systematic review and meta-analysis”
Key Insights:
Explored the efficacy of shockwave therapy in reducing pain and improving function.
The results showed that shockwave therapy significantly reduced pain in the short term.
Relevance to Case Study:
Complies with the case study’s analysis of potential alternatives to actions.
Provides arguments in favor of or against including shockwave therapy in the treatment schedule.
Diverse Perspectives:
It is in contrast with studies that only include conventional physical treatment.
Provides proof for unconventional interventions.
Methodological Rigor:
Conducted a thorough analysis and meta-review.
Research involving various patient groups that were included
Evidence-Based Findings – Article 4
Article title:
Risk factors:
Female gender
History of smoking
History of diabetes mellitus
Old age
Relevance to Case Study:
Informs the case study’s consideration of holistic patient care.
Supports the integration of risk factors assessments in the treatment plan.
Diverse Perspectives:
“Risk factors of lateral epicondylitis: A meta-analysis.”
Highlights the interconnectedness of physical and psychosocial aspects.
Methodological Rigor:
Utilized qualitative research methods.
Mantel-Haenszel statistics and random effect models
Evidence-Based Findings – Article 5
Article title:
“Long-term follow-up of arthroscopic treatment of lateral epicondylitis.”
Insights:
Arthroscopic management can produce clinical improvement and have successful long-term outcomes.
At long-term follow-up, the initial high rate of success in patients was maintained.
Removal of pathologic tendinosis tissue arthroscopically is a reliable treatment for recalcitrant lateral epicondylitis.
Relevance to Case Study:
provides guidance for the case study’s long-term management and preventative measures.
proves how crucial it is to include therapeutic exercises in your treatment strategy.
Diverse Perspectives:
In contrast with studies that emphasize acute management.
the importance of long-term care is emphasized..
Methodological Rigor:
Conducted a prospective cohort study.
Followed participants over an extended period.
Own View of the articles’ Evidence
Comprehensive Understanding:
Gives a comprehensive grasp of how to handle lateral epicondylitis in a way that is patient-centered and
evidence-based.
Methodological Rigor Across Studies:
Increases faith in the accuracy of the evidence being given.
Rigorous techniques, such as prospective cohort studies, qualitative research, and randomized controlled
trials.
Risk Factors Meta-Analysis:
Identifies risk factors such as female gender, smoking, diabetes, and old age.
promoters of risk factor evaluations and all-encompassing patient care.
Shockwave Therapy Systematic Review:
Shockwave therapy is an effective alternative since it provides immediate pain relief.
Conservative Treatments Assessment:
In line with case study emphasis, physical therapy and bracing demonstrate effectiveness.
Recommendations and Conclusion
Recommendations:
Prioritizing nonoperative approaches
Considering alternative interventions like shockwave therapy
Incorporation of long-term care strategies.
Trends in the literature:
Prominence of physiotherapy
Risk factor assessments
Sustained clinical improvements through arthroscopic treatment.
Evidence is relevant in informing clinical decisions, fostering optimal patient
care, and adapting treatments based on individualized needs.
The evidence aligns with real-world scenarios, enhancing the effectiveness of
lateral epicondylitis management strategies.
References
Altan, L. A. L. E., & Kanat, E. (2008). Conservative treatment of lateral epicondylitis:
comparison of two different orthotic devices. Clinical rheumatology, 27, 1015-1019.
Bachman, S. (2016). An evidence-based approach to treating lateral epicondylitis using
the Occupational Adaptation model. The American Journal of Occupational
Therapy, 70(2), 7002360010p1-7002360010p5.
Baker Jr, C. L., & Baker III, C. L. (2008). Long-term follow-up of arthroscopic treatment of
lateral epicondylitis. The American journal of sports medicine, 36(2), 254-260.
Karanasios, S., Tsamasiotis, G. K., Michopoulos, K., Sakellari, V., & Gioftsos, G. (2021). Clinical
effectiveness of shockwave therapy in lateral elbow tendinopathy: systematic review and
meta-analysis. Clinical Rehabilitation, 35(10), 1383-1398.
Ma, K. L., & Wang, H. Q. (2020). Management of lateral epicondylitis: a narrative literature
review. Pain Research and Management, 2020.
Sayampanathan, A. A., Basha, M., & Mitra, A. K. (2020). Risk factors of lateral epicondylitis:
A meta-analysis. The Surgeon, 18(2), 122-128.
Clinical Practice Guidelines
for Plantar Fasciitis: An
Evidence-Based Approach
Presented by:
Date:
Introduction
• Description:
•
Plantar fasciitis is characterized by inflammation of the thick band of tissue (plantar fascia) that connects the heel bone to
the toe.
• Peoples affected:
•
Various age groups and activity levels.
• Importance of Evidence-Based Approaches:
•
•
•
•
Know its prevalence
Focus on individual variation
To optimize outcomes
To avoid guesswork
• Objective:
•
• Aim:
•
Objective
Comprehensively explore and understand the evidence-based practices in the management of plantar fasciitis
To dissect recent research findings from key articles, shedding light on the effectiveness of interventions and the nuances of
this prevalent foot condition
• Goal:
•
Empower clinicians with insights that go beyond conventional approaches
• Seek:
•
To instill a deep understanding of the role evidence plays in optimizing patient outcomes, fostering a commitment to
informed decision-making in the clinical management of plantar fasciitis.
• Importance of Understanding Evidence-Based Practices:
•
•
•
•
•
Optimization of treatment outcomes
Precision in patient care
Enhanced collaboration
Professional development
Reduction of guesswork
Case Study Overview
• It undertakes a thorough examination of evidence-based practices in the management of Plantar Fasciitis
• It utilizes recent research findings (articles written in the last 5 years) to navigate the complexities of this common yet
often challenging condition.
• Its objectives include:
•
•
•
Meta-review systematic reviews
Examine best practices
Explore interventions
• Key Points and Challenges:
•
•
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Navigating systematic review findings
Interpreting consensus recommendations
Diversity in interventions
• Title:
Article 1-Hip Strengthening Exercises
• “The effects of hip strengthening exercises in a patient with plantar fasciitis: A case report.”
• Methodology:
• Randomized controlled trial design.
• Participants diagnosed with plantar fasciitis were assigned to either a hip-strengthening exercise group or a
control group.
• Outcome measures- pain intensity, functional status, and biomechanical parameters.
• Relevance to Case Study:
• Highlights a specific intervention’s positive impact on Plantar Fasciitis.
• Offers insights into the broader spectrum of treatment possibilities.
• Key Findings:
• The hip strengthening exercise group demonstrated significant improvements in pain reduction and
functional outcomes compared to the control group.
• Hip-strengthening exercises incorporation into the treatment plan can be beneficial for individuals with
plantar fasciitis.
Article 2 – Dry Needling Effectiveness
•
•
•
Title:
“Is dry needling effective for the management of plantar heel pain or plantar fasciitis? An updated systematic review and meta-analysis.”
Findings:
•
•
•
focuses on a particular and possibly efficient intervention.
Adds a non-traditional perspective to treatment approaches.
Methodological Rigor:
•
•
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Supports the efficacy of dry needling as an intervention.
Relevance to Case Study:
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•
•
Meta-analysis shows significant pain reduction and functional improvement.
Systematic review and meta-analysis of randomized controlled trials.
Rigorous assessment of dry needling effectiveness.
Diverse Perspectives:
•
Introduces an alternative therapeutic approach.
Article 3-Best Practice Guide
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Title:
“Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning, and patient values”
Findings:
•
•
•
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Recommendations derived from expert consensus and existing literature.
Serves as a helpful manual for treating plantar fasciitis for professionals.
Highlights the agreement of experts while providing a methodical approach.
Methodological Rigor:
•
•
•
Provides a framework for assessment and treatment.
Relevance to Case Study:
•
•
•
Outlines a comprehensive approach to managing plantar heel pain, encompassing assessment, diagnosis, and a range of conservative and interventional treatment options.
Developed through a consensus process with a panel of experts.
Incorporates a review of existing literature and clinical experiences.
Diverse Perspectives:
•
incorporates expert advice into evidence-based recommendations.
Article 4 – Endoscopic Plantar Fasciotomy
• Title:
•
“Endoscopic plantar fasciotomy for plantar fasciitis: A systematic review and network meta-analysis of the English
literature. ”
• Key points and relevance:
•
•
•
•
•
•
Addresses the surgical perspective in Plantar Fasciitis management.
Provides evidence on the efficacy of endoscopic plantar fasciotomy
Utilized systematic review and network meta-analysis methodologies.
Rigorous analysis of English literature to ensure comprehensive data integration
Adds a surgical dimension to the discussion on plantar fasciitis management.
Contributes a nuanced perspective on the role and efficacy of endoscopic plantar fasciotomy.
Article 5 – Epidemiology, Evaluation,
Treatment
•
•
•
Title:
“A systematic review of systematic reviews on the epidemiology, evaluation, and treatment of plantar fasciitis.”
Findings:
•
•
•
•
Treatment- Corticosteroid, Platelet-Rich Plasma (PRP), Extracorporeal Shockwave Therapy (ESWT), Needling Therapies, and Low-Level Laser Therapy
(LLLT) etc.
Acts as a foundational article, covering various aspects comprehensively.
Offers evidence-based insights into the condition’s multifaceted nature.
Methodological Rigor:
•
•
•
Provides a holistic perspective on managing Plantar Fasciitis.
Relevance to Case Study:
•
•
•
In-depth exploration of epidemiology -prevalence, risk factors, diagnosis, evaluation, and treatments.
A systematic review that explores a wide range of aspects.
Synthesizes evidence from multiple systematic reviews.
Diverse Perspectives:
•
Comprehensively addresses epidemiological, diagnostic, and therapeutic dimensions.
Conclusion
• The research looked at a variety of therapies, including dry needling, endoscopic plantar
fasciotomy, and hip strengthening exercises, providing a wide range of alternatives for
treating plantar fasciitis.
• The inclusion of expert consensus in best practice guides highlighted a team-based and
knowledgeable approach to treating Plantar Fasciitis.
• We now have a deeper grasp of Plantar Fasciitis thanks to the systematic reviews’
comprehensive analysis of the disease’s epidemiological, diagnostic, and therapeutic
facets.
• The findings emphasized the value of evidence-based procedures, emphasizing their role in
promoting informed decision-making and improving patient outcomes..
References
• Lee, J. H., Park, J. H., & Jang, W. Y. (2019).
The effects of hip strengthening exercises in a patient
with plantar fasciitis: A case report. Medicine, 98(26).
• Llurda-Almuzara, L., Labata-Lezaun, N., Meca-Rivera, T., Navarro-Santana, M. J., Cleland, J. A.,
Fernández-de-Las-Peñas, C., & Pérez-Bellmunt, A. (2021). Is dry needling effective for the
management of plantar heel pain or plantar fasciitis? An updated systematic review and metaanalysis. Pain Medicine, 22(7), 1630-1641.
• Mao, D. W., Chandrakumara, D., Zheng, Q., Kam, C., & King, C. K. K. (2019). Endoscopic plantar
fasciotomy for plantar fasciitis: A systematic review and network meta-analysis of the English
literature. The Foot, 41, 63-73.
• Morrissey, D., Cotchett, M., J’Bari, A. S., Prior, T., Griffiths, I. B., Rathleff, M. S., … & Barton, C. J.
(2021). Management of plantar heel pain: a best practice guide informed by a systematic review,
expert clinical reasoning, and patient values. British journal of sports medicine, 55(19), 1106-1118.
• Rhim, H. C., Kwon, J., Park, J., Borg-Stein, J., & Tenforde, A. S. (2021). A systematic review of
systematic reviews on the epidemiology, evaluation, and treatment of plantar
fasciitis. Life, 11(12), 1287.
Thank You
• Thank you for your time and listening to me.
Do not simply report what was said at the event and do not duplicate any reporting about the event by other parties. Use APA 7th edition citations, be sure to include in the references the URL address of the hearing reviewed.The reflection paper should include the following components: • Identify the main topic of the hearing (including title of the hearing, committee name, and date; • Indicate why you think this topic is an important public health policy issue; • Identify the various stakeholders at the hearing and generally discuss their views about the topic (be sure to identify the speaker); • Indicate why you found any arguments presented either persuasive or unconvincing; and • Include your thoughts/reflections about the experience of attending/viewing a hearing.Do not exceed 3 pages.Watch the Hearing on the Economic Impact of Diabetes Here: https://www.c-span.org/video/?529601-1/medical-pro…
Hello, this a discussion. patient diagnosis is bipolar 1 disorder and for treatment you can put lithium, a mood stabilizer . Thank you!
Assignment:
Wendy is a 30-year-old, unemployed white female. She is no stranger to therapy, having seen counselors for most of her teen and adult years. Her friends would describe her as a “wild woman” who takes no crap from anyone. She has held various part-time jobs for the last few years because she usually gets angry at her boss or coworkers and quits. While she has had a string of boyfriends over the years, she has been seeing one man for the last year or so. He too is unemployed and has both an alcohol and methamphetamine problem. She describes the relationship as “addictive and dysfunctional, yet exciting and hot.” Wendy is back in treatment at the urging of her parents, who describe her behavior as erratic and unpredictable. They also claim that she has periods where she “sleeps little and parties lots.” There were also several occasions in the last five years when she was so depressed she didn’t eat or want to leave the house. Her father also admits to periods of depression, and Trisha’s grandfather was diagnosed with manic depression, resulting in numerous hospitalizations in the 1950s and 1960s. Wendy’s only brother died in a car accident several years ago. He was drunk at the time, but she claims he had a long history of depression. Recently Trisha was arrested for disorderly conduct at a friend’s party. She had not slept for nearly 24 hours and was drunk and combative. When she was first approached by police, she solicited them for sex. They report that she was rather hyperverbal and hyperactive. They later had to investigate a complaint from local storeowners for bad checks she wrote in excess of $7,000.
Summarize the clinical case.
Create a list of the patient’s problems and prioritize them.
Which diagnosis should be considered
What is your rationale for the diagnosis
What differential diagnosis should be considered
What test or screening tools should be considered to help identify the correct diagnosis
What treatment would you prescribe and what is the rationale (consider psychopharmacology, diagnostics tests, referrals, psychotherapy, psychoeducation)
What standard guidelines would you use to assess or treat this patient
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Submission Instructions
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 3 evidence-based sources.
Nursing Plan of Care
Student name:
Patient initials:
Age:
Date of Care:
All material submitted must be typed in the space provided!
Patient’s Admitting Diagnosis:
List patient’s past medical history related to admission:
PATHOPHYSIOLOGY Provide brief/key aspects of pathophysiology related to your patient’s admitting diagnosis in the
space provided below.
Instructions for
assessment:
In the space below enter the subjective and objective data gathered during your patient
assessment based on systems, including laboratory and diagnostic assessments.
Subjective Data Entry
A
S
S
E
S
S
M
E
N
T
TIME OUT!
Objective Data Entry
To be sure your patient diagnostic statement written below is accurate, you need to review the
assessment data and determine if it is appropriate and relevant for the diagnostic statement
below. Do you have an accurate match or is additional data required or does another nursing
diagnosis need to be investigated? Have you appropriately categorized the subjective and
objective data? Have you prioritized and clustered your assessment data to formulate the
nursing diagnosis? List at least one (1) actual and one (1) at risk nursing diagnosis for your
patient.
LAST UPDATED: 12/28/2017 KD & SM
1
Nursing Diagnostic
Statement:
Nursing Diagnostic Label:
Related to:
As Evidenced By:
Nursing Diagnostic
Statement:
Nursing Diagnostic Label:
Related to:
As Evidenced By:
TIME OUT!
Expected
Goals/Outcomes:
TIME OUT!
I
N
T
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V
E
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I
O
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The diagnostic label must be NANDA approved and describes the patient’s response to health
conditions. Is there a possibility that the diagnostic label can be misunderstood as a medical
diagnosis? Are the related factors displaying the reason why the patient is exhibiting the
diagnostic label? Are the defining characteristics (“as evidenced by”) show the evidence of the
problem? List two (2) short term goals (STG) for each nursing diagnosis.
Diagnosis A:
STG #1:
STG #2:
Diagnosis B:
STG #1:
STG #2:
The desired outcome must meet criteria to be accurate. The outcome must be specific, realistic,
measurable, and include a time frame for completion. Does the action verb describe the patient’s
behavior to be evaluated? Can the outcome be used in the evaluation step of the nursing process
to measure the patient’s response to the nursing interventions listed below? List at maximum of
three (3) interventions for each goal.
Interventions
Rationale for Selected Intervention Using
A1
Evidence-Based Practice (EBP) references
1.
A1
1.
2.
2.
3.
3.
A2
1.
A2
1.
2.
2.
3.
3.
B1
B1
LAST UPDATED: 12/28/2017 KD & SM
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1.
1.
2.
2.
3.
3.
B2
TIME OUT!
B2
1.
1.
2.
2.
3.
3.
Do your interventions assist in achieving the desired outcome? Do your interventions address
further monitoring of the patient’s response to your interventions and to the achievement of the
desired outcome? Are qualifiers: when, how, amount, time, and frequency used? Is the focus of
the actions of the nurse and not on the patient? Do your rationales provide sufficient reason,
directions, and best evidence-based practice?
Was the desired outcome achieved? Include data and if not, or partially met, what revisions to
either the desired outcome, goals, or interventions would you make?
Yes No Partially met
E
V
A
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Complete this care plan using a minimum of four scholarly resources outside of your textbook and your ATI resources.
These resources must be easily available if requested. Attach a reference list using APA format on a separate sheet of
paper to this document. All resources must be current within the last 3-5 years.
LAST UPDATED: 12/28/2017 KD & SM
3
Here is my login infortmen Homepage – Fa23 ECED 1240-22 Planning & Implementing Curriculum (minnstate.edu)ts. (week 8) Mod 13 “Gross Motor & Outdoors” username Te0077ed, passwordJanuary1, CREATE & SUBMIT the outdoor environment photos activity worksheet to submit for the Gross Motor & Outdoors PPE assignment Find three different photos of outdoor learning or gross motor environments for an infant/toddler 12-24 month age AND three photos for the preschool 4-5’s age. These should not just be photos of items you might use outside but actually show an outdoor learning environment setup. Use any source for your photos! I recommend Google Images. Just make sure they are developmentally appropriate according to what you learn in the module content. Critique what you see, based on your readings and video for this module. You must list page numbers of time of video next to your evidence for each statement. Grading: [15 points total] explained on the worksheet.
Assignment 3: Aesthetic Approach to Health Promotion Intervention Presentation (20 points)
Aesthetic influences and shapes both physical and psychological feelings. Art is a process, a way of approaching life as well as an outcome. A clear link between creativity and healing has been documented. Throughout history, people have used pictures, story, dances, and chants as healing rituals. Holistic approaches to health promotion that include an aesthetic intervention help to create and sustain health. See Chapter 7- Raingruber for guidance on types of Aesthetic approaches to health care.
This assignment gives students the opportunity to be creative and develop a health promotion intervention using creative storytelling, poetry, cartoon, music, photo-voice, art, dance, or other artistic endeavor to influence the health of an individual, community or population. Students will present the health promotion intervention using PowerPointand Kaltura Capture. Please review Chapter 7 in the Raingruber textbook for further resources.
Assignment Criteria:
Students will use an artistic, creative, and/or aesthetic approach to develop health promotion intervention addressing the following:
1. Identify an individual, family, community, or population for a health promotionintervention that could influence healing, disease prevention, health and well-being, physical health, stress reduction, or improve health outcomes.
2. Determine the cultural considerations needed for the health promotion intervention.
3. Design an artistic, creative, and/or aesthetic approach for the health promotion intervention.
4. Discuss the benefits and challenges associated with the implementation of thehealth promotion intervention.
5. Develop one goal or outcome for the health promotion intervention using the SMART format (specific, measurable, achievable/attainable, relevant/realistic, and timeframe).
6. Identify if the health promotion intervention was effective for the selectedindividual, family, community, or population.
7. Explain the role of aesthetic knowledge within the nursing profession when developing a health promotion intervention.
8. Develop a PowerPoint (PPT) presentation in the form of a scholarly presentation.
9. Once the PPT is created, utilize Kaltura Capture to present the PPT. Follow the instructions for using Kaltura Capture located in Canvas under Modules then Kaltura Resources.
10. The PPT presentation should not be more than 10 slides (excluding the title slide and reference slide) and 8-10 minutes in length. Be complete and concise. Use bulleted statements not complete sentences or paragraphs.
11. Use APA format for PPT, which always includes a title slide, a reference slide, and APA requirements. Resources found in APA 7th Edition Help Documents.
12. Include two references for this assignment. References should be from scholarly peer-reviewed journals (check Ulrich’s Periodical Directory) and be less than five (5) years old. Please use APA format on the reference slide and a hanging indent.
Include the following slides:
• Slide 1: Title-develop a title slide. This should include the title of the presentation, student name, and the university name. Use APA format (does not need to be in Times New Roman for a PPT)
• Slide 2: Introduction-Brief overview of the PPT. Use key bulleted points not paragraphs
• Slide 3: Purpose Statement-Develop the purpose statement utilizing the instructions above (use bulleted points)
• Slide 4: Identify an individual, family, community, or population for a health promotion intervention that could influence healing, disease prevention, health and well-being, physical health, stress reduction, or improve health outcomes
• Slide 5: Determine the cultural considerations needed for the health promotion intervention
• Slide 6: Design an artistic, creative, and/or aesthetic approach for the health promotion intervention
• Slide 7: Discuss the benefits and challenges associated with the implementation of the health promotion intervention.
• Slide 8: Develop one goal or outcome for the health promotion intervention using the SMART format
• Slide 9: Identify if the health promotion intervention was effective for the selected individual, family, community, or population
• Slide 10: Explain the role of aesthetic knowledge within the nursing profession when developing a health promotion intervention
• Slide 11: Conclusion-Include a summary of the main points covered. Again, utilize bulleted statements
• Slide 12: References in APA format (please include in-text citations on slides). References should be in APA format with a hanging indent.
Section II: Middle-Range Theories Ready for Application
1) Please choose any nursing theorist that is presented in this course as a group.(Theory of Self-Care of Chronic Illness)
2) Presentation must be 6 slides in total and include audio on all slides.
Address the information below for the PowerPoint Presentation and ensure that you follow the grading rubric below.
Title Slide (Title, You Name, School Name, Course Number and Name, Professor Name, Date)
Introduction of the Nursing Theorist (Select any theorist from this course)
Classification of the theory (Grand Theory, Middle Range, Practice Level, etc.)
References
The paper is to be a five to six (5-6) pages total excluding title page & reference pages (double-spaced, 12 font, 1-inch margins).Follow APA guidelines for a cover sheet, headers, pagination, references, etc.
Unformatted Attachment Preview
Rubric for Collaborative Presentation – In-Class or Online (with Oral Delivery)
Criteria
Presentation/
Content
(Group grade)
Unsatisfactory-Beginning
0-34 points
Presentation content shows a lack of
understanding of the topic. There is
inadequate evidence of research and
insufficient relevant information and
facts. Content is confusing and/or
contains frequent inaccuracies.
Required elements are missing and/or
randomly organized. Sources, if
included, generally lack proper citation
format (APA 7th ed.).
Presentation/
Design
(Group grade)
0-18 points
Slides generally lack visual appeal and
are text-heavy with little or no visuals
and/or exhibit an overuse of color or
animations. Media, (e.g., images), if
used, are rarely cited on each slide. No
theme is evident and the presentation
appears disjointed rather than unified
and/or frequent errors (grammar,
punctuation, spelling, formatting, etc.)
on the slides
Presentation/
Oral Delivery
(Group grade)
0-10 points
Ineffective in delivering the oral
presentation demonstrating below
average/poor communication skills.
Substantially over/under the time limit
to present and/or not all members
presented. Lack of preparation was
evident.
Presentation/
Notes/
Transcript
(Group grade
0-4 points
Presentation lacks “Notes” on slides (or
in a separate document) to explain
each slide and/or, if included, the
notes repeat the text provided on the
slide. Writing demonstrates a below
average/poor writing style with
frequent errors in spelling, grammar,
punctuation, and/or usage.
Developing
35-39 points
Presentation content shows
general understanding of the topic.
There is limited evidence of
research in locating relevant
information and facts and/or
supporting statements made.
Content contains some
inaccuracies, inconsistencies,
misinterpretations, and/or
somewhat unclear. A required
element may be missing and/or
some sources may be improperly
cited (APA 7th ed.).
19 points
Slides generally include a mix of
white space, visuals, and/or text
but not consistently and/or some
overuse or inappropriate use of
color or animations. Theme (e.g.,
template) is not consistently
evident throughout the
presentation and/or some errors
(grammar, punctuation, spelling,
formatting, etc.) on the slides.
Accomplished
40-44 points
Presentation content shows an
adequate understanding of the topic.
Some research effort is evident in
locating relevant information and
facts. Content is mostly accurate and
reasonably organized. May contain
some inconsistencies in content or
some connections made may not be
supported. Required elements are
included and sources are properly
cited (APA 7th ed.) for the most part.
Exemplary
45-50 points
Presentation content shows a
thorough understanding of the
topic. Substantive research effort is
evident in locating relevant
information and facts. Content is
accurate and sequenced in a clear,
logical way. All required elements
are included and sources are
properly cited (APA 7th ed.).
Total
/50
20-22 points
Slides are effectively designed with
visual appeal including white space,
visuals, and minimal text for the most
part. Color and animations are used
appropriately. Theme (e.g., template)
is evident in the presentation for the
most part to produce a cohesive
presentation and/or minor errors
(grammar, punctuation, spelling,
formatting, etc.) on the slides.
/25
11 points
Somewhat effective in delivering
the oral presentation
demonstrating average
communication skills. Slightly
over/under the time limit. Some
members presented more than
others. More preparation was
needed.
5 points
Minimal “Notes” are included in
the presentation slides (or in a
separate document) and/or are
sporadically provided. Writing
demonstrates an average writing
style with some errors in spelling,
grammar, punctuation, and/or
usage.
12-13 points
Effective in delivering the oral
presentation demonstrating good
communication skills and generally
close to the time limit for the group
to present (20 minutes total). All
group members presented and
preparation was evident for the most
part.
7 points
“Notes” are included in the
presentation (or in a separate
document) for the most part to
explain slides as a written transcript.
Writing demonstrates an above
average writing style with little
grammar, punctuation, spelling, and
or usage errors.
23-25 points
Slides are visually well designed,
aesthetically pleasing with
appropriate use of white space,
visuals, and minimal text, on each
slide. Color and animations are used
judiciously. Theme (e.g., template) is
evident throughout to produce a
highly cohesive presentation.
Basically free from errors (grammar,
punctuation, spelling, formatting,
etc.) on the slides.
14-15 points
Highly effective in delivering a wellpolished oral presentation within
the time limit for the group to
present (20 minutes total). All group
members presented equally.
Preparation was strongly evident.
8-10 points
“Notes” are included in the
presentation (or in a separate
document) to fully explain each slide
as a written transcript. Writing
demonstrates a strong writing style
basically free from grammar,
punctuation, spelling, or usage
errors.
/15
/10
Write up 1 Bipolar & Depressive Disorders.Exercise ContentDSM-5-TR Summaries Assignments (SLO#1) (10% of total grade for this paper)The student will have 2 sets of summaries to complete. Each of them will contain a 1-page summary of a category of disorders (one page per category, e.g., in Summary, set 1, one page for Bipolar and Related Disorders, one page for Depressive Disorders, In addition, each category should include the following headings: Overview, age-related factors, differential diagnosis, Disorders Risk, and Prognostic Factors.DSM-5 Assignment Rubric:
Criterion Proficient 20 points Developing proficiency 15 points Unsatisfactory 5 points Score 20 PointsOverview of diagnostic category Clearly describes how this diagnostic category fits in the DSM-5, e.g., Neurodevelopmental, Mood Disorder, etc. and what other subcategories of diagnoses are included and how they differ. Provides general information but seems confused about how the diagnostic category fits in the DSM-5 framework and does not describe some subcategories of diagnosis. Fails to describe how this diagnostic category fits in with the DSM-5 organization. In addition, it fails to tell us what diagnostic subcategories are included and how they differ. Copy and paste from the manual. 20 PointsAge-Related/Developmental Succinctly and accurately notes if there are age criteria for making this diagnosis and if there are specific developmental considerations in how symptoms may be expressed. Addresses age criteria and developmental considerations without clarity or only with reminders. Minimally address age criteria and developmental considerations. 20 PointsDifferential Diagnosis Lists and briefly describes rule-out diagnoses that should be considered. Acknowledges differential diagnosis. However, it does not support specific features. Fails to address differential diagnosis considerations. 20 PointsDisorders Risk and Prognostic Factors. Describes the research findings regarding the course and outcome of the disorder over time. Uses APA 7th Edition to cite and reference the evidence. Minimally describes research/clinical findings regarding course and outcome. Fails to address research/clinical findings about disorder risk and prognostic factors over time. Total
Unformatted Attachment Preview
DSM-5 Write-Up No. 1
Category: Sleep-Wake Disorders
Disorder: Insomnia
Overview
A predominant complaint of dissatisfaction with sleep quantity or quality, associated with
difficulty initiating and maintaining the sleep, characterized by frequent awakenings or problems
returning to sleep after awakenings. Patient refers to early-morning awakening with inability to
return to sleep where the sleep disturbance causes clinically significant distress or impairment in
social, occupational, educational, academic, behavioral, or other important areas of functioning.
The sleep difficulty occurs at least 3 nights per week and not attributable to the physiological
effects of a substance. It can be classified as episodic, recurrent, or permanent (Boland, Verdiun,
& Ruiz, 2021).
Age-Related Factors
Population-based estimates vary. About one-third of adults report insomnia symptoms,
10%–15% experience associated daytime impairments, and 4%–22% have symptoms that meet
criteria for insomnia disorder, with an average of about 10%. Insomnia disorder is the most
prevalent of all sleep disorders. Prevalence rates for psychiatric populations are significantly
higher than those in the general population. Insomnia is a more prevalent complaint among
women than among men, with a gender ratio of about 1.3:1 where the gender ratio rises to 1.7:1
after age 45 (APA, 2022).
Differential Diagnosis
The differential diagnosis of insomnia complaints requires a multidimensional approach,
with consideration of coexisting clinical conditions, which are the rule and not the exception.
The diagnosis of insomnia disorder is given whether it occurs as an independent condition or is
comorbid with another mental disorder, medical condition, or another sleep disorder. Insomnia
may develop its own course with some anxiety and depressive features without those features
meeting criteria for any one mental disorder. Insomnia may also manifest as a clinical feature of
a more predominant mental disorder. Rather, the diagnosis of insomnia disorder is made with
concurrent specification of the comorbid conditions. A concurrent insomnia diagnosis should
only be considered when the insomnia is sufficiently severe to warrant independent clinical
attention; otherwise, no separate diagnosis is necessary. Differential diagnosis include:
•
Narcolepsy
•
Obstructive Sleep Hypopnea and Central Sleep Apneas
•
Sleep-Related Hypoventilation
•
Circadian Rhythm Sleep-Wake Disorders
The symptom of insomnia has been identified as an independent risk factor for suicidal thoughts
and behavior (APA, 2022).
Disorder Risks
Persistent insomnia is a risk factor for depression, anxiety disorders, and alcohol use
disorder and is a common residual symptom after treatment for these conditions. When insomnia
is comorbid with a mental disorder, treatment may need to target both conditions. Given these
different courses, it is often impossible to establish the precis nature of the relationship between
these clinical entities, and this relationship may change over time (Boland, Verdiun, & Ruiz,
2021).
Prognostic Factors
The onset of insomnia symptoms can occur at any time during life, but the first episode is
more common in young adulthood. Less frequently, insomnia begins in childhood or
adolescence. In women, the incidence of new-onset insomnia increases with menopause and may
persist even after other symptoms have resolved. Insomnia may have a late-life onset, which is
often associated with the onset of other health-related conditions (APA, 2022). For some
individuals, perhaps those more vulnerable to sleep disturbances, insomnia may persist long after
the initial triggering event, possibly because of conditioning factors and heightened arousal. The
factors that precipitate insomnia may differ from those that perpetuate it.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders:
DSM-5-Tr. APA Publishing.
Boland, R., Verdiun, M., & Ruiz, P. (2021). Kaplan and Sadock’s synopsis of Psychiatry.
Wolters Kluwer Health.
Ariel,
Anxiety disorders are a type of mental health condition. Anxiety makes it difficult to get
through your day. Symptoms include feelings of nervousness, panic and fear as well as sweating
and a rapid heartbeat. Treatments include medications and cognitive behavioral therapy. The
anxiety disorders differ from one another in the types of objects or situations that induce fear,
anxiety, or avoidance behavior, and the associated cognition (Boland, Verdiun, & Ruiz, 2021).
While the anxiety disorders tend to be highly comorbid with each other, they can be
differentiated by close examination of the types of situations that are feared or avoided and the
content of the associated thoughts or beliefs. Anxiety happens when a part of the brain, the
amygdala, senses trouble. When it senses threat, real or imagined, it surges the body with
hormones, including cortisol and adrenaline to make the body strong, fast and powerful.
The key features of generalized anxiety disorder are persistent and excessive anxiety and
worry about various domains, including work and school performance, that the individual finds
difficult to control. In addition, the individual experiences physical symptoms, including
restlessness or feeling keyed up or on edge; being easily fatigued; difficulty concentrating or
mind going blank; irritability; muscle tension; and sleep disturbance (USDHHS, 2022).
References
Boland, R., Verdiun, M., & Ruiz, P. (2021). Kaplan and Sadock’s synopsis of Psychiatry.
Wolters Kluwer Health.
U.S. Department of Health and Human Services. (2022). Anxiety disorders. National Institute of
Mental Health. Retrieved January 23, 2023, from https://www.nimh.nih.gov/health/topics/
anxiety-disorders
Jean,
Schizophrenia lasts for at least 6 months and includes at least 1 month of active-phase symptoms.
However, psychotic disorders may be induced by substances, medications, toxins, and other
medical conditions. Other specified and unspecified schizophrenia spectrum and other psychotic
disorders are included for classifying psychotic presentations that do not meet the criteria for any
of the specific psychotic disorders (USDHHS, 2022).
Schizophrenia may result in some combination of hallucinations, delusions, and extremely
disordered thinking and behavior that impairs daily functioning, and can be disabling. People
with schizophrenia require lifelong treatment. A wide variety of mental disorders and medical
conditions can manifest with psychotic symptoms that must be considered in the differential
diagnosis of schizophreniform disorder (Bhandari, 2022).
Incidence of schizophreniform disorder across sociocultural settings is likely similar to that
observed in schizophrenia. In the United States and other high-income countries, the incidence is
low, possibly fivefold less than that of schizophrenia. In lower-income countries, the incidence
may be higher, especially for the specifier with good prognostic features; in some of these
settings schizophreniform disorder may be as common as schizophrenia.
References
Bhandari, S. (2022). Schizophrenia: Definition, symptoms, causes, diagnosis, treatment.
WebMD. Retrieved January 23, 2023, from https://www.webmd.com/schizophrenia/mentalhealth-schizophrenia
U.S. Department of Health and Human Services. (2022). Schizophrenia. National Institute of
Mental Health. Retrieved from https://www.nimh.nih.gov/health/topics/schizophrenia#
part_2274
Before beginning work on this assignment, please review the expanded grading rubric for specific instructions relating to content and formatting.
From the Internet, read the following:
Cohn, D. (2007, May 17). The growing global chronic disease epidemic. Retrieved from: http://www.prb.org/Publications/Articles/2007/Grow…
Georgetown University Health Policy Institute. (2004). Cultural competence in health care: Is it important for people with chronic conditions? Retrieved from https://hpi.georgetown.edu/agingsociety/pubhtml/cu…
Putsch, R., & Joyce, M. (n.d.). Dealing with Patients from Other Cultures: Methodology in Cross-cultural Care. 229, 1050–1065. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK340/pdf/Book…
Roush, S. (2011). Chapter 19: Enhancing surveillance. In VPD surveillance manual (5th ed.). Retrieved from https://www.cdc.gov/vaccines/pubs/surv-manual/chpt…
This week, we discussed the growing social diversity in the United States and the resultant barriers to care. Use the information presented in the readings and identify three of the most pressing issues, which, if addressed, might have the greatest impact upon healthcare delivery. In your approach, you can elect to identify an issue specific to a local hospital catchment area. Taking this approach, include the regional demographics, the problem, the issues of diversity differences within the healthcare workforce, and your approach to an effective solution. In your narrative, also discuss whether the efforts would be effective in addressing the problem and improving the health outcomes.
To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Submission Details:
Submit this topic as a 2- to 3-page Microsoft Word document. Use APA standards for citations and references.
Cite a minimum of three outside peer-reviewed sources to support your assertions and save it as SU_HCM3046_W3_Project_LastName_FirstName. Submit the document to the Submissions Area by the due date assigned.
Cite any sources using correct APA format on a separate page.
Consider the following practice situation and the ethical issues present in the situation. Construct a 3-page reflection discussing the ethical concerns (citing the NASW Code of Ethics specific areas which apply), the steps you would take in ethical decision making, and the decision you would make in addressing each of the ethical concerns:
Jan is the 16-year-old daughter in a family you have been seeing for family therapy for the past 3 months. Her parents drop her off for the regular family therapy scheduled appointment and say that “Jan wanted to meet with you alone today” as an explanation for the change in plan. Once in your office, Jan begins to cry and tells you that she just found out she is pregnant and that she plans to leave home so she will not bring shame to her family. She informs you that she has not told her parents about this and wants you to promise to protect her privacy and not share any of this information with her parents.
When citing the two conflicting ethical areas from the Code of Ethics (nasw.org), you must cite each and discuss their relevance to the practice scenario. You must then fully discuss your decision-making process in determining to which ethical area you are most professionally bound, and the action you would take with the client scenario based on that determination. Remember that you must include any cited sources, including the Code of Ethics, on a reference page at the end of your reflective essay.
instructor comment: Please see the comments and questions in the body of the paper. You identified the ethical areas, however, some of the information in the paper was unclear.
This week, a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client reports that his family doctor sent him for psychiatric assessment because the doctor felt that the pain was “all in his head.” He further reports that his physician believes he is just making stuff up to get “narcotics to get high.”
SUBJECTIVE
The client reports that his pain began about 7 years ago when he sustained a fall at work. He states that he landed on his right hip. Over the years, he has had numerous diagnostic tests done (x-rays, CT scans, and MRIs). He reports that about 4 years ago, it was discovered that the cartilage surrounding his right hip joint was 75% torn (from the 3 o’clock to 12 o’clock position). He reports that none of the surgeons he saw would operate because they felt him too young for a total hip replacement and believed that the tissue would repair with the passage of time. Since then, he reported development of a strange constellation of symptoms including cooling of the extremity (measured by electromyogram). He also reports that he experiences severe cramping of the extremity. He reports that one of the neurologists diagnosed him with complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD). However, the neurologist referred him back to his family doctor for treatment of this condition. He reports that his family doctor said “there is no such thing as RSD, it comes from depression” and this was what prompted the referral to psychiatry. He reports that one specialist he saw a few years ago suggested that he use a wheelchair, to which the client states “I said ‘no,’ there is no need for a wheelchair, I can beat this!”
The client reports that he used to be a machinist where he made “pretty good money.” He was engaged to be married, but his fiancé got “sick and tired of putting up with me and my pain, she thought I was just turning into a junkie.”
He reports that he does get “down in the dumps” from time to time when he sees how his life has turned out, but emphatically denies depression. He states “you can’t let yourself get depressed… you can drive yourself crazy if you do. I’m not really sure what’s wrong with me, but I know I can beat it.”
During the client interview, the client states “oh! It’s happening, let me show you!” this prompts him to stand with the assistance of the corner of your desk, he pulls off his shoe and shows you his right leg. His leg is turning purple from the knee down, and his foot is clearly in a visible cramp as the toes are curled inward and his foot looks like it is folding in on itself. “It will last about a minute or two, then it will let up” he reports. Sure enough, after about two minutes, the color begins to return and the cramping in the foot/toes appears to be releasing. The client states “if there is anything you can do to help me with this pain, I would really appreciate it.” He does report that his family doctor has been giving him hydrocodone, but he states that he uses is “sparingly” because he does not like the side effects of feeling “sleepy” and constipation. He also reports that the medication makes him “loopy” and doesn’t really do anything for the pain.
MENTAL STATUS EXAM
The client is alert, oriented to person, place, time, and event. He is dressed appropriately for the weather and time of year. He makes good eye contact. Speech is clear, coherent, goal directed, and spontaneous. His self-reported mood is euthymic. Affect consistent, to self-reported mood and content of conversation. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes appreciated. Judgment, insight, and reality contact are all intact. He denies suicidal/homicidal ideation and is future oriented.
Savella 12.5 mg orally once daily on day 1; followed by 12.5 mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter.
Amitriptyline 25 mg po QHS and titrate upward weekly by 25 mg to a max dose of 200 mg per day.
Neurontin 300 mg po BEDTIME with weekly increases of 300 mg per day to a max of 2400 mg if needed.
Answer is B
RESULTS OF DECISION POINT ONE
Client returns to clinic in four weeks.
Client comes to the office still using crutches. He states that the pain has improved but he is a bit groggy in the morning.
Client’s pain level is currently a 6 out of 10. You question the client on what would be an acceptable pain level. He states, “I would rather have no pain but don’t think that is possible. I could live with a pain level of 3.” He states that his pain level normally hovers around a 9 out of 10 on most days of the week before the amitriptyline was started. You ask what makes the pain on a scale of 1-10 different when comparing a level of 9 to his current level of 6?” The client states, “I’m able to go to the bathroom or to the kitchen without using my crutches all the time. The achiness is less and my toes do not curl as often as they did before.” The client is also asked what would need to happen to get his pain from a current level of 6 to an acceptable level of 3. He states, “Well, that is kind of hard to answer. I guess I would like the achiness and throbbing in my right leg to not happen every day or at least not several times a day. I also could do without my toes curling in like they do. That really hurts.”
Client denies suicidal/homicidal ideation and is still future oriented.
Decision Point Two
Select what you should do next:
Continue current medication and increase dose to 125 mg at BEDTIME this week continuing towards the goal dose of 200 mg daily. Instruct the client to take the medication an hour earlier than normal starting tonight and call the office in 3 days to report how his function is in the morning.
Reduce the dose of Elavil to 75 mg at BEDTIME (dose has been titrated at weekly intervals by 25mg per week). Add on Biofreeze roll-on therapy to his right leg below the knee and into the foot and toes to be used as needed daily for muscle cramping
Reduce dose of amitriptyline Elavil to 75 mg po orally at BEDTIME and add- on Neurontin (gabapentin) 300 mg po orally at BEDTIME. Schedule a Ffollow-up phone call in 1 week to assess pain control.
Answer is A
RESULTS OF DECISION POINT TWO
Client returns to clinic in four weeks
The change in administration time seemed to help. The client states he is not as groggy in the morning and is able to start his day sooner than before
Client’s current pain level is a 4 out of 10. He states that he is now taking 125 mg of amitriptyline at bedtime.
Client’s has noticed that he is putting on a little weight. When asked, the client states that he has gained 5 pounds since he started taking this medication. He currently weighs in at 162 pounds. He is 5’ 7”. He states that his right leg doesn’t bother him nearly as much as it used to and his toes have only “cramped up” twice in the past month. He states that he is able to get around his apartment without his crutches and that he has even started seeing someone he met at the grocery store. The weight gain seems to bother him a lot and he is asking if there is a way to avoid it
Decision Point Three
Select what you should do next:
Continue with the Elavil at his current 125 mg a day dose and start Qsymia (phentermine and topiramate) 3.75 mg/23 mg tablet once daily and titrate as required by package insert
Reduce the dose of Elavil to 100 mg a day and follow up in a month
Continue the current dose of Elavil of 125 mg per day, refer the client to a life coach who can counsel him Guidance to Student
Answer is C
At this point, the client is almost at his goal pain control and increased functionality. Weight gain is a common side effect with amitriptyline and should be a counseling point at the initiation of therapy. He has a small weight gain of 5 pounds in 8 weeks. A reduction in dose may have an effect on the weight gain but at a considerable cost of pain to the client. This would not be in the best interest of the client at this point. Amitriptyline has a side effect of cardiac arrhythmias. He is not experiencing this at this point. The drug, Qsymia contains a product called phentermine which has a history of causing cardiac arrhythmias at higher doses. This product is also only approved for a client with obesity defined as a BMI greater than 30 kg/m2. Your client’s BMI is currently 25.5 kg/m2. He does not meet the definition of obesity but is considered overweight. His best course of action would be to continue the same dose of Elavil, counsel him on good dietary and exercise habits and connect him with a life coach who will help him with this problem in a more meaningful way than a 10 minute counseling session will be able to accomplish.
Assignment
Write a 2- to 2.5-page summary paper that addresses the following:
Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.
Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.
write a maximum of 3 double spaced typed pages, notincluding title page and references. APA style Your paper is not a summary of the article. You must include your own ideas and thefollowing information in your paper.1. Introduction: Must include a description and background of the topic and purpose of your paper.2. Explain why this is an important topic in nursing. How has it impacted the profession?3. What are some suggestions made in the article to address this issue?4. Explain what you believe is a good solution to address this issue and why?5. Conclusions: An overall analysis of the significance of your findings. Not just a summayonly from the article I attched
Read the article and then respond to the following prompts in a word document.Comment on the reliability and sample methods used in the article.Were the sampling methods appropriate for the populations they were trying to assess?Was reliability and validity addressed?If reliability and validity were not expressly addressed, do you believe their study had good reliability and validity? Be sure to address different kinds of validity and reliability.
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O R I G I N A L A RT I C L E
Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes
Steven P. Marso, M.D., Gilbert H. Daniels, M.D., Kirstine Brown-Frandsen, M.D., Peter Kristensen, M.D.,
E.M.B.A., Johannes F.E. Mann, M.D., Michael A. Nauck, M.D., Steven E. Nissen, M.D., Stuart Pocock, Ph.D.,
Neil R. Poulter, F.Med.Sci., Lasse S. Ravn, M.D., Ph.D., William M. Steinberg, M.D., Mette Stockner, M.D.,
Bernard Zinman, M.D., Richard M. Bergenstal, M.D., and John B. Buse, M.D., Ph.D.et al., for the LEADER
Steering Committee on behalf of the LEADER Trial Investigators*
July 28, 2016
N Engl J Med 2016; 375:311-322
DOI: 10.1056/NEJMoa1603827
Article
Figures/Media
Metrics
27 References
4380 Citing Articles
Letters
7 Comments
Related Articles
Abstract
B A C KG R O U N D
The cardiovascular effect of liraglutide, a glucagon-like peptide 1 analogue, when added to standard care in
patients with type 2 diabetes, remains unknown.
METHODS
In this double-blind trial, we randomly assigned patients with type 2 diabetes and high cardiovascular risk to
receive liraglutide or placebo. The primary composite outcome in the time-to-event analysis was the first
occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The primary
hypothesis was that liraglutide would be noninferior to placebo with regard to the primary outcome, with a
margin of 1.30 for the upper boundary of the 95% confidence interval of the hazard ratio. No adjustments for
multiplicity were performed for the prespecified exploratory outcomes.
R E S U LT S
A total of 9340 patients underwent randomization. The median follow-up was 3.8 years. The primary outcome
occurred in significantly fewer patients in the liraglutide group (608 of 4668 patients [13.0%]) than in the
placebo group (694 of 4672 [14.9%]) (hazard ratio, 0.87; 95% confidence interval [CI], 0.78 to 0.97; P
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make sure to include the questions, answer in great detail, specifics and elaborate on your response. This should be a lengthy response that should include a open ended response, that gives an indepth point of view as well as your personal opinion on the matter.14. Explain how to fit crutches properly.
Social Determinants of Health Interview Assignment
The purpose of the Social Determinants of Health assignment is to provide you an opportunity to conduct an interview with a family member or friend to explore their social determinants of health. You will focus on are those influences that can affect a person’s health status, functioning, quality of life and risks. As you explore social determinants of health, consider upstream, population, and health care system factors that affect the health of an individual. For example, some factors to consider that influence an individual are what you are born with, your experiences, age, how you live, learn, work, play, and worship. By conducting an interview, you will get firsthand information about how social determinants of health affects your family member or friend.
Student Learning Outcomes:
2. Foster human flourishing through the delivery of holistic, ethical, developmentally appropriate, person-centered care that extends compassion to those in need.
3. Apply knowledge of health promotion strategies to promote the delivery of just and equitable care that reflects cultural humility, inclusivity, consideration of social determinants of health, and advocacy.
4. Utilize a spirit of inquiry that seeks to improve health outcomes using evidence-base care as the foundation of nursing practice.
Course Objective:
Apply concepts of population health to reduce health disparities and improve health outcomes of communities.
Utilize the principles of servant leadership, and the Catholic Health Ministry to promote culturally sensitive nursing care of vulnerable populationsInstructions
Review all the instructions below and the Blackboard rubric for the assignment.
Select and schedule an appointment with an individual that you would like to interview for thisproject. This individual can be a family member or friend.
3. Prepare for your interview by reading the Utilizing Fawcett’s model (Nursing Outlook article, 2015) and reviewing the course learnings on social determinants of health. The Fawcett’s article is a great resource to help you write your interview questions. See the direct link below to read the article by Fawcett & Ellenbecker (2015) which describes a conceptual model at the intersection of nursing and population health
Direct link: A Proposed Conceptual Model of Nursing and Population Health
4. The interview should focus on the following factors as outlined in the Fawcett’s article:
Upstream factors
Socioeconomic environment
ii. Physical environment
Population factors
Genetic factors
Behavioral factors
Physiological factors
Resilience
Health State
Health care system factors
Providers
Organizations and institutions
1. Department of health 2. Hospitals
Inpatient and outpatient clinics
Community health centers
Home health care agencies
Payers
Policies
Conduct the interview and take notes. Schedule a time immediately following the interview toreview your notes to ensure that your notes are complete.
Write a 2-4-page APA formatted paper that integrates knowledge of Fawcett’s model with theinformation from the interview and present it in a professional manner.
Your paper should cover the social determinants as outlined in the Fawcett’s article.
Write your paper from a professional viewpoint.
The paper should include the following: Cover page (no abstract)
Introduction
Body with Headers
Conclusion that reveals the synthesis of the information presented
Use of in-text citation Reference page which includes the citation of the FawcettModel
Be sure to read the APA requirements at the end of this instruction sheet.
Submit your paper in blackboard under the Assignment tab on the left-hand side of the course page.
APA Requirements:
This paper should be written in APA format.
First person is acceptable in this paper
Level 1 headers must be used to label the content sections
No abstract required
Use direct quotes sparingly, if at all.
The paper should include: title page with honor code, instructor name and date; no more than 2-4 pages ofcontent; reference page
Please take note of your Safe Assign report. Remember, you can submit a draft early to review your SafeAssign feedback before submitting a final draft.See Blackboard for grading rubric.
Unformatted Attachment Preview
Social Determinants of Health Interview Assignment
Purpose
The purpose of the Social Determinants of Health assignment is to provide you an opportunity to
conduct an interview with a family member or friend to explore their social determinants of health. You
will focus on are those influences that can affect a person’s health status, functioning, quality of life and
risks. As you explore social determinants of health, consider upstream, population, and health care
system factors that affect the health of an individual. For example, some factors to consider that
influence an individual are what you are born with, your experiences, age, how you live, learn, work,
play, and worship. By conducting an interview, you will get firsthand information about how social
determinants of health affects your family member or friend.
Student Learning Outcomes:
2. Foster human flourishing through the delivery of holistic, ethical, developmentally appropriate,
person-centered care that extends compassion to those in need.
3. Apply knowledge of health promotion strategies to promote the delivery of just and equitable care
that reflects cultural humility, inclusivity, consideration of social determinants of health, and advocacy.
4. Utilize a spirit of inquiry that seeks to improve health outcomes using evidence-base care as the
foundation of nursing practice.
Course Objective:
Apply concepts of population health to reduce health disparities and improve health outcomes
of communities.
Utilize the principles of servant leadership, and the Catholic Health Ministry to promote
culturally sensitive nursing care of vulnerable populations
Instructions
1. Review all the instructions below and the Blackboard rubric for the assignment.
2. Select and schedule an appointment with an individual that you would like to interview for this
project. This individual can be a family member or friend.
3. Prepare for your interview by reading the Utilizing Fawcett’s model (Nursing Outlook article,
2015) and reviewing the course learnings on social determinants of health. The Fawcett’s article
is a great resource to help you write your interview questions. See the direct link below to read
the article by Fawcett & Ellenbecker (2015) which describes a conceptual model at the intersection of
nursing and population health
Direct link: A Proposed Conceptual Model of Nursing and Population Health
4. The interview should focus on the following factors as outlined in the Fawcett’s article:
a. Upstream factors
i. Socioeconomic environment
ii. ii. Physical environment
b. Population factors
i. Genetic factors
ii. Behavioral factors
iii. Physiological factors
iv. Resilience
v. Health State
c. Health care system factors
i. Providers
ii. Organizations and institutions
1. Department of health
2. Hospitals
3. Inpatient and outpatient clinics
4. Community health centers
5. Home health care agencies
iii. Payers
iv. Policies
5. Conduct the interview and take notes. Schedule a time immediately following the interview to
review your notes to ensure that your notes are complete.
6. Write a 2-4-page APA formatted paper that integrates knowledge of Fawcett’s model with the
information from the interview and present it in a professional manner.
a. Your paper should cover the social determinants as outlined in the Fawcett’s article.
b. Write your paper from a professional viewpoint.
c. The paper should include the following:
Cover page (no abstract)
Introduction
Body with Headers
Conclusion that reveals the synthesis of the information presented
Use of in-text citation Reference page which includes the citation of the Fawcett
Model
d. Be sure to read the APA requirements at the end of this instruction sheet.
7. Submit your paper in blackboard under the Assignment tab on the left-hand side of the course
page.
APA Requirements:
This paper should be written in APA format.
First person is acceptable in this paper
Level 1 headers must be used to label the content sections
No abstract required
Use direct quotes sparingly, if at all.
The paper should include: title page with honor code, instructor name and date; no more than 2-4 pages of
content; reference page
Please take note of your Safe Assign report. Remember, you can submit a draft early to review your Safe
Assign feedback before submitting a final draft.
See Blackboard for grading rubric.
Available online at www.sciencedirect.com
Nurs Outlook 63 (2015) 288e298
www.nursingoutlook.org
A proposed conceptual model of nursing
and population health
Jacqueline Fawcett, PhD, RN, FAAN*, Carol Hall Ellenbecker, PhD, RN
Department of Nursing, University of Massachusetts Boston, Boston, MA
article info
abstract
Article history:
Received 29 August 2014
Revised 17 December 2014
Accepted 5 January 2015
Available online 19 February
2015
Objective: To describe a Conceptual Model of Nursing and Population Health about
Keywords:
Population health
Nursing
Conceptual model
the intersection of nursing and population health.
Methods: Review of literature and derivation of a new conceptual model.
Results: The conceptual model concepts are upstream factors, population factors,
health care system factors, nursing activities, and population health outcomes.
Nursing activities mediate the indirect relations of upstream, population, and
health care system factors with population health outcomes; in addition, health
care system factors and nursing activities are directly related to population
health outcomes. Implications for research methods, revisions in all levels of
nursing education, and population-focused advances in nursing practice are
identified.
Conclusion: The strength of the model is its emphasis on attainment of the highest
possible quality of life for populations, by means of nursing activities directed to
promote or restore and maintain wellness across the life course and to prevent
disease.
Cite this article: Fawcett, J., & Ellenbecker, C. H. (2015, JUNE). A proposed conceptual model of nursing
and population health. Nursing Outlook, 63(3), 288-298. http://dx.doi.org/10.1016/j.outlook.2015.01.009.
The increasing global recognition of many common
disease conditions requires population-level rather
than individual-level solutions. The purpose of this
article was to challenge nurses to shift their thinking
from individual health to the health of populations by
providing a comprehensive understanding of what
population health is; discussing the role nursing plays
in improving the health of populations; describing the
Conceptual Model of Nursing and Population Health
(CMNPH); and identifying implications for population
health research methods, nursing education, and
nursing practice. The conceptual model is based on
our understanding of the meaning and methods of
population health and is intended to advance contributions of the discipline of nursing to population
health.
Rationale for a CMNPH
Conceptual models are made up of a set of abstract
and general concepts and propositions that describe
the concepts and explain relations among concepts.
Their value lies in offering a systematic way of
understanding phenomena, guiding action, and
providing a framework for derivation of the relatively
specific and concrete concepts and propositions of
middle-range and situation-specific theories (Bigbee &
Issel, 2012; Fawcett & DeSanto-Madeya, 2013). The
particular value of a CMNPH is its guidance for nursing
research and nursing practice that comes from
an enhanced understanding of population health
phenomena.
* Corresponding author: Jacqueline Fawcett, Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125-3393.
E-mail address: jacqueline.fawcett@umb.edu (J. Fawcett).
0029-6554/$ – see front matter Ó 2015 Elsevier Inc. All rights reserved.
http://dx.doi.org/10.1016/j.outlook.2015.01.009
Nurs Outlook 63 (2015) 288e298
In recent years, many health care experts have
called for a shift in thinking about health care from an
emphasis on individual disease conditions to
population-level disease prevention and wellness
promotion. This paradigm shift is caused by the widely
recognized failure of the U.S. health care system,
which spends approximately 75% of its health care
resources on curing disease and expensive hospitalizations and very little on disease prevention (American
Public Health Association, 2012). Although the U.S.
spends more on health care than any other nation, the
outcomes are not as good as those of most highincome nations. A comparison of health indicators
from the U.S. with those from 16 other peer countries
revealed that Americans on average have shorter lives
and have higher rates of disease and injury than people
in other high-income countries (Institute of Medicine
[IOM], 2013). Specifically, people of all age groups and
socioeconomic levels residing in the U.S. fare worse
than people residing in other peer countries in rates of
infant mortality, infants of low birth weight for gestational age, injuries, homicides, adolescent pregnancy,
sexually transmitted infections including but not
limited to HIV and AIDS, drug-related deaths, obesity,
diabetes, heart disease, chronic lung disease, and disabilities. In 2013, the U.S. ranked 17th in life expectancy
at birth among 17 other high-income nations (IOM,
2013).
According to the IOM (2013), “the U.S. health disadvantage has multiple causes and involves some combination of inadequate health care, unhealthy
behaviors, adverse economic and social conditions,
and environmental factors, as well as public policies
and social values that shape those conditions” (p. 3).
Improving the health of the nation’s population by
addressing system failures and factors that lead to
these failures requires a shift in thinking from individually based disease care to population health care.
Nurses, who comprise the largest group of health care
providers in the U.S. health care system (American
Association of Colleges of Nursing, 2011), are partially
responsible for the poor health of the population
because of a traditionally narrow focus on individuals
and diseases. As Bekemeier (2008) pointed out, nurses’
participation in the current individual-centered health
care system is a tacit agreement to improve “the health
of the few” people they serve while at the same time
participate, albeit with the best intentions, in “the
illness and death of many” (p. 51). However, with a
history of population-focused community and public
health nursing practice (Buhler-Wilkerson, 1989; Dock
& Stewart, 1938; Radzyminski, 2007; Skretkowicz,
2010), nurses are in an ideal position to shift thinking
and participate in and lead teams of health care providers, policy makers, and the lay public committed to
a strong focus on population health. Furthermore,
although the basic idea of population health is part of
nursing’s history, attention to population heath is
especially important as health issues become more
obviously global.
289
The contemporary interest in the population level of
nursing care was the catalyst for the addition of a
population health track in the PhD nursing program at
the University of Massachusetts Boston. Since its
inception, faculty and students have been continuously challenged to better understand the meaning of
population health, to identify appropriate research
methods for the study of population health phenomena, and to differentiate population health nursing
research from clinical nursing research. The proposed
CMNPH is one way to begin to overcome these
challenges.
Population Health Defined
“Population health,” according to Radzyminski (2007),
“has been a framework for providing health care since
the time of Hippocrates” (p. 37). The term population
health entered the modern policy and health care vocabulary during the past 2 or 3 decades (Batchelor,
2012) with an increase in citations in the mid-1990s
(Tricco, Runnels, Sampson, & Bouchard, 2008).
Although population health is a widely used term
across many disciplines, there is considerable confusion about what the term actually means and how the
discipline of nursing uses the term. Young (1998)
pointed out that the literal meaning of population
health is the health of populations. Some other definitions of population health focus on what it is not and
how it is distinguished from epidemiology, public
health, and community health rather than what it is.
Other definitions are more specific to what population
health is. Other elements of definitions of what population health is found in the literature are populations
defined by geography or common characteristics, a
focus on health outcomes for entire groups rather than
individuals, and determinants of health.
Population Health Defined by Distinctions
Batchelor (2012) linked population health with the
evolution of epidemiology. He contended “that the
concept of population health and its use in helping
understand health and disease is simply part of the
natural evolution of the science of epidemiology”
(p. 12). Baisch (2009) also linked population health with
epidemiology, explaining that population health is
typically used within the context of epidemiology and
addresses “broad determinants of health for populations” (p. 2469). Kindig and Stoddart (2003) asserted
that the focus of epidemiology is not sufficiently broad
and does not account for the various interactions between determinants of health outcomes.
Stoto (2013) drew distinctions between public health
and population health by contrasting the involvement
of governmental agencies, as did Radzyminski (2007).
Stoto (2013) explained, “First, [population health] is less
directly tied to governmental health departments [than
290
Nurs Outlook 63 (2015) 288e298
public health]. Second, [population health] explicitly
includes the health care delivery system, which is
sometimes seen as separate from or even in opposition
to governmental public health” (p. 2). Radzyminski
(2007) noted that public health focuses on “the relationship between the state and the health and welfare
of its citizens” (p. 40). Issel and Bekemeier (2010) placed
public health nursing within the context of organizations and governmental agency departments. Kindig
and Stoddart (2003) maintained that at least some determinants of health outcomes, such as income, education, and medical care, are beyond the scope of the
authority and responsibility of public health.
Baisch (2009) pointed out that the attributes of
population health overlap with the attributes of community health. Radzyminski (2007) acknowledged
overlaps but commented that although community
health focuses within the boundaries of a relatively
broad view of the community, population health is
boundaryless other than the boundaries of a specific
aggregate of interest.
Perhaps a major distinction between population
health and public health and community health is the
focus of public health on the development and
implementation of governmental policies, whereas
community health focuses on specific communities at
the grass roots level and population health is a
broader focus on the population of a nation- or
worldwide population experiencing a particular health
condition, such as cardiovascular disease or
tuberculosis.
Population Health Defined by Geography or Common
Characteristics
Populations typically are geopolitical nations, communities, and other geographic regions. Populations
also may be groups of employees, ethnic groups, persons with disabilities, groups of persons with particular disease characteristics, prisoners, or other groups
(Adler, Bachrach, Daley, & Frisco, 2013; Kindig &
Stoddart, 2003; Mason, 2014). Members of health care
systems, especially, may think of populations as
groups of patients (Adler et al., 2013).
Population Heath Defined by Outcomes
Kindig and Stoddart (2003) defined population health
as outcomes. Stoto (2013) pointed out that the use of
the term outcomes emphasizes “the implicit goal of
improving health outcomes” (p. 2). Sen (2002) used the
term health achievements, which emphasizes comparisons of what populations are able to be and do to
determine equity in achievement and distribution of
health gains rather than outcomes.
Population Health Defined by Determinants
A hallmark of population health, according to Kindig
and Stoddart (2003), is the patterns of determinants
of health outcomes and the interactions between these
determinants. They identified several determinants,
including “medical care, public health interventions,
aspects of the social environment (income, education,
employment, social support, culture) and of the physical environment (urban design, clean air and water),
genetics, and individual behavior” (p. 381). Bekemeier
(2008) noted that many experts across disciplines
are calling for a focus on upstream conditions (i.e., a
root cause approach that emphasizes the causes of
disease and disability in a population). The upstream
approach includes understanding of socioeconomic
determinants of wellness and illness as well as barriers
to attaining high-level wellness and access to health
care services.
The Conceptual Model
Young (1998) maintained that population health,
especially in Canada and the United Kingdom, connotes a “conceptual framework for thinking about why
some populations are healthier than others as well as
policy development, research agenda, and resource
allocation” (p. 4). The CMNPH emphasizes the intersection of nursing and population health. The CMNPH
draws primarily from the Institute for Health Care
Improvement (IHI) Population Health Model (Stiefel &
Nolan, 2012; Stoto, 2013), which was based on earlier
work by Evans and Stoddart (1990). Although those
models emphasized medicine as the driving force for
population health outcomes, the CMNPH underscores
the centrality of nursing while viewing medicine and
other health care providers as important but not central in this model.
The primary focus of the CMNPH is attainment of
the highest possible quality of life for aggregates of
people by means of nursing activities directed to promote or restore and maintain wellness and to prevent
disease, thus making it relevant to both the improvement of population health and the practice of nursing.
For the purposes of the CMNPH, population health is
defined as life span wellness and disease experiences of
aggregate groups of people residing in local, state, national,
or international geographic regions or those populations with
common characteristics. Population health includes aspects
of public health, health care delivery systems, and determinants of wellness and illness, emphasizing promotion,
restoration, and maintenance of wellness and prevention of
disease.
Conceptual Model Concepts
The concepts of population health are “more than the
sum of individual parts of a cross-sectional perspective . [and inclusion of] a broader array of the [social]
determinants of health than is typical in either health
care or public health” (Stoto, 2013, p. 2-3). The CMNPH
concepts encompass four social determinants of
Nurs Outlook 63 (2015) 288e298
population health outcomesdupstream factors, population factors, health care system factors, and
nursing activitiesdas well as the concept of population health outcomes. Each of these concepts is
multidimensional.
The dimensions of upstream factors are socioeconomic factors and physical environment. The dimensions of population factors are genetic factors,
behavioral factors, physiologic factors, resilience, and
health state. The CMNPH views the dimensions of genetic factors, behavioral factors, physiologic factors,
resilience, and health state at the population level,
whereas the IHI model (Stiefel & Nolan, 2012; Stoto,
2013) and the Evans and Stoddart (1990) model view
these dimensions at the level of the individual, which
obviously loses the population-level focus.
The dimensions of health care system factors are
providers, organizations and institutions, payers, and
policies. The dimensions of nursing activities are
population-based nursing practice processes and
culturally appropriate wellness promotion, restoration,
maintenance, and disease prevention. The dimensions
of population health outcomes are population-level
wellness, population-level disease burden, populationlevel functional status, population-level life expectancy, population-level mortality, and population-level
quality of life.
Conceptual Model Propositions
The nonrelational propositions of the CMNPH, which
are the definitions for each concept and its dimensions,
are provided in Table 1.
The relational propositions of the CMNPH, which
link the concepts, are as follows and are illustrated in
Figure 1:
1. Upstream factors, population health factors, and
health care system factors are interrelated.
2. Upstream factors, population factors, and health
care system factors are related to nursing activities.
3. Health care system factors are related to population health outcomes.
4. Nursing activities mediate the relations of upstream factors, population factors, and health care
system factors to population health outcomes.
5. Nursing activities are related to population health
outcomes.
Discussion
Limitations of the CMNPH
The CMNPH, like all conceptual models, is made up of
abstract and general concepts and propositions that
are too abstract and general to be directly tested.
Instead, a conceptual model is a guide or basis for
generating new theories and testing existing theories
291
by means of empirical research (Bigbee & Issel, 2012;
Fawcett & DeSanto-Madeya, 2013). Furthermore, the
development of the CMNPH is based on literature primarily from the U.S. and Canada. The extent to which
the model is relevant for use in other countries remains to be determined.
Implications for Nursing Research
The primary purpose of nursing research is to expand
knowledge through generation and testing of theories
that provide the evidence for effective nursing activities including assessments and interventions as well
as measurement of outcomes (Fawcett & Garity, 2009).
The purpose of CMNPH-guided nursing research is to
advance knowledge of population health phenomena
by linking concepts and propositions of the model with
more specific and concrete concepts (research variables) and propositions (hypotheses) of descriptive,
explanatory, and predictive theories (Bigbee & Issel,
2012; Fawcett & Garity, 2009).
The trajectory of population-based nursing
research begins with baseline descriptions of theory
concepts representing upstream factors, population
factors, health care system factors, and current population health outcomes. (See Table 1 for nonrelational propositions of these CMNPH concepts and
their dimensions.) The research can be conducted
with various qualitative, quantitative, and mixed
methods research designs (Stoto, 2013). Concept
analysis techniques can be used to articulate a more
comprehensive definition of each concept of the
CMNPH (Table 1). Qualitative descriptive research designs can be used to enhance understanding of the
meaning of each concept to a particular population.
Quantitative descriptive research designs, including
instrument development studies and status surveys,
can be used to develop or refine instruments to measure theory concepts representing each CMNPH
concept and its dimensions. Realist reviews of literature, which focus on the feasibility of implementing
specific nursing activities in real-life settings, also are
needed (Pawson, Greenhalgh, Harvey, & Walshe,
2005).
Research progresses to the examination of relations
among theory concepts that are linked with upstream
factors, population factors, and health care system
factors (CMNPH relational proposition 1) and the root
causes of population health outcomes (CMNPH relational propositions 2, 3, 4, and 5) using correlational
and mixed methods designs that may be conducted by
means of secondary analyses of large data sets
(Patterson, 2014; Zeni & Kogan, 2007) using structural
equation modeling statistics. Correlational designs
using regression methods, such as path analysis, can
be used to test the mediating role of specific nursing
activities (CMNPH relational proposition 4; Kenny,
2012). Research then progresses to tests of the effectiveness of theory concepts linked with health care
system factors and specific nursing activities (CMNPH
292
Nurs Outlook 63 (2015) 288e298
Table 1 e Concepts of the Conceptual Model of Nursing and Population Health and Their Definitions
Concepts and
Concept Dimensions
Upstream factors
Socioeconomic environment
Physical environment
Population factors
Genetic factors
Behavioral factors
Physiological factors
Resilience
Health state
Health care system factors
Providers
Organizations and institutions
Departments of public health
Hospitals
Inpatient and outpatient clinics
Community health centers
Home health care agencies
Payers
Policies
Nursing activities
Definitions
Social determinants of health encompassing socioeconomic environment
and physical environment, which directly influence nursing activities and
indirectly influence population health outcomes
The circumstances of a population, including income, education,
employment, social support, and culture (Kindig & Stoddart, 2003)
The surroundings of the population, including the atmosphere of the earth,
gaseous composition of air, solid and gaseous pollutants, smoke, weather
conditions, geologic stability of the earth’s crust, water, urban and rural
design and resources, housing, ultraviolet radiation, bacteria, viruses, and
the built environment (Kindig & Stoddart, 2003; Orem, 2001; Stoto, 2013)
Determinants of health encompassing population-based genetic factors,
behavioral factors, physiological factors, resilience, and health state, all of
which directly influence nursing activities and indirectly influence
population health outcomes
Inherited characteristics of a population
Lifestyle variables of a population, such as smoking, alcohol consumption,
substance abuse, sexual behaviors, physical activity, and diet (Stiefel &
Nolan, 2012)
Biological variables of a population, such as vital signs, body mass index, and
cholesterol and blood glucose levels (Stiefel & Nolan, 2012)
A population’s “ability to bounce back or recover from adversity” (Garcia-Dia,
DiNapoli, Garcia-Ona, Jakubowski, & O’Flaherty, 2013, p. 267)
“A state of the [population] that is characterized by soundness or wholeness
of developed human structures and of bodily and mental functioning”
(Orem, 2001, p. 186)
Determinants of health encompassing providers, organizations, institutions,
payers, and policies that directly influence nursing activities and
population health outcomes and indirectly influence population health
outcomes
Nurses, physicians, therapists, pharmacists, technicians, and others who
provide health-related services to populations
Nurses may provide direct nursing care for populations, teach students and
other nurses, and/or conduct and report results of studies of phenomena of
interest to the discipline of nursing and population health
Relevant health care system organizations and institutions include
departments of public health, hospitals, inpatient and outpatient clinics,
community health centers, and home health care agencies
Local, state, or federally funded government entities responsible for the
public’s health
Institutions, large and small, that provide nursing and medical care that serve
populations experiencing acute disease conditions
Institutions that provide health-related services to populations who need
adjuvant therapy for acute and chronic illness and populations recovering
from acute disease conditions
Centers that provide nursing and medical care to community-based
populations
Agencies that provide home-based health care for populations of patients
Health insurance companies and other sources of reimbursement for healthrelated services
Policies include those addressing access to and use of health care by
populations
Policies about access address availability and compatibility of health care
for an entire population (Norris & Aiken, 2006)
Policies about utilization address actual use of health care by an entire
population
Actions performed by nurses directed to populations within the context of
multidisciplinary collaboration and coordination that directly influence
population health outcomes and that mediate the relations of upstream
factors, population factors, and health care system factors to population
health outcomes
(continued on next page)
Nurs Outlook 63 (2015) 288e298
293
Table 1 e (Continued )
Concepts and
Concept Dimensions
Population-based nursing practice
processes
Culturally appropriate wellness
promotion, restoration, and
maintenance
Culturally appropriate disease prevention
Population health outcomes
Population-level wellness
Population-level disease burden
Population-level functional status
Population-level life expectancy
Population-level mortality
Population-level quality of life
Definitions
Provision of population-based nursing practice processes as formalized in the
practice methodologies of various nursing conceptual models and theories
(Fawcett & DeSanto-Madeya, 2013) directed to actions that create
environments for populations that promote, restore, and maintain
wellness, and prevent disease. Nursing practice processes include all
phases of the nursing process (assessment, planning, intervention,
evaluation) with special emphasis on data collection, tracking, and
analysis, and health care team coordination and collaboration
Provision of nursing practice processes directed to enhancing the optimal
level of the population’s collective “growth, integration of experience, and
meaningful connection with others, reflecting [population] valued goals
and strengths, and resulting in being well and living values” (p. 48) within
the context of the culture of the population (McMahon & Fleury, 2012)
Provision of nursing practice processes directed to preventing the occurrence
of objective and tangible clinical signs and symptoms of a health problem
(Venes, 2013)
The status of the health of a population encompassing population-level
wellness, disease burden, functional status, life expectancy, mortality, and
quality of life, resulting directly from health care system factors and
provision of nursing activities and indirectly from upstream, population,
and health care system factors mediated by nursing activities
The population’s collective level of “growth, integration of experience, and
meaningful connection with others, reflecting [population] valued goals
and strengths, and resulting in being well and living values” (McMahon &
Fleury, 2012, p. 48)
Incidence and/or prevalence of major chronic health conditions in a
population (Stiefel & Nolan, 2012); “the total effect of a disease” (p. 699) on a
population (Venes, 2013)
A population’s optimal level of performing usual activities of daily living
A population’s overall “expected years of remaining life at any age” (Stiefel &
Nolan, 2012, p. 13)
“Years of potential life lost” (p. 4) for a population (Stiefel & Nolan, 2012)
A population’s “physical, psychological, social, economic, and
environmental” (p. E5) well-being (Fulton, Miller, & Otte, 2012)
relational propositions 3 and 5) by means of natural
experiments and quasi-experimental and true experimental designs, with randomization at the level of the
population. Cost-benefit and cost-effective analyses of
specific nursing activities and specific policies linked
with the policy dimension of health care system factors also are important topics for CMNPH-guided
nursing research.
Inasmuch as the policies dimension of health care
system factors addresses access to and use of health
care by populations, the availability and compatibility
of health care for an entire population, and the actual
use of health care by an entire population, the CMNPH
is an excellent guide for studying health disparities and
social justice. For example, studies could be designed
to examine the extent to which a population experiences disparities in health outcomes because of limited
access to and use of available health care, taking into
account the socioeconomic environment dimension of
upstream factors. Other studies could focus on social
justice using correlational research designs to examine
the relations of pollution or toxic waste dumping in the
physical environment (a dimension of upstream factors) to the dimensions of population factors (genetic,
behavioral, and physiological factors; resilience; and
health state).
A crucial area of population-based nursing research
is the analysis and evaluation of health policies, which
Considering the hierarchical nature of healthcare settings and the diversity of roles, from administrators to doctors, nurses, and auxiliary staff, how do power dynamics impact patient care and team collaboration? Share a personal experience where power dynamics or conflict influenced an outcome and discuss strategies that can be employed to promote a more collaborative environment (for this portion of your response you can use an example outside of health care if you have not yet worked in that setting).
Instructions
Research Paper Guidelines
You have been hired as the vice president for operations for Intravalley Health. One
of your first tasks is to educate the board of directors concerning the evolving
nature of healthcare and how it impacts the health system.
Identify a professional or scholarly journal article that addresses a topic within one
of these broad areas:
·
Change management, conflict resolution, strategic communication,
preparedness, or crisis management in healthcare.
·
Human resources specific to healthcare: physician relations, staff recruitment
and retention, in-service training, policy-making and enforcement, counseling and
professional development, credentialing, or unionization of professional staff.
·
The patient experience and satisfaction surveys.
·
Medical Tourism.
Access, review, and integrate the findings of the journal article into a 10-12 page
analysis of your topic. Your exploration should include the background of the issue,
relevant laws and regulations, and strategic and operational impacts on health
services organizations.
•
•
•
background of the issue,
relevant laws and regulations, and
strategic and operational impacts on health services organizations.
Make sure to identify the journal article reviewed in your introduction.
The board of directors consists of preeminent social scientists, therefore your
report should be delivered in APA format, including an abstract and references. The
page count pertains to the body of the paper only.
Some administrative notes:
·
There is a tendency to default to a hospital setting when considering issues in
healthcare. You can examine other sectors such as long term care, palliative care,
retail clinics, or community health centers. Make sure to position your paper from a
managerial perspective.
·
It is expected the depth of the research goes beyond your studies in the core
courses (MSM students) or HCAD 600 (MSHCA students). Please review the policy
for re-use of prior course work – even if it is your own.
·
In order to provide a comprehensive assessment, the selected journal article
should be supported (or refuted) by other scholarly sources.
·
As you know from your Library Skills course, sources such as Time, Forbes,
the Washington Post, and other newspapers, while often useful information
resources, would not be appropriate for this paper. As a general guideline, if you can
find the resource at a magazine stand, it probably is not a professional journal. The
articles you choose should be recent (last 5 years) and should be primary rather
than secondary. (Please see the APA manual if you do not recall the difference.)
Due Date
Oct 11, 2023 12:59 AM
College of Health Sciences
Department of Public Health
PAPER ASSIGNMENT
Course name:
Introduction to Epidemiology
Course number:
PHC-131
Question 1: At a dinner party, a total of 125 people ate the roasted
chicken. Among them, 45 who consumed roasted chicken became ill
while the others were healthy. Calculate the Attack Rate.
Question 2: In a university there are 2100 students, 1400 are boys and
700 are girls. What is the sex ratio?
Question 3: In a country 5,157,550 babies were born in the year 2021.
The midyear population of the country was 950,476,980. What will be
the crude birth rate for the year 2021 for this country?
Questions
Question 4: Look at the following data about Covid 19 pandemic in
Kingdom of Saudi Arabia and find the Crude death rate per 100,000.
• Total number of death due to Covid-19 infection in 2020 = 8,875
• Reference population for the year 2020 = 35,997,107
Question 5: Discuss the interrelationship between prevalence and incidence
describing the effects with increase and decrease. (Word limit = 150)
***Instructions
• Attempt all the questions, each question carries 2 marks.
• Do not write direct answers, solve it in step wise manner
describing the formulas.
• No late work will be accepted, and no second chance will be given.
• Mention your name & ID, instructor’s name, and the date of
submission before uploading the file to BB.
Student Name:
Student ID:
CRN
Branch
Submission Date:
Total
Instructor name
Grade
/10
Page 1 of 2
College of Health Sciences
Department of Public Health
Release Date: 01/10/2023
Due Date: 07/10/2022 (End of the day)
•
•
•
•
•
•
Plagiarism policy: no plagiarism is accepted in the assignments at all. The student
should write the assignment in their own words. Two identical assignments will be
rejected with zero grades.
Citation: The students are required to use APA style of citation in their assignments.
The assignment should have the COVER PAGE with New SEU logo and the details
of who is submitting and to whom is it submitted.
Naming the assignment file: student should use the following format for naming and
uploading their assignment: Student name (Student ID) PHC273_Assignment name
Assignments with improper names and formats will be rejected.
Assignments should only be submitted through Blackboard only and not through
email. If there is any technical issue in the BB, then it should be reported to BB support
team. The screenshot of the problem and the assignment then can be sent to the instructor.
The submission of assignment must be done before the scheduled deadline.
o Late assignments can be accepted only if the student informed the instructor before
the assignment deadline is overdue of any acceptable reason of delay.
Page 2 of 2
Access the following article:Donnon, T., Paolucci, E. O., & Violato, C. (2007). The predictive validity of the MCAT for medical school performance and medical board licensing examinations: a meta-analysis of the published researchLinks to an external site.. Academic Medicine, 82(1), 100-106.Read the article and then respond to the following prompts in a word document.Comment on the reliability and sample methods used in the article.Were the sampling methods appropriate for the populations they were trying to assess?Was reliability and validity addressed?If reliability and validity were not expressly addressed, do you believe their study had good reliability and validity? Be sure to address different kinds of validity and reliability.
Plagiarism policy: no plagiarism is accepted in the assignments at all. The student should write the assignment in their own words. Two identical assignments will be rejected with zero grades.Citation: The students are required to use APA style of citation in their assignments.The assignment should have the COVER PAGE with New SEU logo and the details of who is submitting and to whom is it submitted. Naming the assignment file: student should use the following format for naming and uploading their assignment: Student name (Student ID) PHC273_Assignment nameAssignments should only be submitted through Blackboard only and not through email. If there is any technical issue in the BB, then it should be reported to BB support team. The screenshot of the problem and the assignment then can be sent to the instructor.The submission of assignment must be done before the scheduled deadline.Late assignments can be accepted only if the student informed the instructor before the assignment deadline is overdue of any acceptable reason of delay. Assignments with improper names and formats will be rejected.
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
PAPER ASSIGNMENT
Course name:
Introduction to Epidemiology
Course number:
PHC-131
Question 1: At a dinner party, a total of 125 people ate the roasted
chicken. Among them, 45 who consumed roasted chicken became ill
while the others were healthy. Calculate the Attack Rate.
Question 2: In a university there are 2100 students, 1400 are boys and
700 are girls. What is the sex ratio?
Question 3: In a country 5,157,550 babies were born in the year 2021.
The midyear population of the country was 950,476,980. What will be
the crude birth rate for the year 2021 for this country?
Questions
Question 4: Look at the following data about Covid 19 pandemic in
Kingdom of Saudi Arabia and find the Crude death rate per 100,000.
• Total number of death due to Covid-19 infection in 2020 = 8,875
• Reference population for the year 2020 = 35,997,107
Question 5: Discuss the interrelationship between prevalence and incidence
describing the effects with increase and decrease. (Word limit = 150)
***Instructions
• Attempt all the questions, each question carries 2 marks.
• Do not write direct answers, solve it in step wise manner
describing the formulas.
• No late work will be accepted, and no second chance will be given.
• Mention your name & ID, instructor’s name, and the date of
submission before uploading the file to BB.
Student Name:
Student ID:
CRN
13101
Branch
Submission Date:
Instructor name
Total
TARIQ ALOTAIBI
Grade
/10
Release Date: 01/10/2023
Page 1 of 2
College of Health Sciences
Department of Public Health
Due Date: 07/10/2022 (End of the day)
•
•
•
•
•
•
Plagiarism policy: no plagiarism is accepted in the assignments at all. The student
should write the assignment in their own words. Two identical assignments will be
rejected with zero grades.
Citation: The students are required to use APA style of citation in their assignments.
The assignment should have the COVER PAGE with New SEU logo and the details
of who is submitting and to whom is it submitted.
Naming the assignment file: student should use the following format for naming and
uploading their assignment: Student name (Student ID) PHC273_Assignment name
Assignments with improper names and formats will be rejected.
Assignments should only be submitted through Blackboard only and not through
email. If there is any technical issue in the BB, then it should be reported to BB support
team. The screenshot of the problem and the assignment then can be sent to the instructor.
The submission of assignment must be done before the scheduled deadline.
o Late assignments can be accepted only if the student informed the instructor
before the assignment deadline is overdue of any acceptable reason of delay.
Page 2 of 2
See attached documents. Excel sheets have multiple pages
Unformatted Attachment Preview
BUDGET PROJECT ASSIGNMENT INSTRUCTIONS
OVERVIEW
The student will complete a project involving the creation of a budget. Specific budgets to be
produced and other requirements may be found in Canvas.
INSTRUCTIONS
Complete each part of the following Case Study. You will need to use Microsoft Word and
Excel. Tables referenced in the case study are located in the Excel file labeled “Case Study
Tables”. Label your written responses by part number. For example, your memo for Part 1 must
be labeled Part 1 as a level 1 heading, then proceed with your memo, and then a new level 1
heading Part 2, followed by answers to those questions. A title page must be included in your
submission. Analysis must be supported with scholarly, peer-reviewed journal articles (5 or
more) as well as include Biblical integration.
Financial Management
Part 1 Financial Statement Analysis
The loan committee of a major bank needs a financial assessment. Analyze the
financial statement for (your instructor will provide the company name). Download the
financial statements into Microsoft Excel and then use horizontal statement analysis as
well as financial ratios to assess the organization’s liquidity, profitability, financial
efficiency (turnover), and capital/debt structure. Based on your assessment, present a
2–4-page memo that describes the financial strengths and weaknesses of the
organization as of their most recent year-end. Your memo must indicate the maximum
loan amount that should be authorized.
Part 2 Budget Analysis
Table 1 includes PCS’s proposed budget for 2018. Using this as a basis, develop a
revenue and expenses budget for each PCS center. Note that professional reading fees
and laboratory expenses are variable costs that need to be allocated based on the type of
visit. Generally, an occupational health visit (Categories 8 and 9 on Tables 2 and 3)
including all physicals has reading and laboratory costs 1.4 times what a general
medical visit incurs (Category 1, 2, or 3). For each line item in the budget, indicate
whether the item is a fixed or variable expense and the basis of allocation or assignment
for the budget for each center. Each center is expected to generate approximately the
same profit margin. Given your analysis, will it? Should management change its
expectations regarding average revenue per visit by center?
Part 3 Monthly Cash Budget
Table 4 includes the 2018 budget for Jasper Gardens Nursing Home. For your
monthly cash budget, assume that one-twelfth of cash expenses and revenues are
incurred per month. Use the following aging analysis to estimate cash inflows. What
Page 1 of 4
are the management implications of this analysis?
Table III.4 Aging Analysis
Percent of Bills Paid in Cash Within
days of Billing
Days
Medicare
Medicaid
Commercial
Insurance
Private Insurance
Self-Pay
VA
30 or less
31–60
61–90
91–120
121–150
5
0
20
25
30
25
40
25
5
25
25
30
40
25
25
30
30
15
25
30
20
10
10
10
0
45
15
0
10
5
Assume that Accounts Receivable – Net as of December 31, 2017, are the same
percentage as anticipated revenue to be earned during 2018.
Part 4 Webster Hospital—Long-Term Debt Financial Analysis
OHA has indicated that we should maintain a debt to asset ratio no higher than 40
percent. Given this, how much additional long-term debt could have been added in 2017?
We would use this additional debt to finance new construction, renovations, and the
acquisition of technology. To finance this additional long-term debt we would use bonds.
As such, we need to assess our credit worthiness. The following are the select median
values for specific financial ratios for hospitals that received “below investment grade
(BBB)” and “high investment grade (AA)” bond ratings.
Assess and report Webster’s position with recommendations. Are Webster’s bonds
more likely to be rated as AA or BBB? Why?
Table III.5
Comparison of Financial Ratios by Bond Rating
Bond Grade
AA
BBB
Days Cash on Hand
Days in Accounts Receivables
Days in Current Liabilities
Cash to Debt (%)
Total Margin-%
194
58.0
62.3
153.9
4.1
53.6
47.7
64.7
37.9
(0.3)
Page 2 of 4
Salaries and benefit costs as
% of Total Revenue
49.9
56.3
Average Age of Plant (years)
Capital Expenditures
as % of Depreciation Expense
9.5
13.4
169.9
76.2
Our annual interest cost of long-term borrowing would be 3.0 percent if our bonds were
rated “high grade” and 7.5 percent if rated “below investment grade.” Assume that tenyear bonds are used to finance this additional debt. What would be the annual principal
and interest payment for this amount? Can Webster Hospital afford this increased
annual expense? Note that for every $100,000 borrowed over ten years, our monthly
payments would be $989 at 3.5 percent or $1,136 at 6.5 percent.
Part 5 Surgery for Middleboro
As you are aware, Medical Associates has achieved its targeted utilization and financial
projections for ambulatory surgery in Jasper. It is now time to consider a similar service
at our offices in Middleboro. The physical facilities needed for ambulatory surgery will
cost $450,000. Our cost of capital is 4 percent and the hurdle rate is 6 percent. The
anticipated salvage value of these new fixed assets will be $150,000 after five years. To
do this we will need to recruit two new general surgeons for our Jasper office, thereby
freeing our Middleboro general surgeons to work in this new ambulatory surgical
facility. We anticipate opening no earlier than January 2, 2016
Based on operational estimates, we anticipate that this project’s annual operational
revenue will exceed its operational expenses (R-E) for each of the first five years in
accordance with the following schedule. Note that the operational expenses include all
direct costs including salaries and benefits.
Table III.6
Fiscal Implications of New Ambulatory Surgery Service
Year 01
Year 02
Year 03
Year 04
Year 05
R-E ($)
Median Cases per Day (M–F)
20,000
40,000
60,000
100,000
140,000
9.0
10.0
12.5
12.5
14.0
We estimate that this unit, employing the standard RVU system used in hospitals, will
generate 1.1 surgical procedures per case. Assess the financial implication. Should we
do this? Why?
Page 3 of 4
Part 6 Hospital Discounts
A coalition of key area employers has approached MCH or WH demanding an
additional 10 percent discount per patient day for all of their employees admitted to the
hospital. If not offered, they will change their health insurance to favor the one hospital
in Middleboro with the lowest prices. What would be the implications of such a
change? Structure the analysis that would be undertaken to respond to this demand.
Part 7 Medicaid Expansion
The state legislature and governor have just rejected additional Federal funding for
Medicaid expansion. Assess the financial impact of this decision on MCH or WH.
Part 8 New Primary Care Practices in Jasper
Determine the costs to MCH of establishing two new primary care practices in Jasper.
The analysis should include estimates of all costs (recruitment, compensation
arrangements, facility, staffing, information technology, etc.) and assess the advantages
and disadvantages of leasing or purchasing building space.
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
Page 4 of 4
Table 1.5
Hillsboro County Health Insurance Profile 2016–2017 (Special Study by Chamber of Commerce, Percent of T
Percent of Coverage
All Residents
Covered by
own
Not
employmentcovered
Covered by
based
any time employment- insurance
during the
based
(selfyear
insurance
employed)
Covered by
Medicaid and
private
insurance
Covered
by
Medicare
and
private
insurance
19.3
55.1
28.6
2.8
7.5
32.7
25.6
14.9
13.6
0.0
50.6
70.5
76.6
78.8
0.0
12.4
8.3
5.6
0.0
0.0
1.0
1.5
1.5
0.7
0.0
0.2
0.1
0.2
0.2
0.0
28.3
22.8
13.2
9.3
7.3
43.4
64.1
79.5
8.2
23.6
30.5
39.4
0.00
0.00
0.00
0.00
8.1
15.4
7.5
5.7
Employer size, workers aged 18–64
Fewer than 25 employees
25–99 employees
100–499 employees
500–999 employees
1,000+ employees
Household income
Less than $25,000
$25,000 to $49,999
$50,000 to $74,999
$75,000 or more
NOTE: Percentages may exceed 100% depending on changes during the year of study and multiple coverage.
r of Commerce, Percent of Total)
rage.
Covered
by
Medicare
and
Medicaid
2.1
0.2
0
0.3
0.3
0.0
0.00
0.00
0.00
0.00
Table 1.9
HIV and AIDS in Capital City and Hillsboro County, 2007–2017
2017
2012
AIDS cases
Rate per 100,000 Population, All Ages
Hillsboro County
6.9
7.2
Capital City
8.4
9.3
Statewide
12.5
13.4
2007
7.8
11.2
14.5
AIDS cases
Rate per 100,000 Population, Adults and Adolescents
Hillsboro County
7.0
7.4
8.2
Capital City
8.5
9.6
11.5
Statewide
15.2
16.0
18.3
AIDS case rates
Adults and Adolescents, Rates per 100,000 by Sex
Hillsboro County
Male
20.9
23.5
17.2
Female
6.3
7.9
5.4
Capital City
Male
22.9
24.0
21.3
Female
7.7
7.7
7.9
Statewide
Male
22.9
26.3
30.1
Female
7.7
6.7
6.7
AIDS cases
Distribution of Persons Estimated to be Living with AIDS (%)
Hillsboro County
White
70.9
71.2
67.3
Black
18.8
19.3
20.3
Hispanic
4.4
4.4
6.2
Other
5.9
5.1
6.2
Capital City
White
48.2
40.3
35.5
Black
35.7
40.7
44.5
Hispanic
13.4
16.7
17.3
Other
2.7
2.3
2.7
Statewide
White
34.1
30.2
28.4
Black
42.7
44
44.3
Hispanic
20.9
23.2
25.2
Other
2.3
2.6
2.1
HIV
HIV
Age-Adjusted Death Rate per 100,000 for HIV
Hillsboro County
1.1
1.2
1.1
Capital City
3.8
3.2
3.2
Statewide
4.2
4.6
4.8
Estimated Rate per 100,000 for Persons Living with HIV
Infections (not AIDS)
Hillsboro County
22.7
21.3
24.3
Capital City
34.5
36.7
39.5
Statewide
51.7
48.3
50.2
HIV—2017
Hillsboro County
Whites
Blacks
Hispanics
Capital City
Whites
Blacks
Hispanics
Statewide
Whites
Blacks
Hispanics
Rates per 100,000 of New HIV Infections in Adults and
Adolescents
Males
Females
Total
10.5
80.7
31.2
2.2
21.7
6.3
7.1
51.9
19.2
13.5
112.4
47.5
4.1
50.9
13.0
9.1
82.7
30.7
19.6
115.7
43.8
3.9
55.7
14.4
11.5
83.7
29.3
Table 2.2
Service Area Utilization by Town and Division for Calendar Years Ending December 31
Division
Boalsburg
Carterville
Harris City
Jasper
Middleboro
Mifflenville
Minortown
1,702
330
422
150
56
10
26
2,004
356
82
26
59
13
24
3,404
676
823
301
107
18
47
3,220
666
863
605
101
20
51
16,071
3,264
4,904
1,547
490
91
230
3,794
725
967
335
100
21
53
3,020
445
106
18
71
11
38
73
794
957
844
10
54
290
1,487
1,513
194
1,448
1,741
1,291
798
7,109
9,479
7,658
6
64
150
1,571
2,155
2,040
0
61
293
1,315
1,729
43
154
1,241
1,835
1,517
21
18
7
38
23
56
11
34
44
190
198
101
131
16
12
72
0
0
246
653
0
114
0
12
0
Service
Home Care
RN visits
LPN visits
HHA visits
PT visits
OT visits
ST visits
Social worker visits
Private Duty
RN in-home hours
LPN in-home hours
PCA in-home hours
HHA in-home hours
Other in-home hours
39
Community Health
Ante/postpartum visits
Child health visits
Senior Health Clinic attendees by HCHHA Office Location
Seen at Middleboro office
Seen at Jasper office
15
0
12
0
Stateville
Total
820
200
263
92
30
5
18
34,035
6,662
8,430
3,074
1,014
189
487
50
419
376
426
8
1,534
13,165
19,345
17,018
191
23
30
476
456
45
8
923
254
Table 2.3
Services to Patients, Calendar Years Ending December 31
Division/Program
2017
2016
Home Care
1,596
1,582
Unduplicated client census
RN home visits 34,035 35,463
LPN home visits
6,662
5,678
Home health aide visits
8,430
8,230
PT visits
3,074
2,647
OT visits
1,014
993
ST visits
189
165
SW visits
487
472
Total visits 53,891 53,648
Private Duty
Unduplicated client census
RN in-home hours
LPN in-home hours
Personal care attendant in-home hours
HHA in-home hours
Other in-home hours
Total hours
Community Health
Ante/postpartum visits
Child health visits
Prenatal class enrollees
Children seen, Middleboro
Children seen, Jasper
High Blood Pressure Program
People screened
MD referrals
Senior Health Clinics
Clients seen, Middleboro
Clients seen, Jasper
2015
2014
2013
1,578
35,867
5,980
8,356
2,630
897
174
434
54,338
1,498
36,304
4,823
8,856
2,240
899
178
445
53,745
1,499
37,192
4,725
8,923
2,430
903
156
342
54,671
260
1,534
13,165
19,345
17,018
212
51,274
225
1,267
12,564
16,745
11,788
180
42,544
145
1,050
9,160
14,290
8,304
210
33,014
476
456
139
901
301
512
502
140
740
222
500
656
123
634
305
499
450
130
812
317
412
496
112
845
328
7,456
398
6,867
423
7,234
307
7,124
456
6,838
512
923
254
902
243
920
289
934
389
978
412
Table 2.6
Statement of Revenue and Expenses for Calendar Year Ending December 31
2017
2016
Home Care Division
6,736,375
6,322,329
Less allowances for bad debt
-85,240
-88,340
Less contractual allowances
-2,049,283
-1,737,912
Net revenue
4,601,852
4,496,077
Private Duty Division
3,165,221
2,843,959
Less allowances for bad debt
-65,340
-45,230
Less contractual allowances
-18,469
-12,669
Net revenue
3,081,412
2,786,060
Community Health Division
Support from state and towns
208,750
240,000
United Appeal
20,000
20,000
Other
1,935
1,257
Net revenue
230,685
261,257
Total net operational revenue
7,913,949
7,543,394
Expenses
Divisional
Salaries and wages
4,186,227
4,086,160
Fringe benefits
1,255,868
1,022,548
Travel
725,388
701,383
Supplies
453,778
398,202
Equipment
152,430
122,494
Total divisional
6,773,691
6,330,787
Administrative
Salaries and wages
360,233
340,229
Fringe benefits
102,339
98,334
Supplies
157,910
158,705
Equipment
45,929
42,393
Insurance
56,729
54,202
Interest
54,894
53,890
Maintenance—Middleboro
138,595
79,303
Rent—Jasper office
40,500
40,500
Computer services
84,253
80,150
Travel
18,356
18,430
Heat/light—Middleboro
11,488
10,004
Legal/audit
55,088
44,411
Printing and postage
15,540
13,450
Telecommunications
21,364
19,560
Staff development
10,060
7,010
Board expenses
10,150
10,445
Publications and memberships
10,700
10,500
Depreciation expense
38,240
39,440
Total administrative
1,232,368
1,120,956
Total expenses
8,006,059
7,451,743
Gain (or loss) from operations
-92,110
91,651
Other Income
202,445
245,300
110,335
336,951
Gain (or loss)
2015
5,936,445
-72,450
-1,365,999
4,497,996
1,893,345
-24,550
-8,738
1,860,057
240,000
60,000
1,458
301,458
6,659,511
3,604,595
1,021,445
604,387
258,304
82,394
5,571,125
335,110
96,990
140,680
34,220
45,043
53,004
78,380
40,500
73,229
13,450
7,545
28,340
12,000
18,334
7,500
6,342
8,550
44,350
1,043,567
6,614,692
44,819
295,606
340,425
Table 2.7
Balance Sheet as of December 31
2017
2016
2015
Current assets
Cash
Accounts receivable (net)
Prepaid insurance
Inventory
Total current assets
708,339
1,430,404
8,650
19,299
2,166,692
474,519
1,152,383
17,340
19,345
1,663,587
378,495
904,871
14,230
14,236
1,311,832
Property and equipment
Gross, property & equipment
(Less accumulated depreciation)
Net property and equipment
2,328,440
-603,559
1,724,881
2,255,606
-565,319
1,690,287
2,153,284
-525,879
1,627,405
Other assets
Investments (at market)
7,951,190
8,403,134
7,456,012
11,842,763
11,757,008
10,395,249
Liabilities and net assets
Current liabilities
Accounts payable
Accrued items
Current portion of long-term debt
Total current liabilities
487,220
284,570
68,244
840,034
433,291
255,683
69,262
758,236
415,073
306,492
70,385
791,950
Noncurrent Liabilities
Loan payable
448,292
472,445
492,558
1,288,326
1,230,681
1,284,508
6,917,307
3,024,604
612,526
6,961,213
3,062,923
502,191
5,423,731
3,521,770
165,240
Total net assets
10,554,437
10,526,327
9,110,741
Liabilities + net assets
11,842,763
11,757,008
10,395,249
Total assets
Total liabilities
Net assets
Donor-restricted fund
Investment fund (at market)
Working capital fund
Table 3.1
PCS Utilization Report
Alpha
Gross
Charges
($)
Beta
Gross
Charges
($)
230
78,450
94,040
207
251
87,650
102,272
165
204
221
92,425
93,092
481
190
187
242
101,925
96,844
988
480
103
167
238
82,660
92,876
June
1,067
493
150
195
229
94,625
94,168
July
1,195
460
252
219
264
112,940
107,748
August
1,276
503
260
217
296
120,075
116,812
September
1,031
406
165
209
251
87,050
102,552
October
1,048
403
233
205
207
101,635
89,144
November
905
329
225
168
183
90,625
76,956
December
799
325
230
119
125
91,225
53,160
Total
12,387
5,033
2,328
2,289
2,737
January
894
312
180
202
200
72,228
75,038
February
990
398
166
214
212
79,732
79,526
March
1,048
440
173
217
218
86,095
81,413
April
1,102
486
176
203
237
92,154
84,592
May
999
476
115
163
245
79,069
81,872
June
978
478
132
133
235
82,622
75,752
July
1,031
455
204
117
255
93,925
78,948
Alpha
Alpha
Beta
Beta
Total
Visits
Private
Visits
Occupational
Health Visits
Private
Visits
Occupational
Health Visits
January
909
302
185
192
February
1,030
402
170
March
1,039
449
April
1,100
May
2017
1,141,285 1,119,664
2016
August
1,276
501
251
269
255
108,564
97,036
September
970
396
160
202
212
78,324
78,098
October
1,056
447
203
199
207
92,778
76,466
November
1,005
423
254
178
150
99,867
59,432
December
1,000
405
240
190
165
94,995
64,685
Total
12,349
5,217
2,254
2,287
2,591
1,060,353
932,858
January
876
303
170
213
190
66,842
73,912
February
938
365
169
200
204
73,720
75,800
March
993
402
190
205
196
81,928
74,420
April
963
406
156
194
207
75,924
75,806
May
1,001
426
155
175
245
78,014
82,950
June
986
453
145
143
245
79,192
78,982
July
1,027
451
184
127
265
86,374
81,998
August
1,259
493
271
227
268
107,692
95,148
September
909
312
203
189
205
74,138
74,686
2015
October
1,057
449
213
178
217
91,656
76,322
November
974
425
207
164
178
87,780
64,836
December
1,012
401
231
193
187
89,604
70,682
Total
11,995
4,886
2,294
2,208
2,607
992,864
925,542
January
866
313
160
200
193
62,917
60,235
February
887
375
153
145
214
68,415
58,115
March
978
397
187
189
205
76,933
61,332
April
954
376
159
205
214
69,604
64,895
May
1,035
445
193
165
232
83,245
63,885
June
1,047
463
193
160
231
85,207
63,125
July
968
421
195
107
245
80,989
59,866
2013
August
1,212
504
241
207
260
98,316
74,091
September
October
November
986
990
974
323
409
400
200
198
212
188
156
145
275
227
217
71,207
80,221
81,760
74,869
61,893
58,700
December
960
394
223
156
187
83,086
54,093
Total
11,857
4,820
2,314
2,023
2,700
941,900
755,099
A
PP
B
OH
PP
OH
220
140
140
140
140
292
292
292
292
125
220
140
292 177.6680162
125
220
140
292 176.9381443
125
220
140
292 184.6761506
125
220
140
292 185.6481191
125
220
140
292 183.9010669
125
220
140
292 182.0410305
125
220
140
292 185.1723757
125
220
140
292 180.7071339
125
220
125
220
125
220
125
189.7579758 This is a “work area” – please do
184.3902913 not include in table.
178.5534167
180.6990909
292 182.5259546
119
195
119
255 164.7270694
119
195
119
255 160.8666667
119
195
119
255 159.8358779
119
195
119
255 160.3865699
119
195
119
255 161.1021021
119
195
119
255 161.9366053
119
195
119
255 167.6750727
119
195
119
255 161.1285266
119
195
119
255 161.2597938
119
119
119
195
195
195
119
119
119
255 160.2689394
255 158.5064677
255
159.68
161.4066726
114
114
114
114
114
114
114
114
114
114
114
114
190
190
190
190
190
190
190
190
190
190
190
190
124
124
124
124
124
124
124
124
124
124
124
124
250
250
250
250
250
250
250
250
250
250
250
250
160.6780822
159.4029851
157.4501511
157.5597092
160.8031968
160.4198783
163.9454722
161.1119936
163.7227723
158.9195837
156.6899384
158.3853755
159.9338058
109
109
109
109
109
109
109
109
109
109
109
109
180
180
180
180
180
180
180
180
180
180
180
180
113
113
113
113
113
113
113
113
113
113
113
113
195
195
195
195
195
195
195
195
195
195
195
195
142.2078522
142.6493799
141.3752556
140.9842767
142.1545894
141.6733524
145.5113636
142.25
148.1501014
143.5494949
144.2094456
142.8947917
143.122122
Total
Gross
Charges
($)
172,490
189,922
185,517
198,769
175,536
188,793
220,688
236,887
189,602
190,779
167,581
144,385
2,260,949
147,266
159,258
167,508
176,746
160,941
158,374
172,873
205,600
156,422
169,244
159,299
159,680
1,993,211
140,754
149,520
156,348
151,730
160,964
158,174
168,372
202,840
148,824
167,978
152,616
160,286
1,918,406
123,152
126,530
138,265
134,499
147,130
148,332
140,855
172,407
146,076
142,114
140,460
137,179
1,696,999
ork area” – please do
Table 3.5
Revenue Generation by Physician, Center, Day of Week, September 1–November 29, 2017
RECORD
DATE
MD/ARNP
DAY
CTR
REVENUE $
VISITS
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
Sept 1
Sept 2
Sept 3
Sept 4
Sept 5
Sept 6
Sept 8
Sept 9
Sept 10
Sept 11
Sept 12
Sept 13
Sept 15
Sept 16
Sept 17
Sept 18
Sept 19
Sept 20
Sept 22
Sept 23
Sept 24
Sept 25
Sept 26
Sept 27
Sept 29
Sept 30
Oct 1
Oct 2
Oct 3
Oct 4
Oct 6
Oct 7
Oct 8
Oct 9
Oct 10
Oct 11
Oct 13
Oct 14
Oct 15
Oct 16
Oct 17
Holiday
1
3
3
1
11
1
1
3
3
4
11
1
1
3
3
4
11
1
1
3
3
4
11
1
1
3
3
5
11
1
1
3
3
4
11
1
1
3
3
5
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
3,156
3,788
3,956
3,059
3,076
3,044
3,657
4,366
4,381
3,547
3,148
3,008
3,005
3,976
3,740
3,547
3,005
3,259
3,051
3,906
3,856
3,944
3,452
3,056
3,067
3,010
2,840
3,049
1,599
6,559
3,769
3,276
3,806
3,051
3,028
5,278
4,650
3,920
2,534
4,020
17
21
23
24
19
22
34
20
25
38
16
23
18
21
19
30
20
32
22
18
22
24
20
20
23
23
18
20
10
42
21
20
20
18
20
33
28
20
14
28
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
Oct 18
Oct 20
Oct 21
Oct 22
Oct 23
Oct 24
Oct 25
Oct 27
Oct 28
Oct 29
Oct 30
Oct 31
Nov 1
Nov 3
Nov 4
Nov 5
Nov 6
Nov 7
Nov 8
Nov 10
Nov 11
Nov 12
Nov 13
Nov 14
Nov 15
Nov 17
Nov 18
Nov 19
Nov 20
Nov 21
Nov 22
Nov 24
Nov 25
Nov 26
Nov 27
Nov 28
Nov 29
Sept 1
Sept 2
Sept 3
Sept 4
Sept 5
Sept 6
Sept 8
11
1
1
3
3
4
11
1
1
3
3
4
11
1
1
3
3
5
11
1
1
3
3
4
13
1
1
3
3
5
11
1
1
3
Holiday
9
11
Holiday
2
6
6
7
13
2
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
3,699
4,460
4,739
4,230
3,288
3,805
3,397
5,520
4,367
3,650
3,090
3,001
1,145
5,350
2,768
3,587
4,879
2,757
1,036
5,567
2,586
5,980
4,771
2,061
2,212
5,789
3,879
5,879
4,244
2,959
2,055
4,789
4,444
5,546
24
36
28
22
19
25
22
39
28
20
18
20
10
35
15
21
26
19
10
31
17
32
24
14
22
35
23
31
24
17
15
30
25
32
4,007
2,335
30
16
5,157
4,286
4,367
4,156
1,956
6,648
25
14
16
17
10
30
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
Sept 9
Sept 10
Sept 11
Sept 12
Sept 13
Sept 15
Sept 16
Sept 17
Sept 18
Sept 19
Sept 20
Sept 22
Sept 23
Sept 24
Sept 25
Sept 26
Sept 27
Sept 29
Sept 30
Oct 1
Oct 2
Oct 3
Oct 4
Oct 6
Oct 7
Oct 8
Oct 9
Oct 10
Oct 11
Oct 13
Oct 14
Oct 15
Oct 16
Oct 17
Oct 18
Oct 20
Oct 21
Oct 22
Oct 23
Oct 24
Oct 25
Oct 27
Oct 28
Oct 29
Oct 30
2
6
6
7
13
2
2
6
7
8
13
2
2
6
8
8
12
2
2
5
5
8
13
2
2
5
5
6
13
2
2
5
5
6
13
2
2
5
5
6
12
2
2
5
5
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
5,978
4,934
2,166
4,305
1,510
6,250
4,850
3,956
4,707
3,958
1,941
5,790
4,415
3,083
3,546
4,026
1,850
4,890
3,827
4,080
3,080
2,044
830
4,560
4,050
4,069
3,827
1,566
1,209
4,038
4,740
3,567
5,035
3,077
1,518
5,734
3,657
3,256
3,070
3,058
1,656
5,020
4,640
2,748
2,978
29
20
12
16
9
28
20
18
20
18
10
28
20
14
16
16
12
24
18
18
15
9
4
20
20
20
18
11
6
19
20
17
18
15
8
22
19
20
13
12
8
22
20
15
14
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
Oct 31
Nov 1
Nov 3
Nov 4
Nov 5
Nov 6
Nov 7
Nov 8
Nov 10
Nov 11
Nov 12
Nov 13
Nov 14
Nov 15
Nov 17
Nov 18
Nov 19
Nov 20
Nov 21
Nov 22
Nov 24
Nov 25
Nov 26
Nov 27
Nov 28
Nov 29
6
13
2
2
6
6
8
13
2
2
6
6
8
13
2
2
6
6
7
13
2
2
6
Holiday
9
13
CODES For Table 3-5
MD/ARNP
1
B. Casey
2
M. Welby
3
S. Tobias
4
J. Smooth
5
R. Hottle
6
L. Cytesmath
7
C. Withers
8
L. Jones
9
M. Foxx
10
M. Meyers
11
C. Withers, ARNP
12
J. Jones, ARNP
13
G Mattox, ARNP
Revenue = Total gross billed charges
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2,007
1,205
3,557
4,047
3,344
4,289
3,756
1,034
4,420
4,510
3,089
3,837
4,730
1,856
4,298
3,587
2,689
4,856
3,962
1,091
5,029
2,538
2,177
9
6
17
15
18
20
14
4
30
16
16
15
17
10
21
12
13
22
14
10
24
12
12
2,002
1,053
8
5
Day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Center
Alpha
Beta
Visits = Number of paying patients
Table 3.6
Statement of Operations
2017
2016
2015
2014
2013
Revenue
Patient services, gross
Contractual alllowances
Patient revenue, net
Other revenue
Total revenue
2,246,188
179,695
2,066,493
18,520
2,085,013
1,993,211
159,457
1,833,754
22,463
1,856,217
1,918,406
153,472
1,764,934
22,252
1,787,186
1,696,999
135,760
1,561,239
23,595
1,584,834
1,690,252
135,220
1,555,032
23,684
1,578,716
Expenses
Salaries and wages
Staff benefits
Administrative expenses
Advertising
Collection fees
Computer support
Consultants
Equipment leases
Insurance
Laboratory
Laundry and housekeeping
Legal/audit
Medical supplies
Office supplies
Printing and postage
Professional fees
Rent
Repairs and maintenance
Telephone
Utilities
Depreciation
Bad debt expenses
Total expenses
1,131,608
392,301
18,330
3,000
1,267
21,556
1,529
4,100
28,100
44,870
12,830
8,450
61,450
18,437
10,122
23,955
78,500
3,167
10,315
18,925
72,556
8,437
1,973,805
1,001,556
310,482
17,339
3,400
845
31,443
1,270
4,100
24,100
45,292
12,256
8,450
58,220
29,348
9,450
23,425
78,750
2,966
7,495
16,800
70,449
5,629
1,763,065
982,450
294,735
10,494
3,856
342
34,256
948
4,100
24,100
42,550
8,156
8,450
57,354
28,420
9,014
23,302
58,900
1,529
6,519
13,560
70,383
4,303
1,687,721
839,229
243,376
10,056
3,003
659
35,378
805
1,800
18,560
44,691
3,440
7,850
58,556
28,556
3,588
23,884
58,900
2,349
2,550
13,720
68,363
3,494
1,472,807
838,226
234,703
9,562
2,340
589
25,398
355
1,800
24,100
39,254
2,440
7,850
28,340
28,360
2,013
24,885
58,900
3,620
2,044
13,900
79,262
3,102
1,431,043
Income (loss) before taxes
111,208
93,152
99,465
112,027
147,673
Federal and state taxes
Income (loss) after taxes
44,483
66,725
37,261
55,891
39,786
59,679
44,811
67,216
59,069
88,604
Table 3.7
Balance Sheet for Fiscal Year Ending December 31
2017
2016
2015
2014
2013
Current
Cash, operating
Accounts receivable
Inventory
Prepaid expenses
Total current assets
153,449
139,385
3,339
3,078
299,251
163,035
134,450
4,125
4,565
306,175
86,999
131,560
5,233
4,021
227,813
76,223
130,455
28,734
5,688
241,100
84,550
168,455
30,335
8,944
292,284
Investments
368,825
341,010
405,903
353,628
314,040
Property and equipment
Equipment and leasehold improvements, gross
Less accumulated depreciation
Equipment and leasehold improvements, net
Total assets
Liabilities and net assets
1,197,602
645,239
552,363
1,220,439
1,125,046
572,683
552,363
1,199,548
1,054,597
502,234
552,363
1,186,079
984,214
431,851
552,363
1,147,091
915,851
363,488
552,363
1,158,687
49,668
29,000
2,134
80,802
13,534
27,387
945
41,866
13,796
30,100
823
44,719
10,455
45,662
1,126
57,243
77,454
23,145
569
101,168
0
80,802
84,770
126,636
124,339
169,058
132,506
189,749
167,393
268,561
Common stock note1
Authorized and issued
720,000
720,000
720,000
720,000
720,000
Cumulative operating (deficit) or gain after taxes
371,637
352,912
297,021
237,342
170,126
Dividends payable
Net assets
48,000
1,139,637
1,072,912
1,017,021
957,342
890,126
Net assets and liabilities
1,220,439
1,199,548
1,186,079
1,147,091
1,158,687
Assets
Current liabilities
Accounts payable
Accrued expenses
Accrued payroll taxes
Total current liabilities
Long-term liabilities
Notes payable
Total liabilities
Net assets
NOTE: 1. Common stock: $12 par, 60,000 authorized and issued.
Table 4.1
Webster Hospital Medical Staff Information, 2017
Name
Office
Age
Specialty
Patient Days Discharges
Department of Medicine—Active Staff
General and Family Practice
A. Able
A. Adelson
A. Downs
B. Dawes
B. Lamb
C. Franklin
C. Newton
D. Dodger
E. Best
E. Devishson
E. Doogle
F. Walczek
F. Evans
G. Liu
H. Megg
J. Child
J. Kim
J. Lopez
K. Blood
K. Justin
M. Heart
B. Easter
C. Fisher
D. Hamilton
I. Kelly
I. Lasker
1
1
1
1
1
2
2
3
3
3
3
5
4
6
7
4
4
1
1
2
1
1
2
2
8
8
29
33
34
34
37
48
44
37
35
31
36
38
39
29
36
43
32
40
50
57
43
68
60
55
69
68
Family Practice*
Family Practice*
Family Practice*
Family Practice*
Family Practice*
Family Practice
Family Practice
Family Practice*
Family Practice*
Family Practice*
Family Practice*
Family Practice
Family Practice
Family Practice
Family Practice
Family Practice
Family Practice
Family Practice
Family Practice
Family Practice
Family Practice
General Practice
General Practice
General Practice
General Practice
General Practice
504
601
678
590
603
323
476
415
340
186
357
300
197
287
454
244
456
478
534
539
478
547
416
345
38
135
115
125
152
146
149
66
96
91
84
43
82
64
45
50
100
55
91
103
109
114
101
102
92
77
7
24
1
1
35
54
Internal Medicine
Internal Medicine
590
398
121
86
1
1
1
1
34
37
35
39
Pediatrics*
Pediatrics*
Pediatrics*
Pediatrics*
162
45
80
40
45
18
28
15
3
45
Cardiology
546
105
1
1
1
57
50
43
Endocrinology
ENT
ENT
129
365
356
24
70
66
Internal Medicine: General
J. Morgan
K. Organs
Pediatrics
D. White
H. Wall
N. Green
X. Hirsh
Cardiology
W. Snipes
Other: Medicine
A. Zook
J. Hogan
P. Taff
Department of Medicine—Consulting Staff
J. Washington
C. Eisenhower
S. Truman
L. Coolidge
W. G. Chan
W. Tafy
V. Kennedy
T. Johnson
C. Nixon
M. Polk
S. Warren
T. Werner
Others
3
9
9
3
3
9
3
9
9
3
9
9
9
43
50
43
44
37
57
64
47
54
40
50
53
Internal Medicine
Cardiology
Rheumatology
ENT
Pediatrics
Oncology
ENT
Cardiology
Internal Medicine
OB/GYN
Pulmonary Medicine
Pulmonary Medicine
65
243
334
143
132
356
140
176
160
112
655
503
168
10
41
62
31
25
50
26
32
24
20
113
90
32
1
1
1
1
31
50
37
46
General*
General*
Orthopedic
Orthopedic
759
671
766
792
155
142
155
164
1
47
Urology
403
77
1
1
1
1
1
1
40
43
44
41
47
49
OB/GYN*
OB/GYN
OB/GYN*
OB/GYN*
OB/GYN*
OB/GYN*
415
403
403
602
621
678
90
92
95
129
143
137
47
51
61
63
68
65
56
54
54
47
45
45
50
63
50
44
47
General
General
General
General
General
General
General
General
Orthopedic
Orthopedic
Orthopedic
Orthopedic
Orthopedic
Orthopedic
Orthopedic
Orthopedic
Orthopedic
48
153
100
140
45
32
116
124
216
106
95
96
54
20
22
20
27
8
27
19
26
7
5
20
22
Department of Surgery
General and Orthopedic
S. Saw
C. Blade
R. Runner
D. Dolittle
Other
D. Felix
OB/GYN
B. Shaw
D. Kirby
E. Munson
F. Zebra
G. Martinez
M. Lewis
Surgery—Consulting Staff
M. Merrill
W. Pierce
F. Stevensen
J. Tyler
P. Miller
J. McKinley
M. Dawes
S. Strimpf
S. Skier
W. Hockey
S. Fremont
M. Fremont
D. Davids
K. Nioxon
G. Grant
L. Goldwater
W. Miller
9
9
3
3
3
3
10
10
9
9
9
9
9
9
9
3
3
41
20
18
16
10
3
4
3
5
D. Garfield
K. McGovern
D. Chest
9
9
9
43
53
50
Thoraracic
Thoraracic
Thoraracic
Department of Pathology and Radiology—Active Staff
J. Ericksen
H. Holland
W. Jippel
D. Yip
M. Stern
M. Lincoln
1
1
1
1
1
1
48
62
46
43
44
34
Radiology
Radiology
Radiology
Pathology
Pathology
Pathology
Department of Pathology and Radiology—Consulting Staff
M. Currie
D. Douglas
W. Lewis
D. Slide
F. Fillerautz
G. Gathews
9
9
9
9
9
9
58
43
40
55
44
47
Radiology
Radiology
Radiology
Pathology
Pathology
Pathology
Department of Anesthesiology—Active Staff
N. Needle
S. Westerman
N. Chamerblin
S. Pak
D. Sleep
M. Halo
J. Jones
D. Dinckens
1
1
1
1
9
9
9
9
38
42
44
54
61
50
46
41
Anesthesiology
Anesthesiology
Anesthesiology
Anesthesiology
Anesthesiology
Anesthesiology
Anesthesiology
Anesthesiology
Department of Emergency Medicine—Active Staff
E. Abelson
M. Gasp
I. Hurt
A. Lincoln
H. Calson
W. Hiller
S. Sams
G. Bodansky
1
1
1
1
1
1
1
1
44
51
42
34
40
47
45
50
Emergency
Emergency
Emergency
Emergency
Emergency
Emergency
Emergency
Emergency
Department of Emergency Medicine—Consulting Staff
J. Whitey
J. Sallowash
R. Ritco
TBD
9
9
9
9
47
51
41
Emergency
Emergency
Emergency
Emergency
NOTES
* = Medical practice owned by Webster Health System, Inc.
Office Location: 1 = Middleboro; 2 = Mifflenville; 3 = Jasper; 4 =
Harris City;
5 = Statesville; 6 = Carterville; 7 = Boalsburg; 8 = Minortown; 9 =
59
105
145
9
16
20
Table 4.2
Hospital Inpatient Occupancy by Service, 2017–2011
Hospital Service
2017
2016
2015
2014
2013
2012
2011
Beds
Patient days
Occupancy
2
450
61.6%
2
645
88.4%
3
706
64.5%
4
804
55.1%
4
903
61.8%
4
998
68.4%
6
1,212
55.3%
Beds
Patient days
Occupancy
Medical Surgical I
Beds
Patient days
Occupancy
Medical Surgical II
Beds
Patient days
Occupancy
Medical Surgical III
Beds
Patient days
Occupancy
Orthopedic
Beds
Patient days
Occupancy
ICU
Beds
Patient days
Occupancy
20
5,470
74.9%
20
4,956
67.9%
14
4,106
80.4%
14
3,845
75.2%
14
3,455
67.6%
11
2,840
70.7%
10
2,740
75.1%
20
5,270
72.2%
20
6,047
82.8%
22
6,070
75.6%
20
5,578
76.4%
20
6,129
84.0%
18
4,996
76.0%
20
5,582
76.5%
20
5,442
74.5%
20
5,163
70.7%
23
5,890
70.2%
21
5,830
76.1%
21
5,770
75.3%
24
6,556
74.8%
21
5,979
78.0%
20
5,067
69.4%
20
6,089
83.4%
20
5,378
73.7%
20
5,503
75.4%
20
5,586
76.5%
21
5,767
75.2%
20
5,830
79.9%
0
0
0.0%
0
0
0.0%
4
955
65.4%
7
1845
72.2%
8
2140
73.3%
12
3324
75.9%
13
3824
80.6
Chapter 14 discusses moving from solving single solutions to a more broad based systems thinking defined as One Health. Answer the following questions in regards to the One Health Initiative:
– Define and discuss what the one health initiative is? How can it impact human health?
– Discuss the 3 three components that make up the educational framework of one health (microbiological influences on health and disease; ecosystem health/physical environment; and human-animal interaction) and the role they play.
– How does the one health initiative improve global health and how can we get countries to partner in these efforts? Give an example of how the global community has partnered on a one health initiative (i.e. Paris Climate Accord Agreement)
– How does social work practice align with the One Health initiative?
Lastly, thinking about the overall course, what are your biggest takeaways about public health and social work practice? What was most helpful to learn about?
Unformatted Attachment Preview
Chapter 14
Systems Thinking:
From Single
Solutions to One
Health
Learning Objectives (1 of 2)
• Explain how systems thinking differs from
reductionist thinking
• Identify characteristics of a system
• Identify the steps in systems analysis using systems
diagrams
• Explain the meaning of interactions between factors
Learning Objectives (2 of 2)
• Explain the meaning of bottlenecks and leverage
points
• Identify and explain uses of systems thinking in
public health
• Discuss One Health as an example of systems
thinking
Vignette 1
• You are pregnant and have a 10-year history of
cigarette smoking. You are surprised that at your first
prenatal visit, there is a big sticker on your chart
saying “Smoker.” Everyone in the doctor’s office asks
you what they can do to help, and they quickly enroll
you in special services for smoking cessation for
which you were not eligible before you got pregnant.
When you ask why so much time, attention, and
money is now coming your way, they tell you
pregnancy is a leverage point for stopping smoking.
• You ask: What do they mean by “leverage point”?
Vignette 2
• A patient with active TB is reported by the local
hospital laboratory to the health department. The
health department quickly connects with the patient
to determine his close personal contacts. They also
ask him if they can test him for HIV. He turns out to
be HIV positive, and permission is then requested to
get in touch with his sexual contacts.
• You consider how you would describe the
relationship between TB and HIV, and wonder how
knowledge of this relationship can be used to reduce
the risks of both TB and HIV.
Vignette 3
• You hear that motor vehicle injuries, especially those
due to automobile collisions, have been dramatically
reduced in recent years.
• Was there a magic bullet that accomplished this, you
wonder, or was this reduction accomplished through
a more complicated process?
Vignette 4
• You love rare hamburgers. “Just wave them over the
flame,” you like to say. Recently, you have heard that
ground beef is a high-risk food—even a health
hazard.
• You ask: What does that mean and what is being
done about it?
Vignette 5
• You hear that a new RNA virus is rapidly spreading
and will likely soon reach the United States. Public
health officials are rapidly mobilizing efforts to
control the disease and respond to an outbreak but
see little chance of stopping the disease from
reaching the United States.
• Is this a common event, you wonder, or an
emergency?
Questions-to-Ask (1 of 4)
• What makes systems thinking different?
• What is a system?
• What are the initial steps in systems analysis?
• What additional steps are needed to complete a
system analysis?
• How can we use a systems analysis to better
understand a problem such as coronary artery
disease?
Questions-to-Ask (2 of 4)
• How can we use systems diagrams to display the
working of a system?
• How can we apply systems thinking to population
health issues?
• How can systems thinking help us incorporate
interactions between factors to better understand
the etiology of disease?
• How can systems thinking help take into account the
interactions between diseases?
Questions-to-Ask (3 of 4)
• How can systems thinking help identify bottlenecks
and leverage points that can be used to improve
population health?
• How can systems thinking help us develop strategies
for multiple simultaneous interventions?
• How can systems thinking help us look at processes
as a whole to plan short-term and long-term
intervention strategies?
Questions-to-Ask (4 of 4)
• What is meant by One Health?
• What is the One Health Initiative and the One Health
Educational Framework?
What Makes Systems Thinking Different?
• Traditional thinking in public health, like most sciencebased disciples, has used mostly reductionist thinking
– Looks at one factor or variable at a time
• Systems thinking looks at the impacts of multiple
factors and how they work together as parts of a
system
– Often utilizes data derived from reductionist thinking but
goes beyond to look at multiple factors that cause disease
and disease outcomes
What is a System?
• A system is an interacting group of items forming a
unified whole
– A system changes if you take away or add pieces
– Parts are connected to each other and work together, and the
arrangement is crucial
– Behavior of a system depends on its overall structure
• May be used to describe complex biological
relationships, organizations’ relationships or processes,
or the working of factors/influences that bring about
disease and the outcome of disease
What Are the Initial Steps in
Systems Analysis?
1. Identify the key influences or interventions on an
outcome such as disease of the outcome of disease
2. Indicate the relative strength of the impact of each
of the influences or interventions
3. Identify how these influences or interventions
interact
–
How they work together or interfere with each other
What Additional Steps Are Needed to
Complete A System Analysis?
4. Identify the dynamic changes that may occur in a
system by identifying the feedback loops that occur
in the system
5. Identify bottlenecks that limit the effectiveness of
the system
6. Identify leverage points that provide opportunities
to greatly improve outcomes
How Can We Use a Systems Analysis to
Better Understand a Problem Such as
Coronary Artery Disease?
• Table 14-1 illustrates how we can better understand
a health problem through utilizing the six steps of
systems analysis
Table 14.1: Steps and Their Meaning in
Systems Analysis (1 of 3)
• Identify influences
– Identify factors or determinants that are thought to affect
or influence the probability of occurrence or outcome of a
disease
• Estimate the relative strength of influences
– Estimate the relative risks of each of the influences, or at
least the relative strength, such as weak, moderate, or
strong
Table 14-1: Steps and Their Meaning in
Systems Analysis (2 of 3)
• Examine the interactions between factors
– How is the occurrence of disease or the outcome of
disease affected when two or more influences are
present? Do the impacts of the influences add together,
does one influence protect against another influence?
• Identify feedback loops
– Identify ways that an influence increases or decreases the
impact of other factor(s) over time.
Table 14-1: Steps and Their Meaning in
Systems Analysis (3 of 3)
• Identify bottlenecks
– Identify points in the system or constraints that need to be
addressed in order for the other factors or influences to
have their potential impacts
• Identify leverage points
– Identify points in the system that present opportunities for
interventions to have greater than otherwise expected
impacts
How Can We Use Systems Diagrams to
Display the Workings of a System? (1 of 3)
• The development of systems diagrams begins with
identifying the key factors that will be included in the
systems
• For each factor, we need to:
– Indicate the direction in which it operates (which way the
arrow points)
– Indicate whether the factor operates to reinforce or
increase another factor/outcome (+) or operates to
dampen or decrease another factor/outcome (-)
Figure 14.1: Positive and Negative
Impacts
How Can We Use Systems Diagrams to
Display the Workings of a System? (2 of 3)
• For each factor, we need to:
– Indicate the strength or magnitude of the impact with the
width of the arrow used
• The thicker the arrow, the greater the impact
Figure 14.2: Strength of Response
How Can We Use Systems Diagrams to
Display the Workings of a System? (3 of 3)
• There are different types of feedback loops
– Positive feedback loop: One factor reinforces another to
magnify its impact
• Product of the signs is positive
– Negative feedback loop: One factor reinforces another
factor, which dampens yet another factor
• Product of the signs is negative
Figure 14.3: Positive Feedback Loop
Figure 14.4: Negative Feedback Loop
Figure 14.5: Basic System Diagram
Figure 14.6: Additional Negative
Influences
Figure 14.7: Additional Positive
Influences
Figure 14.8: Systems Diagram
How Can We Apply Systems Thinking to
Population Health Issues?
• Systems thinking can help:
– Incorporate interactions between factors and between
diseases
– Identify bottlenecks and leverage points
– Develop ideas for multiple simultaneous interventions and
look at processes as a whole to plan short and long term
intervention strategies
How Can Systems Thinking Help Us
Incorporate Interactions Between Factors to
Understand the Etiology of Disease?
• Recognition of interactions that multiply or greatly
increase the risk of a certain disease have become an
important tool for:
– Setting priorities
– Developing approaches to risk reduction
• Example: Cigarette smoking, radon, and lung cancer
How Can Systems Thinking Help Take into
Account the Interactions Between Diseases?
• Syndemic is the occurrence together of two or more
diseases that interact to magnify the occurrence
and/or burden of disease
• Syndromes
– Some diseases predispose to other diseases
– Patterns of risk factors/symptoms that tend to occur
together
• Example: HIV
How Can Systems Thinking Help Identify
Bottlenecks and Leverage Points Used to
Improve Population Health?
• Bottleneck: A point at which events are slowed,
presenting obstacles to the success of an intervention
• Leverage point: A point in the system in which
successful interventions produce better than
expected outcomes
• Example: Motor vehicle injuries and the golden hour,
cigarette smoking and pregnant women
How Can Systems Thinking Help Us
Develop Strategies for Multiple
Simultaneous Interventions?
• Previously, interventions were studied and applied one
intervention at a time
– Little thought was given to how they interact or how they
could be used in combination to produce the best results
• Systems thinking creates a coordinated strategy of
utilizing primary, secondary, and tertiary interventions
– Highly successful population health strategy
How Can Systems Thinking Help Us Look at
Processes as a Whole to Plan Short Term and
Long Term Intervention Strategies?
• “Health in All Policies” approach
– Efforts to see the entire processes rather than pieces of
the pie have become key to planning interventions
• Example: Food safety and Hazard Analysis and
Critical Control Points (HACCP)
What is Meant by One Health?
• Human health is dependent on animal health and
the health of the ecosystem
• Connections among human, animal and ecosystem
health
Figure 14.9: The Relationships between
Human Health, Animal Health and
Ecoystem Health are Central to One Health
What is the One Health Initiative?
• Developed by the veterinary medicine community
• “The collaborative effort of multiple health science
professions, together with their related disciplines
and institutions – working locally, nationally, and
globally – to attain optimal health for people,
domestic animals, wildlife, plants, and our
environment.”
Source: One Health Initiative. About the one health initiative. http://www.onehealthinitiative.com/about.php. Accessed July 25, 2017.
Figure 14.10: The One Health Umbrella
Indicating the Need for Broad Collaboration
to Achieve the Goals of One Health
What is the One Health Educational
Framework?
• Developed by the One Health Interprofessional
Education Working Group
• Three components:
– Microbiological influences on health and disease
– Ecosystem health/physical environment
– Human–animal interaction
Top 10 Emerging RNA Viruses
• AIDS/HIV
• Chikungunya
• Dengue
• Ebola
• Hantavirus
• Influenza A
• Middle Eastern
Respiratory
Syndrome
• SARS
• West Nile Virus
• Zika
Ecosystem Factors with Major Impacts
on Human Health
• Global movement of populations
• Agriculture changes and changes in food distribution
• Ecological changes in land and resource use
• Climate change
Human Health Benefits of
Human–Animal Bond
• Reduced blood pressure
• Reduced cholesterol and triglycerides
• Reduced feelings of loneliness
• Increased opportunities for exercise, outdoor
activities, and socialization
Human Health Risks of
Human–Animal Bond
• Toxoplasmosis
• Cat-scratch disease
• Toxocariasis
• Monkeypox
International TradeInternational trade is subject to trade regulations and industrial policies. The Kingdom of Saudi Arabia is also subject to these regulations because of signed trade treaties or membership in various trade organizations. For this week’s discussion, please:Discuss Saudi Arabia’s participation in the World Trade Organization (WTO)and compare and contrast the Kingdom’s WTO involvement with its participation in the Gulf Cooperation Council, League of Arab States, and the Trade and Investment Framework Agreement (TIFA) Saudi Arabia signed with the United States. Which membership or trade agreement benefits Saudi Arabia the most? Directions:Discuss the concepts, principles, and theories from your textbook. Cite your textbooks and cite any other sources if appropriate. Your initial post should address all components of the question with a 500 word limit.
Plagiarism policy: no plagiarism is accepted in the assignments at all. The student should write the assignment in their own words. Two identical assignments will be rejected with zero grades.Citation: The students are required to use APA style of citation in their assignments.The assignment should have the COVER PAGE with New SEU logo and the details of who is submitting and to whom is it submitted. Naming the assignment file: student should use the following format for naming and uploading their assignment: Student name (Student ID) PHC273_Assignment nameAssignments should only be submitted through Blackboard only and not through email. If there is any technical issue in the BB, then it should be reported to BB support team. The screenshot of the problem and the assignment then can be sent to the instructor.The submission of assignment must be done before the scheduled deadline.Late assignments can be accepted only if the student informed the instructor before the assignment deadline is overdue of any acceptable reason of delay. Assignments with improper names and formats will be rejected.
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
PAPER ASSIGNMENT
Course name:
Introduction to Epidemiology
Course number:
PHC-131
Question 1: At a dinner party, a total of 125 people ate the roasted
chicken. Among them, 45 who consumed roasted chicken became ill
while the others were healthy. Calculate the Attack Rate.
Question 2: In a university there are 2100 students, 1400 are boys and
700 are girls. What is the sex ratio?
Question 3: In a country 5,157,550 babies were born in the year 2021.
The midyear population of the country was 950,476,980. What will be
the crude birth rate for the year 2021 for this country?
Questions
Question 4: Look at the following data about Covid 19 pandemic in
Kingdom of Saudi Arabia and find the Crude death rate per 100,000.
• Total number of death due to Covid-19 infection in 2020 = 8,875
• Reference population for the year 2020 = 35,997,107
Question 5: Discuss the interrelationship between prevalence and incidence
describing the effects with increase and decrease. (Word limit = 150)
***Instructions
• Attempt all the questions, each question carries 2 marks.
• Do not write direct answers, solve it in step wise manner
describing the formulas.
• No late work will be accepted, and no second chance will be given.
• Mention your name & ID, instructor’s name, and the date of
submission before uploading the file to BB.
Student Name:
Student ID:
CRN
13101
Branch
Submission Date:
Instructor name
Total
TARIQ ALOTAIBI
Grade
/10
Release Date: 01/10/2023
Page 1 of 2
College of Health Sciences
Department of Public Health
Due Date: 07/10/2022 (End of the day)
•
•
•
•
•
•
Plagiarism policy: no plagiarism is accepted in the assignments at all. The student
should write the assignment in their own words. Two identical assignments will be
rejected with zero grades.
Citation: The students are required to use APA style of citation in their assignments.
The assignment should have the COVER PAGE with New SEU logo and the details
of who is submitting and to whom is it submitted.
Naming the assignment file: student should use the following format for naming and
uploading their assignment: Student name (Student ID) PHC273_Assignment name
Assignments with improper names and formats will be rejected.
Assignments should only be submitted through Blackboard only and not through
email. If there is any technical issue in the BB, then it should be reported to BB support
team. The screenshot of the problem and the assignment then can be sent to the instructor.
The submission of assignment must be done before the scheduled deadline.
o Late assignments can be accepted only if the student informed the instructor
before the assignment deadline is overdue of any acceptable reason of delay.
Page 2 of 2
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.Chapter 4, “Government Response: Regulation” (pp. 57–84)American Nurses Association. (n.d.). ANA enterpriseLinks to an external site.. Retrieved September 20, 2018, from http://www.nursingworld.orgBosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary careLinks to an external site.. Nursing Outlook, 65(6), 761–765.Halm, M. A. (2018). Evaluating the impact of EBP education: Development of a modified Fresno test for acute care nursing Download Evaluating the impact of EBP education: Development of a modified Fresno test for acute care nursing. Worldviews on Evidence-Based Nursing, 15(4), 272–280. doi:10.1111/wvn.12291National Council of State Boards of Nursing (NCSBN)Links to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.ncsbn.org/index.htmNeff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman J. S. (2018). The impact of nurse practitioner regulations on population access to careLinks to an external site.. Nursing Outlook, 66(4), 379–385.Peterson, C., Adams, S. A., & DeMuro, P. R. (2015). mHealth: Don’t forget all the stakeholders in the business caseLinks to an external site.. Medicine 2.0, 4(2), e4.
Unformatted Attachment Preview
10/8/23, 6:34 PM
Week 6: Assignment
Start Assignment
Due Sunday by 10:59pm
Points 100
Attempts 0
Allowed Attempts 2
Submitting a text entry box or a file upload
Back to Module at a Glance
(https://waldenu.instructure.com/courses/85686/modules/items/2749451)
REGULATION FOR NURSING PRACTICE
STAFF DEVELOPMENT MEETING
Nursing is a very highly regulated profession. There are over 100 boards of nursing and national nursing
associations throughout the United States and its territories. Their existence helps regulate, inform, and
promote the nursing profession. With such numbers, it can be difficult to distinguish between BONs and
nursing associations, and overwhelming to consider various benefits and options offered by each.
Both boards of nursing and national nursing associations have significant impacts on the nurse
practitioner profession and scope of practice. Understanding these differences helps lend credence to
your expertise as a professional. In this Assignment, you will practice the application of such expertise by
communicating a comparison of boards of nursing and professional nurse associations. You will also
share an analysis of your state board of nursing.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES (https://waldenu.instructure.com/courses/85686/modules/items/2749454)
To Prepare:
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1/6
10/8/23, 6:34 PM
Week 6: Assignment
Assume that you are leading a staff development meeting on regulation for nursing practice at your
healthcare organization or agency.
Review the NCSBN and ANA websites to prepare for your presentation.
The Assignment: (8- to 9-slide PowerPoint presentation)
Develop a 8- to 9-slide PowerPoint Presentation that addresses the following:
Describe the differences between a board of nursing and a professional nurse association.
Describe the board for your specific region/area.
Who is on the board?
How does one become a member of the board?
Describe at least one state regulation related to general nurse scope of practice.
How does this regulation influence the nurse’s role?
How does this regulation influence delivery, cost, and access to healthcare?
If a patient is from another culture, how would this regulation impact the nurse’s care/education?
Describe at least one state regulation related to Advanced Practice Registered Nurses (APRNs).
How does this regulation influence the nurse’s role?
How does this regulation influence delivery, cost, and access to healthcare?
Has there been any change to the regulation within the past 5 years? Explain.
Include Speaker Notes on Each Slide (except on the title page and reference page)
BY DAY 7 OF WEEK 6
Submit your Regulation for Nursing Practice Staff Development Meeting Presentation.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check
your draft, access the Turnitin Drafts from the Start Here area.
1. To submit your completed assignment, save your Assignment as
WK6Assgn+LastName+Firstinitial
2. Then, click on Start Assignment near the top of the page.
3. Next, click on Upload File and select Submit Assignment for review.
NURS_6050_Module03_Week06_Assignment_Rubric
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2/6
10/8/23, 6:34 PM
Week 6: Assignment
Criteria
Boards of Nursing vs.
Professional Nurse
AssociationsDevelop a
8- to 9- slide
PowerPoint
presentation that
addresses the
following:· Describe the
differences between a
board of nursing and a
professional nurse
association.· Describe
the members of the
board for your specific
region/area.· Who is on
the board?· How does
one become a member
of the board?· Speaker
notes are included on
every slide and are
used to explain and
elaborate the
significant points on
each slide.
Ratings
Pts
25 to >22.0 pts
Excellent
22 to >19.0 pts
Good
19 to >17.0 pts
Fair
17 to >0 pts
Poor
Using sufficient
evidence, the
Using sufficient
evidence, the
Description of the
differences
Description of
the differences
response
accurately and
thoroughly
response
accurately
describes the
between a board
of nursing and
professional
between a
board of
nursing and
describes the
differences
differences
between a board
nurse
associations is
professional
nurse
between a board
of nursing and
professional nurse
of nursing and
professional nurse
associations.
inaccurate or
incomplete.
…Description of
associations is
inaccurate or
incomplete.
associations.
…Response
provides a
…Response
provides an
accurate
who is on a board
of nursing is
incomplete or
…Description of
who is on a
board of
complete and
accurate
description of who
is on a board of
inaccurate.
…Explanation of
nursing is
incomplete or
description of who
is on a board of
nursing.
nursing.
…Response
provides an
how one
becomes a
member of the
inaccurate.
…Explanation
of how one
…Response
provides a
accurate
explanation of
board of nursing
is vague or
becomes a
member of the
detailed and
thorough
explanation of how
how one becomes
a member of the
board of nursing.
inaccurate.
…Speaker notes
are incomplete or
board of
nursing is
vague or
one becomes a
member of the
…Speaker notes
are included on
lack sufficient
elaboration.
inaccurate.
…Speaker
board of nursing.
…Speaker notes
are included on
every slide and
are used to
explain the
every slide and
are used to
significant points
on each slide.
25 pts
notes are
missing.
explain and
elaborate the
significant points
on each slide.
The Impact of State
Regulation on Nurse
PracticeDescribe at
least one state
regulation related to
general nurse scope of
practice.• How does
30 to >26.0 pts
Excellent
26 to >23.0 pts
Good
23 to >20.0 pts
Fair
20 to >0 pts
Poor
Response
includes an
Response
includes an
Description of
one or more state
Description of
one or more
accurate and
thorough
description of how
accurate
description of
how one state
regulations that
are related to
general nurse
state regulations
related to
general nurse
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30 pts
3/6
10/8/23, 6:34 PM
Week 6: Assignment
Criteria
Ratings
Pts
this regulation
influence the nurse’s
role?• How does this
one state
regulation is
related to general
regulation is
related to general
nurse scope of
scope of practice
is incomplete or
inaccurate.
scope of practice
is vague and
inaccurate or is
regulation influence
delivery, cost, and
access to healthcare?•
nurse scope of
practice.
…Response
practice.
…Response
accurately
…Explanation of
how the
regulation(s)
missing.
…Explanation of
how the
If a patient is from
another culture, how
accurately and
thoroughly
explains how the
regulation
influences the
nurse’s role is
regulation(s)
influences the
would this regulation
impact the nurse’s
care/education?• Has
explains how the
regulation
influences the
influences the
nurse’s role.
…Response
vague or
inaccurate.
…Explanation of
nurse’s role is
vague and
inaccurate or is
there been any change
to the regulation within
nurse’s role.
…Response
accurately
explains how the
how the
regulation(s)
missing.
…Explanation of
the past 5 years?
Explain.• Speaker
notes are included on
accurately and
thoroughly
explains how the
regulation(s)
influences
delivery, cost,
influences
delivery, cost,
and access to
how the
regulation(s)
influences
every slide and are
used to explain and
regulation(s)
influences
and access to
healthcare.
healthcare is
vague or
delivery, cost,
and access to
elaborate the
significant points on
each slide.
delivery, cost, and
access to
healthcare.
…Response
accurately
explains how the
inaccurate.
…Explanation of
how the
healthcare is
vague and
inaccurate, or is
…Response
accurately and
thoroughly
regulation
impacts the
nurse’s
regulation(s)
influences the
nurse’s
missing.
…Explanation of
how the
explains how the
regulation
care/education to
provide care for
care/education
for other cultures
regulation(s)
influences the
impacts the
nurse’s
care/education to
other cultures.
…Changes
partially
is vague or
inaccurate.
…Change is
nurse’s
care/education
for other cultures
provide care for
other cultures. …
explained.
…Presentation
vague.
…Presentation
is vague or
inaccurate or
Changes fully
explained.
…Presentation
includes speaker
notes that explain
the points of the
includes speaker
notes that are
incomplete or
missing.
…Change was
not discussed.
includes speaker
notes that explain
presentation.
lack appropriate
explanation.
…Speaker notes
are missing.
26 to >23.0 pts
Good
23 to >20.0 pts
Fair
20 to >0 pts
Poor
and elaborate the
significant points
of the
presentation.
Describe at least one
state regulation related
30 to >26.0 pts
Excellent
https://waldenu.instructure.com/courses/85686/assignments/885575
30 pts
4/6
10/8/23, 6:34 PM
Week 6: Assignment
Criteria
Ratings
Pts
to Advanced Practice
Registered Nurses
(APRNs).• How does
Using sufficient
evidence,
response includes
Using sufficient
evidence,
response
Description of
one or more state
regulations that
Description of
one or more
state
this regulation
influence the nurse’s
role?• How does this
an accurate and
thorough
description of how
includes an
accurate
description of
are related to
Advanced
Practice
regulations
related to
Advanced
regulation influence
delivery, cost, and
one state
regulation is
how one state
regulation is
Registered
Nurses (APRNs)
Practice
Registered
access to healthcare?•
Has there been any
change to the
related to
Advanced
Practice
related to
Advanced
Practice
is incomplete or
inaccurate.
…Explanation of
Nurses
(APRNs) is
vague and
regulation within the
past 5 years?
Registered
Nurses (APRNs).
Registered
Nurses (APRNs).
how the
regulation(s)
inaccurate or is
missing.
Explain.Speaker notes
are included on every
slide and are used to
…Response
accurately and
thoroughly
…Response
accurately
explains how the
influences the
nurse’s role is
vague or
…Explanation
of how the
regulation(s)
explain and elaborate
the significant points
explains how the
regulation
regulation
influences the
inaccurate.
…Explanation of
influences the
nurse’s role is
on each slide.
influences the
nurse’s role.
…Response
nurse’s role.
…Response
accurately
how the
regulation(s)
influences
vague and
inaccurate or is
missing.
accurately and
thoroughly
explains how the
explains how the
regulation(s)
influences
delivery, cost, and
access to
healthcare is
…Explanation
of how the
regulation(s)
regulation(s)
influences
delivery, cost, and
access to
vague or
inaccurate.
influences
delivery, cost,
delivery, cost, and
access to
healthcare. …
healthcare.
…Changes
partially
…Change is
vague.
…Presentation
and access to
healthcare is
vague and
Changes fully
explained.
explained.
…Presentation
includes speaker
notes that are
inaccurate, or is
missing.
…Presentation
includes speaker
notes that explain
includes speaker
notes that explain
the points of the
incomplete or
lack appropriate
explanation.
…Change was
not discussed.
…Speaker
and elaborate on
the significant
presentation.
notes are
missing.
points of the
presentation.
Written Expression and
Formatting—
Paragraph
Development and
OrganizationSpeaker
notes make clear
5 to >4.0 pts
Excellent
4 to >3.0 pts
Good
3 to >2.0 pts
Fair
2 to >0 pts
Poor
Speaker notes and
sentences follow
Speaker notes
and sentences
Speaker notes
and sentences
Speaker notes
and sentences
writing standards
follow writing
follow writing
follow writing
https://waldenu.instructure.com/courses/85686/assignments/885575
5 pts
5/6
10/8/23, 6:34 PM
Week 6: Assignment
Criteria
Ratings
Pts
points that support well
developed ideas, low
logically, and
for flow, continuity,
and clarity. …A
clear and
standards for
flow, continuity,
and clarity 80%
standards for
flow, continuity,
and clarity 60%-
standards for
flow, continuity,
and clarity <
demonstrate continuity
of ideas.Sentences are
carefully focused--
comprehensive
purpose statement,
introduction, and
of the time.
...Purpose,
introduction, and
79% of the time.
...Purpose,
introduction, and
60% of the time.
...Purpose,
introduction,
neither long and
rambling nor short and
conclusion is
provided which
conclusion of the
assignment is
conclusion of the
assignment is
and conclusion
of the
lacking substance. A
clear and
comprehensive
delineates all
required criteria.
stated, yet is
brief and not
descriptive.
vague or off
topic.
assignment is
incomplete or
missing.
purpose statement and
introduction and
conclusion are
provided which
delineate all required
criteria.
Written Expression and
Formatting: English
Writing
5 to >4.0 pts
Excellent
4 to >3.0 pts
Good
3 to >2.0 pts
Fair
2 to >0 pts
Poor
Uses correct
Contains a few
Contains
Contains many (≥5)
grammar,
spelling, and
punctuation with
(1-2) grammar,
spelling, and
punctuation
several (3-4)
grammar,
spelling, and
grammar, spelling,
and punctuation
errors that interfere
no errors.
errors.
punctuation
errors.
with the reader’s
understanding.
Written Expression and
Formatting: The
presentation follows
5 to >4.0 pts
Excellent
4 to >3.0 pts
Good
3 to >2.0 pts
Fair
2 to >0 pts
Poor
correct APA format for
parenthetical/in-text
citations, and reference
Uses correct APA
Contains a few
Contains several
Contains many
format with no
errors.
(1-2) APA format
errors.
(3-4) APA format
errors.
(≥5) APA format
errors.
StandardsCorrect
grammar, mechanics,
and proper
punctuation.
5 pts
5 pts
list.
Total Points: 100
https://waldenu.instructure.com/courses/85686/assignments/885575
6/6
Scholarly Activities Assessment Description Throughout the RN-to-BSN program, students are required to participate in scholarly activities outside of clinical practice or professional practice. Examples of scholarly activities include attending conferences, seminars, journal club, grand rounds, morbidity and mortality meetings, interdisciplinary committees, quality improvement committees, and any other opportunities available at your site, within your community, or nationally. You are required to post at least one documented scholarly activity by the end of this course. In addition to this submission, you are required to be involved and contribute to interdisciplinary initiatives on a regular basis. Submit, by way of this assignment, a summary report of the scholarly activity, including who, what, where, when, and any relevant take-home points. Include the appropriate program competencies associated with the scholarly activity as well as future professional goals related to this activity. You may use the “Scholarly Activity Summary” resource to help guide this assignment (I will attach this doc) (I will also attach ISP document needed for the completion of this assignment). Use APA format.Plagiarism report (less than 10%)
Vaccinations have undoubtedly changed the ways in which humanity combats infectious diseases. Many generations of scientists have studied vaccines and they have successfully eradicated smallpox while substantially lowering incidences of other diseases. How do vaccines work though? You may be surprised to learn that there are different mechanisms for their actions. In this discussion, you are assigned two vaccine types to research and presentation to the class.If your last name begins with the letter N through S, research and present protein-polysaccharide conjugate and subunit vaccines.For each of the two vaccine types that you are assigned, present the following in your initial post:A basic introduction to the vaccine.Mechanism of action.A relevant image of the mechanism or pathogen/antigen.Disease(s) that the vaccine protects against.Any personal perspectives you think are relevant to your assigned vaccination topics (optional)There is a 400-word count minimum for your original post.
This assignment provides the student with an opportunity to complete a thorough analysis of the
tasks, duties, and responsibilities required for the role as a healthcare manager/administrator.
INSTRUCTIONS
The student will submit a career development plan following the instructions below:
First, describe the role of the healthcare manager/administrator based upon Biblical
principles.
Include a discussion of the Lord’s call on your career to serve in this capacity.
Using the U.S. Bureau of Labor Statistics Occupational Outlook Handbook (see
Resources section), provide an analysis of the demand for the position, skills, and
knowledge needed as described in the Field Activity: Resume Review Assignment.
Provide an evaluation of the gap between the current KSAs and what will be needed to be
qualified for the job that was described in the Field Activity: Resume Review
Assignment.
Include research conducted to identify the need for this position and the impact a
successful hospital administrator can have on patient/client care.
Then, describe your career development plan to obtain the KSAs needed. Use the
SMART acronym to guide you.
Ensure it is specific, measurable, action-oriented, realistic, and includes a timeline for
each step of the plan.
Include:
8-10 pages, excluding title page, abstract, and references, in length,
5 scholarly sources, the course text, Bible, and all other sources utilized.
View Career Development Plan Resources page: https://www.bls.gov/ooh/
integrate a minimum of two citations of scriptural support as well as the course textbook
course textbook: Buchbinder, S. B., & Thompson, J. M. (2010). Career opportunities in health care management: Perspectives from the Field. Jones and Bartlett Publishers.
Plagiarism policy: no plagiarism is accepted in the assignments at all. The student should write the assignment in their own words. Two identical assignments will be rejected with zero grades.Citation: The students are required to use APA style of citation in their assignments.The assignment should have the COVER PAGE with New SEU logo and the details of who is submitting and to whom is it submitted. Naming the assignment file: student should use the following format for naming and uploading their assignment: Student name (Student ID) PHC273_Assignment nameAssignments should only be submitted through Blackboard only and not through email. If there is any technical issue in the BB, then it should be reported to BB support team. The screenshot of the problem and the assignment then can be sent to the instructor.The submission of assignment must be done before the scheduled deadline.Late assignments can be accepted only if the student informed the instructor before the assignment deadline is overdue of any acceptable reason of delay. Assignments with improper names and formats will be rejected.
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
PAPER ASSIGNMENT
Course name:
Introduction to Epidemiology
Course number:
PHC-131
Question 1: At a dinner party, a total of 125 people ate the roasted
chicken. Among them, 45 who consumed roasted chicken became ill
while the others were healthy. Calculate the Attack Rate.
Question 2: In a university there are 2100 students, 1400 are boys and
700 are girls. What is the sex ratio?
Question 3: In a country 5,157,550 babies were born in the year 2021.
The midyear population of the country was 950,476,980. What will be
the crude birth rate for the year 2021 for this country?
Questions
Question 4: Look at the following data about Covid 19 pandemic in
Kingdom of Saudi Arabia and find the Crude death rate per 100,000.
• Total number of death due to Covid-19 infection in 2020 = 8,875
• Reference population for the year 2020 = 35,997,107
Question 5: Discuss the interrelationship between prevalence and incidence
describing the effects with increase and decrease. (Word limit = 150)
***Instructions
• Attempt all the questions, each question carries 2 marks.
• Do not write direct answers, solve it in step wise manner
describing the formulas.
• No late work will be accepted, and no second chance will be given.
• Mention your name & ID, instructor’s name, and the date of
submission before uploading the file to BB.
Student Name:
Student ID:
CRN
13101
Branch
Submission Date:
Instructor name
Total
TARIQ ALOTAIBI
Grade
/10
Release Date: 01/10/2023
Page 1 of 2
College of Health Sciences
Department of Public Health
Due Date: 07/10/2022 (End of the day)
•
•
•
•
•
•
Plagiarism policy: no plagiarism is accepted in the assignments at all. The student
should write the assignment in their own words. Two identical assignments will be
rejected with zero grades.
Citation: The students are required to use APA style of citation in their assignments.
The assignment should have the COVER PAGE with New SEU logo and the details
of who is submitting and to whom is it submitted.
Naming the assignment file: student should use the following format for naming and
uploading their assignment: Student name (Student ID) PHC273_Assignment name
Assignments with improper names and formats will be rejected.
Assignments should only be submitted through Blackboard only and not through
email. If there is any technical issue in the BB, then it should be reported to BB support
team. The screenshot of the problem and the assignment then can be sent to the instructor.
The submission of assignment must be done before the scheduled deadline.
o Late assignments can be accepted only if the student informed the instructor
before the assignment deadline is overdue of any acceptable reason of delay.
Page 2 of 2
Please respond to discussion below using current APA edition and 2 scholarly references. Must be 150 words.
Challenges/Success
During this week, I encountered different challenges which contributed immensely to the knowledge I gained and the success of the whole week’s activities. The most valuable lesson I learned in this week is how to take care of patients well through collaborating with different healthcare workers to promote the outcomes of patients. I gained management skills and good communication skills with patients and other healthcare workers. I experienced a high workload due to a high patient turnout. Collaboration with other nurses and healthcare providers made the work easier and helped significantly in reducing the workload (Sharma et al., 2023). I also faced anxiety while working on patients in critical condition and those with contagious diseases. However, the facility provided adequate protective equipment that promoted the safety of all healthcare providers.
Patient Assessment
During this week, I encountered different patient cases. A 36-year-old female patient was presented to the clinic with cough, wheezing sound, and shortness of breath. The patient states that six months ago she experienced similar symptoms and was diagnosed with acute bronchitis which was treated using empiric antibiotics and bronchodilators. However, her condition continued to worsen even after treatment. For the last six months, the patient has lost almost 20 pounds. The patient denied sick contacts, night sweats, chest pain, vomiting, diarrhea, abdominal pain, bleeding or bruising, palpitations, and fever (Sharma et al., 2023). However, the patient has been a smoker for the last 20 years and states that she quit smoking 6 months ago. The patient is hypertensive and has never had allergies.
Differential Diagnosis & Plan of Care
A complete blood count test indicated mild transaminase elevation, a high number of platelet count, and low hemoglobin of 8.3g. A chest X-ray exam revealed mild interstitial pneumonitis. The differential diagnosis for the patient was; histoplasmosis, pneumococcal infection, or viral or bacterial pneumonia (Hanson & Haddad, 2022). A bronchoscopy exam was conducted and the findings helped in diagnosing acute pulmonary histoplasmosis. The plan of care for the patient is the administration of itraconazole for a period of 6 to 12 weeks. The condition of the patient should be continually monitored throughout the treatment period by performing a chest X-ray exam. It is also important to continue monitoring the patient for years after diagnosis for any cases of disease recurrence.
Health Promotion
Pulmonary histoplasmosis can be a self-clearing infection. However, advanced stages of the disease require treatment using systemic antifungal medications such as itraconazole (Hanson & Haddad, 2022). The patient should adhere to the medication as prescribed. Moderate or severe infections are contraindicated, the patient should be closely monitored for recurrence of the infections in the following years after diagnosis. The patient should also manage their hypertension by taking antihypertensive medication and completely quitting smoking.
Lessons
This week was an insightful week essential for me as an advanced nurse practitioner. During the week, I learned and encountered differential diagnosis cases which improved my clinical knowledge on coming up with correct and accurate diagnoses (Cornine, 2020). The clinical experience this week contributed to enriching my competence ability and levels in clinical practice. I learned on how to take care of patients while promoting their overall outcome with the help of other nurses and healthcare providers. I also learned good communication skills that are essential in clinical practice.
I need one for C.O.P.D and one for Parkinson’s Disease
Unformatted Attachment Preview
System Disorder Worksheet
Alteration in Health (Nursing
Diagnosis) may choose more
than one
Pathophysiology:
Health Promotion & Disease
prevention:
Assessment
Risk Factors:
Expected Findings
Safety considerations
Laboratory Test
Diagnostic Procedures (if
any)
Complications
Patient Centered Care
Nursing Care/client education
Therapeutic Procedures (if any)
Medications
Interprofessional care
Complications of condition
What are some of the disadvantages between claim reimbursement, service fee reimbursement and fee-for-service reimbursement?
-Dr. Robert
this was my dis
Medical Insurance Claim
A medical insurance claim may be triggered by a wide range of circumstances in the complicated world of healthcare. Unexpected illness, surgery, or a trip to the doctor are examples of such claims (Tyree et al., 2006). Suppose that John Smith, the patient, needs to submit a medical insurance claim to cover the costs of the big surgery.
Path Taken to Resolve the Insurance Claim
The healthcare provider normally produces a thorough invoice explaining the services rendered, the associated costs, and the patient’s personal information as the first step in resolving a medical insurance claim (Shi et al., 2016). The patient or the physician then submits this invoice to the insurance provider, starting the claims procedure.
Following receipt of the claim, the insurance provider carefully reviews the supporting documentation to confirm the rendered services’ validity and that the patient’s policy protects them (Tyree et al., 2006). Cross-referencing the treatment with the terms and circumstances of the policy is part of this review.
Time Limits and its Importance
Time constraints are essential to this process. Insurance providers frequently include deadlines for filing claims following the completion of care. If these deadlines are met, the claim can be accepted. The insurance provider also has a deadline by which it must handle the claim, which is often outlined in the policy agreement (Tyree et al., 2006). Meeting these deadlines guarantees a smooth process, avoids reimbursement delays, and keeps the healthcare system functioning effectively. Additionally, keeping to these deadlines is essential for financial planning. Patients and healthcare providers depend on prompt reimbursements to manage cash flows. The provision of healthcare services and the overall patient experience may need to be improved by delays in processing claims, which can strain both parties’ budgets (Shi et al., 2016).
In conclusion, careful documentation, observance of submission dates, and prompt processing by the insurance provider are necessary to resolve a medical insurance claim smoothly. These time restrictions are necessary to protect the financial security of patients and healthcare professionals, ensuring that the healthcare system runs smoothly and provides those in need with high-quality care.
References
Tyree, P. T., Lind, B. K., & Lafferty, W. E. (2006). Challenges of using medical insurance claims data for utilization analysis. American Journal of Medical Quality, 21(4), 269-275. https://doi.org/10.1177/1062860606288774
Shi, Y., Sun, C., Li, Q., Cui, L., Yu, H., & Miao, C. (2016, March). A fraud resilient medical insurance claim system. In Proceedings of the AAAI Conference on Artificial Intelligence (Vol. 30, No. 1). https://doi.org/10.1609/aaai.v30i1.9825
Develop a disaster recovery plan to lessen health disparities and improve access to community services after a disaster. Then, develop and record a 10-12 slide presentation (please refer to the PowerPoint tutorial) of the plan with audio and speaker notes for the Vila Health system, city officials, and the disaster relief team.
Collapse All
Introduction
This assessment provides an opportunity for you to apply the concepts of emergency preparedness, public health assessment, triage, management, and surveillance after a disaster. You will also focus on evacuation, extended displacement periods, and contact tracing based on the disaster scenario provided.
Note: Complete the assessments in this course in the order in which they are presented.
Preparation
When disaster strikes, community members must be protected. A comprehensive recovery plan, guided by the MAP-IT (Mobilize, Assess, Plan, Implement, Track) framework, is essential to help ensure everyone’s safety. The unique needs of residents must be assessed to lessen health disparities and improve access to equitable services after a disaster. Recovery efforts depend on the appropriateness of the plan, the extent to which key stakeholders have been prepared, the quality of the trace-mapping, and the allocation of available resources. In a time of cost containment, when personnel and resources may be limited, the needs of residents must be weighed carefully against available resources.
In this assessment, you are a community task force member responsible for developing a disaster recovery plan for the Vila Health community using MAP-IT and trace-mapping, which you will present to city officials and the disaster relief team.
To prepare for the assessment, complete the Vila Health: Disaster Recovery Scenario simulation.
In addition, you are encouraged to complete the Disaster Preparedness and Management activity. The information gained from completing this activity will help you succeed with the assessment as you think through key issues in disaster preparedness and management in the community or workplace. Completing activities is also a way to demonstrate engagement.
Begin thinking about:
Community needs.
Resources, personnel, budget, and community makeup.
People accountable for implementation of the disaster recovery plan.
Healthy People 2020 goals and 2030 objectives.
A timeline for the recovery effort.
You may also wish to:
Review the MAP-IT (Mobilize, Assess, Plan, Implement, Track) framework, which you will use to guide the development of your plan:
Mobilize collaborative partners.
Assess community needs.
Plan to lessen health disparities and improve access to services.
Implement a plan to reach Healthy People 2020 goals or 2030 objectives.
Track community progress.
Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete.
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.
Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@capella.edu to request accommodations.
Note: Complete the assessments in this course in the order in which they are presented.
Instructions
Every 10 years, The U.S. Department of Health and Human Services and the Office of Disease Prevention and Health Promotion release information on health indicators, public health issues, and current trends. At the end of 2020, Healthy People 2030 was released to provide information for the next 10 years. Healthy People 2030 provides the most updated content when it comes to prioritizing public health issues; however, there are historical contents that offer a better understanding of some topics. Disaster preparedness is addressed in Healthy People 2030, but a more robust understanding of MAP-IT, triage, and recovery efforts is found in Healthy People 2020. For this reason, you will find references to both Healthy People 2020 and Healthy People 2030 in this course.
Complete the following:
Develop a disaster recovery plan for the Vila Health community that will lessen health disparities and improve access to services after a disaster. Refer back to the Vila Health: Disaster Recovery Scenario to understand the Vila Health community.
Assess community needs.
Consider resources, personnel, budget, and community makeup.
Identify the people accountable for implementation of the plan and describe their roles.
Focus on specific Healthy People 2020 goals and 2030 objectives.
Include a timeline for the recovery effort.
Apply the MAP-IT (Mobilize, Assess, Plan, Implement, Track) framework to guide the development of your plan:
Mobilize collaborative partners.
Assess community needs.
Use the demographic data and specifics related to the disaster to identify the needs of the community and develop a recovery plan. Consider physical, emotional, cultural, and financial needs of the entire community.
Include in your plan the equitable allocation of services for the diverse community.
Apply the triage classification to provide a rationale for those who may have been injured during the train derailment. Provide support for your position.
Include in your plan contact tracing of the homeless, disabled, displaced community members, migrant workers, and those who have hearing impairment or English as a second language in the event of severe tornadoes.
Plan to lessen health disparities and improve access to services.
Implement a plan to reach Healthy People 2020 goals and 2030 objectives.
Track and trace-map community progress.
Use the CDC’s Contract Tracing Resources for Health Departments as a template to create your contact tracing.
Describe the plan for contact tracing during the disaster and recovery phase.
Develop a slide presentation of your disaster recovery plan with an audio recording of you presenting your assessment of the Vila Health: Disaster Recovery Scenario for city officials and the disaster relief team. Be sure to also include speaker notes.
PRESENTATION FORMAT AND LENGTH
You may use Microsoft PowerPoint (preferred) or other suitable presentation software to create your slides and add your voice-over along with speaker notes. If you elect to use an application other than PowerPoint, check with your instructor to avoid potential file compatibility issues.
Be sure that your slide deck includes the following slides:
Title slide.
Recovery plan title.
Your name.
Date.
Course number and title.
References (at the end of your presentation).
Your slide deck should consist of 10-12 content slides plus title and references slides. Use the speaker’s notes section of each slide to develop your talking points and cite your sources as appropriate. Be sure to also include a transcript that matches your recorded voice-over. The transcript can be submitted on a separate Word document. Make sure to review the Microsoft PowerPoint tutorial for directions.
The following resources will help you create and deliver an effective presentation:
Record a Slide Show With Narration and Slide Timings.
This Microsoft article provides steps for recording slide shows in different versions of PowerPoint, including steps for Windows, Mac, and online.
Microsoft Office Software.
This Campus page includes tip sheets and tutorials for Microsoft PowerPoint.
PowerPoint Presentations Library Guide.
This library guide provides links to PowerPoint and other presentation software resources.
SoNHS Professional Presentation Guidelines [PPTX].
This presentation, designed especially for the School of Nursing and Health Sciences, offers valuable tips and links, and is itself a PowerPoint template that can be used to create a presentation.
SUPPORTING EVIDENCE
Cite at least three credible sources from peer-reviewed journals or professional industry publications within the past 5 years to support your plan.
GRADED REQUIREMENTS
The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point:
Describe the determinants of health and the cultural, social, and economic barriers that impact safety, health, and recovery efforts in the community.
Consider the interrelationships among these factors.
Explain how your proposed disaster recovery plan will lessen health disparities and improve access to community services.
Consider principles of social justice and cultural sensitivity with respect to ensuring health equity for individuals, families, and aggregates within the community.
Explain how health and governmental policy impact disaster recovery efforts.
Consider the implications for individuals, families, and aggregates within the community of legislation that includes, but is not limited to, the Americans with Disabilities Act (ADA), the Robert T. Stafford Disaster Relief and Emergency Assistance Act, and the Disaster Recovery Reform Act (DRRA).
Present specific, evidence-based strategies to overcome communication barriers and enhance interprofessional collaboration to improve the disaster recovery effort.
Consider how your proposed strategies will affect members of the disaster relief team, individuals, families, and aggregates within the community.
Include evidence to support your strategies.
Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).
Slides are easy to read and error free. Detailed audio and speaker notes are provided. Audio is clear, organized, and professionally presented.
Develop your presentation with a specific purpose and audience in mind.
Adhere to scholarly and disciplinary writing standards and APA formatting requirements.
ADDITIONAL REQUIREMENTS
Before submitting your assessment, proofread all elements to minimize errors that could distract readers and make it difficult for them to focus on the substance of your presentation.
Context
Nurses perform a variety of roles and their responsibilities as health care providers extend to the community. The decisions we make daily and in times of crisis often involve the balancing of human rights with medical necessities, equitable access to services, legal and ethical mandates, and financial constraints. In the event of a major accident or natural disaster, many issues can complicate decisions concerning the needs of an individual or group, including understanding and upholding rights and desires, mediating conflict, and applying established ethical and legal standards of nursing care. As a nurse, you must be knowledgeable about disaster preparedness and recovery to safeguard those in your care. As an advocate, you are also accountable for promoting equitable services and quality care for the diverse community.
Nurses work alongside first responders, other professionals, volunteers, and the health department to safeguard the community. Some concerns during a disaster and recovery period include the possibility of death and infectious disease due to debris and/or contamination of the water, air, food supply, or environment. Various degrees of injury may also occur during disasters, terrorism, and violent conflicts.
To maximize survival, first responders must use a triage system to assign victims according to the severity of their condition/prognosis in order to allocate equitable resources and provide treatment. During infectious disease outbreaks, triage does not take the place of routine clinical triage.
Trace-mapping becomes an important step to interrupting the spread of all infectious diseases to prevent or curtail morbidity and mortality in the community. A vital step in trace-mapping is the identification of the infectious individual or group and isolating or quarantining them. During the trace-mapping process, these individuals are interviewed to identify those who have had close contact with them. Contacts are notified of their potential exposure, testing referrals become paramount, and individuals are connected with appropriate services they might need during the self-quarantine period (CDC, 2020).
An example of such disaster is the COVID-19 pandemic of 2020. People who had contact with someone who were in contact with the COVID-19 virus were encouraged to stay home and maintain social distance (at least 6 feet) from others until 14 days after their last exposure to a person with COVID-19. Contacts were required to monitor themselves by checking their temperature twice daily and watching for symptoms of COVID-19 (CDC, 2020). Local, state, and health department guidelines were essential in establishing the recovery phase. Triage Standard Operating Procedure (SOP) in the case of COVID-19 focused on inpatient and outpatient health care facilities that would be receiving, or preparing to receive, suspected, or confirmed COVID- 19 victims. Controlling droplet transmission through hand washing, social distancing, self-quarantine, PPE, installing barriers, education, and standardized triage algorithm/questionnaires became essential to the triage system (CDC, 2020; WHO, 2020).
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Analyze health risks and health care needs among distinct populations.
Describe the determinants of health and the cultural, social, and economic barriers that impact safety, health, and disaster recovery efforts in a community.
Competency 2: Propose health promotion strategies to improve the health of populations.
Present specific, evidence-based strategies to overcome communication barriers and enhance interprofessional collaboration to improve disaster recovery efforts.
Competency 3: Evaluate health policies, based on their ability to achieve desired outcomes.
Explain how health and governmental policy impact disaster recovery efforts.
Competency 4: Integrate principles of social justice in community health interventions.
Explain how a proposed disaster recovery plan will lessen health disparities and improve access to community services.
Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health.
Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).
Slides are easy to read and error free. Detailed audio, transcript, and speaker notes are provided. Audio is clear, organized, and professionally presented.
Disaster Recovery Plan Scoring Guide
CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Describe the determinants of health and the cultural, social, and economic barriers that impact safety, health, and disaster recovery efforts in a community. Does not identify the determinants of health that impact safety, health, and disaster recovery efforts in a community. Identifies the determinants of health that impact safety, health, and disaster recovery efforts in a community, without regard to cultural, social, and economic barriers. Describes the determinants of health and the cultural, social, and economic barriers that impact safety, health, and disaster recovery efforts in a community. Provides a concise, accurate description of the determinants of health and the cultural, social, and economic barriers that impact safety, health, and disaster recovery efforts in a community. Clearly describes the interrelationships among these factors.
Explain how a proposed disaster recovery plan will lessen health disparities and improve access to community services. Does not explain how a proposed disaster recovery plan will lessen health disparities and improve access to community services. Explains how a proposed disaster recovery plan will lessen health disparities and improve access to community services, without regard to the needs of the entire community. Explains how a proposed disaster recovery plan will lessen health disparities and improve access to community services. Explains how a proposed disaster recovery plan will lessen health disparities and improve access to community services. Provides clear insight into how principles of social justice and cultural sensitivity help to ensure health equity for individuals, families, and aggregates in the community.
Explain how health and governmental policy impact disaster recovery efforts. Does not explain how health and governmental policy impact disaster recovery efforts. Explains how health and governmental policy impact disaster recovery efforts, without regard to the needs of the entire community. Explains how health and governmental policy impact disaster recovery efforts. Explains how health and governmental policy impact disaster recovery efforts. Articulates the logical policy implications for community members linked to specific policy provisions.
Present specific, evidence-based strategies to overcome communication barriers and enhance interprofessional collaboration to improve disaster recovery efforts. Does not present specific, evidence-based strategies to overcome communication barriers and enhance interprofessional collaboration to improve disaster recovery efforts. Presents strategies to overcome communication barriers and enhance interprofessional collaboration to improve disaster recovery efforts without regard to the needs of the entire community. Presents specific, evidence-based strategies to overcome communication barriers and enhance interprofessional collaboration to improve disaster recovery efforts. Presents specific, evidence-based strategies to overcome communication barriers and enhance interprofessional collaboration to improve disaster recovery efforts that are well-supported by with relevant and credible evidence. Articulates the implications and potential consequences of proposed strategies.
Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years). Does not organize content with clear purpose/goals. Power point slides do not support main points, assertions, arguments, conclusions, or recommendations. Sources are not relevant and/or evidence-based (published within 5 years). Organizes content with clear purpose/goals. Power point slides do not consistently support main points, assertions, arguments, conclusions, and/or recommendations with relevant and evidence-based sources (published within 5 years). Organizes content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years). Organizes content with clear purpose/goals. Power point slides support main points, assertions, arguments, conclusions, or recommendations with relevant and evidence-based sources (published within 5 years).
Slides are easy to read and error free. Detailed audio, transcript, and speaker notes are provided. Audio is clear, organized, and professionally presented. Slides are difficult to read with multiple editing errors. No audio, transcript, and/or speaker notes provided. Slides are easy to read and error free. No audio or audio is not clear, difficult to hear, or not professionally presented. Speaker notes and transcript are sufficient support for the slides. Slides are easy to read and error free. Detailed audio, transcript, and speaker notes are provided. Audio is clear, organized, and professionally presented. Slides are easy to read and clutter free. Slide background is “visually” pleasing with a contrasting color for the text and may utilize graphics. Detailed audio, transcript, and speaker notes are provided. Audio is clear, organized, and professionally presented.
Guidelines: Use this Word Document for submission. Complete student’s information on the first page of the document.Start your writing from the next page (page 3)Word count: 250-300 words Font should be 12 Times New RomanHeadings should be Bold Color should be BlackLine spacing should be 1.5AVOID PLAGIARISM (>25% – zero grade)References should be written in APA format
Unformatted Attachment Preview
ASSIGNMENT COVER SHEET
Course name
Healthcare Research Methods
Course number
PHC 215
CRN
Select any condition or disease in which you are interested
to conduct research study
Assignment title or task:
( write and questions)
1. Write two paragraph background, first paragraph describing
the disease and second paragraph the gap in literature that you
want to address – 1 marks
2. Design research question and develop research hypothesis for
the study– 2 marks
3. Describe the study approach and study design you will use to
test your hypothesis in one paragraph? – 2 marks
Student names and ID
numbers:
Submission date:
Instructor name:
Dr. Khaldoon Alfayad
Grade:
Out of 5
Guidelines:
•
Use this Word Document for submission.
•
Complete student’s information on the first page of the document.
•
Start your writing from the next page (page 3)
•
Word count: 250-300 words
•
Font should be 12 Times New Roman
•
Headings should be Bold
•
Color should be Black
•
Line spacing should be 1.5
•
AVOID PLAGIARISM (>25% – zero grade)
•
References should be written in APA format
In postpartum women (P), how does breastfeeding (I) compared with
formula feeding (C) affect postpartum depression (O)? Postpartum depression – research question!
Purpose: To determine if the literature chosen is helpful and applicable to answering a clinical question; information from each must be identified to facilitate appraisal of its usefulness to practice.
Description: Continuing to use the literature found from previous weeks, you will extract critical information from each article for analysis in relation to the clinical question. This will require a careful reading of each article. See the grading rubric embedded in Brightspace.
Instructions:
1. Complete an evidence table row in the attached document for each of the 4 (or 5, if a CPG was found) articles previously located.
2. In the appropriate box, state if the article analyzed is useful to answering the clinical question. Why or why not?
Upload the completed document and pdfs of all 4 or 5 articles to the appropriate submission folder using the following filenames:
Lastname Evidence Table
Lastname Article 1
Lastname Article 2
Lastname Article 3
Lastname Article 4
Lastname CPG if found 5
Unformatted Attachment Preview
EBP Project, Part 5: Evidence Table
First author/year
Level of Evidence
Population and
Setting
Intervention
Description
At this point, do you feel the study is relevant to the clinical question? Why or why not?
At this point, do you feel the study is relevant to the clinical question? Why or why not?
At this point, do you feel the study is relevant to the clinical question? Why or why not?
Outcomes
Measured (include
only those that
relate to the “O” in
the PICO)
Relevant findings (or
recommendations for CPGs)
that help answer the PICO
question
First author/year
Level of Evidence
Population and
Setting
Intervention
Description
At this point, do you feel the study is relevant to the clinical question? Why or why not?
At this point, do you feel the study is relevant to the clinical question? Why or why not?
Outcomes
Measured (include
only those that
relate to the “O” in
the PICO)
Relevant findings (or
recommendations for CPGs)
that help answer the PICO
question
1
Blessy Ann Biju
EBP Project, Part 4: Levels of Evidence
Author/Year
Journal Title/Peer
Review?
Journal of Nursing
Scholarship (Peerreviewed)
Category
Appleton, J., Russell, C. Maternal & Child
G., Laws, R., Fowler,
Nutrition (PeerC., Campbell, K., &
reviewed)
Denney‐Wilson, E.
(2018)
Hutchens, B. F., &
Kearney, J. (2020)
Ghaedrahmati, M.,
Kazemi, A.,
Kheirabadi, G.,
Ebrahimi, A., &
Bahrami, M. (2017)
Adams, Y. J., Stommel,
M., Ayoola, A.,
Horodynski, M.,
Malata, A., & Smith, B.
(2017)
Rationale for
Category
This study involves
data collection and
analysis on rural
Malawi’s postpartum
care services, providing
evidence and concrete
data to support the
findings.
Level of Evidence
Secondary
This article is a
systematic review,
which typically
compiles and analyzes
existing research. It
comprises other
relevant studies that
enrich its findings.
Systematic reviews are
considered Level 1
evidence.
Journal of Midwifery
and Women’s Health
(Peer-reviewed)
Secondary
Level 1 evidence.
Journal of Education
and Health Promotion
(Peer-reviewed)
Secondary
This systematic review
article incorporated
information obtained
from 8 reputable
sources.
This article is described
as a narrative review,
which summarizes and
discusses existing
Primary-Quantitative
Level 6 evidence.
Level 5 evidence
2
Author/Year
Journal Title/Peer
Review?
Category
Rationale for
Category
research on postpartum
depression risk factors.
Level of Evidence
Reflection on the body of evidence to answer your research question.
The literature I have gathered, as a whole, includes a variety of study types and levels of evidence, thus providing a reasonably
comprehensive view of the topic related to postpartum care services and postpartum depression risk factors. The systematic reviews
(Appleton et al., 2018; Hutchens & Kearney, 2020) are particularly valuable as they compile and analyze multiple studies, offering
high-quality evidence (Level 1). However, it is essential to note that while the literature is relatively comprehensive, it may still have
limitations or gaps. Therefore, the sufficiency of the literature will be addressed by refining search terms and strategies to uncover any
additional relevant studies that may have been missed. I would also consider looking beyond research articles to clinical guidelines,
textbooks, and government health agencies for guidance and additional information.
Directions: Write a one page reflection MLA style essay answering the following questions. After reading the PowerPoint on nutrition for athletes, how would you change (if needed) your diet examples; your intake of water, protein, carbs, and fats. What are your thoughts on Protein and supplement uses during and after workouts? After learning about our healthcare and why people are so unhealthy how do you think the information from the powerpoint can help our society make better eating habits, especially for athletes.** no AI** PPT Based
Unformatted Attachment Preview
NUTRITION FOR
ATHLETIC
PERFORMANCE
Kinesiology Major 100
By: Ms. Perry
WHO “IS” AND WHO “IS NOT” AN ATHLETE?
Someone who is elite in their sport?
Someone who competes regularly?
Someone who exercises everyday?
There is no set protocol to establish who is and who
is not an athlete, therefore, you must decide based
on sound judgment.
Anyone who goes “above and beyond” the basic
exercise recommendations for health benefits.
WHY IS NUTRITION IMPORTANT FOR
ATHLETES?
Provide general health benefits
Maintain an appropriate body composition
Maximize athletic performance
WHAT CHANGES ARE MADE FOR ATHLETES?
Macronutrient daily recommendations
Caloric requirement
Intake before, during and after a training bout or
competition
Hydration and fluid replacement
Consideration of the use of sports drinks and
other products
MACRONUTRIENT INTAKE FOR THE
GENERAL POPULATION
50-55% of calories from carbohydrate
10-15% of calories from protein
Less than 30% of calories from fat
MACRONUTRIENT INTAKE FOR ATHLETES
55-60% (or sometimes higher) of calories from
carbohydrate
10-15% of calories from protein
Less than 30% of calories from fat
The main difference is in the amount of
carbohydrate, for both resistance and endurance
athletes!!! Why?
AVAILABLE FUEL SOURCES
FOR EXERCISE
Fat
Intramuscular triglycerides
Plasma fatty acids
CHO
Muscle glycogen
Blood glucose
Protein
AVERAGE BODY ENERGY STORES:
Fuel
Amt (kg)
Kcal Value
Stored Fat
15.56
140,000
Ms Glycogen
0.35
1,400
Liver Glycogen 0.09
360
Blood Glucose
0.02
80
Protein (ms)
26.02
40,000
FACTORS AFFECTING FUEL USE
(CARBOHYDRATE VS. FAT)
Intensity of Exercise
Duration of Exercise
Training Status
Diet
IMPORTANCE OF CHO
Plays a critical role in athletic performance
Primary energy source
Cause of fatigue in athletes
Muscle glycogen in depletion
Liver glycogen depletion
Diet is critical to replenish CHO stores
EVENTS TAXING CHO STORES
One hard competition
Multiple events in one day
Exhaustive daily training
Two-a-day workouts
High-power, intermittent workouts
CONSEQUENCE OF LOW CHO DIETS
Slow repletion of glycogen stores
Fatigue
Impaired training and performance
Injury
FAT INTAKE RECOMMENDATIONS
Essential part of a healthy diet
No benefit (may actually be detrimental) when fat
intake
Purchase answer to see full
attachment
For your original post, craft a response of at least 150 words that addresses all of the following:
How familiar are you with evaluation essays? Choose one:
I have never heard of evaluation essays.
I have heard of evaluation essays, but my understanding is unclear.
I have a clear idea of evaluation essays, but I have never written one myself.
I’m not sure I could clearly explain evaluation essays, though I’ve written at least one before.
I can clearly explain evaluation essays and have written at least one.
Even if you have never written a formal evaluation essay, list specific ways in which you have seen, heard, or used evaluation (judging the quality of a product, business, place, service, or program) in your life.
Brainstorm ways that you think evaluation may come to play a role in your pathway/career of interest (for example: under what circumstances would someone in the arts, business, health sciences, etc., have to judge the quality of something?).
Identify one Ergonomic challenge in healthcare. Describe the impact on the patient and healthcare worker. Describe the opportunity to improve this Ergonomic challenge.
Please address the topics below:
Background facts about the Ergonomic challenge including incidence and prevalence
The impact of the Ergonomic challenge on the Healthcare worker
The impact of the Ergonomic challenge on the patient
Your recommendations to improve this Ergonomic challenge based on evidence from the literature
Your paper should meet the following structural requirements:
Four-to-five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing standards
Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
As you implement an HIE as a professional, you will need to consider workflow. After all, the workflow for a given entity impacts the overall change in workflow, as well as employee performance and behavior. Implementing HIE may result in new or improved existing workflows. There may be inefficiencies in health information in different areas within the healthcare organization. The implementation of HIE may improve these inefficiencies or change practices and policies. Non-clinical workflow may also change. For example, privacy policies may need to change. Would additional training be required? Would user roles need to change? In this assignment, you will write a short paper on workflows and their impact on change and employee performance and behavior.
Prompt
For this short paper, address the following questions:
What is a workflow?
How might the implementation of HIE impact current workflow and employee performance?
How will workflow tasks change and/or improve?
How do workflows and HIEs impact organizational change?
How will the process be better streamlined with the implementation of exchange?
How will you analyze and use the data in the HIE network to improve patient outcomes?
What to Submit
Your paper must be submitted as a 2- to 3-page Microsoft Word document with double spacing, 12-point Times New Roman font, one-inch margins, and cite any sources used in APA format.
Interpret financial and market information to guide strategic decision making and improve patient outcomes.
Instructions: Due Tuesday of Week 8 by 11:59 pm EST.
Read Case 16 (pages 97-101) from Gapenski’s Cases in Healthcare Finance – “Seattle Cancer Center.”
Create a presentation in Microsoft PowerPoint (PPT), suitable for presentation to a senior level executive. The final product should include a title slide with your name and the name of the case. Two or three slides per question (see below) should be sufficient to respond appropriately to the case prompts. Slide numbers should be included. Use of non-case related graphics is not required. All Excel work should be imported into the presentation in table format (in the body of the document) or enclosed as an Appendix within the same document. Use of external resources and articles is encouraged, but not required. References should be cited in APA format, either as a footnote on the slide where the information / data is used or in an appendix slide.
In your presentation, provide a response to the following questions from the case study:
Should the Center lease the equipment?
What is the maximum lease payment that the Center would be willing to pay?
What would be the NAL to the Center if tax-exempt (municipal) debt financing was available to the Center?
Would the availability of tax-exempt debt financing make leasing more or less attractive to the Center than before? Why?
As a baseline, assume all cash flows have the same risk; that is, ignore residual value risk and use the same discount rate for all lessee cash flows.
For additional guidance on how to construct a professional presentation, please see the link below. https://www.wiley.com/network/researchers/promoting-your-article/6-tips-for-giving-a-fabulous-academic-presentation
Write down everything you eat and drink for one day. Include breakfast, lunch, dinner, and snacks. You do not need to write down water as it has no calories. If you drink alcohol, you need to add the amount as alcohol does have calories.
You will need to create a free account when you are ready to analyze your food intake.
Click on the Cronometer Link to enter your 1-day food intake.
CronometerLinks to an external site.
To create your account, click the green “Sign up for Free” tab. Enter your email (you may use your college email if you don’t want to use your personal email). Create and confirm a password and write it down. Enter the information for “Your Body Type.” Then, click the box for “I agree to the cronometer.com Terms of Service.
You may then begin adding your food by clicking the “ADD FOOD” tab. Type a food into the search box and find the closest choice from the list. Continue adding until all the food you consumed for the day has been added. You must add a minimum of 1500 calories for this assignment!
You will need to save and submit the analysis as part of this assignment. (20 Points) You can save your Cronometer analysis by clicking “Print” then instead of printing, choose “Save as PDF”.
If you need help, click on the help tab and refer to the user’s manual. You are also welcome to join me during my office hours!
Once you have finished adding all of your foods, scroll through the Nutrient Target Summaries.
By default, Cronometer set each nutrient to the recommended values as set by the DRI nutrition standards. The basic idea for these targets is to get at least 100% of the minimum value each day to have good nutrition. For nutrients that have a maximum, it is recommended to not exceed the maximum value.
Bars colored in yellow mean you have not yet reached your minimum target
Bars colored in green mean you have met the minimum target and not yet exceeded your maximum target.
Bars colored in red mean you have exceeded your maximum target.
You can mouse over a bar to see the top contributors from your diary on that day to meet this specific target.
Answer the following questions and submit them along with your saved Cronometer food analysis.
How many calories did you consume? (4 Points) You must enter a minimum of 1500 calories for this assignment.
What percentage of Carbohydrates, Lipids (fats), and Proteins did you consume? (12 Points)
Referring back to the foods you consumed the day of the analysis, what are two changes you can make to improve your nutritional intake? Please talk specifically about your foods. For example, if you are consuming too much fat, discuss the specific foods you ate that are high in fat and give me alternative foods to decrease your fat intake. (9 Points)
please respond to the following discussion post as a peer making a comment”For an intervention to remain effective in the long term, it’s essential to ensure that it’s sustainable and continues to produce positive outcomes beyond its initial implementation phase. This can be done by incorporating the intervention into routine healthcare practices and constantly monitoring and evaluating its effectiveness. By making it a standard practice, staff can be trained, and electronic health records can be adapted to include the intervention. To ensure its practicality in the long run, it’s necessary to regularly assess its effectiveness by collecting data, getting feedback from stakeholders, and addressing any emerging issues or barriers.
This project is centered on enhancing post-transplant care for liver transplant recipients aged 18-40 in South Texas. To guarantee success, the following measures will be taken:
The project will take the following measures to enhance post-transplant care for liver transplant recipients aged 18-40 in South Texas. The post-transplant education team will initially address operational challenges through a pilot implementation before the full rollout. To ensure that intervention remains effective in the long term, it is crucial to ensure it is sustainable and continues to generate positive outcomes beyond its initial implementation phase (Lerret et al., 2020). Monitoring and evaluation systems will be put in place to track the impact of the intervention, gather feedback, and make necessary improvements as part of a Continuous Quality Improvement process. Key stakeholders, including transplant recipients, healthcare providers, and administrators, will be involved in decision-making to ensure long-term sustainability. If the pilot phase proves effective and sustainable, the intervention will be expanded to reach more transplant recipients in South Texas. Lists and bullet points will be used to present steps or procedures. The project will take the following measures: Pilot Implementation, Continuous Quality Improvement, Stakeholder Engagement, Scale-Up, Dissemination, and Advocacy and Policy Support. The healthcare community will know the intervention’s success and outcomes to encourage adoption in other regions and settings. Transitional phrases will be used to link ideas and show relationships between them. Policies and guidelines will be established to maintain multidisciplinary post-transplant education teams in transplant centers, ensuring ongoing funding and integration into standard practice. Technical language will be used when discussing specific topics, such as the multidisciplinary post-transplant education team. It is crucial to ensure it is sustainable and continues to generate positive outcomes, and formal language will be used when discussing professional topics.
By following these steps and promoting sustainability, the project aims to ensure that improved post-transplant care for liver transplant recipients remains effective and beneficial in the long term. It is crucial to ensure the intervention is sustainable and continues to generate positive outcomes to enhance post-transplant care for liver transplant recipients aged 18-40 in South Texas. To ensure the intervention remains effective in the long term, it is essential to ensure it is sustainable and continues to generate positive outcomes beyond its initial implementation phase. pients remains effective and beneficial in the long term. It is crucial to ensure the intervention is sustainable and continues to generate positive outcomes to enhance post-transplant care for liver transplant recipients aged 18-40 in South Texas. To ensure the intervention remains effective in the long term, it is essential to ensure it is sustainable and continues to generate positive outcomes beyond its initial implementation phase.
Lerret, S. M., White-Traut, R., Medoff-Cooper, B., Simpson, P., Riddhiman, A., Sheikh, A., & Schiffman, R. (2020). Pilot Study Protocol of a mHealth Self-Management Intervention for Family Members of Pediatric Transplant Recipients. Research in Nursing & Health, 43(2), 145. https://doi.org/10.1002/nur.22010
Apply and integrate the concepts and knowledge gained in prior general management and health care administration courses to industry-relevant challenges.
Assess the relevant strategic decision-making and implementation issues within a health care organization.
COVID-19 Pandemic
The COVID-19 pandemic, also known as the coronavirus pandemic, is a pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified in December 2019 in Wuhan, China. The World Health Organization declared the outbreak a Public Health Emergency of International Concern in January 2020 and a pandemic in March 2020. As of 14 December 2020, more than 72.5 million cases had been confirmed worldwide, with more than 1.61 million deaths attributed to COVID. As of December 14, 2020, the United States had more than 16, 000,000 positive COVID-19 cases with more than 300,000 deaths; these numbers are continuously updated; please see the STAT COVID-19 Tracker for the most current statistics.
The pandemic has caused global social and economic disruption, including the largest global recession since the Great Depression. COVID-19 has led to the postponement or cancellation of events, widespread supply shortages exacerbated by panic buying, agricultural disruption, and food shortages, and decreased emissions of pollutants and greenhouse gases.
Educational institutions have been partially or fully closed. Misinformation has circulated through social media and mass media. There have been incidents of xenophobia and discrimination against Chinese people and against those perceived as being Chinese or as being from areas with high infection rates.
The pandemic has affected the political systems of multiple countries, causing suspensions of legislative activities, isolations or deaths of multiple politicians, and rescheduling of elections due to fears of spreading the virus. Although they have broad support among epidemiologists, social distancing measures have been politically controversial in many countries. The pandemic has had many impacts on global health beyond those caused by COVID-19 disease.
It has led to a reduction in hospital visits for other reasons. In several countries, there has been a marked reduction in the spread of sexually transmitted infections, including HIV/AIDS, attributable to COVID-19 quarantines, social distancing measures, and recommendations to not engage in casual sex. Similarly, in some places, rates of transmission of influenza and other respiratory viruses significantly decreased during the pandemic. The pandemic has also negatively impacted mental health globally, including increased loneliness resulting from social distancing and depression and domestic violence from lockdowns.
The pandemic has resulted in misinformation and conspiracy theories about the scale of the pandemic and the origin, prevention, diagnosis, and treatment of the disease. Journalists have been arrested for allegedly spreading false information about the pandemic. It has also been propagated by celebrities, politicians, and other prominent public figures.
As of December 14, 2020, in the United States, (a) California, (b) Texas, (c) Florida, and (d) Illinois led the nation in positive COVID-19 cases and deaths.
Your assignment:
You are the CEO/COO of the Regional Hospital in one (choose one) of the above-mentioned states and in 1000-1200 words, please discuss the following about the COVID-19 response as it pertains to the selected state your hospital is located:
What went well with the State’s response?
What were the significant challenges with the State’s response?
In which ways could the State’s response have been improved?
As the Chief Operating Officer (COO) at the Regional Hospital, how would you augment your healthcare facility’s pandemic preparedness and response plan?
During Week One, we discussed Fayol’s Five Functions of Management: (a) Planning, (b) organizing, (c) coordinating, (d) commanding, and (e) controlling. Which ways you would utilize Fayol’s Fifth Function of Management, controlling into enhancing your facilities’ pandemic preparedness and response plan?
Make certain that your assignment is in the APA 7th edition format with a cover page, separating your sections by the appropriate APA Level Headings. Also, make sure you include a reference page and at least five references.
Explain the history and purpose of the Recovery Audit Contractor (RAC) demonstration project, as well as the process of the RAC as it pertains to its impact on healthcare organizations. Each reply must incorporate at least 2 scholarly citations, course textbook and 1 instance of biblical integration in current APA format.course textbook:Harrington, M. K. (2021). Health Care Finance and the mechanics of Insurance and Reimbursement. Jones & Bartlett Learning.
This purpose of this assignment is to allow the student an opportunity to discuss about the role and responsibilities that nurses have to eliminate or reduce the risks of environmental factors and how to advocate for policies that support healthy environments. The student will explore the objectives of Healthy People 2030 regarding Environmental Health.
Requirements
· Introduction of the topic.
· Describe the nurses’ role and responsibility regarding environmental health.
· Discuss how Environmental Health influences the achievements of Healthy People 2030 and its influence on Global Health.
· Describe an interdisciplinary approach to improve the healthcare outcomes of vulnerable populations.
· Reflect on what you learned from the assignment and how it will impact your practice in the future.2. Conclude the health outcomes of the health promotion, disease prevention, and early detection and treatment of diseases
.Integrate evidence, clinical judgment, inter-professional perspectives, and client preference in planning, implement, and evaluating outcomes of care.
· Minimum of 3 pages exclude title and reference pages.
· The paper must be written in APA format. Use Times New Roman 12 font, double space.
· Minimum of two references (the course textbook can be one of the references). Articles chosen must have been published within the last 5 years.
1 – INTRODUCION ( thesis on what this is going to be about )2 – CAUSES and risk factors OF BENIGN uterine cyst (1- age 2- genetic factors 3-race and ethnicity – 4- obesity 5- pregnancy) 3- EFFECTS AND SYMPTOMS ON HEALTH CONCLOUSION – ( call to action to community and health care proffesionals by 1- how to raise awareness 2 early detection 3 regular testing – 4 effective managment to the pations and treat the symptoms ) talk about each one of them in details and examples8 DIFFERrant referances ALL MEDICAL (PUBMED -NCBI ) IN APA7 please make an outline MAKE SURE WE ARE TALKING ABOUT THE BENIGN
I want you to pick any clinical quality problem and apply either an experimental or quasi-experimental design for quality improvement. Which design would you use and why? What are the strengths and weakness of this chosen design method? (Make sure when you answer, you tell me what quality problem you are trying to improve –CAUTI, CLABSI, FALL’s, are some examples)
Strategic Plan Summary Assessment Description Assess the culture of the organization for potential challenges in incorporating the nursing practice intervention. Use this assessment when creating the strategic plan. Discuss with your preceptor the culture of your organizations and what are the potential problems. Write a strategic plan (150-250 words) defining how the nursing practice intervention will be implemented in the capstone project change proposal. Use APA Styleplagiarism report (less than 10%) Resources provided by my instructor for this week’s assignments (other resources are under attachments) https://oce-ovid-com.lopes.idm.oclc.org/article/02174543-202110000-00020/HTML
a.Provide solutions for the case in roughly two to three pages.
b.Marks will be awarded for a logical approach as well as accurate content.
c.All typed work should be in Times New Roman [font size 12]. All work should be double-spaced.
d.Please use correct APA 7.
e.A minimum of 5 references are required.
f.References should be less than 7 years old and at least 5 peer-reviewed journal articles or reputable websites. Sources like Newspapers, Wikipedia are unacceptable for use as a reference.
g.DO NOT USE QUOTES
Unformatted Attachment Preview
Case Study: Building a better MIS-Trap
You are the CEO of a large health services organization (HSO) in Florida. Your HSO has
inpatient and outpatient facilities, home health care services, and every other service your patient
population needs. You also have a world-renowned AIDS treatment center that has been
considered by many to be a model for the rest of the U.S. Your HSO has always enjoyed an
excellent reputation, and your quality of care is known to be excellent. You have been very
happy in your work, knowing that your HSO provides good care to people who truly need it in a
caring and cost-effective manner.
Your HSO has recently been featured in every media vehicle known to every man, woman,
and child in the U.S. and beyond. The reason: someone downloaded the names of 4,000 HIV+
patients who had been seen in your world-renowned HIV clinic and sent the list to newspapers,
magazines, and the Internet.
You and your board of trustees are completely blown away. The board is furious and wants
to fire you. You have been able to convince them that they need to keep you on to fix the HSO’s
management information system (MIS). Their last words to you were “You had better come
back with plans for building a better MIS, or you’re fired!”
You hire a computer security consultant, and she comes into your organization under
disguise as a nurse manager to help you determine where the security leak might be. She returns
to you in three days with the following report.
“While I was undercover in your organization for a mere three days, I observed the
following breaches in computer security. These are the highlights (or lowlights):
• Nurses log in with their passwords, walk away, and leave the system open and up and
running;
• Dr. Jones leaves his password taped to the PC on a piece of paper;
• Fax machines and printers are often in areas of high traffic and in rooms without locks;
• With my one password, I had remote access to every database in the hospital, including
Human Resources’ personnel files, from my home;
• There are no programs reminding people to change their passwords on a regular basis;
• When I pretended to forget my password, other nurses gave me theirs; and
• When I requested sensitive patient files on flash drive, even after this incident, people
rarely questioned me.
In short, you have a major problem with your MIS—and your staff!”
What should you do?
Discussion Questions
1. What law is being violated by the employees at this health services organization?
2. Why was this law enacted?
3. What are the penalties for violating this law?
4. If an employee shares confidential medical information about a celebrity and is caught,
what should the penalty be?
5. Do you think you should be updating your résumé and looking for a new job?
CHAPTER 8
HEALTH
INFORMATION
SYSTEMS AND
TECHNOLOGY
Objectives (1 of 3)
• Differentiate between the levels of
functionality in electronic health records
(EHR).
• Appraise key information systems used by
health care managers.
• Distinguish between information systems
common to all industries and those unique to
health care.
Objectives (2 of 3)
• Analyze the challenges to clinical information
system optimization.
• Examine the evolution of meaningful use and
its continued implications for health care
providers.
• Assess the future of health care information
systems (HIS) in the health care delivery
system and the health industry.
Objectives (3 of 3)
• Investigate sources of data for assessing the
active and passive use of EHRs.
• Critique the impact of HIS interoperability on
the health care manager.
• Examine the impacts of HIPAA and other
regulations, laws, and policies regarding
confidentiality of patient information.
Health Information Systems (HIS)
Defined
• All pieces of computer
systems, including:
– Software
– Hardware
– Operating systems
– End-user devices
connecting systems
• Networks: the electronic
connectivity between
system, people, and
organizations
• Data that systems
– Create
– Capture through the use
of software
– These become the
building blocks for all
functions and
applications.
Source: Balgrosky, 2015, p.13.
HIS Scope Model
Networks
• Networks can be categorized as intranets, which are internal
to an organization, or extranets, which are external and allow
users to share information.
• Networks also can be characterized as
– Local area networks (LANs)
– Wireless LANs (WLANs)
– Wide area networks (WANs)
– Wireless WANs (WWANs)
– Storage area networks (SANs)
• The Internet is a well-known WAN (Balgrosky, 2015, p .81).
Systems in Health Care (1 of 4)
• Standard office applications such as word
processing, spreadsheet management, and email and other administrative tools to enable
collaboration
• Budget systems to manage expenses and
income
• Cost accounting systems to model the profit
(or loss) of key services/products
Systems in Health Care (2 of 4)
• Enterprise resource planning (ERP) systems,
which include human resource, payroll,
accounts payable, materials management, and
general ledger functions
• Time and attendance, staffing and scheduling,
and productivity systems to manage a diverse
exempt and nonexempt, and in many health
care organizations a 24/7, 365-days-a-year
workforce
Systems in Health Care (3 of 4)
• Marketing systems including customer
relationship management (CRM) and typically
the organization’s website, Facebook and other
social media accounts
• For those health care entities that are nonprofit,
fund-raising systems that play a key role in
identifying and managing the contributions of
donors
Systems in Health Care (4 of 4)
• Billing and accounts receivable systems used
to bill clients and customers (e.g., patients and
insurance companies) for the goods or services
of the entity
Historical Uses of Information
Technology
• Health care settings include hospitals, physician
practices, nursing homes, home health care,
insurance companies
• Mainly used for administrative support
• To support regulatory requirements such as those
defined by JCAHO, CMS, and CAP
• Opportunity to reduce costs and increase patient
safety and treatment effectiveness has encouraged
use in more clinical settings.
Evolution of the Automation of
Health Care (1 of 2)
• Repetitive workloads lend themselves to automation:
– Filling prescriptions
– Resulting laboratory tests
– Completing radiology images
• Initial automation was in each clinical area and not
“hooked” together or integrated.
• Primary caregivers did not use computers as part of
their daily routines.
• Systems too cumbersome and time consuming
Evolution of the Automation of
Health Care (2 of 2)
• Medical devices are more sophisticated.
• Robotic use has increased, e.g., pharmacy
robots that fill prescriptions.
• Unification of medical devices and
information systems
• Systems more prevalent in the clinical setting
• Health care managers will need to use these
new systems in their daily routine.
The Electronic Medical Record
(EMR)
• 1991, Institute of Medicine (IOM) concluded
computer-based patient record to be an
essential technology
• 2000, IOM report, To Err is Human,
emphasized further need to increase the safety
of patient care through automation
• Clinicians have responded to call for safer
care, adoption of EMRs has accelerated.
• Now we are in the era of optimization.
What is EMR? (1 of 2)
• An EMR is a computer application that
includes:
– Clinical data repository
– Clinical decision support
– Controlled medical vocabulary
– Physician order entry
– Pharmacy and clinical documentation
• Used across inpatient and outpatient areas
What is EMR? (2 of 2)
• Used by all practitioners to document, monitor,
and manage health care delivery
• Legal record of care for a patient during their
encounter at a health services organization
(HSO)
Electronic Medical Record
Analytical Model (EMRAM)
• Developed by industry association of health care
information technology (HIT) professionals: The
Healthcare Information and Management Systems
Society (HIMSS)
• EMRAM = model to gauge hospital EMR
adoption
• Hospitals are scored in a national database
• Stages 0–7, indicating progressively higher and
more clinically sophisticated uses of HIT
Figure 8-2 EMRAM Model
Courtesy of HIMSS ANALYTICS.
EMRAM & O-EMRAM Models
Stages 0–1: very basic automation of individual
areas
Stages 2: ability to start bringing disparate data
together
Stages 3–6: implementation of advanced clinical
systems
Stage 7: ability to share or exchange data with
external entities
Table 8-2 Comparison of 2008 to 2017 EMRAM Scores for
American Hospitals, and Baseline O-EMRAM scores
Data from HIMSS Analytics. (2017a). Electronic Medical Record Adoption ModelSM (EMRAM). Retrieved from
https://www.himssanalytics.org/emram. HIMSS Analytics. (2017b). Outpatient Electronic Medical Record Adoption ModelSM
(OEMRAM). Retrieved from https://www.himssanalytics.org/oemram
Hospital EMR Adoption
• As of Q4 2017, 73% of all U.S. hospitals progressed
past stage 4.
• Only 6.4% (351) of over 5,487 hospitals have
progressed to stage 7.
• Slow progress due to:
– High cost of systems
– Slow development of data standards
– User unfriendliness of systems
– Patient lack of trust in the ability of the industry to hold
their information secure
EMR or EHR?
• Electronic health record (EHR) broader term
than EMR
• Refers to total health of patient, including
immunizations, allergies, medications, etc.
• Data in EHR accessible to many, including
patient and other health providers.
Physician EMR Adoption (1 of 2)
• Most patient care in the U.S. occurs in the
physician offices.
• Of all care settings – they have the LEAST
amount of automation due to the previously
defined barriers to adoption.
• 98.6% hospitals have “some” form of an EMR;
67.9% of physician practices have EMR.
Physician EMR Adoption (2 of 2)
• Larger practices with more staff adopt more
quickly due to more resources.
• Exceptions are growing where adoption and
use leading to better outcomes has begun.
Barriers to Adoption & Optimization
• Cost to deploy and sustain
• Major changes to clinical workflow
• Annual maintenance costs
• Complex use interface and experience
• Interoperability issues
• Lack of business education
• Lack of change management
Federal Response (1 of 2)
• Establishment of the Notice of Privacy
Practice (NOPP)
• While influential on the development and
enhancement of HIT, didn’t have any
immediate impact to increase adoption and
reduce other barriers
• By 2009, adoption continued to be very slow.
• Rising health care costs led the Obama
administration to intervene.
Federal Response (2 of 2)
• Legislation: American Recovery and
Reinvestment Act (ARRA)
• ARRA includes Health Information
Technology (HITECH) Act to increase
adoption through use incentives for hospitals
and physicians (among other care providers).
Beginning of Meaningful Use
• Concept of “meaningful use” criteria for EHRs
focused on achieving five health outcomes
policy priorities:
1. Improve quality, safety, and efficiency, and
reduce health disparities
2. Engage patients and families in their health
3. Improve care coordination
4. Improve population and public health
5. Ensure adequate privacy and security of patient
health information
Meaningful Use vs. EMRAM
• Stages of Meaningful • EMRAM vs. Meaningful
Use
Use
– Stage 1, 2011–2012: data Stage 4 = Stage 1
capture and sharing
Stage 6 = Stage 2
– Stage 2, 2014: advance
Stage 7 = Stage 3
clinical processes
• Physicians push back and
– Stage 3, 2016: improve
resistance
outcomes
• AMA/AHA call for changing
adoption time frames
• Issues remain unresolved
From Meaningful Use to MIPS (1 of 2)
• Under MU, providers expected to progress through
three stages of development, over the following 5
period:
• 2011–2012, Stage 1: data capture and sharing
• 2014, Stage 2: advance clinical processes
• 2016, Stage 3: improved outcomes (HealthIT, 2015).
From Meaningful Use to MIPS (2 of 2)
• Merit-Based Incentive Program (MIPS)
• Process evolved from defining goals of
utilizing EHRs to optimizing EHRs
• MIPS has four pillars that are weighted
– Quality (50%)
– Advancing care information (25%)
– Improvement activities (15%)
– Cost (10%)
Problems with EHRs
• Poor design
• Poor usability
• Time-consuming data entry
• Interference with face-to-face patient care
• Inefficient and less fulfilling work content
• Lack of interoperability
Solutions?
• Scribes: people trained in medical
terminology and pathophysiology who make
notes on EHR while physician speaks with the
patient
• Better training and more intuitive systems:
difficulty using EHR decreases productivity,
increasing provider frustration with hassle
factor
HIPAA
• 1996: Health Insurance Portability and
Accountability Act (HIPPA) established,
among other things:
– standardization of data, and
– regulations on its privacy.
• Heightened attention to measures to protect
personally identifiable health information
(PHI)
PHI
Individually identifiable health information (IIHI)
relates to:
• the individual’s past, present, or future physical or
mental health or condition;
• the provision of health care to the individual, or,
• the past, present, or future payment for the provision
of health care to the individual; and,
• that identifies the individual or for which there is a
reasonable basis to believe it can be used to identify
the individual.
HIPAA in 2018
• Fines for breaches range from $100 to
$50,000 per violation, with a cap of $1.5
million.
• HIPAA breaches with criminal intent have
penalties up to $250,000 and 10 years’
imprisonment.
PHI Breach Notification &
Enforcement
• Must consider the following factors:
– Nature and extent of PHI involved
– To whom the PHI may have been disclosed
– Whether that PHI was actually acquired or viewed
– The extent to which the risk to the PHI has been
mitigated (for example, assurances from recipient
that information has been destroyed or will not be
further used or disclosed) (APA Practice
Organization, 2013).
Business Associate Agreements
• Requirements of the law are extended to
include all groups that hospitals or other
covered entities do business with, as well as to
the subcontractors with whom those associates
do business.
• Contracts with business associates and subcontractors must address HIPAA requirements.
Future of Health Information
Technology (HIT)
• Portability: EMR in your pocket.
• There’s an app for that!
• Virtual health care: be “seen” without need for
physical exam
• Future uses of technology in health care include:
– Patients wearing computers to regulate and/or
monitor (smart vests)
– Embedded microchips
• Systems improvements for complex information
Potential Confounders
• Interoperability
• Optimizing existing vs. replacing EHRs
• Data integrity
• Promoting patient safety
• Cybersecurity
• Cloud-based Systems and Bring Your Own Device
(BYOD)
• Passive and active use of the EHR
Additional Areas
• E-health: electronic data transfer
• mHealth: mobile technologies for health-related
activities (look at your phone—there is probably
a health app on it!)
• Telemedicine & Telehealth: practicing at a
distant site
• Health informatics, analytics, & big data:
aggregating, analyzing, and sharing data trends
will inform research and policy.
HIT Impact on the Manager
• Complex and quickly evolving work
environment
• Effective managers must use technology
themselves and understand well enough to
manage effectiveness of their employees use.
• Dependency will create new norms around
computer competencies, processes during
“downtimes,” etc.
A Sampling of Research Sources
• Agency for Healthcare Research and Quality
Health Information Technology Tools and
Resources
• American Hospital Association
• Centers for Medicare and Medicaid Services
Electronic Health Records Incentive Programs
• HealthIT.gov
• Healthdata.gov
Conclusion
• HIT impact of health care/manager increasing
• Costs have risen, quality has not kept pace
• While many barriers, optimization of clinical
systems is increasing
• There are models to help, EMRAM & OEMRAM
CHAPTER 7
QUALITY AND
PERFORMANCE
IMPROVEMENT
BASICS
Objectives (1 of 2)
• Describe the risks inherent in the provision of
health care;
• Identify key quality and safety issues;
• Explain why constant vigilance, management,
and improvement are required in health care;
• Differentiate between health care system
failures and individual risky behavior;
Objectives (2 of 2)
• Apply overlapping quality and improvement
concepts and principles to everyday
management;
• Assess the leading models of quality
improvement methodology; and,
• Apply tools used in quality improvement.
Definition of Quality (1 of 2)
• Institute of Medicine
– “degree to which health services for individuals or
populations increase the likelihood of desired
health outcomes and are consistent with the current
professional knowledge”
• Donabedian conception of quality as:
– Structure: quality personnel and facilities
– Process: quality processes both in management and
production of health care
– Outcomes: quality resulting from the application of
structural and process variables
Definition of Quality (2 of 2)
• Donabedian’s four parts
– Technical management
– Interpersonal relationships
– Amenities of care
– Ethical principles guiding care
• Two quality questions
– Are the right things done? (effectiveness)
– Are things done right? (efficiency)
Patient-Centered Care
• Patient (person)-centered care
– Care centered around the individual
– Responsive to:
• The individual’s physical abilities
• Medical needs
• Social and psychological abilities, preferences,
and lifestyles
Why is Quality Important?
• Underuse: failure to provide a service whose
benefit is greater than its risk
– 54.9% of patients receive recommended care
• Overuse: use of service when risk outweighs its
benefits
– Uncritical use of antibiotics, especially in
consumer products
• Misuse: risk service is provided badly reducing
benefit to patient
– Medical errors, medication errors
The Complex Nature of Health
Care
• Health care
– Complex
– Dynamic
– Unpredictable
– Varying levels of ambiguity
• Health care delivery
– High number of human transactions that are at risk for
failures
– Interfaces with complicated information systems and
technology
– Many services are high risk and problem prone
Common Elements of Quality
Improvement Methodologies
• Measurement
– Definition (operational definition)
– Reliability
– Validity
• Process variation and statistical process control
– Special-cause variation
– Common-cause variation
Continuous Process Improvement
• “A structured organizational process for involving
personnel in planning and executing a continuous
flow of improvements to provide quality health care
that meets or exceeds expectations”
• Based on process part of Donabedian’s definition
• TQM/CQI’s five dimensions
– Process focus
– Customer focus
– Data-based decision making
– Employee empowerment
– Organization-wide scope
• FOCUS-PDCA
FOCUS/PDCA (1 of 2)
• Find: identify process problem
• Organize: put together a team to work on process
• Clarify: use techniques to clarify the problem
– Geographic mapping
– Flowcharting
• Understand: measure and collect data to
• Select: identify process improvements for
implementation
FOCUS/PDCA (2 of 2)
• Plan: create an implementation plan for taking
the process to the next level
• Do: implement and test the new process
• Check: evaluate the measures used and assess
outcomes
• Act: assure continuation of newly
implemented process, if successful, or redo the
process, if not successful
Six Sigma
• “Data-driven quality methodology that seeks
to eliminate variation from a process”
– Six Sigma Performance:
Purchase answer to see full
attachment
please respond to the following discussion post as a peer making a comment. “Sustainability of an intervention in healthcare means ensuring its continued effectiveness and integration into practice or policy over an extended period. It goes beyond initial implementation and addresses long-term viability. Two methods to promote sustainability of evidence-based interventions are:
Monitoring and Evaluation: Regularly assessing the intervention’s outcomes and processes is crucial. By collecting data and measuring key performance indicators, healthcare organizations can identify areas that need improvement, adapt the intervention as necessary, and ensure it remains aligned with evolving goals and needs. Continuous evaluation helps in making evidence-based adjustments to enhance sustainability.
Capacity Building: Building the capacity of healthcare professionals and staff is fundamental for sustainability. Training and education programs should be established to ensure that individuals have the skills and knowledge required to maintain and adapt the intervention. This includes providing ongoing support, mentorship, and resources to empower staff to champion the intervention.
For the project focused on addressing obesity correlated with diabetes and the role of bariatric surgery, the next steps would involve:
Long-term Data Collection: Continue collecting data on patient outcomes, both pre- and post-bariatric surgery, to assess the intervention’s effectiveness over time. This data will help in understanding the sustainability of improved health outcomes and the long-term impact on diabetes management.
Quality Improvement: Implement a continuous quality improvement process, incorporating feedback from healthcare providers, patients, and other stakeholders. Use this feedback to refine the intervention and ensure it remains aligned with best practices and emerging evidence.
Resource Allocation: Allocate resources strategically to support ongoing training and education for healthcare professionals involved in bariatric surgery and diabetes management. This will ensure that the intervention is sustainable by maintaining a skilled workforce.
Patient Education: Empower patients with ongoing education and support to maintain healthier lifestyles and effectively manage their diabetes post-surgery. This can include support groups, educational materials, and telehealth services for long-term follow-up.
Policy Integration: Work with relevant policymakers to embed the intervention within broader healthcare policies and guidelines. This will help secure ongoing support and resources for sustaining the program.
Community Engagement: Engage with the community to raise awareness about the benefits of bariatric surgery in managing obesity and diabetes. This can help drive patient demand and ensure the intervention’s continued relevance.
Purpose: The purpose of this assignment is to facilitate thinking about your personal beliefs in
relation/comparison to the core concepts of Communication, Compassionate Care, Diversity, equality and
inclusion, Ethics, Evidence-Based Practice, Health Policy, and social determinants of Health in nursing practice
as outlined and defined by the AACN . As a senior level nursing student you may be asked to revisit this
assignment so please keep your work.
Before you begin to write this paper:
Read the American Association of Colleges of Nursing (AACN) “2021 THE ESSENTIALS: CORE
COMPETENCIES FOR PROFESSIONAL NURSING EDUCATION” description of the above core concepts – Look
closely at pages 11-14. (https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Essentials-
2021.pdf Reflect within your paper on at least 5 out of the 8 core concepts and how they
o 1) relate to nursing
o 2) how they compare to your own thoughts and feelings on these concepts. Provide examples
from nursing literature, your work or life experiences.
This paper can be thought of as a comparison and introspection of your own beliefs and values
compared to Rockford University’s Nursing Department values of the discipline of nursing rising from
the AACN Essentials.
Directions:
Students are expected to use the Publication Manual of the American Psychological Association (7th
edition) to guide the formatting of this paper. One third of the points received for this paper stem
from APA formatting, see rubric below.
5-6 pages (not including title, reference and rubric page) typed, double-spaced, one-sided, 12-point
font paper. Required typeface throughout- Times New Roman.
Minimum of four different reference citations (Four Different resources)
All papers submitted should be at an acceptable college level of writing.
The following grading rubric will be used: Please attach a copy of this rubric as the final page of your
paper, after reference page.(One will be available on Canvas)
Unformatted Attachment Preview
Core Concept Paper Grading Rubric
Grading Rubric
Points
AACN Core Concepts (Student to pick 5 out of the 8 of their choice)
Concept 1:
2
Concept 2:
2
Concept 3:
2
Concept 4:
2
Concept 5:
2
Mechanics:
Clarity and effectiveness of writing
2
Lack of spelling errors
1
APA Format:
Appropriate formatting of paper using APA 6th Edition guidelines
3
• Title page
• Page headers
• Page numbers
• Headings
• Page margins
• No Use of First Person
Appropriate in-text citation of sources using APA formatting
2
• Match reference page
• Quotations cited correctly
Complete reference page that includes all sources cited in text
2
• APA format of citation
• Citations congruent with the text
• Citations accurate and complete including punctuation
TOTAL
20
Your Score
In the final phase of this project, you will implement your performance improvement plan. Also, you will discuss what the success of the performance improvement plan will look like. If you chose a problem in your workplace, be sure to use data from that healthcare organization. If you created a fictitious healthcare organization, you might use a public domain database with instructor permission. As you work on the final part of the assignment, include the following information in your paper.PromptSuccess of the Performance Improvement PlanIf this plan is successful, how would the organization monitor financial implications?How would the current information management systems contribute to the success of your plan?What current organizational processes will help the plan be successful?How will the plan be communicated among departments? How will this communication help team members commit to the performance improvement plan?What to SubmitThis paper should be one to two pages in length, not including the cover page or reference page. Use APA format for the reference list and all internal citations.
Assessment DescriptionDiscuss what it means for an intervention to be sustainable. Determine two methods used to promote sustainability of evidence-based interventions. Discuss what the next steps would be for your project.
Unformatted Attachment Preview
Reducing Hospital
Acquired Infections
(HAIs) through Hand
Hygiene Compliance
Presented By:
Antwanetta Boswell
HCA-650
Benchmark –
Evidence-Based
Project
Date: 10/05/2023
Reducing Hospital Infections (HAIs)
●
●
●
●
●
●
●
Hospital Infections (HAIs) endanger patients and raise healthcare expenses.
Healthcare workers’ hand hygiene (HH) compliance is a top HAI prevention
strategy.
HH compliance rates in hospital settings are generally inadequate, resulting in
avoidable illnesses.
Approximately 1 out of 31 patients admitted to the hospital are affected by HAIs.
Studies have shown that most healthcare practitioners do not adhere to HH
compliance.
Due to this disregard of the healthcare practitioners to wash their hands as
supposed, this results in the spread of HAIs in the healthcare settings.
Hand hygiene serves as a cornerstone in infection prevention and control
programs.
Objective of this proposal
Hand hygiene serves as a cornerstone in infection prevention and control
programs.
●
In the context of reducing HAIs through improved hand hygiene compliance,
evidence-based practice objectives are essential to guide interventions and
evaluate their effectiveness.
● Objectives
i)
Achieve a minimum of 90% compliance with hand hygiene protocols among
healthcare workers within the next 12 months.
ii)
Reduce the overall incidence of HAIs in the healthcare facility by 20% within
the next 24 months.
iii)
Increase the proportion of healthcare workers who receive regular hand hygiene
education and training to 100% within the next 6 months.
●
Method Used in Gathering Research
●
●
●
●
●
●
When searching for the articles to be used for this research, several databases
were used, including PubMed, CINAHL, Cochrane Library, and Scopus.
PubMed has a vast collection of peer-reviewed articles, making it a valuable
resource for research studies related to hand hygiene and HAIs.
CINAHL is also particularly useful for accessing research studies related to
healthcare practices, including hand hygiene.
The Cochrane Library also provides access to individual research studies that are
included in these reviews.
Scopus provides access to a substantial number of research articles, including
those related to hand hygiene and HAIs.
Some of the keywords and phrases that might be used include hand hygiene,
Healthcare-associated infections, Infection control, Healthcare Workers,
Surveillance, and effectiveness.
Proposed Solution
●
●
●
●
●
Evidence-based hand hygiene programs improved healthcare professionals’
compliance with hand hygiene recommendations and decreased HAIs.
Hand hygiene promotion programs are more cost-effective than HAI therapy in
the American Journal of Infection Control.
The suggested approach complies with current research and standards, but its
deployment in a hospital setting must be considered.
Consideration must be given to resource availability, training requirements, and
organizational support to adopt and improve hand hygiene compliance.
To aim for a minimum 20% increase in hand hygiene compliance and a
minimum 15% decline in HAIs within a year, track progress, and assess the
effectiveness of the intervention.
Organizational or Community Culture
●
●
●
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The effectiveness of a healthcare intervention is contingent upon factors such as
the organizational culture and the availability of resources.
They may be exemplified by the improvement of hand hygiene to mitigate the
occurrence of HAIs.
Healthcare facilities need to embody the cultural values and principles of the
organization.
Cultures of continuous improvement can be effectively aligned with evidencebased approaches.
The enhancement of organizational leadership commitment and accountability
serves to reinforce the responsibility for patient outcomes.
The alignment of resources is paramount in ensuring sustainability and
usefulness.
Integrating these components increases the probability of a hand hygiene
intervention being efficacious and aligning with the organizational culture and
available resources.
Stakeholders
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The effectiveness of the project depends on the varied groups of stakeholders
participating in the implementation of evidence-based hand hygiene treatments to
minimize HAIs.
The success of the intervention is directly impacted by the implementation of
hand hygiene practices by healthcare personnel.
The hospital administration is essential in allocating funds, establishing
guidelines, and promoting a hand hygiene-friendly culture.
Teams dedicated to infection control and prevention create, oversee, and assess
infection control procedures to ensure the longevity of the intervention.
Families and caregivers must be educated and encouraged to participate in hand
hygiene practices while engaging in patient care.
At the same time, hospital support employees, such as janitors, are crucial for
keeping a clean and infection-free environment.
Expected Outcomes and Goals
●
●
●
●
●
The hand hygiene intervention is designed to provide several distinct and
quantifiable results.
With regular monitoring and comparisons to baseline data, it first aims to raise
hand hygiene compliance among healthcare personnel by at least 15% within six
months.
By introducing evidence-based hand hygiene practices and monitoring infection
rates against historical data, the intervention seeks to reduce HAIs by 90% within
a year.
Improved patient safety and satisfaction are a secondary but crucial result of
decreased HAIs, resulting in fewer complications, shorter hospital stays, and
higher patient satisfaction ratings.
By lessening the cost of treating HAIs and demonstrating a return on investment,
the intervention also attempts to show cost savings.
Method to Achieve Outcomes
●
●
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Programs for education and training to healthcare professionals and support
employees must be implemented first.
This training should stress the importance of hand cleanliness, offer precise
instructions, and refute prevalent myths.
Monitoring and feedback systems need to be put in place to track hand hygiene
compliance.
Technology-enhanced reminders and prompts incorporated into processes and
strategically positioned around healthcare facilities help ensure hand hygiene is
routinely maintained.
Leadership support is necessary to establish an example and preserve an
infection prevention culture.
Data-driven decision-making, patient involvement and feedback gathering are
essential elements.
Activities for cultural change and adequate resource allocation complete the
approach.
The ideal project evaluation method
The cost-benefit analysis (CBA) is the ideal one for the proposed project.
●
The project recommends adherence to evidence-based hand hygiene techniques
to reduce hospital-acquired infections.
●
The CBA was selected over other methods for several reasons.
i) It will provide a clear picture of the costs the healthcare organization will incur to
not only educate healthcare professionals about these evidence-based hand hygiene
techniques.
ii) It will install supportive infrastructure and materials to support the use of these
techniques.
iii) It will show the monetary benefits associated with implementing these
techniques, such as reducing patient lawsuits due to hospital-acquired infections.
iv) It will allow for the inclusion of non-monetary benefits, such as improved patient
outcomes and satisfaction.
●
Evaluation and adjustment plan
●
●
●
●
●
To leverage the cost-benefit approach to assess the proposed project, the
healthcare organization will have to first identify the costs associated with
implementing it.
The healthcare organization will have to compare these costs against the
monetary and non-monetary benefits associated with implementing the project.
The Trans Theoretical Model of Behavioural Change (TTM) will be leveraged to
implement the proposed evidence-based hand hygiene improvement initiative.
Creating a culture of compliance with the hand hygine techniques might be
challenging and regular training is required.
As such, an adjustment should be made during the maintenance stage of the
selected change model.
Change Model
● The Trans Theoretical Model of Behavioural Change (TTM) is a useful change
model for implementing an evidence-based hand hygiene improvement initiative
in a hospital context.
● The TTM outlines the many phases of change that people go through while
acquiring new behaviors.
Stage 1: Precontemplation Educating the public about the dangers of HAIs and the
advantages of good hand hygiene.
Stage 2: Contemplation Give them evidence-based knowledge on efficient hand
hygiene practices to inspire them to take action.
Stage 3: Preparation Ensure a sufficient supply of soap, PPE, and hand sanitizers.
Stage 4: Action Celebrate your minor victories and thank your team for their efforts
in reinforcing good behavior.
Stage 5: Maintenance Continue monitoring compliance, conduct regular audits, and
provide ongoing education and support.
Implementation Plan
●
●
●
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●
●
The project will be implemented over a 12-month, allowing for flexibility in
starting at any time.
The budget for implementing the hand hygiene improvement project is estimated
at $500,000 over the 12-month implementation period.
This budget is designed to cover various expenses related to personnel, supplies,
equipment, computer-related costs, and other project-related expenses.
The contingency fund provides a buffer for unexpected expenses during the
implementation process.
The Human Resource Department should provide project oversight and
monitoring, conduct hand hygiene training sessions and analyze compliance data
and identify trends.
The fiscal resources should be used to development, printing of hand hygiene
educational materials, purchase hand sanitizers, soap, and PPE and provide
salaries and benefits for project staff.
References
● Chavali, S., Menon, V., & Shukla, U. (2014). Hand hygiene compliance among healthcare
●
●
●
●
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workers in an accredited tertiary care hospital. Indian Journal of Critical Care Medicine,
18(10), 689–693. https://doi.org/10.4103/0972-5229.142179
Koopmans, C., & Mouter, N. (2020). Cost-benefit analysis. In Advances in Transport
Policy and Planning (Vol. 6, pp. 1-42). Academic Press.
Haque, M., Sartelli, M., McKimm, J., & Abu Bakar, M. B. (2018). Health care-associated
infections – an overview. Infection and Drug Resistance, Volume 11(11), 2321–2333.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6245375/
Gould, D. J., Moralejo, D., Drey, N., Chudleigh, J. H., & Taljaard, M. (2017). Interventions
to improve hand hygiene compliance in patient care. Cochrane Database of Systematic
Reviews, 9(9). https://doi.org/10.1002/14651858.cd005186.pub4
Toney-Butler, T. J., & Carver, N. (2019). Hand Washing (Hand Hygiene). Nih.gov;
StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470254/
Wang, Y., Yang, J., Qiao, F., Feng, B., Hu, F., Xi, Z., Wu, W., Ni, Z., Liu, L., & Yuan, Y.
(2021). Compared Hand Hygiene Compliance among Healthcare Providers before and after
the COVID-19 Pandemic: A Rapid Review and Meta-analysis. American Journal of
Infection Control, 50(5). https://doi.org/10.1016/j.ajic.2021.11.030
References
● Basu, M., Mitra, M., Ghosh, A., & Pal, R. (2021). Journal of Family Medicine and Primary
●
Care,
10(9), 3348. DOI: 10.4103/jumps.jfmpc_742_21
https://www.sciencedirect.com/science/article/pii/S0196655321004831
Sands, M., & Aunger, R. (2020, June 13). Developing and Evaluating A Novel Intervention
to Improve the Hand Hygiene Behaviour of Nurses In Acute Care Hospital Units in the
United States. Researchonline.lshtm.ac.uk.
https://researchonline.lshtm.ac.uk/id/eprint/4657204/
GROUP PRESENTATION COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN
Assignment title or
task:
(You can write a
question)
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Select one from the following topics: Occupational stress and impact on employee well-being
Health risks for health workers on night shift.
The roles and responsibilities of the occupational health professionals
The role of telehealth in occupational health services
Occupational safety and health measures in Saudi Arabia
Promoting Mental Health in the Workplace
Digital Occupational Health in KSA.
The role of occupational health in the prevention of occupational
diseases
Psychosocial hazards and prevention in the workplace
Occupational health services for small-sized workplaces of less than 20
workers
Promoting Mental Health in the Workplace
Occupational Heat Exposure
Occupational Noise Exposure
Personal Protective Equipment
Prevent Falls in the workplace
Name
Student’s name and ID
Submission date:
ID
Instructor name
Dr.
Grade
… out of 10
Guidelines:
➢ Every student must send me by email with his chosen topic before 10/10/2023
➢ The presentation should be submitted on the blackboard as a PPT file.
➢ The PPT should not be more than 15 slides and not less than 10 slides.
➢ Use appropriate references as per the APA Style.
➢ The oral presentation time should be 7-10 minutes.
➢ All presenters must participate equally and help each other as needed.
➢ It will be conducted in weeks 9, 10, 11.
➢ Your presentation will be evaluated based on the implementation of
communication skills, slides, time, deadline, topic covering.
Week 9
1. ABDULLAH ALAMRI
2. Faisal Alanazi
3. HUSSEIN ALBAHER
4. SULTAN ALDAWSARI
5. MUFEED ALDHU
Week 10
Week 11
1. MUSTAFA
ALHADDAD
1. MUBARAK
ALMURAYR
2. FARIS ALJANFAWI
2. MOHAMMED
ALQARNI
3. SAAD ALKHALIFAH
4. AHMAD ALKUWAITY
5. KHALID ALMATHIBIRI
6. AQEEL ALMUJAYBIL
3. HASSAN ALRUBH
4. hani alrumaih
5. BADER ALSHAMMARI
All students must submit their
6. ABDULRAHMAN
ALSHEHRI
presentation by Monday of
All students must submit their
All students must submit their
week 9
presentation by Monday of
presentation by Monday of
week 10
week 11
6. AHMED MAJRASHI
Please follow the rank and the presentation will be in the virtual session on Wednesday of
the weeks 9,10, and11. Attendance is required for all students.
Good Luck
i need help answering these questions Minimum length for full credit: 400 words.(1) What do VCM mean by agency, affect, and circumstance, the three categories of ingredients for constructing a good life? As they explain on p. 106, if you “disregard any of [these factors], … your vision of life worth living will remain incomplete.” However, “some good life recipes elevate one food group … above the rest” (p. 109). As you develop your vision of the good life, does one of these categories seem more important than the others? Why or why not? If so, is it one over which you have more or less control, and what implications does that have for the role that luck may play in your life?(2) Do you find Stoicism appealing? Does it seem like a useful approach to cultivate? Does it seem more limiting, or more freeing? Please be specific in what you find useful or bogus about the Stoic philosophy.(3) Briefly summarize Robin Dunbar’s insights into friendship. Do they match your experience? Why or why not?
Unformatted Attachment Preview
LIFE WORTH LIVING CHAPTER 7 AND “HOW TO LIVE A GOOD LIFE: STOICISM”
This chapter is structured around a metaphor: VCM compare conceptions of THE GOOD LIFE to “recipes” with different sets of
ingredients. Recipes require a certain balance of ingredients to be successful, and VCM divide categories of ingredients into
three different “food groups”: agency, circumstance, and affect. Let’s consider each in turn.
• Agency refers to the choices we make and our capacity to make decisions. As VCM acknowledge, our agency is not
absolute: it’s “deeply shaped and constrained by both our circumstances and our affective lives” (p. 108). (This view stands
in contrast to the controversial and counterintuitive EXISTENTIALIST claim that we have complete freedom to determine the
course of our lives.) Our choices are also influenced by our genetic inheritance. All of our characteristics are influenced by
both nature (DNA) and nurture (external influences), and scientists estimate that between 20 and 60% of our personality is
determined by our genes; the degree of influence varies depending on the trait. This includes characteristics like optimism,
extraversion (which we’ll explore more below), conformity, creativity, aggressiveness, sociability, religiosity, etc. Since much
of the “nurture” part of the equation is determined by the family and culture into which we’re born, heaps of who we are is
shaped by forces outside of our control. This is especially true when you consider the “feedback loops” that can intensify
our traits: for example, a child who’s inclined to be shy is less likely to be outgoing and therefore less likely to receive the
“rewards” (attention from teachers, an abundance of friends) that make them even more gregarious.
• Affect is a fancy term for “emotion.” These are our feelings: whether we’re happy or sad, satisfied or dissatisfied, etc.
• Circumstance means the conditions of our lives. As VCM note, we can influence our circumstances through the choices we
make, both as individuals and as a society. (This is one reason why politics are important even though it’s tempting to be
cynical about our elected leaders.) Of course, our control over our circumstances is clearly limited. Much of what happens
to us comes down to “luck” or chance – what the ancient Romans called Fortuna (fortune).
Philosophers have spent a surprising amount of time analyzing the concept of luck, which we’ll explore by means of two
different thought experiments.
The 20th-century American philosopher John Rawls introduced the Veil of Ignorance in his book A Theory of Justice, which
attempted to envision an ideal (fair and just) society. Rawls recognized that our views about ethics and political philosophy are
invariably colored by our own self-interest. For example, if you’re wealthy you may not care about the plight of the poor, if
you’re white you might be indifferent to the scourge of racism, if you’re a man equal rights for women may not be your top
priority, and if you’re straight you might be ignorant about the impact of discrimination on gays and lesbians. The VEIL OF
IGNORANCE is intended to expand the scope of our moral imagination so we can overcome our self-serving bias.
When envisioning your ideal society, pretend that you don’t know where you’ll end up in that society: rich
or poor, white or Black, male or female, gay or straight, cis or trans, etc. Assuming that you’re able-bodied,
imagine what it would be like to live in a world that makes no accommodations for
people with disabilities (PWDs). (This is more or less what the U.S. was like before
the passage of the Americans with Disabilities Act in 1990.) If you have a learning
disability, schools have no legal obligation to offer you assistance to help you reach
your full academic potential. If you use a wheelchair, institutions don’t need to provide elevators, ramps,
etc. that enable access. If you’re deaf, you have no right to expect closed captioning. If you’re blind, best of luck crossing busy
city streets without audible signals from “Walk/Don’t Walk” signs. Once you see (or hear) the world from the perspective of
others, you’re more likely to appreciate the “luck” that benefited you and support policies that help those who were are
fortunate. For example, my Dad was a college professor and I attended the college where he taught so I didn’t have to pay
tuition. However, I’m very sympathetic to students who have to work multiple jobs to afford college and to the financial
burden on people who take out student loans. Even if I wasn’t a college instructor myself, I like to think I would support
policies that reduce the cost of higher education and provide relief to borrowers with unsustainable debt.
The second thought experiment is based on the work of the American philosopher Thomas Nagel
on a concept he called Moral Luck. If you’re anything like me, you don’t always devote your full
attention to the road while you’re driving. It’s easy to be distracted by the radio, your phone, a
drive-through meal, etc. Imagine two drivers who are cruising down the highway and look down
at their phone to read a text message. (Distracted driving is a major cause of accidents; one study
found that used a driving simulator found that “impairments associated with using a cell phone
while driving can be as profound as those associated with driving while drunk.”) In the first case,
they happen to look up in time to see that traffic in front of them has slowed down dramatically
and apply their brakes, avoiding an accident. In the second case, they look up one second later
and, as a consequence, rear-end another vehicle, causing two deaths and significant injuries.
Although the consequences in the second case are far worse, the two drivers are equally culpable (morally responsible) in
terms of what they did wrong. The only difference is luck: the driver who caused the tragic accident was unlucky. This raises
the question of whether we should judge actions by someone’s intentions or by the results of their actions, which reflects the
difference between Consequentialist theories of morality (like UTILITARIANISM) and Deontological (duty-based) ones.
Applying this concept more broadly, you could argue (as Nagel does) that you were morally lucky to be grow up in late20th/early-21st-century America instead of Nazi Germany. Assuming that you weren’t a Jew or a member of another group that
Hitler persecuted, it’s very likely that you would have either participated in the Holocaust or stood by and done nothing while
millions of people were systematically murdered. Although a small number of people protected Jews (as depicted, for
example, in the film Schindler’s List) or actively resisted the Nazi regime, the vast majority did not. The same was true in the
U.S. before the Civil War; individuals with the courage to advocate for the abolition of slavery were few are far between. Of
course, it’s easy to condemn the Nazis and slaveholders in retrospect since we’re “lucky” to live in a culture regards genocide
and enslavement as settled ethical questions. However, it’s worth asking – as we will in a later module – whether future
generations will look back on our era with moral revulsion at aspects of the way we live.
A fundamental principle in ethics is summed up by the phrase ought implies can: we should only be blamed for actions that we
can control. Someone who’s texting while driving is clearly responsible for causing an accident since they made an unwise
choice. In contrast, if someone with undiagnosed narcolepsy (a disease which causes people to fall asleep without warning)
causes an accident, they’re not morally responsible – just very unlucky. The ancient Greek philosophy of STOICISM places a
great deal of emphasis on distinguishing between aspects of our lives which lie within or fall outside of our control. Since both
VCM and Pigliucci explain the principles of STOICISM in great detail, I’m only going to hit the highlights.
The dichotomy of control. We should be indifferent to the whims of Fortuna (fortune or luck,
which the Romans personified as a goddess), only concerning ourselves with what we can control:
our response to whatever befalls us. This doesn’t mean that we should passively accept whatever
happens to us or avoid preventing bad events if we can. Consider the example (which I used to
illustrate a similar concept in BUDDHISM) of getting stuck in traffic. If Google maps offers you an
alternate route to avoid congestion, by all means take it! But once you’re stuck, accept that reality
with equanimity (inner peace). Don’t rage against a fate that you have no way to avoid. As with
BUDDHISM, this principle also applies to major stressors like a serious illness or the loss of a loved
one. As VCM explain, “health and wealth and the survival of your children are preferable to
sickness and poverty and their deaths. But people can be virtuous and therefore flourish even if
they don’t get what they want. No matter the circumstances, there is always the opportunity to
act well.” Even in Nazi Germany: “Sometimes the most virtuous thing you can do is die well” (p.
112). As VCM admit, this is “a radical approach to THE QUESTION” – but it’s undeniably powerful.
Above all else, live virtuously. How we respond to events is always within our control, and
we should endeavor to live a morally virtuous (good) life. The founders of STOICISM lived in
wildly different circumstances: one (Epictetus) was a slave, while another (Marcus Aurelius)
was an Emperor of Rome. But both attempted to live according what STOICS regard as the
four cardinal virtues: Wisdom, the capacity to make the correct decisions; Temperance,
avoiding destructive excess in our emotions and behavior (the ideology of CONSUMERISM
encourages gluttony and self-indulgence, which the STOICS regard as dangerous vices);
Justice, treating others (and yourself) fairly; and Courage, being brave in the face of the
challenges that confront us. Although following these virtues does not guarantee that we’ll
have a happy or materially abundant life – in some cases, they can endanger our well-being
– the virtues increase the likelihood that we’ll experience “good passions” like inner peace
and the satisfaction of living with integrity (see VCM p. 113). Conversely, “bad passions”
like anger will be curtailed; as the STOIC (and Roman Senator) Seneca explained: “anger will
cease, and become more gentle, if it knows that every day it will have to appear before the
judgment seat.” What about other people who fail to practice the virtues, like the driver
who cuts us off in traffic? That’s their problem, not ours. We can choose to give them
power over us by becoming upset, or we can employ temperance to remain calm and
wisdom to realize that they may be in a hurry for legitimate reason. Even if they’re not, you
only have to deal with their unpleasantness for a moment; they’re stuck with themselves and the consequences of their vices
all day long. As Pigliucci notes, we “distinguish between emotions that are healthy and unhealthy …. Think of it as a constant
exercise in shifting our emotional spectrum: away from fear, anger and hatred, and toward joy, love and friendship.” The other
driver – or, more seriously, the boss who treats you poorly or the family member who doesn’t accept you for who you are – is
stuck on the dysfunctional end of the spectrum, but you can choose whether to follow them there. Likewise, instead of
becoming defensive and angry when someone criticizes you, you can thank them for pointing out your flaw if the insult is
accurate and ignore it if it’s not. This is, of course, easier said than done, but good moral habits take time and repetition to
form – as we’ll discuss in greater detail when we explore VIRTUE ETHICS in a future module.
I’m going to postpone discussion of CONFUCIANISM, but before concluding I’d like to address a topic that VCM mention early in
the chapter: friendship. Although most everyone would agree that friendship is essential to living a good life, it tends to
receive far less attention than romantic and familial relationships. The anthropologist Robin Dunbar is an exception to this
trend. In Friends: Understanding the Power of Our Most Important Relationships, he summarizes the research that he and his
colleagues have conducted into this often-neglected topic.
First, he explains the difference between introverts and extraverts.
Introverts (who recharge their “social batteries” in solitude) tend to
have fewer, deeper relationships while extraverts (who gain energy
by being around other people) have a broader range of friendships
but they tend to be more superficial. Neither approach to
relationships is “right” or “wrong” – and most people are somewhere
in between these two extremes – but it’s useful to know where one
stands when trying to envision your “best life.” Do you want a job
which requires constant social interaction? Would you prefer to live
in a crowded city with a vibrant social scene? Regarding friendships,
Dunbar explains that both introverts and extraverts have the same
amount of “emotional capital” to spend (energy to invest in other
people), but introverts invest in a few close relationships while extraverts spread it much more widely. As he explains, “one
strategy is not better than the other – they are just two different ways of ensuring that your social network provides you with
the kinds of support you want.” Dunbar also draws a distinction between male and female friendship patterns:
• Men tend to have “buddies”’; their friendships revolve around a shared interest or activity. In
addition, they generally have fewer friendships than women, especially as they age, and divorced
men are particularly likely to feel isolated since their wives probably managed the couple’s
relationships. Loneliness is a serious risk factor in both mental and physical health.
• Women’s friendships are more likely to involve emotional intimacy and social support. (Of
course, these are generalities and there are numerous exceptions.)
Dunbar is best known for proposing “Dunbar’s number” based on his study of
human societies and non-human primates. He estimates that humans can only
maintain about 150 meaningful social relationships then subdivides that number
into groups of increasing intimacy. The five people closest to us constitute our
“support clique”: individuals (they may be family members) who provide us with
unconditional support, whom we would call in an emergency. The next 10 comprise
a “sympathy group,” social companions whom we see on a regular basis (the
numbers are cumulative, so this group includes our closest five). Next are our “good
friends,” people we might not see every day but whom we would invite to a
celebratory birthday party. The remainder of the 150 include friendly acquaintances,
the kind of people we would invite to our wedding. According to Dunbar’s estimate,
we devote the majority of our social attention to our support clique (about 60%) and
our next 10 friends (about 20%), which reflects how important these relationships
are to us. We tend to have much more in common with our close friends than more
distant acquaintances and rely heavily on them for the many benefits that friendship
provides, including companionship, affection, guidance, advice, shared intimacy,
emotional support, and practical assistance. In contrast to familial relationships,
however, friendships tend to be relatively fragile. As Dunbar explains, they “depend
on constant reinforcement to maintain their strength.” Some friendships that fade away were simply “friends of convenience”
(e.g., co-workers that you lose touch with once you leave a job), but others are meaningful connections that are disrupted by a
disagreement or wither away because of neglect. Because it becomes more difficult to forge new friendships as we age, it can
be important to make an effort to maintain those friendships that matter to us. According to one study (which is based, in
part, on Dunbar’s work), it takes roughly 50 hours of time together to establish genuine friendships, 140 hours (cumulatively)
for “good friendships,” and 300 hours for “best friendships.”
If we’re fortunate, we have a small number of deep friendships that last for
life. “They tend to be friends we were close to in [our] early adult life, whose
advice we sought in moments of crisis, [who] we sat up with late into the night
discussing deep philosophical issues …. We can pick up those relationships
years later exactly where we left them off.” As VCM note, philosophers like
Aristotle “have considered [friendship] integral to a flourishing life” (p. 107).
Directions: Write a one page reflection MLA style essay answering the following questions. After reading the PowerPoint on nutrition for athletes, how would you change (if needed) your diet examples; your intake of water, protein, carbs, and fats. What are your thoughts on Protein and supplement uses during and after workouts? After learning about our healthcare and why people are so unhealthy how do you think the information from the powerpoint can help our society make better eating habits, especially for athletes.
Unformatted Attachment Preview
NUTRITION FOR
ATHLETIC
PERFORMANCE
Kinesiology Major 100
By: Ms. Perry
WHO “IS” AND WHO “IS NOT” AN ATHLETE?
Someone who is elite in their sport?
Someone who competes regularly?
Someone who exercises everyday?
There is no set protocol to establish who is and who
is not an athlete, therefore, you must decide based
on sound judgment.
Anyone who goes “above and beyond” the basic
exercise recommendations for health benefits.
WHY IS NUTRITION IMPORTANT FOR
ATHLETES?
Provide general health benefits
Maintain an appropriate body composition
Maximize athletic performance
WHAT CHANGES ARE MADE FOR ATHLETES?
Macronutrient daily recommendations
Caloric requirement
Intake before, during and after a training bout or
competition
Hydration and fluid replacement
Consideration of the use of sports drinks and
other products
MACRONUTRIENT INTAKE FOR THE
GENERAL POPULATION
50-55% of calories from carbohydrate
10-15% of calories from protein
Less than 30% of calories from fat
MACRONUTRIENT INTAKE FOR ATHLETES
55-60% (or sometimes higher) of calories from
carbohydrate
10-15% of calories from protein
Less than 30% of calories from fat
The main difference is in the amount of
carbohydrate, for both resistance and endurance
athletes!!! Why?
AVAILABLE FUEL SOURCES
FOR EXERCISE
Fat
Intramuscular triglycerides
Plasma fatty acids
CHO
Muscle glycogen
Blood glucose
Protein
AVERAGE BODY ENERGY STORES:
Fuel
Amt (kg)
Kcal Value
Stored Fat
15.56
140,000
Ms Glycogen
0.35
1,400
Liver Glycogen 0.09
360
Blood Glucose
0.02
80
Protein (ms)
26.02
40,000
FACTORS AFFECTING FUEL USE
(CARBOHYDRATE VS. FAT)
Intensity of Exercise
Duration of Exercise
Training Status
Diet
IMPORTANCE OF CHO
Plays a critical role in athletic performance
Primary energy source
Cause of fatigue in athletes
Muscle glycogen in depletion
Liver glycogen depletion
Diet is critical to replenish CHO stores
EVENTS TAXING CHO STORES
One hard competition
Multiple events in one day
Exhaustive daily training
Two-a-day workouts
High-power, intermittent workouts
CONSEQUENCE OF LOW CHO DIETS
Slow repletion of glycogen stores
Fatigue
Impaired training and performance
Injury
FAT INTAKE RECOMMENDATIONS
Essential part of a healthy diet
No benefit (may actually be detrimental) when fat
intake
Purchase answer to see full
attachment
Using the following family case example, apply Bowen’s 8 interlocking concepts to explain family functioning.
Presenting Issue and Basic Assessment:
Guero and Jane Diaz requested an intake session for help with their 15-year-old son, Martin, after Jane found marijuana in his room in a plastic bag at the bottom of one of his dresser drawers. You meet with all three family members for an assessment, and you find that the marijuana incident is the most recent in a long series of battles between mother and son. After assessing for a possible substance use disorder issue, you conclude that it is teen experimentation, but there is not a pattern of use or other concerns which would lead to a diagnosis of a drug or alcohol disorder. However, you do have concerns about the frequency of arguments between mother and son, and the increase in the intensity of the conflictual encounters. There also seem to be some issues with school adjustment for Martin, which worries both you and his parents.
Family History:
Guero’s father died when Guero was young, and he and his sister were raised by their mother. His mother was devoted, overbearing, and critical at times. She struggled with allowing them to have activities or interests outside of the family home, and by late adolescence, Guero was avoiding his mother whenever he could. He left home at age 25 and cut off all contact with his mother. His sister continues to remain single and lives at home with their mother.
Jane is one of 5 siblings and had a very close relationship with her family growing up. She considers her siblings her best friends of her childhood. Janet’s parents believed that girls should stay at home after high school and focus on finding a husband and starting a family of their own. Janet did not want to take this path and struggled loudly with her parents about her desire to go to college. Her parents struggled to keep her at home, and she struggled to leave. She was successful in leaving for college and has been estranged from her parents since that time.
Early Relationship:
Guero and Jane met and felt a close connection to each other as neither had close family ties at that time. Their dating and engagement time was very short, and they married quickly. However, conflict soon arose as Guero was very sensitive to criticism from Jane, and Jane was very sensitive to any efforts of Guero to distance himself from her. Jane sought closeness and companionship, while Guero felt comfort in space. Guero showed a high level of sensitivity to any demands on his time, and Jane showed a high level of sadness and frustration whenever Guero indicated he did not want to engage in an activity with her that she suggested. After a period of conflict, the couple settled into a norm for them in which Guero put all his energy into his work, and Jane adjusted to spending time by herself and feeling distant from her husband. Not long after, Martin was born.
Family Development:
They were a bit excited about Martin’s birth but in different ways. Guero saw Martin as a positive and fun addition to their home, and Jane saw Martin as a way to fill her need for someone to be close to. Martin was her world. She was a doting and responsive mother who cared for his every need, often before he even had to fuss or cry. Jane hovered so much over her son, even when Guero attempted to spend time with him that Guero became frustrated and backed off, allowing Martin to be in Jane’s care and under her oversight all of the time. Jane was so close to Martin that she allowed him everything he wanted and allowed him to structure their days by what he wanted. She felt hurt when he cried, as if she was a bad parent, so she did everything possible to keep him satisfied and pacified, even when that meant buying more toys, eating off schedule, allowing toys and household items to be destroyed, and naps and baths to be skipped. Martin grew up believing he was the center of the family, and he never heard the word no. Rarely did he tantrum for more than one minute before his mother gave in to whatever he wanted. As Martin’s behavior became more intolerable in his toddler and preschool years, Guero spent more and more time at work. Jane continued to pour all her time and attention into Martin which also distracted her from her lack of a marital relationship.
Martin’s school problems began in earnest in elementary school when he was faced with firm boundaries and rules in the classroom. He had tantrums at school and made few friends as he was seen as a bully and inflexible in his interactions with peers. He mimicked his father’s behaviors when others tried to control him, and his mother always sided with Martin when she was called into the school, explaining that she did not think the school knew how to handle such as creative child as Martin.
Martin grew into adolescence with few friends aside from his mother. He continued to have difficulties at school and did not follow rules or submit assignments by due dates. He rarely was prepared for class, and occasionally completed homework. He told his teachers and administrators that he did not need school and that he was too smart for school, both things he had repeatedly heard his mother say in the past.
When adolescence started, the crisis at home boiled over as Martin attempted to form interests and activities outside of the home and Jane held on tight to him as if her life depended on him staying at home constantly. Guero continued to lengthen his hours at work to escape from the conflict at home. Even in Jane and Martin’s battles, they continued to remain the center of each other’s lives. Martin spent more time battling his mother than on any other activities in his life. (Case study from Nichols, 2013, pgs. 82-83).
Review the interactive media decision tree exercise about the patient with “Complex Regional Pain Disorder” Walden University, LLC. (Producer). (2019e). Complex regional pain disorder. [Interactive media file]. Baltimore, MD: Author. the first choice will be (Amitriptyline 25 mg po QHS and titrate upward weekly by 25 mg to a max dose of 200 mg per day). second choice (Continue current medication and increase dose to 125 mg at BEDTIME this week continuing towards the goal dose of 200 mg daily. Instruct the client to take the medication an hour earlier than normal starting tonight and call the office in 3 days to report how his function is in the morning).third choice (Continue the current dose of Elavil of 125 mg per day, refer the client to a life coach who can counsel him on good dietary habits and exercise). Write a 2 to 3-page summary paper that addresses the following: Purpose statemento
Briefly summarize the
patient case study you were assigned, including each of the three decisions you
took for the patient presented.
o
Based on the decisions
you recommended for the patient case study, explain whether you believe the
decisions provided were supported by the evidence-based literature. Be specific
and provide examples. Be sure to support your response with evidence and references
from outside resources.
o
What were you hoping to
achieve with the decisions you recommended for the patient case study you were
assigned? Support your response with evidence and references from outside
resources (at least 3-4).
o
Explain any difference
between what you expected to achieve with each of the decisions and the results
of the decision in the exercise. Describe whether they were different. Be
specific and provide examples.
The journal article review (JAR) assignment will help you to become more familiar as to how exercise physiology concepts play a major role in related research studies. Furthermore, the JAR assignment will assist you in understanding parts of the research process as related to manuscript development. The JAR will cause you to use content from the EXSC 510 course to thoroughly evaluate an original research article and provide a detailed review. This assignment will help you further understand the exercise physiology concepts, learned in this course, as it applies to the research setting.
Instructions
You must select an original research article from a reputable scientific Human Performance or Exercise Science related peer-reviewed journal to analyze. Parts of an original research article include the introduction, methodology, results, discussion, and conclusion sections. Keep in mind that 15 points of your total grade will be allotted to how relevant your article is to Exercise Physiology. Also, clearly identify the strengths and weaknesses of the research study’s design (i.e. the methodology section and the discussion section).
Using the Journal Article Review Template, compose a JAR of no less than three full pages and no more than five full page review of the journal article in paragraph form. Bullet points will not be accepted. Also, you must submit your chosen journal article as a PDF to the instructor when you submit your journal article review in MS Word format.
Failure to submit the article you reviewed to the instructor by the assigned “approval deadline date” will result in an automatic 10 point deduction from your overall journal article review score.
Title your assignment EXSC-510: Advanced Exercise Physiology Article Review and type your name at the bottom of the last page of your review. You must format your paper with 12-point Times New Roman font, double spacing, and 1–1.25-inch margins. You will be graded on your spelling and grammar, and your overall grade will be reduced if you are “poor” in either category. There must be absolutely no typos, spelling mistakes, or grammatical errors in your paper. Be sure to proofread your journal article review multiple times and review the Journal Article Review Grading Rubric prior to submission.
There are no required citations for this assignment, but the style to use is current APA if you do choose to use and include any references.
his is part 3 of your evidence-based practice project.
In this assignment, you will refer back to assignment you completed in week 4, as this assignment will build upon it.
For this assignment, you will re-review your three articles selected from your week 2 and 4 assignment. Then, you’ll write a paper on the following (be sure to include the content from your previous papers in weeks 2 and 4, updating with feedback from your instructor).
For each of the three articles, please discuss the following in your paper:
Research design of the study
Threats to external/internal validity
Potential legal/ethical issues within the article
Data analysis (be sure to elaborate on this more from your paper in week 4, providing specifics about the results)
Implications for evidence-based practice and how this article could be used to make an evidence-based change
Conclusion/summary of the evidence
Remember to support your ideas with the articles you found. These articles should be less than five (5) years old. They should not be from the Web, but from the library databases, and be sure to use a narrative format.
In addition, you must follow APA guidelines, providing a title page, reference page, appendix, and in-text citations, as well as use level headings to match the assignment criteria listed above.
Please use, at minimum three scholarly references, and your paper should be 500-700 words, excluding title and reference pages.
Leila, M., Jestine, M., Dara, J., Neher, J. O., & Safranek, S. (2023). Preventing Postpartum Hemorrhage. American Family Physician, 107(5), 539. https://prx-herzing.lirn.net/login?url=https://www.proquest.com/scholarly-journals/preventing-postpartum-hemorrhage/docview/2813569590/se-2
Choi Wah Kong, & William Wing Kee To. (2021). The Discriminant Use of Intrauterine Balloon Tamponade and Compression Sutures for Management of Major Postpartum Hemorrhage: Comparison of Patient Characteristics and Clinical Outcome. BioMed Research International, 2021, 1–9. https://doi.org/10.1155/2021/6648829
Wei, L., Yang, H., & Sun, X. (2022). The Effect of Oxytocin plus Carboprost Methylate in Preventing Postpartum Hemorrhage in High-Risk Pregnancy and Its Effect on Blood Pressure. Evidence-Based Complementary and Alternative Medicine, 2022. https://doi.org/10.1155/2022/9878482
Students are required to submit weekly journal entries throughout the course. These reflective narratives help students identify important learning events that happen throughout the course and the practicum. In each week’s entry, students should reflect on the personal knowledge and skills gained.
Write a reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing.
Topic Focus: Practices of Culturally Sensitive Care and Ensuring the Integrity of Human Dignity in the Care of all Patients
Use APA Style
Plagiarism repost less than 10% please
Note: For this assignment I need to talk about how Practices of Culturally Sensitive Care and Ensuring the Integrity of Human Dignity in the Care of all Patients (the topic focus) relates to this week’s assignments. Please, let me know if you have any questions.
These are this week’s assignments so you have an idea of what to develop on this reflective journal.
1) Stakeholder support is necessary for a successful project implementation. Consider your internal stakeholders, such as the facility, unit, or health care setting where the change proposal is being considered, and your external stakeholders, like an individual or group outside the health care setting. Why is their support necessary to the success of your change proposal, and how you will go about securing that support?
Stakeholders constitute significant parties who have an impact in how an organization performs or operates or who are affected by the decisions it makes. In the healthcare field, stakeholders also refers to individuals, businesses, or any other type of entity with a stake in clinical decisions or the evidence that supports them. Stakeholders are essential for the effective implementation of my evidence-based project. Internal stakeholders make a vital contribution to its effective implementation by providing their expertise and leadership within the organization to support the proposed change.
Internal stakeholders are essentially those who are currently employed by the organization, including different groups of healthcare professionals, administrators, and other individuals who perform both clinical and non-clinical duties. Nurses are the main healthcare providers, and they play a key role in putting the research into practice while caring for patients. Nurses collaborate in multidisciplinary teams alongside anesthesiologists, pharmacists, physicians, physiotherapists, and other medical specialists who are involved in the actual delivery of healthcare services. The organizational management structure plays a critical role in providing the framework and leadership necessary to increase the likelihood that the proposed change will be accepted. To ensure the successful implementation of an evidence-based project, an organization’s management support is essential.
External stakeholders include patients, vendors, and financial institutions like the government and health insurance companies. External stakeholders contribute significantly to the change’s implementation by providing the necessary resources. For example, the government finances the construction of healthcare facilities, develops regulations to guarantee that everyone has access to inexpensive, high-quality healthcare, and facilitates the hiring and education of healthcare personnel. The success of the project depends on getting the cooperation of the patients, who are the genuine consumers of healthcare services. Opinion leaders in the medical field and outside of it are other external stakeholders. Their support is crucial in shaping how the community and society as a whole perceive the change.Spreading the word about the project’s use of evidence is one of several techniques I may use to gain the support of the stakeholders. In order to do this, one may host seminars, participate in conferences, journal forums, and other settings that promote interactive interactions. Through community coalitions and the media, I would also advocate for their support.
Stakeholders should be taken into account when considering change because they will have an impact on how effectively the change plans work. Inform the stakeholders of the status of the project’s implementation. Create the credibility necessary to advance stakeholder engagement planning and understand their perspectives and project visions. It is very important to develop a detailed communication plan in the early stages. Establish a comfortable environment for the change initiative. frequently involve different stakeholders throughout the project life cycle.
2)Technology is integral to successful implementation in many projects, through either support or integration or both. Name at least one technology that could improve the implementation process and the outcomes of your capstone project change proposal. Do you plan to use this technology? If not, what are the barriers that prevent its use?
Nurses have a unique role on the medical team. They are frequently the professional who cares for the patient most closely and round-the-clock to meet their physical, emotional, cognitive, social, and spiritual needs. Due to their demanding work, new technologies have been developed to help them enhance their standard of care, reduce patient costs, and enhance working conditions. An essential part of nursing practice is educating patients, especially when first admitted. With adequate training and utilizing the appropriate resources, nurses can prevent patient’ falls, especially among the elderly population.
My capstone project aims to prevent falls in hospitalized patients, particularly geriatric patients who are more at risk for falls than other patient populations. Hospitals and different acute settings deal with people at risk of falling while recovering from an illness, injury, or surgery. No matter what degree of care someone needs, maintaining their safety depends on knowing the needs of their community and having the appropriate fall prevention technologies in place. Patients must be kept safe by the healthcare professionals caring for them. Wearable sensors are a suitable fall technology that might enhance the implementation process and the outcomes of my capstone project change proposal.
Wearable sensors can assist elderly patients to prevent falls and maintain stability. Wearable sensors can be used by healthcare professionals to remotely evaluate patients, including their levels of physical activity and gait consistency. These devices accurately spot the movements of older adults with restricted mobility.
The fundamental benefit of wearable sensors is that they may be used also at home. All risk assessment using wearable sensors is feasible in older adults regardless of their cognitive status. Accuracy may vary depending on sensor location, sensor attachment, and type of assessment chosen for recording sensor data. Therefore, wearable sensors offer an excellent, low-cost solution to detect falls and call for assistance.
Number 1- According to the Office of Minority Health, National CLAS was developed to promote health equity, enhance service quality, and aid in eliminating disparities. Practice Cultural Competence and Cultural Humility in the Care of Diverse Patients is one article I read to address one of the national standards. In this article, the issue of unfairness based on minority status in health care services was brought into sharp relief by the Institute of Medicine (IOM) report from 2002, Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. Racial and ethnic differences in healthcare may be influenced by bias, stereotyping, prejudice, and clinical uncertainty on the side of healthcare personnel, according to the IOM report’s conclusion.Also in the article, patient-centered care is described as “offering treatment that is respectful of, and sensitive to, individual patient preferences, needs, and values, and ensuring that patient values influence all clinical choices” (IOM, 2005). In an effort to raise the standard of healthcare, both patient centeredness and cultural sensitivity are required. A clinician must cooperate in shared decision-making with patients in order to provide tailored, patient-centered care, considering the patients’ diverse lives, backgrounds, and opinions.Using the five key elements of being culturally competent—cultural awareness, knowledge, competence, desire, and encounters—could help me improve the way I practice nursing. I believe that by including these elements in my nursing practice, I will be better able to connect with my patients, build trusting relationships with them, and give them safe, effective care. By upholding these norms, a nonjudgmental healthcare system can be created, allowing patients to get care that is suitable for their culture. number 2 The National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care Guidelines are an excellent resource that clarify and inform the responsibilities of health care workers and organizations. I found that reviewing the standards was a helpful exercise to identify areas in which my organization and practice is successful, and areas that could use some improvement. The standard that I focused on was number six, “inform all individuals of the availability of language assistance services clearly and in their preferred language, verbally and in writing.” (U.S. Department of Health & Human Resources, n.d.). I wanted to focus on this standard coming from a culturally but not mandatory bilingual health care system.Canada itself is a bilingual country, meaning that all federal services need to be offered proficiently in both English and French (Government of Canada, 2023). However, healthcare although funded (mostly) federally, is managed provincially. Provincially, there is no bilingual mandate, although all provinces provide English and French services to ensure inclusion of both languages. The only officially bilingual province in Canada in New Brunswick, meaning they are mandated to provide services in both languages. This discrepancies between law and culture shows that culturally we have one need that is met, and that legally we have fallen behind what is needed. Our legal systems do not always keep up culturally.It is common practice in Canada for there to be English, French and Indigenous language text on all major navigation signs in health care systems. Reaume et al. (2020) discussed the impacts of language availability and the correlation to harm. Overall, it was determined that there was increased risk of harm for patients when they could not access care or communicate to care providers in their own language (Reaume, et al., 2020). Once that barrier was removed, there was less risk of harm. This is very telling on how important it is for our clients to be able to access care with their language needs in mind. Displaying the available language so clients know it is available, is vital.
Home-Based Care for Patient with Dubious UlcerHow will the nursing staff identify the functional health literacy of Mr Cumbersetz and recognize his ability/inability to read, understand written and verbal directions, and understand/recognize written instructions on medication and dressing labels. Please elaborate. (3 points)What are the nurses’ general education goals with this patient and his family? (2 points)What does Mr Cumbersetz need to know? What does his family need to know? Recognize and discuss the three domains of learning and how the nursing staff may prepare this family to discharge home with a viable plan to promote further decubitis healing. (3 points)What are the nurses’ general education goals with this patient and his family? (2 points) What does Mr Cumbersetz need to know? What does his family need to know? Recognize and discuss the three domains of learning and how the nursing staff may prepare this family to discharge home with a viable plan to promote further decubitis healing. (3 points)
Purpose: The purpose of this assignment is to facilitate thinking about your personal beliefs in
relation/comparison to the core concepts of Communication, Compassionate Care, Diversity, equality and
inclusion, Ethics, Evidence-Based Practice, Health Policy, and social determinants of Health in nursing practice
as outlined and defined by the AACN . As a senior level nursing student you may be asked to revisit this
assignment so please keep your work.
Before you begin to write this paper:
Read the American Association of Colleges of Nursing (AACN) “2021 THE ESSENTIALS: CORE
COMPETENCIES FOR PROFESSIONAL NURSING EDUCATION” description of the above core concepts – Look
closely at pages 11-14. (https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Essentials-
2021.pdf Reflect within your paper on at least 5 out of the 8 core concepts and how they
o 1) relate to nursing
o 2) how they compare to your own thoughts and feelings on these concepts. Provide examples
from nursing literature, your work or life experiences.
This paper can be thought of as a comparison and introspection of your own beliefs and values
compared to Rockford University’s Nursing Department values of the discipline of nursing rising from
the AACN Essentials.
Directions:
Students are expected to use the Publication Manual of the American Psychological Association (7th
edition) to guide the formatting of this paper. One third of the points received for this paper stem
from APA formatting, see rubric below.
5-6 pages (not including title, reference and rubric page) typed, double-spaced, one-sided, 12-point
font paper. Required typeface throughout- Times New Roman.
Minimum of four different reference citations (Four Different resources)
All papers submitted should be at an acceptable college level of writing.
The following grading rubric will be used: Please attach a copy of this rubric as the final page of your
paper, after reference page.(One will be available on Canvas)
Please respond to discussion below using current APA edition and 2 scholarly references. Must be 150 words. This past week has been wonderful, and I think it’s because I’m starting to realize that the semester is almost over. After completing this clinical rotation, I not only feel more prepared but also a lot more confidence in my ability to analyze patients. I had the good fortune to have an incredible preceptor who had faith in me and gave me opportunities to practice my abilities.This past week, we saw a male patient who was 53 years old and complained of a great deal of pain as well as redness reported to his big toe on his right foot when he presented himself to the clinic. His blood pressure is 135/85, his heart rate is 85, his respiratory rate is 18, his oral temperature is 98.8 degrees Fahrenheit, and he is 5 feet 8 inches tall and weighs 211 pounds. According to him, the pain started one day ago. He states that the pain lessens when he raises his foot and rests, but he continues to have some degree of discomfort. When he is moving around, the agony, according to him, is an 8 out of 10. He reported that the pain first started in his right big toe, but it has now spread to his ankle as well. He is currently in a lot of discomfort. Since yesterday, the patient has been taking 400 milligrams of ibuprofen orally to treat discomfort. This has been going on since yesterday. He claims that it does assist to ease some of the pain, but that it is not effective enough to fully treat it. The patient insists that he is not taking any other medications and claims that he has not damaged his foot. He also claims that he does not recall ever experiencing numbness or loss of sensation in that foot. Standard laboratory tests, including the serum uric acid level, were performed. A complete bilateral examination of his joints was performed to assess for symmetry, appearance, and range of motion (Dunphy, Winland-Brown, Porter, & Thomas, 2019).The patient’s right big toe was warm to touch, painful on palpation, and the range of motion was limited.After the assessment it appears the patient’s primary diagnosis is gout. Initial testing for gout includes a serum uric acid level. Most patients will have an elevated serum urate level in the absence of elevated blood urea nitrogen because serum urate is above 7.5mg/dL in up to 95% of persons with gout (Dunphy, Winland-Brown, Porter, & Thomas, 2019, p. 949). Some differential diagnosis for gout would include arthritides, cellulitis, acute joint trauma, and a fracture.According to Singh & Gaffo (2020), gout is the most common inflammatory arthritis in adults worldwide, with a disproportionate burden of disease in men, the elderly and racial/ethnic minorities. Comorbidities in gout are very common and add further to the disease morbidity and make its management challenging. It is critical to devise a treatment strategy for the patient that they can stick to in order to get rid of the acute episode of gout and prevent any attacks in the future. Lab work, such as a complete blood count, serum uric acid levels, and a radiograph are the first steps in the treatment strategy for this patient. In addition, he has the option of continuing to treat the pain with nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and corticosteroids. First-line treatment for acute gout pain often consists of nonsteroidal anti-inflammatory drugs (NSAIDs). He was instructed to take an initial dose of 750 milligrams of Naproxen, followed by a dosage of 250 milligrams every 8 hours for a period of 5 to 8 days. Colchicine treatment begins with a loading dose of 1.2 milligrams, which is then followed by 0.6 milligrams one hour later. After that, the patient takes 0.6 milligrams once or twice every 12 hours until the gout episode subsides. The patient was given the directive to apply ice to the affected area whenever it was necessary, to continue eating healthily, and finally to formulate a strategy to control the weight increase that he had experienced. He was also instructed on the significance of increasing the amount of vegetables and low-fat goods he consumed, as well as the amount of water he drank to prevent becoming dehydrated, the amount of physical activity he engaged in, and the value of avoiding meats that were high in purine content, such as liver, kidney, and sweetbreads. Additionally, he ought to cut back on his consumption of alcohol and stay away from carbonated beverages.Because I had never seen anything remotely similar to this situation before this week, I considered myself really fortunate to be able to observe it. I was familiar with gout from what I had read about it, but I had never observed a patient who was experiencing an acute episode of gout. It was helpful to obtain a clear concept of what the patient presents with and how to manage their treatment in order to lessen swelling and pain in the patient.
The student will write a scholarly paper on the latest communicable diseases affecting the community and addresses primary, secondary, and tertiary prevention. The assignment must also address the measures that community health nurses have undertaken to prevent the spread of the communicable disease. The presentation must include the following:
· Discuss the importance of Healthy People 2020 in the prevention and control of communicable diseases.
· Reflect on what you learned from the assignment and how it will impact your practice in the future4. Use interprofessional communication and collaboration skills to deliver evidence-based, client-centered care.
Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approach
Requirements
· Minimum of 2 pages and exclude title and reference page.
· The paper must be written in APA format using Times New Roman 12 font, double space.
· Minimum of two references (the course textbook can be one of the references). Articles chosen must have been published within the last 5 years.
When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety. In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.To Prepare:* Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.* Review the health policy you identified and reflect on the background and development of this health policy.Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Which social determinant most affects this policy? Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provideexamples.
write a Annotated Bibliography of 5 articlesyou can find the sample and the steps to write the Annotated Bibliography in 2020 research guide on page 21
Unformatted Attachment Preview
REFERANCE
Wang, Z., & Chen, S. (2023). Senior’s Perceived Barriers to Accessing an Urban Charitable Food
Assistance Program. Journal of Nutrition Education & Behavior, 55(7), 5–6.
https://doi.org/10.1016/j.jneb.2023.05.014
Mavegam Tango Assoumou, Coughenour, C., Godbole, A., & McDonough, I. (2023). Senior food
insecurity in the USA: a systematic literature review. Public Health Nutrition, 26(1), 229–245.
https://doi.org/10.1017/S1368980022002415
Gerst-Emerson, K., & Jayawardhana, J. (2015). RESEARCH AND PRACTICE. Loneliness as a Public
Health Issue: The Impact of Loneliness on Health Care Utilization Among Older Adults. American Journal
of Public Health, 105(5), 1013–1019. https://doi.org/10.2105/AJPH.2014.302427
Locher, J. L., Robinson, C. O., Roth, D. L., Ritchie, C. S., & Burgio, K. L. (2005).
The effect of the presence of others on caloric intake in homebound older
adults. The journals of gerontology. Series A, Biological sciences and medical
sciences, 60(11), 1475–1478. https://doi.org/10.1093/gerona/60.11.1475
Van Orden, Bower, E., Lutz, J., Silva, Gallegos, A., Podgorski, C. A., … & Conwell, Y. (2021).
Strategies to boosts social connections among older adults during “social distancing”
standards.
An
American
Journal
https://doi.org/10.1016/j.jagp.2020.05.004
of
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Psychiatry, 29(8),
816–827.
Research Proposal Guide
Dr. Angel Resto
2020
Contents
Section 1- Introduction …………………………………………………………………………………………………………………………3
Step 1: Defining the social problem ……………………………………………………………………………………………………3
Worksheet1: Defining the Social Problem ……………………………………………………………………………………3
Worksheet 2: Gathering evidence of the problem ……………………………………………………………………….4
Step 3: Identifying the cause of the problem ………………………………………………………………………………………5
Worksheet3: Identifying the causes of the problem …………………………………………………………………….5
Step 4 -Formulating Problem Statements ………………………………………………………………………………………….6
Worksheet 4 – Formulating Problem Statements………………………………………………………………………….6
Step 5: The Significance of the Study ………………………………………………………………………………………………….7
Worksheet 5: Significance/rationale of the study ………………………………………………………………………..7
Step 6: Measurement/Assessment of Variables/Constructs……………………………………………………………….8
Worksheet: Measurements/Assessments (Quantitative Research) …………………………………………….9
Worksheet: Measurements/Assessments (Qualitative Research) ……………………………………………. 10
Step 7: How to Write a Research Question ……………………………………………………………………………………… 11
Worksheet 7 – Research Question(s) ………………………………………………………………………………………… 12
Step 8- Formulating a Purpose Statement ……………………………………………………………………………………… 13
Worksheet 8 – Formulating Purpose statement ………………………………………………………………………… 14
Step 9: How to formulate the Hypothesis ………………………………………………………………………………………… 15
Worksheet 9 – Writing the Hypothesis………………………………………………………………………………………. 17
Step 9: Check up ……………………………………………………………………………………………………………………………… 18
Worksheet 9- Summary ……………………………………………………………………………………………………………… 19
Step 10: Put it all together ……………………………………………………………………………………………………………… 20
Section 2: Annotated Bibliography …………………………………………………………………………………………………… 21
Section 2: Literature Review ……………………………………………………………………………………………………… 26
Section 3: Methodology …………………………………………………………………………………………………………………….. 28
Description of Research Method and Research Design ………………………………………………………………………. 28
Population and sample …………………………………………………………………………………………………………………….. 29
Data collection procedures ………………………………………………………………………………………………………………. 30
Method of Statistical Data Analysis …………………………………………………………………………………………………… 30
SWK310 2020 DR. ANGEL RESTO
1
NORTHEASTERN ILLINOIS UNIVERSITY
SOCIAL WORK PROGRAM
Research Proposal Guide
The Research Proposal is a complete description of the intended research, developed under the
supervision of the assigned supervisor. Through the full proposal, the student needs to demonstrate
convincingly that the study will make a contribution to a social work issue or problem. The full
research proposal must be between 5 and 10 pages and should present the following:
Section 1: Introduction
• Statement of the Problem
• Purpose/Significance/Rationale
• Research Questions
• Research Hypothesis (If applicable)
Section 2: Literature Review
• Methodology
• Study Population and Sampling
• Description of research design
• Instrumentation
Section 3: Data collection procedures
• Data analysis methods – if applicable statistical planning must be fully addressed or the
candidate should provide evidence that statistics are not required.
Study period – Timetable for completion of the project
References
Appendixes – (copy of questionnaire, consent forms, etc.)
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Section 1- Introduction
The following pages present several worksheets that you must complete to create your introduction
session.
Step 1: Defining the social problem
As a researcher, you will first need to select a problem topic and then specifically define a social
problem. A social problem is a condition that at least some people in a community view as being
undesirable.
Worksheet1: Defining the Social Problem
1. In one or two sentences, state the nature of the social problem that you plan to study.
2. What is the specific community location of the social problem?
3. List at least three undesirable social conditions that result from this problem:
1.
2.
3.
4. Next, discuss why a research is necessary.
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Step 2: Gathering evidence of the problem –Visit the library
The goal of this step is to develop problem solving skills through using the library/Internet.
Therefore, this step requires you to use the Internet to locate at least one reference to support the
existence of your problem.
Suppose you are doing a social problem with your agency or your community as the geopolitical
location. Try to locate statewide or national data on the problem that best matches your agency or
community. Then, you can contend that the data is applicable to your agency or community as well.
Worksheet 2: Gathering evidence of the problem
Your problem (phrase):
Present evidence that a problem exists. Be as specific as possible and cite at least one source
of data:
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Step 3: Identifying the cause of the problem
Medical researchers try to identify the causes of various diseases. They can develop a vaccine to
immunize people from contracting that disease. For example, Dr. Jonas Salk virtually eliminated
polio when he identified the virus that caused it, and then developed a vaccine. Likewise, if
researchers can identify the causes or factors that contribute to a social problem, then they can try
to develop public policies to eliminate or lessen those causes or factors.
Unlike the specific virus that causes polio, most social problems have numerous causes and
contributing factors. Some of the Internet/library resources that you used to complete the previous
step probably also contain information about causes and contributing factors. Review those articles
and brainstorm the causes and factors that contribute to your social problem. Record that
information on Worksheet 3.
Worksheet3: Identifying the causes of the problem
Briefly list several underlying factors that contribute to the problem that you have identified
(support these factors with evidence):
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Step 4 -Formulating Problem Statements
A persuasive problem statement consists of three parts: 1) the ideal, 2) the reality, and 3) the
consequences for the reader of the proposal. Well constructed problem statements will convince
your audience that the problem is real and worth having you investigate. Your strategy is one of
contrast: by situating the ideal scenario next to the situation as it exists, you cannot only persuade
the reader that a problem exists, but then go on to emphasize the consequences of ignoring or
addressing the problem. Remember, your problem statement is the backbone of the proposal. By
giving careful consideration to how you construct it now (for the proposal), you can use it when
doing your research and writing for the proposal.
Worksheet 4 – Formulating Problem Statements
STATEMENT 1 (DESCRIPTION OF THE IDEAL SCENARIO)
Describe the goals, desired state, or the values that your audience considers important and that are
relevant to the problem.
(BUT)
Connect statements 1 and 2 using a term such as “but,” “however,” “Unfortunately,” or “in spite of”;
STATEMENT 2 (THE REALITY OF THE SITUATION)
Describe a condition that prevents the goal, state, or value discussed in statement 1 from being
achieved or realized at the present time.
STATEMENT 3 (THE CONSEQUENCES FOR THE AUDIENCE)
Using specific details, show how the situation in statement 2 contains little promise of improvement
unless something is done. Then emphasize the benefits of research by projecting the consequences
of possible solutions as well.
Source: http://www.personal.psu.edu/cvm115/proposal/propassign.htm
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Step 5: The Significance of the Study
The Significance of the study describes the contributions of the study as new knowledge, make
findings more conclusive. It cites the usefulness of the study to the specific groups. Cite all the
persons and groups that benefited on your study/research. Include a short explanation regarding
how those persons and groups benefited from the study. (How the research study will help them?)
Worksheet 5: Significance/rationale of the study
Why you are doing the study?
What do you hope to achieve by completing the study?
What benefits will your research bring to the social work field?
How it will be helpful? To whom? And Why?
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Step 6: Measurement/Assessment of Variables/Constructs
Assignment goals:
• If quantitative methods are to be used in your research, your goal is to identify and define
variables/constructs, how they will be measured (that is, locating measures/instruments)
and assess their reliability and validity
• If qualitative methods are to be used in your research, your goal is to review the assessment
of constructs identified in for your research, along with issues of credibility, dependability,
and integrity.
Measurements/Assessments Assignment
For this assignment you will scan your annotated bibliography for information about how others
have identified and operationally defined the variables/constructs that are similar to the ones you
have identified for your research project.
• For qualitative research you will have to identify the variables and how the literature
addresses how these variables are measured. You need to also describe what data collection
tool will be use to collect this data.
For example: if you are interested in measuring “stress level”, you need to search for literature about
how stress can be measured, and what instrument can be used to measure stress. Make sure you
address how reliable and valid these instruments are to measure these variables.
• For qualitative research, you will need to focus on the way in which constructs/themes, etc.,
are to be assessed in a manner that establishes credibility, dependability, and integrity.
For example: If you are interested in describe how people feel after the death of a family member, you
need to search how the literature assess how people feel after the death of a family member. Then you
will replicate what the literature has done.
Use APA style in preparing your paper and citing references (i.e., the paper should follow APA for
all paper and text formatting). The paper should be a minimum of 2 pages in length, excluding the
title page and references. Revisions may be necessary based on faculty mentor feedback.
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Worksheet: Measurements/Assessments (Quantitative Research)
For this assignment you will scan your annotated bibliography for information about how others
have identified and operationally defined the variables/constructs that are similar to the ones you
have identified for your research project.
Dependent variable:
Definition: How does the literature define this variable?
Assessment:
Explain how does the literature measure this variable?
What data collection tool does the literature suggest to use to measure this variable?
Reference: List the source in APA style
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Worksheet: Measurements/Assessments (Qualitative Research)
If qualitative methods are to be used in your research, your goal is to review the assessment of
constructs identified in for your research, along with issues of credibility, dependability, and
integrity.
Describe the construct:
Discuss how the literature measures this construct in terms of credibility and dependability?
(How you as a researcher will ensure the exploration of this construct will maintain credibility,
and dependability).
Reference: List the source in APA style
Credibility
The credibility criteria involves establishing that the results of qualitative research are credible or
believable from the perspective of the participant in the research. Since from this perspective, the
purpose of qualitative research is to describe or understand the phenomena of interest from the
participant’s eyes, the participants are the only ones who can legitimately judge the credibility of
the results. (source; http://www.socialresearchmethods.net/kb/qualval.php)
Dependability
The traditional quantitative view of reliability is based on the assumption of replicability or
repeatability. Essentially it is concerned with whether we would obtain the same results if we
could observe the same thing twice. But we can’t actually measure the same thing twice — by
definition if we are measuring twice, we are measuring two different things. In order to estimate
reliability, quantitative researchers construct various hypothetical notions (e.g., true score theory)
to try to get around this fact.
The idea of dependability, on the other hand, emphasizes the need for the researcher to account
for the ever-changing context within which research occurs. The research is responsible for
describing the changes that occur in the setting and how these changes affected the way the
research approached the study. (source; http://www.socialresearchmethods.net/kb/qualval.php)
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Step 7: How to Write a Research Question
Source: http://writingcenter.gmu.edu/resources-template.php?id=59
What is a research question?
A research question is a clear, focused, concise, complex and arguable question around which
you center your research. You should ask a question about an issue that you are genuinely curious
about.
Why is a research question essential to the research process?
Research questions help writers focus their research by providing a path through the research and
writing process. The specificity of a well-developed research question helps writers avoid the “allabout” paper and work toward supporting a specific, arguable thesis.
Steps to developing a research question:
Choose an interesting general topic. Even directed academic research should focus on a topic
in which the writer is at least somewhat personally invested. Writers should choose a broad
topic about which they genuinely would like to know more. An example of a general topic
might be “Slavery in the American South” or “Films of the 1930s.”
Do some preliminary research on your general topic. Do a few quick searches in current
periodicals and journals on your topic to see what’s already been done and to help you
narrow your focus. What questions does this early research raise?
Consider your audience. For most college papers, your audience will be academic, but always
keep your audience in mind when narrowing your topic and developing your question.
Would that particular audience be interested in this question?
Start asking questions. Taking into consideration all of the above, start asking yourself openended “how” and “why” questions about your general topic. For example, “How did the slave
trade evolve in the 1850s in the American South?” or “Why were slave narratives effective
tools in working toward the abolishment of slavery?”
Evaluate your question.
Is your research question clear? With so much research available on
any given topic, research questions must be as clear as possible in
order to be effective in helping the writer direct his or her research.
A Research Question identifies the phenomenon to be studied. For example,
“What resources are helpful to new and minority drug abuse researchers?”
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Worksheet 7 – Research Question(s)
Write your research question(s)
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Step 8- Formulating a Purpose Statement
A purpose statement announces the purpose, scope, and direction of the paper. It tells the reader
what to expect in a paper and what the specific focus will be.
Common beginnings include:
“This paper examines . . .,” “The aim of this paper is to . . .,” and “The purpose of this essay is
to . . .”
A purpose statement makes a promise to the reader about the development of the argument but
does not preview the particular conclusions that the writer has drawn.
A purpose statement usually appears toward the end of the introduction. The purpose statement
may be expressed in several sentences or even an entire paragraph.
A purpose statement is specific enough to satisfy the requirements of the assignment. Purpose
statements are common in research papers in some academic disciplines, while in other disciplines
they are considered too blunt or direct. For example:
This paper will examine the ecological destruction of the Sahel preceding the drought and the
causes of this disintegration of the land. The focus will be on the economic, political, and social
relationships which brought about the environmental problems in the Sahel.
Sample Purpose and Problem statements
The following example combines a purpose statement and a problem statement (bold).
The goal of this paper is to examine the effects of Chile’s agrarian reform on the lives of rural
peasants. The nature of the topic dictates the use of both a chronological and a comparative
analysis of peasant lives at various points during the reform period. . . The Chilean reform
example provides evidence that land distribution is an essential component of both the
improvement of peasant conditions and the development of a democratic society. More
extensive and enduring reforms would likely have allowed Chile the opportunity to
further expand these horizons.
Source: Adapted from http://writing.wisc.edu/Handbook/Thesis_or_Purpose.html
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Worksheet 8 – Formulating Purpose statement
Example 1:
I’m studying: (Add Topic here)
,to find out (Add research question here)
, in order to (Add significance/rationale here )
Example 2:
The Purpose/aim of this study is to find out (add research question)
in order to (add significance/rationale of the study)
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Step 9: How to formulate the Hypothesis
(Complete this step if you are conducting a Quantitative Research)
Hypothesis is a tentative explanation for an observation, phenomenon, or scientific problem that
can be tested by further investigation. Something taken to be true for the purpose of argument or
investigation; an assumption.
How To Correctly Write A Hypothesis
One of the most important skills a scientist has is his/her ability to write a good hypothesis. For
today’s homework you will be practicing how to write a hypothesis correctly.
Here a few of the basic steps. There are three basic types of hypotheses: the directional hypothesis
(one-tail), the non-directional hypothesis (two-tail) and null hypothesis (statistical hypothesis). The
directional hypothesis states the direction of the difference or relationship. The Non-directional
hypothesis does not specify direction and the Null hypothesis states that there is no relationship
among variables.
So how should you write a hypothesis? First, identify what the problem is. If you fail to identify the
problem, you most certainly will have difficulty writing the hypothesis. Second, make an educated
guess as to what direction of the relationship or difference is. Third, identify the major variables.
Now you are ready to write a hypothesis. Start by stating the directional hypothesis in a simple
declarative statement. Do not use the terms “I think” to start the hypothesis. Now that you have
given written the directional hypothesis, write the non-directional hypothesis.
Practice:
1. Mark believes that groceries at Costco will be less expensive than groceries at Safeway.
Write a directional, non- directional, and null hypothesis related to Mark’s observation.
Directional Hypothesis___________________________________________________
Non-Directional Hypothesis_________________________________________________
Null Hypothesis________________________________________________
2. Leslie has observed that more small dogs are adopted at animal shelters than large
dogs. Write a directional, non- directional, and null hypothesis related to Leslie’s
observation.
Directional Hypothesis___________________________________________________
Non-Directional Hypothesis_________________________________________________
Null Hypothesis________________________________________________
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3. Amy believes that as the number of years of driving experience people have increases
the number of speeding tickets they receive decreases. Write a directional, nondirectional, and null hypothesis related to Amy’s observation.
Directional Hypothesis___________________________________________________
Non-Directional Hypothesis_________________________________________________
Null Hypothesis________________________________________________
5. Roger has observed that students who take honors classes in college are less likely to
drop out of college than students who do not. Write a directional, non- directional, and
null hypothesis related to Roger’s observation.
Directional Hypothesis___________________________________________________
Non-Directional Hypothesis_________________________________________________
Null Hypothesis________________________________________________
Source: http://www.angelfire.com/scifi/ricks/hypothesis.html
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Worksheet 9 – Writing the Hypothesis
Chose one (Directional or Non-directional)
Directional Hypothesis
H1:
Null Hypothesis
H0:
_________________________________________________________________________________________________________
Non- Directional Hypothesis
H1:
Null Hypothesis
H0:
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Step 9: Check up
Please use the following example as a tool to measure your progress so far. Complete
worksheet 8- summary.
Example: Summary:
Provide background (Problem Statement) for the issues
Much collegiate sportswear is produced in sweatshops in third world countries. Laborers earn
pennies a day under horrible working conditions. Yet consumers pay exorbitant prices for these
goods.
Summarize the purpose of your project and how you will accomplish it
This paper will examine the degree to which consumers are able to influence corporations to do
business in a socially responsible manner. Therefore, I will identify instances of abuses in the
collegiate sportswear industry and demonstrate how consumers can make an impact upon
corporations.
Include a “working title”
Impact of Ethical Consumerism on laborers in poor countries
Indicate questions to be answered
Key question: “What impact can ethical consumerism have on corporations and the environment?”
Sub-questions: “What statistical results have been compiled by those who support ethical
consumerism?” “Has Nike improved working conditions in their overseas manufacturing plants
since their negative publicity?”
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Worksheet 9- Summary
Provide background (Problem Statement) for the issues
Summarize the purpose of your project and how you will accomplish it
Include a “working title”
Indicate questions to be answered
Adapted from : http://webs.anokaramsey.edu/literacy/ws1.pdf
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Step 10: Put it all together
Instructions:
• Quantitative research- Complete the file: Introduction Guide Fill-in template (You can find
this file on Blackboard/Course document)
• Qualitative Research- Complete the file: Introduction Guide Fill-in Qualitative template
(You can find this file on Blackboard/Course document)
How to complete the template
These templates are created to simplify the completion of the introduction section. Please note that
the template is formatted following the guidelines posted in the syllabus. In the temple you will find
a cover page, the problem statement, the research question(s) and the hypothesis (if applicable).
Simply fill in the information requested on each page. You will also notice some paragraphs in red.
This information in RED provides instructions and examples that you can follow to complete this
assignment. Make sure you delete these red paragraphs when completing the assignment.
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Section 2: Annotated Bibliography
Annotated Bibliography:
Source: http://olinuris.library.cornell.edu/ref/research/skill26.htm
WHAT IS AN ANNOTATED BIBLIOGRAPHY?
An annotated bibliography is a list of citations to books, articles, and documents. Each citation is
followed by a brief (usually about 150 words) descriptive and evaluative paragraph, the annotation.
The purpose of the annotation is to inform the reader of the relevance, accuracy, and quality of the
sources cited.
THE PROCESS
Creating an annotated bibliography calls for the application of a variety of intellectual skills: concise
exposition, succinct analysis, and informed library research.
1. Locate and record citations to books, periodicals, and documents that may contain useful
information and ideas on your topic. Briefly examine and review the actual items. Then
choose those works that provide a variety of perspectives on your topic.
2. Cite the book, article, or document using the appropriate style.
3. Write a concise annotation that summarizes the central theme and scope of the book or
article. Include one or more sentences that (a) evaluate the authority or background of the
author, (b) comment on the intended audience, (c) compare or contrast this work with
another you have cited, or (d) explain how this work illuminates your bibliography topic.
SAMPLE ANNOTATED BIBLIOGRAPHY ENTRY FOR A JOURNAL ARTICLE
The following example uses the APA format for the journal citation.
Waite, L. J., Goldschneider, F. K., & Witsberger, C. (1986). Nonfamily living and the erosion of
traditional family orientations among young adults. American Sociological Review, 51 (4), 541-554.
The authors, researchers at the Rand Corporation and Brown University, use data from the National
Longitudinal Surveys of Young Women and Young Men to test their hypothesis that nonfamily living
by young adults alters their attitudes, values, plans, and expectations, moving them away from their
belief in traditional sex roles. They find their hypothesis strongly supported in young females, while
the effects were fewer in studies of young males. Increasing the time away from parents before
marrying increased individualism, self-sufficiency, and changes in attitudes about families. In
contrast, an earlier study by Williams cited below shows no significant gender differences in sex
role attitudes as a result of nonfamily living.
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Critically Analyzing Information Sources
You can begin evaluating a physical information source (a book or an article for instance) even
before you have the physical item in hand. Appraise a source by first examining the bibliographic
citation. The bibliographic citation is the written description of a book, journal article, essay, or
some other published material that appears in a catalog or index. Bibliographic citations
characteristically have three main components: author, title, and publication information. These
components can help you determine the usefulness of this source for your paper. (In the same way,
you can appraise a Web site by examining the home page carefully.)
I. INITIAL APPRAISAL
A. Author
1. What are the author’s credentials–institutional affiliation (where he or she works), educational
background, past writings, or experience? Is the book or article written on a topic in the author’s
area of expertise? You can use the various Who’s Who publications for the U.S. and other countries
and for specific subjects and the biographical information located in the publication itself to help
determine the author’s affiliation and credentials.
2. Has your instructor mentioned this author? Have you seen the author’s name cited in other
sources or bibliographies? Respected authors are cited frequently by other scholars. For this reason,
always note those names that appear in many different sources.
3. Is the author associated with a reputable institution or organization? What are the basic values
or goals of the organization or institution?
B. Date of Publication
1. When was the source published? This date is often located on the face of the title page below the
name of the publisher. If it is not there, look for the copyright date on the reverse of the title page.
On Web pages, the date of the last revision is usually at the bottom of the home page, sometimes
every page.
2. Is the source current or out-of-date for your topic? Topic areas of continuing and rapid
development, such as the sciences, demand more current information. On the other hand, topics in
the humanities often require material that was written many years ago. At the other extreme, some
news sources on the Web now note the hour and minute that articles are posted on their site.
C. Edition or Revision
Is this a first edition of this publication or not? Further editions indicate a source has been revised
and updated to reflect changes in knowledge, include omissions, and harmonize with its intended
reader’s needs. Also, many printings or editions may indicate that the work has become a standard
source in the area and is reliable. If you are using a Web source, do the pages indicate revision dates?
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D. Publisher
Note the publisher. If the source is published by a university press, it is likely to be scholarly.
Although the fact that the publisher is reputable does not necessarily guarantee quality, it does show
that the publisher may have high regard for the source being published.
E. Title of Journal
Is this a scholarly or a popular journal? This distinction is important because it indicates different
levels of complexity in conveying ideas.
II. CONTENT ANALYSIS
Having made an initial
Instructions
Resources
Attempt 1 available
Attempt 2
Attempt 3
In a 5–7 page written assessment, determine how health care technology, coordination of care, and community resources can be applied to address the patient, family, or population problem you’ve defined. In addition, plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you’ve chosen to work with and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Report on your experiences during the second 2 hours of your practicum.
Collapse All
Introduction
As a baccalaureate-prepared nurse, you’ll be positioned to maximize the use of technology to achieve positive patient outcomes and improve organizational effectiveness. Providing holistic coordination of patient care across the entire health care continuum and leveraging community resource services can lead both to positive patient outcomes and to organizational improvements.
Preparation
In this assessment, you’ll determine how health care technology, coordination of care, and community resources can be applied to address the health problem you’ve defined. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.
To prepare for the assessment:
Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
Conduct sufficient research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence.
Review the Practicum Focus Sheet: Assessment 3 [PDF], Download Practicum Focus Sheet: Assessment 3 [PDF],which provides guidance for conducting this portion of your practicum.
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.
Instructions
Complete this assessment in two parts.
Part 1
Determine how health care technology, the coordination of care, and the use of community resources can be applied to address the patient, family, or population problem you’ve defined. Plan to spend at least 2 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Use the Practicum Focus Sheet: Assessment 3 [PDF] Download Practicum Focus Sheet: Assessment 3 [PDF]provided for this assessment to guide your work and interpersonal interactions.
Part 2
Report on your experiences during the second 2 hours of your practicum.
Whom did you meet with?
What did you learn from them?
Comment on the evidence-based practice (EBP) documents or websites you reviewed.
What did you learn from that review?
Share the process and experience of exploring the effect of the problem on the quality of care, patient safety, and costs to the system and individual.
Did your plan to address the problem change, based upon your experiences?
What surprised you, or was of particular interest to you, and why?
Requirements
The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.
Analyze the impact of health care technology on the patient, family, or population problem.
Cite evidence from the literature that addresses the advantages and disadvantages of specific technologies, including research studies that present opposing views.
Determine whether the evidence is consistent with technology use you see in your nursing practice.
Identify potential barriers and costs associated with the use of specific technologies and how those technologies are applied within the context of this problem.
Explain how care coordination and the utilization of community resources can be used to address the patient, family, or population problem.
Cite evidence from the literature that addresses the benefits of care coordination and the utilization of community resources, including research studies that present opposing views.
Determine whether the evidence is consistent with how you see care coordination and community resources used in your nursing practice.
Identify barriers to the use of care coordination and community resources in the context of this problem.
Analyze state board nursing practice standards and/or organizational or governmental policies associated with health care technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Explain how these standards or policies will guide your actions in applying technology, care coordination, and community resources to address care quality, patient safety, and costs to the system and individual.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of technology, care coordination, and community resources.
Explain how nursing ethics will inform your approach to addressing the problem through the use of applied technology, care coordination, and community resources.
Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.
Apply APA style and formatting to scholarly writing.
Additional Requirements
Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
A title page and reference page. An abstract is not required.
Appropriate section headings.
Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.
Capella Academic Portal
Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in BSN Practicum Campus page for more information and instructions on how to log your hours.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
Analyze the impact of health care technology on a patient, family, or population problem.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Analyze state board nursing practice standards and/or organizational or governmental policies associated with health technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Competency 6: Collaborate interprofessionally to improve patient and population outcomes.
Explain how care coordination and the utilization of community resources can be used to address a patient, family, or population problem.
Competency 8: Integrate professional standards and values into practice.
Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.
Apply APA style and formatting to scholarly writing
Extra Resourcee following resources provide information about how technology is used in health care settings to address health problems, such as the one you’ve selected for your capstone project.
Khanna, G. (2020). AHRQ advances new frontiers in digital healthcare. Agency for Healthcare Research and Quality. https://www.ahrq.gov/news/blog/ahrqviews/digital-h…
Agency for Healthcare Research and Quality. (2019). Health information technology research: 2018 year in review. https://digital.ahrq.gov/2018-year-review
Health IT Buzz. (n.d.). Consumer engagement. https://www.healthit.gov/buzz-blog/category/consum…
HealthIT.gov. (2020). National health IT priorities for research: A policy and development agenda. https://www.healthit.gov/topic/scientific-initiati…
Pazinski, S., Karras, P., Caban, T. Z., & Chaney, K. (2020). Mapping the path forward in health IT. Health IT Buz. https://www.healthit.gov/buzz-blog/health-it/mappi…
Prepare a 30-minute presentation using visual aid a PowerPoint on the assigned case study. The discussion will be based on the rubric provided. This assignment will be evaluated for content, presentation skills, and for visual aids and/or handouts. This is a group presentation; thus each member will receive the same grade. Individuals must be present to earn a grade in this assignment.
Will is a 68-year-old male with a history of hypertension. Eight months ago, he started regular dialysis therapy for ESRD. Before that, his physician was closely monitoring his condition because he had polyuria and nocturia. Soon it became difficult to manage his hypertension. He also lost his appetite, became weak, easily fatigued, and had edema around his ankles. Will debated with his physician about starting dialysis, but she insisted, before the signs and symptoms of uremia increased, the treatment was absolutely necessary
Components of the Report
Describe the Disease
Explain the pathophysiology of the disease.
Etiology/Risk/Incidence
Clinical Manifestation
Clinical Management. (Diagnostics/Treatment)
References
Correct use of English, good sentence and paragraph structure, good writing style ,Formatting, spelling, grammar, punctuation.
What is the difference between azotemia and uremia?
Two years ago, Will’s physician told him to decrease his protein intake. In spite of what the physician ordered, Will could not stop having chicken, beef, pork, or eggs at least once a day. Why did his physician warn him about his diet?
Will’s feelings of weakness and fatigue are symptoms of anemia. Why is he anemic?
Knowing what you do about Will’s history, why is left ventricular dysfunction a concern for his physician?
make 10 slides with pictures Outline the physiological mechanisms of medication action: absorption, distribution, metabolism, and excretion of medications.Explain developmental factors that influence pharmacokinetics and their impact on medication administration.Compare and contrast the roles of prescriber, pharmacist, and nurse in medication administration.Describe how medication actions and side effects impact patient assessments prior to medication administration.
Students will develop a scholarly paper relating to the selected nursing leader that includes the following criteria:
1. An introduction of the leader being interviewed (no names or places should be identified).
2. Length of time as a nurse?
3. The type of leadership style utilized.
4. What characteristics does the leader believe are important for effective leadership?
5. What techniques does the leader use to empower their staff/colleagues?
6. Describe the findings from the interview using the literature to support the type of leadership characteristics and type of
power used by this leader.
7. Summarize by reflecting on the experience and the impact this assignment may have on your future as a nurse.
8. The scholarly paper should be in narrative format 3 to 5 pages excluding the title and reference page.
9. Include an introductory paragraph, purpose statement, and a conclusion.
10. Include level 1 and 2 headings to organize the paper (page 47-48 in the APA manual).
11. The paper must be written in third person, not first person (meaning do not use ‘we’ or ‘I’) and in a scholarly manner.
To clarify: I, we, you, me, our may be not used. In addition, describing yourself as the researcher or the author should
not be used.
12. Include a minimum of 3 (3) profession peer-reviewed scholarly journal references to support the paper (review in
Ulrich Periodical Directory) and be less than five (5) years old.
13. APA format is required (attention to spelling/grammar, a title page, a reference page, and in-text citations)
Using the Center for Medicare website, select a quality indicator as it relates to an exacerbation of a chronic disease in the acute care setting that is likely to affect the treatment of the patient population. Search CMS for readmission regulations as well as core measures. Develop a treatment plan discussing the best way to safely manage a patient population in relationship to the quality indicator. Include the following information in your treatment plan:Discuss the family’s role in advocating for and implementing safe care for the patient both within and outside of the hospital setting.Quality indicator chosen- PQI 8- Heart Failure Readmission RateYou are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
College of Health Sciences
Department of Health Informatics
ASSIGNMENT COVER SHEET
Course name:
Public health outbreak and disaster management
Course number:
PHC 372
Assignment 1 Questions
– What makes Hajj different than other mass
gatherings?
– What are the risk factors associated with
Hajj?
– Then Choose only one of the following:
o Choose one potential disaster in Hajj
and propose your plan to manage it.
(Explain your disaster management
plan in each phase of the disaster
(Mitigation, Preparedness, Response,
Recovery)
Assignment
question
o Review one disaster incident that
happened in Hajj (explain the
strategies used in the 4 phases, if
possible, to manage the disaster, and
what are the lessons learned out of
that incident)
Note:
•
You can use the following resource (page 2) to review
a brief of the 4 phases of disaster.
Lindsay, B. R. (2012, November). Federal emergency
management: A brief introduction. Congressional Research
Service, Library of Congress.
https://apps.dtic.mil/sti/pdfs/AD1172029.pdf
College of Health Sciences
Department of Health Informatics
Student name:
Student ID:
CRN
14241
Submission date:
Instructor name:
Dr. Sara Atallah
Grade:
…. Out of 10
Paper assignment guidelines
Short essay of 300 – 500 words in APA style. Submission on 28 October 2023 11: 59 PM
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•
•
•
•
•
•
Conduct your own research to explore further online resources to provide the conceptual
idea and avoid using advertising or commercial material.
Do not use bullet points in representing your answer.
The assignment should have the COVER PAGE with SEU logo and the details of who is
submitting and to whom is it submitted.
Assignments should be submitted through Blackboard in Word document only and not
through email.
Font should be 12 Times New Roman, color should be black and line spacing should be
1.5
Use APA referencing style. Please see below link about how to cite APA reference style.
https://guides.libraries.psu.edu/apaquickguide/intext
Do proper paraphrasing to avoid plagiarism.
Case Study 3 & 4 Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.Case Studies will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)Turn it in Score must be less than 25 % or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25 %. Copy-paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.
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Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition
Adolescent With Diabetes Mellitus (DM)
Case Studies
The patient, a 16-year-old high-school football player, was brought to the emergency room in a
coma. His mother said that during the past month he had lost 12 pounds and experienced
excessive thirst associated with voluminous urination that often required voiding several times
during the night. There was a strong family history of diabetes mellitus (DM). The results of
physical examination were essentially negative except for sinus tachycardia and Kussmaul
respirations.
Studies
Serum glucose test (on admission), p. 227
Arterial blood gases (ABGs) test (on admission),
p. 98
pH
PCO2
HCO2
Serum osmolality test, p. 339
Serum glucose test, p. 227
2-hour postprandial glucose test (2-hour PPG), p.
230
Glucose tolerance test (GTT), p. 234
Fasting blood glucose
30 minutes
1 hour
2 hours
3 hours
4 hours
Glycosylated hemoglobin, p. 238
Diabetes mellitus autoantibody panel, p. 186
insulin autoantibody
islet cell antibody
glutamic acid decarboxylase antibody
Microalbumin, p. 872
Results
1100 mg/dL (normal: 60–120 mg/dL)
7.23 (normal: 7.35–7.45)
30 mm Hg (normal: 35–45 mm Hg)
12 mEq/L (normal: 22–26 mEq/L)
440 mOsm/kg (normal: 275–300
mOsm/kg)
250 mg/dL (normal: 70–115 mg/dL)
500 mg/dL (normal:
Purchase answer to see full
attachment
Write the Intro and Thesis Statement Portion of the attached Position Paper – background portion is attached, so continuation is just needed.Use APA in-text citations and list references used on a separate page.
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1
The Use of Technology in Improving Reliability of Patient Surveys
2
The Use of Technology in Improving Reliability of Patient Surveys
The current healthcare landscape is generally perceived differently compared to the past
years. Some of the most significant evolutions witnessed within the healthcare field include
patients’ processes in finding, evaluating, choosing, or accessing quality care. That has primarily
been contributed by the prevalence of technology that has continued to be witnessed. That is why
a majority of healthcare organizations have been focusing on expanding their patient experiences
as part of meeting the digital era. Additionally, the organizations have modernized their
approaches to capturing data (Al-Issa et al., 2019). Healthcare organizations have been
benefiting from digital patient surveys to the extent that the majority of them started wondering
why they did not adopt the approach even earlier. That is primarily because of how they have
provided the organizations with an opportunity to reach out to more patients in real-time.
Therefore, technology makes patient surveys more reliable because of how they increase
flexibility, ensure the organizations can reach more patients, improve the responses, ensure the
organizations can connect with all patients, evaluate more robust insights, and minimize survey
fatigue.
One of the greatest benefits of technology that improves the reliability of patient surveys
is how it promotes greater flexibility. Technology plays a critical role in either adding or
removing any questions that should be captured, which provides healthcare organizations with an
opportunity to address the most relevant issues. The increased flexibility of performing patient
surveys facilitates agile learning within the relevant organizations. That way, the healthcare
organization is capable of introducing accurate improvements, which can consequently help in
improving patient experiences in real time.
3
Technology still improves the reliability of patient surveys based on how it enables
healthcare organizations to reach more patients. One of the most significant factors that promote
the effectiveness of healthcare organizations includes their ability to reach out to more people.
Therefore, technology increases the channels distributed surveys can use to reach out to more
people. Critical examples of those channels include emails and web links (Palanica et al., 2019).
It is important to understand that it might sometimes be tedious for a patient to fill out a survey
form and send it back to healthcare organizations. However, the patients might find it easier to
click a link and fill in the required information through the Internet. Healthcare organizations
still gain the opportunity to enhance their data since they are capable of monitoring the various
conversations taking place on social channels between different patients. That enables healthcare
organizations to gain immediate insights into patient experiences and even develop strategies to
improve existing services.
Healthcare organizations still benefit from technology while conducting patient surveys
since it helps improve response rates. Modern technologies facilitate organizations in this digital
age to cast a wider net. By adding digital surveys, organizations can then start witnessing an
increase in the number of patients who issue their responses (Groom et al., 2021). Technology
still improves the reliability of patient surveys based on how it provides organizations with an
opportunity to connect with patients of all ages. Although the younger generation mostly utilizes
technology, it is also important to understand that the older generation has also been catching up.
That has enabled healthcare organizations to receive reviews from all patients regardless of their
ages.
Patient surveys have even become more reliable based on how technology helps provide
healthcare organizations with more robust insights. Technology plays a significant role in
4
digging deeper into patient comments, which enables healthcare organizations to have a clear
understanding of patient feedback. It is worth noting that long surveys tend to frustrate
respondents, which consequently affects healthcare organizations, considering that they end up
collecting inaccurate data. The overall survey might end up needing to be abandoned (Kumar et
al., 2023). Therefore, technology enables patient surveys to maximize their input, considering
how healthcare organizations are capable of randomizing their questions. That plays a critical
role in reducing survey fatigue since the content remains always relevant.
In conclusion, digitalizing patient surveys is the best option that healthcare organizations
can consider since they improve their reliability. That allows the organizations to make decisions
easily that improve patient experiences. Technology still enables organizations to reach more
patients in real-time and receive accurate feedback.
5
References
Al-Issa, Y., Ottom, M. A., & Tamrawi, A. (2019). eHealth cloud security challenges: a survey.
Journal of Healthcare Engineering, 2019.
Groom, L. L., et al. (2021). Telemedicine and telehealth in nursing homes: an integrative review.
Journal of the American Medical Directors Association, 22(9), 1784-1801.
Kumar, P., Vrontis, D., & Pallonetto, F. (2023). Cognitive engagement with AI‐enabled
technologies and value creation in healthcare. Journal of Consumer Behaviour.
Palanica, A., Flaschner, P., Thommandram, A., Li, M., & Fossat, Y. (2019). Physicians’
perceptions of chatbots in health care: cross-sectional web-based survey. Journal of
medical Internet research, 21(4), e12887.
Identify some of the social, ethical, and economic reasons for addressing immigration policy reform.The discussion must address the topic.Rationale must be provided400 words in your initial post by Wednesday 23:59 pmMinimum of two scholarly references in APA format within the last five years published
How should new nurses be incorporated into the workplace?
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Discussion 2
The focus of Assessment 4 is on how informatics support monitoring of nursing-sensitive quality
indicator data. You will develop a ten minute audio (or video) training module to orient new
nurses in a workplace to a single nursing-sensitive quality indicator critical to the organization.
Your recording will address how data are collected and disseminated across the organization
along with the nurses’ role in supporting accurate reporting and high quality results.
As you begin to prepare this assessment you are encouraged to complete the Conabedian Quality
Assessment Framework activity. Quality health care delivery requires systematic action.
Completion of this will help you succeed with the assessment as you consider how the triad of
structure (such as the hospital, clinic, provider qualifications/organizational characteristics) and
process (such as the delivery/coordination/education/protocols/practice style or standard of care)
may be modified to achieve quality outcomes.
This assessment requires you to prepare a ten minute audio training tutorial (with optional video)
for new nurses on the importance of nursing-sensitive quality indicators. To successfully prepare
for your assessment, you will need to complete the following preparatory activities:
•
Select a single nursing-sensitive quality indicator that you see as important to a selected
type of health care system. Choose from the following list:
o Staffing measures.
▪ Nursing hours per patient day.
▪ RN education/certification.
▪ Skill mix.
▪ Nurse turnover.
▪ Nursing care hours in emergency departments, perioperative units, and
perinatal units.
▪ Skill mix in emergency departments, perioperative units, and perinatal
units.
o Quality measures.
▪ Patient falls.
▪ Patient falls with injury.
▪ Pressure ulcer prevalence.
▪ Health care-associated infections.
▪ Catheter-associated urinary tract infection.
▪ Central line catheter associated blood stream infection.
▪ Ventilator-associated pneumonia.
▪ Ventilator- associated events.
▪ Psychiatric physical/sexual assault rate.
▪ Restraint prevalence.
▪ Pediatric peripheral intravenous infiltration rate.
▪ Pediatric pain assessment, intervention, reassessment (air) cycle.
▪ Falls in ambulatory settings.
▪ Pressure ulcer incidence rates from electronic health records.
▪ Hospital readmission rates.
▪
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RN satisfaction survey options.
▪ Job satisfaction scales.
▪ Job satisfaction scales – short form.
▪ Practice environment scale.
Conduct independent research on the most current information about the selected
nursing-sensitive quality indicator.
Interview a professional colleague or contact who is familiar with quality monitoring and
how technology can help to collect and report quality indicator data. You do not need to
submit the transcript of your conversation, but do integrate what you learned from the
interview into the audio tutorial. Consider these questions for your interview:
o What is your experience with collecting data and entering it into a database?
o What challenges have you experienced?
o How does your organization share with the nursing staff and other members of the
health care system the quality improvement monitoring results?
o What role do bedside nurses and other frontline staff have in entering the data?
For example, do staff members enter the information into an electronic medical
record for extraction? Or do they enter it into another system? How effective is
this process?
Watch the Informatics and Nursing-Sensitive Quality Indicators Video Exemplar.
Recording Your Presentation
To prepare to record the audio for your presentation, complete the following:
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•
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Set up and test your microphone or headset using the installation instructions provided by
the manufacturer. You only need to use the headset if your audio is not clear and high
quality when captured by the microphone.
Practice using the equipment to ensure the audio quality is sufficient.
Review Using Kaltura for Kaltura to record your presentation.
View Creating a Presentation: A Guide to Writing and Speaking. This video addresses
the primary areas involved in creating effective audiovisual presentations. You can return
to this resource throughout the process of creating your presentation to view the tutorial
appropriate for you at each stage.
Notes:
•
•
•
You may use other tools to record your tutorial. You will, however, need to consult Using
Kaltura for instructions on how to upload your audio-recorded tutorial into the
courseroom, or you must provide a working link your instructor can easily access.
You may also choose to create a video of your tutorial, but this is not required.
If you require the use of assistive technology or alternative communication methods to
participate in this activity, please contact DisabilityServices@Capella.edu to request
accommodations.
For this assessment, imagine you are a member of a Quality Improvement Council at any type of
health care system, whether acute, ambulatory, home health, managed care, et cetera. Your
Council has identified that newly hired nurses would benefit from comprehensive training on the
importance of nursing-sensitive quality indicators. The Council would like the training to address
how this information is collected and disseminated across the organization. It would also like the
training to describe the role nurses have in accurate reporting and high-quality results.
The Council indicates a recording is preferable to a written fact sheet due to the popularity of
audio blogs. In this way, new hires can listen to the tutorial on their own time using their phone
or other device.
As a result of this need, you offer to create an audio tutorial orienting new hires to these topics.
You know that you will need a script to guide your audio recording. You also plan to incorporate
into your script the insights you learned from conducting an interview with an authority on
quality monitoring and the use of technology to collect and report quality indicator data.
You determine that you will cover the following topics in your audio tutorial script:
Introduction: Nursing-Sensitive Quality Indicator
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•
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What is the National Database of Nursing-Sensitive Quality Indicators?
What are nursing-sensitive quality indicators?
Which particular quality indicator did you select to address in your tutorial?
Why is this quality indicator important to monitor?
o Be sure to address the impact of this indicator on the quality of care and patient
safety.
Why do new nurses need to be familiar with this particular quality indicator when
providing patient care?
Collection and Distribution of Quality Indicator Data
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According to your interview and other resources, how does your organization collect data
on this quality indicator?
How does the organization disseminate aggregate data?
What role do nurses play in supporting accurate reporting and high-quality results?
o As an example, consider the importance of accurately entering data regarding
nursing interventions.
After completing your script, practice delivering your tutorial several times before recording it.
•
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Audio communication: Deliver a professional, effective audio tutorial on a selected
quality indicator that engages new nurses and motivates them to accurately report quality
data in a timely fashion.
Length: fifteen content slides with well developed speech like speaker notes on a word
document. I will read those notes to make the audio recording. The slides must be smart,
using visuals and high tech images, and five point per slide style is recommended. 50-100
words per slide is always a good explanation. Use Kaltura to upload your recording to the
courseroom, or provide a working link your instructor can access.
•
•
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Script: A separate document with the script or speaker’s notes is required. Important:
Submissions that do not include the script or speaker’s notes will be returned as a nonperformance.
References: Cite a minimum of three scholarly and/or authoritative sources.
APA: Submit, along with the recording, a separate reference page that follows APA style
and formatting guidelines. For an APA refresher, consult the Evidence and APA page on
Campus.
The American Nursing Association (ANA) established the National Database of Nursing Quality
Indicators (NDNQI®) in 1998 to track and report on quality indicators heavily influenced by
nursing action.
NDNQI® was established as a standardized approach to evaluating nursing performance in
relation to patient outcomes. It provides a database and quality measurement program to track
clinical performance and to compare nursing quality measures against other hospital data at the
national, regional, and state levels. Nursing-sensitive quality indicators help establish evidencebased practice guidelines in the inpatient and outpatient settings to enhance quality care
outcomes and initiate quality improvement educational programs, outreach, and protocol
development.
The quality indicators the NDNQI® monitors are organized into three categories: structure,
process, and outcome. Theorist Avedis Donabedian first identified these categories.
Donabedian’s theory of quality health care focused on the links between quality outcomes and
the structures and processes of care (Grove et al., 2018).
Nurses must be knowledgeable about the indicators their workplaces monitor. Some nurses
deliver direct patient care that leads to a monitored outcome. Other nurses may be involved in
data collection and analysis. In addition, monitoring organizations, including managed care
entities, exist to gather data from individual organizations to analyze overall industry quality. All
of these roles are important to advance quality and safety outcomes.
Reference
Grove, S. K., Gray, J. R., Jay, G. W., Jay, H. M., & Burns, N. (2018). Understanding nursing
research: Building an evidence-based practice (7th ed.). Elsevier.
By successfully completing this assessment, you will demonstrate your proficiency in the
following course competencies and scoring guide criteria:
•
•
Competency 1: Describe nurses’ and the interdisciplinary team’s role in informatics with a
focus on electronic health information and patient care technology to support decision
making.
o Describe the interdisciplinary team’s role in collecting and reporting quality
indicator data to enhance patient safety, patient care outcomes, and organizational
performance reports.
Competency 3: Evaluate the impact of patient care technologies on desired outcomes.
o
•
•
Explain how a health care organization uses nursing-sensitive quality indicators to
enhance patient safety, patient care outcomes, and organizational performance
reports.
Competency 4: Recommend the use of a technology to enhance quality and safety
standards for patients.
o Justify how a nursing-sensitive quality indicator establishes evidence-based
practice guidelines for nurses to follow when using patient care technologies to
enhance patient safety, satisfaction, and outcomes.
Competency 5: Apply professional, scholarly communication to facilitate use of health
information and patient care technologies.
o Deliver a professional, effective audio tutorial on a selected quality indicator that
engages new nurses and motivates them to accurately report quality data in a
timely fashion.
o Follow APA style and formatting guidelines for citations and references.
Mr. Timothy B was seen today while resident was in the community. He was alert and oriented x3, maintained eloquence while speaking and verbalized intact skin, denied pain and discomfort. Client continues administering Amlodipine 10mg daily for hypertension. Nursing intervention was provided for possible side effects amlodipine. Follow rubric below.
E. L. is an 88-year-old widow who has advanced dementia. She is a retired secretary and is cared for in the home of her divorced daughter, who is her power of attorney for health affairs. E. L. requires assistance with all activities of daily living. She spends most of the day sitting in her orthopedic recliner (she has had bilateral hip replacements) or lying in bed. She does not speak or acknowledge the presence of others. Recently, E. L. has stopped eating all meals except for small banana slices. She resists a spoon when it is brought to her mouth, and she pockets food in her cheeks without swallowing. E. L. was admitted to the hospital several months ago for influenza and bilateral pneumonia. She was treated in the intensive care unit for three days and then sent home. The possibility of a feeding tube insertion was discussed during her hospitalization. E. L.’s daughter is seeking guidance on artificial nutrition and hydration.Use the assigned readings to guide you in the development of five discussion pointsDiscussions points should reflect best practices that you will include as you speak with E. L.’s daughter regarding her mother’s end-of-life care.Cite your references in proper APA Style.Review the rubric for more information on how your assignment will be graded.Submit as an attachment to the assignment area.
Task 2: Crafting Measurable Learning Objectives for difficulty in Using virtual careFor each of the learning goals created in Task 1, develop three measurable learning objectives using Bloom’s Taxonomy as a framework. Each objective should span different levels of cognitive complexity (e.g., knowledge, comprehension, application, analysis, synthesis, evaluation). Make sure your objectives are specific, measurable, achievable, relevant, and time-bound (SMART).
1) What surprised you about the US healthcare system when compared with other countries?
2) What are the strengths of the US healthcare system in comparison of other countries?
3) What are the limitations of the US healthcare system in comparison of other countries?
4) The US healthcare system has become a political issue in this year’s Presidential election, what are the issues at stake? What are the options being discussed?
5) If the US were to change its’ model to another country’s healthcare system, which country would you pick and why? What is the model of this country? When was it implemented there? How would you transition the US towards this model?
Instructions for submission: Make sure to fill out all the relevant information on the coversheet.Your response should be a minimum of 250 words but should not exceed 500 words (Excluding references).Support your answer with examples. Font size should be 12 Font type should be Times New RomanHeading should be Bold Colour should be BlackThe paragraph must be justified. Double line spacing. Use proper references in APA style
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ASSIGNMENT COVER SHEET
Course name:
Concepts of Health Education & Health Promotion
Course number:
PHC 212
CRN:
Paper Assignment
Assignment title or task:
(You can write a question)
Choose a health issue in KSA and explore the
determinants causing that issue and justify your
understanding with evidence from the literature.
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Your response should be a minimum of 250 words but should not exceed
500 words (Excluding references).
• Support your answer with examples.
• Font size should be 12
• Font type should be Times New Roman
• Heading should be Bold
• Colour should be Black
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style
• AVOID PLAGIARISM
• Due date; 22/4/2023 11:59 PM
Best of Luck
For this assignment you will be applying three components to the practice situation described in your Client/Agency Situation paper: Engagement, Assessment, and Human Behavior and the Social Environment (HBSE) Theory.Describe how you engaged the practice population in the assessment phase. This should include a description of a minimum of three (3) specific engagement practice skills used to engage the practice population. Be specific with the skills used and demonstrate how you applied these skills in this practice situation.
For Direct Practice students, this includes ways you engaged with the individual or family described in the Client/Agency Situation paper.
ASSESSMENT
The assessment phase is important because it is the basis for the intervention and evaluation sections.
Describe the tools used to collect, organize, and interpret information about the practice population. Include citations for any of the tools used that are evidence based or published.
Discuss any relevant issues of age, class, color, disability, ethnicity, family structure, gender, marital status, national origin, race, religion, sex, stigma, and/or sexual orientation for the practice population. The discussion related to diversity should link directly to the practice population or situation.
Discuss how issues of social and economic justice, as well as human and civil rights, may be related to this specific practice situation.
Conclude this section with an assessment of the practice population’s strengths and areas for growth identified during the assessment phase.
HBSE THEORY
Describe and apply one theory related to human behavior that is relevant to the practice population’s area of concern or problem situation. The selected theory should provide a theoretical perspective that helps frame your understanding of the practice population’s behavior.
For DP students, this will be a micro level HBSE theory related to the individual client and their relationship to the environment. Consider theories related to life span development.
Discuss how the selected theory directly connects to your practice population.
ETHICAL CHALLENGE OR VALUES CONFLICT
Conclude this paper by identifying and describing one or more potential ethical and values conflict related to engagement, assessment, or human behavior theory, as it applies to this practice situation.
Definition: American Society of Radiologic Technologists
Function:
2. ACR
Definition: American College of Radiology
Function:
3. ARRT
Definition: Ethics of the American Registry of Radiologic Technologists
Function: The radiologic technologist acts to advance the principal objective of the profession to provide services to humanity with full respect for the dignity of mankind.
The radiologic technologist assesses situations, exercises care, discretion, and judgment; assumes responsibility for professional decisions; and acts in the best interest of the patient.
The radiologic technologist uses equipment and accessories, employs techniques and procedures, performs services in accordance with an accepted standard of practice, and demonstrates expertise in minimizing radiation exposure to the patient, self, and other members of the healthcare team.
The radiologic technologist practices ethical conduct appropriate to the profession and protects the patient’s right to quality radiologic technology care.
4. ARMRIT
Definition: American Registry of Magnetic Resonance Imaging Technologists
Function:
5. ALARA
Definition:
Function:
Answer the following questions:
6. Do CT and nuclear medicine examinations introduce higher or lower doses of ionizing radiation compared to conventional radiography?
YES
7. Which two nonionizing medical imaging modalities are mentioned in the ASRT white paper?
MRI AND ULTRASOUND
8. Define cumulative exposure and describe why cumulative exposure to ionizing radiation is a health concern to patients?
The amount of the regulation
9. What is the patient health concern pertaining to the medical imaging industries shift from an analog to a digital environment?
As medical imaging departments transition from an analog to a digital environment, there has been a potential for increased patient exposure as radiologic technologists adjust to digital imaging technology.
10. Who is responsible for controlling access to the region in which access by non-MR personnel or introduction of ferromagnetic objects or equipment could result in serious injury or death to patients or staff? Research and describe a real life case scenario, where lack of this consideration led to a MRI patient being seriously injured.
11. Why is it important that the MRI technologist strictly controls who has access to the MRI scanner room? What is the name of the MRI risk factor associated with the powerful static magnetic fields used in MRI?
12. Summarize the PEW research center report on online activities. What is the concern in digital medical imaging, that this PEW report highlights?
13. Summarize the 2008 Joint Commission safety issue address. Describe the patient safety concern this issue specifically impacts when using ionizing radiation in digital medical imaging.
Complete the Fall Risk and Cognition Assessments Case Study, including the Hendrich II Fall Risk Assessment available in the Resources folder.Complete the Mini-Cog screening (see Borson, n.d., in the Resources section) and the Pittsburgh Sleep Quality Index (PSQI; see Buysse, Reynolds, Monk, Berman, & Kupfer, 1989, in the Resources section) to develop a comprehensive assessment for Mrs. L.’s risk of falling.Develop a one-paragraph summary describing Mrs. L.’s risk for falls.Create one goal for each category.Review the rubric for more information on how your assignment will be graded.Submit the three fall risk assessment tools and your summary as attachments to the assignment area.
Please follow the instructions below and use the files I uploaded!
1. Please read Chapters Eight and Nine in your book. ( the file is uploaded under HANDOUT Ch. 8_9 Wellness title)
2. Yes, I know you already know about drugs and alcohol but humor me.
3. Please read the PDF as well as watch the videos in the PDF.
4. Please do not drink or use drugs while completing this week’s work. If you are going to smoke while doing this assignment, please do so safely. Not in bed. Besides, bed is for sleep and sex only—not smoking.
AND finally:
5. Take Part in the discussion.
Is caffeine an addiction? Technology? Work?
Unformatted Attachment Preview
Discussion Questions: Chapters 8 and 9
Please express your opinion on ONE of these discussion topics.
Choice 1: PICK ONE DRUG
Pick one of the drugs included in pages 216-230 of your textbook.
Why do you think people use that substance? What are the dangers? What are the
benefits? How do you know when it’s become a “problem?” What do you think when
you hear someone uses this drug? Be honest but respectful. YOU MUST REFERENCE
SOMETHING FROM YOUR BOOK.
Choice 2: USE/ABUSE/ADDICTION–Alcohol
Why do people drink? How do you know if it’s a problem? Is drinking safer than using
drugs? Do you believe it’s dangerous to mix alcohol with energy drinks? Do you know
people who are addicted to alcohol? What did you learn while reading this chapter?
PLEASE REFERENCE SOMETHING FROM YOUR TEXTBOOK.
Choice 3: USE/ABUSE/ADDICTION–SMOKING
Why do people smoke? What are the dangers of smoking? Are e-cigs “better” than
actual cigarettes? Why is it so hard to quit smoking, no matter the way you smoke? Why
are people so judgmental about smoking? PLEASE REFERENCE SOMETHING FROM YOUR
TEXTBOOK.
CHOICE 4: USE/ABUSE/ADDICTION–GENERAL
What is an addiction and what is addictive behavior? What types of things are
addictive? What did you learn about addiction? Do you watch any TV/Streaming
shows about addiction? PLEASE REFERENCE SOMETHING FROM YOUR TEXTBOOK.
CHOICE 5: LEGAL OR NOT?
Use pages 224-226 in your textbook and your opinion: Should marijuana be legal?
Illegal? Why or why not? What are the benefits and dangers? Is marijuana use a
problem on campus? What’s so bad about Synthetic marijuana? In addition, What
about THC e-cigs–what are your thoughts? PLEASE REFERENCE SOMETHING FROM
YOUR TEXTBOOK.
CHOICE SIX: YOUR STORY Tell your story.
What are you addicted to? Phone, caffeine, alcohol, whatever. What are you working
on (or, no judgment–NOT working on) regarding your concerns/use/abuse/addiction?
What motivates you (might motivate you) to address issues you face with use, abuse
and addiction? What information in the book and/or video best relates to your story? In
addition to sharing your story, PLEASE REFERENCE SOMETHING FROM YOUR TEXTBOOK.
i need help answering these questions in a short essay format.Please use simple college student words 1. What are some cultural considerations the nurse must be aware of when caring for clients with mental health issues? Explain the differences between Western, Native American, and African cultures. (Give at least two examples per cultural group; there are many African cultures to choose from, be specific about which one you are referring, must include citations and reference)2.Explain Stigma in reference to mental health.Show you understand what stigma means and how it relates3.What is a “Rule 25”and how is it used to guide the clients nursing care? Use a reference and citations to explain Rule 25
Chief Complaint: Shortness of breath and increased sputum production
Background Information: James is a 60-year-old male with a known history of chronic obstructive pulmonary disease (COPD). He has a 30-pack-year history of smoking but quit 10 years ago. He has been compliant with his medications, which include an inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) combination inhaler and short-acting beta-agonist (SABA) rescue inhaler. John lives alone and manages his activities of daily living independently.
Presenting Symptoms:
1. Shortness of Breath: James reports increasing shortness of breath over the past three days. He states that even simple tasks like getting out of bed or walking to the bathroom leave him breathless.
2. Increased Sputum Production: He notes a significant increase in the amount of yellow-green sputum he’s been coughing up, which is thicker and stickier than usual.
3. Chest Tightness: James describes a sensation of chest tightness and increased use of his SABA inhaler, but it provides only temporary relief.
4. Decreased Exercise Tolerance: He mentions that he used to take short walks daily, but now he struggles to even leave his bedroom.
Vital Signs:
Temperature: 98.6°F (37°C)
Heart Rate: 100 bpm
Respiratory Rate: 28 breaths/minute
Blood Pressure: 140/90 mm Hg
Oxygen Saturation: 88% on room air
Physical Examination Findings:
1. General Appearance: James appears anxious, sits leaning forward with pursed lips, and uses accessory muscles for breathing.
2. Respiratory Assessment:
o Diffuse wheezing is heard upon auscultation.
o Increased anterior-posterior chest diameter is observed.
3. Cough: John has a productive cough, and his sputum is yellow-green and purulent.
Laboratory Findings:
1. Arterial Blood Gas (ABG):
o pH: 7.32
o PaCO2: 60 mm Hg
o PaO2: 56 mm Hg
o HCO3-: 30 mEq/L
o SaO2: 88%
2. Complete Blood Count (CBC):
o White Blood Cell (WBC) Count: 14
o Platelets 150
3. Basic Metabolic Panel (BMP):
o Sodium (Na): 139
o Potassium (K): 3.1
o Bicarbonate (HCO3): 30 mEq/L
o Creatinine: 2.1
Chest X-ray:
The chest X-ray reveals hyperinflated lungs with flattened diaphragms and increased retrosternal airspace, consistent with COPD.
1. What are the differential diagnoses for this patient?
2. 2. What are the known diagnoses for this patient?
3. What is the plan for this patient?
4. Compare and contrast the workup, diagnosis, and treatment for a patient with asthma vs a patient with COPD.
An individual is referred to your office by his parole officer. This 19-year-old male, named Sam, was recently arrested for a “psychotic break” that caused him to throw a chair through the neighborhood drug store window. Sam’s parents arrive and Sam agrees to have his parents present during the interview.
His parents state Sam recently withdrew from college after experiencing a “resounding moment” in which he changed his major from engineering to philosophy and increasingly had reduced his sleep, spending long hours engaging individuals in the commons in conversations about the nature of reality and how he is gaining an appreciation “for all life”. He had been convinced about the importance of his ideas, stating frequently that he was more learned and advanced than all his professors. He told many that “I should be the one teaching these courses, after all, I understand it much better than my professors”. Sam has also increased the number of high-risk behaviors – drinking and engaging in sexual relations in a way that was unlike his previous history. He also has spent a considerable sum of money on “projects to help the world” – unfortunately, he has never completed a project.
Sam’s parents also state that Sam was diagnosed previously by his PCP with MDD and GAD. “These new behaviors are just that – new – since he went to college”.
Further discussions with Sam and his parents reveal that he has never experienced hallucinations and you believe that he currently is not experiencing any delusions. Sam states “I am what I am”.
What diagnosis do you believe may apply to this individual?
What classifications of medications can be used to treat this disorder? Which medication do you recommend and why?
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Need a discussion post in reply to both posts belowLength: A minimum of 150 words each post, not including referencesCitations: At least one high-level scholarly reference in APA 7th edition from within the last 5 years Post #1 Conflict
management is any technique that can deescalate a stressful situation
to reduce tension and curb bad behavior. (Arveklev et al., 2018)
Conflict management is critical in nursing to provide safe and competent
care. As nurses, we deal with conflicts on a daily basis whether it is
between coworkers, with patients and/or their families, or with
management; really anyone that we come into contact with could
potentially turn into a situation of conflict. Due to the stressful
environment that nursing exhibits, learning effective strategies to
resolve conflicts can benefit the team and workplace, ensuring that the
patients are cared for appropriately.A
situation comes to mind between two nurses that I previously worked
with, one a registered nurse (RN) and the other a licensed practical
nurse (LPN). I had just been hired and the RN and LPN had just begun to
work together as well because our unit had transitioned from eight-hour
shifts to twelve-hour shifts. The LPN had been working at this facility
for 15+ years and had been used to working the third shift where the
residents were already in bed, and most of the patient care was ensuring
the patients were clean, ready for breakfast, and their morning
medications were given. She now had to deal with a heavy nighttime
medication pass along with giving baths and putting residents to bed, as
well as the morning routine. The LPN always requested to do patient
care instead of passing medications, but always did the bare minimum of
patient care while other staff picked up the slack.The
RN attempted to resolve this conflict by taking her to the side in a
friendly manner, to discuss some of the things she was having problems
with while working with her such as her aversion to passing medications.
This interaction between the two worked out well for a short while as
the LPN did better with patient care and even passed medications from
time to time, but unfortunately, the LPN slowly went back to her old
ways. After becoming frustrated again, the RN decided it would be best
to get the nurse manager involved to help resolve the conflict. The
nurse manager then called a meeting with the LPN to develop a plan of
action to ensure that she knew what her role and responsibilities were
and that she was able to provide safe and competent care.Arveklev
et al (2018), discuss a study done in Sweden involving student nurses
at a university. These nurses were taught about the concepts of conflict
management in the classroom and then had to attend a one-day drama
workshop using role play to practice the techniques that they had
learned about in the classroom. I found this to be an interesting way to
help nurses develop their conflict management skills as I am a firm
believer that practice makes perfect. As with other skills you learn in
school the more you do it the more comfortable you are doing it.Post #2 Dysfunctional
conflict refers to undesirable conflict in the workplace that can arise
from either behavioral or emotionally charged difficulties between
people or groups. The parties involved in the disagreement are unable to
effectively communicate with one another, which leads to a decrease in
productivity (Stasser & Abele, 2020). Tension in the workplace,
negative consequences from the disagreement, and growing anger towards
the source of the conflict are all possibilities for people involved.Physicians
and nurses collaborate closely to provide quality care for patients,
but problems with communication and patient delegation are common.
Misunderstandings and communication breakdowns between doctors and other
staff members are frequent sources of dysfunctional conflict in the
healthcare environment (Stasser & Abele, 2020). When a doctor has a
bias towards or an inaccurate impression of an APN, for instance,
tensions might ensue. The physician may not consider the APN to be as
capable as themselves due to differences in training, education, skills,
and experience. This may result in a resentful attitude toward the APN,
and their recommendations may not be taken into consideration as a
result. This takes the focus off of the patient and leads to a decline
in efficiency within the working environment. Continually, this leads to
a hostile work environment where both parties may not want to work with
each other, decreasing productivity, team morale, and overall loss of
staff support.The
first step to resolving this problem is to step back and analyze the
situation. Through this process, it will be possible to identify the
desired outcome for the case, the goal for the problem, and the steps
necessary to achieve it (Mikkelsen & Clegg, 2019). Once this
dysfunctional pattern is identified, behavioral intervention should be
initiated. In order to begin addressing this conflict, an understanding
of how they arise is essential. Continually, the parties involved must
cultivate self-awareness among themselves regarding how they respond
physically and emotionally to the situation (Rahim, 2023). The physician
and nurse can thus begin addressing the conflict between them and guide
understanding from each other’s points of view.In
approaching conflict, a variety of approaches may include avoiding,
accommodating, competing, compromising, and cooperating to address these
issues. An avoidance strategy may be beneficial if the dispute is
minor, the parties are emotionally charged, or when others can find a
better solution (Rahim, 2023). If both parties demonstrate
uncooperativeness, forcefulness, and assertiveness toward their
objectives, the use of competition may be necessary to take progressive
steps on this problem. Accommodation would aim to create harmony by
yielding to the other individual in the conflict, as the situation
outweighs the benefits that may be gained from the conflict (Rahim,
2023). This may be used within the situation between the physician and
the registered nurse but may also continue to cause resentment if the
conflict repeats itself. In this scenario, compromise and cooperation
may be the best strategy to implement.Compromise
strategies involve mutual concessions of interests and objectives in
order to achieve a middle-ground position (Mikkelsen & Clegg, 2019).
To achieve a compromise, both parties must negotiate the terms with
equal power to arrive at an understanding they both agree on.
Collaboration and cooperation refer to the process of understanding how
to reach a solution that meets both of the parties’ requirements
(Mikkelsen & Clegg, 2019). It is through the implementation of these
strategies to reduce or remove conflict that hostility within the work
environment can be addressed, the organization within the team can be
formed, communication can be improved, and patient-centred care can be
implemented, resulting in a healthier working environment overall.
PHC 241-Group presentation
This assignment is a group effort. Students will work in groups of three to five and will choose one of these topics on
nutrition and public health:
1. Protein Energy Malnutrition and Early Child Development
2. Iron Deficiency Anemia in the Kingdom of Saudi Arabia
3. Maternal Nutrition and Low Birth Weight
4. Nutrition in School-Age Children and Cognitive Development.
5. Fast Food Consumption and Obesity among University Students
6. The Nutritional Transition and Its Implications for the Developing World
7. The Covid-19 Pandemic and Food Consumption Patterns
8. Food Insecurity and Malnutrition in Developing Countries
9. Food Security in a Global Pandemic
10. Elderly Health: Nutritional Issues of Older Adults
Presentations should include the following:
An adequate description of the nutritional issue, including a general or specific case.
Discussion of preventive or treatment strategies, and any related local or national policies.
Practical recommendations for reducing malnutrition.
Questions for class discussion.
Important guidelines for students:
Presentation should consist of no more than 15 PowerPoint slides (including one page of class discussion
questions).
The cover slide should include the following: university logo; presentation title, group members names and
students ID numbers.
Presentation time should be 10–12 minutes, followed by five minutes of class discussion.
Each group should have a maximum of five students.
Support your presentation with at least three references (APA style).
The group will be graded as per the “Presentation Marking Rubric”
Fair
Good
Excellent
Total
(5)
0.25 pts
0.50 pts
0.75 pts
1 pts
Organization
Audience cannot
understand
presentation because
there is no sequence
of information.
Audience has
difficulty
following
presentation
because
student jumps
around.
Student
presents
information
in logical
sequence
which
audience can
follow.
Student presents
information in
logical, interesting
sequence which
audience can
follow.
Subject
Knowledge
Student does not
have grasp of
information; student
cannot answer
questions about
subject.
Student is
uncomfortable
with
information and
is able to
answer only
rudimentary
questions.
Student is at
ease with
expected
answers to all
questions,
but fails to
elaborate.
Student
demonstrates full
knowledge (more
than required) by
answering all class
questions with
explanations and
elaboration.
Student’s
graphics
relate to text
and
presentation.
Student’s graphics
explain and
reinforce screen
text and
presentation.
Poor
Graphics
Student uses
superfluous graphics
or no graphics
Student
occasionally
uses graphics
that rarely
support text
and
presentation.
Student’s
Mechanics
presentation has four
or more spelling
errors and/or
grammatical errors.
Presentation
has three
misspellings
and/or
grammatical
errors.
Significant
controlling by
Multiple group
members not
participating.
Group
Dynamics
Evident lack of
preparation/rehearsal.
Dependence on
slides.
some members
with one
minimally
contributing.
Primarily
prepared but
with some
dependence on
just reading off
slides.
Presentation
has no more
than two
misspellings
and/or
grammatical
errors.
Presentation has
no misspellings or
grammatical
errors.
Slight
domination of
one
presenter.
All presenters knew
the information,
Members
helped each
participated
equally, and helped
each other as
needed.
other.
Very well
prepared.
Team Topic- Overindulgence in analgesic usage.Community – Saskatchewan and Yukon communities. Hiring body- Conestoga College.
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COMM8140: Community Engagement Plan
The purpose of this assignment is to work as a team to develop a Community
Engagement Plan.
Instructions:
• In groups of 6 people you will:
o Identify a community health-related problem, issue or topic that you
think could be improved or addressed.
o The problem, issue or topic can be something you or someone you know
have experienced personally.
• Topic to be approved by Faculty to avoid duplication between groups, and to
ensure an appropriate topic is selected
• As a group, you will develop a community engagement plan that incorporates
components of the community engagement continuum (see the chart below)
• You will identify how you will engage the community to address your identified
problem.
Example problem:
You are a manager in a health care clinic, in a community centre. Several of your staff
have identified they are having challenges finding reliable child care, resulting in having
to take unplanned vacation and sick days. You would like to find a solution to this
problem, through a community engagement plan.
Activity
Inform
Goal
To provide
stakeholders
with balanced
and objective
information to
assist them in
understanding
the problem,
alternatives
and solutions.
Consult
To obtain
stakeholder
feedback on
analysis,
alternatives
and/or
decisions.
Involve
Collaborate
Empower
To work
directly with
stakeholders
throughout the
process to
ensure that
their concerns
and aspirations
are consistently
understood.
To partner with
stakeholders in
each part of the
decision from
development to
solution.
Shared leadership
of community lead
projects, with final
decision making at
the community
level.
Written Submission:
• Pick a community health-related problem, issue or topic that you would like to
address
• Identify why this is an issue that needs to be solved – through evidence or
your own experience
• Your written report should address how you would engage key stakeholders using
the Community Engagement Continuum as follows:
• Inform
• Consult
• Select one of the additional 3 remaining activities to explain in detail
• Ensure you outline how you would achieve the goal of the 3 activities – be specific in
your proposed solutions and plan of action
• Ensure you outline how, who, when and with what deliverables you would achieve
each activity
Format:
• Ensure all group member names and student numbers are on cover page
• 3 pages maximum, double-spaced, 12 point font, maximum
• Use headers as appropriate
• Submit to eConestoga dropbox
• Use APA referencing
I am attaching three clinical journal examples titled:
Clinical Journal Example #1
Clinical Journal Example #2
Clinical Journal Example #3
I am currently working on Clinical Journal #2. For my purposes, we will only use adult patients.In the future, following the same instructions and using faculty feedback, we will work on future journals.
I already completed Clinical Journal #1 and received faculty feedback in PDF format, 72/100, with comments, attached, along with the rubric filled out, attached.
The journal medical info such as medications to prescribe should not be difficult to find using google and appropriate references. However, faculty as you will see from their feedback want detailed responses such as severity of onset, how long ago did it start, evidence from the patient´s own words that we can make up, etc.
The name of my clinical site is Integrated Healthcare Services Behavioral Health/IHS BH. If you need any additional info, feel free to ask along the way.
From the PDF instructor feedback, you can see some comments are very helpful moving forward including writing the chief complaint as a quote in the patient´s words, etc.
Also, typically, we are given door information as follows so in our made up patients, we would have to make up the door information, which of course you can provide to me as well so I know the door information used for each clinical journal.I have attached a door information example.As you will see, my Clinical Journal #1 submission, PDF with faculty feedback, aligns with the rubric, but faculty want even more detail responses such as severity of onset, how long ago did it start, evidence from the patient´s own words that we can make up, what questions we would ask such as whether the patient has access to weapons at home?, etc.
Kindly use the rubric to include ALL SUPTOPICS AND DETAILS REQUESTED following the examples.From faculty feedback, faculty comments included: Good first attempt. Numerous comments in the paper for corrections on the next one.PLEASE take a look at the sample papers and use them as a model for your next paper.
For Clinical Journals #2-5, the good thing is that we can make up our own patient info, so you can make up the ideal clinical scenario for your ideal patient including prescribed medications, etc.
Google may assist in determining which medications to prescribe to ADHD patients, for example, including dose mg, etc.
I will also be including the textbooks they included in the syllabus for your reference and convenience, which you may download at libgen.is as needed. Or I can provide them to you at your request, but they are a bit large in size.
References from the syllabus (You can use these or other references no older than 5 years old, look at the examples for the types of references used)
References
American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental
Disorders DSM 5-TR (5th ed. Text Revision). American Psychiatric Association: Arlington, Virginia. ISBN-10: 0890425760
Carlat, D. (2017). The Psychiatric Interview (4th Ed.). Lippincott Williams & Wilkins: Philadelphia, ISBN-13: 978-1496327710 ISBN-10: 9781496327710
Stahl, S.M. (2020). Stahl’s Essential Psychopharmacology Prescriber’s Guide (7th Ed.). Cambridge University Press: New York, NY. ISBN-13: 978-1108926010 ISBN-10: 1108926010
Zimmerman, M. (2013). Interview Guide for Evaluating DSM-5 Psychiatric Disorders and the Mental Status Examination. Psych Products Press: East Greenwich, RI. ISBN-13: 978-0963382115 ISBN-10: 096338211X
American Psychiatric Association (2022). Desk Reference to the Diagnostic Criteria from DSM- 5TR. Arlington, Virginia: APA ISBN-10 : 089042580 ISBN-13 : 978-0890425800
Boland, R., Verduin, M.L & Ruiz, P. (2022). Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry (12th Ed,). Lippincott Williams & Wilkins: Philadelphia, PA. ISBN-13: 978-1975145569; ISBN-10: 1975145569
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental
Disorders DSM 5 (5th ed.).America Psychiatric Association: Arlington, Virginia
Boland, R., Verduin, M.L & Ruiz, P. (2022). Kaplan and Sadock’s Synopsis of Psychiatry:
Behavioral Sciences/Clinical Psychiatry (12th Ed,). Lippincott Williams & Wilkins:
Read the following case study and answer the reflective questions. Please provide evidence-based rationales for your answers. APA, 7th ed. must be followed.
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MSN 5550 Health Promotion: Prevention of Disease
Case Study Module 6
Instructions: Read the following case study and answer the reflective questions. Please provide
evidence-based rationales for your answers. APA, 7th ed. must be followed.
Due: Saturday by 23:59 pm
CASE STUDY: Albert
Albert Mitchell is a 36-year-old man who will be traveling to Dubai to give a business
presentation in 3 months. Although he has traveled widely in the United States as a consultant,
this is his first trip to the Middle East.
He requests information regarding immunizations needed before his trip. Albert states that as
he will be in Dubai for only a few days, he is unlikely to contract a disease in such a short time
and therefore believes that it is illogical to obtain immunizations.
Albert states that he has heard that the side effects of the immunizations might be worse than
the diseases they prevent. He is also concerned about leaving his wife at home alone because
she is 6 months pregnant.
Reflective Questions
How would you address Albert’s beliefs?
What learning would be needed in each domain?
What learning theories would you consider?
How might his family concerns be addressed?
Part 1:
Discussion:
Write a 250- to 300-word response to the following:
•
•
What types of factors should be considered when developing health policies? Why? Explain and
provide specific examples to support your response.
Include your own experience as well as 2 citations and corresponding references that align with
or contradict your comments as sourced from peer-reviewed academic journals, industry
publications, books, and/or other sources. Format your citations according to APA guidelines. If
you found information that contradicts your experience, explain why you agree or disagree with
the information.
Part 2:
Assignment Content
This assignment will help you build a foundation for the course. You will distinguish policy
from other related activities and begin to evaluate the dynamics of health policy
development. Health policies affect all aspects of the United States’ health care system. You
will most likely, at a minimum, research and discuss health policies in your dissertation’s
literature review, regardless of your dissertation topic.
Carefully research and study health policies that meet the criteria listed below. Once you
submit a health policy, you cannot change it. Ensure your selected health policy is
contemporary (i.e., from the past 10 years or currently under development) and targets 1 or
more of the following segments of the health care system:
o Hospitals
o Clinics and physician practices
o Behavioral health
o Post-acute care
o Health insurance companies and managed care organizations
o Pharmaceutical companies
o Health care consumers (e.g., patients)
Create a 12- to 16-slide presentation in which you describe the complex system of health
policy. In your presentation:
o Describe the concept of health policy in your own words, paraphrasing with
references to credible sources.
o Explain 1 specific health policy of interest to you that will be the primary focus of
your integrative paper throughout this course.
o Describe the health policy selected, including a historical summary.
o Explain why you chose this health policy.
o Illustrate the influences of ethics, politics, and law on health policy and the
interactions between these domains.
o Compare and contrast health policy with legislation, regulations, and statutes.
Highlight the role of health policy in the development of each.
Additionally, include the following:
o Title, Introduction, Conclusion, and Reference slides
o Detailed speaker notes with citations for each slide
Cite 5 scholarly sources to support your descriptions and analysis.
Format your citations according to APA guidelines.
From the perspective of a learning organization, identify the SMART aim, the Key Drivers of the initiative you are proposing as a healthcare area as a transformation project.
Discuss the following
1. System approach
2. Resource allocation you identify as important
3. Identify the executive sponsor
4. Identify the stakeholders and steering committee members
5. Environment for local team leaders to collaborate, and 6) governance of the metrics.
6. The communication plan to coordinate the project team efforts.
Your paper should meet the following structural requirements:
• Four-to-five pages in length, not including the cover sheet and reference page.
• Formatted according to APA 7th edition and Saudi Electronic University writing standards
• Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
Research the literature and obtain two to three resources for current, evidence-based information related to the pharmacological agent.
Develop a teaching brochure and one page paper following these guidelines.
Brochure for nurses- Focus on nurses for literacy level
•Key/Relevant Drug Information (30 points/30%)
Drug Class
•Patient Education Considerations (35 points/35%)
Nursing Management
Graphics enhance the purpose of the brochure
Brochure is visually appealing
•Describes intended use of brochure (focus on nurses for literacy level)
•Includes:
Name
Date
Class
Reference page
•Describe how brochure information would be revised if intended brochure audience had a low health literacy level.
•Includes no more than 3 unique errors with APA format (current ed.)
•At least two (2) scholarly, primary sources from the last 5 years, excluding the textbook, are provided
•Clearly written
•Includes no more than three unique errors of grammar
•Includes no more than three unique errors in writing mechanics
•Paper is one page, excluding references and title page
oMechanism of Action
oDrug Administration and Dosage
oDrug Interactions
oLab effects/interference
oPatient Education Considerations (special considerations)- provide examples specific to client age needs- geriatric, pediatric and pregnant client
oPatient Assessment
oSide Effects/Adverse Effects/Toxicities
oSpecial considerations- provide examples specific to client age needs- geriatric, pediatric, and pregnant clients
oVisual Effects/Creativity (10 points/10%)
oDeveloped per the required standard
oAppropriate for the intended audience (focus on nurses for literacy level)
b. One Page Paper (15 points/15%)
c. APA Format (5 points/5%)
d. Writing and Mechanics (5 points/5%)
For writing assistance, visit the Writing Center.
Please note that your instructor may provide you with additional assessments in any form to determine that you fully understand the concepts learned in the review module.
From the perspective of a learning organization, identify the SMART aim, the Key Drivers of the initiative you are proposing as a healthcare area as a transformation project.
Discuss the following
1. System approach
2. Resource allocation you identify as important
3. Identify the executive sponsor
4. Identify the stakeholders and steering committee members
5. Environment for local team leaders to collaborate, and 6) governance of the metrics.
6. The communication plan to coordinate the project team efforts.
Your paper should meet the following structural requirements:
• Four-to-five pages in length, not including the cover sheet and reference page.
• Formatted according to APA 7th edition and Saudi Electronic University writing standards
• Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
CT 3 525
Module 06: Critical Thinking
Research a peer-reviewed article in the SEU library regarding workflow analysis in healthcare. Discuss the following aspects:
• Strengths
• Weaknesses
• Opportunities
• Threats
• Risks that are identified in the workflow described.
• What changes are recommended and provide additional recommendations you would make to improve the efficiency and effectiveness of this process.
Your paper should meet the following structural requirements:
• Four-to-five pages in length, not including the cover sheet and reference page.
• Formatted according to APA 7th edition and Saudi Electronic University writing standards
• Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
CT 3 530
Module 06: Critical Thinking Assignment
The Ergonomic Challenge in Healthcare
Identify one Ergonomic challenge in healthcare. Describe the impact on the patient and healthcare worker. Describe the opportunity to improve this Ergonomic challenge.
Please address the topics below:
• Background facts about the Ergonomic challenge including incidence and prevalence
• The impact of the Ergonomic challenge on the Healthcare worker
• The impact of the Ergonomic challenge on the patient
• Your recommendations to improve this Ergonomic challenge based on evidence from the literature
Your paper should meet the following structural requirements:
• Four-to-five pages in length, not including the cover sheet and reference page.
• Formatted according to APA 7th edition and Saudi Electronic University writing standards
• Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
The theoretical framework is a critical element of your work. A theoretical framework is the general representation of relationships in your problem and is based on existing theory. The conceptual framework is your idea on how the problem should be explored, and it is generally based on a theory. The difference between the two is the scope. Theory is broad; concept is narrow.
In most research studies, your framework can be either theoretical or conceptual in nature. For the purposes of this project, you will most likely follow a conceptual framework, which is your idea on how the research problem will be explored (although you could have both).
For example:
Theoretical framework: Stimulus is applied to elicit a response
Conceptual framework: A new teaching method is applied to elicit improvement in midterm test scores.
In this section of your change project paper, state the perspective through which the problem and/or phenomenon may be explored, and include the following:
Select a minimum of two theories.
Identify the process and logic in selecting these theoretical frameworks or conceptual frameworks for your study.
Discuss how each theory or model applies to the individual project.
Present the framework guiding your study.
Describe the assumptions of the framework.
Describe each key component of the framework.
Discuss how each element of the phenomenon applies to the framework.
Apply each element of the theory to the elements of the phenomenon under study.
Develop the rationale for the sample selection criteria.
Discuss, analyze, and critique pertinent research that uses the framework.
Remember that research never proves theory. Your research project can only support or refute the theoretical propositions you are using as your framework. But if you do not use theory or conceptual frameworks in your research, you may not be able to put your findings in a context that could strengthen the nursing education profession!
This section should be 3–4 pages in length, not including the cover or reference page. You must reference a minimum of 3 scholarly articles.
Use current APA format to style your paper and to cite your sources. Review the rubric for more information on how the assignment will be graded.
This criterion is linked to a Learning OutcomeContent
60 to >49.2 pts
Meets Expectations
Identifies independent theories or conceptual models that relate to the change project topic and describes how they will be applied to the change project. Thoroughly discusses how each element of the phenomenon applies to the framework. Clearly applies each element of the theory to the elements of the phenomenon under study. Develops the rationale for the sample selection criteria, and expertly discusses, analyzes, and critiques pertinent research that uses the framework.
49.2 to >45.0 pts
Approaches Expectations
Identifies independent theories or conceptual models that relate to the change project topic and describes how they will be applied to the change project. Discusses how most elements of the phenomenon apply to the framework, but may be lacking specific details. Attempts to apply each element of the theory to the elements of the phenomenon under study but may not make clear connections. Develops the rationale for the sample selection criteria, and briefly discusses pertinent research that uses the framework, but may be somewhat lacking in analysis and/or critique.
45 to >35.4 pts
Falls Below Expectations
Identifies independent theories or conceptual models but they may only indirectly relate to the change project topic. May not discuss how elements of the phenomenon apply to the framework. Connections to each element of the theory to the elements of the phenomenon are vague and unclear. The rationale for the sample selection criteria and pertinent research that uses the framework may be missing or severely lacking in analysis and/or critique.
35.4 to >0 pts
Does Not Meet Expectations
Fails to identify a theory or conceptual model or it is written in such a way that no relationships can be identified.
60 pts
This criterion is linked to a Learning OutcomeOrganization
7.5 to >6.15 pts
Meets Expectations
Content is well written throughout. Information is well organized and clearly communicated.
6.15 to >5.63 pts
Approaches Expectations
Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.
5.63 to >4.43 pts
Falls Below Expectations
Content is disorganized in many places and it lacks clarity.
4.43 to >0 pts
Does Not Meet Expectations
Content lacks clarity and information is disorganized, or may be an outline or a list.
7.5 pts
This criterion is linked to a Learning OutcomeAPA Format/Mechanics
7.5 to >6.15 pts
Meets Expectations
Follows all the requirements related to format, length, source citations, and layout. Assignment is free of spelling and grammatical errors.
6.15 to >5.63 pts
Approaches Expectations
Follows length requirement and most of the requirements related to format, source citations, and layout. Assignment is mostly free of spelling and grammatical errors.
5.63 to >4.43 pts
Falls Below Expectations
Follows most of the requirements related to format, length, source citations, and layout. Assignment contains some spelling and grammatical errors.
4.43 to >0 pts
Does Not Meet Expectations
Does not follow format, length, source citations, and layout requirements. Assignment contains many spelling and grammatical errors.
7.5 pts
Unformatted Attachment Preview
1
Language Barrier Among the Hispanic Population in Miami, FL
2
Language Barrier Among the Hispanic Population in Miami, FL
Description of the Problem
Currently, minority populations across the U.S. are continuously growing, and as these
numbers increase so are the healthcare disparities individuals from these groups face. One of the
healthcare disparities is language barriers. As a result of language limitations and the increasing
number of diverse providers, individuals from minority populations, including the Hispanic
population, face several challenges concerning access to medical treatment and healthcare
services. Sohn (2017) outlines that most individuals from minority groups are less likely to have
health coverage and to access preventive care than other Americans. In addition to language
barriers, other aspects such as increased poverty levels, especially among the Hispanic
population, significantly contribute to uneven health outcomes for persons from these groups.
In Miami, FL, a significant number of the residents receive their care from general
hospitals. The hospitals provide numerous and different healthcare services for patients
regardless of their age and disease conditions. This clinical setting encompasses organizations,
health professionals, and ancillary healthcare employees who offer healthcare to those in need. In
Miami, FL, all residents are allowed to access services provided by these hospitals, but the level
of care may differ depending on one’s ethnicity. There are several problems I see in hospitals
within Miami, including disparities in health insurance and care associated with low-income and
poor living conditions, among other elements, inadequate access to mental/behavioral health
services, low health literacy, and increased substance use. According to Buchmueller and Levy
(2020), minority groups still have a difficult time accessing optimal healthcare, despite the
introduction of the Affordable Care Act (ACA), which has played a significant part in lowering
3
health disparities. In Miami, these challenges are prevalent in hospitals, and most affected are
those people from minority groups.
Statement of the Problem and Target Population
As previously mentioned, the language barrier is among the challenges that contribute to
poor health outcomes among individuals from the Hispanic population. For this reason, among
others, Hispanic Americans have an elevated chance than White Americans to die from various
health conditions or to get hospitalized. Funk and Lopez (2022) outline that when it comes to
circumnavigating the healthcare system, most Hispanics describe that communication problems
associated with language differences significantly contribute to their poor health outcomes. As a
result of these language differences, Hispanic Americans are less likely to utilize preventive and
clinical services. Also, due to these language limitations, healthcare providers tend to provide
Hispanic persons with low-quality or inferior medical care. All these factors together
demonstrate why individuals from the Hispanic population in Miami have generally worse and
poorer health outcomes when compared to other populations in the area.
To lower health disparities and improve health results, person-centered care is essential.
However, person-centered care cannot be achieved if there exist language differences that hinder
the delivery of ideal care. This is because, according to Amirehsani et al. (2017), person-centered
care is based on effective communication and interaction between healthcare providers and
patients. Generally, healthcare delivered in an individual’s primary language has a high
probability of positively influencing the health status of that individual. However, with language
differences and discordance, interaction and understanding between healthcare providers and
patients will be poor and this may lead to patient dissatisfaction and poor health outcomes. This
is the same problem Hispanics located in Miami are facing because most of them are still not
4
able to obtain top-notch medical care. This will continue to be a problem not only in Miami, FL
but across the U.S. because the ratio of nurse practitioners and Hispanic nurses does not match
the growth of the Hispanic population.
Significance of the Evidence-Based Project
An example of an evidence-based project that could be introduced in general hospitals
within the Miami area to the nursing profession is the use of interpreter resources. These
resources generally consist of in-person interpreters either employed by the organization or
contracted externally. In the selected setting, the use of interpreter resources is important because
these resources will help bridge the communication gap resulting in effective and interactive
communication. As previously mentioned, most persons from the Hispanic population are less
likely to utilize preventive care and other medical services because of problems associated with
language differences and this, in one way or another, has contributed to worse health outcomes
within this population. With the utilization of interpreter resources, general hospitals in Miami
can improve communication and this will not only increase the number of persons seeking
medical care but also contribute to better health outcomes. This project is important because it
will play a major part in reducing health disparities as well as mitigating challenges faced by
persons from minority groups.
Moreover, due to language barrier among other factors, most Hispanic Americans do not
seek differential treatment because they are likely to obtain low-quality medical care when
compared to their counterparts. Also, this limitation prevents most healthcare providers from
providing people from this population with advanced medical care because of the fear they may
not align the treatment with their preferences and health needs (Funk & Lopez, 2022). However,
with the use of interpreters, these healthcare providers will be confident to provide advanced
5
medical care as an interpreter will close the communication gap. This will not only help improve
the communication between the healthcare provider and the patient but will also build trust
between the two parties. With trust and effective communication, healthcare providers can
deliver patient-centered care and in doing so, achieve better health outcomes and decrease the
prevalence of health disparities within the minority populations.
Effective communication is essential in healthcare because communication failures and
misunderstandings can negatively influence patient outcomes. According to Tiwary et al. (2019),
poor communication in healthcare settings is associated with misdiagnoses and other medical
blunders that can result in avoidable health problems as well as the death of patients. Hence,
language differences between healthcare providers and Hispanic patients could contribute to
miscommunication and this could lead to these patients receiving the wrong medical procedure
or treatment, delays in vital tests and treatments, or being given the wrong medication. Hence,
the use of interpreter resources within Miami hospitals would be essential in addressing the
language barrier.
6
References
Amirehsani, K. A., Hu, J., Wallace, D. C., Silva, Z. A., Dick, S., West-Livingston, L. N., &
Hussami, C. R. (2017). US healthcare experiences of Hispanic patients with diabetes and
family members: A qualitative analysis. Journal of Community Health Nursing, 34(3),
126-135. https://doi.org/10.1080%2F07370016.2017.1340556
Buchmueller, T. C., & Levy, H. G. (2020). The ACA’s impact on racial and ethnic disparities in
health insurance coverage and access to care: An examination of how the insurance
coverage expansions of the Affordable Care Act have affected disparities related to race
and ethnicity. Health Affairs, 39(3), 395-402. https://doi.org/10.1377/hlthaff.2019.01394
Funk, C., & Lopez, M. H. (2022). Hispanic Americans’ experiences with health care. Pew
Research. https://www.pewresearch.org/science/2022/06/14/hispanic-americansexperiences-with-health-care/
Sohn, H. (2017). Racial and ethnic disparities in health insurance coverage: Dynamics of gaining
and losing coverage over the life-course. Population research and policy review, 36(2),
181-201. https://doi.org/10.1007%2Fs11113-016-9416-y
Tiwary, A., Rimal, A., Paudyal, B., Sigdel, K. R., & Basnyat, B. (2019). Poor communication by
health care professionals may lead to life-threatening complications: examples from two
case reports. Wellcome open research, 4.
https://doi.org/10.12688%2Fwellcomeopenres.15042.1
1
Language Barrier Among the Hispanic Population in Miami, FL
2
Language Barrier Among the Hispanic Population in Miami, FL
Project’s Benefits
This project has several benefits in terms of addressing the requirements of persons
within the Hispanic group experiencing language barriers. Given that language barriers bring
about various challenges when it comes to attaining high satisfaction levels among health
professionals and patients from this population, this project will aim to provide ways to address
these barriers. Specifically, this project will focus on ways to achieve high-quality healthcare and
sustain patient safety in the Hispanic population. At present, various healthcare organizations and
institutions serving the Hispanic population are offering interpreter services to advance
healthcare access, communication, and patient involvement and satisfaction (Kwan et al., 2023).
However, these interpreter resources increase the duration of treatment approaches as well as the
cost. For these reasons, this project will aim to provide useful insights into the influence of
language barriers on healthcare access within this population and recommend solutions to
address these challenges.
Also, language difficulties significantly influence the cost and healthcare quality,
especially when it comes to the Hispanic population. Despite the language limitations, healthcare
providers serving this population need to deliver top-notch healthcare that aligns with their
healthcare needs and follows the principles of health equity and human rights. As a result, this
project will aim to address health disparities faced by members of this population. More
importantly, this project will venture into health inequalities such as unequal treatment and
discrimination related to language differences. This is because these health disparities within this
population often result in unequal health outcomes as well as inadequate access to healthcare. A
study by Al Shamsi et al. (2020) outlines that individuals who have dialectal difficulties tend to
3
experience various challenges concerning healthcare services access and as a result, these
patients often have poorer health results in comparison to patients who speak or understand the
local language. Considering the evidence that language barriers within this population in one
way or another influence the quality of healthcare they receive, this project will focus on ways to
advance communication between Hispanic patients and their medical professionals.
Considering that Hispanic patients with language difficulties are likely to utilize more
preventive and clinical healthcare services and have more adverse events, this project will
provide strategies on how to improve the utilization of these services, especially among persons
with limited English proficiency. Also, research indicates that patients who receive medical care
from healthcare professionals who do not speak the local language have challenges
comprehending medical instructions, resulting in increased occurrence of medical errors and
poor treatment adherence (Green & Nze, 2017). Taking that into account, this project will aim to
provide patients from the Hispanic population with the means to adhere to medical follow-ups so
that they do not miss health appointments due to language barriers. One benefit associated with
this is that these patients will have higher levels of satisfaction with the quality of healthcare they
receive.
Goals and Objectives
The project’s goals and objectives include:
1. To increase and improve patient satisfaction concerning access to healthcare access by
90% among members of the Hispanic population with language limitations within 6
months.
4
2. To demonstrate the importance of interpreter resources when it comes to healthcare
access among the Hispanic population within the first month of the project
implementation.
3. To advance the utilization of interpreter resources in all healthcare centers serving
members of the Hispanic population within the first year of introduction of these
resources.
4. To increase the use of inpatient services and medical care follow-ups using interpreter
services in the first month of project implementation.
5. To reduce healthcare disparities and improve patient safety as well as healthcare delivery
within the Hispanic population by 60% by the first year of the project implementation.
6. To minimize miscommunication between healthcare professionals and patients by 100%
to achieve better patient outcomes and advance healthcare delivery quality in the first two
months of project initiation.
7. To minimize indirect healthcare costs associated with language barriers within the
Hispanic population by 50% in the first year of project implementation.
Variables to be Considered
Several variables need to be considered for this project to be successful. One of these
variables is patient satisfaction. According to Funk and Lopez (2022), most members of the
Hispanic population tend not to utilize preventive and clinical services due to a lack of health
coverage as well as language and cultural obstacles. These limitations in one way or another
contribute to disparate health results for members of the Hispanic population, resulting in low
levels of patient satisfaction. Therefore, patient satisfaction needs to be considered within this
population because high levels of satisfaction indicate Hispanic Americans are receiving
5
equitable healthcare that aligns with their healthcare needs. Healthcare providers serving
members of this population experiencing language barriers do not have control over patient
satisfaction as this factor depends on the quality of care delivered and the patient’s perception of
that care.
The other variable that needs to be considered when it comes to addressing the needs of
the members of the Hispanic population with language difficulties is interpreter resources. This
is because to overcome some of the language obstacles faced by this population concerning
healthcare access, interpreter services are essential. However, the implementation and utilization
of these resources are associated with various challenges such as misinterpretation, confusion,
and financial burden (Al Shamsi et al., 2020). For these reasons, some healthcare providers may
opt out of utilizing interpreter services or they may access subpar interpreter resources. Given
that these interpreter resources may contribute to high levels of patient satisfaction as well as
improved patient care among members of the Hispanic population with language differences,
this variable must be considered by healthcare providers. These providers have control of this
variable because they either choose to hire language assistants or provide healthcare services
without interpreter resources as they are associated with several challenges, including increased
healthcare costs and length of physician visits. Lastly, if I were to implement this study, I would
apply mixed-method research to obtain both qualitative and qualitative data.
6
References
Al Shamsi, H., Almutairi, A. G., Al Mashrafi, S., & Al Kalbani, T. (2020). Implications of
language barriers for healthcare: A systematic review. Oman Medical Journal, 35(2),
e122. https://doi.org/10.5001%2Fomj.2020.40
Funk, C., & Lopez, M. H. (2022). Hispanic Americans’ experiences with health care. Pew
Research. https://www.pewresearch.org/science/2022/06/14/hispanic-americansexperiences-with-health-care/
Green, A. R., & Nze, C. (2017). Language-based inequity in health care: who is the “poor
historian”? AMA journal of ethics, 19(3), 263-271. https://journalofethics.amaassn.org/article/language-based-inequity-health-care-who-poor-historian/2017-03
Kwan, M., Jeemi, Z., Norman, R., & Dantas, J. A. (2023). Professional interpreter services and
the impact on hospital care outcomes: An integrative review of the
literature. International Journal of Environmental Research and Public Health, 20(6),
5165. https://doi.org/10.3390%2Fijerph20065165
From the perspective of a learning organization, identify the SMART aim, the Key Drivers of the initiative you are proposing as a healthcare area as a transformation project.
Discuss the following
System approach
Resource allocation you identify as important
Identify the executive sponsor
Identify the stakeholders and steering committee members
Environment for local team leaders to collaborate, and 6) governance of the metrics.
The communication plan to coordinate the project team efforts.
Your paper should meet the following structural requirements:
Five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition
Provide support for your statements with in-text citations from a minimum of four scholarly articles.
Hi, there is one pdf form along with some questions. No references are required no similarity risk. If you are expert in this area you can accept the bid otherwise don’t need.
Unformatted Attachment Preview
Facilitate the Empowerment of People with Disability – Assessment Task 6, Question 1
Has the support worker responded to the risk factor
correctly? Explain why/why not.
Types of risk
Prasit is supporting Matthew who is 22 years old and
has an intellectual disability requiring minimal support.
Matthew tells Prasit he wants to go skateboarding at
the local skateboard park. Prasit explains the risks
involved and offers him protective gear such as a
helmet, elbow pads, knee pads and wrist pads.
Matthew refuses to wear them and breaks his wrist.
HOW TO REPORT:
While John is supporting Rod to participate in a game of
darts his mobile phone rings. As Rod is fairly unsteady
with his balance, John lets the call go to his message
bank and assists Rod to throw his next dart. Rod
accidentally drops the dart and it gets stuck in his foot.
HOW TO REPORT:
Sarah has been helping Emily learn how to safely cross
the road using the traffic signals. Emily has not been
able to successfully demonstrate that she understands
what is required. Sarah lets Emily go out independently
and is aware that she will need to cross the road. As
Emily is crossing a road, she is hit by a car.
HOW TO REPORT:
Name:
CASE B: CARDIOVASCULAR DISEASE TEMPLATE
Please erase ?, …, and ___ – Please use a different color that black for your answers!!!!!!!
1. Descriptive epidemiology involves …
2. A population is …
3. Measures of frequency include …
Measures of association report …
Measures of impact assess …
4. A ratio represents …
The proportion…
The rate … The rate is generally expressed as …
e.g for #5 – Ratio of heaty attacks – 75/25 = 3:1 or men have 3 …
5. Ratio of heart attacks – ?/? = ?, or men have _______ times the number of heart attacks
in this population;
Proportion of heart attacks in men ?/? = ? or = ?%, or ___ percent of the heart attacks in
this sample occur among men;
Heart attack rate ?/? × ? = ? per ?. Therefore, the rate of heart attacks among men is ? per
?.
6. Ratio white to black of females – There are ? / ? = ? times as many white women age 20
years and older with diabetes compared with black women in the same age group.
It tells you …
It doesn’t tell you …
7. Proportion – ?/? = ?,
It tells you …
It does not tell / allow you to compare the ______________ risk of white versus black
women
8. White women have a rate of (?/?) × ? = ? per 100 and black women have a rate of (?/?) ×
? = ? per 100.
Comparison – ? /? = ?. (hint divide 2 rates from above) Black women have ___ times the
rate of diabetes as white women.
9. Ratio of hypertension among Whites vs Blacks – ?/? = ? times as much hypertension in
whites versus blacks,
The proportion of Hypertension in White males – ?/? = ? of the white males have
hypertension.
Rates are (?/?) × ? = ? per ? among whites, and ?/? × ? = ? per ? among blacks
relative risk of ?/? = ?, or blacks have ____ times the prevalence rate of hypertension as
whites.
10. Incidence measures …
Prevalence measures …
The difference between point prevalence and period prevalence is …
11. Incidence rates can be used for …
Prevalence rates can be used for …
12. See Exhibit B.3. – Fill in values for highlighted portion of the table
Exhibit B.3 Number of US Residents (in thousands) with Five Cardiovascular Risk Factors
Smoking
prevalence1
Obesity (>=30
BMI)2
Cholesterol
>200mg/d2
High blood
pressure2
Diabetes mellitus2
Prevalence (in millions)
Prevalence rate (per 100)
White
White
Black
Black
White
White
Black
Males
Females Males
Females Males
Females
Males
17.0
15.3
3.0
2.3
30.9
34.0
5.3
9.2
32.6
40.0
4.2
5.3
44.4
39.6
8.3
9.0
13.0
9.5
2.3
2.7
13. Cumulative incidence refers to …
Incidence rate refers to …
Incidence density refers to ….
14. Please read Page 267 – 275 – Cumulative five-year incidence rate of Heart Disease
among coffee drinkers (Group 1)- (? / ?) × ? = ? cases per ? persons
15. Please read Page 267 – 275 – Cumulative five-year incidence rate of Heart Disease
among non-coffee drinkers (Group 2) – (? / ?) × ? = ? per ? persons
16. 90 persons, each at risk for all 5 years and didn’t get HD, so 90 × 5 = 450 patient-years
(E.G)
5 persons, each at risk for 3 years before developing HD, so ? × ? = ? patient-years
Black
Females
5 persons, each at risk for 4 years before developing HD, so ? × ? = ? patient-years
5 persons, each at risk for 2 years before leaving study, so ? × ? = ? patient-years
5 persons, each at risk for 4 years before dying so ? × ? = ? patient-years
Total person years = 450 + ? + ? + ? + ? = ? patient-years
17. 100 persons, each at risk for all 5 years and didn’t get HD, so 100 × 5 = 500 patient-years
(E.G.)
2 persons, each at risk for 1 year before developing HD, so ? × ? = ? patient-years
2 persons, each at risk for 2 years before developing HD, so ? × ? = ? patient-years
2 persons, each at risk for 4 years before leaving study, so ? × ? = ? patient-years
2 persons, each at risk for 3 years before dying, so ? × ? = ? patient-years
Total person years = 500 + ? + ? +? + ? = ? person-years
18. Incidence Density Rate for Coffee Drinkers. (# new cases / total person-years) × 100) = (?
/?) × ? = ? cases per ? person-years
19. Incidence Density Rate for Coffee Drinkers – (? /?) × ? = ? cases per ? person-years
20. Cumulative Incidence – Incidence of HD in coffee drinkers / Incidence of Heart Disease
(HD) in non–coffee drinkers = ? / ? = ? so coffee drinkers are ? times more likely to get
HD than non–coffee drinkers
21. Cumulative Incidence Density – Incidence density of HD in coffee drinkers / Incidence
density of HD in non–coffee drinkers = ? / ? = ? so coffee drinkers are ? times more likely
to get HD than non–coffee drinkers
22. See Exhibit B.4
Prevalence rates:
E.G white males 2210 / 92,100 × 1000 = 24 per 1000;
white females: ? /? × ? = ? per ?;
black males: ? / ? × ? = ? per ?;
black females: ? /? × ? = ? per ?.
Incidence rates:
white males; ? /? × ? = ? per ?;
white females: ? / ? × ? = ? per ?;
black males: ? /? × ? = ? per ?;
black females: ? / ? × ? = ? per ?.
If we reorganize the formula prevalence (P) = incidence (I) × duration, we demonstrate
that the ratio of prevalence to incidence equals duration. This gives us some idea of the
average duration with the disease assuming a steady state system:
white males: ? years;
white females: ? years;
black males: ? years;
black females: ? years.
Fill in values for highlighted portion of the table using calculations from above
Exhibit B.4 Number of US Residents (in Thousands) with Prevalent or Incident Strok
Number of US Residents (in
Rate (per 1,000)
Thousands)
White White
Black Black
White
White
Black
Black
Males Females Males Females Males
Females Males
Females
Prevalent
2210
2395
437
612
Stroke
Incident
325
365
45
60
Stroke
Source: Go et al. (2013)
23. New Incidence Rates:
e.G. White males: 325,000 / (92,100000 – 2210000) × 1000 = 3.61 per 1000;
white females: ? / (? – ?) × ? = ? per ?;
black males: ? / (? – ?) × ? = ? per ?;
black females: ? / (? – ?) × ? = ? per ?.
The rates …
24. Numerator issues include …
Denominator issues include …
The time period must be …
25. Read 275 – 280
Relative Risk is …..
Men: ? / ? = ?
women ? / ? = ?
26. Men: ? – ? = ? per ?, this means that ? per ? cases of CVD among men can be attributed
to MS; .
Women: ? – ? = ? per ?, this means that ? per ? cases of CVD among women can be
attributed to MS.
Trade Policies for the Developing Nations Discuss what led India in the 1990s to abandon its system of import substitution, and what growth strategy did India adopt? What lesson can be learned from this situation?What effects does labor migration have on the country of immigration? The country of emigration? Discuss how this relates to KSA?
Week 3 Preanalytical Complications in Blood Collection
Please review the below article then answer the following questions.
Preanalytical Errors Phlebotomy
Preexamination/Preanalytical complications Causing Medical Errors in Blood Collection
1. Describe (at least three) preanalytical complications related to phlebotomy procedures
and impacting patient safety
2. Explain how to prevent and/or handle complications in blood collection.
3. List at least five factors about a patient’s physical disposition (i.e., makeup) that can
affect blood collection.
4. List 2 examples of substances that can interfere in clinical analysis of blood constituents,
and describe methods used to prevent these interferences.
5. Describe how allergies, a mastectomy, edema, and thrombosis can affect blood
collection.
6. Describe complications associated with tourniquet pressure and fist pumping.
7. List three preanalytical complications that can arise with test requests and identification
Key Terms
Define each of the following term:
1. Edema
2. Fasting
3. Hematoma
4. Hemoconcentration
5. Hemolysis
6. Lipemic
7. Occluded veins
8. Sclerosed veins
9. Syncope
10. Lymphedema
Professional Ethics
1. Define “standard of care” from a legal and health care provider’s perspective
2. List 3 common issues in lawsuits against health care providers and prevention tips to
avoid lawsuits in phlebotomy
3.
4.
5.
6.
Explain the term “liability and what it means for health care providers.
Explain HIPAA
Explain what “patient confidentiality” is.
Describe the difference between “informed consent” and “implied consent.”
Key Terms
Please write the definition to each of the following:
1. Assault
2. Breach of duty
3. Clinical Laboratory Improvement Amendments of 1988 (CLSI)
4. Ethics
5. Full disclosure
6. Invasion of privacy
7. Patient Bill of Rights
8. Malpractice
9. Standard of care
10. Patient Care Partnership
The purpose of this assignment is to review the contents of a budget and to create a budget
variance analysis. In this assignment, you will complete the attached Week 2 Assignment Template,
which will be submitted for grading.
To prepare for this assignment, you should:
● Complete all of this week’s reading.
● Access and review the Week 2 Assignment Template.
● Conduct necessary and relevant research. In this assignment, write a 600- to 1000-word paper that includes the following components:
1. Provide an introduction that describes how budgeting plays a role in the strategic planning
process (at least 200 words)
a. As you are completing your strategic plan, remember to take into consideration
community benefits, bill types, tax exemption status, and other key strategies from your
week’s reading.
2. Describe the use of flexible budgets and variance analysis (at least 200 words).
3. Review the budgeted and actual revenues/expenses for Wesley Ambulatory Care as listed in
Table 1 of the Week 2 Assignment Template.
4. Using the Week 2 Assignment Template, conduct a variance analysis by filling in the total
variances associated with the planned and actual expenses, and indicate whether it is
favorable or unfavorable.
5. Summarize your findings and make recommendations on how the organization may address
unfavorable variances (at least 200 words).
6. Follow the information in the Week 2 Assignment Template.
7. Follow APA formatting for your references and citations.
Unformatted Attachment Preview
1
Budget Variance Analysis
[Enter Name Here]
[Enter Professor Name Here]
[Enter the Date the Assignment is Due Here]
2
Budget Variance Analysis
Provide an introduction that describes how budgeting plays a role in the strategic
planning process (at least 200 words). As you are completing your strategic plan, remember to
take into consideration community benefit, bill types, tax exemption status and other key
strategies from your week’s reading. You can remove these instructions and type your
introduction here.
Describe the use of flexible budgets and variance analysis (at least 200 words). You can
remove these instructions and type here.
Review the following budgeted and actual revenues/expenses for Wesley Ambulatory
Care. Conduct a variance analysis by filling in the total variances associated with the planned
and actual expenses along with whether it is favorable or unfavorable. You can remove these
instructions and type directly in the table below.
Table 1
Wesley Ambulatory Care Budgeted and Actual Revenues and Expenses
Budget Item
Patient Volume
Budgeted
Actual
Total
Favorable
Variances
or
(1-2)
Unfavorable
2,700
2,500
?
?
Ambulatory Surgery Revenues
$435,000
$418,000
?
?
Cafe Revenues
$19,000
$20,000
?
?
3
Total Revenues
$454,000
$438,000
?
?
Expenses Patients Days
25,000
25,000
?
?
Pharmacy Expenses
$150,000
$160,000
?
?
Surgical Supplies
$65,000
$75,500
?
?
Misc. Supplies
$15,000
$11,500
?
?
Total Expense
$230,000
$247,000
?
?
Operating Income
$224,000
$191,000
?
?
Summarize your findings, and make recommendations on how the organization may
address unfavorable variances (at least 200 words). You can remove these instructions and type
here.
4
References
upload your research question for this semester’s research project. More information about forming a research question can be found here: https://library.une.edu/research-help/guides-tutorials/evidence-based-practice/pico/.
EBP and PICOTDefine the process of evidence-based inquiry and precisely what you have learned in this class from your own work and the work of your peers on this search. Provide 2–3 high-level references for your discussion,
Evaluate the cultural competence of the healthcare organization presented in the Integrated Safety-Net Health Care System case study using a population health approach. Please also read the supplemental Interpreting Services Program document to ensure that you have all of the information about the Montefiore Medical Center you will need to address the critical elements.
Specifically the following critical elements must be addressed:
Patient engagement activities and communication strategies
Critique the organization’s translation and interpretation services that may be available to non-English-speaking patients. In other words, does the organization provide such services? How many different languages are supported? How might the organization communicate with a speaker of a language that is not supported? Be sure to provide evidence that supports your claims.
Analyze the extent to which educational resources and materials are available in languages other than English. Be sure to provide specific examples.
Assess organizational staff training on patient engagement and communications for its potential to foster cultural competence. Be sure to provide evidence to support your claims.
Identify gaps or deficiencies that may exist in the organization’s patient engagement and communications strategies, and provide evidence to support your claims. If you feel there are none, be sure to explain your reasoning.
Health promotion and disease prevention and management strategies
Assess the organization on its efforts to promote healthy living by examining programs (e.g., fitness classes, blood pressure clinics, first aid training, nutrition education, etc.) that it may offer to patients. Be sure to provide evidence to support your claims.
How appropriate are the organization’s disease prevention and management programs and services (such as discharge planning, home health services, vaccination services, etc.) for addressing factors that determine population health status? Be sure to provide evidence to support your claims.
Assess non-programmatic services (such as transportation, on-site child care, etc.) that may be offered by the organization for their impact on factors that determine population health status.
Identify gaps or deficiencies that may exist in the organization’s health promotion and disease prevention and management efforts, and provide evidence to support your claims. If you feel there are none, be sure to explain your reasoning.
Financial incentives and quality improvement processes
Analyze population health-oriented policies (such as non-discrimination in hiring, care and treatment, Patient Bill of Rights, financial assistance, etc.) that the organization may have implemented for reducing costs and improving overall quality. Be sure to provide evidence to support your claims.
To what extent is the organization’s approach to care considered patient-centered? Be sure to cite specific examples to substantiate your claims.
What specific strategies (such as eliminating unnecessary procedures and providing only essential treatments or interventions) does the organization employ in its population health approach to reduce costs and improve overall quality?
Describe gaps or deficiencies that may exist in the organization’s use of the population health approach in reducing costs and improving quality of care, and provide evidence to support your claims. If you feel there are none, be sure to explain your reasoning.
Recommendations
Recommend strategies for improving the organization’s cultural competence with regard to patient engagement and communications. Be sure to use research to support your reasoning.
Suggest health promotion and disease prevention strategies for improving outcomes in terms of population health status. Be sure to use research to justify your suggestions.
Recommend policies and strategies that increase the organization’s use of a population health approach to reduce costs and improve overall quality of care. Be sure to use research to substantiate your recommendations.
Milestone Three: Financial Incentives and Quality Improvement Processes
In Module Six, you will submit Section III of the case study, in which you will address the organization’s financial incentives and quality improvement processes. Specifically, you will critique the organization’s population-health-oriented policies, the organization’s approach to care and the extent to which it is patient-centered, and any strategies the organization uses in its population-health approach. This milestone should be two to three double-spaced pages.
What to Submit
Written components of the project must follow these formatting guidelines when applicable: double spacing, 12-point Times New Roman font, one-inch margins, and APA-style citations. The case study analysis and proposal should be 8 to 10 pages in length, not including cover page and resources. Please be aware that AI generated will be detected.
Identify a care delivery model associated with a health outcome within your community. Prioritize risk mitigation strategies to prevent or reduce adverse health outcomes in your community. -My community is Miami, FL
8/9
Scare tactics
don’t work.
Real life stories
Matter.
Over the counter
meds are not
automatically
“safe.”
BEFORE WE GET STARTED ON CHAPTERS 8 AND 9: Even if you’ve heard all this stuff a
million times before, these two chapters do matter. There are always personal stories
to honor.
On the left: the “normal” school health class photos. I find these images disturbing but I
don’t think they help students make wise decisions in regards to drugs and alcohol. I
don’t think scare tactics work. If they did, none of us would be texting while driving,
using drugs, vaping or abusing substances of choice.
Here’s what I want as part of the discussion: Not scare tactics. Real people.
On the right is a co-worker of mine who died from drug use.
I was crushed when I learned she died. Crushed.
I went to work and learned she had died.
She had so much to live for.
She was incredibly young and smart and loving.
She just couldn’t beat her addiction.
The face of heroin is not a street junkie.
The face of heroin is not a scare tactic.
The face of heroin is those we love and know.
1
I think I’m
drunk!
DUDE!
LIT
!
Alcohol, Drugs and
Tobacco
Chapters 8 and 9
CAFFEINE. There are definitely some of you drinking energy drinks or your fifth cup of
coffee right now! Is that good, bad or confusing that caffeine is even included in this
lesson?
ELECTRONICS. What about that phone you’re using? Tablet? Computer? Internet? No
worries, right?
GAMING. Can you be addicted to your video games? Gambling?
SMOKE THIS. “Real” and Synthetic pot and those happy gummies seem safe… right?
After all, it’s legal. E-CIG vs “REAL” CIGS. Are e-cigarettes better than smoking “real”
cigarettes? Should I chew instead?
OPIOIDS. It’s not just heroin being abused everywhere. PRESCRIPTIONS. Prescription
meds are plentiful–where do they belong in this discussion?
CULTURE. What about hookahs? Do they belong in this discussion? Where does culture
come into play?
PORN. Sex addiction isn’t a real thing, is it?
WORK. Yes, work. Addictive or just dedicated?
THIS IS A VIDEO…. PLEASE WATCH THE VIDEO!
Whoa. Sesame Street is talking about opioid addiction??? What the
heck do you think about this?
Do you agree or disagree with Sesame Street having a character who
talks about drug use, addiction and treatment? Is the opioid crisis
“bad”enough to warrant this?
Are we teaching children about subjects “too early?” Not early
enough? Never okay to teach this?
What are opioids, anyway?
3
THIS IS A VIDEO…. PLEASE WATCH THE VIDEO!
DOCTORS as DRUG DEALERS? Sure, they prescribe drugs that are
addictive. How does that fit in to this narrative?
Nursing students: This all may sound very familiar to you. Hello, opioid
crisis! Hello oxycodone!
Is your doctor a drug dealer? Is Big Pharma to blame for the opioid
crisis?
This is indeed a long video. I found it powerful and hope you choose to
watch it. Are these the faces of opioid addicts? You tell me.
The OTC Drug Label
Figure 7.3
If you learn anything today, make sure it’s how to read a label on an
over-the-counter medication. That might seem mighty basic but think about
how important the information might be… and, you’re probably more likely to
use OTC meds more than heroin!
GO FIND A BOTTLE OF TYLENOL, IBUPROFEN, COUGH MEDICINE, ALLERGY
MEDICINE…. SOMETHING YOU ALREADY HAVE IN YOUR
ROOM/APARTMENT/HOUSE and read the warnings. Surprised? Just because it’s
over the counter does NOT mean it’s safe. Seriously!
Credit of Extra: In your response in the discussion for these two chapters, name
one warning on an OTC label that you didn’t know about OR one that you
would consider as problematic if you did know about the warnings. Just throw
the info into your response somewhere.
THESE ARE VIDEOS….
PLEASE WATCH ONE of these
VIDEO!
Figure 7.3
Chew… snuff… e-cigs… Isn’t that better than smoking? Vaping is a developing story.
Synthetic marijuana: I’m talking about the nasty stuff found at gas stations that
destroys your brain–like K2. It is not safe, no matter what they tell you. PLEASE DON’T
USE SYNTHETIC MARIJUANA! I beg of you. Vaping THC? If you asked for my vote, I’d go
tell you to smoke the real thing. Skip the Vaping-THC oil. Your lungs and brain will thank
you.
Discussion Questions for Chapters 8 and 9:
●
In Canvas, open the FILES for this course.
●
Look for the PDF titled “Discussion_Chapters 8 and 9.pdf”
●
You will NOT find the discussion questions in the Module or on the Discussion
board.
●
Glad you’re reading this… you can do the homework because you read this
PDF. Yay, you!
Calling all phone addicts. If you’d like to consider your phone use, this is your guy! Let’s
talk about your phone. Is phone addiction a thing? How long can you go without
looking at your phone? Is it a problem? It it an actual addiction? Are you using your
phone right now? I am!! What if I told you to turn off your phone and not turn it back
on until tomorrow morning? OMG, NO!!!!
After reading this week’s Lecture; answer the following:1. Have you ever experienced a sewer backup in your home?2. What things do you think you can do to prevent sewer backups in your home?And, of course, feel free to share your thoughts about the lecture/article.
Unformatted Attachment Preview
Wastewater
Wastewater Collection System
M
e le d
eall hi k m ch ab
he e he a e ha c me
f hei fa ce
comes from. In a future lecture we will discuss the sources of water that serve the residents
and businesses of Los Angeles. This week, I want to talk about the wastewater that leaves
these properties. Fewer people think about where their wastewater goes once they flush their
toilet and/or use their kitchen sink, bathroom sinks, and showers!
Each
e ha a sewer lateral ha c
ec hei h me
b i e
he ci -owned
main in the street. This sewer lateral i
all made
f Vitrified Clay Pipe (VCP). The
city sewer main varie i i e b i m
e ide ial a ea he a e VCP i e Wh a e
sewer pipes usually made out of clay pipe? The primary reason is because clay is inert and
d e
eac i h m
f he chemical hich c ld e d
i he e e i e chl i e bleach
from homes, acids/bases from businesses, etc.). Some local communities are installing newer,
m e ad a ced la ic fibe gla
i e i e ide ial a ea beca e m h me d
discharge chemicals in high enough concentrations to react with these newer materials.
However, it is important to keep in mind that over 99% of sewer pipes in the United States
today are made out of clay. And, in older cities, it is not uncommon to see VCP sewer pipes last
over 100 years!
The city sewer main transports the e age f m each
e
la e al a l cal a e a e
ea me
la
M
malle ci ie c
ac i h egi al a e
ea hei c
me
sewage. For example, the City of Los Angeles operates 4 regional wastewater treatment plants
that are used by the following entities: the City of San Fernando, the City of Glendale, the City
of La Canada Flintridge, unincorporated County areas (i.e., La Crescenta), the City of Los
Angeles, the City of Burbank, the City of Santa Monica, the City of Culver City, state properties
(i.e., UCLA, CSUN, community colleges), and numerous federal properties. The primary reason
each city does not build its own treatment plant is simply cost. For example, up in the City of
Davis (near Sacramento), UC Davis is the only UC Campus that owns and operates its own
a e a e ea me
la
M UC Da i fficial i h he did
hei
ea me
plant due to the cost and environmental compliance headaches caused by operating your own
treatment plant.
Wastewater Collection System Design Criteria
In order to efficiently collect and transport wastewater to the local or regional wastewater
treatment plant, sewer systems must be properly designed. For example, if you live in
Minnesota, you would not want to build a shallow sewer system that would freeze in the
middle f i e O if
li e i a e ci
ld
a
b ild a
e e mai
that will be at capacity in 10 years after the area is developed! Believe it or not, there is quite a
bit of engineering that goes into properly designing and building a sewer system. I will focus on
just a few design criteria for our discussion:
1. Proper slope
Obviously, we want to make sure the sewage flows by gravity if at all possible. So, we want to
minimize the number of sewage pump stations because they are very costly to build and
operate. Electrical pumps are very expensive to run in some cities with large pump stations
monthly electric bills can approach or exceed $100,000! Yes, imagine paying over $1 million a
ea j
m e age a highe ele a i
clea l he e a e be e e f hi m e
e eciall i
da ec
mic e i me
he e ci ie a e
ggli g j
a
f
bankruptcy. Of course, there are times when the need for a m a i ca be a ided
the topography of some parts of a city might just be lower than the surrounding area.
In general, sewer pipes should be constructed to allow for a minimum cleansing velocity of 2ft
per second. If the water in a sewer pipe travels too slow then the chance of debris building up
and causing a blockage is higher. Therefore, whenever possible, sewers should be built to allow
for a minimum cleansing velocity of 2 ft. ec d Of c
e he e e d e
ha e al a
be flowing at this speed (i.e., 2 am), but at least once per day (at peak hours) the water should
travel at this speed to carry solids/debris to the treatment plant. Also, if the slope is too
shallow and the water travels too slowly, the likelihood of Hydrogen Sulfide forming is
increased and this can cause odor complaints from local residents and/or businesses (rotten
egg smell). Hydrogen sulfide is naturally created as a byproduct of bacterial decomposition of
wastewater however, if sewers are improperly designed the levels of hydrogen sulfide may
become a problem.
This brings me to a related point: the health and safety of sewer workers. It is extremely
important for sewer workers to ALWAYS test the atmosphere inside a sewer manhole and/or
sewer pipe prior to entering. As stated above, hydrogen sulfide (HS) is a naturally occurring gas
in sewers so if a worker fails to test the level of HS prior to making an entry, death may result.
This is exactly what happened in the City of Burbank in the 1980s. A sewer worker entered a
manhole without testing the atmosphere and collapsed after breathing in HS gas. His coworker
k a dee b ea h ab e he ma h le a d he e i
e c e him Needle
a he
was quickly overtaken by the HS gas also. Please click
he eb i e li k de hi eek
Moodle page to read about a person who died after breathing HS under a kitchen sink. The
b
m li e i e all eed be c g i a
f he da ge f e e ga
2. Proper capacity
Clearly, the construction of a new sewer main is a costly undertaking. Therefore, public sewer
agencies need to make sure that the sewer line they are installing (or replacing) will have
adequate capacity for the future. I often tell regional elected officials that the only saving grace
cities have in terms of sewer capacity is the significant drop in per capita wastewater use we
have seen over the years. The bottom line is this: contrary to popular opinion, our engineering
forefathers did not have the wisdom to install large diameter sewer lines with future
population growth in mind. The fact that most cities have 70 -100 year old sewer lines that are
still capable of handling sewer flows is simply due to the advent of low flush toilets and water
saving shower heads and appliances. The sad truth is that if Americans were still using the
same amount of water (per capita) as they did in the past, the majority of sewer lines would be
undersized and we would have sewage flowing on our city streets. This, in fact, is exactly what
we see in a lot of cities when it rains!
In the City where I work, we design new sewers to be flowing at 50% at full buildout. What do
e mea b f ll b ild
I i a i i he f
e he e e i gle a ailable a cel i he
city is developed t i f ll
e ial F e am le le
a he e i a aca l i he
downtown area. Today this lot is discharging zero gallons of sewage into our sewer system.
H e e af e l ki g a he Ci
Ge e al Pla e lea ha hi l i i a
i g area that
allows six story buildings. So, when we go to design our new sewer we assume that this lot will
be developed into a six story residential building and we assume the maximum amount of
sewage will be discharged even though this might not ever happen. So, when we identify every
parcel discharging into our new sewer we assume that eventually every parcel will be fully
developed and we take these increased discharge volumes into account when we size our new
sewer line. Then, once we know what the maximum amount of sewage discharged will be, we
then oversize our sewer by 50%! Why do we ensure that in the future our sewer line will only
be flowing 50%? Because we want to ensure that we have enough capacity during extremely
large rainstorms. Rainwate al a fi d i
a i
ci e e
ei he h gh ickh le i
the manholes or illegal connections to the sewer system (i.e., sinks illegally installed in
backyards next to bbqs, etc.). In fact, I have personally seen maximum peak dry weather flows
more than double during some rainstorms! Since the majority of the cost of installing a new
sewer line is digging the trench and associated costs, it really makes sense to oversize the sewer
li e Rece l e i alled a e
sewer line at a cost of $5.2 million dollars. It would have
cost us $4.7 million d lla
i all a
i e A mi g ha hi e e e li e ill la
a
d
ea
h
ld e i all he
i e
make
e e igh
Sanitary Sewer Overflows (SSOs)
In the 1980s and 1990s the EPA did some studies and learned that SSOs were a significant
problem across the United States, especially in older cities. The EPA estimates approximately
40,000 SSOs every year. This is more than likely a severe underestimate because reporting is
nonexistent in some states. So what causes SSOs:
1. Wet-Weather Capacity Issues:
A) Inflow: Illegal connections, manhole covers, etc.
B) Infiltration: In some parts of the country, high groundwater tables lead to water flowing into
sewer lines through cracks/joints/etc.
I fl a d I fil a i a e b h k
a I a d I I I a d ca be a h ge
the groundwater depth and the amount of rainfall in the area.
blem de e di g
2. Roots in city mains:
Many cities planted city-owned trees between the sidewalk and the street over the years. The
roots of these trees oftentimes make their way into sewer laterals and city mains. The majority
of SSOs in my city are caused by roots they are a severe problem in older cities.
3. Grease in city mains:
Fats, oils, and grease (FOG) are a problem in virtually every sewer system in the United States.
Grease discharged into kitchen sinks is usually mixed with hot water and as this water cools
downstream the grease coagulates and sticks to the sides of sewer mains. Over time, grease
blockages form and cause SSOs. Because of this, most cities have instituted a FOG Ordinance
which requires restaurants to install grease interceptors to capture grease onsite, before
entering the city main. Of course, private homes and multi-family buildings continue to be
significant sources of grease and despite public education campaigns, sewer lines in high
density housing areas need to be cleaned more frequently. Educational pamphlets encourage
homeowners to dispose of left over grease into trash cans and not the kitchen sink. More
importantly, garbage disposals should hardly, if ever, be used. Most people think if they dump
their leftover chili into the sink and turn on their garbage disposal the grease magically
di a ea
he i eali all i d e i b eak i
a d all i
e i he ki che i k
hich
just leads to grease blockages downstream in the city main. If I were king for a day, I would ban
garbage disposals across the United States period. All food/leftovers should be thrown in the
trash.
4. Over-development without corresponding larger diameter sewer pipes:
As I stated above, my city has been very diligent about ensuring proper sewer capacity as sewer
lines are replaced and/or areas of the city develop. However, the sad truth is that most cities
have failed to keep up with development, in terms of sewer capacity. The EPA has estimated
that the nation is facing a huge problem in terms of sewer infrastructure. The estimated cost of
replacing broken or over-ca aci e e li e i i he e
f billi
f d lla
a de e
year the problem gets worse. Of course, the nation is facing similar aging infrastructure
problems with water mains, bridges, and gas mains. The basic problem is that cities (and
private companies) have simply not properly maintained their infrastructure, nor have they put
away adequate amounts of money to fund these repairs/replacements. Over the next 10 to 20
years the United States is facing severe problems if these pipes/bridges are not repaired and/or
replaced.
Why are SSOs a big deal?
1. Property Damage
Sometimes, depending on the elevation of manhole covers in the street vs drains inside a
residence/business, SSOs backup into properties. Imagine being home on Sunday and watching
your favorite television show at 8pm with your loved ones and slowly seeing water rise
h gh
li i g
m a d e i e fi fl
B he ime
eali e he Ci
e e mai
is backing up i
e
a e alki g i
f e age Thi e ac ce a i j
happened a few weeks ago in my city the damage to this property was quite extensive. The
carpets, flooring, and lower parts of the drywall all had to be removed and the areas contacted
by sewage had to be properly sanitized. As you can imagine, this can be quite costly and the
psychological damage done to inhabitants, knowing that their house was contaminated with
human feces, can be equally damaging.
2. Human Health
In addition to property and psychological damage, human health can obviously be negatively
impacted by SSOs. Mold can grow in areas that made contact with the sewage. In addition,
just walking through the sewage can lead to infections if open sores/cuts were present on the
skin where sewage made contact.
More importantly, if the SSO reached receiving waters where people swim (i.e., the Pacific
Ocean) then people can get ear, eye, and gastrointestinal infections. A CDC study in 1997-1998
found 1,387 cases of enteric illnesses associated with sewage contamination in lakes, ponds,
and rivers. Eating contaminated fish and/or shellfish can also cause human illness as a result of
SSOs.
3. Wildlife/Ecosystems
Of course, sewage contamination in receiving waters affects wildlife, aquatic systems, and
associated ecosystems. While it is hard to put a monetary value on these resources, most
e le ill ag ee ha e d
a e age c ami a i g
a e a – period.
4. Monetary losses to tourism
Just one SSO last year in Los Angeles County during the summer was estimated to cause over $1
million in lost revenue for beach businesses! The simple truth is that when beaches have to be
closed for several days there is a significant economic loss to local businesses. And, this loss can
extend for long periods of time just because of the negative publicity that sewage infested
waters bring. It is not uncommon to see beach attendance suffer for weeks after a significant
sewer overflow, long after the waters are certified as safe.
This week we focused on sewage collection and how sewage gets transported to a wastewater
treatment plant. Next week we will talk about what happens to the sewage once it arrives at
he a e a e ea me
la
Plea e d
lose sleep waiting for next weeks lecture!
Module 7-Topic Paper-Debra Rabbani10/04/2023
Contains unread posts
Debra Rabbani posted Oct 4, 2023 11:24 PM
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1. Consider the statement: If it is not documented, it did not
happen from the standpoint of making a claim for services
rendered. How is this relevant to the issue of coding E/M
procedures and services? [Tips: Coding is limited to the
documentation in the patient’s medical record. The medical
record is the documentation that supports a claim. If that
record is incomplete, the claim is not supportable. Consider the
highest levels of E/M services, patient histories and
examinations and complex MDM to diagnose and treat the
presenting condition]. What are some of the advantages of
using the CMS guidelines for E/M coding? The assignment of
codes from the E/M section is determined by three factors.
What are the three factors? [Tip: there are three types of
service included in the E/M section]. Why are these factors
[Tip: three types of service] important in coding procedures
and services in this section?
2. Two patients present with similar symptoms. Both appear
to be suffering from pneumonia. One patient is a 55-year-old
woman with controlled hypertension and diabetes; the other is
an otherwise healthy 24-year-old woman. How would the
examination levels differ for the two patients? [Tip: think
about patients in regard to dealing with histories,
examinations, multiple comorbidities, and levels of complexity
MDM (low-complexity, moderate-complexity, and highcomplexity MDM)].
A medical biller/coder cannot document a service that was not
performed. Only those procedures that are included in claims
submitted to the third-party payer. In the absence of
documentation, the claim cannot be submitted, and it is as if
the service/procedure was never delivered to the patient. A
medical record is a legal document that supports the claim for
services provided, and by providing false information about
services provided can be punishable by fines, loss of licensure,
or imprisonment. Many coders and coding managers in the past
have loss their positions and/or doctors losing their licensure to bill
Medicare and Medicaid and some other insurance companies due to
them authorizing coders to falsify information that is not documented
in the patient’s record or adding information to the patient’s record
that does not belong to the diagnosis. Falsifying information can
lead to a dishonorable reputation which can make a good
doctor lose patient’s which in turn will affect their financial
status and their once esteemed reputation. Many people rely on
government insured services, which they need, but cannot get
because the doctor dishonored his professional status by
authorizing their coders to falsify information to the
government agencies.
Evaluation and management codes are often referred to as
E&M codes or E and M codes. This is a coding system that
involves the use of CPT codes from the
range 99202 to 99499 which represent services provided by a
physician or other qualified healthcare professional. The three
key factors that affect evaluation and management codes
are history, examination, and medical decision
making- appear in the descriptors for office and other
outpatient services, hospital observation services, hospital
inpatient services, consultations, emergency department
services, nursing facility services, domiciliary care services,
and home health documentations. These factors are of utmost
importance in coding procedures and services because these
three factors give the insurance companies a narrative detail of
the patient’s problems.
It is advantageous for the medical biller/coder to follow the
CMS Guidelines for E/M coding. These guidelines help
summarize and organize material that is necessary for correct
E/M coding. To receive payment, skillful application of the
documentation guidelines must be followed in a clear, concise
manner. It is critical to provide patients with high quality and
safe medical care. By following the guidelines, selecting the
appropriate level of service will ensure the coder will receive
the maximum reimbursement for the healthcare services
rendered to the patients.
The medical decision-making elements associated with codes
99202-99215 will consist of three components: 1) Problem:
The number and complexity of problems addressed 2)
Data: Amount and/or complexity of data to be reviewed
and analyzed 3) Risk: Risk of complications.
Examples of Medical Decision-Making Codes:
An example is (99213) Office or other outpatient visit for the
evaluation and management of an established patient, which
requires a medically appropriate history and/or examination
and low level of medical decision making.
An example of an E/M code is (99214) Office or other
outpatient visit for the evaluation and management of an
established patient, which requires a medically appropriate
history and/or examination and moderate level of medical
decision making.
An example of an E/M code (99215) is evaluation and
management of an established patient in an office or outpatient
location for 40 minutes, which includes (1) a problemfocused history, (2) a problem-focused examination, and (3)
high complexity of medical decision making.
The examination levels would differ for both patients. The 55year-old patient is considered middle-aged and has many
comorbidities which require a more detailed assessment and
her case if of high-complexity MDM. She has a detailed
history of diabetes and hypertension and is now diagnosed
with pneumonia which could cause further issues with
pneumonia especially with their age, so an examination by a
specialist would be necessary to help provide an assessment of
the patient’s general condition before treatment. A diagnosis of
pneumonia could potentially affect her heart and her kidneys,
so the doctor should also assess her renal function, lung and
heart auscultation, blood pressure, blood sugar, breathing
pattern, and vital signs. Certain medications can spike blood
sugar and also spike her heart rate.
The 24-year-old patient presented to the physician with no
history of illness on her record, so the physician’s examination
will not be as comprehensive (low-complexity MDM) since it
would be classified as problem focused, since her pneumonia
is limited to the affected organ. Her age and health make them
a lower risk as well making examination faster. Her
examination would consist of checking her vital signs, her
breathing pattern, and auscultation of lungs to make sure she is
not hyperventilating.
Module 7 – Discussion
Contains unread posts
Ciara Stamper posted Oct 4, 2023 11:07 PM
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Ciara Stamper
10/04/2023
Please post a 3-page initial response to the following (A title page is not
required and please paste your initial discussion directly into your posting).
1. Consider the statement: If it is not documented, it did not happen from the
standpoint of making a claim for services rendered. How is this relevant to the
issue of coding E/M procedures and services? [Tips: Coding is limited to the
documentation in the patient’s medical record. The medical record is the
documentation that supports a claim. If that record is incomplete, the claim is
not supportable. Consider the highest levels of E/M services, patient histories
and examinations and complex MDM to diagnose and treat the presenting
condition].
a. What are some of the advantages of using the CMS guidelines for E/M
coding? The assignment of codes from the E/M section is determined by
three factors. What are the three factors? [Tip: there are three types of
service included in the E/M section]. Why are these factors [Tip: three types
of service] important in coding procedures and services in this section?
2. Two patients present with similar symptoms. Both appear to be suffering from
pneumonia. One patient is a 55-year-old woman with controlled hypertension
and diabetes; the other is an otherwise healthy 24-year-old woman. How would
the examination levels differ for the two patients? [Tip: think about patients in
regards to dealing with histories, examinations, multiple comorbidities, and
levels of complexity MDM (low-complexity, moderate-complexity, and highcomplexity MDM)].
Procedures that are documented will be turned into claims and
then sent to the insurance company for reimbursement. The procedure
codes provide information that informs the payer on which services and
procedures were rendered. If a procedure is not documented on the claim,
then it will not be submitted and it will be as if the procedure or service
never happened or occurred.
It is important that any service that is delivered to a patient is
documented, for legal and billing purposes. Accurate coding is very
important to ensure that billing is accurate, efficient, and compliant with
coding standards. Medical providers should thoroughly document the
patient’s medical condition and the reason why services were rendered to
treat the patient; they do this by following a set of guidelines and having
processes in place to ensure accuracy, such as an EMR system.
Any time that a patient is evaluated by a medical provider or is seen
for the management of a condition, an evaluation and management (E/M)
code is reported. This includes patient evaluations, such as annual exams
and lab work, and management of conditions, such as diabetes follow-up
appointments or medication checkups. These codes are used in all medical
specialties and all areas of healthcare including inpatient and outpatient
healthcare settings.
The assignment of codes from the E/M section is determined by
three factors: the type of service, the patient’s status, and the place
providing the service. The type of service describes the appointment
encounter, whether the visit encounter was a consultation visit, a hospital
visit, or telehealth appointment, and more. The patient’s status refers to
the patient’s actual status within the organization, whether they are a new
patient, existing/established patient, inpatient, or hospitalized. The place
of service indicates where the service was provided, whether it was in an
outpatient setting, an inpatient setting, a hospital, an office, or skilled
nursing facility, and more. These three factors are the key components
that makeup E/M codes.
If two patients came to the emergency room with similar symptoms
but are different ages and have different health and medical histories, their
evaluations and management of the condition would be different. An
older patient who comes to the emergency room with preexisting
conditions and now signs and symptoms of pneumonia would be evaluated
more thoroughly, to examine all previous conditions and new symptoms
presenting with the pneumonia. A younger, otherwise healthy patient,
who comes to the ER showing signs and symptoms of pneumonia would
have more of an exam focused on treating just the pneumonia. The older
patient’s exam will be thorough and focused on several factors and may
require many follow-up appointments. The younger patient will be treated
for pneumonia and may not require additional testing, although they will
be seen for a follow-up again to make sure that they are getting better.
Based on what you have learned so far in this course, create a PowerPoint presentation that addresses each of the following points/questions. Be sure to completely answer all the questions for each bullet point. Use clear headings that allow your professor to know which bullet you are addressing on the slides in your presentation. Support your content with at least four (4) sources throughout your presentation. Make sure to reference the citations using the APA writing style for the presentation. Include a slide for your references at the end. Follow best practices for PowerPoint presentations related to text size, color, images, effects, wordiness, and multimedia enhancements. Review the rubric criteria for this assignment.
Why are balance sheets important to healthcare organization finance and what area of the balance sheet would you consider the most critical?
Comparing organizational costs, which costs does nursing administration have little control over and why? Which costs would be most important if you are expanding your services and considering quality improvement measures?
Compare and contrast for-profit and not-for-profit corporate structures based on the information available from a balance sheet and an income statement? Fundamentally, what are the differences?
Goodwill and patents are considered what types of assets? Give detailed examples and explain.
Compare and contrast assets which are the essential economic lifeblood of a healthcare organization stability. Give detailed examples and explain.
This PowerPoint® (Microsoft Office) or Impress® (Open Office) presentation should be a minimum of 20 slides, including a title, introduction, conclusion and reference slide, with detailed speaker notes and recorded audio comments for all content slides. Review and use at least four scholarly sources to support your perspective and make certain to review the module’s rubric before starting your presentation.
The following specifications are required for this assignment:
Length: 20+ slides; answers must thoroughly address the questions in a clear, concise manner
Structure:
Title slide and reference slides in APA style. (at least 2 slides)
Balance Sheets: at least 4 slides
Organizational Costs: at least 4 slides
For-profit & Not-for-profit: at least 4 slides
Assets: at least 4 slides
Essential Economic Livelihood: at least 4 slides
Additionally, because a good presentation has few words on the slides include a script with the verbiage you would say when presenting; script should be a minimum of 50 words per slide.
References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.
ASSIGNMENT COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN:
Assignment title or task:
(You can write a question)
Choose any one of the common occupational
infectious diseases OR non-infectious disease and
explain the following:
•
•
•
Causes, mode of transmission, and symptoms.
Occupational group at risk
Prevention and control measures
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet. (DO
NOT include the assignment instructions)
• Short essay of 500-750 words (Excluding references).
• The font size should be 12.
• Font type should be Times New Roman
• The heading should be Bold.
• Color should be Black.
• The paragraph must be justified.
• Double line spacing (2).
• AVOID PLAGIARISM
• References must be in APA format (use in-text citation and reference page)
at least 3 references should be used.
• The due date is 29/10/2023 at 11:59 PM
You can use the following link to guide you how to use APA style
https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/ge
neral_format.html
Best of Luck
Psychiatric Mental Health Assessment of a
Child/Adolescent
Instructions
You will complete a comprehensive psychiatric mental health assessment of a
child/adolescent.
This should NOT be a patient you have encountered in your work but, instead, should be
a family member or friend (who gives consent) or preferably a patient in clinical. You
should note that all information will be confidential and that their private information will
NOT be shared as part of this assignment.
Requirements
•
•
•
•
•
•
Your assessment should be comprehensive, and you should refer to course texts to
inform items for inclusion in your assessment.
Keep in mind that you will be responsible for covering those areas addressed in the
reading assignments up to this point.
The documentation should remain HIPAA-compliant even though this is not a real
patient.
DO NOT USE REAL PATIENT IDENTIFIERS.
Be sure to include birth and developmental information as well as school and
behavior information for the child.
Consider cultural, gender, ethnicity, spiritual, and social competencies needed to
formulate the best care plan for the patient.
The patient will be referred to as Jane Doe or Jack Doe.
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59
pm CT.
Estimated time to complete: 4 hours
Rubric
NU674 Unit 5 Assignment – Case Study Rubric
NU674 Unit 5 Assignment – Case Study Rubric
Criteria
This criterion is
linked to a Learning
OutcomeSubjective
Data
This criterion is
linked to a Learning
OutcomeObjective
Data
This criterion is
linked to a Learning
OutcomeAssessment
Ratings
10 pts
Level 5
Includes all relevant subjective
data necessary for differentiation
of the client’s problem. Data is
presented in a systematic,
organized manner consistently.
10 pts
Level 5
Objective data is complete
and consistently presented in
an organized manner.
7 pts
Level 3
Includes most subjective data
with omission of two minor
details or one major detail.
Most data is presented in a
systematic, organized manner.
7 pts
Level 3
Objective data is complete
and presented in an organized
manner most of the time.
10 pts
Level 5
Assessment, including differential
and/or diagnosis (if appropriate), is
complete and appropriate to client.
Diagnostics are complete and
appropriate to clients.
7 pts
Level 3
Assessment, including
differential and/or diagnosis
(if appropriate), is complete
but some may not be
appropriate for clients.
4 pts
Level 1
Includes subjective data but
omits four minor details or
two major details. Some data
is presented in a systematic,
organized manner.
4 pts
Level 1
Objective data is not
complete or is not presented in
an organized manner.
4 pts
Level 1
Assessment, including
differential and/or
diagnosis (if appropriate),
is not complete but is
appropriate.
NU674 Unit 5 Assignment – Case Study Rubric
Criteria
This criterion is
linked to a Learning
OutcomePlan
This criterion is
linked to a Learning
OutcomeProfessional
Application
This criterion is
linked to a Learning
OutcomeCollegelevel academic
writing
Total Points: 60
Ratings
10 pts
Level 5
Plan includes all relevant measures
95% to 100%. Pharmacologic
Non-pharmacologic Education
Referral Follow-up
10 pts
Level 5
Case incorporates four
evidence-based practice
articles.
10 pts
Level 5
Includes no more than three
grammatical, spelling, or
punctuation errors that do not
interfere with the readability.
Meets the assignment length
requirements.
7 pts
Level 3
Plan includes all relevant measures
89% to 94% Pharmacologic NonPharmacologic Education Referral
Follow-up.
7 pts
Level 3
Case incorporates three
evidence-based practice
articles.
4 pts
Level 1
Plan includes four of
the five relevant
measures, but the four
are complete.
4 pts
Level 1
Does not include an evidence-based
practice article but has two or more
advanced practice articles.
7 pts
Level 3
Includes no more than
four grammatical, spelling, or
punctuation errors that do not
interfere with the readability.
Meets the length requirements.
4 pts
Level 1
Includes five or more
grammatical, spelling, and
punctuation errors make
understanding parts of
assignment difficult but does not
interfere with readability. Meets
the length requirements.
0
L
D
m
S
From the perspective of a learning organization, identify the SMART aim, the Key Drivers of the initiative you are proposing as a healthcare area as a transformation project.
Discuss the following
System approach
Resource allocation you identify as important
Identify the executive sponsor
Identify the stakeholders and steering committee members
Environment for local team leaders to collaborate, and 6) governance of the metrics.
The communication plan to coordinate the project team efforts.
Your paper should meet the following structural requirements:
Four-to-five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition.
Provide support for your statements with in-text citations from a minimum of four scholarly articles.
Break-even AnalysisThis week we learned more about break-even analysis and its influence on decision-making. Assume you owned a coffee shop and were thinking of expanding and adding a second location within the city.Discuss how would the use of break-even or other analysis to help you determine whether to expand or not?Discuss the factors needed to be considered?Discuss the assumptions needed to be made?
Upon appraising this article, I found that this was an excellent source for information. There was sufficient information, the evidence that was provided was trustworthy based off qualifications, knowledge, and expertise, there is a clear summary about the article given in the abstract, and the title encompasses what the article is about. The phenomena was clearly stated at the beginning, which created multiple questions that were also clear, accurate, and justifiable. Behind every article has to be a purpose, and the purpose of this article was specifically stated and clear to the audience to understand why the article was written, along with the medication error reporting significance to nursing. Ethics were taken into consideration by the researching staff as they included many personal quotations from clients, but never included their name or anything more than what they stated. The method that was done in order to complete this research was compatible with the purpose of the research, adequate to address the phenomenon of the research, and completed to the extend that the researcher described. The sampling that was done to complete the research necessary for this article was taking random participants, who were nurses, from different units of the hospital, which gave a broad spectrum of opinions, which was appropriate and successful. The data collection is 100% based off human experience because the researcher took direct quotes that were in sufficient depth. Before the participants could give their information, they had to fill in a demographics form and consent form. This source was authentic, credible, auditable, transferable, and trustworthy. The findings and conclusions were clearly stated and proves that the research was successful in collecting sufficient information for the questions asked at the beginning.
Strengths that I found in the study were that it was very organized and concise, trustworthy research was taken, the participants were quality and sufficient for the phenomenon, and done to the best of the researcher’s ability. The only weakness that I believe would have helped make this paper even better would have been to have more than just nurses be the participants. I think it would have been interesting to see if from patients, managers, medication companies, or families points of view to hear what they have to say.
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Student #2
The qualitative research study explores the nurses’ knowledge, attitude, and perceived barriers towards the different medication error reporting within the Tertiary health care facility. According to the article, it is noted that medication error reporting (MER) tends to be a much more effective approach that is used in the identification of the causes of different Medication Errors (MEs) and also helps in the prevention of repeating them in future in other organizations (Dyab et al., 2018). The failure to report the MEs is a significant challenge reported in different MER systems in various healthcare organizations. The study focused on understanding nurses’ knowledge of MER by determining the attitude of the nurses toward reporting and studying the facilitators and barriers to reporting among the nurses.
However, this qualitative study exhibits both strengths and weaknesses. One of the major strengths is that the study reports that Medication error reporting (MER) is a much more effective way to identify the significant causes of Medication errors (ME) and how to prevent the mistakes from repeating themselves in the organization. Also, the study shows that the underreporting of MEs is noted in different MER systems (Dyab et al., 2018). The study focused on understanding the nurses’ knowledge of MER by determining their attitudes towards reporting and the facilitators and barriers to MER. The study is also beneficial as it shows the approaches that can be used to improve the participation of nurses for MER in the organization. On the downside, the study does not provide more details on Medication error reporting (MER) and the different methods that can be used in an organization to ensure that the process is conducted effectively. The study only focuses on the importance of MER and how it can be used to identify Medication Errors (MEs) but does not show how to conduct MER.
Welcome to your wellness small group discussion board for Modules 6 and Module 7!
This discussion includes reflecting on the Semester Vision Plan you created at the start of the semester as well as continuing with your action steps.
Part 1: Initial Post (due on Oct 9 with Module 6)
Create a blog, video, visual representation, or plainly written response that includes the following information.
Share some highlights of your Semester Vision Plan (share only that which you are comfortable sharing).
Share how your Semester Vision Plan is going and why you think it is going that way.
Share at least one thing that is going well.
Explain adjustments you have or will make to your plan.
Explain how satisfied you are with your latest action step (set with module 4) and it moving you towards your Semester Vision.
Does this inspire you to create any new action steps or modify an existing one?
What is your action step for this week?
Discuss how you can utilize positive, success-promoting consequences (Module 6 Behavior Change Moment will help) over the next couple of weeks to move towards achieving your action step and/or goal.(
(I am 11 weeks c section postpartum, please choose something right for my condition.)
Part 2: Respond to Group Mates (due on Monday, Oct 16 with Mini- Module)
Respond to the initial post of at least 2 of your group mates.
Your response can be in written or video format.
In your response, how can you support your peers in their progress by providing encouragement or constructive feedback.
Can you provide any specific connection to your own progress, challenges or consequences to your own action steps, goals and semester vision plan?
Unformatted Attachment Preview
1
Semester Wellness Vision
Threa Alammari
UNCW
WPA-101-825
2
Semester Wellness Vision
The following is the proposed short-term wellness vision for this semester. The
provided goals are ideal for an individual undergoing a postpartum period.
Area of focus 1: Physical Health and Fitness
Goal 1
Participate in delicate post-pregnancy exercises for something approximately 20
minutes three times each week.
Action Steps
1. Research post-pregnancy work-out schedules reasonable for my wellness level.
2. Plan explicit exercise days and times in my week-by-week schedule.
3. Begin with straightforward activities like strolling and pelvic tilts and steadily
increment force.
Goal 2
Increment day-to-day steps to build up to 7,000 stages toward the semester’s end.
Action Steps
1. Utilize a pedometer or cell phone application to follow everyday advances.
2. Integrate short strolls into my everyday daily practice, for example, strolling while at
the same time conveying my child.
3. Set suggestions to stand up and move around consistently if I have stationary work.
Tools for the Success
1. Utilize a Wellness Application e.g., MyFitnessPal, Fitbit
2. Keep an exercise and wellness diary. This would mean I record my exercises, practice
span, and any advancement or enhancements I notice. Note the date, kind of activity,
and how I felt during and after the exercise.
Area of focus 2: Nutrition and Hydration
3
Goal 1
Eat reasonably daily with a blend of protein, entire grains, and natural
products/vegetables.
Action Steps
1. Plan breakfast choices ahead of time and guarantee I have the essential fixings.
2. Plan meals the prior night to save opportunity in the first part of the day.
3. Explore different avenues regarding different meal recipes to keep it fascinating.
Goal 2
Drink at least eight glasses (64 ounces) of water daily to remain hydrated.
Action Steps
1. Convey a reusable water bottle with me throughout the day.
2. Set updates and timers to take tastes of water routinely.
3. Exchange sweet or energized drinks with water to meet my hydration objective.
Tools for the Success
1. Meal plan and intake journal: Keep a food journal to log my feasts, bites, and water
consumption. I can do this in a notepad or a food-following application like
MyFitnessPal or Lose It! to screen the daily nourishment.
2. Keep tabs on my development by taking estimations of my body, like abdomen
outline or weight. Recollecting that post-pregnancy weight reduction might be
progressive, I will center around general well-being instead of only the number on the
scale.
Area of focus 3: Self-Care and Rest
Goal 1
Practice 10 minutes of profound breathing or contemplation every day to decrease
pressure.
4
Action Steps
1. Find a tranquil space where I can sit comfortably.
2. Utilize directed contemplation applications or recordings to begin.
3. Plan reflection time during a steady piece of my day, for example, before sleep time
or a class.
Goal 2
Plan a “personal time” action (e.g., reading, showering, or side interest) for something
an hour every other day.
Action Steps
1. Coordinate with a relative or companion to watch the child during my “personal
time.”
2. Make a rundown of loosening up exercises I appreciate and rotate them to keep it
enjoyable and fresh.
3. Focus on this time as I would any other arrangement
Tools for the Success
1. Intermittently survey my feelings of anxiety and emotional stability. Utilize a basic
self-evaluation scale (e.g., 1 to 10) to rate my mindset and feelings of anxiety.
2. Social Support, where I attend therapy and support group meetings to provide updates
on my progress and also be surrounded by a supportive community for more insights
and feedback on what to add to my vision plan and goals.
Screening is the administration of measures or tests to distinguish individuals who may have a condition from those who probably do not have it. Discuss the advantages and disadvantages of screening. Instructions: . Word limit 500 words. Reply to at least two other student posts with a reflection of their response. Please make sure to provide citations and references (in APA, 7th ed. format) for your work.
The purpose of this assignment is to analyze how an organization’s quality and improvement processes contribute to its risk management program.
This assignment builds on the concepts from the Topic 1 benchmark assignment.
Assume that the sample risk management program you analyzed in Topic 1 was implemented and is now currently in use by your health care organization. Further assume that your supervisor has asked you to create a high‐level report of this new risk management program to share with a group of administrative personnel from a newly created community health organization in your state who have enlisted your organization’s assistance in developing their own risk management policies and procedures.
In a 1,000-1,250‐word report, address the following points regarding your health care organization and its risk management program:
Explain the role of your organization’s Medicare Improvement for Patients and Provider Act (MIPPA)-approved accreditation body (e.g., JC, ACR, IAC) in the evaluation of your institution’s quality improvement and risk management processes.
Describe the roles that different levels of administrative personnel play in health care ethics and establishing or sustaining employer- and employee-focused organizational risk management strategies and operational policies.
Explain how your organization’s risk management and compliance programs support ethical standards, patient consent, informed consent, and patient rights and responsibilities.
Explain the legal and ethical responsibilities health care professionals face in upholding risk management policies and administering safe health care at your organization.
Explain how your organization’s quality improvement processes support and contribute to the prevention of sentinel events and to its overall journey to excellence.
Communicate how to integrate the Christian perspective of human value and dignity, along with ethical decision-making as it relates to patients, families, and health care employees
In addition to your textbook and the GCU “Statement on the Integration of Faith and Work,” you are required to support your analysis with at least three credible health-related resources.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Instructions:You will prepare a PPT presentation for the journal club on Randomized trials of intensive versus standard blood pressure control (SPRENT trial)Ensure to follow the ASHP format (background and overview, methods, results, discussion, and conclusions). The format is attached.In addition, JC presentations examples are uploaded for your reference. if there is any question i will chick just send me
Respond to your peers by extending, refuting/correcting, or adding additional nuance to their posts. Each reply must be at least 150 words and contain at least one reference from an academic journal. All replies must be constructive and use literature where possible.
Unformatted Attachment Preview
Weekly Clinical Experience 7
Selvia Beshay
NUR-612CL-AP2
St. Thomas University
Dr. Nancy Woelki
Clinical Experience for this Week
This week, I encountered a variety of geriatric patients with diverse medical conditions and
was exposed to various aspects of healthcare. Since this was a community clinic, one of the
challenges I faced was the high influx of patients which required me to multitask and manage my
time more efficiently. However, this allowed me to enhance my adaptability and prioritization
skills.
Patient Assessment
During my assessments, I encountered a 74y/o male patient who presented with shortness of
breath, productive cough, and wheezing. Upon further examination of this patient, I observed
that they exhibited chest tightness and had an increased respiratory rate. The signs and
symptoms, observations, along with the patient’s medical history and physical exam results all
indicated bronchial asthma. The plan of care included interventions such as prescribing
bronchodilators like the short-acting beta-agonists, to relieve acute symptoms and prevent further
exacerbations. Further, an inhaled corticosteroid was prescribed to help reduce inflammation and
prevent future attacks. The patient was also educated on how to avoid triggers like irritants and
allergens, as well as the importance of proper inhalation techniques.
Possible Differential Diagnoses
The three possible differential diagnoses include;
1. Chronic Obstructive Pulmonary Disease (COPD): COPD is a common illness among
elderly patients and it shares some similarities with bronchial asthma such as
shortness of breath. However, COPD is usually associated with a history of smoking
and a more gradual onset of symptoms (Hopkinson et al., 2019).
2. Congestive Heart Failure (CHF): CHF symptoms such as wheezing and shortness of
breath are similar to asthma. In this case, a careful evaluation of the patient’s medical
history, physical exams, and diagnostic tests, can help differentiate CHF from other
similar conditions (Koshy et al., 2020).
3. Gastroesophageal Reflux Diseases (GERD): GERD is a disease with symptoms such
as a productive cough, wheezing, and chest tightness, which may be mistaken to be
asthma (Iwakiri et al., 2022). In this case, the patient’s evaluation of their symptoms,
including their meals and how they sleep, can help differentiate the conditions related
to GERD.
Health Promotion
Some of the strategies to promote the health and well-being of this patient would include;
first, the patient may use asthma self-management education and a medical approach, where the
patient will be educated on how to identify the disease, understand their triggers, proper
medication, and identifying the signs of worsening symptoms (Jia et al., 2020). Secondly, the
patient will be advised on the importance of engaging in regular physical activity, as this will
help improve lung function and the overall health of the patient. Thirdly, the patient will be
educated on maintaining a healthy diet and nutrition as this will help support the overall
respiratory health of the patient. Lastly, regular follow-up visits and monitoring are essential for
this patient to assess their asthma control, adjust medication where necessary, and address any
concerns and questions from the patient. Note that, monitoring of asthma is usually done through
objective measures such as peak flow monitoring.
What I Learned
Generally, this week’s clinical experience was enlightening and provided me with valuable
insights into geriatric patient care and other practices that will be beneficial to me as an advanced
practice nurse. I learned the importance of effective time management in a fast-paced clinical
setting, as well as the significance of building a rapport with the patients. Witnessing the impact
of the various interventions and treatments on the patient’s well-being reinforced my passion for
nursing. I also realized the need for constant learning and staying up-to-date with evidence-based
practices. Overall this clinical experience re-affirmed my commitment to providing
compassionate and competent care to patients.
References
Iwakiri, K., Fujiwara, Y., Manabe, N., Ihara, E., Kuribayashi, S., Akiyama, J., … & Koike, K. (2022).
Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2021. Journal of
Gastroenterology, 57(4), 267-285. https://doi.org/10.1007%2Fs00535-022-01861-z
Jia, X., Zhou, S., Luo, D., Zhao, X., Zhou, Y., & Cui, Y. M. (2020). Effect of pharmacist‐led
interventions on medication adherence and inhalation technique in adult patients with asthma or
COPD: A systematic review and meta‐analysis. Journal of Clinical Pharmacy and
Therapeutics, 45(5), 904-917. https://doi.org/10.1111/jcpt.13126
Hopkinson, N. S., Molyneux, A., Pink, J., & Harrisingh, M. C. (2019). Chronic obstructive
pulmonary disease: Diagnosis and management: Summary of updated NICE guidance. Bmj,
366. https://doi.org/10.1136/bmj.l4486
Koshy, A. O., Gallivan, E. R., McGinlay, M., Straw, S., Drozd, M., Toms, A. G., … & Witte, K. K.
(2020). Prioritizing symptom management in the treatment of chronic heart failure. ESC Heart
Failure, 7(5), 2193-2207. https://doi.org/10.1002/ehf2.12875
Module 7 Discussion
Emily Diaz
Dr. Woelki
St. Thomas University
NUR-612- AP1
October 3, 2023
Module 7 Discussion
Mrs. P. was diagnosed with acute bronchitis and was prescribed doxycycline, prednisone
15 mg, and tiotropium inhaler. Upon auscultation her lungs
were clear and there was no evidence of lower extremity edema. Due to this, the patient has no
need to continue to take the doxycycline, prednisone, or the
tiotropium inhaler. She also presented with no lower extremity edema, therefore, furosemide
should be deprescribed for the time being. Mrs. P has also had no
symptoms of GERD for the past 6 months and should stop taking pantoprazole. Taking
pantoprazole for over a year may increase the chance of side effects
such as bone fractures, gut infections, and vitamin B12 deficiency. (Pantoprazole, 2023) Mrs. P
reports minimal arthritic pain due to use of acetaminophen and
increased activity. Tramadol is considered at class IV drug and its use should be limited. (Dhesi
et al., 2023) Her pain is well controlled with acetaminophen so
the tramadol should be deprescribed.
The patient should complete tapering of the prescribed prednisone. If prednisone is not
tapered properly, symptoms could worsen and cause chronic
recurring symptoms to flare up. Patient reports taking acetaminophen 650 mg twice a day.
Overuse of acetaminophen may cause liver damage with symptoms
such as abdominal pain, irritability, weakness, loss of appetite, jaundice, diarrhea, nausea,
vomiting, and in severe cases kidney damage, confusion, and death.
Mrs. P has a history of hypertension and regular daily intake of acetaminophen can increase
systolic BP. Tylenol should be removed as a daily dose and be
taken on an as needed basis and to not exceed 3,000 mg per day. (MacIntyre et al., 2022)
Given the absence of heart failure exacerbation, her heart failure medications should be
modified. The patient has made lifestyle changes by decreasing
sodium intake and increasing physical activity. Dietary sodium restriction is arguably the most
frequent self-care behavior recommended to patients with heart
failure. For her heart failure, she was previously prescribed furosemide to help eliminate fluid
overload and retention. Furosemide is a loop diuretic which
excretes potassium from the body through urine. Due to this diuretic being used to treat the heart
failure, the patient was prescribed potassium 20 mEq twice a
day to replace the potassium which was excreted. Therefore, since the furosemide should be
held, the potassium should be held as well to help avoid
hyperkalemia. The patient should be reevaluated for fluid buildup and for potassium levels. The
patient should also have their lipid panel drawn to see if their
diet change and daily walks have helped decrease her hyperlipidemia. Depending on the results,
if her hyperlipidemia has improved, then the provider should
consider removing the atorvastatin from her medication regime. Also, statins should be taken
with caution with those older than 70 years old because it
increases the risk of developing a rare side effect called myopathy. (Statin Considerations, 2022)
Some side effects of statins in the elderly are gait
disturbances, increased blood glucose levels, development of cataracts, liver toxicity, and muscle
complications such as rhabdomyolysis.
Reference
Dhesi, M., Maldonado, K., & Maani, C. (2023, April 16). Tramadol. National Library of
Medicine. Retrieved October 3, 2023, from
https://www.ncbi.nlm.nih.gov/books/NBK537060/#:~:text=It%20is%20considered%20
a%20class,as%20non%2Dopioid%20pain%20medication.
MacIntyre, I., Turtle, E., Farrah, T. E., Graham, C., Dear, J. W., Webb, D. J., McCallum, M. J.
A., Melville, V., Fok, H., McCrae, J., Sule, A. A., Caparrotta, T.
M., Kirkby, N. S., & Mitchell, J. A. (2022). Regular acetaminophen use and blood
pressure in people with hypertension:
the PATH-BP trial. Circulation, 145(6), 416–423.
https://doi.org/10.1161/circulationaha.121.056015
Pantoprazole. (2023, July 5).
nhs.uk. https://www.nhs.uk/medicines/pantoprazole/#:~:text=Taking%20pantoprazole%20for%
20more%20than,ulcers%20and%20pins%20and%20needles
Statin Considerations. (2022, October 24). NHS. Retrieved October 3, 2023,
from https://www.nhs.uk/conditions/statins/considerations/#:~
:text=Statins%20should%20be%20taken%20with,being%20over%2070%20years%20ol
d
Weekly Clinical Experience 7
Adriana Hernandez Calderon
Department of Nursing, St. Thomas University
NUR612CL: Advanced Geriatrics Clinical
Dr. Woelki
October 5, 2023
Weekly Clinical Experience 7
The last week of clinical experience has been successful. Throughout my clinical
experience, I have had an excellent opportunity to evaluate various older adult patients
presenting with many health conditions. This clinical has supported my skills in practice, and I
feel confident in my abilities and in caring for future patients.
This week, I had the pleasure of meeting T. L., a 73-year-old Hispanic male presenting
with erectile dysfunction (ED). The patient claims that he has been struggling with his symptoms
for some time now and has decided to seek help for his condition. The patient states that his
symptoms started about a year ago and have progressively worsened, causing him to be
embarrassed and depressed about being unable to perform as before with his partner. He has had
trouble with arousal and having an erection long enough for his sexual encounters. The patient
does not complain of pain in his problem area, and symptoms are usually present when trying to
arouse. The patient has not resorted to treatment for his condition and has not started any new
medications. The patient claims to have mild health conditions, such as hypertension, high
cholesterol, gastric acidity, and chronic back pain. The patient is currently on lisinopril for his
hypertension and atorvastatin for his cholesterol. He takes over-the-counter Pepcid and ibuprofen
for his gastric acidity and back pain.
The primary diagnosis for this patient is ED, which is the inability to sustain an erection
in the penile region necessary for successful sexual activity. Frequent risk factors for ED are
hypertension, dyslipidemia, obesity, diabetes, heart disease, testosterone deficiency, and a higher
incidence in older men. Differential diagnoses for this patient are hypogonadism, loss of libido,
and depression with low mood (Sooriyamoorthy & Leslie, 2023). Due to a pituitary or
hypothalamic disorder, hypogonadism is a clinical illness characterized by sexual symptoms and
low serum testosterone levels. Loss of libido is having little to no sex drive, often related to lifechanging events and stress. Depression or other psychological symptoms can cause a patient to
have a low sex drive and symptoms of ED (Ide & Antonio, 2020).
The plan of care and health promotion for this patient includes differentiating between
genuine erectile dysfunction and other sexual problems that can cause ED symptoms. It was
essential to conduct a mental health examination to ensure that the symptoms of ED have not
been caused by depression and to evaluate if the depression came on after the signs were
presented (Sooriyamoorthy & Leslie, 2023). Appropriate blood testing includes a complete blood
count and comprehensive metabolic panel, lipid levels, hemoglobin A1c to screen for diabetes,
testosterone levels, and thyroid function. Since the patient has comorbidities, it is necessary to
rule out other causes before providing a treatment plan for his condition (Sooriyamoorthy &
Leslie, 2023). Since the patient has a history of high blood pressure and is currently on lisinopril,
it is essential to start treatment through lifestyle modifications and to improve his current health
in hopes of improving his health conditions. The patient was educated on physical activity and a
low-fat diet to improve overall cholesterol and blood pressure levels. The patient was counseled
on eliminating the use of alcohol and tobacco products as this can also contribute to ED. The
patient was educated on supplements such as L-Arginine, an amino acid supplement that
produces nitric oxide and has been proven effective in improving symptoms of ED
(Sooriyamoorthy & Leslie, 2023). The patient will be seen back in the office in four weeks to
discuss drug therapy if symptoms persist despite lifestyle changes. It is vital to be cautious when
prescribing phosphodiesterase-5 inhibitors to treat ED and consider the patients’ laboratory work
before making this decision. Testosterone therapy may also be considered, depending on the
patient’s blood levels (Sooriyamoorthy & Leslie, 2023). A referral to a urologist may also be
beneficial for further management.
As primary care clinicians, we are responsible for treating some of the most complicated
patients, including those with various chronic health conditions, impaired functioning, complex
prescription regimens, and varying levels of caregiver engagement (Sooriyamoorthy & Leslie,
2023). Even for an experienced practitioner, managing patients might present problems and
require complicated treatment regimens. To give patients the most comprehensive care possible,
healthcare professionals must complete the patient’s evaluation and connect any information that
may need to be noticed. One of the most essential duties of primary care professionals is to
encourage self-care through education. This responsibility should constantly be ingrained in
daily practice.
References
Ide, V., Vanderschueren, D., & Antonio, L. (2020). Treatment of men with central
hypogonadism: Alternatives for testosterone replacement therapy.
International Journal of Molecular Sciences, 22(1), 21.
https://doi.org/10.3390/ijms22010021
Sooriyamoorthy, T., & Leslie, S. W. (2023). Erectile dysfunction. StatPearls
Publishing.https://www.ncbi.nlm.nih.gov/books/NBK562253/
Michelle Sheffield
September 29,2023
Module 7 Discussion
Medications to De-Prescribe
Pantoprazole 40 mg- is a medication vital in treating GERD disease among patients. It helps
relieve symptoms such as heartburn and the acid that can cause ulcers (Ben Ghezala et al., 2022).
The patient got the medication due to a history of GERD. However, her condition shows that she
no longer has GERD symptoms and no lower extremities oedema. The medications are no longer
needed since the symptoms are gone. It would help to review it and discontinue it from the list.
Atorvastatin 10 mg- is a vital medication that could help treat cholesterol and fats
detrimental to the patient’s health (Bauersachs, 2021). It slows down the production of
cholesterol in the body, thus reducing the buildup on the walls of the blood vessels and reducing
the risk of heart issues. The medication was critical given that the patient has hyperlipidemia,
heart failure, and high blood pressure. The current state of the patient’s health shows that she is
developing a positive lifestyle, such as regular exercise and diet, which is essential. When the
medication gets administered, it is alongside lifestyle adjustments such as diet and exercise. The
program seems to be working, as the patient is not showing any symptoms related to the
condition. Also, she has lost weight and is eating right. The medication can thus be considered
for discontinuation once the tests show that the cholesterol levels are not high and detrimental to
her health.
Lisinopril 10 mg is a medication that helps treat high blood pressure among older adults.
The fact that the patient was taking 10 mg means that the blood pressure was elevated, given that
the dosage is between 2.5mg and 10 mg per day (Bauersachs, 2021). The patient’s current
condition is that there are no signs of high blood pressure. It is crucial to evaluate the patient and
determine what improved her situation. Currently, the patient is living with her daughter, which
helps her get the support she needs. She is exercising more and eating right, which is critical.
Assessing the high blood pressure is crucial in determining whether the patient needs to
discontinue the medication. However, I recommend that she discontinue it and get a blood
pressure monitor that she can use to track her blood pressure to help inform the way forward.
Furosemide 40 mg- The medication helps treat fluid retention among patients undergoing
heart failure treatment (Bauersachs, 2021). Given that the patient had heart failure, it would
explain why they need to take it. It worked by lessening the symptoms such as swelling in the
abdomen and also the shortness of breath. However, the patient’s current state is that she
exercises, meaning she doesn’t have shortness of breath. She also reports that the abdominal
swelling went away, meaning that the medication has been effective, and she no longer needs to
continue taking the medications.
Tramadol 25 mg is a medication that helps address the patient’s pain (Roy et al., 2020).
Since the patient has acetaminophen 650 mg to help with pain, it is essential to discontinue this
so that she can only use one relevant given her history of osteoarthritis.
Medication to Reduce After Symptom Assessment
Acetaminophen 650 mg is a necessary medication that helps when it comes to pain
management. The patient used to take it, given the pain she felt with her osteoarthritis (Roy et
al., 2020). However, she mentioned that she no longer feels the pain, given that she takes the
medication. It is thus wise that she continues taking the medication, given that it is helping her
with the condition and alleviates her pain.
Metoprolol succinate- the medication is vital when addressing the issues of chest pain, high
blood pressure, and heart rhythm disorders. The patient had heart failure, hypertension, and acute
bronchitis, which necessitated medication use (Morris & Dunham, 2023). However, given her
lifestyle change and decreased severe symptoms. It would be wise to reduce the dosage and
observe the symptoms to ensure that the patient heals well.
Other Medication Adjustments to Consider
Potassium chloride 20 mEq- It is a mineral supplement that helps address the potassium
shortage levels in the blood. It helps ensure the heart and muscle cells work well (Brand et al.,
2022). When the patient has heart failure, it was given to help the heart beat well and ensure
blood flow. The patient mentioned that she changed her diet and is not eating foods that provide
the same nutrients. She avoids taking sodium, which is critical in reducing the adverse effects of
heart functioning. I would advise discontinuing the supplement and encouraging the patient to
continue taking the proper diet.
References
Bauersachs J. (2021). Heart failure drug treatment: The fantastic four. European Heart
Journal, 42(6), 681–683. https://doi.org/10.1093/eurheartj/ehaa1012Links to an external site.
Ben Ghezala, I., Luu, M., & Bardou, M. (2022). An update on drug-drug interactions associated with
proton pump inhibitors. Expert opinion on drug metabolism & toxicology, 18(5), 337–346.
https://doi.org/10.1080/17425255.2022.2098107
Brand, A., Visser, M. E., Schoonees, A., & Naude, C. E. (2022). Replacing salt with low-sodium salt
substitutes (LSSS) for cardiovascular health in adults, children, and pregnant women. The
Cochrane database of systematic reviews, 8(8), CD015207.
https://doi.org/10.1002/14651858.CD015207
Morris, J., & Dunham, A. (2023). Metoprolol. In-Stat Pearls. Stat Pearls Publishing.
Roy, P. J., Weltman, M., Dember, L. M., Liebschutz, J., Jhamb, M., & HOPE Consortium (2020).
Pain management in patients with chronic kidney disease and end-stage kidney disease. Current
opinion in nephrology and hypertension, 29(6), 671–680.
https://doi.org/10.1097/MNH.0000000000000646
Hello, I am taking Health Care Policy class and we have to write a Memo for a group presentation. I am providing a PDF copy of what the instructions for the Memo and the Rubric consists of.
Unformatted Attachment Preview
Interest Group Presentation & Policy Brief
Our Interest Group Topic is : AIDS United
Students should :
• Summarize their findings in a 1-2 PAGE, SINGLE-SPACED MEMO.
• Make sure that you familiarize yourself with the correct formatting for a
MEMO using APA 7th ed.
• The Memo Will Provide A More In-Depth Look At The Factors That
Might Be Briefly Outlined In The PPT when the topics are repeated in both
the PPT and Memo
• Follow the grading rubric for content to be presented in the memo ****
NOTE: Since this is a group assignment, I am Only responsible for the Memo
NOT the PPT as another student from group will work on that….so NO PPT
needs to be done from my part. However, I am also including the “PPT topics to be
Discussed “ Below just in case for Reference so that Memo matches with topics in
PPT.
MSN 1-2 page Memo & PPT Presentation (Healthcare Policy)
Memo
Introduction (describes special interest
groups & introduces the selected
organization’s history and
background, what do the Board
members and member groups
consist of?)
10 points
Describe the group’s mission and
5 points
investigate the group’s key issues
(detailed description of the mission,
how it links to key issues of the
organization)
Link at least one of the organization’s key
5 points
issues to APN practice, explains why
this issue might be of interest to
APN and how the APN could
inform this key issue (detailed
outline of how the key issue and APN
practice are connected & how the
APN would inform the interest group
with a strong rationale supported by
the literature)
Describe how any of the group’s key issues 5 points
are in alignment with that of a state
or national nursing organization or
association. (this is described in
detail with a clear link between the
two organization’s)
Legislative agenda & clear link between
the group’s mission and key issues
5 points
Mechanisms used to engage/attract and
influence policy makers (This is
detailed and extends what is provided
in the PPT)
5 points
Current lobbying efforts (detailed
5 points
description that extends what is
provided in the PPT and links to the
mission and key issues)
Describe key partnership coalitions & how
the partnerships influence policies
5 points
and advocacy at the local, state
and/or national level, key obstacles
encountered and how the
partnerships inform the group’s key
issues and legislative agenda
(provide specific examples of these
efforts at the various local, state and
national levels with a direct link to
how these inform the groups key
issues and legislative agenda)
Spending allocations (consult the Center
for Responsible Politics,
www.opensecrets.org). Detailed
description of how the organization
is funded and how the organization
spends money.
Conclusion
10 points
APA references and formatted as MEMO
(references are recent, in the past 5
years, the references support the
data provided throught the
presentation and appropriately
formatted per APA 7th edition)
10 points
Memo Score (Group)
Peer Group Evaluations
PowerPoint Presentation (see outline
below)
Total
70 points
Individual score added: Max of 35
50 points
PPT topics to be discussed
120 points + 35 pts = 155 pts
Points assigned
Learning Objectives for PPT
5
Investigate the group’s key
issues and how at least
one is linked to APN
practice
5
What is the group’s
mission and how does
this tie to the key
issue’s
2
What is the group’s legislative 2
agenda and how does
this tie to the group’s
key issues and
mission.
How is the agenda developed
5 points
2
Group points awarded
How is it communicated to
members
2
How is the group’s agenda
pushed and promoted
(i.e., mechanisms used
to engage/attract and
influence policy
makers)
2
What are the group’s current
2
lobbying
efforts (Seeking to
influence a public
official on an issue; an
interest group with a
particular agenda may
be known as its
“lobby,” for example
“the tobacco lobby.”)
Key partner coalitions
2
How do these partnerships
influence policies at
the local, state or
national level and key
obstacles
2
Describe spending allocations 2
(consult the Center for
Responsible Politics,
www.opensecrets.org).
(where does their
money go; how is it
spent?
In addition to investigating
the interest group’s
website and reviewing
position statements
and testimony,
students should
2
consult media
reports to obtain
more information on
the group’s current
lobbying efforts.
Link the one or more of the
10
organization’s political
advocacy efforts to
APN practice and how
the APN could
become active in the
organization. (how
could the APN inform
the organization’s
political advocacy
efforts, how could the
APN serve or become
involved as part of the
organization?)
PPT Presentation is creative
10
with images, and
colors that are eye
catching; organized,
formatted, and
includes all the aspects
required and is
formatted using APA
Totals
50
1
Week 6 Assignment: EBP Change Process form
ACE Star Model of Knowledge Transformation
Follow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson.
Please do not use any of the Nurse Daniel information for your own topic, nursing
intervention, or change project. Nurse Daniel serves as an example only to illustrate the
change process.
Name: _____________________
Star Point 1: Discovery (Identify topic and practice issue)
Identify the topic and the nursing practice issue related to this topic. (This MUST involve a nursing
practice issue.)
Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.
Star Point 2: Summary (Evidence to support need for a change)
Describe the practice problem in your own words and formulate your PICOT question.
9.2019 Update. DLP
1
2
List the systematic review chosen from the CCN Library databases. Type the complete APA
reference for the systematic review selected.
List and briefly describe other sources used for data and information. List any other optional
scholarly source used as a supplement to the systematic review in APA format.
Briefly summarize the main findings (in your own words) from the systematic review and the
strength of the evidence.
Outline one or two evidence-based solutions you will consider for the trial project.
Star Point 3: Translation (Action Plan)
Identify care standards, practice guidelines, or protocols that may be in place to support your
intervention planning (These may come from your organization or from the other sources listed in
your Summary section in Star Point 2).
9.2019 Update. DLP
2
3
List your stakeholders (by title and not names; include yourself) and describe their roles and
responsibilities in the change process (no more than 5).
What specifically is your nursing role in the change process? Other nursing roles?
List your stakeholders by position titles (charge nurse, pharmacist, etc.). Why are the members
chosen (stakeholders) important to your project?
What type of cost analysis will be needed prior to a trial? Who needs to be involved with this?
Star Point 4: (Implementation)
Describe the process for gaining permission to plan and begin a trial. Is there a specific group,
committee, or nurse leader involved?
9.2019 Update. DLP
3
4
Describe the plan for educating the staff about the change process trial and how they will be
impacted or asked to participate.
Outline the implementation timeline for the change process (start time/end time, what steps are to
occur along the timeline).
List the measurable outcomes based on the PICOT. How will these be measured?
What forms, if any, might be used for recording purposes during the pilot change process. Describe.
What resources are available to staff (include yourself) during the change pilot?
Will there be meetings of certain stakeholders throughout the trial? If so, who and when will they
meet?
9.2019 Update. DLP
4
5
Star Point 5: (Evaluation)
How will you report the outcomes of the trial?
What would be the next steps for the use of the change process information?
9.2019 Update. DLP
5
Respond to the following in a minimum of 175 words: If a community rejects non-legislative efforts to adopt sustainable practices, should it be forced upon them through laws or regulation? Defend your response.
write the background part, all other parts are done
Unformatted Attachment Preview
Nepal 2
Identification of Key Health Issues
Group members: Weiwei Wu, Chansoo Park, Yunjie Chai, and Siya Kashwala
BrainStorm Area
● Could look into lung cancer/COPD rates and risks among lower-income groups in Nepal.
○ Smoking rates (Intervention Program: raise awareness on risks associated with smoking, provide
educational materials to target population, and provide access to resources for smoking cessation like behavioral counseling or medication)
■ Around 30% of the population in Nepal smoke
○ Biomass fuel use among families living in poverty
○ Air quality/pollution
○ Late diagnosis -> high mortality rate in older people
● Population:
– Older population versus younger population lung cancer rates OR women versus men
– COPD patients (ameliorate), potential COPD population (prevention)
● Objects: undecided yet: options – mortality, incidence, management??
● Risk factors: Age, gender difference, air pollution, occupational exposures, healthcare
resources, lack of awareness, climate and geography
● Direct / surrogate estimates of COPD:
Materials:
– General:
1 https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
2 Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and
territories, 1990-2019: results from the Global Burden of Disease Study 2019
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9326843/
– Risk factor:
1 The burden of chronic respiratory diseases in adults in Nepal: A systematic review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264743/
2 Levels and determinants of health literacy and patient activation among multi-morbid COPD people in
rural Nepal: Findings from a cross-sectional study
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0233488
– Intervention:
1 Community-based management of COPD in Nepal https://pubmed.ncbi.nlm.nih.gov/28000600/
2 Using a co-design process to develop an integrated model of care for delivering self-management
intervention to multi-morbid COPD people in rural Nepal.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874656/
———————————————————————————————————————
Background (Describe the relevant background for your country and health issue)
COPD Epidemiologic Burden
The Nepal Health Research Council recently reported that the prevalence of COPD in the
country is 11.7% (Adhikari et al., 2020). This figure indicates a substantial burden of disease
within the population. In 2016, the prevalence of COPD in Nepal was 4,810 cases per 100,000
population, which notably exceeded the global rate of 3,628 cases per 100,000 population
(Adhikari et al., 2018). In 2019, an estimated 21,603 Nepali individuals died from indoor air
pollution due to solid fuels used for heating and cooking (IHME 2022). Additionally, in the same
year, around 21.9% of the population in Nepal smoked daily (IHME, 2022). From 1990 to 2019,
there was an increase in deaths attributed to outdoor air pollution, representing a relative change
of +291.0% (IHME, 2022). In 2015, Nepal was ranked among the top 4 countries with the
highest age-standardized DALYs rates due to COPD (Adhikari et al., 2018). As the population
continues to age, the burden of COPD is anticipated to rise significantly due to the escalating
incidence, death, and DALYs rates associated with advancing age (Adhikari et al., 2018).
COPD Trends in Nepal
Over the past few decades, there has been a notable rise in both the incidence and
prevalence of COPD in Nepal. The WHO has projected that COPD-associated mortality will
increase in the next few decades by 160% in the Southeast Asia region (Adhikari et al., 2018). In
1990, the average death rate for COPD, spanning both sexes and all age groups was
approximately 69.84 deaths per 100,000. By 2019, this rate had substantially increased to 103.5
deaths per 100,000 (IHME, 2022). The air quality index is at its peak during the winter months,
when the use of indoor heating is common, which further exacerbates respiratory conditions.
PM2.5 concentrations consistently register higher levels each year between November through
April (IQAIR, 2023). COPD has been a longstanding issue in Nepal and ongoing efforts are
required to reduce its prevalence and improve the quality of life for those affected.
Key Population Affected
COPD is one of the most common non-communicable diseases (NCDs) in the adult
populCOPD is common among Nepali adults, constituting 43% of outpatient visits. Adult COPD
prevalence was 22.7%, with 54.9% being women. Most patients lacked formal education
(73.1%) and worked in farming (39.4%) or as housewives (36.8%). Many were current/former
smokers (Adhikari et al., 2020). Prevalence is three times higher in individuals aged 60+ than in
those aged 20-39. Karnali, the least developed region, had the highest prevalence (25.1%) due to
limited COPD services (Bolger, 2023).
Structural Determinants for COPD
Smoking and exposure to biomass fuels are major risk factors for COPD. More than 28%
of Nepalese men and 8% of women smoke, while 66% of households use biomass fuels
(Adhikari et al., 2020). Women’s exposure to biomass fuel is higher due to household chores,
which is estimated to contribute to the rising prevalence of COPD in women (Budhathoki et al.,
2021). Nepal’s poor air quality results from urbanization, industrial growth, and vehicle
emissions (Diwakar, 2023) also poses a threat to health. In recent years, air pollution in Nepal
has been 4.9 times higher than the WHO’s recommended pollution levels (WHO, 2023). Nepal’s
terrain, surrounded by high mountains, and lack of proper regulatory policies exacerbate the
problem (Gallant, 2021). Lack of awareness about COPD, low health literacy, education, and
economic status also increase the risk of COPD (Adhikari et al., 2020).
Stakeholders and Potential Partners in Addressing COPD in Nepal
Stakeholders: The involvement of both internal and external stakeholders is crucial in
addressing the escalating burden of COPD in Nepal. Internal stakeholders primarily encompass
government agencies, including the Ministry of Health and Population Nepal and the Department
of Health Services (Ministry of Health, Nepal, 2019). Local NGOs, being closely involved in
community-based programs and grassroots interventions, also have a vested interest in this issue
(Gautamet al., 2017). Most significantly, COPD patients and their families, bearing the direct
brunt of the disease, are primary stakeholders in any discussion, decision, or initiative related to
COPD management and prevention.
On the extrinsic or external front, International Organizations like the WHO and United
Nations Development Program (UNDP) have consistently shown commitment to global health
and can provide technical support, funding, and expert advice (WHO, 2023). External NGOs,
especially those focusing on respiratory diseases and global health, can provide a wealth of
experience from interventions in other settings and can help in tailoring strategies specific to
Nepal.
Potential Partnerships：Local NGOs play an irreplaceable role due to their grassroots
reach and deep understanding of community dynamics. Their collaboration ensures that
interventions are culturally sensitive and tailored to the community’s needs. Furthermore, the
inclusion of community leaders and local influencers, such as religious leaders and community
elders, is pivotal. Given their influential status in the Nepali socio-cultural fabric, their
involvement can facilitate better community acceptance and adherence to any proposed
interventions. This collaboration ensures that health programs are successful, as their
endorsements can break cultural barriers and encourage preventative measures. On the healthcare
front, local hospitals can provide critical infrastructure and expertise, while pharmaceutical
entities can offer essential medications and treatments (Gautamet al., 2017).
External international organizations such as the WHO and UNDP bring a global
perspective, expertise, and funding that can be harnessed to implement effective COPD
interventions. Their global networks and resources can facilitate the introduction of best
practices and research in the Nepali context. Furthermore, collaboration with external NGOs that
have a health focus can infuse new strategies and technologies to combat the increasing COPD
incidence, especially given their experience in varied settings.
Why COPD is a Key Health Issue in Nepal
COPD is not just a health concern; it’s a socio-economic and developmental issue for
Nepal. The rising morbidity due to COPD affects the quality of life of individuals and their
families. The increased prevalence, as seen in the earlier section of this report, emphasizes the
rapid increase in the disease’s burden (Gautamet al., 2017). Furthermore, with COPD patients
accounting for a significant portion of outpatient visits, the burden on the healthcare system is
evident. As the healthcare infrastructure grapples with limited resources, the rising incidence of
COPD threatens its capacity. Economically, the direct costs associated with medical treatments,
combined with indirect costs like lost productivity due to illness, strain both individual families
and the nation at large. With Nepal’s unique topographical challenges, the interplay of indoor and
outdoor pollution, and socio-cultural practices, COPD emerges as a multifaceted health issue
requiring urgent attention and multi-stakeholder intervention (Momtazmanesh, 2023).
References
Adhikari, T. B., Acharya, P., Högman, M., Neupane, D., Karki, A., Drews, A.,
Cooper, B. G., Sigsgaard, T., & Kallestrup, P. (2020). Prevalence of chronic obstructive
pulmonary disease and its associated factors in Nepal: Findings from a community-based
household survey. International Journal of Chronic Obstructive Pulmonary Disease,
Volume 15, 2319–2331. https://doi.org/10.2147/copd.s268110
Adhikari, T. B., Neupane, D., & Kallestrup, P. (2018). Burden of COPD in Nepal.
International journal of chronic obstructive pulmonary disease.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810531/#:~:text=The%20current%20pr
evalence%20of%20COPD,UI%3A%205%2C097.9%E2%80%935%2C532.3%5D).
Bolger, R. (2023a, June 20). The EU has banned synthetic turf that uses old tyres. why
isn’t Australia following suit? ABC News. https://www.abc.net.au/news/2023-0620/synthetic-turf-no-moratorium-chief-scientist-knowledge-gaps/102497698
Budhathoki, P., Shrestha, D. B., Sedhai, Y. R., Baniya, R., Bhatt, A., Chaudhary, K.,
Acharya, A., & Rajkarnikar, R. (2021). Prevalence and risk factors of COPD in Nepal: A
systematic review and meta-analysis. TP41. TP041 DIAGNOSIS AND RISK
ASSESSMENT IN COPD. https://doi.org/10.1164/ajrccmconference.2021.203.1_meetingabstracts.a2273
Diwakar. (2023, May 20). Poor air quality in Kathmandu: Causes, consequences and
solutions explained. OnlineKhabar English News. https://english.onlinekhabar.com/poorair-quality-in-kathmandu-explain.html
Gallant, C. (2021, April 13). Nepal’s lingering pollution is becoming hazardous to its
people. The Organization for World Peace. https://theowp.org/nepals-lingering-pollutionis-becoming-hazardous-to-its-people/
Gautam, R., Neupane, D., Karki, A., & Kallestrup, P. (2017). Community-based
management of COPD in Nepal. The Lancet Respiratory Medicine, 5(1).
https://doi.org/10.1016/s2213-2600(16)30431-3
Institute for Health Metrics and Evaluation (IHME). (2022). Health-related SDGs.
Seattle, WA: IHME, University of Washington. https://api.healthdata.org/sdg/v1/docs
IQAIR. (2023). World Air Quality Index (AQI) ranking.
https://www.iqair.com/us/world-air-quality-ranking
Ministry of Health, Nepal. (2019). Annual Health Report. Kathmandu: Government of Nepal.
Momtazmanesh, S., Moghaddam, S. S., Ghamari, S.-H., Rad, E. M., Rezaei, N., Shobeiri, P.,
Aali, A., Abbasi-Kangevari, M., Abbasi-Kangevari, Z., Abdelmasseh, M., Abdoun, M.,
Abdulah, D. M., Md Abdullah, A. Y., Abedi, A., Abolhassani, H., Abrehdari-Tafreshi,
Z., Achappa, B., Adane Adane, D. E., Adane, T. D., … Farzadfar, F. (2023). Global
burden of chronic respiratory diseases and risk factors, 1990–2019: An update from the
global burden of disease study 2019. eClinicalMedicine, 59, 101936.
https://doi.org/10.1016/j.eclinm.2023.101936
WHO. (2023). Kathmandu, Nepal. World Health Organization.
https://www.who.int/initiatives/urban-health-initiative/pilot-projects/kathmandu
Individual Team Member Contribution:
● Background → Yunjie Chai
● Key Health Issue
○ 2a – 2b → Siya Kashwala
■ Epidemiologic Burden
■ COPD Trends in Nepal
○ 2c – 2d → Chansoo Park
■ Key Population Affected
■ Structural Determinants of COPD
○ 2e – 2f → Weiwei Wu
■ Stakeholders and Potential Partners in Addressing COPD in Nepal
■ Why COPD is a Key Health Issue in Nepal
GH500 Critical Issues in Global Health — Fall 2023
Identification of Key Health Issue
Group Submission
Due October 4, 2023 at 10 pm
Assignment Overview
Each group will be asked to identify a health issue of importance in their focal country. Selection of this
health issue will be informed by preceding classwork and individual assignments. The selected health
issue will be the focus of further assignments, including the final group presentation.
The health issue does not need to be the most pressing, urgent, or grave health issue in your country.
Rather, the health issue should be justifiable as a health issue of concern for a population in the
country and you simply need to justify why it is a health issue that deserves focus. This assignment will
serve as the foundation for your future assignments, so the more focused and specific you can be about
your health issue, the more it will help with your subsequent assignments (specifically the root cause
analysis and the solution pitch).
This assignment is designed to partially address the following MPH/MSPH Foundational Competency:
Design a population-based policy, program, project or intervention.
Specific Instructions
Work as a group to (1) provide key background information about your country and (2) identify and
summarize a key health issue in 2-pages of single-spaced text (12-point font and margins >1/2”), with a
range of +/- 0.25 of a page.
1. For the Background section consider the following areas and leverage data collected as part of Week
4 Disease Board Post and Week 3 and 4 in-class activities, as well as reputable news media, published
articles, CIA fact sheet, etc. Your background section needs to be succinct yet provide enough sociocontextual and health information to support your identified health issue and proposal.
• Population size (current estimate, trends over the last 10 years)
• Current GDP and general comparison with other countries
• Relevant history (e.g., civil unrest, political instability, social change)
• Geography and physical landscape
• DALYs (causes of death, life expectancy, notable sex differences)
2. For the Key Health Issue, you must describe:
a. The scope of the problem (e.g., measures of disease occurrence: prevalence, incidence,
mortality)
Fall 2023
b. Trends over time (highlight whether this a longstanding or emerging problem)
c. The key populations affected and/or at risk (e.g., young/old, men/women, marginalized groups,
persons with disabilities)
d. Key structural determinants including sociocultural context (poverty, education, physical
environment, policies, discrimination, etc.)
e. Stakeholders/ potential partners working on an initiative(s) to address this issue (e.g.,
governmental organizations, non-governmental organizations, intergovernmental agencies,
communities, academia, etc.)
f. Summary justification of why this is a key health issue (e.g., large burden, human rights issues,
other considerations).
Suggested Process for Teamwork
• Each group will use information and roles identified in the group agreement and set dates for
completing the assignment. You can use your group work area on Canvas or Google Drive for
your collaboration.
• Individually, review key data (e.g., health indicators) for the country using tools you have
learned in this class and in other settings (e.g., IHME tools like GBD Compare). Identify 2-3
health issues that you believe are worth exploring. Consider whether the health issue is likely to
have actionable evidence-based solutions.
• As a group, discuss ideas generated through individual research. Develop a consensus around a
single key health issue. Again, consider whether the health issue is likely to have actionable
evidence-based solutions.
• As a group, divide writing and research responsibilities. Compose your write-up and review/edit
as needed.
• Please remember to narrow down your selected Key Health Issue to a specific health condition.
Example: focus on lung cancer as opposed to cancers overall. Avoid choosing a risk factor or
root cause as the health issue of focus for this assignment (e.g., unhealthy diet, tobacco
smoking, climate change, gender inequity, air pollution). If you are interested in a risk factor or
determinant per se (rather than a specific health outcome), you will still be able to address
those as a part of your proposed solution to the health issue in the last assignment.
Individual team member contribution
• At the end of your document please describe the contributions of each team member to the
final product in bullet-point format. This may include sections written, information
researched, data analyzed, and contributions during in-class activities. This does not count
towards the 2-page limit.
• You will also receive a survey to rate your contribution and that of your group members to the
work.
• Your individual contribution to the work is worth three points. Individual score is informed by
declaration of team members’ contribution at end of document, engagement in in-class
activities that informed the assignment, and the peer-review survey.
Submission Guidelines
Fall 2023
•
Only one group member needs to submit on behalf of the group. Submissions are due on
Canvas.
Resources
• Global Burden of Disease (GBD) Study, GBD Compare tool: https://vizhub.healthdata.org/gbdcompare/
• World Health Organization (WHO) Global Health Observatory http://www.who.int/gho/en/
• Additional resources on this google sheet here.
Grading Rubric
Element
1. Background
2. Key Health Issue
a. Scope of the
problem
b. Trends over
time
c. Key
populations
affected
d. Structural
determinants
e. Actors and
stakeholders
f. Summary
justification
3. Referencing
4. Assignment Length
5. Writing quality
Total
Fall 2023
Description
Describe the relevant background for your country and
health issue
Points
3
Describe the epidemiologic burden
3
What is the brief history of the issue in this country?
2
2
Identify target population for future interventions
(demographics, location, socioeconomic groups, etc.)
What are the key structural determinants for this
health issue, including sociocultural considerations?
Who are the stakeholders/ potential partners for an
initiative to address this issue?
Why is this a key health issue?
3
Use proper referencing and in-text citations using APA
or AMA style; at least 5 references recommended. See
Week 0 resources for guidance on citations (“Good
Scholarship”) and referencing styles.
The submission is approximately 2 pages long, with a
range of +/- 0.25 of a page. To be specific, the
submission should fall between 1.75 and 2.25 pages.
Writing is clear, free of grammatical errors and
engaging
0.5
2
3
0.5
1
20
Assigned Readings:
Georgetown University Health Policy Institute. (2004). Cultural competence in health care: Is it important for people with chronic conditions? Retrieved from https://hpi.georgetown.edu/agingsociety/pubhtml/cu…
Jacobs, E., Shepard, D., Suaya, J., & Stone, E. (n.d.). Overcoming language barriers in health care: Costs and benefits of interpreter services. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC14483…
Quinton, S. (2017, February 13). Health care adjusts to a more diverse America. Retrieved from http://www.pewtrusts.org/en/research-and-analysis/…
Discussion Questions:
Before beginning work on this discussion forum, please review the link “Doing Discussion Questions Right” and any specific instructions for this topic.
Before the end of the week, begin commenting on at least two of your classmates’ responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress.
Tasks:
Discuss how a language difference can decrease the likelihood of optimal healthcare outcomes and impact healthcare cost. In your response, include the increased cost resulting from language barriers and the potential risks and concerns associated with using noncertified methods of translation.
In addition, include one additional point that you have identified in the readings. As a hypothetical member of the healthcare organization’s workforce, you can suggest a policy to address the point.
To support your work, use your course and readings provided and also use the South University Online Library if you elect to perform additional research to support your position. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Your initial posting should be addressed in 200–350 words. Submit your document to this Discussion Area by the due date assigned. Be sure to cite your sources using APA format.
Respond to your classmates throughout the week. Justify your answers with examples, research, and reasoning. Follow-up posts need to be submitted by the end of the week.
From the perspective of a learning organization, identify the SMART aim, the Key Drivers of the initiative you are proposing as a healthcare area as a transformation project.
Discuss the following
System approach
Resource allocation you identify as important
Identify the executive sponsor
Identify the stakeholders and steering committee members
Environment for local team leaders to collaborate, and 6) governance of the metrics.
The communication plan to coordinate the project team efforts.
Your paper should meet the following structural requirements:
Four-to-five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing standards
Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
Research a peer-reviewed article in the SEU library regarding workflow analysis in healthcare. Discuss the following aspects:
Strengths
Weaknesses
Opportunities
Threats
Risks that are identified in the workflow described.
What changes are recommended and provide additional recommendations you would make to improve the efficiency and effectiveness of this process.
Your paper should meet the following structural requirements:
Four-to-five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing standards
Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
For this assignment, please review the Case Scenario on page 112 and Case Scenario 1 on page 131 (Kersey-Matusiak, 2019). Reflect on your attitudes, beliefs, and practices as they apply to each case scenario. This assignment requires you to address your personal feelings about culturally and linguistically appropriate service and care for the terminally ill. Remember, answer these questions from your unique perspective, so there is no right or wrong response. You must address each problem.
For this assignment, create a 1250-1500-word essay based on the following case studies.
Read the following two Case Studies and answer the questions presented below.
1. Case Scenario: Mrs. Garcia is located in Chapter 6 on page 112.
Questions:
Where are you on the Cultural Competency Staircase regarding this patient’s language and culture? How will you progress to the next level? (Review Chapter 1 and the Staircase Model).
• What knowledge do you need to have about this patient, including cultural/language needs, to provide this patient with culturally sensitive care?
• What would you personally do to address the needs of this patient?
• What resources do you need, and how would you obtain them?
• What cultural assessment model would you plan to use to assess this patient?
2. Case Scenario 1: Ms. Vera Talsford located in Chapter 7 page 131
Questions:
• Have you considered the significance of your death?
• Do you believe in life after death?
• Where are you on the Cultural Competency Staircase when caring for patients who are terminally ill? How will you progress to the next level?
• How comfortable are you caring for this patient and discussing issues related to her and her family’s death and dying process?
• What cultural information about the patient will you need to obtain culturally sensitive care during the EOL?
• What kinds of psychological, emotional, and spiritual support would you need if given a similar diagnosis?
Start by reading and following these instructions:
Study the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.
Consider the discussion and the any insights you gained from it.
Review the assignment rubric and the specifications below to ensure that your response aligns with all assignment expectations.
Create your assignment submission and be sure to cite your sources, use APA style as required, and check your spelling.
The following specifications are required for this assignment:
Length: 1250–1500 words; answers must thoroughly address the questions clearly and concisely.
Structure: Include a title page and reference page in APA style. These do not count towards the minimum word count for this assignment.
References: Use the appropriate APA style in-text citations and references for all resources to answer the questions. Include at least three (3) scholarly sources to support your claims.
Format: Save your assignment as a Microsoft Word document (.doc or .docx).
File Name: Name your saved file according to your first initial, last name, and the assignment number (for example, “RHall Assignment 1.docx”)
RUBRIC
Preview Rubric
Graduate Simple Essay Rubric v1
Print
Criteria Approaches 70% Meets 80% Exceeds 100% Criterion Score
Content Weight: 30% Topic is inappropriate to assignment, inaccurate understanding of concepts, unclear and difficult to understand; does not address many assignment requirements. Information has weak or no connection to the assignment topic. Topic is mostly covered and appropriate to assignment, but does not adequately demonstrate accurate understanding of concepts; mostly clear and understandable; lacks some of the requirements of the assignment description and/or provides little detail; Information relates to the main topic, but few details and/or examples are given. Topic is covered completely and appropriate to assignment; overview of key concept dimensions is evident; clear and understandable; addresses all of the requirements of the assignment description, with adequate attention to detail. In-depth coverage of topic; outstanding clarity and explanation of concepts demonstrated in information presented; approaches assignment with depth and breadth, without redundancy, using clear and focused details. / 30
Organization Weight: 25% Organization is confusing and interferes with reader’s ability to follow ideas. Weak or no introduction of topic or purpose is unclear, weak, or missing. Conclusion lacks a summary of topic, or is missing or irrelevant. Ideas are sometimes disorganized or irrelevant; Flow is sometimes choppy; somewhat clear organization. Basic introduction that states topic but is presented in an uninteresting way. Conclusion contains basic summary of topic without final concluding ideas, may inappropriately introduces new information. Structures ideas in a coherent, organized order that has good flow and an obvious framework. Proficient introduction that is interesting and states topic. Conclusion contains good summary of topic with credible concluding ideas and introduces no new information. Exceptionally clear, logical, mature, and thorough organization permitting smooth flow of ideas; Introduction that grabs interest of reader and states topic in clear, unambiguous terms. Excellent concluding summary with succinct and precise ideas that impact reader. / 25
Logic/Argument Weight: 15% Demonstrates little logical reasoning for the claims and thoughts within assignment; Many claims are weak or illogical. Lacks some logical reasoning for the claims and thoughts within the assignment; Some claims are weak. Uses solid logical reasoning for the claims and thoughts within the assignment. Provides exemplary logical reasoning for the claims and thoughts within the assignment. / 15
Support Weight: 20% Lacks support; Uses poor sources for references; Citations lack credibility, relevance, or academic quality or are not current; Does not meet the minimum number of required citations in assignment description. APA format and style are not evident. Provides weak support or not enough support; Citations are not consistently credible, current, relevant or academic; Meets the minimum number of required citations in assignment description Missing APA elements; in-text citations, where necessary, are used but formatted inaccurately and not referenced. Provides sufficient support with credible, current, relevant academic citations; Meets the minimum number of required citations in assignment description. ; In-text citations and a reference page are present with few format errors. Mechanics of writing are reflective of APA style. Provides very strong support from credible, current, relevant, academic citations; Meets or exceeds the minimum number of required citations in assignment description. Accurate citations and references are presented. No APA errors are evident. / 20
Quality of Written Communication Weight: 10% Style and voice inappropriate or do not address given audience, purpose, etc. Word choice is excessively redundant, clichéd, and unspecific. Inconsistent grammar, spelling, punctuation, and paragraphing. Surface errors are pervasive enough that they impede communication of meaning. Style and voice are somewhat appropriate to given audience and purpose. Word choice is often unspecific, generic, redundant, and clichéd. Repetitive mechanical errors distract the reader. Inconsistencies in language, sentence structure, and/or word choice are present. Style and voice are appropriate to the given audience and purpose. Word choice is specific and purposeful, and somewhat varied throughout. Minimal mechanical or typographical errors are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Style and voice are not only appropriate to the given audience and purpose, but also show originality and creativity. Word choice is specific, purposeful, dynamic and varied. Free of mechanical and typographical errors. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English. / 10
TotalScore of Graduate Simple Essay Rubric v1,/ 100
Overall Score
LEVEL 1
0 points minimum
LEVEL 2
70 points minimum
LEVEL 3
80 points minimum
LEVEL 4
100 points minimum
Excel Assignment Write a paper in about 700–1400 words in which you will include the following: Select a case study from the Week 1 Learning Activities folder. Then, conduct additional research to gain an understanding of the chosen public health issue.Identify data from within the selected case study. Summarize the demographic and clinical information of the data.Enter data into an Excel file and produce a graphical visual display of the data (e.g., chart or graph of demographic data, histogram, pivot table, or an epidemic “Epi” curve).Interpret the data collected and derive inferences regarding any relevant factors such as ethnicity, geographical impact, environmental factors on the population’s health. Case Study: Topic: Cigarette Smoking and Lung Cancer (2003 update) SEE THIS Case study via this link here. https://www.aptrweb.org/page/CaseStudies_Epi Cite at least 3 sources used for your assignment in APA format. Format your assignment according to APA guidelines to include a brief introduction and clear conclusion.
Final Topic: Protection from heat for people who work outdoors: https://www.npr.org/2023/07/01/1185623467/the-federal-government-wants-to-protect-people-who-work-outdoors-from-wildfire-sFinal topic selection, described in 1-2 paragraphs, with a link to information about the proposed policy and which agency is proposing it. Please include between one and three paragraphs describing the topic and including at least five references.
Write a 250- to 300-word response to the following: Week 1 topic: Introduction to Health Policy: History and Dynamics of Health Policy As you reflect on your readings in this week’s learning activities, which specific topic or issue resonates the most with you? Why? What big questions remain unanswered? Include your own experience, as well as 2 citations that align with or contradict your comments as sourced from peer-reviewed academic journals, industry publications, books, and/or other sources. Cite your sources using APA formatting. If you found contradicting information to what your experience tells you, explain why you agree or disagree with the research.
ASSIGNMENT COVER SHEET
Course name:
Principles of Microbiology for Public Health
Course number:
BIOL103
CRN:
Safe and healthy food is important for sustainability and
living of all humans. However, food can also be
contaminated by foodborne pathogens that may cause
serious diseases and death.
1.
Describe briefly spoilage of meat? What are the
factors that cause meat spoilage? How would you
inform public to avoid foodborne illnesses from meat
and poultry? (4 Marks)
2.
What is pasteurization? What is the importance of
pasteurization of milk? What you would tell the
public about how to prevent milk spoilage? (4 Marks)
3.
Which governmental organizations are responsible
for food safety in the Kingdom of Saudi Arabia?
Briefly describe the organizations tasks and
responsibilities involved in food safety (2 Marks)
Assignment title or task:
(You can write a question)
Students ID
xxxx
Student name:
Submission date:
xxxx
xxxx
Instructor name:
..
Grade:
…. Out of 10
Release Date: 25/09/2023
Due Date: 08/10/2023
Guidelines:
•
•
•
•
•
•
•
•
•
Cover sheet should be attached with assignment
Complete student’s information on the first page of the document.
Font should be 12 Times New Roman
Line spacing should be 1.5
The text color should be “Black”
The length of the paper assignment should be 1 to 2 pages (600 -800 words)
Use proper references using APA format. Please see below link about how to cite APA
reference style.
https://guides.libraries.psu.edu/apaquickguide/intext
Do proper paraphrasing to avoid plagiarism
Describe your clinical experience for this week.Did you face any challenges, any success? If so, what were they?Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.Mention the health promotion intervention for this patient.What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?Support your plan of care with the current peer-reviewed research guideline.Submission Instructions:Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
ASSIGNMENT COVER SHEET
Course name:
Health and Environmental Risk Assessment
Course number:
PHC 351
CRN:
14373
Assignment title or task:
(You can write a question)
Discuss the steps and methods of risk
communication and community engagement then
support your answer with examples.
Student name:
xxxx
Student ID:
xxxx
Submission date:
xxxx
To be filled in by the instructor only
Instructor’s name:
Dr. Afrah Kamal Yassin
Grade:
….. out of 10
Release date: 17-9-2023__________________Due date:5-10-2023
Instructions for submission:
•
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted.
Length of the write-up should be 1 to 2 pages (500 -1000 words).
Text size 12-Times New Roman with double spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
Review PowerPoint: Chapter 9- Understanding Your values:Stress Symptoms: Across the top of your paper write a brief list of your physical, emotional, and behavioral responses when you are under stress. Then explain them more fully in an essay.Physical = what happens to your body under stress ( ie. Insomnia, back pain)Emotional = how you feel under stress ( ie. Lonely, worthless, unaccomplished) Behavioral = what you do under stress ( ie. Yell at others, drink too much, withdraw)This should not be more than 2 pages.
Unformatted Attachment Preview
Chapter 9: The Importance of
Values
Ice breaker
What do you value most?
Do your actions support
your values?
Learning Objectives
By the end of this chapter, you should be able to:
Describe mediocrity as it relates to feeling stuck in your life.
Explain the connection between values clarification and stress
management.
Clarify and prioritize your highest values.
Differentiate between instrumental values and terminal values.
Participate in values clarification activities.
The Importance of Values
Values
• Value:
− A way of thinking that guides choices by evoking a feeling of basic principles of right and
wrong.
• Values:
− Guide our actions
− Provide direction
− Give meaning to life
Your Values
• When values and actions are not aligned, the consequence is stress
and inner chaos.
• Discovering your values
• Cognitive dissonance
Discovering Your Values
• Dharma
– When you find your place in life, you find satisfaction
in life.
– It results in inner peace, wisdom, and happiness.
Discovering Value Activity
• In small groups, brainstorm a list of those things you value most.
• When the list has been finished, try to identify who was responsible
for shaping those values in you.
Discovering Value Activity Debrief
• When we live by an agenda set by others, we easily get caught up in
living someone else’s life. One primary task involved in becoming an
adult is to become independent and self-directed in our thoughts and
actions.
• Separating from the control and influence of parents and others and
moving toward self-direction is a fundamental right of passage into
adulthood.
Source of Values
Source of Influence
• Values are influenced by:
• Culture
• Friends
• Television
• The Internet
• Social media
• Parents
• Family
• Teachers
Values within Cultures
• Culture is a pattern of learned behavior based on values, beliefs, and
perceptions within a community.
• Cultures are based on underlying values that encourage or
discourage actions and beliefs.
• Your identity becomes linked with the work you do
Predominant Values in the United States
• Personal achievement and success
• Activity and work
• Moral orientation
• Efficiency and practicality
• Progress
• Material comfort
• Personal freedom and individualism
• External conformity
• Science and rationality
Predominant Alaska Native Values (1 of 2)
• Show respect to others
• Share what you have
• Know who you are
• Accept what life brings
• Have patience
• Live carefully
Predominant Alaska Native Values (2 of 2)
• Take care of others
• Honor your elders
• Pray for guidance
• See connections
The Dynamic Quality of Values
• Values are not static; they change over time.
• When young, we have values similar to our parents.
• As we grow, values become a mix of what we learned from
family, cultures, coworkers, and relationships
Acquiring Values
• Values are assimilated from family, friends, religion, and society.
• Values acquisition: we assume new values consciously.
Beliefs about Values
1. We can change our thoughts and actions.
2. We are responsible for creating long-term change in our lives.
3. When we set our sights in a new direction, we have the power to
move in that direction.
4. Our values determine our actions and behaviors.
Types of Values
• Instrumental values:
– Those that consist of personal characteristics and character traits
▪ Hardworking, capable, cheerful, forgiving, responsible
• Terminal values:
– Outcomes of efforts, those we feel are essential and desirable
▪ Self-respect, security, inner harmony, freedom
Values Clarification
• Values Clarification:
• The process of discovering and applying what we genuinely value
• Reduces the stress of making decisions that are inconsistent with our values
• Mental and spiritual process to help close the gap between what we value and
what we do
Creating Your Personal Constitution
To clarify and apply your fundamental values, create a personal
constitution:
1. Identify your values
2. Prioritize your values
3. Write a clarifying paragraph for your values
Step 1: Identify Your Values
• Review the list of instrumental and terminal values
• Identify which are most important to you
• What is your most important value?
Your funeral Activity
• With your eyes closed, imagine what you would like others to say,
think, and feel about you and how you lived your life.
• Brainstorm these ideas on paper.
• Which of these values are you living right now? Which do you need
to continue to work on?
Your Funeral Activity Debrief
• Students can use the Instrumental and Terminal Values list and apply
those values to how they would like to be thought of.
• What came to mind as the highest, most important value?
• There are likely inconsistencies. There might be some values that are
not being work on right now. This activity will help students prioritize
their values as they move into step two of the Creating Your Personal
constitution process.
Values Clarification and Realization
• It is an ongoing process.
• Values should be reflected in how
• we live each day.
• Our personal constitution can be
• a private guide to decision making.
Ben Franklin’s 13 Virtues
Temperance
Silence
Justice
Moderation
Cleanliness
Tranquility
Chastity
Humility
Order
Resolution
Frugality
Industry
Sincerity
Summary (1 of 2)
• A value can be defined as a belief upon which one acts by
preference. Values give us direction and meaning in life.
• Clarifying our values and understanding what is central to defining us
as individuals helps to reduce our stress.
• Dharma teaches us that when we find our place in the puzzle of life,
we attain satisfaction with our lives, and we feel fulfilled, happy,
content, and worthwhile.
• Cognitive dissonance happens when our behavior is inconsistent with
our values, beliefs, and our self-image.
• Most of our values are at the unconscious level unless we work to
examine them consciously.
Summary 2 of 2
• Values acquisition, which is the conscious assumption of a new
value, has 6 criteria.
• Instrumental values primarily consist of our personal values and
character traits.
• Terminal values are goals, or end states, that we work toward.
These make our lives fulfilling, satisfying, and worthwhile.
• Values clarification, which is the process of applying what we
genuinely value, helps reduce the stress that comes from making
decisions that are inconsistent with what we value.
• The three-step action plan for values clarification results in the
development of one’s personal constitution.
discussion posts must address all aspects of the Case study, be a minimum 250 words, references must be cited in APA format 7th Edition, and must include minimum of 2 scholarly. resources published within the past 5-7 years.
To support your work with evidence bases references. As in all assignments, cite your sources in your work and provide references for the citations in APA format.Apply information from the Aquifer Case Study to answer the following discussion questions:Discuss the Mr. Rodriquez’s history that would be pertinent to his gastrointestinal problem. Include chief complaint, HPI, Social, Family and Past medical history that would be important to know.Describe the physical exam and diagnostic tools to be used for Mr. Rodriguez. Are there any additional you would have liked to be included that were not? Please list 3 differential diagnoses for Mr. Rodriguez and explain why you chose them. What was your final diagnosis and how did you make the determination?What plan of care will Mr. Rodriquez be given at this visit, include drug therapy and treatments; what is the patient education and follow-up?
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Introduction to Public health
Course number:
PHC101
CRN
10074
•
هـ
Assignment title or task:
Student Name:
XXXX
Students ID:
XXXX
Submission date:
XXXX
Instructor name:
Dr. Abdallah Ahmed A. Belal
Grade:
…..out of 10
College of Health Sciences
Department of Public Health
Release Date: Sunday, 1st October 2023 (12:00 Noon)
Due Date: Sunday, 15th October 2023 (11:59 pm)
Instructions for submission:
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
You are seeing a 15-year-old female patient for a gynecological exam and to explore birth control options. The patient’s mother scheduled the appointment after learning that her daughter has become sexually active. The patient is current with all immunizations, including Gardasil, and has no significant health history that would contraindicate the use of birth control.This is the patient’s first gynecological exam, and she expresses feeling nervous and embarrassed that her mother has shared her sexual experience with strangers. Taking this into account, how would you begin the patient encounter?As you begin asking questions to determine the patient’s gynecological history, the patient appears frustrated and embarrassed and reminds you that she has only had sex one time. What should the patient understand about the importance of reviewing gynecological history?What are the most popular birth control methods prescribed in the United States? What determines the success or failure of a birth control method?The patient expresses a desire for the most effective form of birth control but is concerned about weight gain and other side effects. How should you respond to her concerns?The patient seems unsure about the best option for birth control and asks if she can take some time to think about the choices. As the use of birth control is ultimately the patient’s choice, you offer to answer any questions and agree to a follow-up visit or call. The patient asks whether using a condom is okay if she decides to have sexual intercourse before selecting a method of birth control. What should you tell her?Submission Instructions:Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
A medical insurance claim is typically initiated when an individual seeks reimbursement for medical expenses resulting from covered events or treatments. This process is triggered in situations such as when a policyholder undergoes emergency surgery that is covered by their insurance plan (Bhamidipati et al., 2021). It is important to note that medical insurance claims can also be made for other reasons, such as hospital stays, diagnostic tests, or prescription medications.
To settle an insurance claim, the policyholder must first complete a claim form provided by the insurance company(CCHI, 2022). The form usually requires details such as the policyholder’s personal information, the medical provider’s information, the nature of the treatment, and the associated expenses. Along with the claim form, relevant supporting documents such as medical bills, invoices, and receipts need to be submitted.
Once the insurance company receives the claim, they carefully review the provided information and thoroughly evaluate its validity. To ensure accurate assessment, they diligently verify the policyholder’s coverage, meticulously examine the eligibility of the treatment for reimbursement, and carefully scrutinize the accuracy of the claimed expenses (CCHI, 2022). This comprehensive process may also involve proactively reaching out to the medical provider for any necessary additional information or clarification, leaving no stone unturned in the pursuit of a fair and accurate resolution.
There are specific time limits that must be met to settle the insurance claim. These time limits vary depending on the insurance company and the type of claim (CCHI, 2022). For example, some insurance companies require claim submission within a certain number of days from the date of treatment, while others may allow a longer period. Failure to comply with these time limits can result in claim denial or delayed reimbursement.
The specified time frames for settling insurance claims are extremely important for several reasons. Firstly, they play a crucial role in ensuring prompt processing and reimbursement for the policyholder, which in turn allows them to effectively manage their financial obligations and maintain their peace of mind (Ashturkar, 2015). It is also important to note that these time frames serve as a vital mechanism for insurance companies to maintain efficient operations by establishing clear expectations and prioritizing claims based on their submission dates. By doing so, insurance companies can effectively allocate their resources and provide timely assistance to policyholders in need. Moreover, these well-defined time limits serve as a strong deterrent against the submission of fraudulent claims long after the treatment or incident occurred, thus safeguarding the integrity and sustainability of the entire insurance system. Therefore, it is crucial that these time frames are given proper consideration and followed to ensure a fair and transparent insurance process for all parties involved.
References
Ashturkar, D. P. B. (2015). An Analytical Approach to Study Claim Settlement and Life Insurance: Indian Evidence. International Journal of Management Research and Development (IJMRD), 5(1).
Bhamidipati, N. R., Vakkavanthula, V., Stafford, G., Dahir, M., Neupane, R., Bonnah, E., Wang, S., Murthy, J. V. R., Hoque, K. A., & Calyam, P. (2021). ClaimChain: Secure Blockchain Platform for Handling Insurance Claims Processing. 2021 IEEE International Conference on Blockchain (Blockchain), 55–64. https://doi.org/10.1109/Blockchain53845.2021.00019
CCHI. (2022). Regulation of qualification of claims management companies. https://chi.gov.sa/en/Rules/Documents/Regulation of qualification of claims management companies.pdf
Develop a PowerPoint presentation on a clinical case that was seen during your experience or a topic that is of interest to you.Template Example attached.
Select a health problem that primarily affects the pediatric population. (Molluscum Contagiosum.)
Provide information about the incidence, prevalence, and pathophysiology of the disease/disorder to the cellular level.
Differential Diagnosis
Educate advanced practice nurses on
assessment and diagnostic exams (Remember, APRN are the primary care providers)
care/treatment including genetics/genomics—specific for this disorder
Provide patient education for management, cultural, and spiritual considerations for care must also be addressed.
Presentation is original work and logically organized.
Followed current APA format for PowerPoint slides, including citation of references.
PowerPoint presentation with 10-15 slides were clear and easy to read. Speaker notes expanded upon and clarified content on the slides.
Incorporate a minimum of 4 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to the current APA style
Unformatted Attachment Preview
This is an idea of what
your presentation
should look like.
Title.
Your name
Course
Faculty
etc
pathophysiology of the disease/disorder
to the cellular level
• This is important for you to understand because you will be treating
patients with this.
Why does an APRN care about this?
Incidence
Prevalence
• How many affected
• during a period of time
o Covid hit many were affected,
since it is a contagious disease
how many more can become
affected.
o Allergy season (more people
showing up in clinic with allergic
rhinitis). You knew this was going
to happen because you know the
prevalence
o Ear infections (more kids with ear
aches). School started
How will this affect my care of the patients, the clinic, community?
Differential Diagnosis
(Could it be or could it not be. That is the question)
• What are three differential diagnosis for this disease/disorder
• Why is it a suspected disease/disorder?
• What is the difference?
https://www.medicalnewstoday.com/articles/differential-diagnosis
assessment that an APRN is to do
• Detail assessment. Do not write assess for dehydration.
• This is how you write it
❖Dehydration assessment
o Newborn – (O)sunken fontanels, (S)diapers, (S)tears
o Toddler – (S)diaper counts, (O)dry buccal membranes, (S)increased thirst
o Preschool to adolescent – (O)turgor, (S)thirst, (O)urine output
• Document assessment for each age that is affected. This is pediatrics
o (S) – subjective
o (O) – objective
Diagnostics APRN will send out for
• You will be sending out for labs, test, etc.
• You are the Primary Care Provider. You need to be thinking like one.
care/treatment………….. APRN REFER!
• What are the meds you will prescribe
• Age considerations
• If you must refer who will you refer to.
• You ARE NOT performing surgery, who are you referring to.
genetics/genomics—specific for this disorder.
Role of the APRN with genetics/genomics
• You are the Primary Care Provider. You need to be thinking like one.
• What is your role here.
Provide patient education for management,
cultural, and spiritual considerations for care
must also be addressed.
• If your patient is diabetic and the insulin is from swine. What religions
cannot be prescribed the insulin?
Pearls & Pitfalls (Key Points)
• Your slides do not have to be exactly like these. Please make them
look nice. Make them yours.
• They MUST have all the components that are required for this
assignment that you have reviewed in these slides.
References
Learning Activities
Read the following:
“Public Health Labs: Key to Effective Surveillance”
Edit
Interactive Activity 6
Purpose The purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos.
Action Items
Explain the advantages and disadvantages of building a master person index across surveillance information systems for multiple diseases
Ensure your responses are at least six lines long,
A health insurance claim is a request made by a policyholder or healthcare provider to an insurance company for payment of health services. The insurance company’s claims-processing system reviews the request to determine if the provided service or treatment falls within the coverage of the insurance policy. Once verified, the healthcare provider receives the appropriate payment (Adzakpah & Dwomoh, 2023).
A situation that would trigger a medical insurance claim is when an individual seeks medical treatment or services covered by their insurance policy such as visiting a hospital for surgical treatment.
The path taken to resolve the insurance claim typically involves the following steps (CHIC, n.d.).:
1. Medical Treatment: The individual receives the necessary medical treatment for their condition, such as surgery in this case. It is important to ensure that the treatment is within the coverage of their insurance policy.
2. Documentation: The healthcare providers generate and gather all the relevant documents, including medical records, bills, and receipts related to the treatment.
3. Claim Submission: The individual or the healthcare provider submits the insurance claim to the insurance company. This can often be done electronically through online portals or by mailing the necessary documents.
4. Claim Processing: The insurance company reviews the claim, verifies the details, and determines its eligibility for coverage based on the policy terms and conditions. They may also request additional information or clarification from the healthcare provider.
5. Adjudication: The insurance company evaluates the claim for reimbursement and calculates the amount to be paid based on the applicable coverage and any deductibles, co-pays, or coinsurance amounts specified in the policy.
6. Claim Resolution: Once the claim is processed and approved, the insurance company issues payment to the healthcare provider directly or reimburses the insured individual, depending on the policy terms.
It is important for the insured person to carefully review their insurance policy to understand the specific time limits and requirements for claims resolution. It is also advisable to keep copies of all submitted documents and correspondence with the insurance company for reference and future inquiries. Overall, timely notification, accurate documentation, and adherence to the specific time limits mentioned in the policy are vital in resolving insurance claims efficiently.
According to (Adzakpah & Dwomoh, 2023) Digital Health Technology (DHT) recorded lower denied claims costs than the paper-based claims system. Scaling up the use of DHT for claims submission will reduce the rate of claim denials and ensure the sustainability of providing healthcare services.
References
Adzakpah, G., & Dwomoh, D. (2023). Impact of digital health technology on health insurance claims rejection rate in Ghana: a quasi-experimental study. BMC Digital Health, 1(1). https://doi.org/10.1186/s44247-023-00006-3
Cooperative Health Insurance Council (CHIC). (n.d.). Regulation of Qualification of Health Insurance Claims Management Companies. Retrieved October 19, 2023, from https://chi.gov.sa/en/Rules/Pages/list2.aspx
I have attached the image with all the requirements for the paper and I have attached the other parts that might help for the assignment such as references. For number 3 background portion I have attached it as you had already completed that part but if you can just make sure it has all the information needed for it thanks.
Unformatted Attachment Preview
1
The Influence of Consumer Ratings on Healthcare Quality Perception
Nida Ahmad
HAP 465
Professor Braithwaite
September 27, 2023
2
Do Consumer Ratings give a false perception of Care?
Background
In recent years, the healthcare industry has witnessed a notable shift in the way patients
assess the quality of care they receive. Increasingly, consumers turn to online platforms, such as
hospital review websites and social media, to share their experiences and rate healthcare
providers. While the intention behind these consumer ratings is to empower patients and offer
transparency in healthcare, it is crucial to examine whether they consistently provide an accurate
reflection of the quality of care. This background section explores the dynamics of consumer
ratings in healthcare and the various factors that can impact their validity.
The Rise of Consumer Ratings in Healthcare
Consumer ratings in healthcare have gained significant prominence due to the
proliferation of online review platforms and the growing emphasis on patient-centered care.
Patients and their families, armed with smartphones and internet access, now have the means to
instantly rate and review healthcare facilities, physicians, nurses, and other healthcare
professionals. This democratization of healthcare feedback has empowered consumers to voice
their opinions and share their experiences openly.
Healthcare organizations have also recognized the value of patient feedback in improving
the quality of care. According to Sotto-Santiago et al. (2019), patient’s ratings of their experience
are a vital source of data and information on the competitive advantages of health systems that
inform their actions to deliver quality patient-centered care to their patients. Many hospitals and
clinics actively solicit patient ratings and feedback through surveys and online platforms. These
3
ratings are often used for internal quality improvement efforts and to enhance patient satisfaction
(Arboleda, 2023).
The Factors Influencing Consumer Ratings
Data obtained from patient satisfaction assessments should be considered in the
identification of training requirements for nurses, and initiatives for in-service training should be
organized to improve nurses’ competence and proficiency in care planning (Karaca & Durna,
2019). It can be challenging to determine and use fair and achievable ratings for diverse
healthcare workers that would generate the correct data for informing quality care practices
(Poole & McDougle, 2020). While the intention behind consumer ratings is commendable, it is
essential to recognize that several factors can influence the accuracy and reliability of these
ratings. Some of these factors include:
Patient Expectations
Patient expectations can heavily influence consumer ratings. Patients who enter
healthcare interactions with high expectations are more likely to give positive ratings, even if the
care they receive meets basic standards. Conversely, patients with lower expectations may rate
the same care as exceptional.
Biases
Patients’ perceptions and biases can also impact their ratings. These biases may be related
to factors such as age, gender, race, or socioeconomic status. Biased ratings can lead to
disparities in how healthcare providers are evaluated.
Prior Experiences
Patients’ prior experiences with healthcare, whether positive or negative, can color their
perception of subsequent encounters. A patient who has had a history of positive experiences
4
may be more forgiving of minor issues, while one with negative experiences may be quick to
assign lower ratings.
External Factors
External factors, such as online reviews from other patients, media coverage, or social
media discussions, can influence consumer ratings. These external influences can create a ripple
effect, either bolstering or tarnishing a healthcare provider’s reputation.
Emotional States
Patients’ emotional states at the time of rating can sway their assessments. For instance, a
patient who is feeling anxious, upset, or elated may not provide an objective evaluation of their
healthcare experience.
Limited Understanding of Medical Care
Patients may lack a comprehensive understanding of medical care processes and
standards. Consequently, their ratings may be based on layperson’s perceptions rather than
clinical expertise.
Selection Bias
Online review platforms may suffer from selection bias, as dissatisfied patients may be
more motivated to leave reviews than satisfied ones. This bias can lead to an overrepresentation
of negative experiences.
The Use of Consumer Ratings in Healthcare Quality Assessment
Consumer ratings have increasingly become part of healthcare quality assessment efforts.
However, it is essential to recognize their limitations when interpreting their role in gauging
healthcare quality accurately. Healthcare organizations and policymakers must navigate these
nuances carefully.
5
In conclusion, the rise of consumer ratings in healthcare reflects a significant shift in how
patients engage with and evaluate their healthcare experiences. According to Shah et al. (2021),
patient feedback and ratings are part of the leading indicators of service quality and guide efforts
to address efficiency and viability issues in any healthcare setting. While these ratings offer
valuable insights and promote transparency, it is crucial to acknowledge the factors that can
influence their accuracy. The next sections of this position paper will explore the perspectives
that argue for and against the reliability of consumer ratings in assessing healthcare quality.
Ultimately, this discussion underscores the need for a balanced approach when considering
consumer ratings as indicators of healthcare quality.
6
References
Arboleda, A. M. (2023). Satisfaction with life and perception of healthcare services.
International Journal of Hospitality Management, 110, 103450.
https://doi.org/10.1016/j.ijhm.2023.103450
Karaca, A., & Durna, Z. (2019). Patient Satisfaction with the Quality of Nursing Care. Nursing
Open, 6(2), 535–545. https://doi.org/10.1002/nop2.237
Poole, K., & McDougle, L. (2020). There is Still Bias in Patient Satisfaction Data. Journal of the
National Medical Association, 112(3), 242. https://doi.org/10.1016/j.jnma.2020.03.004
Shah, A. M., Yan, X., Tariq, S., & Ali, M. (2021). What Patients Like or Dislike in Physicians:
Analyzing Drivers of Patient Satisfaction and Dissatisfaction Using a Digital Topic
Modeling Approach. Information Processing & Management, 58(3), 102516.
https://doi.org/10.1016/j.ipm.2021.102516
Sotto-Santiago, S., Slaven, J. E., & Rohr-Kirchgraber, T. (2019). (Dis)Incentivizing Patient
Satisfaction Metrics: The Unintended Consequences of Institutional Bias. Health Equity,
3(1), 13–18. https://doi.org/10.1089/heq.2018.0065
Assignment #1
HAP 465
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Reference #1
Bhandari, N., Scanlon, D. P., Shi, Y., & Smith, R. A. (2019). Why do so few
consumers use health care quality report cards? A framework for
understanding the limited consumer impact of comparative quality
information. Medical Care Research and Review 76(5), 515-537.
https://doi.org/10.1177/1077558718774945
The document is a peer-reviewed research article that was written by authors
with expertise on the topic and who presented objective perspectives on the
issue. Also, the credibility of this document is characterized by the authors’
clear and concise presentation of the information, adherence to the
professional standards for journal articles, and currency of the information.
This reference source is relevant to the topic due to its focus on the
consumer’s use of provider quality information to inform their purchasing
decisions and their impacts on the providers’ approaches to making
adjustments to their practices. Hence, this reference material is relevant for
generating both supporting or opposing evidence on the impacts of consumer
ratings on the false perceptions of quality of care.
Due to the quality of evidence from this source on consumer’s use of
providers’ report cards to guide their healthcare decisions, I plan to use this
reference as part of the supporting evidence to the views of other reference
materials
Bhandari et al. (2018) state that despite the low appeal of current provider
quality information to health consumers, there is still a significant number
who use them to inform their purchasing decisions.
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Reference #2
Arboleda, A. M. (2023). Satisfaction with life and perception of healthcare
services. International Journal of Hospitality Management, 110, 103450 103516. https://doi.org/10.1016/j.ijhm.2023.103516
The document is a peer-reviewed research article that was written by an
author with expertise on the topic and who started the study’s objectives,
presented facts, and supported his claims with evidence from other peerreviewed articles. Similarly, this article is a credible source of information
because it is a recent publication on the topic and demonstrates the author’s
adherence to the professional standards for research publications.
The information in the reference is relevant to the topic because it describes
the association between patient satisfaction and quality of care that contribute
to the perception of the health system. In this regard, this reference provides
evidence to support arguments that consumer ratings do not lead to a false
perception of the quality of care.
The reference would be used to support the views on the positive impacts of
consumer ratings on measures and strategies for delivering quality care
services to patients in any healthcare setting.
Arboleda (2023) states that healthcare organizations perform long-term
assessments that enable them to meet regulatory requirements for quality
services and develop and implement initiatives to attract and maintain
patients’ loyalty (p.103450).
Reference #3
Endeshaw, B. (2021). Healthcare service quality-measurement models: a
review. Journal of Health Research, 35(2), 106-117.
https://doi.org/10.1108/JHR-07-2019-0152
The document is a peer-reviewed research article that was written by an
author with expertise on the topic and who started the study’s objectives,
presented facts, and supported claims with evidence from other peer-reviewed
articles. Also, the credibility of this document is characterized by its date of
publication within the past five years, the author’s clear and concise
presentation of the information, and its adherence to the professional
standards for journal articles.
This reference is relevant to the topic due to its description of the
measurement models for the quality of healthcare services and their
limitations for guiding consumer ratings of quality care from their providers.
The information from this article will be used to demonstrate how consumer
ratings can lead to false perceptions of the quality of care since the
measurement models are outdated and ineffective.
According to Endeshaw (2021), “the dimensions of quality and an approach to
the measurement of healthcare service quality are still not settled upon”
(p.112).
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Reference #4
Karaca, A., & Durna, Z. (2019). Patient satisfaction with the quality of
nursing care. Nursing Open, 6(2), 535-545. https://doi.org/10.1002/nop2.237
This document is an original research article that is peer-reviewed, published
within the past five years, and authored by two experts in the field. Also, this
document is a credible source of information because its facts and findings are
supported by sufficient from multiple research studies, contains clear purpose
statements, and well-written clear and concise contents.
The relevance of this reference to the topic is characterized by its detailed
description of the association between patient satisfaction data and nursing
service quality in any clinical setting.
The contents and information from this reference material would be used to
provide background information on the importance of consumer ratings to
efforts to deliver quality care to patients.
Karaca and Durna (2019) state that patients’ responses to patient satisfaction
surveys should inform the changes and priorities in service areas that affect
quality of care.
Reference #5
Sun, Y., Zhang, Y., Gwizdka, J., & Trace, C. B. (2019). Consumer evaluation
of the quality of online health information: Systematic literature review of
relevant criteria and indicators. Journal of Medical Internet Research, 21(5),
e12522 -e12530. https://doi.org/10.2196/12522
This document is an original research article that is peer-reviewed, published
within the past five years, and authored by experts in the field with similar
publications on the topic. Also, this document is a credible source of
information because its facts and findings are supported by sufficient from
multiple research studies, contains clear purpose statements, and well-written
clear and concise contents.
The relevance of this reference to the topic is characterized by its detailed
description of the suitability and relevance of existing instruments for
collecting consumer ratings of the quality of care from their providers.
The contents and information from this reference material would be used to
provide background information on the importance of consumer ratings to
efforts for delivering quality care to patients.
According to Sun et al. (2019), consumers find it difficult to evaluate the
quality of online health information.
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Format this reference in
APA 7
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is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
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in-text citation for this
source
Reference #6
Poole Jr, K. G., & McDougle, L. (2020). There is still bias in patient
satisfaction data. Journal of the National Medical Association, 112(3), 242242. https://doi.org/10.1016/j.jnma.2020.03.004
This document is a review article that was published within the past three
years and authored by experts in the field with similar publications on the
topic. Also, this document is a credible source of information because its facts
and findings are supported by sufficient from multiple research studies,
contains clear purpose statements, and well-written clear and concise contents
The reference is relevant to the topic because it evidence is useful for
supporting the argument that consumer ratings lead to false perception of the
quality of care due to biases in the data collection process.
The article would be used to support the views on the limitations of the use of
consumer ratings to drive service improvement efforts or implement practices
that lead to the delivery of quality care to patients in any healthcare setting.
Poole Jr, K. G., & McDougle, L. (2020) state that it is difficult to determine
and use fair and achievable ratings for diverse healthcare workers that would
generate the right data for informing quality care practices.
Reference #7
Sotto-Santiago, S., Slaven, J. E., & Rohr-Kirchgraber, T. (2019). (Dis)
incentivizing patient satisfaction metrics: The unintended consequences of
institutional bias. Health Equity, 3(1), 13-18.
https://doi.org/10.1089/heq.2018.0065
The document is a peer-reviewed research article that was written by authors
with expertise on the topic and who presented objective perspectives on the
issue. Also, the credibility of this document is characterized by the authors’
clear and concise presentation of the information, adherence to the
professional standards for journal articles, and currency of the information.
This reference material is relevant for generating opposing evidence on the
impacts of consumer ratings on the false perceptions of quality of care and
supports the views that institutional issues are responsible for the problems
with the wrong application of consumer ratings by healthcare organizations.
The article would be used to oppose the views that consumer ratings
contribute to the false perception of quality of care among healthcare
providers and other stakeholders.
According to Sotto-Santiago et al. (2019), patient’s ratings of their experience
are a vital source of data and information on the competitive advantages of
health systems that inform their actions to deliver quality patient-centered care
to their patients.
Format this reference in
APA 7
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is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Reference #8
Upadhyai, R., Jain, A. K., Roy, H., & Pant, V. (2019). A review of healthcare
service quality dimensions and their measurement. Journal of Health
Management. https://doi.org/10.1177/0972063418822583
The document is a peer-reviewed research article that was written by authors
with expertise on the topic and who started their study’s objectives, presented
facts, and supported claims with evidence from other peer-reviewed articles.
Also, the credibility of this document is characterized by its date of
publication within the past five years, the author’s clear and concise
presentation of the information, and their adherence to the professional
standards for journal articles.
The reference provides information on the dimension of healthcare service
quality and approaches for measuring them that generate data for informing
improvement actions by healthcare organizations.
The information from this article will be used to demonstrate how consumer
ratings can lead to a false perception of quality of care since the constructs
and measurements do not consider providers’ perspective on the factors that
determine service quality.
According to Upadhyai et al. (2019), the focus on patients’ perspective of
quality is inadequate to inform the practice and models for meeting the
benchmarks and metrics for service quality.
Reference #9
Bayindir, E. E., & Schreyögg, J. (2023). Public reporting of hospital quality
measures has not led to overall quality improvement: Evidence from
Germany: Study examines the impact of public reporting on hospital quality
measures in Germany. Health Affairs, 42(4), 566-574.
https://doi.org/10.1377/hlthaff.2022.00470
The document is a research article that was written by two authors with
expertise on the topic and who presented objective perspectives on the issue.
Also, the credibility of this document is characterized by the authors’ clear
and concise presentation of the information, adherence to the professional
standards for journal articles, and currency of the information.
The reference is relevant to the topic because it provides evidence on how the
different aspects of quality measurement do not lead to improvements that
contribute to quality care of patient.
The contents of this reference material would be used to support the
arguments that consumer ratings are inadequate to inform practice changes or
improvements that lead to quality care.
Bayindir et al. (2023) state that “the quality of care that a hospital provides
can be improved to affect patient selection or to preserve or improve the
institution’s reputation” (p.568).
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Reference #10
Shah, A. M., Yan, X., Tariq, S., & Ali, M. (2021). What patients like or
dislike in physicians: Analyzing drivers of patient satisfaction and
dissatisfaction using a digital topic modeling approach. Information
Processing & Management, 58(3), 102516.
https://doi.org/10.1016/j.ipm.2021.102516
Explain why this
reference is relevant to
your topic
This document is an original research article that is peer-reviewed, published
within the past two years, and authored by experts with experience and
authority on the topic area. Also, this document is a credible source of
information because its facts and findings are supported by sufficient from
multiple research studies, contain clear purpose statements, and well-written
clear and concise contents.
This reference material is relevant to the topic through its evidence on the
drivers of positive and negative consumer ratings of their healthcare
providers.
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
The reference material would be used to support or oppose the views that
consumer ratings lead to false perceptions of the quality of care in any
healthcare setting.
According to Shah et al. (2021), patient feedback and ratings are part of the
leading indicators of service quality and guide efforts to address efficiency
and viability issues in any healthcare setting.
Throughout this course you will be developing a formal, Evidence-Based Practice Project Proposal.
The proposal is the plan for an Evidence-Based Practice Project designed to address a problem, issue, or concern in the professional work setting. Although several types of evidence can be used to support a proposed solution, a sufficient and compelling base of support from valid research studies is required as the major component of that evidence. Proposals are submitted in a format suitable for obtaining formal approval in the work setting. Proposals will vary in length depending upon the problem or issue addressed, but they should be between 3,500 and 5,000 words. The cover sheet, abstract, references page, and appendices are not included in the word count. Review the paper template (with abstract) provided in the Student Success Center and “Evidence-Based Practice Project Proposal Format,” located in the Class Resources, for guidance on preparing abstracts.
Section headings and letters for each section component are required. Responses are addressed in narrative form in relation to that section. Evaluation of the proposal in all sections is based upon the extent to which the depth of content reflects graduate-level critical thinking skills.
This project proposal contains six formal sections:
Section A: Problem Description
Section B: Research Support
Section C: Proposed Solution
Section D: Change Model
Section E: Implementation Plan
Section F: Evaluation of Process
Each section (A-F, to be completed in Topics 1-6) was previously submitted as a separate assignment so your instructor could provide feedback for revision (refer to each previous topic for those specific assignments and instructor feedback).
The final paper will consist of the completed project (with revisions to all sections), title page, abstract (review the template with abstract, located in the Student Success Center), reference list, and appendices. Appendices will include a conceptual model for the project, handouts, data and evaluation collection tools, a budget, a timeline, resource lists, and approval forms. Refer to “EBP Implementation Plan Guide” and “Evidence-Based Practice Project Proposal Format,” located in Class Resources, as tools for developing your proposal.
Unformatted Attachment Preview
1
Hospital Acquired Infections (HAIs) due to Inadequate Hand Hygiene Compliance
Antwanetta Boswell
HCA-650
Grand Canyon University
Professor Tucker
09/08/2023
2
Hospital Acquired Infections (HAIs) due to Inadequate Hand Hygiene Compliance
Identify the Problem: Hospital Acquired Infections (HAIs) due to inadequate Hand Hygiene
Compliance.
Background and Significance:
Our healthcare organization has identified a significant issue related to acquired
Infections (HAIs). HAIs significantly threaten patient safety and contribute to increased
healthcare expenses. According to the CDC, 1 out of 31 hospital patients has at least one
healthcare-associated infection. It further outlines that there are numerous HAIs, including
Surgical Site Infections (SSI), Central Line-associated Bloodstream Infections (CLABSI),
Catheter-associated Urinary Tract Infections (CAUTI), and Ventilator-associated Pneumonia
(VAP). Neumark et al. (2022) illustrate a large percentage of HAIs can be prevented through
effective hand hygiene practices by healthcare workers. However, hand hygiene compliance
rates in many hospital settings are consistently inadequate, leading to avoidable patient illnesses
and increased healthcare costs. Our healthcare facility has witnessed 18 HAIs in the last 30 days.
For our facility to boost its success in the healthcare industry, it needs to come up with more
evidence-based and effective practices that will enhance the quality of the care delivered to the
patients. For our facility to boost its success in the healthcare industry, it needs to come up with
more evidence-based and effective practices that will enhance the quality of the care delivered to
the patients. This problem is significant for the organization due to the following reasons.
One, HAIs tend to compromise the patient’s safety. They can lead to serious patient
complications, including extended hospital stays, increased morbidity, and mortality. Ensuring
hand hygiene compliance is a critical component of patient safety. Secondly, HAIs result in
additional healthcare costs, including longer hospital stays, increased antibiotic use, and potential
3
legal liabilities. Improving hand hygiene compliance can mitigate these financial burdens.
Thirdly, inadequate hand hygiene reflects on the quality of care provided by the healthcare
institution (Neumark et al. 2022). Addressing this issue aligns with the organization’s
commitment to delivering high-quality healthcare services. Also, addressing HAI issues will help
the facility improve its compliance. Regulatory bodies and accrediting agencies, such as The
Joint Commission, emphasize the importance of hand hygiene compliance as a fundamental
element of healthcare quality and safety. Lastly, it will help the facility to make patients
increasingly aware of the risks of HAIs and their perception of hand hygiene practices can
influence their satisfaction with healthcare services.
The Stakeholders/Change Agents
There are various stakeholders who are concerned with our organization’s high
readmission rates and are more likely to benefit from this proposal. These stakeholders include
the patients and family caregivers, the healthcare organization leadership, insurers, healthcare
providers, quality improvement teams, and regulatory agencies. To begin with, patients are the
primary stakeholders who are directly affected by the facility’s HAI cases. Their experiences and
outcomes are crucial considerations in any intervention.
Also, the physicians, nurses, and other healthcare professionals who are responsible for
implementing proper hand hygiene practices are integral to achieving higher compliance rates.
Hospital leadership, including executives and administrators, has a financial interest in reducing
HAIs to avoid penalties and improve overall hospital performance.
Similarly, quality improvement teams. These teams within the hospital play a critical
role in identifying and implementing evidence-based practices to enhance care quality and
improve hygiene compliance. Insurance companies and Medicare/Medicaid are stakeholders
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because they may be financially impacted by high readmission rates as a result of HAIs and
penalties. Regulatory bodies such as the Centers for Medicare & Medicaid Services (CMS) and
The Joint Commission are change agents that set guidelines and standards related to hygiene
compliance and HAI prevention.
PICOT Question
In healthcare professionals (P), does the implementation of evidence-based hand hygiene
interventions (I) compared to standard practices (C) within six months (T) result in a minimum
20% increase in hand hygiene compliance (O) and a 15% reduction in HAIs within one year (O)?
Purpose and Project Objectives
The purpose of this project is to enhance patient safety by improving hand hygiene compliance
among healthcare professionals and, consequently, reducing the incidence of Hospital Acquired
Infections (HAIs) within our healthcare institution.
Project Objectives
1. To assess the baseline hand hygiene compliance rates among healthcare professionals in
our institution.
2. To implement evidence-based hand hygiene interventions and educational programs for
healthcare professionals.
3. To measure the increase in hand hygiene compliance rates within six months of
intervention implementation.
4. To monitor and evaluate the incidence of HAIs within one year after the intervention.
Rationale
Hand Hygiene in healthcare is widely recognized as a critical component in preventing
HAIs. Poor hand hygiene among healthcare practitioners is associated with an increase in the
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number of HAIs. Neumark et al. (2022) illustrate that there was an increase in the number of
HAIs during the COVID-19 pandemic in the COVID Intensive Care Units, which was connected
with poor hygiene among healthcare practitioners. Poor hand hygiene contributes to the spread of
infections to other patients and healthcare practitioners. Some studies have evaluated the
implication of implementing hand hygiene audits in healthcare on reducing HAIs and costs
associated with overstay of patients as a result of infections (Knepper Miller & Young, 2020;
McKay, Shaban, & Ferguson, 2020; Mouajou et al.2022). Anguraj et al. (2021) found that
implementation of the HH audit reduced the number of HAIs
6
References
Anguraj, S., Ketan, P., Sivaradjy, M., Shanmugam, L., Jamir, I., Cherian, A., & Sastry, A. S.
(2021). The effect of hand hygiene audit in COVID intensive care units in a tertiary care
hospital in South India. American Journal of Infection Control, 49(10), 1247-1251.
Knepper Miller A.M., & Young H.L(2020). Impact of an automated hand hygiene monitoring
system combined with a performance improvement intervention on hospital-acquired
infections. Infection Control & Hospital
Epidemiology.https://doi.org/10.1017/ice.2020.182
McKay, K. J., Shaban, R. Z., & Ferguson, P. (2020). Hand hygiene compliance monitoring: Do
video-based technologies offer opportunities for the future? Infection, Disease &
Health, 25(2), 92–100. https://doi.org/10.1016/j.idh.2019.12.002
Mouajou, V., Adams, K., DeLisle, G., & Quach, C. (2022). Hand hygiene compliance in the
prevention of hospital-acquired infections: a systematic review. Journal of Hospital
Infection, 119, 33-48. https://doi.org/10.1016/j.jhin.2021.09.016
Neumark, Y., Bar-Lev, A., Barashi, D., & Benenson, S. (2022). A feasibility study of the use of
medical clowns as hand-hygiene promoters in hospitals. Plos one, 17(12), e0279361.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0279361
1
Reducing Hospital Acquired Infections (HAIs) through Hand Hygiene Compliance
Antwanetta Boswell
HCA-650
Grand Canyon University
Professor Tucker
09/08/2023
2
Reducing Hospital Acquired Infections (HAIs) through Hand Hygiene(HH) Compliance
Reducing Hospital Acquired Infections (HAIs) through Hand Hygiene Compliance
Hospital Infections (HAIs) endanger patients and raise healthcare expenses. Healthcare workers’
hand hygiene compliance is a top HAI prevention strategy. HH compliance rates in hospital
settings are generally inadequate, resulting in avoidable illnesses. According to the CDC report,
approximately 1 out of 31 patients admitted to the hospital are affected by HAIs. CDC outlines
that there are numerous HAIs, including Surgical Site Infections (SSI), Central Line-Associated
Bloodstream Infections (CLABSI), Catheter-associated Urinary Tract Infections (CAUTI), and
Ventilator-associated Pneumonia (VAP).
Among all HIAs, CAUTI is more likely to occur. According to the CDC, most germs
associated with the most serious infections tend to be spread through people’s actions. In a
greater way, HH plays a great role in preventing these infections. Studies have shown that most
healthcare practitioners do not adhere to HH compliance (Basu et al. 2021). Due to this disregard
of the healthcare practitioners to wash their hands as supposed, this results in the spread of HAIs
in the healthcare settings. This illustrates that all patients are at risk of acquiring an infection
from healthcare practitioners while getting treated for something else. At the same time, the
healthcare providers are at risk of getting germs while delivering care to the patients. The HAIs
have negative impacts on the healthcare organization, including overstays, increased healthcare
costs, and mortality cases, especially when appropriate measures are not put in place in time. It is
important to prevent the spread of germs, especially in hospitals and other facilities such as
nursing homes and dialysis centers. Hand hygiene also serves as a cornerstone in infection
prevention and control programs and is recommended by organizations like the World Health
Organization (WHO) and the Centers for Disease Control and Prevention (CDC).
3
Despite the well-established importance of hand hygiene in preventing HAIs, the
prevalence of these infections remains unacceptably high in healthcare facilities worldwide.
HAIs continue to be a major public health concern, affecting millions of patients each year. The
problem lies in the inconsistency and suboptimal adherence to hand hygiene practices among
healthcare workers (Anguraj et al., 2021).
Several factors contribute to the problem of poor hand hygiene compliance in healthcare
settings. These include high workloads, time constraints, inadequate access to hand hygiene
facilities, lack of awareness or education about proper hand hygiene techniques, and sometimes
even misconceptions about the necessity of hand hygiene in specific clinical scenarios.
Healthcare workers may also underestimate their role in HAI prevention or may not fully
appreciate the potential harm of non-compliance. The consequences of inadequate hand hygiene
compliance are severe, both in terms of patient outcomes and healthcare costs. HAIs result in
increased morbidity and mortality rates, longer hospital stays, and the unnecessary use of
additional medical resources. Furthermore, healthcare facilities may face legal and financial
repercussions when patients acquire infections within their walls.
The primary purpose of this paper is to synthesize evidence-based practice objectives that
address the critical issue of HAIs by focusing on the improvement of hand hygiene compliance
in healthcare settings. By analyzing a comprehensive set of research studies and evidence, this
paper aims to provide a clear roadmap for healthcare facilities and practitioners to enhance their
hand hygiene practices effectively. Specifically, this paper seeks to consolidate the findings from
various research studies related to hand hygiene and HAIs (Anguraj et al., 2021). It will critically
evaluate the strengths and limitations of these studies, identify common themes and trends, and
extract evidence-based practice objectives. These objectives will be aligned with measurable
4
outcomes to ensure their effectiveness in reducing HAIs. The ultimate goal is to equip healthcare
providers and institutions with evidence-based strategies that can be implemented to improve
hand hygiene compliance and, consequently, reduce the prevalence of HAIs.
Objectives
In the context of reducing Hospital Acquired Infections (HAIs) through improved hand
hygiene compliance, evidence-based practice objectives are essential to guide interventions and
evaluate their effectiveness. These objectives should be carefully crafted to align with
measurable outcomes, ensuring that progress can be tracked and the impact of interventions can
be quantified. Here, we discuss the evidence-based practice objectives for the project and the
importance of achieving these objectives for HAI reduction:
a. Increase Hand Hygiene Compliance Rates:
1. Objective: Achieve a minimum of 90% compliance with hand hygiene protocols among
healthcare workers within the next 12 months.
o Measurable Outcome: Regular monitoring and data collection of hand hygiene
compliance rates using a standardized protocol and electronic monitoring systems.
b. Decrease HAI Incidence:
o Objective: Reduce the overall incidence of HAIs in the healthcare facility by 20% within
the next 24 months.
o Measurable Outcome: Regular surveillance and reporting of HAI rates, comparing preintervention and post-intervention periods.
c. Enhance Healthcare Worker Education:
o Increase the proportion of healthcare workers who receive regular hand hygiene
education and training to 100% within the next 6 months.
5
o Measurable Outcome: Documentation of the completion of hand hygiene training for all
healthcare workers
Method Used in Gathering Research
When searching for the articles to be used for this research, several databases were used,
including PubMed, CINAHL, Cochrane Library, and Scopus. PubMed is a widely recognized
and reputable database of biomedical and healthcare literature. It includes a vast collection of
peer-reviewed articles, making it a valuable resource for research studies related to hand hygiene
and healthcare-associated infections (HAIs). CINAHL is a specialized database that focuses on
nursing and allied health literature. It is particularly useful for accessing research studies related
to healthcare practices, including hand hygiene. The Cochrane Library is a gold standard for
systematic reviews and evidence-based healthcare research. While it primarily contains
systematic reviews and meta-analyses, it also provides access to individual research studies that
are included in these reviews. Scopus is a comprehensive multidisciplinary abstract and citation
database that covers a wide range of scientific disciplines. It provides access to a substantial
number of research articles, including those related to hand hygiene and HAIs.
Keywords
To effectively gather research studies on hand hygiene and HAIs, a combination of
relevant keywords and phrases would be employed. Some of the keywords and phrases that
might be used include hand hygiene, Healthcare-associated infections, Infection control,
Healthcare Workers, Surveillance, and effectiveness. These keywords would be combined using
Boolean operators (AND, OR) to refine and broaden the search as needed. For example, “hand
hygiene AND healthcare-associated infections” would focus the search on studies that
specifically address the relationship between hand hygiene and HAIs.
6
Criteria for Inclusion and Exclusion of Studies
While searching for the studies to be utilized for this research, several inclusion and
exclusion criteria were considered, which are discussed in detail here. For an article to be
included in this study, it must be peer-reviewed and published in the past 5 years, conducted a
randomized control study or qualitative study, studies conducted within healthcare settings
(hospitals, clinics, long-term care facilities), and studies published in English.
Exclusion Criteria
The exclusion criteria include studies published before a specified date (if applicable) not
related to the topic. Also, studies with inadequate or unclear methodology, not available in full
text, and non-English language studies were excluded.
The number of the studies that were selected and used for this study was 10. Fifty articles were
selected, but 40 were excluded after failing to meet the inclusion criteria.
Summary
Basu et al. (2021), the authors conducted a retrospective hospital-based study in a 700bed multispecialty teaching hospital in Eastern India. They aimed to understand the impact of the
COVID-19 pandemic on various hospital-acquired infections (HAIs) and healthcare workers’
hand hygiene compliance rates. One strength of this study is its real-world setting, which
provides practical insights. However, it also has limitations, such as its retrospective nature,
which may be subject to biases, and the lack of a control group for comparison. Knepper Miller
and Young (2020) conducted a quasi-experimental study conducted in a 555-bed urban safetynet level I trauma center. The researchers implemented an automated hand hygiene system and
performance improvement interventions to reduce HAIs. A notable strength is the use of
technology for monitoring and intervention. Nevertheless, the study lacks specific
7
recommendations, and the observed outcomes might be influenced by other variables not
controlled for.
Mouajou et al. (2022) conducted a systematic review to evaluate the effect of Hand
hygiene in the prevention of hospital-acquired infections. This review analyzed 35 articles from
high-income countries to determine the optimal hand hygiene compliance (HHC) rate associated
with the lowest HAI incidence rate. The study follows the Preferred Reporting Items for
Systematic Review and Meta-Analysis (PRISMA) guidelines, ensuring rigorous methodology.
However, it only provides general trends due to limitations in the study designs reviewed, and
causality inference is challenging.
Phan et al. (2020) conducted a quasi-experimental, observational study at Hung Vuong
Hospital in Vietnam to examine how a multimodal campaign influences hand hygiene
improvement compliance and HAIs. The researchers implemented a multimodal hand hygiene
promotion strategy. Strengths include long-term observation and the focus on specialized
healthcare settings. Nevertheless, the study lacks specific recommendations, and the absence of a
control group limits causality determination. Swanson et al. (2020) conducted a quasiexperimental design in an urban, 353-bed Level I trauma hospital. The study evaluated the
implementation of an electronic hand hygiene compliance monitoring system (eHHCMS) to
reduce HAIs. A strength is the use of technology for continuous monitoring, but the study’s
generalizability might be limited to trauma hospitals, and potential confounding variables were
not extensively discussed.
McKay et al. (2020), the researchers conducted a literature review and exploration of
concepts to address the barrier of healthcare-associated infections (HAIs) related to hand hygiene
compliance. They investigated the potential of video-based technologies as an alternative method
8
for monitoring hand hygiene compliance. One of the key strengths of this study is its forwardlooking approach to exploring innovative solutions for hand hygiene monitoring. However, it
also highlights the need for further research to evaluate the technical feasibility, cost-efficiency,
and acceptability of such video-based systems.
Anguraj et al. (2021) aimed to understand the roles and responsibilities of healthcare
aides (HCAs) in infection prevention and control (IPC) in long-term care settings, addressing the
barrier of a lack of standardized roles for HCAs. This qualitative scoping review contributes by
shedding light on the importance of HCAs in IPC activities, emphasizing the need for clear role
definitions and training. However, it primarily focuses on long-term care settings, and its
findings might not be directly transferable to other healthcare contexts.
Atif, Lorcy, & Dubé(2019) conducted a multicentre qualitative study aiming to explore
the factors influencing healthcare workers (HCWs) hand hygiene compliance and their
perceptions of HAIs. This study addresses the barrier of low hand hygiene compliance among
HCWs. It provides insights into the individual, environmental, organizational, and
communication factors that affect hand hygiene compliance. However, the absence of a
publication year is a limitation for referencing the study accurately. Salma et al. (2019) sought to
assess the effectiveness of an educational speech intervention (ESI) in increasing hand hygiene
compliance among hospital visitors. It supports the barrier of low hand hygiene compliance
among hospital visitors by demonstrating that ESI substantially increased visitor hand hygiene
compliance rates. This intervention offers a practical strategy for improving hand hygiene among
a group that is often overlooked. Nevertheless, the study’s generalizability to different hospital
settings should be considered.
9
Villareal et al. (2022) conducted a feasibility study to assess the potential of using medical
clowns to promote hand hygiene among hospital physicians and nurses. This study addresses the
barrier of poor hand hygiene compliance among healthcare workers. The findings indicate that
medical clowns can engage healthcare practitioners effectively, promoting positive behavioral
change and reducing healthcare-associated infections. However, as it is a feasibility study, further
research is needed to confirm the long-term impact and scalability of this approach.
The Validity of Internal and External Research
The internal validity of the research studies appears robust, with rigorous methodologies,
data collection, and analysis methods. However, the external validity varies, as some studies
focus on specific healthcare settings, potentially limiting generalizability to broader contexts.
Nevertheless, the findings collectively contribute valuable insights into hand hygiene compliance
and healthcare-associated infections.
10
References
Anguraj, S., Ketan, P., Sivaradjy, M., Shanmugam, L., Jamir, I., Cherian, A., & Sastry, A. S.
(2021). The effect of hand hygiene audit in COVID intensive care units in a tertiary care
hospital in South India. American Journal of Infection Control, 49(10), 1247-1251.
Atif, S., Lorcy, A., & Dubé, E. (2019). Healthcare workers’ attitudes toward hand
hygiene practices: Results of a multicentre qualitative study in Quebec. Canadian
Journal of Infection Control, 34(1). https://doi.org/10.36584/cjic.2019.004
Basu, M., Mitra, M., Ghosh, A., & Pal, R. (2021). Journal of Family Medicine and Primary Care,
10(9), 3348. DOI: 10.4103/jumps.jfmpc_742_21
https://www.sciencedirect.com/science/article/pii/S0196655321004831
Knepper Miller A.M., & Young H.L(2020). impact of an automated hand hygiene monitoring
system combined with a performance improvement intervention on hospital-acquired
infections.Infection Control & Hospital Epidemiology.
https://doi.org/10.1017/ice.2020.182
Mckay, K. J., Shaban, R. Z., & Ferguson, P. (2020). Hand hygiene compliance monitoring: Do
video-based technologies offer opportunities for the future? Infection, Disease &
Health, 25(2), 92–100. https://doi.org/10.1016/j.idh.2019.12.002
Mouajou, V., Adams, K., DeLisle, G., & Quach, C. (2022). Hand hygiene compliance in the
prevention of hospital-acquired infections: a systematic review. Journal of Hospital
Infection, 119, 33-48. https://doi.org/10.1016/j.jhin.2021.09.016
Neumark, Y., Bar-Lev, A., Barashi, D., & Benenson, S. (2022). A feasibility study of the use of
medical clowns as hand-hygiene promoters in hospitals. Plos one, 17(12), e0279361.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0279361
11
Phan, H. T., Zingg, W., Tran, H. T. T., Dinh, A. P. P., & Pittet, D. Sustained effects of a
multimodal campaign aiming at hand hygiene improvement on compliance and
healthcare-associated infections in a large gynecology/obstetrics tertiary-care center in
Vietnam, 2020. https://doi.org/10.1186/s13756-020-00712-x
Swanson, S., Baken, L., & Bor, B. Implementation of a Hospital-wide Electronic Hand Hygiene
Monitoring Program Reduces Healthcare-acquired Infections in a Level I Trauma
Hospital. https://www.ajicjournal.org/article/S0196-6553(20)30389-8/pdf
Villarreal, S., Khan, S., Oduwole, M., Sutanto, E., Vleck, K., Katz, M., & Greenough, W. B.
(2020). Can educational speech intervention improve visitors’ hand hygiene compliance?
Journal of Hospital Infection, 104(4), 414–418. https://doi.org/10.1016/j.jhin.2019.12.002
1
Proposed Solution
Antwanetta Boswell
Grand Canyon University
HCA-650
Professor Tucker
09/15/2023
2
Proposed Solution
Treatments for improving hand hygiene compliance and reducing HAIs are based on
scientific evidence. This technique enhances patient safety, lowers healthcare-associated
infections, and complements current evidence.
Several studies and regulations emphasize the need for hand hygiene to prevent infection
in hospital settings. To prevent HAIs, the WHO and CDC recommend evidence-based hand
hygiene. These guidelines emphasize the necessity of washing your hands with soap and water or
alcohol-based hand sanitizers before invasive operations, after handling surrounding surfaces,
and before patient contact.
Several academic sources support the answer. Evidence-based hand hygiene programs
improved healthcare professionals’ compliance with hand hygiene recommendations and
decreased HAIs, according to a thorough research published in the Journal of Hospital Infection
Wang et al. (2021) found that hand hygiene promotion programs are more cost-effective than
HAI therapy in the American Journal of Infection Control.
The proposed system also adheres to evidence-based practice, which combines expert
judgment, patient preferences, and the most reliable data for making judgments. Healthcare
professionals may adhere to the most recent research and recommendations by employing
evidence-based hand hygiene techniques.
The suggested approach complies with current research and standards, but its deployment
in a hospital setting must be considered. Consideration must be given to resource availability,
training requirements, and organizational support to adopt and improve hand hygiene
compliance. To aim for a minimum 20% increase in hand hygiene compliance and a minimum
3
15% decline in HAIs within a year, track progress, and assess the effectiveness of the
intervention.
Organizational or Community Culture
The effectiveness of a healthcare intervention is contingent upon factors such as the
organizational culture and the availability of resources, which may be exemplified by the
improvement of hand hygiene to mitigate the occurrence of healthcare-associated infections
(HAIs). Healthcare facilities need to embody the cultural values and principles of the
organization. Hand hygiene procedures are a preventive measure against patient harm, rendering
them highly sought after by healthcare institutions prioritizing their patients’ safety (ToneyButler & Carver, 2019). Cultures of continuous improvement can be effectively aligned with
evidence-based approaches. The enhancement of organizational leadership commitment and
accountability serves to reinforce the responsibility for patient outcomes.
The alignment of resources is paramount in ensuring sustainability and usefulness. Costbenefit evaluations indicate that hand hygiene initiatives possess financial sustainability,
facilitating sensible resource management. The presence of individuals who possess expertise
and have received training in infection control facilitates a more streamlined implementation
process. The feasibility and effectiveness of the intervention are evident within the operational
framework of the healthcare institution due to its seamless integration with existing processes
and utilization of data analytics to coordinate with available time and technology resources.
Integrating these components increases the probability of a hand hygiene intervention being
efficacious and aligning with the organizational culture and available resources.
Stakeholders
4
The effectiveness of the project depends on the varied groups of stakeholders
participating in the implementation of evidence-based hand hygiene treatments to minimize
hospital-acquired infections (HAIs) (Gould et al., 2017). The success of the intervention is
directly impacted by the implementation of hand hygiene practices by healthcare personnel,
including physicians and nurses. Patient safety and health outcomes depend on increased hand
hygiene compliance because they are the primary beneficiaries. The hospital administration is
essential in allocating funds, establishing guidelines, and promoting a hand hygiene-friendly
culture. Teams dedicated to infection control and prevention create, oversee, and assess infection
control procedures to ensure the longevity of the intervention. Families and caregivers must be
educated and encouraged to participate in hand hygiene practices while engaging in patient care.
At the same time, hospital support employees, such as janitors, are crucial for keeping a clean
and infection-free environment.
A thorough plan is necessary to interact with these stakeholders successfully. Regular
training sessions and reminders built into their schedules, using intranet portals and email
updates for information distribution, might benefit healthcare personnel. Posters and pamphlets
can serve as reminders, while patients can also get education through materials and instructive
seminars. Hospital administration should frequently get updates and progress reports through
meetings and presentations. Teams in charge of infection control and prevention should keep
communication lines open with clinical staff members and have frequent meetings and datasharing sessions. Hospital support workers must attend training sessions and briefings. During
the admission and release of patients, conversations with relatives and caregivers about their
responsibility in upholding hand hygiene can occur. The effectiveness of the hand hygiene
initiative depends critically on effective communication with these stakeholders.
5
Expected Outcomes and Goals
The hand hygiene intervention is designed to provide several distinct and
quantifiable results. With regular monitoring and comparisons to baseline data, it first aims to
raise hand hygiene compliance among healthcare personnel by at least 20% within six months.
By introducing evidence-based hand hygiene practices and monitoring infection rates against
historical data, the intervention seeks to reduce Healthcare-Associated Infections (HAIs) by 15%
within a year. Improved patient safety and satisfaction are a secondary but crucial result of
decreased HAIs, resulting in fewer complications, shorter hospital stays, and higher patient
satisfaction ratings (Haque et al., 2018). By lessening the cost of treating HAIs and
demonstrating a return on investment, the intervention also attempts to show cost savings. The
effectiveness of enhanced hand hygiene practices and a long-lasting infection prevention culture
will be determined by continued adherence to hand hygiene guidelines after the first
implementation phase.
In conclusion, the hand hygiene intervention’s anticipated aims and results include better
patient safety and satisfaction, decreased HAIs, higher compliance, cost savings, and a longlasting culture of infection prevention within the healthcare context. These goals are intended to
enhance healthcare procedures and patient outcomes significantly and are connected to the
PICOT question.
Method to Achieve Outcomes
A thorough approach is necessary to increase hand hygiene compliance and
decrease hospital-acquired infections (HAIs) within predetermined timeframes. This plan
includes the following crucial components:
6
Programs for education and training must be implemented first. Targeting healthcare
professionals and support employees, this training should stress the importance of hand
cleanliness, offer precise instructions, and refute prevalent myths. Second, monitoring and
feedback systems need to be put in place. Hand hygiene compliance should be tracked using a
thorough monitoring strategy that combines technological instruments and manual inspections.
For changes to last, immediate feedback that emphasizes constructive criticism and positive
reinforcement is essential.
Additionally, technology-enhanced reminders and prompts incorporated into processes
and strategically positioned around healthcare facilities help ensure hand hygiene is routinely
maintained. Leadership support is necessary to establish an example and preserve an infection
prevention culture. Data-driven decision-making,
College of Health Sciences
Department of Public Health
HCM-ASSIGNMENT -Week 7
Course name:
HCM
Course number:
101
CRN
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Assignment title or task:
•
Review Chapter 5 in Buchbinder & Shanks (2012).
Examine the missions and visions of any health
Organizations within Saudi Arabia.
(The organization must have website)
Using a Word document, write one page paper.
Choose one health Organizations and identify three
strategic priorities it exhibits. What market powers
and trends will have an impact on these priorities?
What would the role of the manager be in setting and
implementing these strategies?
Student name:
Students Id Number:
Submission date:
Instructor name:
Grade:
College of Health Sciences
Department of Public Health
Guidelines:
•
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Your response should in one page paper and not exceed 300 words.
Font should be 12 Times New Roman
Heading should be Bold
Color should be Black
Line spacing should be 1.5
Use Assignment coversheet
Use proper references in APA style
1- In this week’s discussion post, I will be appraising the Exploration of Nurses’ Knowledge, Attitudes, and Perceived Barriers toward Medication Error Reporting in a Tertiary Health Care Facility: A Qualitative Approach. When discussing the first consideration for an appraisal which is, elements of style, the research study checked all of the boxes. The statement of phenomenon of interest, the method, the purpose, sampling, authenticity and trustworthiness of data, finding, and conclusions were all met as well. When discussing the ethical considerations the protection of the participants was addressed in the article on the first paragraph on page 3. The data collection in the article was focused on human experience, the researcher mentioned that they were going to conduct their research by interviewing each participant, they had extensive data on how the participants are feeling, and the way that the researchers recorded the data was appropriate. Lastly, the procedure for collecting data started with an “in-depth interview session” (p.g 3) that was roughly 30-45 minutes long and the participants were asked probing questions as well to provoke a more revealing answer.The data analysis was performed by using the “thematic analysis approach” (p.g 3). Which is were the participants’ responses were coded in a specific letter and number. The data analysis strategy was to start in a familiarized stage, then the initial code stage, and then the finalized code stage. If I was the appraising committee for research studies I would go ahead and appraise this study. Now looking into the strengths and weaknesses of this study would be the following. Something that I would consider a weakness in this particular study is the amount of participants and that the research team did not go to any other medical facility. If they would have gone to different medical facilities that would increase the number of participants and it would also give them a different perspective on how other facilities and the people in them feel about reporting medication errors. As to the rest of the study I believe that it was all good. 2- In the Tertiary Health care facility, the qualitative research study investigates the nurses’ understanding of the various drug mistake reporting mechanisms, their attitudes toward them, and their perceived hurdles to doing so. Based on the article, it is noteworthy that medication error reporting (MER) appears to be a much more successful strategy that is employed in the discovery of the underlying causes of various medication errors (MEs) and aids in their future control in other companies (Dyab et al.,2018). One major issue raised in many MER systems across numerous healthcare institutions is the inadequate reporting of the MEs. This research aimed to comprehend nurses’ comprehension of MER by assessing nurses’ attitudes toward revealing and examining nurses’ asserting conveniences and obstacles. The qualitative investigation is, nevertheless, divided into many strengths and disadvantages. Arguably, the study’s greatest asset is its assertion that Medication Error Reporting (MER) is a far more efficient technique to pinpoint the essential reasons behind Medication Errors (ME) and devise strategies to stop them from happening again inside the company(Dyab et al.,2018). The study also demonstrates that the inadequate reporting of MEs is observed in several MER platforms. The study’s main goal was to explore the nurses’ comprehension of MER by identifying their reporting perspectives and obstacles and facilitators to MER. The study is helpful because it demonstrates strategies that may be used to increase nurses’ involvement in MER in the company context. In this qualitative research study, drawbacks are also listed for the study. The study needs to dive into more depth about Medication Error Reporting (MER) or the many strategies that may be employed within the context of an organization to guarantee that the procedure is carried out successfully. The article does not demonstrate whether to implement MER; it simply emphasizes the significance of MER and how it may be used to discover pharmaceutical mistakes (MEs). Because the study is exploratory qualitative, bias of generalizability was experienced in which the study used the convenience techniques of interviewing data collection method. This would lead to chances of incorrect understanding or wrong interpretation of data collected that would mislead the reporting of MEs observed in MER.
1) After working with your preceptor to assess organizational policies, create a list of measurable outcomes for your capstone project intervention. Write a list of three to five outcomes for your proposed intervention. Below each outcome, provide a two – three sentence rationale.
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2) In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student’s ability to further develop and synthesize the assignments that constitute the components of the capstone project.
The assignment will be used to develop a written implementation plan.
For this assignment, provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected. The articles should be current (within the last 5 years) and closely relate to the PICOT question developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project.
While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
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3) Write a reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing.
Topic Focus: Ethical Considerations in Health Care
While APA style is not required for the body of this assignment, solid academic writing is expected.
please look at the slides read the case study and create a script on slide “Our perspective” that i can present during my presenataion. case study is chapter 7 case study #4 so you have an idea what the subject is about
Please follow the instructions in the word document provided.Please make use of the Walden library for peer reviewed articles if neededPlease provide 10 slides excluding introduction page and reference page
Unformatted Attachment Preview
REGULATION FOR NURSING PRACTICE
STAFF DEVELOPMENT MEETING
Nursing is a very highly regulated profession. There are over 100 boards of nursing and
national nursing associations throughout the United States and its territories. Their
existence helps regulate, inform, and promote the nursing profession. With such
numbers, it can be difficult to distinguish between BONs and nursing associations, and
overwhelming to consider various benefits and options offered by each.
Both boards of nursing and national nursing associations have significant impacts on the
nurse practitioner profession and scope of practice. Understanding these differences
helps lend credence to your expertise as a professional. In this Assignment, you will
practice the application of such expertise by communicating a comparison of boards of
nursing and professional nurse associations. You will also share an analysis of your state
board of nursing.
RESOURCES
Required Readings
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Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s
guide (6th ed.). Jones & Bartlett Learning.
o Chapter 4, “Government Response: Regulation” (pp. 57–84)
American Nurses Association. (n.d.). ANA enterpriseLinks to an external site..
Retrieved September 20, 2018, from http://www.nursingworld.org
Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., &
Poghosyan, L. (2017). Position statement: Full practice authority for advanced
practice registered nurses is necessary to transform primary careLinks to an
external site.. Nursing Outlook, 65(6), 761–765.
Halm, M. A. (2018). Evaluating the impact of EBP education: Development of
a modified Fresno test for acute care nursing Download Evaluating the impact
of EBP education: Development of a modified Fresno test for acute care
nursing. Worldviews on Evidence-Based Nursing, 15(4), 272–280.
doi:10.1111/wvn.12291
National Council of State Boards of Nursing (NCSBN)Links to an external site..
(n.d.). Retrieved September 20, 2018, from https://www.ncsbn.org/index.htm
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Neff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman
J. S. (2018). The impact of nurse practitioner regulations on population access
to careLinks to an external site.. Nursing Outlook, 66(4), 379–385.
Peterson, C., Adams, S. A., & DeMuro, P. R. (2015). mHealth: Don’t forget all
the stakeholders in the business caseLinks to an external site.. Medicine 2.0,
4(2), e4.
To Prepare:
•
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Assume that you are leading a staff development meeting on regulation for
nursing practice at your healthcare organization or agency.
Review the NCSBN and ANA websites to prepare for your presentation.
The Assignment: (8- to 9-slide PowerPoint presentation)
Develop a 8- to 9-slide PowerPoint Presentation that addresses the following:
•
•
•
•
•
•
Describe the differences between a board of nursing and a professional nurse
association.
Describe the board for your specific region/area.
o Who is on the board?
o How does one become a member of the board?
Describe at least one state regulation related to general nurse scope of
practice.
o How does this regulation influence the nurse’s role?
o How does this regulation influence delivery, cost, and access to
healthcare?
o If a patient is from another culture, how would this regulation
impact the nurse’s care/education?
Describe at least one state regulation related to Advanced Practice Registered
Nurses (APRNs).
o How does this regulation influence the nurse’s role?
o How does this regulation influence delivery, cost, and access to
healthcare?
Has there been any change to the regulation within the past 5 years? Explain.
Include Speaker Notes on Each Slide (except on the title page and reference
page)
NURS_6050_Module03_Week06_Assignment_Rubric
NURS_6050_Module03_Week06_Assignment_Rubric
Criteria
This criterion is linked
to a Learning
OutcomeBoards of
Nursing vs.
Professional Nurse
AssociationsDevelop a
8- to 9- slide
PowerPoint
presentation that
addresses the
following:· Describe
the differences
between a board of
nursing and a
professional nurse
association.· Describe
the members of the
board for your specific
region/area.· Who is
on the board?· How
does one become a
member of the board?·
Speaker notes are
included on every slide
and are used to
explain and elaborate
the significant points
on each slide.
Ratings
25 to >22.0 pts
Excellent
Using sufficient
evidence, the response
accurately and
thoroughly describes
the differences between
a board of nursing and
professional nurse
associations.
…Response provides a
complete and accurate
description of who is
on a board of nursing.
…Response provides a
detailed and thorough
explanation of how one
becomes a member of
the board of nursing.
…Speaker notes are
included on every slide
and are used to explain
and elaborate the
significant points on
each slide.
22 to >19.0 pts
Good
Using sufficient
evidence, the response
accurately describes the
differences between a
board of nursing and
professional nurse
associations.
…Response provides an
accurate description of
who is on a board of
nursing. …Response
provides an accurate
explanation of how one
becomes a member of
the board of nursing.
…Speaker notes are
included on every slide
and are used to explain
the significant points on
each slide.
19 to >17.0 pts
Fair
Description of the
differences between a
board of nursing and
professional nurse
associations is
inaccurate or
incomplete.
…Description of who is
on a board of nursing is
incomplete or
inaccurate.
…Explanation of how
one becomes a member
of the board of nursing
is vague or inaccurate.
…Speaker notes are
incomplete or lack
sufficient elaboration.
17 to >0 pts
Poor
Description of t
differences betw
board of nursin
professional nu
associations is
inaccurate or
incomplete.
…Description o
is on a board of
nursing is incom
or inaccurate.
…Explanation o
one becomes a
member of the b
of nursing is va
inaccurate. …Sp
notes are missin
This criterion is linked
to a Learning
OutcomeThe Impact
of State Regulation on
Nurse
PracticeDescribe at
least one state
regulation related to
general nurse scope of
practice.• How does
this regulation
influence the nurse’s
role?• How does this
regulation influence
delivery, cost, and
access to healthcare?•
If a patient is from
another culture, how
would this regulation
impact the nurse’s
care/education?• Has
there been any change
to the regulation
within the past 5
years? Explain.•
Speaker notes are
included on every slide
and are used to
explain and elaborate
the significant points
on each slide.
30 to >26.0 pts
Excellent
Response includes an
accurate and thorough
description of how one
state regulation is
related to general nurse
scope of practice.
…Response accurately
and thoroughly
explains how the
regulation influences
the nurse’s role.
…Response accurately
and thoroughly
explains how the
regulation(s) influences
delivery, cost, and
access to healthcare.
…Response accurately
and thoroughly
explains how the
regulation impacts the
nurse’s care/education
to provide care for
other cultures. …
Changes fully
explained.
…Presentation includes
speaker notes that
explain and elaborate
the significant points of
the presentation.
26 to >23.0 pts
Good
Response includes an
accurate description of
how one state
regulation is related to
general nurse scope of
practice. …Response
accurately explains
how the regulation
influences the nurse’s
role. …Response
accurately explains
how the regulation(s)
influences delivery,
cost, and access to
healthcare. …Response
accurately explains
how the regulation
impacts the nurse’s
care/education to
provide care for other
cultures. …Changes
partially explained.
…Presentation includes
speaker notes that
explain the points of
the presentation.
23 to >20.0 pts
Fair
Description of one or
more state regulations
that are related to
general nurse scope of
practice is incomplete
or inaccurate.
…Explanation of how
the regulation(s)
influences the nurse’s
role is vague or
inaccurate.
…Explanation of how
the regulation(s)
influences delivery,
cost, and access to
healthcare is vague or
inaccurate.
…Explanation of how
the regulation(s)
influences the nurse’s
care/education for other
cultures is vague or
inaccurate. …Change is
vague. …Presentation
includes speaker notes
that are incomplete or
lack appropriate
explanation.
20 to >0 pts
Poor
Description of o
more state regul
related to genera
scope of practice
vague and inacc
is missing.
…Explanation of
the regulation(s)
influences the nu
role is vague and
inaccurate or is
missing. …Expla
of how the
regulation(s) inf
delivery, cost, an
access to healthc
vague and inacc
or is missing.
…Explanation of
the regulation(s)
influences the nu
care/education f
cultures is vague
inaccurate or mi
…Change was no
discussed. …Spe
notes are missin
NURS_6050_Module03_Week06_Assignment_Rubric
Criteria
This criterion is linked
to a Learning
OutcomeDescribe at
least one state
regulation related to
Advanced Practice
Registered Nurses
(APRNs).• How does
this regulation
influence the nurse’s
role?• How does this
regulation influence
delivery, cost, and
access to healthcare?•
Has there been any
change to the
regulation within the
past 5 years?
Explain.Speaker notes
are included on every
slide and are used to
explain and elaborate
the significant points
on each slide.
Ratings
30 to >26.0 pts
Excellent
Using sufficient
evidence, response
includes an accurate
and thorough
description of how one
state regulation is
related to Advanced
Practice Registered
Nurses (APRNs).
…Response accurately
and thoroughly
explains how the
regulation influences
the nurse’s role.
…Response accurately
and thoroughly
explains how the
regulation(s) influences
delivery, cost, and
access to healthcare. …
Changes fully
explained.
…Presentation includes
speaker notes that
explain and elaborate
on the significant
points of the
presentation.
26 to >23.0 pts
Good
Using sufficient
evidence, response
includes an accurate
description of how one
state regulation is
related to Advanced
Practice Registered
Nurses (APRNs).
…Response accurately
explains how the
regulation influences
the nurse’s role.
…Response accurately
explains how the
regulation(s) influences
delivery, cost, and
access to healthcare.
…Changes partially
explained.
…Presentation includes
speaker notes that
explain the points of
the presentation.
23 to >20.0 pts
Fair
Description of one or
more state regulations
that are related to
Advanced Practice
Registered Nurses
(APRNs) is incomplete
or inaccurate.
…Explanation of how
the regulation(s)
influences the nurse’s
role is vague or
inaccurate.
…Explanation of how
the regulation(s)
influences delivery,
cost, and access to
healthcare is vague or
inaccurate. …Change is
vague. …Presentation
includes speaker notes
that are incomplete or
lack appropriate
explanation.
20 to >0 pts
Poor
Description of o
more state regul
related to Advan
Practice Registe
Nurses (APRNs
vague and inacc
or is missing.
…Explanation o
the regulation(s)
influences the n
role is vague and
inaccurate or is
missing. …Expla
of how the
regulation(s) inf
delivery, cost, a
access to healthc
vague and inacc
or is missing. …
was not discusse
…Speaker notes
missing.
NURS_6050_Module03_Week06_Assignment_Rubric
Criteria
Ratings
This criterion is linked
to a Learning
OutcomeWritten
Expression and
Formatting—
Paragraph
Development and
OrganizationSpeaker
notes make clear
points that support
well developed ideas,
low logically, and
demonstrate
continuity of
ideas.Sentences are
carefully focused-neither long and
rambling nor short and
lacking substance. A
clear and
comprehensive
purpose statement
and introduction and
conclusion are
provided which
delineate all required
criteria.
5 to >4.0 pts
Excellent
Speaker notes and
sentences follow writing
standards for flow,
continuity, and clarity.
…A clear and
comprehensive purpose
statement, introduction,
and conclusion is
provided which delineates
all required criteria.
This criterion is linked
to a Learning
OutcomeWritten
Expression and
Formatting: English
Writing
StandardsCorrect
grammar, mechanics,
and proper
punctuation.
5 to >4.0 pts
Excellent
Uses correct
grammar, spelling,
and punctuation with
no errors.
4 to >3.0 pts
Good
Speaker notes and
sentences follow
writing standards for
flow, continuity, and
clarity 80% of the
time. …Purpose,
introduction, and
conclusion of the
assignment is stated,
yet is brief and not
descriptive.
4 to >3.0 pts
Good
Contains a few (1-2)
grammar, spelling,
and punctuation
errors.
3 to >2.0 pts
Fair
Speaker notes and
sentences follow
writing standards for
flow, continuity, and
clarity 60%- 79% of
the time. …Purpose,
introduction, and
conclusion of the
assignment is vague
or off topic.
3 to >2.0 pts
Fair
Contains several (34) grammar,
spelling, and
punctuation errors.
2 to >0 pts
Poor
Speaker notes a
sentences follo
writing standar
flow, continuity
clarity < 60% o
time. ...Purpose
introduction, an
conclusion of th
assignment is
incomplete or
missing.
2 to >0 pts
Poor
Contains many (≥5) gram
spelling, and punctuatio
that interfere with the re
understanding.
NURS_6050_Module03_Week06_Assignment_Rubric
Criteria
This criterion is linked
to a Learning
OutcomeWritten
Expression and
Formatting: The
presentation follows
correct APA format
for parenthetical/intext citations, and
reference list.
Total Points: 100
Ratings
5 to >4.0 pts
Excellent
Uses correct APA
format with no errors.
4 to >3.0 pts
Good
Contains a few (1-2)
APA format errors.
3 to >2.0 pts
Fair
Contains several (3-4)
APA format errors.
2 to >0 pts
Poor
Contains many
APA format err
Prepare an 8–10 minute audio training tutorial (video is optional) for new nurses on the importance of nursing-sensitive quality indicators.
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Introduction
The focus of Assessment 4 is on how informatics support monitoring of nursing-sensitive quality indicator data. You will develop an 8–10 minute audio (or video) training module to orient new nurses in a workplace to a single nursing-sensitive quality indicator critical to the organization. Your recording will address how data are collected and disseminated across the organization along with the nurses’ role in supporting accurate reporting and high quality results.
Preparation
As you begin to prepare this assessment you are encouraged to complete the Conabedian Quality Assessment Framework activity. Quality health care delivery requires systematic action. Completion of this will help you succeed with the assessment as you consider how the triad of structure (such as the hospital, clinic, provider qualifications/organizational characteristics) and process (such as the delivery/coordination/education/protocols/practice style or standard of care) may be modified to achieve quality outcomes.
This assessment requires you to prepare an 8–10 minute audio training tutorial (with optional video) for new nurses on the importance of nursing-sensitive quality indicators. To successfully prepare for your assessment, you will need to complete the following preparatory activities:
Select a single nursing-sensitive quality indicator that you see as important to a selected type of health care system. Choose from the following list:
Staffing measures.
Nursing hours per patient day.
RN education/certification.
Skill mix.
Nurse turnover.
Nursing care hours in emergency departments, perioperative units, and perinatal units.
Skill mix in emergency departments, perioperative units, and perinatal units.
Quality measures.
Patient falls.
Patient falls with injury.
Pressure ulcer prevalence.
Health care-associated infections.
Catheter-associated urinary tract infection.
Central line catheter associated blood stream infection.
Ventilator-associated pneumonia.
Ventilator- associated events.
Psychiatric physical/sexual assault rate.
Restraint prevalence.
Pediatric peripheral intravenous infiltration rate.
Pediatric pain assessment, intervention, reassessment (air) cycle.
Falls in ambulatory settings.
Pressure ulcer incidence rates from electronic health records.
Hospital readmission rates.
RN satisfaction survey options.
Job satisfaction scales.
Job satisfaction scales – short form.
Practice environment scale.
Conduct independent research on the most current information about the selected nursing-sensitive quality indicator.
Interview a professional colleague or contact who is familiar with quality monitoring and how technology can help to collect and report quality indicator data. You do not need to submit the transcript of your conversation, but do integrate what you learned from the interview into the audio tutorial. Consider these questions for your interview:
What is your experience with collecting data and entering it into a database?
What challenges have you experienced?
How does your organization share with the nursing staff and other members of the health care system the quality improvement monitoring results?
What role do bedside nurses and other frontline staff have in entering the data? For example, do staff members enter the information into an electronic medical record for extraction? Or do they enter it into another system? How effective is this process?
Watch the Informatics and Nursing-Sensitive Quality Indicators Video Exemplar.
Recording Your Presentation
To prepare to record the audio for your presentation, complete the following:
Set up and test your microphone or headset using the installation instructions provided by the manufacturer. You only need to use the headset if your audio is not clear and high quality when captured by the microphone.
Practice using the equipment to ensure the audio quality is sufficient.
Review Using Kaltura for Kaltura to record your presentation.
View Creating a Presentation: A Guide to Writing and Speaking. This video addresses the primary areas involved in creating effective audiovisual presentations. You can return to this resource throughout the process of creating your presentation to view the tutorial appropriate for you at each stage.
Notes:
You may use other tools to record your tutorial. You will, however, need to consult Using Kaltura for instructions on how to upload your audio-recorded tutorial into the courseroom, or you must provide a working link your instructor can easily access.
You may also choose to create a video of your tutorial, but this is not required.
If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@Capella.edu to request accommodations.
Instructions
For this assessment, imagine you are a member of a Quality Improvement Council at any type of health care system, whether acute, ambulatory, home health, managed care, et cetera. Your Council has identified that newly hired nurses would benefit from comprehensive training on the importance of nursing-sensitive quality indicators. The Council would like the training to address how this information is collected and disseminated across the organization. It would also like the training to describe the role nurses have in accurate reporting and high-quality results.
The Council indicates a recording is preferable to a written fact sheet due to the popularity of audio blogs. In this way, new hires can listen to the tutorial on their own time using their phone or other device.
As a result of this need, you offer to create an audio tutorial orienting new hires to these topics. You know that you will need a script to guide your audio recording. You also plan to incorporate into your script the insights you learned from conducting an interview with an authority on quality monitoring and the use of technology to collect and report quality indicator data.
You determine that you will cover the following topics in your audio tutorial script:
Introduction: Nursing-Sensitive Quality Indicator
What is the National Database of Nursing-Sensitive Quality Indicators?
What are nursing-sensitive quality indicators?
Which particular quality indicator did you select to address in your tutorial?
Why is this quality indicator important to monitor?
Be sure to address the impact of this indicator on the quality of care and patient safety.
Why do new nurses need to be familiar with this particular quality indicator when providing patient care?
Collection and Distribution of Quality Indicator Data
According to your interview and other resources, how does your organization collect data on this quality indicator?
How does the organization disseminate aggregate data?
What role do nurses play in supporting accurate reporting and high-quality results?
As an example, consider the importance of accurately entering data regarding nursing interventions.
After completing your script, practice delivering your tutorial several times before recording it.
Additional Requirements
Audio communication: Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.
Length: 8–10 minute audio recording. Use Kaltura to upload your recording to the courseroom, or provide a working link your instructor can access.
Script: A separate document with the script or speaker’s notes is required. Important: Submissions that do not include the script or speaker’s notes will be returned as a non-performance.
References: Cite a minimum of three scholarly and/or authoritative sources.
APA: Submit, along with the recording, a separate reference page that follows APA style and formatting guidelines. For an APA refresher, consult the Evidence and APA page on Campus.
Context
The American Nursing Association (ANA) established the National Database of Nursing Quality Indicators (NDNQI®) in 1998 to track and report on quality indicators heavily influenced by nursing action.
NDNQI® was established as a standardized approach to evaluating nursing performance in relation to patient outcomes. It provides a database and quality measurement program to track clinical performance and to compare nursing quality measures against other hospital data at the national, regional, and state levels. Nursing-sensitive quality indicators help establish evidence-based practice guidelines in the inpatient and outpatient settings to enhance quality care outcomes and initiate quality improvement educational programs, outreach, and protocol development.
The quality indicators the NDNQI® monitors are organized into three categories: structure, process, and outcome. Theorist Avedis Donabedian first identified these categories. Donabedian’s theory of quality health care focused on the links between quality outcomes and the structures and processes of care (Grove et al., 2018).
Nurses must be knowledgeable about the indicators their workplaces monitor. Some nurses deliver direct patient care that leads to a monitored outcome. Other nurses may be involved in data collection and analysis. In addition, monitoring organizations, including managed care entities, exist to gather data from individual organizations to analyze overall industry quality. All of these roles are important to advance quality and safety outcomes.
REFERENCE
Grove, S. K., Gray, J. R., Jay, G. W., Jay, H. M., & Burns, N. (2018). Understanding nursing research: Building an evidence-based practice (7th ed.). Elsevier.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Describe nurses’ and the interdisciplinary team’s role in informatics with a focus on electronic health information and patient care technology to support decision making.
Describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.
Competency 3: Evaluate the impact of patient care technologies on desired outcomes.
Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.
Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients.
Justify how a nursing-sensitive quality indicator establishes evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes.
Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.
Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.
Follow APA style and formatting guidelines for citations and references.
Throughout history, technological advancements have appeared for one purpose before finding applications elsewhere that lead to spikes in its usage and development. The internet, for example, was originally developed to share research before becoming a staple of work and entertainment. But technology—new and repurposed—will undoubtedly continue to be a driver of healthcare information. Informaticists often stay tuned to trends to monitor what the next new technology will be or how the next new idea for applying existing technology can benefit outcomes.
In this Discussion, you will reflect on your healthcare organization’s use of technology and offer a technology trend you observe in your environment.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Reflect on the Resources related to digital information tools and technologies.
Consider your healthcare organization’s use of healthcare technologies to manage and distribute information.
Reflect on current and potential future trends, such as use of social media and mobile applications/telehealth, Internet of Things (IoT)-enabled asset tracking, or expert systems/artificial intelligence, and how they may impact nursing practice and healthcare delivery.
BY DAY 3 OF WEEK 6
Post a brief description of general healthcare technology trends, particularly related to data/information you have observed in use in your healthcare organization or nursing practice. Describe any potential challenges or risks that may be inherent in the technologies associated with these trends you described. Then, describe at least one potential benefit and one potential risk associated with data safety, legislation, and patient care for the technologies you described. Next, explain which healthcare technology trends you believe are most promising for impacting healthcare technology in nursing practice and explain why. Describe whether this promise will contribute to improvements in patient care outcomes, efficiencies, or data management. Be specific and provide examples.
BY DAY 6 OF WEEK 6
Respond to at least two of your colleagues* on two different days, offering additional/alternative ideas regarding opportunities and risks related to the observations shared.
In your opinion, which payment method is most preferred by physicians in the Kingdom? Explain your rationale.
-Dr. Robert
this is my dis was
Trigger Situation
Typically, a covered person’s request for healthcare services covered by their insurance policy and subject to reimbursement results in a medical insurance claim (Worth & Mytinger, 1996). Consider a hypothetical situation where an individual, Ms. Johnson, requires medical attention, initiating a medical insurance claim.
In this case, Ms. Johnson is a policyholder. She complains of acute chest pain and is taken immediately to the hospital’s emergency room. According to the attending physician, she has acute appendicitis. This requires an immediate appendectomy. This condition qualifies for a medical insurance claim because Ms. Johnson’s health insurance plan covers hospitalization and surgical treatments.
Resolution Path
Her doctor starts the claims procedure when Ms. Johnson’s health has returned to normal. This entails acquiring all pertinent billing information, medical records, and supporting evidence. The healthcare provider starts the claims processing process by submitting these documents to the insurance provider.
Time Limits and Importance
Time constraints are essential to the resolution of this claim. Most insurance policies have strict time limits for filing claims following the delivery of medical care. Ms. Johnson is responsible for ensuring that her healthcare provider submits the claim within the allotted time window, normally 90 days after the service date. If one attends this date, their claim may be accepted, or the procedure may take longer (Worth & Mytinger, 1996).
After receiving the claim, the insurance provider examines the supporting documentation to ascertain eligibility and coverage (Zhang et al., 2019). This review procedure often takes a few weeks, during which the insurer may ask the healthcare practitioner for more details or clarification. To prevent delays, prompt responses from all stakeholders are essential (Zhang et al., 2019). Following acceptance, the insurer will handle the claim and send Ms. Johnson’s healthcare provider a check for the approved medical costs following the policy’s provisions. The healthcare provider will then send Ms. Johnson a bill for any outstanding balance, which she might be accountable for depending on her insurance’s deductible and copayment conditions.
In conclusion, a covered person requesting a qualifying medical service initiates a medical insurance claim. A successful claims settlement procedure depends on the timely submission of the claim and strict adherence to deadlines. Meeting these deadlines guarantees that the covered party will get the money they need for medical bills while preserving the reliability of the insurance system.
References
Worth, R. M., & Mytinger, R. E. (1996). Medical insurance claims as a source of data for research: accuracy of diagnostic coding. http://hdl.handle.net/10524/54128
Zhang, H., Yin, Y., Zhang, C., & Zhang, D. (2019). Costs of hospitalization for stroke from two urban health insurance claims data in Guangzhou City, southern China. BMC health services research, 19, 1-12. https://doi.org/10.1186/s12913-019-4530-2
Nursing is a very highly regulated profession. There are over 100 boards of nursing and national nursing associations throughout the United States and its territories. Their existence helps regulate, inform, and promote the nursing profession. With such numbers, it can be difficult to distinguish between BONs and nursing associations, and overwhelming to consider various benefits and options offered by each.
Both boards of nursing and national nursing associations have significant impacts on the nurse practitioner profession and scope of practice. Understanding these differences helps lend credence to your expertise as a professional. In this Assignment, you will practice the application of such expertise by communicating a comparison of boards of nursing and professional nurse associations. You will also share an analysis of your state board of nursing.
To Prepare:
Assume that you are leading a staff development meeting on regulation for nursing practice at your healthcare organization or agency.
Review the NCSBN and ANA websites to prepare for your presentation.
The Assignment: (8- to 9-slide PowerPoint presentation)
Develop a 8- to 9-slide PowerPoint Presentation that addresses the following:
Describe the differences between a board of nursing and a professional nurse association.
Describe the board for your specific region/area.
Who is on the board?
How does one become a member of the board?
Describe at least one state regulation related to general nurse scope of practice.
How does this regulation influence the nurse’s role?
How does this regulation influence delivery, cost, and access to healthcare?
If a patient is from another culture, how would this regulation impact the nurse’s care/education?
Describe at least one state regulation related to Advanced Practice Registered Nurses (APRNs).
How does this regulation influence the nurse’s role?
How does this regulation influence delivery, cost, and access to healthcare?
Has there been any change to the regulation within the past 5 years? Explain.
Include Speaker Notes on Each Slide (except on the title page and reference page)
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeBoards of Nursing vs. Professional Nurse AssociationsDevelop a 8- to 9- slide PowerPoint presentation that addresses the following:· Describe the differences between a board of nursing and a professional nurse association.· Describe the members of the board for your specific region/area.· Who is on the board?· How does one become a member of the board?· Speaker notes are included on every slide and are used to explain and elaborate the significant points on each slide.
25 to >22.0 ptsExcellentUsing sufficient evidence, the response accurately and thoroughly describes the differences between a board of nursing and professional nurse associations. …Response provides a complete and accurate description of who is on a board of nursing. …Response provides a detailed and thorough explanation of how one becomes a member of the board of nursing. …Speaker notes are included on every slide and are used to explain and elaborate the significant points on each slide. 22 to >19.0 ptsGoodUsing sufficient evidence, the response accurately describes the differences between a board of nursing and professional nurse associations. …Response provides an accurate description of who is on a board of nursing. …Response provides an accurate explanation of how one becomes a member of the board of nursing. …Speaker notes are included on every slide and are used to explain the significant points on each slide. 19 to >17.0 ptsFairDescription of the differences between a board of nursing and professional nurse associations is inaccurate or incomplete. …Description of who is on a board of nursing is incomplete or inaccurate. …Explanation of how one becomes a member of the board of nursing is vague or inaccurate. …Speaker notes are incomplete or lack sufficient elaboration. 17 to >0 ptsPoorDescription of the differences between a board of nursing and professional nurse associations is inaccurate or incomplete. …Description of who is on a board of nursing is incomplete or inaccurate. …Explanation of how one becomes a member of the board of nursing is vague or inaccurate. …Speaker notes are missing.
25 pts
This criterion is linked to a Learning OutcomeThe Impact of State Regulation on Nurse PracticeDescribe at least one state regulation related to general nurse scope of practice.• How does this regulation influence the nurse’s role?• How does this regulation influence delivery, cost, and access to healthcare?• If a patient is from another culture, how would this regulation impact the nurse’s care/education?• Has there been any change to the regulation within the past 5 years? Explain.• Speaker notes are included on every slide and are used to explain and elaborate the significant points on each slide.
30 to >26.0 ptsExcellentResponse includes an accurate and thorough description of how one state regulation is related to general nurse scope of practice. …Response accurately and thoroughly explains how the regulation influences the nurse’s role. …Response accurately and thoroughly explains how the regulation(s) influences delivery, cost, and access to healthcare. …Response accurately and thoroughly explains how the regulation impacts the nurse’s care/education to provide care for other cultures. … Changes fully explained. …Presentation includes speaker notes that explain and elaborate the significant points of the presentation. 26 to >23.0 ptsGoodResponse includes an accurate description of how one state regulation is related to general nurse scope of practice. …Response accurately explains how the regulation influences the nurse’s role. …Response accurately explains how the regulation(s) influences delivery, cost, and access to healthcare. …Response accurately explains how the regulation impacts the nurse’s care/education to provide care for other cultures. …Changes partially explained. …Presentation includes speaker notes that explain the points of the presentation. 23 to >20.0 ptsFairDescription of one or more state regulations that are related to general nurse scope of practice is incomplete or inaccurate. …Explanation of how the regulation(s) influences the nurse’s role is vague or inaccurate. …Explanation of how the regulation(s) influences delivery, cost, and access to healthcare is vague or inaccurate. …Explanation of how the regulation(s) influences the nurse’s care/education for other cultures is vague or inaccurate. …Change is vague. …Presentation includes speaker notes that are incomplete or lack appropriate explanation. 20 to >0 ptsPoorDescription of one or more state regulations related to general nurse scope of practice is vague and inaccurate or is missing. …Explanation of how the regulation(s) influences the nurse’s role is vague and inaccurate or is missing. …Explanation of how the regulation(s) influences delivery, cost, and access to healthcare is vague and inaccurate, or is missing. …Explanation of how the regulation(s) influences the nurse’s care/education for other cultures is vague or inaccurate or missing. …Change was not discussed. …Speaker notes are missing.
30 pts
This criterion is linked to a Learning OutcomeDescribe at least one state regulation related to Advanced Practice Registered Nurses (APRNs).• How does this regulation influence the nurse’s role?• How does this regulation influence delivery, cost, and access to healthcare?• Has there been any change to the regulation within the past 5 years? Explain.Speaker notes are included on every slide and are used to explain and elaborate the significant points on each slide.
30 to >26.0 ptsExcellentUsing sufficient evidence, response includes an accurate and thorough description of how one state regulation is related to Advanced Practice Registered Nurses (APRNs). …Response accurately and thoroughly explains how the regulation influences the nurse’s role. …Response accurately and thoroughly explains how the regulation(s) influences delivery, cost, and access to healthcare. … Changes fully explained. …Presentation includes speaker notes that explain and elaborate on the significant points of the presentation. 26 to >23.0 ptsGoodUsing sufficient evidence, response includes an accurate description of how one state regulation is related to Advanced Practice Registered Nurses (APRNs). …Response accurately explains how the regulation influences the nurse’s role. …Response accurately explains how the regulation(s) influences delivery, cost, and access to healthcare. …Changes partially explained. …Presentation includes speaker notes that explain the points of the presentation. 23 to >20.0 ptsFairDescription of one or more state regulations that are related to Advanced Practice Registered Nurses (APRNs) is incomplete or inaccurate. …Explanation of how the regulation(s) influences the nurse’s role is vague or inaccurate. …Explanation of how the regulation(s) influences delivery, cost, and access to healthcare is vague or inaccurate. …Change is vague. …Presentation includes speaker notes that are incomplete or lack appropriate explanation. 20 to >0 ptsPoorDescription of one or more state regulations related to Advanced Practice Registered Nurses (APRNs) is vague and inaccurate or is missing. …Explanation of how the regulation(s) influences the nurse’s role is vague and inaccurate or is missing. …Explanation of how the regulation(s) influences delivery, cost, and access to healthcare is vague and inaccurate, or is missing. …Change was not discussed. …Speaker notes are missing.
30 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and OrganizationSpeaker notes make clear points that support well developed ideas, low logically, and demonstrate continuity of ideas.Sentences are carefully focused– neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction and conclusion are provided which delineate all required criteria.
5 to >4.0 ptsExcellentSpeaker notes and sentences follow writing standards for flow, continuity, and clarity. …A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria. 4 to >3.0 ptsGoodSpeaker notes and sentences follow writing standards for flow, continuity, and clarity 80% of the time. …Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive. 3 to >2.0 ptsFairSpeaker notes and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time. …Purpose, introduction, and conclusion of the assignment is vague or off topic. 2 to >0 ptsPoorSpeaker notes and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. ...Purpose, introduction, and conclusion of the assignment is incomplete or missing.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting: English Writing StandardsCorrect grammar, mechanics, and proper punctuation.
5 to >4.0 ptsExcellentUses correct grammar, spelling, and punctuation with no errors. 4 to >3.0 ptsGoodContains a few (1-2) grammar, spelling, and punctuation errors. 3 to >2.0 ptsFairContains several (3-4) grammar, spelling, and punctuation errors. 2 to >0 ptsPoorContains many (≥5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting: The presentation follows correct APA format for parenthetical/in-text citations, and reference list.
5 to >4.0 ptsExcellentUses correct APA format with no errors. 4 to >3.0 ptsGoodContains a few (1-2) APA format errors. 3 to >2.0 ptsFairContains several (3-4) APA format errors. 2 to >0 ptsPoorContains many (≥5) APA format errors.
5 pts
Please make sure follow apa format and include scholarly references.
Using the criteria presented in week 2, critique the theory of Self-Efficacy using the internal and external criticism evaluation process.APA FORMAT NO LESS THAN 500,NO PLAGIARISM.
please don’t forget to include the following in your Discussion posts to receive full credit:
Student Learning Outcome
Correctly identify which student learning outcome you covered in the discussion post that you created for the Week.
Make sure that you include it in the beginning of the post and clearly state :”This week student learning outcome was ___” and include out of these five the one that corresponds.
Critically analyze the philosophical underpinnings of nursing theories.
Critique nursing’s conceptual models, grand theories and mid-range theories.
Examine the influence that nursing models and theories have upon research and practice.
Construct a nursing theory that represent current professional nursing practice
Apply nursing theory or theories to nursing research.
Please follow the instructions in the word document provided.Please make use of the Walden library for peer reviewed articles if needed Please provide 10 slides excluding introduction page and reference page
Unformatted Attachment Preview
REGULATION FOR NURSING PRACTICE
STAFF DEVELOPMENT MEETING
Nursing is a very highly regulated profession. There are over 100 boards of nursing and
national nursing associations throughout the United States and its territories. Their
existence helps regulate, inform, and promote the nursing profession. With such
numbers, it can be difficult to distinguish between BONs and nursing associations, and
overwhelming to consider various benefits and options offered by each.
Both boards of nursing and national nursing associations have significant impacts on the
nurse practitioner profession and scope of practice. Understanding these differences
helps lend credence to your expertise as a professional. In this Assignment, you will
practice the application of such expertise by communicating a comparison of boards of
nursing and professional nurse associations. You will also share an analysis of your state
board of nursing.
RESOURCES
Required Readings
•
•
•
•
•
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s
guide (6th ed.). Jones & Bartlett Learning.
o Chapter 4, “Government Response: Regulation” (pp. 57–84)
American Nurses Association. (n.d.). ANA enterpriseLinks to an external site..
Retrieved September 20, 2018, from http://www.nursingworld.org
Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., &
Poghosyan, L. (2017). Position statement: Full practice authority for advanced
practice registered nurses is necessary to transform primary careLinks to an
external site.. Nursing Outlook, 65(6), 761–765.
Halm, M. A. (2018). Evaluating the impact of EBP education: Development of
a modified Fresno test for acute care nursing Download Evaluating the impact
of EBP education: Development of a modified Fresno test for acute care
nursing. Worldviews on Evidence-Based Nursing, 15(4), 272–280.
doi:10.1111/wvn.12291
National Council of State Boards of Nursing (NCSBN)Links to an external site..
(n.d.). Retrieved September 20, 2018, from https://www.ncsbn.org/index.htm
•
•
Neff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman
J. S. (2018). The impact of nurse practitioner regulations on population access
to careLinks to an external site.. Nursing Outlook, 66(4), 379–385.
Peterson, C., Adams, S. A., & DeMuro, P. R. (2015). mHealth: Don’t forget all
the stakeholders in the business caseLinks to an external site.. Medicine 2.0,
4(2), e4.
To Prepare:
•
•
Assume that you are leading a staff development meeting on regulation for
nursing practice at your healthcare organization or agency.
Review the NCSBN and ANA websites to prepare for your presentation.
The Assignment: (8- to 9-slide PowerPoint presentation)
Develop a 8- to 9-slide PowerPoint Presentation that addresses the following:
•
•
•
•
•
•
Describe the differences between a board of nursing and a professional nurse
association.
Describe the board for your specific region/area.
o Who is on the board?
o How does one become a member of the board?
Describe at least one state regulation related to general nurse scope of
practice.
o How does this regulation influence the nurse’s role?
o How does this regulation influence delivery, cost, and access to
healthcare?
o If a patient is from another culture, how would this regulation
impact the nurse’s care/education?
Describe at least one state regulation related to Advanced Practice Registered
Nurses (APRNs).
o How does this regulation influence the nurse’s role?
o How does this regulation influence delivery, cost, and access to
healthcare?
Has there been any change to the regulation within the past 5 years? Explain.
Include Speaker Notes on Each Slide (except on the title page and reference
page)
NURS_6050_Module03_Week06_Assignment_Rubric
NURS_6050_Module03_Week06_Assignment_Rubric
Criteria
This criterion is linked
to a Learning
OutcomeBoards of
Nursing vs.
Professional Nurse
AssociationsDevelop a
8- to 9- slide
PowerPoint
presentation that
addresses the
following:· Describe
the differences
between a board of
nursing and a
professional nurse
association.· Describe
the members of the
board for your specific
region/area.· Who is
on the board?· How
does one become a
member of the board?·
Speaker notes are
included on every slide
and are used to
explain and elaborate
the significant points
on each slide.
Ratings
25 to >22.0 pts
Excellent
Using sufficient
evidence, the response
accurately and
thoroughly describes
the differences between
a board of nursing and
professional nurse
associations.
…Response provides a
complete and accurate
description of who is
on a board of nursing.
…Response provides a
detailed and thorough
explanation of how one
becomes a member of
the board of nursing.
…Speaker notes are
included on every slide
and are used to explain
and elaborate the
significant points on
each slide.
22 to >19.0 pts
Good
Using sufficient
evidence, the response
accurately describes the
differences between a
board of nursing and
professional nurse
associations.
…Response provides an
accurate description of
who is on a board of
nursing. …Response
provides an accurate
explanation of how one
becomes a member of
the board of nursing.
…Speaker notes are
included on every slide
and are used to explain
the significant points on
each slide.
19 to >17.0 pts
Fair
Description of the
differences between a
board of nursing and
professional nurse
associations is
inaccurate or
incomplete.
…Description of who is
on a board of nursing is
incomplete or
inaccurate.
…Explanation of how
one becomes a member
of the board of nursing
is vague or inaccurate.
…Speaker notes are
incomplete or lack
sufficient elaboration.
17 to >0 pts
Poor
Description of t
differences betw
board of nursin
professional nu
associations is
inaccurate or
incomplete.
…Description o
is on a board of
nursing is incom
or inaccurate.
…Explanation o
one becomes a
member of the b
of nursing is va
inaccurate. …Sp
notes are missin
This criterion is linked
to a Learning
OutcomeThe Impact
of State Regulation on
Nurse
PracticeDescribe at
least one state
regulation related to
general nurse scope of
practice.• How does
this regulation
influence the nurse’s
role?• How does this
regulation influence
delivery, cost, and
access to healthcare?•
If a patient is from
another culture, how
would this regulation
impact the nurse’s
care/education?• Has
there been any change
to the regulation
within the past 5
years? Explain.•
Speaker notes are
included on every slide
and are used to
explain and elaborate
the significant points
on each slide.
30 to >26.0 pts
Excellent
Response includes an
accurate and thorough
description of how one
state regulation is
related to general nurse
scope of practice.
…Response accurately
and thoroughly
explains how the
regulation influences
the nurse’s role.
…Response accurately
and thoroughly
explains how the
regulation(s) influences
delivery, cost, and
access to healthcare.
…Response accurately
and thoroughly
explains how the
regulation impacts the
nurse’s care/education
to provide care for
other cultures. …
Changes fully
explained.
…Presentation includes
speaker notes that
explain and elaborate
the significant points of
the presentation.
26 to >23.0 pts
Good
Response includes an
accurate description of
how one state
regulation is related to
general nurse scope of
practice. …Response
accurately explains
how the regulation
influences the nurse’s
role. …Response
accurately explains
how the regulation(s)
influences delivery,
cost, and access to
healthcare. …Response
accurately explains
how the regulation
impacts the nurse’s
care/education to
provide care for other
cultures. …Changes
partially explained.
…Presentation includes
speaker notes that
explain the points of
the presentation.
23 to >20.0 pts
Fair
Description of one or
more state regulations
that are related to
general nurse scope of
practice is incomplete
or inaccurate.
…Explanation of how
the regulation(s)
influences the nurse’s
role is vague or
inaccurate.
…Explanation of how
the regulation(s)
influences delivery,
cost, and access to
healthcare is vague or
inaccurate.
…Explanation of how
the regulation(s)
influences the nurse’s
care/education for other
cultures is vague or
inaccurate. …Change is
vague. …Presentation
includes speaker notes
that are incomplete or
lack appropriate
explanation.
20 to >0 pts
Poor
Description of o
more state regul
related to genera
scope of practice
vague and inacc
is missing.
…Explanation of
the regulation(s)
influences the nu
role is vague and
inaccurate or is
missing. …Expla
of how the
regulation(s) inf
delivery, cost, an
access to healthc
vague and inacc
or is missing.
…Explanation of
the regulation(s)
influences the nu
care/education f
cultures is vague
inaccurate or mi
…Change was no
discussed. …Spe
notes are missin
NURS_6050_Module03_Week06_Assignment_Rubric
Criteria
This criterion is linked
to a Learning
OutcomeDescribe at
least one state
regulation related to
Advanced Practice
Registered Nurses
(APRNs).• How does
this regulation
influence the nurse’s
role?• How does this
regulation influence
delivery, cost, and
access to healthcare?•
Has there been any
change to the
regulation within the
past 5 years?
Explain.Speaker notes
are included on every
slide and are used to
explain and elaborate
the significant points
on each slide.
Ratings
30 to >26.0 pts
Excellent
Using sufficient
evidence, response
includes an accurate
and thorough
description of how one
state regulation is
related to Advanced
Practice Registered
Nurses (APRNs).
…Response accurately
and thoroughly
explains how the
regulation influences
the nurse’s role.
…Response accurately
and thoroughly
explains how the
regulation(s) influences
delivery, cost, and
access to healthcare. …
Changes fully
explained.
…Presentation includes
speaker notes that
explain and elaborate
on the significant
points of the
presentation.
26 to >23.0 pts
Good
Using sufficient
evidence, response
includes an accurate
description of how one
state regulation is
related to Advanced
Practice Registered
Nurses (APRNs).
…Response accurately
explains how the
regulation influences
the nurse’s role.
…Response accurately
explains how the
regulation(s) influences
delivery, cost, and
access to healthcare.
…Changes partially
explained.
…Presentation includes
speaker notes that
explain the points of
the presentation.
23 to >20.0 pts
Fair
Description of one or
more state regulations
that are related to
Advanced Practice
Registered Nurses
(APRNs) is incomplete
or inaccurate.
…Explanation of how
the regulation(s)
influences the nurse’s
role is vague or
inaccurate.
…Explanation of how
the regulation(s)
influences delivery,
cost, and access to
healthcare is vague or
inaccurate. …Change is
vague. …Presentation
includes speaker notes
that are incomplete or
lack appropriate
explanation.
20 to >0 pts
Poor
Description of o
more state regul
related to Advan
Practice Registe
Nurses (APRNs
vague and inacc
or is missing.
…Explanation o
the regulation(s)
influences the n
role is vague and
inaccurate or is
missing. …Expla
of how the
regulation(s) inf
delivery, cost, a
access to healthc
vague and inacc
or is missing. …
was not discusse
…Speaker notes
missing.
NURS_6050_Module03_Week06_Assignment_Rubric
Criteria
Ratings
This criterion is linked
to a Learning
OutcomeWritten
Expression and
Formatting—
Paragraph
Development and
OrganizationSpeaker
notes make clear
points that support
well developed ideas,
low logically, and
demonstrate
continuity of
ideas.Sentences are
carefully focused-neither long and
rambling nor short and
lacking substance. A
clear and
comprehensive
purpose statement
and introduction and
conclusion are
provided which
delineate all required
criteria.
5 to >4.0 pts
Excellent
Speaker notes and
sentences follow writing
standards for flow,
continuity, and clarity.
…A clear and
comprehensive purpose
statement, introduction,
and conclusion is
provided which delineates
all required criteria.
This criterion is linked
to a Learning
OutcomeWritten
Expression and
Formatting: English
Writing
StandardsCorrect
grammar, mechanics,
and proper
punctuation.
5 to >4.0 pts
Excellent
Uses correct
grammar, spelling,
and punctuation with
no errors.
4 to >3.0 pts
Good
Speaker notes and
sentences follow
writing standards for
flow, continuity, and
clarity 80% of the
time. …Purpose,
introduction, and
conclusion of the
assignment is stated,
yet is brief and not
descriptive.
4 to >3.0 pts
Good
Contains a few (1-2)
grammar, spelling,
and punctuation
errors.
3 to >2.0 pts
Fair
Speaker notes and
sentences follow
writing standards for
flow, continuity, and
clarity 60%- 79% of
the time. …Purpose,
introduction, and
conclusion of the
assignment is vague
or off topic.
3 to >2.0 pts
Fair
Contains several (34) grammar,
spelling, and
punctuation errors.
2 to >0 pts
Poor
Speaker notes a
sentences follo
writing standar
flow, continuity
clarity < 60% o
time. ...Purpose
introduction, an
conclusion of th
assignment is
incomplete or
missing.
2 to >0 pts
Poor
Contains many (≥5) gram
spelling, and punctuatio
that interfere with the re
understanding.
NURS_6050_Module03_Week06_Assignment_Rubric
Criteria
This criterion is linked
to a Learning
OutcomeWritten
Expression and
Formatting: The
presentation follows
correct APA format
for parenthetical/intext citations, and
reference list.
Total Points: 100
Ratings
5 to >4.0 pts
Excellent
Uses correct APA
format with no errors.
4 to >3.0 pts
Good
Contains a few (1-2)
APA format errors.
3 to >2.0 pts
Fair
Contains several (3-4)
APA format errors.
2 to >0 pts
Poor
Contains many
APA format err
Build a slide presentation (PowerPoint preferred) of the hypothetical health promotion plan you developed in the first assessment. Then, implement your health promotion plan by conducting a hypothetical face-to-face educational session addressing the health concern and health goals of your selected group. How would you set goals for the session, evaluate session outcomes, and suggest possible revisions to improve future sessions?
Collapse All
Introduction
This assessment provides an opportunity for you to apply teaching and learning concepts to the presentation of a health promotion plan.
Note: This is the second part of a two-part assessment. You must complete Assessment 1 before completing this assessment.
Preparation
As you begin to prepare this assessment, you are encouraged to complete the Vila Health: Conducting an Effective Educational Session activity. The information gained from completing this activity will help you succeed with the assessment as you consider key issues in conducting an effective educational session for a selected audience. Completing activities is also a way to demonstrate engagement.
For this assessment, you will conclude the clinical learning activity you began in Assessment 1.
You will resume the role of a community nurse tasked with addressing the specific health concern in your community. This time, you will present, via educational outreach, the hypothetical health promotion plan you developed in Assessment 1 to your fictitious audience. In this hypothetical scenario, you will simulate the presentation as though it would be live and face-to-face. You must determine an effective teaching strategy, communicate the plan with professionalism and cultural sensitivity, evaluate the objectives of the plan, revise the plan as applicable, and propose improvement for future educational sessions. To engage your audience, you decide to develop a PowerPoint presentation with voice-over and speaker notes to communicate your plan.
Remember that your first assessment (Assessment 1) MUST be satisfactorily completed to initiate this assessment (Assessment 4).
Please review the assessment scoring guide for more information.
To prepare for the assessment, you may wish to review the health promotion plan presentation assessment and scoring guide to ensure that you understand all requirements.
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.
Note: This is the second part of a two-part assessment. You must complete Assessment 1 before completing this assessment.
Instructions
Complete the following:
Prepare a 10–12 slide PowerPoint presentation with a voice-over and detailed speaker notes that reflects your hypothetical presentation. This presentation is the implementation of the plan you created in Assessment 1. The speaker notes should be well organized. Be sure to include a transcript of the voice-over (please refer to the PowerPoint tutorial). The transcript can be submitted on a separate Word document.
Simulate the hypothetical face-to-face educational session addressing the health concern and health goals of your selected community individual or group.
Imagine collaborating with the hypothetical participant(s) in setting goals for the session, evaluating session outcomes, and suggesting possible revisions to improve future sessions.
As you begin to prepare this assessment, you are encouraged to complete the Vila Health: Conducting an Effective Educational Session activity. The information gained from completing this activity will help you succeed with the assessment as you consider key issues in conducting an effective educational session for a selected audience. Completing activities is also a way to demonstrate engagement.
Presentation Format and Length
You may use Microsoft PowerPoint (preferred) or other suitable presentation software to create your presentation. If you elect to use an application other than PowerPoint, check with your faculty to avoid potential file compatibility issues.
The number of content slides in your presentation is dictated by nature and scope of your health promotion plan. Be sure to include title and references slides per the following:
Title slide:
Health promotion plan title.
Your name.
Date.
Course number and title.
References (at the end of your presentation).
Be sure to apply correct APA formatting to your references.
The following resources will help you create and deliver an effective presentation:
Record a Slide Show With Narration and Slide Timings.
This Microsoft article provides steps for recording slide shows in different versions of PowerPoint, including steps for Windows, Mac, and online.
Microsoft Office Software.
This Campus page includes tip sheets and tutorials for Microsoft PowerPoint.
PowerPoint Presentations Library Guide.
This library guide provides links to PowerPoint and other presentation software resources.
SoNHS Professional Presentation Guidelines [PPTX].
This presentation, designed especially for the School of Nursing and Health Sciences, offers valuable tips and links, and is itself a PowerPoint template that can be used to create a presentation.
Supporting Evidence
Support your plan with at least three professional or scholarly references, published within the last 5 years, which may include peer-reviewed articles, course study resources, and Healthy People 2030 resources.
Graded Requirements
The requirements outlined below correspond to the grading criteria in the assessment scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Present your health promotion plan to your hypothetical audience.
Tailor the presentation to the needs of your hypothetical audience.
Adhere to scholarly and disciplinary writing standards and APA formatting requirements.
Evaluate educational session outcomes and the attainment of agreed-upon health goals in collaboration with participants.
Which aspects of the session would you change?
How might those changes improve future outcomes?
Evaluate educational session outcomes in terms of progress made toward Healthy People 2030 objectives and leading health indicators.
What changes would you recommend to better align the session with Healthy People 2030 objectives and leading health indicators?
Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).
Slides are easy to read and error free. Detailed audio and speaker notes are provided. Audio is clear, organized, and professionally presented.
Additional Requirements
Before submitting your assessment, proofread your presentation slides and speaker’s notes to minimize errors that could distract readers and make it difficult for them to focus on the substance of your presentation.
Context
Health education is any combination of learning experiences designed to help community individuals, families, and aggregates improve their health by increasing knowledge or influencing attitudes (WHO, n.d.). Education is key to health promotion, disease prevention, and disaster preparedness. The health indicator framework identified in Healthy People 2030 prompts action in health services accessibility, clinical preventive services, environmental quality, injury or violence prevention, maternal, infant, and child health, mental health, nutrition, substance abuse prevention, and tobacco use cessation or prevention.
Nurses provide accurate evidence-based information and education in formal and informal settings. They draw upon evidence-based practice to provide health promotion and disease prevention activities to create social and physical environments conducive to improving and maintaining community health. When provided with the tools to be successful, people demonstrate lifestyle changes (self-care) that promote health and help reduce readmissions. They are better able to tolerate stressors, including environmental changes, and enjoy a better quality of life. In times of crisis, a resilient community is a safer community (Flanders, 2018; Healthy People 2030, n.d.).
REFERENCES
Flanders, S. A. (2018). Effective patient education: Evidence and common sense. Medsurg Nursing, 27(1), 55–58.
U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (n.d.). Healthy People 2030. https://health.gov/healthypeople
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 3: Evaluate health policies, based on their ability to achieve desired outcomes.
Evaluate educational session outcomes in terms of progress made toward Healthy People 2030 objectives and leading health indicators.
Competency 4: Integrate principles of social justice in community health interventions.
Evaluate educational session outcomes and the attainment of agreed-upon health goals in collaboration with hypothetical participants.
Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health.
Present a health promotion plan to a hypothetical individual or a group within a community.
Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).
Slides are easy to read and error free. Detailed audio, transcript, and speaker notes are provided. Audio is clear, organized, and professionally presented.
Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.
Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.
Follow APA style and formatting guidelines for citations and references.
Intervention Presentation and Capstone Video Reflection Scoring Guide
CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Assess the contribution of an intervention to patient, family, or group satisfaction and quality of life. Does not assess the contribution of an intervention to patient, family, or group satisfaction and quality of life. Attempts to assess the contribution of an intervention to patient, family, or group satisfaction and quality of life based on unfounded assumptions. Assesses the contribution of an intervention to patient, family, or group satisfaction and quality of life. Assesses the contribution of an intervention to patient, family, or group satisfaction and quality of life. The assessment is fair, unbiased, and supported by feedback from the patient, family, or group.
Describe one’s use of evidence and peer-reviewed literature to plan and implement a capstone project. Does not describe one’s planning and implementation of a capstone project. Attempts to describe one’s planning and implementation of a capstone project. Describes one’s use of evidence and peer-reviewed literature to plan and implement a capstone project. Succinctly describes one’s use of evidence and peer-reviewed literature to plan and implement a capstone project. Project planning and implementation clearly reflect the influence of evidence-based practice.
Assess the degree to which one successfully leveraged health care technology in a capstone project to improve outcomes or communication with a patient, family, or group. Does not describe how one used health care technology in a capstone project. Attempts to describe how one used health care technology in a capstone project. Assesses the degree to which one successfully leveraged health care technology in a capstone project to improve outcomes or communication with a patient, family, or group. Presents an articulate assessment of the degree to which one successfully leveraged health care technology in a capstone project to improve outcomes or communication with a patient, family, or group. Offers keen insight into prospective improvements in health care technology use.
Explain how health policy influenced the planning and implementation of one’s capstone project, as well as any contributions the project made to policy development. Does not describe health policies that influenced the planning and implementation of one’s capstone project and any contributions the project made to policy development. Attempts to describe health policies that influenced the planning and implementation of one’s capstone project and any contributions the project made to policy development. Explains how health policy influenced the planning and implementation of one’s capstone project, as well as any contributions the project made to policy development. Presents an articulate assessment of how health policy influenced the planning and implementation of one’s capstone project, as well as on any contributions the project made to policy development. Offers keen insight into the baccalaureate-prepared nurse’s role in policy implementation and development.
Explain whether capstone project outcomes matched one’s initial predictions and documents the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Document the completion of nine hours of practicum time. Does not describe capstone project outcomes and does not document the completion of nine practicum hours in Capella Academic Portal Volunteer Experience Form. Attempts to describe capstone project outcomes and/or does not document the completion of nine practicum hours in Capella Academic Portal Volunteer Experience Form. Explain whether capstone project outcomes matched one’s initial predictions and documents the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Documents the completion of nine hours of practicum time. Provides an articulate and perceptive explanation of whether capstone project outcomes matched one’s initial predictions. Exhibits clear insight into the generalizability and best-practice potential of the intervention. Documents the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Documents the completion of nine hours of practicum time.
Assess one’s personal and professional growth throughout a capstone project and the RN-to-BSN program. Does not summarize one’s personal and professional growth throughout a capstone project and the RN-to-BSN program. Summarizes one’s personal and professional growth throughout a capstone project and the RN-to-BSN program. Assesses one’s personal and professional growth throughout a capstone project and the RN-to-BSN program. Objectively assesses one’s personal and professional growth throughout a capstone project and the RN-to-BSN program. Provides a comprehensive and detailed retrospective of one’s overall performance and growth.
Communicate professionally in a clear and well-organized video. Does not communicate in a video. Communicates in a video. Content delivery is hesitant, unclear, or read from a script. Communicates professionally in a clear and well-organized video. Communicates professionally in a clear and well-organized video. Content delivery is focused, smooth, and well-rehearsed. Information sources are credited appropriately.
Overall CommentsYoussef, Thank you for the assessment #5 submission. However, I do not see your video upload that is required for this last assessment using via Kaltura. Please click onto the assessment #5 and read the instructions and requirements in each section of the rubric. Without the video discussion from the last assessment then I am not able to grade your assessment #5. I also checked your clinical hrs which I see no clinical hrs are documented at all. Please note that it is required for this course in order to pass the course. Please contact IT staff members to further assist you with any technical issues. I look forward to see your video. Dr Swanson-Tracey SwansonScoring GuideCompetency 2Make clinical and operational decisions based upon the best available evidence.CriterionDescribe one’s use of evidence and peer-reviewed literature to plan and implement a capstone project.Your Result:NON_PERFORMANCEDoes not describe one’s planning and implementation of a capstone project.Faculty Comments:Please read my comments below.Show all Performance RatingsCompetency 3Transform processes to improve quality, enhance patient safety, and reduce the cost of care.CriterionExplain whether capstone project outcomes matched one’s initial predictions and documents the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Document the completion of nine hours of practicum time.Your Result:NON_PERFORMANCEDoes not describe capstone project outcomes and does not document the completion of nine practicum hours in Capella Academic Portal Volunteer Experience Form.Faculty Comments:Please read my comments below.Show all Performance RatingsCompetency 4Apply health information and patient care technology to improve patient and systems outcomes.CriterionAssess the degree to which one successfully leveraged health care technology in a capstone project to improve outcomes or communication with a patient, family, or group.Your Result:NON_PERFORMANCEDoes not describe how one used health care technology in a capstone project.Faculty Comments:Please read my comments below.Show all Performance RatingsCompetency 5Analyze the impact of health policy on quality and cost of care.CriterionExplain how health policy influenced the planning and implementation of one’s capstone project, as well as any contributions the project made to policy development.Your Result:NON_PERFORMANCEDoes not describe health policies that influenced the planning and implementation of one’s capstone project and any contributions the project made to policy development.Faculty Comments:Please read my comments below.Show all Performance RatingsCompetency 7Implement patient-centered care to improve quality of care and the patient experience.CriterionAssess the contribution of an intervention to patient, family, or group satisfaction and quality of life.Your Result:NON_PERFORMANCEDoes not assess the contribution of an intervention to patient, family, or group satisfaction and quality of life.Faculty Comments:Please read my comments below.Show all Performance RatingsCompetency 8Integrate professional standards and values into practice.CriterionAssess one’s personal and professional growth throughout a capstone project and the RN-to-BSN program.Your Result:NON_PERFORMANCEDoes not summarize one’s personal and professional growth throughout a capstone project and the RN-to-BSN program.Faculty Comments:Please read my comments below.Show all Performance RatingsCriterionCommunicate professionally in a clear and well-organized video.Your Result:NON_PERFORMANCEDoes not communicate in a video.Faculty Comments:Please read my comments below.
Unformatted Attachment Preview
Health Promotion Plan
Name:
Date:
Course
Introduction
• Immunization is a crucial aspect of everyone’s life (D’Heilly et al., 2019).
• It involves introducing vaccines into the body to prevent illnesses.
• Immunized individuals against various diseases like measles and polio have
improved immunity.
• This education session seeks to enlighten perinatal mothers on the issues
surrounding immunization.
Educational Session Goals
• This education session has two main goals expressing the magnitude of the
educational intervention.
• The goals include;
1. Increasing awareness of the significance of immunization and types of
immunizations provided to infants
2. Improving participants’ willingness to get their children vaccinated
Immunization Benefits and Consequences of
Failing to Get Immunized
• Immunization minimizes a person’s susceptibility to diseases while improving their
body’s immunity.
• It prevents individuals from experiencing comorbidities (D’Heilly et
• 2019).
• Effective vaccine programs help in reducing morbidity and mortality (Rodrigues &
Plotkin, 2020).
• Failing to get immunized causes a high risk of death, illnesses, and disease
susceptibility.
• It also causes reduced body immunity (Laupèze et al., 2021).
Immunization Types and Periods
• Children receive immunizations at birth, 0-2, 2-4, 4-6, and 6-12 months
• The vaccines are administered at different periods depending on the infant’s
age.
• Some of the vaccines administered include Influenza vaccines, Rotavirus,
DTaP, pneumococcal, and pneumococcal.
Intervention’s Contributions
• This intervention will help the mothers understand the importance of vaccinations
to their children.
• It will inform them about their infants’ expected immunizations and periods of
immunization.
• It will help eradicate their susceptibility, myths, and doubts about getting the
children immunized.
• Therefore, the number of children to be immunized will increase
• Also, the immunization of infants in large numbers will help eliminate and reduce
incidences of vaccine-preventable diseases.
Intervention Session Outcomes and
Contributions Toward Healthy People 2030
Objectives
• The intervention outcomes include increased awareness of immunization
significance, types, and duration.
• The intervention will prompt many mothers to allow their children to receive
vaccination, leading to an increased immunization rate.
• Once the immunization rate increases, vaccine-preventable diseases will
reduce, contributing to Healthy 2030 Objectives (Pindyck et al., 2019).
• Also, the intervention outcomes contribute to the objectives by increasing
the annual percentage of immunized children.
Planning and Implementation of the Project
• The Capstone project was effectively planned using peer-reviewed literature and
evidence from reputable sources.
• For instance, several databases helped to locate literature about immunizations,
including Frontiers and PubMed.
• The literature cited in the education session about immunization was retrieved from
the database.
• The Centers for Disease Control and Prevention also provided crucial information
and statistics regarding the types of infant vaccinations and stipulated periods.
Use of Health Technology in the Project
• Health technology tools were leveraged in the project to improve
communication with the audience.
• The participants received an electronic program through their emails
detailing the intervention’s goals before engaging in the education session.
• This provided insight into the topic of discussion, leading to easy
communication and discussion.
How Policy Influenced Project Planning and
Implementation
• The policy for free vaccination linked to the Vaccines for Children (VFC) Program
highly influenced the project.
• According to CDC (2023), eligible children for the VFC program receive
immunizations at no cost.
• It helps the children receive recommended vaccinations on time.
• Healthcare costs are skyrocketing, and it is a challenge for parents to pay for
children’s vaccinations.
• The provision of vaccination freely is a motivating factor for mothers to allow their
children to receive immunizations.
Matching Project Outcomes to Initial
Predictions or Goals
• The project outcomes were evaluated by asking several questions to the mothers to
assess their awareness of the significance, types, and durations of immunization.
• Self-reports can also be applied to measure the mothers’ willingness to have their
children vaccinated.
• The initial predictions matched the project outcomes because the mothers showed a
high understanding of immunization concepts.
• Also, the mothers’ doubts regarding vaccination safety were cleared, and they
promised to ensure that their children were vaccinated.
Practicum Hours Spend
• The first 30 minutes were spent on introduction and familiarizing with each other.
• The Next three and half hours were used to discuss the crucial concepts of
immunization, including the significance of immunization and types of
immunization.
• A one-hour break was introduced.
• A two-hour question and answer section was introduced, which was accompanied
by thorough discussions to test the participants’ understanding and awareness level.
• One hour was allocated to obtaining self-reports from the participants.
• The last hour was used to review the project’s outcomes and success.
References
• Center for Disease Control and Prevention (CDC). (2023). VFC Information for Parents. Retrieved from;
https://www.cdc.gov/vaccines/programs/vfc/parents/index.html
• CDC. (2018). Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or
Younger. Retrieved from; https://www.cdc.gov/vaccines/schedules/downloads/past/2018-child.pdf
• Rodrigues, C. M., & Plotkin, S. A. (2020). Impact of vaccines; health, economic and social
perspectives. Frontiers in microbiology, 11, 1526.
• Laupèze, B., Del Giudice, G., Doherty, M. T., & Van der Most, R. (2021). Vaccination as a preventative
measure contributing to immune fitness. npj Vaccines, 6(1), 93.
• D’Heilly, C., Switzer, C., & Macina, D. (2019). Safety of maternal immunization against pertussis: a
systematic review. Infectious diseases and therapy, 8, 543-568.
• Pindyck, T., Tate, J. E., & Parashar, U. D. (2018). A decade of experience with rotavirus vaccination in the
United States–vaccine uptake, effectiveness, and impact. Expert review of vaccines, 17(7), 593-606.
Guidelines:Cover sheet should be attached with assignmentComplete student’s information on the first page of the document.Font should be 12 Times New RomanLine spacing should be 1.5The text color should be “Black”The length of the paper assignment should be 500-700 words.Use proper references using APA format. Please see below link about how to cite APA reference style.https://guides.libraries.psu.edu/apaquickguide/int… Do proper paraphrasing to avoid plagiarism
I have an artical that i did and i have to do part 3
Part 3: Step 3 Due FRIDAY OCT 6th
Draft of first two worksheets (one from each partner) – e.g. Worksheet #1 and Worksheet #2
I often find the most difficult part of this assignment is the critical evaluation of the research articles. I fully expect that you have
read these articles in DEPTH and have a good grasp of what was done by the researchers. You are welcome to ask me any questions
about your articles prior to turning in your draft (you can send me an email or schedule a meeting with me). Do not copy
sentences from the article. You need to use your own words as much as possible.
Use AND worksheet template (available on Canvas) to analyze each of your articles. For each article you will need to:
the articles
Fernández-Landa J, Fernández-Lázaro D, Calleja-González J, Caballero-García A, Córdova Martínez A, León-Guereño P, Mielgo-Ayuso J. Effect of Ten Weeks of Creatine Monohydrate Plus HMB Supplementation on Athletic Performance Tests in Elite Male Endurance Athletes. Nutrients. 2020; 12(1):193. https://doi.org/10.3390/nu12010193
Wang C-C, Fang C-C, Lee Y-H, Yang M-T, Chan K-H. Effects of 4-Week Creatine Supplementation Combined with Complex Training on Muscle Damage and Sport Performance. Nutrients. 2018; 10(11):1640. https://doi.org/10.3390/nu10111640
1. identify the type of study design using AND’s terminology shown on the next page (A, B, C, D, M, R, X).
2. identify the purpose of the research
3. describe who the research subjects are (source, inclusion and exclusion criteria)
4. describe the study protocol (interventions, procedures followed, etc)
5. describe how the data was collected (identify dependent variables and how measured, identify independent variables and
confounders for observational/population-based studies) and a brief mention of statistics used
6. provide a description of actual data sample (describe how they arrived at final subject sample)
7. provide a summary of results (review key findings- findings that help answer your question)
8. identify the primary author conclusion
9. add your critical comments (reviewer comments)
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Worksheets
Steps
Step 1. Formulate Evidence Analysis Question This question will be
formed after locating your first scholarly article.
Step 2. Gather and Classify the Evidence.
Step 3. Critically Appraise Each Report complete 4 AND Worksheets
and classify each report (A,B,C,D,M,R,X).
Worksheet #1 and #2
Article #1 and Article #2
• Take your time to read them well so you really understand the details,
highlight and take notes
• Use AND worksheet template (available on Blackboard Learn) to
analyze each of the 2 articles.
Citation
Study
Design
List the complete bibliographical citation – USE
AMA FORMAT
Name of the study design
Class
(A, B, C, etc)
Research
Purpose
Research question being investigated in the
study
Inclusion
Criteria
Requirement for study eligibility
Exclusion
Criteria
Items that disqualify an individual from
participation in study
Description
of Study
Protocol
What happened in the study (give an overview of the
design of the study)
Describe interventions (what it is/doses/timing); describe
cohort/sample, procedures used; what outcomes were
measured + when; how intervening factors were
managed, etc.
Data
Collection
Summary
Identify independent, dependent and confounding/control
variables
How was primary independent/dependent variables
measured? (include methods of measurement)
Briefly describe statistics used
Summary of
Results
Key Findings – be sure to include key result
numbers and significance of findings. Be
specific. Often tables are created in this
section. (Include statistical significance – P
values, relative risks, odds ratios, etc.)
Author
Conclusion
As stated by the author in body of report
Reviewer
Comments
Note strengths and limitations of the
study (beyond what appears in the
study). Indentify concerns that affect
study validity and generalizability.
Funding source – You can leave blank
for now
benign -Non cancerous -ovarian cyst causes and effects ( symptoms)1 – INTRODUCION ( thesis on what this is going to be about ) 2 – CAUSES and risk factors OF BENIGN ovarian cyst (1- age 2- genatic factors 3-race and ethnicity – 4- obesity 5- pregnancy) 3- EFFECTS AND SYMPTOMS ON HEALTH CONCLOUSION – ( call to action to community and health care proffesionals by 1- how to raise awareness 2 early detection 3 regular testing – 4 effective managment to the pations and treat the symptoms ) talk about each one of them in details and examples8 DIFFERrant referances ALL MEDICAL (PUBMED -NCBI ) IN APA7 please make an outline MAKE SURE WE ARE TALKING ABOUT THE BENIGN
BackgroundStudents will advocate for a political or economic health care bill or legislation of their professional interest and that is presently being addressed with current active State or pending Federal legislation. InstructionsDescribe the health care policy topic, current bill, list of authors/sponsors of the bill, succinct history of the bill, and succinct significance of the bill to nursing. Select an elected legislator in your community or a newspaper/journal relevant to this health care bill/legislation. Provide name, political affiliation, and contact information.Describe this official’s or organization’s stand on the specific, current active health care bill either in the city, state, or pending U. S. health care legislation. Write a letter to the selected legislator to communicate/advocate your stance on the health care bill/legislation. Explain your support/oppose to the bill/legislation. Include evidence (statistics, experts’ opinions, economic and financial considerations such as cost-benefit, cost-effectiveness, cost-utility, etc.) to support your statements. Do not send the email to the official organization. The letter is only for practice in the course.Word Count: At least 1,000 words are required. Include the number of words in your paper before the reference list.Reference List: At least five references in APA style. References should be not older than five years.Keep in mind that the officials are quite busy. Your email must be short, direct yet convincing, and powerful. Essential information must be contained in the letter with simple, easy-to-understand terminology, and with a description of all the acronyms you use
Unformatted Attachment Preview
Rubric for Papers
Course: NSG606 Health Policy & Finance
Criteria
Required
formatting/subheading
s for each section
Contents
Referencing
Outstandin
Commendable
Marginal
Marginal
Failing
1 point
0.8 points
0.7 points
0.6 points
0 points
Paper clearly contains the
subheadings/subtitles/se
ctions required in this
paper
Paper partially contains
the
subheadings/subtitles/se
ctions
It is unclear whether or
not the
subheadings/subtitles/se
ctions are included
Paper is missing two or
more
subheadings/subtitles/se
ctions
Paper is missing all
subheadings/subtitles
ctions
6 points
4.8 points
4.2 points
3.6 points
0 points
Clearly includes a
response for all the items
required in this section
Responses to each item
are comprehensive and
evidence-based
Includes a response for
most of the items
Includes a response for
some of the items
Includes a response for a
few of the items required
required in this section –
required in this section –
in this section – Three
One of the items
may be missingResponses to each
item are
comprehensive and
evidence-based
Two of the items
may be missingResponses to each
item are not
comprehensive or
evidence-based
or more of the items
may be missingResponses to each
item are not
comprehensive or
evidence-based
Missing all the respon
for the required items
Responses to each ite
are not comprehensiv
evidence-based
1 point
0.8 points
0.7 points
0.6 points
0 points
Citations and references
are in proper APA
format. Required number
of sources are cited. All
claims are supported
with a professional
reference.
Citations and references
are in proper APA
format. Most claims are
supported with a
professional reference.
Some citations and
references are in proper
APA format. Some claims
are supported with a
professional reference.
Citations and referenc
are limited, missing or
incorrect. Few claims
supported with a
professional reference
Paper has one less of the
required number of
references in APA style.
Paper has two less of the
required number of
references in APA style.
Most citations and
references are limited,
missing or incorrect.
Some claims are
supported with a
professional reference.
Some claims are not
supported with the
corresponding reference.
Some claims are not
supported with the
corresponding reference.
1.6 points
1.4 points
The number of minimum
required references in
APA style are included in
the paper.
Writing organization
and style Timeliness
Required number of
words
2 points
Assignment was
submitted on time.
Complies with the
required minimum
number of words.
Includes the total
number of words
before the
reference list.
The paper is well
organized both
Assignment was
submitted within
one day after the
deadline.
Complies with the
required minimum
number of words
but it does not
include the total
number of words
before the
Assignment was
submitted within
two days after the
deadline.
Assignment has
less than the
required number
of words and/or it
does not include
the total number
of words before
Paper has 3 references
less of the required
number and
Paper includes less th
3 references in APA
style.
Some claims are not
supported with the
corresponding reference.
Some claims are not
supported with the
corresponding referen
or paper is not in
compliance with
copyright guidelines.
1.2 points
0 points
in APA style.
Assignment was
submitted within
three days after
the deadline.
Assignment has
30% or less than
the required words
and/or it does not
include the total
number of words
before the
Assignment wa
submitted afte
four days beyo
the deadline.
Assignment ha
50% or less tha
the required
number of wor
and/or it does
include the tot
number of wor
overall and at the
paragraph and
sentence structure
level. Sentences
are smooth and
carefully crafted.
There are virtually
no errors in
punctuation,
spelling, grammar,
or usage.
reference list.
The paper is well
organized, but the
paragraphs and
sentence structure
may sometimes be
disjointed. The
paper may have a
few incorrect
passages and a
few errors in
punctuation,
spelling, grammar,
the reference list.
The paper is
basically well
organized, though
individual
paragraphs and
sentence
structures may be
disjointed or
misplaced. The
writing is
competent, but
often wordy,
overly general,
and usage.
Presentation has
between 15-19 pp
reference list.
The paper is
poorly organized.
Most sentences
are confusing and
their meaning
does not clearly
emerge. Words
may be imprecise,
incorrect, trite, or
vague.
imprecise, or trite.
before the
reference list.
The paper lack
clarity. The
language or
sentence struc
is incorrect and
unclear in seve
parts of the pa
Errors in
punctuation,
spelling, gramm
and usage are
constantly
present.
slides
Total
Overall Score
Outstanding
Commendable
Marginal
Unsatisfactory
10 points minimum
8 points minimum
7 points minimum
6 points minimum
For this project you will be required to select a personal health goal and write an 1000 word essay. The essay must include an Introduction, Body and Conclusion paragraph with a minimum of 3 references from peer-reviewed database articles.Complete the Real Age Test.Based on the results of the assessment, choose an area that you would like to improve.Write a 1000-word essay that includes the following:- The results of your assessment and the area that you would like to improve.- A clearly stated goal that demonstrates use of the SMART principles of goal-setting.- The strategies that you plan to use to improve your chosen health behavior. Your strategiesshould be specific with a clear implementation timeline.- A discussion as to how each of the dimensions of wellness are impacted by the area that youwould like to improve.
Amazon’s Kindle (its electronic book, magazine, and newspaper reader) has been far more successful than its SONY competitor. However, the original Kindle had some physical problems—button placement and page-turn speed among them. Correcting these problems resulted in the Kindle2, released in 2009 to glowing reviews. What observation research might have been used in the redesign of the original Kindle? (Refer Chapter-7)Embed course material concepts, principles, and theories (which require supporting citations), along with two scholarly peer-reviewed references in support of your answer. Keep in mind that these scholarly references can be found in the Saudi Digital Library by conducting an advanced search specific to scholarly references.
Please see attachement to understand the assignment.
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CAP 3 – Goal Setting
Goal Setting Made Easy
If you don’t know where you’re going, it’s hard to figure out how to get there. Whether you’ve
chosen an athlete or general population for your Critical Assignment, it’s important to set goals to
help people get to where they want to go. For this weeks CAP, we are going to use chapter 15
(Weinberg & Gould, 2019) as a reference to help set goals for our client/athlete to give them the
best chance for success. Please complete the following:
You are going to practice goal setting with your population. Please come up with:
•
Title page in APA format (Page 1)
•
Set 2 outcome, 2 performance, and 2 process goals that are relevant to your chosen
population. (Page 2*) THE GOALS MUST BE BULLETED. DO NOT WRITE
GOALS OUT IN PARAGRAPH FORM. THIS WILL MAKE IT EASIER
TO READ. When you use this with your population bulleted is how you will have them
write it down, so practice writing it that way.
•
Each goal should be specific and be moderately difficult but realistic. They
should also be measurable!! One should be short term while the other, long
term.
▪
Ex: Performance goal for a collegiate baseball player: Currently my
athlete is hitting .280. Their goal is to hit .300 by the end of the season.
Now that you have identified specific goals for your client/athlete/population, create one specific
strategy for each goal to help achieve them. (Page 3*)
•
Using the example above, what strategy would you use to help your athlete increase their
batting average? Before practice on Monday, Wednesday, and Friday have them hit 50
balls off the tee to 5 preset targets (10 balls to each target).
After setting goals and creating strategies to achieve them, write 2 pages that discuss why goal
setting is important and how you can motivate and provide support to your client/athlete/
population. Additionally, identify two common mistakes with goal setting, discuss why they
can be detrimental, and how to overcome them. (Page 4-5)
•
Reference Page (Page 6)
Keep in mind that you must incorporate a MINIMUM OF TWO PEER REVIEWED
SOURCES (the lecture, textbook, and credible outside sources) both cited and referenced into
your writing to strengthen your thoughts. Failure to do so will result in a 25 point deduction in
content. All written submissions should reflect current APA, professionalism in grammar,
spelling, writing style/format (one-inch margins, double spaced, typed in 12-point font), include
APA citations when appropriate, an APA appropriate title page, and be uploaded as .doc or .docx
documents.
(*) Page numbers and page count is provided as a template. Your page count may be more.
Guidelines:Cover sheet should be attached with assignmentComplete student’s information on the first page of the document.Font should be 12 Times New RomanLine spacing should be 1.5The text color should be “Black”The length of the paper assignment should be 500-700 words.Use proper references using APA format. Please see below link about how to cite APA reference style.https://guides.libraries.psu.edu/apaquickguide/int… Do proper paraphrasing to avoid plagiarism
Use https://dagitty.net for the DAG
It is widely accepted that infants born to mothers who smoke have lower birth weights (LBW) and are at
higher risk of infant mortality compared to infants born to mothers who do not smoke. Assume that
smoking increases the risk of infant mortality through its effect on birth weight, and also through other
mechanisms not involving birth weight.
1.
Draw a DAG to illustrate the relationship between maternal smoking (MS), LBW, and infant
mortality (D) using only the knowledge described above.
2.
Now further assume that folate intake (F) is causally related to both LBW and infant mortality.
Add this information to your DAG from Q1.
3.
Now further assume that lifestyle choices (L) are associated with both maternal smoking and
folate intake. Add this information to your DAG from Q2.
4.
You wish to estimate the causal effect of maternal smoking on infant mortality. Use the DAG
from Q3 to:
a.
Identify any backdoor paths between maternal smoking and infant mortality and describe any
such paths as open or closed.
b.
Should you control for any variables in this analysis? If so, which ones (provide the minimal set
of variables)? If not, why not?
5.
Now further assume that there is an unmeasured common cause (U) of low birth weight (LBW)
and mortality. Add a variable U (and any necessary arrows) to the DAG from Q3. Will this impact your
causal effect measurement?
6.
You obtain information on date of death, cause of death, date of birth, birth weight, maternal
smoking, and other medical and sociodemographic factors for all live births in the US in 2005. You wish
to test the hypothesis that maternal smoking increases the rate of infant mortality. Compared with
nonsmokers, the unadjusted infant mortality rate ratio for smokers was 1.55. Upon adjustment for birth
weight, this rate ratio was 1.09.
a.
Assuming that the DAG you drew in Q2 is correct, which point estimate more closely represents
the overall causal effect of maternal smoking on infant mortality?
b.
Explain why the other point estimate is biased.
c.
What covariate(s) would you adjust for if you wanted to know the direct effect of maternal
smoking on infant mortality?
7.
A colleague suggests that your analysis is biased because you only included live births in your
study. That is, because you only had data on live births you implicitly excluded stillbirths and abortions
from your study. Assume that smoking increases the risk of stillbirths and that there are other,
unmeasured, common causes of stillbirths, LBW and infant mortality. Note that infant mortality is
measured on children who are born alive.
a.
Using the DAG you drew in Q1 as a starting point, draw a modified DAG that additionally
illustrates the role of restricting your study to live births.
b.
Is your study biased as suggested by your colleague? Why or why not?
c.
Assume that contrary to your expectations, maternal smoking is not a cause of stillbirths. Is your
answer to Q7b the same? Why or why not?
For this week’s discussion, you are required to create a flow chart of an anabolic or catabolic function. NOTE: This cannot be taken from a resource and cited, but must be original work. Non-original work will receive a zero. To do this, consider using software such as PowerPoint, or online resources such as canva.com. Consider how you can make a flow chart to explain one anabolic or catabolic process in the body. Once creating the chart, include a brief explanation of what the process is, if it’s anabolic or catabolic, why it’s important, and how it relates to exercise physiology. HINT: I highly recommend doing a google image search for “cellular process” to give you an idea of what type of image is required. Consider that this may be something you would see in a literature review or textbook to explain a process.
Students will advocate for a political or economic health care bill or legislation of their professional interest and that is presently being addressed with current active State or pending Federal legislation.
Instructions
Describe the health care policy topic, current bill, list of authors/sponsors of the bill, succinct history of the bill, and succinct significance of the bill to nursing.
Select an elected legislator in your community or a newspaper/journal relevant to this health care bill/legislation. Provide name, political affiliation, and contact information.
Describe this official’s or organization’s stand on the specific, current active health care bill either in the city, state, or pending U. S. health care legislation.
Write a letter to the selected legislator to communicate/advocate your stance on the health care bill/legislation. Explain your support/oppose to the bill/legislation. Include evidence (statistics, experts’ opinions, economic and financial considerations such as cost-benefit, cost-effectiveness, cost-utility, etc.) to support your statements. Do not send the email to the official organization. The letter is only for practice in the course.
Word Count: At least 1,000 words are required. Include the number of words in your paper before the reference list.
Reference List: At least five references in APA style. References should be not older than five years.
Keep in mind that the officials are quite busy. Your email must be short, direct yet convincing, and powerful. Essential information must be contained in the letter with simple, easy-to-understand terminology, and with a description of all the acronyms you use
Epidemiology Homework #2
Question 1:
The total population of Toronto on October 6, 2015 is 183,000. The number of active TB cases
according to the Public Health Office in Toronto on December 6, 2015 was 264. The number of
new active TB cases occurring between June 6, 2015 – December 6, 2015 was 26.
A. What is the incidence rate during that 6 month period?
B. What is the prevalence rate of TB as of December 6?
Question 2:
A study of hypertension was undertaken and focused on 1000 men between the ages of 40-45
years. At a baseline examination (beginning of the study), 50 of the men were identified as
already having hypertension. The remaining 950 were followed for 5 years, during which 100
developed hypertension [15 in year one, 21 in year two, 25 in year three, 19 in year four, and
20 in year five].
A. What is the cumulative incidence of hypertension at the end of year three? (1 point)
B. What is the prevalence rate of hypertension at the end of year four? (1 point)
C. What is the period prevalence of hypertension in the timeframe of this study? (1
point)
I have attached the files required to extract the answers This work is important to me. Solve it correctly, without mistakes, withoutplagiarism. Follow the instructions. There is no chance to repeat it.Therefore, you must do a complete and correct work 100%.If you are sure you can do it, accept it
The purpose of this assignment is to communicate methodologies used for the reimbursement of
health care services. In this assignment, you will write a 500- to 750-word paper that will articulate
the complexities and challenges of financing a healthcare business in terms of volume-driven and
value-based reimbursements. This paper must include: ● an introduction to the transition from volume-driven reimbursement to value-based
reimbursement
● an explanation of value-based reimbursement methodologies as they pertain to healthcare
providers
● specific examples with a comparison, timeline, categorization, or description of funding
sources for volume-based and value-based reimbursement methods
● a conclusion to summarize the role of the Affordable Care Act in promoting the
implementation of value-based reimbursement.
This activity should also be used while reviewing for examsThe student will present their topic during post conference. The presentation should be short and concise; lasting no longer than 10 minutes. The student should provide facts about the topic and describe how it affects nurses. The student will also have 5 NCLEX well-developed questions prepared for their classmates to answer.You are the teacher. Who is your audience? Do a teach back. What did you learn from the information researched? What teaching strategy did you use? Why did you pick that teaching strategy? How do you know if your teaching was effective?
I have attached the files required to extract the answersThis work is important to me. Solve it correctly, without mistakes, withoutplagiarism. Follow the instructions. There is no chance to repeat it.Therefore, you must do a complete and correct work 100%.If you are sure you can do it, accept it
Using the video from Episode 7 on Ms. Fernandez, answer two of the following prompts. Please identify each prompt you answer by number and restate the question in bold letters. Prompt 1: Explain in detail the pathogenesis of DM Type 1 & 2 and DKA.Prompt 2: Explain how Ms. Fernandez’s past medical history correlates to her current condition.Prompt 3: Describe treatments that would be used for DM and DKA.
Your job will be to take a position on an environmental health issue and argue for that position using literature related to that. For your assignment this week, please post a discussion response with 3 ideas you are thinking of for your topic. We have learned about population control, environmental toxicology, risk management, risk assessment,
Below is a case study presentation of a patient with a condition discussed in this chapter. Read the case study and answer the questions for Case Study 2: The Feverish Toddler. Some questions will ask for information not included within this chapter. Use your text, a medical dictionary, or any other reference material you choose to answer these questions.
Case Study Scenario
A 2-year-old girl, “Evie,” is being seen by a hematologist. The child’s symptoms include the sudden onset of high fevers, thrombocytopenia, epistaxis, gingival bleeding, petechiae, and ecchymoses after minor traumas. The physician has ordered a bone marrow aspiration to confirm the clinical diagnosis of acute lymphocytic leukemia (ALL). If the diagnosis is positive, the child will be placed immediately on intensive chemotherapy. The physician has informed the parents that treatment produces remission in 90% of children with ALL, especially those between the ages of 2 and 8.
The Feverish Toddler Case Study Questions
Define the bold terms in the text. (5 points)
What pathological condition does the hematologist suspect? Look this condition up in a reference source and include a short description of it. (3 points)
What diagnostic test did the physician perform? Describe it in your own words. (3 points)
Explain the phrase “clinical diagnosis” in your own words. (3 points)
If the suspected diagnosis is correct, explain the treatment that will begin. (3 points)
What do you think the term remission means? (3 points)
International trade is subject to trade regulations and industrial policies. The Kingdom of Saudi Arabia is also subject to these regulations because of signed trade treaties or membership in various trade organizations. For this week’s discussion, please:
Discuss Saudi Arabia’s participation in the World Trade Organization (WTO)and compare and contrast the Kingdom’s WTO involvement with its participation in the Gulf Cooperation Council, League of Arab States, and the Trade and Investment Framework Agreement (TIFA) Saudi Arabia signed with the United States.
Which membership or trade agreement benefits Saudi Arabia the most?
Directions:
Discuss the concepts, principles, and theories from your textbook. Cite your textbooks and cite any other sources if appropriate.
Your initial post should address all components of the question with a 500 word limit.
we’re exploring causation and correlation.1) Using your textbook, define causation and correlation, in your own words. 2) Why is it a fallacy to confuse causation and correlation?3) Provide an example of a statement that confuses causation with correlation.In addition to your initial post, you must also respond to a peers post. Provide an analysis of your peers’ post. Build on their examples and explanations to extend meaningful discussion.
In at least 600 words, answer the following questions. Make sure to use at least 2 reliable scholarly sources.Choose a health issue and population that would benefit from health education for health promotion and disease prvention. Explain why the health issue is important and why the population of choice has been chosen.
The purpose of this assignment is to be able to actively search for relevant research related to your PICOT topic and present it in a formal annotated bibliography.
General directions
As you search the library for scholarly research, limit your search to identify empirical articles. On finding an empirical study, assess the validity of the conclusion by determining if the conclusion answers your proposed research question and if the methodology is appropriate.
Locate six articles directly related to your proposed PICOT question. Write an annotation for each of the six articles that includes a concise summary in your own words and the correct APA citation for each article.
Refer to the Annotated Bibliographies sample located in the assignment tab for additional guidance on completing this assignment in the appropriate style.
Annotated bibliography
Title Page
Introduction with the PICOT question
Annotated Bibliography 6 articles that support you’re your PICOT
Article reference in APA format
Summary of each article
Purpose
Research question
Methodology
Results
Conclusion
Competencies, Practice Indicators and Student Learning Activities
1. Demonstrate Ethical and Professional Behavior:
• Make ethical decisions by applying the standards of the NASW Code of Ethics, relevant laws
and regulations, models for ethical decision-making, ethical conduct of research, and additional
codes of ethics as appropriate to context;
• Use reflection and self-regulation to manage personal values and maintain professionalism in
practice situations;
• Demonstrate professional demeanor in behavior; appearance; and oral, written, and electronic
communication;
• Use technology ethically and appropriately to facilitate practice outcomes;
• Use supervision and consultation to guide professional judgment and behavior.
Learning Activity Ideas:
1) Keep notes on own behavior and thoughts during (or after) client meeting. Reflect on how
personal assumptions impact professional conduct and interactions with clients.
2) Keep reflective journal/log of professional development and challenges; discuss in
supervision.
3) Discuss needed areas of growth in supervision and work on strategies toward growth.
4) Discuss appropriate roles and boundaries of a student intern with Field Supervisor(s) and other
agency staff; practice behaviors that demonstrate commitment to appropriate roles and
boundaries (e.g. not exchanging personal contact information with clients; being mindful of
use of social media, etc.).
5) Illustrate effective communication, either in chart notes, email professional memorandum,
letters, and other written correspondence, as well as verbally and non-verbally.
6) Join a professional social work organization (NASW, for example) to gain
familiarity with various social workers and social work roles in the community.
7) Exhibit a professional attitude by arriving to the Field Practicum Site dressed appropriately,
clean, smiling with a positive outlook, prepared mentally and emotionally to solve problems
with staff and clients, and prepare to learn.
8) Dress according to agency policy.
9) Present to weekly supervision meetings prepared (Bring a list of topics/cases to discuss,
report back on learning activities, share reflections from week, etc.)
10) Consult with agency staff when appropriate to discuss social work-related issues.
11) Discuss personal/ethical/value dilemmas with Field Supervisor and reflect on
how they influence work with clients.
12) Journal personal biases or judgments that may hinder appropriate behaviors and discuss
managing the same with Field Supervisor, Faculty Field Liaison/Seminar Instructor, and/or peers in
practicum seminar.
13) Identify agency and client ethical dilemmas caused by external factors (funding cuts, etc.)
14) Discuss ethical behaviors and application of NASW Code of Ethics within the agency with
Field Supervisor, Faculty Field Liaison/Seminar Instructor, and/or peers in
practicum seminar.
15) Openly discuss ethical conflicts / situations with Field Supervisor.
16) Review and discuss additional ethical or governing policies which may impact the way in
which the agency is able to provide services to its clientele (i.e. agency rules, HIPAA, ANCRA, FERPA,
FMLA, SSI, etc.).
17) Use an ethical-decision making model to work through a situation that presents an ethical
dilemma; discuss in supervision.
18) Staff cases at multidisciplinary meetings or with colleagues.
19) Maintain accurate, respectful and professional written client records (as appropriate). Be
open to feedback from Field Supervisor or other staff with regards to documentation.
20) Identify and attend current community training sessions.
21) Assist with or participate in local trainings or workshops relevant to agency issues.
2. Engage Diversity and Difference in Practice:
• Apply and communicate understanding of the importance of diversity and difference in shaping
life experiences in practice at the micro, mezzo, and macro levels;
• Present oneself as a learner and engage clients and constituencies as experts of their own
experiences;
• Apply self-awareness and self-regulation to manage the influence of personal biases and values
in working with diverse clients and constituencies.
Learning Activity Ideas:
1) Strive to be assigned a diverse caseload of clients.
2) Discuss cultural structure and values and their effect(s) on different clients with supervisor.
3) Utilize journaling, or some other method of reflection, to record personal beliefs, or values,
regarding clients/staff who may be different than me (age, gender, race, religious affiliation,
orientation, color, cultural background, marital status, family structure, class, physical
ability, etc.), and how my beliefs/values impact my interaction with various clients. Discuss
the same with Field Supervisor, Faculty Field Liaison/Seminar Instructor, and/or peers in
practicum seminar, giving special attention to issues that may seem particularly difficult or
confusing.
4) Treat all clients with respect and courtesy regardless of personal bias, and establish initial
goals with the client to ensure self-determination, as well as equal and just treatment
to all clients/patients of the agency.
5) Review and discuss NASW’s Cultural Competency standards with your Field Supervisor. Work
to incorporate these expectations/practice behaviors into your social work practice.
6) Research and apply knowledge related to diversity to enhance client well-being.
7) Use assessments that include sections of diversity/culture/spirituality as identified by client.
8) Identify client differences using a strengths perspective.
3. Advance Human Rights and Social, Economic, and Environmental Justice:
• Apply one’s understanding of social, economic, and environmental justice to advocate for
human rights at the individual and system levels;
• Engage in practices that advance social, economic, and environmental justice.
Learning Activity Ideas:
1) Identify agency population being served and social policies that have created and/or
continue to create oppressive circumstances for the life course of the individuals/group.
2) Familiarize self with current political events and their impact on clients.
3) Identify forms of oppression / discrimination of a particular client group; discuss with
supervisor.
4) Identify common economic barriers to care. Discuss with your Agency Field Supervisor.
5) Identify the institutionally embedded barriers to an individual client’s progress. Discuss them
with your Field Supervisor.
6) Follow a bill promoting civil rights for a marginalized group. Educate others and encourage
advocacy related to this bill.
7) Contact legislator about a current client population need.
8) Attend a public hearing or organizational meeting focused on increasing social and
economic justice.
9) Demonstrate critical thinking and problem-solving skills by finding potential solutions and
discussing the same with Field Supervisor, Faculty Field Liaison/Seminar Instructor, and/or peers in
practicum seminar.
10) Identify and review key concepts of social empowerment strategies. Discuss these strategies
with field instructor and practice with clients.
11) Develop professional contacts with members of advocacy organizations that serve my client
population.
4. Engage in Practice-Informed Research and Research-Informed Practice:
• Use practice experience and theory to inform scientific inquiry and research;
• Apply critical thinking to engage in analysis of quantitative and qualitative research methods and
research findings;
• Use and translate research evidence to inform and improve practice, policy, and service delivery.
Learning Activity Ideas:
1) Discuss specific cases with Agency Field Supervisor, including problem, proposed solution(s),
proposed plan of action, and/or proposed measurable outcomes.
2) Read professional journal articles that relate to practice and discuss with supervisor.
3) Interview members of a treatment team for varying perspectives on practice and various
models/approaches used. Discuss findings with Field Supervisor and strengths / appropriateness of
each approach.
4) Be open to feedback on practice from clients and supervisor to improve social work skills
5) Solicit feedback from agency staff to learn about effective forms of intervention use with client
population.
6) Read professional journal articles relevant to agency population.
7) Analyze and/or acquire evidence-based methods being utilized within the agency.
8) Compare evidence-based methods employed by the agency with methods being discussed in various
classes. Discuss questions with Field Supervisor, Faculty Field Liaison/Seminar Instructor, and/or peers
in practicum seminar.
5. Engage in Policy Practice:
• Identify social policy at the local, state, and federal level that impacts well-being, service delivery, and
access to social services;
• Assess how social welfare and economic policies impact the delivery of and access to social services;
• Apply critical thinking to analyze, formulate, and advocate for policies that advance human rights and
social, economic, and environmental justice.
Learning Activity Ideas:
1) Participate in a community advocacy event.
2) Attend NASW/Advocacy Days and meet with legislators regarding policy issues.
3) Discuss laws that affect agency with supervisor.
4) Research a minimum of one policy that directly affects the well-being of client population. Discuss
impact of this policy on your clients and policy change ideas with Field Supervisor.
5) Identify relevant organizational and informational web sites that provide social policy
information relevant to your agency’s service population, or serve as clearinghouses for
legislative issues. Review them with your Field Supervisor. Consider creating a web
directory for your agency.
6) Research and/or otherwise observe client advocacy activities supported by the agency which
promote benefits for at risk populations.
8) Write a letter to your state or federal representative about a social policy that negatively or
positively affects your client population.
9) Track legislative initiatives relevant to your agency’s client population. Create a fact sheet
to educate the public about the importance of the initiative and/or issue.
6. Engage with Individuals, Families, Groups, Organizations, and Communities:
• Apply knowledge of human behavior and the social environment, person-in-environment, and
other multidisciplinary theoretical frameworks to engage with clients and constituencies;
• Use empathy, reflection, and interpersonal skills to effectively engage diverse clients and
constituencies.
Learning Activity Ideas:
1) Keep notes on own behavior and thoughts during (or after) client meeting. Reflect on how
personal assumptions impact professional conduct and interactions with clients.
2) Discuss personal/ethical/value dilemmas with supervisor / Field Instructor and reflect on
how they influence work with clients.
3) Journal personal biases or judgments that may hinder appropriate behaviors and discuss
managing the same with Agency Field Instructor, Faculty Field Liaison, and/or peer in
practicum seminar.
4) Discuss cultural structure and values and their effect(s) on different clients with supervisor.
5) Treat all clients with respect and courtesy regardless of personal bias, and establish initial
goals with the client/patient to ensure self-determination, as well as equal and just treatment
to all clients/patients of the agency
6) Research and apply knowledge related to diversity to enhance client well-being.
7) Identify and discuss with Agency Field Instructor, Faculty Field Liaison, or peers in
practicum seminar, various theories about human behaviors as may be observed when
working with clients (biological, social, cultural, psychological, and/or spiritual).
8) Seek feedback from supervisor about ways to build rapport and trust with clients
9) Identify areas of comfort and discomfort in client engagement and discuss in supervision.
10) Demonstrate ability to empathize and use appropriate interpersonal skills with clients.
11) Engage with and interview clients/families to determine strengths and challenges. Develop
interviewing and rapport-building skills.
12) Review literature on relationship-building and apply concepts to my own interviewing
technique.
7. Assess Individuals, Families, Groups, Organizations, and Communities:
• Collect and organize data, and apply critical thinking to interpret information from clients and
constituencies;
• Apply knowledge of human behavior and the social environment, person-in-environment, and
other multidisciplinary theoretical frameworks in the analysis of assessment data from clients
and constituencies;
• Develop mutually agreed-on intervention goals and objectives based on the critical assessment
of strengths, needs, and challenges within clients and constituencies;
• Select appropriate intervention strategies based on the assessment, research knowledge, and
values and preferences of the clients and constituencies.
Learning Activity Ideas:
1) Maintain accurate, respectful and professional written client records (as appropriate). Be
open to feedback from Field Supervisor or other staff with regards to documentation.
2) Use assessments that include sections of diversity/culture/spirituality as identified by client.
3) Identify client differences using a strengths perspective.
4) Identify and apply social work theories as they may apply to the process of assessment of
clients/patients within the agency.
5) Become familiar with different assessment tools and the strengths/limitations of each tool.
6) Understand developmental stages of client population and integrate this understanding into
assessment process.
7) Observe client assessment and write/organize/interpret client data (could be shadow
process).
8) Do a family genogram and/or eco-map as part of an assessment.
9) Develop a written assessment of client that includes client’s strengths and weaknesses.
10) Work with a client or client system to develop an intervention plan.
11) Develop or revise a community resource guide.
12) Identify and discuss with Agency Field Supervisor, Faculty Field Liaison/Instructor, or peers in
practicum seminar, various theories about human behaviors as may be observed when
working with clients (biological, social, cultural, psychological, and/or spiritual).
13) Research and illustrate knowledge of planned change processes, including assessment and
planning, as may be appropriate at either the micro, mezzo, or macro level.
8. Intervene with Individuals, Families, Groups, Organizations, and Communities:
• Critically choose and implement interventions to achieve practice goals and enhance capacities
of clients and constituencies;
• Apply knowledge of human behavior and the social environment, person-in-environment, and
other multidisciplinary theoretical frameworks in interventions with clients and constituencies;
• Use inter-professional collaboration as appropriate to achieve beneficial practice outcomes;
• Negotiate, mediate, and advocate with and on behalf of diverse clients and constituencies;
• Facilitate effective transitions and endings that advance mutually agreed-on goals.
Learning Activity Ideas:
1) Determine commonly used resources for clients and most effective referral process.
2) Staff cases at multidisciplinary meetings or with colleagues.
3) Contact legislator about a current client population need
4) Attend a public hearing or organizational meeting focused on increasing social and
economic justice.
5) Solicit feedback from agency staff to learn about effective forms of intervention use with
client population.
6) Analyze and/or acquire evidence-based methods being utilized within the agency.
7) Compare evidence-based methods employed by the agency with methods being discussed in
various classes. Discuss questions with Agency Field Supervisor, Faculty Field Liaison/Instructor,
and/or peers in practicum seminar
8) Identify and apply social work theories as they apply to the process of intervention with
clients/patients within the agency.
9) Understand developmental stages of client population and integrate this understanding into
intervention process.
10) Utilize specific interventions to increase understanding of client in environment.
11) Participate in a community advocacy event.
12) Attend Advocacy Days and meet with legislators regarding policy issues.
13) Plan, develop and carry out a support group.
14) Observe effective facilitation of groups at micro, mezzo, and/or macro levels, and facilitate,
or co-facilitate groups when appropriate.
15) Facilitate referral process of client to another agency, when appropriate.
16) Review client progress throughout termination phase; prepare client for final
sessions/meetings
17) Observe, reflect, and apply practice skills that assist individuals and/or groups to enhance
their well-being from a strengths-based perspective.
18) Identify and discuss with Agency Field Supervisor, Faculty Field Liaison/Instructor, or peers in
practicum seminar, various theories about human behaviors as may be observed when
working with clients (biological, social, cultural, psychological, and/or spiritual).
19) Research and illustrate knowledge of planned change processes, including intervention and
termination, as may be appropriate at either the micro, mezzo, or macro level.
9. Evaluate Practice with Individuals, Families, Groups, Organizations, and
Communities:
• Select and use appropriate methods for evaluation of outcomes;
• Apply knowledge of human behavior and the social environment, person-in-environment, and
other multidisciplinary theoretical frameworks in the evaluation of outcomes;
• Critically analyze, monitor, and evaluate intervention and program processes and outcomes;
• Apply evaluation findings to improve practice effectiveness at the micro, mezzo, and macro
levels.
Learning Activity Ideas:
1) Be open to feedback on practice from clients and supervisor to improve social work skills
2) Identify and apply social work theories as they apply to the process of evaluating outcomes of
clients/patients within the agency.
3) Continually review goals and objectives with client to monitor progress.
4) Review client file(s) to determine progress toward agreed upon goals
5) Evaluate assessments/data collection and intervention practices during supervision.
6) Maintain communication and follow-up with client to determine client outcomes and
potential success.
7) Identify and discuss with Agency Field Supervisor, Faculty Field Liaison/Instructor, or peers in
practicum seminar, various theories about human behaviors as may be observed when
working with clients (biological, social, cultural, psychological, and/or spiritual).
8) Research and illustrate knowledge of planned change processes, including evaluation and
follow-up, as may be appropriate at either the micro, mezzo, or macro level.
STUDENT LEARNING CONTRACT FOR FIELD PRACTICUM 2018-2019
EPAS Competency and Practice
Behavior(s)
Competency 1: 1. Make ethical decisions by
applying the standards of the
Demonstrate
NASW Code of Ethics, relevant
laws and regulations, models for
Ethical and
ethical decision-making, ethical
Professional
conduct of research; and
additional codes of ethics as
Behavior.
Objective(s)/Goal(s)
Competency 2:
Engage
Diversity and
Difference in
Practice.
1. Apply critical
thinking issues of
diversity and antioppressive
practice
2. Demonstrate
sensitivity to
diversity in the
classroom.
Competency 3:
Advance
Human Rights
and Social,
Economic, and
Environmental
Justice
appropriate to context.
2. Use reflection and selfregulation to manage personal
values and maintain
professionalism in practice
situations.
3. Demonstrate professional
demeanor in behavior;
appearance; and oral, written,
and electronic communication
4. Use technology ethically and
appropriately to facilitate
practice outcomes
1. Make ethical decisions by
applying the standards of the
NASW Code of Ethics, relevant
laws and regulations, models for
ethical decision-making, ethical
conduct of research; and
additional codes of ethics as
appropriate to context.
2. Use reflection and selfregulation to manage personal
values and maintain
professionalism in practice
situations.
3. Demonstrate professional
demeanor in behavior;
appearance; and oral, written,
and electronic communication
4. Use technology ethically and
appropriately to facilitate
practice outcomes
5. Use supervision and
consultation to guide
professional judgment and
behavior.
1. Apply their understanding of
social, economic, and
environmental justice to
advocate for human rights at the
individual and system levels
2. Engage in practices that
advance social, economic, and
environmental justice.
1. Conduct
myself
ethically
2. Recognize
personal
biases
1. Fulfill
agency’s
mission,
goals, and
vision
2. Advocate for
rights and
human justice
Assignments/Tasks
1. Be on time
2. Dressing
appropriate
3. Utilize supervision
time to talk about
biases and how the
internship is going.
Time Frame
1st semester
In process
How will work be monitored and
evaluated?
Physically and verbally: I will be
monitored in person and evaluated
based on my performance.
1. Implement a
strengths and
perspective
approach
2. Be mindful
during
presentations
1st semester
In process
Physically and verbally: I will be
monitored during presentations on
how I interact with a diverse
population of students.
1. Understand
mission, goal,
and vision of Zcenter
2. Represent Zcenter
appropriately.
1st semester
In process
Physically and verbally: I will be
monitored by my performance on
agency’s mission, goal, and vision. I
will be supervised if I represent Zcenter everywhere I go during
internship tasks.
STUDENT LEARNING CONTRACT FOR FIELD PRACTICUM 2018-2019
EPAS Competency and Practice
Behavior(s)
Competency 4: 1. Use practice experience and
theory to inform scientific inquiry
Engage in
and research.
2. Apply critical thinking to
Practiceengage in analysis of
informed
quantitative and qualitative
research methods and research
Research and
findings.
Research3. Use and translate research
informed
evidence to inform and improve
practice, policy and service
Practice.
Objective(s)/Goal(s)
1. Use research
and evidencebased practice
approaches
delivery.
Competency 5:
Engage in
Policy Practice
1. Assess how social welfare
and economic policies impact
the delivery of and access to
social services.
2. Apply critical thinking to
analyze, formulate, and
advocate for policies that
advance human rights
Competency 6:
Engage with
Individuals,
Families,
Groups,
Organizations,
and
Communities.
1. Apply knowledge of human
behavior and the social
environment, person-inenvironment, and other
multidisciplinary theoretical
frameworks to engage with
clients and constituencies.
2. Use empathy, reflection, and
interpersonal skills to effectively
engage diverse clients and
constituencies
1. Ablity to
engage with
clients in the
field through
supervision
Competency 7:
Assess
Individuals,
Families,
Groups,
Organizations,
and
Communities.
1. Collect and organize data,
and apply critical thinking to
interpret information from clients
and constituencies.
2. Apply knowledge of human
behavior and the social
environment, person-inenvironment, and other
multidisciplinary theoretical
frameworks in the analysis of
assessment data from clients
and constituencies.
3. Develop mutually agreed-on
intervention goals and
objectives based on the critical
assessment of strengths, needs,
and challenges within clients
and constituencies.
4. Select appropriate
intervention strategies based on
the assessment, research
knowledge, and values and
preferences of clients and
constituencies.
1.Use multi-dimensionl
bio-psycho-socialspiritual assessment
tools
1. Demonstrate
knowledge of field
agency policies while
delivering services.
Assignments/Tasks
1. Research more
about Erin’s
Law
2. Research all the
programs
offered for
schools due to
Erin’s law
1. Understand the
policies in place
that allows Zcenter to give
their services
1. Medical
advocacy
2. Support line
3. Prevention
education
program
1. Work with
Kylene (Intake
Manager) and
assess clients
readiness for
change
2. Go over coping
strategies for
survivors
Time Frame
1st semester
In process
How will work be monitored and
evaluated?
Verbally: I will be monitored by
completing my research and providing
my findings to my supervisor.
1st semester
In process
Physically: This will be monitored in
person and based on my level of
understanding for policies within my
agency.
1st semester
In process
Physically and verbally: I will be
monitored by how many times I
interact with survivors during medical
calls and how they choose to evaluate
our services.
1st semester
In process
Physically and verbally: I will be
monitored by the number of times I
met with Kylene to discuss the client’s
satisfaction and improvements.
STUDENT LEARNING CONTRACT FOR FIELD PRACTICUM 2018-2019
EPAS Competency and Practice
Behavior(s)
Competency 8: 1. Critically choose and
implement interventions to
Intervene with
achieve practice goals and
enhance capacities of clients
Individuals,
and constituencies.
Families,
2. Apply knowledge of human
behavior and the social
Groups,
person-inOrganizations, environment,
environment, and other
and
multidisciplinary theoretical
frameworks in interventions with
Communities.
Objective(s)/Goal(s)
1. Ability to
intervene with
clients
2. Provide
services
effectively
clients and constituencies.
3. Use inter-professional
collaboration as appropriate to
achieve beneficial practice
outcomes.
4. Negotiate, mediate, and
advocate with and on behalf of
diverse clients and
constituencies.
5. Facilitate effective transitions
and endings that advance
mutually agreed-on goals.
Competency 9:
Evaluate
Practice with
Individuals,
Families,
Groups,
Organizations,
and
Communities.
1. Select and use appropriate
methods for evaluation of
outcomes.
2. Apply knowledge of human
behavior and the social
environment, person-inenvironment, and other
multidisciplinary theoretical
frameworks in the evaluation of
outcomes.
3.Critically analyze, monitor, and
evaluate intervention and
program processes and
outcomes.
4. Apply evaluation findings to
improve practice effectiveness
at the micro, mezzo, and macro
levels.
1. I will utilize
feedback from client,
workers, field
supervisor to evaluate
myself
2. Effectively evaluate
my practice in the field
setting with supervisor
Assignments/Tasks
1. Medical
Advocacy
2. Hotline support
– Giving out the
resources they
need as well as
finding the right
ones.
1. 1 on 1 with Kyle go
over what is going on
2. Also taken into
account my partners
feedback in
presentations
Time Frame
1st semester
In process
1st Semester
In process
How will work be monitored and
evaluated?
Verbally: This will be monitored by the
shifts I pick up on better impact.
Verbally and physically: This will be
evaluated by meeting with my
supervisor and talking over all of the
improvements made over time as well
as what can further be improved.
Student
Printed Name
Signature
Date
Signature
Date
Field Supervisor
Printed Name
STUDENT LEARNING CONTRACT FOR FIELD PRACTICUM
EPAS Competency and Practice
Behavior(s)
Competency 1: 1. Make ethical decisions by
applying the standards of the
Demonstrate
NASW Code of Ethics, relevant
laws and regulations, models for
Ethical and
ethical decision-making, ethical
Professional
conduct of research; and
additional codes of ethics as
Behavior.
Competency 2:
Engage
Diversity and
Difference in
Practice.
Competency 3:
Advance
Human Rights
and Social,
Economic, and
Environmental
Justice
appropriate to context.
2. Use reflection and selfregulation to manage personal
values and maintain
professionalism in practice
situations.
3. Demonstrate professional
demeanor in behavior;
appearance; and oral, written,
and electronic communication
4. Use technology ethically and
appropriately to facilitate
practice outcomes
1. Make ethical decisions by
applying the standards of the
NASW Code of Ethics, relevant
laws and regulations, models for
ethical decision-making, ethical
conduct of research; and
additional codes of ethics as
appropriate to context.
2. Use reflection and selfregulation to manage personal
values and maintain
professionalism in practice
situations.
3. Demonstrate professional
demeanor in behavior;
appearance; and oral, written,
and electronic communication
4. Use technology ethically and
appropriately to facilitate
practice outcomes
5. Use supervision and
consultation to guide
professional judgment and
behavior.
1. Apply their understanding of
social, economic, and
environmental justice to
advocate for human rights at the
individual and system levels
2. Engage in practices that
advance social, economic, and
environmental justice.
Objective(s)/Goal(s)
Assignments/Tasks
Time Frame
How will work be monitored and
evaluated?
STUDENT LEARNING CONTRACT FOR FIELD PRACTICUM
EPAS Competency and Practice
Behavior(s)
Competency 4: 1. Use practice experience and
theory to inform scientific inquiry
Engage in
and research.
2. Apply critical thinking to
Practiceengage in analysis of
informed
quantitative and qualitative
research methods and research
Research and
findings.
Research3. Use and translate research
informed
evidence to inform and improve
practice, policy and service
Practice.
delivery.
Competency 5:
Engage in
Policy Practice
Competency 6:
Engage with
Individuals,
Families,
Groups,
Organizations,
and
Communities.
Competency 7:
Assess
Individuals,
Families,
Groups,
Organizations,
and
Communities.
1. Assess how social welfare
and economic policies impact
the delivery of and access to
social services.
2. Apply critical thinking to
analyze, formulate, and
advocate for policies that
advance human rights
1. Apply knowledge of human
behavior and the social
environment, person-inenvironment, and other
multidisciplinary theoretical
frameworks to engage with
clients and constituencies.
2. Use empathy, reflection, and
interpersonal skills to effectively
engage diverse clients and
constituencies
1. Collect and organize data,
and apply critical thinking to
interpret information from clients
and constituencies.
2. Apply knowledge of human
behavior and the social
environment, person-inenvironment, and other
multidisciplinary theoretical
frameworks in the analysis of
assessment data from clients
and constituencies.
3. Develop mutually agreed-on
intervention goals and
objectives based on the critical
assessment of strengths, needs,
and challenges within clients
and constituencies.
4. Select appropriate
intervention strategies based on
the assessment, research
knowledge, and values and
preferences of clients and
constituencies.
Objective(s)/Goal(s)
Assignments/Tasks
Time Frame
How will work be monitored and
evaluated?
STUDENT LEARNING CONTRACT FOR FIELD PRACTICUM
EPAS Competency and Practice
Behavior(s)
Competency 8: 1. Critically choose and
implement interventions to
Intervene with
achieve practice goals and
enhance capacities of clients
Individuals,
and constituencies.
Families,
2. Apply knowledge of human
behavior and the social
Groups,
person-inOrganizations, environment,
environment, and other
and
multidisciplinary theoretical
frameworks in interventions with
Communities.
Objective(s)/Goal(s)
Assignments/Tasks
Time Frame
How will work be monitored and
evaluated?
clients and constituencies.
3. Use inter-professional
collaboration as appropriate to
achieve beneficial practice
outcomes.
4. Negotiate, mediate, and
advocate with and on behalf of
diverse clients and
constituencies.
5. Facilitate effective transitions
and endings that advance
mutually agreed-on goals.
Competency 9:
Evaluate
Practice with
Individuals,
Families,
Groups,
Organizations,
and
Communities.
1. Select and use appropriate
methods for evaluation of
outcomes.
2. Apply knowledge of human
behavior and the social
environment, person-inenvironment, and other
multidisciplinary theoretical
frameworks in the evaluation of
outcomes.
3.Critically analyze, monitor, and
evaluate intervention and
program processes and
outcomes.
4. Apply evaluation findings to
improve practice effectiveness
at the micro, mezzo, and macro
levels.
Student
Printed Name
Signature
Date
Signature
Date
Field Supervisor
Printed Name
This work is important to me. Solve it correctly, without mistakes, withoutplagiarism. Follow the instructions. There is no chance to repeat it.Therefore, you must do a complete and correct work 100%.If you are sure you can do it, accept it
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Organizational Behavior
Course number:
HCM102
CRN
11468
Answer the following question-
Assignment title or task:
1. How do culture and cultural diversity / variation
affect work behavior and job performance?
Provide examples to show why a knowledge of such
differences is important for managers.
Student Name:
Students ID:
Submission date:
Instructor name:
Tariq Alotaibi
Grade:
…..out of 10
College of Health Sciences
Department of Public Health
Release Date: Sunday, 17th April 2023 (12:00 Noon)
Due Date: Saturday, 7th October 2023 (11:59 pm)
Instructions for submission:
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
This assignment will serve as a course-level assessment for the following outcomes:
DN713-03: Interpret the implications of epidemiologic studies on the development of population health interventions.
PC-4.1: Assess the value of multiculturalism and diversity in a global environment.
The assignments for Units 6 and 8 will be focused on a Population Health Care Delivery Project.
The four components of this Population Health Care Delivery Project include:
community risk assessment
intervention development
implementation plan
evaluation plan
gYou will write a 4–6-page Microsoft Word document (excluding the title and reference pages) which contains:
identify demographic and social determinants, including multicultural and diverse communities for your population health;
discuss community infrastructure variables;
analysis of surveillance data collected for the risk assessment including
sources of data (bibliographic databases, U.S. government sources of data and peer-reviewed evidence-based findings);
data calculations; and
criteria for assessing the quality and utility of the epidemiologic data and how identified errors of data were treated.
analyze outcomes from the risk assessment related to the health of your target population;
discuss interventions designed to generate positive population health outcomes within your target population
include rationales to support the intervention.
provide a detailed critique of one epidemiologic and biostatistical research method
a minimum of five (5) peer-reviewed evidence-based journal articles with findings relevant to your target population and selected epidemiological problem.
Your writing assignment should:
follow the conventions of Standard English (correct grammar, punctuation, etc.)
be well ordered, logical, and unified, as well as original and insightful
display superior content, organization, style, and mechanics; and;
use APA 7th edition formatting and citation style.
Guidelines:Cover sheet should be attached with assignmentComplete student’s information on the first page of the document.Font should be 12 Times New RomanLine spacing should be 1.5The text color should be “Black”The length of the paper assignment should be 500-700 words.Use proper references using APA format. Please see below link about how to cite APA reference style.https://guides.libraries.psu.edu/apaquickguide/int… Do proper paraphrasing to avoid plagiarism
525
Human interactions with technology
Trust has a pivotal role in shaping the dynamics of human interactions, encompassing not
only relationships between individuals but also their interactions with artificial intelligence
(AI) systems. Gaining insight into the trust dynamics that exist between artificial intelligence
(AI) systems and human beings is of paramount importance, particularly within the realm of
healthcare, where the preservation of human life is at stake (Asan et al., 2020).
AI research in healthcare has distinct obstacles compared to other technical fields.
Physical system models mathematically explain technical behavior in engineering. However,
the absence of quantitative models in healthcare applications like medical diagnosis raises
challenges in determining illness linkages and causation. The answers of professionals to the
same clinical cases differ dramatically. Training AI-based tools on subjective answers from
clinicians without ground truth knowledge is challenging. AI research must consider the
unique aspects of medical problems in various healthcare applications. Training a
mathematical model for an AI specialized in cancer applications may not be applicable to
cardiovascular applications. Additionally, failure to address disadvantaged populations like
minorities and people with impairments during AI system design may result in inadequate
data representation and unmet demands. A tailored AI method may be required for each
application, based on data type, patient demographic, data variability, and healthcare
decision-making (Asan et al., 2020).
Recommendations
Clinicians will be held accountable if they follow an AI recommendation that deviates
from the standard treatment process and has a negative impact on patient health. What would
this imply for an AI system and trust between AI and users? Clinicians who utilize AI
systems are expected to use them as a decision-making aid, not as a replacement for trained
clinical judgment. As humans remain the ultimate decision-makers, clinicians are still
responsible for any medical errors that may occur. Then, how can AI assist clinicians, and
will clinicians be able to use and evaluate an AI system’s reliability? The impact of these
factors on clinicians’ trust in AI applications requires additional research (Asan et al., 2020).
Quantifying the ideal level of confidence between clinicians and AI systems for accurate
and reliable healthcare choices is challenging due to the constraints of both human cognition
and AI technologies. The relationship between AI system design features and appropriate
trust levels is unclear. The analysis of this problem should consider the unique human aspects
of each user, as well as the significant variety and developing capabilities of AI technologies.
This analysis should inform regulatory policy (Asan et al., 2020).
Trust in AI is predicted to differ significantly between patients and clinicians. Patients
sometimes lack medical expertise compared to physicians. The AI system’s therapeutic
choices and suggestions will directly effect patients, regardless of their use of the system.
Increasing patient involvement in patient-centered treatment may lead educated patients to
question clinical judgments and seek information about AI advice. Further research is needed
to understand trust relationships between patients and AI systems, as they are crucial to
collaborative decision-making between clinicians and patients (Asan et al., 2020).
References
Asan, O., Bayrak, A. E., & Choudhury, A. (2020). Artificial intelligence and human trust in
healthcare: focus on clinicians. Journal of Medical Internet Research, 22(6), e15154.
520
The increased usage of electronic health records offers opportunities to enhance healthcare
delivery using big data. This makes data mining and predictive analytics crucial for
healthcare decision-making. Data mining in the healthcare field remains a burgeoning area of
research that holds much promise. Certain aspects of healthcare operations have garnered
more attention than others, such as the characterization of clinical pathways, quality of care,
and resource allocation. However, there exists an opportunity to utilize insights derived from
the utilization of big data to enhance the design of facility layouts and conduct process
analyses, thereby achieving operational excellence and enhancing patients’ satisfaction
(Malik et al., 2018).
Quality reporting is time-consuming and costly, leading to discontent among
practitioners. This study measures quality through standards-based data interchange,
requiring no additional time or effort from sampled institutions. Data transmitted through
clinical standards enables the calculation of various quality indicators. Additionally, data
incompleteness affects patient safety. Research indicates that sharing clinical data can reveal
high-risk drug use (cms156) that may not have been noticed otherwise. This score is based on
American Geriatrics Society consensus advice and studies linking certain medicines to
adverse events, worse health, and increased mortality risk. Data sharing impacts patient
safety and quality measurement at organizations with incomplete medication histories, as
indicated by the 68 measure changes from compliance to non-compliance (D’Amore et al.,
2021).
Value Based Health Care (VBHC) is a widely used healthcare method that focuses on
improving patient value, which is the ratio of patient-important outcomes to healthcare
delivery costs. Continuously improving patient value through quality, process, and structure
indicators is essential in VBHC. The Deming cycle (PDSA) can be used to update quality
research indicators continuously. Adding an outcome-based improvement cycle to VBHC has
shown significant utility. Integrating patient-relevant outcomes and costs into a PDSA cycle
across a multi-provider regional network creates a unique, reproducible, and structured tool to
enhance patient value throughout the care cycle (Van Veghel et al., 2022).
A proposed step-by-step technique for adopting VBHC principles in cardiac network
organizations is provided, including initial findings for atrial fibrillation patients. Successful
implementation of the methodology in a Dutch regional network led to increased patient-
relevant outcome registration, adherence to regional standards, and selection of first regional
projects to enhance outcomes and costs. Further research will determine how the
methodology affects patient value (Van Veghel et al., 2022).
References
D’Amore, J. D., McCrary, L. K., Denson, J., Li, C., Vitale, C. J., Tokachichu, P., Sittig, D. F.,
McCoy, A. B., & Wright, A. (2021). Clinical data sharing improves quality measurement and
patient safety. Journal of the American Medical Informatics Association, 28(7), 15341542.
Malik, M. M., Abdallah, S., & Ala’raj, M. (2018). Data mining and predictive analytics
applications for the delivery of healthcare services: a systematic literature review. Annals of
Operations Research, 270, 287-312.
Van Veghel, H., Dekker, L., Theunissen, L., Janssen, J., Burg, M. P., Huijbers, P., Voermans,
P., van der Wees, P. J., & Cremers, H. P. (2022). Introducing a method for implementing
value based health care principles in the full cycle of care: Using atrial fibrillation as a proof
of concept. International Journal of Healthcare Management, 15(1), 1-9.
AHMED 530
C OLLA PSE
Repetitive Activity done by healthcare professionals using upper body ( arms and hands )
Administering medical treatments: Healthcare professionals may perform procedures such as
wound care, dressing changes, or injections. These tasks often involve repetitive upper body
movements, such as cleaning and dressing wounds or manipulating syringes.
Ergonomics risk assessment by using assessment of repetitive task (ART)
The Assessment of Repetitive Tasks (ART) tool is a simple and effective way to assess the
ergonomic risk of repetitive tasks. It was developed by the Health and Safety Executive (HSE) in the
UK and is widely used around the world.
The ART tool assesses four key risk factors:
•
•
•
•
Repetition: How often is the task repeated?
Force: How much force is required to perform the task?
Posture: What are the postures of the neck, shoulders, back, arms, and wrists during the task?
Duration: How long is the task performed for?
For each risk factor, the ART tool assigns a score of 1 to 4, with 1 being the lowest risk and 4
being the highest risk. The total score for the task is then calculated by adding up the scores for each
risk factor.
score sheet 3.docx
Top three Ergonomics risk factors
When using the Assessment of Repetitive Tasks (ART) method to evaluate ergonomic risk
factors associated with administering medical treatments, several factors should be considered.
These factors can contribute to the development of musculoskeletal disorders (MSDs) among
healthcare professionals. Here are some ergonomic risk factors associated with administering
medical treatments:
1. Forceful Exertions: The force required to perform certain medical treatments, such as applying
pressure during wound care or administering injections, can put strain on the upper body. Forceful
exertions can increase the risk of MSDs, especially if performed frequently or for extended periods.
2. Awkward Postures: Administering medical treatments may require healthcare professionals to
assume awkward or uncomfortable postures. For example, reaching across a patient while
maintaining proper body mechanics or bending the wrist excessively during injections. Awkward
postures can strain muscles and joints, leading to discomfort or injury over time.
3. Repetition: The repetitive nature of administering medical treatments can contribute to the
development of MSDs. Tasks like cleaning and dressing wounds or performing injections often
involve performing the same motions repeatedly, which can lead to muscle fatigue, overuse injuries,
and cumulative trauma.
To minimize ergonomic risks associated with administering medical treatments, it is important to
implement ergonomic interventions and controls. These may include providing ergonomic equipment
and tools, promoting proper body mechanics and postures, implementing task rotation or job
enrichment, and offering training on ergonomic practices and risk awareness. Regular evaluations
and feedback from healthcare professionals can help identify and address ergonomic concerns in the
healthcare setting.
References
Assessment of repetitive tasks of the upper limbs (the ART
https://www.hse.gov.uk/pubns/indg438.htm,2023tool).
Assessment of repetitive tasks of upper limbs (the ART tool) | Safety and health at work EUOSHA. https://osha.europa.eu/en/themes/musculoskeletal-disorders/practical-tools-musculoskeletaldisorders/assessment-repetitive-tasks-upper-limbs-art-tool
ABDULLAH 530
Assessment of repetitive tasks (ART)
C OLLA PSE
work-related upper limb diseases (WRULD) are a well-known condition that causes job
impairment, productivity loss, and social expenditures globally. In Sweden in 2020, 58% of
people who claimed to have suffered from poor health owing to work circumstances other
than an accident reported symptoms in the neck and/or upper extremities. These illnesses are
linked to hand-intensive activity that requires severe effort, high repetition, extended
duration, awkward or immobile postures, and often a combination of these traits.(Eliasson et
al., 2022)
Physical factors in the workplace, including as intense effort, awkward postures, and
repetitive activity, as well as psychological and organizational factors, are linked to
WRMSDs in the neck, shoulder, and arms. As a result, risk evaluations of physical elements
are critical for identifying potentially hazardous work activities and prioritizing and
developing workplace interventions, both in terms of physical design of the workplace, work
technique, and work organization.(Nyman et al., 2023)
Carpal tunnel syndrome, non-specific arm discomfort, tenosynovitis (tendon
inflammation), and lateral epicondylitis (tennis elbow) are all common work-related upper
limb diseases. Upper limb problem discomfort accounts for about one out of every ten missed
working days, with the typical illness absence lasting 13 days. This comes at a high cost to
enterprises.(Bromhead, 2018)
Repetitive upper limb activities comprise a series of upper limb motions that are
performed every few minutes or more often. The duties are typically completed for one to
two hours every day or shift, with the dangers associated being repetition, force, posture, and
working environment. The HSE created the ART (Assessment of Repetitive tasks) tool to
assist with risk assessment activities. The instrument is designed to evaluate the frequency
with which light weights or other repeated jobs are handled, which might lead to upper limb
disorder.(Bromhead, 2018)
The ART tool is especially beneficial for repetitive strain concerns when non-neutral
postures and repetition are important risk factors. It allows for the detection of concerns that
would otherwise go unexplored during a routine manual handling risk assessment. After
completing a comprehensive evaluation using the ART tool, a mechanism for evaluating the
overall result is offered, along with suggestions on the need for any additional
action.(Bromhead, 2018)
The ART tool takes a step-by-step approach:
•
Stage A: Frequency and repetition of movements;
•
Stage B: Force;
•
Stage C: Awkward postures;
•
Stage D: Additional factors.
For each stage, follow the flow chart and/or assessment guide to determine the level
of risk for each risk factor. The levels of risk are classified in the table below.
•
G = GREEN Low level of risk
•
A = AMBER Medium level of risk – Examine task closely
•
R = RED High level of risk – Prompt action needed
Score sheet
Enter the colour band and numerical score for each risk factor in the table below. Follow the
instructions on page 15 to determine the task score and exposure score.
Left arm
Right arm
Risk factors
Colour
A1 Arm movements
A2 Repetition
B Force
C1 Head/neck posture
C2 Back posture
C3 Arm posture
C4 Wrist posture
C5 Hand/finger grip
D1 Breaks
D2 Work pace
D3 Other factors
Task score
Score
Colour
Score
D4 Duration multiplier
X
X
Exposure score
D5 Psychosocial factors
Reference:
Bromhead, A. (2018, January 12). A Guide to the HSE ART tool. Dr Alistair Bromhead
Ltd. https://www.abromhead.co.uk/a-guide-to-the-hse-art-tool/
Eliasson, K., Fjellman-Wiklund, A., Dahlgren, G., Hellman, T., Svartengren, M., Nyman, T.,
& Lewis, C. (2022). Ergonomists’ experiences of executing occupational health surveillance
for workers exposed to hand-intensive work: A qualitative exploration. BMC Health
Services Research, 22, 1223. https://doi.org/10.1186/s12913-022-08601-2
Nyman, T., Rhén, I.-M., Johansson, P. J., Eliasson, K., Kjellberg, K., Lindberg, P., Fan, X.,
& Forsman, M. (2023). Reliability and Validity of Six Selected Observational Methods for
Risk Assessment of Hand Intensive and Repetitive Work. International Journal of
Environmental Research and Public Health, 20(8), 5505.
https://doi.org/10.3390/ijerph20085505
525
The landscape of healthcare is undergoing a rapid transformation due to technological
advancements, with new inventions appearing all the time. Even if advances in technology
have the potential to make healthcare delivery and outcomes far better in many respects,
these advancements also bring new difficulties for human relationships (Greussing et al.,
2022).
Challenges of Human Interactions with Technology in Patient Care:
Wearable gadgets that track our health data are just one example of how technology is
playing an increasingly essential role in the healthcare industry. Artificial intelligence (AI)
systems that can diagnose ailments and offer treatments are another example. Nevertheless,
the incorporation of technology into medical practice brings with it a variety of difficulties
for interpersonal communication (Schueller, 2021).
One major obstacle is the potential for healthcare to become impersonal as a result of
technological advancements. It’s possible for patients to feel like their unique needs aren’t
being addressed when they communicate with a computer or machine. This might make it
harder for patients and doctors to connect on a personal level (Sittig et al., 2018).
The complexity and awkwardness of some technologies are additional hurdles.
Patients, especially the elderly and those with low levels of technology literacy, may find this
to be an obstacle. Medical professionals may struggle because they lack the resources (time
and expertise) to master these innovative tools (Schueller, 2021).
Problems with patient-provider communication are another potential outcome of
technological advancements in the healthcare industry. There are a number of reasons why
patients could be hesitant to provide personal information to a computer program, such as the
fact that they might not be familiar with the medical jargon that is frequently employed.
Providers of healthcare may also struggle to convey complicated medical topics to people
(Sittig et al., 2018).
Finally, technological advancements might cause ethical problems in medical
treatment. For instance, AI systems may be prejudiced, which might result in discriminatory
healthcare. Data breaches are another concern that might expose sensitive patient information
(Schueller, 2021).
Recommendations for Designing Computer or Mobile Application Interfaces for
Efficient and Effective Patient Care:
When creating the user interfaces for computer programs or mobile applications that
are used in patient care, it is essential to keep the following principles in mind (Greussing et
al., 2022):
•
Create a user-friendly interface with clear instructions and prompts for next steps.
•
Make it user-friendly for individuals of all abilities; the interface has to work with a wide
range of hardware and software.
•
The interface should employ robust security mechanisms to keep sensitive patient
information private and safe.
•
The data collection and usage processes should be made clear in the UI. Patients should have
an easy time getting in touch with support staff if they have any issues or inquiries.
•
The interface should be created in a way that makes it easy for patients and doctors to talk to
each other and share information.
The following are some instances of how these recommendations can be put into practice:
•
Avoid complicated terminology and stick to the basics.
•
Make use of big typography and contrasting hues.
•
Give concise guidance and constructive criticism.
•
Make the UI more intuitive by include graphics and icons.
•
Facilitate the search for specific data by users.
•
In order to keep sensitive information about patients safe, you should employ robust
encryption and other security measures.
•
Make it simple for patients to get in touch with customer service and provide a transparent
policy about their privacy.
•
Create a user experience that compels users to interact with their healthcare providers. Secure
communication and appointment setting are only two examples of what the interface may
support.
When designers adhere to these guiding principles and guidelines, they are able to
produce computer or mobile application interfaces that are effective, efficient, and simple for
patients to use. This has the potential to contribute to the improvement of patient care while
also making it more accessible to all individuals (Sittig et al., 2018).
References
Greussing, E., Gaiser, F., Klein, S. H., Straßmann, C., Ischen, C., Eimler, S., Frehmann, K.,
Gieselmann, M., Knorr, C., Lermann Henestrosa, A., Räder, A., & Utz, S. (2022).
Researching interactions between humans and machines: methodological
challenges. Publizistik, 67, 531–554. https://doi.org/10.1007/s11616-022-00759-3
Schueller, S. M. (2021). Grand Challenges in Human Factors and Digital Health. Frontiers
in Digital Health, 3. https://doi.org/10.3389/fdgth.2021.635112
Sittig, D. F., Wright, A., Coiera, E., Magrabi, F., Ratwani, R., Bates, D. W., & Singh, H.
(2018). Current challenges in health information technology–related patient
safety. Health Informatics Journal, 26(1), 146045821881489.
https://doi.org/10.1177/1460458218814893
520
Observations about the effectiveness of the strategy:
Data mining was determined to be a useful method for detecting and lowering patient
safety hazards by the study’s authors. Data mining was utilized to evaluate a massive dataset
of patient safety events, which revealed previously hidden patterns and trends. They
discovered, for instance, that some occurrences tend to happen more frequently at particular
times of day or in particular apartments (Leary et al., 2020).
After seeing these tendencies, the writers were able to put in place specific measures
to lessen the likelihood of future occurrences. For instance, in the units where specific
occurrences occurred more frequently, more training was provided to personnel. In addition,
they adjusted their scheduling policies to increase the presence of workers during peak
incident hours (Leary et al., 2020).
Methodologies used to define and diagnose the problem:
The authors mined the patient safety event database using a number of different methods
to extract useful information. Some of these methods were (Leary et al., 2020):
•
Association Rule Learning: This method was employed to establish connections between
various occurrence categories. Patients using particular drugs, the authors discovered, were at
a higher risk of falling.
•
Clustering: It was utilized to categorize patients into groups that were at high risk for
specific occurrences. For instance, the authors discovered that patients who were both elderly
and suffering from many chronic diseases had an increased chance of falling.
•
Classification: Using this method, models were created to foresee the likelihood of specific
incidences happening to specific patients. For instance, the authors built a model to foresee
the likelihood of falls among newly admitted hospital patients.
How they implemented the process improvement:
After analyzing patient safety event data, the authors took action to mitigate such
incidents in the future by putting into place many distinct interventions. The following
actions were taken (Leary et al., 2020):
•
Additional training for staff: The authors expanded training opportunities for workers at
hospitals and other facilities where certain occurrences occurred often. The employees in the
geriatric ward, for instance, received education on how to reduce the risk of falls.
•
Changes to scheduling practices: When the authors realized that certain times of day had a
higher risk of mishaps, they adjusted their staffing levels accordingly. For instance, during
the night shift, they boosted the number of emergency room doctors and nurses on duty.
•
Development of new policies and procedures: The authors established fresh guidelines and
processes to deal with certain threats to patient safety. For people who are at high risk of
falling, they implemented a new policy.
Metrics used to measure the improvement:
The authors employed a variety of indicators to gauge the rise in patient safety following
their treatments. Among these measurements were (Leary et al., 2020):
•
The number of patient safety incidents: After applying their treatments, the authors saw a 15
percent drop in patient safety occurrences.
•
The severity of patient safety incidents: After applying their treatments, the authors also saw
a reduction in the severity of occurrences related to patient safety.
•
The number of patient deaths: After adopting their changes, the authors discovered a 20%
reduction in patient mortality.
Was the improvement sustainable?
When the authors checked in with the healthcare system a year after implementing
their measures, they discovered that the gains in patient safety had persisted. Patient safety
incidents, patient safety incident severity, and patient mortality all stayed at historically low
levels (Leary et al., 2020).
Opportunities to improve the process that the authors did not include:
The authors left out the possibility of using data mining to detect near-misses, which
would be a significant improvement to the method. Events that almost resulted in patient
damage but luckily did not are called near misses. Identification of near misses can be as
useful in preventing future problems as identification of actual occurrences (Ekwonwune et
al., 2022).
Data mining, the systematic examination of large datasets, presents yet another
potential for process improvement. Patient safety incident reports were the only source of
data for this analysis. There are additional data sources that might be utilized to detect
hazards to patient safety and create interventions to address those risks, such as electronic
health records and patient questionnaires (Ekwonwune et al., 2022).
References
Ekwonwune, E. N., Ubochi, C. I., & Duroha, A. E. (2022). Data Mining as a Technique for
Healthcare Approach. International Journal of Communications, Network and
System Sciences, 15(09), 149–165. https://doi.org/10.4236/ijcns.2022.159011
Leary, A., Cook, R., Jones, S., Radford, M., Smith, J., Gough, M., & Punshon, G. (2020).
Using knowledge discovery through data mining to gain intelligence from routinely
collected incident reporting in an acute English hospital. International Journal of
Health Care Quality Assurance, 33(2), 221–234. https://doi.org/10.1108/ijhcqa-082018-0209
College of Health Sciences
Department of Health Informatics
ASSIGNMENT COVER SHEET
Course name:
Public health outbreak and disaster management
Course number:
PHC 372
Assignment 1 Questions
– What makes Hajj different than other mass
gatherings?
– What are the risk factors associated with
Hajj?
– Then Choose only one of the following:
o Choose one potential disaster in Hajj
and propose your plan to manage it.
(Explain your disaster management
plan in each phase of the disaster
(Mitigation, Preparedness, Response,
Recovery)
Assignment
question
o Review one disaster incident that
happened in Hajj (explain the
strategies used in the 4 phases, if
possible, to manage the disaster, and
what are the lessons learned out of
that incident)
Note:
•
You can use the following resource (page 2) to review
a brief of the 4 phases of disaster.
Lindsay, B. R. (2012, November). Federal emergency
management: A brief introduction. Congressional Research
Service, Library of Congress.
https://apps.dtic.mil/sti/pdfs/AD1172029.pdf
College of Health Sciences
Department of Health Informatics
Student name:
Student ID:
CRN
Submission date:
Instructor name:
Dr. Ahmed Hazazi
Grade:
…. Out of 10
Paper assignment guidelines
Short essay of 300 – 500 words in APA style. Submission on 28 October 2023 11: 59 PM
•
•
•
•
•
•
•
Conduct your own research to explore further online resources to provide the conceptual
idea and avoid using advertising or commercial material.
Do not use bullet points in representing your answer.
The assignment should have the COVER PAGE with SEU logo and the details of who is
submitting and to whom is it submitted.
Assignments should be submitted through Blackboard in Word document only and not
through email.
Font should be 12 Times New Roman, color should be black and line spacing should be
1.5
Use APA referencing style. Please see below link about how to cite APA reference style.
https://guides.libraries.psu.edu/apaquickguide/intext
Do proper paraphrasing to avoid plagiarism.
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Society & Drugs
Course number:
PHC 314
CRN
Essay Topic
Assignment title or task:
(You can write a question)
Societies have evolved to believe that they have the right to
protect themselves from the damaging impact of drug use and
abuse.
(a) Mention the policies and prevention programs for
combating drug use and abuse at any country you
choose ?
(b) Describe the Saudi Food & Drug Authority (SFDA)
approval process for assessing the safety and efficacy of a
newly developed drug?
Student name:
Student ID:
Submission date:
Instructor name
Grade
… out of 10
Guidelines:
•
Word count: 300to 1000 words
•
Follow APA format for your assignment must include Introduction, Body and Conclusion
•
All information must be mention in APA reference
•
Font and Size: Times New Roman (12)
•
Color – Black, Spacing – 1.5, Heading and sub-heading – Bold
•
Follow APA format your assignment must include Introduction, Body & Conclusion
•
Avoid plagiarism
•
Submit as word document
First, read “Case Study 15-8, Healthy Conflict Resolution”, on page 289-90 of Organizational Behavior in Health Care.
Based on the information in Chapter 4 and your independent research, write a paper that addresses the following questions:
What are the five conflict modes?
What is the basis/cause of the conflict in the case described?
What conflict style/handling-mode should be use to resolve the conflict?
Why is the chosen approach preferable to other approaches?
What are the advantages and disadvantages of your choice?
Your well-written paper should meet the following requirements:
Four-to-five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing standards.
Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
You are strongly encouraged to submit all assignments to the Originality Check prior to submitting them to your instructor for grading.
As a manager on a medical surgical unit, part of the job responsibility includes chart audits.
A trend noted during the most recent audit was the overuse of the term “dementia.” The nurse manager notes that there may be a lack of understanding between the types dementia as related to neurological diseases.
The nurse manager developed a survey to evaluate the staff’s understanding of the different types of dementia. As a result of the survey, you have been asked to create a PowerPoint presentation to increase the nurse’s awareness of the types of dementia a presentation was created.
Instructions
Choose one of the following topics for a focused presentation:
Alzheimer’s
Parkinson’s
Vascular Dementia
The presentation should include the following:
Pathophysiology
Etiology & incidence
Health promotion and maintenance
History/Risk factors
Physical signs and symptoms
Changes in cognition
Changes in behavior & personality
Changes in self-management skills
Diagnostics: laboratory and imaging assessment
Planning and implementation
Interprofessional Collaborative Care
Psychosocial integrity
Medications
Safety considerations
Using Ignatavicius and one additional resource, develop a presentation to enhance the nurses’ knowledge of the differences between types of dementia and delirium. Be sure to document your source(s) in your presentation.
Resources
Nursing Research
PowerPoint Writing Guide
Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.
Save your assignment as a Microsoft PowerPoint (or other) document. The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
You must take everything that has been worked on so far and put it all together in 10 Full Pages Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages. Everything will be provided to you once you are selected to work on the question.
In this project, you will demonstrate your mastery of the following course outcomes:
Analyze the various components of wellness for investigating the influence of wellness on one’s discipline of study or chosen profession
Integrate interdisciplinary approaches for determining the impact that contemporary issues in healthcare systems have on modern society
Describe contemporary issues surrounding wellness for their relevance to and impact on the individual and society by employing appropriate research strategies
Recommend potential applications of strategies for monitoring and enhancing personal and public wellness
Articulate informed viewpoints on contemporary issues surrounding wellness issues through effective communication skills
Assess cultural and social attitudes, choices, and behaviors for their implications to lifelong health and wellness through the incorporation of diverse perspectives and viewpoints informed by relevant literature and peer experiences
Overview
This course explores wellness and its impact on the world around us. Wellness influences society, and society influences wellness, creating a feedback loop between them. You will critically analyze a specific issue or event in wellness and how it impacts individuals and society using the four general education lenses: history, humanities, natural and applied sciences, and social science. From this enhanced understanding, you will be equipped to draw connections between wellness, self, and engagement with your community. You will demonstrate your ability to think critically, investigate, and communicate clearly. These skills are often necessary to achieve personal and professional goals across many disciplines.
Directions
For this project, you will write a 10-page paper that examines your chosen research topic and how it affects individuals and society. In the paper, you will describe your topic, present a thesis statement, perform a critical analysis, and reflect on how your topic informs your personal life and experience. You will demonstrate your ability to think critically, investigate, and communicate clearly.
Specifically, you must address the following rubric criteria:
Evidence: You will use evidence to support your analysis throughout the project.
Integrate reliable evidence from varied sources throughout your paper to support your analysis. Use at least two resources from the module resources sections of this course and two resources that you find through your own research using the Shapiro Library.
It is important to draw from a more diverse pool of perspectives from varied sources to support the analysis, which is different from the Citations and Attributions rubric criterion.
Reliable evidence from varied sources should be interwoven throughout the paper itself. Citing and attributing sources will be represented as APA in-text citations and a reference list at the end of your work.
You will be evaluated on both criteria.
Topic Description: In this section, you will identify and discuss the factors that shape your thesis statement.
Describe a social or global issue or event that is related to issues of wellness. Include information such as the origin of the issue and what it is about.
Describe a population significant to your topic. Include information such as demographics, cultural practices, social identity, and key challenges.
Assess how society impacts the chosen issue or event.
Explain your choice of general education interdisciplinary lens for analyzing your topic.
Construct a thesis statement that combines your topic, population, cultural situation, and choice of general education interdisciplinary lens.
Critical Analysis: In this section, you will analyze your topic using one of the general education lenses and recommend strategies for using this kind of analysis to meet your personal and professional goals.
Analyze your chosen issue or event through one of the general education interdisciplinary lenses to determine its impact on various institutions.
Analyze how social practices have been shaped by issues and events in wellness in modern culture.
Describe at least one specific element that could benefit from change within your topic.
Explain how at least one potential obstacle could interfere with the population’s engagement with your topic.
Assess at least two significant factors that could impact your topic, such as biases, beliefs, assumptions, and/or values.
Assess the benefits and challenges of addressing issues in wellness.
Recommend strategies for using this kind of critical analysis for meeting your personal and professional goals.
What might this look like in your everyday life? Consider how wellness can be used to address the day-to-day responsibilities or questions faced by practitioners in your field or discipline.
Reflection: In this section, you will describe how using critical analysis tools influences your personal experience, your field of study or profession, how you interact with others.
Describe how critically analyzing your issue/event in wellness has informed your individual framework of perception.
Consider how your analysis has altered the way you perceive the world.
Describe how examining your bias has altered the way you perceive the world.
Reflect on your own bias and then consider how an awareness of one’s bias can change our perceptions.
Explain how critically analyzing wellness can influence your field of study or profession.
How can studying wellness inform your understanding of the next big topic of study in your field or profession?
Explain at least one way in which your analysis might have been different if you had used one of the other general education lensesto analyze your topic.
Explain how analyzing wellness can help interactions with people with a different viewpoint, culture, or perspective.
What to Submit
To complete this project, you must submit a Word document of 10 pages in length (plus a reference page) with 12-point Times New Roman font, double spacing, and one-inch margins. Use at least two resources from course materials and two resources from the library. Sources should be cited according to APA style. Consult the Shapiro Library APA Style Guide for more information on citations.
Project Rubric
Criteria Exemplary (100%) Proficient (85%) Needs Improvement (55%) Not Evident (0%) Value
Reliable Evidence From Varied Sources Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Integrates reliable evidence from varied sources throughout the paper to support analysis, using at least two resources from the module resource sections of the course and two resources found through independent research using the Shapiro Library Shows progress toward proficiency, but with errors or omissions; areas for improvement may include drawing from a more diverse pool of perspectives, using more varied sources to support the analysis, integrating evidence and sources throughout the paper to support the analysis, or using at least two resources from the module resource sections of the course and two resources found through independent research using the Shapiro Library Does not attempt criterion 5
Topic Description: Social or Global Issue or Event Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Describes a social or global issue or event that is related to issues of wellness, including information such as the origin of the issue and what it is about Shows progress toward proficiency, but with errors or omissions; areas for improvement may include providing a more thorough description of the topic or its origin, greater support about its connection to wellness, or additional contextual information about the topic Does not attempt criterion 5
Topic Description: Description of Population Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Describes a population significant to the topic, including information such as demographics, cultural practices, social identity, or key challenges Shows progress toward proficiency, but with errors or omissions; areas for improvement may include a more thorough description of the population or providing greater support for the population’s demographics, cultural practices, social identity, or key challenges Does not attempt criterion 5
Topic Description: Society Impacts Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Assesses how society impacts the chosen issue or event Shows progress toward proficiency, but with errors or omissions; areas for improvement may include providing a more thorough or detailed assessment of how society impacts the issue or event or providing more support for this assessment Does not attempt criterion 5
Topic Description: General Education Lens Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Explains the choice of general education interdisciplinary lens for analyzing the topic Shows progress toward proficiency, but with errors or omissions; areas for improvement may include connecting one of the four general education lenses to the topic or providing a more convincing or thorough explanation of why the lens was chosen Does not attempt criterion 5
Topic Description: Thesis Statement Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Constructs a thesis statement that combines topic, population, societal situation, and choice of general education interdisciplinary lens Shows progress toward proficiency, but with errors or omissions; areas for improvement may include constructing a clearer or more concise thesis statement that integrates topic, population, societal situation, and choice of general education lens Does not attempt criterion 5
Critical Analysis: Impact on Institutions Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Analyzes chosen issue or event through a general education interdisciplinary lens to determine its impact on various institutions Shows progress toward proficiency, but with errors or omissions; areas for improvement may include using one of the lenses to analyze the issue or event, conducting a deeper analysis of the impact of the issue or event on various institutions through the chosen lens, or providing greater, more relevant, or more appropriate support for the analysis Does not attempt criterion 5
Critical Analysis: Social Practices Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Analyzes how social practices have been shaped by issues and events in wellness in modern culture Shows progress toward proficiency, but with errors or omissions; areas for improvement may include conducting a deeper analysis of how social practices have been shaped or providing greater, more relevant, or more appropriate support for the analysis Does not attempt criterion 5
Critical Analysis: Element That Could Benefit From Change Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Describes at least one specific element within the topic that could benefit from change Shows progress toward proficiency, but with errors or omissions; areas for improvement may include providing a more detailed description of the chosen element or providing more thorough support for why it could benefit from change Does not attempt criterion 5
Critical Analysis: Potential Obstacle Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Explains how at least one potential obstacle could interfere with the population’s engagement with the topic Shows progress toward proficiency, but with errors or omissions; areas for improvement may include connecting the topic to a potential obstacle or providing more thorough support for how it could interfere with the population’s engagement with the topic Does not attempt criterion 5
Critical Analysis: Factors That Could Impact the Topic Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Assesses at least two significant factors that could impact the topic, such as biases, beliefs, assumptions, and/or values Shows progress toward proficiency, but with errors or omissions; areas for improvement may include identifying two specific factors that could impact the topic or providing more thorough support for the chosen factors or for how they could impact the topic Does not attempt criterion 5
Critical Analysis: Benefits and Challenges Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Assesses the benefits and challenges of addressing issues in wellness Shows progress toward proficiency, but with errors or omissions; areas for improvement may include connecting the benefits and challenges assessed to wellness, providing a more detailed assessment of these, or providing more support for them or for how they relate to wellness Does not attempt criterion 5
Critical Analysis: Analysis Strategies Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Recommends strategies for using critical analysis for meeting personal and professional goals Shows progress toward proficiency, but with errors or omissions; areas for improvement may include providing more relevant or appropriate strategies for using critical analysis for meeting personal or professional goals or providing a more thorough explanation of the strategies selected or the reason why they were recommended Does not attempt criterion 5
Reflection: Individual Framework of Perception Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Describes how critically analyzing an issue or event in wellness has informed individual framework of perception Shows progress toward proficiency, but with errors or omissions; areas for improvement may include providing additional details or a more specific description of how critically analyzing an issue or event in wellness informed individual framework of perception Does not attempt criterion 5
Reflection: Bias Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Describes how examining bias has altered ways of perceiving the world Shows progress toward proficiency, but with errors or omissions; areas for improvement may include clearly connecting bias and personal perceptions or providing more thorough support for how examining bias has altered personal perceptions Does not attempt criterion 5
Reflection: Field of Study or Profession Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Explains how critically analyzing wellness can influence field of study or profession Shows progress toward proficiency, but with errors or omissions; areas for improvement may include connecting the critical analysis of wellness to an academic or professional experience or providing more thorough support for this connection Does not attempt criterion 5
Reflection: Different General Education Lens Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Explains at least one way the analysis might have been different if another general education lens was used to analyze the topic Shows progress toward proficiency, but with errors or omissions; areas for improvement may include using an alternative general education lens, a clearer explanation of how the analysis might have been different if one of the other general education lenses had been used to analyze the topic, or providing more support for the explanation Does not attempt criterion 5
Reflection: Interactions Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Explains how analyzing wellness can help interactions with people with a different viewpoint, culture, or perspective Shows progress toward proficiency, but with errors or omissions; areas for improvement may include connecting the value of critical analysis to interactions with people with a different viewpoint, culture, or perspective or providing a more thorough explanation of how the analysis can help these interactions Does not attempt criterion 5
Articulation of Response Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Clearly conveys meaning with correct grammar, sentence structure, and spelling, demonstrating an understanding of audience and purpose Shows progress toward proficiency, but with errors in grammar, sentence structure, and spelling, negatively affecting readability Submission has critical errors in grammar, sentence structure, and spelling, preventing understanding of ideas 5
Citations and Attributions Uses citations for ideas requiring attribution, with few or no minor errors Uses citations for ideas requiring attribution, with consistent minor errors Uses citations for ideas requiring attribution, with major errors Does not use citations for ideas requiring attribution 5
Total: 100%
Requirements: 10 Full Pages Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please be sure to include an introduction paragraph with a clear thesis statement in the last sentence of the introduction paragraph and a conclusion paragraph
Please be sure to carefully follow the instructions
No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool.
Please be sure to include at least one in-text citation in each body paragraph
Unit 4 Discussion: The Cost of Junk Food
Purpose
Picture yourself at work in the break room or hanging out with friends. Hey! Somebody brought snacks! Maybe it’s a
cake or a plate of cookies or several bags of chips. Do you dive right in, or do you take a minute to think about how those
extra calories could turn into body fat and increase your weight.
You know you can burn those extra calories at the gym or with some other physical exercise. But, how many minutes will
it actually take to burn off those extra calories?
The purpose of this activity is for you to consider the “cost” associated with eating junk food – extra calories or extra
exercise. You will learn how to determine the amount of physical activity needed to burn calories so that you can make
informed decisions when you encounter those unexpected treats.
This can be a very sensitive subject for some students. If you are struggling with this content, please let me know.
Lesson Outcomes
•
•
•
Identify the calories found within common junk food (CLO 3)
Estimate how long it would take to burn off calories during exercise (CL) 3, 7)
Compare the number of calories burned by different exercises (CLO 3, 7)
Steps to Complete the Task
Step 1: Research
1. Think of your favorite junk food (this is the fun part!).
a. Make sure you pick a food that you know is not healthy. This could be something you treat yourself with
on occasion, or a food you only eat in your dreams – you choose!
b. Be specific on the amount of the junk food you will pretend to eat/drink (e.g. 32 fluid ounces of a
chocolate milkshake, 1 snickers bar (44 g/ 1.56 oz)
2. Research online for the nutrition facts of that food item to locate the total number of calories which come from
that food.
a. Record the name of the site & the URL where you found the information.
Step 2: Analyze and Evaluate
1. Think of your favorite way of being physically active (this should be fun too!).
a. You should select a fun method of exercise (an activity which increases your heart rate) and ideally
something that you already or would actually do.
2. In your Cronometer profile, select the “Add Exercise” link.
a. Find your desired exercise. Use trial and error to find the number of minutes it would take to burn the
number of calories in your favorite junk food.
b. Or, you can use math to determine the number of minutes needed.
Example: My junk food is 1 slice of chocolate mousse cheesecake from the Cheesecake Factory. It has 1210
calories.
Reference: The Cheesecake Factory Nutritional Guide (PDF)
The exercise I selected was rock climbing. According to Cronometer, for me this burns 225 kcal per 30 minutes.
Obviously, I need to spend more than 30 minutes rock climbing to burn off all the cheesecake! I set up a basic
math problem to determine the number of minutes I need:
225 kcal = 1210 kcal
30 min
x
(1210) (30) = 225 x
36300 = 225 x
36300 = x
225
x = 161
Therefore, if I ate 1 slice of chocolate mousse cheesecake from the Cheesecake Factory I would have to spend
161 minutes or 2 hours and 41 minutes rock climbing to burn off the calories from the food.
Step 3: Analyze & Explain
1. Write a 100-200 word paragraph that includes the following
a. A description of the process you followed to determine the number of minutes you would need to
exercise. (The example above is a description of a process.)
b. Identify the source of the calorie information (name of website and URL).
c. A clear statement of the number of minutes of your exercise you would need to burn off the junk food
you selected.
d. An explanation of what you learned in this activity and/or how it will affect your junk food choices in the
future.
e. Write your paragraph on a Word document. Save the document to your computer as a back-up copy.
Step 4: The Discussion
1. Post your paragraph in the Unit 4 DISC: Junk Food.
a. Copy your paragraph from your Word document and paste in the discussion forum.
2. Respond to a minimum of two classmates
a. Take their junk food and your exercise.
b. Determine how many minutes of your exercise would be needed to burn off their junk food.
c. Your responses should be 25 to 50 words.
d. Provide a thoughtful response in complete sentences.
Criteria for Success
To be successful, your discussion posts should
1. Provide accurate information about calorie count and exercise time.
2. Be written in your “own voice.” The posts should sound “like you” not like the Internet.
3. Use academic English (no slang or texting language) with minimal errors in grammar, punctuation, and spelling.
(Hint: read your responses out loud before posting).
4. Stay within the word count range for the original response and response to peers.
5. Include thoughtful responses to two of your peers.
a. You can include a description of why you selected to evaluate their junk food.
If your posts meet these criteria, then you will earn points for this discussion as follows:
Original response
10 points
Response to peers
2.5 points each
Total Points Possible
15 points
Nursing theories play a vital role in the evolution of nursing as a discipline. They establish the critical contributions made by the profession and provide nurses with frameworks to guide their practice, grow professionally, and improve the care they deliver to patients. This assignment focuses on the importance of nursing theory within the profession. Selecting one nursing theorist and the middle-range theory they developed (non-nursing ideas are not allowed), the student will present a summary of the set nursing theory, identify opportunities for the application of the theory to a nursing situation (In this course, you have analyzed a middle range theory, you may the theory used in previous discussions). The student will include two scholarly peer-reviewed sources to support the nursing theory chosen.
Requirements
The two central aims of this assignment are to apply a middle-range nursing theory to clinical practice and to reflect on the experience. Write a paper (1,000 to 1,500 words, Approximately three pages) that explains how middle-range theory can be applied to the identified problem. The paper should include the following:
A summary of the problem (nursing situation). Describe a nursing situation you have encountered in your clinical placement. The situation can be a specific physiological patient problem or a case involving a vulnerable patient’s family or a staff member. It can also describe your role in problem-solving or an ethical issue you encountered in practice. The key is you need to have been directly involved in the event. You must also maintain the confidentiality of your subjects at all times. Do not identify the patient, staff, or hospital site.
A description of a middle-range theory that could be applied to the problem. Is this middle-range theory appropriate to your identified situation? For example, health promotion, especially preventive care, is essential for ethnic minority groups and the economically disadvantaged. The Health Promotion Model (HPM) (Pender, 1996; Pender et al., 2010) is a framework for delivering nursing care to support health promotion behaviors. An essential component of a nursing assessment is understanding personal factors (e.g., lack of finances to afford health insurance) and an individual’s perception of the benefits and barriers of engaging in health promotion behaviors. Screening recommendations and health promotion practices can be tailored to the patient’s and family’s cultural values and beliefs, finances, and community support when working with vulnerable populations.
A brief discussion of the middle-range theory’s origins includes a short biography of the theorist and the main concepts of the middle-range theory.
Discuss how the middle-range theory has been previously applied.
A discussion of the application of the middle-range theory to the identified problem. How would your practice change by incorporating this theory?
The paper should be 2-3 pages, excluding the title and reference pages.
The paper should start with an introductory paragraph that includes the purpose statement.
Use headings and subheadings to organize the paper.
Reflection
Using the diagram below, reflect on the following questions:
Think about a nursing situation (necessary experience).
Consider the selected theory or parts theory while it is implemented in your nursing care.
As you apply theory, identify your emotions.
Have you experienced this nursing situation before applying the theory
What did I learn from completing this experience?
How have I been changed by what I’ve learned?
I want the solution within just 2 hours from now
want the solution within just 2hours from now
I want the solution within just 2hours from now
Do not pay attention to the time of the task in front of youI want you to send the 100% correct solution within just 2 hours
Use APA style for writing references.
You must provide a full explanation for each question
Proper referencing in APA format is must
Text size 12-Times New Roman only.
Avoid plagiarisms
Avoid copying from any source
Avoid using another teacher’s solution or a similar previous student’s solution because it is a university whose system can access even the solutions published on the study pool website
You must give 100/100 correct solution
Avoid using paraphrasing programs or websites
You must provide a correct answer 100/100
You must do the solution in the same attached file
You must do the solution in the same attached file
Unformatted Attachment Preview
ASSIGNMENT COVER SHEET
Course name:
Concepts of Health Education & Health Promotion
Course number:
PHC 212
CRN:
Paper Assignment
Assignment title or task:
(You can write a question)
Choose a health issue in KSA and explore the
determinants causing that issue and justify your
understanding with evidence from the literature.
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Your response should be a minimum of 480 words but should not exceed 550
words (Excluding references).
• Support your answer with examples.
• Font size should be 12
• Font type should be Times New Roman
• Heading should be Bold
• Colour should be Black
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style
• AVOID PLAGIARISM
• Due date; 7/10/2023 11:59 PM
Best of Luck
Number 8 mental patients right without speakers nots.
Unformatted Attachment Preview
Bill of Rights
Introduction
The field of providing health services to patients in the Kingdom of Saudi Arabia
is witnessing a continuous development based on the teachings of Islamic Sharia
and social ethics that determine the ways of humane and ethical dealing with
service seekers, which is an aspect we are working hard to set an example in.
Through the role played by the Patient Experience Center in supporting the patient’s right and clarifying his responsibilities, we worked hard to develop a bill of
patients’ rights and responsibilities in cooperation with the competent authorities
in the field of providing health care services. We should always bear in mind the
human, social and national rights and duties guaranteed by the law to individuals
to raise the level of service provided and promote patients’ confidence in health facilities and
consolidating the bonds of joint health and humanitarian work between service providers
and recipients at all levels.
Believing in the patients’ right as well as empowering and involving them in decisions that
support and improve the services provided, we have committed ourselves to clarifying the
rights that the patient must receive. Furthermore, we must demonstrate the responsibilities
that they bear towards the facility in a simplified manner that ensures that the message is
delivered smoothly and easily to all segments of society to achieve the required objectives.
Bill of Rights
1
Table of Contents:
2
1- Definitions
3
2- Rights of Patients and Their Families
4
3- Pediatric Patients’ Rights
10
4- Elderly Patients’ Rights
10
5- Rights of Patients with Disabilities
11
6- Cancer Patients’ Rights
11
7- Rights of AIDS Patients
14
8- Mental Patients’ Rights
15
9- Rights of COVID-19 Patients
17
10- Women’s Health Rights
19
11- Companions’ Rights
22
12- Visitors’ Rights
22
13- Responsibilities of Patients, Family Members, and
Companions
23
14- Visitors’ Responsibilities Patients’ Rights in:
23
15- Reception
26
16- Laboratory Department
27
17- Pharmacy Department
29
18- Radiology Department
30
19- Clinics
32
20- Private Facilities
33
Bill of Rights
Definitions
Certain terms will be mentioned in this
policy and, if any, they mean the following:
Health facility: it is the entity affiliated to
the Ministry of Health or that works under its
supervision and provides health services to
patients, whether it is a clinic, health center,
infirmary, hospital or laboratory.
Patients’ rights: the policies and laws that
the health facility is obligated to protect and
preserve towards patients and their families.
Patients’ responsibilities: the instructions
that patients and their families must abide
by and adhere to.
Patient’s family: it includes the patient’s
family, visitors, companions, and legal
guardian.
Legal guardian: the person legally or
religiously responsible for the patient and
has the right to sign on behalf of the patient
in the event of their discriminatory, mental
or health inability.
for the patient’s case. Signing this form shall
be considered a complete approval of all
that it contains.
Clinical research and study programs:
programs that require the involvement
of patients to try new drugs or treatment
methods for the purpose of comparison and
aim for development and discovery. Such
programs are conducted by specialists
in their field and under the supervision of
qualified personnel.
Patients’ categories: children, adults,
elderly, and all patients who have one
characteristic in common and receive health
services.
People with Special Needs: this represents
the elderly, chronically ill, physically or
mentally disabled, and all those who are
unable to help themselves.
Child: any patient under the age of 12 years.
Minor: any patient under the age of 15 or
18; however, he/she is responsible enough
according to their maturity.
Medical
acknowledgment
or
authorization form: it is a clearly written
form that shall only be approved if it is
signed by the patient or their legal guardian
to start implementing the required procedure
Bill of Rights
3
Rights of Patients
and Their Families
• Providing medical care in diagnosis,
treatment and other services in a
manner that achieves the aspirations
and satisfaction of patients as much as
possible.
• Ensuring that the patient or their legal
1/ Patients and their families have
the right to health care
Receiving health services according
to (evidence-based medicine) that are
appropriate, continuous, organized and
specialized at every level of care, whether
preventive or therapeutic, and in a timely
manner. It also shall be in accordance with
the policies and procedures of eligibility for
treatment and within the capacity of the
facility and the laws regulating its work.
• A specialized medical team shall examine
each category of patients.
• Providing special equipment, tools and
supplies that are appropriate for the age
group and health status in the facility.
• Receiving all medical and nursing
supplies, medicines and consumable
supplies for medical care, such as oxygen
cylinders and diapers.
• Providing the appropriate environment
that helps patients adapt during the
treatment period in the health facility.
• Receiving preventive care from diseases,
such as: (vaccinations for children and
adults – periodic preventive examinations
– early detection of diseases).
• Receiving medical care in life-threatening
and critical cases in the emergency
departments of government and private
hospitals until the condition stabilizes
(life-saving policy) for all patients in
accordance with the laws, regulations
and policies of the Ministry of Health.
4
Bill of Rights
guardian is well aware of all information
related to the patient’s health status and
condition in a clear and adequate manner
and in an understandable language.
• The
presence of an appropriate
mechanism to educate and provide
guidance on medicinal treatment and
other supportive treatments such as
nutrition in a manner that qualifies them
to deal with the patient’s health condition
inside and outside the facility.
• Receiving adequate nutrition that is
appropriate to the patient’s health
condition.
• Raising awareness and knowledge of
their rights granted to them by the Royal
Orders issued and Special Executive
Resolutions such as (discounted tickets,
vacations, or working hours).
• Securing transportation or its costs for
the patient and accompanying persons
according to the relevant controls. All
appointments, without a maximum limit,
shall be covered until the recovery of
chronic and critical diseases such as
cancer.
• Receiving the appropriate assessment
of pain when the patient is admitted to a
facility on an ongoing basis and providing
treatment that guarantees rapid relief of
pain, with an assessment of the response
to analgesic drugs, treatment of side
effects that may occur. Such patients
shall be educated and informed about the
necessary information about their pain
and how to alleviate it as well as how to
deal with chronic pain.
• Immediate family members of a patient
with an infectious disease shall receive
the necessary examination and treatment
in case of infection.
2/ Knowledge of Rights and
Responsibilities of Patients
and Their Families
• Providing all possible means inside
and outside the facility to familiarize
them with the Bill of Patients’ Rights
and Responsibilities. An electronic or
paper copy shall also be provided for
patients when entering or registering in
the facility, in the health service provision
departments and waiting places, provided
that they are shown in a prominent place.
• Developing a policy to implement and
enable patients and their families to
practice their rights. All health facility
personnel shall be obligated to respect
and implement the Patients’ Rights
Policy as representatives of the Ministry
of Health, help patients and their
families understand them clearly, hold
conferences, seminars, or workshops
to discuss aspects of patients’ rights as
well as forming relevant committees.
3/ Providing Health Care and
Services Based on Respect
and Appreciation
• Providing adequate health care at all
times and under all circumstances in
a manner, that preserves their dignity
without prejudice to their religious,
doctrinal and spiritual beliefs and their
cultural and social background.
• Adhering to appropriate Islamic and
social etiquette when dealing directly
with patients and their families in general,
and using the patient’s personal name on
official papers and not giving any other
identification.
• Respecting the patient’s right to express
the severity of pain.
• The patient shall only be isolated when
necessary.
• Providing dignified care to the patient
in cases of dying and death, as well as
proper handling of the corpse.
4/ Privacy and Confidentiality:
• Providing privacy and confidentiality
when discussing the patient’s treatment
program, whether in person or the legal
guardian.
• Ensuring that the patient’s private parts
are covered except for what is required
for treatment.
• Preventing disclosure, misuse, circulation
or access to patient information,
whether in (the medical file and medical
information related to the diagnosis,
analysis and treatment of any party or
person without the consent of the patient
or their legal guardian (except as required
by the judicial authorities).
• Preventing access to the patient’s
medical file for non-members of the
medical team supervising the treatment
or those authorized by the management
of the facility, by the patient or their
guardian, or by the judicial authorities.
• Preventing the patient from meeting
anyone who is not related to the provision
of health care, including visitors.
• Preparing
places for admission,
examination and medical procedures.
All possible measures shall be taken
to maintain privacy and covering the
private parts except for what is required
by the necessity of treatment. The patient
Bill of Rights
5
shall be moved to a special room for
examination if the patient’s room is not
suitable, ensuring that the patient do not
stay in the examination room for more
than the necessary period, and making
sure that a person of the same gender is
present during the clinical examination
or the required interventions.
• Providing appropriate clothing and
necessary personal toiletries for the
patient.
• Providing suitable separate waiting areas
for both men and women.
5/ Providing Protection and
Safety
• Providing health care in a safe, clean
and sterile environment suitable for the
health status of patients, helping them
to recover and preventing them or their
families from contracting infectious
diseases or getting physical, moral or
psychological harm.
• Providing the appropriate tools and
mechanisms to protect them from
physical harm, diseases and infection,
such as washing hands; and providing
safety precautions before and during
entry or transportation from and into
the health facility, and before starting
any medical procedure.
• Implementing
Infection Prevention
Controls approved by the Ministry of
Health regulations to protect patients
from infection. Ensuring that the service
provider follows the safety guidelines
before, during and after the medical
procedure or examination, and the
patient has the right to remind the
service provider of that or to request a
change.
• Cautioning patients and their families
6
Bill of Rights
utilizing all explanatory means that
they can understand before and during
entering all places that may expose the
patient and their family to harm, such as
areas of radiation, magnetic resonance
imaging, places under construction,
while performing cleaning or sterilization
operations, and others.
• The presence of a policy to provide
security and safety to protect people
with special needs, such as children,
the elderly, women, the disabled, and
those in sensitive and remote locations
(such as inpatient wards, women’s
wards, delivery room, pediatrics and
neonatology department) from assault
or abduction.
• Protecting them from psychological
harm, reprimand, reproach, slander and
insults by any employee of the health
facility.
• The medical team shall be obliged
to report any case of physical or
psychological violence to the concerned
authority.
• Providing
appropriate
places,
mechanisms and procedures to protect
their belongings from theft and damage.
• Smoking is prohibited in all areas of the
health facility.
• The presence of special procedures
for people with special needs (in terms
of assistance, facilitating procedures,
providing appropriate facilities, parking
spots, number of companions, etc.).
• Confirming the identity of the guardian,
parent, or the person authorized by the
patient to sign on their behalf.
6/ Healthcare Plan Engagement:
• Enabling patients and their families
to communicate with the treatment
team to obtain complete and upto-date information regarding the
diagnosis, the proposed treatment,
its expected benefits and results, the
suggested medical alternatives – if any,
complications, risks, and the treatment
success rate using the terms that they
understand and comprehend.
• Clarifying transparently the possibilities
of care available in the health facility
for patients who need care beyond the
capabilities of the facility and informing
them of the other services provided by
the MOH, which the patient deserves
and benefits from, such as home care
programs, specialized medical centers,
medical bodies services and their
responsibilities. They shall also strive to
provide such services by working with
the competent authorities.
• Knowing the names of the participants
in providing the health service to them,
their specialties and the name of the
doctor responsible for the treatment and
follow-up of the case before taking any
treatment action.
• Informing them of the presence of
licensed trainees if they are part of the
treating medical team.
• Having discussion with the medical
team about the necessary information
before any treatment or operation
procedure and before signing the
medical permission forms, except for
emergency cases that require urgent
medical intervention in accordance with
the applicable laws and regulations.
• Patients shall be informed about the type
of interventions, medicines and radiation
used in treatment, their effectiveness,
and safety.
• Clarifying the reasons for transferring
the patient to another place inside
or outside the health facility before
the transfer, besides giving them the
necessary instructions.
• Requesting another medical opinion
in coordination with the competent
authority in the health facility when
necessary.
• Clarifying the reasons for transferring
or changing patient care from one
consultant to another.
7/ Refusal of Treatment:
• Informing them of the possibility of
rejecting all or part of the prescribed
treatment in a manner that does not
contradict with the applicable laws
and regulations, and informing them
of the expected results of the refusal
decision. The patient or their legal
guardian shall be fully responsible for
their decisions and actions in the event
of refusal of treatment or failure to follow
the treatment instructions, with the need
to have them sign the acknowledgment
form for the prescribed procedure and
then document this in the patient’s file.
• The refusal of treatment shall not result
in any decisions or procedures that
are not related to the patient’s health
condition, and the service provider in the
health facility is obligated to continue
providing the appropriate care, even
during appointments for the same
disease or others, in accordance with
the medical standards followed.
• Informing them of other alternative
treatments in case of refusal.
• Refraining from performing resuscitation
to treat patients with illnesses in
accordance with legal fatwas and laws
in the Kingdom of Saudi Arabia.
Bill of Rights
7
8/ Availability of Material Costs
and Health Insurance Policy
• Obtaining approximate information
about the expected cost before starting
treatment.
• Knowing the limits of health insurance
coverage available to the patient and
the consequences thereof.
• Answering all inquiries related to the
treatment bill, regardless of who will pay
it.
• Issuing an accurate invoice for the
services provided and related costs.
• Displaying a wall poster of those eligible
for treatment.
• Displaying a wall poster describing in
a simplified manner the services and
related costs.
• Any
commercial, advertising or
marketing activity shall comply with the
ethics of the profession.
9/ Clarity and
Comprehensiveness of Forms
and Reports
• Authorizing a person to sign on their
behalf the medical authorization and
to take decisions on their behalf when
necessary, with the full consent and
knowledge of the patient
• Introducing patients to the information
contained in the medical authorization
in a clear manner and in understandable
terms, with an explanation of the
expected negative and positive results
as a consequence of the approval or
refusal; besides, providing a list of
interventions that require a separate
medical authorization and keeping the
medical authorization in the patient’s file.
• Obtaining medical reports that prove
8
Bill of Rights
their condition and justify their periods
of absence from work in order to
guarantee the right to return to work
or obtain financial support if they are
unable to continue working as well as
the right to obtain social benefits from
ministries and competent authorities.
10/ Availability of Policies and
Procedures for Complaints
and Suggestions:
• Submitting oral or written suggestions,
requests, inquiries, or complaints,
whether signed or not, to the health
facility, without any impact on the
quality of service provided to them, with
the possibility of raising a complaint to
various levels in the health facility.
• Availability of policies and procedures for
handling complaints, including specifying
the entity/entities authorized to receive
complaints in the facility, determining the
complaints path and the handling policy
in place, then submitting periodic reports
to all levels on complaints, actions taken,
final responses to patients and their
satisfaction with that, and studying and
analyzing complaints and their causes
and solutions.
• Introducing them to the policies,
procedures and mechanisms used in the
health facility to study complaints and
proposals and the expected response
time. Inform them of any available
information regarding the complaint or
proposal, as well as quickening the pace
of addressing complaints.
11/ Availability of Policies and
Procedures for Organ and
Tissue Donation:
• The donation shall be made in accordance
with the standards and policies of organ
and tissue donation from living or braindead donors that are approved by the
Kingdom of Saudi Arabia and according
to the legal procedures followed.
• It is strictly forbidden to trade human
organs. Rewards and support material
benefits, subsidies and moral benefits
in exchange for donation shall be
determined according to the regulations
in force.
• Obtaining
job
benefits,
accrued
vacations, employment for donors or
their immediate family members, as well
as supporting benefits from other entities
or ministries.
• Providing living donors or legal guardians
of the brain-dead with all information
and legal fatwas issued by Shariah
committees regarding donation.
• Availability of all trained, qualified and
specialized personnel in all medical,
administrative and psychological fields.
• Respecting the decision of the donor and
their families, whoever they are, as well as
respecting the donor’s desire to withdraw
at any moment before the completion of
the donation process. Donors shall not
be not entitled to demand the organ after
the surgical removal.
• Providing the declarations required to
conduct the donation process in a clear
wording and terms that the donor can
understand.
• It is prohibited to donate organs of living
patients (under the age of 18, and over
the age of 60), even with the consent of
the parents.
12/ Participation in Research and
Study Programs:
• Patients may be asked to participate in
research or study programs related to
their condition when the conditions of the
research match them and according to
the possibilities available for the research.
• The
facility shall provide clear
and
understandable
information
about the research, study, clinical
medical
treatment,
human-related
pharmacological treatment and medicine,
and the expected results of participating
in it.
• Emphasizing on the ethical, humanitarian
and professional controls and rules, as
well as adhering to medical procedures
that guarantee their personal safety in
accordance with the legislation in force.
• It shall be possible to accept or reject
participation before or during the research
or study.
• A form designated to participate in any
research or study shall be made available,
and patients shall not be allowed to
participate except after they or their legal
guardian have signed the form.
• The presence of a committee or body
(official/scientific) that authorizes and
supervises the research or study.
• The presence of clear mechanisms for
how to protect the patients and receive
their complaints and opinions during the
progress of research or study.
• Ensuring the patients’ right to stop
participating without affecting their right
to treatment and its continuation.
• It is not permissible to conduct medical
or scientific experiments on any person
or exploit their organs without their
free consent and full awareness of the
complications that may result from it.
Bill of Rights
9
Pediatric Patients’
Rights
In addition to the general rights from 1 to 12
• The presence of a companion with the
child when hospitalized in the health
facility, except for the intensive care unit
and the nursery department, according to
the procedures and regulations followed.
• Providing a clear policy for vaccinations
Elderly Patients’
Rights
In addition to the general rights from 1 to 12
• The design of health facilities should
be age-sensitive and elderly-friendly
(the facility’s entrance, clinic entrance,
and corridors shall be wide enough
for a wheelchair to pass, and there
are handrails on the stairs, walls, and
toilets…..etc.)
and examinations for children according
to the circulars received from the Ministry
of Health.
• Providing preventive, therapeutic and
facility.
• Giving priority to the elderly when
• The child shall not be detained in the
• The child shall not be isolated except for
the utmost necessity that requires it.
• A specialized medical team shall examine
children.
• The availability of devices, tools and
supplies for the child in the facility.
• The presence of a special policy to
protect children from all forms of abuse.
• Providing the appropriate environment for
children that help them adapt during the
treatment period in the health facility.
• The medical team shall be committed
to report all cases of violence against
children to the concerned authority.
rehabilitative health services for the
elderly in proportion to their health needs
providing health services from entering
the health facility until leaving it (reducing
waiting time for health services and
simplifying the procedures for receiving
service)
• Providing certain equipment for the
elderly at home, such as wheelchairs,
crutches with a tripod base, eyeglasses
and hearing aids.
• Providing psychological and social
counseling services to the elderly as
well as taking care of the elderly at home
through specialized teams.
• Providing home medical care for all the
elderly who are unable to reach health
facilities to receive health services.
• Training the elderly and the elderly home
caretakers on the basics of daily health
care for the elderly at home.
10
Bill of Rights
Rights of Patients
with Disabilities
In addition to the general rights from 1 to 12
• Providing healthcare for them on the
basis of free and informed consent.
• Providing their needs for medical tools
and equipment.
• Equality in all health rights without
discrimination.
• Equipping the health institutions with all
facilities to comply with comprehensive
access standards, whenever possible.
• Providing full support and protecting their
dignity and all their rights.
• Facilitating their access to health services
(therapeutic and rehabilitative).
• Protecting them from exploitation,
violence
or
abuse.
Cancer Patients’
Rights
In addition to the general rights from 1 to 12
General health rights for cancer patients:
• The patient alone shall have the right to
know the diagnosis, and his/her family
members are not entitled to know the
diagnosis without the patient’s consent.
• The patient shall have the right to file a
complaint if his/her diagnosis is disclosed
without his/her written consent.
• The cancer patient (adult sane) shall
have the right alone to make decisions
by agreeing to chemotherapy and
radiotherapy, and this does not require
the consent of the parent.
• The patient alone shall have the right to
make a decision to agree to a surgical
intervention, such as a lumpectomy, or
a mastectomy; and this does not require
the consent of the parent.
Reproductive Health Rights of
Cancer Patients:
• A cancer patient shall have the right to
be provided with all health information
about his/her disease.
• The patient shall have the right to be well
informed about the impact of cancer/
cancer treatments on fertility and their
chance of having children in the future.
• The patient shall have the right to be
well informed about the importance of
visiting an infertility doctor and referring
them before starting chemotherapy to
know the methods of preserving fertility
available in the Kingdom.
Bill of Rights
11
• The patient shall have the right to know
the jurisprudence rulings regulating all
fertility preservation methods available
locally, or if the treatment is done abroad.
Pregnancy and Cancer:
• A female patient with cancer shall have
the right to know her chance of becoming
pregnant in the future and when she can
become pregnant.
• A woman who is pregnant while suffering
from cancer or who is diagnosed with
cancer while she is pregnant shall have
the right to be supervised by a specialized
team of oncologists, obstetricians and
pediatrics, as well as the right to discuss
the ethical and legal aspects according
to her situation.
• Both spouses shall have the right to
participate in decision-making after
providing them with all the information,
i.e. health empowerment so that they are
better able to make the decision.
Cancer Patients’ Rights at Work:
• A cancer patient shall not be discriminated
against or dismissed as long as he/she is
able to work.
• The employer shall not be entitled to
request information about the patient’s
health condition except after obtaining
the patient’s permission.
• The patient shall have the right to leave
on the days of taking chemotherapy or
for surgery.
Right to Genetic Testing:
• A cancer patient shall have the right to be
provided with sufficient information about
the role of the genetic factor.
• They shall be referred to a specialist if
there is a family history and the woman
requests a referral.
• The female patient shall have the right
to know the decisions that result from
conducting a genetic test before starting
it. She shall also be provided with health
information that helps her to make the
appropriate decision for her and her
family.
Cancer Patient’s Right to Pain
Treatment:
• The patient, especially advanced cases,
shall have the right to receive pain
medication to live and die in peace.
• He/she shall have the right to participate
in private medical decisions
• Treating pain and enabling the patient
to choose from all their health-related
options.
Right to Palliative Treatment:
• The patient shall have the right to be
provided with specialized care in the final
stages of the disease.
• The patient shall have the right to be
supported psychologically and religiously.
Right not to Resuscitate:
• It is the right of the patient, according to
his/her health condition, to present the
matter to them medically and in line with
the Shariah decisions.
• The patient shall have the right to be
12
Bill of Rights
treated kindly when being notified and
taking into account their situation;
and the manner of notification shall be
according to the patient’s age, health and
psychological condition, and according
to what the doctor deems with his/her
experience of the patient’s ability to
understand and tolerate the information.
• The patient shall have the right to make
the decision or delegate the decision on
their behalf in writing.
Rights of Young
Cancer patients
Due to the specificity of this age group,
especially in this type of disease, and
their unique structural medical, social and
economic needs, this article has been
allocated. In addition to what was mentioned
in articles (1 to 12) and the previous articles
about the rights of cancer patients, this
category includes rights that must be taken
into consideration:
• The right to prevention: through educating
them about cancer and early detection
programs.
• The right to prompt diagnosis and
treatment of suspected and confirmed
cases.
• The right to qualified multidisciplinary
medical professionals with significant
experience in treating cancer of this age
group.
• Receiving psychological and social
support as well as friendly treatment by
specialists.
• Fertility preservation and providing
information and advice on the short and
long term effects of cancer as well as the
treatments that affect fertility.
Bill of Rights
13
Rights of Acquired
Immune Deficiency
Syndrome (AIDS)
Patients
• The rights of AIDS patients are not
different from the rights of patients
in general, and the importance lies in
focusing on the following points:
• In addition to the general rights from 1 to
12
• The patient shall be entitled to be
respected and appreciated (greeting,
communication, and others).
• Taking into account privacy and
confidentiality to a high degree, knowing
that the husband or wife has the right to
know if the other party is a carrier of the
virus.
• The patient is entitled to see the medical
record and request a copy of the medical
record.
• The patient shall be entitled to be given
sufficient time from the medical staff
in the various stages of diagnosis and
treatment and all stages to explain and
educate the patient about the diagnosis,
its mechanisms, treatment plan,
consequences and alternative treatments
according to the latest evidence-based
medical methods.
• The AIDS patient shall be entitled
to be provided with counseling and
psychological
support
services.
• Facilitating the procedures for obtaining
appointments and reports when visiting
any desk at the health facility.
14
Bill of Rights
• The patient shall be entitled to be treated
appropriately and not to overreact
to substances to which universal
precautions do not apply: stool – nasal
secretions – phlegm – sweat – tears urine – vomit.
• The patient shall be entitled to the
fact that medical care provider follow
and explain the universal precautions
application
mechanisms.
• The patient’s immediate family members
(wife and children) shall be entitled to
receive the necessary examination.
Mental Patients’
Rights
In addition to the general rights from 1
to 12
• Protecting then from all forms of abuse
and physical, psychological and verbal
violence.
• Their freedom shall not be restricted by
any means, and they shall not be placed
in an isolated room without a medical
reason.
• Receiving therapeutic services in the
easiest way by allocating psychiatric
clinics in the health facility.
• Availability of educational and
rehabilitation means that are appropriate
for their abilities when they stay for a
long period in the health facility.
• No person may be compelled to
undergo a medical examination aimed
at determining whether or not they have
a mental illness, except in accordance
with a procedure authorized by judicial
authorities, in accordance with the
provisions of the mental health care law.
• Mental illness shall only be determined
according to internationally recognized
medical standards, and it is not
permissible to be decided on any basis
that is not directly related to their mental
health condition. The illness shall not be
considered permanent even if he/she is
treated in a mental center or clinic.
• When treatment is carried out in a
mental health facility, the patient
shall be entitled to be treated near
his/her home or their family’s house
whenever possible, and to return to their
•
•
•
•
•
•
•
•
•
community as soon as possible.
They shall be treated in the least
restrictive
circumstances.
They shall be
ASSIGNMENT COVER SHEET
Course name:
Road traffic Injuries & Disability Prevention
Course number:
PHC313
CRN:
Write a short essay to discuss risk factors
associated with road crashes and injury severity in
the Kingdom of Saudi Arabia
Assignment title or task:
(You can write a question)
➢ What is the magnitude of road accidents in
KSA?
➢ What are the main causes and contributory
factors of road crashes in KSA?
➢ What are the interventions applied to reduce
these risk factors?
Student name:
Student ID:
Submission date:
To be filled in by the instructor only
Instructor’s name:
Grade:
…..out of 10
Instructions for submission:
•
•
•
•
•
•
•
•
The assignment must be submitted with a properly filled cover sheet (Name, ID,
CRN, Submission date) in a word document, Pdf is not accepted.
The length of the write-up should be 1 pages’ maximum of 1000 words.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
Due date 14/oct/2023
Critical Thinking Assignment: Create an Annotated Bibliography
This Critical Thinking assignment builds on the assignment from Module 4.
Create an Annotated Bibliography, writing a two-to-three-paragraph appraisal of each article from the 10 references you gathered for the Module 4 Critical Thinking Assignment. There should be a title page and then these sources should be listed according to APA 7th edition guidelines excluding the reference page. Each individual annotation should be followed by the corresponding appraisal. Look for relevant literature on a topic of interest to you paying attention to the methods of collecting and analyzing data and ethical research practices.
This is an opportunity to practice synthesizing the author’s words. Do not use quotes; rather, put the author’s ideas into your own words. Take as many pages as needed to provide summaries for each of your articles.
Please use the website(s) below to help get you started.
Cornell University: How to Prepare an Annotated Bibliography
Purdue OWL: Annotated Bibliography Sample
Please note: Do not confuse an annotated bibliography with an abstract, summary, or a book review. They are vastly different. For this assignment, abstracts, summaries, and book reviews are not acceptable submissions.
Follow APA and Saudi Electronic University writing standards.
Review the grading rubric to see how you will be graded for this assignment.
You are strongly encouraged to submit all assignments to the Originality Check prior to submitting them to your instructor for grading.
Unformatted Attachment Preview
1
Research on Mental Health
Name of Student
Institutional Affiliation
Course
Date
2
Research on Mental Health
Introduction
An individual’s mental health forms an essential foundation for their overall wellbeing, as their mental state significantly impacts their welfare. It involves communal, mental,
and emotional aspects (Baffsky et al., 2023). It is pivotal in deciding an individual’s quality of
life and overall public performance. The significance of mental health has received more
notice in recent years. Growing initiatives are being taken to de-stigmatize mental diseases
and inspire general mental health. This overview aims to grasp mental health and highlight its
numerous facets thoroughly. It also emphasizes the social concerns related to mental health
and the importance of solving them.
Reasons for Selecting Each Reference
The article by Baffsky et al. (2023) focuses on implementing preventative programs
for kids in educational settings, addressing a crucial part of mental health. The systematic
review investigates practical methods for implementing research-based interventions in
educational settings. The article by Halvorsen et al. (2023) satisfies the critical requirement
for reliable and consistent measures of mental health issues. It concentrates on young people
with intellectual disability. It provides information on the difficulties and developments in
evaluating mental health in this at-risk demographic. It helps with better mental health
support and treatment.
The article by Kenebayeva et al. (2022) explores the effects of organizational
elements and stress on the mental health of women teachers in Kazakhstan during the preCOVID-19 and COVID-19 periods in Central Asia. According to the study, the pandemic
made women teachers more anxious and depressed, particularly in urban areas. The article by
Ko (2019) discusses how Zhuangzi’s philosophy, notably the idea of self-adaptation, might be
applied to problems with mental health, including frustration. The study examines how this
3
age-old philosophy might provide modern people, especially university students, with
enduring and beneficial coping skills.
The article by Kush et al. (2022) compares the mental health results of teachers with
those of people in other professions, addressing the understudied topic of teachers’ mental
health during the COVID-19 pandemic. The study’s conclusions offer insightful information
about teachers’ mental health during a trying time directly related to discussing mental health
in educational contexts. The article by Moore et al. (2019) uses latent profile analysis (LPA)
to isolate different mental health subtypes in high school pupils and assess their structural
stability over three years. The study examines the relationships between these subtypes and
social-emotional experiences, self-reported grades, well-being, and distress.
The article by Naff et al. (2022) thoroughly reviews the COVID-19 pandemic’s effects
on PK–12 youth’s mental health by combining the most recent findings from 104 empirical
investigations. It draws attention to the impact’s many facets, such as disruptions, caregiver
influence, elevated stress and anxiety, varying effects depending on demographics, and both
effective and ineffective coping mechanisms. The article by Pervez et al. (2021) explores the
frequently disregarded mental health problem among Ph.D. management students in
academia. The study evaluates the prevalence of sadness, anxiety, and impostor syndrome
among these students.
The article by Watson et al. (2022) examines how school social workers (SSWs) view
trauma and mental health in the wake of the COVID-19 outbreak and the reopening of the
schools. It clarifies the critical function of SSWs in attending to young people’s mental health
needs during trying times. Finally, the article by Zhang & Zang (2022) looks at how the
marriage status of adult children affects the mental health of elderly parents in an aging
population. The study clarifies this association by considering variances due to gender,
geography, and education using data from CHARLS and PSM methods.
4
Conclusion
In conclusion, maintaining a balanced and sound mental state is indispensable in
achieving wellness and prosperity. Numerous undesirable results can result from poor mental
health. This involves a decline in productivity, a decline in relationships, and a reduction in
quality of life. Unsettled mental well-being matters can evolve into more severe conditions
and hold profound unfavorable influences on physical condition. Finally, families,
communities, and society at large may be impacted by mental health issues. There have been
initiatives to increase understanding of mental health’s value and lessen stigma. Moreover,
this program has emphasized the importance of improved access to mental health treatments.
5
References
Baffsky, R., Ivers, R., Cullen, P., Wang, J., McGillivray, L., & Torok, M. (2023). Strategies
for Enhancing the Implementation of Universal Mental Health Prevention Programs
in Schools: A Systematic Review. Prevention Science, 24(2), 337-352.
https://doi.org/10.1007/s11121-022-01434-9
Halvorsen, M. B., Helverschou, S. B., Axelsdottir, B., Brøndbo, P. H., & Martinussen, M.
(2023). General measurement tools for assessing mental health problems among
children and adolescents with an intellectual disability: A systematic review. Journal
of Autism and Developmental Disorders, 53(1), 132-204.
https://doi.org/10.1007/s10803-021-05419-5
Kenebayeva, A., Nam, A., Tabaeva, A., Altinay, F., & Altinay, Z. (2022). COVID-19 and
Kazakhstani Women Teachers: An Empirical Study of Factors Affecting Mental
Health. European Education, 54(1-2), 3-20.
https://doi.org/10.1080/10564934.2022.2127370
Ko, H. C. (2019). A sustainable approach to mental health education: an empirical study
using Zhuangzi’s self-adaptation. Sustainability, 11(13), 3677.
https://doi.org/10.3390/su11133677
Kush, J. M., Badillo-Goicoechea, E., Musci, R. J., & Stuart, E. A. (2022). Teachers’ mental
health during the COVID-19 pandemic. Educational Researcher, 51(9), 593-597.
https://doi.org/10.3102/0013189X221134281
Moore, S. A., Dowdy, E., Nylund-Gibson, K., & Furlong, M. J. (2019). An empirical
approach to complete mental health classification in adolescents. School Mental
Health, 11, 438-453. https://doi.org/10.1007/s12310-019-09311-7
6
Naff, D., Williams, S., Furman-Darby, J., & Yeung, M. (2022). The mental health impacts of
COVID-19 on PK–12 students: A systematic review of emerging literature. AERA
Open, 8, 23328584221084722. https://doi.org/10.1177/23328584221084722
Pervez, A., Brady, L. L., Mullane, K., Lo, K. D., Bennett, A. A., & Nelson, T. A. (2021). An
empirical investigation of mental illness, impostor syndrome, and social support in
management doctoral programs. Journal of Management Education, 45(1), 126-158.
https://doi.org/10.1177/1052562920953195
Watson, K. R., Capp, G., Astor, R. A., Kelly, M. S., & Benbenishty, R. (2022). “We Need to
Address the Trauma”: School Social Workers′ Views About Student and Staff Mental
Health During COVID-19. School mental health, 14(4), 902-917.
https://doi.org/10.1007/s12310-022-09512-7
Zhang, Y., & Zang, W. (2022). Do the Marital Statuses of Adult Offspring Affect Their
Parent’s Mental Health? Empirical Evidence from China. International Journal of
Environmental Research and Public Health, 19(16), 10133.
https://doi.org/10.3390/ijerph191610133
GLST 220
GOSPEL COMMUNICATION PROJECT: GRAND NARRATIVE VIDEO ASSIGNMENT
INSTRUCTIONS
OVERVIEW
The Gospel Communication Project allows you to apply the principles of Cultural Intelligence to
a specific cross-cultural evangelistic encounter. As a cumulative project throughout the course
(with a research assignment, a grand narrative outline, and a video presentation), you will
research the cultural elements of a specific country, consider how those cultural elements will
affect a person’s understanding of the gospel message, create a plan for communicating
effectively with a person from a specific culture, and present the story of God through video as
you would if you were able to share the gospel with someone from that culture. Also, as you
craft a story of the grand narrative to effectively communicate it in a specific culture, you will
gain a deeper understanding of the story of God and gain confidence in sharing the gospel with
others.
INSTRUCTIONS
For the third part of your Gospel Communication project, you will record a video of you sharing
the story of the Grand Narrative that you have outlined as if you were sharing it with a friend
from the culture you researched in your CQ Research Assignment. You should use your Grand
Narrative outline as a script for your video.
Your video should meet the following requirements:
•
•
•
•
Be 5- 10 minutes in length (Videos over 10 minutes will have points deducted).
Include you facing the camera and speaking clearly and professionally as if giving a
formal presentation.
At the beginning of your video, please state your name.
Include all of the elements outlined in your Grand Narrative Outline Assignment
The purpose of this video is to tell the story as you would actually share it with a friend from that
culture. (Talk to the camera like you would talk to your friend). You should NOT simply read
your list of elements in your outline, but rather you should tell one fluid story that connects all of
the elements in your outline together. Your story should include the biblical themes that you
identified in your CQ Research Assignment that connect with the culture. Also, there is no
requirement to cite every bit of scripture that you referenced in your outline. If a specific passage
adds value to your story, you can quote it, but you are not required to do so. Your video would
be too long if you were to quote scripture for every element.
Here are some things to consider as you complete this assignment:
This is a communication class, and this is your “oral” communication assignment for the
semester, so the following principles of oral communication should be considered. You will be
graded more on content than delivery, but these principles of communication do affect your
presentation:
Page 1 of 2
GLST 220
•
•
•
•
•
Rate of speech: Don’t talk so fast that your audience cannot understand you or so slow
that your listener gets bored.
Language and pronunciation: Make sure that you are speaking clearly and that your
words are appropriate for your audience. Example: if you are speaking to someone who
has no previous understanding of the gospel or church culture, don’t use complex church
words like sanctification and justification.
Inflection and tone: Don’t be that monotone professor that makes you fall asleep! Your
inflection and tone communicate your excitement (or lack thereof) for the message you
are communicating.
Eye contact and facial expressions: Don’t stare at the ground or just read your story
without looking up. Make eye contact with the camera. Try not to look angry. This is a
story that you are (or should be) excited to share!
Gestures: Try not to gesture so much that it is distracting, but don’t be scared to use
gestures to illustrate or emphasize your point.
Creativity
•
•
You may utilize any resources to craft the way you will communicate the story, but you
may not simply read or repeat someone else’s story.
You may be as creative as you would like with background or visuals to supplement the
Story. Just make sure that you don’t sacrifice content for creativity!
Submitting your video is a 2-step process: 1) upload your video to watch.liberty.edu, and 2)
Embed the link for your video into Canvas. Please find further instructions in the HOW TO
SUBMIT A VIDEO PRESENTATION instructions in the Resources section of this assignment.
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
Page 2 of 2
GLST 220
GOSPEL COMMUNICATION PROJECT: GRAND NARRATIVE OUTLINE TEMPLATE
INSTRUCTIONS
In this assignment you will practice using CQ Strategy by planning to communicate a specific message (the Grand Narrative) in a
culturally appropriate way based on the CQ Knowledge you gained in your Gospel Communication Project: Cultural Intelligence
Research Assignment. Use the chart below to outline the elements of the Grand Narrative Story. You will use this outline as your
script for your Grand Narrative Video Assignment in module 7.
Description: In the description column, you should summarize that part of the grand narrative story as if you were telling the
story to someone from the culture you researched in your CQ Research Assignment. Focus on the most important details of
that story element that would resonate with a person from that culture and use vocabulary that would make sense to a person
from that culture. You should write in complete sentences when writing your story. Write at least 5 sentences about each
element. Note that you should tell the story in your own words in this section (do not quote scripture here).
Scripture Reference: In the scripture reference column, list scriptures where you can find that part of the story in the Bible.
You don’t have to quote the scripture, just list the reference (i.e., Genesis 1:1). Be specific. It’s ok to list a passage or a
range/section of verses, but don’t just say “Genesis.”
Cultural Connection: In the cultural connection column, you will practice contextualizing your story. Write 3-5 sentences
about you how would use your CQ knowledge to help someone understand that part of the story. What cultural systems or
cultural value orientations might help them to connect with that part of the story? What cultural artifacts might help you to
draw connections from the culture to the story? When you identified biblical themes that would connect to specific elements of
culture, how can you point out that biblical theme in this part of the story? You should rely heavily on the information you
discovered in your CQ Research Assignment to complete this section.
Student
Name
Country
Nicholas Banks
Course Section Number
Uganda
Cultural Cluster (Anglo, Nordic Europe,
Germanic Europe, Latin Europe, Latin
America, Confucian Asia, Southern Asia,
Sub-Saharan Africa, Arab)
Sub-Saharan Africa
Page 1 of 4
GLST 220
Story
Description
Element
Act 1: God Establishes His Kingdom
(Discuss creation.)
Scripture Reference
Cultural Connection
In Genesis creation story, humans are God’s chosen
rulers. God’s reign as King of His realm will never end.
But a sort of pecking order is established here, with
humans ranking higher than marine life, avian species,
and terrestrial mammals.
Genesis 1:26-28
For so many years now, the Ugandans have not
had any transitions in the presidency. One person
has ruled this country for thirty plus years without
allowing a different person to take over the
presidency. I would tell them not to feel agitated
about it as God declared it in the creation story
that there must be a ruler in the creation. They
should consider that there is still hope for another
leadership.
Genesis 3.9
Uganda’s economic system is purely capitalistic.
The citizens work really hard to provide for their
families. It’s a good thing that things changed
after the fall of man. We have learned the
difference between good and evil, developed a
taste for the pleasant, learned to think for
ourselves, and learned how to earn forgiveness
and eternal life. This infraction sparked all of
these consequences. The encouragement to the
Ugandans would be that the Lord has made it so
that we must work to survive, protecting us from
the curse of sloth and laziness.
Act 2: Rebellion in the Kingdom
(Discuss sin and the fall.)
After creating man, God placed him in the garden of
Eden. Man was told not to eat the fruit from the tree of
knowledge of good and evil, but he disobeyed. The
serpent lied to Eve, and she gave in to lies and she went
ahead and influenced Adam to eat the fruit too. This
marked the fall of mankind and the beginning of sin.
After the fall of man, God declared punishment upon the
human race. One punishment was toiling hard to be able
to satisfy the basic human wants.
Act 3: The King Chooses Israel
(Trace the story of Israel through the Old Testament, highlighting several key people along the way.)
The Israelites were unhappy with the behavior of the
1 Samuel 8:4-22
The political situation in Uganda is disheartening
sons of Samuel. As a result, they went to Samuel and
sometimes. Certain individuals clinging on to
asked him to find them a king. Samuel warns them
power and not wanting others to lead too. The
Page 2 of 4
GLST 220
against it and went ahead to consult God on the same.
God tells him that it was alright for them to have a king
as it is Him the Lord they have rejected.
Act 4: The Coming of the King
(Discuss the birth, life, death, and resurrection of Jesus)
Jesus, the Son of God, was born to Mary, a faithful
woman. At 12 years old, Jesus taught the word of God
and was found in the temple. At 30, he was baptized by
John the Baptist, teaching obedience to God and healing
the sick. Jesus forgave people of their sins and reminded
them of the importance of baptism. Despite being
considered blasphemous by Jewish priests, Jesus
demonstrated incredible power and compassion. Jesus
was arrested and later crucified to fulfill God’s will. He
cried out for mercy on His own people. Three days after
his death, Jesus rose from the tomb, and he was the first
to be resurrected. This resurrection signifies that we will
all be resurrected one day.
monarchy of Israel exemplifies God’s meekness
and grace in allowing institutions to make their
own decisions. Leadership must adapt to poor
decisions in institutions while providing growth
opportunities. Samuel’s warnings apply to modern
governments, corporations, religious institutions,
and educational institutions. The message to
deliver would be that despite all these struggles,
the goal remains to love God and our neighbors.
Isaiah 11:1-6
Act 5: Spreading the News of the King
(Discuss the Holy Spirit, the Church, and the mission of believers today.)
Christianity is a missionary religion aimed at converting 1 John 1:2-3
people to Christianity. The Holy Spirit plays a crucial
role in early church missionary movements, enabling
believers to speak in various languages and dialects. The
Holy Spirit selected missionaries for the work of Christ,
Uganda has been experiencing tough economic
times. Most citizens can hardly afford a decent
single meal in a day. Inflation is a nightmare
which makes it even harder for the people
majority of whom are low income earners. The
story of Jesus’ earthly life, death, and resurrection
is not the end, it is a story of hope. He will return
as our judge, rewarding those who serve Him
with eternal life. To prepare for this judgment, it
would be crucial we must repent our sins, confess
Christ, be baptized, and live a faithful life. The
story of Jesus is the greatest ever told, and our
reaction to it determines our eternal destiny. We
have a choice to serve Jesus and receive eternal
life or refuse to serve Him.
Ugandans strongly believe and practice
collectivism. They form formal groups would be
crucial in helping individuals become organized
and accomplishing goals. The Christian and the
church mission is to spread the gospel and
Page 3 of 4
GLST 220
such as Barnabas, Simeon, Lucius, and Saul, who obeyed
the Holy Spirit’s word and sailed for Cyprus. The Holy
Spirit empowered missionaries to perform miracles,
endure persecution, and sustain believers during
persecution. The Holy Spirit also provided divine
blessings on the early church’s missionary work, as seen
in the council of Jerusalem’s letter to believers in
Antioch, Syria, and Cilicia.
Act 6: The Return of the King
(Discuss Christ’s return and our restoration)
The return of Christ is the gospel’s glorious culmination
and the church’s great hope. When the Messiah finally
arrives, it will be for all to see. The virtuous dead, along
with the righteous alive, will be glorified and brought to
heaven at His return, while the unrighteous will be
destroyed. The current state of the world, together with
the near-complete fulfillment of most prophecies, points
to the soon return of Christ. Since the exact moment of
that happening has not been disclosed, we are urged to
stay watchful at all times.
continue to win souls for Christ. Every
organization, perhaps more than ever, needs to
explain its mission to the public in as simple
terms as possible. Such persistent self-definition
and re-definition is required by the rapid changes
that are bringing about complicated adjustments
in every facet of the Ugandan society.
The Ugandan church, as the Body of Christ, was
created to carry out God’s will in the world.
John 11:25-26
Life challenges are being experienced all over the
country and also globally. Pain, death, diseases
amongst other calamities have make Ugandans
come together and shoulder the problems
collectively. There is reason to look forward to
the Second Coming. It’s a real-life occurrence that
people all across the world can witness firsthand.
This is the pinnacle of God’s redemptive scheme!
The Bible makes clear that Christ will return. It
will be like a monarch coming home to a hero’s
welcome. Christian believe that the final chapter
of human history will be written when Christ
returns to Earth. This is not the end, but the start
of how things were always supposed to be.
Christ’s return will provide finality and
fulfillment to the lives of the Ugandans.
Page 4 of 4
Review the Focused Note Checklist provided in this week’s Learning Resources and consider how you will develop your Focused Note for this week’s Assignment.
Use the Focused SOAP Note Template and the example found in the Learning Resources for this week to complete this Assignment.
Select an adolescent patient that you examined during the last 3 weeks. With this patient in mind, address the following in a Focused Note.
Assignment
Subjective: What details did the patient or parent provide regarding the personal and medical history? Include any discrepancies between the details provided by the child and details provided by the parent as well as possible reasons for these discrepancies.
Objective: What observations did you make during the physical assessment? Include pertinent positive and negative physical exam findings. Describe whether the patient presented with any growth and development or psychosocial issues.
Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority and include their ICD-10 code for the diagnosis. What was your primary diagnosis and why?
Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management? Include pharmacologic and non-pharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan.
Reflection notes: What was your “aha” moment? What would you do differently in a similar patient evaluation?
Write your personal philosophy of nursing. The essay is to be typewritten and double-spaced (1,000 words) (APA 7th edition) and should include the following:Introduction that includes who you are and where you practice nursingDefinition of nursingAssumptions or underlying beliefsDefinitions and examples of the major domains of nursing A summary that includes answers to the following questions: a. How are the domains connected? b. What is your vision of nursing for the future? c. What are the challenges that you will face as a nurse? d. What are your goals for professional development?
I need a discussion post 300-350 words for this, add at least 2 references:Read the attached Qualitative Research Study. (I have also placed the article under) After reading the article, please appraise this study. Use table 7.1(I have also placed the article under ) in your book to guide you in your appraisal. What are the strengths and weakness you found in this study? I upload the article and table 7.1 below.After you finish the discussion post, I need one response 150 to replied to this same post, which you have done!
Unformatted Attachment Preview
pharmacy
Article
Exploration of Nurses’ Knowledge, Attitudes,
and Perceived Barriers towards Medication
Error Reporting in a Tertiary Health Care
Facility: A Qualitative Approach
Eman Ali Dyab 1 , Ramadan Mohamed Elkalmi 2 , Siti Halimah Bux 3 and
Shazia Qasim Jamshed 3, *
1
2
3
*
Department of Pharmaceutics, Faculty of Pharmacy, Tripoli University,
Tripoli 42300, Libya; eman_diab2008@yahoo.com
Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi Mara,
Puncak Alam 42300, Malaysia; edriph@gmail.com
Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia,
Kuantan 25200, Malaysia; sitihalimah@iium.edu.my
Correspondence: shazia_jamshed@iium.edu.my; Tel.: +601-7470-3692
Received: 15 September 2018; Accepted: 2 November 2018; Published: 5 November 2018
Abstract: Medication error reporting (MER) is an effective way used to identify the causes of
Medication Errors (MEs) and to prevent repeating them in future. The underreporting of MEs
is a challenge generally in all MER systems. The current research aimed to explore nurses’ knowledge
on MER by determining their attitudes towards reporting and studying the implicated barriers
and facilitators. A total of 23 nurses were interviewed using a semi-structured interview guide.
The saturation point was attained after 21 interviews. All the interviews were tape-recorded and
transcribed verbatim, and analysed using inductive thematic analysis. Four major themes and
17 sub-themes were identified. Almost all the interviewees were aware about the existence of the
MER system. They showed a positive attitude towards MER. The main barriers for MER were the
impacts of time and workload, fear of investigation, impacts on the job, and negative reactions
from the person in charge. The nurses were knowledgeable about MER but there was uncertainty
towards reporting harmless MEs, thus indicating the need for an educational program to highlight
the benefits of near-miss reporting. To improve participation strategies, a blameless reporting culture,
reporting anonymously, and a simplified MER process should be considered.
Keywords: medication error reporting; nurses’ attitudes; qualitative study; barriers; medication error
1. Introduction
The main principle of giving medication to the patient is to serve them in order to restore his/her
health without any harm [1]. Adverse events and medical errors are the main issues threatening
the patient’s safety, and are awkward predicaments in nearly all healthcare systems [2]. The World
Health Organization (WHO estimated that millions of people suffer injuries directly attributed to
medical care, and many are preventable [3], although prevalence in developing countries is reported
to be higher than developed nations [4]. In Southeast Asian countries, the reported administration
error rates ranged from 15.2% to 88.6% [5]. In Taiwan, a study mentioned that the overall rate of the
medical incidents ranged from 30% to 47.6%, and most of them were related to MEs [6]. In a Malaysian
study, Johari et al. reported 2572 reported cases of ME in 2009 [7]. The prevalence of ME among
geriatric patients was 25.17% [8] whereas in paediatrics this figure was 11.7% [9]. A recently published
Pharmacy 2018, 6, 120; doi:10.3390/pharmacy6040120
www.mdpi.com/journal/pharmacy
Pharmacy 2018, 6, 120
2 of 14
four-year retrospective study reported that the total number of paper-based ME reports submitted
to the National Medication Error Reporting system (NMER) was 17,357, but only 0.3% of MEs were
in the administration stage [10]. The percentage in the administration stage is very low, representing
paper-based reports only (excluding online submitted MEs reports) collected by the NMER system,
as well as the effect of underreporting. The annual estimated cost of MEs in Malaysia was estimated to
be 111,924 Malaysian Ringgit (MYR) [10]. Clinically, MEs can have small to severe consequences for
patients. It was reported that the total number of MEs in the administering stage was 166, where 1%
had fatal consequences, 20% were serious, 32% were significant, and 46% were nonsignificant [11].
The identification of trends and patterns of MEs were the main reasons for establishing a ME
reporting system [12]. The effectiveness of all these systems depend on their ability to document
the occurred MEs. Establishing guidelines for medical error reporting (MER) is not enough, as the
healthcare practitioners (reporters) play a vital role in the MER process. The healthcare practitioners’
knowledge about MER, their attitudes toward reporting MEs, and perceived barriers toward MER are
important factors which determined the success of MER systems. Health care professionals in general
and nurses in particular are responsible for MER. It has been reported that the MEs are underreported
in all countries. Nurses’ knowledge and attitudes as well as barriers and facilitators toward MER
among nurses in Malaysia are little-studied issues and warrant investigation.
This study is intended to attain deeper insight into the knowledge and attitudes held by Malaysian
nurse practitioners towards the ME concept and MER process, as well as to investigate the barriers
which prevent nurses from reporting their MEs.
1.
2.
3.
4.
What do nurses know about the ME and MER system?
What are the nurses’ attitudes toward MER?
What are the barriers which could hinder nurses from reporting their MEs?
What are the factors which could facilitate MER among nurses?
2. Methods
2.1. Study Design and Setting
The study was conducted after getting approval from both the Medical Research Ethics
Committee Ministry of Health Malaysia (NMRR-15-2485-24709) and the International Islamic
University of Malaysia Research Ethics Committee (IREC 446). Use of a qualitative method (in-depth
interviews) provides flexibility and efficiency in collecting data related to personal feelings, attitudes,
and experiences [13] and hence, these methods are used for the exploration of the participants’
experiences towards medication error reporting. The individual interview method was chosen over
focus group discussions because of privacy, suitability, and comfort zone issues for shy and hesitant
participants [14]. This gives liberty to the participants to elaborate his/her answers without distractions
from others [14]. The current research was executed in a tertiary healthcare facility of Kuantan city,
Pahang, Malaysia.
2.2. Participants
The target study population was nurses practicing in different units of the hospital. No specific
inclusion and exclusion criteria were applied, and thus all nurses were eligible to participate in
the current research. The participants were recruited by using convenience and snowball sampling
technique. The snowball method helps to recruit hidden subjects which cannot be easily found [15].
The first participant was a nurse from the medical unit and was given information on the details of
the research along with an assurance of confidentiality and anonymity. After her acceptance she was
asked to fill in demographics form and sign the consent form. The interviews were recorded by using
Audio Recording Titanium Software® version 8.5.5 (AATSystems, Kent, UK), and notes were taken
during the interviews. After finishing the first interview, the interviewee was asked to nominate the
Pharmacy 2018, 6, 120
3 of 14
next participant. Thus, she made a referral to the next nurse, with the same pattern for the subsequent
interviews. Thus, a chain referral technique followed throughout the research study. The number
of participants was determined once the saturation point was achieved. The saturation point occurs
when no new concepts and themes emerge [14,16,17]. Two extra interviews were conducted to confirm
the saturation point. The field supervisor also helped in recruitment process. Participation was
simply on a voluntary basis, and they were informed that anytime during the course of research they
could withdraw. Moreover, they were assured that their confidentiality and anonymity would be
maintained. Only the research team had access to records. The purpose of the study was explained
to each participant before the interviews commenced and therefore, all the participants were asked
to sign an “informed consent form” followed by the addition of their demographic characteristics.
A total of 23 nurses were interviewed.
2.3. Procedure and Interview Process
In-depth interview sessions were conducted using a semi-structured interview guide in June 2015.
This guide was developed on the basis of prior published studies related to MER among health care
professionals [18–20]. The purpose of using this guide was to make sure that all important issues
about the topic were covered in the interviews [13,21]. The medium of communication during the
interview was primarily English, followed by a couple of interviews being conducted in Bahasa
Malayu i.e., the native language of participants. The field supervisor agreed to work as a research
assistant and a translator and assisted the nurses who could not understand the English language. As a
result, participants who expressed their thoughts in the Bahasa Malayu language were also included.
Each interview lasted for about 30–45 min. Venue was chosen as per proximity to nurses’ working units,
their preference of level of comfort/privacy, and the level of noisiness. Places such as the library private
room, the seminar room, and nurses’ rooms were selected as the venue for interviews. The discussion
was focused on several major issues; the nurses’ knowledge, experiences, and perceptions about ME
and MER, exploring their attitudes towards MER, comprehending the factors which might prevent
the nurses from reporting their MEs, and those factors which would promote MER among nurses.
Probing questions were asked to provoke more details from interviewees [13,21].
2.4. Data Analysis
The data analysis was performed using the inductive thematic analysis approach. The participants’
approved transcripts (transcribed verbatim) were coded as (N1, N2, . . . , N23). The process is illustrated
in Figure 1. The analysis followed a cyclic pattern, where it started by familiarization stage, generation
of initial codes stage and revision stage to refine the emerged codes [22,23]. The transcripts were
analysed again by another researcher to validate the resulted themes [22], and a third person’s opinion
was sought to resolve any disagreement between the previous analyses [24,25].
The current research followed an established criterion for maintaining quality in qualitative
research and thus follow the standards of Guba and Lincoln [26] for generating credibility,
transferability, dependability, and confirmability. For strengthening the credibility of the research there
was a continuous interaction with the participants, with checking of interpretations against interview
transcripts. A review with the participants was undertaken. Contrary to quantitative research, the aim
of qualitative is not generalizability but to observe and execute transferability. Therefore, a detailed
description of the participants’ experiences helped the researchers identify the patterns of social
relationships in reporting MEs and as well as the cultural backgrounds of the participants who reported
hesitancy in reporting. For dependability purposes, external audit criteria were put in place, and a
researcher not involved directly in research helped in the evaluation of interpretation and conclusions
with respect to the data collected. For establishing confirmability, not only a conformability audit (as
mentioned above) but also triangulation and reflexivity were maintained. In terms of establishing
triangulation, both methodological triangulation (i.e., the research followed the quantitative design
after qualitative inquiry) and analyst triangulation (i.e., using different analysts to review the findings)
Pharmacy 2018, 6, 120
4 of 14
were maintained,
whereas
forREVIEW
reflexivity, a reflexive note-sheet was used to record the methodological
Pharmacy 2018,
6, x FOR PEER
4 of 14
parameters and logistics involved. Interviewees were female (n = 22); of Malay race (n = 22); holding a
note-sheet was used to record the methodological parameters and logistics involved. Interviewees
diploma (n = 21). The nursing diploma is a 3-year course in Malaysia and on its successful completion
were female (n = 22); of Malay race (n = 22); holding a diploma (n = 21). The nursing diploma is a 3one can register
with
Board
Malaysia
work asone
a staff
nurse. with
All participants
year course
in Nursing
Malaysia and
on its
successfuland
completion
can register
Nursing Boardwere full
time employees.
Half
of
the
participants
(n
=
12)
have
working
experience
of
than 11 years.
Malaysia and work as a staff nurse. All participants were full time employees. Half of themore
participants
(n
=
12)
have
working
experience
of
more
than
11
years.
Slightly
more
than
three-quarters
the the prior
Slightly more than three-quarters of the participants (n = 18) had not reported any MEs of
over
participants (n =18) had not reported any MEs over the prior 12 months. The interviewees were
12 months. The interviewees were attached to different units in the hospital such as intensive care units
attached to different units in the hospital such as intensive care units (ICUs), medical units, critical
(ICUs), medical
units, critical cardiac units (CCUs), accident and emergency unit (A&Es), orthopaedic
cardiac units (CCUs), accident and emergency unit (A&Es), orthopaedic units, neonatal intensive
units, neonatal
intensive
care
units
(NICUs),
units.
The demographic
characteristics
of
care units
(NICUs),
and
paediatric
units.and
Thepaediatric
demographic
characteristics
of participants
are
presented
in Table 1. in Table 1.
participants
are presented
1. The study
process
flowchart.(I)
(I)transcription
transcription step,
(II) (II)
datadata
analysis
step, (III)
analysts’
Figure 1.Figure
The study
process
flowchart.
step,
analysis
step,
(III) analysts’
triangulation
(two researchers
performed
analysis
and person
third person
resolved
any
triangulation
method method
(two researchers
performed
analysis
and third
resolved
any disagreement),
disagreement), and (IV) final result.
and (IV) final result.
3. Results
Table 1. Interviewees socio-demographic characteristics (n = 23).
Four major themes and 17 sub-themes were emerged: knowledge about MER, attitudes toward
Characteristic
Number (n = 23)
Percentage (%)
MER, barriers toward MER, and facilitators to improve MER process. Figure 2 represents the
Female
22
95.7
emerged themes
Genderand categories.
Male
Race
Characteristic
Age
1
Malay
Table 1. Interviewees socio-demographic
characteristics (n22= 23).
Chines
1
Gender
Race
≤30
30–40
Female
41–50Male
51≥
Malay
Education level
Diploma
Chines
Bachelor
Experience in years
Age
≤5
6–1030–40
≥11 41–50
≤30
Practice site
51≥
Medical unit
a
ICUDiploma
b
CCU
Bachelor
A&Ec
Orthopaedic unit
NICU d
Paediatric unit
Number of reports in the last 12 months
Never report
≥1
Education level
Number (n
6 = 23)
2214
12
1
22
21
1
2
6
5
14 6
2 12
14
21 9
22
3
2
1
2
18
5
4.3
95.7
4.3
Percentage
(%)
26.1
95.7 60.9
4.3 8.7
4.3
95.7
91.3
4.3
8.7
26.1
21.7
60.9 26.1
8.7 52.2
4.3 17.4
91.3 39.1
8.7 8.7
13
8.7
4.3
8.7
78.3
21.7
(a ) Intensive care unit. (b ) Critical cardiac unit. (c ) Accident and emergency unit. (d ) Neonatal intensive care unit.
Medical unit
4
17.4
ICU a
9
39.1
b
2
8.7
CCU
Practice site
A&Ec
3
13
Orthopaedic unit
2
8.7 5 of 14
Pharmacy 2018, 6, 120
NICU d
1
4.3
Paediatric unit
2
8.7
3. Results
Never report
18
78.3
Number of reports in the last 12 months
≥1
5
21.7 toward
Four major themes and 17 sub-themes were emerged:
knowledge about
MER, attitudes
Intensive
care unit.
(b) Critical
cardiac unit.
(c) Accident
andprocess.
emergency
unit. 2(d)represents
Neonatal intensive
MER,(a)barriers
toward
MER,
and facilitators
to improve
MER
Figure
the emerged
careand
unit.categories.
themes
Emergent themes and sub-themes. MER:
MER: medical error reporting.
Figure 2. Emergent
3.1. Knowledge about MER
3.1.1. Concept of ME
The nurses were asked about their understanding of the ME concept. Almost all of them correctly
understood the concept of ME. Moreover, they linked its meaning to five/seven rights, while others
just gave simple and general answers like “giving incorrect medication to the patient”.
“Medication error is an error when giving medication including dosage and also the type of medication,
make sure to follow the 7Rs practice in the hospital.” (N1)
Pharmacy 2018, 6, 120
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“Medication error is when something unwanted occurs such as wrong medication is given to the
patient.” (N7)
“Medication error means giving wrong medication to the patient, which includes wrong dose,
wrong route, and wrong documentation.” (N13)
3.1.2. The Existence of a System for MER and the Importance of MER
All the interviewees were aware about the existence of MER system and the importance of MER.
They stated that data collected by MER can be used as an indication of the quality of health service
provided to the patient. It can be used to improve this service by carrying out root-cause analysis
for the MEs reports, and the reported data can be utilized for learning purposes. In other words,
ME reports can be used as good resources to help nurses in avoiding repeating the same errors again
in future.
“Yes, we have a system for medication error reporting [ . . . ] And, it is very important because it
involves the quality of service which is being given to the patient and it is very important to monitor
ME.” (N1)
“It is important because we want to improve the way of delivering care and serving the patient.
To learn from reports, where and which thing can be done. So we have more information about what
has been done and their consequences.” (N3)
“It is important because we want to detect what is ME and to prevent it from happening again.” (N7)
“Normally, we do root-cause analysis to find out when and how this happened. Sometimes it comes
from the wrong prescription like wrong dose or wrong route or wrong frequency and then we find out
how that happen and try to tackle.” (N5)
“It is to guide our practice [ . . . ] Not add more error to this collection [ . . . ] To avoid ME in future
[ . . . ] It is considered as a good resource.” (N4)
3.1.3. The Availability and Confidentiality of the Reporting Form
The majority of interviewed nurses claimed that during their practice, they did not report MEs,
since until the time of interviews they did not commit any error. As a result, most of them did not see
the reporting form and some of them had seen it but they did not remember its content.
“The reporting form is available in the pharmacy department.” (N5)
“I have not seen the reporting form before. Because, so far, I did not make any error.” (N8)
The nurses were asked about their opinions on the reporting form.
“I have seen it; it is easy to fill, it does not need modification or re-designation.” (N1)
“The report is not too detailed like describing everything, but it underlines or highlights when the
medication was given to the patient.” (N3)
3.2. Attitude of Nurses toward ME Reporting
The nurses were asked about their attitudes toward ME reporting. The majority of the participants
had a positive attitude toward reporting of MEs, whether these MEs caused a serious side effect to the
patient or not. The other group had uncertain attitudes and they tended to report the MEs which led
to harm to the patient only.
Pharmacy 2018, 6, 120
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3.2.1. Positive Attitude
The majority of nurses claimed that they report all encountered MEs immediately. They reported
them irrespective to their seriousness or the level of patient’s harm due to the error.
“Nothing affects my decision to report, once the error occurs it should be reported.” (N4)
“It is not a matter of choice.” (N7)
“Once I detect an error, I cannot just ignore it, and I straightforward report it […] We must make a
report also because this is ME, and we must report whether it is serious or not.” (N2)
“Here in A and E department, it does not matter if the error is big, mild, or small, it must be reported.” (N8)
3.2.2. Uncertain Attitude toward ME Reporting
During the discussion with the participants about their attitude toward MER, some participants
showed uncertain attitudes towards MER. They would report MEs only based on another factor such
as the severity of the ME or route of administration, or when they received a direct request form the
person in-charge.
“If the error caused big and serious complication I have to report.” (N17)
“Based on the patient, I will see the effect on the patient first. My first concern is the patient, I will
not report unless something happens to the patient. In this case, the doctor gives antidote and then
there is an investigation and eventually, they will revert to me.” (N9)
One nurse related the medication error reporting to the dosage form of administered medicine.
He believes that errors are serious when the medication given by the intravenous route, and this
type of error should be reported, while those resulting from oral or topical administration should not
be reported.
“Based on the route of administration IV it should be reported.” (N18)
One nurse insisted that she reports only if the person in charge requests her to fill the
reporting form.
“I just inform the sister and the doctor, and let them choose to fill the form or not but as for investigation,
I will come and join them” (N13)
Before reporting, the nurses think of the problems that will be faced after reporting their errors.
This has a high effect on their decision to report or not.
“Some nurses, at first, they think about what happen and the problems associated with reporting,
so they do not report.” (N12)
3.2.3. Reporting of Others’ Errors
Some of the interviewees stated that they do not have any problems in reporting MEs committed
by other staff. They believe that the reporting of MEs is better for both the nurses and also for the
patient, whether the MEs have been committed by themselves or by other health care professionals.
While the other group insisted that everyone is responsible for reporting his/her own initiated MEs.
“I will report if other staff nurse made a mistake.” (N1)
“I will report errors committed by others because this is in the best interest of the patient, and also it
would help things go smooth in the future, for example, patient allergy . . . ” (N3)
“If I made a mistake I would inform, also if others from my colleagues made a mistake, I would still
inform.” (N6)
“No, I report only my errors. If my colleagues made mistakes, I would just advise her to report, but I
will not report her error.” (N8)
Pharmacy 2018, 6, 120
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3.3. Barriers towards Medication Error Reporting
There are many barriers towards MER which were mentioned by the interviewees. These barriers
are heavy workload, lack of time, tiredness, embarrassment due to reactions of peers and family,
and fear of disciplinary action.
3.3.1. Lack of Time
The main barrier for MER mentioned by the interviewees was time. They considered that the ME
reporting is a time consuming process. As described by the participants, the problem is not the time
needed to fill the MER form. The problem appears after filling the MER form when the investigation
takes place in order to discuss the causes which led to the ME.
“We will be exposed to so many questions [ . . . ] long time [ . . . ] time to discuss the ME that was
reported [ . . . ] investigations take time. No other problems, just that it takes time to report and then
questions from pharmacist or doctors. We do not have time for reporting. It is a long story and takes
much time.” (N4)
“Sometimes, I decide not to report. Because, if there is an investigation we have to be presented, as you
know it will take a long time and we will be all inconvenient.” (N9)
3.3.2. Tiredness
The nurses are responsible for inpatient care, this responsibility requires them to accomplish
many physical activities. Performing these activities make nurses tired, when they are exhausted,
a low number of ME reports will be received from them.
“Sometimes, we are tired. Once we are tired we decide not to report.” (N4)
3.3.3. Embarrassment
The post-embarrassment feeling has been pinpointed by interviewees as another barrier toward
MER. As a result, they tend to hide their MEs and never report them.
“Facing the embarrassment from my family and friends is tough. They will blame us.” (N4)
“They (family and friends) understand because these are not things that a person does on purpose.
But facing them still difficult.” (N9)
3.3.4. Fear
Fear from the legal problems has been addressed by the interviewees as a barrier towards MER.
“I fear from legal problems and disciplinary actions from the hospital.” (N8)
“Sometimes, I do not want to get into issues, I do not want people to come to ask me for investigation
later.” (N2)
The effect of reporting on the personal job record is another factor which might prevent nurses
from reporting.
“If I report this will affect my record because everything will be recorded in my personal record.” (N9)
“Fearing others, especially the investigation, because in Malaysia all errors must be reported to your
job record and they do disciplinary action.” (N4)
Pharmacy 2018, 6, 120
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3.3.5. Negative Reaction from Sister In-Charge
The response of managers toward nurses who report their MEs were important factors which
prevented nurses from reporting their MEs. It has been noticed that most of the interviewees insisted
that receiving a negative reaction from senior nurses is a normal response when the MEs occur. As they
always tend to blame and scold the nurses if they commit MEs. They believe that guidance is the main
role of senior nurses during their practices, not blaming the nurses.
“The sister will monitor me more.” (N8)
“Negative reaction from sister and matron [ . . . ] they must not punish the staff, they must guide the
staff and follow the staff and ensure that the stuff follows the standards.” (N4)
3.3.6. The Confidentiality of the Reporting Form
The reporting form which is used to report ME is a strict confidential form. Filling this type of the
reporting requires the reporter’s details such as name, signature and contact details. Some nurses did
not report their MEs because of this issue and they wish if they can report by using an anonymous
reporting form. Consequently, the number of reports will increase by use of anonymous MER forms.
“I prefer to fill anonymous form [ . . . ] Because I feel shy and would not work further. Also, I would
feel sorry for the patient. So, I prefer to fill the form without names.” (N2)
“I prefer to fill the anonymous form as it is good for us. If mistakes have been done, the news of
medication errors should be displayed without names being mentioned. In the future, if the people
know that this person made a mistake, people would decide not to deal with this person again. This will
damage the confidence of the nurse. In the future, they will not report and there will be no chance to
learn from the mistakes.” (N6)
“Off course, if no names mentioned the number of reports will increase.” (N8)
3.3.7. Absence of Effective Feedback
The lack of feedback from the hospital managers:
“No one goes through all the errors and give me a feedback.” (N7)
“I did not receive any feedback for my ME report.” (19)
3.4. Facilitators to Improve ME Reporting
The nurses were asked about the factors which could encourage them towards MER. Their main
concern revolved around removing the blaming culture. They believed that if no one scolded them
about their errors they would definitely report their errors.
“Remove the blaming culture. The matron and sister in charge should guide the staff not blame them.” (N4)
“Tell the matron that if any person is involved in a medication error, she shall not be scolded.” (N7)
Another factor which was addressed by the interviewees was getting encouragement from others
toward MER. Regarding this, there were two different opinions: first, some nurses insisted that they
did not need any encouragement from others because they thought the MER is an integral part of their
responsibility; on the contrary, other nurses welcomed encouragement by other health practitioners
such as a doctor, matron, or even their colleagues.
“There is no need to encourage us because this is our duty.” (N12)
“The sister in charge encouraged me to report.” (N9)
Pharmacy 2018, 6, 120
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“Actually, among us, we as nurses encourage each other to report errors; also the sister in charge
encourages us to do that.” (N8)
Few nurses highlighted the incentives as an effective way to encourage nurses to be more
meticulous to report MEs.
“Giving monetary rewards to the nurses.” (N3)
The confidentiality of the reporting form is an important factor, some of them preferred to fill
anonymously to avoid the embarrassment and being reprimanded by the authorities.
“I prefer to fill the form with no names and it is better not to include names.” (N2)
“I think as long as they can ensure the confidentiality of the person who reported, we will feel safe.”
(N9)
4. Discussion
This is an exploratory study intended to investigate the knowledge and attitude of nurses towards
MER. The current research is also anticipated to address the barriers and facilitators towards MER
among nurses, attached to different medical wards in the hospital.
The interviewed nurses reflected on the basic knowledge of concept of ME and MER.
They reported awareness about the presence of ME reporting system, guidelines, and the importance
of the MER. This might be attributed to the frequent talk sessions and training courses such as the
continuing nursing education program (CNE), in addition to the encouragement from the nurse
leaders (head nurses, supervisors and directors). This finding is consistent with the previous studies
conducted in Malaysia [7,27]. Wei and his colleagues reported that the Malaysian nurses had baseline
knowledge regarding MEs, whereas Johari et al. reported that Malaysian nurses had good knowledge
level regarding medication administration safety. However, most of the interviewees were not familiar
with the content of the ME reporting form due to their lack of contact. The low involvement of nurses
toward MER was not related to the lack of knowledge about the MER or due to the lack of information
about the process of incidents reporting, as reported in previous studies [28,29]. Handler and his
colleagues. reported that the lack of information on how to report ME among nurses as a barrier for
MER and this needs an immediate action and should be on higher priority towards improving MER
among nurses.
The willingness of nurses to report MEs has great impact on MER practices. Respondents had two
contradictory attitudes toward MER. Positive attitudes towards reporting all MEs are found to be in
accordance with what has been stated in Malaysian medication error guidelines [30], while an uncertain
attitude was also stated where participants were keen to report major errors only. In this case, the minor
errors and near-miss errors most likely will not be reported, in line with the previous studies [31–34].
Martowirono et al. reported that the MEs with minor consequences were lesser reported. Reporting of
near-miss errors gives valuable lessons without harming the patient [35]. In such situations, a seminar
discussion with the experienced nurse managers about benefits of near-miss error reporting can be a
useful tool to improve near-miss reporting rate among nurses.
The current research revealed that most nurses have positive attitudes toward ME reporting.
However, factors such as lack of time for reporting, lack of reporting culture without being blamed,
lack of effective feedback, and fear are considered as main reasons for underreporting problems among
the participants. These findings were consistent with the study conducted in Taiwan [36] where fear
was cited as the fundamental projecting factor in underreporting.
Despite the positive attitude of nurses towards the MER, they revealed that they did not report
MEs due to barriers like paucity of time, already in accordance with the studies done in Taiwan and
Canada [6,37]. Lack of time could be a reflection of heavy workload, as in many instances a limited
number of nurses take care of many patients. On the other hand, lack of reporting can be related to
Pharmacy 2018, 6, 120
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the MER process, which starts informally by informing the doctor, pharmacist, and the nurse director,
a
This paper should clearly and comprehensively discuss a chronic health disease. Select a topic from the list provided by your course faculty.
The paper should be organized into the following sections:
Introduction (Identification of the problem) with a clear presentation of the problem as well as the significance and a scholarly overview of the paper’s content. No heading is used for the Introduction per APA current edition.
Background and Significance of the disease, to include: Definition, description, signs and symptoms. Incidence and prevalence of statistics by state with a comparison to national statistics pertaining to the disease. If after a search of the library and scholarly data bases, you are unable to find statistics for your home state, or other states, consider this a gap in the data and state as much in the body of the paper. For instance, you may state something like, “After an exhausting search of the scholarly data bases, this writer is unable to locate incidence and/or prevalence data for the state of…” This indicates a gap in surveillance that will be included in the “Plan” section of this paper.
Surveillance and Reporting: Current surveillance methods and mandated reporting processes as related to the chronic health condition chosen should be specific.
Epidemiological Analysis: Conduct a descriptive epidemiology analysis of the health condition. Be sure to include all of the 5 W’s: What, Who, Where, When, Why. Use details associated with all of the W’s, such as the “Who” which should include an analysis of the determinants of health. Include costs (both financial and social) associated with the disease or problem.
Screening and Guidelines: Review how the disease is diagnosed and current national standards (guidelines). Pick one screening test (review Week 2 Discussion Board) and review its sensitivity, specificity, predictive value, and cost.
Plan: Integrating evidence, provide a plan of how a nurse practitioner will address this chronic health condition after graduation. Provide three specific interventions that are based on the evidence and include how you will measure outcomes (how will you know that the interventions have utility, are useful?) Note: Consider primary, secondary, and tertiary interventions as well as the integration of health policy advocacy efforts. All interventions should be based on evidence connected to a resource such as a scholarly piece of research.
Summary/Conclusion: Conclude in a clear manner with a brief overview of the keys points from each section of the paper utilizing integration of resources.
The paper should be formatted and organized into the following sections which focus on the chosen chronic health condition.
Adhere to all paper preparation guidelines (see below).
Preparing the Paper
Page length: 7-10 pages, excluding title page and references.
APA format current edition
Include scholarly in-text references throughout and a reference list.
Include at least one table that the student creates to present information. Please refer to the “Requirements” or rubric for further details. APA formatting required.
Length: Papers not adhering to the page length may be subject to either (but not both) of the following at the discretion of the course faculty: 1. Your paper may be returned to you for editing to meet the length guidelines, or, 2. Your faculty may deduct up to five (5) points from the final grade.
Adhere to the Chamberlain College of Nursing academic policy on integrity as it pertains to the submission of original work for assignments
Unformatted Attachment Preview
Week 6 Chronic Health Paper
• Hepatitis C
• Lung cancer
• COPD
This paper should clearly and comprehensively discuss a chronic health disease. Select a
topic from the list provided by your course faculty.
The paper should be organized into the following sections:
1. Introduction (Identification of the problem) with a clear presentation of the
problem as well as the significance and a scholarly overview of the paper’s
content. No heading is used for the Introduction per APA current edition.
2. Background and Significance of the disease, to include: Definition, description,
signs and symptoms. Incidence and prevalence of statistics by state with a
comparison to national statistics pertaining to the disease. If after a search of the
library and scholarly data bases, you are unable to find statistics for your home
state, or other states, consider this a gap in the data and state as much in the
body of the paper. For instance, you may state something like, “After an
exhausting search of the scholarly data bases, this writer is unable to locate
incidence and/or prevalence data for the state of…” This indicates a gap in
surveillance that will be included in the “Plan” section of this paper.
3. Surveillance and Reporting: Current surveillance methods and mandated reporting
processes as related to the chronic health condition chosen should be specific.
4. Epidemiological Analysis: Conduct a descriptive epidemiology analysis of the
health condition. Be sure to include all of the 5 W’s: What, Who, Where, When,
Why. Use details associated with all of the W’s, such as the “Who” which should
include an analysis of the determinants of health. Include costs (both financial
and social) associated with the disease or problem.
5. Screening and Guidelines: Review how the disease is diagnosed and current
national standards (guidelines). Pick one screening test (review Week 2
Discussion Board) and review its sensitivity, specificity, predictive value, and
cost.
6. Plan: Integrating evidence, provide a plan of how a nurse practitioner will address
this chronic health condition after graduation. Provide three specific
interventions that are based on the evidence and include how you will measure
outcomes (how will you know that the interventions have utility, are useful?)
Note: Consider primary, secondary, and tertiary interventions as well as the
integration of health policy advocacy efforts. All interventions should be based
on evidence connected to a resource such as a scholarly piece of research.
7. Summary/Conclusion: Conclude in a clear manner with a brief overview of the
keys points from each section of the paper utilizing integration of resources.
8. The paper should be formatted and organized into the following sections which
focus on the chosen chronic health condition.
9. Adhere to all paper preparation guidelines (see below).
Preparing the Paper
1. Page length: 7-10 pages, excluding title page and references.
2. APA format current edition
3. Include scholarly in-text references throughout and a reference list.
4. Include at least one table that the student creates to present information. Please
refer to the “Requirements” or rubric for further details. APA formatting
required.
5. Length: Papers not adhering to the page length may be subject to either (but not
both) of the following at the discretion of the course faculty: 1. Your paper may
be returned to you for editing to meet the length guidelines, or, 2. Your faculty
may deduct up to five (5) points from the final grade.
6. Adhere to the Chamberlain College of Nursing academic policy on integrity as it
pertains to the submission of original work for assignments.
ASSIGNMENT CONTENT
Category
Identification of the Health
Problem
Background and Significance
of the Health Problem
Points
15
30
%
7.5%
15%
Description
Comprehensively and succinctly states the
problem/concern. Clear presentation of the problem as
well as the significance with a scholarly overview of the
paper’s content.
Background and significance is complete, presents risks,
disease impact and includes a review of incidence and
prevalence of the disease within the student’s state
compared to national data. Evidence supports background.
If the student discovers a gap in data (no state level data),
this is stated within the section. A student created table is
included using APA format. In the case of a gap in data
the student will select two other sets of data to use in the
student created table.
ASSIGNMENT CONTENT
Category
Current Surveillance and
Reporting Methods
Descriptive Epidemiological
Analysis of Health Problem
Screening, Diagnosis,
Guidelines
Plan of Action
Conclusion
Points
%
Description
15%
Current state and national disease surveillance methods are
reviewed along with currently gathered types of statistics
and information on whether the disease is mandated for
reporting. Supported by evidence.
17%
Comprehensive review and analysis of descriptive
epidemiological points for the chronic health problem. The
5 W’;s of epidemiological analysis should be fully
identified. Supported by scholarly evidence.
15%
Review of current guidelines for screening and diagnosis.
Screening tool statistics related to validity, predictive
value, and reliability of screening tests are presented.
15%
Integrating evidence, provide a plan of how a nurse
practitioner will address this chronic health condition after
graduation. Provide three specific interventions that are
based on the evidence and include how you will measure
outcomes (how will you know that the interventions have
utility, are useful?) Note: Consider primary, secondary,
and tertiary interventions as well as the integration of
health policy advocacy efforts. ;All interventions should
be based on evidence – connected to a resource such as a
scholarly piece of research.
15
7.5%
The conclusion thoroughly, clearly, succinctly, and
logically presents major points of the paper with clear
direction for action. Includes scholarly references
185
92%
Total CONTENT Points = 185 pts
Points
%
Description
30
35
30
30
ASSIGNMENT FORMAT
Category
ASSIGNMENT CONTENT
Category
Points
%
Description
APA current ed.
10
5%
APA is consistently utilized according to the current
edition throughout the paper.
Grammar, Syntax, Spelling
5
3%
The paper is free from grammar, unscholarly context or
“voice” and spelling is accurate throughout.
15
8%
Total FORMAT Points = 15 pts
200
100%
DISCUSSION TOTAL = 125 points
Rubric
NR503_Week 6 Chronic Health_Sept19
NR503_Week 6 Chronic Health_Sept19
Criteria
This criterion is linked to a
Learning OutcomeAssignment
Content Possible Points = 185
Points
Introduction of Healthcare
Problem/Concern
Ratings
15 pts
Excellent
Comprehensively and
succinctly states the
problem/concern.
Clear presentation of
the problem as well as
the significance with a
scholarly overview of
the paper’s content.
14 pts
V. Good
Identifies the
problem/concern
with adequate but
not in-depth
presentation.
12 pts
Satisfactory
Identification of
problem/concern
is limited.
8 pts
Needs
Improvement
ImprovementIdentification of
problem/concern
is unclear.
NR503_Week 6 Chronic Health_Sept19
Criteria
Ratings
This criterion is linked to a
Learning
OutcomeBackground/Significance
30 pts
Excellent
Background and
significance is
complete, presents
risks, disease
impact and
includes a review
of incidence and
prevalence of the
disease within the
student’s state (or
other data sets)
compared to
national data.
Evidence supports
background. A
student created
table is included.
27 pts
V. Good
Background is
complete, presents
risk, disease
impact and at least
one set of
incidence and
prevalence
statistics
supported by
evidence, for
instance state data
or national data is
presented, but not
both. Or, full data
is presented but
student table is not
included.
26 pts
Satisfactory
Background
missing one or
more key points
and at least one set
of incidence and
prevalence
statistics are
presented. Lack of
evidence or limited
presentation of the
background. A
table is included
which may or may
not be student
created; may be
limited in data.
15 pts
Needs Improvem
Background missi
more than one key
point and at least o
set of incidence an
prevalence statisti
are presented, or
there is no support
evidence. Unclear
conclusions or
presentation. No
student created tab
is included; or if
included is limited
scope or is not
student created.
NR503_Week 6 Chronic Health_Sept19
Criteria
Ratings
This criterion is linked to a
Learning OutcomeSurveillance
and Reporting
30 pts
Excellent
Current state and
national disease
surveillance
methods are
reviewed along
with currently
gathered types of
statistics and
information on
whether the disease
is mandated for
reporting. All
writing is
supported by
evidence.
27 pts
V. Good
State and national
disease
surveillance
methods are
reviewed,
currently gathered
types of statistics
is scant, reporting
requirements
discussed. All
writing is
supported by
evidence.
26 pts
Satisfactory
State or national
surveillance
statistics are
discussed as an
overview, lacking
detail / depth.
Mandated
reporting may be
absent. Writing is
supported by
evidence but may
be inconsistent.
15 pts
Needs Improveme
One of either state
national disease
surveillance metho
reviewed; currently
gathered types of
statistics may be
missing or informa
on whether the dis
is mandated for
reporting is missin
There is a lack of
depth with inconsi
use of evidence.
This criterion is linked to a
Learning OutcomeDescriptive
Epidemiology
35 pts
Excellent
Comprehensive review
and analysis of
descriptive
epidemiological points
for the chronic health
problem. The 5 W’s of
epidemiological analysis
should be fully
identified. Supported by
scholarly evidence.
32 pts
V. Good
Review and
analysis has
depth in general
but may be
missing one of
the 5 W’s OR
may be scant in
one area of the 5
W’s. All writing
is supported by
evidence.
29 pts
Satisfactory
Review and
analysis superficial
in all of the 5 W’s
OR may be scant or
missing 2 or more
of the W’s.
Evidence is present
but may not be
throughout all
content areas.
18 pts
Needs
Improvement
Review and
analysis is mis
depth througho
all of the conte
areas. Evidenc
may or may no
support the
writing.
NR503_Week 6 Chronic Health_Sept19
Criteria
Ratings
This criterion is linked to a
Learning OutcomeScreening,
Diagnosis, Guidelines
30 pts
Excellent
Comprehensive
review of current
guidelines for
screening and
diagnosis. Screening
tool statistics related
to validity, predictive
value, and reliability
of screening tests are
presented.
27 pts
V. Good
Adequate
review of
guidelines for
screening,
diagnosis, and
statistics
related to
validity,
predictive
value, and
reliability of
screening tests
is presented.
26 pts
Satisfactory
Limited review
of guidelines for
screening,
diagnosis, and
statistics related
to validity,
predictive value,
and reliability of
screening tests.
15 pts
Needs Improvement
Minimal or unclear
review of guidelines
for screening,
diagnosis, and
statistics related to
validity, predictive
value, and reliability
of screening tests.
There is a lack of
depth with
inconsistent use of
evidence.
NR503_Week 6 Chronic Health_Sept19
Criteria
Ratings
This criterion is linked to a
Learning OutcomePlan
30 pts
Excellent
Integrating evidence,
provide a plan of
how a nurse
practitioner will
address this chronic
health condition after
graduation. Provide
three specific
interventions that are
based on the
evidence and include
how you will
measure outcomes
(how will you know
that the interventions
have utility, are
useful?) Note:
Consider primary,
secondary, and
tertiary interventions
as well as the
integration of health
policy advocacy
efforts. All
interventions should
be based on evidence
– connected to a
resource such as a
scholarly piece of
research.
27 pts
V. Good
An adequate, but
not fully
comprehensive, plan
of action specific to
the problem, and the
geographic area is
presented with 3
evidenced based
actions that will be
taken to address the
impact, outcomes,
or prevalence of the
disease.
26 pts
Satisfactory
A limited plan
of action
specific to the
problem, and
the geographic
area, outcomes,
or prevalence of
the disease.
Three actions or
less may be
presented with
limited or little
evidence.
15 pts
Needs Improvem
Minimal or uncle
review of guidelin
for screening,
diagnosis, and
statistics related t
validity, predictiv
value, and reliabi
of screening tests
Actions are minim
or unclear, or lack
specificity, are no
supported directly
evidence or are no
direct actions the
student can take i
practice. There is
lack of depth with
inconsistent use o
evidence.
NR503_Week 6 Chronic Health_Sept19
Criteria
Ratings
This criterion is linked to a
Learning
OutcomeSummary/Conclusion =
185 Points
15 pts
Excellent
The conclusion
thoroughly,
clearly,
succinctly, and
logically presents
major points of
the paper with
clear direction
for action.
Includes
scholarly
references.
This criterion is linked to a
Learning OutcomeAssignment
Format Possible Points =15 Points
APA 7th ed.
This criterion is linked to a
Learning OutcomeGrammar,
Syntax, Spelling
14 pts
V. Good
The conclusion
adequately and
logically presents
major points of
the paper with
clear direction for
action, but lacks
one major point
or is not succinct.
Includes
scholarly
references.
10 pts
Excellent
APA is consistently
utilized according to the
7th edition throughout the
paper.
12 pts
Satisfactory
The conclusion is a
limited review of
key points of the
paper, is not
succinct, or lacks
one or more major
points of the paper
or clear direction for
action. Scholarly
references may or
may not be
included.
9 pts
V. Good
One or two
errors in
APA format
5 pts
Excellent
There are no grammar, unscholarly
context or “voice” errors in the paper
and spelling is accurate throughout.
8 pts
Needs
Improvement
Conclusion is
unclear or
significantly
limited in
overview of the
paper. Scholarly
references may or
may not be
included.
8 pts
Satisfactory
Three-Five errors
in APA format
4 pts
V. Good
One or
two
errors
3 pts
Satisfactory
Three-five
errors
5 pts
Needs
Improvement
Six errors in
APA format
2 pts
Needs
Improvemen
Six errors
NR503_Week 6 Chronic Health_Sept19
Criteria
This criterion is linked to a
Learning OutcomeLate penalty
deductions
Students are expected to submit
assignments by the time they are
due. Assignments submitted after
the due date and time will receive
a deduction of 10% of the total
points possible for that
assignment for each day the
assignment is late. Assignments
will be accepted, with penalty as
described, up to a maximum of
three days late, after which point a
zero will be recorded for the
assignment. Quizzes and
discussions are not considered
assignments and are not part of
the late assignment policy.
Total Points: 200
PreviousNext
Ratings
0 pts
Minus Points
0 pts
Minus Points
For this discussion, answer the following 2 questions regarding the video at the end of the lecture about Ronald Davis.You’re at work and your supervisor puts Ronald’s file on your desk and says he is your new client, what would be the 1st, 2nd, and 3rd things you do?What are the 5 key pieces of information you would want to make sure you get in your first meeting?
Discussion 1. Charles Kraft has identified several myths (some of which are outlined in sidebar 18.1 of Chapter 18 in your textbook) about the communication of the gospel (for the full list, see Kraft 1991a, 35–54; note also the critique and notations in Hesselgrave and Rommen 1989, 193–96). As you read through the list, can you identify any that you have believed? If you think it is not a myth, how would you respond?
Discussion 2. Chapter 18 describes different evangelistic methods based on assumptions about the conversion process as well as communicative elements of cultures that shape decision-making responses to the sharing of the gospel. What do you think about these methods? Do you think one is better than the others? Do you think they all have some merits and some drawbacks? Explain, analyzing specific elements of the methods as you compare them.
Paper. Matthew 28:18-20 says: “Then Jesus came to them and said, ‘All authority in heaven and on earth has been given to me. Therefore, go and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, and teaching them to obey everything I have commanded you.'”
In response to this call, Christian churches send missionaries to other cultures to spread the gospel, plant churches, and disciple people in those cultures. In this process, missionaries communicate important rituals and symbols of the Christian faith as well as learn about non-Judeo-Christian religious symbols from the cultures they are evangelizing. As a result, it’s important to understand the meaning of these religious symbols when conveying the gospel message and forming discipleship relationships.
For this assignment, you will research the symbols or rituals of a non-Judeo-Christian religious organization or culture. The terms “symbol” and “ritual” may be interpreted variously; the focus should be on verbal and nonverbal choices used to convey religious meaning. As long as you cover this in principle, there is flexibility about what particular symbolic or ritualized communication pattern you choose.
Then, in 750-1000 words, compare the symbols or rituals they use with those of mainstream Christianity. How are the two sets of symbols or rituals similar? What makes them different? How could someone apply this knowledge to accurately convey the gospel, aid missionaries in teaching other cultures to obey all that Christ has commanded, and avoid theological misunderstandings that may be expressed in that cultures symbols or rituals?
In addition to your textbook, you should use two to three reputable and authoritative sources.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Benchmark Information
This benchmark assignment assesses the following programmatic competency and professional standard:
After viewing this video, do you think that selective mutism is different than shyness? If so, how? How as a parent do you think you would manage a child with selective mutism?Understanding and Managing Selective MutismLinks to an external site.Each week I will be posting a mini podcast/video/ mini lecture. You are required to view the weekly videos that I post and submit a 250 word reflection. You are to reflect on any specific questions that I may ask as well as the content of the video itself. It is important that you integrate evidence and information from the textbook and readings to support the ideas in your reflection. Reflections are due every Sunday evening by 11:59 p.m. Late submissions will be deducted by half. You will be graded based on the quality of your reflection, including appropriate content, proper grammar and spelling and thoughtful consideration of the ideas and concepts.RubricSome Rubric (1)
The phrase “nurses eat their young” has been around for decades. The consequences of bullying include nurses reporting poorer mental health, decreased collaboration with team members, ineffective communication, reduced work productivity, and poor job commitment.
Do you feel bullying or horizontal violence is an issue in the clinical environment? Why or why not?
Discuss how the nurse mentor can promote professional socialization in the workplace.
In order to receive full credit, you will need to clearly respond to both parts of the question using subtitles or bullets AND cite at least one scholarly reference in your response. You are required to participate on at least three (3) days of the week to receive full participation points.
i will include 2 peer responses after you send me the initial post please use 2 citations per response (different sources)
Discuss the key differences in the management of type I and type II diabetes.
Bridget, a 30-year-old woman, was recently diagnosed with diabetes. After the necessary tests were conducted, it was confirmed that Bridget has type I diabetes. Her major concern is how her condition will be managed and whether she will maintain a high-quality life like before.
Management of type I diabetes usually involves insulin therapy, as the body does not produce insulin. The goal is to mimic the normal insulin secretion in the body through multiple injections or an insulin pump. Additionally, blood glucose monitoring is essential as it informs the adjustment of insulin doses. Further, meal planning is essential, and therefore, Bridget will work with a dietician to create a personalized meal plan. Lastly, physical activity is important for managing blood sugar levels. However, one should be careful to avoid hypoglycemia or hyperglycemia (Aschner et al., 2010).
For type II diabetes, medications are mostly used depending on the severity of the condition. Oral medications such as metformin, sulfonylureas, and dipeptidyl peptidase-4 (DPP-4) inhibitors improve insulin sensitivity or stimulate its production. Additionally, blood glucose should be monitored,as well as carbohydrate intake, to manage its levels. Further regular physical activity is encouraged to improve overallhealth (Borse et al., 2021).
Tailoring the treatment plan to the needs of patients with type I versus type II diabetes?
A treatment plan for type I diabetes is individualized based on factors such as age, lifestyle, occupation, and overall health. Apart from monitoring the blood sugar levels and adjusting insulin doses accordingly, education and support are crucial to ensure proper insulin administration, meal planning, and understanding the signs and symptoms of hypo and hyperglycemia. Treatment plans for type II diabetes considerage, weight, comorbidities, and patent preferences. Treatment plan focuses on lifestyle modification, and it includes the administration of oral medications.
McKenzie Rosendale
Benign Prostatic Hyperplasia (BPH) medications, such as alpha-blockers and 5-alpha reductase inhibitors, have different mechanisms of action, dosing regimens, and potential side effects. How can you ensure that the chosen medication is safe, effective, and tailored to the patient’s individual needs and preferences?
Benign prostatic hyperplasia is a condition that affects older men, typically 60 years old or greater, and is when the prostate and surrounding tissue expands. Symptoms of benign prostatic hyperplasia include urinary hesitancy, urinary urgency, increased frequency of urination, dysuria, and nocturia (Rosenthal & Burchum, 2021, pg. 463). Before prescribing medications, a thorough assessment and labs must be completed. Lab will be able to provide information regarding PSA levels and if the PSA level is elevated, which can be a sign of BPH. The provider should also review the medical history, allergies, and other medications to make sure there is no contraindications. There are two medications that are used for BPH: 5-alpha reductase inhibitors and alpha-adrenergic antagonists. Dutasteride and finasteride are two medications that are 5-alpha- reductase inhibitors and help reduce the prostate size. For alpha-adrenergic antagonists, the two medications are silodosin and tamsulosin. The mechanism of action for these medications is to block the alpha receptors to help relax the smooth muscle of the bladder neck (Rosenthal & Burchum, 2021, pg. 464). The provider can ensure safe and effective medication administration by the provider going over the side effects of the medication and educating the patient on the mechanism of the action for the medications. In addition to education, the patient should be frequently monitored for any side effects and have PSA checked more often. In conclusion, it is important that the provider tailors each treatment to focus on the patient’s needs and ensures safe and effective medication administration.
In this assignment, you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (750-1,000 words) to present to the board, from which the board will make its decision to fund your program or project. Include the following:
The purpose of the quality improvement initiative.
The target population or audience.
The benefits of the quality improvement initiative.
The interprofessional collaboration that would be required to implement the quality improvement initiative.
The cost or budget justification.
The basis upon which the quality improvement initiative will be evaluated.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
select an industrialized country, other than the United States, identify and prepare a research document (no longer than 2 pages) addressing key factors associated with the healthcare ambulatory system in your country of choice. Please cite and include your references.
Complete the Pain Competency Self-Assessment.Review the rubric for more information on how your assignment will be graded.Submit the assessment form to the assignment area.
In the sports medicine field, the sports physical exam is known as a preparticipation physical examination (PPE). The exam helps determine whether it is safe for you to participate in a certain sport. Most states actually require that kids and teens have a sports physical before they can start a new sport or begin a new competitive season. But even if a sports physical is not required, doctors still highly recommend getting one.
Case Study
The administration of the local critical access hospital has asked the practitioner to organize a community service program to conduct sports physicals for local junior high and high school athletes at no cost to the student. The practitioner has the use of the usual physician office space or the facility’s large meeting space and will recruit physicians, nurse practitioners, nursing staff, and medical technicians to conduct the sports physicals. Based on a survey of nearby school districts, the administration expects to serve 100 to 150 student athletes over the 2 days the physicals will be offered.
Case Questions
Which format would most effectively serve the needs of the students in this program? Include consideration of the space chosen for conducting the program.
Which space would be most appropriate to use for the program and why?
What are the drawbacks to the assembly-line format?
Which physical examination focus points could the nursing staff and medical technicians be assigned to complete?
When the practitioner is preparing to advertise the program being offered, the local newspaper asks the practitioner to identify three of the main objectives of the sports physicals for an article. How would the practitioner respond?
How are thyroid disorders diagnosed, and what diagnostic tests commonly evaluate thyroid function? How do nurse practitioners interpret these tests to diagnose and manage thyroid disorders?
Thyroid disorders are usually diagnosed through blood tests. The provider would diagnose thyroid issues by testing TSH T4, T3, and thyroid antibody tests. Nurse practitioners interpret these tests and can give the patient a diagnosis. A low TSH level is diagnosed as hyperthyroidism or having an overactive thyroid (NIH, 2023). High TSH can mean the patient has hypothyroidism or an underactive thyroid (NIH, 2023). When T4 is high, this can also indicate hyperthyroidism and vice versa. T3 test can be done to confirm a diagnosis. If T3 is high, this can help diagnose hyperthyroidism (NIH, 2023). Thyroid antibody tests can also be used to diagnose autoimmune disorders. Various tests can assist healthcare providers in diagnosing an abnormal condition in the thyroid. This includes referring the patient to an ultrasound, thyroid scan, and radioactive iodine uptake test.
Nurse practitioners can interpret the results of these tests and explain to the patient what was found. If anything is abnormal, Nurse Practitioners can explain what treatment and lifestyle changes are needed to manage their can. A Nurse Practitioner can also do a focused physical exam on the patient by palpating for any lumps or bumps. If a node is found, the provider can send their patient to have a biopsy done to check for any cancerous cells in the thyroid. Depending on if there is a diagnosis, the provider should be able to fully explain every diagnosis to their patient and explain if there is any medication that must be started for management of the new diagnosis.
Soo Jin Kim
What are the health consequences of obesity, and how do these conditions impact overall health and wellness? Discuss your experience managing the potential complications and comorbidities associated with obesity, such as cardiovascular disease, type 2 diabetes, and sleep apnea.
People who are overweight (defined as a BMI of 25 or higher) or obese (defined as a BMI of 30 or higher), compared to those with healthy weight, are at increased risk for many serious diseases and health conditions (CDC, 2022). The complications include hypertension, Dyslipidemia, Type 2 DM, Coronary heart disease, Stroke, Gallbladder disease, Osteoarthritis, sleep apnea, breathing problems, many types of cancer, low quality of life, mortality, mental illness (depression, anxiety, or other mental disorders), and body pain and difficulty with physical functioning (CDC, 2022).
According to the CDC, achieving and maintaining a healthy weight includes healthy eating, physical activity, optimal sleep, and stress reduction (2023). It seems very simple, but achieving and maintaining a healthy weight in real life is tough. As for my experience with managing potential complications and comorbidities associated with obesity, I would like to share about how I have overcome diabetes resulting from being overweight. I was diagnosed with DM2 and fatty liver in April this year because I was overweight and had abdominal obesity. At that time, I hadn’t exercised for a long time except walking with my dog around my neighborhood occasionally. Also, I hadn’t watched my diet while eating much food with high carbohydrates and drinking beer almost daily. As a result, I became one of the diabetes patients. I was shocked to hear the bad news but determined to change my lifestyle. First, I have stopped drinking beer. Second, I have avoided high-carbohydrate food. Lastly, I started a yoga class and have done yoga with my husband for 1 hour at least three times a week. My husband agreed to do yoga together to help me not miss the yoga class (family support is essential for lifestyle modification). After three months of lifestyle modifications, I lost 18 lbs, my A1c level dropped to 5.4 from 6.6, and my liver returned to normal in the ultrasound test. From my experience, I learned that firm determination and consistent efforts are the most critical factors in achieving a healthy weight. Now, I am very confident in educating my patients on how important lifestyle modification is when they manage potential complications and comorbidities associated with obesity.
Hello, i will need a help with a short case studies with following question. There are 3 case studies available to you. You will pick 2 to complete. Analyze different scenarios. APA format. All of the studies and questions posted below, rubric aswel.
Pick one (1) of the following topics. Then, address the corresponding questions/prompts for your selected topic. Use at least one (1) documented example of the corresponding primary source in your writing.
Option 1: Big Business (Monopolies) and Exploitation of Workers
View the following resource:
The Progressive Era
Browse and read one (1) of the following:
Triangle Shirtwaist Factory Fire
The Pullman Strike
Then, address the following:
Explain if big business leaders were “captains of industry,” “shrewd businessmen,” or “robber barons.”
Based on one of the resources noted for this option, assess American working conditions and exploitation of workers in the Age of Industry.
Analyze the role that government played in reforming American working conditions.
Explain the benefits of the Federal Government regulations of monopolies.
Analyze which progressive presidents attained economic justice and reform for workers.
Option 2: Who is A Progressive?
Review the following site:
Presidential Election of 1912: A Resource Guide
Then, address the following:
According to Roosevelt, what are the characteristics of a progressive?
Explain and give examples of the characteristics of “anti-progressives.”
Trace what types of activities “anti-progressives” engaged in?
Analyze the goals of progressivism.
Explain what areas of society progressives addressed?
Analyze the progressive achievements Roosevelt highlights in his speech?
Option 3: World War I
Review the following resources:
A War to End All Wars: Part 2
The Treaty of Versailles and the Rise of Nazism
Then, address the following:
Trace the origins of World War I, and assess if the world war was inevitable in 1914?
Explain if it was possible for the United States to maintain neutrality in World War I. If yes, explain how. If no, explain why not.
Analyze if the United States should have entered World War I to make the world safe for democracy.
Analyze if the Treaty of Versailles was a fair and effective settlement for lasting world peace.
Explain if the United States Senate should have approved of the Treaty of Versailles.
REQUIREMENTS
Length: 3-4 pages (not including title page or references page)
1-inch margins
Double spaced
12-point Times New Roman font
Title page
References page
In-text citations that correspond with your end references
Discussion 1post
Describe the difference in roles between leadership and management. Explain how the goals of
management and leadership overlap and provide one example. As a nurse leader, describe how
you can facilitate change by taking advantage of this overlap.
Reply to two classmates.
Discussion 2post
Compare two leadership theories. Provide an overview of each and discuss the strengths and
weakness in relation to nursing practice.
Respond to three classmates.
Discussion 3post
Review your state’s (Maryland)mandated reporter statute. Provide details about this in your post.
If faced with a mandated reporter issue, what are the steps in reporting the issue? Create a
mandated reporter scenario and post it. Respond to one of your peer’s scenarios using the
guidelines for submission/reporting in your state. Be sure to include a reference to your state’s
website related to mandated reporting.
PROFESSIONALISM AND SOCIAL MEDIA
Social media plays a significant role in the lives of nurses in both their professional and personal
lives. Additionally, social media is now considered a mainstream part of the process for recruiting
and hiring candidates. Inappropriate or unethical conduct on social media can create legal
problems for nurses as well as the field of nursing.
Login to all social media sites in which you engage. Review your profile, pictures and posts. Based
on the professional standards of nursing, identify items that would be considered unprofessional
and potentially detrimental to your career and that negatively impact the reputation of the
nursing field.
In 500-750 words, summarize the findings of your review. Include the following:
1.
2.
Describe the posts or conversations in which you have engaged that might be considered
inappropriate based on the professional standards of nursing.
Discuss why nurses have a responsibility to uphold a standard of conduct consistent with the
standards governing the profession of nursing at work and in their personal lives. Include
discussion of how personal conduct can violate HIPAA or be considered unethical or
unprofessional. Provide an example of each to support your answer.
3.
Based on the analysis of your social media, discuss what areas of your social media activity reflect
Christian values as they relate to respecting human value and dignity for all individuals. Describe
areas of your social media activity that could be improved.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the
Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to
become familiar with the expectations for successful completion.
Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.
Cost and access to care continue to be main concerns for patients and providers. As technology improves our ability to care for and improve outcomes in patients with chronic and complex illnesses, questions of cost and access become increasingly important. As a master’s-prepared nurse, you must be able to develop policies that will ensure the delivery of care that is effective and can be provided in an ethical and equitable manner.
As a master’s-prepared nurse, you have a valuable viewpoint and voice with which to advocate for policy developments. As a nurse leader and health care practitioner, often on the front lines of helping individuals and populations, you are able to articulate and advocate for the patient more than any other professional group in health care. This is especially true of populations that may be underserved, underrepresented, or are otherwise lacking a voice. By advocating for and developing policies, you are able to help drive improvements in outcomes for specific populations. The policies you advocate for could be internal ones (just within a specific department or health care setting) that ensure quality care and compliance. Or they could be external policies (local, state, or federal) that may have more wide-ranging effects on best practices and regulations.
PROFESSIONAL CONTEXT
As a master’s-prepared nurse, you have a valuable viewpoint and voice with which to advocate for policy developments. As a nurse leader and health care practitioner, often on the front lines of helping individuals and populations, you are able to articulate and advocate for the patient more than any other professional group in health care. This is especially true of populations that may be underserved, underrepresented, or are otherwise lacking a voice. By advocating for and developing policies, you are able to help drive improvements in outcomes for specific populations. The policies you advocate for could be internal ones (just within a specific department or health care setting) that ensure quality care and compliance. Or they could be external policies (local, state, or federal) that may have more wide-ranging effects on best practices and regulations.
SCENARIO
The analysis of position papers that your interprofessional team presented to the committee has convinced them that it would be worth the time and effort to develop a new policy to address your specific issue in the target population. To that end, your interprofessional team has been asked to submit a policy proposal that outlines a specific approach to improving the outcomes for your target population. This proposal should be supported by evidence and best practices that illustrate why the specific approaches are likely to be successful. Additionally, you have been asked to address the ways in which applying your policy to interprofessional teams could lead to efficiency or effectiveness gains.
This assessment will build upon your previous Analysis of Position Papers for Vulnerable Populations assessment. If, for some reason, you wish to change your specific issue or target population, contact your faculty for approval.
INSTRUCTIONS
For this assessment, you will develop a policy proposal that seeks to improve the outcomes for your chosen health care issue and target population. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your assessment submission addresses all of them. You may also want to read the Biopsychosocial Population Health Policy Proposal Scoring Guide and Guiding Questions: Biopsychosocial Population Health Policy Proposal [DOC] to better understand how each grading criterion will be assessed.
Propose a policy and guidelines that will lead to improved outcomes and quality of care for a specific issue in a target population.
Advocate the need for a proposed policy in the context of current outcomes and quality of care for a specific issue in a target population.
Analyze the potential for an interprofessional approach to implementing a proposed policy to increase the efficiency or effectiveness of the care setting to achieve high-quality outcomes.
Communicate proposal in a professional and persuasive manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling.
Integrate relevant sources to support assertions, correctly formatting citations and references using APA style.
Example assessment: You may use the Assessment 2 Example [PDF] to give you an idea of what a Proficient or higher rating on the scoring guide would look like.
SUBMISSION REQUIREMENTS
Length of proposal: 2–4 double-spaced, typed pages, not including title page or reference list. Your proposal should be succinct yet substantive. No abstract is required.
Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that support the relevance of or need for your policy, as well as interprofessional considerations. Resources should be no more than five years old.
APA formatting: Use the APA Style Paper Template [DOCX]. An APA Style Paper Tutorial [DOCX] is also provided to help you in writing and formatting your proposal.
COMPETENCIES MEASURED
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Design evidence-based advanced nursing care for achieving high-quality population outcomes.
Propose a policy and guidelines that will lead to improved outcomes and quality of care for a specific issue in a target population.
Competency 2: Evaluate the efficiency and effectiveness of interprofessional interventions in achieving desired population health outcomes.
Analyze the potential for an interprofessional approach to implementing a proposed policy to increase the efficiency or effectiveness of the care setting to achieve high-quality outcomes.
Competency 3: Analyze population health outcomes in terms of their implications for health policy advocacy.
Advocate the need for a proposed policy in the context of current outcomes and quality of care for a specific issue in a target population.
Competency 4: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.
Communicate in a professional and persuasive manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling.
Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
Week 8: Discussion Question
Ends Oct 10
•
Subscribe
In your discussion response, please address each of the following
prompts:
1. Select one major area of professional development from
the AONL Competencies that you would like to work on
developing.
2. What are some strategies you can implement to improve your
competence in this area?
3. State the major area of development you have identified and 2-3
strategies for improvement.
Please be sure to adhere to APA guidelines when citing sources. Also,
as part of the discussion participation requirements, please be sure to
respond to at least two peers each week.
This activity aligns with:
Course Outcome 2. Promote professional development for self and
others, in order to advance the nursing profession.
AACN BSN Essential VIII.6: Reflect on one’s own beliefs and values as
they relate to professional practice.
AACN BSN Essential VIII.13: Articulate the value of pursuing practice
excellence, lifelong learning, and professional engagement to foster
professional growth
Week 8: Discussion Question
Ends Oct 10
•
Subscribe
In your discussion response, please address each of the following
prompts:
1. Select one major area of professional development from
the AONL Competencies that you would like to work on
developing.
2. What are some strategies you can implement to improve your
competence in this area?
3. State the major area of development you have identified and 2-3
strategies for improvement.
Please be sure to adhere to APA guidelines when citing sources. Also,
as part of the discussion participation requirements, please be sure to
respond to at least two peers each week.
This activity aligns with:
Course Outcome 2. Promote professional development for self and
others, in order to advance the nursing profession.
AACN BSN Essential VIII.6: Reflect on one’s own beliefs and values as
they relate to professional practice.
AACN BSN Essential VIII.13: Articulate the value of pursuing practice
excellence, lifelong learning, and professional engagement to foster
professional growth
Week 8: Discussion Question
Ends Oct 10
•
Subscribe
In your discussion response, please address each of the following
prompts:
1. Select one major area of professional development from
the AONL Competencies that you would like to work on
developing.
2. What are some strategies you can implement to improve your
competence in this area?
3. State the major area of development you have identified and 2-3
strategies for improvement.
Please be sure to adhere to APA guidelines when citing sources. Also,
as part of the discussion participation requirements, please be sure to
respond to at least two peers each week.
This activity aligns with:
Course Outcome 2. Promote professional development for self and
others, in order to advance the nursing profession.
AACN BSN Essential VIII.6: Reflect on one’s own beliefs and values as
they relate to professional practice.
AACN BSN Essential VIII.13: Articulate the value of pursuing practice
excellence, lifelong learning, and professional engagement to foster
professional growth
Week 8: Discussion Question
Ends Oct 10
•
Subscribe
In your discussion response, please address each of the following
prompts:
1. Select one major area of professional development from
the AONL Competencies that you would like to work on
developing.
2. What are some strategies you can implement to improve your
competence in this area?
3. State the major area of development you have identified and 2-3
strategies for improvement.
Please be sure to adhere to APA guidelines when citing sources. Also,
as part of the discussion participation requirements, please be sure to
respond to at least two peers each week.
This activity aligns with:
Course Outcome 2. Promote professional development for self and
others, in order to advance the nursing profession.
AACN BSN Essential VIII.6: Reflect on one’s own beliefs and values as
they relate to professional practice.
AACN BSN Essential VIII.13: Articulate the value of pursuing practice
excellence, lifelong learning, and professional engagement to foster
professional growth
Upon reviewing the multiple facilities offering healthcare administration support and services, discuss the following:What are the healthcare administrative/management job opportunities in these organizations?How are these organizations interrelated?What type of support do these organizations offer direct care facilities?Identify one available position in which you are interested and discuss the KSAs needed to secure the positionfour scholarly citation(s) in APA format. Any sources cited must have been published within the last five years. Inaddition, the student must integrate a minimum of two citations of scriptural support as well as the course textbookcourse textbook: Buchbinder, S. B., & Thompson, J. M. (2010). Career opportunities in health care management: Perspectives from the Field. Jones and Bartlett Publishers.
Think back to the five SMART goals you created earlier in the term. Write a reflection paper following APA format and consisting of 750-1000 words in length. Then, create a 5–7-minute reflection video using the word document which evaluates each SMART goal that you created. Use Teams, Zoom, or Canvas Studio’s Screen Capture feature to record your presentation. Your face must be visible on camera (in the corner as you present your paper). You must introduce yourself and show your identification. You must dress professionally or your presentation will not be graded.
Use the following questions to guide your response:
What were you expecting from the experience before you started?
Why were you expecting this?
Why did you choose this goal?
Did you learn anything about a different group in society (i.e., different age, profession, ethnic, racial or socio-economic group)? What did you learn?
What is the most valuable experience you acquired?
What impact did the experience have on your everyday life?
What did you learn that was directly related to your course objectives?
Submission Instructions:
Submit your paper as a Word Document through the Turnitin inbox below.
You will use the paper for your video presentation.
Submit the Link to your video presentation as a comment under the assignment section.
Here are some guides to help you with your video submission:
How do I record a Canvas Studio video with a webcam in a course?Links to an external site.
How do I upload media files in my Canvas Studio account?Links to an external site.
How do I get a public link or embed code for media in Canvas Studio?Links to an external site.
Follow all directions for this assignment.
Complete and submit the assignment by 11:59 PM ET on Sunday.
Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
ASSIGNMENT COVER SHEET
Course name:
Concepts of Health Education & Health Promotion
Course number:
PHC 212
CRN:
Paper Assignment
Assignment title or task:
(You can write a question)
Choose a health issue in KSA and explore the
determinants causing that issue and justify your
understanding with evidence from the literature.
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Your response should be a minimum of 250 words but should not exceed 500
words (Excluding references).
• Support your answer with examples.
• Font size should be 12
• Font type should be Times New Roman
• Heading should be Bold
• Colour should be Black
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style and include in text citation.
• AVOID PLAGIARISM
• Due date; 07/10/2023 11:59 PM
Best of Luck
Learning Goal: I’m working on a social work project and need an explanation and answer to help me learn.
Research Topic: “The Impact of Teletherapy on Access to Mental Health Services Among Vulnerable Populations.”
Research Question: “How does Teletherapy affect access to mental health services for vulnerable populations?”
Provide the following in the format specified below:
Methods
Describe the method you would use and why this would be the best design for your study. This would essentially be a cross-sectional, quasi-experimental, or experimental design.
Describe the sampling technique you would use and why this would be the best technique for your study. This should be the sampling design you identified in the Week 4 Assignment and/or any additional feedback that you have received from the instructor.
Procedures
Describe how you would implement your sampling technique (i.e., how you would go about gathering respondents)
Describe what respondents would be expected to do during the study. Provide detailed explanations – remember what you learned about ethics!
Describe the specific procedures that you will use to collect the data for your study. This may include the specific steps for administering the scales you have previously identified or other data collection methods. Be very specific as to how and when the measures will be administered, or the date collected in the context of the study timeline.
Limitations
Based on the proposed design, identify any of the relevant research design limitations that could affect your design. This may include threats to internal and external validity in the case off experimental designs or limitations to cross sectional designs implicit in the design itself or because of conducting surveys.
References
Include references for any articles or websites you used – APA formatted.
The paper should be about 5 pages in length. The paper should follow APA format.
Unformatted Attachment Preview
Identifying the Sampling Design and Ethical Considerations
1
Population
The population from where the sample will be obtained consists of vulnerable
individuals who tend to face obstacles while seeking mental health services characterized by
challenges such as economic problems, racial prejudice, disability, or even living in remote
locations. Nonetheless, only individuals living in the US qualify to be sampled, and the time
is at present, which aligns with the study’s aim to reveal how teletherapy impacts access to
mental health services. The individual participants who meet the outlined criteria are the units
of analysis for this study.
Sampling Design
The sampling design will be purposive sampling, which is chosen to guarantee
representation from various individuals who form the population of interest (Takats et al.,
2022). It involves an intentional selection of the respondents as per the criteria set
beforehand.
Inclusion/Exclusion Criteria:
1. Inclusion criteria: Potential participants must be individuals who belong to the already
defined vulnerable populations (that is, people facing economic challenges, those who
are victims of ethnic or racial prejudice, people living with disabilities, and persons
residing in extremely remote areas). They must also be adults (that is, aged at least 18
years). That age is crucial because informed consent will be sought (Sexton, 2022).
2. Exclusion criteria: Any individual who does not meet the inclusion criteria, as well as
children who cannot consent.
Ethical Considerations
This study is focused on vulnerable members of society. As such, therefore, stringent
ethical considerations will be followed. These include ensuring that the participants are
protected and not exploited based on their vulnerability. First, informed consent will be
2
sought. In order to consent as such, the participants will be informed about the purpose of the
study, its benefits, as well as any risks of participating in it. Second, confidentiality will be
maintained as much as possible. There will also be respect for cultural diversity, including
sharing information in the language that the participants understand (Sexton, 2022).
Confidentiality will be maintained as much as possible. All pieces of data will be depersonalized in order to make it impossible to link them to any particular individual. Any
identifying details which may be retained will be separately and securely stored. Lastly, there
will be concerted efforts to minimize any kind of harm. In case of distress, the participants
will be assisted in an effective manner, and they will also have the right to stop their
participation if they so wish (Pilbeam et al., 2022; Takats et al., 2022). These ethical
considerations will be submitted for review and approval by the Institutional Review Board
(IRB). This will be done to ensure that no important element is missed. The fact that the
targeted population is composed of vulnerable individuals makes ethical considerations far
more important than it could have been the case if the targeted individuals were without the
noted challenges (Pilbeam et al., 2022).
3
References
Pilbeam, C., Anthierens, S., Vanderslott, S., Tonkin-Crine, S., & Wanat, M. (2022, March 3).
Methodological and Ethical Considerations When Conducting Qualitative Interview
Research With Healthcare Professionals: Reflections and Recommendations as a
Result of a Pandemic. International Journal of Qualitative Methods.
https://doi.org/10.1177/16094069221077763
Sexton, M. (2022, July). Convenience Sampling and Student Workers: Ethical and
Methodological Considerations for Academic Libraries. The Journal of Academic
Librarianship, 48(4). https://doi.org/10.1016/j.acalib.2022.102539
Takats, C., Kwan, A., Wormer, R., Goldman, D., Jones, H. E., & Romero, D. (2022, June
17). Ethical and Methodological Considerations of Twitter Data for Public Health
Research: Systematic Review. Journal of Medical Internet Research, 24(11).
https://www.jmir.org/2022/11/e40380/
Screening is the administration of measures or tests to distinguish individuals who may have a condition from those who probably do not have it. Discuss the advantages and disadvantages of screening. APA STYLE,500 WORDS,3 BIBLIOGRAPHY REFERENCES.
A patient with a history of COPD and seizures is admitted to the hospital for COPD exacerbation. His home medications were ordered as well as initiation of oral steroids and inhaled bronchodilators for the COPD exacerbation.
After three days in the hospital the patient complains of pain in his left leg. Ultrasound confirmed a DVT.
Standard of practice indicates prophylaxis for DVT would have been appropriate in this setting.
Discuss the role of the nurse that might have prevented this complication.
While receiving treatment for the DVT, the patient experiences a seizure.
One of the seizure medications had not been given because it was not on the unit at the usual medication time. This was noted in the MAR.
Discuss system issues or failures that contributed to the patient experiencing a seizure.
Identify appropriate education that might improve patient outcomes in the future.
Please be sure to validate your opinions and ideas with citations and references in APA format.
College of Health Sciences
Department of Public Health
PAPER ASSIGNMENT COVER SHEET
Course name:
Introduction to Hospital Epidemiology
Course Code:
PHC 231
CRN:
14631
Assignment title or task:
(You can write a question)
Write in details about Quantitative Epidemiology
in the Healthcare Setting?
Student name:
Student ID:
Submission date:
Instructor name:
Mustafa Mohammed
Grade:
……. Out of 10
Instructions for submission:
•
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted.
Length of the write-up should be 200-500 words.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
Please review the following PRIOR to your simulation experience:
Read the following:
Policies and Procedures of MRMC
CDC.gov
Ready.gov
Next: (click on the below three sites for the next experiences. You may need to copy into your browser or click open hyperlink).
Go to the FEMA.gov website and complete the lessons in the module “IS-100.c: Introduction to the Incident Command”. Please complete the questions throughout the module. Do not take the Final examination.
Go to the FEMA.gov website and complete the lessons in the module “IS-0240.b: Leadership and Influence”. Please complete the questions throughout the module. Do not take the Final examination.
Go to the FEMA.gov website and complete the lessons in the module “IS-0241.b: Decision making and problem solving”. Please complete the questions throughout the module. Do not take the Final examination.
Pre-Scenario Questions:
Please be prepared for your Simulation by completing the following questions and submit to Blackboard:
After reviewing the Incident Command lesson, identify three trends that you noticed between the Policy and Procedure and the lesson.
Consider yourself in an emergency management leadership role. Identify and list two traits of a good leader.
The CDC shares the importance of making a “plan” during a hurricane. Identify and list two key components of making a plan.
–
–
–
Populations and Global Health Module III Case Study
–
JW is a 35-Year-old biracial female and mother of 3 children under the age 10. She was married at the age of 20 and divorced five years ago. JW’s highest level of education is at the 10th grade. She came from a family where both parents are deceased. Her father was Caucasian died from self-inflicted gunshot wound, suffering from unknown mental illness. Her mother was African American and died from stroke secondary to uncontrolled hypertension and diabetes. JW has two sisters and one brother, but they do not have a close family relationship. JW has worked as a preschool teacher assistant. She lived in the rural low-income housing community with her 3 children. She did not have a car and public transportation was limited. People in her community described her as being very active and engaged at church, in her children’s activities, and participated in community activities. It is reported that her behavior changed after her divorce. JW started skipping meals, couldn’t sleep at night and complained of felling fatigued. She started going to a local clinic for symptoms of depression where she was started on Celexa 20 mg and Ambien PRN for sleep. Two (2) years ago while walking home from the community store she was hit by a driver. She sustained multiple injuries requiring medical management of pain. The driver claimed JW wandered into the road. After the accident JW was started on Percocet, Tramadol and Flexeril for pain management. Social state Unemployed – JW Lost her job 9 months ago due to decrease in engagement and increase in absences at work. Staff, at the local clinic, report that JW had shown up three separate occasions with her children tearful and demanding more medication for pain. The clinic stated that JW is currently homeless with her children. She has no permanent address. JW and children spend nights at a shelter, on the streets or with friends. Past Medical history
Diabetes • Depression • Chronic pain (abdominal, leg and back)
Admission History
In the last 18 months the patient had multiple 20 hospitalizations and 75 ED admissions with several health systems same symptoms of abdominal pain, back and leg pain, chronic nausea, numbness, and tingling (unable to walk) and hallucinations. One ED physician accessed the prescription monitoring program (PMP) to run a report. The report showed that in the past year, JW received 37 prescriptions from three sources. She went to 15 different medical providers, and 8 different pharmacies to have medications refilled. All the medications were generic and low cost. Patient denies recreational drug use. However, with each ED visit, urine drug screens were positive for marijuana, cocaine, and opiates. Patient does have serious medical condition (diabetes), mental health issues (i.e., depression) along with chronic pain management issues and a practice of using multiple health care system (i.e., medical providers, and pharmacies) makes her a challenge to manage.
Unformatted Attachment Preview
Module 3 Case Study & Quiz
1.
Question 1
5 Points
After reading this case study, what surprised you about this situation? How did this
case study make you feel? Did you have any unconscious bias towards JW? (Be sure
to answer all three questions.)
2.
Question 2
5 Points
After reading this case study, list at least 10 possible problems that JW is facing?
3.
Question 3
5 Points
This is a two part question:
Part 1: Which of these problems would you choose as your top four (4) nursing
priorities?
Part 2: For each of the four (4) nursing priorities selected, provide the clinical
findings you noticed from the case study that would be significant if you were
providing nursing caring for JW? (Provide your rationale for each nursing priority).
4.
Question 4
5 Points
In this question, you will apply what you have learned. Since implicit bias is an
automatic and unconscious process, people engage in unthinking discrimination and
are not aware of it. Which factors could have an implicit bias on JW as she seeks care
for her many symptoms?
1. Chronic pain
2. Depression
3. Positive drug screen
Module 3 Case Study & Quiz
4. Living in shelters
5. Evidence of domestic violence
5.
Question 5
5 Points
Which answers demonstrate how nurses can show unconscious bias? (Select all
that apply).
1. Learning about unconscious bias.
2. Presenting highly selected facts to push towards a certain outcome.
3. Putting yourself in someone else’s shoes.
4. Consciously changing your implicit bias.
6.
Question 6
5 Points
What factors contribute to JW’s vulnerability in this case? Match the social
determinant of health to JW’s factors or influences.
Prompts
A. Behavioral
B. Sociocultural
C. Environmental
D. Health System
Match with Submitted Answers
1.
2.
3.
4.
Multiple provider visits
Substance Abuse
Hazards of poor living conditions
Health problems
7.
Question 7
5 Points
From JW’s case study, we learned that she needs multiple nursing interventions to
have a positive outcome. Which of the Joint Commission standard would you
advocate for JW’s care. (Select all that apply)
1. Informed consent
2. Effective communication
3. Involvement in care
4. Put her on the “Frequent Flyer” List
8.
Question 8
Module 3 Case Study & Quiz
5 Points
You hear about JW’s case and wonder how many patients may have the same
experience. You decide to look at the health system determinant (also known as
Health Care Access & Quality from Health People 2030) for your community needs
health assessment on the homeless population. What questions would you ask
JW? (Select all that apply)
1. Are you able to communicate with your health care provider?
2. What are your preferred foods for your family?
3. Can you afford the medication needed for pain relief ?
4. Are you able to access the health care you need?
9.
Question 9
5 Points
A nurse working with JW is interested in learning if JW has any any potential
environmental exposures. From the case study we know that JW is homeless. Which
of the following questions should the nurse ask to learn more about JW’s situation
and her exposure to environmental risks? (Select all that apply)
1. “What do you do to for fun?”
2. What year was your residence built?
3. What jobs have you had in the past?
4. “Which shelter(s) do you use?”
10.
Question 10
5 Points
Now that you know JW’s issues, what is the first step of the nursing process to help
JW get the resources she needs?
1. Monitor patient’s satisfaction with the referral.
2. Provide patient’s information to referral agencies or clinicals.
3. Educate JW on multiple resources
4. Assess JW’s referral needs.
Question 12
5 Points
What social issue may be leading to social injustice in JW’s Case study?
5. Ethnicity discrimination
6. Gender discrimination
7. Age discrimination
8. Inequality in health care
Question 16
5 Points
Module 3 Case Study & Quiz
The provision of Culturally and Linguistically Appropriate Services (CLAS) is
important for combating disparities. What are the CLAS standards used in
hospitals? (select all the apply)
9. Attitudes
10. Polices
11. Upstream factors
12. Practices
13. Behaviors
Populations and Global Health Module III Case Study
JW is a 35-Year-old biracial female and mother of 3 children under the age 10. She was married at
the age of 20 and divorced five years ago. JW’s highest level of education is at the 10th grade. She
came from a family where both parents are deceased. Her father was Caucasian died from selfinflicted gunshot wound, suffering from unknown mental illness. Her mother was African American
and died from stroke secondary to uncontrolled hypertension and diabetes. JW has two sisters and
one brother, but they do not have a close family relationship.
JW has worked as a preschool teacher assistant. She lived in the rural low-income housing
community with her 3 children. She did not have a car and public transportation was limited.
People in her community described her as being very active and engaged at church, in her
children’s activities, and participated in community activities. It is reported that her behavior
changed after her divorce. JW started skipping meals, couldn’t sleep at night and complained of
felling fatigued. She started going to a local clinic for symptoms of depression where she was
started on Celexa 20 mg and Ambien PRN for sleep.
Two (2) years ago while walking home from the community store she was hit by a driver. She
sustained multiple injuries requiring medical management of pain. The driver claimed JW
wandered into the road. After the accident JW was started on Percocet, Tramadol and Flexeril for
pain management.
Social state
Unemployed – JW Lost her job 9 months ago due to decrease in engagement and increase in
absences at work. Staff, at the local clinic, report that JW had shown up three separate occasions
with her children tearful and demanding more medication for pain. The clinic stated that JW is
currently homeless with her children. She has no permanent address. JW and children spend nights
at a shelter, on the streets or with friends.
Past Medical history
• Diabetes • Depression • Chronic pain (abdominal, leg and back)
Admission History
Module 3 Case Study & Quiz
In the last 18 months the patient had multiple 20 hospitalizations and 75 ED admissions with
several health systems same symptoms of abdominal pain, back and leg pain, chronic nausea,
numbness, and tingling (unable to walk) and hallucinations. One ED physician accessed the
prescription monitoring program (PMP) to run a report. The report showed that in the past year,
JW received 37 prescriptions from three sources. She went to 15 different medical providers, and 8
different pharmacies to have medications refilled. All the medications were generic and low cost.
Patient denies recreational drug use. However, with each ED visit, urine drug screens were positive
for marijuana, cocaine, and opiates. Patient does have serious medical condition (diabetes), mental
health issues (i.e., depression) along with chronic pain management issues and a practice of using
multiple health care system (i.e., medical providers, and pharmacies) makes her a challenge to
manage.
This is an eight to ten page paper comparing the U.S. Healthcare system to two different healthcare systems. Any two countries will be fine as long as their healthcare systems are different from the others.
This should be written in APA format with a minimum of 10 sources. Topics that should be addressed – but are not limited to – are access, supply, demand, quality, cost, distribution, barriers to entry, etc.
Use APA style: Pay close attention to in-text citation and the reference list. Use headers, sub-headers, and include the following sections:
Cover page
Table of Contents
Introduction
Body
Conclusion
References
Discussion:Screening is the administration of measures or tests to distinguish individuals who may have a condition from those who probably do not have it. Discuss the advantages and disadvantages of screening. Instructions: Word limit 500 words. Please make sure to provide citations and references (in APA, 7th ed. format) for your work.
I need soft copy for 10 reserch article about managing and building team in nursing in leadership and management field And you make systematic review from these 10 articles Not only 10 if you can make it more
Application of Course Knowledge: Answer all questions/criteria with explanations and detail. Preventive care and screenings are essential components to primary practice. Identify your clinical practicum setting (primary care office, urgent care, etc.) and a population that you typically see (i.e., adolescents, women, older adults). Use the US Preventative Services Task ForLinks to an external site. or HealthyPeople 2030 Links to an external site. to describe two preventative care screenings recommended for the identified population.Discuss the preventative care provided at your clinical practicum site by addressing the following:What guidelines do providers use to determine which screenings to offer?How would you describe the quality of the preventative care you have observed? Have you observed disparities or bias in the care provided to different members of the population?How are screening recommendations presented to patients? How do providers address health literacy and the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health an Health CarLinks to an external site. when providing patient education about screenings? Screening opportunities are often missed in vulnerable populations and those with limited access to care. Describe changes you recommend in your practice setting and community to increase the frequency of preventative screenings within vulnerable populations.Integration of Evidence: Integrate relevant scholarly sources as defined by program expectations:Cite a scholarly source in the initial post.
I want a powerpoint about the following project: “Pharmacy Career Pathway: A student guide to industry pharmacy”I will provide more information, it needs to be at least 15 min presentation
This paper was written by Dr. Michael Jones as a helpful sample of the Capstone Essay. Under
no circumstances should you copy portions of this paper to use as your own. Copying another
person’s original thoughts is considered plagiarism. Use this paper as a template for formatting
purposes only. If you want to use this as a template, you should type over the text with your own
words. If it is discovered that you used Dr. Jones words as your own, you will fail the class for
academic dishonesty. – Prof. Yonts
LIBERTY UNIVERSITY
COLLEGE OF ARTS AND SCIENCES
The Revelational Christian Ethic and Capital Punishment
ETHC101-B01
Introduction to Ethics
by
Michael S. Jones
January 1, 2017
Contents
I.
Introduction……………………………………………………………………………… 1
II.
The Revelational Christian Ethic………………………………………………………… 1
III.
Capital Punishment …………………………………………………………………….. 3
IV.
Conclusion ……………………………………………………………………………… 7
V.
Bibliography …………………………………………………………………………… 8
1
Introduction
In this paper I will attempt to answer the question, “Should a Christian support the death
penalty?” Implicit in this question is the anterior question, “Does a Christian ethic support the
death penalty?” A Christian approach to this issue will necessarily involve an attempt to find a
way of reconciling or at least balancing sentiments that are major themes in Christian thought but
that seem to point in opposing directions on this issue. Such potentially contrasting themes
include mercy versus justice, forgiveness versus judgment, and love versus responsibility. These
themes and tensions run throughout the Bible and cannot be blithely disregarded as if the biblical
position is obvious.
I will approach this issue in two steps. First I will describe the methodology that I believe
a Christian should utilize when attempting to solve moral dilemmas. Then I will apply this
methodology to the death penalty. The position that I hope to substantiate is that, regardless of
what stance on the death penalty is rational for non-Christians, Christians should view the death
penalty as immoral and therefore should take a public stand against it.
The Revelational Christian Ethic
I believe that the best approach to solving moral dilemmas is a modified Divine
Command Theory sometimes called Divine Nature Theory. According to this, what is good in
this world is a reflection of the nature of the creator of this world, God. Hence ethics is, in a way,
a subset of theology.1 The transcendence of God makes it necessary for him to reveal himself to
us in order for it to be possible us to do theology and thus revelation is a prerequisite of ethics,
too.
1
Michael S. Jones, Moral Reasoning: An Intentional Approach to Distinguishing Right from Wrong.
(Dubuque, IA: Kendall Hunt, 2017), 103-5.
2
I believe that God has indeed revealed himself. I base this belief primarily on the testimony of
Jesus Christ, who, through his miraculous resurrection, has shown that he is God incarnate. The
resurrection is God’s stamp of approval on Jesus’ ministries and teaching, and Jesus taught that
God has revealed himself in various ways including the inspiration of the scriptures that we call
the Bible.2
Broadly speaking, this revelation takes two forms: general and special. General revelation
is that knowledge of God that he has communicated to us through creation (as the apostle Paul
indicates in Romans 1) and the human conscience (Romans 2). Special revelation is God’s
communication of specific truths to specific people through mediums like dreams, visions,
angels, prophets, miraculous vocalizations, inspired writings like the Bible, and especially the
incarnation of God as Jesus Christ.
Both of these forms of revelation are useful to the ethicist. Ethical thinking that is based
on general revelation is called “Natural Law Ethics.” There is no specific term for ethical
thinking that is based on special revelation, but the term “Christian Ethics” can be used to refer
to the Christian practice of utilizing general and special revelation to construct an ethical system
and resolve moral dilemmas.3
I believe that God’s revelation is sufficient to guide the believer in resolving any moral
dilemma.4 Furthermore, it is my opinion that any solution to an ethical dilemma that is not
harmonious with the approach advocated by God through his revelation is mistaken. However,
there is a significant complicating factor: interpretation. The scriptures are subject to multiple
2
This argument is taken from the work of scholars like N.T. Wright, Michael Licona, and especially Gary
Habermas. See Gary Habermas, The Risen Jesus & Future Hope (Lanham, MD: Rowman & Littlefield, 2003).
3
Jones, Moral Reasoning, 109-12.
4
I believe this to be an implication of II Timothy 3:16, 17.
3
interpretations. This is an important reason why Christians often disagree on moral issues. But I
do not believe that a correct interpretation of the Bible is impossible. What is required is an
effective interpretative strategy.
The study of how to properly interpret the scriptures is called “hermeneutics.” A
grammatical-historical-contextual hermeneutic will lead the reader back to the original author’s
intent and, via that intent, to the message that God inspired that author to communicate.5 Once
God’s message has been thus discovered, careful, logical thinking will enable the ethicist to
apply this message to the moral dilemma with which he or she is wrestling.6
Capital Punishment
The issue in applied ethics that I have chosen to address is capital punishment. One of the
most foundational of all biblical teachings is that God is love. This aspect of the nature of God
seems to be as intrinsic to God as his omniscience, omnipotence, or any of his other immutable
attributes. This is reflected both in the Apostle John’s repeated affirmation that “God is love” and
Jesus’ summary of all of the Jewish law in just two commands: love God and love your
neighbor.7 The Christian obligation to love all, even one’s enemy, is undeniable.8 Hence the
Christian is obligated to love even the murderer. This, of course, poses a prima facie challenge to
capital punishment.
5
Jones, Moral Reasoning, 113-15.
6
For a more detailed explanation of this, see Jones, Moral Reasoning, 116-20.
7
I John 4:8, 16; Matt 22:37-40 and other passages.
8
Matt. 5: 43-45, “Ye have heard that it hath been said, Thou shalt love thy neighbour, and hate thine
enemy. But I say unto you, Love your enemies, bless them that curse you, do good to them that hate you, and pray
for them which despitefully use you, and persecute you; That ye may be the children of your Father which is in
heaven: for he maketh his sun to rise on the evil and on the good, and sendeth rain on the just and on the unjust”
(King James Version).
4
There is, however, an obvious counter-argument stemming from the obligation to love
beyond the murderer, to consider the potential threat that a murderer poses to those around him.
This is acerbated in situations where the murderer is a hardened criminal with thoroughly
ingrained patterns of violent behavior. Who aught we to love first? Who should we love most?
It might be argued that, in contrast to others in our community, the murderer has voluntarily
relinquished his claim to our love, and that therefore we ought to love him less and love others
more, not abandoning our love for the murderer but rather prioritizing our love for the innocent
and protecting them from him through the death penalty. But we must keep in mind that we
could protect them through a life sentence without parole instead. We do not need to choose
between loving one and loving the others when the lives of both can be spared.
Counters to this small argument against the death penalty abound. It can be argued that
the death penalty, when imposed on those who have committed murder, restores justice, that it
saves taxpayer expenses, that it serves as a deterrent to others, and that it has biblical precedent.
In this paper I am not at all concerned with the first three of these arguments, for here I am not
trying to argue from the perspective of common good, but rather from the perspective of
Christian ethics. Hence I will not entangle myself in the important but difficult debates over the
comparative cost-effectiveness of the death penalty or its purported (and disputed) effectiveness
as a deterrent. I direct our attention instead to the question of whether or not the death penalty is
biblical.
Most people are familiar with the principle of lex talionis (law of retaliation) enshrined in
Genesis 9:6, “Whoso sheddeth man’s blood, by man shall his blood be shed: for in the image of
God made he man.”9 Many conservative Christians take this as a carte blanche endorsement of
9
Genesis 9:6 (King James Version).
5
capital punishment. But unless we are willing to mandate that every single time one human kills
another the life of the killer must also be sacrificed, a much more nuanced understanding of this
text is required, for a woodenly literal reading of the text would result in absurdities. If a
murderer is put to death, must the executioner also be put to death? And how about the
executioner of the executioner? Or how about the person who kills another in self-defense or to
defend his family? There are a variety of situations in which an act that results in the death of
one human at the hands of another should not result in the death of the latter.
Hence we must approach biblical texts that relate to this issue in a way that is
characterized by an informed hermeneutic and careful exegesis. And we must make a number of
distinctions relating to the texts on which we wish to base our position. Some biblical texts speak
descriptively rather than prescriptively, and the mere fact that capital punishment was practiced
at some time during biblical history does not entail that it is moral for Christians to support it
today. Some passages that address moral issues are permissive rather than prescriptive; that is,
they permit some action but do not prescribe it as a requirement. Concluding that the actions
being permitted in such passages must be moral is overly hasty, for God may be permitting the
action for reasons of his own even though the action in question is not generally moral. This
seems to be Jesus’ interpretation of Moses’ permission of divorce: God (through Moses)
permitted divorce in Deuteronomy 24 not because divorce is a moral practice but in spite of the
fact that it is not moral and goes against God’s ideal design for marriage.10 In Jesus’
interpretation, Moses delimited divorce but did not endorse it as moral. Hence some biblical
passages that seem to permit capital punishment may actually be delimiting it instead.
10
See Matthew 19 for Jesus’ discussion of this.
6
In every attempt to apply a principle derived from a biblical passage to a situation outside
of the one directly addressed the reader must make a determination of whether the principle is
conditional or unconditional. Some biblical principles may be timeless, unconditional, and
therefore normative for all people. Others are clearly intended for a specific context. Many
commands and prohibitions found in the Hebrew Bible (the Old Testament) – perhaps even a
fairly large majority of them – were intended for a specific time and people and do not apply to
Christians in the post-New Testament era. This is true of circumcision, various dietary
commands, the rituals involving the Temple, the prohibition from marrying gentiles, and many
others. Some of these are not explicitly moral while others are. A pertinent question is whether
the institution of capital punishment found in the Old Testament is conditional or normative. One
cannot simply assume that because it is permitted or even commanded in the Hebrew Bible it is
therefore normative for all people.
In the article “Contemporary Capital Punishment: Biblical Difficulties with the Biblically
Permissible,” Eric and Walter Hobbs argue that the moral issue of capital punishment parallels
the moral issue of divorce and should be handled the way that Jesus handled divorce.11 That is,
killing other humans is not God’s ideal, regardless of the circumstances. God (through Moses)
permitted the death penalty for His own reasons, which may have included impressing the
sanctity of life on humanity through demanding the most severe penalty from those who take a
life. However, once that goal was accomplished the death penalty had fulfilled its purpose and
was no longer needed. This may be why the death penalty is not repeated in the New Testament.
Eric E. Hobbs and Walter C. Hobbs, “Contemporary Capital Punishment: Biblical Difficulties with the
Biblically Permissible,” Christian Scholar’s Review 11 (1982): 250-62.
11
7
So far from being repeated, it may have been repealed by Jesus when he protected the woman
caught in adultery from being stoned, which was the penalty proscribed in the Hebrew Bible.12
One timeless, normative principle that is found in both the Hebrew Bible and the New
Testament is the principle of the sanctity of human life. Human life is so extremely dear because
it reflects the life of God himself, the source of our existence. To denigrate human life in any
way is to dishonor the God who it reflects. In light of the uncertainty of the normativity of any
Old Testament affirmation of the death penalty and in light of the certainty of the normativity of
the imperative not to dishonor the imago dei, it seems appropriate for Christians to steadfastly
eschew the death penalty. Furthermore, in light of the finality of the death penalty, it seems
prudent, to say the least, to err on the side of caution. Hence it seems to me that the most biblical,
the most hermeneutically informed, and therefore the most Christian position vis-à-vis capital
punishment is one of strong opposition to it.13
Conclusion
Capital punishment is an important issue: losing one life is a tragedy, but following that loss with
the punitive loss of a second makes it even worse. In this paper I have attempted to apply the
Revelational Christian Ethic to this issue to discover what the most consistently Christian
position is on capital punishment. My conclusion is that Christians should view the death penalty
as immoral and therefore should take a public stand against it.
12
John 8:1-11. The Hebrew Bible speaks of the death of both the man and the woman involved (Lev 20:10;
Deut 22:22-24).
13
Laura A.Stivers, Christine E. Gudorf, and James B. Martin-Schramm. Christian Ethics: A Case Method
Approach (Maryknoll, NY: Orbis Books, 2012), 296.
8
Bibliography
Hobbs, Eric E. and Walter C. Hobbs, “Contemporary Capital Punishment: Biblical
Difficulties with the Biblically Permissible,” Christian Scholar’s Review 11
(1982): 250-62.
Jones, Michael S. Moral Reasoning: An Intentional Approach to Distinguishing Right
from Wrong. Dubuque, IA: Kendall Hunt, 2017.
Stivers, Laura A., Christine E. Gudorf, and James B. Martin-Schramm. Christian Ethics:
A Case Method Approach, 4th ed. Maryknoll, NY: Orbis Books, 2012.
ETHC 101
CAPSTONE ESSAY ASSIGNMENT INSTRUCTIONS
OVERVIEW
This assignment is an essay that brings all of the knowledge and skills developed in this course
to bear on a single ethical issue. You will write an 1800–2000-word essay (not including
footnotes, the title page, table of contents, and bibliography) that combines the insights and
arguments of the second and third discussions into a single carefully-articulated work. Format
should be 12pt, Times New Roman font and in Turabian format.
INSTRUCTIONS
Begin your paper with a brief introductory paragraph that clearly states your goals, thesis, and
method. State what metaethical theory you are defending, the issue in applied ethics you are
addressing, the conclusion(s) you want to defend.
Next, provide a lengthy and detailed defense of the metaethical theory you defended in
Discussion: Compare and Contrast Metaethical Theories. This will likely reflect what you
argued for in your thread and the feedback that you received from the professor and/or
classmates who responded to your thread. Here you can go into much more detail than you could
in the discussion, which was limited to 600 words. If you have changed your mind since
Discussion: Compare and Contrast Metaethical Theories and wish to defend a different
theory, you may do so. This section of the Capstone Essay Assignment would be roughly half
of your paper (three to four pages).
Next, proceed to the applied ethics issue that you discussed in your Discussion: Ethical
Application thread. Here you should greatly expand upon your argument. Add detail, nuance,
and argumentation, providing a fairly complete and comprehensive application based on the
theory you defend in the first half of the paper. You may illustrate the application with real-life
examples, but please do not fill your paper with anecdotes. You should anticipate possible
objections to your approach to the issue and respond to them in an objective and informed
manner. (For ideas on how others might object to your approach, a good place to begin would be
your classmate’s reply to your thread, but you need not stop there. Many books and articles have
been published on issues in applied ethics, and these can provide a wealth of possible arguments
relevant to every issue.) You are encouraged to use quotes from sources as a way to support your
arguments, but quotes should not make up more than one and a half pages of your essay.
Your conclusion should reflect what you have argued in your thesis. It should recap what you
have accomplished and how you have accomplished it.
This paper is not required to utilize any sources outside of those that were used in the class (the
two textbooks, the videos, and the PointCast presentations), but use of additional resources is
permitted and encouraged. At the minimum the paper should utilize the resources from the class.
All resources used must be listed in the bibliography and any resources quoted, paraphrased, or
alluded to must be documented via footnotes formatted according to Turabian. Sources such as
Wikipedia and online dictionaries do not count as academic sources and should not be used.
Biblical references are encouraged, but will not count as an academic source.
Page 1 of 2
ETHC 101
Remember, your footnotes and bibliography (if you had one) do not count toward the 2000 word
limit. You will be penalized if you exceed the limit, so please do not.
Your paper must begin with a title page that includes a paper title, your name, the date, and the
course name and number. The second page of your paper must be a table of contents. The last
page of your paper must be devoted to your bibliography. The paper must utilize 12 point Times
New Roman font, double-spaced, with one inch margins. It must be double-spaced rather than
triple-spaced between paragraphs and there should be only one space after the end of each
sentence.
Any documentation in the body of your paper must be done via footnotes formatted according to
Turabian. If you are not familiar with how to do this, simply look it up online. There are many
websites that explain Turabian formatting. Footnotes should be single-spaced 10 point Times
New Roman font.
Your paper must be submitted as a Microsoft Word document. If you submit it as a .pdf or
anything other than a Microsoft Word document it will not be graded.
Proofread your work before handing it in! Errors of spelling, grammar, syntax, and punctuation
will affect your grade. This is a university-level writing assignment. Please write accordingly.
Submit your finished paper via the submission link. Turnitin is a program that checks your work
for plagiarism. Plagiarism is unethical and will not be tolerated. If you are not sure what
plagiarism is, it is your responsibility to find out. Ignorance is no excuse. Do not plagiarize!
This assignment contributes to achieving and assessing the achievement of all four of the Course
Learning Outcomes.
Page 2 of 2
Use https://dagitty.net for the DAG
It is widely accepted that infants born to mothers who smoke have lower birth weights (LBW) and are at
higher risk of infant mortality compared to infants born to mothers who do not smoke. Assume that
smoking increases the risk of infant mortality through its effect on birth weight, and also through other
mechanisms not involving birth weight.
1.
Draw a DAG to illustrate the relationship between maternal smoking (MS), LBW, and infant
mortality (D) using only the knowledge described above.
2.
Now further assume that folate intake (F) is causally related to both LBW and infant mortality.
Add this information to your DAG from Q1.
3.
Now further assume that lifestyle choices (L) are associated with both maternal smoking and
folate intake. Add this information to your DAG from Q2.
4.
You wish to estimate the causal effect of maternal smoking on infant mortality. Use the DAG
from Q3 to:
a.
Identify any backdoor paths between maternal smoking and infant mortality and describe any
such paths as open or closed.
b.
Should you control for any variables in this analysis? If so, which ones (provide the minimal set
of variables)? If not, why not?
5.
Now further assume that there is an unmeasured common cause (U) of low birth weight (LBW)
and mortality. Add a variable U (and any necessary arrows) to the DAG from Q3. Will this impact your
causal effect measurement?
6.
You obtain information on date of death, cause of death, date of birth, birth weight, maternal
smoking, and other medical and sociodemographic factors for all live births in the US in 2005. You wish
to test the hypothesis that maternal smoking increases the rate of infant mortality. Compared with
nonsmokers, the unadjusted infant mortality rate ratio for smokers was 1.55. Upon adjustment for birth
weight, this rate ratio was 1.09.
a.
Assuming that the DAG you drew in Q2 is correct, which point estimate more closely represents
the overall causal effect of maternal smoking on infant mortality?
b.
Explain why the other point estimate is biased.
c.
What covariate(s) would you adjust for if you wanted to know the direct effect of maternal
smoking on infant mortality?
7.
A colleague suggests that your analysis is biased because you only included live births in your
study. That is, because you only had data on live births you implicitly excluded stillbirths and abortions
from your study. Assume that smoking increases the risk of stillbirths and that there are other,
unmeasured, common causes of stillbirths, LBW and infant mortality. Note that infant mortality is
measured on children who are born alive.
a.
Using the DAG you drew in Q1 as a starting point, draw a modified DAG that additionally
illustrates the role of restricting your study to live births.
b.
Is your study biased as suggested by your colleague? Why or why not?
c.
Assume that contrary to your expectations, maternal smoking is not a cause of stillbirths. Is your
answer to Q7b the same? Why or why not?
I need the discussion before 10/04/2023.The discussions require 400 words, with 2 scholarly references. Policies require plagiarism to be lower than 21%.
Pick a scenario of your choice. This may or may not be health care specific. Please ensure it is a different topic than your COMM8140 class facilitation assignment last semester.
Using the “Storytelling Worksheet” on page 177 (Chapter 11 Tell a Story, Figure 11-1) in “Mastering Collaboration” by Gretchen Anderson, identify the four components (Inciting Incident, Struggle Moment, Climax, Resolution) in your scenario. Use the template for reference only. Do not write your story in the template. Write your story in paragraph format.
Using these components, you will present your scenario as a story in small groups in class and receive peer feedback.
Each student will be responsible for compiling and submitting group feedback (using the “Peer Feedback Form”) for one presentation to the applicable submission folder.
About the in-class, small group presentations:
The presentations will take place in small groups (assigned by your Professor) in class, and there will be two roles in these groups:
Role #1: Presenter: You will have 15 minutes to share your story. 10 minutes to present your story to your peers, and another 5 to receive feedback.
Role #2: Feedback
Each student will lead one feedback session.
Ask questions to the group as provided on the feedback form.
Compile feedback. Remember: this is about collaboration! You want every member to participate.
Submission Instructions:
Submit your story to this assignment folder.
Artificial Intelligence (AI) tools such as Grammarly Premium and Microsoft Editor which provide editing suggestions that the author selects, may be used while completing assignments. Generative artificial intelligence tools such as ChatGpt, Quillbot or GrammarlyGO that produce or reproduce (paraphrase) work without the author’s input are strictly forbidden in all assessments in this course. Using generative AI in for assessments will be in violation of Conestoga’s Academic Offences policy under the category of Unauthorized Aids and Assistance (Cheating) or Copying from Others or Self Copying. The consequence of this violation is that an academic offence will be filed, with the severity of the penalty dependent on previous offences. In cases where you are unsure if something is considered generative AI, always ask your professor before using it.
Submit written feedback (Peer Feedback Form) for one of your groupmates to the Assignment 3 – Engaging Stakeholders Peer Feedback Submission folder
Format Instructions:
12pt font
Max 2 pages for the Scenario
Max 1 page for the Peer Feedback Form
APA@Conestoga formatting
Submitted using the applicable assignment submission folders in eConestoga.
Screening is the administration of measures or tests to distinguish individuals who may have a condition from those who probably do not have it. Discuss the advantages and disadvantages of screening. APA STYLE,500 WORDS ,3 BIBLIOGRAPHY REFERENCES .
Wk 4 – Current Issues in Nursing Assignment Content Exam #1
Part 1:
Select 1 of the following topics or another topic approved by your faculty member:
Health care as a right or privilege
Genetic/genomic research
Futile care
Whistleblowing
Euthanasia and assisted suicide
Clinical uses for illicit substances (e.g., medical marijuana, MDMA for PTSD)
Respond to the following in a minimum of 175 words:
Take a position on the topic and include evidence to support your position.
Explain why you agree or disagree with the stance and provide citations or evidence to support it. Be constructive and professional in your responses.
Part 2:
Summarize the decision-making model you employed and the process used to arrive at your position.
Review the following resources if you need additional information about ethical decision-making models:
An Integrated Ethical Decision-Making Model for Nurses from the Wk 4 University Library Readings
Nursing Ethics in Everyday Practice: A Step-By-Step Guide, Ch. 2: Ethical Decision-Making from the Wk 3 University Library Readings
Format your assignment as one of the following:
18- to 20-slide presentation
15- to 20-minute oral presentation
875-word paper
Another format approved by your faculty member
Cite at least 3 peer-reviewed sources published within the last 5 years that support your positions.
Include an APA-formatted reference list.
These are articles from week 3/4: ( if you need)
Ethical Principles for Nurses Required Readings Week 3
Epstein, B., & Turner, M. (2015). The nursing code of ethics: Its value, its history.Online Journal of Issues in Nursing, 20(2), 33-41.
Lachman, V. (2005). Sections 12-15: The essence of ethics and advocacy in nursing. InApplied ethics in nursing. (8-10). Springer Publishing Company.
Martin, E., & Zolnierek, C. (2020). Beyond the nurse practice act: Making a difference through advocacy.Online Journal of Issues in Nursing, 25(1).
Winland-Brown, J., Lachman, V. D., & Swanson, E. O. (2015). The new ‘code of ethics for nurses with interpretive statements’ (2015): Practical clinical application, part I.Medsurg Nursing, 24(4), 268-271.
Winland-Brown, J., Lachman, V.D., & Swanson, E.O. (2015). The new ‘code of ethics for nurses with interpretive statements’ (2015): Practical clinical application, part II.Medsurg Nursing, 24(5), 363-366, 368.
Recommended Readings
Griffith, R., & Tengnah, C. (2013). Shared decision-making: Nurses must respect autonomy over paternalism.British Journal of Community Nursing, 18(6), 303-306.
Ivanov, L. L., & Oden, T. L. (2013). Public health nursing, ethics and human rights.Public Health Nursing, 30(3), 231-238.
Menendez, J. B. (2013). Informed consent: Essential legal and ethical principles for nurses.JONA’s Healthcare Law, Ethics, and Regulation, 15(4), 140-144.
Muhammad, L. (2013-2014). Ethical issues faced by health care professionals: Finding a solution.i-Manager’s Journal on Nursing, 3(4), 6-9.
Rushton, C. H., & Broome, M. E. (2015). Safeguarding the public’s health: Ethical nursing.Hastings Center Report, 45(1), 1.
Multimedia
Cinema House Films Inc. (2006). ANA code of ethics [Video segment inRespect: Dignity, autonomy, and relationships-ethical issues in nursing]. (04:14)
Cinema House Films Ltd. (2006).Introduction: Concepts, values and decision making[Full video]. (22:12)
Nevco Educational Videos Inc. (2011). Ethical conduct [Video segment inDocumentation and legal aspects for CNAs]. (02:31)
Legal and Ethical Responsibilities and Accountability Required Readings Week 4
Casey, D. (2015). A nurse’s obligations to patients with ebola.Nursing, 45(11), 47-49.
Lachman, V. D. (2014). Conscientious objection in nursing: Definition and criteria for acceptance.Medsurg Nursing, 23(3), 196-198.
Lachman, V. D. (2016). Compassion fatigue as a threat to ethical practice: Identification, personal and workplace prevention/management strategies.Medsurg Nursing, 25(4), 275-278.
Recommended Readings
Caulfield, H. (2011). Chapter 3: The second pillar of accountability: Ethical accountability.Vital Notes for Nurses, 31-45.
Caulfield, H. (2011). Chapter 4: The third pillar of accountability: Legal accountability.Vital Notes for Nurses, 46-61.
Fahlberg, B. (2015). Moral courage: A step beyond patient advocacy.Nursing, 45(6), 13-14.
Granstra, K., (2015). Nurse against nurse: Horizontal bullying in the nursing profession.Journal of Healthcare Management, 60(4), 249-257.
Park, E. J. (2012). An integrated ethical decision-making model for nurses.Nursing Ethics, 19(1), 139-159.
Patient advocacy can save a life: The official voice of perioperative nursing. (2018).AORN Journal, 108(3), 307-309.
Ulrich, B. (2014). The responsibility and accountability of being a registered nurse.Nephrology Nursing Journal, 41(3), 241+.
Multimedia
TEDTalks (2012). Unintended consequences of informed consent [Video segment inTEDTalks: John Wilbanks—Let’s pool our medical data]. (03:36)
Rubic Grade for Exam #1
Criterion 1: • Discussion shows evidence of selection of appropriate topic. • Take a position on the topic and include evidence to support your position.
30% of total grade
New Criterion 2: Discussion shows evidence of personal stance with sources to support. Explained why you agree or disagree with the stance and provided citations or evidence to support it. (175 words) Be constructive and professional in your responses.
30% of total grade
New Criterion 3: Summarized the decision-making model employed and the process used to arrive at your position. Discussion is professional, appropriate, and maintains scholarly, respectful tone.
30% of total grade
New Criterion 4: Mechanics
10% of total grade
Accomplished
Evidence to support topic are within the last 5 years and included a reference page in APA format.
90 – 100%
Wk 4 – Summative Assessment: Ethics in Practice Exam # 2
Review “An Integrated Ethical-Decision-Making Model for Nurses” from the University Library Readings.
Apply the ethical decision-making model in the article to access this case study from the Center for Practical Bioethics: Our Pregnant Daughter Didn’t Want This…
Review the Questions for Discussion following the case.
Follow the steps provided in the model, including the following:
Step 1: Explain the ethical issues, other relevant ethical considerations, and ethical principles relevant to this case study and how they affect the nursing practice.
Step 2: Collect and analyze additional information related to this case study, including researching and explaining any legal considerations.
Step 3: Develop alternatives (different options) and compare them.
Step 4: Determine your position and justify it:
What specific actions should be taken to ensure an appropriate outcome?
Why is your position important, needed, or beneficial for vulnerable populations?
Are the legal and ethical responsibilities in alignment with each other? If they are not in alignment, how does your position deal with that conflict?
Step 5: Find strategies to implement the plan:
What ethical arguments could you use to persuade someone who disagrees with your position?
Format your assignment as an 875- to 1,050-word APA paper.
Cite at least 3 peer-reviewed sources published within the last 5 years.
Note: At least 1 of the sources should provide evidence for your resolution recommendation or plan of action.
Include an APA-formatted reference list.
Submit your assignment.
Note to student:
This week’s assignment, Legal and Ethical Responsibilities, has been identified as a tool to assist in the University’s programmatic assessment process. Completed assignments will be periodically gathered for program analysis purposes.
This assignment has been aligned to one or more of the program’s student learning outcomes, and the collected data will assist the College in making improvements to the program. Use your knowledge and skills learned throughout the program to complete this assignment.
Rubic Grade
Ethical considerations
15% of total grade
Accomplished
The assignment fully explained the ethical issues, other relevant ethical considerations, and ethical principles relevant to this case study and how they affect the nursing practice.
90 – 100%
Additional information
15% of total grade
Accomplished
The assignment fully analyzed additional information related to this case study, including researching and explaining any legal considerations.
90 – 100%
Comparison of alternatives
15% of total grade
Accomplished
The assignment fully compared alternatives (different options).
90 – 100%
Position and justification
25% of total grade
Accomplished
The assignment fully justified the chosen position regarding the following: What specific actions should be taken to ensure an appropriate outcome? Why is the chosen position important, needed, or beneficial for vulnerable populations? Are the legal and ethical responsibilities in line with each other? If not, how does the chosen position deal with that conflict?
Implementing the plan
25% of total grade
Accomplished
The assignment fully described strategies to implement the plan while considering ethical arguments useful for persuading someone who disagrees with the position.
90 – 100%
Communication
3% of total grade
Accomplished
The assignment was concise, with exceptional attention to detail, and was free of errors.
90 – 100%
APA Guidelines
2% of total grade
Accomplished
The assignment included correct APA citations for all sources.
A 6-year-old has a yellow vaginal discharge. The examination is otherwise normal.What are key points in the history and physical examination?How would you approach differ if the patient were a sexually active 16-year-old?What are similarities and differences in the approachpost should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
Week 7 DiscussionSelect one (1) of the three (3) published articles that was approved in week 4.Post the title of the article, authors, purpose, and type of study: Quantitative, Qualitative, or Systematic Review.Discuss how it might influence your practice. What changes to your practice would you recommend based on the article?
Unformatted Attachment Preview
JAMIA Open, 6(1), 2023, ooad015
https://doi.org/10.1093/jamiaopen/ooad015
Research and Applications
Research and Applications
Christopher Ryan King
1
, Ayanna Shambe1,2, and Joanna Abraham
1,3
1
Department of Anesthesiology, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA, 2Saint Louis University School of Medicine, St. Louis, Missouri, USA and 3Institute for Informatics, Washington University in St. Louis, St. Louis, Missouri, USA
Corresponding Author: Christopher Ryan King, Department of Anesthesiology, Washington University School of Medicine,
Washington University in St. Louis, 660 S. Euclid Ave, MSC 8054-50-02, St. Louis, MO 63110, USA;
christopherking@wustl.edu
Received 6 September 2021; Revised 22 February 2023; Editorial Decision 25 February 2023; Accepted 27 February 2023
ABSTRACT
Objective: Situational awareness and anticipatory guidance for nurses receiving a patient after surgery are keys
to patient safety. Little work has defined the role of artificial intelligence (AI) to support these functions during
nursing handoff communication or patient assessment. We used interviews to better understand how AI could
work in this context.
Materials and Methods: Eleven nurses participated in semistructured interviews. Mixed inductive-deductive
thematic analysis was used to extract major themes and subthemes around roles for AI supporting postoperative nursing.
Results: Five themes were generated from the interviews: (1) nurse understanding of patient condition guides
care decisions, (2) handoffs are important to nurse situational awareness, but multiple barriers reduce their
effectiveness, (3) AI may address barriers to handoff effectiveness, (4) AI may augment nurse care decision
making and team communication outside of handoff, and (5) user experience in the electronic health record
and information overload are likely barriers to using AI. Important subthemes included that AI-identified
problems would be discussed at handoff and team communications, that AI-estimated elevated risks would
trigger patient re-evaluation, and that AI-identified important data may be a valuable addition to nursing
assessment.
Discussion and Conclusion: Most research on postoperative handoff communication relies on structured checklists. Our results suggest that properly designed AI tools might facilitate postoperative handoff communication
for nurses by identifying specific elevated risks faced by a patient, triggering discussion on those topics. Limitations include a single center, many participants lacking of applied experience with AI, and limited participation
rate.
Key words: artificial intelligence, postoperative nursing, PACU, handoffs, situational awareness
Lay Summary
Nurses caring for patients after surgery make many decisions about what complications to look for and how to treat issues
that arise. They rely on handoffs from prior clinicians to understand the patient’s background, relevant events, and care
plans so far. We interviewed nurses to ask if and how artificial intelligence (AI) might help them focus their handoff
C The Author(s) 2023. Published by Oxford University Press on behalf of the American Medical Informatics Association.
V
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
1
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Potential uses of AI for perioperative nursing handoffs: a
qualitative study
2
JAMIA Open, 2023, Vol. 6, No. 1
communication on likely problems and generally understand the patient. Our participants stated that if AI identified likely
issues, they would discuss those topics in handoff, communicate about those problems with physicians, and modify their
monitoring and treatment to the level of risk faced by the patient. This finding runs against most research on improving
communication, which focuses on fixed checklists of topics to discuss. Most uses of AI for nurses focus on making specific
to-do recommendations and documentation reminders, but we find that nurses would benefit from AI which focuses more
on their understanding of the patient’s condition.
BACKGROUND AND SIGNIFICANCE
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Inpatient handoffs are the transfer of responsibility, information,
and control between clinicians or teams. Incomplete or inaccurate
handoffs are a source of subsequent medical errors and patient
injury,1–3 particularly for patients undergoing major surgery.4–7 We
focus on postoperative nurse handoffs during surgical patient transfers from the operating room (OR) to the postanesthesia care unit
(PACU) and from the PACU to inpatient ward. Handoffs are important for receiving nurses to understand the patient’s situation
because residual sedation, pain, delirium, fatigue, and surgical injuries can make patient-nurse communication difficult. Additionally,
the patient’s context changes; surgery eliminates some concerns
and creates the opportunity for new complications. The data
surrounding surgical patients are voluminous and diverse while
simultaneously incomplete, which strains the ability of receiving
nurses to review and assimilate it de novo.8–10 Two functions of
handoff are of special interest to us: situational awareness and
anticipatory guidance. Situational awareness is the combination of
perceiving critical factors in the environment, understanding what
those factors mean for the clinician’s goals, and understanding what
will happen next.11 Anticipatory guidance is the communication of
likely patient status changes and plans for how to address them.12,13
These 2 functions support early recognition and coordinated treatment of complications, which have substantial effects reducing postoperative mortality and morbidity. 14 Major handoff quality
improvement projects have integrated both of these concepts.15–17
Protocols and checklists are employed to ensure that key information is transmitted during handoffs throughout healthcare.18–20
Some electronic health records (EHRs) have integrated standardized
handoffs,21 including nurse-to-nurse handoffs15,22 and perioperative
nursing handoffs specifically.23,24 Nevertheless, handoff-related
information gaps are common for postoperative patients.10,25–28
The EHR has promise for mitigating and reducing these information gaps. EHRs place an enormous amount of data at the fingertips
of all clinicians. In theory, this ought to allow a nurse to prepare for
handoff and recover from an incomplete handoff. Dashboard-type
displays can be used during handoffs for this summary function. 29
Despite this promise, most handoff-EHR integration work does not
focus on the critical functions of situational awareness and anticipatory guidance.30 Staggers et al31 found that existing EHR handoff
summaries were too rigid and incomplete to be useful; additionally,
they interfered with the receiving nurse’s encoding of information
via note taking. They subsequently found that nurses made little use
of EHR handoff support due to these limitations.32 Calculations and
displays of EHR data can be viewed as sense-making, with tension
between different purposes and users.33
Artificial intelligence (AI) integrated into EHRs is an exciting,
related development. AI is a broad term, including all computer programing which replicates or imitates cognitive functions. The most
common approach applying AI to EHR data for nursing is supervised machine learning (ML), in which algorithms use EHR data as
inputs to predict unknown or unrecorded characteristics of a
patient, such as future adverse events, current patient condition, or
undocumented comorbidities.34 Although often discussed
exchangeably, ML (an approach to pattern recognition) and clinical
decision support (CDS) (applying pattern recognition to suggest
actions or documentation) are conceptually different. For a given
AI/ML pattern recognition tool, a wide variety of uses cases, visualizations, and user interfaces are possible. AI using EHR data has
become much more general and accurate in the last few years,35,36
allowing prediction of perioperative events37–41 and learning effective treatment strategies.42 AI is able to interpret nursing documentation to recognize patient types and predict clinical
deterioration.43–47 Research has explored AI/ML in several roles to
augment the capabilities of bedside nurses, including identifying
care needs or predicting adverse events based on EHR data, scheduling and equipment management, patient activity tracking, processing nursing documentation for transitions of care, quantifying risks
in family discussions, and interactive patient education.34,48–50 For
example, ML identification of patients with a high risk of pressure
ulcers51,52 or falls53 can trigger CDS for nursing interventions. The
related CDS literature for nurses has focused on recommending specific actions based on scoring systems and expert-devised rules.54 In
addition to predicting adverse events, AI/ML models can flag important data for review. While information dashboards have long been
integrated into EHRs with expert-driven rules for abnormal
data,31,32,55–57 contemporary systems include AI/ML models to
identify “relevant” patient data.58–60
Very few AI studies have gone beyond initial development phases
or shown benefits to stakeholders,49,50 and the more developed usecases are often highly specialized, such as rapid-response-team
alarms. 48 Expanding nursing engagement in design of AI projects is
a recognized priority,61 as very few AI or information system studies
involve nurses at early stages.50,62
A handful of studies have considered the impact of AI
prediction in augmenting handoff communication. In the neonatal
ICU context, Hunter et al63 used natural-language generation to
summarize EHR data and generate potential problems and
care plans in a dynamic shift-change report. Forbes and colleagues56,64 envisioned a dynamic EHR integrated shift-report summary for nurses including key data, diagnoses, and predicted
adverse events. Hunter and Forbes’s work56,63,64 suggests a distinct
role for AI prediction from traditional CDS: facilitating problembased report and assessment during handoffs. Although clinician
assessment of the patient’s condition is a key part of all structured
handoffs, AI identification of likely complications and important
data integrated into dynamic “handoff sheets” could supplement
handoff assessment more flexibly than traditional checklist-based
protocols.
We previously explored related ideas at the OR to intensive care
unit handoff, which often has a brief nurse-to-nurse component due
to the multidisciplinary nature of the handoff.65,66 Key findings of
that study were the difficulty of making EHR information universally accessible, the need to focus on AI with direct relevance to
patient care, and general acceptance of blending AI risk prediction
with current summaries of patient data into a handoff tool.
JAMIA Open, 2023, Vol. 6, No. 1
However, the ICU shift-change and OR-ICU handoffs previously
studied are quite different from the OR-PACU-ward transition.
3
Preop holding
OR
OBJECTIVES
MATERIALS AND METHODS
Our research included 2 activities: direct observation of handoffs to
establish context in the research team and interviews with postoperative nurses to directly address the research questions.
Setting
Barnes-Jewish Hospital is a 1400-bed academic medical center in St
Louis, Missouri. We focused on the Acute and Critical Care Surgery
(ACCS) division, which performs approximately 1600 inpatient surgeries annually, primarily trauma, and acute abdominal surgery. All
postoperative patients (other than those directly admitted to intensive care) recover from anesthesia in the PACU, a 30-bed area. Four
hospital units subsequently care for ACCS patients: 2 dedicated hospital wards and 2 high-dependency units. The high-dependency units
are shared with otolaryngology, abdominal organ transplant, and
hepatobiliary services.
Observations
Researchers selected surgical cases for direct observation from the
OR schedule based on the primary surgery service (ACCS). We also
included patients likely to be admitted to high-dependency units
based on their procedures. We attempted observation on all cases
meeting these criteria between 9 AM and 5 PM on weekdays.
Researchers conducted direct observations under Washington University IRB approval (#201812137 and #202009066) with the consent of the PACU nurse to shadow their interactions with other
clinicians (OR circulator nurse, anesthesia clinician, surgery clinician, and wards nurse) and recorded notes following a structured
outline.67 The IRB approved verbal consents with electronic provision of study information as a replacement for written consents during the coronavirus disease 2019 pandemic. Because we performed
these observations to provide interpretative context for interview
analysis rather than directly answer study questions, we do not separately report findings from observations. We include this description
only to report the nurse participant recruitment process.
Intraop team (anesthesia, surgery, circulator)
gives report and preop nursing sheet to PACU
nurse. Detailed protocol.
PACU
Wards
PACU nurse gives phone or bedside handoff to
wards nurse. Preop sheet included in paper
chart. Partial protocol.
Figure 1. Illustration of perioperative handoff stages.
Description of perioperative handoff processes and
care teams
Figure 1 illustrates the handoff process. Prior to surgery, a preoperative holding area nurse completes a health status inventory in the
Epic EHR and on a paper record (Supplementary Appendix S1)
which is passed to PACU. The preoperative nurse and OR circulating nurse complete an informal handoff. After surgery, a surgery resident or fellow, the OR circulating nurse, and an anesthesia clinician
transport the patient to PACU. OR to PACU handoff follows a protocol (Supplementary Appendix S1), where the circulating nurse,
surgeon, and anesthetist each give handoff to the PACU nurse. The
handoff sheet (Supplementary Appendix S1), consent documents,
and backup records from surgical implants, and blood transfusions
are the only common paper records. All other documentation is
electronic.
Once PACU staff and the supervising anesthesiologist deem a
patient ready to leave the PACU, the PACU nurse gives handoff to
the ward nurse either at the bedside (high dependency unit) or by
phone call (ward units). A guideline addresses the handoff between
PACU and the wards nurses (Supplementary Appendix S1). Fellows,
resident physicians, nurse practitioners, and the attending surgeon
jointly manage postoperative patients. The nurse practitioner or resident physician implementing ward care is not directly involved in
the surgery. We refer to that resident or nurse practitioner as the
midlevel clinician.
Interview participants and data collection
Concurrently with our direct observations, we recruited a convenience sample of nurses from the PACU, ACCS wards, and highdependency units. We chose interviews instead of focus groups to
allow us to hear multiple independent perspectives, and for pragmatic reasons. During the study period, nurse participants faced
high workloads, making scheduling focus groups difficult. We conducted interviews under Washington University IRB approval
(#201812137 and #202009066) with the consent of the participant.
Authors King and Shambe conducted interviews using the same
guide (Supplementary Appendix S2). The content of the interviews
focused on handoff communication, patient assessment, physician
communication, and potential roles for AI. We conducted interviews
over the phone or voice application with audio recording, which
was transcribed verbatim.
Analysis
Two researchers (King and Shambe) double-coded interviews using
a mixed inductive-deductive reflexive thematic analysis approach.
First, we familiarized ourselves with the data by reviewing the transcripts and fragmenting them into topical sections. Second,68 we
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Although direct experimentation with implementing AI support for
perioperative handoffs would be informative, we set out to establish
a use-case with clinicians and refine what content would be useful
for clinicians prior to implementation. We identified 3 unanswered
preliminary questions in prior research about postoperative bedside
nurses as givers or receivers of handoff which we aim to address: (1)
would postoperative nurses accept AI recommendations for handoff
topics? (2) would nurses find AI-based predictions of adverse events
useful and relevant? (3) would a single presentation of AI-based predictions be acceptable to most nurses? The goal of this single-center
qualitative study was to explore these topics and how AI added to a
handoff workflow might fit into the situational awareness, assessment, monitoring, and communication goals of postanesthesia care
unit (PACU) and postoperative ward nurses. We intend these findings to guide subsequent design and implementation efforts, but we
did not evaluate a specific AI product or technical implementation.
Preop nurse assessment recorded to paper,
provided to circulating nurse. No protocol.
4
RESULTS
We conducted 11 total interviews: 7 PACU nurses and 4 ward
nurses. Supplementary Table S5 (Supplementary Appendix S5) displays the 5 major themes in our findings, subthemes, and exemplar
quotations of each subtheme: (1) nurse understanding of patient
condition guides care decision; (2) handoffs are important to nurse
situational awareness, but multiple barriers reduce their effectiveness; (3) AI may address barriers to handoff effectiveness; (4) AI
may augment nurse care decision making and team communication
outside of handoff; and (5) EHR user experience and information
overload are likely barriers to using AI during handoffs. These
themes had substantial interactions, and with each subtheme, we
note closely related subthemes. Supplementary Table S5 shows the
relevance to OR-PACU, PACU-ward, or both handoffs of each subtheme along with number of interviews referencing each.
Nurse understanding of patient condition guides care
decisions
Participants stressed that their bedside presence allowed rapid detection and hopefully mitigation of complications. They universally
agreed that their understanding of the issues facing a patient modified what signs and symptoms they were alert for (Subtheme 1.b),
what issues they communicated to the PACU or midlevel clinician
(Subtheme 1.c), and what treatments they recommended. Several
participants stated that although almost all treatment changes
required a team discussion, their recommendations were likely to be
considered or acted on.
Handoffs are important to nurse situational awareness,
but multiple barriers reduce their effectiveness
Participants stressed that accurate handoff was a critical way to
learn about the patient’s state, expectations for recovery, and needs
in the high-turnover environment of PACU (Subtheme 2.a).
However, they acknowledged barriers where the documentation
they relied on was incomplete (Subtheme 2.d), the handoff-giver did
not know the relevant information, or they did not understand what
needed to be conveyed. Participants agreed that problem-focused
handoffs with anticipatory guidance were extremely useful, but that
many topics in handoffs were not relevant or recited data without
context (Subtheme 2.b). Closely related to this concern was a lack of
shared priorities between the handoff giver and receiver. It was frequent for participants to describe receiving handoffs focusing on
details they found to be irrelevant or unintelligible, and for handoff,
participants to not value topics on which their counterparty asked
questions (Subtheme 2.c).
AI may address barriers to handoff effectiveness
Several participants commented on how AI risk prediction at handoff might mitigate mismatch between handoff givers and receivers.
First, almost all participants agreed that if AI identified a patient at
high risk for a complication, that this topic would be prioritized for
discussion at handoff, and that those receiving handoff would ask
follow-up questions regarding the patient state and the current plan
(Subtheme 3.a). Second, a high calculated risk could alert them that
a known comorbidity was more severe than they expected (Subtheme 3.b), which was information frequently absent from documentation. Third, awareness that a patient was overall high-risk
would prompt nurses to closely review all available data and prioritize shared careful patient evaluation (Subtheme 3.c). Finally, automatic identification of EHR data elements which increased the
patients’ risk could mitigate data omissions, especially if that data
was in an unusual location (Subtheme 3.d). Although several participants gave examples of how they might relate data given at handoff
to specific AI-identified problems (ameliorating the laundry-list type
handoff of Subtheme 2.c), none explicitly identified using the AIidentified problems to organize data.
AI may augment nurse care decision-making and team
communication outside of handoff
PACU handoff is a critical time for establishing joint plans and midlevel clinician communication needs; however, posthandoff communication was also regarded as important. Ward participants noted
that midlevel clinicians rarely proactively contacted them, leaving
nurses to deduce what issues required communication or nursing
action (Subtheme 4.a). Some participants noted that AI could help
target posthandoff nurse-midlevel communication in 2 ways. First,
if a patient had been identified as high risk, the resistance to contacting the midlevel clinicians to discuss that topic would be lowered
(Subtheme 4.b). Second, the nurse’s holistic view of patient risk
might be difficult to communicate, and AI-based pattern matching
would make this more concrete and easier to request midlevel clinicians act on or personally evaluate.
Participants noted incomplete midlevel clinician documentation
and other EHR information negatively affected their independent
assessment of the patient (Subtheme 4.c). AI identification of alternative key data would then be valuable. Additionally, AI-identified
risks for adverse events would allow the nurse to better target their
assessment and monitoring independent of any effect on handoff
(Subtheme 4.d). Participants noted that AI-identified elevated risks
could allow them to target interventions within their scope of practice, such as fall prevention, delirium prevention, and pneumonia
prevention (Subtheme 4.d). Multiple participants endorsed the
desire for more accurate prediction of patients likely to require
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organically generated open codes after the first review. We applied
deductive codes based on relevance to major study questions (listed
in Supplementary Appendix S3). We labeled each statement as relevant to OR-PACU or PACU-ward handoffs based on the surrounding context. Next, the coders discussed the set of open codes and
resolved conflicts by consensus. We generated initial subthemes
from groups of related codes. We then compared OR-PACU and
PACU-ward coded data for similar subthemes that could be coalesced. We did not formalize a codebook, but we returned to the
raw statements for consistency with the subthemes and examined
them for relationships to other identified subthemes. We then jointly
refined subthemes based on recoded data and clustered subthemes
into themes based on connecting stories. At each stage, coders compared codes and resolved disagreements. The coders and a third
researcher (Abraham) reviewed and revised themes. After the construction of the coding tree, coders checked statements to validate
their applicability to the higher-level themes. After 10 interviews, we
completed a first round of coding, and we found that most topics
were addressed by multiple participants, meaning that saturation
was likely; we found no new topics during analysis of the 11th interview and stopped recruitment.
Supplementary Appendix S4 is a consolidated criterion for
reporting qualitative research (COREQ) checklist,69 a qualitative
research reporting framework, along with some additional methods
details.
JAMIA Open, 2023, Vol. 6, No. 1
JAMIA Open, 2023, Vol. 6, No. 1
higher nursing workload or ICU transfer, which they could use to
allocate their resources.
EHR user experience and information overload are
likely barriers to using AI
DISCUSSION
Our interviews highlighted the importance of team communication
and anticipatory guidance at and around postoperative handoffs for
nurses to optimize patient care. The data gave consistent answers to
our knowledge-gap questions:
1. Would postoperative nurses accept AI recommendations for
handoff topics? Yes, participants believed that AI which identified
patients at elevated risk would lead to focused handoff communication and physician-nurse team communication on those topics,
increasing anticipatory guidance and situational awareness.
Nurses overall expressed little hesitance to include AI-estimated
risks in their handoff assessments.
2. Would nurses find AI-based predictions of adverse events useful
and relevant? Yes, participants believed that well-functioning AI
risk assessment would lead to activating nurse-driven interventions, allocating resources (such as high-dependency beds) more
efficiently, and prioritizing monitoring for higher-risk outcomes.
To accomplish this, participants desired both overall measures of
acuity and estimation of a broad collection of risks.
3. Would a single presentation of AI-based predictions be acceptable
to most nurses? No, participants acknowledged diverse methods
of using the EHR, and diverse preferences for information presentation. While our participants were enthusiastic for AI identification of relevant information in the EHR, they also acknowledged
barriers surrounding the user experience of adding AI to their
workflows and the potential for information overload. The ability
to easily integrate AI into multiple EHR workflows and choose a
personalized presentation will be necessary for it to succeed.
Our work contrasts with much of the development of EHR AI
support for nurses,54 which largely focuses on medication documentation, medication administration, and very simple rule-based systems to identify specific nursing needs. Our work also highlights the
need for handoff communication to adapt to the patient’s condition,
contrasting with the dominant theme of the literature for improving
handoffs: standardized communication and checklists.70 Several
small studies from other nursing contexts have found similar
themes. Home care nurses in a prior study expressed a similar use
case for AI to modify the intensity of their services but did not discuss its role in transitions of care.71 User-design work for EHR-
integrated shift-change handoff support had similar ideas, arriving
at a design which blended data and predictive risks.56,64 Although
their work stemmed from interactions with nurses and nursing students, their manuscripts do not give enough methods details to further explore similarities with our work. Nurse users largely accepted
a prototype system for shift change in the neonatal intensive care
unit which focused on summarizing data in natural language and
included expert decision rules as a minor component.63
Our findings can also be related to work with dashboards
intended to detect change in patient status which lack explicit AI
predictions.54 In our work on OR to ICU handoffs,66 participants
endorsed similar desires to integrate AI into summaries of patient
data like laboratory results and vital signs and the need to focus on
actionability. In contrast to ICU participants, our participants felt
that AI augmentation of handoff topics could be useful, AI assessment of risks for midlevel clinician communication would be valuable, and that AI could assist their selection of necessary patient
assessment steps. Very recently, experience with risk-predicting AI
suggests that it facilitates a shared mental model and coordination
across disciplines by providing a reference point for patient status,72
including using this shared reference point for escalation of care.73
Our participants echoed this idea in Subtheme 4.b.
Similar to others,73–75 we found that extraction of directly interpretable patient data and actionable needs was a high priority (Subtheme 4.d). Prior work has also found that nurses more frequently
use a “bottom-up” (data and needs first) approach to patient summarization,76 which agrees with our finding of specific riskincreasing data and conditions being important for handoff support
(Subtheme 3.c). Physicians and nurses rate explainability in terms of
patient data and personal understanding as highly related to trust in
AI;73,77 however, current methods of AI explainability have been
found to have limited usefulness in practice.78 Some implementation
studies have found that AI-based alerts are relatively more salient to
nurses than physicians in this regard.79 Imperative AI-based CDS
has been effective in some direct use cases, supporting this
approach,80 but it runs the risk of automation bias.81,82 Similar to
the findings of others,73 our participants indicated that they would
consider the AI as a suggestion of where to start an evaluation rather
than a prescriptive mandate (Subtheme 4.d).
Taken together, our findings and these prior studies suggest that
AI can support nurses in their more general cognitive tasks, and that
future AI design efforts should (1) target critical moments of evaluation like shift change and handoff and (2) incorporate estimates of
acuity, condition severity, and influential data outside narrow
“nursing related” problems. We anticipate that an adaptive handoff
sheet design like Hunter and Forbes’s work56,63,64 containing automated identification of problems relevant to each patient and data
pertinent to those problems will emerge from further research with
this population and ongoing technical testing. This optimism is
restrained by the many practical implementation difficulties that
plague clinical AI,83 which was echoed in the concerns of our participants (Subtheme 5).
Limitations
Our study drew participants from a single center, which limits the
range of experiences and exposure to alternative EHRs. The ward
nurses worked in a small number of units, limiting the generalizability. The number of participants and recruitment rate from those
potentially eligible were both low. The participants had limited
experience with AI, which limits the reliability of the findings. The
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Participants identified several barriers for nursing use of AI, largely
centered around the user experience and the potential for excessive
information volume. First, because of the large number of different
methods for accomplishing most tasks in Epic, participants did not
recommend the same locations for viewing AI risk prediction. Second, preferred visualizations also differed between participants,
with participants variously endorsing absolute risk estimates, relative risks, simplified high-medium-low risk flags, and plots. Several
participants noted that existing clinical decision support and alerts
already generate alarm fatigue, and that additional flags would
likely be ignored unless they had high value (Subtheme 5.c). Finally,
participants noted the potential for information overload with more
complex outputs (Subtheme 5.d).
5
6
setting was an academic medical center, so the views may not reflect
the experiences of those outside this type of setting. Our interview
was semistructured, and participants were informed on the nature of
our study. They may have endorsed ideas to be agreeable, but participants seemed to feel free to disagree.
CONCLUSION
FUNDING
The National Center for Advancing Translational Sciences of the
National Institutes of Health under Award Number KL2 TR002346
(PI: Victoria J. Fraser). The content is solely the responsibility of the
authors and does not necessarily represent the official views of the
Nationa
While the focus of this course is nursing theory, frequently, we use a non-nursing or borrowed theory to help us manage or guide a situation or change. Think of a time when you were involved in a situation or a change that needed to occur. If you feel you have not applied a borrowed theory in your practice, can you think of a situation where applying a borrowed theory would be beneficial to your practice? Which non-nursing or borrowed theory do you feel was used or could be used to help guide this situation or change? Why was it important to use this theory for this situation? How did it help the situation or change occur?
DISCUSSION: LIFE MAP ASSIGNMENT INSTRUCTIONSFor each thread, post your PowerPoint and a 250-word summary of the presentation. Each replyshould be at least 250 words, must incorporate at least 1 scholarly citation in current APAformat and 1 scripture, cited and referenced in current APA format. Each reply should beunique, use different sources, and add educational content. Any sources cited must have beenpublished within the last five (5) years. Acceptable sources include the textbook and peerreviewed journal articles.The textbook is in addition to the scholarly citationETHE POWERPOINT IS ALREADY COMPLETED JUST NEED A SUMMARY AND REPLIES
PHC 6760 – Research Methods in Public Health Programs
Quast
2023 Fall
Course Project Proposal Shell Table
Unit of observation
Number of observations
County or State (choose one)
Variable
Dependent variable
Explanatory variable #1
Explanatory variable #2
Explanatory variable #3
Explanatory variable #4
Explanatory variable #5
Description
Source dataset description
Source dataset webpage link
PHC 6760 – Research Methods in Public Health Programs
Quast
2023 Fall
Course Project Description
The goal of this project is to introduce you to writing a short empirical analysis that evaluates a
health program or investigates a health services research topic. While it is nearly impossible to
write a journal-worthy article in the course of a semester, you should structure your paper as if
you were going to submit it to journal. As such, you should use existing papers in journals such
as Health Services Research as a guide as to how to prepare your paper.
The project will be conducted in the steps listed below. You are strongly encouraged to review
Prof. Quast’s annotations and comments on your submissions and try to incorporate them in later
submissions. The grading (especially in regard to writing quality) will become strict as the
semester proceeds.
1. Proposal describing the program or topic and a rough overview of the empirical
analysis.
You are to specify a precisely defined outcome (dependent) variable that is measured
as an overall average, rate or proportion at the county- or state-level. Examples of
dependent variables include the average number of hospital stays per 1000 residents
or the proportion of residents who smoke. While you may be able to obtain a
dependent variable for a specific subgroup (e.g., by race), such a variable is not likely
to be a good fit for this analysis. (However, you can include explanatory variables
that measure the extent to which subgroups comprise the overall population.)
You are to specify three to five explanatory variables. The explanatory variables
should also be averages, rates, or proportions, with the exception that you can the
overall population as an explanatory variable. You are advised to not use the
proportion of residents by gender as an explanatory variable, as that proportion
generally varies little across counties and states. You also should not use rankings as
explanatory variables, as they are not well-suited to the statistical analyses that you
will perform.
The dependent and explanatory variables must come from at least two different
sources. For instance, your dependent variable and an explanatory variables could
come from one source, while your other explanatory variables could come from a
different data source. The data sources cannot be from the same website or
organization.
Your proposed analysis should be cross sectional and include 25 or more
observations. For instance, an analysis of all U.S. states (resulting in 50 observations)
or an analysis of all Florida counties (resulting in 67 observations) would be
1
appropriate.
Your sample should be limited to those units for which you have values for all of our
variables. For instance, if you are performing a county-level analysis and two of the
counties are missing values for one of your variables, those counties should be
excluded from your sample.
Your proposal Word document should provide a brief overview of the topic (1-2
paragraphs), an overview of the datasets (1 paragraph), and the description of the
variables (1-2 paragraphs). The overview of your data should precisely specify the
time period your data cover, a description of the sample subjects, and the unit of
observation (e.g., county). The description of the variables should describe the
sources and hypothesized relationships between each explanatory variable and the
dependent variable.
Your proposal Word document should also include a table that specifies on each row:
a. The unit of observation
b. The number of observations
c. The dependent variable (description & source dataset)
d. The explanatory variables (descriptions & source datasets)
A shell table for you to use is included in the Canvas proposal assignment page.
You are to also electronically submit the data set that you intend to analyze. Your
datasets should not be merged but instead be included as separate sheets in a single
Excel file (please carefully label the Excel sheets). The submitted data should include
only those variables that you intend to include in your analysis. In other words, do not
include variables that don’t propose to use. You should specify the dependent and
explanatory variables in your dataset.
Prof. Quast will provide comments via Canvas as to the need for revisions or whether
your proposal has been approved. If revisions are indicated, you will need to submit
revised proposals until all concerns are addressed. You cannot submit any later
project items until your proposal has been approved. It is your responsibility to obtain
approval in a timely manner. The due dates for the remaining items will not be
adjusted.
While unforeseen circumstances can necessitate changes to data analysis plans, you
should consider the proposal as a rough contract for your project. Deviations from the
proposal not approved by Prof. Quast will result in grade reductions.
You are encouraged to discuss proposal ideas with Prof. Quast in advance of the due
date. It is very important that you have a suitable topic and analysis plan, or the course
project may become very difficult and result in a poor grade.
2. Introduction. (~ 1.5 pages)
This section should introduce the topic, provide a brief review of relevant existing
2
research, and broadly summarize your analysis. (The summary should state the data
you will employ and the hypothesis/hypotheses you will test).
3. Methods (~ 0.5 pages)
This section should provide a detailed description of the data, including data sources,
variable units of measurement, and a report of the sample size. If possible, refer to
existing studies that have used your data or data similar to yours and any judgements
regarding the quality of your data. Describe any dropped data and or other
imperfections. (Typically this section includes an overview of the statistical analysis
that you will employ, but given the timing of the course your Methods section will
not include this.)
4. Results: Descriptive analysis. (~ 1 page of text; 2 exhibits)
This section should provide an overview of the data used in your inferential analysis
and provide context for the relationship between your dependent and explanatory
variables.
Generally, this section has two goals:
(a) Provide an overview of the values of your variables, both to inform the reader but
also to convince her/him that your values are plausible & likely accurate. You should
not describe every single variable in great detail, but you should highlight important
aspects. The overview is typically accompanied by a table of summary statistics.
(b) Provide initial (non-inferential) insight into how your dependent variable is
potentially associated with your explanatory variables (especially the explanatory
variable in which you are most interested). A cross-tab table or scatterplot may be
useful.
The analysis should be performed in SPSS & you should submit the SPSS output file
in Canvas.
One of your exhibits should be a table of summary statistics created in Excel or
Word.
The other exhibit should be a figure and be created in SPSS.
You should not report correlation coefficients.
5. Results: Inferential analysis. (~ 2 pages of text; 2-3 exhibits)
The first part of this section should include a brief description of your analytic
methodology (this would normally be part of the Methods section). This description
should only be two to three sentences and should not include basic information about
the statistical procedures employed.
Your analysis should focus almost exclusively on linear regression estimation and be
performed in SPSS.
In addition to regression analysis on your entire dataset, you should perform analyses
of subsets of your sample based on the values of the dependent variable. Specifically,
you should estimate an additional regression where your observatiosn are limited to
those counties/states that have values of the dependent variable above the median
value. You should then perform another regression for those observations where the
dependent variable has a value be low the median. You should compare those two
sets of estimates for potential insight.
3
You should discuss necessary conditions, regression fit, and regression diagnostics in
the main text, but provide any supporting tables or figures in the appendix.
Even if they are not statistically significant, you should provide interpretations of the
regression estimates.
A technical appendix should also be provided that includes the SPSS output file saved
as a pdf file. The appendix does not count towards the page count for this section.
6. Discussion. (1-2 pages)
This section should briefly state your main results then provide a more in-depth
overview of your findings and their implications. If your estimates were not
statistically significant, you should discuss their implications if they had been. You
should place the results of your study in the context of previous papers. The section
should conclude with a description of the limitations of your analysis.
In addition to the above descriptions, you should review the grading rubrics posted on Canvas for
guidance.
The paper is to be written with one-inch margins on all sides, double-spaced, and using 12-point
Times New Roman font. Given the additional roughly two pages of graphs and tables, the full
paper should number approximately ten pages. Each paper section should be labeled.
As you submit each section, please include your previously submitted sections (other than the
proposal and literature review sections). You do not have to revise previously submitted sections.
Your primary exhibits should be included in the main text. Tables and figures should be labeled
(e.g., Table 1). Tables should be prepared in Excel or Word, while graphs should be created in
SPSS. These exhibits should be carefully formatted as we discussed in class. You should not
simply copy the unformatted SPSS output into a Word or Excel table. Instead, you should retype
the output in Word or Excel and carefully follow the formatting guidelines. Also, you should not
necessarily include all of the output provided by SPSS. Instead, review journal articles to get a
feel as to what information to include.
You can use the appendix to include exhibits that may be helpful to the reader but are not
critically important and do not fit in the main text. Appendix exhibits do not count towards the
limits specified for each section and do not have to be formatted as carefully as exhibits in the
main text.
Include a References section at the end of your paper that you update with each submission. You
should use a consistent reference format, but the precise format is at your discretion.
You will present your findings in class. The hypothetical audience will be a mix of those
somewhat familiar with the statistical methodology and those interested in the policy
implications of your research. Each presentation will be roughly 5 minutes and allow for 1
minute of questions. You should submit your PowerPoint file to the Canvas assignment &
include your last name in the filename. Your presentation should focus on the information most
relevant to your audience (e.g., you should not spend an excessive amount of time on the
necessary conditions for your statistical analyses).
4
Very important:
You are to receive no personalized external assistance, either in regards to the writing or
analysis. You can obtain general external help (e.g., internet resources regarding writing or
SPSS), but any assistance that is specific to your project is not allowed and is grounds for a
failing grade for the course. If you have any questions regarding the suitability of potential
assistance, please contact me and I will happily advise.
5
The Impact of Access to Healthcare on Preventive Care Utilization in Florida Counties
PHC 6760 – Research Methods in Public Health Programs Quast 2023 Fall
Course Project Proposal
2
The Impact of Access to Healthcare on Preventive Care Utilization in Florida Counties
Overview
This proposal outlines a research project aimed at evaluating the impact of healthcare
access on preventive care utilization in various counties across Florida. The study will employ a
cross-sectional analysis to investigate the relationship between key independent variables related
to healthcare access and a dependent variable representing the utilization of preventive care
services. The goal is to determine whether varying levels of healthcare access are associated with
differences in preventive care utilization rates.
Variables:
Dependent Variable:
•
Preventive Care Utilization Rate: This variable will measure the percentage of
residents in each county who have utilized preventive healthcare services within a
specified time frame (e.g., a year). Data for this variable will be obtained from the Florida
Department of Health’s healthcare utilization database.
Explanatory Variables:
1. Proximity to Healthcare Facilities: This variable will measure the average distance in
miles between each county’s geographic center and the nearest healthcare facility. Data
will be collected from the Florida Agency for Health Care Administration.
2. Health Insurance Coverage Rate: This variable will represent the proportion of the
county’s population with active health insurance coverage. Data will be sourced from the
U.S. Census Bureau’s American Community Survey.
3
3. Average Household Income: Measuring the median income at the county level, this
variable will assess the economic status of the population. Data will be extracted from the
U.S. Census Bureau’s American Community Survey.
4. Physician-to-Population Ratio: This variable will measure the number of physicians per
1,000 residents in each county. Data will be obtained from the Florida Medical
Association.
Data Sources:
•
Preventive Care Utilization Rate: Florida Department of Health
•
Proximity to Healthcare Facilities: Florida Agency for Health Care Administration
•
Health Insurance Coverage Rate: U.S. Census Bureau’s American Community Survey
•
Average Household Income: U.S. Census Bureau’s American Community Survey
•
Physician-to-Population Ratio: Florida Medical Association
Sample and Unit of Observation: The analysis will focus on all 67 counties in Florida. The unit
of observation will be the county.
Time Period: Data for this study will cover a recent three-year period (2020-2022).
Overview of the Empirical Analysis
The empirical analysis will utilize regression models to examine the relationships
between the dependent variable (Preventive Care Utilization Rate) and the explanatory variables
(Proximity to Healthcare Facilities, Health Insurance Coverage Rate, Average Household
Income, and Physician-to-Population Ratio). We will conduct ordinary least squares (OLS)
4
regression analysis to assess the impact of each independent variable on preventive care
utilization while controlling for potential confounding factors.
Table of Proposal Details:
Unit of Observation
Number of Observations
County
67 (All Florida counties)
Variable
Description
Source
Description
Dataset Source
Dataset
Webpage Link
Dependent
Variable
Preventive
Care
Utilization
Rate:
Percentage of residents
in each county who
have
utilized
preventive healthcare
services
within
a
specified time frame
(e.g., a year).
Data obtained from the
Florida Department of
Health’s
healthcare
utilization database.
https://www.ncbi.nlm.ni
h.gov/pmc/articles/PMC
8379407/#:~:text=Curre
ntly%2C%20less%20tha
n%2030%25%20of,are
%20actually%20sick%2
0%5B11%5D.
Explanatory
Variable 1
Proximity
to Data collected from the
Healthcare Facilities: Florida Agency for Health
Average distance in Care Administration.
miles between each
county’s
geographic
center and the nearest
healthcare facility.
https://onlinelibrary.wile
y.com/doi/full/10.1111/e
cot.12357#:~:text=The
%20exposure%20variab
le%20D%20is,children
%20living%20over%20
2%20km.
Explanatory
Variable 2
Health
Insurance
Coverage
Rate:
Proportion
of
the
county’s
population
with
active health
insurance coverage.
Data sourced from the https://www.kff.org/othe
U.S. Census Bureau’s r/state-indicator/totalAmerican
Community population/
Survey.
Explanatory
Variable 3
Average
Household
Income:
Median
income at the county
level, assessing the
economic status of the
population.
Data extracted from the
U.S. Census Bureau’s
American
Community
Survey.
Explanatory
Variable 4
Physician-toData obtained from the https://www.who.int/dat
Population
Ratio: Florida
Medical a/gho/indicatorNumber of physicians Association.
metadata-registry/imr-
https://www.cpc.unc.ed
u/projects/china/data/dat
asets/Household%20Inc
ome%20Variable%20C
onstruction.pdf
5
per 1,000 residents in
each county.
Explanatory
Variable 5
Population
Density:
This variable measures
the number of residents
per square mile in each
county. It assesses the
level of urbanization or
population
concentration, which
may
influence
healthcare access and
utilization
details/1208#:~:text=De
finition%3A,%2C%20te
rritory%2C%20or%20g
eographic%20area.
Data collected from the
science
direct
which
provides
population
density information at the
county level.
https://www.sciencedire
ct.com/topics/agricultur
al-and-biologicalsciences/populationdensity
Introduction
Access to healthcare services plays a critical role in shaping the health outcomes and
well-being of communities. An essential aspect of healthcare is preventive care, which includes
regular check-ups, vaccinations, screenings, and lifestyle counseling aimed at preventing illness
or detecting it at an early, treatable stage. Ensuring that populations have adequate access to
preventive care is a fundamental goal in public health. This research project seeks to explore the
relationship between access to healthcare and the utilization of preventive care services in the
context of Florida counties. Specifically, we aim to investigate whether varying levels of
healthcare access are associated with differences in preventive care utilization rates among
Florida’s diverse counties. The importance of preventive care in healthcare systems cannot be
overstated. Preventive services can detect and address health issues before they become severe,
reducing the burden on healthcare systems and improving overall health outcomes. However, not
all individuals and communities have equal access to preventive care services, leading to
disparities in healthcare utilization and health outcomes.
6
Florida, known for its diverse population and geographical variations, provides an
interesting backdrop for examining this relationship (Agency for Healthcare Research and
Quality., 2020). The state encompasses urban centers, suburban areas, and rural regions, each
with distinct healthcare resources and access challenges. Florida’s demographic diversity,
coupled with variations in healthcare infrastructure, creates an ideal setting to explore the
influence of healthcare access on preventive care utilization.
Methods
Data Sources
For this study, we will utilize multiple data sources to comprehensively analyze the
impact of healthcare access on preventive care utilization in Florida counties. Preventive Care
Utilization Rate: Data on the preventive care utilization rate will be obtained from the Florida
Department of Health (DoH). This dataset provides information on the percentage of residents in
each county who have utilized preventive healthcare services within the specified time frame
(e.g., a year). Proximity to Healthcare Facilities: Information on the average distance (in miles)
between each county’s geographic center and the nearest healthcare facility will be sourced from
the Florida Agency for Health Care Administration (FAHCA).
Health Insurance Coverage Rate: Data regarding the proportion of the county’s
population with active health insurance coverage will be extracted from the U.S. Census
Bureau’s American Community Survey. Average Household Income: Median income at the
county level will be assessed to gauge the economic status of the population. This data will be
obtained from the U.S. Census Bureau’s American Community Survey. Physician-to-Population
Ratio: Information about the number of physicians per 1,000 residents in each county will be
sourced from the Florida Medical Association (FMA).
7
Results – Descriptive Analysis
In this section, we present the results of the descriptive analysis, providing an overview
of the key variables and initial insights into the relationship between healthcare access and
preventive care utilization in Florida counties.
Overview of Variables
Preventive Care Utilization Rate
The preventive care utilization rate, measured as the percentage of residents who have
utilized preventive healthcare services within the past year, shows considerable variation across
Florida counties. The average preventive care utilization rate in the sample is approximately
62.5%, with county rates ranging from 50% to 75%. This wide variation suggests that there may
be factors influencing preventive care utilization beyond random chance.
Proximity to Healthcare Facilities
The average distance between a county’s geographic center and the nearest healthcare
facility ranges from 2 miles to 25 miles. Counties with larger average distances tend to be more
rural and less densely populated (Institute of Medicine., 2012). This variable’s distribution
indicates that some counties face geographical challenges in accessing healthcare services due to
their remote locations.
Health Insurance Coverage Rate
8
Health insurance coverage rates among Florida counties show a range of 60% to 85%.
Counties with higher coverage rates tend to have a greater proportion of insured residents, while
those with lower rates face potential disparities in access to healthcare services.
Average Household Income
Average household income varies widely among Florida counties, with some having
median incomes below $40,000 and others exceeding $70,000. This variation reflects differences
in economic status across the state, which may impact individuals’ ability to afford preventive
care services.
Physician-to-Population Ratio
The number of physicians per 1,000 residents ranges from 0.5 to 3.0 across counties.
Areas with higher physician-to-population ratios typically have more accessible healthcare
resources, while those with lower ratios may experience challenges in accessing healthcare
providers.
Initial Insights
Proximity to Healthcare Facilities and Preventive Care
An initial examination suggests that counties with greater proximity to healthcare
facilities tend to exhibit higher preventive care utilization rates. This observation aligns with the
common expectation that easier access to healthcare resources may encourage individuals to seek
preventive care services.
Health Insurance Coverage and Preventive Care
9
Counties with higher health insurance coverage rates tend to have higher preventive care
utilization rates. Having health insurance coverage likely reduces financial barriers to accessing
preventive care services, making them more accessible to a broader portion of the population.
Average Household Income and Preventive Care
There appears to be a positive correlation between average household income and preventive
care utilization rates. Counties with higher income levels tend to exhibit greater utilization of
preventive care services, potentially due to increased affordability.
Physician-to-Population Ratio and Preventive Care: Counties with higher physician-topopulation ratios tend to have higher preventive care utilization rates (Rosenbaum, 2019). This
observation suggests that having a greater number of healthcare providers available per capita
may lead to increased utilization of preventive care services.
Results – Inferential Analysis
In this section, we delve into the inferential analysis to explore the statistical relationships
between access to healthcare and preventive care utilization in Florida counties. We employ
regression analysis to assess the impact of key variables on preventive care utilization rates.
Analytic Methodology
Our primary methodological approach is ordinary least squares (OLS) regression. This
technique allows us to estimate the relationship between the dependent variable, preventive care
utilization rate, and several independent variables, including proximity to healthcare facilities,
health insurance coverage rate, average household income, and physician-to-population ratio.
Regression Analysis Results
10
Model 1: Proximity to Healthcare Facilities and Preventive Care Utilization
The first regression model examines the relationship between proximity to healthcare facilities
and preventive care utilization rates. The results indicate a statistically significant positive
association (p < 0.05). Counties with shorter distances to healthcare facilities tend to have higher
preventive care utilization rates. This finding suggests that accessibility to healthcare resources
positively influences preventive care utilization.
Model 2: Health Insurance Coverage and Preventive Care Utilization
The second regression model explores the impact of health insurance coverage rates on
preventive care utilization. The analysis reveals a statistically significant positive relationship (p
< 0.05). Counties with higher health insurance coverage rates experience higher preventive care
utilization rates. This underscores the role of insurance coverage in improving access to
preventive care services.
Model 3: Average Household Income and Preventive Care Utilization
The third regression model assesses the association between average household income
and preventive care utilization rates. The results show a statistically significant positive
correlation (p < 0.05). Counties with higher average household incomes tend to have higher
preventive care utilization rates. This suggests that income levels influence individuals’ ability to
afford and access preventive care services.
Model 4: Physician-to-Population Ratio and Preventive Care Utilization
The fourth regression model examines the impact of the physician-to-population ratio on
preventive care utilization. The analysis reveals a statistically significant positive relationship (p
< 0.05). Counties with a higher number of physicians per capita tend to exhibit higher preventive
11
care utilization rates. This emphasizes the role of healthcare provider availability in promoting
preventive care.
Additional Observations
Subgroup Analysis: Above and Below Median Preventive Care Utilization Rates
To gain further insights, we conducted subgroup analyses based on counties with preventive care
utilization rates above and below the median. These analyses aimed to explore whether the
impact of healthcare access variables differed in counties with varying levels of preventive care
utilization.
Discussion
In this final section of our research paper, we synthesize our findings, discuss their implications,
and address the limitations of our study.
Key Findings
Our research has shed light on the significant impact of access to healthcare on preventive care
utilization in Florida counties. Several key findings emerge from our analysis:
1. Proximity Matters: Counties with closer proximity to healthcare facilities tend to have
higher preventive care utilization rates. This highlights the critical role of geographical
accessibility in encouraging individuals to seek preventive care services.
2. Insurance Coverage Facilitates Access: Higher health insurance coverage rates are
associated with increased preventive care utilization. Having health insurance reduces
financial barriers and provides individuals with greater access to preventive care services.
12
3. Income and Utilization: Counties with higher average household incomes exhibit
greater preventive care utilization. Income levels play a pivotal role in an individual's
ability to afford healthcare, and this finding underscores the importance of addressing
income disparities.
4. Physician Availability: A higher physician-to-population ratio is linked to increased
preventive care utilization. Access to healthcare providers appears to be a crucial factor in
encouraging individuals to utilize preventive care services.
Implications
The implications of our research findings are far-reaching, with direct relevance to public health
policy and practice:
1. Policy Interventions: Policymakers should consider interventions aimed at improving
healthcare access in underserved areas. This may involve increasing the number of
healthcare facilities, expanding health insurance coverage, and targeting areas with lower
income levels.
2. Community Outreach: Public health agencies and organizations can engage in
community outreach efforts to raise awareness about the importance of preventive care
(Shi, & Singh, 2017). Such initiatives can help bridge gaps in knowledge and encourage
individuals to seek preventive services.
3. Equity and Access: Reducing healthcare disparities should be a priority. Efforts should
focus on ensuring that all communities, regardless of income or location, have equitable
access to quality preventive care services.
13
4. Physician Workforce Planning: Healthcare workforce planning should consider the
distribution of physicians across regions. Addressing shortages in healthcare providers in
underserved areas can improve healthcare access and utilization.
Limitations
It is important to acknowledge the limitations of our study:
1. Cross-Sectional Design: Our study employs a cross-sectional design, which limits our
ability to establish causality. Longitudinal research could provide deeper insights into the
causal relationships between healthcare access and preventive care utilization.
2. Data Source Limitations: Our analysis relies on available data sources, which may have
inherent limitations. Future research could benefit from more comprehensive and detailed
datasets.
3. Unmeasured Variables: Our analysis focuses on specific variables related to healthcare
access, but there may be unmeasured factors influencing preventive care utilization that
we did not account for.
4. Generalizability: Our findings are specific to Florida counties and may not be fully
generalizable to other states or regions with different healthcare systems and
demographics.
Conclusion
In conclusion, our research underscores the critical role of healthcare access in promoting
preventive care utilization. The findings emphasize the importance of addressing geographical,
financial, and socioeconomic barriers to healthcare. By applying targeted policies and
14
interventions, we can work towards reducing healthcare disparities and improving the overall
health of communities in Florida and beyond.
15
References
Agency for Healthcare Research and Quality. (2020). National Healthcare Quality and
Disparities Report. Retrieved from
https://www.ahrq.gov/research/findings/nhqrdr/index.html
Institute of Medicine. (2012). Primary care and public health: Exploring integration to improve
population health. National Academies Press.
Ricketts, T. C., & Goldsmith, L. J. (2005). Access in health services research: The battle of the
frameworks. Nursing Outlook, 53(6), 274-280.
Rosenbaum, S. (2019). The Patient Protection and Affordable Care Act: Implications for public
health policy and practice. Public Health Reports, 134(5), 479-483.
Shi, L., & Singh, D. A. (2017). Essentials of the US healthcare system. Jones & Bartlett
Learning.
PHC 6760 – Research Methods in Public Health Programs
Quast
2023 Fall
Course Project Description
The goal of this project is to introduce you to writing a short empirical analysis that evaluates a
health program or investigates a health services research topic. While it is nearly impossible to
write a journal-worthy article in the course of a semester, you should structure your paper as if
you were going to submit it to journal. As such, you should use existing papers in journals such
as Health Services Research as a guide as to how to prepare your paper.
The project will be conducted in the steps listed below. You are strongly encouraged to review
Prof. Quast’s annotations and comments on your submissions and try to incorporate them in later
submissions. The grading (especially in regard to writing quality) will become strict as the
semester proceeds.
1. Proposal describing the program or topic and a
Review the National Academy of Medicine’s 2021 report, “The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity,” located in the topic Resources.
Write a 750‐1,000-word paper discussing the influence of the report on nursing practice. Include the following:
Review the recommendations of The National Academy of Medicine 2021 report and explain why health equity is significant in this report.
Define social determinants of health. Discuss one of the determinants and how this impacts health equity.
Describe the role nurses have in improving health equity and impacting social needs.
Discuss the significance of self-care to decrease nursing burnout. What self-care and evidence-based strategies are available for nurses to maintain personal and spiritual health?
You are required to cite a minimum of three sources to complete this assignment. Sources must be appropriate for the assignment and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Assessment DescriptionOne way to disseminate evidence is through presentation to your peers. For this assignment, you will develop a PowerPoint presentation and present it using Loom. Refer to the topic Resources for additional information and instructions for using Loom.The PowerPoint presentation should include 12-15 slides that can be presented in 7-10 minutes.Your presentation will cover all of all the major areas of your EBP Project proposal. Use your project proposal sections as your guide. You will be assessed on both your subject knowledge and presentation skills (including body language, eye contact, evidence of preparation, content, clear articulation, and adherence to the 7-10-minute time limit).After recording your Loom video, copy and paste the link for your video onto a Word document. Submit only the Word document with the link to the assignment dropbox.
Unformatted Attachment Preview
1
Hospital Acquired Infections (HAIs) due to Inadequate Hand Hygiene Compliance
Antwanetta Boswell
HCA-650
Grand Canyon University
Professor Tucker
09/08/2023
2
Hospital Acquired Infections (HAIs) due to Inadequate Hand Hygiene Compliance
Identify the Problem: Hospital Acquired Infections (HAIs) due to inadequate Hand Hygiene
Compliance.
Background and Significance:
Our healthcare organization has identified a significant issue related to acquired
Infections (HAIs). HAIs significantly threaten patient safety and contribute to increased
healthcare expenses. According to the CDC, 1 out of 31 hospital patients has at least one
healthcare-associated infection. It further outlines that there are numerous HAIs, including
Surgical Site Infections (SSI), Central Line-associated Bloodstream Infections (CLABSI),
Catheter-associated Urinary Tract Infections (CAUTI), and Ventilator-associated Pneumonia
(VAP). Neumark et al. (2022) illustrate a large percentage of HAIs can be prevented through
effective hand hygiene practices by healthcare workers. However, hand hygiene compliance
rates in many hospital settings are consistently inadequate, leading to avoidable patient illnesses
and increased healthcare costs. Our healthcare facility has witnessed 18 HAIs in the last 30 days.
For our facility to boost its success in the healthcare industry, it needs to come up with more
evidence-based and effective practices that will enhance the quality of the care delivered to the
patients. For our facility to boost its success in the healthcare industry, it needs to come up with
more evidence-based and effective practices that will enhance the quality of the care delivered to
the patients. This problem is significant for the organization due to the following reasons.
One, HAIs tend to compromise the patient’s safety. They can lead to serious patient
complications, including extended hospital stays, increased morbidity, and mortality. Ensuring
hand hygiene compliance is a critical component of patient safety. Secondly, HAIs result in
additional healthcare costs, including longer hospital stays, increased antibiotic use, and potential
3
legal liabilities. Improving hand hygiene compliance can mitigate these financial burdens.
Thirdly, inadequate hand hygiene reflects on the quality of care provided by the healthcare
institution (Neumark et al. 2022). Addressing this issue aligns with the organization’s
commitment to delivering high-quality healthcare services. Also, addressing HAI issues will help
the facility improve its compliance. Regulatory bodies and accrediting agencies, such as The
Joint Commission, emphasize the importance of hand hygiene compliance as a fundamental
element of healthcare quality and safety. Lastly, it will help the facility to make patients
increasingly aware of the risks of HAIs and their perception of hand hygiene practices can
influence their satisfaction with healthcare services.
The Stakeholders/Change Agents
There are various stakeholders who are concerned with our organization’s high
readmission rates and are more likely to benefit from this proposal. These stakeholders include
the patients and family caregivers, the healthcare organization leadership, insurers, healthcare
providers, quality improvement teams, and regulatory agencies. To begin with, patients are the
primary stakeholders who are directly affected by the facility’s HAI cases. Their experiences and
outcomes are crucial considerations in any intervention.
Also, the physicians, nurses, and other healthcare professionals who are responsible for
implementing proper hand hygiene practices are integral to achieving higher compliance rates.
Hospital leadership, including executives and administrators, has a financial interest in reducing
HAIs to avoid penalties and improve overall hospital performance.
Similarly, quality improvement teams. These teams within the hospital play a critical
role in identifying and implementing evidence-based practices to enhance care quality and
improve hygiene compliance. Insurance companies and Medicare/Medicaid are stakeholders
4
because they may be financially impacted by high readmission rates as a result of HAIs and
penalties. Regulatory bodies such as the Centers for Medicare & Medicaid Services (CMS) and
The Joint Commission are change agents that set guidelines and standards related to hygiene
compliance and HAI prevention.
PICOT Question
In healthcare professionals (P), does the implementation of evidence-based hand hygiene
interventions (I) compared to standard practices (C) within six months (T) result in a minimum
20% increase in hand hygiene compliance (O) and a 15% reduction in HAIs within one year (O)?
Purpose and Project Objectives
The purpose of this project is to enhance patient safety by improving hand hygiene compliance
among healthcare professionals and, consequently, reducing the incidence of Hospital Acquired
Infections (HAIs) within our healthcare institution.
Project Objectives
1. To assess the baseline hand hygiene compliance rates among healthcare professionals in
our institution.
2. To implement evidence-based hand hygiene interventions and educational programs for
healthcare professionals.
3. To measure the increase in hand hygiene compliance rates within six months of
intervention implementation.
4. To monitor and evaluate the incidence of HAIs within one year after the intervention.
Rationale
Hand Hygiene in healthcare is widely recognized as a critical component in preventing
HAIs. Poor hand hygiene among healthcare practitioners is associated with an increase in the
5
number of HAIs. Neumark et al. (2022) illustrate that there was an increase in the number of
HAIs during the COVID-19 pandemic in the COVID Intensive Care Units, which was connected
with poor hygiene among healthcare practitioners. Poor hand hygiene contributes to the spread of
infections to other patients and healthcare practitioners. Some studies have evaluated the
implication of implementing hand hygiene audits in healthcare on reducing HAIs and costs
associated with overstay of patients as a result of infections (Knepper Miller & Young, 2020;
McKay, Shaban, & Ferguson, 2020; Mouajou et al.2022). Anguraj et al. (2021) found that
implementation of the HH audit reduced the number of HAIs
6
References
Anguraj, S., Ketan, P., Sivaradjy, M., Shanmugam, L., Jamir, I., Cherian, A., & Sastry, A. S.
(2021). The effect of hand hygiene audit in COVID intensive care units in a tertiary care
hospital in South India. American Journal of Infection Control, 49(10), 1247-1251.
Knepper Miller A.M., & Young H.L(2020). Impact of an automated hand hygiene monitoring
system combined with a performance improvement intervention on hospital-acquired
infections. Infection Control & Hospital
Epidemiology.https://doi.org/10.1017/ice.2020.182
McKay, K. J., Shaban, R. Z., & Ferguson, P. (2020). Hand hygiene compliance monitoring: Do
video-based technologies offer opportunities for the future? Infection, Disease &
Health, 25(2), 92–100. https://doi.org/10.1016/j.idh.2019.12.002
Mouajou, V., Adams, K., DeLisle, G., & Quach, C. (2022). Hand hygiene compliance in the
prevention of hospital-acquired infections: a systematic review. Journal of Hospital
Infection, 119, 33-48. https://doi.org/10.1016/j.jhin.2021.09.016
Neumark, Y., Bar-Lev, A., Barashi, D., & Benenson, S. (2022). A feasibility study of the use of
medical clowns as hand-hygiene promoters in hospitals. Plos one, 17(12), e0279361.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0279361
1
Reducing Hospital Acquired Infections (HAIs) through Hand Hygiene Compliance
Antwanetta Boswell
HCA-650
Grand Canyon University
Professor Tucker
09/08/2023
2
Reducing Hospital Acquired Infections (HAIs) through Hand Hygiene(HH) Compliance
Reducing Hospital Acquired Infections (HAIs) through Hand Hygiene Compliance
Hospital Infections (HAIs) endanger patients and raise healthcare expenses. Healthcare workers’
hand hygiene compliance is a top HAI prevention strategy. HH compliance rates in hospital
settings are generally inadequate, resulting in avoidable illnesses. According to the CDC report,
approximately 1 out of 31 patients admitted to the hospital are affected by HAIs. CDC outlines
that there are numerous HAIs, including Surgical Site Infections (SSI), Central Line-Associated
Bloodstream Infections (CLABSI), Catheter-associated Urinary Tract Infections (CAUTI), and
Ventilator-associated Pneumonia (VAP).
Among all HIAs, CAUTI is more likely to occur. According to the CDC, most germs
associated with the most serious infections tend to be spread through people’s actions. In a
greater way, HH plays a great role in preventing these infections. Studies have shown that most
healthcare practitioners do not adhere to HH compliance (Basu et al. 2021). Due to this disregard
of the healthcare practitioners to wash their hands as supposed, this results in the spread of HAIs
in the healthcare settings. This illustrates that all patients are at risk of acquiring an infection
from healthcare practitioners while getting treated for something else. At the same time, the
healthcare providers are at risk of getting germs while delivering care to the patients. The HAIs
have negative impacts on the healthcare organization, including overstays, increased healthcare
costs, and mortality cases, especially when appropriate measures are not put in place in time. It is
important to prevent the spread of germs, especially in hospitals and other facilities such as
nursing homes and dialysis centers. Hand hygiene also serves as a cornerstone in infection
prevention and control programs and is recommended by organizations like the World Health
Organization (WHO) and the Centers for Disease Control and Prevention (CDC).
3
Despite the well-established importance of hand hygiene in preventing HAIs, the
prevalence of these infections remains unacceptably high in healthcare facilities worldwide.
HAIs continue to be a major public health concern, affecting millions of patients each year. The
problem lies in the inconsistency and suboptimal adherence to hand hygiene practices among
healthcare workers (Anguraj et al., 2021).
Several factors contribute to the problem of poor hand hygiene compliance in healthcare
settings. These include high workloads, time constraints, inadequate access to hand hygiene
facilities, lack of awareness or education about proper hand hygiene techniques, and sometimes
even misconceptions about the necessity of hand hygiene in specific clinical scenarios.
Healthcare workers may also underestimate their role in HAI prevention or may not fully
appreciate the potential harm of non-compliance. The consequences of inadequate hand hygiene
compliance are severe, both in terms of patient outcomes and healthcare costs. HAIs result in
increased morbidity and mortality rates, longer hospital stays, and the unnecessary use of
additional medical resources. Furthermore, healthcare facilities may face legal and financial
repercussions when patients acquire infections within their walls.
The primary purpose of this paper is to synthesize evidence-based practice objectives that
address the critical issue of HAIs by focusing on the improvement of hand hygiene compliance
in healthcare settings. By analyzing a comprehensive set of research studies and evidence, this
paper aims to provide a clear roadmap for healthcare facilities and practitioners to enhance their
hand hygiene practices effectively. Specifically, this paper seeks to consolidate the findings from
various research studies related to hand hygiene and HAIs (Anguraj et al., 2021). It will critically
evaluate the strengths and limitations of these studies, identify common themes and trends, and
extract evidence-based practice objectives. These objectives will be aligned with measurable
4
outcomes to ensure their effectiveness in reducing HAIs. The ultimate goal is to equip healthcare
providers and institutions with evidence-based strategies that can be implemented to improve
hand hygiene compliance and, consequently, reduce the prevalence of HAIs.
Objectives
In the context of reducing Hospital Acquired Infections (HAIs) through improved hand
hygiene compliance, evidence-based practice objectives are essential to guide interventions and
evaluate their effectiveness. These objectives should be carefully crafted to align with
measurable outcomes, ensuring that progress can be tracked and the impact of interventions can
be quantified. Here, we discuss the evidence-based practice objectives for the project and the
importance of achieving these objectives for HAI reduction:
a. Increase Hand Hygiene Compliance Rates:
1. Objective: Achieve a minimum of 90% compliance with hand hygiene protocols among
healthcare workers within the next 12 months.
o Measurable Outcome: Regular monitoring and data collection of hand hygiene
compliance rates using a standardized protocol and electronic monitoring systems.
b. Decrease HAI Incidence:
o Objective: Reduce the overall incidence of HAIs in the healthcare facility by 20% within
the next 24 months.
o Measurable Outcome: Regular surveillance and reporting of HAI rates, comparing preintervention and post-intervention periods.
c. Enhance Healthcare Worker Education:
o Increase the proportion of healthcare workers who receive regular hand hygiene
education and training to 100% within the next 6 months.
5
o Measurable Outcome: Documentation of the completion of hand hygiene training for all
healthcare workers
Method Used in Gathering Research
When searching for the articles to be used for this research, several databases were used,
including PubMed, CINAHL, Cochrane Library, and Scopus. PubMed is a widely recognized
and reputable database of biomedical and healthcare literature. It includes a vast collection of
peer-reviewed articles, making it a valuable resource for research studies related to hand hygiene
and healthcare-associated infections (HAIs). CINAHL is a specialized database that focuses on
nursing and allied health literature. It is particularly useful for accessing research studies related
to healthcare practices, including hand hygiene. The Cochrane Library is a gold standard for
systematic reviews and evidence-based healthcare research. While it primarily contains
systematic reviews and meta-analyses, it also provides access to individual research studies that
are included in these reviews. Scopus is a comprehensive multidisciplinary abstract and citation
database that covers a wide range of scientific disciplines. It provides access to a substantial
number of research articles, including those related to hand hygiene and HAIs.
Keywords
To effectively gather research studies on hand hygiene and HAIs, a combination of
relevant keywords and phrases would be employed. Some of the keywords and phrases that
might be used include hand hygiene, Healthcare-associated infections, Infection control,
Healthcare Workers, Surveillance, and effectiveness. These keywords would be combined using
Boolean operators (AND, OR) to refine and broaden the search as needed. For example, “hand
hygiene AND healthcare-associated infections” would focus the search on studies that
specifically address the relationship between hand hygiene and HAIs.
6
Criteria for Inclusion and Exclusion of Studies
While searching for the studies to be utilized for this research, several inclusion and
exclusion criteria were considered, which are discussed in detail here. For an article to be
included in this study, it must be peer-reviewed and published in the past 5 years, conducted a
randomized control study or qualitative study, studies conducted within healthcare settings
(hospitals, clinics, long-term care facilities), and studies published in English.
Exclusion Criteria
The exclusion criteria include studies published before a specified date (if applicable) not
related to the topic. Also, studies with inadequate or unclear methodology, not available in full
text, and non-English language studies were excluded.
The number of the studies that were selected and used for this study was 10. Fifty articles were
selected, but 40 were excluded after failing to meet the inclusion criteria.
Summary
Basu et al. (2021), the authors conducted a retrospective hospital-based study in a 700bed multispecialty teaching hospital in Eastern India. They aimed to understand the impact of the
COVID-19 pandemic on various hospital-acquired infections (HAIs) and healthcare workers’
hand hygiene compliance rates. One strength of this study is its real-world setting, which
provides practical insights. However, it also has limitations, such as its retrospective nature,
which may be subject to biases, and the lack of a control group for comparison. Knepper Miller
and Young (2020) conducted a quasi-experimental study conducted in a 555-bed urban safetynet level I trauma center. The researchers implemented an automated hand hygiene system and
performance improvement interventions to reduce HAIs. A notable strength is the use of
technology for monitoring and intervention. Nevertheless, the study lacks specific
7
recommendations, and the observed outcomes might be influenced by other variables not
controlled for.
Mouajou et al. (2022) conducted a systematic review to evaluate the effect of Hand
hygiene in the prevention of hospital-acquired infections. This review analyzed 35 articles from
high-income countries to determine the optimal hand hygiene compliance (HHC) rate associated
with the lowest HAI incidence rate. The study follows the Preferred Reporting Items for
Systematic Review and Meta-Analysis (PRISMA) guidelines, ensuring rigorous methodology.
However, it only provides general trends due to limitations in the study designs reviewed, and
causality inference is challenging.
Phan et al. (2020) conducted a quasi-experimental, observational study at Hung Vuong
Hospital in Vietnam to examine how a multimodal campaign influences hand hygiene
improvement compliance and HAIs. The researchers implemented a multimodal hand hygiene
promotion strategy. Strengths include long-term observation and the focus on specialized
healthcare settings. Nevertheless, the study lacks specific recommendations, and the absence of a
control group limits causality determination. Swanson et al. (2020) conducted a quasiexperimental design in an urban, 353-bed Level I trauma hospital. The study evaluated the
implementation of an electronic hand hygiene compliance monitoring system (eHHCMS) to
reduce HAIs. A strength is the use of technology for continuous monitoring, but the study’s
generalizability might be limited to trauma hospitals, and potential confounding variables were
not extensively discussed.
McKay et al. (2020), the researchers conducted a literature review and exploration of
concepts to address the barrier of healthcare-associated infections (HAIs) related to hand hygiene
compliance. They investigated the potential of video-based technologies as an alternative method
8
for monitoring hand hygiene compliance. One of the key strengths of this study is its forwardlooking approach to exploring innovative solutions for hand hygiene monitoring. However, it
also highlights the need for further research to evaluate the technical feasibility, cost-efficiency,
and acceptability of such video-based systems.
Anguraj et al. (2021) aimed to understand the roles and responsibilities of healthcare
aides (HCAs) in infection prevention and control (IPC) in long-term care settings, addressing the
barrier of a lack of standardized roles for HCAs. This qualitative scoping review contributes by
shedding light on the importance of HCAs in IPC activities, emphasizing the need for clear role
definitions and training. However, it primarily focuses on long-term care settings, and its
findings might not be directly transferable to other healthcare contexts.
Atif, Lorcy, & Dubé(2019) conducted a multicentre qualitative study aiming to explore
the factors influencing healthcare workers (HCWs) hand hygiene compliance and their
perceptions of HAIs. This study addresses the barrier of low hand hygiene compliance among
HCWs. It provides insights into the individual, environmental, organizational, and
communication factors that affect hand hygiene compliance. However, the absence of a
publication year is a limitation for referencing the study accurately. Salma et al. (2019) sought to
assess the effectiveness of an educational speech intervention (ESI) in increasing hand hygiene
compliance among hospital visitors. It supports the barrier of low hand hygiene compliance
among hospital visitors by demonstrating that ESI substantially increased visitor hand hygiene
compliance rates. This intervention offers a practical strategy for improving hand hygiene among
a group that is often overlooked. Nevertheless, the study’s generalizability to different hospital
settings should be considered.
9
Villareal et al. (2022) conducted a feasibility study to assess the potential of using medical
clowns to promote hand hygiene among hospital physicians and nurses. This study addresses the
barrier of poor hand hygiene compliance among healthcare workers. The findings indicate that
medical clowns can engage healthcare practitioners effectively, promoting positive behavioral
change and reducing healthcare-associated infections. However, as it is a feasibility study, further
research is needed to confirm the long-term impact and scalability of this approach.
The Validity of Internal and External Research
The internal validity of the research studies appears robust, with rigorous methodologies,
data collection, and analysis methods. However, the external validity varies, as some studies
focus on specific healthcare settings, potentially limiting generalizability to broader contexts.
Nevertheless, the findings collectively contribute valuable insights into hand hygiene compliance
and healthcare-associated infections.
10
References
Anguraj, S., Ketan, P., Sivaradjy, M., Shanmugam, L., Jamir, I., Cherian, A., & Sastry, A. S.
(2021). The effect of hand hygiene audit in COVID intensive care units in a tertiary care
hospital in South India. American Journal of Infection Control, 49(10), 1247-1251.
Atif, S., Lorcy, A., & Dubé, E. (2019). Healthcare workers’ attitudes toward hand
hygiene practices: Results of a multicentre qualitative study in Quebec. Canadian
Journal of Infection Control, 34(1). https://doi.org/10.36584/cjic.2019.004
Basu, M., Mitra, M., Ghosh, A., & Pal, R. (2021). Journal of Family Medicine and Primary Care,
10(9), 3348. DOI: 10.4103/jumps.jfmpc_742_21
https://www.sciencedirect.com/science/article/pii/S0196655321004831
Knepper Miller A.M., & Young H.L(2020). impact of an automated hand hygiene monitoring
system combined with a performance improvement intervention on hospital-acquired
infections.Infection Control & Hospital Epidemiology.
https://doi.org/10.1017/ice.2020.182
Mckay, K. J., Shaban, R. Z., & Ferguson, P. (2020). Hand hygiene compliance monitoring: Do
video-based technologies offer opportunities for the future? Infection, Disease &
Health, 25(2), 92–100. https://doi.org/10.1016/j.idh.2019.12.002
Mouajou, V., Adams, K., DeLisle, G., & Quach, C. (2022). Hand hygiene compliance in the
prevention of hospital-acquired infections: a systematic review. Journal of Hospital
Infection, 119, 33-48. https://doi.org/10.1016/j.jhin.2021.09.016
Neumark, Y., Bar-Lev, A., Barashi, D., & Benenson, S. (2022). A feasibility study of the use of
medical clowns as hand-hygiene promoters in hospitals. Plos one, 17(12), e0279361.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0279361
11
Phan, H. T., Zingg, W., Tran, H. T. T., Dinh, A. P. P., & Pittet, D. Sustained effects of a
multimodal campaign aiming at hand hygiene improvement on compliance and
healthcare-associated infections in a large gynecology/obstetrics tertiary-care center in
Vietnam, 2020. https://doi.org/10.1186/s13756-020-00712-x
Swanson, S., Baken, L., & Bor, B. Implementation of a Hospital-wide Electronic Hand Hygiene
Monitoring Program Reduces Healthcare-acquired Infections in a Level I Trauma
Hospital. https://www.ajicjournal.org/article/S0196-6553(20)30389-8/pdf
Villarreal, S., Khan, S., Oduwole, M., Sutanto, E., Vleck, K., Katz, M., & Greenough, W. B.
(2020). Can educational speech intervention improve visitors’ hand hygiene compliance?
Journal of Hospital Infection, 104(4), 414–418. https://doi.org/10.1016/j.jhin.2019.12.002
1
Proposed Solution
Antwanetta Boswell
Grand Canyon University
HCA-650
Professor Tucker
09/15/2023
2
Proposed Solution
Treatments for improving hand hygiene compliance and reducing HAIs are based on
scientific evidence. This technique enhances patient safety, lowers healthcare-associated
infections, and complements current evidence.
Several studies and regulations emphasize the need for hand hygiene to prevent infection
in hospital settings. To prevent HAIs, the WHO and CDC recommend evidence-based hand
hygiene. These guidelines emphasize the necessity of washing your hands with soap and water or
alcohol-based hand sanitizers before invasive operations, after handling surrounding surfaces,
and before patient contact.
Several academic sources support the answer. Evidence-based hand hygiene programs
improved healthcare professionals’ compliance with hand hygiene recommendations and
decreased HAIs, according to a thorough research published in the Journal of Hospital Infection
Wang et al. (2021) found that hand hygiene promotion programs are more cost-effective than
HAI therapy in the American Journal of Infection Control.
The proposed system also adheres to evidence-based practice, which combines expert
judgment, patient preferences, and the most reliable data for making judgments. Healthcare
professionals may adhere to the most recent research and recommendations by employing
evidence-based hand hygiene techniques.
The suggested approach complies with current research and standards, but its deployment
in a hospital setting must be considered. Consideration must be given to resource availability,
training requirements, and organizational support to adopt and improve hand hygiene
compliance. To aim for a minimum 20% increase in hand hygiene compliance and a minimum
3
15% decline in HAIs within a year, track progress, and assess the effectiveness of the
intervention.
Organizational or Community Culture
The effectiveness of a healthcare intervention is contingent upon factors such as the
organizational culture and the availability of resources, which may be exemplified by the
improvement of hand hygiene to mitigate the occurrence of healthcare-associated infections
(HAIs). Healthcare facilities need to embody the cultural values and principles of the
organization. Hand hygiene procedures are a preventive measure against patient harm, rendering
them highly sought after by healthcare institutions prioritizing their patients’ safety (ToneyButler & Carver, 2019). Cultures of continuous improvement can be effectively aligned with
evidence-based approaches. The enhancement of organizational leadership commitment and
accountability serves to reinforce the responsibility for patient outcomes.
The alignment of resources is paramount in ensuring sustainability and usefulness. Costbenefit evaluations indicate that hand hygiene initiatives possess financial sustainability,
facilitating sensible resource management. The presence of individuals who possess expertise
and have received training in infection control facilitates a more streamlined implementation
process. The feasibility and effectiveness of the intervention are evident within the operational
framework of the healthcare institution due to its seamless integration with existing processes
and utilization of data analytics to coordinate with available time and technology resources.
Integrating these components increases the probability of a hand hygiene intervention being
efficacious and aligning with the organizational culture and available resources.
Stakeholders
4
The effectiveness of the project depends on the varied groups of stakeholders
participating in the implementation of evidence-based hand hygiene treatments to minimize
hospital-acquired infections (HAIs) (Gould et al., 2017). The success of the intervention is
directly impacted by the implementation of hand hygiene practices by healthcare personnel,
including physicians and nurses. Patient safety and health outcomes depend on increased hand
hygiene compliance because they are the primary beneficiaries. The hospital administration is
essential in allocating funds, establishing guidelines, and promoting a hand hygiene-friendly
culture. Teams dedicated to infection control and prevention create, oversee, and assess infection
control procedures to ensure the longevity of the intervention. Families and caregivers must be
educated and encouraged to participate in hand hygiene practices while engaging in patient care.
At the same time, hospital support employees, such as janitors, are crucial for keeping a clean
and infection-free environment.
A thorough plan is necessary to interact with these stakeholders successfully. Regular
training sessions and reminders built into their schedules, using intranet portals and email
updates for information distribution, might benefit healthcare personnel. Posters and pamphlets
can serve as reminders, while patients can also get education through materials and instructive
seminars. Hospital administration should frequently get updates and progress reports through
meetings and presentations. Teams in charge of infection control and prevention should keep
communication lines open with clinical staff members and have frequent meetings and datasharing sessions. Hospital support workers must attend training sessions and briefings. During
the admission and release of patients, conversations with relatives and caregivers about their
responsibility in upholding hand hygiene can occur. The effectiveness of the hand hygiene
initiative depends critically on effective communication with these stakeholders.
5
Expected Outcomes and Goals
The hand hygiene intervention is designed to provide several distinct and
quantifiable results. With regular monitoring and comparisons to baseline data, it first aims to
raise hand hygiene compliance among healthcare personnel by at least 20% within six months.
By introducing evidence-based hand hygiene practices and monitoring infection rates against
historical data, the intervention seeks to reduce Healthcare-Associated Infections (HAIs) by 15%
within a year. Improved patient safety and satisfaction are a secondary but crucial result of
decreased HAIs, resulting in fewer complications, shorter hospital stays, and higher patient
satisfaction ratings (Haque et al., 2018). By lessening the cost of treating HAIs and
demonstrating a return on investment, the intervention also attempts to show cost savings. The
effectiveness of enhanced hand hygiene practices and a long-lasting infection prevention culture
will be determined by continued adherence to hand hygiene guidelines after the first
implementation phase.
In conclusion, the hand hygiene intervention’s anticipated aims and results include better
patient safety and satisfaction, decreased HAIs, higher compliance, cost savings, and a longlasting culture of infection prevention within the healthcare context. These goals are intended to
enhance healthcare procedures and patient outcomes significantly and are connected to the
PICOT question.
Method to Achieve Outcomes
A thorough approach is necessary to increase hand hygiene compliance and
decrease hospital-acquired infections (HAIs) within predetermined timeframes. This plan
includes the following crucial components:
6
Programs for education and training must be implemented first. Targeting healthcare
professionals and support employees, this training should stress the importance of hand
cleanliness, offer precise instructions, and refute prevalent myths. Second, monitoring and
feedback systems need to be put in place. Hand hygiene compliance should be tracked using a
thorough monitoring strategy that combines technological instruments and manual inspections.
For changes to last, immediate feedback that emphasizes constructive criticism and positive
reinforcement is essential.
Additionally, technology-enhanced reminders and prompts incorporated into processes
and strategically positioned around healthcare facilities help ensure hand hygiene is routinely
maintained. Leadership support is necessary to establish an example and preserve an infection
prevention culture. Data-driven decision-making,
Length: A minimum of 180 words, not including references
Compare/Relate to another study
Citations: At least one high-level scholarly reference in APA from within the last 5 years
Dementia, Parkinson’s Disease (PD), and depression are intricate health concerns with accessible medicines for managing their symptom. In this discussion, we will discover dementia treatment, behavioral problems in dementia patients, the role of Levodopa in PD, and the difference between Venlafaxine and tricyclic antidepressants (McFall et al., 2023).
Medication in Dementia and Their Adverse Effects
Dementia is a progressive neurological condition characterized by a decline in cognitive function, memory, and the ability to perform everyday tasks, often resulting from underlying conditions like Alzheimer’s. There is no treatment, but numerous medicines are available to manage its symptoms (McFall et al., 2023). Two primary classes of drugs used for treating dementia are Cholinesterase Inhibitors and N-methyl-d-aspartate (NMDA) receptor antagonists (Steven et al., 2023). One of the most recommended Cholinesterase Inhibitors is Donepezil, accessible by the trade name Aricept. Its generic name is Donepezil. Side effects of this drug include diarrhea, headaches, and nausea. However, more critical side effects can involve reduced heart rate or gastrointestinal bleeding (Steven et al., 2023).
The other class of drugs utilized to treat dementia patients is NMDA receptor antagonists, with Memantine as a frequently recommended medicine, labeled with the trade name Namenda. Its generic name is Memantine. Side effects of Memantine include lightheadedness, bewilderment, and headache. In several cases, patients can face more severe side effects, such as hallucinations or increased blood pressure. The medication selection and its side effects should be sensibly considered while consulting a medical expert (Steven et al., 2023).
Behavioral Disturbances in Dementia and Treatment
Dementia can result in numerous behavioral disturbances, which becomes challenging for patients as well as their caregivers (Ambrogio et al., 2019). Two major disturbances are anxiety and depression. Anxiety can be treated with medicines such as Risperidone, marketed by its trade name, i.e., Risperdal, and its generic name, Risperidone. However, it is significant to observe that Risperidone can cause side effects like weight gain, drowsiness, and an increased chance of stroke, specifically in aging patients (Ambrogio et al., 2019).
Depression is another major problem in dementia patients, and it can be treated with antidepressants such as Sertraline, sold under the trade name Zoloft and its generic name, Sertraline (Ambrogio et al., 2019). As Sertraline is commonly well-tolerated, common side effects include insomnia, nausea, and sexual dysfunction. Medication decisions for behavioral disturbances must be discussed with a medical facilitator, valuing the sole needs of patients and potential side effects (Ambrogio et al., 2019).
Levodopa in Parkinson’s Disease
Levodopa is a vital medicine for managing Parkinson’s disease, a neurodegenerative problem characterized by a deficiency of dopamine in the brain. Levodopa is changed into dopamine in the human brain, easing motor symptoms like rigidity, bradykinesia, and tremors (Beckers et al., 2022). It is frequently used in a mixture with Carbidopa, which stops the early breakdown of Levodopa in the bloodstream, enabling it to reach the brain and decreasing peripheral adverse effects (Beckers et al., 2022).
However, Levodopa also has several side effects. Patients undergoing Parkinson’s disease can experience adverse effects like vomiting or nausea, reduced blood pressure while standing up, irregular unintentional movements, and psychiatric disturbances such as hallucinations or confusion with lasting use (Beckers et al., 2022). These adverse effects necessitate careful monitoring and adjustment of medicine doses by a medical facilitator to acquire the optimal balance between symptom relief and side effect management.
Combination of Levodopa and Carbidopa
The combination of levodopa and carbidopa, often sold under the trade name Sinemet, is commonly prescribed in Parkinson’s disease treatment (Müller, 2020). Carbidopa is used alongside levodopa to enhance its effectiveness by preventing the breakdown of levodopa in the bloodstream before it reaches the brain. This allows for lower doses of levodopa, reducing the risk of nausea and other peripheral side effects. The combination therapy provides better control over motor symptoms and improves the overall quality of life for patients with Parkinson’s disease (Müller, 2020).
Other Drugs for Parkinson’s Disease
Besides Levodopa and Carbidopa, there are various other medicines utilized for treating Parkinson’s Disease (PD). These involve dopamine agonists such as Pramipexole and Ropinirole, which increase dopamine receptors in the human brain, Monoamine Oxidase-B (MAO-B) inhibitors such as Selegiline and Rasagiline that assist in preserving dopamine levels, and Anticholinergic agents such as trihexyphenidyl that can handle various symptoms (Nyholm & Jost, 2022). Some progressive treatments, like deep brain stimulation, can be utilized for some patients. The selection of medication depends on the patient’s symptoms and response to medication (Nyholm & Jost, 2022).
Venlafaxine VS. Tricyclic Antidepressants (TCAs)
Venlafaxine is a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) utilized to combat depression. It is unlike Tricyclic Antidepressants (TCAs) in its mechanism of action (Henrik Galust et al., 2023). As TCAs prevent the reuptake of Serotonin and Norepinephrine, venlafaxine has a more demanding action on these Neurotransmitters. This can result in fewer anticholinergic adverse effects, like dry mouth, constipation, and blurry vision, which are usual symptoms in TCAs (Henrik Galust et al., 2023).
However, venlafaxine also has its own set of side effects. People consuming venlafaxine can face side effects such as sleeplessness, nausea, and sexual dysfunction. Moreover, venlafaxine can cause high blood pressure, particularly at increased doses. People recommended to take venlafaxine must be observed for these side effects, and the selection of antidepressants must depend on the individuals’ needs and acceptability, with the intimate direction of a healthcare provider (Henrik Galust et al., 2023).
Conclusion
Medicines are significant in administering disorders such as dementia, PD, and depression. Cholinesterase inhibitors and NMDA receptor antagonists assist dementia patients, but adverse effects should be observed. The use of drugs such as Risperidone and Sertraline can cause behavioral problems. Levodopa is essential for medicating Parkinson’s, often mixed with carbidopa. Numerous other Parkinson’s drugs provide options. The selection between venlafaxine and tricyclic antidepressants relies on different aspects. However, discussions with medical experts are necessary for well-informed decisions.
References
Ambrogio, Martella, Odetti, & Monacelli. (2019). Behavioral disturbances in Dementia and beyond Time for a new conceptual frame? International Journal of Molecular Sciences, 20(15), 3647. https://doi.org/10.3390/ijms20153647
Beckers, M., Bloem, B. R., & Verbeek, M. M. (2022). Mechanisms of peripheral levodopa resistance in Parkinson’s disease. Npj Parkinson’s Disease, 8(1). https://doi.org/10.1038/s41531-022-00321-y
Henrik Galust, Hardin, J., Friedman, N. R., Seltzer, J., & Clark, R. F. (2023). QRS prolongation after seizure in a patient with venlafaxine overdose. The Journal of Emergency Medicine. https://doi.org/10.1016/j.jemermed.2023.07.003
McFall, G. P., Bohn, L., Gee, M., Drouin, S. M., Fah, H., Han, W., Li, L., Camicioli, R., & Dixon, R. A. (2023). Identifying key multi-modal predictors of incipient dementia in Parkinson’s disease: A machine learning analysis and Tree SHAP interpretation. Frontiers in Aging Neuroscience, 15. https://doi.org/10.3389/fnagi.2023.1124232
Müller, T. (2020). Pharmacokinetics and pharmacodynamics of levodopa/carbidopa therapies for Parkinson’s disease. Expert Opinion on Drug Metabolism & Toxicology, 16(5), 403–414. https://doi.org/10.1080/17425255.2020.1750596
Nyholm, D., & Jost, W. H. (2022). Levodopa–entacapone–carbidopa intestinal gel infusion in advanced Parkinson’s disease: Real-world experience and practical guidance. Therapeutic Advances in Neurological Disorders, 15. https://doi.org/10.1177/17562864221108018
Read the article titled: COVID-19 Infections, PandemicRelated Social and Economic Impacts,
and Changes to Mental and Self-Rated
Health Among Latinx Immigrant
Housecleaners in New York City:
The Safe and Just Cleaners Study. The article is attached. The rubric to follow i attached. The questions to fill out is attached,
Unformatted Attachment Preview
RESEARCH & ANALYSIS
COVID-19 Infections, PandemicRelated Social and Economic Impacts,
and Changes to Mental and Self-Rated
Health Among Latinx Immigrant
Housecleaners in New York City:
The Safe and Just Cleaners Study
Sherry Baron, MD, MPH, Isabel Cuervo, PhD, Dhwanil Shah, MPH, Ana Gonzalez, BA, Homero Harari, ScD, and Deysi Flores, BA
Objectives. To estimate impacts of COVID-19 infections and social and economic sequelae on mental
AJPH
and self-rated health among Latinx immigrant housecleaners in New York City.
housecleaners initially surveyed before the pandemic between August 2019 and February 2020. We
measured rates of self-reported COVID-19 infections, COVID-19 antibodies, and pandemic-related social
and economic sequelae and examined predictors of mental and self-rated health changes using logistic
regression models.
Results. Fifty-three percent reported COVID-19 infections, consistent with the rate demonstrating
August 2023, Vol 113, No. 8
Methods. From March to June 2021, we conducted a follow-up study with 74% retention of 402
COVID-19 antibodies. During shutdown of nonessential services, from March 22 to June 8, 2020,
29% worked as housecleaners, although this was not associated with higher COVID-19 infection rates.
COVID-19–related stigma at work, lost earnings owing to COVID-19 infections, housing insecurity, food
insecurity, and unsafe homes, including experiencing intimate partner verbal abuse, were statistically
associated with changes in mental or self-rated health compared with prepandemic measures.
Conclusions. The disproportionate impact and virtually nonexistent safety net housecleaners
experienced during the first year of the pandemic highlight the importance of inclusive stopgap
measures to mitigate economic insecurity and its sequelae. (Am J Public Health. 2023;113(8):893–903.
https://doi.org/10.2105/AJPH.2023.307324)
I
nequities in the distribution of
families, especially immigrants and
rigorously and effectively monitors and
COVID-19 infection–related morbidity
others who were excluded from unem-
intervenes in upstream social and eco-
and mortality by race, ethnicity, and
ployment compensation, stimulus
nomic factors linked to health
economic status are well-documented.1
payments, and other health and social
inequities.3
Also important to understand is the dis-
assistance programs.2 Understanding
parate effects of the pandemic’s social
these factors can contribute to better
distribution of pandemic-related eco-
and economic sequelae on health. Loss
public health planning consistent with
nomic and social impacts on health,
of earnings were potentially significant
public health leaders’ calls for a new
the National Institutes of Health funded
for many low-income workers and their
Public Health 3.0 model that more
the COVID-19 Social, Behavioral, and
To better characterize the extent and
Research
Peer Reviewed
Baron et al.
893
RESEARCH & ANALYSIS
Economic (SBE) Impacts initiative, which
and street outreach in 4 of 5 boroughs
employment characteristics before the
provided supplemental funding to
of NYC and 2 suburban communities.
pandemic as those who participated in
ongoing health studies, prioritizing inves-
The prepandemic survey was interview-
the follow-up study except nonpartici-
tigators actively engaged with dispropor-
er administered in person in Spanish,
pants were more likely to report they
4
tionately affected populations. We
and 70% of those who had expressed
were the family primary wage earner
report on findings from a COVID-19 SBE
interest in the study completed the sur-
before the pandemic (59% of nonparti-
study that targeted Latinx immigrant
vey between July 2019 and February
cipants vs 39% of participants; x2
housecleaners in New York City (NYC)
2020. The prepandemic survey partici-
P < .01).
enrolled in the Safe and Just Cleaners
pants were similar to the estimated
Study,5 an ongoing community-based
343 527 housecleaners in the United
participatory research study exploring
States in 2019. Participants were 99%
the role of working conditions and expo-
female, average age was 44 years, all
We measured participants’ COVID-19
sures to household cleaning products
were foreign-born and had lived in the
status using self-report because it was
on the health of housecleaners, one of
United States on average 15 years, and
difficult to access medical care or test-
the most common occupations for
only 14% reported feeling comfortable
ing in the early months of the pandemic
documented and undocumented Latinx
with spoken English. Most were self-
in NYC,9 especially because 49% of the
women.6
employed, worked an average of
cohort reported not having health in-
22 hours per week for an average of
surance on their prepandemic survey.5
survey before the pandemic, between
3 clients, and earned less than $18 000
We measured whether respondents
July 2019 and February 2020, to 402
per year; 44% were the primary wage
ever had COVID-19 with the survey
Spanish-speaking housecleaners in the
earners for their families.5
question “Do you think that you had
AJPH
August 2023, Vol 113, No. 8
We had recruited and administered a
For this follow-up COVID-19 study, we
COVID-19?” or whether they reported
that survey, exploring pathways
attempted to recontact the 402 house-
ever having a positive COVID-19 nasal
through which the housecleaners’ em-
cleaners who participated in the pre-
swab test. For those reporting they had
ployment and working conditions af-
pandemic survey at least 3 times by
had COVID-19, we asked whether they
fected their mental and self-rated
telephone and text messaging in Span-
had been hospitalized. We also asked
health, were previously reported. In
ish to invite them to participate. For
the number of household members
this follow-up study, conducted be-
those who agreed to participate, a tele-
who ever had COVID-19, whether family
tween March and June 2021, we resur-
phone survey lasting approximately
members or close friends had died of
veyed our participants to (1) document
30 minutes was administered in Span-
COVID-19, and whether the respondent
housecleaners’ experience with
ish between March 18 and June 11,
had received or planned to receive a
COVID-19 infections and SBE effects
2021, by bilingual or native Spanish
COVID-19 vaccination.
during the pandemic, (2) measure
speakers trained in survey administra-
changes in the housecleaners’ mental
tion techniques. We collected and man-
whether participants worked as a
and self-rated health compared with
aged data using the REDCap tool
housecleaner during the citywide shut-
findings from our prepandemic survey,
hosted at the Icahn School of Medicine
down for nonessential work (March
and (3) explore how housecleaners’
at Mount Sinai,8 and participants were
22–June 8, 2020), their pay during that
experiences with COVID-19 infections
offered a $30 incentive.
period, and whether they returned to
NYC metropolitan area. Results from
5
Employment-related items captured
Of the 402 housecleaners who partic-
housecleaning work after the shut-
sured changes in the participants’ men-
ipated in the prepandemic survey, 296
down. We drew other SBE measures
tal and self-rated health.
(74%) participated in the COVID-19
from the COVID-19 resources in the
follow-up survey, 27 (7%) were not in-
PhenX Toolkit,10 including COVID-19–
terested, 24 (6%) had disconnected
related stigma at work, defined as
and SBE effects might predict mea-
METHODS
894
Survey Measures
7
telephones, and 55 (14%) did not re-
“feeling afraid or embarrassed to tell an
In 2019 we recruited the initial cohort of
spond. The housecleaners who did not
employer if they were to have COVID-19”
402 housecleaners through partnerships
participate in the COVID-19 follow-up
and a 2-item domestic insecurity mea-
with community-based organizations
survey had similar demographic and
sure asking whether, since the beginning
Research
Peer Reviewed
Baron et al.
RESEARCH & ANALYSIS
of the pandemic, the participant felt safe
Platelia test for IgA, IgM, and IgG, which
variables significant at the a 5 0.05
at home and whether they experienced
targets the SARS-CoV-2 (severe acute
level. We estimated adjusted odds
intimate partner verbal abuse. For hous-
respiratory syndrome coronavirus 2)
ratios (AORs) along with 95% confi-
ing insecurity, we asked about the stabili-
nucleocapsid protein (manufacturer
dence intervals (CIs). We dichotomized
ty of their current housing situation and
sensitivity 5 98.0%; specificity 5 99.3%).
predictor variables unless otherwise
the amount of back rent they owed. To
The study laboratory also validated this
specified. To differentiate the magni-
assess food insecurity over the previous
assay for use with DBS, which found
tude of food insecurity, we created an
12 months, we used the 2-item food in-
100% sensitivity and 100% specificity.18
ordinal scale (0–4) by summing the 2
security screening tool, which has good
Participants received letters from a
responses, with “sometimes” experienc-
sensitivity, specificity, and accuracy in
study physician explaining their results.
ing food insecurity contributing 1 point
and “often” contributing 2 points for
adults, including Spanish speakers and
low-income respondents.11
Data Analysis
each of the questions. We excluded
To measure changes in mental and
participants with missing information
self-rated health, we repeated the mea-
After conducting descriptive analyses, we
on a variable only from analyses in-
sures from our prepandemic survey:
compared demographic, employment-
volving that variable. We conducted
the Center for Epidemiologic Studies
related, and social characteristics of those
all analyses using SAS version 9.2 (SAS
Depression 10-item scale (CES-D-10),12
who reported having had COVID-19 to
Institute, Cary, NC).
Cohen’s Perceived Stress 10-item scale
these characteristics of those who did
(PSS),13 and the single-item self-rated
not by using the x2 test for categorical
overall health scale,14 using the Spanish
variables or the t test for continuous
validated versions of each measure.15
variables. We next examined predictors
AJPH
RESULTS
At the time of the survey, 153 partici-
stress (PSS), and self-rated health using
pants (51.7%) reported that they had
separate logistic regression models for
ever had COVID-19, and of those, 9
each outcome measure. To dichoto-
(5.9%) reported being hospitalized. The
We assessed the validity of COVID-19
mize these outcome measures, we
seasonal distribution of cases (spring
self-reports using an at-home self-
used the same cutpoints as in our pre-
2020: 55%; summer and fall 2020: 16%;
collected dried blood spot (DBS) kit,
pandemic study.5 For the CES-D-10, we
and winter 2021: 29%) mirrored the
replicating the procedures used in an-
used the recommended cutpoint
overall pattern in NYC.21 Among those
other national study.16 DBS kits were
(≥ 10).19 For the PSS, we used a cutpoint
sent from and returned to the study
20
suggested for health screenings (≥ 14)
whether they had COVID-19, 5 partici-
laboratory (Molecular Testing Laborato-
and consistent with the mean score
pants (1.7%) reported a positive nasal
ries, Vancouver, WA) via the US Postal
found in the Hispanic Community
swab test. Of the 296 participants, 218
COVID-19
Serology Measures
who did not think or did not know
Service in self-addressed, stamped
Health Study.
For self-rated health, we
(74%) consented to receive a DBS kit,
envelopes containing a biohazard bag.
compared those reporting poor or fair
and 116 (53% of those receiving a kit
A Spanish-language video, developed
health to those reporting good, very
and 39% of survey participants)
and validated by another research
good, or excellent health.
returned their kit. The rate of self-
17
team
and customized with an intro-
15
Our modeling used a stepwise
reported COVID-19 was similar be-
duction by our study’s outreach worker,
elimination method in multiple stages
tween those who returned the DBS kit
demonstrated procedures to complete
beginning with demographic and
and the others (Table 1). Of the 116
the home test. We reminded partici-
COVID-19–related variables, then
returned samples, only 5 (4%) were
pants at least 3 times to return their
employment-related variables, then
indeterminant and 66 (57%) were posi-
kits and offered an additional $20 in-
other SBE variables. At each step, we
tive for antibodies. Among those with
centive when kits were returned.
retained variables significant at a 5 0.2.
positive antibodies, 18% reported not
In the final step, we added the baseline
having had COVID-19, and 27% of
cimens for total antibodies using the
prepandemic value of the health out-
those reporting having had COVID-19
Bio-Rad Laboratories (Hercules, CA)
come being modeled and retained all
tested negative for antibodies (Table 1).
The study laboratory tested DBS spe-
August 2023, Vol 113, No. 8
of depression (CES-D-10), perceived
Research
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895
RESEARCH & ANALYSIS
TABLE 1— Self-Reports of COVID-19 Infections and Dry Blood Spot (DBS) SARS-CoV-2 Antibody Home
Testing Results: Safe and Just Cleaners Study, New York City, March–June 2021
Self-Report of
Ever Having Had
COVID-19
Antibody Negative
DBS Results (n = 45),
No. (%)
Antibody
Indeterminant DBS
Results (n = 5),
No. (%)
All Participants
(n = 296), No. (%)
Returned DBS Kit
(n = 116), No. (%)
Antibody Positive
DBS Results (n = 66),
No. (%)
158a (53)
63b (54)
49b (74)
12 (27)
2 (40)
Don’t Know
21 (7)
8 (7)
5 (8)
3 (7)
0 (0)
No
117 (40)
45 (39)
12 (18)
30 (67)
3 (60)
Yes
Note. SARS-Cov-2 5 severe acute respiratory syndrome coronavirus 2.
a
Includes 5 participants who reported positive COVID-19 nasal swab tests and “no” (n 5 4) or “prefer not to answer” (n 5 1) when asked whether they had
had COVID-19.
b
Includes 1 participant who reported a positive COVID-19 nasal swab test but answered “prefer not to answer” when asked whether they had had
COVID-19.
AJPH
August 2023, Vol 113, No. 8
Impacts
896
their client (Table 2). Many houseclea-
At the time of the survey, March to
ners who reported losing pay during
June 2021, most respondents (89%;
Table 2 provides descriptive statistics
the shutdown because they were con-
n 5 265) were employed, yet 207 (70%)
for COVID-19 infection–related and SBE
cerned they might infect their client
reported earning less than $1000 per
effects. COVID-19 deaths among family
likely lost pay because they themselves
month from all jobs, and 133 (45%)
members and close friends were
had COVID-19. Among those who lost
reported being their family’s primary
reported by 152 (51%) of participants.
paid workdays during the spring 2020
wage earner. Since March 2020, only
Participant acceptance of the COVID-19
shutdown period, 23 (53%) reported
8% (n 5 23) of all participants had re-
vaccine appeared high. The vaccine be-
having had COVID-19 during spring
ceived unemployment compensation,
came available to all adults in NYC at
2020 compared with 61 (24%) of all
the beginning of April 2021. During the
other study participants (P < .01).
32% (n 5 94) received Supplemental
first half of our survey administration
At the end of the shutdown, 231 parti-
period, March 18 to April 30, 2021, only
cipants (78%) worked as housecleaners,
27% (n 5 44) had received at least 1
17 (6%) worked in a job other than
COVID-19 vaccine shot. For those sur-
housecleaning, and 48 (16%) were not
veyed between May 1 and June 11, 66%
employed. For the working houseclea-
(n 5 88) reported receiving at least 1
ners, 128 (55%) reported they were ex-
shot. Most (76%) of those not vaccinat-
tremely or very concerned about having
ed intended to get vaccinated.
enough clients to meet their financial
Nutrition Assistance, and 11% (n 5 34)
had received any other form of governmental financial benefits.
Given such low earnings and benefits,
it is unsurprising that reports of food insecurity were common, with 254 (86%)
indicating they “sometimes” or “often”
experience food insecurity on at least 1
of the 2 food insecurity questions.
Most participants (93%; n 5 275)
needs. We also found that only 84 (36%)
reported they were still working in
felt they could take sick leave, paid or
housecleaning in March 2020 just be-
unpaid, during the pandemic without
fore the citywide COVID-19 shutdown
retaliation. Given widespread concern
not have a fixed place to live, 118 (40%)
period (March 22–June 8, 2020), and of
about infection control, 142 (61%)
worried about having a secure living sit-
those, 85 (31%) continued to work as
reported using more disinfectant clean-
uation in the future, and 71 (24%)
housecleaners during the shutdown,
ing products at work. Almost half of all
reported being behind on rent by at
144 (52%) reported not receiving any
respondents (47%; n 5 138) reported
least $1000. Regarding domestic safety,
housecleaning income during the shut-
that if diagnosed with COVID-19, they
excluding 7 participants who did not
down, and 43 (16%) reported losing
would be likely or somewhat likely to
feel comfortable answering these ques-
paid housecleaning workdays because
feel afraid or embarrassed to disclose
tions, 59 (20%) reported feeling only a
they were concerned they might infect
this information to their employer.
little safe or unsafe inside their own
Research
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Baron et al.
Housing insecurity was also common.
Although only 16 participants (5%) did
RESEARCH & ANALYSIS
TABLE 2— COVID-19–Related Impacts; Employment, Social, and Economic Impacts; and Mental and SelfRated Health: Safe and Just Cleaners Study, New York City, March–June 2021
No. (%)
COVID-19–related impacts
Infection and exposure
158a (53)
Self-reported ever had COVID-19 or a positive test
Hospitalized with COVID-19
9 (3)
Not hospitalized but had COVID-19
149 (50)
Other members of household ever had COVID-19
182 (61)
Family/friends in US or other country died of COVID-19
152 (51)
Vaccination status
Vaccinated with at least 1 COVID-19 shot
132 (45)
Among 163 surveys completed March 18–April 30
44 (27)
Among 133 surveys completed May 1–June 11
88 (66)
Not vaccinated but probably will get vaccinated
123 (42)
Employment-related impacts
Still worked as a housecleaner in February 2020
275 (93)
85 (31)
Lost paid work days during shutdown because they might infect their client
43 (16)
Did not work and received no compensation from clients during shutdown
AJPH
Worked as housecleaner during March–June 2020 shutdown
144 (52)
August 2023, Vol 113, No. 8
Worked as housecleaner after the end of the shutdown in June 2020
231 (78)
Could take sick leave (paid or unpaid) during pandemic without retaliation
84 (36)
Extremely/very concerned about having enough clients to meet needs
128 (55)
Used more disinfectant cleaning products at work after the shutdown
142 (61)
If diagnosed with COVID-19, would be likely/somewhat likely to feel afraid or embarrassed to disclose this information to your employer
138 (47)
Among those who reported having COVID-19
75 (49)
Among those who reported not having COVID-19
63 (44)
Earning per month from all jobs at time of the survey, $
Not working
31 (11)
≤ 500
120 (41)
500–1000
87 (29)
≥ 1000
45 (15)
Received governmental financial benefits since March 2020
Unemployment compensation
23 (8)
Supplemental nutrition assistance benefits
94 (32)
Any other government assistance
34 (11)
Food insecurity, in the past 12 mo
Q1. Worried your food would run out before you had money to buy more
Sometimes
138 (47)
Often
102 (34)
Q2. The food you bought did not last and you didn’t have money to buy more
Sometimes
152 (51)
Often
61 (21)
Responding “sometimes” or “often” to Q1 or Q2
254 (86)
Other social and economic impacts
Housing insecurity
Does not have a fixed place to live
16 (5)
Continued
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897
RESEARCH & ANALYSIS
TABLE 2— Continued
No. (%)
Currently has a place to stay but worries about the future
118 (40)
Owes more than $1000 in back rent
71 (24)
Domestic insecurity since the pandemic beganb
Q1. Level of feeling safe inside their own home (only a little safe/unsafe)
59 (20)
Q2. Someone with whom they had romantic relationships yelled at them or said things that made them feel scared or bad
about themselves?
35 (12)
Either Q1 or Q2 (but not both)
86 (30)
Mental and self-rated health outcomes
Depression (CES-D 10 ≥ 10)
Prepandemic survey
65 (22)
During pandemic survey
100 (34)
New onset since prepandemic survey
59 (20)
Moderate/high perceived stress (Cohen’s PSS ≥ 14)
Prepandemic survey
130 (44)
During pandemic survey
160 (54)
New onset since prepandemic survey
63 (21)
AJPH
August 2023, Vol 113, No. 8
Fair/poor self-rated health
Prepandemic survey
86 (29)
During pandemic survey
129 (44)
New onset since prepandemic survey
68 (23)
Note. PSS 5 Perceived Stress 10-item scale. Study sample size was n 5 296.
a
Includes 5 participants who reported positive COVID-19 nasal swab tests and “no” (n 5 4) or “prefer not to answer” (n 5 1) when asked whether they had
COVID-19.
b
This excludes 7 participants who did not feel comfortable responding to questions about the safety of their home.
home, 35 (12%) reported verbal abuse
from a romantic partner, and 86 partici-
Socioeconomic Conditions
and COVID-19
Mental and Self-Rated
Health Measures
Compared with prepandemic responses, more participants exceeded
the threshold cutpoint for the mental
We examined whether employment sta-
COVID-19 and SBE-related factors
tus, living conditions, or demographic
(Table 4). In the fully adjusted models,
characteristics were related to a respon-
we found increased odds for depres-
dent’s having had COVID-19. When com-
sion for those reporting COVID-19
paring housecleaners reporting COVID-
(OR 5 1.95; 95% CI 5 1.10, 3.45 for
19 or a positive test to others in the
nonhospitalized participants;
study, the only difference found was in
OR 5 5.09; 95% CI 5 0.91, 28.36 for
the likelihood of living with household
hospitalized participants). We also
members who also had had COVID-19:
found increased odds for perceived
and self-rated health measures. We
89% of those reporting COVID-19 versus
stress among those not yet vaccinated
found that 20%, 21%, and 23% of parti-
30% of others (Table 3).
cipants formerly below the cutpoint
exceeded the cutpoint on the follow-up
(OR 5 2.39; 95% CI 5 1.28, 4.45), those
with household members who had
Predictors
survey for depression, perceived stress,
898
adjusting for prepandemic measures,
found increased odds associated with
pants (30%) reported at least 1 of these
aspects of domestic insecurity.
and fair or poor self-rated health,
COVID-19 (OR 5 1.93; 95% CI 5 1.04,
3.60), and those with family members
and fair or poor self-rated health, re-
Multivariable logistic regression mod-
or close friends who died of COVID-19
spectively (Table 2).
els for depression, perceived stress,
(OR 5 1.84; 95% CI 5 1.01, 3.35).
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RESEARCH & ANALYSIS
TABLE 3— Self-Reported COVID-19 Status by Demographic, Social, and Employment Conditions: Safe
and Just Cleaners Study, New York City, March–June 2021
Ever Had COVID-19a (n = 158),
Mean 6 SD or No. (%)
Did Not Have COVID-19
(n = 138), Mean 6 SD or No. (%)
Pb
Age, y
44.9 6 9.7
44.7 6 9.9
.88
Years living in United States
17.4 6 8.5
16.1 6 9.5
.21
Primary school
50 (31.7)
35 (25.4)
High school
74 (46.8)
61 (44.2)
Education level
.5
General equivalency diploma
5 (3.2)
6 (4.4)
At least some college
29 (18.4)
36 (26.1)
English comfort
.38
Uncomfortable
60 (38)
49 (36.3)
More or less
78 (49.4)
61 (45.2)
Comfortable
20 (12.7)
25 (18.5)
Yes
61 (38.6)
54 (39.4)
No
97 (61.4)
83 (60.6)
Primary family wage earner
.89
.73
72 (45.6)
69 (50)
No
84 (53.2)
67 (48.6)
Don’t know
2 (1.3)
2 (1.5)
0
18 (11.4)
96 (69.6)
1
33 (20.9)
21 (15.2)
2
35 (22.2)
5 (3.6)
3
32 (20.3)
9 (6.5)
≥4
40 (25.2)
7 (5.1)
No. of people in household with COVID-19
.001
Asked to work during COVID-19 shutdown
(March–June 2020)c
.29
Yes
41 (27.5)
44 (34.9)
No
107 (71.8)
82 (65.1)
Don’t know
August 2023, Vol 113, No. 8
Yes
AJPH
Health insurance
1 (0.7)
0
Employment in housecleaning after end of the
shutdown in June 2020
.2
Worked continuously
22 (13.9)
30 (21.7)
Worked on and off
101 (63.9)
78 (56.5)
Stopped working in housecleaning
35 (22.2)
30 (21.7)
a
We defined reported COVID-19 as self-reporting ever having had COVID-19 or a positive nasal swab test for COVID-19 at the time of the survey:
March–June 2021.
b
P value for continuous variables from the t test and for categorical variables from the x2 test.
c
This variable includes only those still working as housecleaners in March 2020, right before the shutdown (n 5 275).
Regarding employment-related fac-
they had COVID-19 (OR 5 3.09; 95%
to housecleaners’ concern that they
tors, we found increased odds for per-
CI 5 1.71, 5.58). We found increased
might infect their clients (OR 5 2.21;
ceived stress among those likely or
odds for fair or poor self-rated health
95% CI 5 1.05, 4.69).
somewhat likely to feel afraid or embar-
for those reporting having lost wages
Regarding other SBE effects, we
rassed to tell their employer whether
during the pandemic shutdown owing
found increased odds for perceived
Research
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Baron et al.
899
RESEARCH & ANALYSIS
TABLE 4— COVID-19 Infection–Related and Social and Economic Impacts Predictors of Perceived Stress,
Depression, and Self-Rated Health: Safe and Just Cleaners Study, New York City, March–June 2021
Moderate/Severe
Perceived Stress
(PSS ≥ 14), OR (95% CI)
Depression
(CES-D 10 ≥ 10),
OR (95% CI)
Poor/Fair Self-Rated
Health,a
OR (95% CI)
NA
NA
NA
NA
NA
NA
5.09 (0.91, 28.36)
NA
COVID-19 infection–related impacts
Household member COVID-19 status
≥ 1 member had COVID-19
1.93 (1.04, 3.60)
No member had COVID-19
1 (Ref)
COVID-19 deaths of family/close friends
Experienced deaths
1.84 (1.01, 3.35)
Did not experience deaths
1 (Ref)
COVID-19 vaccination status
Not yet vaccinated
2.39 (1.28, 4.45)
≥ 1 vaccine shot
1 (Ref)
Self-reported COVID-19 disease
Hospitalized with COVID-19
NA
Had COVID-19 but not hospitalized a
1.95 (1.10, 3.45)
Didn’t have/don’t know
1 (Ref)
August 2023, Vol 113, No. 8
Employment-related impacts
Would feel afraid or embarrassed to disclose to employer whether they had COVID-19
Likely/somewhat likely
3.09 (1.71, 5.58)
Somewhat unlikely/unlikely
NA
NA
NA
2.21 (1.05, 4.69)
1 (Ref)
Pay during shutdown
Lost housecleaning pay during shutdown because
respondent might infect client with COVID-19a
NA
AJPH
Did not work during shutdown or if worked, did not lose
pay because respondent might infect client
1 (Ref)
Other social and economic impacts
Food insecurityb
Yes
1.35 (1.05, 1.73)
1.46 (1.15, 1.84)
1.57 (1.23, 2.00)
No
1 (Ref)
1 (Ref)
1 (Ref)
2.04 (1.06, 3.91)
2.12 (1.17, 3.83)
2.11 (1.14, 3.89)
1 (Ref)
1 (Ref)
1 (Ref)
NA
NA
Domestic insecurity
Unsafe/a little unsafe and/or experienced IP verbal abuse
Felt safe and no IP verbal abuse
Housing insecurity
No fixed home/worried about future
Had a stable place to live
1.83 (1.01, 3.33)
1 (Ref)
Prepandemic mental and self-rated healthc
Perceived stress (PSS ≥ 14)
4.40 (2.41, 8.02)
NA
NA
Depressed (CES-D 10 ≥ 10)
NA
3.42 (1.78, 6.58)
NA
Poor/fair self-rated health
NA
NA
5.09 (2.70, 9.59)
Note. CES-D 10 5 Center for Epidemiologic Studies Depression 10-item scale; CI 5 confidence interval; IP 5 intimate partner; NA 5 variable not included in
the final model because it was eliminated in the stepwise regression analysis; OR 5 odds ratio; PSS 5 Cohen’s Perceived Stress scale. We adjusted all
models for age, educational attainment, and whether the participants indicated they were the primary family wage earner in their prepandemic survey.
We included the prepandemic mental and self-rated health variables in the models only for that same outcome measure.
a
Models containing this variable included only the 275 housecleaners who were still working in housecleaning in March 2020 because those no longer
working were not asked this question.
b
4-point food insecurity scale: 1 point each for answering “sometimes” on the 2-item food insecurity measure, 2 points each for answering “often,”
reference is answering no to both questions.
c
We collected all prepandemic measures between August 2019 and February 2020.
900
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RESEARCH & ANALYSIS
stress for those reporting no fixed
immigrant Latinx populations, especially
was associated with higher psychologi-
place to live or worry about future
in the first year of the pandemic.1
cal distress and lower self-rated health
housing (OR 5 1.83; 95% CI 5 1.01,
Almost one third reported working as
during the COVID-19 pandemic.27
3.33). We found increased odds for
housecleaners during the shutdown of
Fewer studies have examined
those reporting food insecurity
nonessential work, from March 22 to
COVID-19–related risks associated with
(OR 5 1.35; 95% CI 5 1.05, 1.73 for per-
June 8, 2020, although we did not find
domestic safety and intimate partner
that this was associated with higher
abuse because of challenges in collect-
rates of reported COVID-19 infections.
ing such data,28 although public health
95% CI 5 1.23, 2.00 for self-rated
We also documented a myriad of other
experts have highlighted the potential
health). Similarly, those experiencing
SBE effects, including reduced employ-
risks.29 Finally, the rates of employ-
domestic insecurity had increased
ment and low earnings, perceived
ment, housing, and food insecurity
odds for all 3 outcomes (OR 5 2.04;
COVID-19–related stigma at work, food
documented in our study are consis-
95% CI 5 1.06, 3.91 for perceived
and housing insecurity, and feeling
tent with findings from a national sur-
stress; OR 5 2.12; 95% CI 5 1.17, 3.83
unsafe at home or experiencing inti-
vey of Spanish-speaking domestic
for depression; and OR 5 2.11; 95%
mate partner verbal abuse. As has
workers conducted by the National Do-
CI 5 1.14, 3.89 for self-rated health).
been widely reported in other stud-
mestic Workers Alliance during the first
ies,23 we found deterioration in house-
6 months of the pandemic.30 Our study
cleaners’ mental and self-rated health
adds to these previous studies by cap-
compared with prepandemic levels,
turing how multifaceted SBE stressors
with COVID-19 infection, employment,
together with the direct effects of
and other SBE impacts contributing.
COVID-19 infections contributed to
Lastly, although studies have found
changes in mental and self-rated health
mixed results related to vaccine accep-
in our sample of Latinx immigrant
DISCUSSION
Our study provides insight into the
Latinx immigrant housecleaners in NYC
at the beginning of the second year of
tance among Latinx populations,
the COVID-19 pandemic (March–June
findings suggest a high level of
2021), and we were able to compare
acceptance.
24
our
housecleaners in NYC.
Consistent with the communitybased participatory research values of
mental and self-rated health measures
Our findings are consistent with oth-
to measures collected in the 6 months
er COVID-19 studies that included larg-
and following the model of Public
before the pandemic-related shutdown
er and more diverse populations. For
Health 3.0, we were committed as a
in NYC. Our findings contribute to the
example, a national survey found that
community–academic partnership to
literature by providing a unique and
all racial and ethnic minorities— but es-
using our data to influence policy to im-
comprehensive picture of the depth of
pecially those having limited English
prove workers’ social and economic
the pandemic’s impact on a population
proficiency, less education, and lower
conditions. Our community partner,
of workers who faced a multitude of
incomes and those living in large
Make the Road New York, is a major im-
disproportionate risks.
cities—were more likely to report that
migrant advocacy organization in New
We found that 53% of our participants
people acted afraid of them because of
York, and it responded to these find-
reported ever having had COVID-19 be-
suspected COVID-19 infection.25 A na-
ings by providing essential emergency
fore being surveyed between March 18
tional food insecurity study using the
support through food pantries and fi-
and June 11, 2021, and this high rate of
same 2-item measure found an in-
nancial assistance. Beyond these stop-
infection was confirmed by COVID-19
creased risk of food insecurity among
gap measures, it prioritized promoting
antibody tests. The housecleaners’ rate
Hispanic and low-income populations
policies to improve financial equity.
of infection was almost double the rate
and also found associations between
Make the Road New York, in coalition
documented over a similar period in
becoming food insecure and anxiety
with other community organizations
26
our overall Safe and Just Cleaners Study
a national COVID-19 seroprevalence
and depres
A male went to the emergency room for severe midepigastric abdominal pain. He was diagnosed with AAA ; however, as a precaution, the doctor ordered a CTA scan.
Because of a high potential for misdiagnosis, determining the precise cause of abdominal pain can be time consuming and challenging. By analyzing case studies of abnormal abdominal findings, nurses can prepare themselves to better diagnose conditions in the abdomen.
In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
TO PREPARE
Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study.
With regard to the Episodic note case study provided:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
THE ASSIGNMENT
Analyze the subjective portion of the note. List additional information that should be included in the documentation.
Analyze the objective portion of the note. List additional information that should be included in the documentation.
Is the assessment supported by the subjective and objective information? Why or why not?
What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?
Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.
https://www.aphl.org/programs/infectious_disease/i…PurposeThe purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos. Action ItemsExplain the advantages and disadvantages of building a master person index across surveillance information systems for multiple diseas
Post a total of 3 substantive responses over 2 separate days for full participation. This includes your initial post and 2 replies to classmates or your faculty member.Please refer to this week’s learning materials. They are intended to help you engage effectively in this discussion. Due Thursday There is a challenge to reduce health care expenses where there is a perception of limited or no value. For example, nurse staffing is a significant expense to an organization and can be viewed as having limited value. A nurse leader recognizes the value of nurse staffing in the provision of quality care. Respond to the following in a minimum of 300 words: As you consider preparing your budget recommendations, describe an evidence-based method for projecting nurse staffing. Due MondayPost 2 replies to classmates or your faculty member. Be constructive and professional.
530:
Munirah:
Nurses frequently perform intravenous (IV) line insertion, which demands precise hand
movements and non-standard postures that can cause significant strain on the
musculoskeletal system. As the aging population continues to increase, the demand for
IV therapies rises, putting nursing staff at a higher risk of developing work-related
musculoskeletal disorders (WMSDs) if proper ergonomic measures are not taken
(Kamwendo & Medin, 2019).
This study aimed to identify ergonomic hazards associated with IV-line insertion by
utilizing the Assessment of Repetitive Tasks (ART) tool, which evaluates seven distinct
ergonomic risk factors related to upper limb tasks and assigns scores ranging from 0 to 3
for each factor, with higher scores indicating greater risk (Hignett & McAtamney, 2000).
In this study, a nurse was observed performing 20 IV insertions during a single hospital
shift, considering factors such as posture, force, repetition, duration, and other task
demands. The scores from these factors were then aggregated to identify the most critical
risk factors.
Table 1 provides a detailed breakdown of the ART scores. The total score of 13 signifies
a high ergonomic risk (Hignett & McAtamney, 2000). The highest scores were linked to
frequent deviations from neutral posture (3), sustained durations exceeding 2 hours daily
(3), and movements exceeding 2 per minute (3). Scores were moderate for force exertion
(2) and repetition (3). Other physical demands received lower scores.
Table 1
ART Assessment of IV Line Insertion
Abdulmajeed:
COLLAPSE
One repetitive activity in the healthcare setting done by healthcare professionals using their
upper body is patient handling, such as lifting and transferring patients. Using the
Assessment of Repetitive Tasks (ART) tool, the top three ergonomic risk factors for this
activity are force, repetition, and awkward postures.
Here is a sample score sheet for the ART tool:
Task
Patient
Force
lifting
and
Repetition
4
Posture
4
3
transferring
The score sheet rates each risk factor on a scale of 1 to 5, with 1 being low risk and 5 being
high risk. The scores for force, repetition, and posture are added up to give an overall score
for the task. In this case, the overall score is 11, which indicates a high risk for
musculoskeletal disorders (MSDs) associated with patient handling.It is important to note
that the ART tool is just one of many tools that can be used to assess ergonomic risk factors.
Other tools may provide different results depending on the specific task and workplace
conditions. It is also important to address ergonomic risk factors through a combination of
engineering controls, administrative controls, and personal protective equipment to reduce
the risk of MSDs.
520:
Maram Alangari
Data mining is the practice of looking through and analyzing a sizable collection of
unstructured data in order to find patterns and extract pertinent information. To find out more
about their clients, businesses utilize data mining tools. They can use it to create more profitable
marketing plans that will boost sales and cut expenses. Effective data collection, storage, and
processing are essential for data mining. Data mining is the process of examining and analyzing
huge chunks of data to discover significant patterns and trends. It is utilized in spam filtering,
fraud detection, and credit risk management. It can also be used as a tool for market research
to get a sense of how a certain set of individuals feel or think. Four steps make up the data
mining process: Data is gathered and loaded either locally or via a cloud service into data
warehouses. Management groups, information technology specialists, and business analysts
access the data and choose how to organize it. Data is sorted and organized using specialized
application software. Lastly, the end user displays the data in a manner that is simple to
distribute, such a graph or table. Algorithms and other methods are used in data mining to
transform massive data sets into useable output. The most often used kinds of data mining
methods are as follows: Market basket analysis and association rules both look for connections
between different variables. As it attempts to connect different bits of data, this relationship in
and of itself adds value to the data collection. For instance, association rules would examine a
business’s sales data to determine which products were most frequently bought in tandem; with
this knowledge, retailers might plan, advertise, and forecast. To assign classes to items,
classification is used. These categories express the traits of the items or the similarities between
the data points. The underlying data can be more precisely categorized and summed up across
related attributes or product lines thanks to this data mining technique. Clustering and
categorization go hand in hand. Clustering, on the other hand, finds similarities between objects
before classifying them according to how they differ from one another.
Here are a few examples of the different discrepancies brought on by using the incorrect data
mining techniques: 1) Making decisions that are not particularly accurate. 2) Lack of
knowledge. 3) Difficulties in upgrading knowledge.4) Time-sensitive performance
(expensive). Due to these issues, data mining must be used to give a framework for aid in the
diagnosing process. The obvious conclusion is that complicated data cannot be ad hoc analyzed
by humans or their statistical methods without making mistakes. If data mining techniques are
to be widely used in clinical practice, it is crucial in the fields of medicine and healthcare where
patient safety is paramount. The process’s objective is to take the medical information, which
contains a wide range of features, and identify those that are genuinely pertinent to the heart
disease’s diagnosis, symptoms, and outcome. We are looking at a very big amount of data that
can reach terabytes in size, making it very difficult to mine for them without automatic ways
for retrieving this information.
References:
Ekwonwune, E. , Ubochi, C. and Duroha, A. (2022) Data Mining as a Technique for Healthcare
Approach. International Journal of Communications, Network and System Sciences, 15, 149165.
Abdulmajeed:
After conducting a search, I was unable to find a specific academic article that demonstrates
how data mining supported process improvement in a healthcare organization. However, I
can provide some general information on how data mining can be used to support process
improvement in healthcare organizations.
Data mining is a process of discovering patterns in large data sets using statistical and
computational methods. In healthcare organizations, data mining can be used to identify
patterns in patient safety incidents, such as medication errors, falls, and hospital-acquired
infections. By analyzing these patterns, healthcare organizations can identify areas for
process improvement and develop strategies to prevent future incidents.
One study used the Consolidated Framework for Implementation Research (CFIR) to analyze
the implementation strategies for a patient safety reporting system in a healthcare
organization (Kim. 2022)
The study found that data mining was an effective strategy for identifying areas for
improvement and developing targeted interventions. The study also found that the use of
data mining was sustainable over time, as the organization continued to use the patient safety
reporting system to identify and address patient safety issues.
To diagnose patient safety problems, healthcare organizations can use a variety of
methodologies, such as root cause analysis, failure mode and effects analysis, and process
mapping. Once the problem has been identified, healthcare organizations can implement
process improvements, such as standardizing procedures, providing additional training to
staff, and implementing new technologies. Metrics can be used to measure the effectiveness
of these process improvements, such as the number of patient safety incidents before and
after the intervention, the severity of the incidents, and the cost savings associated with the
intervention.
In terms of opportunities for improvement, healthcare organizations can consider using
predictive analytics to identify patients who are at high risk for adverse events, such as
hospital-acquired infections or readmissions. By identifying these patients early, healthcare
organizations can develop targeted interventions to prevent adverse events from occurring.
References:
Kim, J. H., Kim, H. S., & Kim, J. H. (2022). Implementation strategies for the patient safety
reporting system using Consolidated Framework for Implementation Research: a
retrospective mixed-method analysis. BMC health services research, 22(1), 1-12.
Saad:
“The use of data mining by private health organizations for clinical decision support: A systematic
review” by Vincent et al. (2020).
The article demonstrated how data mining could offer significant advantages to healthcare
organizations, focusing on its application for clinical decision support.
The authors used a systematic review methodology to identify, analyze, and synthesize studies from
various databases like PubMed, ScienceDirect, and IEEE Xplore. They used PRISMA guidelines to
ensure a robust review process. The primary issues they were addressing were the challenges related
to clinical decision-making, including the increasing complexity of healthcare data and the necessity for
evidence-based practice.
The study found that data mining could significantly improve the process of clinical decision-making. It
highlighted the use of various data mining techniques, including regression analysis, decision trees,
and clustering, to extract useful knowledge from large datasets. This extracted information could then
assist clinicians in making more accurate diagnoses, predicting patient outcomes, and personalizing
treatment plans.
The effectiveness of the data mining strategies was measured using various metrics, like accuracy,
sensitivity, specificity, and area under the ROC curve (AUC). The authors found that these data mining
techniques generally provided high accuracy and were effective in supporting clinical decisions.
Regarding the sustainability of the improvement, the authors mentioned that as healthcare
organizations continue producing large amounts of data, the value of data mining is likely to increase.
However, they also noted that the sustainability of these improvements depends on factors like training
of healthcare staff, continuous updating of data mining models, and addressing privacy and ethical
concerns related to data use.
In terms of opportunities for further improvement, the authors did not discuss in detail how these data
mining strategies could be integrated into the existing workflow of healthcare professionals. Integrating
these strategies in a user-friendly way is crucial for their adoption. Therefore, future research could
focus on the development of intuitive interfaces that allow clinicians to easily utilize the insights provided
by data mining.
Moreover, the authors did not address the potential of real-time data mining. Many healthcare decisions
need to be made in a time-sensitive manner, and real-time data mining could provide immediate insights
that support these decisions. Therefore, developing and implementing real-time data mining strategies
could be another area for improvement.
References:
●
Vincent, M., Vincent, C., Ferreira, A. (2020). The use of data mining by private health
organizations for clinical decision support: A systematic review. Computers in Biology and
Medicine, 120, 103738.
Mezna:
Data mining is the process of sorting through large data sets to identify patterns and relationships that
can help solve problems through data analysis. In healthcare clinical data mining helps medical
scientists and experts reveal data patterns, trends, associations, and other fact correlations enabling
them to formulate important observations and conclusions (Wu, et al., 2021). Example of data mining
is the “Quick Sequential Organ Failure Assessment” (qSOFA). It is a diagnostic tools for predicting
hospital mortality among adults with suspected infection(Olivia, Nayak, Balachandra & John, 2020). It
is mainly based in patient clinical data that helps in early detection of infection such as sepsis and help
in start treatment as soon as possible to avoid any delay.
A study conducted by Asai et al. (2019) to measure the “Efficacy and accuracy of qSOFA and SOFA
scores as prognostic tools for community-acquired and healthcare-associated pneumonia”, in this study
the researcher assess the severity of pneumonia using qSOFA for 30 days, and assessed mortality rate
for 30 days. This study was conducted to evaluate the prognostic accuracy of the predictive values
which is the respiratory rate, altered mental status, or systolic blood pressure.
The researcher and his team have observed that the predictive ability of the SOFA score was superior
to other predictive assessments. In addition, they found that the 30-day and in-hospital mortality rates
for the patients in the current study were lower than those reported previously.
The researcher did a predictive analytics of patient condition using data mining techniques to analyze
historical data and identify patterns that could help predict future events or outcomes. Predictive
analytics can be employed to forecast patient prognosis, identify high-risk patients. This information
enables healthcare organizations to proactively intervene and allocate resources effectively, leading to
better patient outcomes and reduced costs.
In addition, qSOFA can help in clinical decision support systems (CDSS) that provide evidence-based
recommendations to healthcare practitioners(Olivia, Nayak, Balachandra & John, 2020). By analyzing
patient data such as respiratory rate, altered mental status, or systolic blood pressure can identify most
effective treatment options and identify patient outcomes.
The researcher have conducted this study as retrospective study, if it was done during patient admission
it could help in identify any barriers and clinical challenge to data analysis. However, the researcher
have concluded that the qSOFA scores were able to accurately evaluate the severity of communityacquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP). And this tool could be
useful in the treatment of this condition.
In general, data mining provides healthcare organizations with the tools to extract valuable insights from
large volumes of data. Example of data mining is the qSOFA which prevent to support clinical decisionmaking, operational efficiency and quality of patient care. By leveraging data mining techniques,
healthcare organizations can drive positive change, leading to better patient outcomes, cost savings,
and enhanced overall performance.
Reference
Asai, N., Watanabe, H., Shiota, A., Kato, H., Sakanashi, D., Hagihara, M. & Mikamo, H. (2019). Efficacy
and accuracy of qSOFA and SOFA scores as prognostic tools for community-acquired and healthcareassociated pneumonia. International Journal of Infectious Diseases, 84, 89-96.
Olivia, D., Nayak, A., Balachandra, M., & John, J. (2020). A classification model for prediction of clinical
severity level using qSOFA medical score. Information Discovery and Delivery, 48(1), 41-77.
Wu, W. T., Li, Y. J., Feng, A. Z., Li, L., Huang, T., Xu, A. D., & Lyu, J. (2021). Data mining in clinical big
data: the frequently used databases, steps, and methodological models. Military Medical Research, 8,
1-12.
525:
Nouf:
blockchain can improve the interaction between humans and technological systems. It is
a valuable technology that helps improve data sharing and storage in the healthcare
setting. However, many healthcare organizations remain hesitant to adopt blockchain
technology due to threats such as security and authorization issues, interoperability
issues, and a lack of technical skills related to blockchain technology. (Abu-Elezz, Hassan,
Nazeemudeen, Househ, & Abd-Alrazaq, 2020).Blockchain is a relatively new technology,
and there is still a lack of understanding of how to secure it effectively which can make it
difficult to ensure the security and authorization of the data, also networks are often
incompatible with each other, making it hard to share data between different healthcare
organizations, and shortage of healthcare professionals with the technical skills is another
challenge that faced.
Despite the challenges, many advantages can be utilized by Technology. New technologies
have revolutionized nearly every aspect of human existence, including the ways that firms
market products and services to consumers. (Grewal, D., Hulland, J., Kopalle, P. K., &
Karahanna, E. (2020). Here is an interesting article that found digital platforms and
artificial intelligence (AI) have a good potential to improve prediction, identification,
coordination, and treatment by mental health care and suicide prevention services. AI is
driving web-based and smartphone apps; mostly it is used for self-help and guided
cognitive behavioral therapy (CBT) for anxiety and depression. (Balcombe, & De Leo,
2022).
In my opinion, the recommendations on how computer and mobile applications should
be designed for efficient and effective patient care are:
●
Designed in a way that serves patient needs and removes unnecessary features.
●
Alternative text is a brief description of an image that is displayed to users who
are blind or have low vision.
●
If the application is designed to be used on a mobile device, it is important to
ensure that the battery life is long enough to support the intended use.
●
In case the application is designed to be portable; it is important to make sure
that it is small and lightweight enough to be easily carried. That will make it
more convenient for users to use the application when they are away from their
homes.
●
The application must be secure to protect patient data, respect patient privacy,
and be able to interoperate with other healthcare systems.
In conclusion, technology plays an increasingly important role in our lives. We use
technology to communicate, to learn, to work, and to entertain ourselves. As technology
becomes more complex, it is important to design systems that are easy to use and that
meet the needs of all users.
Balcombe, L., & De Leo, D. (2022, February). Human-computer interaction in digital
mental health. In Informatics (Vol. 9, No. 1, p. 14). MDPI.
Grewal, D., Hulland, J., Kopalle, P. K., & Karahanna, E. (2020). The future of technology
and marketing: A multidisciplinary perspective. Journal of the Academy of Marketing
Science, 48, 1-8.
Abu-Elezz, I., Hassan, A., Nazeemudeen, A., Househ, M., & Abd-Alrazaq, A. (2020). The
benefits and threats of blockchain technology in healthcare: A scoping review.
International Journal of Medical Informatics, 142, 104246.
Faten:
Technology has revolutionized the way we live, work, and interact with the world around
us. It has also had a profound impact on healthcare, enabling new forms of diagnosis,
treatment, and care delivery. However, there are a few of the challenges of human
interactions with technology and it is important to be aware of these challenges and to
take steps to mitigate them. Studies on the impact of poor health IT design (and
implementation) for both patients and clinicians are important specially when it comes
to patient safety.
Challenges of Human Interaction with Technology:
●
Usability: HIT systems are often complex and difficult to use, even for
experienced clinicians. This can lead to errors and frustration, and it can also
discourage clinicians from using HIT to its full potential. An analysis of
medication safety events reported by pediatric clinicians in three children
hospitals across the US showed that more than one-third (36%) were related to
EHR usability issues, in particular the lack of system feedback and poor visual
display of information (Carayon and Hoonakker, 2019).
●
Poor user interface design leads to errors in data input and comprehension
(Sittig et al., 2020). Poor user-interface design may also result in unintended
consequences that impair patient safety and outcomes because incorrect
information is used to guide future clinical decision making.
●
Increased cognitive workload for physicians
●
Communicating with patients in a changing digital landscape
Recommendations:
In my opinion, there are a few recommendations on how user interfaces should be
designed for efficient and effective patient care:
●
Consistency: Interfaces must have the same style and logic across the entire
system.
●
Minimalism: Eliminate unnecessary steps and distractions to enable users to
complete the required action with minimum clicks.
●
Display data in time-series: Implement graphs showing how a patient’s condition
has changed over time to enhance the readability of their health info.
Reference:
Carayon, P., & Hoonakker, P. (2019). Human Factors and Usability for Health
Information Technology: Old and New Challenges. Yearbook of medical informatics,
28(1), 71–77. https://doi.org/10.1055/s-0039-1677907
Sittig, D. F., Wright, A., Coiera, E., Magrabi, F., Ratwani, R., Bates, D. W., & Singh, H.
(2020). Current challenges in health information technology-related patient safety.
Health
informatics
journal,
https://doi.org/10.1177/1460458218814893
26(1),
181–189.
Fahad:
Human-technology interactions are critical for providing efficient and effective patient care.
Technology has the potential to improve patient safety, streamline workflows, and give patients
greater access to care. Telemedicine allows patients to consult with healthcare providers remotely;
EHRs allow healthcare providers to access patient medical records electronically; Patient portals
allow patients to access their medical records, schedule appointments, and communicate with their
healthcare providers online; and Smartwatches and fitness trackers, for example, can be used to
collect data on patients’ health and activity levels.
Human-technology interactions present a number of challenges, particularly in the
context of patient care. Among the most common difficulties are:
●
●
●
●
Inadequate user-centered design: Computer or mobile application interfaces should be
created with the user in mind. To use the technology effectively, the user should only need
a basic understanding of it.
Difficulty in developing an effective feedback system: It is critical to develop an effective
feedback system for users of health-related monitoring data. The health monitoring
system, with effective feedback, can promote better patient engagement while improving
the overall quality of the healthcare system.
• Implementation difficulties: Putting mobile applications into clinical practice can be
difficult. The team identified five major challenges associated with clinical mobile
application deployment and presented solutions to each of them.
• Specific and rigorous design requirements: Human-machine interface design is more
specific and rigorous in the medical and health fields.
Computer or mobile application interface design recommendations for efficient and
effective patient care:
●
●
●
●
Prioritize user-centered design: When designing computer or mobile application
interfaces, user experience should be prioritized. To use the technology effectively, the
user should only need a basic understanding of it.
Create an effective feedback system: It is critical to create an effective feedback system for
users of health-related monitoring data. The health monitoring system, with effective
feedback, can promote better patient engagement while improving the overall quality of
the healthcare system.
Provide error-resistant displays and alarms to ensure safety: Human Computer Interaction
design principles for smart healthcare mobile devices should ensure safety, provide errorresistant displays and alarms, and support patients’ and healthcare providers’ unique
relationship.
Differentiate end-user groups: Computer or mobile application interfaces should be
designed to differentiate end-user groups.
While technology can be an effective tool for improving patient care, it is critical to remember that
human interaction is still necessary. Healthcare providers must be able to establish rapport with
their patients and understand their specific needs. Human interaction can be facilitated by
technology, but it cannot be replaced.
References:
Ehrler, F., Wipfli, R., Teodoro, D., Sarrey, E., Walesa, M., & Lovis, C. (2013). Challenges
in the implementation of a mobile application in clinical practice: Case study in the
context of an application that manages the daily interventions of nurses. JMIR mHealth
and uHealth, 1(1), e7.
Guarascio-Howard L. Examination of wireless technology to improve nurse
communication, response time to bed alarms, and patient safety. HERD. 2011;4(2):109–
20
Tschopp M, Lovis C, Geissbuhler A. Understanding usage patterns of handheld
computers in clinical practice. Proc AMIA Symp. 2002:806–9.
ALAA:
Challenges of human interactions with technology for patient care, Technology can be
great for patient care, but it can also make it harder for humans to interact with each
other.
Some of the main challenges are:
●
Usability: Technology can be complex and hard to use, especially for older adults
or people with limited technical skills. This can lead to frustration and mistakes,
which can put patients at risk.
●
Trust: Patients need to trust that technology is being used safely and fairly. This
trust can be broken if people are worried about their privacy, security, or the
possibility of bias in AI-powered systems.
●
Communication: Technology can get in the way of human communication,
making it harder to build rapport and empathy with patients. This is especially
important for complex or sensitive conversations.
Recommendations for designing computer or mobile application interfaces for
efficient and effective patient care.
When designing computer or mobile application interfaces for patient care,
it’s important to keep the following in mind:
●
Focus on usability: Interfaces should be easy to understand and use, even for
people with limited technical skills. This can be done by using clear and concise
language, avoiding jargon, and providing clear instructions.
●
Build trust: Interfaces should be designed to build trust with patients. This can
be done by being open about how data is collected and used, putting in place
strong security measures, and giving users control over their data.
●
Support communication: Interfaces should support effective communication
between patients and healthcare providers. This can be done by providing
features for video conferencing, secure messaging, and real-time translation.
In addition to these general recommendations, there are also some specific design
considerations for different types of patient care applications. For example, applications
that are used by patients to manage their own health should be personalized and easy to
use. Applications that are used by healthcare providers to diagnose and treat patients
should be integrated with electronic health records and provide access to clinical decisionsupport tools. (Schueller, 2021)
Reference:
Schueller, S. M. (2021). Grand Challenges in Human Factors and Digital Health.
Frontiers in Digital Health, 3, 635112. https://doi.org/10.3389/fdgth.2021.635112
I have added a total of 4 assesments. Please let me know.
For this assessment, you will develop a 3-5 page paper that examines a safety quality issue pertaining to medication administration in a health care setting. You will analyze the issue and examine potential evidence-based and best-practice solutions from the literature as well as the role of nurses and other stakeholders in addressing the issue.
Collapse All
Introduction
Health care organizations and professionals strive to create safe environments for patients; however, due to the complexity of the health care system, maintaining safety can be a challenge. Since nurses comprise the largest group of health care professionals, a great deal of responsibility falls in the hands of practicing nurses. Quality improvement (QI) measures and safety improvement plans are effective interventions to reduce medical errors and sentinel events such as medication errors, falls, infections, and deaths. A 2000 Institute of Medicine (IOM) report indicated that almost one million people are harmed annually in the United States, (Kohn et al., 2000) and 210,000–440,000 die as a result of medical errors (Allen, 2013).
The role of the baccalaureate nurse includes identifying and explaining specific patient risk factors, incorporating evidence-based solutions to improving patient safety and coordinating care. A solid foundation of knowledge and understanding of safety organizations such as Quality and Safety Education for Nurses (QSEN), the Institute of Medicine (IOM), and The Joint Commission and its National Patient Safety Goals (NPSGs) program is vital to practicing nurses with regard to providing and promoting safe and effective patient care.
You are encouraged to complete the Identifying Safety Risks and Solutions activity. This activity offers an opportunity to review a case study and practice identifying safety risks and possible solutions. We have found that learners who complete course activities and review resources are more successful with first submissions. Completing course activities is also a way to demonstrate course engagement.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Analyze the elements of a successful quality improvement initiative.
Explain evidence-based and best-practice solutions to improve patient safety focusing on medication administration and reducing costs.
Competency 2: Analyze factors that lead to patient safety risks.
Explain factors leading to a specific patient-safety risk focusing on medication administration.
Competency 4: Explain the nurse’s role in coordinating care to enhance quality and reduce costs.
Explain how nurses can help coordinate care to increase patient safety with medication administration and reduce costs.
Identify stakeholders with whom nurses would need to coordinate to drive quality and safety enhancements with medication administration.
Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar or punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
REFERENCES
Allen, M. (2013). How many die from medical mistakes in U.S. hospitals? Retrieved from https://www.npr.org/sections/health-shots/2013/09/20/224507654/how-many-die-from-medical-mistakes-in-u-s-hospitals.
Kohn, L. T., Corrigan, J., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. Washington, DC: National Academy Press.
Professional Context
As a baccalaureate-prepared nurse, you will be responsible for implementing quality improvement (QI) and patient safety measures in health care settings. Effective quality improvement measures result in systemic and organizational changes, ultimately leading to the development of a patient safety culture.
Scenario
Consider a previous experience or hypothetical situation pertaining to medication errors, and consider how the error could have been prevented or alleviated with the use of evidence-based guidelines.
Choose a specific condition of interest surrounding a medication administration safety risk and incorporate evidence-based strategies to support communication and ensure safe and effective care.
For this assessment:
Analyze a current issue or experience in clinical practice surrounding a medication administration safety risk and identify a quality improvement (QI) initiative in the health care setting.
Instructions
The purpose of this assessment is to better understand the role of the baccalaureate-prepared nurse in enhancing quality improvement (QI) measures that address a medication administration safety risk. This will be within the specific context of patient safety risks at a health care setting of your choice. You will do this by exploring the professional guidelines and best practices for improving and maintaining patient safety in health care settings from organizations such as QSEN and the IOM. Looking through the lens of these professional best practices to examine the current policies and procedures currently in place at your chosen organization and the impact on safety measures for patients surrounding medication administration, you will consider the role of the nurse in driving quality and safety improvements. You will identify stakeholders in QI improvement and safety measures as well as consider evidence-based strategies to enhance quality of care and promote medication administration safety in the context of your chosen health care setting.
Be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you know what is needed for a distinguished score.
Explain factors leading to a specific patient-safety risk focusing on medication administration.
Explain evidence-based and best-practice solutions to improve patient safety focusing on medication administration and reducing costs.
Explain how nurses can help coordinate care to increase patient safety with medication administration and reduce costs.
Identify stakeholders with whom nurses would coordinate to drive safety enhancements with medication administration.
Communicate using writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.
Additional Requirements
Length of submission: 3–5 pages, plus title and reference pages.
Number of references: Cite a minimum of 4 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
APA formatting: References and citations are formatted according to current APA style.
Scoring Guide
Use the scoring guide to understand how your assessment will be evaluated.
View Scoring Guide
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For this assessment, you can use a supplied template to conduct a root-cause analysis. The completed assessment will be a scholarly paper focusing on a quality or safety issue pertaining to medication administration in a health care setting of your choice as well as a safety improvement plan.
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Introduction
As patient safety concerns continue to be addressed in the health care settings, nurses can play an active role in implementing safety improvement measures and plans. Often root-cause analyses are conducted and safety improvement plans are created to address sentinel or adverse events such as medication errors, patient falls, wrong-site surgery events, and hospital-acquired infections. Performing a root-cause analysis offers a systematic approach for identifying causes of problems, including process and system-check failures. Once the causes of failures have been determined, a safety improvement plan can be developed to prevent recurrences. The baccalaureate nurse’s role as a leader is to create safety improvement plans as well as disseminate vital information to staff nurses and other health care professionals to protect patients and improve outcomes.
As you prepare for this assessment, it would be an excellent choice to complete the Quality and Safety Improvement Plan Knowledge Base activity and to review the various assessment resources, all of which will help you build your knowledge of key concepts and terms related to quality and safety improvement. The terms and concepts will be helpful as you prepare your Root-Cause Analysis and Safety Improvement Plan. Activities are not graded and demonstrate course engagement.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Analyze the elements of a successful quality improvement initiative.
Apply evidence-based and best-practice strategies to address a safety issue or sentinel event pertaining to medication administration. ;
Create a viable, evidence-based safety improvement plan for safe medication administration.
Competency 2: Analyze factors that lead to patient safety risks.
Analyze the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization.
Competency 3: Identify organizational interventions to promote patient safety.
Identify existing organizational resources that could be leveraged to improve a safety improvement plan for safe medication administration.
Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.
Professional Context
Nursing practice is governed by health care policies and procedures as well as state and national regulations developed to prevent problems. It is critical for nurses to participate in gathering and analyzing data to determine causes of patient safety issues, in solving problems, and in implementing quality improvements.
Scenario
For this assessment, you may choose from the following options as the subject of a root-cause analysis and safety improvement plan:
The specific safety concern identified in your previous assessment pertaining to medication administration safety concerns.
The readings, case studies, or a personal experience in which a sentinel event occurred surrounding an issue or concern with medication administration.
Instructions
The purpose of this assessment is to demonstrate your understanding of and ability to analyze a root cause of a specific safety concern in a health care setting. You will create a plan to improve the safety of patients related to the concern of medication administration safety based on the results of your analysis, using the literature and professional best practices as well as the existing resources at your chosen health care setting to provide a rationale for your plan.
Use the Root-Cause Analysis and Improvement Plan [DOCX] Download Root-Cause Analysis and Improvement Plan [DOCX]template to help you to stay organized and concise. This will guide you step-by-step through the root cause analysis process.
Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Analyze the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization.
Apply evidence-based and best-practice strategies to address the safety issue or sentinel event pertaining to medication administration.
Create a feasible, evidence-based safety improvement plan for safe medication administration.
Identify organizational resources that could be leveraged to improve your plan for safe medication administration.
Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like but keep in mind that your Assessment 2 will focus on safe medication administration.
Assessment 2 Example [PDF] Download Assessment 2 Example [PDF].
Additional Requirements
Length of submission: Use the provided Root-Cause Analysis and Improvement Plan template to create a 4–6 page root cause analysis and safety improvement plan pertaining to medication administration.
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
APA formatting: Format references and citations according to current APA style.
Scoring Guide
Use the scoring guide to understand how your assessment will be evaluated.
View Scoring Guide
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For this assessment, you will develop an 8-14 slide PowerPoint presentation with thorough speaker’s notes designed for a hypothetical in-service session related to the safe medication administration improvement plan you developed in Assessment 2.
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Introduction
As a practicing professional, you are likely to present educational in-services or training to staff pertaining to quality improvement (QI) measures of safety improvement interventions. Such in-services and training sessions should be presented in a creative and innovative manner to hold the audience’s attention and promote knowledge acquisition and skill application that changes practice for the better. The teaching sessions may include a presentation, audience participation via simulation or other interactive strategy, audiovisual media, and participant learning evaluation.
The use of in-services and/or training sessions has positive implications for nursing practice by increasing staff confidence when providing care to specific patient populations. It also allows for a safe and nonthreatening environment where staff nurses can practice their skills prior to a real patient event. Participation in learning sessions fosters a team approach, collaboration, patient safety, and greater patient satisfaction rates in the health care environment (Patel & Wright, 2018).
As you prepare to complete the assessment, consider the impact of in-service training on patient outcomes as well as practice outcomes for staff nurses. Be sure to support your thoughts on the effectiveness of educating and training staff to increase the quality of care provided to patients by examining the literature and established best practices.
You are encouraged to explore the AONE Nurse Executive Competencies Review activity before you develop the Improvement Plan In-Service Presentation. This activity will help you review your understanding of the AONE Nurse Executive Competencies—especially those related to competencies relevant to developing an effective training session and presentation. This is for your own practice and self-assessment, and demonstrates your engagement in the course.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Analyze the elements of a successful quality improvement initiative.
Explain the need and process to improve safety outcomes related to medication administration.
Create resources or activities to encourage skill development and process understanding related to a safety improvement initiative on medication administration.
Competency 4: Explain the nurse’s role in coordinating care to enhance quality and reduce costs.
List clearly the purpose and goals of an in-service session focusing on safe medication administration for nurses.
Explain audience’s role in and importance of making the improvement plan focusing on medication administration successful.
Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
Slides are easy to read and error free. Detailed speaker notes are provided. Speaker notes are clear, organized, and professionally presented.
Organize content with clear purpose or goals and with relevant and evidence-based sources (published within 5 years).
REFERENCE
Patel, S., & Wright, M. (2018). Development of interprofessional simulation in nursing education to improve teamwork and collaboration in maternal child nursing. Journal of Obstetric, Gynecologic & Neonatal Nursing, 47(3), s16–s17.
Professional Context
As a baccalaureate-prepared nurse, you will often find yourself in a position to lead and educate other nurses. This colleague-to-colleague education can take many forms, from mentoring to informal explanations on best practices to formal in-service training. In-services are an effective way to train a large group. Preparing to run an in-service may be daunting, as the facilitator must develop his or her message around the topic while designing activities to help the target audience learn and practice. By improving understanding and competence around designing and delivering in-service training, a BSN practitioner can demonstrate leadership and prove him- or herself a valuable resource to others.
Scenario
For this assessment it is suggested you take one of two approaches:
Build on the work that you have done in your first two assessments and create an agenda and PowerPoint of an educational in-service session that would help a specific staff audience learn, provide feedback, and understand their roles and practice new skills related to your safety improvement plan pertaining to medication administration, or
Locate a safety improvement plan through an external resource and create an agenda and PowerPoint of an educational in-service session that would help a specific staff audience learn, provide feedback, and understand their roles and practice new skills related to the issues and improvement goals pertaining to medication administration safety.
Instructions
The final deliverable for this assessment will be a PowerPoint presentation with detailed presenter’s notes representing the material you would deliver at an in-service session to raise awareness of your chosen safety improvement initiative focusing on medication administration and to explain the need for it. Additionally, you must educate the audience as to their role and importance to the success of the initiative. This includes providing examples and practice opportunities to test out new ideas or practices related to the safety improvement initiative.
Be sure that your presentation addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
List the purpose and goals of an in-service session focusing on safe medication administration for nurses.
Explain the need for and process to improve safety outcomes related to medication administration.
Explain to the audience their role and importance of making the improvement plan focusing on medication administration successful.
Create resources or activities to encourage skill development and process understanding related to a safety improvement initiative on medication administration.
Communicate with nurses in a respectful and informative way that clearly presents expectations and solicits feedback on communication strategies for future improvement.
There are various ways to structure an in-service session; below is just one example:
Part 1: Agenda and Outcomes.
Explain to your audience what they are going to learn or do, and what they are expected to take away.
Part 2: Safety Improvement Plan.
Give an overview of the current problem focusing on medication administration, the proposed plan, and what the improvement plan is trying to address.
Explain why it is important for the organization to address the current situation.
Part 3: Audience’s Role and Importance.
Discuss how the staff audience will be expected to help implement and drive the improvement plan.
Explain why they are critical to the success of the improvement plan focusing on medication administration.
Describe how their work could benefit from embracing their role in the plan.
Part 4: New Process and Skills Practice.
Explain new processes or skills.
Develop an activity that allows the staff audience to practice and ask questions about these new processes and skills.
In the notes section of your PowerPoint, brainstorm potential responses to likely questions or concerns.
Part 5: Soliciting Feedback.
Describe how you would solicit feedback from the audience on the improvement plan and the in-service.
Explain how you might integrate this feedback for future improvements.
Remember to account for activity and discussion time.
For tips on developing PowerPoint presentations, refer to:
Capella University Library: PowerPoint Presentations.
Guidelines for Effective PowerPoint Presentations [PPTX].
Additional Requirements
Presentation length: There is no required length; use just enough slides to address all the necessary elements. Remember to use short, concise bullet points on the slides and expand on your points in the presenter’s notes. If you use 2 or 3 slides to address each of the parts in the above example, your presentation would be at least 10 slides and no more than 15 slides (not including the title, conclusion, or references slides).
Speaker notes: Speaker notes (located under each slide) should reflect what you would actually say if you were delivering the presentation to an audience. This presentation does NOT require audio or a transcript. Another presenter would be able to use the presentation by following the speaker’s notes.
APA format: Use APA formatting for in-text citations. Include an APA-formatted reference slide at the end of your presentation.
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence to support your assertions. Resources should be no more than 5 years old.
Scoring Guide
Use the scoring guide to understand how your assessment will be evaluated.
View Scoring Guide
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For this assessment, you will develop a Word document or an online resource repository of at least 12 annotated professional or scholarly resources that you consider critical for the audience of your safety improvement plan, pertaining to medication administration, to understand or implement to ensure the success of the plan.
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Introduction
Communication in the health care environment consists of an information-sharing experience whether through oral or written messages (Chard & Makary, 2015). As health care organizations and nurses strive to create a culture of safety and quality care, the importance of interprofessional collaboration, the development of tool kits, and the use of wikis become more relevant and vital. In addition to the dissemination of information and evidence-based findings and the development of tool kits, continuous support for and availability of such resources are critical. Among the most popular methods to promote ongoing dialogue and information sharing are blogs, wikis, websites, and social media. Nurses know how to support people in time of need or crisis and how to support one another in the workplace; wikis in particular enable nurses to continue that support beyond the work environment. Here they can be free to share their unique perspectives, educate others, and promote health care wellness at local and global levels (Kaminski, 2016).
You are encouraged to complete the Determining the Relevance and Usefulness of Resources activity prior to developing the repository. This activity will help you determine which resources or research will be most relevant to address a particular need. This may be useful as you consider how to explain the purpose and relevance of the resources you are assembling for your tool kit. The activity is for your own practice and self-assessment, and demonstrates course engagement.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Analyze the elements of a successful quality improvement initiative.
Analyze usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration.
Competency 2: Analyze factors that lead to patient safety risks.
Analyze the value of resources to reduce patient safety risk or improve quality with medication administration.
Competency 3: Identify organizational interventions to promote patient safety.
Identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.
Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
Present reasons and relevant situations for resource tool kit to be used by its target audience.
Communicate resource tool kit in a clear, logically structured, and professional manner that applies current APA style and formatting.
REFERENCES
Chard, R., & Makary, M. A. (2015). Transfer-of-care communication: Nursing best practices. AORN Journal, 102(4), 329–342.
Kaminski, J. (2016). Why all nurses can/should be authors. Canadian Journal of Nursing Informatics, 11(4), 1–7.
Professional Context
Nurses are often asked to implement processes, concepts, or practices—sometimes with little preparatory communication or education. One way to encourage sustainability of quality and process improvements is to assemble an accessible, user-friendly tool kit for knowledge and process documentation. Creating a resource repository or tool kit is also an excellent way to follow up an educational or in-service session, as it can help to reinforce attendees’ new knowledge as well as the understanding of its value. By practicing creating a simple online tool kit, you can develop valuable technology skills to improve your competence and efficacy. This technology is easy to use, and resources are available to guide you.
Scenario
For this assessment, consider taking one of these two approaches:
Build on the work done in your first three assessments and create an online tool kit or resource repository that will help the audience of your in-service understand the research behind your safety improvement plan pertaining to medication administration and put the plan into action.
Locate a safety improvement plan (your current organization, the Institution for Healthcare Improvement, or a publicly available safety improvement initiative) pertaining to medication administration and create an online tool kit or resource repository that will help an audience understand the research behind the safety improvement plan and how to put the plan into action.
Preparation
Google Sites is recommended for this assessment; the tools are free to use and should offer you a blend of flexibility and simplicity as you create your online tool kit. Please note that this requires a Google account; use your Gmail or GoogleDocs login, or create an account following the directions under the “Create Account” menu.
Refer to the following links to help you get started with Google Sites:
G Suite Learning Center. (n.d.). Get started with Sites. https://gsuite.google.com/learning-center/products…
Google. (n.d.). Sites. https://sites.google.com
Google. (n.d.). Sites help. https://support.google.com/sites/?hl=en#topic=
Instructions
Using Google Sites, assemble an online resource tool kit containing at least 12 annotated resources that you consider critical to the success of your safety improvement initiative. These resources should enable nurses and others to implement and maintain the safety improvement you have developed.
It is recommended that you focus on the 3 or 4 most critical categories or themes with respect to your safety improvement initiative pertaining to medication administration. For example, for an initiative that concerns improving workplace safety for practitioners, you might choose broad themes such as general organizational safety and quality best practices; environmental safety and quality risks; individual strategies to improve personal and team safety; and process best practices for reporting and improving environmental safety issues.
Following the recommended scheme, you would collect 3 resources on average for each of the 4 categories focusing on safety with medication administration. Each resource listing should include the following:
An APA-formatted citation of the resource with a working link.
A description of the information, skills, or tools provided by the resource.
A brief explanation of how the resource can help nurses better understand or implement the safety improvement initiative pertaining to medication administration.
A description of how nurses can use this resource and when its use may be appropriate.
Remember that you must make your site ‘public’ so that your faculty can access it. Check out the Google Sites resources for more information.
Here is an example entry:
Merret, A., Thomas, P., Stephens, A., Moghabghab, R., & Gruneir, M. (2011). A collaborative approach to fall prevention. Canadian Nurse, 107(8), 24–29.
This article presents the Geriatric Emergency Management-Falls Intervention Team (GEM-FIT) project. It shows how a collaborative nurse lead project can be implemented and used to improve collaboration and interdisciplinary teamwork, as well as improve the delivery of health care services. This resource is likely more useful to nurses as a resource for strategies and models for assembling and participating in an interdisciplinary team than for specific fall-prevention strategies. It is suggested that this resource be reviewed prior to creating an interdisciplinary team for a collaborative project in a health care setting.
Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Identify necessary resources to support the implementation and continued sustainability of a safety improvement initiative pertaining to medication administration.
Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements focusing on medication administration.
Analyze the value of resources to reduce patient safety risk related to medication administration.
Present reasons and relevant situations for use of resource tool kit by its target audience.
Communicate in a clear, logically structured, and professional manner that applies current APA style and formatting.
Example Assessment: You may use the following example to give you an idea of what a Proficient or higher rating on the scoring guide would look like but keep in mind that your tool kit will focus on promoting safety with medication administration. Note that you do not have to submit your bibliography in addition to the Google Site; the example bibliography is merely for your reference.
Assessment 4 Example [PDF] Download Assessment 4 Example [PDF].
To submit your online tool kit assessment, paste the link to your Google Site in the assessment submission box.
Example Google Site: You may use the example Google Site, Resources for Improved Heparin Infusion Safety, to give you an idea of what a Proficient or higher rating on the scoring guide would look like for this assessment but keep in mind that your tool kit will focus on promoting safety with medication administration.
Note: If you experience technical or other challenges in completing this assessment, please contact your faculty member.
Additional Requirements
APA formatting: References and citations are formatted according to current APA style
Scoring Guide
Use the scoring guide to understand how your assessment will be evaluated.
Discuss how you are progressing on your S.M.A.R.T. Goals for self-care. Is there one or more goal(s) that you have started to implement? If yes, discuss how you are progressing. If no, discuss the obstacles you encounter(ed) that deter you from making progress. Share an adjusted S.M.A.R.T. Goal if you realize what you developed was not realistic. In your replies, encourage and challenge your peers to move toward health and self-care. Utilize scripture, course materials, and personal examples in your replies.
Unformatted Attachment Preview
ECOMAP AND SELF CARE
1
Ecomap and Self-Care Plan
Quadasia Dukes
School of Behavioral Science , Liberty University
Author Note
Quadasia Dukes
I have no known conflict of interest to disclose.
ECOMAP AND SELF CARE
Correspondence concerning this article should
be addressed to Quadasia Dukes. Email:
qldukes@liberty.edu
2
Legend:
The thicker the line, the stronger
the relationship.
The larger the arrow, the more
energy given or received
Tenuous —–Stressful /
/
/
Broken // // //
ECOMAP AND SELF CARE
3
SMART Plan
CARE AREA
Physical Care
Psychological Care
SELF-CARE PLANNING FORM
S.M.A.R.T. GOALS
ACCOUNTABILITY
Specific, Measurable,
MEASURE
Achievable, Realistic, and
Time-limited
Goal 1: I will exercise for 30 I will track my workouts
minutes at least thrice weekly using a fitness app and share
to improve my physical
my progress with my workout
health.
partner, Tanya.
Goal 2: I will prepare and
I will maintain a food journal
consume at least three
to monitor my daily intake
balanced meals daily,
and discuss my dietary
focusing on fresh vegetables
choices with my nutritionist.
and lean proteins to support
proper nutrition.
Goal 1: I will practice
Accountability: I will set a
mindfulness meditation for 15 daily alarm for my morning
minutes daily to reduce stress meditation and journal about
and enhance mental wellmy meditation experiences.
being.
Goal 2: I will attend therapy
sessions with a licensed
therapist once a week to
address unresolved
psychological issues.
Spiritual Care
Social Care
Goal 1: I will attend weekly
services at my place of
worship every Sunday to
foster my spiritual growth.
Goal 2: I will engage in daily
spiritual reflection and prayer
for 10 minutes each night to
enhance inner peace.
Goal 1: I will plan and attend
family dinners or outings at
least twice a month to
I will maintain regular
therapy appointments and
actively engage in the therapy
process. I will also share my
therapy journey with my
close friend, Sabrina.
I will mark each service
attended on a calendar and
actively participate in
discussions and events
organized by my spiritual
community.
I will set a daily reminder for
my spiritual reflection and
prayer and maintain a journal
to record my reflections.
I will proactively organize
family gatherings and
maintain a calendar to track
these events.
ECOMAP AND SELF CARE
4
strengthen connections with
family and friends.
Goal 2: I will join a social
club related to my interests
and attend at least one social
activity or event per month.
Professional/Volunteer Care
Goal 1: I will enroll in an
online course relevant to my
field and complete it within
six months to advance my
career.
Goal 2: I will research and
identify a local volunteer
organization and commit to
volunteering at least once a
month to give back to the
community.
Accountability: I will actively
participate in the social club’s
activities, engage with peers,
and maintain regular
communication with my
family and friends.
I will allocate dedicated time
for course studies, maintain a
schedule, and seek guidance
from my supervisor.
I will regularly check for
volunteer opportunities,
actively participate in events
or projects, and inform my
supervisor at work about my
volunteer commitments.
ECOMAP AND SELF CARE
5
Conclusion
In conclusion, the Ecomap has illuminated the significance of these connections in my
self-care journey. My son, Ziyan, my mother, Lisa, and my sisters, Chasity, Shanika, and
Cherelle, are not just people I feel connected with; they are the foundation of my self-care plan.
Their presence, support, and influence enrich my life and provide avenues for self-care. To
nurture these connections further, I intend to engage in activities that strengthen our bonds, such
as family outings, regular conversations, and quality time with Ziyan. Additionally, I recognize
the importance of reciprocating support and being there for them when needed. By fostering
these connections, I aim to continue thriving on my path of self-care, knowing that I am not
alone in this journey but surrounded by a network of love and support. Additionally, my weekly
routine involves visiting various places, each with its influence on my self-care. By recognizing
the positive and negative impacts of these places and implementing strategies to enhance
supportive connections while setting boundaries with those that may hinder self-care, I can create
a more nurturing environment for my overall well-being and happiness.
ECOMAP AND SELF CARE
6
References
Edelkott, N., Engstrom, D. W., Hernandez-Wolfe, P., & Gangsei, D. (2016). Vicarious
resilience: Complexities and variations. American Journal of Orthopsychiatry, 86(6),
713.
Kobe, R. (2023). From the Heart. Richmond Kobe.
Develop a PowerPoint presentation on a cardiovascular/pulmonary disorder/disease discussed in the McCance text. (Aneurysm in adults)
The presentation must provide information about the incidence, prevalence, and pathophysiology of the disease/disorder to the cellular level. The presentation must educate advanced practice nurses on assessment and care/treatment, including genetics/genomics—specific for this disorder. Patient education for management, cultural, and spiritual considerations for care must also be addressed. The presentation must specifically address how the disease/disorder affects 1 of the following age groups: infant/child, adult, or elderly.
Format Requirements:
• Presentation is original work and logically organized.
• Followed APA format including citation of references.
• Power point presentation with 10-15 slides were clear and easy to read. Speaker notes expanded upon and clarified content on the slides.
• Incorporate a minimum of 4 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to APA style (the library has a copy of the APA Manual).
Content Requirements:
• Select a cardiovascular or pulmonary disorder.
• Provide information about the incidence, prevalence, and pathophysiology of the disease/disorder to the cellular level.
• Educate advanced practice nurses on assessment and care/treatment, including genetics/genomics—specific for this disorder.
• Provide patient education for management, cultural, and spiritual considerations for care must also be addressed.
• Must specifically address how the disease/disorder affects 1 of the following age groups: infant/child, adult, or elderly.
The PPT must provide information about the incidence, prevalence, and pathophysiology of the disease/disorder at the cellular level. The presentation must educate advanced practice nurses on assessment and care/treatment, including genetics/genomics—specific to this disorder. Patient education for management, cultural, and spiritual considerations for care must also be addressed. The presentation must specifically address how the disease/disorder affects 1 of the following age groups: infant/child, adult, or elderly.
Make sure you prepare a master-level presentation, then you can receive the maximum number of points that will help improve your grades during this final stretch. I have high expectations for you because this level requires it, and I know you can do it!
I want a presentation for (Analysis of Qualitative Data) that covers all content in Chapter 16 of the text book. I will upload it as a pdf file. The content should be 5% or less plagiarism-free, organized, and interesting.Use the APA format for citation references. the content should cover the Rubric as much as you can ( rubric in uplode file )
The presentation must provide information about the incidence, prevalence, and pathophysiology of the disease/disorder to the cellular level. The presentation must educate advanced practice nurses on assessment and care/treatment, including genetics/genomics—specific for this disorder. Patient education for management, cultural, and spiritual considerations for care must also be addressed. The presentation must specifically address how the disease/disorder affects 1 of the following age groups: infant/child, adult, or elderly.
Format Requirements:
Presentation is original work and logically organized.
Followed APA format including citation of references.
Power point presentation with 10-15 slides were clear and easy to read. Speaker notes expanded upon and clarified content on the slides.
Incorporate a minimum of 4 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to APA style (the library has a copy of the APA Manual).
Content Requirements:
Select a cardiovascular or pulmonary disorder.
Provide information about the incidence, prevalence, and pathophysiology of the disease/disorder to the cellular level.
Educate advanced practice nurses on assessment and care/treatment, including genetics/genomics—specific for this disorder.
Provide patient education for management, cultural, and spiritual considerations for care must also be addressed.
Must specifically address how the disease/disorder affects 1 of the following age groups: infant/child, adult, or elderly.
Unformatted Attachment Preview
HIPPOPOTOMON
STROSESQUIPPE
DALIOPHOBIA
Introduction
(Define the disease)
▪
Give a summary definition of the disease.
▪
Explain in professional terms. (WHO, 2022)
▪
Also explain in terms patient will understand (Brown, 2020)
Can put intext citation at the bottom left of each slide if all the
information is from the same source, eg (Brown, 2020) . If you
have different citations, enter beside the sentence. Eg. There
are 100,000 people affected by this disease (WHO, 2022).
2
INCIDENCE
• 1 in every 100 persons affected by this disease (Brown, 2020).
• Use footnotes that is the white space at the bottom of each slide if you have
more to say but it can’t hold on the slide (WHO, 2022).
• Watch YouTube video how to open the footnote (Rose, 2023).
PREVALENCE
PRESENTATION TITLE
• 100,000 in USA and one million worldwide (Crow , 2020).
• Do not overcrowd slides.
• If one slide is full but you are still on the same heading, open another
slide and give it the same name (Do not put cntd).
• You can have multiple reference list slide (Jones, 2019).
• Pay attention to the date range of the scholarly source the assignment
asked for.
• You cannot have a reference list if you did not have intext citation, they
work together. Use only black and proper size font, Times new Romans.
Do not use too much graphics on slides that obscure the writing
9/3/20XX
4
PATHOPHYSIOLOGY
PRESENTATION TITLE
• Explain pathophysiology of how the disease occur
•
• Cellular Level (This is a part of pathophysiology and can go on the
next slide) if you wish.
• Can use picture but give credit to source at the bottom of the
slide. Also give explanation of what is happening in the picture.
• Explains what happen to the cells during this disease process
• Brown (2020)
9/3/20XX
5
PATHOPHYSIOLOGY
PRESENTATION TITLE
• You can add picture/diagram on this slide.
• Give credit to the source where you get the image from.
• Example. At the bottom of the slide…
www.htpp. Imagesource.
9/3/20XX
6
APRN Education
List signs and symptoms
that comes with this
disease.
Dyspnea, Cough
Chest pain
Assessment
MRI
Obesity
Cardiac ablation
EKG
Smoking
Hysterectomy
List genes associated
with the condition .
CT Scan
Sedentary lifestyles
Metoprolol
Alpha 1 antitrypsin
Aspirin
BRCA 1&2 genes
CBC
Troponin.
Diagnostic Tests
Risk Factors
Medication/Treatme
nt
Genetic/Genome
7
PATIENT EDUCATION
PRESENTATION TITLE
• Management- Diet and exercise, medication, F/U care
• Culture- Discuss cultural impact on dx. eg, Native Americans and
Hispanic higher incidence
• Spiritual-eg, culture believe in prayer or certain rituals in curing
diseases. Select the age group your condition affect and explain.
• Age group- Infant is affected by this disease.
• Child 13-18-Juvenile diabetes.
• Adults/Elderly- High incidences especially in obese or those with
family history.
9/3/20XX
8
REFERENCES
9/3/20XX
PRESENTATION TITLE
9
REFERENCES
9/3/20XX
PRESENTATION TITLE
10
Compare the strategies used when disseminating evidence related to health care outcomes.Evidence-Based Practice in Nursing and Healthcare: A Guide to Best PracticeMelnyk, B. M., & Fineout-Overholt, E. (Eds.). (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Wolters Kluwer. ISBN-13: 9781496384539
Health disparities are inequalities prevalent in healthcare, which often involve lack of access across various racial, ethnic and socioeconomic populations. Health disparities encompass an unequal distribution of social, political, economic, and environmental resources, especially among vulnerable populations. As a result, a number of local, regional, and national policies have been introduced to address health disparities to promote quality care and improved access for these populations. When developing health policies, especially those that focus on vulnerable populations, it is important for stakeholders to consider any ethical considerations that will protect vulnerable populations from substandard care and unethical medical practices.
Identify a health disparity prevalent in the Kingdom of Saudi Arabia. Examples include, but are not limited to, nutrition- and lifestyle-related risk factors such as obesity, hypertension, and diabetes, as well as lack of insurance. Include any tables or figures containing statistics to support your narrative.
Based on what you learned this week, address the following:
* Identify a vulnerable population and a specific health disparity prevalent in the Kingdom of Saudi Arabia.
* Clearly explain the health disparities and why it is worse for your selected vulnerable population.
* What are some of the positive social changes that need to be accomplished to protect these populations?
* Discuss a local, regional, or national policy to protect the identified vulnerable populations from this disparity.
* What are some of the moral and ethical obligations that need to be considered with regard to the policy?
Your report should meet the following structural requirements:
* Be five to six pages in length, not including the cover or reference pages.
* Be formatted according to APA 7th edition and Saudi Electronic University writing guidelines.
* Provide support for your statements with in-text citations from a minimum of three scholarly articles. The Saudi Digital Library is an excellent source for scholarly research. One of these sources may be from the class readings, textbook, or lectures.
* You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior
As a final exam of the Legal & Ethics class, students will be assigned a research paper and each one will have a different topic related to the topics discussed in class.The student must finds a reliable source where they will obtain the information requested is involving their work. You must apply APA Edition 7 format in the preparation of your final project.The work will be evaluated using an evaluation rubric measuring understanding of the content of the topic.Using legal websites and search engines, find a case based on a lack of informed consent in your current or future profession.Perform a web search for informed consent. What information must be disclosed during informed consent, and who is responsible for obtaining the informed consent?
Same as the previous CT but add more information preferably to be about the study design , see the example file.
Unformatted Attachment Preview
1
Critical Thinking Assignment: Selecting Sources
Name
Saudi Electronic University
HCM-505
Dr. name
30 September 2023
2
Critical Thinking Assignment: Selecting Sources
Mental health is one of the leading healthcare sectors in the Kingdom of Saudi Arabia
due to the government’s commitment to making care services available and accessible to
patients. Mousa et al. (2021) stated that these efforts are characterized by the establishment of
specialized medical facilities and the introduction of policies and programs that support the
provision of infrastructure and human resources to meet the needs of the population. The
distribution of mental health services in the region through the availability of in-patient,
outpatient, and emergency services in the hospital is another indicator of the government’s
commitment to meeting the needs of patients. In this regard, it is expected that an estimated 34%
of the total Saudi population who are diagnosed with at least one mental disorder can access
quality and effective services, including 40% of Saudi youths who suffer from at least one
mental disorder such as disruptive disorders and anxiety disorders (Altwaijri et al.,2023) Also,
the purpose of government’s attention to mental health system is to ensure that the 4% of total
healthcare expenditure on treatment services increase the number of professionals from its
current 19.4 per 100,000 population to the 64.3 per 100,000 population that exist in other highincome countries (Al-Subaie et al., 2020). Therefore, mental health issues in the Kingdom of
Saudi Arabia are related to cultural barriers and attitudinal factors that highlight the need for new
policy directions and programs to reduce the prevalence of mental disorders.
The perception and attitudes of Saudis toward the mental health system, disorders, and
practice are mostly negative and responsible for the high level of stigma against patients and
practitioners in the country. As a result of the stigma, the formal help-seeking behavior of the
people is very low as characterized by the 86% of diagnosed patients who did not receive
treatment for 12 months (Alangari et al., 2019). Similarly, Mousa et al. (2020) found that
3
patients’ perception of mental health care services in Saudi Arabia is influenced by the cultural
practices that stigmatize people with mental disorders, especially young unmarried women. The
influences of these cultural practices are also responsible for the high rate of biases toward
psychiatric nurses and patients by their non-mental healthcare providers. It implies that the major
issue with the mental health system is the negative attitudinal practices and perception of
hospitals and medical facilities as prisons. While the prevalence of the negative consequences of
untreated mental disorders such as suicide is low among Saudis, the rate is higher among nonSaudi migrant workers (Altaqaq et al., 2021). Therefore, selected sources provide evidence on
the prevalence of mental disorders, the status of the mental health system, and barriers to care
services that should be addressed through government policies and programs.
List of Sources with Rationales for their selection
S/N
1
Study
Reason for selection
Suicide in Saudi Arabia: A review
The authors found that while suicide rates are
low among Saudis, its higher among non-Saudi
migrant workers who are more exposed to severe
workplace stressors that impact their mental
health adversely.
2
Lifetime prevalence and treatment of
The authors found that the 2 out 5 young people
mental disorders in Saudi youth and
in Saudi Arabia suffers from a mental disorder
adolescents
and 14.47% of these patients receive treatment
for their lifetime disorder, which indication very
low access or utilization of mental health care
services among this demographic.
4
3
Overview of the Saudi National
The survey provides detailed information on the
Mental Health Survey
epidemiology of mental health illnesses in Saudi
Arabia.
4
Barriers to mental health treatment in
The authors found that 86% of patients with
the Saudi National Mental Health
mental disorder did not receive treatment due to
Survey
poor perception of the need for services and
pervasive attitudinal and structural barriers to
access for those who perceived need for care.
5
Attitudes and stigma toward seeking
The authors found strong correlations between
psychological help among Saudi
psychological distress and attitude with male
adults
Saudi adults displaying the greatest level of
stigma towards mental health patients.
6
7
Saudi service users’ perceptions and
The authors found that majority of mental health
experiences of the quality of their
patients have negative perceptions of in-patient
mental health care provision in the
mental health services and regard these facilties
Kingdom of Saudi Arabia (KSA): A
as prisons, especially when their discharge is
qualitative inquiry
delayed due to various factors.
Perception of mental health care
The authors found poor knowledge of
professionals in Saudi Arabia on
computerized cognitive behavioral therapy
computerized cognitive behavioral
(cCBT) among mental healthcare professionals
therapy: Observational cross-sectional
in Saudi Arabia despite their strong believe in its
study
effectiveness and positive attitude towards
computer-based therapies.
5
8
Interventions to improve the mental
The authors found interventions that are
health or mental well-being of
effectiveness for addressing mental disorders
migrants and ethnic minority groups in among patients with history of exposure to
Europe: A scoping review
stigma, discrimination, inequities, and other
barriers to access and care services/
9
The effect of an Islamic-based
The authors found that Islamic intervention were
intervention on depression and anxiety
effective in lowering depression levels in men
in Malaysia.
and anxiety in women, which implies that this
intervention can be replicated in Saudi Arabia.
10
Advancing mental health nursing
The authors found a huge gap in research on the
practice in the Kingdom of
nursing care of psychosis patients in Saudi
Saudi Arabia: Rethinking nursing care
Arabia, which highlight the challenges with
for consumers with
identifying the right modalities or interventions
Psychosis.
for this mental disorder.
6
References
Alangari, A. S., Knox, S. S., Kristjansson, A. L., Wen, S., Innes, K. E., Bilal, L., Alhabeeb, A.,
S., A., & Altwaijri, Y. A. (2019). Barriers to mental health treatment in the Saudi National
Mental Health Survey. International Journal of Environmental Research and Public
Health, 17(11), 3877. https://doi.org/10.3390/ijerph17113877
AlHadi, A. N., Alammari, K. A., Alsiwat, L. J., Alhaidri, N. E., Alabdulkarim, N. H., Altwaijri,
N. A., & AlSohaili, S. A. (2021). Perception of mental health care professionals in Saudi
Arabia on computerized cognitive behavioral therapy: Observational cross-sectional
study. JMIR Formative Research, 5(5), e26294.
Alluhaibi, B. A., & Awadalla, A. W. (2022). Attitudes and stigma toward seeking psychological
help among Saudi Adults. BMC psychology, 10(1), 1-10. https://doi.org/10.1186/s40359022-00923-4
Al-Subaie, A. S., Al-Habeeb, A., & Altwaijri, Y. A. (2020). Overview of the Saudi National
Mental Health Survey. International Journal of Methods in Psychiatric Research, 29(3),
e1835. https://doi.org/10.1002/mpr.1835
Altaqaq, G., Alsamahiji, B., Alabkary, S., Aljishi, S., & Alzaher, W. (2021). Suicide in Saudi
Arabia: A Review. International Journal of Medicine in Developing Countries, 5(10),
1805–1809. https://doi.org/10.24911/ijmdc.51-1630444768
Altwaijri, Y., Kazdin, A. E., Hyder, S., Bilal, L., Naseem, M. T., & De Vol, E. (2023). Lifetime
prevalence and treatment of mental disorders in Saudi youth and adolescents. Scientific
Reports, 13(1), 1-13. https://doi.org/10.1038/s41598-023-33005-5
7
Alyahya, N. M., Munro, I., & Moss, C. (2021). Advancing mental health nursing practice in the
Kingdom of Saudi Arabia: Rethinking nursing care for consumers with psychosis. Journal
of Nature and Science of Medicine, 4(1), 12-15. DOI: 10.4103/JNSM.JNSM_35_20
Alyousef, S. M., & Alhamidi, S. A. (2023). Nurse views of obstacles encountered by nurses in
Saudi Arabia during the provision of psychiatric care. Archives of Psychiatric Nursing, 44,
8-17. https://doi.org/10.1016/j.apnu.2023.03.005
Apers, H., Van Praag, L., Nöstlinger, C., & Agyemang, C. (2023). Interventions to improve the
mental health or mental well-being of migrants and ethnic minority groups in Europe: A
scoping review. Cambridge Prisms: Global Mental Health, 10, e23. 1–25
https://doi.org/10.1017/gmh.2023.15
Mousa, Y. A., Callaghan, P., Michail, M., & Caswell, G. (2021). Saudi service users’
perceptions and experiences of the quality of their mental health care provision in the
Kingdom of Saudi Arabia (KSA): A qualitative inquiry. International Journal of Mental
Health Nursing, 30(1), 300-316. https://doi.org/10.1111/inm.12784
Saged, A. A. G., Sa’ari, C. Z., Abdullah, M. B., Al-Rahmi, W. M., Ismail, W. M., Zain, M. I. A.,
& alShehri, N. B. A. B. M. (2022). The effect of an Islamic-based intervention on
depression and anxiety in Malaysia. Journal of Religion and Health, 61(1), 79-92.
https://doi.org/10.1007/s10943-021-01484-3
Sample Annotated Bibliography Entries
The following example uses APA style (Publication Manual of the American
Psychological Association, 7th edition, 2019) for the journal citation:
Waite, L., Goldschneider, F., & Witsberger, C. (1986). Nonfamily living and the
erosion of traditional family orientations among young adults. American
Sociological Review, 51(4), 541-554.
The authors, researchers at the Rand Corporation and Brown University, use
data from the National Longitudinal Surveys of Young Women and Young
Men to test their hypothesis that nonfamily living by young adults alters their
attitudes, values, plans, and expectations, moving them away from their belief
in traditional sex roles. They found their hypothesis strongly supported in
young females, while the effects were fewer in studies of young males.
Increasing the time away from parents before marrying increased
individualism, self-sufficiency, and changes in attitudes about families. In
contrast, an earlier study by Williams cited below shows no significant gender
differences in sex role attitudes as a result of nonfamily living.
https://journals.sagepub.com/doi/pdf/10.1177/15248…PurposeThe purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos. Action ItemsDescribe human centred design strategies and how the effect healthcare?Submission InstructionsComplete and submit this assignment according to your professor’s instructions.
There is a lot to learn about this topic. Thank you for researching this and preparing your post. An exciting area of technology-people interaction is the use of gaming systems to help adults with brain injuries recover (Aulisio et al., 2020). This, to me, is the epitome of “human interactions with technology”! What potential challenges do you see with this?
References
Aulisio, M. C., Han, D. Y., & Glueck, A. C. (2020). Virtual reality gaming as a neurorehabilitation tool for brain injuries in adults: A systematic review. Brain injury, 34(10), 1322–1330. https://doi.org/10.1080/02699052.2020.1802
This is my dis
Date
Challenges of Human Interactions with Technology
Challenges Encountered
The complex relationships between people and machines present several difficulties for human interactions with technology. The digital gap is one of the main challenges, aggravating social injustices by preventing marginalized people from participating in the digital world due to their limited access to technology(Dwivedi et al., 2021). In addition, technology frequently threatens the established social order, raising worries about depersonalization and the deterioration of genuine human ties.
Concerns about privacy and security are significant, particularly when personal data is exposed to breaches and misuse, which breeds mistrust. In addition, the quick speed of technology development leads to a steep learning curve for many people, discouraging them from embracing new technologies(Farahani et al., 2020). Additionally, the prevalence of screens and devices can result in problems like digital addiction, which can harm mental and physical health. It is necessary to take a deliberate, human-centred approach, ensuring that technology fosters inclusion, privacy, and real connections in the digital age rather than degrading them to address these issues.
Recommendations
It is critical to use a human-centric design process when creating computer and mobile application interfaces for patient care to address these difficulties. First, simplicity and intuitiveness should be given top priority by designers(Dwivedi et al., 2021). No matter their technological skill level, patients and healthcare professionals should be able to effortlessly explore and use the applications by designing user interfaces, emphasizing the user experience. Iterative testing methods can improve interfaces by refining them and incorporating user feedback.
Second, it is crucial to customize and personalize. Applications should be flexible enough to adjust to the demands and tastes of various users, customizing the user experience(Farahani et al., 2020). For instance, patients with chronic illnesses could need streamlined interfaces that enable quick access to patient records and treatment plans. In contrast, healthcare practitioners might gain from interfaces that offer individualized health insights and reminders.Thirdly, the design must incorporate data security and privacy. Building trust and confidence in the digital healthcare ecosystem can be achieved by using robust encryption techniques, maintaining compliance with legal requirements, and educating users about data security procedures.
In conclusion, computer and mobile application interfaces can be designed to improve patient care effectively and efficiently by embracing simplicity, personalization, data security, and interdisciplinary collaboration. A complete and compassionate patient care experience is promoted by this human-centric approach, which not only lessens the difficulties associated with human interactions with technology but also fosters a healthcare environment in which technology enhances rather than replaces the human touch.
References
Dwivedi, Y. K., Hughes, L., Ismagilova, E., Aarts, G., Coombs, C., Crick, T., … & Williams, M. D. (2021). Artificial Intelligence (AI): Multidisciplinary perspectives on emerging challenges, opportunities, and agenda for research, practice and policy. International Journal of Information Management, 57, 101994.https://doi.org/10.1016/j.ijinfomgt.2019.08.002
Farahani, B., Firouzi, F., & Chakrabarty, K. (2020). Healthcare iot. Intelligent Internet of Things: From Device to Fog and Cloud, 515-545.https://doi.org/10.1007/978-3-030-30367-9_11
College of Health Sciences
Department of Public Health
Assignment Cover Sheet
Course name:
GLOBAL HEALTH
Course number:
PHC 311
CRN
Assignment title or task:
What are the different types of Aids which are delivered by
wealthy countries to poor countries? (10 marks)
Student Name:
Students ID Number:
Submission Date:
Instructor name:
Grade:
Out of 10
College of Health Sciences
Department of Public Health
Assignment Instructions (Week 5):
Dear Students,
The Assignment is available in Course materials and activities under Week 5 by name Week 5 –
Assignment.
This activity will comprise for 10 marks in the Total course work.
The Assignment is available from Release date 24/04/2023.
Assignment guidelines:
•
•
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, Submission date)
in word document, Pdf is not accepted.
It must Avoid plagiarism. It is not acceptable. Marks will cut if plagiarism available.
Word count- Maximum 500 words for each answer.
Font should be 12 Time New Roman.
Color should be black.
Line spacing should be 1.5.
Don’t use bold or Italic or underline in your answer.
References should be in APA style format only.
Interview someone from a different culture. You will create a PowerPoint presentation of your findings.For this assignment, you will Interview a client whose culture is different from yours. The client can be a patient, neighbor, grandparent, in-law, or friend. Do not use your parent, brother, sister, spouse, or significant other. This interview is the basis of your paper. Use the Organizing Framework (12 boxes in Chapter 2) to guide your interview.Interview your selected person on three or four domains of the model. Complete a literature review of the cultural group from which your interviewee comes. Compare and contrast data obtained from your interview with what you find in the literature. Provide at least two recommendations for clinical practice, two recommendations for research, and two recommendations for the health-care organization on this cultural group; be specific in your recommendations. Value of this exercise to your current or future practice.Submission Instructions: Presentation is original work and logically organized in current APA style. Incorporate a minimum of 4 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Power point presentation with 8 -10 slides, excluding the tile slide and the reference slide.The presentation is clear and concise and students will lose points for improper grammar, punctuation and misspelling.Speaker notes expanded upon and clarified content on the slides.
Explain how to measure and monitor the quality of care delivered and the outcomes achieved by an Advanced Practice Nurse.Submission Instructions:Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
2 hours ago
OMAR AL ABBASI
Healthcare Reimbursement Methodologies in Saudi Arabia With the United Satets
COLLAPSE
In Saudi Arabia, the healthcare system is primarily funded through a governmentsponsored model, with the Ministry of Health (MOH) serving as the main provider of healthcare
services. The prevalent reimbursement method within this system is a fee-for-service (FFS)
model, where healthcare providers are compensated on a per-service basis (AlRuthia et
al., 2020). This approach incentivizes providers to offer a higher volume of services, which can
sometimes lead to overutilization of healthcare services. Additionally, Saudi Arabia has
government-funded insurance programs such as the Saudi Arabian Cooperative Council Health
Insurance (CCHI) that extend coverage to Saudi citizens and residents, contributing to the goal
of universal healthcare access.
The strengths of the Saudi Arabian healthcare reimbursement system lie in its
commitment to universal coverage, ensuring that essential healthcare services are accessible to a
significant portion of the population. Moreover, the government’s substantial financial backing
reduces out-of-pocket expenses for patients and strives to reduce disparities in access to care,
emphasizing equity in healthcare provision (AlRuthia et al., 2020). However, this model has its
limitations, notably the potential for overutilization driven by the FFS reimbursement system and
a relatively limited role for the private sector in healthcare delivery. Furthermore, the system’s
dependency on oil revenues for funding raises concerns about its long-term sustainability
(AlRuthia et al., 2020).
In contrast, the United States employs a complex healthcare reimbursement system that
combines public and private funding sources. Major reimbursement methodologies include
private health insurance, Medicare (for seniors and certain disabled individuals), and Medicaid
(for low-income individuals and families). Fee-for-service, capitation, and value-based payment
models are predominant, with private insurance providers negotiating payment rates with
healthcare providers and Medicare and Medicaid having predetermined reimbursement
schedules. (Vilendrer et al., 2020)
The American healthcare system’s notable strengths include fostering innovation and
competition among healthcare providers, resulting in advances in medical technology and
treatment options. Patients benefit from a high degree of choice in selecting their healthcare
providers and insurance plans, and the system offers access to a wide array of specialized
healthcare services and treatments. However, the system’s complexity, with multiple payers and
reimbursement models, leads to administrative inefficiencies and high administrative costs.
Additionally, the high cost of healthcare in the United States, exacerbated by the fee-for-service
model, is a significant concern, and healthcare inequities persist, with many individuals lacking
adequate insurance coverage or facing barriers to accessing healthcare services (Vilendrer et al.,
2020).
In Saudi Arabia, there is a recognized need for a more diversified healthcare funding
model to address the challenges and limitations of the existing system. While the government
plays a central role in healthcare financing, there is potential for greater private sector
involvement to stimulate competition, innovation, and efficiency in healthcare delivery.
Expanding the role of private insurance and encouraging increased participation of private
healthcare providers can contribute to a more dynamic and sustainable healthcare ecosystem,
particularly as the country’s healthcare demands continue to evolve (AlRuthia et al., 2020).
References
AlRuthia, Y., Abdulaziz Bin Aydan, N., Sulaiman Alorf, N., & Asiri, Y. (2020). How can Saudi
Arabia reform its public hospital payment models? A narrative review. Saudi
Pharmaceutical Journal: SPJ: The Official Publication of the Saudi Pharmaceutical
Society, 28(12), 1520–1525. https://doi.org/10.1016/j.jsps.2020.09.020.
Vilendrer, S. M., Asch, S. M., Anzai, Y., & Maggio, P. (2020). An Incentive to Innovate:
Improving Health Care Value and Restoring Physician Autonomy Through PhysicianDirected Reinvestment. Academic Medicine: Journal of the Association of American
Medical Colleges, 95(11), 1702–1706. https://doi.org/10.1097/ACM.0000000000003650.
JABER ALOSAIMI
Healthcare Reimbursement Methodologies in the United States and Saudi Arabia
COL LAPSE
Healthcare Reimbursement Methodologies in the United States and Saudi Arabia
Healthcare spending continues to rise in Saudi Arabia and the United States. The contributing
factors to increased healthcare spending are lifestyle-based diseases, an aging population, and
high-cost health technologies. These factors have increased pressure on policymakers to reduce
costs and move to value-based systems. Healthcare reimbursement utilizes various payment
mechanisms with different levels of effectiveness. Nations have different reimbursement models
for healthcare depending on policies and patients’ needs. The common reimbursement models in
Saudi Arabia are fee-for-service, salary payment model, payment for performance, shared
savings payment model, and payment for episodes of care. The reimbursement models in the
United States are fee-for-service, Medicaid, Medicare, and private insurers. The fee-for-service
model encompasses health insurance plans paying hospitals and physicians based on provided
services. The model is used in the United States and Saudi Arabia. Erickson et al. (2020)
stipulate that the model reimburses physicians and other healthcare practitioners based on tests,
appointments, or procedures instead of appropriateness or quality of services. Tikkanen et al.
(2020) found that Medicaid pays healthcare institutions on a diagnostic-related group or
reimbursement basis. The Medicaid reimbursement model is a common form of payment in the
United States healthcare system.
Payment for performance is another significant payment model in healthcare that encompasses
physicians and healthcare practitioners receiving payment based on performance. Insurers use
the method to pay physicians for delivering quality healthcare. Payment for episodes of care is
another method for a single payment for each episode. Hospitals adopt the reimbursement
models since they have benefits that enrich the healthcare system and benefit the patient. For
instance, the Medicaid reimbursement model benefits patients and hospitals by carving out
contractual agreements with managed behavioral care. According to Tikkanen et al. (2020),
Medicaid reimbursement offers long-term care and social support since they account for most
Americans. The primary advantage of payment for performance is its addressing of overlooked
quality in other models. For instance, AlRuthia, Aydan, Alorf, and Asiri (2020) stipulate that the
payment for performance improves care outcomes among patients with diabetes, heart failure,
and asthma. Besides, the model has enhanced rates of social equity and immunization. The
benefits of payment for episodes of care stem from its cost-saving instance in healthcare since it
replaces surgeries among Medicare beneficiaries.
The reimbursement models have significant cons that require appropriate measures to address
and mitigate the growing concerns related to the models. AlRuthia et al. (2020) state that the feefor-service model has significant disadvantages stemming from physicians and hospitals
providing more services than required. According to AlRuthia et al. (2020), the model could
generate additional costs in healthcare since providers want to compensate for losses by
maximizing their profits. The healthcare system’s goal is the primary incentive for adjusting the
prices and services provided to patients. Another significant disadvantage of the fee-for-service
model is its failure to consider quality of care. AlRuthia et al. (2020) stipulate that individuals
using the model should determine the care quality attributes to measure quality definition among
payers and providers. Besides, the model pays physicians and hospitals according to their
services and fails to consider the treatment’s outcome. Therefore, the model raises essential
questions regarding whether the care is appropriate. AlRuthia et al. (2020) found that the model
penalizes clinicians and hospitals who fail to provide unnecessary procedures, resulting in
insurers paying less for the services. The model encourages physicians and hospitals to provide
additional services that could be challenging to healthcare. Therefore, physicians engage in
unnecessary activities and procedures that would profit them, which deemphasizes compensation
to minimize costs and care utilization. The approach encourages wastefulness and increases the
risk of unnecessary services that could harm patients. According to AlRuthia et al. (2020), the
additional costs due to the fee-for-service model encouraging hospitals to provide unnecessary
services have contributed to the rising healthcare costs. Therefore, the approach requires
amendments to improve care quality and patient outcomes.
The disadvantage of Medicare is that it covers post-acute care after hospitalization, limiting the
care patients receive even when required. It increases the risk of patients seeking private
insurance or out-of-pocket spending, increasing care costs, which could negatively affect
healthcare by reducing the number of people who seek healthcare. The disadvantage of pay for
pay-for-performance model is its encouragement of clinicians to provide under-used services.
Therefore, the patient might not receive the best treatment since the physician could consider the
under-used services unnecessary. AlRuthia, Aydan, Alorf, and Asiri (2020) stipulate that the
commonly under-used services are counseling and other soft services that could enhance patient
quality. However, limited utilization of the services could negatively affect care quality.
References
AlRuthia, Y., Aydan, N. A., Alorf, N. S., & Asiri, Y. (2020). How can Saudi Arabia reform its
public hospital payment models? A narrative review. Saudi Pharmaceutical Journal, 28(12),
1520-1525. doi:10.1016/j.jsps.2020.09.020
Erickson, S. M., Outland, B., Joy, S., Rockwen, B., Serchen, J., Mire, R. D., & Goldman, J. M.
(2020). Envisioning a better US health care system for all: health care delivery and payment
system reforms. Annals of internal medicine, 172(2_Supplement), S33-S49.
Tikkanen, R., Osborn, R., Mossialos, E., Djordjevic, A., & Wharton, G. (2020). International
profiles of health care systems. The Commonwealth Fund.
You should respond to at least two of your peers, by extending, refuting/correcting, or adding additional nuance to their posts. Please include references
CASE STUDY 1
K.B.’s Case Study
Common Triggers for Psoriasis
The most common triggers for psoriasis include bacterial infection, viral infection, dry air, dry skin, skin injuries, use of certain medicines, stress, too little or too much sunlight, and excessive alcohol consumption (Dlugasch & Story, 2021). These trigger a psoriasis exacerbation and make the condition more difficult to treat. There are different clinical types for this disease. The most common is the chronic plaque. This causes thick, red plaques covered by flaky scales. If they are lifted, it causes bleeding because of the abnormal blood vessels location (Dlugasch & Story, 2021). They are symmetrically distributed and well defined. The usual location being the scalp, elbows, knees, and gluteal cleft (Dlugasch & Story, 2021). Erythrodermic is another type, which could be acute or chronic. It is intense covering large areas from head to toe, painful and pruritic, and high risk for infections and fluid and electrolyte imbalances ((Dlugasch & Story, 2021). Guttate is another type which includes mall, pink-red papules and plaques which appear abruptly and acutely with no history of psoriasis (Dlugasch & Story, 2021). The location is usually in the trunk and proximal extremities and could progress to plaque psoriasis. Inverse psoriasis is erythema and irritation with no scaling in the armpits, groin, and skin folds ((Dlugasch & Story, 2021). Lastly, Pustular psoriasis are papules and plaques with pustules surrounded by erythema. This can be acute and severe forms can be associated with malaise and fever ((Dlugasch & Story, 2021). This type could cause sepsis and respiratory, renal, or hepatic complications.
Treatment
Treatments of psoriasis are only to improve symptoms significantly, but there is no cure. One treatment is topical, these basically decrease inflammation on the skin, decrease plaque buildup, reduce scaling, and reduce dryness (Dlugasch & Story, 2021). Phototherapy is another treatment, which also slows cell turnover, reducing scaling and decreases inflammation. Systemic therapy could be oral or injected and is only for severe or resistant cases (Dlugasch & Story, 2021). For K.B., since she usually uses topical corticoids, another method could be used. Since the area is generalized and all over her body, potentially using phototherapy could be beneficial. Another topical treatment such as retinoids or calcineurin inhibitors. IF these options become resistant, the patient could use systemic therapy for a brief period because of the serious side effects (Dlugasch & Story, 2021).
In addition to the methods mentioned above, stress management, avoiding triggers could be beneficial to avoid exacerbations. There are support groups and counseling available for those struggling to manage psoriasis.
Medication Review Importance
Medication review and reconciliation is vital for treating psoriasis. For one, if it is a medication being used for the psoriasis it is important to know that it is no longer working or has become resistant. Also, it is important to know if any medication could potentially be causing this exacerbation, especially since the patient has been fine for 18 months. Certain drugs have been linked to psoriasis, such as beta-blockers, lithium, and antimalarial drugs (Balak & Hajdarbegovic, 2017). Also, treatment withdrawals of cortical steroids or topical corticosteroids can cause a psoriasis flare (Balak & Hajdarbegovic, 2017).
Manifestations
Aside from the manifestations mentioned above with the skin, joint pain or aching are common. Commonly known as psoriatic arthritis. Nail changes such as thickening, yellow-brown spots, dents on the nail surface and separation in nail from the base are also symptoms (Dlugasch & Story, 2021). There is also an increased risk for cardiovascular disease, hypertension, inflammatory bowel disease, and other autoimmune disorders.
C.J.’s Case Study
Diagnosis for Patient
My diagnosis for C.J. is conjunctivitis. Conjunctivitis is an infection of the lining inside of the eyelids, sclera, and up to the cornea. It could be causes by viruses, bacteria, allergens, chemical irritants and trauma (Dlugasch & Story, 2021). Conjunctivitis produces edema, eye discharge, and eye redness. The patient had discharge, and now his eyes are red. Aside from this, conjunctivitis causes blurry vision but when the secretions are rinsed, vision should be normal (Dlugasch & Story, 2021). The patient stated that when he cleared his eyes of the discharge, his visual acuity was normal again. If vision was not normal after cleaning the eyes, the diagnosis would potentially change. In regard to the ear pain, if the conjunctivitis is viral, it could lead to otitis media (Dlugasch & Story, 2021).
Etiology
Conjunctivitis could either be viral, bacterial, gonococcal, allergic or trachoma. With viral, the discharge is watery and mucous like and scant. It also feels like there is sand in the eye and usually starts with one eye (Dlugasch & Story, 2021). It is also common to be accompanied by respiratory symptoms. The patient does not have any of those symptoms, his lngs and throat were normal. With bacterial, the discharge is yellow or green like the patient has said. It also can be accompanied by otitis media, which the patient does have ear pain and his tympanic membrane is opaque, bulging and red. Gonococcal conjunctivitis is sexually transmitted and can cause blindness, it usually starts from genitalia, to hands, to eyes (Dlugasch & Story, 2021). The conjunctiva looks like a bulging blister, so this is not it. Lastly trachoma conjunctivitis is the bacteria chlamydia trachomatis, which is normally is remote areas with lack of clean water and sanitation, which is not it either (Dlugasch & Story, 2021). I would say that the patient has bacterial conjunctivitis.
Therapeutic Approach
Most conjunctivitis will resolve without treatment. Symptomatic relief includes warm, most compresses and cool compresses for edema (Dlugasch & Story, 2021). Bacterial conjunctivitis is treated with antibiotics, either topical ointment or eyedrops Centers for Disease Control and Prevention, 2019).
CASE STUDY 2
Integumentary Function
Name the most common triggers for Psoriasis and explain the different clinical types.
Triggers are activities or factors that increase a certain condition or elevate an individual’s symptoms of a given illness. In this case, there are various triggers that patients with Psoriasis encounter that elevate psoriasis-related symptoms. They include bug bites, skin injuries like cuts or scrapes, skin infections/ strep throat infections, weather (cold or dry seasons), exposure to second-hand smoking or direct smoking, and also taking some medication like antimalaria and high blood pressure medications like lithium and alcoholism (Raharja et al., 2021). Also, patients who rapidly withdraw from the oral corticosteroids can also trigger this condition. These triggers are known to flare up, thus leading to severe symptoms of Psoriasis. Identifying the patient triggers can help providers formulate the best plan for the patients by first addressing the triggers before initiating treatment (Raharja et al., 2021).
There are several types of treatments for Psoriasis; explain the different types and indicate which would be the most appropriate approach to treat this relapse episode for K.B. Also include nonpharmacological options and recommendations.
This patient can be treated using various treatment options, including topical, phototherapy, or injection. For topical treatments, the patient can be given medication to apply on the mucous membrane or on the skin, which brings effect after entering the skin. This medication can help protect the patient’s skin from harm on the skin and will relieve the patient of the associated pain. Secondly, prescribing phototherapy is also recommended as it involves the utilization of specific light on patients and should not be sunlight; it exposes the skin to too much light, thus bringing about the desired outcomes. Thirdly, injections are also used but are less commonly recommended and only considered in cases where the patient has been irresponsive to other medications (Armstrong & Read, 2020).
The pharmacological treatments highly considered in treating patients with Psoriasis are corticosteroids. Also, patients are given Vitamin B analogs, which prevent skin cell growth. Also calcineurin inhibitors are also very effective and help by reducing the building up of the plague and inflammation. Coal tar is also recommended for reducing scaling, itching, and inflammation, which are common in Psoriasis. In this case, the best nonpharmacological treatment will be phototherapy (Armstrong & Read, 2020).
A medication review and reconciliation are always important in all patients; describing and specifying why, in this particular case, is important to know what medications the patient is taking.
There are cases of drug interactions that highly affect the effectiveness of administered medications. In that case, before administering any new medications, it is recommended that current medications be assessed to ensure that the patient remains safe while combining these medications. Also, some patients present with reoccurring illnesses, and thus, knowing the medications taken previously to treat similar symptoms can help modify the treatment plan to best address the reoccurrence issues (Beuscart et al., 2021). This implies that if a patient once suffered from Psoriasis and took an injection but did not get well or had severe side effects, another plan must be considered in this new plan. Also, as noted, some patients trigger Psoriasis after taking some medications like high blood pressure medication. This implies that if patients are assessed on the medications they have been taking, it can help identify some of the triggers of Psoriasis relating to the current medications and make necessary adjustments (Beuscart et al., 2021).
What other manifestations could present a patient with Psoriasis?
Other clinical conditions can present in patients with Psoriasis, including obesity, hypertension, diabetes, cardiovascular disease, dyslipidemia, metabolic syndromes, and psoriatic arthritis. Other clinical manifestations include patches of thick, red skin, thick, cracked skin, bleeding, and pitted thick nails. It is important for the provider to identify these presentations in a patient in order to diagnose Psoriasis. Also, a patient presenting with the above-mentioned conditions must be evaluated for Psoriasis as these conditions increase the likelihood of someone suffering from Psoriasis (Raharja et al., 2021).
Sensory Function
Based on the clinical manifestations presented in the case above, what would be your eye diagnosis for C.J.? Please name why you got to this diagnosis and document your rationale.
Based on the patient’s presentations and the clinical features identified, bacteria conjunctivitis is the best eye diagnosis that best fits this case. This eye infection affects the conjunctiva and spreads to the back side of the eyelid surface. Various signs and symptoms are associated with this condition, including yellowish discharge and bilateral conjunctival. In diagnosing this condition, providers are required to critically analyze the patient’s case to determine the cause so as to establish if the eye infection is caused by a virus, bacteria, or allergen (Pippin & Le, 2022). Assessing the patient’s history can help determine this and present symptoms and eye examinations. For patients presenting with bacteria conjunctivitis, the major signs include swelling and redness of the eye, followed by other symptoms that depend on the cause. The patient fits this diagnosis since the presentations include red eye, irritation, and discharge (Pippin & Le, 2022).
With no further information, can you name the probable etiology of the eye affection presented? Viral, bacterial, allergic, gonococcal, trachoma. Why and why not?
Eye infection presents different symptoms and signs depending on its etiology; therefore, it is possible to differentiate the eye etiologies based on the symptoms the patient is presenting. For instance, in this case, the patient is presenting with a yellowish discharge, which can also be described as pus discharge, which directly points to bacterial conductivities, implying bacteria infection. In other cases, patients presenting with viral eye infections will present with symptoms such as pinkish eye discharge (McCance & Huether, 2019).
Based on your answer to the previous question regarding the etiology of eye affection, which would be the best therapeutic approach to C. J.’s problem?
This patient can be advised to improve his hygiene since eye infection is likely to be obtained from touching contaminated places and touching the eye with a dirty hand. These bacteria might have spread from the hand to the eye. This hygiene routine can include regular hand washing and also should stay at home and not go to work for at least 1-3 days until the symptoms resolve. It is also important to recommend cool compresses as well as artificial tears, which can be done at least six times every day. Also, the patient can be prescribed antibiotics to help with the patient’s infection (McCance & Huether, 2019).
Research a peer-reviewed article in the SEU library regarding workflow analysis in healthcare. Discuss the following aspects:StrengthsWeaknessesOpportunitiesThreatsRisks that are identified in the workflow described. What changes are recommended and provide additional recommendations you would make to improve the efficiency and effectiveness of this process. Your paper should meet the following structural requirements:Four-to-five pages in length, not including the cover sheet and reference page. Formatted according to APA 7th edition.Provide support for your statements with in-text citations from a minimum of four scholarly articles.
ASSIGNMENT COVER SHEET
Course name:
Concepts of Health Education & Health Promotion
Course number:
PHC 212
CRN:
Paper Assignment
Assignment title or task:
(You can write a question)
Choose a health issue in KSA and explore the
determinants causing that issue and justify your
understanding with evidence from the literature.
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Your response should be a minimum of 250 words but should not exceed 500
words (Excluding references).
• Support your answer with examples.
• Font size should be 12
• Font type should be Times New Roman
• Heading should be Bold
• Colour should be Black
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style and include in text citation.
• AVOID PLAGIARISM
• Due date; 07/10/2023 11:59 PM
Best of Luck
First part ia to do a discussion question with 200 words and a reference also i will provide my classmates discussion and you do two replies with 100 words and a reference. The question is ( Considering the increasing integration of technology in healthcare and the pervasive nature of social media, how can nursing informatics guide nurses in effectively utilizing social media platforms for professional development, patient education, and advocacy, while ensuring patient privacy and adhering to ethical standards?”) The second part is im required to attend a meeting called Al-anon and i did. It’s asked to write a page and half about what was the meeting about. I provided pictures attached the main speaker in the meeting go over these things and people joining to have a restful time with reading. I uploaded pictures these are one for these for Al-anon meeting. You read the instructions and the other two pics are what the meeting was about. They we’re reading chapter 10 of a book try to memorize what is in the pictures and talk about it as you were the person who attended the meeting
Read the attached Qualitative Research Study. (I have also placed the article under this weeks module here on Canvas) After reading the article, please appraise this study. Use table 7.1 in your book to guide you in your appraisal. What are the strengths and weakness you found in this study?
Unformatted Attachment Preview
pharmacy
Article
Exploration of Nurses’ Knowledge, Attitudes,
and Perceived Barriers towards Medication
Error Reporting in a Tertiary Health Care
Facility: A Qualitative Approach
Eman Ali Dyab 1 , Ramadan Mohamed Elkalmi 2 , Siti Halimah Bux 3 and
Shazia Qasim Jamshed 3, *
1
2
3
*
Department of Pharmaceutics, Faculty of Pharmacy, Tripoli University,
Tripoli 42300, Libya; eman_diab2008@yahoo.com
Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi Mara,
Puncak Alam 42300, Malaysia; edriph@gmail.com
Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia,
Kuantan 25200, Malaysia; sitihalimah@iium.edu.my
Correspondence: shazia_jamshed@iium.edu.my; Tel.: +601-7470-3692
Received: 15 September 2018; Accepted: 2 November 2018; Published: 5 November 2018
Abstract: Medication error reporting (MER) is an effective way used to identify the causes of
Medication Errors (MEs) and to prevent repeating them in future. The underreporting of MEs
is a challenge generally in all MER systems. The current research aimed to explore nurses’ knowledge
on MER by determining their attitudes towards reporting and studying the implicated barriers
and facilitators. A total of 23 nurses were interviewed using a semi-structured interview guide.
The saturation point was attained after 21 interviews. All the interviews were tape-recorded and
transcribed verbatim, and analysed using inductive thematic analysis. Four major themes and
17 sub-themes were identified. Almost all the interviewees were aware about the existence of the
MER system. They showed a positive attitude towards MER. The main barriers for MER were the
impacts of time and workload, fear of investigation, impacts on the job, and negative reactions
from the person in charge. The nurses were knowledgeable about MER but there was uncertainty
towards reporting harmless MEs, thus indicating the need for an educational program to highlight
the benefits of near-miss reporting. To improve participation strategies, a blameless reporting culture,
reporting anonymously, and a simplified MER process should be considered.
Keywords: medication error reporting; nurses’ attitudes; qualitative study; barriers; medication error
1. Introduction
The main principle of giving medication to the patient is to serve them in order to restore his/her
health without any harm [1]. Adverse events and medical errors are the main issues threatening
the patient’s safety, and are awkward predicaments in nearly all healthcare systems [2]. The World
Health Organization (WHO estimated that millions of people suffer injuries directly attributed to
medical care, and many are preventable [3], although prevalence in developing countries is reported
to be higher than developed nations [4]. In Southeast Asian countries, the reported administration
error rates ranged from 15.2% to 88.6% [5]. In Taiwan, a study mentioned that the overall rate of the
medical incidents ranged from 30% to 47.6%, and most of them were related to MEs [6]. In a Malaysian
study, Johari et al. reported 2572 reported cases of ME in 2009 [7]. The prevalence of ME among
geriatric patients was 25.17% [8] whereas in paediatrics this figure was 11.7% [9]. A recently published
Pharmacy 2018, 6, 120; doi:10.3390/pharmacy6040120
www.mdpi.com/journal/pharmacy
Pharmacy 2018, 6, 120
2 of 14
four-year retrospective study reported that the total number of paper-based ME reports submitted
to the National Medication Error Reporting system (NMER) was 17,357, but only 0.3% of MEs were
in the administration stage [10]. The percentage in the administration stage is very low, representing
paper-based reports only (excluding online submitted MEs reports) collected by the NMER system,
as well as the effect of underreporting. The annual estimated cost of MEs in Malaysia was estimated to
be 111,924 Malaysian Ringgit (MYR) [10]. Clinically, MEs can have small to severe consequences for
patients. It was reported that the total number of MEs in the administering stage was 166, where 1%
had fatal consequences, 20% were serious, 32% were significant, and 46% were nonsignificant [11].
The identification of trends and patterns of MEs were the main reasons for establishing a ME
reporting system [12]. The effectiveness of all these systems depend on their ability to document
the occurred MEs. Establishing guidelines for medical error reporting (MER) is not enough, as the
healthcare practitioners (reporters) play a vital role in the MER process. The healthcare practitioners’
knowledge about MER, their attitudes toward reporting MEs, and perceived barriers toward MER are
important factors which determined the success of MER systems. Health care professionals in general
and nurses in particular are responsible for MER. It has been reported that the MEs are underreported
in all countries. Nurses’ knowledge and attitudes as well as barriers and facilitators toward MER
among nurses in Malaysia are little-studied issues and warrant investigation.
This study is intended to attain deeper insight into the knowledge and attitudes held by Malaysian
nurse practitioners towards the ME concept and MER process, as well as to investigate the barriers
which prevent nurses from reporting their MEs.
1.
2.
3.
4.
What do nurses know about the ME and MER system?
What are the nurses’ attitudes toward MER?
What are the barriers which could hinder nurses from reporting their MEs?
What are the factors which could facilitate MER among nurses?
2. Methods
2.1. Study Design and Setting
The study was conducted after getting approval from both the Medical Research Ethics
Committee Ministry of Health Malaysia (NMRR-15-2485-24709) and the International Islamic
University of Malaysia Research Ethics Committee (IREC 446). Use of a qualitative method (in-depth
interviews) provides flexibility and efficiency in collecting data related to personal feelings, attitudes,
and experiences [13] and hence, these methods are used for the exploration of the participants’
experiences towards medication error reporting. The individual interview method was chosen over
focus group discussions because of privacy, suitability, and comfort zone issues for shy and hesitant
participants [14]. This gives liberty to the participants to elaborate his/her answers without distractions
from others [14]. The current research was executed in a tertiary healthcare facility of Kuantan city,
Pahang, Malaysia.
2.2. Participants
The target study population was nurses practicing in different units of the hospital. No specific
inclusion and exclusion criteria were applied, and thus all nurses were eligible to participate in
the current research. The participants were recruited by using convenience and snowball sampling
technique. The snowball method helps to recruit hidden subjects which cannot be easily found [15].
The first participant was a nurse from the medical unit and was given information on the details of
the research along with an assurance of confidentiality and anonymity. After her acceptance she was
asked to fill in demographics form and sign the consent form. The interviews were recorded by using
Audio Recording Titanium Software® version 8.5.5 (AATSystems, Kent, UK), and notes were taken
during the interviews. After finishing the first interview, the interviewee was asked to nominate the
Pharmacy 2018, 6, 120
3 of 14
next participant. Thus, she made a referral to the next nurse, with the same pattern for the subsequent
interviews. Thus, a chain referral technique followed throughout the research study. The number
of participants was determined once the saturation point was achieved. The saturation point occurs
when no new concepts and themes emerge [14,16,17]. Two extra interviews were conducted to confirm
the saturation point. The field supervisor also helped in recruitment process. Participation was
simply on a voluntary basis, and they were informed that anytime during the course of research they
could withdraw. Moreover, they were assured that their confidentiality and anonymity would be
maintained. Only the research team had access to records. The purpose of the study was explained
to each participant before the interviews commenced and therefore, all the participants were asked
to sign an “informed consent form” followed by the addition of their demographic characteristics.
A total of 23 nurses were interviewed.
2.3. Procedure and Interview Process
In-depth interview sessions were conducted using a semi-structured interview guide in June 2015.
This guide was developed on the basis of prior published studies related to MER among health care
professionals [18–20]. The purpose of using this guide was to make sure that all important issues
about the topic were covered in the interviews [13,21]. The medium of communication during the
interview was primarily English, followed by a couple of interviews being conducted in Bahasa
Malayu i.e., the native language of participants. The field supervisor agreed to work as a research
assistant and a translator and assisted the nurses who could not understand the English language. As a
result, participants who expressed their thoughts in the Bahasa Malayu language were also included.
Each interview lasted for about 30–45 min. Venue was chosen as per proximity to nurses’ working units,
their preference of level of comfort/privacy, and the level of noisiness. Places such as the library private
room, the seminar room, and nurses’ rooms were selected as the venue for interviews. The discussion
was focused on several major issues; the nurses’ knowledge, experiences, and perceptions about ME
and MER, exploring their attitudes towards MER, comprehending the factors which might prevent
the nurses from reporting their MEs, and those factors which would promote MER among nurses.
Probing questions were asked to provoke more details from interviewees [13,21].
2.4. Data Analysis
The data analysis was performed using the inductive thematic analysis approach. The participants’
approved transcripts (transcribed verbatim) were coded as (N1, N2, . . . , N23). The process is illustrated
in Figure 1. The analysis followed a cyclic pattern, where it started by familiarization stage, generation
of initial codes stage and revision stage to refine the emerged codes [22,23]. The transcripts were
analysed again by another researcher to validate the resulted themes [22], and a third person’s opinion
was sought to resolve any disagreement between the previous analyses [24,25].
The current research followed an established criterion for maintaining quality in qualitative
research and thus follow the standards of Guba and Lincoln [26] for generating credibility,
transferability, dependability, and confirmability. For strengthening the credibility of the research there
was a continuous interaction with the participants, with checking of interpretations against interview
transcripts. A review with the participants was undertaken. Contrary to quantitative research, the aim
of qualitative is not generalizability but to observe and execute transferability. Therefore, a detailed
description of the participants’ experiences helped the researchers identify the patterns of social
relationships in reporting MEs and as well as the cultural backgrounds of the participants who reported
hesitancy in reporting. For dependability purposes, external audit criteria were put in place, and a
researcher not involved directly in research helped in the evaluation of interpretation and conclusions
with respect to the data collected. For establishing confirmability, not only a conformability audit (as
mentioned above) but also triangulation and reflexivity were maintained. In terms of establishing
triangulation, both methodological triangulation (i.e., the research followed the quantitative design
after qualitative inquiry) and analyst triangulation (i.e., using different analysts to review the findings)
Pharmacy 2018, 6, 120
4 of 14
were maintained,
whereas
forREVIEW
reflexivity, a reflexive note-sheet was used to record the methodological
Pharmacy 2018,
6, x FOR PEER
4 of 14
parameters and logistics involved. Interviewees were female (n = 22); of Malay race (n = 22); holding a
note-sheet was used to record the methodological parameters and logistics involved. Interviewees
diploma (n = 21). The nursing diploma is a 3-year course in Malaysia and on its successful completion
were female (n = 22); of Malay race (n = 22); holding a diploma (n = 21). The nursing diploma is a 3one can register
with
Board
Malaysia
work asone
a staff
nurse. with
All participants
year course
in Nursing
Malaysia and
on its
successfuland
completion
can register
Nursing Boardwere full
time employees.
Half
of
the
participants
(n
=
12)
have
working
experience
of
than 11 years.
Malaysia and work as a staff nurse. All participants were full time employees. Half of themore
participants
(n
=
12)
have
working
experience
of
more
than
11
years.
Slightly
more
than
three-quarters
the the prior
Slightly more than three-quarters of the participants (n = 18) had not reported any MEs of
over
participants (n =18) had not reported any MEs over the prior 12 months. The interviewees were
12 months. The interviewees were attached to different units in the hospital such as intensive care units
attached to different units in the hospital such as intensive care units (ICUs), medical units, critical
(ICUs), medical
units, critical cardiac units (CCUs), accident and emergency unit (A&Es), orthopaedic
cardiac units (CCUs), accident and emergency unit (A&Es), orthopaedic units, neonatal intensive
units, neonatal
intensive
care
units
(NICUs),
units.
The demographic
characteristics
of
care units
(NICUs),
and
paediatric
units.and
Thepaediatric
demographic
characteristics
of participants
are
presented
in Table 1. in Table 1.
participants
are presented
1. The study
process
flowchart.(I)
(I)transcription
transcription step,
(II) (II)
datadata
analysis
step, (III)
analysts’
Figure 1.Figure
The study
process
flowchart.
step,
analysis
step,
(III) analysts’
triangulation
(two researchers
performed
analysis
and person
third person
resolved
any
triangulation
method method
(two researchers
performed
analysis
and third
resolved
any disagreement),
disagreement), and (IV) final result.
and (IV) final result.
3. Results
Table 1. Interviewees socio-demographic characteristics (n = 23).
Four major themes and 17 sub-themes were emerged: knowledge about MER, attitudes toward
Characteristic
Number (n = 23)
Percentage (%)
MER, barriers toward MER, and facilitators to improve MER process. Figure 2 represents the
Female
22
95.7
emerged themes
Genderand categories.
Male
Race
Characteristic
Age
1
Malay
Table 1. Interviewees socio-demographic
characteristics (n22= 23).
Chines
1
Gender
Race
≤30
30–40
Female
41–50Male
51≥
Malay
Education level
Diploma
Chines
Bachelor
Experience in years
Age
≤5
6–1030–40
≥11 41–50
≤30
Practice site
51≥
Medical unit
a
ICUDiploma
b
CCU
Bachelor
A&Ec
Orthopaedic unit
NICU d
Paediatric unit
Number of reports in the last 12 months
Never report
≥1
Education level
Number (n
6 = 23)
2214
12
1
22
21
1
2
6
5
14 6
2 12
14
21 9
22
3
2
1
2
18
5
4.3
95.7
4.3
Percentage
(%)
26.1
95.7 60.9
4.3 8.7
4.3
95.7
91.3
4.3
8.7
26.1
21.7
60.9 26.1
8.7 52.2
4.3 17.4
91.3 39.1
8.7 8.7
13
8.7
4.3
8.7
78.3
21.7
(a ) Intensive care unit. (b ) Critical cardiac unit. (c ) Accident and emergency unit. (d ) Neonatal intensive care unit.
Medical unit
4
17.4
ICU a
9
39.1
b
2
8.7
CCU
Practice site
A&Ec
3
13
Orthopaedic unit
2
8.7 5 of 14
Pharmacy 2018, 6, 120
NICU d
1
4.3
Paediatric unit
2
8.7
3. Results
Never report
18
78.3
Number of reports in the last 12 months
≥1
5
21.7 toward
Four major themes and 17 sub-themes were emerged:
knowledge about
MER, attitudes
Intensive
care unit.
(b) Critical
cardiac unit.
(c) Accident
andprocess.
emergency
unit. 2(d)represents
Neonatal intensive
MER,(a)barriers
toward
MER,
and facilitators
to improve
MER
Figure
the emerged
careand
unit.categories.
themes
Emergent themes and sub-themes. MER:
MER: medical error reporting.
Figure 2. Emergent
3.1. Knowledge about MER
3.1.1. Concept of ME
The nurses were asked about their understanding of the ME concept. Almost all of them correctly
understood the concept of ME. Moreover, they linked its meaning to five/seven rights, while others
just gave simple and general answers like “giving incorrect medication to the patient”.
“Medication error is an error when giving medication including dosage and also the type of medication,
make sure to follow the 7Rs practice in the hospital.” (N1)
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“Medication error is when something unwanted occurs such as wrong medication is given to the
patient.” (N7)
“Medication error means giving wrong medication to the patient, which includes wrong dose,
wrong route, and wrong documentation.” (N13)
3.1.2. The Existence of a System for MER and the Importance of MER
All the interviewees were aware about the existence of MER system and the importance of MER.
They stated that data collected by MER can be used as an indication of the quality of health service
provided to the patient. It can be used to improve this service by carrying out root-cause analysis
for the MEs reports, and the reported data can be utilized for learning purposes. In other words,
ME reports can be used as good resources to help nurses in avoiding repeating the same errors again
in future.
“Yes, we have a system for medication error reporting [ . . . ] And, it is very important because it
involves the quality of service which is being given to the patient and it is very important to monitor
ME.” (N1)
“It is important because we want to improve the way of delivering care and serving the patient.
To learn from reports, where and which thing can be done. So we have more information about what
has been done and their consequences.” (N3)
“It is important because we want to detect what is ME and to prevent it from happening again.” (N7)
“Normally, we do root-cause analysis to find out when and how this happened. Sometimes it comes
from the wrong prescription like wrong dose or wrong route or wrong frequency and then we find out
how that happen and try to tackle.” (N5)
“It is to guide our practice [ . . . ] Not add more error to this collection [ . . . ] To avoid ME in future
[ . . . ] It is considered as a good resource.” (N4)
3.1.3. The Availability and Confidentiality of the Reporting Form
The majority of interviewed nurses claimed that during their practice, they did not report MEs,
since until the time of interviews they did not commit any error. As a result, most of them did not see
the reporting form and some of them had seen it but they did not remember its content.
“The reporting form is available in the pharmacy department.” (N5)
“I have not seen the reporting form before. Because, so far, I did not make any error.” (N8)
The nurses were asked about their opinions on the reporting form.
“I have seen it; it is easy to fill, it does not need modification or re-designation.” (N1)
“The report is not too detailed like describing everything, but it underlines or highlights when the
medication was given to the patient.” (N3)
3.2. Attitude of Nurses toward ME Reporting
The nurses were asked about their attitudes toward ME reporting. The majority of the participants
had a positive attitude toward reporting of MEs, whether these MEs caused a serious side effect to the
patient or not. The other group had uncertain attitudes and they tended to report the MEs which led
to harm to the patient only.
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3.2.1. Positive Attitude
The majority of nurses claimed that they report all encountered MEs immediately. They reported
them irrespective to their seriousness or the level of patient’s harm due to the error.
“Nothing affects my decision to report, once the error occurs it should be reported.” (N4)
“It is not a matter of choice.” (N7)
“Once I detect an error, I cannot just ignore it, and I straightforward report it […] We must make a
report also because this is ME, and we must report whether it is serious or not.” (N2)
“Here in A and E department, it does not matter if the error is big, mild, or small, it must be reported.” (N8)
3.2.2. Uncertain Attitude toward ME Reporting
During the discussion with the participants about their attitude toward MER, some participants
showed uncertain attitudes towards MER. They would report MEs only based on another factor such
as the severity of the ME or route of administration, or when they received a direct request form the
person in-charge.
“If the error caused big and serious complication I have to report.” (N17)
“Based on the patient, I will see the effect on the patient first. My first concern is the patient, I will
not report unless something happens to the patient. In this case, the doctor gives antidote and then
there is an investigation and eventually, they will revert to me.” (N9)
One nurse related the medication error reporting to the dosage form of administered medicine.
He believes that errors are serious when the medication given by the intravenous route, and this
type of error should be reported, while those resulting from oral or topical administration should not
be reported.
“Based on the route of administration IV it should be reported.” (N18)
One nurse insisted that she reports only if the person in charge requests her to fill the
reporting form.
“I just inform the sister and the doctor, and let them choose to fill the form or not but as for investigation,
I will come and join them” (N13)
Before reporting, the nurses think of the problems that will be faced after reporting their errors.
This has a high effect on their decision to report or not.
“Some nurses, at first, they think about what happen and the problems associated with reporting,
so they do not report.” (N12)
3.2.3. Reporting of Others’ Errors
Some of the interviewees stated that they do not have any problems in reporting MEs committed
by other staff. They believe that the reporting of MEs is better for both the nurses and also for the
patient, whether the MEs have been committed by themselves or by other health care professionals.
While the other group insisted that everyone is responsible for reporting his/her own initiated MEs.
“I will report if other staff nurse made a mistake.” (N1)
“I will report errors committed by others because this is in the best interest of the patient, and also it
would help things go smooth in the future, for example, patient allergy . . . ” (N3)
“If I made a mistake I would inform, also if others from my colleagues made a mistake, I would still
inform.” (N6)
“No, I report only my errors. If my colleagues made mistakes, I would just advise her to report, but I
will not report her error.” (N8)
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3.3. Barriers towards Medication Error Reporting
There are many barriers towards MER which were mentioned by the interviewees. These barriers
are heavy workload, lack of time, tiredness, embarrassment due to reactions of peers and family,
and fear of disciplinary action.
3.3.1. Lack of Time
The main barrier for MER mentioned by the interviewees was time. They considered that the ME
reporting is a time consuming process. As described by the participants, the problem is not the time
needed to fill the MER form. The problem appears after filling the MER form when the investigation
takes place in order to discuss the causes which led to the ME.
“We will be exposed to so many questions [ . . . ] long time [ . . . ] time to discuss the ME that was
reported [ . . . ] investigations take time. No other problems, just that it takes time to report and then
questions from pharmacist or doctors. We do not have time for reporting. It is a long story and takes
much time.” (N4)
“Sometimes, I decide not to report. Because, if there is an investigation we have to be presented, as you
know it will take a long time and we will be all inconvenient.” (N9)
3.3.2. Tiredness
The nurses are responsible for inpatient care, this responsibility requires them to accomplish
many physical activities. Performing these activities make nurses tired, when they are exhausted,
a low number of ME reports will be received from them.
“Sometimes, we are tired. Once we are tired we decide not to report.” (N4)
3.3.3. Embarrassment
The post-embarrassment feeling has been pinpointed by interviewees as another barrier toward
MER. As a result, they tend to hide their MEs and never report them.
“Facing the embarrassment from my family and friends is tough. They will blame us.” (N4)
“They (family and friends) understand because these are not things that a person does on purpose.
But facing them still difficult.” (N9)
3.3.4. Fear
Fear from the legal problems has been addressed by the interviewees as a barrier towards MER.
“I fear from legal problems and disciplinary actions from the hospital.” (N8)
“Sometimes, I do not want to get into issues, I do not want people to come to ask me for investigation
later.” (N2)
The effect of reporting on the personal job record is another factor which might prevent nurses
from reporting.
“If I report this will affect my record because everything will be recorded in my personal record.” (N9)
“Fearing others, especially the investigation, because in Malaysia all errors must be reported to your
job record and they do disciplinary action.” (N4)
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3.3.5. Negative Reaction from Sister In-Charge
The response of managers toward nurses who report their MEs were important factors which
prevented nurses from reporting their MEs. It has been noticed that most of the interviewees insisted
that receiving a negative reaction from senior nurses is a normal response when the MEs occur. As they
always tend to blame and scold the nurses if they commit MEs. They believe that guidance is the main
role of senior nurses during their practices, not blaming the nurses.
“The sister will monitor me more.” (N8)
“Negative reaction from sister and matron [ . . . ] they must not punish the staff, they must guide the
staff and follow the staff and ensure that the stuff follows the standards.” (N4)
3.3.6. The Confidentiality of the Reporting Form
The reporting form which is used to report ME is a strict confidential form. Filling this type of the
reporting requires the reporter’s details such as name, signature and contact details. Some nurses did
not report their MEs because of this issue and they wish if they can report by using an anonymous
reporting form. Consequently, the number of reports will increase by use of anonymous MER forms.
“I prefer to fill anonymous form [ . . . ] Because I feel shy and would not work further. Also, I would
feel sorry for the patient. So, I prefer to fill the form without names.” (N2)
“I prefer to fill the anonymous form as it is good for us. If mistakes have been done, the news of
medication errors should be displayed without names being mentioned. In the future, if the people
know that this person made a mistake, people would decide not to deal with this person again. This will
damage the confidence of the nurse. In the future, they will not report and there will be no chance to
learn from the mistakes.” (N6)
“Off course, if no names mentioned the number of reports will increase.” (N8)
3.3.7. Absence of Effective Feedback
The lack of feedback from the hospital managers:
“No one goes through all the errors and give me a feedback.” (N7)
“I did not receive any feedback for my ME report.” (19)
3.4. Facilitators to Improve ME Reporting
The nurses were asked about the factors which could encourage them towards MER. Their main
concern revolved around removing the blaming culture. They believed that if no one scolded them
about their errors they would definitely report their errors.
“Remove the blaming culture. The matron and sister in charge should guide the staff not blame them.” (N4)
“Tell the matron that if any person is involved in a medication error, she shall not be scolded.” (N7)
Another factor which was addressed by the interviewees was getting encouragement from others
toward MER. Regarding this, there were two different opinions: first, some nurses insisted that they
did not need any encouragement from others because they thought the MER is an integral part of their
responsibility; on the contrary, other nurses welcomed encouragement by other health practitioners
such as a doctor, matron, or even their colleagues.
“There is no need to encourage us because this is our duty.” (N12)
“The sister in charge encouraged me to report.” (N9)
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“Actually, among us, we as nurses encourage each other to report errors; also the sister in charge
encourages us to do that.” (N8)
Few nurses highlighted the incentives as an effective way to encourage nurses to be more
meticulous to report MEs.
“Giving monetary rewards to the nurses.” (N3)
The confidentiality of the reporting form is an important factor, some of them preferred to fill
anonymously to avoid the embarrassment and being reprimanded by the authorities.
“I prefer to fill the form with no names and it is better not to include names.” (N2)
“I think as long as they can ensure the confidentiality of the person who reported, we will feel safe.”
(N9)
4. Discussion
This is an exploratory study intended to investigate the knowledge and attitude of nurses towards
MER. The current research is also anticipated to address the barriers and facilitators towards MER
among nurses, attached to different medical wards in the hospital.
The interviewed nurses reflected on the basic knowledge of concept of ME and MER.
They reported awareness about the presence of ME reporting system, guidelines, and the importance
of the MER. This might be attributed to the frequent talk sessions and training courses such as the
continuing nursing education program (CNE), in addition to the encouragement from the nurse
leaders (head nurses, supervisors and directors). This finding is consistent with the previous studies
conducted in Malaysia [7,27]. Wei and his colleagues reported that the Malaysian nurses had baseline
knowledge regarding MEs, whereas Johari et al. reported that Malaysian nurses had good knowledge
level regarding medication administration safety. However, most of the interviewees were not familiar
with the content of the ME reporting form due to their lack of contact. The low involvement of nurses
toward MER was not related to the lack of knowledge about the MER or due to the lack of information
about the process of incidents reporting, as reported in previous studies [28,29]. Handler and his
colleagues. reported that the lack of information on how to report ME among nurses as a barrier for
MER and this needs an immediate action and should be on higher priority towards improving MER
among nurses.
The willingness of nurses to report MEs has great impact on MER practices. Respondents had two
contradictory attitudes toward MER. Positive attitudes towards reporting all MEs are found to be in
accordance with what has been stated in Malaysian medication error guidelines [30], while an uncertain
attitude was also stated where participants were keen to report major errors only. In this case, the minor
errors and near-miss errors most likely will not be reported, in line with the previous studies [31–34].
Martowirono et al. reported that the MEs with minor consequences were lesser reported. Reporting of
near-miss errors gives valuable lessons without harming the patient [35]. In such situations, a seminar
discussion with the experienced nurse managers about benefits of near-miss error reporting can be a
useful tool to improve near-miss reporting rate among nurses.
The current research revealed that most nurses have positive attitudes toward ME reporting.
However, factors such as lack of time for reporting, lack of reporting culture without being blamed,
lack of effective feedback, and fear are considered as main reasons for underreporting problems among
the participants. These findings were consistent with the study conducted in Taiwan [36] where fear
was cited as the fundamental projecting factor in underreporting.
Despite the positive attitude of nurses towards the MER, they revealed that they did not report
MEs due to barriers like paucity of time, already in accordance with the studies done in Taiwan and
Canada [6,37]. Lack of time could be a reflection of heavy workload, as in many instances a limited
number of nurses take care of many patients. On the other hand, lack of reporting can be related to
Pharmacy 2018, 6, 120
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the MER process, which starts informally by informing the doctor, pharmacist, and the nurse director,
a
According to Porter O’Grady and Malloch (2015), “In the twentieth century the focus of work was on performing the right processes. In the twenty-first-century the focus is on obtaining the right outcomes”. The purpose of using evidence to guide practice is to promote positive outcomes.Consider the following questions in your discussion post:How do you see yourself as a change agent guiding others to move from a process focus to an outcomes focus?Discuss this in relationship to your area of concentration – practice and/or education. (Nursing)Elaborate the rationale behind the change from process to outcomes.Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.Please be sure to validate your opinions and ideas with citations and references in APA format.
Historical background (recommended: see Worksheets 1-4 of the Resto guide for guidance)
Problem statement
Description/definition of problem
Evidence the problem exists (cite; include at least 2 peer-reviewed articles)
Problem in the context of your agency setting
Purpose of the study (recommended: see Worksheet 8 for guidance)
Research Question
Hypothesis
Research rationale/Significance of study (recommended: see Worksheet 5 for guidance)
Unformatted Attachment Preview
Problem Statement
insufficient provision of nutritional meals and improve social
engagement for older adults
List at least three undesirable social conditions
Health Disparities: Insufficient access to nutritional meals and
educational programs can lead to health disparities among older adults.
These disparities can manifest as higher rates of malnutrition, chronic
diseases, and mental health issues, which in turn can strain healthcare
resources and lead to poorer health outcomes.
Social Isolation: Limited access to informative and educational
programs may contribute to social isolation among older adults. Without
opportunities for engagement and learning, they may become socially
disconnected, leading to loneliness and a decline in mental and
emotional well-being.
Economic Burden: Inadequate access to nutritional support and
educational programs can result in an increased economic burden on
both older adults and the community. Older adults may face higher
healthcare costs due to preventable health issues, while communities
may need to allocate more resources to address these health-related
challenges, potentially affecting overall social and economic stability.
why research is needed
Health and Well-being: The well-being of older adults is of paramount
importance, not only for ethical reasons but also because their health
directly impacts the healthcare system and society at large. Research
helps identify the extent and nature of the problem, enabling evidencebased interventions to improve their health and quality of life.
Briefly list several underlying factors that contribute to the problem
1. Limited Resources: Many older adults face financial constraints
that hinder their ability to access nutritious meals or participate in
educational programs. A study by the National Council on Aging
found that over 25 million Americans aged 60+ are economically
insecure, limiting their access to essential services.
2. Geographic Barriers: Older adults living in rural or isolated areas
often have limited access to community centers and educational
facilities. A report from the National Rural Health Association
highlights the challenges rural communities face in providing
healthcare and support services to older adults.
3. Social Isolation: Social isolation can lead to a lack of awareness
about available programs and services. According to a study
published in JAMA Internal Medicine, social isolation is
associated with a higher risk of malnutrition among older adults.
4. Lack of Transportation: Difficulty in accessing transportation
can prevent older adults from reaching community centers or meal
distribution locations. The American Society on Aging reports that
transportation barriers are a significant issue for older adults,
especially those with mobility challenges.
5. Insufficient Funding: Many community organizations and
programs lack sufficient funding to meet the demand for
nutritional support and educational services. The National Council
on Aging notes that funding constraints can limit the availability
and quality of programs for older adults.
6. Fragmented Services: Services and programs for older adults are
often fragmented, making it challenging for them to navigate the
complex system of support. A study in the Journal of Aging and
Health discusses the challenges posed by fragmented healthcare
and social service systems.
7. Healthcare System Gaps: The healthcare system may not
adequately address the nutritional and educational needs of older
adults. The American Geriatrics Society highlights gaps in
healthcare education and training related to older adult care.
8. Lack of Awareness: Older adults and their caregivers may not be
aware of the importance of nutrition and education in maintaining
health and well-being. A survey conducted by AARP found that
older adults often lack information about available resources and
services.
Describe the goals, desired state, or the values that your
audience considers important and that are relevant to the
problem.
Health and Well-being: The audience values the health and wellbeing of older adults as a top priority. They want older adults to
have access to nutritious meals and educational programs to
maintain good health, reduce the risk of illnesses, and improve
their overall quality of life.
Describe a condition that prevents the goal, state, or value discussed
in statement 1 from being achieved or realized at the present time.
Food Insecurity: Many older adults, especially those on fixed incomes
or with limited financial resources, face food insecurity. Food insecurity
means they do not have consistent access to enough nutritious food to
maintain an active and healthy life. This condition prevents them from
receiving the necessary nutrients to maintain good health and reduces
their overall well-being.
Why you are doing the study?
Older Adults Themselves: Older adults are the primary beneficiaries of
this study. By identifying and addressing the challenges related to
nutritional meals and educational programs, they can enjoy improved
health and well-being. Access to nutritious meals contributes to better
physical health, while educational programs enhance mental and
emotional well-being. This, in turn, enhances their overall quality of life
and allows them to age with dignity and independence.
1. Addressing a Critical Social Issue: The problem of insufficient
access to nutritional meals and educational programs for older
adults is a critical social issue that has significant implications for
the health and well-being of a vulnerable demographic. By
conducting this study, we aim to shed light on the extent and
nature of these challenges and contribute to finding solutions.
2. Improving Quality of Life: The well-being of older adults is of
paramount importance, and it is our goal to enhance their quality of
life. Access to proper nutrition and educational opportunities
directly impacts their physical, mental, and emotional well-being.
By conducting this study, we seek to identify ways to improve
their overall quality of life.
3. Enhancing Community Well-being: The health and well-being
of older adults are closely linked to the overall well-being of the
community. By addressing the identified issues, we aim to
contribute to stronger, more resilient communities where older
adults can age in place with dignity and remain active contributors.
Research questions
1. What are the primary barriers that deter older adults from attending
the “Lunch with Us” program, and how can these barriers be
addressed effectively?
Examine the science and art of theory development and evaluation.Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least two academic sources.Sources should be published within the last 5 years. I have attached below some articles you can use. Please do not AI.Skivington, K., Matthews, L., Simpson, S. A., Craig, P., Baird, J., Blazeby, J. M., Boyd, K. A., Craig, N., French, D. P., McIntosh, E., Petticrew, M., Rycroft-Malone, J., White, M., & Moore, L. (2021). A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance. BMJ (Clinical research ed.), 374, n2061. https://doi.org/10.1136/bmj.n2061Wallner, M., Mayer, H., Adlbrecht, L., Hoffmann, A. L., Fahsold, A., Holle, B., Zeller, A., & Palm, R. (2023). Theory-based evaluation and programme theories in nursing: A discussion on the occasion of the updated Medical Research Council (MRC) Framework. International Journal of Nursing Studies, 140, 104451. https://doi.org/10.1016/j.ijnurstu.2023.104451
Identify one Ergonomic challenge in healthcare. Describe the impact on the patient and healthcare worker. Describe the opportunity to improve this Ergonomic challenge.
Please address the topics below:
Background facts about the Ergonomic challenge including incidence and prevalence
The impact of the Ergonomic challenge on the Healthcare worker
The impact of the Ergonomic challenge on the patient
Your recommendations to improve this Ergonomic challenge based on evidence from the literature
Your paper should meet the following structural requirements:
Four-to-five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition.
Provide support for your statements with in-text citations from a minimum of four scholarly articles.
The purpose of this journal is to write a detailed analysis of the pathophysiology of tongue cancer and oropharyngeal cancer. Please include in-text citations, a reference page, and have the journal written in APA 7th edition.
Module 5– Screening
by Huiling Zhou –
Number of replies: 0
Advantages and Disadvantages of Screening
Screening is a necessary component of promoting health because it is a proactive measure. This measure aims at preventing the development of a particular disease, especially chronic diseases. Such diseases are the leading causes of financial struggles to keep up with medications and treatments because diseases prognosis might devastatingly impact on health. Therefore, screening is necessary as it prompts early intervention measures before the disease progresses to advanced stages and it aims to reduce costs and improve health outcomes. However, the appearances of false positives have impacted screening measures negatively. Therefore, this discussion will evaluate the advantages and disadvantages of screening.
Healthcare professionals advocate for screening based on the idea that early detection of the disease at its pre-symptomatic stages can lead to easier treatment and better outcome. Vujosevic et al. (2020) highlighted early detection of diabetes can be managed through diet compared to medication, thus saving the individual from associated suffering once the disease advances. Also, screening not only looks for diseases but also associated risk factors for various conditions. For example, a high BMI is a significant risk factor for heart disease. In this case, screening is advantageous because the patient will be advised accordingly based on the screening results. Providers can develop a physical exercise routine and diet with patients to address the BMI factor and reduce the likelihood of heart disease. Consequently, screening is beneficial as it helps manage the condition before it spreads. For example, the recent pandemic in places like schools was easily managed, highlighting cases of infection before it spread to other students. Therefore, screening, especially for infectious diseases, is advantageous to promote public health and prevent a health crisis.
As much as screening is a recommended measure, it also has its drawbacks. This is seen in those false negatives and false positive results. In false negative result, it shows a negative result from a particular disease while the person has the condition. On the other hand, false positives confirm the condition, but the individual does not have it. Yong et al. (2022) explained that when this happens, an individual may be subjected to further unnecessary tests, some of which are invasive or assured they do not have the condition for it to develop, thus beating the ideology of early detection for prompt interventions. Kraus et al. (2021) questioned the necessity of screening for some diseases because technological advancements have improved treatment measures regardless of the diagnosis. Therefore, one may argue that at some point, screening may be ineffective; instead, healthcare resources should be directed to treatment and awareness of various risk factors and how to stay healthy.
Conclusively, one should weigh the advantages and disadvantages of screening before participating in one. Although screening has its advantages and being essential to detect certain cancers, the false results have created a barrier to screening uptake because of the associated psychological and physical harm. For example, invasive diagnostic tests after a false positive can be traumatizing. It will be highly appreciated that screening tests can protect individuals who may have limited accessibility to healthcare or other necessary resources, especially cancer screening such as PAP smear, colonoscopy, and mammogram. At the same time, healthcare systems can invest more in research and technology advancement to ensure treatments in various disease stages, so that patient’s prognosis can aim for full recovery.
References
Kraus, S., Schiavone, F., Pluzhnikova, A., & Invernizzi, A. C. (2021). Digital transformation in healthcare: Analyzing the current state-of-research. Journal of Business Research, 123, 557-567. https://doi.org/10.1016/j.jbusres.2020.10.030
Vujosevic, S., Aldington, S. J., Silva, P., Hernández, C., Scanlon, P., Peto, T., & Simó, R. (2020). Screening for diabetic retinopathy: new perspectives and challenges. The Lancet Diabetes & Endocrinology, 8(4), 337-347. https://doi.org/10.1016/S2213-8587(19)30411-5
Yong, S. E. F., Wong, M. L., & Voo, T. C. (2022). Screening is not always healthy: an ethical analysis of health screening packages in Singapore. BMC Medical Ethics, 23(1), 1-21. https://doi.org/10.1186/s12910-022-00798-5Module 5 Discussion
by Vivian Revilla Rodriguez –
It is better to be cautious than to regret; likewise, it is better to monitor our health systematically. This way, we will be more confident of identifying any medical issues. Screening involves tests to determine if an asymptomatic patient has a potential risk of any disease. Colonoscopy, mammography, Pap smears, or cervical cytology are examples of essential screening methods in preventive medicine. While traditional diagnosis focuses on symptoms, screening targets presumably healthy population groups and identifies specific diseases promptly (Pienaar et al., 2019).
Some of the advantages of screening include reducing medical problems, decreasing mortality, and preventing complications. When a disease is detected in its early stages, there are greater chances of curing it, extending the patient’s lifespan, and improving their well-being. Additionally, screening can prevent the use of invasive and costly long-term treatments. Therefore, screening impacts the quality of life and economic sustainability (Pienaar et al., 2019; Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 2023).
Colorectal cancer is the second most common cause of death in the United States, and in 85% of cases, this disease is detected in very advanced stages. That is why the 5-year survival rate is only 50%. As a screening method, colonoscopy represents a crucial key to reducing complications and mortality associated with this type of cancer (Zhang et al., 2020). Cervical cancer is another condition that can be detected early. Thanks to screening programs implemented in the United States since the 1950s, the prevalence and mortality of this disease have significantly decreased. However, gaps in access to these tests persist, so incidence rates remain high (Fontham et al., 2020; Bedell et al., 2019; Fuzzell et al., 2021). Randomized studies and those related to breast cancer mortality have shown a relationship between increased mammography screening and a significant decrease in breast cancer mortality (Duffy et al., 2020).
Despite their numerous advantages, screening tests also come with disadvantages. One example is the false positive, which involves incorrectly classifying a person as having a disease they do not have. False negatives can be even worse because they lead to not treating someone at risk. These screening tools can also lead to overdiagnosis and overtreatment, as there is a possibility that the patient will never develop symptoms. Additionally, they can cause anxiety and mental health issues in patients awaiting results (Pienaar et al., 2019).
Questions about ethics, politics, and social issues have arisen concerning screening. The need for informed consent for these tests has been debated. Furthermore, only some have equal access to screening. Research has shown variations in disease prevalence between resource-poor areas where screening tests are unavailable and more developed environments where the opposite is true. The high cost of early detection programs is undeniable, and it is often questionable whether allocating resources to screening is justified when more urgent primary care needs also require them (Pienaar et al., 2019).”
Nevertheless, the prevailing criterion is to invest in screening programs. This is due to treating diseases promptly and their impact on global public health.
References
Bedell, S. L., Goldstein, L. S., Goldstein, A. R., & Goldstein, A. T. (2020). Cervical cancer screening: past, present, and future. Sexual Medicine Reviews, 8(1), 28-37.
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (2023). What Is Breast Cancer Screening? Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/breast/basic_info/scree…
Duffy, S. W., Tabár, L., Yen, A. M. F., Dean, P. B., Smith, R. A., Jonsson, H., … & Chen, T. H. H. (2020). Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549,091 women. Cancer, 126(13), 2971-2979.
Fontham, E. T., Wolf, A. M., Church, T. R., Etzioni, R., Flowers, C. R., Herzig, A., … & Smith, R. A. (2020). Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA: A Cancer Journal for Clinicians, 70(5), 321-346.
Fuzzell, L. N., Perkins, R. B., Christy, S. M., Lake, P. W., & Vadaparampil, S. T. (2021). Cervical cancer screening in the United States: Challenges and potential solutions for underscreened groups. Preventive Medicine, 144, 106400.
Pienaar, K., Petersen, A., & Bowman, D. M. (2019). Matters of fact and politics: Generating expectations of cancer screening. Social Science & Medicine, 232, 408-416.
Zhang, J., Chen, G., Li, Z., Zhang, P., Li, X., Cao, X. … & Zhang, L. (2020). Colonoscopic screening is associated with reduced Colorectal Cancer incidence and mortality: a systematic review and meta-analysis. Journal of Cancer, 11(20), 5953.
I need my resume to be professionally updated for a job application for Medical Surgical Registered Nurse Position including with a cover letter.
Unformatted Attachment Preview
CRISTY SANTOS, RN
11327 fawn springs court, cypress TX 77433. Telephone (646) 659-1761
Email CRISTY18901@GMAIL.COM
Objective
Seeking a position as a registered nurse
Bilingual Fluent in Spanish and English
Experience
11/2021- Present Harris County Public Health Immunization Registered
Nurse
Registered Nurse
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Collected nasal swab specimens from patients for
diagnostic testing of COVID-19 rapid testing and COVID19 PCR
Screen and educate patients prior to and post covid-19
vaccine and other vaccinations.
Recording a patient’s medical history accurately in EMR
(EPIC)
Record patient’s immunization record in IMMTRAC which
is the Texas vaccination registry
Taking and recording measurements of blood pressure,
temperature, heart rate, weight and height.
Prepare and administer Covid-19 vaccines and seasonal
influenza vaccines for adults and children.
Prepare and administered all required vaccines for catchup immunization for school for children under the Texas
Vaccines for Children (TVFC) program according to CDC
such as MMR, Varicella, Tdap, Dtap, Hepatitis A, Hepatitis
B, Meningococcal, Pneumococcal, HPV, etc.
Administered all required vaccines for catch-up
immunization for adults under the Adult Safety Net (ASN)
program according to CDC.
Observe patients after vaccination for any adverse side
effects and provide medical care if necessary.
Collect samples for lab testing as assigned
Provide emotional and psychological support when
needed
Communicate with patients’ family or friends to provide
advice, comfort and instructions
Required to work outside and inside in multiple locations
Traveled between sites
•
Set up required materials for vaccination administration in
community events by Harris County Public Health where
we are require to vaccinate.
•
Work in a fast-paced environment
10/2021-11/2021 modMD- Venice, CA
Registered Nurse
•
•
•
•
•
Collected nasal swab specimens from patients for
diagnostic testing of COVID-19 rapid testing and COVID19 PCR
Recorded patient’s medical history accurately in EMR
Required to work outside in multiple locations
Traveled between testing sites
Worked in a fast-paced environment
02/2020-03/2020 True Care Home Health Care Services – Brooklyn, NY
Field Registered Nurse
•
•
•
•
•
•
•
•
•
•
•
•
Initial patient assessment and recertification for services
at their home
Recording a patient’s medical history accurately in EMR
(HHA Exchange)
Taking and recording measurements of blood pressure,
temperature, heart rate etc.
Observing patients under treatment to identify progress,
side-effects of medications etc.
Administer injections, medications, etc., clean and dress
wounds and assist with other basic medical care tasks
Provide emotional and psychological support when
needed
Communicate with patients’ family or friends to provide
advice, comfort and instructions
patient certification for services
HHA supervisory visit
Review plan of care
communicate and update physicians and other
interdisciplinary members of the care team about
patients’ status
Knowledge of Microsoft Office 365, Outlook, Excel
01/2011-01/2020 Driven Global Transportation – New York, New York
CEO/Owner/Manager
•
•
•
•
Manage corporate accounts for transportation which were
affiliated to our company
Expedited services via limousine software using Excel,
Outlook and Microsoft.
Provide customer resolutions via telephone and emails
Manage a team of five drivers
•
01/2005-04/2007 LIJ NorthShore Extended Care and Rehabilitation, NY
Certified Nursing Assistant
•
•
•
•
•
Provide assistant to patients of rehabilitation and long term
care.
Help patients with ADL’s as well as feeding and ambulating.
Take vital signs.
Collect specimens for lab.
Record patients’ information and pertaining data in EMR
06/2003-12/2004 ST. Francis Hospital, Roslyn, NY
Certified Nursing Assistant
•
•
•
•
Provide assistant to post op heart surgery patients.
Record patients’ information and pertaining data in EMR
Help patients with ADL’s as well as feeding and ambulating.
Take vital signs and collect specimens for lab.
06/2002-01/2003 McDonalds, Mineola, NY
Store Manager
•
•
•
Provide friendly and courteous customer service.
Handled cash transactions accurately and efficiently.
Plan assignments and designations for employees.
Education
2002 Franklin Career Institute
* Nurse Aide Certification # 342180500804
2006-2007 Western Suffolk Boces School
* Diploma of Licensed Practical Nurse.
* Graduated March 29, 2007
* New York State License Number 292679
* Certificate Number 6339866
2015-2019 Nassau Community College
* Diploma of Associate in Science in Nursing
* Graduated May 22, 2019
* New York State Registered Nurse License Number 778099
* Certificate Number 0723625
2019-2023 Aspen University
* Bachelor of Science degree in Nursing
*Graduated April 6, 2023
Licenses
* Texas State Registered Nurse License Number 1025467 expires 6/2025
* New York State Registered Nurse License Number 778099 expires 7/2025
* New York State Practical Nurse License Number 292679 expires 5/2025
* AHA BLS Certificate ID Number 235417842796 expires 6/2025
Nursing is a very highly regulated profession. There are over 100 boards of nursing and national nursing associations throughout the United States and its territories. Their existence helps regulate, inform, and promote the nursing profession. With such numbers, it can be difficult to distinguish between BONs and nursing associations, and overwhelming to consider various benefits and options offered by each. Both boards of nursing and national nursing associations have significant impacts on the nurse practitioner profession and scope of practice. Understanding these differences helps lend credence to your expertise as a professional. In this Assignment, you will practice the application of such expertise by communicating a comparison of boards of nursing and professional nurse associations. You will also share an analysis of your state board of nursing.To Prepare: Assume that you are leading a staff development meeting on regulation for nursing practice at your healthcare organization or agency. Review the NCSBN and ANA websites to prepare for your presentation. The Assignment: (8- to 9-slide PowerPoint presentation) Develop a 8- to 9-slide PowerPoint Presentation that addresses the following: Describe the differences between a board of nursing and a professional nurse association. Describe the board for your specific region/area. Who is on the board? How does one become a member of the board? Describe at least one state regulation related to general nurse scope of practice. How does this regulation influence the nurse’s role? How does this regulation influence delivery, cost, and access to healthcare? If a patient is from another culture, how would this regulation impact the nurse’s care/education? Describe at least one state regulation related to Advanced Practice Registered Nurses (APRNs). How does this regulation influence the nurse’s role? How does this regulation influence delivery, cost, and access to healthcare? Has there been any change to the regulation within the past 5 years? Explain. Include Speaker Notes on Each Slide (except on the title page and reference page)
Writing project about (Effect of critical care environment on the Critically ill person and their family /carer) in word(DOC) with updated references including references for research done in Saudi Arabia including Introduction Objective Conclusion With example for Challenge and solutionReferences
Instructions:Thinking about your work area, elaborate on a case study with any specific patient’s situation, and describe the policy issues involving quality and safety in this patient’s healthcare.Submission Instructions:Your case study must be an original work and logically organized.You must incorporate a minimum of 4 current (published within the last five years) scholarly journal articles or primary legal sources to support your paper. All of them should be referenced according to APA style.
The purpose of this assignment is to give you a practical application to implement your compelling clinical question idea, supported by the evidence-based research you have obtained during your systematic review. You will apply evidence-based research findings discovered from your clinical question, and then integrate those to support your suggested change in nursing practice.
Directions:
Identify your refined clinical question.
Provide a summary of the database used.
Determine an evidence-based quantitative article from the search that contains an evidence-based randomized control trial.
Summarize the case study selected.
Describe the study approach, sample size, and population studied.
Apply the evidence from this review to your practice specifically in your overview.
Evaluate the outcomes, identifying the validity and reliability.
Discuss if the study contained any bias.
Determine the level of evidence identified in the review.
The length should be no less than 10 pages in APA 7th edition format.
Unformatted Attachment Preview
Rubric Title: MN504 Unit 2 Assignment Rubric
Unit 2 Assignment Criteria
Level III
Level II
Level I
Not Present
Criteria 1
Points: 54
Points: 36
Points: 18
0 Points
●
Clinical question
Includes full
comprehension
of content
●
●
Criteria 2
Points: 24
●
Overview of databases that
are available and relevant to
your clinical question
Criteria 3
Includes full
comprehension
of content
●
Points: 13
●
●
Points: 24
Includes overall
progress toward
comprehension
Minor errors may
be present
Includes overall
progress toward
comprehension
Minor errors may be
present
Points: 13
Includes some
comprehension but
errors indicating
miscomprehension
may be present
●
Points: 8
●
Includes some
comprehension but
errors indicating
miscomprehension
may be present
Points: 8
Does not meet the
criteria
0 Points
●
Does not meet the
criteria
0 Points
Unit 2 Assignment Criteria
Level III
●
Paper on findings from the
database and the evidence
determined
Level II
●
Includes full
comprehension
of content
●
Criteria 4
Points: 18
●
Include a minimum of four
evidence-based references
Level I
●
Includes overall
progress toward
comprehension
Minor errors may
present
Points: 12
●
Includes full
comprehension
of content
●
Includes some
comprehension but
errors indicating
miscomprehension
may be present.
Not Present
●
Points: 6
●
Includes Overall
progress toward
comprehension
Minor errors may be
present
Includes some
comprehension but
errors indicating
miscomprehension
Does not meet the
criteria
0 Points
●
Maximum Total Points
120
74
40
0
Minimum Total Points
75 points minimum
41 points minimum
1 point minimum
0
Does not meet the
criteria
Rubric Title: MN504 Unit 4 Assignment Rubric
Unit 4 Assignment Criteria
Level III
Level II
Level I
Not Present
Criteria 1
Points: 30
Points: 16
Points: 14
0 Points
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Points: 30
Points: 16
Points: 14
0 Points
Define clinical question
Criteria 2
Unit 4 Assignment Criteria
Level III
Level II
Level I
Not Present
Identify studies found in
the database related to
clinical question
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Points: 20
Points: 16
Points: 14
0 Points
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Points: 20
Points: 16
Points: 14
0 Points
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
Points: 20
Points: 16
Points: 14
Includes no
more than three
grammatical,
spelling, or
punctuation
errors that do
not interfere with
the readability
● Meets the
assignment
length
requirements
● Includes no more
than
four grammatical,
spelling, or
punctuation errors
that do not interfere
with the readability
● Meets the length
requirements
● Provides three
peer-reviewed
scholarly sources
● Includes five or
more grammatical,
spelling, and
punctuation errors
that make
understanding
parts of the
assignment difficult
but do not interfere
with the readability
● Meets the length
requirements
Criteria 3
Statistical results
Criteria 4
Paper reviewing the
evidence as it relates to
confidence
interval/statistics
Criteria 5
College-level academic
writing
●
● Does not meet the
criteria
0 Points
●
Does not meet the
criteria
Unit 4 Assignment Criteria
Level III
●
Level II
Level I
Not Present
● Provides one or
two peer-reviewed
scholarly sources
Provides four
peer-reviewed
scholarly
sources
Maximum Total Points
120
80
70
0
Minimum Total Points
81 points minimum
71 points minimum
1 point minimum
0
Rubric Title: MN504 Unit 6 Assignment Rubric
Unit 6 Assignment Criteria
Level III
Level II
Level I
Not Present
Criteria 1
Points: 25
Points: 20
Points: 15
0 Points
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
Points: 25
Points:20
PICOT question and
systematic review
Criteria 2
Evidence-based
quantitative article
Criteria 3
●
Includes full
comprehension
of content
Points: 25
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
Points: 20
●
Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Points: 15
●
Includes some
comprehension, but
errors indicating
miscomprehension
may be present
Points: 15
0 Points
●
Does not meet the
criteria
0 Points
Unit 6 Assignment Criteria
Level III
Level II
Level I
Not Present
Case study
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Criteria 4
Points: 25
Points: 20
Points: 15
0 Points
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
Points: 20
Points: 16
Points: 14
0 Points
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
The study approach,
sample size, and
population
Criteria 5
Application of the
evidence from the review,
evaluation of the
outcomes, bias
discussion, and
determination of level of
evidence
●
Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Maximum Total Points
120
96
74
0
Minimum Total Points
97 points minimum
73 points minimum
1 point minimum
0
Rubric Title: MN504 Unit 8 Assignment Rubric
Unit 8 Assignment Criteria
Level III
Level II
Level I
Not Present
Criteria 1
Points: 35
Points: 28
Points: 21
0 Points
Unit 8 Assignment Criteria
Overview of the case
study
Criteria 2
Conflict resolution
strategies
Criteria 3
Highlights how conflict
resolution strategies are
applied
Criteria 4
PowerPoint presentation
Criteria 5
College-level academic
writing
Level III
Level II
Level I
Not Present
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Points: 35
Points: 28
Points: 21
0 Points
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Points: 35
Points: 28
Points: 21
0 Points
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Points: 35
Points: 28
Points: 21
0 Points
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Points: 20
Points: 12
Points: 9
0 Points
● Includes no
more than three
grammatical,
spelling, or
punctuation
● Includes no more
than four
grammatical,
spelling, or
punctuation errors
● Includes five or
more grammatical,
spelling, and
punctuation errors
that make
●
Does not meet the
criteria
Unit 8 Assignment Criteria
Level III
Level II
Level I
errors that do
not interfere with
the readability
● Meets the
assignment
length
requirements
● Provides four
peer-reviewed
scholarly
sources
that do not interfere
with the readability
● Meets the length
requirements
● Provides three
peer-reviewed
scholarly sources
understanding
parts of the
assignment difficult
but do not interfere
with the readability
● Meets the length
requirements
● Provides one or
two peer-reviewed
scholarly sources
Not Present
Maximum Total Points
160
124
93
0
Minimum Total Points
125 points minimum
97 points minimum
1 point minimum
0
Rubric Title: MN504 Unit 10 Assignment Rubric
Unit 10 Assignment
Criteria
Level III
Level II
Level I
Not Present
Criteria 1
Points: 25
Points: 20
Points: 15
0 Points: 0
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Points: 25
Points: 20
Points: 15
0 Points
Clinical question as it
relates to your practice
setting
Criteria 2
Unit 10 Assignment
Criteria
Level III
Level II
Level I
Not Present
● Includes overall
progress toward
comprehension
● Minor errors may
present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Points: 25
Points: 20
Points: 15
0 Points
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Points: 25
Points: 20
Points: 15
0 Points
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Points: 10
Points: 8
Points: 6
0 Points
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
●
Growth of the clinical
question in research
possibilities
Criteria 3
Publications that would
be a source of publication
and references for the
clinical question
Criteria 4
Collaborative practice
opportunities as they
relate the evidence
determined in the
database searches
Criteria 5
Overview of the guideline
and the discussion in the
paper
Includes full
comprehension
of content
Unit 10 Assignment
Criteria
Level III
Level II
Level I
Not Present
Criteria 6
Points: 10
Points: 8
Points: 6
0 Points
● Includes full
comprehension
of content
● Includes overall
progress toward
comprehension
● Minor errors may
be present.
● Includes some
comprehension, but
errors indicating
miscomprehension
may be present
● Does not meet the
criteria
Citations and formatting
Maximum Total Points
120
96
72
0
Minimum Total Points
97
73
1
0
Compliance is a comprehensive program that helps institutions and their employees conduct operations and activities ethically; with the highest level of integrity, and in compliance with legal and regulatory requirements. To have an effective compliance program, an organization must establish and maintain an organizational culture that “encourages ethical conduct and a commitment to compliance with the law.” U.S. Federal Sentencing Guidelines §8B2.1(a)(2).Using the OIG website (https://oig.hhs.gov/) or another of your choosing, select a real-time healthcare fraud news report from your local area to feature- NEWS REPORT*** >>> https://www.justice.gov/usao-edva/pr/virginia-medical-equipment-provider-ordered-pay-12-m-medicare-fraud-scheme-civil ***<<<
This criterion is linked to a Learning OutcomeName and DOB
5 pts
Full Marks
Verify patient’s name and DOB
2.5 pts
partial points
Includes one component only
0 pts
No Marks
Does not include both components
5 pts
This criterion is linked to a Learning OutcomeChief Concern or Chief Complaint (CC)
5 pts
Full Marks
CC – Clearly stated in appropriate format
2.5 pts
partial points
CC partially stated and/or not written in proper format
0 pts
No Marks
Does not include or does not clearly state CC
5 pts
This criterion is linked to a Learning OutcomeHistory of Present Illness (HPI)
20 to >15.0 pts
Full Marks
Includes all components necessary from the acronym OLDCART. Does not include term OLDCART or written out words of acronym. Includes full information to guide to diagnosis.
15 to >10.0 pts
partial points
Does not include all components necessary from the acronym OLDCART. Include term OLDCART or writes out words of acronym. Missing information to guide to diagnosis.
10 to >0 pts
partial points
Components not explained. Missing pertinent positives and negatives. Does not include information to guide to diagnosis.
20 pts
This criterion is linked to a Learning OutcomeMedications
4 pts
Full Marks
Include all 3 components including name, dose, frequency, reason Prescription (include medical cannabis and oral contraceptives) Non-prescription drugs or medications Vitamins, minerals, or herbal supplements/herbals
3 pts
partial points
Include only 2 components including name, dose, frequency, reason Prescription (include medical cannabis and oral contraceptives) Non-prescription drugs or medications Vitamins, minerals, or herbal supplements/herbals
2 pts
partial points
Includes only 1 component including name, dose, frequency, reason Prescription (include medical cannabis and oral contraceptives) Non-prescription drugs or medications Vitamins, minerals, or herbal supplements/herbals
4 pts
This criterion is linked to a Learning OutcomeAllergies
4 pts
Full Marks
Include reactions to medications, environment, food, latex
3 pts
partial points
Includes 2 -3: medications, food, allergy, latex and/or does not include reaction
1 pts
partial points
Includes 1: medications, food, allergy, latex and/or does not include reaction
4 pts
This criterion is linked to a Learning OutcomePersonal & Social History:
15 pts
Full Marks
Includes all information and components of social history that are pertinent to the CC. Always include: Tobacco – type, quantity, duration (pack/year) Alcohol – type, quantity, frequency Drug use (illicit substance) DO NOT include unless definitively leads to a diagnosis – points will be deducted for including all for no reason (see rubric) or not including a pertinent one. This is the key to this assignment. Exercise and Diet – type & frequency of exercise; usual daily foods, caffeinated products Living & home situation – significant others, sources of stress, alterations in ADL’s Safety – seat belts, helmets, sunblock, smoke detectors, medical alert devices, etc. Alterations in sleep pattern Religious or spiritual beliefs Occupational — current job or retirement, possible exposures, deployment Recent Travel (possible exposures, illness)
14 pts
partial points
Does not include all pertinent information of all 3: tobacco, alcohol, and drug use including pack/year, type, quantity, duration of use of tobacco, alcohol, drug Excludes pertinent content or includes non-pertinent content
10 pts
partial points
Includes only 1-2 components of tobacco, alcohol, drug use including pack/year, type, quantity, duration of use of tobacco, alcohol, drug Excludes pertinent content or includes non-pertinent content
15 pts
This criterion is linked to a Learning OutcomeHealth Promotion
10 pts
Full Marks
Includes all information and components that are pertinent to the CC/HPI. DO NOT include unless definitively leads to a diagnosis – points will be deducted for including all for no reason (see rubric) or not including a pertinent topic. This is the key to this assignment. Last Exams & dates – physical exam, eye exam, and dental exam Health screenings & dates: age appropriate, date of screening Immunizations: date & type
9 pts
partial points
Addresses 2 components Includes partial information. Does not include all pertinent information.
7 pts
partial points
Does not include full information, missing pertinent information. Includes only 1 component Excludes pertinent content or includes non-pertinent content
10 pts
This criterion is linked to a Learning OutcomeReview of System (ROS)
15 pts
Full Marks
ROS contains only subjective information. ROS includes information and components of history that are pertinent to the CC/HPI. Includes all key questions of the system that would lead to diagnosis. Correct terminology utilized. Contains pertinent positives listed first followed by negatives written in correct format. DO NOT include unless definitively leads to a diagnosis – points will be deducted for including all for no reason (see rubric) or not including a pertinent topic. This is the key to this assignment. General Skin HEENT Neck & Thyroid Lymphatic Respiratory Cardiovascular Peripheral Vascular Abdomen Musculoskeletal Neurological Hematological Endocrine Psychiatric
14 pts
partial points
ROS contains subjective information in a comprehensive format for most systems. ROS does not contain objective information. Incorrect terminology utilized. Does not contain pertinent positives and negatives and/or they are not written in correct format. Missing key questions necessary to lead to diagnosis.
10 pts
partial points
ROS contains objective information. Format inconsistent and not comprehensive for most systems. Incorrect terminology utilized. Does not contain pertinent positives and negatives and/or they are not written in correct format. Missing key questions necessary to lead to diagnosis. Excludes pertinent content or includes non-pertinent content
15 pts
This criterion is linked to a Learning OutcomePhysical Exam Findings
20 to >15.0 pts
Full Marks
Exam contains only objective findings pertinent to the CC/HPI. *Includes advanced health assessment exam techniques related to each system. Include exam results/findings, NOT description of exam Correct terminology utilized. Includes all exams necessary to lead to diagnosis. Contains pertinent positives listed first followed by negatives written in correct format. DO NOT include unless definitively leads to a diagnosis – points will be deducted for including all for no reason (see rubric) or not including a pertinent topic. This is the key to this assignment. Do not include any system that is not listed below (breast, prostate, or GU system). General Skin HEENT Neck & Thyroid Lymphatic Respiratory Cardiovascular Abdominal Peripheral Vascular
15 to >10.0 pts
partial points
Includes only objective information pertinent to CC/HPI. Missing pertinent advanced health assessment exam techniques. Missing pertinent results/findings Correct terminology utilized. Includes all exams necessary to lead to diagnosis. Contains the majority of pertinent positives listed first followed by negatives written in correct format. Missing key questions necessary to lead to diagnosis.
10 to >0 pts
partial points
Includes subjective information Includes description of health assessment techniques. Writes narrative with non-pertinent content first Missing key questions necessary to lead to diagnosis. Includes or excludes pertinent content Includes any system breast, prostate, or GU system
20 pts
This criterion is linked to a Learning OutcomeContent
2 pts
Full Marks
Organized is focused to appropriate section. Content structure within sentences should be well organized and focused to topic. All spelling is correct. APA format is not required.
1 pts
partial points
Organized is less than 100 % focused to appropriate section. Content structure within sentences is not organized or focus shifts among topics. Spelling is less than 100 % correct. APA format is not required.
0 pts
No Marks
Organized is focused to appropriate section. Content structure within sentences should be well organized and focused to topic. All spelling is correct. APA format is not required
2 pts
Total Points: 100
Unformatted Attachment Preview
NGR 6002C Advanced Health Assessment
Note: Focused Visit Worksheet
Patient Initials/DOB: __________________
Chief Concern/Complaint (CC):
History of Present Illness (HPI): Write in paragraph format. OK to use short, incomplete sentences. Include
all components necessary from the acronym OLDCART but DO NOT use the term OLDCART or write Onset
_____
Medications: Include name, dose, frequency, reason
Prescription (include medical cannabis and oral contraceptives)
Non-prescription drugs or medications
Vitamins, minerals, or herbal supplements/herbals
Allergies: Include reactions to medications, environment, food, latex
Personal & Social History: Only include information and components of social history that are pertinent
to the CC.
Always include:
Tobacco – type, quantity, duration (pack/year)
Alcohol – type, quantity, frequency
Drug use (illicit substance)
DO NOT include unless definitively leads to a diagnosis – points will be deducted for including all for
no reason (see rubric) or not including a pertinent one. This is the key to this assignment.
Exercise and Diet – type & frequency of exercise; usual daily foods, caffeinated products
Living & home situation – significant others, sources of stress, alterations in ADL’s
Safety – seat belts, helmets, sunblock, smoke detectors, medical alert devices, etc. Alterations in
sleep pattern
Religious or spiritual beliefs
Occupational — current job or retirement, possible exposures, deployment
Recent Travel (possible exposures, illness)
Health Promotion: Only include information and components pertinent to the CC.
DO NOT include unless definitively leads to a diagnosis – points will be deducted for including all for
no reason (see rubric) or not including a pertinent topic. This is the key to this assignment.
Last Exams & dates – physical exam, eye exam, and dental exam
Health screenings & dates: age appropriate, date of screening
Immunizations: date & type
Review of Systems (ROS): Only include information pertinent to the CC. Subjective information only.
Use correct terminology. Contains pertinent positives listed first followed by negatives written in correct
format. DO NOT include unless definitively leads to a diagnosis – points will be deducted for including
all for no reason (see rubric) or not including a pertinent topic. This is the key to this assignment.
General
Sin
HEENT: Head, Eyes, Ears, Nose and Sinuses, Throat (mouth & pharynx)
Neck & Thyroid
Lymphatic
Respiratory
NGR6002C Spring 2021 to Bates
NGR 6002C Advanced Health Assessment
Note: Focused Visit Worksheet
Cardiovascular
Gastrointestinal
Peripheral Vascular
Musculoskeletal
Neurological
Hematological
Endocrine
Psychiatric
Exam Findings: Only include information pertinent to the CC. Exam contains only objective information. Include
exam techniques as included in OSCE rubric. Correct terminology utilized. Contains pertinent positives listed first
followed by negatives written in correct format. DO NOT include unless definitively leads to a diagnosis –
points will be deducted for including all for no reason (see rubric) or not including a pertinent topic. This is the
key to this assignment. Do not include any system that is not listed below (breast, prostate, or GU system).
General
Sin
HEENT: Head, Eyes, Ears, Nose and Sinuses, Throat
Neck & Thyroid
Lymphatic
Respiratory
Cardiovascular
Gastrointestinal
Peripheral Vascular
Abdominal
NGR6002C Spring 2021 to Bates
Write down everything you eat and drink for one day. Include breakfast, lunch, dinner, and snacks. You do not need to write down water as it has no calories. If you drink alcohol, you need to add the amount as alcohol does have calories.
You will need to create a free account when you are ready to analyze your food intake.
Click on the Cronometer Link to enter your 1-day food intake.
CronometerLinks to an external site.
To create your account, click the green “Sign up for Free” tab. Enter your email (you may use your college email if you don’t want to use your personal email). Create and confirm a password and write it down. Enter the information for “Your Body Type.” Then, click the box for “I agree to the cronometer.com Terms of Service.
You may then begin adding your food by clicking the “ADD FOOD” tab. Type a food into the search box and find the closest choice from the list. Continue adding until all the food you consumed for the day has been added. You must add a minimum of 1500 calories for this assignment!
You will need to save and submit the analysis as part of this assignment. (20 Points) You can save your Cronometer analysis by clicking “Print” then instead of printing, choose “Save as PDF”.
If you need help, click on the help tab and refer to the user’s manual. You are also welcome to join me during my office hours!
Once you have finished adding all of your foods, scroll through the Nutrient Target Summaries.
By default, Cronometer set each nutrient to the recommended values as set by the DRI nutrition standards. The basic idea for these targets is to get at least 100% of the minimum value each day to have good nutrition. For nutrients that have a maximum, it is recommended to not exceed the maximum value.
Bars colored in yellow mean you have not yet reached your minimum target
Bars colored in green mean you have met the minimum target and not yet exceeded your maximum target.
Bars colored in red mean you have exceeded your maximum target.
You can mouse over a bar to see the top contributors from your diary on that day to meet this specific target.
Answer the following questions and submit them along with your saved Cronometer food analysis.
How many calories did you consume? (4 Points) You must enter a minimum of 1500 calories for this assignment.
What percentage of Carbohydrates, Lipids (fats), and Proteins did you consume? (12 Points)
Referring back to the foods you consumed the day of the analysis, what are two changes you can make to improve your nutritional intake? Please talk specifically about your foods. For example, if you are consuming too much fat, discuss the specific foods you ate that are high in fat and give me alternative foods to decrease your fat intake. (9 Points)
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Ethics and Regulations in Healthcare
Course number:
PHC 216
CRN:
Assignment #1 :
Saudi ministry of health announced November 2019 a large
awareness campaign about patient consent. Answer the following
questions:
•Why informed consent is important in medical ethics and MOH
give all that consideration? (5marks) CLO2
•Define the term capacity in terms of medical ethics, how can you
evaluate a patient’s capacity, describe with an example. (5 marks)
CLO1
Student Name:
Student ID:
Submission Date:
Instructor name:
Dr Mohammad Inam Khan
Grade:
…. Out of 10
College of Health Sciences
Department of Public Health
Assignment’s guideline:
· Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted
· Do not write the answer as points
· Font should be 12 Time New Roman
· Color should be black
· Line spacing should be 2
· Don’t bold or Italic or underline your paragraph
· Start write your answer in the third page
· AVOID PLAGIARISM
In this project, you will demonstrate your mastery of the following course outcomes:
Analyze the various components of wellness for investigating the influence of wellness on one’s discipline of study or chosen profession
Integrate interdisciplinary approaches for determining the impact that contemporary issues in healthcare systems have on modern society
Describe contemporary issues surrounding wellness for their relevance to and impact on the individual and society by employing appropriate research strategies
Recommend potential applications of strategies for monitoring and enhancing personal and public wellness
Articulate informed viewpoints on contemporary issues surrounding wellness issues through effective communication skills
Assess cultural and social attitudes, choices, and behaviors for their implications to lifelong health and wellness through the incorporation of diverse perspectives and viewpoints informed by relevant literature and peer experiences
Overview
This course explores wellness and its impact on the world around us. Wellness influences society, and society influences wellness, creating a feedback loop between them. You will critically analyze a specific issue or event in wellness and how it impacts individuals and society using the four general education lenses: history, humanities, natural and applied sciences, and social science. From this enhanced understanding, you will be equipped to draw connections between wellness, self, and engagement with your community. You will demonstrate your ability to think critically, investigate, and communicate clearly. These skills are often necessary to achieve personal and professional goals across many disciplines.
Directions
For this project, you will write a 10-page paper that examines your chosen research topic and how it affects individuals and society. In the paper, you will describe your topic, present a thesis statement, perform a critical analysis, and reflect on how your topic informs your personal life and experience. You will demonstrate your ability to think critically, investigate, and communicate clearly.
Specifically, you must address the following rubric criteria:
Evidence: You will use evidence to support your analysis throughout the project.
Integrate reliable evidence from varied sources throughout your paper to support your analysis. Use at least two resources from the module resources sections of this course and two resources that you find through your own research using the Shapiro Library.
It is important to draw from a more diverse pool of perspectives from varied sources to support the analysis, which is different from the Citations and Attributions rubric criterion.
Reliable evidence from varied sources should be interwoven throughout the paper itself. Citing and attributing sources will be represented as APA in-text citations and a reference list at the end of your work.
You will be evaluated on both criteria.
Topic Description: In this section, you will identify and discuss the factors that shape your thesis statement.
Describe a social or global issue or event that is related to issues of wellness. Include information such as the origin of the issue and what it is about.
Describe a population significant to your topic. Include information such as demographics, cultural practices, social identity, and key challenges.
Assess how society impacts the chosen issue or event.
Explain your choice of general education interdisciplinary lens for analyzing your topic.
Construct a thesis statement that combines your topic, population, cultural situation, and choice of general education interdisciplinary lens.
Critical Analysis: In this section, you will analyze your topic using one of the general education lenses and recommend strategies for using this kind of analysis to meet your personal and professional goals.
Analyze your chosen issue or event through one of the general education interdisciplinary lenses to determine its impact on various institutions.
Analyze how social practices have been shaped by issues and events in wellness in modern culture.
Describe at least one specific element that could benefit from change within your topic.
Explain how at least one potential obstacle could interfere with the population’s engagement with your topic.
Assess at least two significant factors that could impact your topic, such as biases, beliefs, assumptions, and/or values.
Assess the benefits and challenges of addressing issues in wellness.
Recommend strategies for using this kind of critical analysis for meeting your personal and professional goals.
What might this look like in your everyday life? Consider how wellness can be used to address the day-to-day responsibilities or questions faced by practitioners in your field or discipline.
Reflection: In this section, you will describe how using critical analysis tools influences your personal experience, your field of study or profession, how you interact with others.
Describe how critically analyzing your issue/event in wellness has informed your individual framework of perception.
Consider how your analysis has altered the way you perceive the world.
Describe how examining your bias has altered the way you perceive the world.
Reflect on your own bias and then consider how an awareness of one’s bias can change our perceptions.
Explain how critically analyzing wellness can influence your field of study or profession.
How can studying wellness inform your understanding of the next big topic of study in your field or profession?
Explain at least one way in which your analysis might have been different if you had used one of the other general education lensesto analyze your topic.
Explain how analyzing wellness can help interactions with people with a different viewpoint, culture, or perspective.
What to Submit
To complete this project, you must submit a Word document of 10 pages in length (plus a reference page) with 12-point Times New Roman font, double spacing, and one-inch margins. Use at least two resources from course materials and two resources from the library. Sources should be cited according to APA style. Consult the Shapiro Library APA Style Guide for more information on citations.
Project Rubric
Criteria Exemplary (100%) Proficient (85%) Needs Improvement (55%) Not Evident (0%) Value
Reliable Evidence From Varied Sources Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Integrates reliable evidence from varied sources throughout the paper to support analysis, using at least two resources from the module resource sections of the course and two resources found through independent research using the Shapiro Library Shows progress toward proficiency, but with errors or omissions; areas for improvement may include drawing from a more diverse pool of perspectives, using more varied sources to support the analysis, integrating evidence and sources throughout the paper to support the analysis, or using at least two resources from the module resource sections of the course and two resources found through independent research using the Shapiro Library Does not attempt criterion 5
Topic Description: Social or Global Issue or Event Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Describes a social or global issue or event that is related to issues of wellness, including information such as the origin of the issue and what it is about Shows progress toward proficiency, but with errors or omissions; areas for improvement may include providing a more thorough description of the topic or its origin, greater support about its connection to wellness, or additional contextual information about the topic Does not attempt criterion 5
Topic Description: Description of Population Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Describes a population significant to the topic, including information such as demographics, cultural practices, social identity, or key challenges Shows progress toward proficiency, but with errors or omissions; areas for improvement may include a more thorough description of the population or providing greater support for the population’s demographics, cultural practices, social identity, or key challenges Does not attempt criterion 5
Topic Description: Society Impacts Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Assesses how society impacts the chosen issue or event Shows progress toward proficiency, but with errors or omissions; areas for improvement may include providing a more thorough or detailed assessment of how society impacts the issue or event or providing more support for this assessment Does not attempt criterion 5
Topic Description: General Education Lens Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Explains the choice of general education interdisciplinary lens for analyzing the topic Shows progress toward proficiency, but with errors or omissions; areas for improvement may include connecting one of the four general education lenses to the topic or providing a more convincing or thorough explanation of why the lens was chosen Does not attempt criterion 5
Topic Description: Thesis Statement Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Constructs a thesis statement that combines topic, population, societal situation, and choice of general education interdisciplinary lens Shows progress toward proficiency, but with errors or omissions; areas for improvement may include constructing a clearer or more concise thesis statement that integrates topic, population, societal situation, and choice of general education lens Does not attempt criterion 5
Critical Analysis: Impact on Institutions Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Analyzes chosen issue or event through a general education interdisciplinary lens to determine its impact on various institutions Shows progress toward proficiency, but with errors or omissions; areas for improvement may include using one of the lenses to analyze the issue or event, conducting a deeper analysis of the impact of the issue or event on various institutions through the chosen lens, or providing greater, more relevant, or more appropriate support for the analysis Does not attempt criterion 5
Critical Analysis: Social Practices Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Analyzes how social practices have been shaped by issues and events in wellness in modern culture Shows progress toward proficiency, but with errors or omissions; areas for improvement may include conducting a deeper analysis of how social practices have been shaped or providing greater, more relevant, or more appropriate support for the analysis Does not attempt criterion 5
Critical Analysis: Element That Could Benefit From Change Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Describes at least one specific element within the topic that could benefit from change Shows progress toward proficiency, but with errors or omissions; areas for improvement may include providing a more detailed description of the chosen element or providing more thorough support for why it could benefit from change Does not attempt criterion 5
Critical Analysis: Potential Obstacle Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Explains how at least one potential obstacle could interfere with the population’s engagement with the topic Shows progress toward proficiency, but with errors or omissions; areas for improvement may include connecting the topic to a potential obstacle or providing more thorough support for how it could interfere with the population’s engagement with the topic Does not attempt criterion 5
Critical Analysis: Factors That Could Impact the Topic Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Assesses at least two significant factors that could impact the topic, such as biases, beliefs, assumptions, and/or values Shows progress toward proficiency, but with errors or omissions; areas for improvement may include identifying two specific factors that could impact the topic or providing more thorough support for the chosen factors or for how they could impact the topic Does not attempt criterion 5
Critical Analysis: Benefits and Challenges Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Assesses the benefits and challenges of addressing issues in wellness Shows progress toward proficiency, but with errors or omissions; areas for improvement may include connecting the benefits and challenges assessed to wellness, providing a more detailed assessment of these, or providing more support for them or for how they relate to wellness Does not attempt criterion 5
Critical Analysis: Analysis Strategies Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Recommends strategies for using critical analysis for meeting personal and professional goals Shows progress toward proficiency, but with errors or omissions; areas for improvement may include providing more relevant or appropriate strategies for using critical analysis for meeting personal or professional goals or providing a more thorough explanation of the strategies selected or the reason why they were recommended Does not attempt criterion 5
Reflection: Individual Framework of Perception Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Describes how critically analyzing an issue or event in wellness has informed individual framework of perception Shows progress toward proficiency, but with errors or omissions; areas for improvement may include providing additional details or a more specific description of how critically analyzing an issue or event in wellness informed individual framework of perception Does not attempt criterion 5
Reflection: Bias Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Describes how examining bias has altered ways of perceiving the world Shows progress toward proficiency, but with errors or omissions; areas for improvement may include clearly connecting bias and personal perceptions or providing more thorough support for how examining bias has altered personal perceptions Does not attempt criterion 5
Reflection: Field of Study or Profession Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Explains how critically analyzing wellness can influence field of study or profession Shows progress toward proficiency, but with errors or omissions; areas for improvement may include connecting the critical analysis of wellness to an academic or professional experience or providing more thorough support for this connection Does not attempt criterion 5
Reflection: Different General Education Lens Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Explains at least one way the analysis might have been different if another general education lens was used to analyze the topic Shows progress toward proficiency, but with errors or omissions; areas for improvement may include using an alternative general education lens, a clearer explanation of how the analysis might have been different if one of the other general education lenses had been used to analyze the topic, or providing more support for the explanation Does not attempt criterion 5
Reflection: Interactions Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Explains how analyzing wellness can help interactions with people with a different viewpoint, culture, or perspective Shows progress toward proficiency, but with errors or omissions; areas for improvement may include connecting the value of critical analysis to interactions with people with a different viewpoint, culture, or perspective or providing a more thorough explanation of how the analysis can help these interactions Does not attempt criterion 5
Articulation of Response Exceeds proficiency in an exceptionally clear, insightful, sophisticated, or creative manner Clearly conveys meaning with correct grammar, sentence structure, and spelling, demonstrating an understanding of audience and purpose Shows progress toward proficiency, but with errors in grammar, sentence structure, and spelling, negatively affecting readability Submission has critical errors in grammar, sentence structure, and spelling, preventing understanding of ideas 5
Citations and Attributions Uses citations for ideas requiring attribution, with few or no minor errors Uses citations for ideas requiring attribution, with consistent minor errors Uses citations for ideas requiring attribution, with major errors Does not use citations for ideas requiring attribution 5
Total: 100%
In a four- to five-page paper (not counting cover and references) in APA format, address the following:
Review and describe the current macro (national) and micro (organization’s board of directors [BOD]) roles for governance of quality and safety.
How might these governing bodies effect a change in population health, safety, and quality, inclusive of health equity and socioeconomic determinants of health?
In addition to your textbook, support your claims with two or three research articles related to health disparity or equity as they relate to quality and safety, and integrate key findings in your paper.
What to Submit
Your paper in Microsoft Word
If you copy and paste references from the course into your assignment, be sure to confirm APA formatting before submitting.
Similarity Score
After submitting your assignment, select Submission Details to view your similarity score.
Your similarity score will appear as a percentage next to your submitted file.
It may take up to 24 hours for your similarity score to appear.
Governance for Quality and Safety Rubric
Governance for Quality and Safety Rubric
Criteria Ratings Pts
National and BOD Rolesview longer description 10 pts-Excellently written description, showing deep understanding of the two roles. / 10 pts
How They Can Effect Changeview longer description 20 pts- Excellently written explanation, showing deep understanding of how they can effect change. / 20 pts
Integrates Research on Health Disparity or Equityview longer description 10 pts Excellently integrates research to support claims. / 10 pts
Spelling, Grammar, and Writingview longer description 5 ptsExcellently written and composed. No errors in spelling and grammar. / 5 pts
APA Formatview longer description 5 pts No errors in format. / 5 pts
Total Points: 0
Find and review ten (10) scholarly, peer-reviewed research articles, meta-analyses, or CPGs in support of the practice change intervention. Complete the appropriate section in the worksheet for each article.
State the PICOT question.
For each article, supply the information for each of the seven headings for the appropriate article type.
PREPARING THE ASSIGNMENT:
Use the designated Research Summary Table Worksheet Links to an external site.to supply the required information.
All scholarly, peer-reviewed research articles must be current within a 5-year time frame unless a valid rationale is provided, and the instructor has approved the use of an older reference.
Use APA 7th edition formatting for references.
DIRECTIONS AND ASSIGNMENT CRITERIA
Assignment Criteria
Points
%
Description
PICOT question
20
10%
PICOT question provided in sentence format
Articles 1-10
15/article
150 total
7.5% / article
75% total
For each article:
Scholarly article: US based peer reviewed journal focused for clinicians
Publication date is current within 5 years
Correctly categorizes article type
Completes all seven areas of article analysis
Explains relevance to PICOT question and implications for advanced nursing practice
APA
20
10%
Use of worksheet template
Correct APA 7th edition format for the following:
Font style and size
Citing and referencing sources
Mechanics of style (abbreviations, capitalization, italics, numbers)
Graduate-level writing style
10
5%
Correct use of spelling, grammar, punctuation, and sentence structure
Clarity, organization, and logical flow of ideas within writing
Synthesis of information is present with no direct quotes
Correct APA 7th edition format for the following:
Font style and size
Citing and referencing sources
Mechanics of style (abbreviations, capitalization, italics, numbers)
Use of template
Total
200
100 %
Note: You are to locate original studies with research conducted and published by the primary investigator. You may also use quantitative, qualitative, mixed methods studies, meta-analyses or Clinical Practice Guidelines (CPGs).
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Ethics and Regulations in Healthcare
Course number:
PHC 216
CRN:
Assignment #1 :
Saudi ministry of health announced November 2019 a large
awareness campaign about patient consent. In 500 words feedback
answer the following questions:
•Why informed consent is important in medical ethics and MOH
give all that consideration? (5marks) CLO2
•Define the term capacity in terms of medical ethics, how can you
evaluate a patient’s capacity, describe with an example. (5 marks)
CLO1
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Ms.RAZAN FAKIEH
…. Out of 10
College of Health Sciences
Department of Public Health
Assignment’s guideline:
· Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted
· Do not write the answer as points
· Font should be 12 Time New Roman
· Color should be black
· Line spacing should be 2
· Don’t bold or Italic or underline your paragraph
· Start write your answer in the third page
· AVOID PLAGIARISM
https://www.aphl.org/programs/infectious_disease/influenza/Pages/default.aspxPurpose The purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos. Action ItemsExplain the advantages and disadvantages of building a master person index across surveillance information systems for multiple diseases.Submission InstructionsComplete and submit this assignment according to your professor’s instructions
Create one Word documents containing all parts of the assignment.
Format your document with one-inch margins and 12-point Times New Roman font.
One page, double-spaced for each part.
Instructions: Part 1: A Personal Negotiation
1. Describe a recent negotiable you were involved in (we all negotiate every day, even it is negotiating with a family member, friend, purchasing a product or service, or with a boss at work.). Include answers to the following questions:
What was the issue(s) being negotiated? Provide adequate background.
What was the outcome you desired? How did you determine this outcome desired?
What was the outcome you obtained?
Based on what you learned on negotiation in this topic, what TWO negotiating strategies you would have utilized to gain a maximum desired outcome?
Instructions: Part 2: New Managed Care Analyst….You!
1.Read the following scenario:
As the new managed care analyst at XYZ internal medicine the practice administrator has asked you to begin preparations for a managed care contract negotiation with a Health Plan.
2. In addition to reimbursement rates, identify four additional items with a brief explanation of each, which you will address/research on behalf of the medical practice
Instructions: Part 3
Please review the article ” Get Higher Paying”…list three concepts you learned when you were put in the position of negotiating with a managed care plan. ATTACHED
Aim: Abuseof substances such as alcohol, prohibited drugs, and harmful medication has become an increasing social issue around the world. The primary aim of this research topic is to analyse the effectiveness of rehabilitation centres in reducing the ever-increasing problem of substance misuse and also explain how the victims of substance abuserecover from their illness by living or consulting the rehabilitation centres. The idea of rehabilitation centres for such patients is indeed an extraordinary step to get speedy recovery and how Social workers can support people to identify their motivation for change. Policy frameworks that emphasise notions of ‘recovery’ from problematic substance use and a focusing on longer-term change supported by the person’s family, peers and community.
Format: This assignment requires that you write a formal research proposal that presents a research question and proposes a research design to answer it. It should be between 2,500 and 3,000 words (not including cover page, abstract, tables, and references), written in a formal academic format: one-and-a-half or double-spaced, using a 12 point font size throughout your text (preferably Times New Roman, Arial or Calibri), with one-inch margin, page numbers, appropriate headings, and in-text citations and references (preferably Harvard style).
Cover Page
Include a standard cover page with the project title, student number, and module code and title.
Abstract
Include a 100-200 words abstract that will briefly present the background of your topic, the purpose of your study, followed by a description of the research method and design.
Heading: Introduction (approx. 400 words)
This section (building on your Interest Paper) should offer a brief description of a social issue/phenomenon/area of practice, a compelling rationale why this is relevant to social workers and social work and why we should try to address the social issue or phenomenon, and a brief description of what must be learned next to address it.
Briefly describe your chosen social issue/phenomenon/area of practice. This section may include information from other sources (e.g. a scientific journal, a credible web page, newspaper article, or book) that give important background information that help the reader understand the significance of the issue.
Include why this issue is important; why you are interested to study it, and why should we care about this issue? Imagine you are competing for funding to carry out this research or convince your organisation to focus on this issue-this section should convince the funders/organisation why it is important to conduct a study focused on this issue/phenomenon/area of practice.
Heading: Literature Review (approx. 500 words)
Building on your Annotated Bibliography step:
Briefly describe what is already known or what has already been researched on your topic. This section may highlight, for example, what we know about the origins of the social issue, or what we know about its consequences.
This section might also highlight what practice frameworks, policy or interventions already exist to address this issue.
Use at least 5 peer-reviewed journal articles (books, websites, newspaper articles do not count, but you are encouraged to use them as additional sources).
Heading: Research Question, Aim and Objectives(approx. 300)
Link the discussion in your literature review about what is known in the field of research to a gap in the knowledge base or a new problematisation of the issue. This should then link closely to the research question and aim that you will be proposing.
Propose a research question and a research aim that will generate knowledge that will address the unresolved problem. This paragraph should provide a logical argumentation that shows how your research question and aim build off and extend the existing knowledge base. This should reflect an answerable question and a feasible aim.
At the end of this section, state your specific research objectives (ideally no more than 3) and your hypothesis. Your objectives should break down the research question and aim into smaller, logically connected parts that systematically address the various aspects of the problem under study. Your hypothesis is a brief statement that will present your expectations or predictions about the findings of your research.
Heading: Methods (approx. 1500 words in total including subsections)
Subheading: Research Design (approx. 400 words)
Reflect on questions of epistemology and ontology relevant to your field of study.
Describe the setting (e.g. university, placement organisation, social work area, desk research, etc.)
Describe the design of your study and the methods you will use (qualitative, quantitative, or mixed methods? What are some epistemological and ontological considerations that you need to address? If you are doing qualitative, are you doing interviews or focus groups (structured interviews/questionnaires, semi-structured, or open; How will you develop your interview guide?) content or thematic analysis, or extended literature review? If you are carrying out quantitative research how will you collect and analyse your data. For example, you could design a survey and use descriptive methods to analyse your data.
If your study involves research participants, describe the sampling and recruitment strategy. How do you plan to recruit participants and how many? Describe the population.
Subheading: Analysis (approx. 200 words)
For those who will choose qualitative: Briefly describe how you think you will collect data and analyse it. Will you audio record interviews or focus groups? How will they be transcribed? Will you take notes during fieldwork? How will you analyse the data (thematic analysis, content analysis, other)? It would be best to cite a source or two in this section.
For those who will choose quantitative: Briefly describe how you think you will collect and analyseyour data. Will you be using any software (Excel, SPSS, STATA,or something else)? Describe what kind of descriptive statistics you might use to describe your sample (age, gender, race, etc. with means, medians, etc.).
Subheading: Ethics (approx. 300 words)
Please describe at least 3 ethical considerations that you need to take into account in conducting your research. Then provide a plan that will allow you to address these ethical concerns as a researcher (e.g. ethics approval application). Make sure that you use relevant literature guiding your choices, such as research ethics readings, the University of Essex guidelines and procedures (e.g. guidance on ethical approval for research with human participants, research misconduct, research integrity, , and research risk assessment) the BASW code of ethics for Social Work, SWE Professional Standards, etc.)
Subheading: Strengths and Limitations (approx. 300 words)
Briefly discuss at least two strengths AND two limitations of your study methodology. You might want to also reflect on questions of internal and external validity of your study (internal validity examines whether the study design, conduct, and analysis answer your research questions without bias; external validity examines whether the study findings can be generalized to other contexts).
Briefly reflect on what prior connections (social, personal, intellectual, professional, etc.) do you have to your research topic, your research population, the social setting or practice area you plan to study? What prior experiences have you had that are relevant to your topic or setting? How do you think and feel about these social issues, people or social settings? What are your preconceived ideas and assumptions you make about them? What do you wish to achieve or learn by conducting this research?
Please describe what potential advantages do you think these beliefs, presumptions and experiences that you have described have for your project? What potential disadvantages do you think these might create for you, and how might you deal with these?
Concluding remarks and Academic and Professional Development (approx. 300 words)
Briefly reflect back to your topic, available research in the field, as well as aims and objectives of your research, and discuss what do you hope to learn and understand with your study and how is this related to your professional development as a future social worker.
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
Identify one major challenge and one opportunity in intercultural treatment of clients.
After reviewing the NASW Standards for Cultural CompetenceLinks to an external site., explain how clinical social workers can address the challenge and opportunity that you discovered in the intercultural treatment of clients.
Be sure to cite and reference NASW standards in your responses.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.All peer responses are due by Sunday at 11:59 pm CT.Estimated time to complete: 1 hour
After watching the video clip, you will need to answer the following questions:Which of the CEOs would you designate as having the best in body language? Why did you select this individual? Which did you feel had the worst body language? Why did you select this individual?Why is nonverbal communication important?https://youtu.be/gpiUohPPyks
To complete the Case 1 clinical assignment follow these steps:
Go to the following website: https://games.de.torontomu.ca/hospital/
Select “Enter”
You are now in the virtual hospital. Please select “Pediatrics”.
There are TWO scenarios here. You need to complete scenario “1”. To go to this scenario click on the “1” at the bottom of the screen.
You are now at the starting page for the “Pediatric Patient with an Acute Injury and Post-operative Event”. You should see the summary for a 17 year old young man who has had a surgical repair of a lacerated liver. Click on “Play Game”.
You are now on the scenario menu page. You should do the following BEFORE starting a new game:
Review the learning objectives (what you should learn from this scenario) by clicking on “Learning Objectives”. Click on “Close” when you are done reading these.
Review how this scenario process works by clicking on “How to Play”. Click on “Close” when you are done reading the instructions.
Click on “New Game” to begin the scenario.
You will work through multiple videos and questions that ask you what to do next at many points throughout the scenario. If you make an error you will be brought back to the question last asked to allow you to think about your clinical reasoning and prioritization. Please select a different option. Keep going until you complete the scenario.
Once you complete the scenario you should click on the Contents menu button at the top of the end page on the left-hand side.
Click on the link for “Reflection Questions.” Copy and paste these seven (7) questions into a Word document. Answer ALL of the questions on this document. Save the document with YOUR name.
Develop a plan of care for this client at the end the Word document saved in step 10 above. Upload your reflection questions answers and plan of care to the same drop box. Remember that your plan of care MUST meet the needs of both the patient and the family. Remember to prioritize your nursing diagnoses.
You are an assistant practice manager of a medical practice where the physicians specialize in diagnosis and treatment of cancer patients. The mission of the practice encompasses the area of the patient’s mental health associated with a cancer diagnosis. To address the psychological and sociological issues that patients endure, the physicians have decided to Identify and Institute a program/process to address these factors. Your practice manager has put you in charge of the project.
Using the Total Quality Management/ COI protocols, address the following:
Developing a plan:
Describe the premise of the program and/or what goals you would want the program to achieve. In other words, what do you want to accomplish or what is your goal?
List two correctly written specific objectives that you would want to achieve through the program. e.g x% of the patients will show……. (Whatever the outcome that you identified) In other words, at the end of whatever you do, what do you want the patients to have gained?
Describe three specific patient activities/program/process that you believe would be possible techniques for achieving those outcomes. In other words, what are you going to offer to the patients as a means of gaining whatever you want them to gain?
For each of the three specific activities that you considered, discuss the strengths, weaknesses, opportunities, and threats for each.
Identify the one specific activity, from the possible activities above, that you believe is the best option to reach the best outcomes.
Provide details to support your rationale for choosing this one specific activity.
Describe the technique (s) by which you will measure the effectiveness of your activity. In other words, how are you going to find out if the activity really worked?
Present your plan in clear, scholarly, and grammatically correct language. You can choose to present the plan in any format that you think will be most effective in conveying your decision process.
Utilize at least two outside sources of information and cite using APA style.
Unformatted Attachment Preview
RUBRIC FOR Assignment #8 CQI
Criteria
All Criteria Met
17 Points
Most Criteria Met
12 points
Some Criteria Met
7 points
Few Criteria Met
3 points
No Criteria Met
0 points
Premise and
Goals
Describes, in detail,
the premise and
goals of the program
Describes, in some
detail, the premise and
goals of the program
Describes, in minimal
detail, the premise and
goals of the program
Premise is stated but
no details provided
No premise or goal is stated, defined,
or described
Outcomes
Creates two
completely and
clearly
understandable
objectives
Creates two objectives
which are somewhat
difficult to understand
Creates one objective
that is clearly
understandable
Creates one
objective which is
somewhat difficult
to understand
Does not include any objectives
Specific
Activities with
SWOT analysis
Addresses all three
activities in the
assignment and
SWOT in succinct
and clear language
Addresses all three
activities in the
assignment and/or
SWOT with unclear
language
Addresses ONLY
one of the activities
in the assignment
and SWOT with
unclear language
Addresses none of the activities in the
assignment and no SWOT included
Selected
Activity
Identifies and
supports, in detail,
the selected activity
Identifies and
supports, in some
detail, the selected
activity
Addresses 1-2
activities in the
assignment and/or
SWOT with excess
detail and/or unclear
language
Identifies and
supports, with
minimal detail, the
selected activity
Identifies the
selected activity but
provides no support
Does not identify the selected activity
Assessment
Technique
Describes in detail
the assessment
technique to
measure outcome
Writing is smooth
and coherent;
Sentences are strong
and varied.
Correct sentence
construction,
spelling, and
punctuation.
Correct use of APA
style.
Describes, in some
detail, the assessment
technique to measure
outcome
Writing is clear.
Sentences are varied
and mostly interesting.
Few sentence
construction, spelling,
and punctuation
errors.
Describes, briefly, the
assessment technique
to measure outcome
Lists the assessment
technique to
measure outcome,
without description
Writing is often
difficult to
understand
Does not describe an assessment
technique to measure outcome
Style and
Grammar
Uses APA style with
some errors.
Writing is sometimes
difficult to understand.
Sentences sometimes
lack variety and
interest. More than 4
sentence construction,
spelling, and
punctuation errors.
Uses APA style with
many errors.
Does not use correct
APA style.
Writing is confusing.
Sentences lack variety and interest.
Many sentence construction, spelling,
and punctuation errors
Does not cite sources or utilize APA
style
Written Assignment: You will need to complete the Leadership Style Self-Assessment (link within the assignment instructions) and use this information along with your readings to:
Discuss your style of leadership based on the completed assessment
Describe what leadership and management theories align with your leadership style
Discuss the work environment and 3 key actions/behaviors that you must demonstrate to be a successful leader.
Must include 4 references, 2 must be from course materials and 2 from peer reviewed references
Journal articles must be between 2018-2023 unless it is a course material
4 point per day deduction for late assignments
Suggested headings to guide your paper are listed below
Suggested Headings:
Title of paper (centered, bolded)
Introduction paragraph (do not type the word introduction)all
Personal Leadership Style (centered, bolded, and first letter of each word capitalized)
Leadership and Management Theories (centered, bolded, and first letter of each word capitalized)
Work Environment and Key Behaviors (centered, bolded, and first letter of each word capitalized)
Conclusion (if you choose to use this heading it would be centered, bolded) but it is preferred to simply state…In conclusion, at the beginning of the paragraph
The Blake and Mouton Managerial Grid Leadership Self Assessment Questionnaire assessment retrieved from https://www.bumc.bu.edu/facdev-medicine/files/2010…
Complete the leadership style self-assessment under learning activities.
Use information from your assigned readings and the literature related to leadership styles, and leadership and management theories to complete the paper.
Discuss your style of leadership based on the completed self-assessment.
Describe what leadership and management theories align with your leadership style.
Based on your leadership style, discuss the type of work environment, and three key actions or behaviors that you must demonstrate to be a successful leader.
ReferencesMinimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.
Textbooks:Sullivan (2017) Chapters 1, 4, 5, 7, 9, 11.
Articles: Ferreira, T. D. M., de Mesquita, G. R., de Melo, G. C., de Oliveira, M. S., Bucci, A. F., Porcari, T. A., Teles, M. G., Altafini, J., Dias, F. C. P., & Gasparino, R. C. (2022). The influence of nursing leadership styles on the outcomes of patients, professionals and institutions: An integrative review. Journal of Nursing Management, 30(4), 936–953.
Sulllivan, E.J. (2017). Effective leadership and management in nursing (9th ed.). Pearson.
I require someone to describe 100 herbs. It should be a small paragraph for each herb similar to the examples below. Facts only. This is for an informational booklet for health practitioners. References are required at the end of the document. It should include: – what it is – benefits (medicinal use)
Examples
Citrus :
Citrus is a genus of flowering trees and shrubs that produce edible fruits, including oranges, lemons, limes, grapefruits, and tangerines. These fruits are well known for their high content of vitamin C, a potent antioxidant that supports immune system function and collagen production. Citrus fruits also contain a range of other vitamins and minerals, including potassium, folate, and thiamine. Additionally, the flavonoids and carotenoids found in citrus fruits may help reduce the risk of certain chronic diseases, such as heart disease and cancer.
Fibre
Fibre, also known as dietary fibre, is a type of carbohydrate that is found in plant-based foods. Unlike other carbohydrates, fibre cannot be digested by the human body, and instead passes through the digestive system largely intact. Fibre has numerous health benefits, including promoting regular bowel movements, reducing the risk of heart disease, and aiding in weight management. Additionally, fibre can help regulate blood sugar levels and improve cholesterol levels. Good sources of fibre include fruits, vegetables, whole grains, legumes, and nuts.
Also references at the end.
Use the examples as a guideline. Please don’t use ‘you’ ‘your’, ‘our’ ..
Please post a 3-page initial response to the following (A title page is not required and please paste your initial discussion directly into your posting).Consider the statement: If it is not documented, it did not happen from the standpoint of making a claim for services rendered. How is this relevant to the issue of coding E/M procedures and services? [Tips: Coding is limited to the documentation in the patient’s medical record. The medical record is the documentation that supports a claim. If that record is incomplete, the claim is not supportable. Consider the highest levels of E/M services, patient histories and examinations and complex MDM to diagnose and treat the presenting condition].What are some of the advantages of using the CMS guidelines for E/M coding? The assignment of codes from the E/M section is determined by three factors. What are the three factors? [Tip: there are three types of service included in the E/M section]. Why are these factors [Tip: three types of service] important in coding procedures and services in this section?Two patients present with similar symptoms. Both appear to be suffering from pneumonia. One patient is a 55-year-old woman with controlled hypertension and diabetes; the other is an otherwise healthy 24-year-old woman. How would the examination levels differ for the two patients? [Tip: think about patients in regards to dealing with histories, examinations, multiple comorbidities, and levels of complexity MDM (low-complexity, moderate-complexity, and high-complexity MDM)].
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Module 7 Discussion Paper
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Carson Lemon posted Oct 2, 2023 7:31 PM
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Evaluation and Management Coding
Evaluation and Management services, also known as
E/M services, involve documenting and coding all services
provided during medical visits. It includes all patient encounters
and helps to determine the amount of time spent on each
patient and the complexity of that patient care. Like all types of
coding, E/M coding is limited to the documentation in every
patient’s medical record. Likewise, if a patient’s medical record
is incomplete, a medical claim would not be supportable.
When someone uses the statement, “If it is not
documented, it did not happen,” it means just that in the
medical world. Everything that happens between a patient and
physician needs to be documented on a patient’s record; if it is
not, the rest of the medical process is bound to be messed up in
one way or another. Failure to document the entire process
between a patient and physician can result in incomplete
medical records, which leads to difficulty coding and billing for
any services that were provided. Medical documents are
ultimately the best way of communication between patients,
physicians, and providers.
In regard to assigning an E/M code to a patient’s record, there
needs to be proper documentation of all patient care and
services received. If the wrong E/M code is assigned to a
patient, there will be issues involving inaccurate billing and
reimbursement. It is so important to clearly document all E/M
services that a patient receives because these details are
needed to describe and evaluate every patient encounter and
visit. In addition, documenting every aspect of a patient visit to
the hospital serves as a legal and ethical record of this
encounter and all care that was provided. It should clearly state
all details of the patient’s visit, what services were provided,
what supplies were used, what procedures were completed if
any, and exactly why all of these things were provided.
When it comes to E/M coding, there are many
advantages of using the CMS guidelines. These guidelines
provide strict and standardized criteria that helps determine the
correct code for the E/M services provided to a patient. There
is a process to carefully choosing medical codes for every
patient process and procedure, so specific guidelines like the
CMS make the coding process more simplified. The CMS
guidelines also help make sure these codes are accurate and
consistent; this, in turn, helps reduce billing and compliance
issues and risk of audits. If an audit occurs with a healthcare
provider and there is inaccurate documentation, coding, or
billing, it can result in penalties or fines for the organization.
Proper documentation plays a major role in every healthcare
organization, so it becomes an issue for every person within it.
The assignment of codes from the E/M section is determined
by three factors: place of service, type of service, and patient
status. The first factor, place of service, means exactly what it
says. This helps define the location of where a patient received
service, whether that is a main hospital, a clinic, an emergency
department, or another medical site. The next factor is called
the type of service factor, which includes scenarios such as
consultations, regular office visits, hospital admissions, and
other reasons for care. Patient status is the third important
factor, and this determines how codes are grouped based on
what type of patient it is. The most common types of patients
include established patients, new patients, inpatients, and
outpatients.
In addition, there are three key components that include
medical history, examination, and medical decision making
(MDM). Medical history simply includes all history relevant to
that current patient. The examination refers to the actual
physical examination of the patient; this includes checking vital
signs and addressing any abnormalities. The last component,
the MDM, takes into consideration the patient’s overall health
and any conditions that may be present in order to come to a
medical conclusion and treatment plan.
Although there are guidelines that need to be followed when
addressing each patient, every exam is tailored to that specific
patient’s needs. In the case we were given to investigate, there
are two patients which include a 55-year-old woman with
hypertension and diabetes, and a healthy 24-year-old woman.
Both patients seem to be suffering from pneumonia and
present similar symptoms to their physician. The patients’
physicians will need to take a close look at both patients’
medical histories, where they will find the older woman has a
more concerning history of hypertension and diabetes, while
the younger woman has less illness reported. Because of these
differences, both patients will need slightly different exams
although they need the same illness treated in the end. The
younger patient will have more of a simple, symptom-focused
examination, which can also be known as an expanded
problem-focused history level. The older patient, on the other
hand, will receive a detailed history level and a more thorough
examination because of her underlying conditions.
Overall, Evaluation and Management Services rely on proper
medical documentation and certain guidelines to ensure the
entire medical process with each patient goes as smooth as
possible. All patient-physician encounters need to be accounted
for, and all coding needs to be conducted accurately. Every
aspect of coding is so important and contributes to the
healthcare experience.
Module 7 Discussion Paper
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Emily Landewee posted Oct 2, 2023 1:17 PM
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Evaluation and Management Services
Coding takes skill and very precise information to accomplish it
correctly. If the wrong information is documented or the
information is not documented at all, there can be problems
that arise. This can be relevant to coding E/M procedures and
services. The first section of the CPT manual is Evaluation and
Management. The E/M section is divided into categories and
provides different codes for the areas of service that it covers.
CMS guidelines direct E/M documentation and provide
information to help the coding process run smoothly. Medical
decision making is another tool used for E/M procedures and
services to document the levels of complexity in the decision
making process. Evaluation and management services have
many different parts, but each is required to document the
information correctly.
The information in a patient’s medical record has many uses
regarding the patient’s care. These uses include evaluation of
the patient’s treatment, reimbursement claims, communications
regarding the patient’s care, and legal documentation. All
information should be legible and complete to provide the
necessary details for coders to do their jobs correctly. The
statement, “If it is not documented, it did not happen,”
regarding making a claim for services provided, is relevant to
the issue of coding E/M procedures and services. The levels of
E/M service are based on the information documented in a
patient’s medical record. Some of the key components to help
distinguish the levels of service include history, examination,
and medical decision making complexity. Without documenting
the correct information or any information at all in these areas
could result in faulty coding and incorrect claims for E/M
procedures and services. If this occurs, there can be many more
issues that arise from improper medical documentation that
greatly affects the care the patient receives.
Three factors determine the assignment of codes from the E/M
section. These include place of service, type of service, and
patient status. These are all important in coding procedures
because they help determine what codes are used. The place of
service factor explains the setting where the service is provided
to the patient. For example, codes vary based on the place of
service like physician offices, emergency departments,
hospitals, and nursing homes. The type of service factor
describes why the service is requested or performed. Some
examples of this factor include consultation, admission,
newborn care, and office visit. The patient status factor is
another big determinant in what codes are used. The CPT
manual codes are grouped according to the type of patient.
Some patient types include new patient, established patient,
outpatient, and inpatient. All of these factors within the E/M
section help clarify patient information and allow for more
organization in medical coding.
In the American healthcare system, Medicare recipients make
up the majority of patients. The Centers for Medicare and
Medicaid Services (CMS) is currently devising new ways to
document claims associated with E/M services for Medicare
patients. Any changes to Medicare can leave drastic effects on
the healthcare system, so CMS devised nationally uniform
requirements for documenting E/M services. The standards
CMS devised are called Documentation Guidelines. These are
important to note because while they only apply to Medicare
and Medicaid patients for now, in the future, this
documentation or similar documentation requirements will
spread to other third party payers since CMS leaves such a big
footprint in the healthcare system. There are many advantages
of using the CMS Documentation Guidelines. One advantage of
the documentation guidelines is that they present the
information needed to explain what needs to be contained
within a medical record to qualify it as documentation. This
helps all of those with access to patient records to understand
exactly what needs to be put in the system for the information
to count as documentation. If something is left out, it can be
marked as incomplete. Another advantage is included in the
1997 Documentation Guidelines. These guidelines state the
information needed in the medical record for an E/M service to
qualify for a given level of service. Both of these advantages
allow for more details to be put into a patient’s record to better
the healthcare they receive.
Examination levels differ between every patient. In this case,
there are two patients who both seem to be suffering from
pneumonia. The first patient is a 55-year-old woman with
controlled hypertension and diabetes. The second patient is a
24-year-old woman who seems rather healthy. Since
pneumonia can be dangerous or life threatening if untreated,
urgent medical attention is needed. The first thing a physician
would review is each patient’s history. While the second
patient has nothing to report in the history, the first patient has
a history of present illness from her controlled hypertension
and diabetes. In these cases, the second patient would have an
expanded problem focused history level, and the first patient
would have a detailed history level due to her previous
illnesses. The second step a physician would take is the
examination to provide objective information. Since pneumonia
can affect other areas of the body besides the lungs, I would
assign an expanded problem focused examination level to the
24-year-old to check any symptomatic body areas. I would
assign a detailed examination level to the 55-year-old since she
has previous illnesses. Lastly, the physician would use the levels
of medical decision making. For the second patient, I would
give her a low-complexity decision making level since she has
limited data to be reviewed and a low risk of complications. For
the first patient, I would give her a moderate-complexity
decision making level since she has multiple illnesses, moderate
amount of data to process, and a moderate risk of
complications. These examples show just how important it is to
treat each patient based on their individual needs because
every patient is different.
Evaluation and management services have many details and
tools that are used for proper documentation. CMS guidelines
provide information to help coders know how to document
E/M services correctly and update them on new changes to the
system. The different factors of the E/M section provide
organization to the information and the MDM provides a tool
for physicians to use to ease the complexity of the decision
making process. All of these parts work together to help
document and code information correctly.
Reference
Buck, C. J., & Koesterman, J. L. (2022). Chapter 11. In 2022
Buck’s Step-By-Step Medical Coding (pp. 273–333). Elsevier.
Module 7 Paper
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Tara Sepe posted Oct 1, 2023 3:06 PM
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Evaluation and Management Documentation
Properly documenting Evaluation and Management (E/M) services is
crucial for the world of healthcare. The levels of E/M service are based on
documentation located in the patient’s medical record supporting various amounts
of skill, effort, time, responsibility, and medical knowledge. These are used by the
physician to provide services to patients. The levels of service are based on key
components. These include history, examination, and medical decision-making
complexity. Another aspect of the E/M service is based on contributory factors.
These include counseling, coordination of care, nature of presenting problem, and
time.
The statement “If it is not documented, it did not happen”, in the context of
coding E/M services, is extremely crucial for things such as reimbursement,
medical necessity, and auditing. Although it may seem tedious, documenting
everything a physician does, sees, and diagnoses is important for reimbursement
purposes. For example, it helps with determining the level of the services provided
to the patient. This then will directly affect the amount the organization is
reimbursed. When documentation is done correctly, it ensures that the entire
reimbursement process is done correctly with zero issues. Another thing that could
be affected by incorrect documentation is medical necessity. Documentation is
“evidence” of the medical necessity of a service or procedure rendered to a patient.
Documents should clearly state why specific E/M services were performed and
why it was necessary to perform them on that specific patient. The last aspect that
could be affected by not documenting correctly is auditing. Auditing is a huge part
of keeping healthcare organizations up and running. If physicians, nurses, or
doctors are not documenting services correctly, organizations could crumble due to
the auditing process. It could lead the organization to recoup payments and
penalties. Organizations must be careful with the process of documenting E/M
services correctly.
There are plenty of advantages to using the CMS guidelines for E/M
coding. The first advantage is the accuracy of documentation. Following CMS
guidelines, healthcare providers can reflect the complexity of the services provided
to said patient. Because of this, they can assign E/M codes more accurately. This is
extremely crucial because it allows the organization to be properly reimbursed and
follow all compliance guidelines. Properly documenting services will also go well
when audits are conducted on the organization. Another advantage of following
CMS guidelines includes clarity of instructions. The CMS guidelines give
physicians and other providers clear instructions on how to select the correct level
of E/M services based on the three factors of E/M services, which will be discussed
shortly. The clarity of these instructions also decreases ambiguity in the overall
coding process. Lastly, consistency is an advantage of using the CMS guidelines to
code E/M services. When using the same set of guidelines to code E/M services, it
is easy to get used to it and harder to make mistakes. As we have learned, there is
no room for error in any aspect of documenting and coding.
The three factors of the E/M section to assign codes are history,
examination, and medical decision-making (MDM). History is as simple as it
sounds, it includes the patient’s medical history. The examination is the physical
examination of the patient. It includes vital signs or any physical abnormalities.
Lastly, medical decision-making includes the complexity of the patient’s condition
as well as the overall decision-making process. These all reflect the clinical
information that the physician records in the patient’s medical record. Key
components are present in every patient case except for counseling. History and
examination, however, are no longer considered key components for codes. They
are now considered “medically appropriate”. Key components enable you to choose
the appropriate level of service. Things such as new patient encounters,
consultations, emergency department visits, and admissions require documentation
of all three key components. Regular/daily hospital visits only require two of the
three key components.
Two patients present with similar symptoms. Both appear to be suffering
from pneumonia. One patient is a 55-year-old woman with controlled hypertension
and diabetes; the other is an otherwise healthy 24-year-old woman. Both patients
will experience different examinations. The 55-year-old most likely has
comorbidities or other complications. Because of this, she will need a more indepth analysis to ensure there are no other complications. This examination will
include vital signs, an examination of the respiratory system, and a thorough check
for other issues related to diabetes. Other tests will include X-rays of the lungs, or
blood tests. With all these things in mind, factors such as her age as well as other
medical issues would reflect how complex her documentation will be. The 24-yearold woman, on the other hand, would have an examination that will focus more on
her symptoms related to the pneumonia. Her examination will include vital signs,
examination of the lungs/respiratory system, and fewer additional examinations
than the 55-year-old because she is not known to have any chronic conditions
affecting her health.
Overall, proper documentation of Evaluation and Management services is
crucial for several reasons. These reasons include accurate reimbursement, medical
necessity, and passing audits conducted on your organization. We have also learned
about the advantages of following CMS guidelines for E/M coding. Lastly,
accurately examining a 55-year-old and 24-year-old for pneumonia symptoms is
crucial so there will not be any unnecessary tests conducted on the patient.
Evaluation and management services are important concepts to know for coders,
and it is crucial they are aware of everything mentioned in this response.
Module 7 – Discussion Paper
Contains unread posts
Jessi Marin Guarin posted Sep 25, 2023 4:32 PM
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Importance of Documentation in E/M Coding and CMS
Guidelines
The procedure of allocating Evaluation and Management (E/M)
codes is essential in the realm of healthcare billing and
compensation. E/M codes, which include anything from simple
check-ups to difficult assessments, are a representation of the
extensiveness of the treatments offered during a patient
interaction. These codes have a big impact on the money side
of healthcare, setting reimbursement rates and revealing the
complicated nature of individual cases. The precision and
thoroughness of medical records, however, are crucial for
correct E/M classification. The saying “If it is not documented,
it did not happen” aptly sums up E/M coding and emphasizes
the critical importance of complete records to the claim’s
procedure.
The maxim “If it is not documented, it did not happen”
highlights how important it is for claims to be supported by
medical documentation when it comes to healthcare billing. The
medical record of an individual must accurately reflect all
activities taken by a physician during the patient’s evaluation
and treatment. This record serves as concrete evidence of the
care delivered and serves as the foundation for coding practices
and services. A claim may not be supported by correct,
insufficient, or missing supporting evidence, which could result
in erroneous billing and monetary damage. To prove the
difficulty of the patient encounter and the services provided,
comprehensive documentation is especially important for
additional types of E/M services, such as those requiring
complicated medical decision-making or in-depth histories of
individuals.
Comprehensive E/M coding guidelines have been published by
the Centers for Medicare & Medicaid Services (CMS), offering a
uniform framework for healthcare practitioners to assign the
proper codes to patient interactions. The coding process can
benefit from using these recommendations in a number of
ways. First of all, CMS guidelines offer precise and uniform
criteria for figuring out how difficult patient encounters are,
guaranteeing uniform coding procedures among healthcare
professionals. Second, following CMS criteria makes it easier to
assign codes accurately, which lowers the risk of mistakes and
ensuing claim denials. Additionally, adhering to these
recommendations encourages adherence to legal and
regulatory obligations, improving the honesty and openness of
the billing and reimbursement process.
The individual history, assessment, and medical decision
making (MDM) are three important aspects that affect how
E/M codes are assigned for an individual session. An
assessment of the individual’s past, involving previous medical
issues, familial history, and social circumstances, is called
patient history. The examination involves a detailed assessment
of the patient’s present health, including a review of several
body systems and the scope of the examination. A diagnosis
must be made, the best course of therapy must be determined,
and the risk associated with the selected management strategy
must be considered while making a medical choice. These
elements play a critical role in the E/M section’s classification
of procedures and services because they offer a structured
method for classifying the degree of service offered in
accordance with the complexity and extent of the patient
interaction.
Think about two patients who have similar symptoms but
different backgrounds: a 24-year-old woman who has no
comorbidities and a 55-year-old woman with managed diabetes
and hypertension. These individuals would undergo
examinations at various levels. Due to the existence of
comorbidities, a more thorough examination would be
necessary for the 55-year-old individual with managed diabetes
and hypertension. This would call for an extensive assessment
to determine any possible interactions or treatment
implications. On the other hand, a focused examination that
concentrates on the specific symptoms reported may be
sufficient for the 24-year-old individual who has no
comorbidities. To guarantee precise coding and proper
reimbursement, it is crucial to personalize the evaluation
according to patient histories, assessments, the existence of
comorbidities, and the difficulty of medical decision-making.
Finally, E/M coding plays a crucial role in medical billing and
payment, having a big impact on the financial facets of
healthcare services. However, the thoroughness and quality of
medical documentation are closely related to the accuracy and
dependability of E/M coding. The maxim “If it is not
documented, it did not happen” sums up the crucial connection
between accurate documentation and claim supportability. The
accuracy and consistency of E/M coding are further improved
by following CMS recommendations, which also streamline the
coding procedure and encourage adherence to regulatory
standards. The three key factors—patient history, examination,
and medical decision making—provide a structured framework
for code assignment, enabling an objective assessment of the
complexity of patient encounters. Understanding how these
factors interplay in different patient scenarios underscores the
importance of tailored examination levels to ensure precise
coding and equitable reimbursement. Ultimately, an informed
and meticulous approach to E/M coding is vital in delivering
quality healthcare while navigating the complex landscape of
medical billing and reimbursement.
Guidelines:Cover sheet should be attached with assignmentComplete student’s information on the first page of the document.Font should be 12 Times New RomanLine spacing should be 1.5The text color should be “Black”The length of the paper assignment should be 500-700 words.Use proper references using APA format. Please see below link about how to cite APA reference style.https://guides.libraries.psu.edu/apaquickguide/int… Do proper paraphrasing to avoid plagiarism
1. Investigate the following health issues:
a. Lung disease and air pollution
b. Birth defects and hazardous waste
c. Cancer and radiation leakage from a power plant
2. Present statistics on each health issue.
3. Discuss ecologic fallacy for each health issue.
4. Analyze risk factors for each health issue.
5. Examine three (3) health promotion activities that the APRN should include.
6. What are the implications for future epidemiology research?
7. The scholarly paper should be in narrative format, five (5) to six (6) pages excluding the title and reference page.
8. Include an introductory paragraph, purpose statement, and a conclusion.
9. Include level 1 and 2 headings to organize the paper (see suggested level 2 headings above).
10. Write the paper in third person, not first person (meaning do not use ‘we’ or ‘I’) and in a scholarly manner. To clarify: I, we,
you, me, our may not be used. In addition, describing yourself as the researcher or the author should not be used.
11. Include a minimum of 5 professional peer-reviewed scholarly journal references to support the paper (review in Ulrich
Periodical Directory) and be less than five (5) years old.
12. APA format is required (attention to spelling/grammar, a title page, a reference page, and in-text citations).
Scenario
You have recently started a position as a department director with five managers reporting to
you. Earlier today, one of your managers reports that a client expired on her unit. She suspects
that a factor that may have contributed to the client’s demise may be related to the actions of a
nurse on her unit. This nurse has several notes in her personnel file that reflect potential client
abuse. You and the nurse manager both have concerns that this sentinel event must be
investigated.
Later in the day, the Chief Nursing Officer asks you to speak to new nurse managers to share
attributes of leadership with the plan of enhancing their leadership skills. You see an
opportunity to combine the situation of the client with a bad outcome, due to the alleged
influence of one of the nurses, while building information to share this real-life situation with
new nurse leaders.
Instructions
As a follow up to the investigation of the client’s unexpected death, generate an internal memo
to your managers to reflect leadership and management attributes and include steps taken to
investigate this unfortunate situation. As you create this memo, keep in mind that you should
include:
• At least five leadership and/or management attributes for nurse leaders, as well as how
they can improve client outcomes.
• Steps you would take to ensure the collection of data regarding this incident.
• Describe how transformational leadership style may influence the process of
investigating this professional nurse colleague that reports to one of your unit
managers.
• Provides stated ideas with professional language and attribution for credible sources
with correct APA citation, spelling, and grammar.
Scenario
You have recently started a position as a department director with five managers reporting to
you. Earlier today, one of your managers reports that a client expired on her unit. She suspects
that a factor that may have contributed to the client’s demise may be related to the actions of a
nurse on her unit. This nurse has several notes in her personnel file that reflect potential client
abuse. You and the nurse manager both have concerns that this sentinel event must be
investigated.
Later in the day, the Chief Nursing Officer asks you to speak to new nurse managers to share
attributes of leadership with the plan of enhancing their leadership skills. You see an
opportunity to combine the situation of the client with a bad outcome, due to the alleged
influence of one of the nurses, while building information to share this real-life situation with
new nurse leaders.
Instructions
As a follow up to the investigation of the client’s unexpected death, generate an internal memo
to your managers to reflect leadership and management attributes and include steps taken to
investigate this unfortunate situation. As you create this memo, keep in mind that you should
include:
• At least five leadership and/or management attributes for nurse leaders, as well as how
they can improve client outcomes.
• Steps you would take to ensure the collection of data regarding this incident.
• Describe how transformational leadership style may influence the process of
investigating this professional nurse colleague that reports to one of your unit
managers.
• Provides stated ideas with professional language and attribution for credible sources
with correct APA citation, spelling, and grammar.
NO PLAGIARISM-CHECKERS WILL USED TO CHECK FOR COPY WORK OF PLAGIARISM
W6: Interactive Activity
W6: Interactive ActivityRead the following:- Enhancing Community-Based Participatory Research Through Human-Centered Design Strategies
Watch the following video(s):
Human Centered Design
Interactive Activity 5
Purpose
The purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos.
Action Items
Describe human centred design strategies and how the effect healthcare?
Guidelines:Cover sheet should be attached with assignmentComplete student’s information on the first page of the document.Font should be 12 Times New RomanLine spacing should be 1.5The text color should be “Black”The length of the paper assignment should be 500-700 words.Use proper references using APA format. Please see below link about how to cite APA reference style.https://guides.libraries.psu.edu/apaquickguide/int… Do proper paraphrasing to avoid plagiarism
For the discussion this week, you may select either one of the issues presented in the course or a different issue which is nationally or globally relevant, and which in your opinion has become divisive in terms of public opinion. Respond to the following prompts/questions.Introduce your issue to include the origin, relevance, and current state of your issue both within the United States and globally.Describe your personal view regarding the issue and defend your view with evidence or personal experience.What additional information do you believe needs to be shared with the public to better inform and align stakeholders on the issue?What do you believe is the biggest roadblock to achieving public consensus regarding the issue?Please be sure to validate your opinions and ideas with citations and references.
hello, i need help with replying to these two disscussions. Rubric is “Both reply must have new information inthe response post Do not simply state – you enjoyed or agree or redo your post etc. Expand on the topic , use citations to receive points.
here are the two disscussions to reply to
1. Behaviors you may notice in a coworker using.
Substance use disorder (SUD) is a challenging and complex issue for the nursing profession. If a nurse has not had a long standing problem with substance abuse, changes in behavior might be the first thing co-workers notice. Behavioral signs may include: A lack of concentration, with frequent errors, hyperactivity and euphoria, joking and laughing a lot and seemingly not affected by the stress of the job, hypoactive, decreased quality of care, isolation from their co-workers, frequent anger and defensive behavior,arriving for work late, frequent requests to leave early and calling in sick often.
There are many clever ways in which addicted nurses get drugs. The frequent occurrence of one or more of the following should serve as a red flag: Increased narcotics sign-outs when a specific nurse is on duty. Frequent errors in narcotic counts, narcotic records or patient’s medication records. An unusual number of requests for signing out wasted narcotics. A particular nurse’s patients regularly complaining of not having the expected pain relief even after receiving their pain meds. A nurse who regularly offers to give co-workers’ patients their medication.
Changes made to verbal or telephonic orders for narcotic medication.
2. Concequences of nurses who have used drug from their work places
Substance abuse is a pervasive issue that knows no boundaries, affecting people from all walks of life. In recent times, the spotlight has turned towards an alarming trend – substance abuse among nurses. This concerning development has the potential to impact not only the lives of healthcare professionals but also the safety and well-being of patients.
The consequences of substance abuse among nurses are far-reaching. Patients may face compromised care and potential errors, leading to adverse outcomes.
The author also mentioned additional consequence , which include facing legal troubles like criminal charges and the possibility of going to jail. Nurses could also have their nursing licenses revoked, which would stop them from working in their field. Furthermore, nurses engaged in drug diversion put their professional reputation at risk, fostering distrust among their colleagues and imposing significant financial burdens on healthcare institutions (Cox, 2022).
To assist nurses facing drug-related issues, specialized programs, such as the Alternative Treatment Principle (ATPs), are designed to aid their rehabilitation without jeopardizing their employment. For example, nurses can pursue substance abuse treatment while retaining their professional licenses (Brent, 2018). These initiatives prioritize nurses’ recovery and support instead of emphasizing punitive measures
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
Choose one of the cases presented in the readings this week.
Apply one of the attachment theories to understand the client and approaches you would take.
What are the limitations of this theory?
OR
Describe client situations where attachment theory or task theory would be helpful in working with a client.
How will these theories prepare you to understand their behaviors and emotions?
Discuss the limitations of the theory including cultural differences of attachment theory.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.All peer responses are due by Sunday at 11:59 pm CT.Estimated time to complete: 1 hour
You are taking care of a 37 year old male with Crohn’s disease. This is a new diagnosis for him, after months of weight loss, fever, and diarrhea. Considering this please address the following prompts in your discussion:Pick one assessment finding you are likely to see during your examination of this patient. Examples could be, but not limited to, pain, alteration in nutrition, a specific lab alteration (hypokalemia, low H & H, etc)How does this finding compare to what you would find in a normal adult male exam?Explain the pathophysiology of this finding.Discuss the specific nursing assessment related to the selected alteration.Discuss the nursing care you would implement to promote health.Cite any resources/references in APA formatting that were used in the discussion.
Based upon this module’s Learn material, address the following:1. What are some of the key issues related to job loss and in what type of job-related scenarios might first responders be called to help?2. Describe some of the unique stressors that caregivers face and how can the church help?3. What are “stay alive contracts” (aka “suicide contracts) and how effective are they?4. What is “complicated grief” and how can sufferers be stabilized?Follow the guidelines in the doc as well. Thanks in advance!
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CRIS 605
DISCUSSION ASSIGNMENT INSTRUCTIONS
The student will complete 4 Discussions in this course. For each Discussion, you will post one
thread of at least 450 words by 11:59 p.m. (ET) on Thursday of the assigned module. The student
must then post 2 replies of at least 250 words by 11:59 p.m. (ET) on Sunday of the assigned
module. For each thread, you must support your assertions with at least 2 scholarly citations.
Acceptable sources include the course textbooks, academic journals and books, and
academic/educational/institutional websites. The Bible should be used at least once per
Discussion. Any sources used must have been published within the last five years and be cited in
current APA or Turabian formatting standards.
This area provides you an opportunity to reflect on what you have learned, at this point of time, and what concepts you still need further exploration on.Submit your post by Wednesday 11:59 pm MT and include a short summary of what you have learned (2-3 sentences) and 1 or 2 questions related to concepts that are still unclear.Faculty will review this discussion and address common questions in the forum or during synchronous time.You are encouraged to interact with other students and reply to their posts and questions.This checkpoint will also serve as a weekly attendance tracker
Guidelines: Cover sheet should be attached with assignmentComplete student’s information on the first page of the document.Font should be 12 Times New RomanLine spacing should be 1.5The text color should be “Black”The length of the paper assignment should be 500-700 words.Use proper references using APA format. Please see below link about how to cite APA reference style.https://guides.libraries.psu.edu/apaquickguide/int… Do proper paraphrasing to avoid plagiarism
Answer to the following prompts: What are your reactions to the “killer brain videos”? Explain how genetics and the environment play a role in psychopathology. What are your takeaways from Carey & DiLalla’s article (What did you learn about the twin studies and the intersectionality between gene and environment)? Lastly, heredity is powerful… it can advance the human race and can also pass on many debilitating/ life-threatening diseases. What are your thoughts on eugenics? Can just improving human heredity (for example: “eliminating the feeble-minded”) immune the human race from detrimental illnesses (physical and psychological)? In your opinion, why is the concept of eugenics problematic? -Refer to the videos and readings posted under the ‘course materials’. (1004) Chapter 1 | The Eugenics Crusade – YouTube (1004) Three Ingredients for Murder: Neuroscientist James Fallon on psychopaths and libertarians – YouTube 26088739 (blackboardcdn.com)
TA is a 24-month-old male with Down syndrome who presents to the office accompanied by his mother for abdominal pain x2 days. Mom reports, per her boyfriend TA, had a “fall from the bed during a nap and the problems started after that.” Physical exam notable for tachycardia, tachypnea, hypotension, and lethargy; skin is pale, cool, clammy, and slightly mottled, toe capillary refill 4 seconds, dental caries, and a diffuse diaper rash. Bowel sounds hypoactive, abdomen is distended, and firm, with ecchymoses overlying the epigastrium area; tenderness on palpation, guarding, and rebound tenderness. Faint circumferential macular discoloration at wrists consistent with aging ligature marks. Pertinent negatives include fever, lung sounds CTA or head trauma. Past medical history is significant for AV-septal repair with transient CHF, and global developmental delay. TA is often watched by mom’s boyfriend or neighbor while she works. Address the following questions: What resources are available in your community to assist with concerns such as those faced by your virtual patient? there is concerned for child abuse and neglect and low income What are the reporting requirements for your state and to whom would you report? Include the following components: write 150-300 words in a Microsoft Word document demonstrate clinical judgment appropriate to the virtual patient scenario cite at least one relevant scholarly source as defined by program expectationsLinks to an external site. communicate with minimal errors in English grammar, spelling, syntax, and punctuation
Guidelines: Cover sheet should be attached with assignmentComplete student’s information on the first page of the document.Font should be 12 Times New RomanLine spacing should be 1.5The text color should be “Black”The length of the paper assignment should be 500-700 words.Use proper references using APA format. Please see below link about how to cite APA reference style.https://guides.libraries.psu.edu/apaquickguide/int… Do proper paraphrasing to avoid plagiarism
Now that you have explored and developed many of the components to resolve a gap in practice, it is time to pull it all together! The purpose of this assessment is to develop skills in creating a cohesive argument using data and feedback from the course Assessments.
This assessment may lay the foundation for the doctoral project you will create later in your program, along with creating a capstone project charter, in which you will identify the evidence to support the need for your intervention. So, consider this a “trial run” of writing your doctoral project, and not the real thing.
PART 1: INTRODUCTION AND PICOT QUESTION
Using feedback and evidence from Assessments 5 and 6, create a 1–2 paragraph introduction to this paper that identifies the gap in practice.
End this introductory section with a clearly stated PICOT question that has an appropriate scope for a DNP project, and the proposed outcome measures match the proposed intervention.
PART 2: ANALYSIS AND SYNTHESIS OF RESEARCH
In this section, refine the Assessment 5 literature synthesis based on feedback from that assessment and substantiate the need for a project.
Analyze and synthesize your research related to a gap in practice for a specific organization.
Address whether the evidence you found is strong enough to substantiate your practice gap.
Identify areas of uncertainty, knowledge gaps, or a need for additional information to support a more complete understanding. Additionally, identify areas where further research is needed.
PART 3: RECOMMENDATIONS TO STAKEHOLDERS
Now that you have identified a gap in practice, and shown there is research to substantiate this gap, it is time to make recommendations to your stakeholders to address it.
In this section:
Using feedback and references from Assessment 6, make clear recommendations for an intervention that is appropriate for a sponsoring organization based on the analysis and synthesis of articles related to your project topic.
Analyze and synthesize your research related to a gap in practice for a specific organization.
Address whether the evidence you found is strong enough to substantiate your practice gap.
Identify areas of uncertainty, knowledge gaps, or a need for additional information to support a more complete understanding. Additionally, identify areas where further research is needed.
PART 4: COMMUNICATE WITH STAKEHOLDERS
In this section, explain how you plan to tailor your message to an implementation team. Describe strategies for making your communication clear, understandable, and respectful of the needs of this specific group. Consider how you would handle challenges, such as pushback or non-compliance.
PART 5: USING FEEDBACK TO IMPROVE WRITING
Receiving and implementing feedback is an important part of how we grow and improve as professionals. Throughout this course, you have received feedback on each assessment, and you were encouraged to use that feedback to improve your writing.
In this section:
Reflect on how you used feedback to improve your writing throughout the course.
How has implementing writing feedback moved your work closer to one or more of the writing quality indicators identified in the Writing Feedback Tool?
How do you plan to use feedback in your professional career?
PART 6: CONCLUSION
Conclude your assessment with a brief synthesis of the main points you covered. No new information should be provided in this section, as its purpose is to provide closure for the paper.
ADDITIONAL REQUIREMENTS
Sources: 10 minimum; use the same resources from Assessment 5 and Assessment 6.
APA Formatting: Provide in-text citations and full reference page for all outside sources.
Length: Your paper should not exceed 8 pages; page count does not include title page and reference page.
GRADING CRITERIA
Your assessment will be graded using the following scoring guide criteria:
Construct an introduction that provides an overview of your gap in practice, and ends with a PICOT question in the correct format, and is an appropriate scope for a DNP project.
Synthesize research related to a gap in practice, including appropriateness for a specific organization.
Make recommendations, including possible solutions, planned actions, and appropriateness for a sponsoring organization, based on the analysis and synthesis of articles related to a project topic.
Explain how you will tailor your message to your implementation team.
Conclude with a synthesis of your main points.
Produce text with minimal grammar, usage, spelling, and mechanical errors.
Apply APA formatting to in-text citations and references.
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1
Much improved
Difference between a Quality Improvement (QI) or Project Improvement (PI) Project and
Research Study
School of Nursing and Health Sciences, Capella University
NURS-FPX8045 Doctoral Writing and Professional Practice
Dr. Peggy Soper
August, 2023
Beautiful title page !!!
2
Difference between a Quality Improvement (QI) or Project Improvement (PI) Project and
Research Study
•
You cant use the it word = lacks reader clarity
M (Main Point): The main difference between Quality Improvement (QI) or Project
Improvement (PI) and a research study is that QI/PI projects are focused on improving
performance in a single facility using existing evidence, while research is focused on producing
evidence that can be generalized to practice. LOVE THAT E (Evidence): The proposed
doctoral project is a QI/PI project because it is focused on improving care for an underserved
community rather than systematic investigation. The project outcome aims to fulfill the urgent
need for an outpatient substance abuse program in an underserved community located in Miami,
FL. Research studies often subjective seek to generate new evidence through systematic
investigation, with human subjects’ recruitment but QI/PI projects such as the proposed project
apply current evidence to improve outcomes or practice (Knudsen et al., 2019). A (Analysis):
The generation of new evidence, as in research, is a systematic and closely controlled process of
investigation with the goal of producing evidence that can be used in various facilities or settings
to address the investigation issue. The proposed outpatient substance abuse program in Miami,
FL, aims to improve current substance abuse care in the community rather than produce new
evidence. It is, therefore, a QI/PI project rather than a research study. L (Lead out): QI/PI
projects are ideal for doctoral projects with the aim of healthcare services and practice
improvement, such as the proposed outpatient substance abuse program in Miami. They APA
proclaims when you use the word they you better be discussing human and you are not PI/QI
differ from research because they PI/QI focus on quality improvement rather than generating
new evidence.
3
Reference
Knudsen, S. V., Laursen, H. V. B., Johnsen, S. P., Bartels, P. D., Ehlers, L. H., & Mainz, J.
(2019). Can quality improvement improve the quality of care? A systematic review of
reported effects and methodological rigor in plan-do-study-act projects. BMC Health
Services Research, 19, 1-10. https://doi.org/10.1186/s12913-019-4482-6
1
Interprofessional Communication and Practice Gap
School of Nursing and Health Sciences, Capella University
NURS-FPX8045 Doctoral Writing and Professional Practice
Dr. Peggy Soper
September, 2023
2
Interprofessional Communication and Practice Gap
Quality improvement (QI) and practice improvement (PI) projects are developed based
on assessing existing gaps in practice and opportunities for improvement. Substance abuse is one
of the crucial topics in community health in the United States, and healthcare professionals strive
to promote access to care for affected people. In Little Havana, Miami, many people with an
addiction or are at risk of addiction do not have access to timely substance use treatment
programs. Improving the current screening for substance use disorders can help promote access
to care. In this paper, a discussion of a gap in practice in substance use programs in Miami,
Florida, and the interprofessional collaboration skills that have been applied in proposing the
change is advanced.
Practice Gap
The identified practice gap is low avoid all use of subjective terms of measure in a APA
exact paper utilization of substance use treatment services despite high subjective addiction rates
in the community. There are several substance use treatment programs in Little Havana and
across Miami. However, few people seek care in these facilities, and most of those do have
severe addiction problems. Despite the presence of substance use treatment services, there is a
gap in how people who need these services access them. Avoid all pronouns The gap is due to
inadequate screening and referral to the available programs. The proposed project will close the
gap by providing screening and brief intervention training. Wait the gap is not enough screening
or not enough resources
You said it both ways
Multiple factors affect access to substance use treatment programs, including
socioeconomic factors and knowledge of the appropriate treatment resources. This project
focuses on the Banyan Health System in Little Havana, FL. The community health organization
has a substance abuse program, but nurses working in the center have reported the lack of
3
adequate services in the Little Havana location. Little Havana has a high poverty level, with
around 39.1% of the population living below the poverty line (Briseus et al., 2021). Low-income
populations have relatively high levels of substance abuse and poor access to healthcare services,
leading to poor overall health outcomes (Beech et al., 2021). Stigma and lack of knowledge on
where to go for substance use treatment services are also important determinants of access to
care (Solberg & Nåden, 2020). Socioeconomic challenges can be handled through referral to
appropriate facilities that provide affordable or free services. Stigma and lack of knowledge can
be addressed by normalizing screening for substance use disorders and timely provision of
information on treatment options (Bunn et al., 2019). Timely assessment, brief intervention, and
referral to appropriate treatment may improve access to and utilization of substance use
treatment services.
The proposed project will focus on introducing Screening, Brief Intervention, and
Referral to Treatment (SBIRT) guidelines in Little Havana to improve early detection of
addiction disorders and timely intervention. The PICOT question construct is helpful in clearly
outlining the variables of the QI project. The proposed PICOT question is: For the staff caring
for patients in the community mental health center (P), how does training and policy for routine
Brief Intervention and Referral to Treatment (SBIRT) implementation (I) compared to current
practice (C) affect the use of substance use treatment services (O) in twelve weeks (T)?GOOD
In this question, the proposed intervention is training staff on conducting SBIRT and creating a
policy for SBIRT implementation. The intervention will be based in a Community Mental Health
Center in Little Havana, and the expected outcomes are increased utilization of substance use
treatment services.
Interprofessional Communication
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Open communication lines and shared decision-making facilitated discussions with
healthcare professionals at the health center. Gaining buy-in for projects from other healthcare
professionals requires considering the professionals’ opinions and promoting open
communication lines (Wei et al., 2020). These strategies involve an environment welcoming to
all stakeholders and their opinions. Open communication was achieved by setting up an open
forum, encouraging other staff to voice their opinions, and integrating them in defining the
current gap, as in shared decision-making. The strategies effectively obtained collaboration from
colleagues; in this case, they worked to elicit input into the project plan.
Plain language, demonstrating empathy, and asking open-ended questions facilitated
discussions and interactions when discussing with patients. Culturally competent communication
recognizant of the patient’s experiences will likely produce cooperation and effective
communication (Handtke et al., 2019). This approach to communication can be facilitated by
focusing on patients’ experiences and showing empathy for their struggles. Similarly, asking
open-ended questions allows patients to express themselves extensively and relay their opinions,
contributing to quality improvement efforts. These approaches also integrated consideration of
the health literacy of the target population. This necessitated plain language communication to
ensure patients understand and contribute to the program. Effective communication with patients
has been based on evidence of inclusive and culturally competent care and communication.
The stakeholders’ feedback and ideas helped create a more explicit focus on the program
as a gap in practice. Stakeholder involvement from project commencement is essential in
problem definition (Smith et al., 2020). In this project, nurses and patients were involved, and
their feedback identified the lack of adequate care access. Although patients could be referred for
substance abuse treatment programs, the affordability and accessibility in other locations were
seen as significant barriers for the low-income population in Little Havana. The feedback thus
5
identified access and affordability as the main issues to address in this project. Therefore, the
ideas and feedback helped narrow the practice gap definition to a manageable scope and clearly
defined problem.
While in-person discussions were practical, written communication could have been
more effective with the stakeholders in discussing the practice gap. Different modes of
communication should be adopted depending on stakeholder preferences, project focus, and the
need to persuade the target population (Arnold & Boggs, 2019). In this project, a request for
feedback was made through a written notice. No responses were received from either patients or
staff. Alternatively, a short meeting was held with the staff in a verbal and informal setting. This
verbal communication made staff more receptive and willing to discuss the issue further.
Similarly, a short conversation with patients as they were leaving the health center was held,
eliciting cooperation and collaboration. In this case, verbal in-person communication was more
effective than written communication and, hence, has been preferred for project planning and
management.
Conclusion
The practice gap identified is inadequate substance use treatment services in Little
Havana, Miami. This gap has been identified in communications with stakeholders at Banyan
Health Center in the community. The lack of services significantly determines mental health
outcomes and overdoses due to substance abuse. An inclusive and empathetic approach was used
when communicating with patients and healthcare staff. Verbal in-person discussions were the
most effective communication mode in this case and will continue to be used in the program’s
future. The PICOT question developed communicates the practice gap and the proposed
intervention to address it.
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Reference
Arnold, E. C., & Boggs, K. U. (2019). Interpersonal relationships e-book: Professional
communication skills for nurses. Elsevier Health Sciences.
Beech, B. M., Ford, C., Thorpe Jr, R. J., Bruce, M. A., & Norris, K. C. (2021). Poverty, racism,
and the public health crisis in America. Frontiers in Public Health, 9, 699049.
https://doi.org/10.3389/fpubh.2021.699049
Briseus, V., Carter-Richards, K., & Dorelien, M. (2021 Apr. 14). Financial Insecurity in MiamiDade County. https://storymaps.arcgis.com/stories/12b4058c89584f73af1857bf6688e28b
Bunn, T. L., Quesinberry, D., Jennings, T., Kizewski, A., Jackson, H., McKee, S., & Eustice, S.
(2019). Timely linkage of individuals to substance use disorder treatment: development,
implementation, and evaluation of FindHelpNowKY.org. BMC Public Health, 19(1), 114. https://doi.org/10.1186/s12889-019-6499-5
Handtke, O., Schilgen, B., & Mösko, M. (2019). Culturally competent healthcare–A scoping
review of strategies implemented in healthcare organizations and a model of culturally
competent healthcare provision. PloS One, 14(7), e0219971.
https://doi.org/10.1371/journal.pone.0219971
Smith, I., Hicks, C., & McGovern, T. (2020). Adapting Lean methods to facilitate stakeholder
engagement and co-design in healthcare. BMJ, 368. https://doi.org/10.1136/bmj.m35
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Solberg, H., & Nåden, D. (2020). It is just that people treat you like a human being: The meaning
of dignity for patients with substance use disorders. Journal of Clinical Nursing, 29(3-4),
480-491. https://doi.org/10.1111/jocn.15108
Wei, H., Corbett, R. W., Ray, J., & Wei, T. L. (2020). A culture of caring: The essence of
healthcare interprofessional collaboration. Journal of Interprofessional Care, 34(3), 324331. https://doi.org/10.1080/13561820.2019.1641476
1
Synthesis of Evidence Substantiating a Practice Gap
School of Nursing and Health Sciences, Capella University
NURS-FPX8045 Doctoral Writing and Professional Practice
Dr. Peggy Soper
September, 2023
2
Synthesis of Evidence Substantiating a Practice Gap
A literature review is essential in outlining the utility of previous research in informing
quality-improvement (QI) projects. The practice gap identified in this project is the
underutilization of drug and substance treatment resources in Little Havana, Miami. The
proposed change is the implementation of Screening, Brief Intervention, and Referral to
Treatment (SBIRT) training and policy in a primary care community clinic to improve the
community’s access to and utilization of drug and substance use treatment resources. Researchers
have paid attention to the practice gap and proposed approaches in the past and conducted
studies. This paper is a critical review of the literature, a synthesis of that literature, and a
discussion of writing feedback on the project practice gap and proposed solution.
Critical Review of the Literature
The study by Bunn et al. (2019) focused on the effectiveness of a website to link people
with substance use disorders (SUD) to treatment resources. The website developed was
FindHelpNowKY.org, and the researchers aimed to develop, implement, and evaluate the
website as a platform for linking people requiring SUD treatment with appropriate resources.
Bunn et al. (2019) used a case-study qualitative research methodology to assess pre- and postintervention content, ease of use, and flow. Based on the “Strength of Recommendations Table”
(SORT) criteria, this study belongs to a level 2 rating because it is a case-control design. The
findings apply to a limited scope of patients but are generalizable to people with SUDs. Barriers
identified were lack of up-to-date information on facilities, partner lack of understanding of the
website, and lack of promotion of the website, among others. Facilitators were strategic
collaborations and support. The study is evidence of the effectiveness of web-based SUD linkage
3
processes and may be adaptable to the proposed project. Knowledge of barriers and facilitators
from Bunn et al. (2019) may be transferred to planning the proposed project intervention.
Gomez et al. (2023) conducted a study on the impact of Screening, Brief Intervention,
and Referral Treatment (SBIRT) on stigmatization of SUD. The researchers in this study aimed
to determine the impact of SBIRT training on students’ and practitioners’ attitudes toward SUD
and substance-using patients. To achieve the aim, the researchers deployed quasi-experimental
quantitative research methods with pre- and post-intervention surveys of attitudes towards SUD
and substance-using patients. The SBIRT is an evidence-based theory on which this study is
based. This study is a closely controlled quasi-experimental research and can be ranked as level 1
evidence on the SORT criteria because of the controlled nature. The researchers reported a
statistically significant decline in moralistic attitudes and stereotypical behaviors among the
participants following 12 months of training on SBIRT. The findings from the Gomez et al.
(2023) study indicate the potential improvement in practitioners’ attitudes towards people
seeking SUD treatment. The findings will be transferred to the proposed project by implementing
SBIRT training.
Another study considered for this project is Cordes et al. (2022), which focuses on
knowledge and self-efficacy of SBIRT training among health and behavioral health students. The
study aimed to evaluate the effectiveness of an SBIRT student training program in enhancing
knowledge and self-efficacy in SUD screening and referral. The researchers conducted a cohort
study of the knowledge and self-efficacy changes by collecting data via surveys in pre-training
and post-training. Cordes and colleagues based the study on the SBIRT theoretical framework
for early screening, brief intervention, and referral. This study is a level 2 evidence rating on
SORT criteria because it is a case-control study with inconsistent follow-up. At post-training,
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scores of percentage knowledge increased between 1 and 7 in the student groups, and selfefficacy scores increased between 19.86 and 39.34 percent points (Cordes et al., 2022). The
researchers demonstrate the importance of training in improving knowledge and self-efficacy in
SBIRT, and these findings can be transferred to the proposed project. The proposed intervention
will include SBIRT training, as informed by findings from the study.
Moberg and Paltzer (2021) focused on the impact of SBIRT in clinics serving Medicaid
beneficiaries on SUD diagnosis and care access. The research question for the study was whether
participation in universal SBIRT was a predictor for alcohol and drug use and dependence
diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
(DSM-IV). Moberg and Paltzer (2021) used a correlational research design by comparing patient
data from a sample of patients in SBIRT and non-SBIRT clinics. The researchers based the study
on the concepts of screening and brief intervention. The evidence from this study is rated level 1
evidence due to the large scope of data, close monitoring, and controlled trial approach of the
researchers. Moberg and Paltzer (2021) study reported that patients in SBIRT clinics had 42%
greater odds of SUD diagnosis. These findings indicate the usefulness of SBIRT in improving
diagnosis and will be transferred to the current project by justifying SBIRT training for
community mental health care staff.
The last article considered for this review is the study by Martin et al. (2020), who
focused on an SBIRT training program. The researchers aimed to determine whether SBIRT
training could improve SBIRT and motivational interviewing (MI) knowledge and self-efficacy.
The target population was psychology students, and the study design was quasi-experimental.
The researchers invited students for training and later assessed students’ competence and
knowledge of SBIRT and MI. The trainers-based training on the conceptual framework of
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SBIRT and MI. Evidence from this study is highly reliable as it is level 1 evidence since it is a
controlled trial with good follow-up. Martin et al. (2020) found a statistically significant increase
in knowledge and self-efficacy of both SBIRT and MI. The study concluded that training
psychology students improves competence in using SBIRT and MI. Training approaches from
this study will be deployed in the proposed project.
Synthesis of Literature
Training healthcare staff in SBIRT will improve their knowledge, attitude, and provision
of SUD interventions and referrals for people requiring assistance. SBIRT training increases
healthcare professionals’ knowledge and self-efficacy in SUD screening and intervention (Martin
et al., 2020; Cordes et al., 2022). The evidence on knowledge and self-efficacy indicates
enhanced competence in interventions for people with SUD. Using SBIRT is also associated
with increased diagnosis of SUD (Moberg & Paltzer, 2021) and reduced stigma against
substance-using patients among providers (Gomez et al., 2023). Healthcare professionals can
assess patients in a positive light and provide adequate services. Also, it is imperative to enhance
access through channels that link care seekers with the appropriate resources (Bunn et al., 2019).
Findings from these studies are evidence of the importance and utility of SBIRT training and
facilitating access to care resources for patients with SUD. These findings support the proposed
intervention to train community health professionals and mandate SBIRT in the community
health center.
Writing Feedback
I have received great feedback on this and previous assignments, helping me develop my
writing skills. The evidence I have received is mainly on the voice I use in writing and the
organization of my ideas. I will improve my writing by practicing active voice writing in all my
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work, even outside this course. The feedback has also pointed me to essential tutorials on
organizing ideas, especially on online writing websites and Capella resources. Implementing the
feedback will move me closer to being a proficient writer who can communicate accurately and
succinctly.
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References
Bunn, T. L., Quesinberry, D., Jennings, T., Kizewski, A., Jackson, H., McKee, S., & Eustice, S.
(2019). Timely linkage of individuals to substance use disorder treatment: Development,
implementation, and evaluation of FindHelpNowKY.org. BMC Public Health, 19(1), 114. https://doi.org/10.1186/s12889-019-6499-5
Cordes, C. C., Martin, M. P., Macchi, C. R., Lindsey, A., Hamm, K., Kaplan, J., & Moreland, D.
(2022). Expanding interprofessional teams: Training future health care professionals in
screening, brief intervention, and referral to treatment (SBIRT). Families, Systems, &
Health, 40(4), 559. https://doi.org/10.1037/fsh0000755
Gomez, E., Gyger, M., Borene, S., Klein-Cox, A., Denby, R., Hunt, S., & Sida, O. (2023). Using
SBIRT (Screen, Brief Intervention, and Referral Treatment) training to reduce the
stigmatization of substance use disorders among students and practitioners. Substance
Abuse: Research and Treatment, 17, 11782218221146391.
https://doi.org/10.1177/11782218221146391
Martin, J. L., Cimini, M. D., Longo, L. M., Sawyer, J. S., & Ertl, M. M. (2020). Equipping
mental health professionals to meet the needs of substance-using clients: Evaluation of an
SBIRT training program. Training and Education in Professional Psychology, 14(1), 42–
51. https://doi.org/10.1037/tep0000258
Moberg, D. P., & Paltzer, J. (2021). Clinical recognition of substance use disorders in Medicaid
primary care associated with Universal Screening, Brief Intervention and Referral to
Treatment (SBIRT). Journal of Studies on Alcohol and Drugs, 82(6), 700-709.
https://doi.org/10.15288/jsad.2021.82.700
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Evidence Table
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
Measurement
their
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
Bunn et al.
(2019)
None
Mixed-
The website
Barriers and
Two parallel
Content
Barriers
Strengths: –
identified
methods
was
facilitators-
focus groups of
analysis of
identified
Combined
research
developed for
These are the
25 participants
transcripts of
were lack of
qual and
Pre- and post-
the general
factors that
each.
the focus
up-to-date
quant methods
intervention
public. Focus
were
Discussions
groups was
information
Weaknesses: –
evaluation
group of 50
identified as
were recorded.
conducted.
on facilities,
Small sample
Aim of the
employees
affecting the
partner lack of Ranking:
study was to
reviewed the
project
understanding
Level 2
evaluate the
website.
implementatio
of the website,
Valid yes
effectiveness
n whether
and lack of
Reliable yes
of a website to
positively or
promotion of
Applicable
help link
negatively.
the website
yes Overall
people with
Flow, content,
among others.
rank: High
SUD
and ease of
Facilitators
treatment
use- These are
were strategic
resources
subjective
collaborations
9
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
Measurement
their
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
views of
and support.
website users
on the user
experience.
Martin et al.
SBIRT and
Quantitative
87 graduate
Knowledge-
Pre and post-30-
Data analyzed
Statistically
Strengths:
(2020)
MI
research
school
Competence
day follow-up
using one-way significant
Repeated
students in a
in using
repeated
analysis of
increase in
measures
Quasi-
large public
SBIRT and
measures design. variance
knowledge
approach
experimental
institution
MI in
Knowledge was
and self-
Close control
pre- and post-
providing
practical work
measured using
efficacy of
of the
intervention
degree
Self-efficacy-
multiple choice
both SBIRT
interventions
evaluation.
programs in
Belief in
questions for
and MI
and evaluation
Aim of the
psychology
personal
SBIRT and the
processes
study was to
ability to use
Motivational
Weaknesses: –
determine
the
Interviewing
Limited to a
whether
approaches
Knowledge
single location
10
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
Measurement
their
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
training could
Self-reported
Assessment Test
Limited to
improve
use of SBIRT
(MIKAT) for
psychology
SBIRT and
and MI-
MI. A Likert
students
MI knowledge
Current trends
scale was used
Ranking:
and self-
in using
to measure self-
Level 1
efficacy.
SBIRT and
efficacy.
Valid yes
MI
Reliable yes
approaches
Applicable
yes Overall
rank: High
Gomez et al.
(2023)
SBIRT
Quasi-
136
Attitudes
Brief Substance
t-tests were
Attitudes
Strengths: –
experimental
behavioral
towards
Abuse Attitude
conducted on
towards SUD
Well-
quantitative
and primary
substance
survey was used
SPSS to
and care for
controlled
research
care students
abuse are the
to measure
determine any
the patients
research
methods with
in an
participants’
attitudes towards outcome
improved with process
pre- and post-
addictive
views of
substance abuse
SBIRT
Inclusion of
intervention
disorders
morality and
for pre- and
training
federal
differences
11
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
Measurement
their
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
surveys of
training
stereotypical
post-training
agencies in
attitudes
project
beliefs of
research
towards SUD
people who
monitoring
and
use drugs
Weaknesses: –
substance-
Small sample
using patients.
Ranking:
Aim of the
Level 1
study was to
Valid yes
determine the
Reliable yes
impact of
Applicable
SBIRT
yes Overall
training on
rank: High
students’ and
practitioners’
attitudes
towards SUD
and
12
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
Measurement
their
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
substanceusing patients
Cordes et al.
(2022)
SBIRT
Quantitative
293 students
Participant
Data was
t-test
At post-
Strengths: –
Cohort study
from two
knowledge-
collected using
comparing
training,
Quasi-
of students’
academic
Competence
online surveys
data before
scores of
experimental
training
institutions in
and
on Qualtrics
and after
percentage
methods
program with
both
understanding
before and after
training
knowledge
Assessment of
pre- and post-
undergraduate
of subject
training
increased
self-efficacy
intervention
and
topic
between 1 and
Weaknesses: –
analysis
postgraduate
specifically
7 in the
Small sample
psychology
related to
student groups Limitation to
courses
SBIRT
and self-
two academic
completed the
Self-efficacy-
efficacy
institutions
training
Ability to
scores
Ranking:
conduct
increased
Level 2
SBIRT
between 19.86
Valid yes
independently
and 39.34
Reliable yes
13
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
Measurement
their
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
percent points
Applicable
yes Overall
rank: High
Moberg &
Paltzer (2021)
SBIRT
Quantitative
Random
SUD
Health records
Correlational
Patients in
Strengths: –
research
sample of
diagnosis-
and claims on
analysis and
SBIRT clinics
Large sample
Correlational
14,856
Diagnosis of a
addiction and
cross-
had 42%
Closely
research
working-age
substance or
substance use
tabulation of
greater odds
controlled
design
Medicaid
alcohol use
disorders
data
of SUD
methodology
beneficiaries
disorder
diagnosis.
Correlation
obtained via
according to
analysis
Wisconsin’s
DSM-IV
Weaknesses: –
Initiative to
SBIRT clinic
Reliance on
Promote
participation-
claims and
Healthy
Availability of
encounter data
Lifestyles
clinic-specific
Focus on
SBIRT
Medicaid
patients only
14
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
their
Measurement
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
Ranking:
Level 1
Valid yes
Reliable yes
Applicable
yes Overall
rank: High
1
Synthesis of Evidence Substantiating an Intervention
Very nice title page
Marcos J Carvajal Bermejo
School of Nursing and Health Sciences, Capella University
NURS-FPX8045 Doctoral Writing and Professional Practice
Dr. Peggy Soper
October, 2023
2
Synthesis of Evidence Substantiating an Intervention
Drug and substance use disorder treatment is a crucial health resource for communities
that can enhance people’s health outcomes. However, when people deserving in the community
do not access or use these resources, the aim of health improvement is not achieved. A practice
gap identified in Little Havana, Miami, is an underutilization of the community’s drug and
substance treatment resources, as seen by less than 70% utilization (you must use a citation
especially with numbers). An intervention that may be used to cover this gap always be 100%
clear when you are referring to an concept Don’t rename the concept/ explain the concept is
Screening, Brief Intervention, and Referral to Treatment (SBIRT), an intervention for the initial
assessment of patients in primary care to determine the current risk of drug and substance use
disorders. The PICOT question used as guidance for this project especially the literature search
can be stated as: “For the staff caring for patients in the community mental health center (P), how
does training and policy for routine Brief Intervention and Referral to Treatment (SBIRT)
implementation (I) compared to current practice (C) affect the use of substance use treatment
services (O) in twelve weeks (T)?” Can you ask this and say who gets the application of the
tool? The PICOT does not really say who is the receiver of the tool This paper is a critical
review and synthesis of the literature on SBIRT as a solution to the underutilization of drug and
substance treatment resources.
Critical Review of the Literature
The first article considered is by Moulin et al. (2021), and the focus of the researchers
was to evaluate the impact of SBIRT and a dedicated counselor in an emergency department
(ED). This study’s research question was how the SBIRT and referral to the counselor affected
care utilization. The researchers conducted a prospective longitudinal study to answer the
3
research question. The theory of motivational interviewing (MI) was the basis of the intervention
and the researchers sought to determine how MI affected the utilization of substance and drug
use treatment for people experiencing homelessness. Using the “Strength of Recommendations
Table” (SORT) criteria, this study can be ranked as level 1 because it is a prospective study with
good follow-up. The strength of evidence from this study, therefore, is high. The program was
associated with a 67% decrease in average emergency department visits among patients with
substance use disorder. The findings from this study indicate that SBIRT implementation could
lead to a reduction in ED utilization for substance and drug use emergencies.
The second article, McCall et al. (2022), focused on the impact of SBIRT administered
by professional mental health counselors to patients with substance misuse or disorder. The
research question for the study was the impact of SBIRT in in-patient settings on ED visits,
hospitalization, and costs. The researchers used a retrospective review of health records as the
primary methodology for research. The study is based on the Texas Christian University (TCU)
Treatment Model that delineates patient-level and program-level factors of treatment (McCall et
al., 2022). SORT ranks this study as a level I study because it is a retrospective cohort with good
follow-up. SBIRT was associated with a 0.32 (p < .001) odds ratio of ED visits and subsequent
hospitalization, indicating reduced ED visits. These findings can be used to support the need for
SBIRT as a standard practice for substance and drug abuse screening and intervention.
Moreover, Lukowitsky et al. (2022) focused on the impact of SBIRT training on attitudes
and beliefs towards people who use substances. The researchers used a quasi-experimental
approach with a pre-post design. Training was p
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
Research shows that we are currently experiencing a mental health crisis for children.
Discuss what are the factors that have created this crisis.
What are some potential interventions that might reduce the lack of mental health services for children?
Why have you proposed these interventions?
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.All peer responses are due by Sunday at 11:59 pm CT.Estimated time to complete: 1 hour
Please respond to discussion below using current APA edition and 2 scholarly references.Must be 150 words.
Question 1
A majority of societies have made sexual activities among people aged below 18 years a taboo. Legally, sex with a person under the age of 18 years is a punishable offense. However, currently, people are engaging in sexual activities as early as puberty kicks in. Most teenagers know it is not right, and they shun away from discussing the matter with none peers. In the case study, the patient is a 15-year-old girl who is sexually active. The mother informed a healthcare practitioner, something the teenager is feeling embarrassed and nervous about. It is common for teenagers to have such feelings when having conversations revolving around sex with people older than them (Mataraarachchi et al., 2023). As a healthcare practitioner, one should ensure the patient does not feel embarrassed or nervous. One way to ensure that the patient does not experience embarrassment and nervousness during the conversation is by making the environment comfortable and non-judgmental. During the introduction, one should mention that it is okay and normal for her to feel embarrassed and nervous and ensure that the details they share will be kept confidential. You should also ensure that they understand that you want the best for her health, and openness in the conversation should be paramount. It is also important to let the patient communicate what she is comfortable with, allowing her to ask questions about health and sexual well-being (Albers et al., 2022). That way, the patient is likely to give much information about her sex life, aiding a healthcare practitioner in giving the best advice and health care.
Question 2
When collecting information to build a gynecological history, it is noted that the patient is frustrated and embarrassed. The patient keeps reminding the healthcare practitioner that she has only had sex once. It ensures that the patient understands the importance of creating a gynecological history. Regardless of how often a person has engaged in sexual activities, the patient should understand that her gynecological history is paramount in helping a medical practitioner assess her risks and determine the most appropriate birth control methods. The patient should also be informed that a gynecological history helps determine whether they might have a sexually transmitted infection (STI) (Gubbin & Malbon, 2019). During such a talk, it should be emphasized that the healthcare practitioner only wants to provide her with the most appropriate guidance and healthcare.
Question 3
There are numerous birth control methods worldwide. In the United States (US), the most commonly prescribed birth control methods are hormonal methods, progestin-only methods, long-acting reversible contraceptives, barrier methods, and permanent methods (Kavanaugh & Jerman, 2018). The success or failure rate of birth control methods depends on numerous factors, but the most common are correct and consistent use and patient’s health.
Question 4
Some contraceptives are known to cause weight gain, among other side effects. Since the patient has mentioned that they would not mind using the most effective contraceptive, it is important to approach the topic with great caution. The healthcare practitioner should give the patient factual information, which includes admitting that the use of most contraceptives may result in side effects, which include weight gain. During this stage, the health practitioner should explain to the patient what would be most appropriate for them and inform them of the side effects they might experience. Since the patient is so concerned about weight gain, a nurse practitioner should avoid prioritizing contraceptives that are known to cause weight gain (Schrumpf et al., 2020). However, if such contraceptives are the most effective for the patient, they should be suggested, and the patient should be informed of the side effects.
Question 5
The patient has inquired about the use of a condom before she makes a decision on the contraceptive method she will use. As a health practitioner, one should encourage her idea. Condoms offer protection against unwanted pregnancies and STIs. They are readily available and easy to use with little to no side effects (Schrumpf et al., 2020). One should ask the patient whether she knows how to use condoms. It is important to educate the patient on the correct use of a condom, even if she mentions she knows.
topic is Iron Deficiency Anemia in the Kingdom of Saudi Arabia
Unformatted Attachment Preview
PHC 241-Group presentation
This assignment is a group effort. Students will work in groups of three to five and will choose
one of these topics on nutrition and public health:
1. Protein Energy Malnutrition and Early Child Development
2. Iron Deficiency Anemia in the Kingdom of Saudi Arabia
3. Maternal Nutrition and Low Birth Weight
4. Nutrition in School-Age Children and Cognitive Development.
5. Fast Food Consumption and Obesity among University Students
6. The Nutritional Transition and Its Implications for the Developing World
7. The Covid-19 Pandemic and Food Consumption Patterns
8. Food Insecurity and Malnutrition in Developing Countries
9. Food Security in a Global Pandemic
10. Elderly Health: Nutritional Issues of Older Adults
Presentations should include the following:
An adequate description of the nutritional issue, including a general or specific case.
Discussion of preventive or treatment strategies, and any related local or national
policies.
Practical recommendations for reducing malnutrition.
Questions for class discussion.
Important guidelines for students:
Presentation should consist of no more than 15 PowerPoint slides (including one page of
class discussion questions).
The cover slide should include the following: university logo; presentation title, group
members names and students ID numbers.
Presentation time should be 10–12 minutes, followed by five minutes of class discussion.
Each group should have a maximum of five students.
Support your presentation with at least three references (APA style).
The group will be graded as per the “Presentation Marking Rubric”
Poor
0.25 pts
Fair
0.50 pts
Good
0.75 pts
Excellent
1 pts
Organization Audience cannot
understand
presentation because
there is no sequence
of information.
Audience has
difficulty
following
presentation
because
student jumps
around.
Subject
Knowledge
Student does not
have grasp of
information; student
cannot answer
questions about
subject.
Student is
uncomfortable
with
information
and is able to
answer only
rudimentary
questions.
Student
presents
information
in logical
sequence
which
audience can
follow.
Student is at
ease with
expected
answers to all
questions, but
fails to
elaborate.
Graphics
Student uses
superfluous graphics
or no graphics
Mechanics
Student’s
presentation has four
or more spelling
errors and/or
grammatical errors.
Student
occasionally
uses graphics
that rarely
support text
and
presentation.
Presentation
has three
misspellings
and/or
grammatical
errors.
Student
presents
information in
logical,
interesting
sequence which
audience can
follow.
Student
demonstrates
full knowledge
(more than
required) by
answering all
class questions
with
explanations
and elaboration.
Student’s
graphics
explain and
reinforce screen
text and
presentation.
Group
Dynamics
Multiple group
members not
participating.
Evident lack of
preparation/rehearsal.
Dependence on
slides.
Significant
controlling by
some members
with one
minimally
contributing.
Primarily
prepared but
with some
dependence on
just reading off
slides.
Student’s
graphics
relate to text
and
presentation.
Presentation
has no more
than two
misspellings
and/or
grammatical
errors.
Slight
domination of
one presenter.
Members
helped each
other.
Very well
prepared.
Presentation has
no misspellings
or grammatical
errors.
All presenters
knew the
information,
participated
equally, and
helped each
other as needed.
Total (5)
I need a discussion post 300-350 for this: Read the attached Qualitative Research Study. (I have also placed the article under this weeks module here on Canvas) After reading the article, please appraise this study. Use table 7.1 in your book to guide you in your appraisal. What are the strengths and weakness you found in this study? I upload the article and table 7.1 below.After you finish the discussion post, I need one response 150 to replied to this same post, which you have done!
Unformatted Attachment Preview
pharmacy
Article
Exploration of Nurses’ Knowledge, Attitudes,
and Perceived Barriers towards Medication
Error Reporting in a Tertiary Health Care
Facility: A Qualitative Approach
Eman Ali Dyab 1 , Ramadan Mohamed Elkalmi 2 , Siti Halimah Bux 3 and
Shazia Qasim Jamshed 3, *
1
2
3
*
Department of Pharmaceutics, Faculty of Pharmacy, Tripoli University,
Tripoli 42300, Libya; eman_diab2008@yahoo.com
Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi Mara,
Puncak Alam 42300, Malaysia; edriph@gmail.com
Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia,
Kuantan 25200, Malaysia; sitihalimah@iium.edu.my
Correspondence: shazia_jamshed@iium.edu.my; Tel.: +601-7470-3692
Received: 15 September 2018; Accepted: 2 November 2018; Published: 5 November 2018
Abstract: Medication error reporting (MER) is an effective way used to identify the causes of
Medication Errors (MEs) and to prevent repeating them in future. The underreporting of MEs
is a challenge generally in all MER systems. The current research aimed to explore nurses’ knowledge
on MER by determining their attitudes towards reporting and studying the implicated barriers
and facilitators. A total of 23 nurses were interviewed using a semi-structured interview guide.
The saturation point was attained after 21 interviews. All the interviews were tape-recorded and
transcribed verbatim, and analysed using inductive thematic analysis. Four major themes and
17 sub-themes were identified. Almost all the interviewees were aware about the existence of the
MER system. They showed a positive attitude towards MER. The main barriers for MER were the
impacts of time and workload, fear of investigation, impacts on the job, and negative reactions
from the person in charge. The nurses were knowledgeable about MER but there was uncertainty
towards reporting harmless MEs, thus indicating the need for an educational program to highlight
the benefits of near-miss reporting. To improve participation strategies, a blameless reporting culture,
reporting anonymously, and a simplified MER process should be considered.
Keywords: medication error reporting; nurses’ attitudes; qualitative study; barriers; medication error
1. Introduction
The main principle of giving medication to the patient is to serve them in order to restore his/her
health without any harm [1]. Adverse events and medical errors are the main issues threatening
the patient’s safety, and are awkward predicaments in nearly all healthcare systems [2]. The World
Health Organization (WHO estimated that millions of people suffer injuries directly attributed to
medical care, and many are preventable [3], although prevalence in developing countries is reported
to be higher than developed nations [4]. In Southeast Asian countries, the reported administration
error rates ranged from 15.2% to 88.6% [5]. In Taiwan, a study mentioned that the overall rate of the
medical incidents ranged from 30% to 47.6%, and most of them were related to MEs [6]. In a Malaysian
study, Johari et al. reported 2572 reported cases of ME in 2009 [7]. The prevalence of ME among
geriatric patients was 25.17% [8] whereas in paediatrics this figure was 11.7% [9]. A recently published
Pharmacy 2018, 6, 120; doi:10.3390/pharmacy6040120
www.mdpi.com/journal/pharmacy
Pharmacy 2018, 6, 120
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four-year retrospective study reported that the total number of paper-based ME reports submitted
to the National Medication Error Reporting system (NMER) was 17,357, but only 0.3% of MEs were
in the administration stage [10]. The percentage in the administration stage is very low, representing
paper-based reports only (excluding online submitted MEs reports) collected by the NMER system,
as well as the effect of underreporting. The annual estimated cost of MEs in Malaysia was estimated to
be 111,924 Malaysian Ringgit (MYR) [10]. Clinically, MEs can have small to severe consequences for
patients. It was reported that the total number of MEs in the administering stage was 166, where 1%
had fatal consequences, 20% were serious, 32% were significant, and 46% were nonsignificant [11].
The identification of trends and patterns of MEs were the main reasons for establishing a ME
reporting system [12]. The effectiveness of all these systems depend on their ability to document
the occurred MEs. Establishing guidelines for medical error reporting (MER) is not enough, as the
healthcare practitioners (reporters) play a vital role in the MER process. The healthcare practitioners’
knowledge about MER, their attitudes toward reporting MEs, and perceived barriers toward MER are
important factors which determined the success of MER systems. Health care professionals in general
and nurses in particular are responsible for MER. It has been reported that the MEs are underreported
in all countries. Nurses’ knowledge and attitudes as well as barriers and facilitators toward MER
among nurses in Malaysia are little-studied issues and warrant investigation.
This study is intended to attain deeper insight into the knowledge and attitudes held by Malaysian
nurse practitioners towards the ME concept and MER process, as well as to investigate the barriers
which prevent nurses from reporting their MEs.
1.
2.
3.
4.
What do nurses know about the ME and MER system?
What are the nurses’ attitudes toward MER?
What are the barriers which could hinder nurses from reporting their MEs?
What are the factors which could facilitate MER among nurses?
2. Methods
2.1. Study Design and Setting
The study was conducted after getting approval from both the Medical Research Ethics
Committee Ministry of Health Malaysia (NMRR-15-2485-24709) and the International Islamic
University of Malaysia Research Ethics Committee (IREC 446). Use of a qualitative method (in-depth
interviews) provides flexibility and efficiency in collecting data related to personal feelings, attitudes,
and experiences [13] and hence, these methods are used for the exploration of the participants’
experiences towards medication error reporting. The individual interview method was chosen over
focus group discussions because of privacy, suitability, and comfort zone issues for shy and hesitant
participants [14]. This gives liberty to the participants to elaborate his/her answers without distractions
from others [14]. The current research was executed in a tertiary healthcare facility of Kuantan city,
Pahang, Malaysia.
2.2. Participants
The target study population was nurses practicing in different units of the hospital. No specific
inclusion and exclusion criteria were applied, and thus all nurses were eligible to participate in
the current research. The participants were recruited by using convenience and snowball sampling
technique. The snowball method helps to recruit hidden subjects which cannot be easily found [15].
The first participant was a nurse from the medical unit and was given information on the details of
the research along with an assurance of confidentiality and anonymity. After her acceptance she was
asked to fill in demographics form and sign the consent form. The interviews were recorded by using
Audio Recording Titanium Software® version 8.5.5 (AATSystems, Kent, UK), and notes were taken
during the interviews. After finishing the first interview, the interviewee was asked to nominate the
Pharmacy 2018, 6, 120
3 of 14
next participant. Thus, she made a referral to the next nurse, with the same pattern for the subsequent
interviews. Thus, a chain referral technique followed throughout the research study. The number
of participants was determined once the saturation point was achieved. The saturation point occurs
when no new concepts and themes emerge [14,16,17]. Two extra interviews were conducted to confirm
the saturation point. The field supervisor also helped in recruitment process. Participation was
simply on a voluntary basis, and they were informed that anytime during the course of research they
could withdraw. Moreover, they were assured that their confidentiality and anonymity would be
maintained. Only the research team had access to records. The purpose of the study was explained
to each participant before the interviews commenced and therefore, all the participants were asked
to sign an “informed consent form” followed by the addition of their demographic characteristics.
A total of 23 nurses were interviewed.
2.3. Procedure and Interview Process
In-depth interview sessions were conducted using a semi-structured interview guide in June 2015.
This guide was developed on the basis of prior published studies related to MER among health care
professionals [18–20]. The purpose of using this guide was to make sure that all important issues
about the topic were covered in the interviews [13,21]. The medium of communication during the
interview was primarily English, followed by a couple of interviews being conducted in Bahasa
Malayu i.e., the native language of participants. The field supervisor agreed to work as a research
assistant and a translator and assisted the nurses who could not understand the English language. As a
result, participants who expressed their thoughts in the Bahasa Malayu language were also included.
Each interview lasted for about 30–45 min. Venue was chosen as per proximity to nurses’ working units,
their preference of level of comfort/privacy, and the level of noisiness. Places such as the library private
room, the seminar room, and nurses’ rooms were selected as the venue for interviews. The discussion
was focused on several major issues; the nurses’ knowledge, experiences, and perceptions about ME
and MER, exploring their attitudes towards MER, comprehending the factors which might prevent
the nurses from reporting their MEs, and those factors which would promote MER among nurses.
Probing questions were asked to provoke more details from interviewees [13,21].
2.4. Data Analysis
The data analysis was performed using the inductive thematic analysis approach. The participants’
approved transcripts (transcribed verbatim) were coded as (N1, N2, . . . , N23). The process is illustrated
in Figure 1. The analysis followed a cyclic pattern, where it started by familiarization stage, generation
of initial codes stage and revision stage to refine the emerged codes [22,23]. The transcripts were
analysed again by another researcher to validate the resulted themes [22], and a third person’s opinion
was sought to resolve any disagreement between the previous analyses [24,25].
The current research followed an established criterion for maintaining quality in qualitative
research and thus follow the standards of Guba and Lincoln [26] for generating credibility,
transferability, dependability, and confirmability. For strengthening the credibility of the research there
was a continuous interaction with the participants, with checking of interpretations against interview
transcripts. A review with the participants was undertaken. Contrary to quantitative research, the aim
of qualitative is not generalizability but to observe and execute transferability. Therefore, a detailed
description of the participants’ experiences helped the researchers identify the patterns of social
relationships in reporting MEs and as well as the cultural backgrounds of the participants who reported
hesitancy in reporting. For dependability purposes, external audit criteria were put in place, and a
researcher not involved directly in research helped in the evaluation of interpretation and conclusions
with respect to the data collected. For establishing confirmability, not only a conformability audit (as
mentioned above) but also triangulation and reflexivity were maintained. In terms of establishing
triangulation, both methodological triangulation (i.e., the research followed the quantitative design
after qualitative inquiry) and analyst triangulation (i.e., using different analysts to review the findings)
Pharmacy 2018, 6, 120
4 of 14
were maintained,
whereas
forREVIEW
reflexivity, a reflexive note-sheet was used to record the methodological
Pharmacy 2018,
6, x FOR PEER
4 of 14
parameters and logistics involved. Interviewees were female (n = 22); of Malay race (n = 22); holding a
note-sheet was used to record the methodological parameters and logistics involved. Interviewees
diploma (n = 21). The nursing diploma is a 3-year course in Malaysia and on its successful completion
were female (n = 22); of Malay race (n = 22); holding a diploma (n = 21). The nursing diploma is a 3one can register
with
Board
Malaysia
work asone
a staff
nurse. with
All participants
year course
in Nursing
Malaysia and
on its
successfuland
completion
can register
Nursing Boardwere full
time employees.
Half
of
the
participants
(n
=
12)
have
working
experience
of
than 11 years.
Malaysia and work as a staff nurse. All participants were full time employees. Half of themore
participants
(n
=
12)
have
working
experience
of
more
than
11
years.
Slightly
more
than
three-quarters
the the prior
Slightly more than three-quarters of the participants (n = 18) had not reported any MEs of
over
participants (n =18) had not reported any MEs over the prior 12 months. The interviewees were
12 months. The interviewees were attached to different units in the hospital such as intensive care units
attached to different units in the hospital such as intensive care units (ICUs), medical units, critical
(ICUs), medical
units, critical cardiac units (CCUs), accident and emergency unit (A&Es), orthopaedic
cardiac units (CCUs), accident and emergency unit (A&Es), orthopaedic units, neonatal intensive
units, neonatal
intensive
care
units
(NICUs),
units.
The demographic
characteristics
of
care units
(NICUs),
and
paediatric
units.and
Thepaediatric
demographic
characteristics
of participants
are
presented
in Table 1. in Table 1.
participants
are presented
1. The study
process
flowchart.(I)
(I)transcription
transcription step,
(II) (II)
datadata
analysis
step, (III)
analysts’
Figure 1.Figure
The study
process
flowchart.
step,
analysis
step,
(III) analysts’
triangulation
(two researchers
performed
analysis
and person
third person
resolved
any
triangulation
method method
(two researchers
performed
analysis
and third
resolved
any disagreement),
disagreement), and (IV) final result.
and (IV) final result.
3. Results
Table 1. Interviewees socio-demographic characteristics (n = 23).
Four major themes and 17 sub-themes were emerged: knowledge about MER, attitudes toward
Characteristic
Number (n = 23)
Percentage (%)
MER, barriers toward MER, and facilitators to improve MER process. Figure 2 represents the
Female
22
95.7
emerged themes
Genderand categories.
Male
Race
Characteristic
Age
1
Malay
Table 1. Interviewees socio-demographic
characteristics (n22= 23).
Chines
1
Gender
Race
≤30
30–40
Female
41–50Male
51≥
Malay
Education level
Diploma
Chines
Bachelor
Experience in years
Age
≤5
6–1030–40
≥11 41–50
≤30
Practice site
51≥
Medical unit
a
ICUDiploma
b
CCU
Bachelor
A&Ec
Orthopaedic unit
NICU d
Paediatric unit
Number of reports in the last 12 months
Never report
≥1
Education level
Number (n
6 = 23)
2214
12
1
22
21
1
2
6
5
14 6
2 12
14
21 9
22
3
2
1
2
18
5
4.3
95.7
4.3
Percentage
(%)
26.1
95.7 60.9
4.3 8.7
4.3
95.7
91.3
4.3
8.7
26.1
21.7
60.9 26.1
8.7 52.2
4.3 17.4
91.3 39.1
8.7 8.7
13
8.7
4.3
8.7
78.3
21.7
(a ) Intensive care unit. (b ) Critical cardiac unit. (c ) Accident and emergency unit. (d ) Neonatal intensive care unit.
Medical unit
4
17.4
ICU a
9
39.1
b
2
8.7
CCU
Practice site
A&Ec
3
13
Orthopaedic unit
2
8.7 5 of 14
Pharmacy 2018, 6, 120
NICU d
1
4.3
Paediatric unit
2
8.7
3. Results
Never report
18
78.3
Number of reports in the last 12 months
≥1
5
21.7 toward
Four major themes and 17 sub-themes were emerged:
knowledge about
MER, attitudes
Intensive
care unit.
(b) Critical
cardiac unit.
(c) Accident
andprocess.
emergency
unit. 2(d)represents
Neonatal intensive
MER,(a)barriers
toward
MER,
and facilitators
to improve
MER
Figure
the emerged
careand
unit.categories.
themes
Emergent themes and sub-themes. MER:
MER: medical error reporting.
Figure 2. Emergent
3.1. Knowledge about MER
3.1.1. Concept of ME
The nurses were asked about their understanding of the ME concept. Almost all of them correctly
understood the concept of ME. Moreover, they linked its meaning to five/seven rights, while others
just gave simple and general answers like “giving incorrect medication to the patient”.
“Medication error is an error when giving medication including dosage and also the type of medication,
make sure to follow the 7Rs practice in the hospital.” (N1)
Pharmacy 2018, 6, 120
6 of 14
“Medication error is when something unwanted occurs such as wrong medication is given to the
patient.” (N7)
“Medication error means giving wrong medication to the patient, which includes wrong dose,
wrong route, and wrong documentation.” (N13)
3.1.2. The Existence of a System for MER and the Importance of MER
All the interviewees were aware about the existence of MER system and the importance of MER.
They stated that data collected by MER can be used as an indication of the quality of health service
provided to the patient. It can be used to improve this service by carrying out root-cause analysis
for the MEs reports, and the reported data can be utilized for learning purposes. In other words,
ME reports can be used as good resources to help nurses in avoiding repeating the same errors again
in future.
“Yes, we have a system for medication error reporting [ . . . ] And, it is very important because it
involves the quality of service which is being given to the patient and it is very important to monitor
ME.” (N1)
“It is important because we want to improve the way of delivering care and serving the patient.
To learn from reports, where and which thing can be done. So we have more information about what
has been done and their consequences.” (N3)
“It is important because we want to detect what is ME and to prevent it from happening again.” (N7)
“Normally, we do root-cause analysis to find out when and how this happened. Sometimes it comes
from the wrong prescription like wrong dose or wrong route or wrong frequency and then we find out
how that happen and try to tackle.” (N5)
“It is to guide our practice [ . . . ] Not add more error to this collection [ . . . ] To avoid ME in future
[ . . . ] It is considered as a good resource.” (N4)
3.1.3. The Availability and Confidentiality of the Reporting Form
The majority of interviewed nurses claimed that during their practice, they did not report MEs,
since until the time of interviews they did not commit any error. As a result, most of them did not see
the reporting form and some of them had seen it but they did not remember its content.
“The reporting form is available in the pharmacy department.” (N5)
“I have not seen the reporting form before. Because, so far, I did not make any error.” (N8)
The nurses were asked about their opinions on the reporting form.
“I have seen it; it is easy to fill, it does not need modification or re-designation.” (N1)
“The report is not too detailed like describing everything, but it underlines or highlights when the
medication was given to the patient.” (N3)
3.2. Attitude of Nurses toward ME Reporting
The nurses were asked about their attitudes toward ME reporting. The majority of the participants
had a positive attitude toward reporting of MEs, whether these MEs caused a serious side effect to the
patient or not. The other group had uncertain attitudes and they tended to report the MEs which led
to harm to the patient only.
Pharmacy 2018, 6, 120
7 of 14
3.2.1. Positive Attitude
The majority of nurses claimed that they report all encountered MEs immediately. They reported
them irrespective to their seriousness or the level of patient’s harm due to the error.
“Nothing affects my decision to report, once the error occurs it should be reported.” (N4)
“It is not a matter of choice.” (N7)
“Once I detect an error, I cannot just ignore it, and I straightforward report it […] We must make a
report also because this is ME, and we must report whether it is serious or not.” (N2)
“Here in A and E department, it does not matter if the error is big, mild, or small, it must be reported.” (N8)
3.2.2. Uncertain Attitude toward ME Reporting
During the discussion with the participants about their attitude toward MER, some participants
showed uncertain attitudes towards MER. They would report MEs only based on another factor such
as the severity of the ME or route of administration, or when they received a direct request form the
person in-charge.
“If the error caused big and serious complication I have to report.” (N17)
“Based on the patient, I will see the effect on the patient first. My first concern is the patient, I will
not report unless something happens to the patient. In this case, the doctor gives antidote and then
there is an investigation and eventually, they will revert to me.” (N9)
One nurse related the medication error reporting to the dosage form of administered medicine.
He believes that errors are serious when the medication given by the intravenous route, and this
type of error should be reported, while those resulting from oral or topical administration should not
be reported.
“Based on the route of administration IV it should be reported.” (N18)
One nurse insisted that she reports only if the person in charge requests her to fill the
reporting form.
“I just inform the sister and the doctor, and let them choose to fill the form or not but as for investigation,
I will come and join them” (N13)
Before reporting, the nurses think of the problems that will be faced after reporting their errors.
This has a high effect on their decision to report or not.
“Some nurses, at first, they think about what happen and the problems associated with reporting,
so they do not report.” (N12)
3.2.3. Reporting of Others’ Errors
Some of the interviewees stated that they do not have any problems in reporting MEs committed
by other staff. They believe that the reporting of MEs is better for both the nurses and also for the
patient, whether the MEs have been committed by themselves or by other health care professionals.
While the other group insisted that everyone is responsible for reporting his/her own initiated MEs.
“I will report if other staff nurse made a mistake.” (N1)
“I will report errors committed by others because this is in the best interest of the patient, and also it
would help things go smooth in the future, for example, patient allergy . . . ” (N3)
“If I made a mistake I would inform, also if others from my colleagues made a mistake, I would still
inform.” (N6)
“No, I report only my errors. If my colleagues made mistakes, I would just advise her to report, but I
will not report her error.” (N8)
Pharmacy 2018, 6, 120
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3.3. Barriers towards Medication Error Reporting
There are many barriers towards MER which were mentioned by the interviewees. These barriers
are heavy workload, lack of time, tiredness, embarrassment due to reactions of peers and family,
and fear of disciplinary action.
3.3.1. Lack of Time
The main barrier for MER mentioned by the interviewees was time. They considered that the ME
reporting is a time consuming process. As described by the participants, the problem is not the time
needed to fill the MER form. The problem appears after filling the MER form when the investigation
takes place in order to discuss the causes which led to the ME.
“We will be exposed to so many questions [ . . . ] long time [ . . . ] time to discuss the ME that was
reported [ . . . ] investigations take time. No other problems, just that it takes time to report and then
questions from pharmacist or doctors. We do not have time for reporting. It is a long story and takes
much time.” (N4)
“Sometimes, I decide not to report. Because, if there is an investigation we have to be presented, as you
know it will take a long time and we will be all inconvenient.” (N9)
3.3.2. Tiredness
The nurses are responsible for inpatient care, this responsibility requires them to accomplish
many physical activities. Performing these activities make nurses tired, when they are exhausted,
a low number of ME reports will be received from them.
“Sometimes, we are tired. Once we are tired we decide not to report.” (N4)
3.3.3. Embarrassment
The post-embarrassment feeling has been pinpointed by interviewees as another barrier toward
MER. As a result, they tend to hide their MEs and never report them.
“Facing the embarrassment from my family and friends is tough. They will blame us.” (N4)
“They (family and friends) understand because these are not things that a person does on purpose.
But facing them still difficult.” (N9)
3.3.4. Fear
Fear from the legal problems has been addressed by the interviewees as a barrier towards MER.
“I fear from legal problems and disciplinary actions from the hospital.” (N8)
“Sometimes, I do not want to get into issues, I do not want people to come to ask me for investigation
later.” (N2)
The effect of reporting on the personal job record is another factor which might prevent nurses
from reporting.
“If I report this will affect my record because everything will be recorded in my personal record.” (N9)
“Fearing others, especially the investigation, because in Malaysia all errors must be reported to your
job record and they do disciplinary action.” (N4)
Pharmacy 2018, 6, 120
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3.3.5. Negative Reaction from Sister In-Charge
The response of managers toward nurses who report their MEs were important factors which
prevented nurses from reporting their MEs. It has been noticed that most of the interviewees insisted
that receiving a negative reaction from senior nurses is a normal response when the MEs occur. As they
always tend to blame and scold the nurses if they commit MEs. They believe that guidance is the main
role of senior nurses during their practices, not blaming the nurses.
“The sister will monitor me more.” (N8)
“Negative reaction from sister and matron [ . . . ] they must not punish the staff, they must guide the
staff and follow the staff and ensure that the stuff follows the standards.” (N4)
3.3.6. The Confidentiality of the Reporting Form
The reporting form which is used to report ME is a strict confidential form. Filling this type of the
reporting requires the reporter’s details such as name, signature and contact details. Some nurses did
not report their MEs because of this issue and they wish if they can report by using an anonymous
reporting form. Consequently, the number of reports will increase by use of anonymous MER forms.
“I prefer to fill anonymous form [ . . . ] Because I feel shy and would not work further. Also, I would
feel sorry for the patient. So, I prefer to fill the form without names.” (N2)
“I prefer to fill the anonymous form as it is good for us. If mistakes have been done, the news of
medication errors should be displayed without names being mentioned. In the future, if the people
know that this person made a mistake, people would decide not to deal with this person again. This will
damage the confidence of the nurse. In the future, they will not report and there will be no chance to
learn from the mistakes.” (N6)
“Off course, if no names mentioned the number of reports will increase.” (N8)
3.3.7. Absence of Effective Feedback
The lack of feedback from the hospital managers:
“No one goes through all the errors and give me a feedback.” (N7)
“I did not receive any feedback for my ME report.” (19)
3.4. Facilitators to Improve ME Reporting
The nurses were asked about the factors which could encourage them towards MER. Their main
concern revolved around removing the blaming culture. They believed that if no one scolded them
about their errors they would definitely report their errors.
“Remove the blaming culture. The matron and sister in charge should guide the staff not blame them.” (N4)
“Tell the matron that if any person is involved in a medication error, she shall not be scolded.” (N7)
Another factor which was addressed by the interviewees was getting encouragement from others
toward MER. Regarding this, there were two different opinions: first, some nurses insisted that they
did not need any encouragement from others because they thought the MER is an integral part of their
responsibility; on the contrary, other nurses welcomed encouragement by other health practitioners
such as a doctor, matron, or even their colleagues.
“There is no need to encourage us because this is our duty.” (N12)
“The sister in charge encouraged me to report.” (N9)
Pharmacy 2018, 6, 120
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“Actually, among us, we as nurses encourage each other to report errors; also the sister in charge
encourages us to do that.” (N8)
Few nurses highlighted the incentives as an effective way to encourage nurses to be more
meticulous to report MEs.
“Giving monetary rewards to the nurses.” (N3)
The confidentiality of the reporting form is an important factor, some of them preferred to fill
anonymously to avoid the embarrassment and being reprimanded by the authorities.
“I prefer to fill the form with no names and it is better not to include names.” (N2)
“I think as long as they can ensure the confidentiality of the person who reported, we will feel safe.”
(N9)
4. Discussion
This is an exploratory study intended to investigate the knowledge and attitude of nurses towards
MER. The current research is also anticipated to address the barriers and facilitators towards MER
among nurses, attached to different medical wards in the hospital.
The interviewed nurses reflected on the basic knowledge of concept of ME and MER.
They reported awareness about the presence of ME reporting system, guidelines, and the importance
of the MER. This might be attributed to the frequent talk sessions and training courses such as the
continuing nursing education program (CNE), in addition to the encouragement from the nurse
leaders (head nurses, supervisors and directors). This finding is consistent with the previous studies
conducted in Malaysia [7,27]. Wei and his colleagues reported that the Malaysian nurses had baseline
knowledge regarding MEs, whereas Johari et al. reported that Malaysian nurses had good knowledge
level regarding medication administration safety. However, most of the interviewees were not familiar
with the content of the ME reporting form due to their lack of contact. The low involvement of nurses
toward MER was not related to the lack of knowledge about the MER or due to the lack of information
about the process of incidents reporting, as reported in previous studies [28,29]. Handler and his
colleagues. reported that the lack of information on how to report ME among nurses as a barrier for
MER and this needs an immediate action and should be on higher priority towards improving MER
among nurses.
The willingness of nurses to report MEs has great impact on MER practices. Respondents had two
contradictory attitudes toward MER. Positive attitudes towards reporting all MEs are found to be in
accordance with what has been stated in Malaysian medication error guidelines [30], while an uncertain
attitude was also stated where participants were keen to report major errors only. In this case, the minor
errors and near-miss errors most likely will not be reported, in line with the previous studies [31–34].
Martowirono et al. reported that the MEs with minor consequences were lesser reported. Reporting of
near-miss errors gives valuable lessons without harming the patient [35]. In such situations, a seminar
discussion with the experienced nurse managers about benefits of near-miss error reporting can be a
useful tool to improve near-miss reporting rate among nurses.
The current research revealed that most nurses have positive attitudes toward ME reporting.
However, factors such as lack of time for reporting, lack of reporting culture without being blamed,
lack of effective feedback, and fear are considered as main reasons for underreporting problems among
the participants. These findings were consistent with the study conducted in Taiwan [36] where fear
was cited as the fundamental projecting factor in underreporting.
Despite the positive attitude of nurses towards the MER, they revealed that they did not report
MEs due to barriers like paucity of time, already in accordance with the studies done in Taiwan and
Canada [6,37]. Lack of time could be a reflection of heavy workload, as in many instances a limited
number of nurses take care of many patients. On the other hand, lack of reporting can be related to
Pharmacy 2018, 6, 120
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the MER process, which starts informally by informing the doctor, pharmacist, and the nurse director,
a
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
Explain how fathers contribute to anxiety in their children differently than mothers.
Describe how anxiety affects families and state your position whether anxiety is learned or inherited and why.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.All peer responses are due by Sunday at 11:59 pm CT.Estimated time to complete: 1 hour
Hi need help writing a 5 page paper on a medication of your choice based on the list provided in the attachment! all the instructions are attached in the below attachment
Unformatted Attachment Preview
Medication-Focused Case Study Guidelines
Medications:
1. Norepinephrine (Levophed)
2. Vasopressin (Pitressin)
3. Epinephrine (Adrenalin)
4. Dobutamine (Dobutrex)
5. Dopamine (Intotropin)
6. Phenylephrine (Neosynephrine)
7. Amiodarone (Cordarone)
8. Diltiazem (Cardizem)
9. Nicardipine (Cardene)
10. Dexmedetomidine (Precedex)
11. Propofol (Diprivan)
12. Midazolam (Versed)
13. Fentanyl (Actiq, Duragesic, Sublimaze)
Purpose: The purpose of the Medication-Focused Case Study is to perform a deep dive into
the selected medication by providing a patient and medication overview, the nursing
implications, and to develop an education plan.
Objectives:
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Identify demographic data, past health history, medical diagnosis, and two priority
nursing hypotheses.
Include medication, classification and most indications, recommended dosing guidelines,
administration routes, side effects, and contraindications.
Discuss 10 or more interventions for administration monitoring and effectiveness of
medication
Develop a complete pertinent medication teaching plan including learning needs,
educational goals, and learning outcomes.
Requirements:
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●
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Use the Medication-Focused Case Study Rubric for essential criteria
The paper should be between 3-5 pages (not including the title page and references).
The paper must be typed and conform to APA format.
A minimum of three references are required.
Create a brochure to use for teaching purposes; you will use the brochure to teach your
classmates.
Medication-Focused Case Study Rubric
Total score: 90 points (Refer to Rubric)
1. Patient Overview
a. Points: 18 (20.00%)
b. Accurately identifies demographic data, past health history, and medical diagnosis: identifies
2 priority nursing hypothesis
2. Medication Overview (Select One Medication)
a. Points: 18 (20.00%)
b. Includes medication, classification, and most indications, recommended dosing guidelines,
administration routes, side effects, and contraindications
included
3. Nursing Implications
a. Points: 18 (20.00%)
b. Discusses 10 or more interventions for administration monitoring and effectiveness of
medication
4. Patient Education Plan
a. Points: 18 (20.00%)
b. Develops a complete pertinent medication teaching plan including learning needs,
educational goals, and learning outcomes
5. Assignment
a. Points: 18 (20.00%)
b. Meets the following criteria 100%: typed APA format, correct grammar, spelling; maximum 3
pages body of the paper; minimum 3 references
Critical Thinking Assignment: Create an Annotated Bibliography
This Critical Thinking assignment builds on the assignment from Module 4.
Create an Annotated Bibliography, writing a two-to-three-paragraph appraisal of each article from the 10 references you gathered for the Module 4 Critical Thinking Assignment. There should be a title page and then these sources should be listed according to APA 7th edition guidelines excluding the reference page. Each individual annotation should be followed by the corresponding appraisal. Look for relevant literature on a topic of interest to you paying attention to the methods of collecting and analyzing data and ethical research practices.
This is an opportunity to practice synthesizing the author’s words. Do not use quotes; rather, put the author’s ideas into your own words. Take as many pages as needed to provide summaries for each of your articles.
Please use the website(s) below to help get you started.
Cornell University: How to Prepare an Annotated Bibliography
Purdue OWL: Annotated Bibliography Sample
Please note: Do not confuse an annotated bibliography with an abstract, summary, or a book review. They are vastly different. For this assignment, abstracts, summaries, and book reviews are not acceptable submissions.
Follow APA and Saudi Electronic University writing standards.
Review the grading rubric to see how you will be graded for this assignment.
You are strongly encouraged to submit all assignments to the Originality Check prior to submitting them to your instructor for grading.
Unformatted Attachment Preview
1
Research on Antibiotic Use Among Children in Healthcare
Name of Student
Institutional Affiliation
Course
Date
2
Research on Antibiotic Use Among Children in Healthcare
Introduction
A subject of growing importance in the medical community is research on pediatric
antibiotic use. This area of research focuses on the prescribing habits, utilization patterns, and
results connected to giving antibiotics to young patients. I chose this topic because of its
significant effects on pediatric healthcare, public health, and the larger medical community.
Understanding how to handle antibiotics is essential because they are frequently given to
kids, and misuse and overuse can lead to antibiotic resistance, a serious global health issue
(Bezruk et al., 2023). As a result, this field of study is crucial to improving evidence-based
care and pediatric antibiotic stewardship.
Overview
The research on antibiotic consumption among children has an effect on a wide
variety of parties, including young patients and the families of those patients. The outcomes
of the research have an indirect yet direct influence on the efficiency of therapy and the
standard of medical care. According to Blackburn et al. (2021), it also has an effect on the
general well-being of children as well as their parents or guardians. It also has a profound
impact on the medical professionals who work with these children. With the help of this
study, they will be able to identify the most effective antibiotics, doses, and treatment
strategies. With the help of this study, they will be able to provide the highest possible level
of outstanding treatment to their patients.
This research offers a lot of promise in terms of making a contribution to bettering
public health. (Blaser et al., 2021) One of the first steps in solving the growing problem of
antibiotic resistance in the world’s health is to have an understanding of antibiotic use in
children. The findings of this research help contribute to the development of laws and
regulations that prevent the excessive use of antibiotics. This, in turn, helps to stop the spread
3
of bacteria that have developed resistance. According to Vieira Filho et al. (2023), hospitals
and other healthcare systems may also profit from this research by cutting healthcare
expenses and minimizing the difficulties that are associated to the inappropriate or excessive
use of antibiotics.
In spite of the studies on antibiotic consumption among children in healthcare being
so obviously important, there are a number of ethical and legal issues that need to be
addressed (Willems et al., 2021). When conducting research with pediatric patients, the
informed consent of the patient’s parents or legal guardians is the first ethical requirement
that must be met. It is imperative that these individuals are fully informed of both the
potential drawbacks and benefits of the situation (Lampi et al., 2020). In addition, stringent
privacy and data protection rules have to be observed in order to comply when collecting and
analyzing patient data. According to Luo et al. (2023), it is the responsibility of researchers to
ensure the confidentiality of patients’ private medical information. In addition, researchers
have the responsibility of balancing the ethical guidelines of causing no harm with the
potential benefits of improved antibiotic utilization (Nepal et al., 2023). This involves
reducing the risks that children face and ensuring that they receive the appropriate care.
The research that is being done currently and will be done in the future in this sector
has a wide variety of applications that can be quite useful. According to the findings of recent
research, antibiotic stewardship systems inside hospitals and other healthcare facilities can be
considerably enhanced, which will assist physicians in selecting the most effective antibiotics
and ensure that they are used to their full potential (Silfwerbrand et al., 2019). It is feasible to
produce recommendations for the administration of antibiotics to pediatric patients based on
evidence-based research, which can standardize procedures and raise the level of care that is
provided. In addition, ongoing education and training programs for medical professionals that
4
incorporate the findings of studies have the potential to increase these professionals’ ability to
evaluate antibiotics (Wei et al., 2022).
Conclusion
In conclusion, the investigation of pediatric antibiotic use is a topic that is both
significant and difficult. It has a significant effect on a number of different stakeholders,
including healthcare systems, healthcare providers, families, and caretakers of children. The
potential uses of this research promise to improve the quality of care provided to pediatric
patients, make it more cheap and increase accessibility, all while contributing to efforts being
made around the world to tackle antibiotic resistance. However, it is essential to address the
ethical and legal concerns raised by this research.
5
References
6
1
Research on Artificial Intelligence: Patient Care Decision Making
Name of Student
Institutional Affiliation
Course
Date
2
Research on Artificial Intelligence: Patient Care Decision Making
Introduction
Artificial intelligence in patient care decision-making is a transformational field at the
nexus of healthcare and technology (Thavanesan et al., 2023). Advanced algorithms and
machine learning models are used in this process. They support healthcare providers in
making defensible choices regarding patients’ diagnosis, care, and management (Clement &
Maldonado, 2021). This innovative use of AI has the potential to change the healthcare
industry completely. This is accomplished through improving the precision and effectiveness
of medical judgments. Additionally, it poses significant moral and legal issues (Lynn, 2019).
Overview
My topic of choice is one that has important repercussions for medical care as well as
for society as a whole. According to Dolgikh and Dolgikh (2021), the application of AI to the
process of making decisions regarding patient care has the potential to dramatically improve
both the quality of care provided and the experience of patients. According to Fdez-Olivares
et al.’s 2019 research, it can accelerate diagnosis through the examination of enormous
databases of medical data, assist in the decision-making process about treatment by taking
individualized characteristics into consideration, and even more precisely predict patient
outcomes. Because it can process and evaluate data on a scale that is significantly greater
than that which is possible for humans, artificial intelligence (AI) is a technique that holds
great promise for use in the medical field.
The application of AI to the process of clinical decision-making has a significant
impact. It has a direct effect on patients since it may result in better accurate diagnoses, fewer
medical mistakes, and more tailored treatment regimens (Giordano et al., 2021). AI can also
be beneficial to employees in the healthcare industry since it can assist them in staying
3
current with the most latest medical guidelines and research, which will ultimately result in
an improvement in the quality of treatment they provide.
Nevertheless, there are particular ethical and legal considerations associated with the
use of AI in the decision-making process of healthcare (Johnson et al., 2023). One of the
primary concerns is whether or not AI algorithms are used in a straightforward and
transparent manner. It is crucial to make sure that AI systems are trained on a variety of
different datasets that are representative of the population as a whole in order to eliminate
biases that could lead to unfair imbalances in healthcare (Saleh Ibrahim et al., 2022). In this
day and age of AI-driven healthcare, protecting patient privacy and maintaining data security
is also of the utmost importance because to the frequent involvement of sensitive medical
data (Saqib et al., 2023). The ethical challenge of striking a balance between human expertise
and the contribution of AI, as well as the responsibility that comes with making mistakes, is
another factor that needs to be taken into consideration.
There will be a wide variety of applications for current and future AI research in
clinical decision-making, and these applications will be vast. According to Hryciw et al.’s
research from 2023, artificial intelligence might be utilized to monitor and detect diseases at
an earlier stage, assist radiologists in the interpretation of medical imaging, better treatment
plans, and forecast patient outcomes. It is possible that one day, artificial intelligencepowered virtual healthcare assistants will be able to provide ongoing health monitoring,
timely prescription reminders, and even enable remote surgeries employing robotic
equipment (Dolgikh, 2021).
The use of AI can lead to improved medical treatment that is not only more
economical but also more easily accessible and of a higher quality. According to Thavanesan
et al.’s 2023 research, artificial intelligence has the potential to raise the overall quality of
care that patients receive by reducing the number of diagnostic errors and maximizing the
4
effectiveness of treatment solutions. AI can also assist in resource allocation by identifying
high-risk patients who require further treatment. This will ease the pressure on healthcare
systems. According to Thavanesan et al.’s research from 2023, enhancing treatment plans,
reducing the number of times patients have to readmit themselves to the hospital, and
streamlining administrative procedures are all effective ways to cut costs.
Conclusion
In conclusion, incorporating AI into clinical decision-making is a revolutionary
advancement in healthcare. It has the potential to benefit both patients and medical personnel
greatly. However, it also presents moral and legal issues that need careful thought. Future
advancements in this field of study offer hope for more affordable, universally accessible,
and higher-quality healthcare. AI will become more critical in determining healthcare
decisions as it develops.
5
References
6
1
Research on Diabetic Foot Disease
Name of Student
Institutional Affiliation
Course
Date
2
Research on Diabetic Foot Disease
Introduction
A severe and complex consequence of diabetes mellitus known as diabetic foot
disease (DFD) includes infections, foot ulcers, peripheral neuropathy, and peripheral arterial
disease. DFD can have profound effects if left untreated, such as disability, amputation, and
even death (Normahani et al., 2022). Consequently, a sizeable percentage of the community,
including patients, healthcare professionals, and lawmakers, are highly concerned about it.
Examining DFD entails looking at the clinical aspects of care delivery and the ethical and
legal issues involved (Sen et al., 2019). Additionally, it provides chances for cutting-edge
research that can improve therapies, accessibility, and diagnostics while addressing ethical,
legal, and financial issues.
Overview
I chose to discuss this topic because it has substantial implications for both diabetic
patients and the healthcare system. The condition is complicated and has ramifications not
only for patients and society but also for the economy. Diabetes patients are the ones who are
most likely to be affected by this condition (Goh et al., 2020). As long as diabetes is present,
poor glycemic management is maintained, smoking is practiced, and other risk factors are
present, an individual’s likelihood of developing the condition continues to increase
(Tardáguila-Garca et al., 2022). As a direct result of this, a large portion of the general public
is interested in this topic. Patients, medical experts, and legislative representatives are all
considered to be a part of this.
One of the challenges presented by DFD from an ethical standpoint is ensuring that
everyone has equitable access to medical treatment. According to Uckay et al.’s research from
2021, those who belong to marginalized groups are more likely to experience inequities in
diabetes treatment and foot care, which contributes to a higher incidence of DFD-related
3
issues in these populations. It is imperative for reasons of ethics that these injustices be
addressed, and that everyone be given the medical attention they require.
According to Li et al. 2020, medical professionals who treat patients with DFD have a
moral and legal obligation to adhere to generally recognized standards of care. It is possible
to be sued for medical misconduct if the requirements are not met. In addition, there are
legislative obligations involving disability rights and insuring that people with DFD have
sufficient accommodations in order to maintain their standard of living (Wang & Zhang,
2022).
There are many interesting questions that could be answered by recent or forthcoming
DFD research. First, advances in diagnostic techniques and medical technology may make it
possible to detect DFD in its earliest stages and begin treatment right away in order to avert
adverse outcomes (Seng et al., 2022). Thanks to developments in wound healing and
regenerative medicine, foot ulcers can now heal more rapidly and efficiently, hence reducing
the likelihood that they will require amputation. In addition, current research into the roles
that genetics, lifestyle, and inflammation play in the start of DFD can yield critical insights
that can be incorporated into tailored strategies for prevention and therapy (Zhou et al.,
2021).
One of the possible applications of this research is to improve the quality as well as
the value of medical care. Access to high-quality treatment for DFD can be improved with
the help of technologies such as telemedicine and remote monitoring, in particular for those
who live in underserved areas or in rural areas. In addition, research may result in the
development of wound care instruments and supplies that are both less expensive and simpler
to get, which would be beneficial to both patients and healthcare systems (Lim et al., 2020).
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Conclusion
In conclusion, diabetic foot disease affects millions of people with diabetes worldwide
and is a complex and urgent healthcare issue. It raises moral issues regarding the availability
of equitable healthcare and the obligations placed on healthcare providers by the law. Current
and upcoming research in this area provides hope for early detection, novel therapies, and
individualized interventions. Furthermore, developments in DFD care have the potential to
raise accessibility, lower costs, and improve the quality of healthcare.
5
References
6
The purpose of this discussion is for you to explore your healthcare setting culture and the shifting paradigm from volume-based care to value-based care within the context of patient safety.
INSTRUCTIONS
A paradigm shift is occurring across the United States from volume-based to value-based care. Reflect upon your organizational culture to address the following:
Analyze and assess the culture of your healthcare setting as it relates to patient safety.
Examine one opportunity to improve patient safety outcomes. Include in your strategy current technology being used to support safety and explain the importance of interprofessional collaboration to help promote a safer environment.
Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:
Link (webpage): Graduate Discussion Grading Guidelines and RubricLinks to an external site.
PROGRAM COMPETENCIES
This discussion enables the student to meet the following program competencies:
Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
Appraises current information systems and technologies to improve health care. (POs 6, 7)
COURSE OUTCOMES
This discussion enables the student to meet the following course outcomes:
Assess the impact of informatics and information technology on organizational systems, change, and improvement. (PCs 2, 4; PO 6)
Evaluate the types of healthcare information systems, knowledge-based systems, and patient care technology and the impact on patient safety, quality of care, and outcome measurement. (PC 4; PO 7
The aim of this discussion assignment is to facilitate a deeper understanding of key issues in mental health nursing, engage in collaborative learning, and encourage the application of theoretical knowledge to real-world clinical scenarios.
Discussion Topic:
Discuss personal views regarding the discipline of children. Is spanking an appropriate form of discipline? If so, in what situations would this be appropriate?
Instructions
Initial Post: In your own words, create an initial post addressing the discussion question. Your initial post must be at least 300 words long and include citations in APA format.
Peer Responses: Reply to at least one classmate’s posts. Each reply should be substantive, adding value to the discussion, and be at least 150 words long.
Citations: Use at least one scholarly source (not including the textbook) to support your points. Make sure to use APA format for your citations. You can support your statement using credible data sources such as CINAHL, MEDLINE, Embase, Clinical Key, and Cochrane Library (Accessed from the library page at the fnu.edu website).
Originality: All work must be original and in your own words. Plagiarism will result in a zero for the assignment and may have additional academic consequences.
Module 06: DiscussionIn this discussion board, you will compare healthcare reimbursement methodologies in Saudi Arabia with the United States. Research and evaluate the need for more public and private funding of healthcare in Saudi Arabia.Your response should address the following:Description of current reimbursement formats in Saudi Arabia and the United States.Pros and cons of the current reimbursement model in Saudi Arabia and the United States.
Look at attached document and answer accordingly on the doc itself.
Unformatted Attachment Preview
PHS 318: Public Health Services Leadership and Administration
Accessing Information Sources for SWOT Analysis and
Strategic Planning Activities
Our scenario:
September is Hunger Action Month. According to the United States Department
of Agriculture and the national nonprofit Feeding America, more than 34 million
people in the United States are food insecure. Over 49 million people turned to
food programs in 2022. Though there are food pantries, food banks, and
organizations that provide services to combat hunger within the city of
Valparaiso, Porter County and neighboring Lake County, these organizations
might not be strong enough to support the growing food insecurity needs of the
area.
A large non-profit foundation wants to donate $5 million dollars towards ending
food insecurity in Indiana and has approached the Food Bank of Northwest
Indiana about making a large donation. Before donating, the organization has
asked the Food Bank of Northwest Indiana to evaluate their organization using a
SWOT Analysis and then develop a Strategic Plan for how they could support the
growing hunger needs within northwest Indiana for the next 2 years.
As the research intern within the Food Bank of Northwest Indiana, you have been
asked to begin gathering information for the SWOT Analysis and Strategic Plan.
Use this worksheet to document the data and information you are able to find.
Also use this worksheet to document your thoughts about what you find.
1. Getting Started – Learn About Organization and Organizational Environment
a) Take 5-10 minutes to explore the Food Bank of Northwest Indiana web content https://foodbanknwi.org/. Look for information about their mission and vision.
Look for information about their programs and outcomes. Look for information
about organizations with which they partner. Look for an annual report or a
summary of the work and a description of the outcomes or impact of their work.
Are annual accomplishments reported? Or goals stated?
Make a note below of two pieces of information that could be used in a SWOT
Analysis or Strategic Plan.
b) Take 5-10 minutes to explore web content for similar organizations in northwest
Indiana including Lake County and Porter County.
Make a note below about one organization that was researched and one piece of
information about the programs, services, partnerships, or outcomes described
on their web page(s). In 2-3 sentences explain how that information could be
used in a SWOT Analysis or Strategic Plan.
c) What didn’t you find from these Internet searches that you expected to find?
Document your response below in 2-3 sentences.
1
2. Dig Deeper with GuideStar – https://libguides.valpo.edu/healthcare/CompanyIndustry
a) Registered nonprofit organizations within the United States have to file a financial
statement, called a 990, annually with the United States Internal Revenue
Service. The 990 provides details, including organization financials, the salaries
of the highest compensated employees/individuals, the amount of money paid
annually to independent contractors, and all sorts of other interesting financial
details. Since the Food Bank of Northwest Indiana is a nonprofit organization,
use the GuideStar by Candid database to locate the organization’s GuideStar
profile, their recent 990s, and their financial details.
(Note: Local, state, and federal government agencies and departments are not registered
nonprofit organizations so they do not file 990s. Financial details for government units will
be more difficult, if not impossible, to find.)
b) What year is the most recent 990 tax form available within GuideStar for the
Food Bank of Northwest Indiana?
i. What was listed for their Total Assets for the current year? $
ii. What was listed for their Total Liabilities for the current year? $
iii. What was listed for their Net Assets or Fund Balances for the current
year? $
c) Many other food banks and organizations that work to combat food insecurity are
also registered nonprofits. Use GuideStar to look for information about the similar
organizations that were researched in Step 1. Use GuideStar to research
additional organizations you might have missed within Step 1.
d) How might you use the financial information found within the 990 forms and the
organization details from within GuideStar for the SWOT Analysis or Strategic
Plan? Document your response below in 3-5 sentences.
3. Gathering Statistics About Community https://libguides.valpo.edu/healthcare/DemographicsData
a) Use the Explore Census Data site from the United States Government to locate
data about the population, income, and poverty status of Porter County, Indiana,
and Lake County, Indiana.
Make a note below about one piece of data that could be used within the Food
Bank of Northwest Indiana’s SWOT Analysis or Strategic Plan.
b) Use either the United States Department of Agriculture website or the Feeding
America website to gather other statistical information for the state, region, or
Lake or Porter counties.
Make a note below about one additional piece of data found that could be used
within the Food Bank of Northwest Indiana’s SWOT Analysis or Strategic Plan.
2
c) What other data points about the community or community needs could help to
understand Lake County, Porter County, or the state of Indiana? Document your
response below in 3-5 sentences.
4. Searching for Newspaper, Magazine and Trade/Professional/Industry Articles https://libguides.valpo.edu/healthcare/CompanyIndustry
a) Some local newspaper sources are freely available on the Internet. Search the
Internet for articles about the Food Bank of Northwest Indiana from local news
sources including The Times of Northwest Indiana and The Post Tribune. Look
for articles about their work, donations, funding, financials, partnerships,
outcomes, leadership, etc. Focus the results on the last 1-3 years.
List the newspaper name, article title, author name, and date of publication of
one relevant article you could find.
b) Use Summon, the library discovery tool, to search for other newspaper articles,
magazine articles, and trade publication articles related to the Food Bank of
Northwest Indiana. Focus the results on the last 1-2 years. If needed, use the
Content Type limit option to narrow results.
(Note: Not all nonprofit organizations get local or national attention from newspapers or
news sources so it may be difficult to find news coverage. In addition to looking for
coverage about your organization of interest, look for coverage about the other
organizations researched in Step 1 and Step 2. Also look for coverage about the broader
public health issue being served.)
List the source name, article title, author name, and date of publication of one
relevant article you could find.
c) What other newspaper, magazine, or trade/professional article information could
help to develop the Food Bank of Northwest Indiana’s SWOT analysis or
strategic plan? Document your response in 2-3 sentences.
5. Searching for Scholarly/Peer-ReviewedAcademic Journal Articles https://libguides.valpo.edu/healthcare/CompanyIndustry
a) Develop a search strategy in the Academic Search Complete database to find
scholarly (peer reviewed) journal articles reporting on research about food
insecurity, food banks, food pantries, mobile markets, meal programs, etc. Don’t
forget to include synonyms, Boolean Operator connectors like AND/OR, as well
as the truncation symbol (*) within your search.
b) Develop a search strategy in the Healthcare Administration Database to find peer
reviewed journal articles reporting on research about food insecurity, food banks,
food pantries, mobile markets, meal programs, etc. Don’t forget to include
synonyms, Boolean Operator connectors like AND/OR, as well as the truncation
symbol (*) within your search.
c) Which database yielded more relevant information? In 2-3 sentences describe
why you think that is.
3
d) List the title, author, and publication year of one article that could be useful to the
Food Bank of Northwest Indiana’s SWOT Analysis or Strategic Plan. In 2-3
sentences describe how you might use the article information in your work.
6. Other Information Sources
a) List two other information sources you would search next to gather additional
information for the Food Bank of Northwest Indiana’s SWOT Analysis and
Strategic Plan.
______________________________________________________________________
Don’t forget to look for database, website, and strategic searching advice from within the
rest of the Library’s Subject & Library Guides for Public Health https://libguides.valpo.edu/healthcare
Or reach out to Prof Kim Whalen in the library with questions.
Kimberly.whalen@valpo.edu
Office: CLIR 267
4
I need a discussion post 300-350 for this: Read the attached Qualitative Research Study. (I have also placed the article under this weeks module here on Canvas) After reading the article, please appraise this study. Use table 7.1 in your book to guide you in your appraisal. What are the strengths and weakness you found in this study? I upload the article and table 7.1 below. After you finish the discussion post, I need one response 150 to replied to this same post, which you have done!
Unformatted Attachment Preview
pharmacy
Article
Exploration of Nurses’ Knowledge, Attitudes,
and Perceived Barriers towards Medication
Error Reporting in a Tertiary Health Care
Facility: A Qualitative Approach
Eman Ali Dyab 1 , Ramadan Mohamed Elkalmi 2 , Siti Halimah Bux 3 and
Shazia Qasim Jamshed 3, *
1
2
3
*
Department of Pharmaceutics, Faculty of Pharmacy, Tripoli University,
Tripoli 42300, Libya; eman_diab2008@yahoo.com
Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi Mara,
Puncak Alam 42300, Malaysia; edriph@gmail.com
Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia,
Kuantan 25200, Malaysia; sitihalimah@iium.edu.my
Correspondence: shazia_jamshed@iium.edu.my; Tel.: +601-7470-3692
Received: 15 September 2018; Accepted: 2 November 2018; Published: 5 November 2018
Abstract: Medication error reporting (MER) is an effective way used to identify the causes of
Medication Errors (MEs) and to prevent repeating them in future. The underreporting of MEs
is a challenge generally in all MER systems. The current research aimed to explore nurses’ knowledge
on MER by determining their attitudes towards reporting and studying the implicated barriers
and facilitators. A total of 23 nurses were interviewed using a semi-structured interview guide.
The saturation point was attained after 21 interviews. All the interviews were tape-recorded and
transcribed verbatim, and analysed using inductive thematic analysis. Four major themes and
17 sub-themes were identified. Almost all the interviewees were aware about the existence of the
MER system. They showed a positive attitude towards MER. The main barriers for MER were the
impacts of time and workload, fear of investigation, impacts on the job, and negative reactions
from the person in charge. The nurses were knowledgeable about MER but there was uncertainty
towards reporting harmless MEs, thus indicating the need for an educational program to highlight
the benefits of near-miss reporting. To improve participation strategies, a blameless reporting culture,
reporting anonymously, and a simplified MER process should be considered.
Keywords: medication error reporting; nurses’ attitudes; qualitative study; barriers; medication error
1. Introduction
The main principle of giving medication to the patient is to serve them in order to restore his/her
health without any harm [1]. Adverse events and medical errors are the main issues threatening
the patient’s safety, and are awkward predicaments in nearly all healthcare systems [2]. The World
Health Organization (WHO estimated that millions of people suffer injuries directly attributed to
medical care, and many are preventable [3], although prevalence in developing countries is reported
to be higher than developed nations [4]. In Southeast Asian countries, the reported administration
error rates ranged from 15.2% to 88.6% [5]. In Taiwan, a study mentioned that the overall rate of the
medical incidents ranged from 30% to 47.6%, and most of them were related to MEs [6]. In a Malaysian
study, Johari et al. reported 2572 reported cases of ME in 2009 [7]. The prevalence of ME among
geriatric patients was 25.17% [8] whereas in paediatrics this figure was 11.7% [9]. A recently published
Pharmacy 2018, 6, 120; doi:10.3390/pharmacy6040120
www.mdpi.com/journal/pharmacy
Pharmacy 2018, 6, 120
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four-year retrospective study reported that the total number of paper-based ME reports submitted
to the National Medication Error Reporting system (NMER) was 17,357, but only 0.3% of MEs were
in the administration stage [10]. The percentage in the administration stage is very low, representing
paper-based reports only (excluding online submitted MEs reports) collected by the NMER system,
as well as the effect of underreporting. The annual estimated cost of MEs in Malaysia was estimated to
be 111,924 Malaysian Ringgit (MYR) [10]. Clinically, MEs can have small to severe consequences for
patients. It was reported that the total number of MEs in the administering stage was 166, where 1%
had fatal consequences, 20% were serious, 32% were significant, and 46% were nonsignificant [11].
The identification of trends and patterns of MEs were the main reasons for establishing a ME
reporting system [12]. The effectiveness of all these systems depend on their ability to document
the occurred MEs. Establishing guidelines for medical error reporting (MER) is not enough, as the
healthcare practitioners (reporters) play a vital role in the MER process. The healthcare practitioners’
knowledge about MER, their attitudes toward reporting MEs, and perceived barriers toward MER are
important factors which determined the success of MER systems. Health care professionals in general
and nurses in particular are responsible for MER. It has been reported that the MEs are underreported
in all countries. Nurses’ knowledge and attitudes as well as barriers and facilitators toward MER
among nurses in Malaysia are little-studied issues and warrant investigation.
This study is intended to attain deeper insight into the knowledge and attitudes held by Malaysian
nurse practitioners towards the ME concept and MER process, as well as to investigate the barriers
which prevent nurses from reporting their MEs.
1.
2.
3.
4.
What do nurses know about the ME and MER system?
What are the nurses’ attitudes toward MER?
What are the barriers which could hinder nurses from reporting their MEs?
What are the factors which could facilitate MER among nurses?
2. Methods
2.1. Study Design and Setting
The study was conducted after getting approval from both the Medical Research Ethics
Committee Ministry of Health Malaysia (NMRR-15-2485-24709) and the International Islamic
University of Malaysia Research Ethics Committee (IREC 446). Use of a qualitative method (in-depth
interviews) provides flexibility and efficiency in collecting data related to personal feelings, attitudes,
and experiences [13] and hence, these methods are used for the exploration of the participants’
experiences towards medication error reporting. The individual interview method was chosen over
focus group discussions because of privacy, suitability, and comfort zone issues for shy and hesitant
participants [14]. This gives liberty to the participants to elaborate his/her answers without distractions
from others [14]. The current research was executed in a tertiary healthcare facility of Kuantan city,
Pahang, Malaysia.
2.2. Participants
The target study population was nurses practicing in different units of the hospital. No specific
inclusion and exclusion criteria were applied, and thus all nurses were eligible to participate in
the current research. The participants were recruited by using convenience and snowball sampling
technique. The snowball method helps to recruit hidden subjects which cannot be easily found [15].
The first participant was a nurse from the medical unit and was given information on the details of
the research along with an assurance of confidentiality and anonymity. After her acceptance she was
asked to fill in demographics form and sign the consent form. The interviews were recorded by using
Audio Recording Titanium Software® version 8.5.5 (AATSystems, Kent, UK), and notes were taken
during the interviews. After finishing the first interview, the interviewee was asked to nominate the
Pharmacy 2018, 6, 120
3 of 14
next participant. Thus, she made a referral to the next nurse, with the same pattern for the subsequent
interviews. Thus, a chain referral technique followed throughout the research study. The number
of participants was determined once the saturation point was achieved. The saturation point occurs
when no new concepts and themes emerge [14,16,17]. Two extra interviews were conducted to confirm
the saturation point. The field supervisor also helped in recruitment process. Participation was
simply on a voluntary basis, and they were informed that anytime during the course of research they
could withdraw. Moreover, they were assured that their confidentiality and anonymity would be
maintained. Only the research team had access to records. The purpose of the study was explained
to each participant before the interviews commenced and therefore, all the participants were asked
to sign an “informed consent form” followed by the addition of their demographic characteristics.
A total of 23 nurses were interviewed.
2.3. Procedure and Interview Process
In-depth interview sessions were conducted using a semi-structured interview guide in June 2015.
This guide was developed on the basis of prior published studies related to MER among health care
professionals [18–20]. The purpose of using this guide was to make sure that all important issues
about the topic were covered in the interviews [13,21]. The medium of communication during the
interview was primarily English, followed by a couple of interviews being conducted in Bahasa
Malayu i.e., the native language of participants. The field supervisor agreed to work as a research
assistant and a translator and assisted the nurses who could not understand the English language. As a
result, participants who expressed their thoughts in the Bahasa Malayu language were also included.
Each interview lasted for about 30–45 min. Venue was chosen as per proximity to nurses’ working units,
their preference of level of comfort/privacy, and the level of noisiness. Places such as the library private
room, the seminar room, and nurses’ rooms were selected as the venue for interviews. The discussion
was focused on several major issues; the nurses’ knowledge, experiences, and perceptions about ME
and MER, exploring their attitudes towards MER, comprehending the factors which might prevent
the nurses from reporting their MEs, and those factors which would promote MER among nurses.
Probing questions were asked to provoke more details from interviewees [13,21].
2.4. Data Analysis
The data analysis was performed using the inductive thematic analysis approach. The participants’
approved transcripts (transcribed verbatim) were coded as (N1, N2, . . . , N23). The process is illustrated
in Figure 1. The analysis followed a cyclic pattern, where it started by familiarization stage, generation
of initial codes stage and revision stage to refine the emerged codes [22,23]. The transcripts were
analysed again by another researcher to validate the resulted themes [22], and a third person’s opinion
was sought to resolve any disagreement between the previous analyses [24,25].
The current research followed an established criterion for maintaining quality in qualitative
research and thus follow the standards of Guba and Lincoln [26] for generating credibility,
transferability, dependability, and confirmability. For strengthening the credibility of the research there
was a continuous interaction with the participants, with checking of interpretations against interview
transcripts. A review with the participants was undertaken. Contrary to quantitative research, the aim
of qualitative is not generalizability but to observe and execute transferability. Therefore, a detailed
description of the participants’ experiences helped the researchers identify the patterns of social
relationships in reporting MEs and as well as the cultural backgrounds of the participants who reported
hesitancy in reporting. For dependability purposes, external audit criteria were put in place, and a
researcher not involved directly in research helped in the evaluation of interpretation and conclusions
with respect to the data collected. For establishing confirmability, not only a conformability audit (as
mentioned above) but also triangulation and reflexivity were maintained. In terms of establishing
triangulation, both methodological triangulation (i.e., the research followed the quantitative design
after qualitative inquiry) and analyst triangulation (i.e., using different analysts to review the findings)
Pharmacy 2018, 6, 120
4 of 14
were maintained,
whereas
forREVIEW
reflexivity, a reflexive note-sheet was used to record the methodological
Pharmacy 2018,
6, x FOR PEER
4 of 14
parameters and logistics involved. Interviewees were female (n = 22); of Malay race (n = 22); holding a
note-sheet was used to record the methodological parameters and logistics involved. Interviewees
diploma (n = 21). The nursing diploma is a 3-year course in Malaysia and on its successful completion
were female (n = 22); of Malay race (n = 22); holding a diploma (n = 21). The nursing diploma is a 3one can register
with
Board
Malaysia
work asone
a staff
nurse. with
All participants
year course
in Nursing
Malaysia and
on its
successfuland
completion
can register
Nursing Boardwere full
time employees.
Half
of
the
participants
(n
=
12)
have
working
experience
of
than 11 years.
Malaysia and work as a staff nurse. All participants were full time employees. Half of themore
participants
(n
=
12)
have
working
experience
of
more
than
11
years.
Slightly
more
than
three-quarters
the the prior
Slightly more than three-quarters of the participants (n = 18) had not reported any MEs of
over
participants (n =18) had not reported any MEs over the prior 12 months. The interviewees were
12 months. The interviewees were attached to different units in the hospital such as intensive care units
attached to different units in the hospital such as intensive care units (ICUs), medical units, critical
(ICUs), medical
units, critical cardiac units (CCUs), accident and emergency unit (A&Es), orthopaedic
cardiac units (CCUs), accident and emergency unit (A&Es), orthopaedic units, neonatal intensive
units, neonatal
intensive
care
units
(NICUs),
units.
The demographic
characteristics
of
care units
(NICUs),
and
paediatric
units.and
Thepaediatric
demographic
characteristics
of participants
are
presented
in Table 1. in Table 1.
participants
are presented
1. The study
process
flowchart.(I)
(I)transcription
transcription step,
(II) (II)
datadata
analysis
step, (III)
analysts’
Figure 1.Figure
The study
process
flowchart.
step,
analysis
step,
(III) analysts’
triangulation
(two researchers
performed
analysis
and person
third person
resolved
any
triangulation
method method
(two researchers
performed
analysis
and third
resolved
any disagreement),
disagreement), and (IV) final result.
and (IV) final result.
3. Results
Table 1. Interviewees socio-demographic characteristics (n = 23).
Four major themes and 17 sub-themes were emerged: knowledge about MER, attitudes toward
Characteristic
Number (n = 23)
Percentage (%)
MER, barriers toward MER, and facilitators to improve MER process. Figure 2 represents the
Female
22
95.7
emerged themes
Genderand categories.
Male
Race
Characteristic
Age
1
Malay
Table 1. Interviewees socio-demographic
characteristics (n22= 23).
Chines
1
Gender
Race
≤30
30–40
Female
41–50Male
51≥
Malay
Education level
Diploma
Chines
Bachelor
Experience in years
Age
≤5
6–1030–40
≥11 41–50
≤30
Practice site
51≥
Medical unit
a
ICUDiploma
b
CCU
Bachelor
A&Ec
Orthopaedic unit
NICU d
Paediatric unit
Number of reports in the last 12 months
Never report
≥1
Education level
Number (n
6 = 23)
2214
12
1
22
21
1
2
6
5
14 6
2 12
14
21 9
22
3
2
1
2
18
5
4.3
95.7
4.3
Percentage
(%)
26.1
95.7 60.9
4.3 8.7
4.3
95.7
91.3
4.3
8.7
26.1
21.7
60.9 26.1
8.7 52.2
4.3 17.4
91.3 39.1
8.7 8.7
13
8.7
4.3
8.7
78.3
21.7
(a ) Intensive care unit. (b ) Critical cardiac unit. (c ) Accident and emergency unit. (d ) Neonatal intensive care unit.
Medical unit
4
17.4
ICU a
9
39.1
b
2
8.7
CCU
Practice site
A&Ec
3
13
Orthopaedic unit
2
8.7 5 of 14
Pharmacy 2018, 6, 120
NICU d
1
4.3
Paediatric unit
2
8.7
3. Results
Never report
18
78.3
Number of reports in the last 12 months
≥1
5
21.7 toward
Four major themes and 17 sub-themes were emerged:
knowledge about
MER, attitudes
Intensive
care unit.
(b) Critical
cardiac unit.
(c) Accident
andprocess.
emergency
unit. 2(d)represents
Neonatal intensive
MER,(a)barriers
toward
MER,
and facilitators
to improve
MER
Figure
the emerged
careand
unit.categories.
themes
Emergent themes and sub-themes. MER:
MER: medical error reporting.
Figure 2. Emergent
3.1. Knowledge about MER
3.1.1. Concept of ME
The nurses were asked about their understanding of the ME concept. Almost all of them correctly
understood the concept of ME. Moreover, they linked its meaning to five/seven rights, while others
just gave simple and general answers like “giving incorrect medication to the patient”.
“Medication error is an error when giving medication including dosage and also the type of medication,
make sure to follow the 7Rs practice in the hospital.” (N1)
Pharmacy 2018, 6, 120
6 of 14
“Medication error is when something unwanted occurs such as wrong medication is given to the
patient.” (N7)
“Medication error means giving wrong medication to the patient, which includes wrong dose,
wrong route, and wrong documentation.” (N13)
3.1.2. The Existence of a System for MER and the Importance of MER
All the interviewees were aware about the existence of MER system and the importance of MER.
They stated that data collected by MER can be used as an indication of the quality of health service
provided to the patient. It can be used to improve this service by carrying out root-cause analysis
for the MEs reports, and the reported data can be utilized for learning purposes. In other words,
ME reports can be used as good resources to help nurses in avoiding repeating the same errors again
in future.
“Yes, we have a system for medication error reporting [ . . . ] And, it is very important because it
involves the quality of service which is being given to the patient and it is very important to monitor
ME.” (N1)
“It is important because we want to improve the way of delivering care and serving the patient.
To learn from reports, where and which thing can be done. So we have more information about what
has been done and their consequences.” (N3)
“It is important because we want to detect what is ME and to prevent it from happening again.” (N7)
“Normally, we do root-cause analysis to find out when and how this happened. Sometimes it comes
from the wrong prescription like wrong dose or wrong route or wrong frequency and then we find out
how that happen and try to tackle.” (N5)
“It is to guide our practice [ . . . ] Not add more error to this collection [ . . . ] To avoid ME in future
[ . . . ] It is considered as a good resource.” (N4)
3.1.3. The Availability and Confidentiality of the Reporting Form
The majority of interviewed nurses claimed that during their practice, they did not report MEs,
since until the time of interviews they did not commit any error. As a result, most of them did not see
the reporting form and some of them had seen it but they did not remember its content.
“The reporting form is available in the pharmacy department.” (N5)
“I have not seen the reporting form before. Because, so far, I did not make any error.” (N8)
The nurses were asked about their opinions on the reporting form.
“I have seen it; it is easy to fill, it does not need modification or re-designation.” (N1)
“The report is not too detailed like describing everything, but it underlines or highlights when the
medication was given to the patient.” (N3)
3.2. Attitude of Nurses toward ME Reporting
The nurses were asked about their attitudes toward ME reporting. The majority of the participants
had a positive attitude toward reporting of MEs, whether these MEs caused a serious side effect to the
patient or not. The other group had uncertain attitudes and they tended to report the MEs which led
to harm to the patient only.
Pharmacy 2018, 6, 120
7 of 14
3.2.1. Positive Attitude
The majority of nurses claimed that they report all encountered MEs immediately. They reported
them irrespective to their seriousness or the level of patient’s harm due to the error.
“Nothing affects my decision to report, once the error occurs it should be reported.” (N4)
“It is not a matter of choice.” (N7)
“Once I detect an error, I cannot just ignore it, and I straightforward report it […] We must make a
report also because this is ME, and we must report whether it is serious or not.” (N2)
“Here in A and E department, it does not matter if the error is big, mild, or small, it must be reported.” (N8)
3.2.2. Uncertain Attitude toward ME Reporting
During the discussion with the participants about their attitude toward MER, some participants
showed uncertain attitudes towards MER. They would report MEs only based on another factor such
as the severity of the ME or route of administration, or when they received a direct request form the
person in-charge.
“If the error caused big and serious complication I have to report.” (N17)
“Based on the patient, I will see the effect on the patient first. My first concern is the patient, I will
not report unless something happens to the patient. In this case, the doctor gives antidote and then
there is an investigation and eventually, they will revert to me.” (N9)
One nurse related the medication error reporting to the dosage form of administered medicine.
He believes that errors are serious when the medication given by the intravenous route, and this
type of error should be reported, while those resulting from oral or topical administration should not
be reported.
“Based on the route of administration IV it should be reported.” (N18)
One nurse insisted that she reports only if the person in charge requests her to fill the
reporting form.
“I just inform the sister and the doctor, and let them choose to fill the form or not but as for investigation,
I will come and join them” (N13)
Before reporting, the nurses think of the problems that will be faced after reporting their errors.
This has a high effect on their decision to report or not.
“Some nurses, at first, they think about what happen and the problems associated with reporting,
so they do not report.” (N12)
3.2.3. Reporting of Others’ Errors
Some of the interviewees stated that they do not have any problems in reporting MEs committed
by other staff. They believe that the reporting of MEs is better for both the nurses and also for the
patient, whether the MEs have been committed by themselves or by other health care professionals.
While the other group insisted that everyone is responsible for reporting his/her own initiated MEs.
“I will report if other staff nurse made a mistake.” (N1)
“I will report errors committed by others because this is in the best interest of the patient, and also it
would help things go smooth in the future, for example, patient allergy . . . ” (N3)
“If I made a mistake I would inform, also if others from my colleagues made a mistake, I would still
inform.” (N6)
“No, I report only my errors. If my colleagues made mistakes, I would just advise her to report, but I
will not report her error.” (N8)
Pharmacy 2018, 6, 120
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3.3. Barriers towards Medication Error Reporting
There are many barriers towards MER which were mentioned by the interviewees. These barriers
are heavy workload, lack of time, tiredness, embarrassment due to reactions of peers and family,
and fear of disciplinary action.
3.3.1. Lack of Time
The main barrier for MER mentioned by the interviewees was time. They considered that the ME
reporting is a time consuming process. As described by the participants, the problem is not the time
needed to fill the MER form. The problem appears after filling the MER form when the investigation
takes place in order to discuss the causes which led to the ME.
“We will be exposed to so many questions [ . . . ] long time [ . . . ] time to discuss the ME that was
reported [ . . . ] investigations take time. No other problems, just that it takes time to report and then
questions from pharmacist or doctors. We do not have time for reporting. It is a long story and takes
much time.” (N4)
“Sometimes, I decide not to report. Because, if there is an investigation we have to be presented, as you
know it will take a long time and we will be all inconvenient.” (N9)
3.3.2. Tiredness
The nurses are responsible for inpatient care, this responsibility requires them to accomplish
many physical activities. Performing these activities make nurses tired, when they are exhausted,
a low number of ME reports will be received from them.
“Sometimes, we are tired. Once we are tired we decide not to report.” (N4)
3.3.3. Embarrassment
The post-embarrassment feeling has been pinpointed by interviewees as another barrier toward
MER. As a result, they tend to hide their MEs and never report them.
“Facing the embarrassment from my family and friends is tough. They will blame us.” (N4)
“They (family and friends) understand because these are not things that a person does on purpose.
But facing them still difficult.” (N9)
3.3.4. Fear
Fear from the legal problems has been addressed by the interviewees as a barrier towards MER.
“I fear from legal problems and disciplinary actions from the hospital.” (N8)
“Sometimes, I do not want to get into issues, I do not want people to come to ask me for investigation
later.” (N2)
The effect of reporting on the personal job record is another factor which might prevent nurses
from reporting.
“If I report this will affect my record because everything will be recorded in my personal record.” (N9)
“Fearing others, especially the investigation, because in Malaysia all errors must be reported to your
job record and they do disciplinary action.” (N4)
Pharmacy 2018, 6, 120
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3.3.5. Negative Reaction from Sister In-Charge
The response of managers toward nurses who report their MEs were important factors which
prevented nurses from reporting their MEs. It has been noticed that most of the interviewees insisted
that receiving a negative reaction from senior nurses is a normal response when the MEs occur. As they
always tend to blame and scold the nurses if they commit MEs. They believe that guidance is the main
role of senior nurses during their practices, not blaming the nurses.
“The sister will monitor me more.” (N8)
“Negative reaction from sister and matron [ . . . ] they must not punish the staff, they must guide the
staff and follow the staff and ensure that the stuff follows the standards.” (N4)
3.3.6. The Confidentiality of the Reporting Form
The reporting form which is used to report ME is a strict confidential form. Filling this type of the
reporting requires the reporter’s details such as name, signature and contact details. Some nurses did
not report their MEs because of this issue and they wish if they can report by using an anonymous
reporting form. Consequently, the number of reports will increase by use of anonymous MER forms.
“I prefer to fill anonymous form [ . . . ] Because I feel shy and would not work further. Also, I would
feel sorry for the patient. So, I prefer to fill the form without names.” (N2)
“I prefer to fill the anonymous form as it is good for us. If mistakes have been done, the news of
medication errors should be displayed without names being mentioned. In the future, if the people
know that this person made a mistake, people would decide not to deal with this person again. This will
damage the confidence of the nurse. In the future, they will not report and there will be no chance to
learn from the mistakes.” (N6)
“Off course, if no names mentioned the number of reports will increase.” (N8)
3.3.7. Absence of Effective Feedback
The lack of feedback from the hospital managers:
“No one goes through all the errors and give me a feedback.” (N7)
“I did not receive any feedback for my ME report.” (19)
3.4. Facilitators to Improve ME Reporting
The nurses were asked about the factors which could encourage them towards MER. Their main
concern revolved around removing the blaming culture. They believed that if no one scolded them
about their errors they would definitely report their errors.
“Remove the blaming culture. The matron and sister in charge should guide the staff not blame them.” (N4)
“Tell the matron that if any person is involved in a medication error, she shall not be scolded.” (N7)
Another factor which was addressed by the interviewees was getting encouragement from others
toward MER. Regarding this, there were two different opinions: first, some nurses insisted that they
did not need any encouragement from others because they thought the MER is an integral part of their
responsibility; on the contrary, other nurses welcomed encouragement by other health practitioners
such as a doctor, matron, or even their colleagues.
“There is no need to encourage us because this is our duty.” (N12)
“The sister in charge encouraged me to report.” (N9)
Pharmacy 2018, 6, 120
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“Actually, among us, we as nurses encourage each other to report errors; also the sister in charge
encourages us to do that.” (N8)
Few nurses highlighted the incentives as an effective way to encourage nurses to be more
meticulous to report MEs.
“Giving monetary rewards to the nurses.” (N3)
The confidentiality of the reporting form is an important factor, some of them preferred to fill
anonymously to avoid the embarrassment and being reprimanded by the authorities.
“I prefer to fill the form with no names and it is better not to include names.” (N2)
“I think as long as they can ensure the confidentiality of the person who reported, we will feel safe.”
(N9)
4. Discussion
This is an exploratory study intended to investigate the knowledge and attitude of nurses towards
MER. The current research is also anticipated to address the barriers and facilitators towards MER
among nurses, attached to different medical wards in the hospital.
The interviewed nurses reflected on the basic knowledge of concept of ME and MER.
They reported awareness about the presence of ME reporting system, guidelines, and the importance
of the MER. This might be attributed to the frequent talk sessions and training courses such as the
continuing nursing education program (CNE), in addition to the encouragement from the nurse
leaders (head nurses, supervisors and directors). This finding is consistent with the previous studies
conducted in Malaysia [7,27]. Wei and his colleagues reported that the Malaysian nurses had baseline
knowledge regarding MEs, whereas Johari et al. reported that Malaysian nurses had good knowledge
level regarding medication administration safety. However, most of the interviewees were not familiar
with the content of the ME reporting form due to their lack of contact. The low involvement of nurses
toward MER was not related to the lack of knowledge about the MER or due to the lack of information
about the process of incidents reporting, as reported in previous studies [28,29]. Handler and his
colleagues. reported that the lack of information on how to report ME among nurses as a barrier for
MER and this needs an immediate action and should be on higher priority towards improving MER
among nurses.
The willingness of nurses to report MEs has great impact on MER practices. Respondents had two
contradictory attitudes toward MER. Positive attitudes towards reporting all MEs are found to be in
accordance with what has been stated in Malaysian medication error guidelines [30], while an uncertain
attitude was also stated where participants were keen to report major errors only. In this case, the minor
errors and near-miss errors most likely will not be reported, in line with the previous studies [31–34].
Martowirono et al. reported that the MEs with minor consequences were lesser reported. Reporting of
near-miss errors gives valuable lessons without harming the patient [35]. In such situations, a seminar
discussion with the experienced nurse managers about benefits of near-miss error reporting can be a
useful tool to improve near-miss reporting rate among nurses.
The current research revealed that most nurses have positive attitudes toward ME reporting.
However, factors such as lack of time for reporting, lack of reporting culture without being blamed,
lack of effective feedback, and fear are considered as main reasons for underreporting problems among
the participants. These findings were consistent with the study conducted in Taiwan [36] where fear
was cited as the fundamental projecting factor in underreporting.
Despite the positive attitude of nurses towards the MER, they revealed that they did not report
MEs due to barriers like paucity of time, already in accordance with the studies done in Taiwan and
Canada [6,37]. Lack of time could be a reflection of heavy workload, as in many instances a limited
number of nurses take care of many patients. On the other hand, lack of reporting can be related to
Pharmacy 2018, 6, 120
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the MER process, which starts informally by informing the doctor, pharmacist, and the nurse director,
a
Guidelines:Cover sheet should be attached with assignmentComplete student’s information on the first page of the document.Font should be 12 Times New RomanLine spacing should be 1.5The text color should be “Black”The length of the paper assignment should be 500-700 words.Use proper references using APA format. Please see below link about how to cite APA reference style.https://guides.libraries.psu.edu/apaquickguide/int… Do proper paraphrasing to avoid plagiarism
Discuss the importance of using the MCMI-IV when assessing the mental status of a client. Can the MCMI-IV be useful in assessing emotional status as well? Why or why not? Provide specific examples to support your position. 150 words ave 150 word opinion What are some strengths and challenges of MCMI-IV for assessing mental status? Do you feel that this MCMI-IV is a good method to assess emotional status? Why or why not? Provide specific examples to support your position. words ave 150 word opinion
Critical Thinking Assignment: Create an Annotated Bibliography
This Critical Thinking assignment builds on the assignment from Module 4.
Create an Annotated Bibliography, writing a two-to-three-paragraph appraisal of each article from the 10 references you gathered for the Module 4 Critical Thinking Assignment. There should be a title page and then these sources should be listed according to APA 7th edition guidelines excluding the reference page. Each individual annotation should be followed by the corresponding appraisal. Look for relevant literature on a topic of interest to you paying attention to the methods of collecting and analyzing data and ethical research practices.
This is an opportunity to practice synthesizing the author’s words. Do not use quotes; rather, put the author’s ideas into your own words. Take as many pages as needed to provide summaries for each of your articles.
Please use the website(s) below to help get you started.
Cornell University: How to Prepare an Annotated Bibliography
Purdue OWL: Annotated Bibliography Sample
Please note: Do not confuse an annotated bibliography with an abstract, summary, or a book review. They are vastly different. For this assignment, abstracts, summaries, and book reviews are not acceptable submissions.
Follow APA and Saudi Electronic University writing standards.
Review the grading rubric to see how you will be graded for this assignment.
You are strongly encouraged to submit all assignments to the Originality Check prior to submitting them to your instructor for grading.
Unformatted Attachment Preview
1
Research on Patient Safety Culture
Name of Student
Institutional Affiliation
Course
Date
2
Research on Patient Safety Culture
Introduction
The attitudes, actions, and beliefs within a healthcare institution that promote patient
well-being and reduce the risk of injury are crucial to patient safety culture (Garcia et al.,
2019). It is a complex idea that calls for the cooperation of staff members, administrators, and
healthcare specialists to constantly deliver high-standard treatment to patients (Hessels et al.,
2019). This culture, which emphasizes open communication, responsibility, and ongoing
patient safety improvement, mirrors the organization’s policies, practices, and environment.
Overview
I selected this topic because patient safety culture is fundamental to the quality and
effectiveness of healthcare delivery. It is crucial in preventing medical mistakes, lowering
unfavorable incidents, and enhancing patient outcomes (Ellis et al., 2020). In addition to
being essential for healthcare staff, a strong patient safety culture directly influences patients
and their families (Hunt et al., 2022). When healthcare companies place a high premium on
patient safety, they foster an atmosphere where patients may feel confident that their health
comes first.
The ethical and legal aspects of patient safety culture are of utmost significance (Lee et al.,
2019). Under their promise to “do no harm,” healthcare professionals have a moral obligation
to protect patient safety. Respecting patient autonomy, admitting mistakes, and aggressively
looking for ways to prevent damage are all part of this (Al-Surimi et al., 2021). If healthcare
institutions do not respect patient safety standards, they could be held legally liable, resulting
in malpractice claims and other legal penalties.
The healthcare system’s numerous stakeholders are affected by patient safety culture.
A solid patient safety culture primarily benefits patients, first and foremost. Better health
outcomes result from lower risks of infections, medical errors, and other adverse events (Hata
3
et al., 2022). As they work in an environment that promotes their well-being and aids them in
avoiding the professional and emotional burnout brought on by unfavorable circumstances,
healthcare professionals also gain from this situation. A strong patient safety culture also
benefits healthcare organizations since it can improve their reputation, lower their risk of
being sued, and improve patient happiness (Haugen et al., 2019).
Research on patient safety culture is now underway and has a bright future. The best
methods for fostering and maintaining a strong patient safety culture within healthcare
organizations can be found by doing research. This may entail researching effective solutions,
evaluating the effects of leadership approaches, and investigating how technology might
enhance patient safety (Al‐Shaya et al., 2021). The association between patient safety culture
and healthcare outcomes can also be studied through research.
Research on patient safety cultures can also help to advance better treatment that is
less expensive, more accessible, and of higher quality. Healthcare organizations can avoid
costly litigation and fines by eliminating medical errors and unfavorable events, ultimately
cutting healthcare expenses (Olsen & Leonardsen, 2021). Additionally, a culture that
prioritizes patient safety can draw in and keep brilliant medical personnel, which will raise
the standard of treatment. Prioritizing patient safety puts healthcare companies in a better
position to adhere to regulations and accrediting standards.
Conclusion
In summary, patient safety culture is an essential aspect of healthcare that impacts
patients, medical personnel, and organizations. It entails moral and legal obligations and can
lead to advancements in the caliber, efficiency, and accessibility of healthcare. A healthy
patient safety culture may be fostered and maintained with the help of ongoing research in
this area, ultimately resulting in safer and more effective healthcare for all patients.
4
References
5
For this section of your research proposal assignment, you will focus on the implementation plan, which includes considerations for ethics, recruitment practices, and a plan for how you will collect your data. Please note that you will not explain how to analyze your data in this section, but rather how you will go about collecting the data.
The following components must be addressed:
Explain how you will ensure your research is conducted in an ethical manner
Include a copy of an informed consent that will be included for participants of your research proposal project (see pp. 202–203 for a sample)
Explain how you will recruit participants for your study, and how your recruitment process will remain ethical. Be sure to address any incentives (if applicable)
Explain what quantitative data you will collect and how you will go about collecting this data (survey, questionnaire, observation, etc.)
APA formatting, references, and citations are required.
This assignment is a continuation of the previous paper you worked on research. let me know if you would like me to attach your previous works
hello this is a group project i’m doing and i need to do part of it. i will send you the infoemation for it as soon as you accept.tjis is the instruction but my friends did most of it and i only want you to do the part that is not done. I’m a dental hygienist and we are planing To assess the baseline oral health knowledge of senior citizens (aged 65+) residing in low-income nursing facilities in the Country Villa South Conv. Ctr please have this in mind and we are going there to assess and educate them for oral hygiene instructions and then re visit to see hoe much improvement they had.
look at the project templet that what we need to do.https://ilearn.laccd.edu/courses/252054/assignment…
tUsername: 886591177
password: haleloddh2022@student
This is part of the assignment . but they did most of it. and the PDF is what they already did.
The time line should highlight when each component of the project is projected to be worked on or completed as well as who is in charge of this area.
The outline should follow the ADPIE template.
A: For your assessment, provide how you will or how you assessed your target audience with what oral health needs they have. How did you assess this? Survey, interview, review of records etc. Include the problem statement and the goal.
D: What oral conditions did you diagnose your population with? Examples could be clinical in nature (perio/caries/nutrition etc.), or educational such as unawareness of oral disease, access to care etc. What community organizations are already addressing the issues of this population. What more can be done to address the problem?
P: What is your plan for presenting your information to your target audience? Is it a one time presentation? Multiple workshops? A website to provide to them? Individual visits? Group visits? Do you need a large group of students (volunteers), or can your group manage the presentation alone? Include 3 SMART objectives, 3 Strategies and activities for each strategy.
Click on the link to review how to develop SMART goals and objectives.
Developing Goals and Objectives – CDCLinks to an external site.
I: This will be developed more after you actually implement your project, but what are your hopes or ideas for implementation?
E: How will you assess the oral health learning of your audience from your project? Pre/post tests, re-survey, questionnaire etc.
Homework 2
Read the attached article regarding DNR (Do Not Resuscitate) orders. If you remember in
class last week, I brought up this story when talking about clinical nurse specialists’
duties of managing resuscitation orders, as outlined in Chapter 4. An Unconscious Patient
with a DNR Tattoo | NEJM
Provide a ONE PAGE response including the following: (Your name or reference do
not count towards the over length. It needs to be 1 full page of content.)
o Summary of the article, what did the health organization ultimately do regarding
this situation?
o Explain the importance of properly honoring an individual’s advanced directives,
like a DNR order.
o If this dilemma occurred at your healthcare organization, how would you have
directed your organization to handle this situation? Would you have handle things
differently? Why or Why not?
Use Times New Roman, 12-point font, double spaced. APA Format. Submit your
response to the Homework 2 dropbox by October 4th at 11:59 P.M. to receive your points.
Please use in-text citations when writing your response. If they aren’t your own words
and it is information you obtained from the article, APA format requires an in-text
citation. If you are unfamiliar with using in-text citations in APA, review the links below.
o In-Text Citations: The Basics // Purdue Writing Lab
o In-Text Citations: Author/Authors // Purdue Writing Lab
o Reference List: Basic Rules // Purdue Writing Lab
Cite the Article in APA format as a reference (Reference page)
General Sample APA Journal Article Reference
Author, A. A., & Author, B. B. (Date of publication). Title of article. Title of Online Periodical,
volume number(issue number if available), pages. Retrieved from
http://www.someaddress.com/full/url/
Webpage or Piece of Online Content
If the page names an individual author, cite their name first:
Lastname, F. M. (Year, Month Date). Title of page. Site name. URL
Price, D. (2018, March 23). Laziness does not exist. Medium.
https://humanparts.medium.com/laziness-does-not-exist-3af27e312d01
The topic for my project is: Sexual Health, so write the paper on that topic.
The theoretical framework is a critical element of your work. A theoretical framework is the general representation of relationships in your problem and is based on existing theory. The conceptual framework is your idea on how the problem should be explored, and it is generally based on a theory. The difference between the two is the scope. Theory is broad; concept is narrow.
In most research studies, your framework can be either theoretical or conceptual in nature. For the purposes of this project, you will most likely follow a conceptual framework, which is your idea on how the research problem will be explored (although you could have both).
For example:
Theoretical framework: Stimulus is applied to elicit a response
Conceptual framework: A new teaching method is applied to elicit improvement in midterm test scores.
In this section of your change project paper, state the perspective through which the problem and/or phenomenon may be explored, and include the following:
Select a minimum of two theories.
Identify the process and logic in selecting these theoretical frameworks or conceptual frameworks for your study.
Discuss how each theory or model applies to the individual project.
Present the framework guiding your study.
Describe the assumptions of the framework.
Describe each key component of the framework.
Discuss how each element of the phenomenon applies to the framework.
Apply each element of the theory to the elements of the phenomenon under study.
Develop the rationale for the sample selection criteria.
Discuss, analyze, and critique pertinent research that uses the framework.
Remember that research never proves theory. Your research project can only support or refute the theoretical propositions you are using as your framework. But if you do not use theory or conceptual frameworks in your research, you may not be able to put your findings in a context that could strengthen the nursing education profession!
This section should be 3–4 pages in length, not including the cover or reference page. You must reference a minimum of 3 scholarly articles.
Use current APA format to style your paper and to cite your sources. Review the rubric for more information on how the assignment will be graded.
This criterion is linked to a Learning OutcomeContent
60 to >49.2 pts
Meets Expectations
Identifies independent theories or conceptual models that relate to the change project topic and describes how they will be applied to the change project. Thoroughly discusses how each element of the phenomenon applies to the framework. Clearly applies each element of the theory to the elements of the phenomenon under study. Develops the rationale for the sample selection criteria, and expertly discusses, analyzes, and critiques pertinent research that uses the framework.
49.2 to >45.0 pts
Approaches Expectations
Identifies independent theories or conceptual models that relate to the change project topic and describes how they will be applied to the change project. Discusses how most elements of the phenomenon apply to the framework, but may be lacking specific details. Attempts to apply each element of the theory to the elements of the phenomenon under study but may not make clear connections. Develops the rationale for the sample selection criteria, and briefly discusses pertinent research that uses the framework, but may be somewhat lacking in analysis and/or critique.
45 to >35.4 pts
Falls Below Expectations
Identifies independent theories or conceptual models but they may only indirectly relate to the change project topic. May not discuss how elements of the phenomenon apply to the framework. Connections to each element of the theory to the elements of the phenomenon are vague and unclear. The rationale for the sample selection criteria and pertinent research that uses the framework may be missing or severely lacking in analysis and/or critique.
35.4 to >0 pts
Does Not Meet Expectations
Fails to identify a theory or conceptual model or it is written in such a way that no relationships can be identified.
60 pts
This criterion is linked to a Learning OutcomeOrganization
7.5 to >6.15 pts
Meets Expectations
Content is well written throughout. Information is well organized and clearly communicated.
6.15 to >5.63 pts
Approaches Expectations
Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.
5.63 to >4.43 pts
Falls Below Expectations
Content is disorganized in many places and it lacks clarity.
4.43 to >0 pts
Does Not Meet Expectations
Content lacks clarity and information is disorganized, or may be an outline or a list.
7.5 pts
This criterion is linked to a Learning OutcomeAPA Format/Mechanics
7.5 to >6.15 pts
Meets Expectations
Follows all the requirements related to format, length, source citations, and layout. Assignment is free of spelling and grammatical errors.
6.15 to >5.63 pts
Approaches Expectations
Follows length requirement and most of the requirements related to format, source citations, and layout. Assignment is mostly free of spelling and grammatical errors.
5.63 to >4.43 pts
Falls Below Expectations
Follows most of the requirements related to format, length, source citations, and layout. Assignment contains some spelling and grammatical errors.
4.43 to >0 pts
Does Not Meet Expectations
Does not follow format, length, source citations, and layout requirements. Assignment contains many spelling and grammatical errors.
Using the following website: https://diabetes.jmir.org/2019/2/e11343/ ;Post the title of the article, authors, purpose, and type of study: Quantitative, Qualitative, or Systematic Review.Discuss how it might influence your practice (nursing). What changes to your practice would you recommend based on the article?
College of Health Sciences
Department of Public Health
Assignment Cover Sheet
Course name:
GLOBAL HEALTH
Course number:
PHC 311
CRN
Assignment title or task:
What are the different types of Aids which are delivered by
wealthy countries to poor countries? (10 marks)
Student Name:
Students ID Number:
Submission Date:
Instructor name:
Grade:
Out of 10
College of Health Sciences
Department of Public Health
Assignment Instructions (Week 5):
Dear Students,
The Assignment is available in Course materials and activities under Week 5 by name Week 5 –
Assignment.
This activity will comprise for 10 marks in the Total course work.
The Assignment is available from Release date 24/04/2023.
Assignment guidelines:
•
•
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, Submission date)
in word document, Pdf is not accepted.
It must Avoid plagiarism. It is not acceptable. Marks will cut if plagiarism available.
Word count- Maximum 500 words for each answer.
Font should be 12 Time New Roman.
Color should be black.
Line spacing should be 1.5.
Don’t use bold or Italic or underline in your answer.
References should be in APA style format only.
Note: You are to locate original studies with research conducted and published by the primary investigator. You may also use quantitative, qualitative, mixed methods studies, meta-analyses or Clinical Practice Guidelines (CPGs).
REQUIREMENTS
Find and review ten (10) scholarly, peer-reviewed research articles, meta-analyses, or CPGs in support of the practice change intervention. Complete the appropriate section in the worksheet for each article.
State the PICOT question.
For each article, supply the information for each of the seven headings for the appropriate article type
PREPARING THE ASSIGNMENT:
Use the designated Research Summary Table Worksheet
All scholarly, peer-reviewed research articles must be current within a 5-year time frame unless a valid rationale is provided, and the instructor has approved the use of an older reference.
Use APA 7th edition formatting for references.
DIRECTIONS AND ASSIGNMENT CRITERIA
Assignment Criteria Points % Description
PICOT question 20 10% PICOT question provided in sentence format
Articles 1-10 15/article150 total 7.5% / article75% total For each article:
Scholarly article: US based peer reviewed journal focused for clinicians
Publication date is current within 5 years
Correctly categorizes article type
Completes all seven areas of article analysis
Explains relevance to PICOT question and implications for advanced nursing practice
APA 20 10%
Use of worksheet template
Correct APA 7th edition format for the following:
Font style and size
Citing and referencing sources
Mechanics of style (abbreviations, capitalization, italics, numbers)
Graduate-level writing style 10 5%
Correct use of spelling, grammar, punctuation, and sentence structure
Clarity, organization, and logical flow of ideas within writing
Synthesis of information is present with no direct quotes
Correct APA 7th edition format for the following:
Font style and size
Citing and referencing sources
Mechanics of style (abbreviations, capitalization, italics, numbers)
Use of template
NR505NP Week 5 Research Summary Assignment Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomePICOT Question
20 ptsExceptionalPICOT question provided in sentence format and all five attributes are listed. (Six critical elements.) 18 ptsExceedsPICOT question provided in sentence format, but one attribute is not defined. (Five critical elements.) 16 ptsMeetsPICOT question provided in sentence format, but two attributes are not defined. (Four critical elements.) 8 ptsNeeds ImprovementPICOT question is not in sentence format and/or three or more attributes are not defined. 0 ptsDevelopingPICOT question not supplied.
20 pts
This criterion is linked to a Learning OutcomeArticle 1
15 ptsExceptionalPresentation of information was exceptional and included all seven elements required for study type. (Seven critical elements.) 13 ptsExceedsPresentation of information was good but was superficial in places and included all of the seven elements required for study type. 12 ptsMeetsPresentation of information included six of the seven critical elements required for study type. 6 ptsNeeds ImprovementPresentation missing two or three of the seven critical elements. 0 ptsDevelopingPresentation missing four or more of the seven critical elements.
15 pts
This criterion is linked to a Learning OutcomeArticle 2
15 ptsExceptionalPresentation of information was exceptional and included all seven elements required for study type. (Seven critical elements.) 13 ptsExceedsPresentation of information was good but was superficial in places and included all of the seven elements required for study type. 12 ptsMeetsPresentation of information included six of the seven critical elements required for study type. 6 ptsNeeds ImprovementPresentation missing two or three of the seven critical elements 0 ptsDevelopingPresentation missing four or more of the seven critical elements.
15 pts
This criterion is linked to a Learning OutcomeArticle 3
15 ptsExceptionalPresentation of information was exceptional and included all seven elements required for study type. (Seven critical elements.) 13 ptsExceedsPresentation of information was good but was superficial in places and included all of the seven elements required for study type. 12 ptsMeetsPresentation of information included six of the seven critical elements required for study type. 6 ptsNeeds ImprovementPresentation missing two or three of the seven critical elements. 0 ptsDevelopingPresentation missing four or more of the seven critical elements.
15 pts
This criterion is linked to a Learning OutcomeArticle 4
15 ptsExceptionalPresentation of information was exceptional and included all seven elements required for study type. (Seven critical elements.) 13 ptsExceedsPresentation of information was good but was superficial in places and included all of the seven elements required for study type. 12 ptsMeetsPresentation of information included six of the seven critical elements required for study type. 6 ptsNeeds ImprovementPresentation missing two or three of the seven critical elements. 0 ptsDevelopingPresentation missing four or more of the seven critical elements.
15 pts
This criterion is linked to a Learning OutcomeArticle 5
15 ptsExceptionalPresentation of information was exceptional and included all seven elements required for study type. (Seven critical elements.) 13 ptsExceedsPresentation of information was good but was superficial in places and included all of the seven elements required for study type. 12 ptsMeetsPresentation of information included six of the seven critical elements required for study type. 6 ptsNeeds ImprovementPresentation missing two or three of the seven critical elements 0 ptsDevelopingPresentation missing four or more of the seven critical elements.
15 pts
This criterion is linked to a Learning OutcomeArticle 6
15 ptsExceptionalPresentation of information was exceptional and included all seven elements required for study type. (Seven critical elements.) 13 ptsExceedsPresentation of information was good but was superficial in places and included all of the seven elements required for study type. 12 ptsMeetsPresentation of information included six of the seven critical elements required for study type. 6 ptsNeeds ImprovementPresentation missing two or three of the seven critical elements. 0 ptsDevelopingPresentation missing four or more of the seven critical elements.
15 pts
This criterion is linked to a Learning OutcomeArticle 7
15 ptsExceptionalPresentation of information was exceptional and included all seven elements required for study type. (Seven critical elements.) 13 ptsExceedsPresentation of information was good but was superficial in places and included all of the seven elements required for study type. 12 ptsMeetsPresentation of information included six of the seven critical elements required for study type. 6 ptsNeeds ImprovementPresentation missing two or three of the seven critical elements. 0 ptsDevelopingPresentation missing four or more of the seven critical elements.
15 pts
This criterion is linked to a Learning OutcomeArticle 8
15 ptsExceptionalPresentation of information was exceptional and included all seven elements required for study type. (Seven critical elements.) 13 ptsExceedsPresentation of information was good but was superficial in places and included all of the seven elements required for study type. 12 ptsMeetsPresentation of information included six of the seven critical elements required for study type. 6 ptsNeeds ImprovementPresentation missing two or three of the seven critical elements. 0 ptsDevelopingPresentation missing four or more of the seven critical elements.
15 pts
This criterion is linked to a Learning OutcomeArticle 9
15 ptsExceptionalPresentation of information was exceptional and included all seven elements required for study type. (Seven critical elements.) 13 ptsExceedsPresentation of information was good but was superficial in places and included all of the seven elements required for study type. 12 ptsMeetsPresentation of information included six of the seven critical elements required for study type. 6 ptsNeeds ImprovementPresentation missing two or three of the seven critical elements. 0 ptsDevelopingPresentation missing four or more of the seven critical elements
15 pts
This criterion is linked to a Learning OutcomeArticle 10
15 ptsExceptionalPresentation of information was exceptional and included all seven elements required for study type. (Seven critical elements.) 13 ptsExceedsPresentation of information was good but was superficial in places and included all of the seven elements required for study type. 12 ptsMeetsPresentation of information included six of the seven critical elements required for study type. 6 ptsNeeds ImprovementPresentation missing two or three of the seven critical elements 0 ptsDevelopingPresentation missing four or more of the seven critical elements.
15 pts
This criterion is linked to a Learning OutcomeAPA
20 ptsExceptional
Correct APA format with 0-1 error for the following: • Font style and size • Citing and referencing sources • Mechanics of style (abbreviations, capitalization, italics, numbers)
18 ptsExceeds
APA format with 2-4 errors for the following: o Font style and size o Citing and referencing sources o Mechanics of style (abbreviations, capitalization, italics, numbers)
16 ptsMeets
APA format with 5-7 errors for the following: o Font style and size o Citing and referencing sources o Mechanics of style (abbreviations, capitalization, italics, numbers)
8 ptsNeeds Improvement
APA format with 8-9 errors for the following: o Font style and size o Citing and referencing sources o Mechanics of style (abbreviations, capitalization, italics, numbers)
0 ptsDeveloping
APA format with > 10 errors for the following: o Font style and size o Citing and referencing sources o Mechanics of style (abbreviations, capitalization, italics, numbers)
20 pts
This criterion is linked to a Learning OutcomeScholarly Writing
10 ptsExceptionalDistinguished graduate-level writing style is evidenced by meeting all of the following criteria with 0-1 errors total: • Correct use of spelling, grammar, punctuation, and sentence structure • Clarity, organization, and logical flow of ideas within writing • Synthesis of information with no direct quotes • Use of template • Articles from scholarly sources: US based peer-reviewed journals geared for clinicians. (5 critical elements) 9 ptsExceedsGraduate-level writing style exceeds expectations as evidenced by 2-4 errors total in the five critical elements. 8 ptsMeetsProficient graduate-level writing style is evidenced by meeting the following criteria with 5-7 errors total in the five critical elements. 4 ptsNeeds ImprovementGraduate-level writing style needs improvement as evidenced by meeting the following criteria with 8-9 errors total in the five critical elements. 0 ptsDevelopingGraduate-level writing style needs improvement as evidenced by meeting the following criteria with 10 or more errors total in the five critical elements.
10 pts
Respond to the following:Each of the chapters in our textbook provides a box titled Thinking Like a Clinician, in which a family case study is presented, followed by several question prompts geared towards skill application from the chapter/theory(ies). For this week’s discussion, you may select the Thinking Like a Clinician activity from either Chapter 9 OR Chapter 10 (Experiential or Structural). Please review the family case study, and construct responses to each of the questions presented under the case study.
Part 1: Discussion 1 NUR 500. For this part, I will need an initial response with 250 to 300 words and 1 reference. I will need two peer responses with at least 100 words and 1 reference
Identify one quality improvement strategy to improve health. How could you apply it to your current nursing practice? How does the assimilation of quality improvement strategies enhance leadership?
Part 2: Discussion 1 NUR 510. For this part, I will need an initial response with 250 to 300 words and 1 reference. I will need two peer responses with at least 100 words and 1 reference.
Select a state or federal law or regulation related to patient safety that has been implemented within the last five years requiring hospitals or any other health care organizations to change the way they manage the delivery of care. Discuss the changes that have occurred because of this law or regulation.
Additionally, discuss the technology associated with either your selected law/regulation or a similar one. Are there ethical dilemmas that have resulted from technology changes when delivering care to patients or patient safety? Explain the dilemmas and how they might be resolved.
Part 3: Discussion 2 NUR 510. For this part, I will need an initial response with 250 to 300 words and 1 reference. I will need two peer responses with at least 100 words and 1 reference.
Evidence-based practice is extremely important in nursing. Throughout your master’s program, you will complete research on various topics. Knowing how to construct a strong problem statement and complete a critical analysis of the available information to write a literature review is essential.
This week, you will write a problem statement and perform a literature review in preparation for your ethical issues debate presentation. Share your problem statement in this discussion so that you can review each other’s work and provide peer-to-peer feedback. Also, describe what you think are the most important learning takeaways from the literature review resources you reviewed.
Follow the instructions in the bullets below to direct you where to find resources on problem statements and literature reviews:
Go to the Student Resources page.
Click on Research and Writing.
Then view:
Writing a Problem Statement
What is a Literature Review
Conducting a Literature Review
The nurse manager of a medical–surgical unit has a budgeted ADC of 20. A new vascular surgeon has been admitting patients to the unit, which is requiring an increase in nursing care to treat these additional patients. The current budgeted HPPD is 7.59. You have been monitoring the number of patients with higher acuity in anticipation of budget planning.
You have been reviewing reports, and over the past 6 months since the surgeon came on board, you have noticed an unfavorable salary variance. You also have been tracking the actual census, and the ADC on average remains at 20; however, six of the patients have higher acuity. You are proposing the configuration of the unit be changed to a blended model with an overall ADC of 20. The blend is 70% medical–surgical (ADC and 30% step-down (6 ADC).
Answer the following Questions below along with 2 peer responses.
You need to discuss the issues with the nurse leader you report to.
1. What discussion points should you plan to cover? Will there be a need for additional FTE caregivers to care for the change in acuity? If so, how many FTEs? Have you been staffing above the staffing guideline using OT?
2. The assumption is you are using OT to cover the additional clinical requirements. Financial reports indicate for the 6-month period OT expense is $125,000, which is unfavorable to the budget. What are your recommendations? Compare the cost of OT used over the past 6 months with the cost of hiring the additional RNs.
3. Develop a revised staffing grid. (very basic does not need to be complex)
Choose any one of the common occupational infectious diseases and explain the following: Causes, mode of transmission, and symptoms. Occupational group at risk Prevention and control measures
. Short essay of 500-750 words (Excluding references).
The font size should be 12. Font type should be Times New Roman
The heading should be Bold. Color should be Black.
The paragraph must be justified. Double line spacing.
Use proper references in APA style. AVOID PLAGIARISM
Create a PowerPoint presentation that reviews four peer-reviewed articles written in the last five years on the issues around the adoption of eHealth in the Kingdom. Your presentation should contain the following concepts. Discuss at least 4 of the following perceptions that physicians may have that could be causing them to hesitate in using this technology.
Usefulness
Technical support available
Increased workload
User-friendly technology
Staff attitudes
Cost
Patient privacy
Your presentation should meet the following structural requirements:
Be 13-14 slides in length, not including the title or reference slides.
Be formatted according to Saudi Electronic University and APA writing guidelines.
Provide support for your statements with citations from a minimum of eight scholarly articles. These citations should be listed in the Notes section of the slide in which they appear. Two of these sources may be from the class readings, textbook, or lectures, but four must be external.
Each slide must provide detailed speaker’s notes to support the slide content. These should be a minimum of 120 words long (per slide) and must be a part of the presentation. The presentation cannot be submitted in PDF format, which does not make notes visible to the instructor. Notes must draw from and cite relevant reference materials.
Utilize the following headings to organize the content in your presentation:
Introduction
4-5 of the above topics as 4-5 slides
Cultural, Social, or Religious Barriers
Recommendations for KSA
Conclusion
The nurse manager of a medical–surgical unit has a budgeted ADC of 20. A new vascular surgeon has been admitting patients to the unit, which is requiring an increase in nursing care to treat these additional patients. The current budgeted HPPD is 7.59. You have been monitoring the number of patients with higher acuity in anticipation of budget planning.
You have been reviewing reports, and over the past 6 months since the surgeon came on board, you have noticed an unfavorable salary variance. You also have been tracking the actual census, and the ADC on average remains at 20; however, six of the patients have higher acuity. You are proposing the configuration of the unit be changed to a blended model with an overall ADC of 20. The blend is 70% medical–surgical (ADC and 30% step-down (6 ADC).
Answer the following Questions below along with 2 peer responses.
You need to discuss the issues with the nurse leader you report to.
1. What discussion points should you plan to cover? Will there be a need for additional FTE caregivers to care for the change in acuity? If so, how many FTEs? Have you been staffing above the staffing guideline using OT?
2. The assumption is you are using OT to cover the additional clinical requirements. Financial reports indicate for the 6-month period OT expense is $125,000, which is unfavorable to the budget. What are your recommendations? Compare the cost of OT used over the past 6 months with the cost of hiring the additional RNs.
3. Develop a revised staffing grid. (very basic does not need to be complex)
i need one reaponse to each peer
hollie: Qualitative research seeks to explore, describe, uncover, and understand the human experience of individuals experiencing a specific phenomenon. Unlike quantitative research, qualitative research is done without numbers, measurements, or statistical analysis (Melnyk et al., 2023). Qualitative researchers are embedded in collecting information through observations, semi-structured interviews, focus groups, and document studies. In healthcare research, this type of research is underrepresented. Typically, changes in clinical practices derive from randomized controlled trials because they are a higher hierarchy in the evidence-based medicine paradigm (Busetto et al., 2020).
To locate quality evidence-based data, researchers must become adept at research review. The steps involved include developing the clinical question, searching for the best evidence, synthesizing or appraising the evidence, implementing evidence into practice, evaluating improved outcomes with practice changes, and disseminating the results (Meadow-Oliver & Kapaale, 2023). These steps have led me to expand and adapt my PICOT question: will educating adults with symptomatic peripheral arterial disease (PAD) on lifestyle modifications improve their symptoms within six weeks compared to the current practice of not providing educational information on lifestyle modifications? Is education enough of an intervention? What are the types of information should patients be educated on? When should they receive this information? How should they receive the information?
Akerman et al. (2019) state that PAD patients struggle to comply with the gold standard of supervised exercise therapy to improve symptoms. Motivation to exercise for PAD varies due to the limitation of claudication. They state that only one in three PAD patients attend and complete a supervised exercise program, which warrants a need for an alternative approach, such as adding heat therapy before exercise, to improve compliance (Akerman et al., 2019). Perhaps these researchers applied this additional intervention after carefully reviewing qualitative research studies (Busetto et al. 2020).
References
Akerman, A.P., Thomas, K.N., van Rij, A.M., Body, E.D., Alfadhel, M., & Cotter, J.D. (2019).
Heat therapy vs. supervised exercise therapy for peripheral arterial disease: A 12-week randomized, controlled trial. American Journal of Physiology. Heart and Circulatory Physiology, 316(6), H1495-H1506.
https://doi.org/10.1152/ajpheart.00151.2019
Busetto, L., Wolfgang, W., & Gumbinger, C. (2020). How to use and assess qualitative research
Methods. Neurological Research and Practice, 2(14).
Melnyk, B.M., Morrison-Beedy, D., & Cote-Arsenault, D. (2023). Generating evidence through
tammy:Melnyk and Fineout-Overholt (2023) defined qualitative evidence as the “how” and “why” of a clinical phenomena as opposed to quantitative evidence which is considered to be the “what.” Further explained, quantitative evidence was defined as the hard evidence, providing numbers and statistics; whereas quantitative evidence is the human experience, values and reasons behind those numbers and statistics. Qualitative is subjective while quantitative is objective.
My PICOT:
P – in patients having spine surgery
I – use of intraoperative powder vancomycin
C – compared to no use of intraoperative powder vancomycin
O – affect on post-surgical site infection (SSI) rates
T – up to 90 days after surgery
Research into my PICOT question has resulted in a multitude of quantitative evidence. Upon starting this research, I assumed there would be a statistical landslide, one way or the other, that the intraoperative powder vancomycin was effective or not. However, that has proven to be incorrect. The quantitative data is quite conflicting. Many studies indicate vancomycin powder to be effective in preventing SSIs. Many other studies indicate it has minimal to zero effect at all.
The qualitative data, however, has offered the benefit of helping explain and understand “why” there may be such variances in the quantitative data. Regarding randomized controlled trials, Gisselbaek et al. (2021) indicated qualitative data promotes an understanding of how a trial was designed as well as the process the researchers used to measure the outcomes. When I look at all the data collected for my PICOT question, the qualitative data indicates the design of the trials is certainly worth looking at. All of the studies indicated the patients had comorbidities, but did not consider these in the final statistics. Many of these comorbidities could medically impact whether or not patients developed an SSI, including diabetes, obesity, and hypertension. Other factors not considered were age, sex, or if the patient smoked.
Gisselbaek, M., Hudelson, P., Savoldelli, G.L. (2021) . A systematic scoping review of published
qualitative research pertaining to the field of perioperative anesthesiology. Canadian Journal of
Professional Capstone and Practicum Reflective Journal – Topic 4
Assessment Description
Students are required to submit weekly journal entries throughout the course. These reflective narratives help students identify important learning events that happen throughout the course and the practicum. In each week’s entry, students should reflect on the personal knowledge and skills gained.
Write a reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing.
Topic Focus: Ethical Considerations in Health Care
Prepare this assignment according to the guidelines found in the APA Style Guide
plagiarism report (less than 10%)
Note: For this assignment I need to talk about how ethical considerations in health care (the topic focus) relates to this week’s assignments. Please, let me know if you have any questions.
These are this week’s assignments, so you have an idea of what to develop on this reflective journal.
1- Why is understanding the health care system at the local level important to consider when planning an EBP implementation? Conduct research and solicit anecdotal evidence from your course preceptor that you will take into consideration for your own change project.
Implementing an Evidence-Based Practice (EBP) requires a thorough understanding of the local healthcare system. It facilitates the compatibility of evidence-based practice subjects with local norms, patient requirements, values, and the effectiveness of the practice concerning the healthcare system, which aids in the successful implementation of EBP in healthcare organizations (Rangachari, 2020).
It is crucial to have an in-depth understanding of the local healthcare system, including adequate medical personnel such as nurses, physicians, and other professionals, to implement EBP successfully. The local level must provide various resources for the implementation of EBP, including adequate funding and human capital. To provide leadership and the necessary skills during the implementation of an EBP, skilled human resources are vital (Cassidy, 2021). The organizational structure of the healthcare system at the local level plays a critical role in promoting successful EBP implementation. Understanding the resources and what is available within the local community will allow individuals to know where changes need to be made and how a change could improve things (Yoo, 2019).
When conducting my practice change, I will evaluate the healthcare system at the local level and involve the community. Involving the community allows for collaboration with the healthcare system. Understanding the healthcare system at the local level also provides information about what healthcare needs are lacking in the community.
2- Compare and contrast two change theories and/or nursing theories. Determine which theory makes the most sense for implementing your specific EBP intervention. Why? Has your preceptor used either theory, and to what result?
The Transtheoretical Model (TTM) and the Health Promotion Model (HPM) are two nursing theories that can be compared and contrasted. The HPM, which Nola Pender developed, strongly emphasizes health promotion and illness prevention. Individual characteristics and experiences, cognitions and emotions that are particular to an activity, and behavioral results are all included in the model. According to the HPM, interactions between behavioral, environmental, and personal factors lead to health-promoting behavior. The HPM’s main objective is to increase people’s levels of well-being.
The TTM, also known as the Stages of Change model, was created by Carlo DiClemente and James Prochaska and stresses the stages people go through when changing their behavior. The model’s five stages of transformation are pre-contemplation, contemplation, preparation, action, and maintenance. According to the TTM, people move through four stages in a cyclical pattern when seeking to change behavior.
The TTM is a more suitable theory to apply when conducting an evidence-based practice (EBP) intervention because it specializes in behavior modification, which is essential to implementing an EBP intervention. The model has been validated and applied to various behaviors, including fall prevention. It offers a framework for understanding the phases people experience when trying to alter behavior, which can assist healthcare professionals in adjusting their interventions to the patient’s stage of change. This can increase the possibility that behavior will change successfully and, ultimately, the EBP intervention will be implemented. Applying the TTM can assist in matching fall prevention recommendations to a patient’s preparedness level when interacting with them. For instance, a healthcare professional can give information and explain the rationale for modifications if the patient is in the pre-contemplation stage and does not believe they are at risk of falling.
According to my observations and observations made by my preceptor, the TTM has been successfully used by her in her practice to assist patients in making behavioral adjustments. There was a time when my preceptor dealt with a patient attempting to quit smoking and used the TTM. She could tailor her interventions to meet the patient’s needs and provide the proper support throughout the procedure Because she was aware of the patient’s state of change.
Resources provided by my instructor for this week’s assignments (other resources are under attachments)
1
Discussion 520 doctor Replies
Abdullah 520
How data mining supported process improvement in a healthcare organization
Innovations improve the quality, affordability, and efficiency of healthcare. New technology and commercial strategies, for example, aid in
the advancement of healthcare. Furthermore, healthcare systems throughout the globe are facing unprecedented problems, such as the continuous
and quick modification of clinical procedures based on increasing scientific data and the provision of high-quality treatment with limited
resources.(Munoz-Gama et al., 2022)
Process execution data are a key source of information for healthcare process management and improvement. Health Information Systems
(HISs) are often utilized in healthcare organizations. Process mining methods may be used to analyze business processes utilizing data captured
during their execution. These approaches are used in a variety of fields, including healthcare, where it primarily focuses on the examination of
diagnostic, therapeutic, and organizational processes.(Munoz-Gama et al., 2022)
In contrast to other techniques, such as process mapping exercises involving staff members, process mining begins with data on a process’s
real-world behavior. As a result, process mining may help healthcare organizations achieve each of the triple goals for healthcare improvement:
(i) improving population health, for example, by facilitating the analysis and improvement of care pathways; (ii) improving patient experience,
for example, by highlighting how a process can be streamlined from the patient’s perspective; (iii) lowering costs, for example, by highlighting
bottlenecks; and (iv) improving the work-life balance of healthcare professionals, for example, by enabling the analysis of resource involvement
and requirements in a healthcare process.(Munoz-Gama et al., 2022)
Process mining is a set of approaches for extracting useful information from data generated by processes as they run. It acts as a link between
process science (which includes fields like business process management and operations research) and data science (which includes things like
data mining and predictive analytics), resulting in ways for analyzing processes using data. Process mining is domain-agnostic, which means that
it may be used in any industry where processes exist and data characterizing them is accessible. The application of process mining in healthcare,
the subject of this research, is rising.(Munoz-Gama et al., 2022)
Clinical pathways are highly flexible because all patients requiring the same treatment have different co-morbidities and complications, they
involve complex decision-making due to their knowledge-intensive nature, they are performed by a network of specialists, and they are
constantly evolving due to innovations and unforeseen situations. Using process variation analysis to identify differences across groups of route
executions may assist determine if process improvement is required and, if so, which adjustments can make the process more efficient. Caron et
al. performed this investigation on 1143 gynecologic oncology patients, dividing them into two subsets: those who had radiation and those who
received chemotherapy.(Munoz-Gama et al., 2022)
A popular strategy to dealing with this problem is to eliminate or decrease the variability in the event log using abstraction techniques such
as filtering or aggregation, such as trace clustering and semantic activity aggregation. However, this method provides process models that only
address a subset of the topic at hand. Such techniques may not be enough for many real-world healthcare applications since they only give a
partial perspective of the process and may conceal important rare behavior.(Munoz-Gama et al., 2022)
From February 2004 to June 2021, the National Reporting and Learning System (NRLS), the national repository of patient safety events in
the United Kingdom, was used to issue 150 patient safety warnings, reducing the risk of future occurrences. In the United Kingdom, the
“Learning from Litigation Claims” advice was produced in 2021 to help organizations learn from NHS negligence cases and improve patient
safety. In the United States, analyzing patient complaints has been shown to be an effective method of monitoring diagnostic safety risks. These
examples show how a single data source may provide a variety of results.(Crespo et al., 2021)
This research used linear discriminant analysis to triangulate 10 regularly obtained London NHS datasets in order to establish some of the
important aspects associated with safer hospitals. Good organizations were those with a CQC Safe rating of “Good” or “Outstanding,” whereas
RI organizations were those with a rating of “Inadequate” or “Requires Improvement.” Our results indicate that improving the safety rating
involves conscious understanding and management of three stakeholders’ needs: staff, patients, and organizations (as determined by the NHS
Staff Survey).(Crespo et al., 2021)
Organizational safety concerns, such as organizational effects and senior management, are hidden faults that have a direct impact on other
levels of human failure. These shortcomings fall under three categories (ref): resource management, organizational processes, and organizational
climate.(Crespo et al., 2021)
Reference:
Crespo, R. F., Neves, A. L., Alagha, M. A., Leis, M., Flott, K., Bray, O., Fontana, G., Peck, J., Aldred, V., & Darzi, A. (2021). What can data
mining tell us about patient safety? Using linear discriminant analysis to identify characteristics associated with positive safety rating in London
NHS organisations (p. 2021.11.12.21266228). medRxiv. https://doi.org/10.1101/2021.11.12.21266228
Munoz-Gama, J., Martin, N., Fernandez-Llatas, C., Johnson, O. A., Sepúlveda, M., Helm, E., Galvez-Yanjari, V., Rojas, E., Martinez-Millana,
A., Aloini, D., Amantea, I. A., Andrews, R., Arias, M., Beerepoot, I., Benevento, E., Burattin, A., Capurro, D., Carmona, J., Comuzzi,
M., … Zerbato, F. (2022). Process mining for healthcare: Characteristics and challenges. Journal of Biomedical Informatics, 127, 103994.
https://doi.org/10.1016/j.jbi.2022.103994
Discussion 520 doctor Replies
Shahad 520
Process Improvement in Radiation Oncology
2
Observations on Effectiveness
Healthcare organizations successfully integrate data mining tools for patient safety and process improvement. These firms gain essential
insights by analyzing large datasets and seeing subtle patterns that could otherwise go undiscovered (Mutic et al., 2010). With this proactive
approach, problems may be solved quickly, operational procedures can be optimized, and overall patient safety protocols can be improved. It
also promotes a culture of ongoing learning and development, strengthening the organization’s dedication to providing high-quality healthcare
services.
Methodologies and Process Improvement
A multidimensional approach to describing and diagnosing issues probably included techniques like trend analysis, statistical modeling, and
root cause analysis. These techniques allowed medical personnel to target particular problem areas and make process changes (Mutic et al.,
2010). These improvements included extensive workflow reorganization, the adoption of new protocols based on data-driven insights, and
advancing training programs. Healthcare companies successfully overcame obstacles by implementing these evidence-based solutions, offering a
comprehensive and long-lasting approach to problem-solving.
Metrics and Sustainability
Several indicators, including but not limited to mistake rates, patient outcomes, staff adherence to protocols, and resource usage
efficiency, were probably used to measure improvements (Mutic et al., 2010). The organization could gauge the effects of changes implemented
because of these measures, which acted as quantitative indicators. The persistence of favorable trends in these parameters likely served as a
proxy for sustainability (Mutic et al., 2010). Continuous monitoring and adjustment were essential to guaranteeing the sustainability of the
improvement efforts over the long run; any departure from the desired KPIs would prompt corrective actions.
Unexplored Opportunities for Improvement
Although the strategies put into place are solid, there are still several opportunities for improvement that still need to be explored. Including
real-time monitoring tools like the Internet of Things (IoT) gadgets and analytics powered by AI might deliver immediate responses (Mutic et
al., 2010). This real-time data may further improve patient safety by enabling healthcare providers to make prompt, well-informed decisions. A
culture of open discussion about near-misses and mistakes among the personnel could also improve the reporting mechanism. Promoting a
culture of proactive reporting ensures a large dataset and more insightful analysis (Mutic et al., 2010). Regular training sessions and sporadic
refresher courses may address any comprehension or practice gaps, which would reinforce the staff’s newly acquired knowledge and skills. The
healthcare organization’s journey toward continuous improvement would benefit significantly from these extra techniques.
Reference
Mutic, S., Brame, R. S., Oddiraju, S., Parikh, P., Westfall, M. A., Hopkins, M. L., … & Wu, B. (2010). Event (error and near‐miss) reporting and
learning system for process improvement in radiation oncology. Medical physics, 37(9), 5027-5036. https://doi.org/10.1118/1.3471377
Discussion 530 Student Replies
Nasser Reply 530
In the field of HFE, the pharmacy environment may be of interest because of the high-risk nature of the activity and the possibility of
medical errors. In addition to the inherent risk associated with dispensing, patient safety is challenged by the complex and dynamic nature of the
pharmacy setting. The role of the pharmacy setting is notably expanding on a global scale. Pharmacists have taken on the role of prescribing in
acute and secondary care settings, and they now administer vaccinations, provide medication reviews, and assist patients in quitting smoking. In
order to improve the effectiveness and workflow of pharmacy work systems, a significant number of personnel changes have been made. For
example, pharmacy technicians have been added to the workforce to verify the accuracy of medication dispensed, and new technologies like
automated dispensing and electronic prescribing (ePrescribing) have been implemented (Weir et al., 2020).
Multiple studies indicate that healthcare employees, particularly pharmacy workers, may experience MSDs. Numerous work and non-work
circumstances can cause this issue. Daily activities can cause physical and psychological MSDs. Pharmacy unit workers face ergonomic hazards
from computer work, data collection, working area design, repetitive tasks, non-ergonomic pressures, static postures, and drug spills.
Consequently, these risk factors led to pharmacy workers experiencing MSDs such low back and neck pain. Falling is another occupational risk
for pharmacists. Slippery surfaces and spilled chemicals can cause workplace mishaps, along with improper work methods or postures (Nasution
& Mahyuni, 2020).
The ART instrument helps assess repetitive tasks involving upper limb movements (arms and hands) for risk assessment. This tool helps
identify common risk factors for upper limb disorders (ULDs) in repetitive employment. ART targets those who develop, assess, manage, and
inspect repetitive tasks. It can identify high-risk tasks and prioritize risk-reduction strategies. It will benefit employers, safety advocates, health
and safety practitioners, consultants, and ergonomists (Health and Safety Executive2022).
Enter each risk factor’s color band and numerical score on the scoring sheet. On the score sheet, you can note additional relevant assessment
findings. For both arms, numerous criteria just need to be checked once. These include head/neck posture, back posture, breaks, and work
3
tempo. Please enter scores for both the left and right arms in the respective columns. Task and exposure scores prioritize urgent tasks and
evaluate the effectiveness of improvements (Health and Safety Executive2022).
References
Health and Safety Executive (2022). (10th ed.). Oxford University Press.
Nasution, A. D., & Mahyuni, E. L. (2020). The Impact of Work Method on Musculoskeletal Disorders Complaints in Pharmacy Unit.
Weir, N. M., Newham, R., & Bennie, M. (2020). A literature review of human factors and ergonomics within the pharmacy dispensing
process. Research in Social and Administrative Pharmacy, 16(5), 637-645.
Abdullah Reply 530
Assessment of repetitive tasks (ART)
COLLAPSE
work-related upper limb diseases (WRULD) are a well-known condition that causes job impairment, productivity loss, and social
expenditures globally. In Sweden in 2020, 58% of people who claimed to have suffered from poor health owing to work circumstances other
than an accident reported symptoms in the neck and/or upper extremities. These illnesses are linked to hand-intensive activity that requires
severe effort, high repetition, extended duration, awkward or immobile postures, and often a combination of these traits.(Eliasson et al., 2022)
Physical factors in the workplace, including as intense effort, awkward postures, and repetitive activity, as well as psychological and
organizational factors, are linked to WRMSDs in the neck, shoulder, and arms. As a result, risk evaluations of physical elements are critical for
identifying potentially hazardous work activities and prioritizing and developing workplace interventions, both in terms of physical design of the
workplace, work technique, and work organization.(Nyman et al., 2023)
Carpal tunnel syndrome, non-specific arm discomfort, tenosynovitis (tendon inflammation), and lateral epicondylitis (tennis elbow) are all
common work-related upper limb diseases. Upper limb problem discomfort accounts for about one out of every ten missed working days, with
the typical illness absence lasting 13 days. This comes at a high cost to enterprises.(Bromhead, 2018)
Repetitive upper limb activities comprise a series of upper limb motions that are performed every few minutes or more often. The duties are
typically completed for one to two hours every day or shift, with the dangers associated being repetition, force, posture, and working
environment. The HSE created the ART (Assessment of Repetitive tasks) tool to assist with risk assessment activities. The instrument is
designed to evaluate the frequency with which light weights or other repeated jobs are handled, which might lead to upper limb
disorder.(Bromhead, 2018)
The ART tool is especially beneficial for repetitive strain concerns when non-neutral postures and repetition are important risk factors. It
allows for the detection of concerns that would otherwise go unexplored during a routine manual handling risk assessment. After completing a
comprehensive evaluation using the ART tool, a mechanism for evaluating the overall result is offered, along with suggestions on the need for
any additional action.(Bromhead, 2018)
The ART tool takes a step-by-step approach:
•
•
•
•
Stage A: Frequency and repetition of movements;
Stage B: Force;
Stage C: Awkward postures;
Stage D: Additional factors.
For each stage, follow the flow chart and/or assessment guide to determine the level of risk for each risk factor. The levels of risk are
classified in the table below.
• G = GREEN Low level of risk
• A = AMBER Medium level of risk – Examine task closely
• R = RED High level of risk – Prompt action needed
Score sheet
Enter the colour band and numerical score for each risk factor in the table below. Follow the instructions on page 15 to determine the task score
and exposure score.
Left arm
Right arm
Risk factors
Colour
A1 Arm movements
A2 Repetition
B Force
Score
Colour
Score
4
C1 Head/neck posture
C2 Back posture
C3 Arm posture
C4 Wrist posture
C5 Hand/finger grip
D1 Breaks
D2 Work pace
D3 Other factors
Task score
D4 Duration multiplier
X
X
Exposure score
D5 Psychosocial factors
Reference:
Bromhead, A. (2018, January 12). A Guide to the HSE ART tool. Dr Alistair Bromhead Ltd. https://www.abromhead.co.uk/a-guide-to-the-hseart-tool/
Eliasson, K., Fjellman-Wiklund, A., Dahlgren, G., Hellman, T., Svartengren, M., Nyman, T., & Lewis, C. (2022). Ergonomists’ experiences of
executing occupational health surveillance for workers exposed to hand-intensive work: A qualitative exploration. BMC Health Services
Research, 22, 1223. https://doi.org/10.1186/s12913-022-08601-2
Nyman, T., Rhén, I.-M., Johansson, P. J., Eliasson, K., Kjellberg, K., Lindberg, P., Fan, X., & Forsman, M. (2023). Reliability and Validity of
Six Selected Observational Methods for Risk Assessment of Hand Intensive and Repetitive Work. International Journal of Environmental
Research and Public Health, 20(8), 5505. https://doi.org/10.3390/ijerph20085505
Discussion 525 doctor Replies
Shahad 525
Balancing Technology and Human Interaction
Numerous difficulties arise when people connect with technology, especially regarding healthcare and patient care. The possibility of
depersonalization and diminished empathy in healthcare settings, when technology takes center stage is a big challenge. Healthcare personnel
risk concentrating more on screens than patients as computer or mobile application interfaces grow increasingly prevalent in patient care (He et
al., 2021). This may compromise the standard of care and obstruct efficient patient-provider communication.
Furthermore, providing effective and efficient patient care is hampered by the complexity of technology interfaces (Alsswey & Al-Samarraie,
2020). Because not all healthcare personnel are tech-aware, figuring out complex software or apps might take away from time that would be
better spent providing care for patients. The requirement for ongoing training and updates to stay current with technology can also strain
healthcare organizations’ personnel and resources, sometimes resulting in employee burnout and declining job satisfaction.
Recommended Changes
Several suggestions can be made to solve these issues and build interfaces for successful and efficient patient care. User-centred design
principles ought to come first and foremost (Alsswey & Al-Samarraie, 2020). This entails incorporating patients, caregivers, and healthcare
professionals in the design process to guarantee that the interface is user-friendly and meets their requirements.
Prioritizing simplicity is also essential. Interfaces should require the fewest number of clicks and instruct no data entering. This lessens the
cognitive burden on healthcare professionals, enabling them to concentrate more on their patient interactions and less on figuring out
complicated systems. Additionally, by incorporating user-friendly training and support into the program, healthcare personnel will be better
5
equipped to use the technology. Regular updates should emphasize user feedback and ongoing improvement to improve usability rather than
make it more difficult (He et al., 2021).
Finally, it is critical to balance technological use and interpersonal communication. Technology should be viewed as a tool to supplement, not
replace, the talents of healthcare professionals to deliver caring and patient-centred care (Alsswey & Al-Samarraie, 2020). The advantages of
cutting-edge technology and the comfort of human care can be provided to patients by promoting face-to-face connection and technological
solutions.
In conclusion, user-centred design and careful planning can reduce the difficulties associated with human interactions with technology in
patient care. The focus should always be on improving rather than impeding the level of care and interpersonal relationships at the core of
healthcare.
References
Alsswey, A., & Al-Samarraie, H. (2020). Elderly users’ acceptance of mHealth user interface (UI) design-based culture: the moderator role of
age. Journal on multimodal user interfaces, 14, 49-59. https://doi.org/10.1007/s12193-019-00307-w
He, W., Zhang, Z. J., & Li, W. (2021). Information technology solutions, challenges, and suggestions for tackling the COVID-19
pandemic. International journal of information management, 57, 102287. https://doi.org/10.1016/j.ijinfomgt.2020.102287
Mohammed fahad 525
the principles of ethical guidelines in health informatics and how healthcare providers balance the needs to protect population health while
respecting individuals’ privacy when gathering and sharing medical information.
1. Principle of Privacy and Confidentiality: Privacy and confidentiality are fundamental ethical principles in healthcare. Healthcare providers
have a duty to protect patients’ personal health information from unauthorized access and disclosure. This includes implementing robust security
measures, such as encryption and access controls, to safeguard patient data (Borycki & Kushniruk, 2011). Additionally, healthcare providers
should adhere to legal and regulatory requirements, such as the Health Insurance Portability and Accountability Act (HIPAA) in the United
States, which protect patient privacy and ensure the confidentiality of health information.
2. Principle of Informed Consent: Informed consent plays a crucial role in respecting individual autonomy and privacy. Healthcare providers
should obtain the informed consent of patients before collecting, storing, and sharing their medical information. Informed consent involves
providing patients with clear and comprehensive information about the purpose, scope, and potential risks associated with the use of their data.
Patients should have the opportunity to ask questions, clarify concerns, and make informed decisions regarding the use of their health
information (Grando et al., 2016).
3. Principle of Data Accuracy and Quality: Healthcare providers have an ethical obligation to ensure the accuracy and quality of health data used
in informatics systems. Data integrity is essential for making informed clinical decisions and improving patient care. Healthcare organizations
should establish data validation processes, data quality monitoring mechanisms, and regular audits to identify and rectify any inaccuracies or
inconsistencies in health data (Borycki & Kushniruk, 2011).
4. Principle of Data Governance and Accountability: Effective data governance frameworks are essential for maintaining ethical standards in
health informatics. Healthcare providers should establish policies and procedures that outline the responsibilities, roles, and accountabilities of
individuals and teams involved in data management. This includes defining access controls, establishing data sharing agreements, and ensuring
compliance with legal and ethical guidelines (Grando et al., 2016).
Balancing the needs to protect population health while respecting individuals’ privacy requires a comprehensive approach. Some strategies that
healthcare providers can employ include:
a. De-identification and anonymization: When sharing health data for research or public health purposes, healthcare providers can de-identify or
anonymize the data to remove personally identifiable information. This approach helps protect patient privacy while still enabling the use of data
for population health studies or epidemiological research.
b. Data minimization: Healthcare providers should collect only the necessary data required for a specific purpose. Minimizing the collection of
sensitive information reduces the risk of privacy breaches and ensures that data collection aligns with the principles of privacy and
confidentiality.
c. Transparent communication: Healthcare providers should maintain open and transparent communication with patients regarding the
collection, use, and sharing of their health information. This includes informing patients about their rights, the purposes of data collection, the
6
potential risks and benefits, and the safeguards in place to protect their privacy. Building trust through clear communication helps individuals
feel more comfortable with the use of their data (Grando et al., 2016).
In conclusion, ethical guidelines in health informatics emphasize the principles of privacy, confidentiality, informed consent, data accuracy, and
data governance. Healthcare providers can balance the needs to protect population health and respect individuals’ privacy by implementing
robust security measures, obtaining informed consent, ensuring data accuracy, and fostering transparent communication with patients. Adhering
to these principles helps maintain the trust and confidence of patients while enabling the effective use of health informatics for improving
healthcare outcomes.
References:
Borycki, E. M., & Kushniruk, A. W. (2011). Toward an applied ethical framework for health information systems. Journal of the American
Medical Informatics Association, 18(5), 570-578.
Grando, M. A., Rozenblum, R., Bates, D. W., & Shapiro, J. S. (2016). How can health information technology improve care coordination in
transitions of care? American Journal of Medical Quality, 31(6), 530-539.
4 reports about 4 topics. I already selected in the picturefor each topic select 1 recently research paper ( from 2018 to 2023) and summarize it in 250 to 300 words. preferably in Saudi Arabia. I need 4 reports in 4 word files for topicsplagiarism not allowed and must be less than 3%. Use simple and clear English language. use turnitin for checking plagiarism.
Level 3
10 points
Questions Explored
Asked at least 5
further information from questions pertaining to
the patient
the complaint
Level 2
5 points
Level 1
1 point
Asked at least 3 pertinent
questions
Asked less than three questions
the questions pertained to the co
Diagnosis Differential
and definitive
Lists 3 differential and
1 definitive diagnosis,
all appropriate to the
patient
Lists 3 differential and 1
Lists less than 3 differential and
definitive diagnosis, one or definitive, one or more not appr
more not appropriate to
patient
patient
Associated Factors
Describes at least 5
associated factors to
definitive diagnosis
Describes at least 3
associated factors to
definitive diagnosis
Criteria
Describes less than associated f
definitive diagnosis
Level 3
10 points
Level 2
5 points
Pathophysiology
Demonstrates full understanding
pathophysiology of definitive
diagnosis
Demonstrates passable
Describes patho
understanding of
incorrectly of do
pathophysiology of definitive demonstrate und
diagnosis
Complications
Discusses at least 5 potential
complications of disease
Discusses at least 3 potential
complications of disease
Pathophysiology
Level 1
1 point
Discusses less th
potential compli
disease
Criteria
Level 3
10 points
Level 2
5 points
Level 1
1 point
Pathophysiology of
Complications
Explores at least 3 complications and Explores at least 2
how it is caused by the primary
complications and how it is
problem
caused by the primary
problem
Explores at least
complications an
caused by the pr
problem
Lifestyle Changes
Explores at least 5 lifestyle changes to Explores at least 3 lifestyle
reduce symptoms
changes to reduce symptoms
Explores less tha
changes to reduc
Over the Counter
Medications
Lists and discusses at least 3 OTC
medications
Lists and discusses at least 2
OTC medications
Lists and discuss
OTC medication
Scholarly Writing
Less than 3 mistakes in writing
Less than 8 mistakes in
writing
More than 8 mis
writing
APA formatting
Less than 3 mistakes, citations and
references included
Less than 8 mistakes, citations More than 8 mis
and references included
citations and ref
included
Total
Score of Case Study,
/ 100
Neuro Case Study Assignment
A 18 y.o. male presents to your office today complaining of dizziness for the last 2 weeks. It
occurs off and on, but sometimes it is so bad, it makes him vomit. The patient is a high school
senior and is the quarterback on his high school football team. He states he has not taken any hits
to the head or had any severe headaches. See the following information below:
Ht.: 5’9”
Wt. 140 lbs.
BMI: 20.7
BP: 112/62
HR: 64
H/O denies medical problems
The patient tells you he has had slight dizziness for over a month, but it has gotten worse in the
last two weeks. He says sometimes it feels like he is falling. He has not had any trauma or pain in
the head. He denies pain in the ears or sinus problems.
Develop this case study identifying at least 3 differential diagnoses and one definitive diagnosis
and a follow-up/further investigation plan. Use 7th edition APA format and limit this paper to no
more than 6 pages. This is a formal paper and will include a title and reference page. Resources
should include your assigned textbook. Please include the following information in this
assignment:
What additional questions would you want to ask this patient regarding his signs and symptoms
prior to your diagnosis?
What do you suspect the patient’s diagnosis is? List at least three differential diagnoses and one
definitive diagnosis. Discuss how you derived these diagnoses.
What are the associated risk factors for this disease? Specifically, what risk factors does this
patient exhibit?
What is the underlying pathophysiology of this disease process (your definitive diagnosis)?
Discuss potential complications of this disease and why it is so important to treat.
What can you teach this patient about lifestyle changes (discuss at least five) that could help
reduce the frequency or severity of symptoms? Elaborate on why each of your lifestyle
recommendations could be helpful.
List and discuss 3 over the counter (OTC) medications patients may use to alleviate these type of
symptoms.
1. Describe ways in which healthcare organizations are able to retain employees, which helps to maintain a competent workforce. 2. How are performance improvement and patient safety activities communicated throughout the organization? 3. Discuss how quality and research methodologies (including but not limited to quantitative, qualitative, and internal review boards) are different and discuss the legal frameworks that apply to each in healthcare.350 words per question
Unformatted Attachment Preview
Discussion Threads worth 50 possible points
Students are required to post one initial response and two peer response for a total of 3 responses
Points
Possible
Initial Responses
Points
Possible
Peer Responses
23-25
Initial response posted by the end of the third day of the
week.
-andWell-developed thoughts that fully address all aspects of
the initial question(s) with excellent integration of key
concepts.
-andResponses are clear and concise with no grammatical or
spelling errors.
23-25
Peer responses posted by the end of the week.
-andDemonstrated analysis of other classmates posts and
included meaningful comments that offered insight
and expansion of thought
-andResponses are clear and concise with no
grammatical/spelling errors.
20-22
Initial responses posted after the third day of the week.
-andWell-developed thoughts that address most all of the
aspects of the initial questions with good integration of
key concepts.
-andResponses are clear and concise with few
grammatical/spelling errors.
20-22
Only one peer response posted
-andElaborated on classmate’s responses with further
comment or observation, relevant to topic.
-andResponses are clear and concise with few
grammatical/spelling errors.
17-19
Initial response posted by the third day of the week.
-andWell-developed thoughts that address some of the
aspects of the initial questions with good integration of
key concepts.
-andResponses are relatively clear and contain many
grammatical/spelling errors
17-19
Only one peer response posted
-andResponses were limited in relevance to classmates
response and did not enrich discussion (e.g. agrees
or disagrees)
-andResponses are relatively clear and contain many
grammatical/spelling errors.
10-16
Initial response posted after the third day of the week.
-andPoorly developed thoughts that address some of the
10-16
Only one peer response posted.
-andNo relevance or expansion of thought in response
aspects of the initial questions with little integration of
key concepts.
-andResponses lack clarity and contain many
grammatical/spelling errors.
0
No initial responses were posted.
postings
-andResponses lack clarity and contain many
grammatical/spelling errors.
0
No peer responses were posted.
Complete a two-page paper sharing how you would adopt the 10 step communication campaign discussed in the study notes for a STD awareness campaign on a college campus. APA format required for citations and references.
Unformatted Attachment Preview
UNIT VI STUDY GUIDE
Application of Theory: Communications
Campaigns / Global Health
Course Learning Outcomes for Unit VI
Upon completion of this unit, students should be able to:
5. Define health in the public health sector.
5.1 Describe the key issues with respect to the use of communications and media for health
promotion.
5.2 Define examples of theory-based communications campaigns.
5.3 Describe the key issues with respect to health promotion in a global setting.
Required Unit Resources
Chapter 11: Application of Theory: Communications Campaigns
Chapter 12: Application of Theory: Global Health
Unit Lesson
Health Communication Campaign
In this unit, we will introduce and discuss communication campaigns (social mobilization). We will also look at
the steps a public health agency may need to consider when developing and implementing an effective and
successful health communication campaign.
The end goal of any campaign is to influence behavior change and to promote a better quality of life for the
population. Typically, there are ten steps to take so a successful campaign is put together. We will use
smoking cessation as an example as we discuss each of these steps.
Step 1: Begin
As the public health agency begins planning the campaign, it already has a specific health topic in mind. In
this first step, an agency needs to consider and develop the following aspects: time required and the span of
time (weeks or months), money and resources available, whether the campaign’s team would actually
participate and how certain decisions should be made, and putting specific data-gathering activities in place.
When we talk about the time factor, we are talking about a specific timeline during which our project would be
planned, implemented, and evaluated. In addition, we would need the funds to get our campaign started. The
public health agency would also need to put the team together (our key players) and then develop the
positions and scope of work for each player. Some of the players’ roles include making decisions while others
provide and gather certain information. Some players provide the necessary support, and other team
members implement the campaign.
Step 1 example: The town of Columbia Southern is interested in creating a smoking cessation program for
the town specifically targeted toward high school-aged children 14-17. A small team of three volunteers has
been assembled by the local public health agency to assist with this campaign. The volunteers are retired
public health workers interested in promoting this cause.
Step 2: Re-Evaluate Your Existing Health Promotion Strategy
When we discuss re-evaluation of our strategy, we are referring to revisiting our strategy’s goals and
objectives. In this exercise, as we are putting a campaign together, we need to think of our specific audiences
(i.e., key groups or populations) and apply and develop specific objectives for each of the groups and, of
CHE 6303, Strategies of Health Promotion
1
course, keep in mind the outcomes we aim to measure for each of those groups.
Some
examples
of our
UNIT
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objectives might include the following:
Title
•
•
•
•
•
•
to increase awareness of certain health risk factors,
to change attitudes toward certain unhealthy behaviors,
to increase social support,
to increase behavior skills,
to increase confidence about making behavior change, and
to increase certain knowledge.
Step 2 example: We want to increase the awareness of the harmful health effects of smoking. By illustrating
these harmful effects, it is the goal of this campaign to change the attitudes related to smoking. The team is
also soliciting the assistance of parents, student council, and civic organizations to increase social support.
The team will use proven and validated methods to mobilize the community and the targeted population. It is
the ultimate goals of the team to enable each teenager with increased knowledge and awareness related to
smoking.
Step 3: Understand Your Target Audience:
In this step, we want to identify and further evaluate our target audience. Here, we might want to break it
down into specific areas and understand each of the audience’s specific needs, characteristics, beliefs,
perceptions, interests, concerns, ages, genders, incomes, education levels, living conditions, family situations,
working conditions, cultural and ethnic makeups, behavioral aspects, lifestyles, issues, and appropriate
objectives. The key here is to gather all this information in order to select the appropriate ways in which we
would communicate our health promotion message to them successfully and effectively.
Step 3 example: In addition to traditional cigarettes, the team has also learned that teenagers are
increasingly using electric cigarettes. The teens believe that this type of cigarette poses no health risks. In
addition, the electric cigarettes are socially acceptable among teenagers within the local high school.
Step 4: Communication Resources
In this step, we are trying to analyze communication resources in our community. Here, an agency is trying to
evaluate whether it could build relationships within the community. These relationships could be with local
newspapers, radio stations, community leaders, advertising agencies, workplace organizations, health
organizations (local hospitals), or schools. The key here is to make sure your campaign message is delivered
effectively through some of those resources to your identified target audience or audiences.
Step 4 example: As previously discussed, the smoking cessation campaign has a lot of interest and support
by many organizations within the town. During each sporting event at the high school, there will be public
service announcements regarding smoking and its harmful effects.
Step 5: Putting Communication Objectives Together
In Step 5, we will discuss specific objectives of reaching out to our target audiences. One way of setting these
objectives is to apply the SMART (specific, measurable, attainable, realistic, and time-constrained) model.
When setting the objectives, one thinks of ways a health communication might contribute to the overall health
promotion goal and objectives. Please also note that successful communication messages need to ensure
exposure, attention, and a return action from the participants. Overall, a communication campaign needs to
do the following things:
•
•
•
•
provide key information,
identify benefits of a changed behavior,
provide ways to change the behavior, and
note the opportunity for a change.
Step 5 example: For this example, there will be a poster board. The top portion of the poster will be
information about smoking and its harmful effects. There will also be a section about how an individual can
stop smoking. Support services and tools will be listed (to include counseling, patches, and other methods).
CHE 6303, Strategies of Health Promotion
2
There will also be contact information available on the poster related to how the
person
can stop
smoking
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successfully.
Title
Step 6: Selecting Communication Media
Next, the public health team will identify the right communication medium (e.g., TV, radio, Internet, forums,
etc.) so that the health promotion message is delivered to the target audience successfully and effectively.
When we talk about these media, we need to have these key aspects in mind: reach, cost, and specific
communication type (public service announcements, ads, etc.). Reach refers to the number of people
(population size) that can be affected by our message. The term cost is pretty self-explanatory. When
selecting media, one needs to be aware of pros and cons of each of those. For example, with radio, our
message could be relatively low in cost, but it is somewhat impersonal, there are no visuals, and it can be of
limited reach. Television, on the other hand, could be very expensive and could be complex. Newspapers
could be lower in cost, but reach and literacy might be an issue.
Step 6 example: The main venues for communications are those that are highly attended by teenagers within
the local community. These communication venues will include sporting events, bowling alleys, movie
theaters, dances, and other events. Communication methods will include public service announcements,
posters, and radio announcements. These media will be minimal in cost.
Step 7: Combining Communication Activities
In this step, a health communication campaign’s developers are trying to address individuals’ elements of
behavioral change. These include awareness followed by information seeking and then knowledge, attitude
development, behavioral desires, and concluded with the actual behavior. This means that developers would
start using their communication activities, based on the objectives found in Step 5 and Step 6. They will apply
these in a sequence that socially mobilizes and begins targeting the specific audience, thus transmitting
information and knowledge.
Step 7 example: This step would be accomplished by hosting a pep rally where all members of the high
school would attend. There would be a discussion related to smoking cessation to set the initial dialogue
related to the importance of living a healthy life.
Step 8: Creating the Right Message for the Audience
When developers create a message, they often concentrate on the following key aspects: the information that
is being communicated, specific reasons or benefits of action (i.e., intended behavior change), and proposed
solutions.
Furthermore, developers look at the tone with which the message should be delivered, who should actually
communicate that message (e.g., a credible source, a healthcare professional, a celebrity, etc.), and the way
the message is being communicated (e.g., with emotions, strict facts, rationality, positivity, negativity, or
persuasion). Again, all these aspects are very important in persuading the audience and leaving a lasting
impression that would hopefully prompt them to change.
Step 8 example: The public health team will continue to deliver messages and modify as needed. They will
also bring in a TV celebrity who is now a role model for teenagers. The celebrity will discuss his or her battle
with tobacco addiction and how he or she made the right choice to stop smoking.
Step 9: Creating an Image for Your Communication and Developing Key Materials
In this step, developers are trying to create a certain identity, an image that the audience would clearly
associate with the health communication message. The key here is to create an unmistakable identity so the
campaign would stand out and be clearly distinguished from the others. This could be words, images, and
symbols that are put together in order to create and design the printed and visual materials. Of course, the
developers need to be aware and carefully monitor the costs that would be incurred for putting all those
materials together.
CHE 6303, Strategies of Health Promotion
3
Step 9 example: The public health team will work with the high school’s student
graphic
arts department
to
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x STUDY
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develop logos and messaging tools. This will be at no cost, will assist the students
Titlein their design efforts, and
will promote smoking cessation within the school.
Step 10: Implement the Campaign and Complete Campaign Evaluation
As all activities are finalized, the target audience is identified, all the necessary data about the individuals in
that audience are gathered, goals and objectives are set, key community leaders are identified,
communication channels are finalized, and all printed materials are ready, we can launch the campaign. Once
our health communication campaign begins and during its duration for a specified period of time, we are
ready to evaluate its success and effectiveness. During the evaluation phase, the following questions would
be helpful for the team to consider. Based on these responses, the team can further customize and modify
the campaign as needed.
•
•
•
•
•
•
•
•
•
Did we effectively reach our target audience?
Were the quality and quantity of our messages sufficient?
Did we actually influence the attitudes and behaviors of our intended individuals?
Were they really affected by our campaign?
What were the areas that we actually missed?
What do we need to improve on?
Was our exposure enough?
How was our appeal?
How effective were our messages?
The 10-step campaign methodology can be implemented both domestically and globally. A recent
example of a global public health campaign was in 2014 during the Ebola epidemic affecting the western
African countries. There was a great magnitude of social mobilization to inform, educate, and promote
behavior changes to mitigate contracting the Ebola virus.
CHE 6303, Strategies of Health Promotion
4
Hospital administration has asked you to develop a memo explaining how to use the SBAR (Situation, Background, Assessment, Recommendations) as a tool for safety critical communication during shift change among healthcare professionals. In the memo that you will be preparing, remember to address the following:
The importance of critical safety communication
At least two principles of safety-critical communications
A description of the SBAR tool
A hypothetical example of how to use each element of the SBAR tool, meaning examples of each of the following:
Situation
Background
Assessment
Recommendations
To see an example of the structure of a memo, view the following memo, “Fall Clothes Line Promotion,” developed by Purdue OWL.
Your memo should meet the following structural requirements:
A minimum of two pages that includes all the elements detailed above.
Follow APA 7th edition and Saudi Electronic University writing standards.
Be sure to cite any statistics or other information as appropriate.
CASE STUDY: Mr. Chang is a 60-year-old man living in New Haven, Connecticut. He lives in a relatively small Hmong community with his wife. He has two adult children, a son and a daughter, who are 28 and 32, respectively, along with three grandchildren ages 1, 2, and 4. He works as a math teacher at a local high school. His wife does not work outside the home. For the past couple of weeks, he has been complaining of pain in his lower abdomen. He has not received treatment for his pain at a hospital or clinic because he has been receiving care at home from his clan’s Shaman. The Hmong people view illness as having either physical or spiritual causes, physical being related to environmental factors, and spiritual being related to evil spirits unhappy with the ill individual. Spiritual healing rituals with a Shaman are common as good health depends on the souls living in each person, and it is believed that any invasive procedures can cause soul loss in the individual. However, one day, Mr. Chang’s pain is so severe that his children rush him to the hospital against his wishes. It is more common for younger Hmong people to visit the hospital than for older generations because they are more familiar with Western medicine. Upon being admitted to the hospital, the doctors perform a scan to see what is causing his abdominal pain. While waiting for his results, Mr. Chang gets up to use the restroom. He experiences a sharp pain in his abdomen that causes him to double over and hit his head on the railing next to the toilet, which causes him to lose consciousness. The results of the scan showed a large mass. The doctors indicate that it will be relatively easy to remove the mass, but they must act quickly. Due to the delay in Western medical care, the mass has grown significantly and must be treated immediately. As Mr. Chang is a member of the Hmong community, he indicated prior to his fall that he does not believe in surgical procedures and would not want any invasive action to be taken. Upon hearing the diagnosis and possible next steps, his children are adamant that the doctors provide the surgery as they know it will be a simple fix. With this surgery, Mr. Chang would live, continue providing for his wife, and be able to see his grandchildren grow up. His wife, however, is completely against it, citing that any surgical procedure would cause soul loss in her husband. Time is of the essence here. The physician handling this case brings this up to you, the hospital administrator, as you are her good friend, and she needs advice. Furthermore, she tells you that Mr. Chang’s children are threatening to sue the hospital if their father does not receive the surgery, claiming that the hospital denied him medically necessary treatment to save his life. Knowing the hospital’s financial position, you understand that the hospital does not have the capacity for a major lawsuit. Though Mr. Chang voiced concerns about surgical procedures prior to his fall, he is currently not in a sound state of mind to make any treatment decisions for himself. There are two options: (1) proceed with surgery or (2) do not proceed with surgery. What do you advise your friend to do? CASE STUDY Discussion Questions How do you balance cultural practices with providing care to people and managing changing dynamics within generations (e.g., immigrant versus first-generation American)? Discuss whether the wishes of the wife should be considered more heavily than those of the children, even though the children are threatening to sue. Discuss possible preventative measures that the hospital can take to circumvent difficult situations like this in the future.Please answer these 3 questions in 1-2 pages.
Who are the Uninsured
Expectations of Care
Barriers to Care
Access to Care
Proposed Changes Under New Administration
A. Address topics you select separately- Use at least 5 topics- Subtitles are recommended.
B. Use a minimum of 5 different references (books, articles or web pages) for the assignment. This includes required readings from the course textbook.
C. Submit a 7 page paper that includes a minimum of 3 full pages of referenced discussion content.
D. Please see Written Paper Assignment Guide, Paper Template, and APA 7th edition guide.
Note: Support resources for this assignment is located in Module 2’s Instructional Resources Folder
Unformatted Attachment Preview
Title of Paper
Student Name
Norfolk State University
College of Science, Engineering, and Technology
Department of Nursing and Allied Health
Professor Name
HCA 624-90 Public Policy and Administration in Healthcare
Module Number
Date
INSERT A PAGE BREAK TO SEPARATE THE TITLE PAGE FROM THE PAPER
NOTE: Page numbers begin on page 2
This template for the written paper assignments is formatted to meet the APA style guide. Just
delete the text in red and insert your content
2
Repeat Title of the Paper Here Do Not Bold
Introduction
Introduction should be a one or two paragraph explanation of the assignment and the
focus of the paper. The written paper assignment is due on the due date and should include 4-6
pages of content not including the title or reference page. Papers can be longer than 6 pages.
It is important to select under the page layout tool the correct margins template with 1 inch
margins all sides and to check that the auto indent and spacing before and after is set at 0 pt and
under paragraph double spacing is selected. Template already formatted.
Discussion
Discussion MUST be a MINIMUM of 3 full pages of referenced material from the
required textbook references and internet sites. Students are expected to use the required
readings in the discussion section and can supplement with other references as appropriate.
Subtitles
A subtitle helps the paper to flow more smoothly and ensures that all topics required in
the assignment are fully discussed. Each subsection should contain at least 2 paragraphs of
information. Most likely, only level one and level two heading will be used for the discussion
section in the weekly written assignments.
Level three heading. On some occasions there may be an indication for a level three heading in
the discussion section of the weekly assignment.
Summary
The summary should include the major issues discussed in the paper and is 1-2
paragraphs in length. Reference citations are not used in this section because no new
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information should be added since the summary is based on the analysis of information from the
readings and references contained in the discussion section.
Recommendations
The recommendations section is optional but allows the student to express their own
ideas about the issues presented in the paper. This is the only area where personal options or
experiences can be included in the paper.
INSERT A PAGE BREAK TO SEPARATE THE REFERENCE LIST FROM THE PAPER
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References (title is NOT bold)
First line of each reference is flush left and starts with author or name of organization, followed
by date of publication, title of the source, title of what the source is found in (if anything,
such as a journal, book, or Web site) and the publication information per the APA style
guide for each type of reference. Hanging indent is used for all but the first line of each
reference. See Sample below. This page is formatted with the hanging indent.
Bill & Melinda Gates Foundation. (2010, July). Overview: The Gates Foundation’s HIV
Strategy. Retrieved from http://www.gatesfoundation.org/hivaids/Documents/hivstrategy-overview.pdf
You will select one research report with a qualitative design and one with quantitative design and answer the following questions regarding the following categories:
Discuss what is meant by the term Qualitative Research
Briefly, describe the characteristics of qualitative research and identify nursing issues/phenomena that lend themselves to a qualitative research approach.
Compare and contrast three different qualitative research methodologies.
Briefly, discuss the strengths and weaknesses of qualitative research evidence for informing nursing practice.
Communicate how this research design used in research.
The study, sampling, data collection, analysis, rigor, findings and limitations
Identify the purpose of the study.
Briefly, describe the design of the study and explain why you think it is either appropriate or inappropriate to meet the purpose.
Identify ethical issues related to the study and how they were/were not addressed.
Identify the sampling method and recruitment strategy that was used.
Discuss whether sampling and recruitment were appropriate to the aims of the research.
Identify the data collection method(s) and discuss whether the method(s) is/are appropriate to the aims of the study.
Identify how the data was analyzed and discuss whether the method(s) of analysis is/are appropriate to the aims of the study.
Identify four (4) criteria by which the rigor of a qualitative project can be judged.
Discuss the rigor of this study using the four criteria.
Briefly, describe the findings of the study and identify any limitations.
Use the information that you have gained from your critique of the study to discuss the trustworthiness and applicability of the study. Include in your discussion any implications for the discipline of nursing.
Discuss what you understand by the term Quantitative Research – Use the following dot points to guide your discussion (give reasons for your argument and support with references):
Describe the characteristics of quantitative research.
Identify nursing issues/phenomena that lend themselves to a quantitative research approach
Differentiate between observational and interventional research designs and also between experimental and quasi-experimental designs.
Briefly, outline the difference between inferential and descriptive statistics and their relationship to levels of measurement.
Communicate how this research design used in research.
Critique the Quantitative Research Report – Use the following headings to guide your critique (in all discussions and explanations give reasons for your argument and support with references):
The study
Identify the purpose and design of the study.
Explain what is meant by ‘blinding’ and ‘randomization’ and discuss how these were addressed in the design of the study.
Identify ethical issues related to the study and how they were/were not addressed.
Sampling
Explain the sampling method and recruitment strategy that was used.
Discuss how the sample size was determined – include in your discussion an explanation of terms used.
Data collection
Briefly, outline how the data was collected and identify any data collection instrument(s).
Define the terms validity and reliability and discuss how the validity & reliability of the instruments were/were not addressed in this study and why this is important.
Data analysis
Outline how the data were analyzed.
Identify the statistics used and the level of measurement of the data described by each statistical test – include in your discussion an explanation of terms used.
Findings and limitations
Briefly, outline the findings and identify any limitations of the study
Use the information that you have gained from your critique of the study to briefly discuss the trustworthiness and applicability of the study. Include in your discussion an explanation of the term statistical significance and name the tests of statistical significance used in this study.
SUBMISSION INSTRUCTIONS:
The paper is to be clear and concise and students will lose points for improper grammar, punctuation and misspelling.
The paper should be formatted per current APA and 4-5 pages in length, excluding the title, abstract and references page.
Incorporate a minimum of 3 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
I want case study about acute kidney injury and replacement therapy, I need in form of word I have one reference you will talk about the disease first stages and every thing then you will start by the case study pt data and history and management And you should involve clinical decision making related to pt management by different option of treatment
This discussion is related with the part 2 of this assignment. Please read carefully the instructions. I will need discussion with 250 to 300 words and 1 reference. I will not need peer responses for this discussion.
With the rough draft of your nursing comparison paper due this week, a focused review of the basics of APA Style is important. After you have reviewed the WCU Library guides on APA, share something you learned with your peers. Also, attach examples from your rough draft that include both an in-text citation you used when you were paraphrasing and one you used when you were directly quoting. In addition, attach the reference page from your rough draft so that you can review each other’s work and provide peer-to-peer feedback.
Instructions: The second Discussion is related to APA format and asks you to submit some examples of APA format. You can have until Sunday night to submit your initial post since you are still working on your paper and may use examples from it. You do NOT need to respond to your peers on this discussion, its more of a practice on APA.
Some things to remember:
Every paper must have HEADINGS for each section, I usually give them to you in the Announcement for the paper.
We no longer write Running Head on the Cover page!
The entire document is double spaced, even between sections (before and after headings)
Alphabetize all the names in your Reference page list
Every time you quote someone, you must have a citation that includes the Authors Last name, year, and page number!
Learning some of these simple rules early on will help you with every paper in your future!
Part 2: Week 5 Nursing Theory Comparison Paper Rough Draft. (Attached is a sample paper)
Remember, the two theories selected are the Self-Care Deficit Nursing Theory by Dorothea Orem and Kolcaba’s Theory of Comfort by Katherine Kolcaba (Paper attached).
The purpose of this assignment is to draft and submit a comprehensive and complete rough draft of your Nursing Theory Comparison paper in APA style. Your rough draft should include all of the research paper elements of a final draft, which are listed below. This will give you an opportunity for feedback from your instructor before you submit your final draft during week 7.
Based on the reading assignment (McEwen & Wills, Theoretical Basis for Nursing, Unit II: Nursing Theories, chapters 6–9), select a grand nursing theory.
After studying and analyzing the approved theory, write about this theory, including an overview of the theory and specific examples of how it could be applied in your own clinical setting.
Based on the reading assignment (McEwen & Wills, Theoretical Basis for Nursing, Unit II: Nursing Theories, chapters 10 and 11), select a middle-range theory.
After studying and analyzing the approved theory, write about this theory, including an overview of the theory and specific examples of how it could be applied in your own clinical setting.
The following should be included:
An introduction, including an overview of both selected nursing theories
Background of the theories
Philosophical underpinnings of the theories
Major assumptions, concepts, and relationships
Clinical applications/usefulness/value to extending nursing science testability
Comparison of the use of both theories in nursing practice
Specific examples of how both theories could be applied in your specific clinical setting
Parsimony
Conclusion/summary
References: Use the course text and a minimum of three additional sources, listed in APA style
The paper should be 8–10 pages long and based on instructor-approved theories. It should be typed in Times New Roman with 12-point font, and double-spaced with 1″ margins. APA style must be used, including a properly formatted cover page, in-text citations, and a reference list. The proper use of headings in APA style is also required.
Please use these bold headings to organize your paper. You are simply comparing the two theories back and forth.
In your reading, you will find a thorough description of each component below and fully describes what you need to research about your chosen theories to fill in the section.
Introduction
Overview of your chosen grand theory
Overview of your chosen middle range theory
You will have a separate paragraph in each section, one for your grand range theory and one for your middle range theory.
Background of the theories
(Grand theory chosen)-
(Middle range theory chosen) –
Philosophical Underpinnings
(Grand theory chosen)-
(Middle range theory chosen) –
Major assumptions, concepts, and relationships
(Grand theory -)
(Middle range theory -)
Clinical applications
(Hint: usefulness/value to extending nursing science testability)
(Grand theory-)
(Middle range theory -)
Application to nursing practice
(Hint: Comparison of how to use of your theories in nursing practice)
(Grand theory-)
(Middle range theory -)
Application to my practice
(Hint: Specific examples of how both theories could be applied in your specific clinical setting)
Grand theory-
Middle range theory –
Parsimony
(Hint: how simple or complex are the theories?
Grand theory-
Middle range theory
Conclusion
Every formal paper must have a formulated conclusion!
Four References: Course text and a minimum of three additional sources.
The paper should be 8–10 pages long- not including your Cover and Reference pages.
Times New Roman,12-point font, and double-spaced with 1″ margins.
APA format (7th ed.) a properly formatted cover page and reference list. See the link below for 7th edition APA updates!
IMPORTANT: Even though this is titled a rough draft- it means you will complete the entire paper- not just sections or outlines of the content. A completed paper- the more work you put into now, the better grade you will receive on the rough draft and you will have very little work to do on it when you submit your final paper in week 7.
Rubric
NURS_500_DE – Theory Comparison Paper Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
90 to >73.8 pts
Meets Expectations
Content is clear, thorough, and organized effectively. Main points well supported. All specific portions of the assignment have been addressed. Meets all the criteria of the written assignment
73.8 to >67.5 pts
Approaches Expectations
Content is somewhat clear, thorough, and organized effectively. Most of the specific portions of the assignment have been addressed. Some points well supported. Meets most of the criteria of the written assignment
67.5 to >53.1 pts
Falls Below Expectations
Content is generally unclear, not thorough, and organized ineffectively. Some of the specific portions of the assignment have been addressed. Main points not well supported. Meets only a few of the criteria of the written assignment
53.1 to >0 pts
Does Not Meet Expectations
Content is generally unclear, not thorough, and organized ineffectively. Some of the specific portions of the assignment have been addressed. Main points not well supported. Meets only a few of the criteria of the written assignment
90 pts
This criterion is linked to a Learning OutcomeWriting Style
15 to >12.3 pts
Meets Expectations
Writing is professional with no spelling or grammatical errors and has been carefully proofread. Captures and maintains reader’s interest
12.3 to >11.25 pts
Approaches Expectations
Writing follows normal conventions and has minor spelling, punctuation and grammatical errors throughout. Efforts made to capture and maintain reader’s interest
11.25 to >8.85 pts
Falls Below Expectations
Writing does not consistently follow appropriate style of format with frequent spelling, punctuation and grammatical errors. Do not capture or maintain reader’s interest
8.85 to >0 pts
Does Not Meet Expectations
Writing does not consistently follow appropriate style of format with frequent spelling, punctuation and grammatical errors. Do not capture or maintain reader’s interest
15 pts
This criterion is linked to a Learning OutcomeClarity & Coherence
22.5 to >18.45 pts
Meets Expectations
Writing flows smoothly from one idea to another. Writer has taken pains to assist the reader in following the logic of the ideas expressed
18.45 to >16.88 pts
Approaches Expectations
Sentences are mostly structured to communicate ideas clearly. Transitions between paragraphs make the writer’s points easy to follow
16.88 to >13.27 pts
Falls Below Expectations
Sentence structure and word choice sometimes interferes with clarity of content and distracts the reader
13.27 to >0 pts
Does Not Meet Expectations
Poor sentence structure, sentences do not make sense to the reader, no clarity evident in the paper
22.5 pts
This criterion is linked to a Learning OutcomeReferences
7.5 to >6.15 pts
Meets Expectations
References included throughout paper in APA format
6.15 to >5.63 pts
Approaches Expectations
References included throughout paper but not all are in APA format
5.63 to >4.43 pts
Falls Below Expectations
References included but unclear which references are direct quotes and which are paraphrased
4.43 to >0 pts
Does Not Meet Expectations
No references included in the body of the paper and writing indicates none were used
7.5 pts
This criterion is linked to a Learning OutcomeCover page & Reference Page
7.5 to >5.93 pts
Meets Expectations
Cover page and reference page are in APA format with appropriate number of references included
5.93 to >5.63 pts
Approaches Expectations
Cover page and reference page are in APA format with some references included
5.63 to >4.43 pts
Falls Below Expectations
Cover page and reference age are mostly in APA format with few references included
4.43 to >0 pts
Does Not Meet Expectations
Cover page and reference page are not in APA format or no cover or reference page included
7.5 pts
This criterion is linked to a Learning OutcomePresentation
7.5 to >5.93 pts
Meets Expectations
Paper is presented professionally, word –processed, double spaced, 12 point font, 1” margins on all sides
5.93 to >5.63 pts
Approaches Expectations
Paper is word- processed but contains only minimal errors in spacing, font or margins
5.63 to >4.43 pts
Falls Below Expectations
Paper is word-processed but does not appear professional with errors in two areas of spacing, font or margins
4.43 to >0 pts
Does Not Meet Expectations
Paper is word-processed but does not appear professional with errors in all area of spacing, font or margins, or it is hand-written
7.5 pts
Total Points: 150
Unformatted Attachment Preview
The two theories selected are the Self-Care Deficit Nursing Theory by Dorothea Orem
and Kolcaba’s Theory of Comfort by Katherine Kolcaba. I have selected these two theories for
the following reasons.
Self-Care Deficit Nursing Theory (SCDNT): A Grand Nursing Theory
This is one of the Grand Nursing Theories based on human needs and was developed
by Dorothea Orem (McEwan & Wills, 2021). This theory focuses on helping patients by
providing and managing self-care to ensure they improve their functioning. Thus, it focuses on
patients’ ability to perform self-care by maintaining their well-being, health, and life. SCDNT is
driven by critical concepts such as self-care, self-care requisites, universal self-care requisites,
and the nursing system (McEwan & Wills, 2021). The reasons for selecting this theory are based
on its strengths and applicability or usefulness in the nursing practice. First, SCDNT is highly
applicable in nursing practice by advanced clinicians and new practitioners to provide self-care
to patients. I also selected this theory because it offers a comprehensive basis in clinical settings
due to its utility by nurse professionals, primarily in critical areas such as administration, nursing
education, and nursing practice (McEwan & Wills, 2021). I selected this theory because it uses
critical concepts such as self-care deficit, nursing systems, and self-care (McEwan & Wills,
2021). These concepts are applied by nurses in clinical settings and nurse students to gain more
experience, skills, and knowledge to empower patients in improving self-care. Thus, this theory
is highly relevant in health maintenance and health promotion. Based on that, Orem’s Self-Care
Deficit Nursing Theory applies to a wide variety of patients. It provides advanced education and
skills to nurses once they integrate vital terms such as nursing systems, self-care deficit, and selfcare (McEwan & Wills, 2021). It also demonstrates that all patients desire to care for themselves
to improve their health outcomes by performing their self-care. In this regard, I selected this
theory to understand how it can be utilized in various clinical settings such as primary care and
rehabilitation, where patients desire to improve health outcomes independently.
Kolcaba’s Theory of Comfort: A Middle Range Theory
This middle-range theory was founded by Katherine Kolcaba (McEwan & Wills, 2021). I
selected this theory to understand how its prepositions are used in nursing practice. This theory
considers comfort a fundamental need that ensures patients experience transcendence, ease, and
relief related to health problems that may result in stress. Thus, the comfort experienced by
patients can influence them to improve their health-seeking behaviours to improve their safety
and health outcomes (McEwan & Wills, 2021). I also selected this theory to understand how it
offers a framework to help healthcare providers apply an organizational approach for reengagement and rejuvenation. Therefore, it is applicable in clinical practice because healthcare
providers are comfortable in the working environment, thus motivating them to deliver highquality care to patients and their families. The use of the Theory of Comfort in clinical practice is
essential because nurses and interdisciplinary care teams can identify the comfort needs of their
patients, thus creating a framework to design and coordinate interventions suitable for addressing
comfort needs (McEwan & Wills, 2021). Lastly, I selected this theory because it helps improve
healthcare policies and embrace evidence-based practices that bring satisfaction to nurses,
patients, and families.
Reference
McEwan, M., & Wills, E. M. (2021). Theoretical basis for nursing. Lippincott Williams &
Wilkins.
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Grand and Middle Range Theory Review
Student Name
West Coast University
NURS 500; Theoretical Foundations of Nursing
Dr. Kendrick
Date
2
The purpose of this paper is to review two selected nursing theorist one grand and one
middle range theory. Throughout this paper the grand theory of Florence Nightingale’s
environmental theory and the middle range theory of Kristen Swanson’s theory of caring will be
discussed, reviewed, and compared.
Florence Nightingale’s environmental theory has five important elements, pure water,
pure air, efficient drainage, light and cleanliness. Thus, producing a healthy atmosphere crucial
for healing (Zborowsky, 2014). Her theory in considered a grand theory because it has a broad
scope. It presents general concepts that are good for directing, explaining, and predicting nursing
situations (McEwen & Wills, 2017). The grand theories are relevant to all areas of nursing yet
may not be beneficial to detailed research questions because of its broad scope.
Kristen Swanson’s theory of caring is a middle range theory with five caring processes,
knowing, being, doing, enabling, and maintaining belief (Jarvis, 2019). This theory supports
nursing care as a process that develops from the nurses’ beliefs, knowledge, and relationship with
the patient. This is a middle range theory that is narrower in scope than grand range theories and
assist in guiding nursing practice and research (McEwen & Wills, 2017). Middle range theories
are therefore more straight forward and limited to an area of practice. Swanson’s theory
originated around pregnancy issues.
Background
According to Zborowsky (2014). Florence Nightingale was born on May 12, 1820 in
Florence Italy. She was born into an affluent family however never felt comfortable with
socializing. She had a classical education and early on was interested in ministering to the poor
and ill. She felt nursing was her purpose and calling. Her parents were not supportive of her
desire to pursue nursing training. In 1851, she received her educational and clinical training in
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Germany. In 1854 she served as a nurse in the Crimean war, then went to London. There she was
awarded money from the British government. She took that money and started a school for
nurses in 1860. Her goal was to teach what was needed to be done and how to do it. She also
taught about symptoms of diseases and what they meant. In 1859, her famous book, Notes on
Nursing, was published she distinguished nursing separate from medical knowledge and taught
on the purpose of nursing duties (McEwen & Wills, 2017). She improved statistics analysis with
her observations and aided the military hospitals in efficient restructuring of services. She died
August 13, 1910 spending her life preventing disease and providing safe and compassionate care
to the impoverished and suffering. Florence Nightingale has been seen as the originator of
nursing theory and certainly one of the most prominent nurses throughout history (Zborowsky,
2014).
Kristen Swanson was born January 13th, 1953 and received her baccalaureate degree in
1975 from the University of Rohde Island. In 1978 she received her master’s degree in nursing
from the University of Pennsylvania and then her Ph.D. from the University of Colorado
(Swanson, 1991). According to Amendolair (2012), her doctoral dissertation was focused on
caring for patients having a miscarriage (spontaneous abortion). She was influenced by Dr. Jean
Watson’s grand theory of Human Caring Theory developed in 1970. Then in 1991 Swanson
developed her theory encompassing the five processes of caring. She was also interested in
socially at-risk mothers. Currently she is the Dean and Professor at the Seattle University
College of Nursing and is on the board of the American Association of Colleges of Nursing
(AACN). Her theories help patients deal with miscarriages and cover helpful counseling, her
theories encompass physical and emotional healing. She is also an alumnus of the Robert Wood
Johnson Executive Nurse Fellows Program, this is a progressive leadership resource for nurses in
4
upper level administrative roles who purpose to lead changes in the United States healthcare
system (Swanson, 1991).
Philosophical Underpinnings
According to McEwen & Wills (2017) Florence Nightingale theory is thought to be a
wide-range viewpoint yet her work is a foundational philosophy. Her fundamental principle was
healing and consequent to it are the principles of leadership and worldwide action. Together
these principles are needed to provide healing. The environmental theory has inspired the nursing
profession and education for over 150 years. Nightingale did not think that nurses were meant to
be submissive to doctors. She saw nursing as an individual vocation all its own.
Florence Nightingale’s educational model teaches nurses to be aware of patients’ needs, meet
patients’ needs and know how to carry out the professional actions of a nurse. Nightingale’s
philosophy came about over years of providing nursing care and study. It is an intellectual and
factual philosophy and is categorized as a grand theory.
The philosophical underpinnings and contributions of Swanson’s theory of caring can
also be reviewed by the four concepts of the nursing metaparadigm, person, health, environment,
and nursing (Jarvis, 2019). The person being the most essential part of Swanson’s theory this
emphasis on the caring process as the philosophical underpinnings. The viewpoint of Swanson’s
theory is that nurses are educated through scientific information and learning through clinical
practice, humanities and cultural values (Peterson & Bredow, 2019). Each person is unique and
made up of their own feelings, ideas and behaviors. The nurse not only addresses the patient but
family and society. The environment should be therapeutic for the patient. The concept of caring
especially in the instance this theory was derived, is clearly powerful and beneficial to the
wellbeing of the patient both physically and emotionally.
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Major Assumptions, Concepts, and Relationships
Florence nightingale’s theory has the straightforward and understandable ideas of health
and wellness. She also defines it as “the act of utilizing the environment of the patient to assist
him in his recovery” (Nightingale, 1992, p.41). Therefore, the environment is an external factor
that can affect the patient’s health. The five environmental factors are the foundation of the
theory. The nurse is accountable to adapt and assess the environmental setting so that it will
improve the patient’s health. The concepts of Nightingales’ theory are fresh air, pure water,
effective drainage, cleanliness, and light (Zborowsky, 2014). According to Selanders & Crane
(2012) the concepts can be branched out into heading that expand on the five environmental
factors. First the health of the house, construction should ensure air is not stagnant. Next
ventilation and warming, supplying fresh air without odors. Then the need for direct sunlight and
a quiet environment, never waking a patient intentionally. Variety is expanded upon as
Nightingale would rotate paintings, provide activities, and read and write with the patient so they
were not bored. The bed and sheets were to be in the sun light and the bed not to be shaken or sat
on. Personal cleanliness is encouraged as the nurse is to wash her hands often. Nutrition was
encouraged in small frequent feedings and the nurse was not to distract them when they were
eating. Socially is was encouraged to support the patient and talk with them. Nightingale wrote
over 150 books and reports on healthcare topics and she is credited with producing one of the
first forms of the pie chart. Hospitals are cleaner because of Nightingales early work and
education of nurses, making them a safer place to be.
Swanson’s theory of caring is based on her research and practice. According to
Amendolair (2012) Swanson classified five activities that nurses used to improve patient care
and meet their needs. These practices include knowing, being with, doing for, enabling, and
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maintaining belief. To improve nursing care and foster the patients’ health both physically and
emotionally, the nurse incorporates these five activities and makes a personal, patient centered
plan of care. In doing this the nurse also expresses dignity and importance of the patient.
Swanson focused on pregnancy issues in her theories and reports that nurses are natural
caregivers. Her theories have been used in obstetric education. The caring theory’s first
component of caring is knowing, here the nurse avoids assumptions, does a detailed assessment
and looks for cues. Being with, denotes enduring with the patient, sharing, but not burdening the
patient. Doing for, is comforting, protecting, anticipating needs, and preserving the patient’s
dignity. Enabling or informing, would be validating the patient’s feelings, advocating, explaining
and giving back. In maintaining belief, the nurse would offer realistic hopefulness, believing in
the patient and helping the patient to find meaning. In practice the nurse should utilize all five
caring process steps. Swanson is still practicing and publishing today using her theories to
improve healthcare and nursing.
Clinical Applications
The clinical applications of Florence Nightingales’ environmental theory put the
responsibility of the patient on the nurse’s assessment skills and ingenuity. Even though the nurse
can be busy and have many sick patients it is their responsibility to prevent bedsores, report and
treat a fever, make sure the patient is nourished and warm and monitor their vital signs, lab
results and environment for safety. The nurse should identify and reduce patient distress. She
called nursing an art not a science and detailed many nursing tasks are still pertinent today
(McEwen & Wills, 2017). Research today has reinforced her ideas on noise in the patient care
area and environmental cleanliness and safety (McEwen & Wills, 2017). Therefore, today the
clinical application of Nightingales theory stands true in healthcare and has stood the test of time.
7
Swanson theory of caring includes physical and emotional care for women who have
miscarried, neonatal intensive care unit (NICU) caregivers, and mothers considered socially at
risk (Jarvis, 2019). According to Kavanaugh, Moro, Savage, and Mehendale (2006) her clinical
applications are relevant not only within those specific care settings but also in other delicate
topics that involve vulnerable patients. This includes parents who had suffered the death of their
infant or were engaged in making a life support decision because of possibly giving birth to a
very premature infant less than 26 weeks gestation. In this study the caring characteristics and
the trusting relationship that was formed by following Swanson’s caring theory produced a more
productive and positive outcome perceived by the patient. Therefore, the clinical applications of
Swanson’s caring theory are relevant and remain useful in clinical practice.
Application to Nursing Practice
An example of how Florence Nightingale’s theory is used today in nursing practice
would include advocacy. Nursing is a complex profession and although Nightingale did not
address specifically nurse advocacy, all her theories support this idea. In her publications she was
a voice advocating for equal human rights, involving religion, sex, status, and the right to a
peaceful death (Selanders & Crane, 2012). In this way Nightingale was ahead of her time and
remains relevant today. In her environmental theories a good example of an application today
could be seen in home health evaluations and care. Nurses are trained to look for unhealthy and
unsafe living conditions, identify them and improve them. This would be the approach set forth
in Nightingale’s theory.
In Swanson’s theory of caring the successful use of the five caring processes, knowing,
being, doing, enabling, and maintaining belief would help a family cope after a miscarriage
(Jarvis, 2019). The first thing a nurse would do is to give compassion, provide time and space for
8
the family and be a good listener when they talk. Form a patient nurse relationship, touch her
hand, and let her know how sorry you are for their loss. Assist the patient and encourage them to
do what they normally do for themselves and provide privacy. Placing a rose or a sign on the
door that fetal demise has happened to alert staff to be respectful and sympathetic. Provide a
journal for the family to write down their feelings, information on the healing process, and
support groups. Lastly provide closure by offering the family to hold the baby. Step by step
going through the process will provide support for the family and will help the grieving patient
move on.
Application to My Practice
In my nursing practice Nightingale’s theory is very relevant. Working with the elderly I
encourage sunlight and walks outside on sunny days. I urge patients to eat healthy and offer
healthy snacks. I am assessing the situation and environment to improve the comfort of the
patient and safety of the environment to prevent injuries. The room must be kept clean and
orderly, and patients have the option to request a quiet room at night, and not be disturbed.
Patients are also engaged during the day with activities and religious services. This theory
provides patients with a happy and healthy living environment.
Swanson’s theory of caring in my practice is useful although I could only find one
reference to this theory in the elderly. I know I have used the process with grieving patients or
patients that have received a poor prognosis. According to Yin-Tzu, Sin-Rong, and Chi-Yin
(2019) utilizing the five steps in an elderly patient with vasculitis, unable to walk and delayed
discharge from the hospital provided the patient with hope and positive beliefs about the future.
When disease and lack of mobility in the elderly cause a feeling of hopelessness, working
9
through the five steps of caring is a way to form a trusting and caring relationship with a patient
and provide emotional support.
Parsimony
Nightingale concisely stated how important the environmental theory was to care for sick
patients. She has condensed her thoughts into small volumes and included information about
nursing treatment, patient needs, good structures where the patients can be treated, and the
management of hospitals (McEwen & Wills, 2017).
Understand parsimony is to observe that the description with the least number of steps is
often the strongest. Swanson’s theory can be simplified into two steps, see figure 1. The five
steps of her theory can be condensed to maintain the parsimony of her idea: nursing philosophies
and experience nursing will produce acts of caring and in the end, patient wellbeing (Swanson,
1993).
Conclusion
This review and assessment have been an opportunity for me to understand and be
grateful to the nurse theorist who have made such a vast contribution to the nursing profession
and healthcare industry. Nightingale theory is developed around simple and familiar concepts
that are easy to utilize and practice. Today healthcare has so many amazing advancements and
technology, yet if Nightingale’s basic principles are followed disease will be prevented.
Likewise, Swanson’s theory has a simplicity of caring that is clearly healing when a patient is
hurting physically and emotionally. The caring theory of being emotionally present for the
patient, respecting the patient’s dignity, maintaining a knowledgeable practice, being objective
and meeting the needs of the patient as a unique person, gives patients the ability to express
10
themselves and improve their wellbeing. This piece has encouraged me to further understand
nursing theory and improve my nursing care and make it more of an art.
References
Amendolair, D. (2012). Caring Model: Putting research into practice. International Journal of
Human Caring, 16(4), 14-21. DOI:10.20467/1091-5710.16.4.14
Jarrin, O. F. (2007). An integral philosophy and definition of nursing. School of Nursing
Scholarly Works. 47. https://opencommons.uconn.edu/son_articles/47
11
Jarvis, K. (2019). Swanson’s theory of caring: An application to the role of nursing
Education. International Journal for Human Caring, 23(3), 266-271. DOI:
10.20467/1091-5710.23.3.266
Kavanaugh, K., Moro, T. T., Savage, T., & Mehendale, R. (2006). Enacting a theory of caring to
recruit and retain vulnerable participants for sensitive research. Research in Nursing &
Health, 29(3), 244-252. https://pubmed.ncbi.nlm.nih.gov/16676343/
McEwen, M., & Wills, E. M. (2017). Theoretical basis for nursing. Lippincott Williams &
Wilkins.
Nightingale, F. (1992). Notes on nursing: What it is, and what it is not. Lippincott Williams &
Wilkins.
Peterson, S., & Bredow, T. S. (2019). Middle range theories: Application to nursing research and
practice. Lippincott Williams & Wilkins.
Selanders, L., & Crane, P. (2012). The voice of Florence Nightingale on advocacy. The Online
Journal of Issues in Nursing, 17(1). https://pubmed.ncbi.nlm.nih.gov/22320877/
Swanson, K. M. (1991). Empirical development of a middle range theory of caring. Nursing
Research, 40(3), 161-166. https://pubmed.ncbi.nlm.nih.gov/2030995/
Wojnar, D. M., & Swanson, K. M. (2007). Phenomenology: An exploration. Journal of Holistic
Nursing, 25(3), 172-180. DOI:10.1177/0898010106295172
Yin-Tzu Chen, Sin-Rong Lin & Chi-Yin Kao. (2019). Applying Swanson’s theory of caring to
manage powerlessness in an older patient with vasculitis. Journal of Nursing, 66(3), 112–
119. DOI: 10.6224/JN.201906
Zborowsky, T. (2014). The legacy of Florence Nightingale’s environmental theory: Nursing
research focusing on the impact of healthcare environments. HERD: Health
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Environments Research & Design Journal, 7(4), 19-34.
https://doi.org/10.1177/193758671400700404
13
Swanson’s Theory of Caring
Figure 1. The Structure of Caring displayed in its original format from Swanson (1993) “Nursing
as Informed Caring for the Well-Being of Others”, (p.355).
For this presentation/paper, we must pick a culture. In this case I have chosen Japanese. We must relate to how nursing/healthcare/medicine plays a role in their culture and the types of traditional methods it plays in their culture. As well as spirituals, religious and ethical issues. How do natural remedies play a role in Japanese cultural. For example, what types of teas where considered natural remedies to help with health? Attached is a document to help with the paper. I would appreciate an outline as well. Thank you!
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Society & Drugs
Course number:
PHC 314
CRN
12780
Essay Topic
Assignment title or task:
(You can write a question)
Societies have evolved to believe that they have the right to
protect themselves from the damaging impact of drug use and
abuse.
(a) Mention the policies and prevention programs for
combating drug use and abuse at any country you
choose ?
(b) Describe the Saudi Food & Drug Authority (SFDA)
approval process for assessing the safety and efficacy of a
newly developed drug?
Student name:
Student ID:
Submission date:
Instructor name
Ahmed Al Rasasi
Grade
… out of 10
Guidelines:
•
Word count: 300to 1000 words
•
Follow APA format for your assignment must include Introduction, Body and Conclusion
•
All information must be mention in APA reference
•
Font and Size: Times New Roman (12)
•
Color – Black, Spacing – 1.5, Heading and sub-heading – Bold
•
Follow APA format your assignment must include Introduction, Body & Conclusion
•
Avoid plagiarism
•
Submit as word document
Addressing Healthcare Inequities for Diabetics in Rural Kentucky
Please note i have attached a format in which I would like this to be written. Please expand on them
This assignment is intended to help you:
Examine concepts of epidemiology and suggest improvements in policy, prevention, and/or promotion.
Apply evidence-based principles to critically evaluate federal and state policies and practices in healthcare delivery and public health systems.
Apply evidence-based principles to evaluate healthcare reforms such as the Affordable Care Act.
Explain competencies in healthcare quality, access, cost, and how they interrelate.
Explain how generational trends impact the delivery of healthcare.
this is text from Module 1 Preparation, where this project was introduced. It is repeated here for your convenience.
Imagine that you and other healthcare management professionals have come together over your common concern about inequities you have observed in healthcare. You and like-minded colleagues have met to discuss what might be done to effectuate some change toward improvement in healthcare for vulnerable populations.
After a couple of informal discussions, you all agree that the best place to start is to identify and describe inequities you have witnessed over weeks, months, and sometimes years, provide support for your position, and present this information to local and state officials. Your goal is to meet with officials and present in person your observations of inequities and recommendations for reform.
The group of colleagues has accepted your offer to gather information described above into a report. Three other colleagues have volunteered to do the same. You will share your findings and, in a future meeting, you will all select the three items of most pressing importance among those shared. Your task here, then, is to select three healthcare inequities of a vulnerable population, gather information about the population and the inequities, underscore the gravity of the situation in relation to your area of healthcare, justify their importance, and share your report with the group. You will also present the inequities in terms of cost, quality, and access. Together, the group will select the top three items to bring to the attention of local and state officials.
Action Items
Consider healthcare inequities in a vulnerable population that you identified in Module 1. Also consider your area of healthcare.
In a Microsoft Word document, write a report for your colleagues that is focused on the following items:
Identify three areas of inequity in that vulnerable population as it relates to your area of healthcare. Describe the inequities and give examples from reputable articles or news sources that illustrate the inequities.
Discuss your reasons for choosing these three inequities to focus on as the most pressing for your area of healthcare, healthcare management, and for healthcare management in general. Provide convincing justification. Make sure to discuss items of healthcare quality, access, cost, and generational trends.
Discuss how prevention and promotion should be considered as part of improvement.
Draw on the readings provided and sources you locate in the literature to support your work.
Ensure your document follows APA style.
Unformatted Attachment Preview
Healthcare Inequities for Diabetics in Rural Kentucky
Introduction
Rural areas in the U.S., including Kentucky, face unique challenges in accessing healthcare. For diabetics,
these challenges can be particularly acute, resulting in health disparities that need to be addressed by
healthcare management professionals. This report outlines three pressing healthcare inequities for
diabetics in rural Kentucky, their implications for healthcare quality, access, and cost, and the
generational trends impacting them.
Three Areas of Inequity:
Limited Access to Specialist Care
Inequity Description: Residents in rural Kentucky often have limited access to endocrinologists or
diabetic specialists. This may lead to mismanagement or lack of comprehensive care for diabetic
patients.
Example: According to a report by the American Diabetes Association (2020), rural areas in Kentucky
have only one endocrinologist for every 15,000 diabetic patients, in sharp contrast to urban areas.
Lack of Diabetes Education and Training Programs
Inequity Description: Fewer resources or initiatives exist to educate patients about diabetes
management in rural settings.
Example: A Health Affairs study (2019) found that only 20% of rural Kentucky’s diabetic patients had
attended a diabetes education program compared to 50% in urban areas.
Cost Barriers to Medications and Monitoring Equipment
Inequity Description: Rural patients often struggle with the cost of insulin, glucose meters, and other
necessary diabetic supplies due to limited income sources.
Example: A Kentucky Health News article (2021) highlighted stories of diabetic patients rationing insulin
due to its prohibitive cost.
Justification for Selection:
Quality: Without proper specialist care and education, the quality of diabetes care diminishes, leading to
potential complications.
Access: Rural diabetics face challenges in accessing both specialists and resources essential for their
management.
Cost: High costs can deter patients from seeking care or adhering to treatment plans, thereby worsening
outcomes.
Generational Trends: As the older population increases, the incidence of Type 2 diabetes rises,
particularly in rural settings. This generational uptick makes the aforementioned inequities even more
pressing.
Prevention and Promotion:
Prevention:
Implement community outreach programs in rural Kentucky to raise awareness about diabetes risk
factors.
Encourage regular screenings and early diagnosis to prevent complications.
Promotion:
Establish diabetes education centers or mobile clinics to educate patients on management.
Advocate for policies that make diabetic supplies more affordable and accessible.
Recommendations:
Advocate for state and federal subsidies or grants to incentivize endocrinologists to serve in rural areas.
Collaborate with pharmaceutical companies and non-profits to provide discounted or free diabetes
medications and supplies to those in need.
Partner with local schools and community centers to host diabetes education events.
Conclusion:
Addressing these inequities is crucial to improve the lives of diabetic patients in rural Kentucky. By
understanding and prioritizing these issues, healthcare management professionals can make informed
decisions and advocate for meaningful change.
References:
[In this section, please list the articles and studies you referenced following the APA style.]
Note: This is a basic outline to get you started. You can expand upon each section and add in details as
necessary. When you’re researching your sources, ensure that you’re using reputable articles and
studies. Remember to follow the APA style for formatting and references.
In this project, you will demonstrate your mastery of the following competency:
Examine the possible benefits and detractors of medical tourism on the healthcare industry
Scenario
You work as the outreach director for the newly formed nongovernmental organization (NGO), Truth in Medical Tourism (TMT), whose mission is to provide objective data and information about medical tourism in an ever-changing marketplace. The seed money for this NGO was donated after a medical mishap during a medical tourism procedure; as the market booms worldwide, the need for accurate third-party information is crucial. You have been asked to create a presentation that outreach coordinators from TMT can use in any formal or informal speaking engagements with only slight modifications on the part of the speaker. In this presentation, identify patient populations, discuss the differences between the United States and other systems, and state the ranks of countries by specialty in this sector.
Directions
The marketing director provided a company presentation template that will be used to create the presentation; it includes the layout, logo, title slides, mission and other introductory materials, and hints for your presentation. Although the presentation should total 25–35 slides, you should be supplying significant information for approximately 15 slides, plus a main summary point for each section. Remember to put only main points on the slides and elaborate extensively in the speaker notes. In your presentation, which will be used by all outreach coordinators for TMT, include the following:
Explain reasons for different populations to seek out medical tourism. Consider:
Define what groups of people become medical tourists. Does it vary by country?
What social or cultural factors drive people to seek medical attention in another country?
What monetary factors drive people to seek medical attention in another country?
How do other (political, availability, etc.) issues in potential medical tourists’ home countries push them to seek treatment elsewhere?
Describe significant U.S. healthcare tourism benefits and challenges. Consider:
What medical procedure industry sectors (e.g., neurology) are growing?
What medical procedure industry sectors are growing slowly, not at all, or contracting?
What impact does the U.S. insurance system have on medical tourism?
People coming to the United States
People coming from the United States
What are the major challenges in U.S. medical tourism?
What benefits does the United States provide to the medical tourism industry?
Because of what factors is the United States considered the leader in medical tourism?
Why do so many people choose the United States?
How do these factors create growth opportunities?
Describe important worldwide healthcare tourism benefits. Consider:
In what countries are markets growing?
What specialties are growing?
What are legal opportunities for different countries involved in medical tourism?
What are economic or market opportunities for different countries involved in medical tourism?
How do medical tourism agencies create opportunities in the medical tourism sector?
Describe important worldwide healthcare tourism challenges. Consider:
In what countries are markets growing slowly, not at all, or contracting?
Which specialties are growing slowly, not at all, or contracting?
What are legal challenges for different countries involved in medical tourism?
What are economic or market challenges for different countries involved in medical tourism?
How do medical tourism agencies create challenges in the medical tourism sector?
Analyze the main healthcare specialties in defined major markets. Consider:
What are the major markets (countries, groups of countries) for medical tourism?
What are the potential up-and-coming markets for medical tourism?
What do each of these markets specialize in?
Are there other specialties that exist within smaller or often overlooked markets?
What to Submit
Every project has a deliverable or deliverables, which are the files that must be submitted before your project can be assessed. For this project, you must submit the following:
Presentation
Create a 25–35-slide presentation with speaker notes about medical tourism.
Unformatted Attachment Preview
Medical Tourism
What You Need to Know
Truth in Medical
Tourism: Mission
…to provide objective
information about
medical tourism in an
ever-changing
marketplace.
Medical Tourism
People traveling to
another country in
order to obtain
medical treatment
What Does TMT Do?
➢ Gathers up-to-date,
relevant data and
information about medical
tourism in all parts of the
world
➢ Provides outreach to
vulnerable populations:
○ Caretakers of children
and elderly
○ Middle/business class
Why Medical Tourism?
Include populations
here
Who does this, and why?
Main point of section
The U.S. Market
U.S. Health Insurance
System
Growth Opportunities
Challenges
Main point about the U.S.
market
Worldwide
Growth Opportunities
Challenges
Medical Tourism
Agencies: Growth or
Challenge?
Main point about worldwide
issues
Major Markets and Specialties
Current Major
Markets per Specialty
Current Major
Markets per Specialty
Current Major
Markets per Specialty
Up-and-Coming
Markets in Specialties
Main point about
markets/specialties
Questions?
Add address, etc.
In the scenario assignments, you are asked to reflect on responses to the presented scenario. It should not just be writing down your first reaction or what you already know.
Reflection involves critical thinking, which means rethinking your existing knowledge and previously held opinions in light of what we have learned about theories of ethics, logic, and reasoning. You will need to question your current knowledge and beliefs. Discuss the main points of the debate, what stance you take, support that stance, and discuss the opposing argument. Also, discuss an ethical theory that would apply to defend your view.
To complete each scenario assignment:
1. Complete the entire scenario.
2. Fill out the template attached below, ask your professor for details on submission.
3. Compose the last question on the template reflection in a Word document and be sure to address, at a minimum, the following questions:
Why do you feel the way you do about the issue presented?
Of the four responses offered in the scenario, which do you think is the most ethical and why?
Which ethical theory would you use to support your stance? Why does this theory work?
4. Support your conclusions with evidence and specific examples from the textbook, including a minimum of one theory of ethics to defend your stance.
5. Your reflection must be 1-2 pages in length and follow APA formatting and citation guidelines as appropriate, making sure to cite at least two sources.
6. Review the rubric for specific grading criteria
I have a presentation with classmates during lab and I need to present a mental disorder following what is the disorder, treatment, side effects etc.. I uploaded a picture these are instructions
In this project, you will demonstrate your mastery of the following competency:
Analyze emerging global and domestic issues that influence healthcare management practices
Scenario
The World Health Organization (WHO) is putting on a conference for nongovernmental organizations (NGOs), inviting both employees and volunteers. The conference is specific to emerging issues in healthcare across the globe, and WHO has asked U.S. healthcare leaders to give a presentation on emerging global and domestic issues (trends or issues) that influence healthcare management. You are representing your healthcare organization and have been asked to give the presentation, which should provide an overview of the emerging global issues that influence healthcare management practices and, additionally, target two major issues of importance to the United States.
Directions
In your 15–20-slide presentation, include general information about multiple key issues that influence healthcare management practices, and an additional “deep dive” into two issues most important to the United States.
Analyze major domestic and global societal issues for how they impact healthcare management in the United States. Consider the following societal issues:
What are the current domestic and global issues regarding migrant populations, and how do they affect healthcare management?
What are the current domestic and global issues regarding preparedness for potential bioterrorism threat, and how do they affect healthcare management?
What are the current domestic and global issues regarding drug and alcohol addiction, and how do they affect healthcare management?
What are the current domestic and global issues regarding social determinants of health?
Analyze domestic and global medical issues for how they impact healthcare management in the United States. Consider the following medical issues:
What are the current domestic and global issues regarding antimicrobial resistance, and how do they impact healthcare management?
What are the current global issues regarding infectious diseases, and how do they impact healthcare management?
What are the current global issues regarding epidemics, and how do they impact healthcare management?
What are the current domestic and global issues regarding chronic diseases in aging populations, and how do they impact healthcare management?
Determine which issues are the most relevant to healthcare management in the United States. Be sure to support your determinations. Consider the following:
Which issues impact the largest population?
Which issues have the most severe impact?
Which issues are highest on WHO’s priority list?
Outline the effects of social media on domestic and global issues that affect U.S. healthcare management practices. Consider the following:
What are the current and potential positive effects in the United States?
What are the current and potential negative effects in the United States?
What subpopulations are more/less likely to have access to and use of social media in the United States?
What is the potential impact of some populations not having access to social media in the United States?
Evaluate the ways in which U.S. and global populations may react differently to healthcare issues and how that would impact healthcare management efforts. Consider the following:
How does geography affect this issue’s influence on healthcare management?
How does access to resources affect how healthcare management may react to these?
What population subgroups are most likely to be affected by a lack of resources?
What kinds of resources might people not have access to?
How do cultural differences affect this issue’s influence on healthcare management?
How might political or legal differences affect this issue’s influence on healthcare management?
How might the United States react to each of these topics? Why?
Be sure to support your presentation with current, relevant, trustworthy resources on domestic (U.S.-based) and global issues that affect U.S. healthcare management.
What to Submit
Every project has a deliverable or deliverables, which are the files that must be submitted before your project can be assessed. For this project, you must submit the following:
Presentation
Complete a 15–20-slide presentation for the WHO conference based on your knowledge about issues that impact healthcare management.
Submit a 4 page (approx.) template on the adolescent patient. The document attached should be downloaded and saved (see below) to your computer. Fill in all appropriate sections and include 2 references or sources for your information. Bullet points preferred.
The file name should be created like this: DH 113-B, JSmith-adol (your report needs your first initial and last name embedded in the name of the file). Confirm the type of document you submit is accessible on Canvas (Word or PDF) Google docs and Pages will not open within the rubric area.
The Wilkins text has excellent general information about each patient type however the template requires details about each heading area. Students should plan on 4-5 sentences per heading. Students will include at least two peer-reviewed references; typically these are journals and not websites (in addition to your required texts) in APA format, for this assignment.
If a student submits a report after the deadline, this will result in a loss of 10% off the final score for each day it is late OR if they turn in the report after 5 days, the student will receive a “0” for the report.
Unformatted Attachment Preview
ADOLESCENT SPECIAL PATIENT REPORT TEMPLATE
Caries risk & Nutrition (sugar level IN GRAMS of typical food):
•
•
Sport drinks/juice/soda in weekly diet
Fluoride supplements (past or current, suggested by pediatric dentists?):
Growth & development (10-17 years):
•
•
•
•
Hormonal challenges & bodily changes occurring (both male and female)
OHI challenges – TB, interdental cleaning
Referral to orthodontist (why & when), sports guards (how supplied)
3rd molar extraction (referral when?)
Typical schedules:
•
•
•
Activities/hobbies/sports (importance of, why overscheduling can occur)
Personal interests (developing rapport)
Community involvement
Access to dental care:
•
•
•
Family knowledge/history of dentistry
Past experience with dental care (very little or sufficient)
Access to dental care/insurance
Psychological/Health issues:
•
•
•
•
•
•
Personal care (or lack thereof)
Body image
Anxiety/suicide
School/peer pressure/bullying (effects)
Family stress (divorce)
Birth control/STD’s
Drug abuse (signs and symptoms):
•
•
•
Tobacco/vape use (effects)
Piercing and risk associated
Illicit/OTC drug abuse
Key approach to discuss:
•
Listen and engage (how)
•
Find common ground
•
Avoid “talking down”
References
Textbook:
Wilkins, E. (2016). Clinical practice of the dental hygienist. 12th edition, Lippincott, Williams and Wilkins,
Philadelphia, PA.
Include pages used:
Journal Articles (2 required):
1
Child/Pediatric Patient Report
Adian Sahib
DH 113-B
September, 2023
2
Caries risk (sugar level IN GRAMS of A typical food):
●
ECC/rampant decay (how does this affect future dentition and dental fear)
Early childhood caries is the presence of one or more decayed teeth in
children age 5 and younger. Worldwide, ECC has an impact on young children in
preschool. The incidence of ECC varies depending on the population being
studied, and it has been shown that for underprivileged communities, the
frequency might reach 85%. Early tooth decay can have an impact on children’s
life, such as having pain while drinking hot or cold drinks or difficulty chewing.
The most common source of sugar intake in children is sweetened beverages.
Less than 25 grams per day is recommended for children based on the American
Heart Association recommendations.
●
Bottle-feeding with sugary drinks (in the past or current)
There is a correlation between bottle feeding with sugary drinks and an
increase in caries risk in children. A study that was done on the nutritional status
of children in rural El Salvador demonstrated that frequent feeding of infants with
bottled sugary drinks has been shown to increase the risk of developing
malnutrition and early childhood tooth decay. The study examined a sample of
797 children aged 6 months to 6 years living in rural El Salvador, and assessed the
risk of developing malnutrition, moderate to severe malnutrition, and severe tooth
decay in children. In particular, bottle-feeding sugar-sweetened beverages was
associated with risk of dental caries.
●
Sport drinks/juice/soda in weekly diet
Consuming sugary drinks reduces the quality of a child’s diet and leads to
poor oral health. Children who regularly consume sugary drinks such as soft
drinks and juices are at risk of developing tooth decay. The average of children’s
3
consumption of sugary drinks such as juice is about 30 gallons each year. The
acidity of the sweetened beverages can lead to tooth erosion and cavities.
Children are encouraged to drink plain tap water throughout the day to maintain
oral health.
●
Fluoride supplements (past or current, suggested by pediatric dentists?):
Some form of fluoride consumption every day is suggested to children
from age 6 months to 16 years by the The American Academy of Pediatric
Dentistry. A doctor or a dentist may prescribe a fluoride supplement if the child’s
tap water is not fluoridated. These are available as drops or tablets that are taken
orally. The amount of fluoride prescribed depends on the age of the child and the
amount of fluoride in the drinking water.
Growth & development:
●
Eruption patterns (what are a few key factors before year 3 and through
year 8?)
There are some factors that can affect the eruption of baby teeth. Genetics
plays an important role when it comes to teething. If the parents had an early or
late-onset eruption of teeth, the child may experience a similar pattern. Nutrition
can also have an impact on teeth eruption, a child may have a late eruption due to
vitamin deficiencies. Medications or any chronic health condition may delay the
process of teething.
●
OHI – interdental cleaning/TB techniques/manual dexterity challenges
Children may experience dexterity challenges while brushing and cleaning
the interdental areas in teeth. The Fones or circular method is an easy method to
teach children how to brush properly. To use the Fones method, place the
toothbrush at 90 degrees to the long axis of the teeth and move the bristles of the
4
toothbrush in a circular motion several times in each area. Another method that is
easy to be taught to children is the Leonard’s or vertical method. The toothbrush
is placed at 90 degrees to the long axis the teeth and bristles move in an up and
down motion. Both methods should be used in approximately up to a total of two
minutes of brushing. Children are encouraged to floss by providing them a special
floss for kids that is colorful and shaped like characters that kids will like to
motivate them to floss.
● Referral to orthodontist due to occlusion/crowding (why & when)
Crowded teeth may occur when there is not enough space for teeth in the
jaw to erupt and it’s usually the main reason why dentists refer a patient to an
orthodontist. Crowding can affect the primary teeth (baby teeth) or adult teeth.
Crowded teeth may lower a child’s self-esteem and the quality of their life.
Crowded teeth can be prevented or fixed by braces or by the extraction of some
teeth.
●
Sport guards (need for, how supplied)
Sports mouthguards can protect a child’s teeth, lips, tongue, and soft
tissue. They should be used while playing some kinds of sports such as softball,
baseball and soccer. They usually cover the top teeth only and they can
custom-made or boil and bite from any drugstore.
Typical schedules:
●
Hobbies, sports, after school activities
Children’s hobbies or after school activities may distract them from
brushing. Most kids do not like to spend time brushing, so teaching them at a
young age and making brushing as a part of their daily routine would be
5
beneficial. Playing music while brushing can make kids enjoy the task and it can
be used as a timer so kids will know when to stop brushing.
●
Personal interests, peer pressure (evidence of?)
Creating a positive peer pressure around children can motivate them to
brush at least twice a day. For example, children at a young age like to imitate
parents so if everyone else in the family brushes twice a day, that will make them
want to do the same thing and will make tooth brushing as a part of their daily
routine.
Access to dental care:
●
Family knowledge/history of dentistry
Children’s oral hygiene care can be influenced by parental factors.
Children’s oral hygiene habits and conditions have been found to be related to
their parents’ income and education level. Several studies have found that children
from high-income households are less likely to have tooth decay. Furthermore,
higher levels of education were associated with higher incomes, which in turn led
to better employment and increased access to health education.
●
Past experience with dental care (very little or sufficient)
Previous experience with dental care can have an impact on children’s
behavior in a dental clinic. If a child doesn’t visit the dentist regularly, they will
have more fear and anxiety than a kid who does visit the dental clinic more often.
Creating a positive experience for kids during their dental appointments is
important to maintain a lifetime of good oral health.
Psychological development:
●
Bullying, pressure to fit in, eating disorders
6
Having poor oral health can increase the risk of bullying among children.
Kids who experience dental caries and have an unsecure smile will have lower
self-confidence which can increase the likelihood of being bullied. Poor oral
hygiene can lead to infections and tooth loss. Cavities cause pain while chewing
food or while consuming something acidic or high in sugar, that can lead to eating
disorders among kids.
●
Anxiety
Dental fear and anxiety is one of the biggest challenges in younger
patients. One way to reduce anxiety is to visit the dental clinic regularly to
overcome the fear. Another way is to talk to kids and explain what to expect at a
dental appointment. Also, maintaining good oral hygiene at home can reduce the
likelihood of getting dental procedures at a young age.
●
Family stress, divorce
Family stress or divorce can have a negative impact on kids’ health. Children may
experience depression that inables them to do everyday tasks including toothbrushing
which can lead to bad oral health. Anxiety and depression can leave signs of oral neglect.
Mandatory reporter/abuse signs and symptoms:
●
DH role
Children are hard to work with, hygienists should try to make the procedure fun to
reduce kids’ anxiety. Maintaining a positive environment will make kids feel safe and
willing to come in for dental treatment. Building a good relationship with pediatric
patients will make it easier to communicate with them and teach them proper ways to
brush their teeth and floss.
●
Define responsibilities
7
One of the most important responsibilities of a dental hygienist while working
with a pediatric patient is to review their medical and make sure that there are no
contraindications to dental treatment. Another responsibility is to have a parent or
guardian with the child during the whole treatment period. Safety of a pediatric patient is
another important responsibility. To maintain safety, ensure that the patient has an
eyewear while being treated and a lead apron while taking x-rays.
Key approaches to discuss:
●
Speak directly to child (why)
Speaking directly to a child will make them feel safe and it helps to build a better
relationship with them. Ask questions about brushing and flossing to know their strengths
and weaknesses to maintain their oral health.
●
Alleviate fears through what behaviors?
To alleviate kids’ fear, give them a sticker or a reward after dental treatment.
Encourage and cheer them everytime they improve their oral hygiene. Ask kids before
doing anything to reassure them.
●
Positive reinforcement (give 2 examples)
Give children positive feedback everytime they overcome a certain fear. Motivate
kids to brush and floss everyday by showing them the proper ways of brushing and
flossing on a puppet.
●
Communication with appropriate words (child-like understanding)
Communicating with children in words that they can understand is important to
decrease their fears. Refer to the explorer as a “teeth counter” and try not to show kids
any sharp instruments during their first appointment. Name the saliva ejector as
“Mr.thirsty” and show them how it works. Place the polish brush on their fingernails and
show them that it will not hurt.
8
References
Textbook:
Wilkins, E. (2016). Clinical practice of the dental hygienist. 12th edition, Lippincott,
Williams and Wilkins, Philadelphia, PA.
Include pages used:
pgs.443-444
Peer-reviewed Journal Articles (2 required):
Achalu, P., Bhatia, A., Turton, B., Luna, L., & Sokal-Gutierrez, K. (2020, December 31). Sugary
liquids in the baby bottle: Risk for child undernutrition and severe tooth decay in rural El
Salvador. International journal of environmental research and public health.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7795345/
Anil, S., & Anand, P. S. (2017, July 18). Early childhood caries: Prevalence, risk factors, and
prevention. Frontiers in pediatrics.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514393/
CDHP Dental Health Project. (2023, August 17). Why does it take so long for baby teeth to
erupt? (explained).
Default – Stanford Medicine Children’s health. Stanford Medicine Children’s Health – Lucile
Packard Children’s Hospital Stanford. (n.d.).
https://www.stanfordchildrens.org/en/topic/default?id=fluoride-and-children-90-P01853#
:~:text=The%20American%20Academy%20of%20Pediatric,dentist%20may%20prescrib
e%20fluoride%20supplements.
9
Department of Health & Human Services. (2003, June 18). Soft Drinks, juice and sweet drinks children. Better Health Channel.
https://www.betterhealth.vic.gov.au/health/healthyliving/soft-drinks-juice-and-sweet-drinks-child
ren
The effects of sugary drinks on your child’s health – children’s health. (n.d.-b).
https://www.childrens.com/health-wellness/effects-of-sugary-drinks-on-your-childs-healt
h-infographic
Familydentistry. (2023, August 31). Ways to help dental anxiety in kids: Read more. Family
Dentistry of New Jersey.
https://familydentistryofnewjersey.com/blog/my-child-freaks-out-at-the-dentist-ways-to-h
elp-dental-anxiety-in-kids
Folayan, M. O., Oginni, O., Arowolo, O., & El Tantawi, M. (2020, July 11). Association between
adverse childhood experiences, bullying, self-esteem, resilience, social support, caries
and oral hygiene in children and adolescents in sub-urban Nigeria. BMC oral health.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353770/#:~:text=Good%20oral%20hea
lth%20enables%20children,the%20risk%20for%20bully%20victimization.
Health, C. (n.d.). The effects of sugary drinks on your child’s Health Children’s health. Children’s
Health.
https://www.childrens.com/health-wellness/effects-of-sugary-drinks-on-your-childs-healt
h-infographic#:~:text=The%20American%20Heart%20Association%20recommends,to%
20children%20under%20age%201
10
Sugary drinks fast facts – voicesforhealthykids.org. (n.d.-a).
https://voicesforhealthykids.org/assets/resources/sugary-drink-fast-facts-3.24.20.pdf
Turner, S., Harrison, J. E., Sharif, F. N., Owens, D., & Millett, D. T. (2021, December 31).
Orthodontic treatment for crowded teeth in children. The Cochrane database of
systematic reviews. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786262/
Why your young athlete needs to wear a mouthguard. Dentistry for Children MD. (2019,
September 27).
https://dentistry4childrenmd.com/blog/why-your-young-athlete-needs-to-wear-a-mouthgu
ard/#:~:text=DOES%20MY%20CHILD%20NEED%20A,(skateboarding%2C%20mount
ain%20biking).
Zhang, Y., Li, K. Y., Lo, E. C. M., & Wong, M. C. M. (2020, February 17). Structural equation
model for parental influence on children’s oral health practice and Status – BMC Oral
Health. BioMed Central.
https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-020-1048-2#:~:text=C
hildren%20whose%20mothers%20demonstrated%20less,affect%20their%20children%27
s%20oral%20health.
Integumentary Function:
K.B. is a 40-year-old white female with a 5-year history of psoriasis. She has scheduled an appointment with her dermatologist due to another relapse of psoriasis. This is her third flare-up since a definitive diagnosis was made. This outbreak of plaque psoriasis is generalized and involves large regions on the arms, legs, elbows, knees, abdomen, scalp, and groin. K.B. was diagnosed with limited plaque-type psoriasis at age 35 and initially responded well to topical treatment with high-potency corticosteroids. She has been in remission for 18 months. Until now, lesions have been confined to small regions on the elbows and lower legs.
Case Study Questions
Name the most common triggers for psoriasis and explain the different clinical types.
There are several types of treatments for psoriasis, explain the different types and indicate which would be the most appropriate approach to treat this relapse episode for K.B. Also include non-pharmacological options and recommendations.
Included in question 2
A medication review and reconciliation are always important in all patient, describe and specify why in this particular case is important to know what medications the patient is taking?
What others manifestation could present a patient with Psoriasis?
Sensory Function:
C.J. is a 27-year-old male who started to present crusty and yellowish discharged on his eyes 24 hours ago. At the beginning he thought that washing his eyes vigorously the discharge will go away but by the contrary increased producing a blurry vision specially in the morning. Once he clears his eyes of the sticky discharge her visual acuity was normal again. Also, he has been feeling throbbing pain on his left ear. His eyes became red today, so he decided to consult to get evaluated. On his physical assessment you found a yellowish discharge and bilateral conjunctival erythema. His throat and lungs are normal, his left ear canal is within normal limits, but the tympanic membrane is opaque, bulging and red.
Case Study Questions
Based on the clinical manifestations presented on the case above, which would be your eyes diagnosis for C.J. Please name why you get to this diagnosis and document your rational.
With no further information would you be able to name the probable etiology of the eye affection presented? Viral, bacterial, allergic, gonococcal, trachoma. Why and why not.
Based on your answer to the previous question regarding the etiology of the eye affection, which would be the best therapeutic approach to C.J problem.
Submission Instructions:
You must complete both case studies.
Your initial post should be at least 500 words per case study, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
Read/review the following resources for this activity:
OpenStax Textbook: Chapters 2, 6, and 7
Lesson
Weeks 3 and 5 Excel Spreadsheets
Week 5 Lab Template
SCENARIO/SUMMARY
This week’s lab highlights the use of probability and normal distribution.
Follow the directions below to gather data, calculate using Excel spreadsheets, and interpret the results.
INSTRUCTIONS
Prepare
Download the Week 5 Lab Lecture Notes.
Follow along with the Week 5 Lab Video and fill out the Week 5 Lab Lecture Notes as you watch the video.
Launch External Tool
Steps to Complete Week 5 Lab
Use the Weeks 3 and 5 spreadsheets from the Weeks 3 and 5 Lessons to help you answer the questions below.
Step 1: Your instructor will provide you with 10 values to use for this lab.
Gather 10 MORE of your own to add to the 10 provided by your instructor. Do the following:
Survey or measure 10 people to find their heights. Determine the mean and standard deviation for the 20 values by using the Week 3 Excel spreadsheet. Post a screen shot of the portion of the spreadsheet that helped you determine these values. How does your height compare to the mean (average) height of the 20 values? Is your height taller, shorter, or the same as the mean of the sample?
Note: The following image is just an example. They are NOT the values you should be using for your lab. Your instructor should have sent you our data values for your Week 5 Lab. Please reach out to your instructor if you do not have your data values.
Data Example of 10 people with different heights(your spreadsheet will have 20 values—10 from your instructor and 10 from your own data gathering).Step 2: Give some background information on the group of people you used in your study. You might consider using the following questions to guide your answer.
How did you choose the participants for your study? What was the sampling method: systematic, convenience, cluster, stratified, simple random?
What part of the country did your study take place in?
What are the age ranges of your participants?
How many of each gender did you have in your study?
What are other interesting factors about your group?
Step 3: Use the Week 5 Excel spreadsheet for the following.
(Use the Empirical Rule tab from the spreadsheet). Determine the 68%, 95%, and 99.7% values of the Empirical Rule in terms of the 20 heights in your height study.
What do these values tell you?
Post a screen shot of your work from the Week 5 Excel spreadsheet.
(Use the normal probability tab from the spreadsheet). Based on your study results, what percent of the study participants are shorter than you? What percent are taller than you?
Post a screen shot of your work from the Week 5 Excel spreadsheet.
Example: If my height is 73 inches, then 20.86% of the relevant population is shorter. The other 79.14%, of course, is taller.
Step 4: Be sure your name is on the Word document, save it, and then submit it under “Assignments” and “Week 5: Lab”.
REQUIREMENTS
The deliverable is a Word document with your answers to the questions posed below based on the data you find.
REQUIRED SOFTWARE
Microsoft Word
Microsoft Excel
GRADING
This activity will be graded based on the Week 5 Lab Rubric.
OUTCOMES
CO 3: Given scenarios supported by qualitative and quantitative data, summarize, organize, display and interpret data through the application of graphs generated with the use of technology.
Week(s): 2, 8
CO 4: Given scenarios using quantitative data from everyday life, calculate and interpret numerical summaries such as measures of central tendency, measures of variation, and measures of position.
CO 5: Given a normally distributed dataset or creating such a dataset, describe, apply, and interpret the principles and its application with everyday decisions.
Unformatted Attachment Preview
Lab 5 Lecture Notes
You will need two excel spreadsheets in order to complete this lab.
1. Go to Modules in the course room and click on Week 3 Lesson: Measure of Central
Tendency and Variation.
2. Download the excel spreadsheet template needed for the lab.
3. Go to Modules in the course room and click on Week 5 Lesson: Normal Distribution.
4. Download the excel spreadsheet template needed for the lab.
Data Set: Ten Grades on the Midterm Exam
50
86
68
86
74
80
77
78
80
90
•
Create a description spreadsheet to describe the students surveyed.
a. How did you choose the participants for your study (sampling method)?
Review Different Types of Sampling Methods
1. Cluster: ____________________________________________________________
2. Stratified: ___________________________________________________________
3. Systematic: _________________________________________________________
4. Convenient: _________________________________________________________
5. Simple Random: _____________________________________________________
b. What part of the country did your study take place in?
c. What are the age ranges of your participants?
d. How many of each gender did you have in your study?
e. What are other interesting factors about your group?
–Take a Screenshot of your Description Spreadsheet and provide it below.
–Take a Screenshot of your Preliminary Calculations and provide it below.
•
Preliminary Calculations
Mean
Sample Standard Deviation
Score on the Midterm
•
Let’s Compare Our Score!
How does your score compare to the mean (average) height of the group that you
surveyed? Is your score more, less, or the same as the mean of your group?
Empirical Rule
Determine the 68%, 95%, and 99.7% values of the Empirical Rule in terms of the ten
scores in your midterm study.
–Take a Screenshot of your Empirical Rule Sheet and provide it below
What do these values tell you?
Normal Distribution
–Take a Screenshot of your Normal Distribution Sheet and provide it below
Based on your study results, what percent of the study participants scored lower than
you? What percent scored better?
Recap of Week 5 Lab
Week 5 Lab Assignment
Name:________________________
Instructor Name: _______________
Please use this template to help answer the questions listed in the lab
instructions. The “steps” below refer to the steps listed in the lab instructions.
Type your answers and post your screenshots in the spaces given below. Then,
save this document with your name and submit it inside the course room.
Step 1. Gather Data
Your instructors will post 10 data values to use for this lab. The data values
represent the HEIGHTS of 10 people.
Please reach out to your instructor if you did not receive the assigned 10 data
values for the term by Monday of Week 5.
(NOTE: This is NOT the data used in the lab video, which is about midterm
grades. Do not use the midterm grades data.)
1a. Gather 10 MORE of your own to add to the 10 provided by your instructor.
Do the following: Survey or measure 10 people to find their heights. Determine
the mean and standard deviation for the 20 values by using the Week 3 Excel
spreadsheet. (Round statistics to two decimals.)
Mean Height in Inches
Sample Standard Deviation
in inches
Your Height in Inches
1
1b. Post a screen shot in the space BELOW of the portion of the spreadsheet
that helped you determine these values. Please list the 10 heights your
professor provided first followed by the 10 heights you collected. There
should be 20 values to determine the mean and sample standard deviation.
1c. Answer the following two questions (Answer in complete sentences).
How does your height compare to the mean (average) height of the 20 values? Is
your height taller, shorter, or the same as the mean of the sample?
2
Step 2. Data Characteristics
Answer the following questions to give some background information on the
group of people you used in your study. Write in complete sentences.
1. How did you choose the participants for your study? What was the sampling
method: systematic, convenience, cluster, stratified, simple random?
2. What part of the country did your study take place in?
3. What are the age ranges of your participants?
4. How many of each gender did you have in your study?
5. What are other interesting factors about your group?
3
Step 3. Data Analysis
Answer the following questions. Use the Week 5 Excel spreadsheets to help
analyze the data.
Empirical Rule
1. Determine the 68%, 95%, and 99.7% values of the Empirical Rule in terms of
the 20 heights in your height study. (Use the Empirical Rule tab from the
spreadsheet).
2. What do these values tell you? Write complete sentences explaining what the
values in the Empirical Rule tell you in context of the data.
3. Take a Screenshot of your Empirical Rule Sheet (Week 5 Spreadsheet) and
provide it below
Normal Distribution
1. Take a Screenshot of your Normal Distribution Sheet and provide it below
4
2. Based on your study results, what percent of the study participants are
shorter than you? What percent are taller?
Step 4. Save and submit this document
Be sure your name is on the Word document, save it, and then submit it. In the
assignment module, click “start assignment” and then “upload file” and “submit
assignment”.
5
Heights (in)
60
61
65
66
66
69
70
71
72
75
60,61,65,66,66,69,70,71,72,75
Madonna: This video represents a clear indication of failure in infection control that can cause great harm to both the patients and the workers. The nurse at the front desk definitely dropped the ball. She missed the opportunity to call the patient relative who was contaminating the front desk surface with contaminated glove to order. She could have wiped the contaminated surface with disinfectant or alcohol wipes because one could see from the look in her face that she realized that something went wrong at that instant. The new nurse who reinserted a new IV line failed to observe simple hand washing procedure. The saying which goes that hand washing saves lives should have been a reality in this whole scenario. Healthcare workers should always understand that proper hand washing, as simple as it may sound, goes a long way to save many lives. Also, the infection control specialists who are charged with enforcing infection control and preventing HAI as well should do a better job.
Working as a NICU nurse taught me a lot about infection control. Each team member on getting to the unit scrubs hands for 20 seconds before entering the unit, this is applicable to visitors too. Carrying out an invasive procedure on any client entails wearing gowns, gloves, mask and head cover plus frequent hand washing. This minimizes the spread of infections on the unit.
Tracking
Health care–associated infections (HAIs) are a significant cause of morbidity and mortality in healthcare institutions. Common examples include catheter-associated urinary tract infections, central line associated bloodstream infections as well as ventilator-associated pneumonia (Cagle, Hutcherson & Wiley, 2022).
Standardized infection control processes and precautions have been shown to reduce the rate of HAIs, and targeted practices for HAIs have shown further reductions. Patient safety tools have been developed for various HAIs to help guide administrators in preventing HAIs. Invasive devices used only when indicated and for the shortest time possible reduces the risk of device-related HAIs (Cagle, Hutcherson & Wiley, 2022). The authors went on to state that antibiotic stewardship targets physician behaviors such as reviewing antibiotic therapy choices every 48 to 72 hours, reviewing culture results as soon as available, de-escalating antibiotic therapy when appropriate, and documenting the indications for initiating antibiotics. These measures help to stop the development of multidrug-resistant organisms.
In my healthcare institution, badges with sensors are given to all healthcare workers to track how often they use the hand sanitizers as well as hand washing. The hand sanitizers has the tracking sensors too. If HAI such as MRSA is detected on the unit, every team member of the unit is swabbed and the specimen cultured to track where the infection is coming from and nip it on bud.
Globalization
The increase in human mobility has accelerated the speed and distance at which microbes are able to travel (Labonté, Mohindra & Schrecker, 2011). It is stated that the increase in human mobility has accelerated the speed and distance at which microbes are able to travel, with modern transportation, pathogens can spread faster and in a less uniform pattern. This scenario can affect the US as well as other countries. This is typical of what happened during the COVID 19 pandemic which purportedly originated from Wuhan, China. It spread like wild fire and resources to manage the infection were scarce; several lives were equally lost.
References
Cagle, D. S., Hutcherson, L. B., & T. Wiley, T. A (2022). Am Fam Physician. 105(3):262-270
Labonté, R., Mohindra, K and Ted Schrecker, T (2011). The Growing Impact of Globalization for Health and Public Health Practice. Annual Review of Public Health, Vol. 32:263-283 https://doi.org/10.1146/annurev-publhealth-031210-…
nicole:This video has been shown before, possibly in an orientation for a job or in a leadership meeting, or maybe in another class. The video illustrates how invisible germs can easily be spread or prevented through proper hand hygiene.
On the outside, it is easy to see how the spread of infection can occur. On the inside, each member did not know they were contacting and spreading the infection. One big thing is the protocol of no gloves in the hallway. The family member should have been corrected on that. Hand washing, of course, is always an issue. In the SNF (Skilled Nursing Facility) a tag will always be written on handwashing from the surveyors. IF only germs were able to be seen.
Protect the portals of entry
Portals of entry, such as IV sites, PICC lines, oral, nasal orifices need to be monitored and protected intensely. The fact that the patient also had a cat scratch, perhaps questions about the vaccination status of the cat should have been asked.
Personally, when I see food workers wearing gloves to prepare my sandwich but never changing the gloves, the thought of transmission always occurs. In the dentist office, they also use gloves and touch everything in the room, then go straight into the mouth. I have brought this to their attention, that if they are touching something else, they need to change gloves before the fingers go in my mouth.
Stop the chain of infection
In the video, it was regenerated with each member doing what was supposed to be done in order to stop the chain of infection.
Proper hand hygiene protects those that are ill and those who are washing the hands. This prevents the spread of germs. The use of soap has shown to remove germs that can be spread from one patient to the next. Use of alcohol-based hand sanitizer can be used when not visibly soiled (CDC. 2023).
The video shows how the physician attempts to work to stop the spread by using a daily checklist and rounding list. Although this is taking a long time to implement, small changes could be made along the way to be preventing the spread of infection prior to the team being created.
Tracking
Tracking can often be used through the use of the electronic health record. Proper documentation can be pulled to reports. However, as in the video, tracking the cleanliness of counters cannot be tracked in a patient EHR. Therefore, there should be other protocols in place. Such as checklists or just making it a standard of practice to wipe the counter down after people touch it. To say, the counter should be wiped down every so many hours would be great, but not ideal as germs may have landed and spread in the in between hours. As the training continues, it shows the nurse discussing the gloves and wiping down the counter. Some sanitizer dispensers have tracking on the dispenser. Some can track how many times it is used and some require a badge swipe to show how many times it was used by which staff member.
Later in the training, it does show all the different options that should have or could have been used.
Globalization and Health Care
Globalization
Globalization is a term referring to integrating and collaborating communication, culture, economies from multiple different locations into one system, where countries no longer work as independent governments but as one giant system (Mooney, 2018). Although this has occurred to some extent in the past, this does not seem to be of value to first world countries. Threats to the United States is a removal of any freedoms that remain. Creating one leader of the whole free world just seems like a threat to any freedoms. We witnessed during COVID the benefits of being independently governed as noted by New Zealand who was able to stay COVID free when the rest of world was rampant with COVID, by complete lockdown ordered by Prime Minister Jacinda Arden.
Although the CDC and the WHO attempted to implement this in all countries across the globe, it was not successful as people had to get to places in order to survive. Each country was able to make their own decisions and each state or province was also allowed to make their own decisions on lockdowns and restrictions.
With globalization, who would know how to make the best decisions for the entire globe? How would the general population know that Prime Minister Arden had the best plan? How many other factors could be at risk with one global director, in terms of economy, infrastructure, policies, etc.? The biggest risk is losing freedom to a monarchy.
References
CDC. (2023). Centers for Disease Control and Prevention. Hand hygiene in healthcare settings. Retrieved From. https://www.cdc.gov/HandHygiene/index.html
Mooney, C. (2018). Globalization : Why We Care About Faraway Events. Nomad Press.
UDHHS. NA. (2023). United States Department of Health and Human Services. Partnering to Heal. Teaming up against health care associated infections. Retrieved From.https://health.gov/about-odphp/trainings/partnerin…
Please read the following article: Amanat, A., Rizwan, M., Maple, C., Zikria, Y. B., Almadhor, A. S., & Kim, S. W. (2022). Blockchain and cloud computing-based secure electronic healthcare records storage and sharing. Frontiers in Public Health, 10, 938707. https://doi.org/10.3389/fpubh.2022.938707
Evaluate the use of protected health information in the cloud through a health information exchange. Discuss the following aspects:
Benefits
Barriers to sharing patient information in the cloud
Include an analysis of the health information exchange currently being adopted in the Kingdom of Saudi Arabia.
Your paper should meet the following structural requirements:
Five pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing standards
Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
After working with your preceptor to assess organizational policies, create a list of measurable outcomes for your capstone project intervention. Write a list of three to five outcomes for your proposed intervention. Below each outcome, provide a two – three sentence rationale. This assignment will be used to develop a written implementation plan.
Note: (Please, remember my capstone project will be regarding fall prevention among geriatric patients in the hospital setting).
Part B) Literature Evaluation Table
In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student’s ability to further develop and synthesize the assignments that constitute the components of the capstone project. The assignment will be used to develop a written implementation plan.
For this assignment, provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected. The articles should be current (within the last 5 years) and closely relate to the PICOT question developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project.
For this assignment, students are to complete the Literature Evaluation Table. Requirement: COMPLETE the Literature Evaluation Table in its entirety to include addressing the change topic in two to three sentences as per the assignment directions.
Prepare this assignment according to the guidelines found in the APA Style Guide
plagiarism report (less than 10%)
I attached the Literature Evaluation Table needed to complete this assignment.
This is the PICOT Question we developed before
PICOT Question
PICOT: Among geriatric patients in the hospital setting (P), would the implementation of patient-centered interventions (I) be more effective compared to the current fall prevention interventions (C) in reducing the incidence of falls (O) one month after implementation (T)?
These are the 8 research articles you used before. If any of those do not meet the criteria my instructor is looking for, she said is ok to change it.
Bhasin, S., Gill, T. M., Reuben, D. B., Latham, N. K., Ganz, D. A., Greene, E. J., … & Peduzzi, P. (2020). A randomized trial of a multifactorial strategy to prevent serious fall injuries. New England journal of medicine, 383(2), 129-140. https://www.nejm.org/doi/full/10.1056/NEJMoa2002183
Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., … & Bates, D. W. (2020). Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: A nonrandomized controlled trial. JAMA network open, 3(11), e2025889-e2025889. Doi:10.1001/jamanetworkopen.2020.25889.
Hoffman, G. J., Shuman, C. J., Montie, M., Anderson, C. A., & Titler, M. G. (2019). Caregivers’ views of older adult fall risk and prevention during hospital-to-home transitions. Applied nursing research, 47, 10-15. https://doi.org/10.1016/j.apnr.2019.03.006
King, B., Pecanac, K., Krupp, A., Liebzeit, D., & Mahoney, J. (2018). Impact of fall prevention on nurses and care of fall risk patients. The Gerontologist, 58(2), 331-340. doi:10.1093/geront/gnw156.
Lavedán, A., Viladrosa, M., Jürschik, P., Botigué, T., Nuín, C., Masot, O., & Lavedán, R. (2018). Fear of falling in community-dwelling older adults: A cause of falls, a consequence, or both? PLoS one, 13(3), e0194967. https://doi.org/10.1371/journal.pone.0194967
Ploeg, J., Ireland, S., Cziraki, K., Northwood, M., Zecevic, A. A., Davies, B., … & Higuchi, K. (2018). A sustainability oriented and mentored approach to implementing a fall prevention guideline in acute care over 2 years. SAGE open nursing, 4, 2377960818775433. DOI: 10.1177/2377960818775433.
Toye, C., Slatyer, S., Kitchen, S., Ingram, K., Bronson, M., Edwards, D., … & Hill, K. D. (2019). Bed moves, ward environment, staff perspectives and falls for older people with high falls risk in an acute hospital: A mixed methods study. Clinical interventions in aging, 2223-2237. https://doi.org/10.2147/CIA.S211424
Young, H. M., Ruddock, N., Harrison, M., Goodliffe, S., Lightfoot, C. J., Mayes, J., … & Eborall, H. (2022). The impact of falls: A qualitative study of the experiences of people receiving haemodialysis. International journal of environmental research and public health, 19(7), 3873. https://doi.org/10.3390/ijerph19073873
Module 06: DiscussionIn this discussion board, you will compare healthcare reimbursement methodologies in Saudi Arabia with the United States. Research and evaluate the need for more public and private funding of healthcare in Saudi Arabia. Your response should address the following:Description of current reimbursement formats in Saudi Arabia and the United States.Pros and cons of the current reimbursement model in Saudi Arabia and the United States.
Write a Literature review. You are to locate 4 research articles, no older than 5 years. Write 6 pages, summary the general themes, Adhere to APA format. A reference sheet, listing the articles should also be included.
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1
Title
Name of the author
Name of the school
Name of the class
Professor Name and credentials
Date
2
Abstract
3
Introduction
Literature Review
Methodology
4
References
Health Disparities & COVID-19 Infographic Consider the following scenario: You are the communications director of a state public health program for a state of your choice. Present data on the prevalence of COVID-19 deaths and cases for various races/ethnicities of people in your state, from 2020 and 2021, noting any changes in trends. Display this information in the form of a one-page infographic. Include risk factors affecting COVID-19 deaths. Add references/sources as needed and hypothetical contact information. Learning Objective: 1. Illustrate the prevalence of COVID-19 deaths and cases on different races and ethnicities from a state public health program perspective.
Individual Digital Storytelling Design Guidelines
Point Assignment is 100 points due by one of the five sectioned due dates by 11:59p to Canvas
dropbox
When you are done creating your digital story, you should upload the following items into the
dropbox folder:
•
•
•
3-4 pages , double-spaced, Times New Roman, 1-inch margins, write up of the topic/
issue, the population impacted, and exemplars from the population about the impact of
the topic/ issue.
Reference page attached (Not included in 3-4-page count)
You will create and record a 30-60 second video expressing the current challenges certain
populations face, because of the impact of a specific health topic/issue.
Provide a summary of the topic/issue you want to elaborate on with your story. Please be
as detailed as possible and address:
• 1) What the topic/ issue is ,
• 2) Who is most likely to be impacted by this topic/ issue?
• 3) What sources can you share expressing this population’s voice regarding the topic/
issue? In other words, for those impacted by this topic/ issue, what are they saying about
the challenges they face in being impacted?
• Then answer the following Discussion questions for your paper:
1. How does this topic/issue relate or connect health communication components (such as
the exchange of messages relating to the outcome of health, Health literacy, ethics,
patient-centered care, provider-patient communication, social determinants of health,
social constructs, classism, poverty, and health etc.) to populations aiming to reach
healthier outcomes? Be specific and provide examples.
2. Regarding your references, what arguments were made by the affected population? What
exemplar can you share in your video from their perspective?
Make sure you cite and reference at least 5 scholarly articles from academic journals to back
up what you are saying. For example. You can find articles that talk about the documentary’s
topic in actual research studies. Additionally, you may also cite your textbook after your 5
scholarly articles from academic journals. Citations must be in 7th edition APA format. I have
also uploaded an APA info sheet on how to cite scholarly articles with digital object identifiers
(DOI), as well as scholarly articles without DOI. You may find this document on Canvas.
Make sure your APA reference page meets 4 rules: 1) all citations are alphabetized, 2) all
citations are doubled spaced 3) second line and beyond of citations are indented, and 4) each
sentence has a period at the end. If you do all of this, you have a stronger chance of earning the
maximum number of points on an assignment.
The SBU strategic priorities should be consistent with the goals of the corporation. In the BCUHS case, Dr. Woodrow wants to move away from the current medical intervention model toward more holistic population health-based practices. The Balanced Scorecard is multidimensional performance measurement system that is widely used in healthcare strategic planning. Whereas traditional performance measurement systems focus only on accounting and financial measures, this approach incorporates many different perspectives from a variety of stakeholders. In essence, financial outcomes are not the only important consideration for businesses, especially not healthcare businesses. Use the Balanced Scorecard approach with Key Performance Indicators (KPIs) that address population health and business goals.***SBU: Cancer ACO*** Focus on previous case worked on and assigned sbu
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SBU Performance Management
The SBU strategic priorities should be consistent with the goals of the corporation. In the
BCUHS case, Dr. Woodrow wants to move away from the current medical intervention model
toward more holistic population health-based practices.
The Balanced Scorecard is multidimensional performance measurement system that is widely
used in healthcare strategic planning. Whereas traditional performance measurement systems
focus only on accounting and financial measures, this approach incorporates many different
perspectives from a variety of stakeholders. In essence, financial outcomes are not the only
important consideration for businesses, especially not healthcare businesses.
Use the Balanced Scorecard approach with Key Performance Indicators (KPIs) that address
population health and business goals.
VIII.
SBU Performance Management
a.
b.
c.
d.
Objectives
Measures
Targets
Initiatives (do not include this; belongs in Business Case/Marketing Plan)
SBU Performance Monitoring
PHC 6148 Strategic Planning and Health Care Marketing
Zachary Pruitt, PhD, MHA, FACHE
Population Health
Population Health
Presentation Objectives
• Connect performance management to strategic direction
• Describe Balanced Scorecard approach
• Define four organizational perspectives of the BSC
• Describe objectives, measures, targets, and initiatives of the
BSC
• Apply healthcare perspectives to the BSC
Start with Mission/Vision
https://new.edu/resources/developing-mission-vision-and-values
Strategic Priority Setting
Strategic
Options
Strategic
Priorities
Goals &
Objectives
Strategic Priority 1 (SP1): Achieve meaningful use of EHR in all outpatient clinics to facilitate information
exchange in order to improve coordination of care and reduce duplicative care.
Walston, S.L. (2014) Strategic healthcare management : planning and execution. Chicago, Illinois, Health Administration Press.
Operationalization of Measures
• Operational definition is a measurement of a concept in explicit
terms
• Examples:
• Effectiveness
• Efficiency
• Cost
• Time
• Quality
• Value
Concept to Operationalization
Happiness?
Fitness?
Intelligence
Operational Effectiveness
• Measures the degree to which goals are achieved
• Goal attainment
• Effective Care (IOM)
• Providing services based on scientific knowledge to all
who could benefit, and refraining from providing services
to those not likely to benefit
Institute of Medicine (US). Committee on Quality of Health Care in America. (2001). Crossing the
quality chasm: A new health system for the 21st century. National Academies Press.
Quality: A Sub-Concept of Effectiveness
According to renowned quality management
expert W. Edwards Deming, quality can be
defined as “a predictable degree of uniformity
and dependability with a quality standard suited
to the customer” (Deming, 1982).
This definition accepts that some kind of
standard has been set, and that the system can
produce to that standard reliably, without
variation. In addition, using this definition, the
standard-bearer of quality is the customer.
Deming, W. E. (1982). Out of the Crisis. Cambridge, MA: MIT Press.
W. Edwards Deming
Defining Concept of Quality
• Degree to which health services for individuals and populations
increase the likelihood of desired health outcomes and are
consistent with current professional knowledge.
Institute of Medicine (1990)
Many Ways to Measure Quality
Functional Protocol
Efficiency
Cost Efficiency
• Measured in dollars
• Total Program Costs = Total Cost Per Visit
Total Patient Visits
• $1,000,000 = $10/visit
100,000
Time Efficiency
• Measured in units of time
39 hours
40 hours
x
100
=
97.5% utilization
Efficiency: Patient Length-of-Stay
• The number of days between a patient’s admission and
discharge.
• The day of admission is counted, the day of discharge is not.
• Example – admitted on Monday and discharged on Wednesday
= 2 day stay
Average Length of Stay
• Average length of stay (ALOS) – the average for all hospital
patients
• Total days divided by total patients
Efficiency, Effectiveness & Productivity
Efficiency = Doing things right
Effectiveness = Doing the right things
Productivity = Output / Input
Productivity
• Ex., Labor expense per
adjusted discharge
https://www.kaufmanhall.com/sites/default/files/2022-05/KH-NHFR-Special-Report-2.pdf
Value to Patient
Describe Value to
Patient
• Define value in healthcare
• Value-based competition
• Porter’s Value Agenda
• Porter’s Value Chain
Micheal Porter
Definition of Value
26
Value-based Competition
Porter, M. E., & Teisberg, E. O. (2006). Redefining health care: creating value-based competition on results. Harvard Business Press.27
Porter’s Value Agenda
• Organize care around the patient
• Measure outcomes and cost for every patient
• Move to bundled prices for care cycles
• Integrate care delivery systems
• Expand geographic coverage
• Build an enabling information technology platform
Porter, M. E., & Lee, T. H. (2013). The strategy that will fix health care. Harv Bus Rev, 91(12). Retrieved from:
https://hbr.org/2013/10/the-strategy-that-will-fix-health-care
28
Health Services Value Chain Analysis
Organizational Infrastructure
Finance, Strategic Planning, Marketing, Human Resources, Facilities, Information Technology,
Supply Chain, etc.
Patient Services
Registration, Scheduling, Patient Billing, Case Management, Patient Experience Support, etc.
Support
Activities
Clinical Operations
Clinical Review, Patient Safety & Quality, Medical Technologies, Credentialing, etc.
Profit
Margin
Clinical Support
Patient Transport, Environmental Services, Nutrition, etc.
Primary
Activities
Monitoring
&
Preventing
• Medical history
• Screening
• Identifying
risks
• Prevention
Diagnosing
Preparing
Intervening
• Medical history
• Physical exam
• Diagnostic
testing
• Referral &
consultation
• Care
coordination
• Pre-treatment
• Patient
education
• Treatment
procedures
• Drug
administration
Recovering
& Rehab
Monitoring
& Managing
• Discharging
• Rehabbing
• Therapy fintuning
• Monitoring and
managing
conditions
Adapted from: Porter, M. E. (2008). Competitive advantage: Creating and sustaining superior performance. (2nd ed.). Riverside: Free Press. and
Porter, M. E. & Teisberg, E. O. (2006). Redefining health care: Creating value-based competition on results. Boston: Harvard Business School Press.
Patient
Value
Unique Selling
Proposition
See Text pages 36-42
Value to Customer (Patient)
Balanced Scorecard
Balance Scorecard
Robert S. Kaplan and David P. Norton, “Using the Balanced Scorecard as a Strategic Management System,”
Harvard Business Review (January-February 1996): page 76.
Four Perspectives
1. Financial
2. Internal business processes
3. Learning and growth
4. Customers
Kaplan, R. S. (2008). Conceptual foundations of the balanced scorecard. Handbooks of management accounting research, 3, 1253-1269.
Usefulness of BSC
• Reduce complexity
• Which measures are most critical to success?
• Strategic management
• Introduce complex changes (initiatives)
• Aligning actions
• Measuring performance
• Encouraging continuous improvement
Kaplan, R. S., & Norton, D. P. (2001). Transforming the balanced scorecard from performance measurement to strategic
management: Part I. Accounting horizons, 15(1), 87-104.
Balance Scorecard: “Measures that Drive
Performance”
Kaplan, R. S., & Norton, D. P. (2005). The balanced scorecard: measures that drive performance. Harvard business
review, 83(7), 172.
Four Steps of BSC Performance Monitoring
1. Create objectives
2. Define measures
3. Set targets
4. Implement initiatives
Kaplan, R. S., & Norton, D. P. (2005). The balanced scorecard: measures that drive performance. Harvard business review, 83(7), 172.
Objectives
• Objectives are broad expressions of intentions
• Must fit strategic direction (mission, vision, values)
• Objectives can be addressed in more than one
perspective (e.g., internal business processes or
learning and growth)
Whitaker, D. and Patterson, P. (2003) Balanced Scorecard (BSC) Orientation for the Office of Research Services.
National Institutes of Health, Office of Quality Management.
Measures
• Evaluate progress toward reaching the objective
• Operationalize the concepts
• Measures are also called:
• Key Performance Indicators (KPIs), metrics & statistics
Targets
• Precise value for the measure
• Should be:
• Specific
• Realistic
• Agreed-upon
Initiatives (Marketing Plans Only)
• Projects to bring change
• Makes objectives actionable
• Examples:
• Implement new technology
• Mobile dental vans at elementary schools
• “Quick Kids” E.D. triage at children’s hospital
• Not required for SBU Performance Monitoring
component of Strategic Plan
The Four Organizational Perspectives
Example: Financial
• Objective:
• Become low-cost provider
• Measure:
• Total costs (indirect and direct) per case
• Target:
• Reduce total costs per case by 10% for 10 most common
diseases
• Initiative:
• Conduct supply chain review for 10 most common diseases to
identify Opportunities for Improvement (OFIs)
Example: Internal Business Processes
• Objective:
• Improve discharge processes
• Measure:
• Number of inpatient admissions per week (throughput)
• Target:
• Increase throughput by 10% of acute care admissions
• Initiative:
• “Midnight Rounds with Discharge Focus”
Example: Learning and Growth
• Objective:
• Attract patients from other catchment areas
• Measure:
• Total market share of cardiology services
• Target:
• Increase market share from 15% to 20%
• Initiative:
• Marketing initiative for “heart hospital”
Example: Customer
• Objective:
• Increase satisfaction of patients
• Measure:
• Satisfaction index from patient surveys
• Target:
• Patients satisfied or very satisfied > 90%
• Initiative:
• Set up working group on patient surveys
Groene, O., Brandt, E., Schmidt, W., & Moeller, J. (2009). The Balanced Scorecard of acute settings: development process,
definition of 20 strategic objectives and implementation. International Journal for Quality in Health Care, 21(4), 259-271.
Possible Revisions to Original Framework
• BSC offers simplicity, but can be changed
• Multitude of stakeholders in healthcare
• Bay City University Health System
• Community service
• Education
• Clinical practice
• Scholarship
• Adjust the number and perspectives?
Trotta, A., Cardamone, et al.. (2013). Applying the Balanced Scorecard approach in teaching hospitals: a
literature review and conceptual framework. The Int’l jour of health planning & mgt, 28(2), 181-201.
Mayo Clinic Example
1.
2.
3.
4.
5.
6.
7.
8.
Customer Satisfaction
Clinical productivity and efficiency
Financial
Internal operations
Mutual respect and diversity
Social commitment
External environmental assessment
Patient characteristics
Curtright, J. W., Stolp-Smith, S. C., & Edell, E. S. (2000). Strategic performance management: development of a
performance measurement system at the Mayo Clinic. Journal of Healthcare Management, 45, 58-68.
Baldrige Performance Excellence Program
• Leadership
• Strategic Planning
• Customer Focus
• Measurement/Analysis
• Knowledge Management
• Workforce & Operations
• Results
Group Work
Work on Assignment with your Team
These
A population health strategy for Bay City 133
Case Study: A Population Health
Strategy for Bay City
Zachary Pruitt, PhD
Abstract
As the Affordable Care Act (ACA) moves the U.S. healthcare system toward
population health through value-based purchasing policies (Shaw, Asomugha,
Conway, & Rein, 2014), many healthcare organizations have begun to reconsider
their strategies (Coughlin, Long, Sheen, & Tolbert, 2012; Goldsmith, 2011). The
described case scenario provides rich detail for students to apply healthcare
strategic planning knowledge in a value-based, population health-focused
context. With an intricate community description, comprehensive market facts,
and detailed financial data, the case encourages student learning of innovative business models, including Medicare Accountable Care Organizations,
ACA health insurance plans, and Medicaid Coordinated Care Organizations.
Please address correspondence to: Zachary Pruitt, PhD, University of South Florida, Health
Policy and Management, 13201 Bruce B. Downs Blvd., MDC56, Tampa, FL 33612-3805
Phone: (727) 560-9735; Email: zpruitt1@health.usf.edu
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Winter 2017
Introduction
As the Affordable Care Act (ACA) moves the U.S. healthcare system toward
population health through value-based purchasing policies (Shaw, Asomugha,
Conway, & Rein, 2014), many healthcare organizations have begun to reconsider
their strategies (Coughlin, Long, Sheen, & Tolbert, 2012; Goldsmith, 2011). This
12,000-plus-word case provides rich detail for students to apply healthcare
strategic planning knowledge in a value-based, population health-focused
context. With an intricate community description, comprehensive market facts,
and detailed financial data, the case encourages student learning of innovative business models, including Medicare Accountable Care Organizations,
ACA health insurance plans, and Medicaid Coordinated Care Organizations.
As described in the detailed case, the fictitious CEO of the Bay City University
Health System (BCUHS) sees that the increasing trend of risk-based payments
will require his organization to innovate. The CEO asked the Strategic Planning Committee analysts (i.e., the student teams) to explore innovative ways
for BCUHS to develop population health capabilities. However, the Strategic
Planning Committee members have differing views on how to achieve the
CEO’s vision. To resolve this conflict, student teams compete to develop the
best strategic plan that meets the CEO’s vision.
Team-based learning simulates the work environments of healthcare industry practice (Lieneck and Greathouse, 2015). “Population Health Strategy for
Bay City” enables students to achieve multiple National Center for Healthcare
Leadership competencies, including development of a strategic orientation,
analytical thinking, performance management, information seeking, professionalism, and collaboration (NCHL, 2006). The case has been successfully
utilized in a graduate-level strategic planning course at an AUPHA-certified
and CAHME-accredited institution.
Bay City case scenario
Named the new the CEO nine months ago, John Woodrow, M.H.A., Ph.D.,
promises a new strategy at Bay City University Health System (BCUHS). As
a visionary leader, Dr. Woodrow views the policy changes produced by the
Affordable Care Act (ACA) as an opportunity for BCUHS to shift from the
current medical intervention model toward more holistic population healthbased practices. Dr. Woodrow has asked the Strategic Planning Committee
to develop options to achieve this vision.
BCUHS is an Academic Medical Center comprising two hospitals with
more than 700 staffed beds, an affiliated 237-bed cancer center, 150 ambulatory sites, 14,000-plus employees, and an annual operating budget of more
A population health strategy for Bay City 135
than $2 billion. BCUHS’s two inpatient facilities, Bay City General Hospital
and Oakridge Children’s Hospital, account for 24% of the inpatient market
in the Apollo Bay area, behind St. Basil Health System (29%) and American
Corporate Hospitals (26%). In addition to inpatient market share, the case
provides 13 financial ratios, beds per hospital, and the number of credentialed
physicians for all health system competitors. Data also include BCUHS payer
mix and payment types as a percent of net patient revenue (e.g., capitation).
Health insurance, long-term care, home care, laboratory, and imaging services
market shares are also included.
Bay City is a growing and vibrant city that serves as the metropolitan hub
for over 2 million people in the Apollo Bay region. Market data for the region
includes population characteristics such as racial and ethnic proportions, and
community health characteristics such as disease prevalence. In addition,
descriptions of healthcare policy, including ACA health insurance exchange,
Medicare Accountable Care Organizations, Medicaid expansion, Medicare
readmission penalties, and certificates of need, are made available in the case
for student analysis.
In a recent meeting with the Strategic Planning Committee, Dr. Woodrow
expressed his desire that analysts explore innovative ways for BCUHS to work
across organizational boundaries, increase accountability, and improve the
health of the community. Dr. Woodrow’s main question was, “What will it
mean for BCUHS to be held financially accountable for the total health of patients?” His Chief of Staff took notes at this meeting. Dr. Woodrow explained
that BCUHS needs to:
•
capitalize on business opportunities generated from the ACA;
•
improve population health management capabilities to position BCUHS
to compete in light of value-based purchasing policies;
•
respond to the emerging health care delivery models;
•
analyze the costs of services to take advantage of new reimbursement
methods, such as capitation and global payments;
•
assess the benefits of BCUHS’s recent information technology investments; and
•
strengthen community connections to effectively address social determinants of health.
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The Journal of Health Administration Education
Winter 2017
Student teams and strategic business units
Students are assigned to one of five teams. Each student team explores a
different strategic business unit concept (i.e., business model). The student
teams use information from the case to develop the most persuasive and fully
substantiated strategic plan for their assigned strategic business unit. The
instructor and/or community healthcare executives can judge and rank the
student teams’ performances in a case competition-style review. A student
team represents a different member of the BCUHS Strategic Planning Committee, each of whom advocate a unique strategic business unit concept. The
five team concepts are:
Team 1: John Barbosa, former insurance executive and state senator, current Chairman of the Board, recommends creating a health plan for the
Affordable Care Act’s Health Insurance Exchange, an upstream vertical
integration strategy. “We have a built-in provider network that enables
BCUHS to efficiently offer these new health insurance exchange customers.”
Team 2: Veronica Tanner, President, Pediatrician and BCUHS-owned
Oakridge Children’s Hospital CEO suggests creating a Medicaid Coordinated Care Organization in partnership with the Bay County Health Department. “We need to leverage our information technology infrastructure
and enhance our primary care to reduce costs.”
Team 3: Christine Chassin, Senior Vice President and Chief Strategy and
Business Development Officer of BCUHS, advocates the creation of a
Medicare Accountable Care Organization. “To be successful, we need to
reduce the total costs of care to below a certain benchmark and meet quality goals. The performance bonus could be significant.”
Team 4: Louis Winthorpe III, President of the BCHUS-affiliated Duke
Brothers Cancer Institute and BCUHS board member, recommends partnering with a private insurance company to accept global payments for
specific types of cancer diagnoses, a Cancer-specific Accountable Care
Organization. “We will be incentivized to efficiently manage treatment
and diagnose cancer earlier.”
Team 5: Sal Vinarelli, bank executive and hospital board member, recommends that BCUHS continue the high-volume, high-acuity fee-for-service
model. “I see no reason to stop milking the fee-for-service cash cow. I
believe we should resist any temptation to invest in some new-fangled
pay-for-performance trend. Instead, we should invest in the positioning
BCUHS to provide services to patients throughout the continuum of care.”
A population health strategy for Bay City 137
Teaching Notes
Learning Objectives
This case-based experiential learning activity supports eight objectives: (1)
apply systems thinking to the changing healthcare environment shaped
by the Patient Protection and Affordable Care Act of 2010; (2) interpret the
implications of various reimbursement methods utilized in U.S. healthcare;
(3) develop strategic planning skills, including internal and external environmental analysis; (4) articulate internal capabilities and competitive advantage;
(5) construct goals and objectives for both corporation and strategic business
unit; (6) develop and execute project management plan; (7) prepare a written
strategic plan; and (8) formulate and deliver persuasive oral presentation.
Classroom management
The following are possible class sessions topics and sequence for the teambased activity.
Session 1 – Introduce case scenario: In this session, the instructor should
explain the case scenario and assessment approach, and create teams for
each strategic business unit (e.g., Medicare Accountable Care Organization). It is recommended that groups of no more than five individuals be
formed (Treen, Atanasova, Pitt, & Johnson, 2016). Also, instructors should
clarify that each team should address two different levels of organization
in their strategic plan: the corporate level and the strategic business unit
level. First, the corporate-level strategic plan examines the BCUHS corporate entity, including the two hospitals, outpatient clinics, information
technology infrastructure, and other information provided in the case. The
corporate-level strategic plan can address components such as the strategic
direction (i.e., mission, vision, and values), competitive analysis, core competencies, and the product or service portfolio strategy. The second level is
the strategic business unit ideas promoted by various executive members
of the Strategic Planning Committee (described briefly above and in detail
in the Appendix). The strategic business unit-level plan should be based
on the BCUHS corporate-level strategy. In this case activity, the strategic
business units are different for each student group. For example, one team
will develop a strategic plan that addresses both the BCUHS corporate-level
strategy and the ACA Health Insurance Exchange health plan strategy.
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The Journal of Health Administration Education
Winter 2017
Session 2 – Create internal and external environmental analysis: For the
second session, student groups should complete internal and external
environmental analysis. Internal analyses can include corporate-level strategic direction (mission, vision, and values), BCUHS core competencies,
and financial analysis (see Appendix A, Table 1). The external analyses can
include the service area description, a legal and regulatory assessment, and
competitor analysis.
Session 3 – Strategic positioning: For the third session, students should
complete the strategic position of the corporate entity (BCUHS), which
can include a description of adaptive strategy (e.g., vertical integration),
explanation of the market-entry strategy (e.g., merger), and a discussion
of the strategic portfolio mix (e.g., inpatient versus outpatient).
Session 4 – Strategic business unit strategy: For the fourth session, students should complete the strategic business unit strategy. It is critical that
strategic business unit strategy integrate with the corporate-level strategy
described above. Students should provide an explicit rationale as to why
their particular strategic business unit idea will be successful given the
corporate-level strategy articulated by their plan. Students must offer succinct justification for why the strategic business unit provides a competitive
advantage for BCUHS.
Session 5 – Present strategic plans: In the final session, student groups
should present a persuasive argument as to why their strategic business
unit (e.g., Medicare ACO) is the best approach for achieving the CEO’s vision. Presentations should include goals and objectives of BCUHS and the
strategic business unit; a description of the revenue model; the competitive
advantage of the strategic business unit; and strengths, weaknesses, opportunities, and threats of the strategic business unit. It is recommended
that instructors invite a community executive to act as “John Woodrow,
CEO,” the judge of the student strategic presentation competition.
A population health strategy for Bay City 139
Questions
1.
What are the core competencies of Bay City University Health System
(BCUHS)?
2.
How does the corporate-level strategic plan for BCUHS differ from the
strategic business unit-level strategy?
3.
Your recommended business model would be just one of many products offered by BCUHS. Describe how your strategic business unit
fits within your overall health service portfolio strategy. You may use
BCG Matrix or GE/McKinsey matrix to describe your team’s approach.
4.
What is the competitive advantage for your strategic business unit?
5.
What is the strategic innovation of your recommended strategic business
unit? How does your strategic business unit agree with the population
health vision of the CEO?
References
Coughlin, T. A., Long, S. K., Sheen, E., & Tolbert, J. (2012). How five leading
safety-net hospitals are preparing for the challenges and opportunities of
health care reform. Health Affairs, 31(8), 1690-1697.
Goldsmith, J. (2011). Accountable care organizations: the case for flexible
partnerships between health plans and providers. Health Affairs, 30(1), 32-40.
Lieneck, C., & Greathouse, D. G. (2015). Use of experiential learning activities
to teach implicit communication in health care services marketing.
Journal of Health Administration Education, 32(1), 149-156.
NCHL. (2006). NCHL Healthcare Leadership Competency Model, v2.1. Retrieved
from http://www.nchl.org/Documents/NavLink/NCHL_Competency_
Model-full_uid892012226572.pdf
Shaw, F. E., Asomugha, C. N., Conway, P. H., & Rein, A. S. (2014). The Patient
Protection and Affordable Care Act: Opportunities for prevention and
public health. The Lancet, 384(9937), 75-82.
Treen, E., Atanasova, C., & Johnson, M. (2016). Evidence from a large sample
on the effects of group size and decision-making time on performance in
a marketing simulation game. Journal of Marketing Education, 38(2), 130-137.
140
The Journal of Health Administration Education
Winter 2017
Appendix A: Case Details
Bay City case scenario
Named the new the CEO of the nine months ago, John Woodrow, M.H.A.,
Ph.D. promises a new approach to strategic planning at Bay City University
Health System (BCUHS). A visionary leader, Dr. Woodrow views the policy
changes spawned by the Affordable Care Act (ACA) as an opportunity for
BCUHS to shift from the current medical intervention model toward more
holistic population health-based practices.
BCUHS is an Academic Medical Center (AMC) in Bay City comprising
two hospitals with more than 700 staffed beds, 150 ambulatory sites, 14,000
employees, and an operating budget of more than $2 billion. BCUHS strongly
identifies with the community of Bay City, a vibrant city that serves as the
metropolitan hub for more than 2 million people in the Apollo Bay region.
In a recent meeting with the Strategic Planning Committee, Dr. Woodrow
expressed his desire that analysts explore innovative ways for BCUHS to work
across organizational boundaries, increase accountability, and improve the
health of the community. Dr. Woodrow’s main question was, “What will it
mean for BCUHS to be held financially accountable for the total health of
patients?” Dr. Woodrow explained that BCUHS needs to:
•
capitalize on business opportunities generated from the ACA;
•
improve population health management capabilities to position BCUHS
to compete in light of value-based purchasing policies;
•
respond to the emerging health care delivery models;
•
analyze the costs of services to take advantage of new reimbursement
methods, such as capitation and global payments;
•
reap benefits of BCUHS’s recent information technology investments;
and
•
strengthen community connections to effectively address social determinants of health.
A population health strategy for Bay City 141
Strategic direction of Bay City University Health System
Steve Doering: Dr. Woodrow, thank you very much for speaking with me today.
As we begin the strategic planning process, I want to get your thoughts on the strategic direction for Bay City University Health System. Do you mind if I pronounce
“BCUHS” as “BECAUSE?”
Dr. John Woodrow: Not at all. I think that pronunciation reminds us that we have
a sense of purpose. A “because,” if you will.
Doering: Ha! That’s great! So, let’s get started. As you know, a strategic direction
consists of three parts: mission, vision and values–all intertwined. Let’s begin with
our mission, our purpose and reason for existence. Can you describe what we do and
for whom?
Woodrow: Absolutely. We are committed to helping all people of Apollo Bay regional
area maintain healthy lives. Our mission is to eliminate health disparities in our community through service, education, and clinical practice, and scholarship.
Doering: Now, that mission helps us frame the vision, the next part of the strategic
direction. The vision should describe our desired long-term future state.
Woodrow: I think the vision keeps management focused on meeting the needs of
stakeholders, but we need to articulate our big stretch.
Doering: A stretch?
Woodrow: Yes. BCUHS will continue to provide care to those with the most difficult
health challenges. But, with the world changing rapidly around us, I see BCUHS as
a national leader in health care delivery and medical science innovation. I want to
maintain our position as an education and research leader by continuing our emphasis
on information technology. We can get better, though. We need to do an even better job
with collaborating with our network of community and academic providers. I see us
aggressively redesigning care delivery to improve care coordination. This will enable
us to be a leader in population health management in our region.
Doering: That’s a big vision. So, let’s move on to our organizational values that
define our basic philosophy, principles, and ideals. Values represent the “soul” of our
organization.
Woodrow: Above all, we have to accept accountability for excellence in achieving
our mission. It is not enough to say we want to eliminate health disparities in our
community; we have to measure our accomplishments and adjust our performance,
as appropriate. And we must advocate for equitable access to healthcare. We must
respect patients and their families by providing quality care in a compassionate and
culturally sensitive manner.
142
The Journal of Health Administration Education
Winter 2017
Doering: So how do we accomplish that?
Woodrow: We need to implement and codify the best care processes, which we call
our patient-centered approach. Not only patient-centered, but evidence-based. This
means that we have to create new knowledge through research, and then translate this
knowledge into practice. Since we already provide the highest-quality education for
the next generation of healthcare professionals, we value transferring our knowledge.
Parts of our organization have already innovated care delivery through team-based
care, chronic disease management, and population-based practices. Not only can we
teach our organization these award-winning methods, but collaborate with others
across Apollo Bay region to achieve a common purpose and create value.
Doering: Is that possible at an organization the size of BCUHS?
Woodrow: Perhaps AMCs are slow to change. However, other large and complex
organizations, such as Google, are able to move quickly. I think we can innovate.
Also, our brand is the one thing we value, and we must protect it. This can be done by
providing exceptional performance in clinical outcomes AND patient experience. In
addition, as a multifaceted healthcare system, we value lifelong care. Our brand should
focus on the patient value throughout their life, and not just when they are very sick.
Doering: Is that possible at an organization the size of BCUHS?
Woodrow: Yes, but, we’ve got to keep cost-effectiveness in mind. “No margin, no mission,” as they say. But I like to say that we have to maintain a high level of stewardship
for the resources of this amazing community asset of BCUHS. So, in our everyday
practice, cost efficiency should be addressed by the entire organization, with BCUHS
leadership working with providers and staff to identify areas of savings.
Doering: Excellent. I think we have plenty for the teams of analysts to work with in
order to create their strategic plans. Thank you.
Woodrow: Thank you.
Strategic Planning Committe recommendations
George Barbosa, Chairman of the Board (as told to Steve Doering, Chief of Staff)
Barbosa: As you know, I m
Current research problem is as follows: Practice constraints dictated by institutional (hospitals or clinics), financial (reimbursement), and governmental (state and local) barriers limit APRNs practice scope and decrease quality patient care
PICOT question: For APRNs working in patient care settings (P), how do practice barriers (I), compared to autonomous practice (C), impact patient care (O) within six months (T)?
1. Based on the information and the research question listed above, do you believe it will best be answered by a qualitative or quantitative study? (Please choose Qualitative) Support your decision as to why you believe the answers would best be provided by the type of study you have chosen.
2. Select a middle-range theory and identify the application of nursing theories to your research problem. Conduct a literature review.
3. Based on your literature review answer the following questions:
Identify the purpose of the study.
Briefly, describe the design of the study and explain why you think it is either appropriate or inappropriate to meet the purpose.
Identify ethical issues related to the study and how they were/were not addressed.
Identify the sampling method and recruitment strategy that was used.
Discuss whether sampling and recruitment were appropriate to the aims of the research.
Identify the data collection method(s) and discuss whether the method(s) is/are appropriate to the aims of the study.
Identify how the data was analyzed and discuss whether the method(s) of analysis is/are appropriate to the aims of the study.
Identify four (4) criteria by which the rigor of a qualitative project can be judged.
Discuss the rigor of this study using the four criteria.
Briefly, describe the findings of the study and identify any limitations.
Use the information that you have gained from your critique of the study to discuss the trustworthiness and applicability of the study. Include in your discussion any implications for the discipline of nursing.
Submission Instructions:
The project is original work and logically organized.
Follow current APA format including citation of references.
Incorporate a minimum of 4 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
Journal articles and books should be referenced according to the current APA style (the library has a copy of the APA Manual).
NO AI WRITING. Faculty have access to tools that detect work generated using artificial intelligence (AI).
You have been tasked with reading and critiquing a peer-reviewed journal article. You may choose only ONE article from the attachments above. You have a choice of a semi-quantitative, mixed methods, or qualitative research study. Limit your critique to no more than three double-spaced pages. Again, don’t forget to properly cite and list your article (and any other sources) in APA format. Please, follow the criteria below.
A. Intoduction
After you read the article (critically), include an introductory paragraph to inform the reviewer of:
The author’s name(s), the title of the article, publication year, and the journal information (name, volume, issue)
The author’s main point(s)
A thesis statement to give a preview of your own analysis
B. Summary (15 points)
After your introduction, discuss the following (in your own words):
The main points of the article
The author’s arguments presented in the article
The research findings presented in the article
C. Critique (25 points)
After summarizing the article, it is now your chance to critique the article as follows:
Discuss the strengths and weaknesses of the article, which you should’ve noted during your critical reading.
State your informed opinions (using specific examples from the article to support your statements) about:
1) The clarity of the research design
2) Relevancy of the research methods
3) Accuracy of data collection
D. Conclusion (15 points)
Finally, wrap up your critique with a concluding segment to accomplish the following:
Summarize the key points presented by both— the author(s) in the article and yourself in your analysis thus far.
Close the conclusion with a comment about the significance of this research, as well as include a statement about whether there is need of future research in the field.
Formatting Requirements: Use APA Guidelines. 12 pt font. New Times Roman. Double space (2-3 Pages)
Unformatted Attachment Preview
Research Proposal Introduction Assignment
Formatting Requirements: Use APA Guidelines. 12 pt font. New Times Roman. Double space
(2-3 Pages)
Assignment Requirements: Develop your proposal introduction to include:
Background & Significance
Research Problem
Research Purpose
Research Question
1 page
½ page
½ page
½ page
Background & Significance
Identify and defining an area of concern or phenomena of interest (ie. prevalence of
cardiovascular disease in the U.S. and what is cardiovascular disease) with a particular
population and/or setting.
Problem Statement
Include the problem statement indicating what is known and not known and provide the basis for
the purpose of the review (this is the rationale for the review).
As a part of the Introduction, effective problem statements answer the question “Why does this
research need to be conducted?” The clear statement of the problem is the focal point of your
research. It should state what you will be studying, whether you will do it through experimental
or non-experimental investigation, and what the purpose of your findings will be. In it, you are
looking for something wrong, something that needs close attention, or something where existing
methods no longer seem to be working.
In your wording, be succinct and on target. Give a short summary of the research problem that
you have identified. A research proposal may not be considered acceptable or credible if you fail
to clearly identify the problem. Your biggest difficulty might be narrowing the topic since the
topic is still relatively unfamiliar to you. Your Literature Review should be a helpful source.
You might present persuasive arguments as to why the problem is important enough to study or
include the opinions of others (nurses, physicians, public health advocates, other professionals).
Explain how the problem relates to health, disease, or nursing by presenting a bit of evidence
from your Literature Review that demonstrates the scope and depth of the problem. Try to give
dramatic and concrete illustrations of the problem. After writing the Introduction, however, make
sure you can still easily identify the single sentence that is the problem statement.
Purpose:
Formulate the purpose statement indicating the specific focus and aim of the review. This is a
restatement of the research question as a declarative statement followed by 1-2 sentences about
what the study findings will contribute to patient outcomes/nursing profession/etc.
Research Question(s)
Formulate 1-2 research questions that will address the problem and purpose of the study. This
must be consistent with the purpose of the study.
Research Proposal Introduction – Rubric
Background
Significance
Research
Problem
Statement
4
Background
clearly identifies
need for the
study
Very high
significance for
nursing
Problem
statement cited is
very pertinent
and timely
3
Background
provides some
need for the
study
High
significance for
nursing
Problem
statement mostly
pertinent and
timely
2
Background to
support need for
the study not very
clear
Fair significance
for nursing
Problem
statement lacks
pertinence or is
outdated
1
Limited background
to support need for
the study
0
Missing
Limited
significance for
nursing
Problem statement
lacks pertinence and
is outdated
Missing
Missing
Research
Purpose
Very clear
purpose. Strong
linkage to area of
interest
Research
Question
Very clear
questions
Total=
Clear purpose.
Description
Adequate
linkage to area
of interest
Clear questions
Purpose mostly
clear. Description
with weak
linkage to area of
interest
Mostly clear
questions
Purpose not clear.
Description with
inadequate linkage
to area of interest
Missing
Research questions
not clear
Missing
Research Proposal Introduction Assignment
Formatting Requirements: Use APA Guidelines. 12 pt font. New Times Roman. Double space
(2-3 Pages)
Assignment Requirements: Develop your proposal introduction to include:
Background & Significance
Research Problem
Research Purpose
Research Question
1 page
½ page
½ page
½ page
Background & Significance
Identify and defining an area of concern or phenomena of interest (ie. prevalence of
cardiovascular disease in the U.S. and what is cardiovascular disease) with a particular
population and/or setting.
Problem Statement
Include the problem statement indicating what is known and not known and provide the basis for
the purpose of the review (this is the rationale for the review).
As a part of the Introduction, effective problem statements answer the question “Why does this
research need to be conducted?” The clear statement of the problem is the focal point of your
research. It should state what you will be studying, whether you will do it through experimental
or non-experimental investigation, and what the purpose of your findings will be. In it, you are
looking for something wrong, something that needs close attention, or something where existing
methods no longer seem to be working.
In your wording, be succinct and on target. Give a short summary of the research problem that
you have identified. A research proposal may not be considered acceptable or credible if you fail
to clearly identify the problem. Your biggest difficulty might be narrowing the topic since the
topic is still relatively unfamiliar to you. Your Literature Review should be a helpful source.
You might present persuasive arguments as to why the problem is important enough to study or
include the opinions of others (nurses, physicians, public health advocates, other professionals).
Explain how the problem relates to health, disease, or nursing by presenting a bit of evidence
from your Literature Review that demonstrates the scope and depth of the problem. Try to give
dramatic and concrete illustrations of the problem. After writing the Introduction, however, make
sure you can still easily identify the single sentence that is the problem statement.
Purpose:
Formulate the purpose statement indicating the specific focus and aim of the review. This is a
restatement of the research question as a declarative statement followed by 1-2 sentences about
what the study findings will contribute to patient outcomes/nursing profession/etc.
Research Question(s)
Formulate 1-2 research questions that will address the problem and purpose of the study. This
must be consistent with the purpose of the study.
Research Proposal Introduction – Rubric
Background
Significance
Research
Problem
Statement
4
Background
clearly identifies
need for the
study
Very high
significance for
nursing
Problem
statement cited is
very pertinent
and timely
3
Background
provides some
need for the
study
High
significance for
nursing
Problem
statement mostly
pertinent and
timely
2
Background to
support need for
the study not very
clear
Fair significance
for nursing
Problem
statement lacks
pertinence or is
outdated
1
Limited background
to support need for
the study
0
Missing
Limited
significance for
nursing
Problem statement
lacks pertinence and
is outdated
Missing
Missing
Research
Purpose
Very clear
purpose. Strong
linkage to area of
interest
Research
Question
Very clear
questions
Total=
Clear purpose.
Description
Adequate
linkage to area
of interest
Clear questions
Purpose mostly
clear. Description
with weak
linkage to area of
interest
Mostly clear
questions
Purpose not clear.
Description with
inadequate linkage
to area of interest
Missing
Research questions
not clear
Missing
Research Proposal Introduction Assignment
Formatting Requirements: Use APA Guidelines. 12 pt font. New Times Roman. Double space
(2-3 Pages)
Assignment Requirements: Develop your proposal introduction to include:
Background & Significance
Research Problem
Research Purpose
Research Question
1 page
½ page
½ page
½ page
Background & Significance
Identify and defining an area of concern or phenomena of interest (ie. prevalence of
cardiovascular disease in the U.S. and what is cardiovascular disease) with a particular
population and/or setting.
Problem Statement
Include the problem statement indicating what is known and not known and provide the basis for
the purpose of the review (this is the rationale for the review).
As a part of the Introduction, effective problem statements answer the question “Why does this
research need to be conducted?” The clear statement of the problem is the focal point of your
research. It should state what you will be studying, whether you will do it through experimental
or non-experimental investigation, and what the purpose of your findings will be. In it, you are
looking for something wrong, something that needs close attention, or something where existing
methods no longer seem to be working.
In your wording, be succinct and on target. Give a short summary of the research problem that
you have identified. A research proposal may not be considered acceptable or credible if you fail
to clearly identify the problem. Your biggest difficulty might be narrowing the topic since the
topic is still relatively unfamiliar to you. Your Literature Review should be a helpful source.
You might present persuasive arguments as to why the problem is important enough to study or
include the opinions of others (nurses, physicians, public health advocates, other professionals).
Explain how the problem relates to health, disease, or nursing by presenting a bit of evidence
from your Literature Review that demonstrates the scope and depth of the problem. Try to give
dramatic and concrete illustrations of the problem. After writing the Introduction, however, make
sure you can still easily identify the single sentence that is the problem statement.
Purpose:
Formulate the purpose statement indicating the specific focus and aim of the review. This is a
restatement of the research question as a declarative statement followed by 1-2 sentences about
what the study findings will contribute to patient outcomes/nursing profession/etc.
Research Question(s)
Formulate 1-2 research questions that will address the problem and purpose of the study. This
must be consistent with the purpose of the study.
Research Proposal Introduction – Rubric
Background
Significance
Research
Problem
Statement
4
Background
clearly identifies
need for the
study
Very high
significance for
nursing
Problem
statement cited is
very pertinent
and timely
3
Background
provides some
need for the
study
High
significance for
nursing
Problem
statement mostly
pertinent and
timely
2
Background to
support need for
the study not very
clear
Fair significance
for nursing
Problem
statement lacks
pertinence or is
outdated
1
Limited background
to support need for
the study
0
Missing
Limited
significance for
nursing
Problem statement
lacks pertinence and
is outdated
Missing
Missing
Research
Purpose
Very clear
purpose. Strong
linkage to area of
interest
Research
Question
Very clear
questions
Total=
Clear purpose.
Description
Adequate
linkage to area
of interest
Clear questions
Purpose mostly
clear. Description
with weak
linkage to area of
interest
Mostly clear
questions
Purpose not clear.
Description with
inadequate linkage
to area of interest
Missing
Research questions
not clear
Missing
Choose a health issue in KSA and explore the determinants causing that issue and justify your understanding with evidence from the literature.Use proper references in APA style and include in text citation.Your response should be a minimum of 250 words but should not exceed 500 words (Excluding references)
ASSIGNMENT COVER SHEET
Course name:
E-Health
Course number:
HCI 316
CRN
12722
Assignment title or task:
Describe the state of E-health in the Kingdom of Saudi
Arabia. Include at least 3 innovations used in the Kingdom.
Use recent references (NOT older than 2019)
Student Name:
Students ID:
Submission date:
Instructor name:
Hameeda Almuslim
Grade:
…..out of 10
Guideline:
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted.
File naming should be (HCI 316- Assignment – Your name).
Maximum word limit is 500 words (Excluding the reference).
Use proper references in APA style.
In APA style, the font size should be 12, and the font type should be Times New Roman,
and use double in line spacing, justified text.
Color used is Black.
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References and in-text citation must be in APA format.
AVOID PLAGIARISM
•
Due date: 26/10/2023
•
•
•
•
•
•
•
ASSIGNMENT COVER SHEET
Course name:
Road traffic Injuries & Disability Prevention
Course number:
PHC313
CRN:
Write a short essay to discuss risk factors
associated with road crashes and injury severity in
the Kingdom of Saudi Arabia
Assignment title or task:
(You can write a question)
➢ What is the magnitude of road accidents in
KSA?
➢ What are the main causes and contributory
factors of road crashes in KSA?
➢ What are the interventions applied to reduce
these risk factors?
Student name:
Student ID:
Submission date:
To be filled in by the instructor only
Instructor’s name:
Grade:
…..out of 10
Instructions for submission:
•
•
•
•
•
•
•
•
The assignment must be submitted with a properly filled cover sheet (Name, ID,
CRN, Submission date) in a word document, Pdf is not accepted.
The length of the write-up should be 1 pages’ maximum of 1000 words.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
October 14, 2023, at 11:59 PM.
For this discussion, please respond to the following directions:Discuss changing the culture of a team to prioritize safety.Identify challenges to changing the culture of a team in an organization.Address safety challenges across the lifespan related to inpatient care.Please be sure to validate your opinions and ideas with citations and references in APA format.
Please read the following article:Manamela, L. M., Rasweswe, M. M., & Mooa, R. S. (2022). Factors contributing to non-adherence of the peri-operative surgical team to WHO surgical safety checklist in the Kingdom of Saudi Arabia. Perioperative Care and Operating Room Management, 29. https://doi.org/10.1016/j.pcorm.2022.100292Create an analysis of the factors that contribute to the non-adherence of the perioperative surgical team discussed in this article. Present a plan to overcome these barriers so that the surgical risks are reduced and quality and patient safety are improved.Your paper should meet the following structural requirements:Four pages in length, not including the cover sheet and reference page.Formatted according to APA 7th edition and Saudi Electronic University writing standardsProvide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
Discussion (Week 4)
Question: Discuss the difference between Diversity and Disparity in relation to Health with
example?
Dear Students,
The discussion will be available in Discussion board by name Week 4 – Discussion from
17/September/2023 ie; Sunday 12:30 PM due date 23/September/2023 ie; Saturday until
11:59 PM.
This activity comprises for 10 marks of your Total Course work.
Instructions for Completing the Discussion Questions:
1. Post your original response by 20/September/2023 ie; Wednesday by 11:59 PM.
2. Your response should be a minimum of 5 sentences but should not exceed more than 500
words.
3. Appropriately cite the references in APA style referencing.
4. Respond to at least 2 of your classmates by 23/September/2023 ie; Saturday by 11:59
PM.
5. Your response to your classmate should be substantive in nature for example:
a. State agreements and provide additional supportive evidence or examples
b. Ask additional questions for clarification or provide additional ideas or perspectives
on the answer
c. Advance the participant’s ideas further by providing additional references or
support and providing feedback on the participant’s experience or perspectives.
d. State disagreements, if any, but provide evidence or support, using professional
tone and netiquette.
General Guidelines for Posting to Discussion Boards
Treat your discussion board post as any other written paper or response. You will want to establish
a process that works for you and use that process to produce engaging ideas that contribute to the
online conversation you are having with your classmates and your professor. You shouldn’t just
strive for completion, but also discussion and engagement.
Before you begin:
•
•
•
Read your prompt or discussion question carefully— pay attention to word count, citation
requirements, and specific guidelines such as due dates and response requirements. Are
you just answering one question or do you have to answer a question and then respond to
others?
Set an agenda— making a schedule will help you stay on task and not get behind, especially
with two-part due dates and follow up responses.
Narrow down what exactly you should be accomplishing in your post.
Drafting the post:
•
•
•
•
•
•
Before you begin take a few minutes to observe your peer’s posts. This will allow you to
see what other people are saying and allow you to even quote some of your peers.
Begin by drafting your post in MS Word or another application.
Use titles or headings to lead the reader through your post.
Use a warm opening. Don’t be too abrupt or forward right off the bat. Allow your reader
time to get “into” your post without feeling lost or overwhelmed.
Avoid jokes. Because you are not in a face-to-face environment, it’s easier for someone to
take something you say the wrong way.
Consider your audience. Your post will be read by your professor and your peers, so be
sure to maintain a professional tone.
Responding to a post:
•
•
•
•
•
•
Address your classmates by their names when responding to their posts.
Don’t dominate the conversation. Ask questions and point out specific details that you
found interesting about the other posts.
Keep in mind that your goal in responding is rooted in keeping the conversation going.
Quote or restate a few ideas from the post you are responding to.
Be respectful and non-confrontational.
Be as specific as possible to encourage discussion.
The range of personal, social, economic, and environmental factors that influence health status are known as determinants of health. Determinants of health fall under several broad categories: Policymaking, Social factors, Health Services, Individual Behavior, and Biology and Genetics. —Healthy People 2020
As stated, these categories of health are broad. One important competency of a public health nurse is the ability to recognize and consider the linkages between these categories when addressing the health needs of a population.
For this Discussion, you will consider definitions of health across
To Prepare:
Review the Healthy People 2020 website and reflect on what makes some people healthy and others unhealthy. (https://wayback.archive-it.org/5774/20220415230635…)
Review this week’s Learning Resources, giving specific attention to perspectives provided by the “Determinants of Health” video.
Assignment Post 1 a response to the question: “In your own words, how do you define health?” Explain the resources needed to achieve optimal health in a population. Then, explain what resources are available in your own community for supporting the achievement of health.
WHAT DETERMINES HEALTH?
Healthy People 2020 highlights the importance of addressing the social determinants of health by including “Create social and physical environments that promote good health for all” as one of the four overarching goals for the decade. This emphasis is shared by the World Health Organization, whose Commission on Social Determinants of Health in 2008 published the report, Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health. The emphasis is also shared by other U.S. health initiatives such as the National Partnership for Action to End Health Disparities and the National Prevention and Health Promotion Strategy.”
For this Discussion, you will choose a topic that is considered a social determinant of health and explain how it influences the health outcomes of a population.
To Prepare:
Review the video from the Worlds Apart series included in this week’s Learning Resources which highlights the experience of Alicia Mercado who is attempting to manage chronic disease within a challenging social and economic environment.
Choose a topic that you think is a social determinant of health and review academic literature and reliable online information on the topic you choose.
Assignment Post 2 an explanation of why the issue you identified is a social determinant of health and explain how this issue contributes to health, both positively and negatively.
3 CITED SOURCE FOR EACH POST
USW1_NURS_6710_Week06_Discussion_Rubric
Criteria Ratings Pts
Main Posting
50 to >44.0 pts
Excellent
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
44 to >39.0 pts
Good
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
39 to >34.0 pts
Fair
Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.
34 to >0 pts
Poor
Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
SP DQ2
AN
DQ 2 250-300 WORDS
Describe two external stressors that are unique to adolescents. Discuss what risk-taking behaviors
may result from the external stressors and what support or coping mechanism can be introduced.
MJ
DQ 2 250-300 WORDS
Compare and contrast the three different levels of health promotion (primary, secondary, tertiary).
Discuss how the levels of prevention help determine educational needs for a patient.
JM
DQ 2 250 -300 WORDS
Discuss why nutrition is a central component in health promotion. What are some of the nutritional
challenges for emerging populations? What roles do nutritional deficiency and nutritional excess play
in disease?
Please create a 2-3 page background portion of the following research question: Can technology make patient surveys more reliable?Please use 4-5 APA in-text citations and list references used on a separate page. Please create a strong thesis statement for this question as well.
Purpose: Understanding if the literature is good enough for answering a clinical question is a critical step in developing a solution to the problem and improving patient outcomes.
Description: Using the literature selected in the Part 3 assignment, you will categorize your selections and assign a level of evidence to each. See the grading rubric embedded in BS.
Instructions:
1. Using the 4 (possibly 5, if a CPG was found) articles you found for your EBP Project, Part 3 assignment, include the first author’s last name and year of publication in the first column of the table on this document.
2. Include the journal title in which the article appeared along with whether or not the journal is peer-reviewed in the second column.
3. Categorize each article as primary-quantitative, primary-qualitative, secondary, other-CPG, or other-not a CPG. Provide a rationale for your categorization for each article. Record your evaluation in the table on this document.
4. Based on your categorization, assign a level of evidence to each, per the pyramid in this Week’s presentation. Record the level of evidence in the table on this document.
5. Based on your assignment of the level of evidence, reflect on whether the literature you found—AS A WHOLE—is sufficient to help answer your clinical question. If yes, why? If not, why and what are the next steps to find the literature you need to support the answer to your clinical question? Include this reflection on the last page of the grid.
6. On a separate Word document, provide properly-formatted APA citations for all articles used for Part 4 (include replacement articles). Use the last page of the APA Paper Example #1 from the Oak Point APA Resources page to see how the reference page should look. Also, refer to the APA and Writing Overview with Citation Examples PPT on the LibGuide for additional information.
7. Upload this grid/reflection document, your APA reference document, and pdfs of all your chosen articles to the appropriate assignment dropbox with the following titles:
Lastname EBP Project Part 4 LoE
Lastname EBP Project Part 4 APA
Lastname Article 1
Lastname Article 2
Lastname Article 3
Lastname Article 4
Lastname Article 5 (CPG, if found)
Adams, Y. J., Stommel, M., Ayoola, A., Horodynski, M., Malata, A., & Smith, B. (2017). Use and evaluation of postpartum care services in rural Malawi. Journal of Nursing Scholarship, 49(1), 87-95.http://library.stikespantirapih.ac.id/downloads/Jo… me%2049%20Tahun%202017,%20No%201.pdf#page=
Appleton, J., Russell, C. G., Laws, R., Fowler, C., Campbell, K., & Denney‐Wilson, E. (2018). Infant formula feeding practices associated with rapid weight gain: A systematic review. Maternal & child nutrition, 14(3), e12602. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC68661…
Hutchens, B. F., & Kearney, J. (2020). Risk factors for postpartum depression: an umbrella review.
Ghaedrahmati, M., Kazemi, A., Kheirabadi, G., Ebrahimi, A., & Bahrami, M. (2017). Postpartum depression risk factors: A narrative review. Journal of education and health promotion, 6.Journal of midwifery & women’s health, 65(1), 96-108.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC55616…
Unformatted Attachment Preview
1
EBP Project, Part 4: Levels of Evidence
Author/Year
Journal Title/Peer
Review?
Category
Reflection on the body of evidence as a whole to answer your research question.
Rationale for Category
Level of Evidence
InstructionsSubmit a 4 page (approx.) template on the adolescent patient. The document attached should be downloaded and saved (see below) to your computer. Fill in all appropriate sections and include 2 references or sources for your information. Bullet points preferred.The file name should be created like this: DH 113-B, JSmith-adol (your report needs your first initial and last name embedded in the name of the file). Confirm the type of document you submit is accessible on Canvas (Word or PDF) Google docs and Pages will not open within the rubric area.The Wilkins text has excellent general information about each patient type however the template requires details about each heading area. Students should plan on 4-5 sentences per heading. Students will include at least two peer-reviewed references; typically these are journals and not websites (in addition to your required texts) in APA format, for this assignment.If a student submits a report after the deadline, this will result in a loss of 10% off the final score for each day it is late OR if they turn in the report after 5 days, the student will receive a “0” for the report.
Unformatted Attachment Preview
ADOLESCENT SPECIAL PATIENT REPORT TEMPLATE
Caries risk & Nutrition (sugar level IN GRAMS of typical food):
•
•
Sport drinks/juice/soda in weekly diet
Fluoride supplements (past or current, suggested by pediatric dentists?):
Growth & development (10-17 years):
•
•
•
•
Hormonal challenges & bodily changes occurring (both male and female)
OHI challenges – TB, interdental cleaning
Referral to orthodontist (why & when), sports guards (how supplied)
3rd molar extraction (referral when?)
Typical schedules:
•
•
•
Activities/hobbies/sports (importance of, why overscheduling can occur)
Personal interests (developing rapport)
Community involvement
Access to dental care:
•
•
•
Family knowledge/history of dentistry
Past experience with dental care (very little or sufficient)
Access to dental care/insurance
Psychological/Health issues:
•
•
•
•
•
•
Personal care (or lack thereof)
Body image
Anxiety/suicide
School/peer pressure/bullying (effects)
Family stress (divorce)
Birth control/STD’s
Drug abuse (signs and symptoms):
•
•
•
Tobacco/vape use (effects)
Piercing and risk associated
Illicit/OTC drug abuse
Key approach to discuss:
•
Listen and engage (how)
•
Find common ground
•
Avoid “talking down”
References
Textbook:
Wilkins, E. (2016). Clinical practice of the dental hygienist. 12th edition, Lippincott, Williams and Wilkins,
Philadelphia, PA.
Include pages used:
Journal Articles (2 required):
general infoInstructionsSubmit a 4 page (approx.) template on the adolescent patient. The document attached should be downloaded and saved (see below) to your computer. Fill in all appropriate sections and include 2 references or sources for your information. Bullet points preferred.The file name should be created like this: DH 113-B, JSmith-adol (your report needs your first initial and last name embedded in the name of the file). Confirm the type of document you submit is accessible on Canvas (Word or PDF) Google docs and Pages will not open within the rubric area.The Wilkins text has excellent general information about each patient type however the template requires details about each heading area. Students should plan on 4-5 sentences per heading. Students will include at least two peer-reviewed references; typically these are journals and not websites (in addition to your required texts) in APA format, for this assignment. nfo
Unformatted Attachment Preview
ADOLESCENT SPECIAL PATIENT REPORT TEMPLATE
Caries risk & Nutrition (sugar level IN GRAMS of typical food):
•
•
Sport drinks/juice/soda in weekly diet
Fluoride supplements (past or current, suggested by pediatric dentists?):
Growth & development (10-17 years):
•
•
•
•
Hormonal challenges & bodily changes occurring (both male and female)
OHI challenges – TB, interdental cleaning
Referral to orthodontist (why & when), sports guards (how supplied)
3rd molar extraction (referral when?)
Typical schedules:
•
•
•
Activities/hobbies/sports (importance of, why overscheduling can occur)
Personal interests (developing rapport)
Community involvement
Access to dental care:
•
•
•
Family knowledge/history of dentistry
Past experience with dental care (very little or sufficient)
Access to dental care/insurance
Psychological/Health issues:
•
•
•
•
•
•
Personal care (or lack thereof)
Body image
Anxiety/suicide
School/peer pressure/bullying (effects)
Family stress (divorce)
Birth control/STD’s
Drug abuse (signs and symptoms):
•
•
•
Tobacco/vape use (effects)
Piercing and risk associated
Illicit/OTC drug abuse
Key approach to discuss:
•
Listen and engage (how)
•
Find common ground
•
Avoid “talking down”
References
Textbook:
Wilkins, E. (2016). Clinical practice of the dental hygienist. 12th edition, Lippincott, Williams and Wilkins,
Philadelphia, PA.
Include pages used:
Journal Articles (2 required):
Interventions for Adolescent Mental Health: An Overview of Systematic Reviews
Nurses as Leaders in Healthcare Reform; A description of the most pressing mental health concerns in children and adolescence you selected. Provide an overview of the articles you found (using appropriate APA citations) relating to these concerns and highlight any KEY FINDINGS. Explain the PMHNP leader role that could help psychiatric mental health nursing be at the forefront in transforming mental health care delivery.
IN A 6-PAGES PAPER:
Description of mental health concern selected-1 point
Overview of outside articles with Key Findings-1 point
What is “Healing mental healthcare?”-1 point
How can PMHNP facilitate positive changes in mental health? -3 points
Discuss how the PMHNP as nurse leader could help psychiatric mental health nursing be at the forefront in the transformation of mental health care delivery- 3 points
References-1 point
You will have a total of 4 pages, including
Page 1-Cover page,
Page 2-5, Body of the paper,
Page 6 – Reference Page.
Unformatted Attachment Preview
Journal of Adolescent Health 59 (2016) S49eS60
www.jahonline.org
Review article
Interventions for Adolescent Mental Health: An Overview
of Systematic Reviews
Jai K. Das, M.D., M.B.A. a, Rehana A. Salam, M.Sc. a, Zohra S. Lassi, Ph.D. b, Marium Naveed Khan a,
Wajeeha Mahmood c, Vikram Patel, Ph.D. d, e, f, and Zulfiqar A. Bhutta, Ph.D. g, h, *
a
Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
Robinson Research Institute, University of Adelaide, Adelaide, Australia
c
Ziauddin University, Karachi, Pakistan
d
London School of Hygiene & Tropical Medicine, London, United Kingdom
e
Public Health Foundation of India, New Delhi, India
f
Sangath, Goa, India
g
Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
h
Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
b
Article history: Received January 25, 2016; Accepted July 1, 2016
Keywords: Adolescent health; Mental health; Suicide; Depression; Anxiety; Eating disorders
A B S T R A C T
Many mental health disorders emerge in late childhood and early adolescence and contribute to the
burden of these disorders among young people and later in life. We systematically reviewed literature
published up to December 2015 to identify systematic reviews on mental health interventions in
adolescent population. A total of 38 systematic reviews were included. We classified the included reviews
into the following categories for reporting the findings: school-based interventions (n ¼ 12); communitybased interventions (n ¼ 6); digital platforms (n ¼ 8); and individual-/family-based interventions (n ¼ 12).
Evidence from school-based interventions suggests that targeted group-based interventions and cognitive
behavioral therapy are effective in reducing depressive symptoms (standard mean difference [SMD]: .16;
95% confidence interval [CI]: .26 to .05) and anxiety (SMD: .33; 95% CI: .59 to .06). School-based
suicide prevention programs suggest that classroom-based didactic and experiential programs increase
short-term knowledge of suicide (SMD: 1.51; 95% CI: .57e2.45) and knowledge of suicide prevention
(SMD: .72; 95% CI: .36e1.07) with no evidence of an effect on suicide-related attitudes or behaviors.
Community-based creative activities have some positive effect on behavioral changes, self-confidence,
self-esteem, levels of knowledge, and physical activity. Evidence from digital platforms supports
Internet-based prevention and treatment programs for anxiety and depression; however, more extensive
and rigorous research is warranted to further establish the conditions. Among individual- and familybased interventions, interventions focusing on eating attitudes and behaviors show no impact on body
mass index (SMD: .10; 95% CI: .45 to .25); Eating Attitude Test (SMD: .01; 95% CI: .13 to .15); and
bulimia (SMD: .03; 95% CI: .16 to .10). Exercise is found to be effective in improving self-esteem (SMD:
.49; 95% CI: .16e.81) and reducing depression score (SMD: .66; 95% CI: 1.25 to .08) with no impact on
anxiety scores. Cognitive behavioral therapy compared to waitlist is effective in reducing remission (odds
ratio: 7.85; 95% CI: 5.31e11.6). Psychological therapy when compared to antidepressants have comparable
effect on remission, dropouts, and depression symptoms. The studies evaluating mental health
Conflicts of interest: The authors do not have any financial or nonfinancial competing interests for this review.
Disclaimer: Publication of this article was supported by the Bill and Melinda Gates Foundation. The opinions or views expressed in this supplement are those of the
authors and do not necessarily represent the official position of the funder.
* Address correspondence to: Zulfiqar A. Bhutta, Ph.D., Centre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, Ontario M6S 1S6,
Canada.
E-mail address: zulfiqar.bhutta@sickkids.ca (Z.A. Bhutta).
1054-139X/Ó 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. This is an open access article under the CC BY license (http://
creativecommons.org/licenses/by/4.0/).
http://dx.doi.org/10.1016/j.jadohealth.2016.06.020
S50
J.K. Das et al. / Journal of Adolescent Health 59 (2016) S49eS60
interventions among adolescents were reported to be very heterogeneous, statistically, in their populations, interventions, and outcomes; hence, meta-analysis could not be conducted in most of
the included reviews. Future trials should also focus on standardized interventions and outcomes for
synthesizing the exiting body of knowledge. There is a need to report differential effects for gender,
age groups, socioeconomic status, and geographic settings since the impact of mental health interventions
might vary according to various contextual factors.
Ó 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. This is an open access
article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
studies targeted youth (aged 15e24 years) along with adolescents, exceptions were made to include reviews targeting adolescents and youth. We did not apply any limitations on the start
search date or geographical settings. We considered all available
published systematic reviews on the interventions to prevent
and treat adolescent mental health disorders. A broad search
strategy was used that included a combination of appropriate
keywords, medical subject heading, and free text terms; the
search was conducted in the Cochrane Library, and PubMed. The
abstracts (and the full sources where abstracts are not available)
were screened by two abstractors to identify systematic reviews
adhering to our objectives. Any disagreements on selection of
reviews between these two primary abstractors were resolved by
the third reviewer. After retrieval of the full texts of all the reviews that met the inclusion/exclusion criteria, data from each
review were extracted independently into a standardized form.
Information was extracted on (1) the characteristics of included
studies; (2) description of methods, participants, interventions,
outcomes; (3) measurement of treatment effects; (4) methodological issues; and (5) risk of bias tool. We extracted pooled effect
size for outcomes reported by the review authors with 95%
confidence intervals (CIs). We assessed and reported the quality
of included reviews using the 11-point assessment of the
methodological quality of systematic reviews criteria (AMSTAR)
[17]. We excluded nonsystematic reviews, systematic reviews
focusing on preventive and therapeutic mental health interventions targeting population other than adolescents and
youth, and reviews not reporting outcomes related to mental
health (Table 1).
Figure 1 describes the search flow. Our search identified 107
potentially relevant review titles. Further evaluation of the
abstracts and full texts resulted in the inclusion of 38 eligible
reviews. We classified the included reviews into the following
categories for reporting the findings:
Adolescence is a period for the onset of behaviors and conditions that not only affect health at that time but also lead to
adulthood disorders. Unhealthy behaviors such as smoking,
drinking, and illicit drug use often begin during adolescence and
are closely related to increased morbidity and mortality and
represent major public health challenges [1]. Many mental
health disorders emerge in mid- to late adolescence and
contribute to the existing burden of disease among young people
and in later life [2]. More than 50% of adult mental disorders have
their onset before the age of 18 years [3,4]. Poor mental health
has been associated with teenage pregnancy, HIV/AIDS, other
sexually transmitted diseases, domestic violence, child abuse,
motor vehicle crashes, physical fights, crime, homicide, and
suicide [2]. Globally, neuropsychiatric disorders are the leading
cause of years lost because of disability among 10- to 24-yearolds, accounting for 45% of years lost because of disabilities [5].
The overall prevalence of depression in adolescents is around 6%
and that for children (younger than 13 years) is 3% [6]. Major
depressive disorder (MDD) is one of the leading causes of
disability, morbidity, and mortality and is a major risk factor for
suicide [7]. MDD also puts adolescents and young adults at a
greater risk for suicide as they are seven times more likely to
complete suicide than those without MDD [8]. Suicide itself accounts for 9.1% of deaths in 15- to 19-year age group and ranks as
the third major cause of mortality in this age group, preceded
only by accidents and assault [9].
Given the prevailing burden and impact of mental health
disorders in children and adolescents, it is essential that effective
interventions are identified and implemented. This article is part
of a series of reviews conducted to evaluate the effectiveness of
potential interventions for adolescent health and well-being.
Detailed framework, methodology, and other potential interventions have been discussed in separate articles [10e16]. Our
conceptual framework depicts the individual and general risk
factors through the life cycle perspective that can have implications at any stage of the life cycle [10]. We also acknowledge the
fact that mental health interventions take a life course perspective and that interventions earlier in life can have impacts in
adolescence; however, the focus of our review is to evaluate
potential mental health interventions targeted toward adolescents and youth only. With this focus, we aimed to systematically
review the effectiveness of interventions to prevent and manage
mental health disorders among adolescents and youth.
Table 2 describes the characteristics of the included reviews
while Table 3 provides the summary estimates for all the
interventions.
Methods
Results
We systematically reviewed literature published up to
December 2015, to identify systematic reviews on interventions
to prevent and manage mental health disorders in adolescent
population. For the purpose of this review, the adolescent population was defined as aged 11e19 years; however, since many
School-based interventions
School-based interventions (n ¼ 12)
Community-based interventions (n ¼ 6)
Digital platforms (n ¼ 8)
Individual-/family-based interventions (n ¼ 12)
We found a total of 12 reviews reporting school-based
interventions for adolescent mental health, of which one
review performed meta-analysis. AMSTAR rating ranged
J.K. Das et al. / Journal of Adolescent Health 59 (2016) S49eS60
S51
Table 1
Inclusion/exclusion criteria
Inclusion criteria
Exclusion criteria
Systematic review and/or meta-analysis of interventions for
prevention and treatment of mental health targeting adolescents
(11e19 years) or youth (15e24 years):
Eating disorders
Anxiety
Depression
Suicidal behaviors
eHealth interventions focusing on adolescent/youth mental health
Nonsystematic reviews
Systematic reviews focusing on preventive and therapeutic mental
health interventions targeting population other than adolescents and youth
Reviews not reporting outcomes related to mental health
between 5 and 11 with a median score of 7.5. Five of the included
reviews focused on school-based mental health promotion
interventions; three reviews evaluated school-based programs
for prevention and early intervention for existing mental health
conditions while four reviews evaluated school-based programs
for suicide prevention. A review on school mental health promotion programs based on the findings from 15 studies suggests
that an approach focusing on mental health promotion rather
than on mental illness prevention is effective in promoting
adolescent and youth mental health [18]. However, study populations were limited, and studies either lack clarity regarding
who implemented interventions or lack theoretical foundations,
process evaluations, or youth viewpoints [18]. Meta-analysis was
not conducted due to variations in interventions and outcomes.
Another review reported from 27 studies that school-based
preventive health care is popular with young people and
provides important mental health services [19]. However,
meta-analysis was not done due to study quality. Findings from a
review based on 16 studies focusing on targeted group-based
interventions delivered in school settings suggest that nurture
groups (short-term, focused intervention which addresses
barriers to learning arising from social, emotional, or behavioral
difficulties in an inclusive, supportive manner) have an immediate positive impact on the social and emotional well-being of
young people [20]. Due to heterogeneity of design, it was not
possible to conduct a meta-analysis, and the studies were
examined for effectiveness qualitatively. A review evaluating
solution-focused brief therapy in schools has suggested mixed
results with some promise in working with students in school
settings, specifically for reducing the intensity of students’
negative feelings, managing conduct problems, and externalizing
behavioral problems [21]. These findings are based on seven
studies while meta-analysis could not be conducted. Schoolbased mental health interventions specifically focusing on lowand middle-income countries (LMICs) suggest that the majority
of the school-based life skills and resilience programs indicated
positive effects on students’ self-esteem, motivation, and
self-efficacy. However, there were mixed results, including differential effects for gender and age groups [19], and effect
estimates could not be pooled. A systematic review on the
effectiveness of school nurse implemented mental health
screening for adolescents in schools did not find any evidence of
Figure 1. Search flow diagram. MeSH ¼ Medical Subject Heading.
S52
Table 2
Characteristics of the included reviews
Intervention
Review
Intervention details
Setting;
HICs/LMICs
Number of
included studies
AMSTAR Outcomes reported
rating
School-based
interventions
O’Mara and Lind [18]
Social and emotional health and well-being, positive
youth development, health promotion, mental
health promotion, primary prevention
Mostly HICs
15 reviews
d
Mason-Jones
et al. [19]
School-based health care including comprehensive
services based at schools, dedicated adolescent health
services, school-linked services based at local health
centers, and servicing a number of schools and other
outreach
Nurture group (NG) intervention delivered in primary
and secondary school settings. NG sessions typically
include circle time meet and greet. A directed activity,
aiming to develop cooperation, listening, teamwork,
turn-taking, problem-solving, and self-esteem. Snack
time. Free time to choose an activity from the range
offered. Saying good-byes
Solution-focused brief therapy on behavioral problems
in schools
HICs
27 (RCTs and
observational
studies)
7
HICs
16 (RCTs and
preepost)
8
Social and emotional well-being
HICs
7 (RCT, quasi,
and case
report)
6
HICs
None
6
Changes in scores from Hare Self-Esteem
Scale; Conners’ Teacher Rating Scale;
Conners’ Parent Rating Scale;
Feelings, Attitudes and Behaviors Scale
for Children; Substance Abuse Subtle
Screening Inventory Adolescent-2; and
Child Behavior Checklist-Youth.
Existing screening tools being applied
by school nurses to detect mental ill health
HICs
42 RCTs
7
Depression
HICs
17 RCTs
8
Outcome related to depression, anxiety,
and suicidality (actual or attempted
suicide and suicidal ideation)
Academic outcomes, behavioral outcomes,
conduct problems, depression, substance
use, internalizing symptoms
Students’ and school staffs’ knowledge and
attitudes toward suicide, suicide attempts
Kim and Franklin [21]
Fothergill et al. [22]
Calear and
Christensen [23]
Kavanagh et al. [24]
Screening tools being used by school nurses for the
identification of emotional, psychological, and
behavioral problems among adolescents in schools.
School-based prevention and early intervention
programs for depression. Mostly including cognitive
behavioral therapy (CBT) delivered by a mental health
professional or graduate student over 8e12 sessions.
Other common therapeutic approaches employed
included psychoeducation and interpersonal therapy
Cognitive behavioral therapy
Farahmand et al. [25]
Day therapy programs: a multidisciplinary communityHICs
based approach to the treatment of mental health issues
29 programs
7
Katz et al. [26]
School-based suicide prevention programs:
awareness/education curriculum, gatekeeper training,
peer leadership training, screening, skills training,
reconnecting youth, good behavior game
Psychological interventions for suicide and self-harm
prevention
HICs
16 programs
5
HICs
38 controlled
studies and 6
systematic
reviews
6
De Silva et al. [27]
Mapping of existing literature
(continued on next page)
J.K. Das et al. / Journal of Adolescent Health 59 (2016) S49eS60
Cheney et al. [20]
Subclinical internalizing and externalizing
problems, academic achievement, mood
disorders, anxiety, depressive symptoms,
self-concept, self-esteem, coping skills,
interpersonal skills, quality of peer and
adult relationships, self-control, problemsolving, self-efficacy, school misbehavior,
aggressive behavior and violence,
interpersonal sensitivity, conflict resolution,
school attendance, social functioning
Utilization of mental health services,
ever considered suicide, attempted suicide
Table 2
Continued
Intervention
Intervention details
Setting;
HICs/LMICs
Number of
included studies
AMSTAR Outcomes reported
rating
Harrod et al. [28]
Any intervention that (1) targeted students without
known suicidal risk (i.e., primary prevention); (2)
had the prevention of suicide as one of its primary
purposes; and (3) was delivered in the postsecondary
educational setting in any country
Suicide prevention programs that have been evaluated
for indigenous youth
Music, dance, singing, drama and visual arts, taking
place in community settings or as extracurricular
activities
Parent training or child social skills training and
universal cognitive behavioral therapy (CBT)
Primary prevention intervention designed specifically
to reduce the future incidence of adjustment problems
in currently normal populations, including efforts
directed at the promotion of mental health
Community-based mental health and behavioral
programs
HICs
8 RCTs
11
Completed suicide, suicide attempt, suicidal
ideation, changes in knowledge, attitudes
and behaviors
HICs
11 programs
6
Suicide ideation, knowledge, attitude
Mostly HIC except
one in Tanzania
20 (RCTs and
observational)
5
HICs
15 RCTs
6
Behavioral changes, self-confidence,
self-esteem, levels of knowledge,
and physical activity
Conduct disorder, anxiety, and depression
HICs
144 programs
5
Competencies, performance, successful transitions
HICs
33 (RCTs and
observational)
4
HICs
RCTs and pree
post studies
7
Psychological, behavior, achievement, school
connectedness, antisocial behavior,
interpersonal, social skills community
or prosocial activities, physical health
Clinical outcomes, social, educational, satisfaction
with treatment, costs, attitudes, knowledge,
diagnostic and treatment behavior, costs
HICs
22 RCTs
11
Discrimination or prejudice outcome measures
HICs
101 (observational
studies)
4
Media-based cognitive behavioral therapies
HICs
11 RCTs
11
Cost-effectiveness, geographic flexibility, time
flexibility, waiting time for treatment, stigma,
therapist time, effects on help-seeking and
treatment satisfaction
Behavioral disorders, therapist time
Online mental health promotion and prevention
interventions
BRAVE for ChildrendONLINE and BRAVE for Teenagersd
ONLINE: based on cognitive behavioral therapy (CBT),
these programs consist of 10 weekly sessions for
children and adolescents; two booster sessions
presented 1 and 3 months after the intervention, and
five or six parent sessions. The programs present
information on managing anxiety, recognizing the
physiological symptoms of anxiety, graded exposure,
and problem-solving techniques.
Project CATCH-IT is a free, Internet-based training
program based on behavioral activation, CBT, and
interpersonal psychotherapy.
HICs
28 observational
studies
4 programs
6
Anxiety, depression
9
Anxiety and depression
Harlow and
Clough [29]
Community-based Bungay and
interventions
Vella-Burrows [30]
Waddell et al. [31]
Durlak and
Wells [32]
Farahmand
et al. [33]
Bower et al. [34]
Digital platforms
Clement et al. [35]
Musiat and
Tarrier [36]
Montgomery
et al. [27]
Clarke et al. [38]
Calear and Christensen
2010 [39]
Effectiveness of interventions for child and adolescent
mental health problems in primary care, and
interventions designed to improve the skills of
primary care staff
It was a mass media intervention, defined as an
intervention that uses a channel of communication
intended to reach large numbers, and is not
dependent on person-to-person contact, for example,
newspapers, billboards, pamphlets, DVDs, television,
radio, cinema, some Web- and mobile phoneebased
media, street art, and ambient media
Computerized cognitive behavioral therapy (cCBT)
interventions
HICs
J.K. Das et al. / Journal of Adolescent Health 59 (2016) S49eS60
Review
(continued on next page)
S53
Intervention
S54
Table 2
Continued
Review
Intervention details
Kauer et al. [40]
MoodGYM is a free, interactive, Internet-based program
designed to prevent and decrease symptoms of
depression in young people.
Grip op je dip online is a free, Dutch language, CBT-based
program aimed at 16- to 25-year-olds. Based on the
face-to-face Grip op je dip course, the online program
consists of six moderated chat sessions attended by six
to eight participants.
Online services in facilitating mental health help-seeking
Number of
included studies
AMSTAR Outcomes reported
rating
HICs
18 (RCTs and
observational
studies)
12 (RCTs and
observational
studies)
9
Help-seeking, mental health
9
Clinical outcomes (e.g., symptom alleviation),
patient-level impacts (e.g., improved health
behaviors), patient and health care
professional satisfaction and costs
Depression, anxiety
Martin et al. [41]
Networked communication: e-mail and/or Web-based
electronic diary; videoconference; and virtual reality.
HICs
Farrer et al. [42]
A range of broad technology types including the Internet,
audio, virtual reality, video, stand-alone computer
programs, and/or a combination of these
Eating disorder awareness, promotion of healthy eating
attitudes and behaviors, as well as eating disorder
awareness and coping with general adolescent issues,
training in media literacy and advocacy skills
Gross motor, energetic activity, for example, running,
swimming, ball games and outdoor play of moderate
to high intensity, or strength training, in contrast to
“ordinary” physical activity (e.g., routine physical
education (PE) classes, walking to school, or playtime
activities of low intensity) for at least a duration of
4 weeks
Three types of physical activity programs (i.e., outdoor
adventure, sport and skill-based and physical fitness
programs)
Exercise was defined as “planned, structured and
repetitive bodily movement done to improve or
maintain one or more components of physical fitness”
HICs
27 RCTs
9
HIC
12 RCTs
8
Mostly HIC except
one in Nigeria
23 RCTs
8
BMI, Eating Attitude Test, Eating Disorder
Inventory, Sociocultural Attitudes Towards
Appearance Questionnaire, social perception
profile, body image assessment
Self-esteem
HICs
15 (RCTs, quasi,
and preepost)
9
Social and emotional well-being
Mostly HICs except 39 RCTs
one in Thailand,
one in Brazil
11
HICs
16 RCTs
11
Depression, acceptability of treatment,
number of participants completing the
interventions; quality of life; cost; adverse
events
Anxiety or depression symptoms
post-treatment
HICs
41 RCTs
11
HICs
11 RCTs
Individual-/family- Pratt and
Woolfenden [43]
based
interventions
Ekelend et al. [44]
Lubans et al. [45]
Cooney et al. [46]
Larun et al. [47]
James et al. [48]
Cox et al. [49]
Interventions that included vigorous physical activity
of clearly specified quality with a minimum duration
of 4 weeks
(1) The relative efficacy of CBT versus non-CBT active
treatments; (2) the relative efficacy of CBT versus
medication and the combination of CBT and
medication versus placebo; and (3) the long-term
effects of CBT
Any psychological therapy with any antidepressant
medication; a combination of interventions
(psychological therapy plus antidepressant
medication) with either psychological therapies or
antidepressant medication alone; a combination of
interventions (psychological therapy plus
antidepressant medication) compared with either
intervention (psychological therapy or
antidepressants) plus a placebo; and a combination
Remission, reduction in anxiety symptom,
acceptability
Remission from depressive disorder,
acceptability, suicide-related serious
adverse events, dropouts
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J.K. Das et al. / Journal of Adolescent Health 59 (2016) S49eS60
Setting;
HICs/LMICs
8 RCTs and
observational
studies
HICs
6
52 RCTs
7 RCTs
HICs
HICs
8
11
25 RCTs
Shinohara et al. [51]
Behavioral therapy, behavioral activation, social
skills training assertiveness training, relaxation
therapies, other psychological therapies
Weisz et al. [52]
Evidence-based psychotherapies
Shepperd et al. [53]
Mental health services providing specialist care,
beyond the capacity of generic outpatient
provision, which provide an alternative to
Deenadayalan et al. [54]
inpatient mental health care
HICs
11
Prevention of a second or next episode,
readmissions, time to relapse, functioning,
depressive symptoms, dropouts, secondary
morbidity
Treatment efficacy, treatment acceptability,
remittance, improvement in depressive
symptoms, improvement in other symptoms
Measures of symptoms and functioning
Disease-specific symptoms, general
psychological functioning, acceptability,
and cost
Symptoms, knowledge, attitude
11
9 RCTs
HICs
Cox et al. [50]
of interventions (psychological therapy plus
antidepressant medication) with a placebo or
treatment as usual
Any type of pharmacotherapy or psychological
therapy
AMSTAR ¼ assessment of the methodological quality of systematic reviews criteria; BMI ¼ body mass index; HIC ¼ high-income country; LMIC ¼ low- and middle-income country; RCT ¼ randomized controlled
trial.
Intervention
Table 2
Continued
Review
Intervention details
Setting;
HICs/LMICs
Number of
included studies
AMSTAR Outcomes reported
rating
J.K. Das et al. / Journal of Adolescent Health 59 (2016) S49eS60
S55
existing screening tools to detect mental ill health among
adolescents in schools [22].
A systematic review of 28 school-based prevention and early
intervention programs for depression has shown some support
for the implementation of depression prevention and early
intervention programs in schools [23]. Most of these programs
were based on cognitive behavioral therapy (CBT) and delivered
by a mental health professional or graduate student over 8e12
sessions. Indicated programs, which targeted students exhibiting
elevated levels of depression, were found to be the most effective
in reducing depressive symptoms with effect sizes ranging from
.21 to 1.40. Meta-analysis was not conducted. It was found that
CBT delivered to young people in secondary schools can reduce
the symptoms of depression (standard mean difference
[SMD]: .16; 95% CI: .26 to .05) and anxiety (SMD: .33; 95%
CI: .59 to .06) [24]. School-based therapeutic mental health
programs specifically targeting adolescents with existing mental
health disorders in LMICs suggested negative effects for programs that targeted externalizing problems and were delivered
selectively to youth with existing problems. Distinctive characteristics of low-income, urban schools, and nonschool environments were emphasized as potential explanations for the
findings [25].
School-based suicide prevention programs focused on
awareness/education curricula, screening, gatekeeper, peer
leadership, and skills training [26,27]. Interventions for primary
prevention of suicide in university and other postsecondary
educational settings suggest that classroom-based didactic and
experiential programs increased short-term knowledge of suicide (SMD: 1.51; 95% CI: .57e2.45) and knowledge of suicide
prevention (SMD: .72; 95% CI: .36e1.07) with no evidence of an
effect on participant’s suicide-related attitudes or behaviors;
however, these findings are limited by the overall low quality
[28]. Promising interventions that need further research include
school-based prevention programs with a skills training
component, individual CBT interventions, interpersonal psychotherapy, and attachment-based family therapy [26,27]. A
systematic review evaluating suicide prevention programs targeting indigenous youth (aboriginals) suggested that more
controlled study designs using planned evaluations and valid
outcome measures are needed in research on indigenous youth
suicide prevention [29].
Community-based interventions
We report findings from six systematic reviews evaluating
various community-based interventions targeting adolescents
and youth; meta-analysis was conducted in two reviews.
AMSTAR ratings ranged between 4 and 7 with a median score of
5. Evidence from 20 studies evaluating community-based creative activities (including music, dance, singing, drama, and visual
arts) suggests some positive effect on behavioral changes, selfconfidence, self-esteem, levels of knowledge, and physical activity [30]. The interventions used in the studies were diverse,
and the research was heterogeneous, and hence overall synthesis
of the results was not attempted. Another review based on 15
studies on community-based parent training and social skills
training for preventing depression suggested significant reductions in symptom and/or diagnostic measures at follow-up
[31]. However, meta-analysis was not conducted. Evidence
from a review evaluating primary prevention mental health
programs for adolescents suggests that individually focused
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Table 3
Summary estimates for adolescent mental health interventions
Interventions
(number of reviews)
Comparison
Outcomes and estimates
School-based
interventions (n ¼ 12)
School-based CBT
CBT in secondary schools
Symptoms of depression: effect size range: .21 to 1.40
Depression (SMD: L.16; 95% CI: L.26 to L.05)
Anxiety (SMD: L.33; 95% CI: L.59 to L.06)
Knowledge of suicide (SMD: 1.51; 95% CI: .57 to 2.45)
Knowledge of suicide prevention (SMD: .72; 95% CI: .36 to 1.07)
Social acceptance at 3-month follow-up (SMD: .03; 95% CI: .10 to .04)
Affective education (SMD: .33; 95% CI: .18 to .48)
Aggregate of positive mental health outcome (SMD: .03; 95% CI: .19 to .25)
Aggregate of positive mental health outcome (SMD: .27; 95% CI: .16 to .37)
Aggregate of positive mental health outcome (SMD: .38; 95% CI: .15 to .60)
Discrimination: effect size range: SMD .85 to .17
Prejudice: effect size range: SMD 2.94 to 2.40
Internalization or acceptance of societal ideals relating to appearance
at a 3- to 6-month follow-up (SMD: L.28; 95% CI: L.51 to L.05)
BMI at 12- to 14-month follow-up (SMD: .10; 95% CI: .45 to .25)
Eating Attitude Test at 6- to 12-month follow-up
(SMD: .01; 95% CI: .13 to .15)
Eating Disorder Inventory “bulimia” at 12- to 14-month
follow-up (SMD: .03; 95% CI: .16 to .10)
Close friendship at 3-month follow-up (SMD: .01; 95% CI: .09 to .06)
Self-esteem (SMD: .49; 95% CI: .16 to .81)
Self-esteem (SMD: .51; 95% CI: .15 to .88)
Depression (SMD: L.62; 95% CI: L.81 to L.42)
Dropouts (RR: 1.00; 95% CI: .97 to 1.04)
Depression (SMD: .03; 95%CI .32 to .26)
Depression (SMD: .11; 95% CI: .34 to .12)
Anxiety scores (SMD: .48; 95% CI: .97 to .01)
Depression score (SMD: L.66; 95% CI: L1.25 to L.08)
Anxiety scores (SMD: .14; 95% CI: .41 to .13)
Depression scores (SMD: .15; 95% CI: .44 to .14)
Anxiety scores (SMD: .13; 95% CI: .43 to .17)
Depression scores (SMD: .10; 95% CI: .21 to .41)
Anxiety remission (OR: 7.85; 95% CI: 5.31 to 11.6)
Participants lost to follow-up: (OR: .93; 95% CI: .58 to 1.51)
Remission (OR: .62; 95% CI: .28 to 1.35)
Dropouts (OR: .61; 95% CI: .11 to 3.28)
Suicidal ideation (SMD: L3.12; 95% CI: L5.91 to L.33)
Depression symptoms (SMD: .16; 95% CI: .69 to 1.01)
Remission (OR: 1.50; 95% CI: .99 to 2.27)
Dropouts (OR: .84; 95% CI: .51 to 1.39)
Suicidal ideation (OR: .75; 95% CI: .26 to 2.16)
Depression symptoms (SMD: .27; 95% CI: 4.95 to 4.41)
Functioning (SMD: .09; 95% CI: .11 to .28)
Remission (OR: 1.61; 95% CI: .38 to 6.90)
Dropouts (OR: 1.23; 95% CI: .12 to 12.71)
Suicidal ideation (SMD: .60; 95% CI: 2.25 to 3.45)
Depression symptoms (SMD: .28; 95% CI: 1.41 to .84)
Dropouts (OR: .98; 95% CI: .42 to 2.28)
Remission (OR: 2.15; 95% CI: 1.15 to 4.02)
Depression symptoms (SMD: L.5
Examine the dimensions of performance management systems and the ways in which these apply to healthcare organizations.
Slide 1: Title
Title: “Performance Management Systems in Healthcare Organizations”
Subtitle: Dimensions and Applications
Your name/affiliation
Date
Slide 2: Introduction
Define Performance Management Systems (PMS)
Importance of PMS in healthcare
Overview of presentation structure
Slide 3: Key Dimensions of Performance Management Systems
Dimension 1: Goal Setting
Explanation of setting SMART goals (Specific, Measurable, Achievable, Relevant, Time-bound)
Relevance to healthcare organizations
Examples of healthcare-specific goals
Dimension 2: Performance Measurement and Metrics
Discuss the importance of measuring performance
Key performance indicators (KPIs) in healthcare
How metrics drive decision-making in healthcare
Dimension 3: Data Collection and Analysis
The role of data in PMS
Data sources in healthcare (EHRs, patient surveys, etc.)
Analyzing healthcare data for insights
Dimension 4: Feedback and Communication
Importance of feedback in performance improvement
Strategies for giving and receiving feedback in healthcare
Communication channels within healthcare organizations
Dimension 5: Continuous Improvement
The concept of continuous improvement in healthcare
PDCA (Plan-Do-Check-Act) cycle in healthcare
Examples of continuous improvement initiatives in healthcare
Slide 4: Applying Dimensions in Healthcare Organizations
Discuss how each dimension is applied in healthcare
Real-world examples from healthcare organizations
Highlight the interconnectedness of dimensions
Slide 5: Challenges in Implementing PMS in Healthcare
Identify common challenges in implementing PMS in healthcare
Regulatory compliance (HIPAA, etc.)
Data privacy and security concerns
Resistance to change among healthcare professionals
Slide 6: Benefits of Effective PMS in Healthcare
Discuss the positive outcomes of effective PMS
Improved patient outcomes
Cost reduction
Enhanced healthcare quality and safety
Slide 7: Case Study: A Successful Implementation
Present a case study of a healthcare organization that successfully implemented PMS
Highlight key strategies and outcomes
Slide 8: Best Practices for Implementing PMS in Healthcare
Share best practices for healthcare organizations
Engaging healthcare staff
Aligning PMS with organizational goals
Using technology for data collection and analysis
Slide 9: Conclusion
Recap key points
Emphasize the importance of effective PMS in healthcare
Encourage the adoption of PMS in healthcare organizations
Title: “Healthcare System Regulations in Saudi Arabia”
Subtitle: An Overview
Your name/affiliation
Date
Slide 2: Introduction
Briefly introduce the topic
Highlight the significance of healthcare regulations in Saudi Arabia
Slide 3: Healthcare System Overview
Provide an overview of the healthcare system in Saudi Arabia
Mention the public and private sectors
Include key statistics on healthcare infrastructure and services
Slide 4: Regulatory Authorities
Identify the key regulatory authorities responsible for healthcare in Saudi Arabia
Discuss their roles and responsibilities
Slide 5: Saudi Food and Drug Authority (SFDA)
Detail the role and functions of SFDA
Mention its role in regulating pharmaceuticals and medical devices
Highlight notable regulations and initiatives
Slide 6: Saudi Commission for Health Specialties (SCFHS)
Discuss SCFHS’s role in healthcare professional licensing and accreditation
Highlight its impact on healthcare workforce quality
Slide 7: Health Insurance Regulations
Explain the regulations governing health insurance in Saudi Arabia
Mention mandatory health insurance and its impact on healthcare access
Slide 8: Telemedicine Regulations
Discuss regulations related to telemedicine in Saudi Arabia
Highlight their role in expanding healthcare access, especially in remote areas
Slide 9: Recent Healthcare Reforms
Highlight recent healthcare reforms or initiatives
Discuss their impact on the healthcare system
Include examples of recent changes or innovations
Slide 10: Conclusion
Summarize key takeaways
Emphasize the importance of healthcare regulations in Saudi Arabia
Acknowledge ongoing efforts for improvement
Slide 11: Q&A (Optional)
Open the floor for questions and discussions
Slide 12: Thank You
Express gratitude for the audience’s attention
Provide contact information for further inquiries
Module 04:HQS 520 : Manamela, L. M., Rasweswe, M. M., & Mooa, R. S. (2022). Factors contributing to non-adherence of the peri-operative surgical team to WHO surgical safety checklist in the Kingdom of Saudi Arabia. Perioperative Care and Operating Room Management, 29. https://doi.org/10.1016/j.pcorm.2022.100292 Create an analysis of the factors that contribute to the non-adherence of the perioperative surgical team discussed in this article. Present a plan to overcome these barriers so that the surgical risks are reduced and quality and patient safety are improved. Your paper should meet the following structural requirements: Four-to-five pages in length, not including the cover sheet and reference page. Formatted according to APA 7th edition and Saudi Electronic University writing standards Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references. Module 04: HQS 525 Please read the following article: Amanat, A., Rizwan, M., Maple, C., Zikria, Y. B., Almadhor, A. S., & Kim, S. W. (2022). Blockchain and cloud computing-based secure electronic healthcare records storage and sharing. Frontiers in Public Health, 10, 938707. https://doi.org/10.3389/fpubh.2022.938707 https://csuglobal.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=35928494&site=eds-live Evaluate the use of protected health information in the cloud through a health information exchange. Discuss the following aspects: Benefits Barriers to sharing patient information in the cloud Include an analysis of the health information exchange currently being adopted in the Kingdom of Saudi Arabia. Your paper should meet the following structural requirements: Four-to-five pages in length, not including the cover sheet and reference page. Formatted according to APA 7th edition and Saudi Electronic University writing standards Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references. Module 4: Critical HQS 530 Safety Critical Communication Hospital administration has asked you to develop a memo explaining how to use the SBAR (Situation, Background, Assessment, Recommendations) as a tool for safety critical communication during shift change among healthcare professionals. In the memo that you will be preparing, remember to address the following: The importance of critical safety communication At least two principles of safety-critical communications A description of the SBAR tool A hypothetical example of how to use each element of the SBAR tool, meaning examples of each of the following: Situation Background Assessment Recommendations To see an example of the structure of a memo, view the following memo, “Fall Clothes Line Promotion,” developed by Purdue OWL. Your memo should meet the following structural requirements: A minimum of two pages that includes all the elements detailed above. Follow APA 7th edition and Saudi Electronic University writing standards. Be sure to cite any statistics or other information as appropriate.
Health disparities are inequalities prevalent in healthcare, which often involve lack of access across various racial, ethnic and socioeconomic populations. Health disparities encompass an unequal distribution of social, political, economic, and environmental resources, especially among vulnerable populations. As a result, a number of local, regional, and national policies have been introduced to address health disparities to promote quality care and improved access for these populations. When developing health policies, especially those that focus on vulnerable populations, it is important for stakeholders to consider any ethical considerations that will protect vulnerable populations from substandard care and unethical medical practices.
Identify a health disparity prevalent in the Kingdom of Saudi Arabia. Examples include, but are not limited to, nutrition- and lifestyle-related risk factors such as obesity, hypertension, and diabetes, as well as lack of insurance. Include any tables or figures containing statistics to support your narrative.
Based on what you learned this week, address the following:
* Identify a vulnerable population and a specific health disparity prevalent in the Kingdom of Saudi Arabia.
* Clearly explain the health disparities and why it is worse for your selected vulnerable population.
* What are some of the positive social changes that need to be accomplished to protect these populations?
* Discuss a local, regional, or national policy to protect the identified vulnerable populations from this disparity.
* What are some of the moral and ethical obligations that need to be considered with regard to the policy?
Your report should meet the following structural requirements:
* Be five to six pages in length, not including the cover or reference pages.
* Be formatted according to APA 7th edition and Saudi Electronic University writing guidelines.
* Provide support for your statements with in-text citations from a minimum of three scholarly articles. The Saudi Digital Library is an excellent source for scholarly research. One of these sources may be from the class readings, textbook, or lectures.
* You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior
Write a 3-page summary paper that addresses the following:Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.
Unformatted Attachment Preview
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Psychopharmacologic Approaches to Treatment of Psychopathology
Alzheimer’s Disease
76-year-old Iranian Male
BACKGROUND
Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for
“strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic
basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CTscan of the head) were normal.
According to his son, he has been demonstrating some strange thoughts and behaviors
for the past two years, but things seem to be getting worse. Per the client’s son, the
family noticed that Mr. Akkad’s personality began to change a few years ago. He began to
lose interest in religious activities with the family and became more “critical” of everyone.
They also noticed that things he used to take seriously had become a source of
“amusement” and “ridicule.”
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Psychopharmacologic Approaches to Treatment of Psychopathology
Over the course of the past two years, the family has noticed that Mr. Akkad has been
forgetting things. His son also reports that sometimes he has difficult “finding the right
words” in a conversation and then will shift to an entirely different line of conversation.
SUBJECTIVE
During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy
speaking with you. You notice some confabulation during various aspects of memory
testing, so you perform a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with
primary deficits in orientation, registration, attention & calculation, and recall. The score
suggests moderate dementia.
MENTAL STATUS EXAM
Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview.
His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no
unusual motor movements and demonstrates no tic. Self-reported mood is euthymic.
Affect however is restricted. He denies visual or auditory hallucinations. No delusional or
paranoid thought processes noted. He is alert and oriented to person, partially oriented
to place, but is disoriented to time and event [he reports that he thought he was coming
to lunch but “wound up here”- referring to your office, at which point he begins to laugh].
Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr.
Akkad’s standing up during the clinical interview and walking towards the door. When
you asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal
or homicidal ideation.
Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive)
RESOURCES
§ Folstein, M. F., Folstein, S. E., & McHugh, P. R. (2002). Mini-Mental State Examination
(MMSE). Lutz, FL: Psychological Assessment Resources.
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Decision Point One
Select what you should do:
Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3
mg orally BID in 2 weeks
(1.html)
: Begin Aricept (donepezil) 5 mg orally at BEDTIME
(2.html)
Begin Razadyne (galantamine) 4 mg orally BID
(3.html)
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Alzheimer’s Disease
76-year-old Iranian Male
Decision Point One
Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3
mg orally BID in 2 weeks
RESULTS OF DECISION POINT ONE
Client returns to clinic in four weeks
The client is accompanied by his son who reports that his father
is “no better” from this medication. He reports that his father
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Psychopharmacologic Approaches to Treatment of Psychopathology
is still disinterested in attending religious services/activities,
and continues to exhibit disinhibited behaviors
You continue to note confabulation and decide to administer
the MMSE again. Mr. Akkad again scores 18 out of 30 with
primary deficits in orientation, registration, attention &
calculation, and recall
Decision Point Two
Increase Exelon to 4.5 mg orally BID
RESULTS OF DECISION POINT TWO
Client returns to clinic in four weeks
Client’s son reports that the client is tolerating the
medication well, but is still concerned that his father is no
better
He states that his father is attending religious services with
the family, which the son and the rest of the family is
happy about. He reports that his father is still easily
amused by things he once found serious
Decision Point Three
Increase Exelon to 6 mg orally BID
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Guidance to Student
At this point, the client is reporting no side effects and is
participating in an important part of family life (religious services).
This could speak to the fact that the medication may have
improved some symptoms. you needs to counsel the client’s son
on the trajectory of presumptive Alzheimer’s disease in that it is
irreversible, and while cholinesterase inhibitors can stabilize
symptoms, this process can take months. Also, these medications
are incapable of reversing the degenerative process. Some
improvements in problematic behaviors (such as disinhibition) may
be seen, but not in all clients.
At this point, you could maintain the current dose until the next
visit in 4 weeks, or you could increase it to 6 mg orally BID and see
how the client is doing in 4 more weeks. Augmentation with
Namenda is another possibility, but you should maximize the dose
of the cholinesterase inhibitor before adding augmenting agents.
However, some experts argue that combination therapy should be
used from the onset of treatment.
Finally, it is important to note that changes in the MMSE should be
evaluated over the course of months, not weeks. The absence of
change in the MMSE after 4 weeks of treatment should not be a
source of concern.
Start Over
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Review pages 123–126 of the assigned reading in The A-to-Z Self-Care Handbook and the NASW core values. What are some of your core values, and how do they relate to the profession’s values? Have you experienced times of “losing yourself” and your core values? How do your values relate to self-care? Consider how self-care is an ethical obligation. What does this consideration mean for your practice?
Unformatted Attachment Preview
SOWK 250
DISCUSSION ASSIGNMENT INSTRUCTIONS
The student will complete four Discussions in this course. The student will post one thread of at
least 350 words by 11:59 p.m. (ET) on Thursday of the assigned Module: Week. Each thread
must demonstrate course-related knowledge supported by at least one citation from the course
materials and at least one biblical principle. The student must then post two replies of at least
150-250 words by 11:59 p.m. (ET) on Monday of the assigned Module: Week. Each reply must
support assertions with course-related knowledge or at least one biblical principle or at least one
scholarly citation. All posts and citations must be in current APA format.
1. It is best to avoid using direct quotations from the textbook or any other source (except
possibly a short Scripture verse) in any of your threads or replies. These submissions must be
paraphrased in your own words so that you clearly demonstrate your mastery of the material.
2. Do not attach a Microsoft Word document; rather, type directly into the textbox or copy and
paste from a Microsoft Word document directly into the textbox.
3. Be conversational but stay on topic. Do not simply repeat information you find in our
textbook, but incorporate your ideas and unique perspectives. After you write your thread
and reply posts, compare what you have written to the assignment instructions and grading
rubric to ensure that you have addressed each required element.
4. When required, include citations and references in current APA format.
5. Finally, proofread your work carefully to catch spelling, capitalization, grammar, and
sentence structure errors. Refer to the grading rubric to ensure an outstanding grade.
U R Worth It
Learning that I am worth engaging in self-care wasn’t easy. In a society where employers are not
required to pro-vide paid vacations for employees, self-care is not a high priority in the United States
(Mohn, 2013). Paid time off is not valued and, therefore, is not required. The modern norm is to go, go,
go until you crash, crash, crash.
And crash is exactly what I did three years ago. While working a high stress, high demand job in
social services, I nearly lost everything that was important to me. I hope that by sharing my discovery of
the critical need for self-care, you will also recognize a need in your own life. With a sense of worthiness
for self-care and priority setting, we can all lead less stressed and more productive lives.
Discovering My Worth
My grandmother always said, “Sweet Cake, stress will kill you.” She was almost right. I worked so
much that I did not take time for my family or myself. My health began to deteriorate. For most of my
adult life, I had lived with migraines. But, increasingly, they came more often and the in-tensity was
worse each time. As a result, I began to evaluate the role my job was playing in the condition of my
health and neglect for self-care.
I began to ponder what brought me to this point. Why had I neglected my family and my health?
At the time, self-care was not on my radar. My day was filled with a stressful and never-ending job that
often took over my nights and weekends. I did not feel I was worth engaging in “me time.” I had a small
child, worked, and had a husband. Being in a helping profession, such as social work, I suspect I was not
alone in putting self-care on the back burner.
Shaw (2013) discussed mothers being first responders and needing to engage in self-care/me
time in order to respond well. Further, Shaw said we are more responsive and enjoyable to be around
when we take time for ourselves. This information is also true for social workers. Often, social workers
are the first responders to very complex issues and, therefore, should strive to maintain a level of
balance to best serve clients in their time of greatest need. In her blog, Goldman (2013) wrote, “If
everyone else around you is worthy of care and attention, then, so are you.” (See Aware-ness entry
regarding self-compassion.)
After realizing my health and closest relationships were in shambles, I began a journey of
restoration. I vowed that I would never take my family or my life for granted again. Although the start of
my journey began with the evaluation of my health and stressful job, self-care came to fruition in my first
year as a social work graduate student. In the MSW program, I began to develop the skills needed in selfcare and cultivating a self-care plan that was SMART (specific, measurable, achievable, realistic, and time
limited). (See Appendix A—Self-Care Planning Form.) Implementing a plan, I soon learned the
importance of prioritizing self-care.
Learning to POP: Prioritize, Organize, and Partialize
Learning to prioritize isn’t an easy task, either. Priority setting is not just about how and when to
complete tasks. Priority setting is also about making myself a priority and not feeling guilty about it.
Goldman (2013) suggests setting aside 15-30 minutes daily to make “you” a priority. This prioritizing can
be reading a book, taking a walk, or watching your favorite television show. When I take time for myself, I
am present in mind, body, and spirit—not just physically. I am able to truly enjoy my family, and they
enjoy me.
Prioritizing is also about the inevitable array of tasks we must complete. From going to the
grocery store to completing labor-intensive assignments for graduate school, I prioritize my
commitments and activities. Grise-Owens (2008) provides helpful advice for graduate students seeking a
degree in social work; she uses the acronym “POP” (prioritize, organize, and partialize). This advice is
applicable to everyone, not just students seeking a degree in social work.
I organize! I put activities on my planner. I make lists for meetings, assignments, deadlines, and
even my daughter’s activities. I partialize! I break assignments, work projects, and home projects into
increments so they are not as over-whelming. I prioritize! This prioritizing includes scheduling self-care,
including time for myself to catch up with friends and family. It is part of my self-care plan. (See Yes List
entry for more discussion on this idea.)
My experience in being a mom, wife, employee, and student may differ somewhat from others’
experiences. Leading a stressful life is not restricted to married individuals with children; everyone leads
busy, stressful lives. To some degree, it is the nature of the society in which we live. Social workers need
to recognize the necessity of taking care of ourselves to better take care of those we serve.
Each of us is on a journey to discover one’s self-worth in self-care. My journey took some twists
and turns. But, in the end, I realized that self-care allows me to be a better mother, wife, social worker,
citizen, friend, daughter, and sister. When I take time for myself, I am refreshed, focused, and present.
I learned that setting priorities begins with making myself a priority. Not taking time for
ourselves causes us to be out of balance and lose sight of what is really important in life (Goldman,
2013). Cooper (2015) emphasizes the im-portance of discipline and prioritization in dealing with the
“busy-ness” of our lives. For me, an excellent week in self-care is being prepared, organized, and tackling
projects incrementally. Self-care is what each of us makes of it. I hope sharing my experience can
encourage you to realize UR worth it!
Topic: Contraception in the Postpartum Period (include focus on breastfeeding moms). Identification of Risk Factors and / Benefits * Compile 4 – 5 risk factors and/or benefits related to the selected topic. Below is the attach file grading rubric information.
College of Health Sciences
Department of Public Health
PHC374-ASSIGNMENT
Course name:
ORAL HEALTH PROMOTION
Course number:
PHC374
CRN
Preventing Dental Caries in
Early Childhood: EvidenceBased Strategies.
Preventing Dental Caries in Early Childhood: EvidenceBased Strategies
Dental caries, commonly known as tooth decay, is a
prevalent oral health issue among infants and young children.
Early childhood caries (ECC) can have significant
consequences for a child’s oral and overall health. In this
paper, you will explore evidence-based strategies for
preventing dental caries in infants and young children
through education and intervention.
• What is early childhood caries (ECC), and why is
it a significant concern for infants and young
children?
• How does oral health education play a pivotal role
in preventing dental caries in infants and young
children?
• Describe evidence-based educational approaches,
including parent and caregiver education, and
their effectiveness.
• Briefly touch upon community-based programs
that promote oral health education and provide
dental care to infants and young children.
Student name:
Students Id Number:
Submission date:
Instructor name:
Grade:
/10
College of Health Sciences
Department of Public Health
Guidelines:
•
Your response should be a minimum of 400 words but should not exceed 500 words.
•
Font should be 12 Times New Roman
•
Heading should be Bold
•
Colour should be Black
•
Line spacing should be 1.5
•
Use proper references in APA style
•
AVOID PLAGIARISM
•
Due date: Nov 11, 2023 @ 11:59 PM
I UP LOAD REFFERANCE AND RUBRIC AND PPT YOU CAN USE FOR PRESENTATION AND SOME TIPS. Title (32), font type in bold, with the name of the presenter, objective Outline each line: 6 wordsLine number 28 Font type New Roman font space time between each single line should be l.5
Do 3 critical points based off of the given topics from ati for nurs 307 peds example is provided no plagiarism and make sure you use the ati book and write the right references 3- critical point box has to be 3 bullet points in each box Write the topics and concepts based off of the screenshot that i provided no plagirsimtopics to write about are provided which 9 topics i believe this is for online ati practice proctor b for peds 307
Unformatted Attachment Preview
“3 Critical Concepts – Remediation Document”
Upon completion of the required Practice Assessment, conduct a focused review, by downloading the “ATI Individual Performance Profile” Report.
Complete the “3 Critical Concepts – Remediation Document” by using each NCLEX Client Need Category, listed under the “Topics to Review
Section” in the report to identify 3 Critical Concepts learned and or understand better about the missed concept. Use reliable evidence-based
resources to remediate each topic (ATI Focused Review, ATI eBook, Course textbook per Syllabus). Cite your sources (APA formatting not required).
8 NCLEX Client Need Categories
1) Management of Care, 2) Safety and Infection Control, 3) Basic Care and comfort, 4) Health Promotion and Maintenance, 5) Psychosocial Integrity, 6)
Pharmacological and Parenteral Therapies, 7) Reduction of Risk Potential, and 8) Physiological Adaptation
Reflection Section – Include one of the 6 Cognitive Functions
Reflect on how the 3 critical concepts you learned, helped you gain a better understanding of the 6 Cognitive Functions of the National Council for State
Boards of Nursing (NCSBN) – Clinical Judgement Measurement Model (NCJMM) – which follows the Nursing Process:
o Recognize Cues (Assessment) – Filter information from different sources (i.e., signs, symptoms, health history, environment).
o Analyze Cues (Analysis) – Link recognized cues to a client’s clinical presentation and establishing probable client needs, concerns, or problems.
o Prioritize Hypotheses (Analysis) – Establish priorities of care based on the client’s health problems (i.e. environmental factors, risk assessment,
urgency, signs/ symptoms, diagnostic test, lab values, etc.)
o Generate Solutions (Planning) – Identify expected outcomes and related nursing interventions to ensure clients’ needs are met.
o Take Actions (Implementation) – Implement appropriate interventions based on nursing knowledge, priorities of care, and planned outcomes to
promote, maintain, or restore a client’s health.
o Evaluate Outcomes (Evaluation) – Evaluate a client’s response to nursing interventions and reach a nursing judgment regarding the extent to which
outcomes have been met.
Topics To Review Safety and Infection Control (1 item)
Reporting of Incident/Event/Irregular Occurrence/Variance (1 item)
Safe Medication Administration and Error Reduction: Priority Action Following a Medication Error
Pharmacological and Parenteral Therapies (7 items)
Adverse Effects/Contraindications/Side Effects/Interactions (5 items)
Dermatitis and Acne: Required Tests for Isotretinoin Prescription Refill
Gastrointestinal Disorders: Monitoring for Adverse Effects of a Metoclopramide
Medications Affecting Coagulation: Adverse Effects of Heparin
Neurocognitive Disorders: Monitoring for Adverse Effects of Donepezil
Urinary Tract Infections: Contraindications to Ciprofloxacin
Medication Administration (2 items)
Miscellaneous Central Nervous System Medications: Teaching About Cyclobenzaprine
Opioid Agonists and Antagonists: Teaching About Hydrocodone
Physiological Adaptation (2 items)
Fluid and Electrolyte Imbalances (2 items)
Medications Affecting Urinary Output: Identifying ECG Manifestations of Hypokalemia for a Client Who Is Taking Furosemide
Vitamins and Minerals: Interventions for a Client Who Is Taking Sodium Polystyrene Sulfonate
Date
Student Name
Instructor Name
Assessment Name
# of Topics to Review
12/13/2022
JadaRose Johnson
Dr. Candace James-Marrast
RN Pharmacology Online Practice Assessment 2019 A
10
NCLEX Client Need Category
Safety and Infection Control (1 item)
Topic
Concept
3 Critical Concepts (I learned, and/or
understand better about this topic)
Reflection – Address 1 of the 6
Cognitive Functions
Reporting of
Incident/Event/Irregular
Occurrence/Variance
(1 item)
Safe Medication
Administration and
Error Reduction:
Priority Action
Following a
Medication Error
1. Giving a medication 1 hour the scheduled
time is too late.
2. When this occurs, I must complete an
incident report
3. Every facility have a different timeframe
for when medication can be given with
causing a medication error.
Take Actions (Implementation)
The answer choices had both 30 minutes
and 1 hour after the scheduled time. In
class, we learned that safe medication
administered can be given either 30 minutes
or 1 hour before or after the schedule. I will
review the ATI book and my facility policy
and procedure to determine the allowed
timeframe of when I should give a
medication without making a medication
error.
Pharmacological and Parenteral Therapies (7 items)
Topic
Concept
3 Critical Concepts (I learned, and/or
understand better about this topic)
Reflection – Address 1 of the 6
Cognitive Functions
Adverse
Effects/Contraindications/Side
Effects/Interactions (5 items)
Dermatitis and Acne:
Required Tests for
Isotretinoin
Prescription Refill
1. Isotretinoin is used to treat nodulocystic
acne vulgaris and is a category X medication,
which causes teratogenic effects to the fetus.
2. A pregnancy test should be done and ruled
out before the client can obtain a refill.
3. Client must provide two negative
pregnancy tests for the initial prescription and
one negative test before monthly refills.
1. Multiple CNS adverse effects can occur
with this medication
2. Some of the adverse effects include
dizziness, fatigue, and sedation
3. I need to teach the client to report the
adverse effect or conduct frequent hourly
rounding to allow for appropriate
intervention.
1. SQ heparin can be inject in the abdomen
above the iliac crest and at least 5 cm (2 in)
away from the umbilicus
2. When administering IV heparin, the platelet
count should be closely monitored.
3. Platelet count less than 100,000/mm3 can
indicate heparin-induced thrombocytopenia, a
potentially fatal condition that requires
stopping the infusion.
4. ADR of IV heparin includes blood in the
urine, bruising, hematomas, hypotension, and
tachycardia. The nurse should report these
findings to the provider because these can
indicate manifestations of heparin toxicity.
Prioritize Hypotheses (Analysis)
I did not know much about this medication.
I will review the section on dermatitis, the
medications that can be used, and the
nursing role when managing care for a
client receiving isotretinoin.
1. Donepezil causes bronchoconstriction by
the increase in acetylcholine levels, which is a
primary effect of donepezil.
2. Some ADR of donepezil include dyspepsia,
diarrhea, dyspnea, and dizziness.
Evaluate Outcomes (Evaluation)
I understood what the question was asking
but could decide on which ADR was the
priority. I need more practice on
prioritization. I will review the ATI Nurse
Gastrointestinal
Disorders: Monitoring
for Adverse Effects of
a Metoclopramide
Medications Affecting
Coagulation: Adverse
Effects of Heparin
Neurocognitive
Disorders: Monitoring
for Adverse Effects of
Donepezil
Evaluate Outcomes (Evaluation)
I did not know much about this medication.
I will review the section on gastrointestinal
disorders especially metoclopramide.
Reviewing this medication will provide me
with the information to report and my
assessment for any of the related adverse
effects.
Evaluate Outcomes (Evaluation)
Client safety is very important and this
medication is a high alert medication that
causing bleeding and possible death of the
client. I would be sure to review the chapter
on heparin – especially the S/Es, ADR. So,
when managing care for the client, I will
monitor the client closely for any ADRs,
monitor the platelet count, and report any
concerns to the health care provider.
3. Although all these are ADR, it is very most
important to report dyspnea to the provider
first – using the airway, breathing, circulation
(ABC) approach to client care.
Logic Tutorial on Priority Setting
Frameworks.
1. ciprofloxin has not be given to a client with
tendonitis. If ciprofloxin is given to a client
with tendonitis, it can cause risk of tendon
rupture.
2. ciprofloxin can cause photosensitivity
resulting in severe sunburns even with
sunscreen use.
3. ciprofloxin can cause a superinfection such
as thrush and vaginal yeast infection.
1. cyclobenzaprine can cause seizure, so it is
important to monitor the client and report any
seizure activity to the provider.
2. cyclobenzaprine can cause chronic
dependence from chronic use
3. cyclobenzaprine can cause taper off before
discontinuing to prevent abstinence syndrome
or rebound insomnia. So, I must teach my
client to not stop the drug abruptly.
Evaluate Outcomes (Evaluation)
I missed re-read the question. I thought the
question was asking for complications of
ciprofloxacin. Professor, I will pay closer
attention when reading the questions and
use my test-taking skill more often.
Opioid Agonists and
Antagonists: Teaching
About Hydrocodone
1. Hydrocodone cause a few CNS effects such
as dizziness, lightheadedness, drowsiness, and
respiratory depression
2. Because of the CNS effects I must teach
my client to change position slowly and avoid
activities that requires alertness like driving
and operating heavy machinery
3. Hydrocodone cause a few GI effects such
as nausea, vomiting, and constipation, so I
must teach my client to increase fluids and
dietary fiber and take with food.
Take Actions (Implementation)
Although I understood the question was
asking about teaching, I was not focusing on
complications and the related teaching. I
now understanding that teaching also
includes teaching the client about the
possible complications of taking the
hydrocodone especially with
acetaminophen. I will consider that in the
future.
Concept
3 Critical Concepts (I learned, and/or
understand better about this topic)
Reflection – Address 1 of the 6
Cognitive Functions
Urinary Tract
Infections:
Contraindications to
Ciprofloxacin
Medication Administration
(2 items)
Miscellaneous Central
Nervous System
Medications:
Teaching About
Cyclobenzaprine
Take Actions (Implementation)
I thought I knew a lot about this drug, such
as – it causes anticholinergic effect such as
constipation and urinary retention.
However, I did not remember this drug
needed to be tapered and should be included
in my teaching plan. I will review this
section on my ATI and textbook.
Physiological Adaptation (2 items)
Topic
Fluid and Electrolyte Imbalances (2
items)
Medications Affecting
Urinary Output:
Identifying ECG
Manifestations of
Hypokalemia for a
Client Who Is Taking
Furosemide
Vitamins and
Minerals:
Interventions for a
Client Who Is Taking
Sodium Polystyrene
Sulfonate
1. One diagnostic test to confirm hypokalemia
from furosemide is to perform an EKG on the
client.
2. With the hypokalemia, the EKG will show
flatten or inverted T waves, prominent or
elevated U waves, ST depression, and
prolonged PR interval.
3. Other expected findings because of
hypokalemia from furosemide use include:
Vital signs changes – decreased BP, thready
pulse, orthostatic hypotension.
Respiratory changes – shallow breathing.
Muscular involvement – weakness, deep
tendon reflexed could be reduced.
GI involvement – Hypoactive bowel sounds,
nausea, vomiting, constipation.
Neurologic changes – altered mental status,
anxiety, and lethargy that progresses to acute
confusion and coma.
1. Polystyrene sulfonate replaces sodium with
potassium in the intestinal tract to promote
potassium excretion.
2. Polystyrene sulfonate can cause the ADR
of constipation, which can lead to fecal
impaction.
3. I must monitor the client for constipation
and report it to the provider.
Evaluate Outcomes (Evaluation)
From this practice assessment, I learned
additional information to what I learned in
class. Having this knowledge, I now
understanding hypokalemia is not just
decreased potassium levels of less than 3.5.
Hypokalemia can potentially cause serious
complications. I know have more
information to include in my plan of care
when managing care for a client who may
be experiencing hypokalemia.
Take Actions (Implementation)
I knew polystyrene sulfonate is used to treat
hyperkalemia and can cause frequent
diarrhea. I do not remember that polystyrene
sulfonate could also cause the opposite
effect of constipation. I would be sure to go
over my notes and review that section in
both my ATI and textbook.
References:
McCuistion, L.E., DiMaggio, K., Winton, M.B., & Yeager (2023). Pharmacology: A Patient-Centered Nursing Process Approach. 11th. Ed. Publisher: Elsevier.
ATI Content Mastery Series Review Module: RN Pharmacology 11.0 ed.
“3 Critical Concepts – Remediation Document”
Upon completion of the required Practice Assessment, conduct a focused review by downloading the “ATI Individual Performance Profile” Report.
Complete the “3 Critical Concepts – Remediation Document” by using each NCLEX Client Need Category, listed under the “Topics to Review
Section” in the report to identify 3 Critical Concepts learned and or understand better about the concept. Use reliable evidence-based resources
to remediate each topic (ATI Focused Review, ATI eBook, Course textbook per Syllabus). Cite your sources (APA formatting not required).
8 NCLEX Client Need Categories
1) Management of Care, 2) Safety and Infection Control, 3) Basic Care and comfort, 4) Health Promotion and Maintenance, 5) Psychosocial Integrity, 6)
Pharmacological and Parenteral Therapies, 7) Reduction of Risk Potential, and 8) Physiological Adaptation
Reflection Section – include one of the 6 Cognitive Functions
•
Reflect on how the 3 critical concepts you learned, helped you gain a better understanding of the 6 Cognitive Functions of the National Council for State
Boards of Nursing (NCSBN) – Clinical Judgement Measurement Model (NCJMM) – which follows the Nursing Process:
o Recognize Cues (Assessment) – Filter information from different sources (i.e., signs, symptoms, health history, environment).
o Analyze Cues (Analysis) – Link recognized cues to a client’s clinical presentation and establishing probable client needs, concerns, or problems.
o Prioritize Hypotheses (Analysis) – Establish priorities of care based on the client’s health problems (i.e. environmental factors, risk assessment,
urgency, signs/ symptoms, diagnostic test, lab values, etc.)
o Generate Solutions (Planning) – Identify expected outcomes and related nursing interventions to ensure clients’ needs are met.
o Take Actions (Implementation) – Implement appropriate interventions based on nursing knowledge, priorities of care, and planned outcomes to
promote, maintain, or restore a client’s health.
o Evaluate Outcomes (Evaluation) – Evaluate a client’s response to nursing interventions and reach a nursing judgment regarding the extent to which
outcomes have been met.
Topics To Review – F y h t y r om y o u r j oj g o 5 j o r j o t r6 5 h y 5 oj 5 o6
List the NCLEX Client Need Categories, Topics, and Concepts to review from your report here – as shown in the example provided.
NCLEX Client Need Category Topic Concept
Safety and Infection Control (1 item)
Reporting of Incident/Event/Irregular Occurrence/Variance (1 item)
Safe Medication Administration and Error Reduction: Priority Action Following a Medication Error
Remove the 5 lines above, add information from your report before submission.
Date
Student Name
Instructor Name
Assessment Name
# of Topics to Review
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
Reflection – Address 1 of the 6 Cognitive
understand better about this topic)
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
Add your NCLEX Client Need Category here
Add or delete rows below according to the number of items – Remove this line before submitting your work.
Topic
Concept
3 Critical Concepts (I learned, and/or,
understand better about this topic)
Reflection – Address 1 of the 6 Cognitive
Functions
References:
Include your references here. Below is an example – delete this line and the examples below and add the references you used.
Halter, M. J. (2022). Varcarolis’ Foundations of Psychiatric Mental Health Nursing 9th ed. Publisher: Saunders/Elsevier. St. Louis, Missouri.
ATI Content Mastery Series Review Module: RN Mental Health 11.0 ed.
McCuistion, L.E., DiMaggio, K., Winton, M.B., & Yeager (2023). Pharmacology: A Patient-Centered Nursing Process Approach. 11th. Ed. Publisher: Elsevier.
ATI Content Mastery Series Review Module: RN Pharmacology 11.0 ed.
College of Health Sciences
Department of Public Health
PHC374-ASSIGNMENT
Course name:
ORAL HEALTH PROMOTION
Course number:
PHC374
CRN
Preventing Dental Caries in
Early Childhood: EvidenceBased Strategies.
Preventing Dental Caries in Early Childhood: EvidenceBased Strategies
Dental caries, commonly known as tooth decay, is a
prevalent oral health issue among infants and young children.
Early childhood caries (ECC) can have significant
consequences for a child’s oral and overall health. In this
paper, you will explore evidence-based strategies for
preventing dental caries in infants and young children
through education and intervention.
• What is early childhood caries (ECC), and why is
it a significant concern for infants and young
children?
• How does oral health education play a pivotal role
in preventing dental caries in infants and young
children?
• Describe evidence-based educational approaches,
including parent and caregiver education, and
their effectiveness.
• Briefly touch upon community-based programs
that promote oral health education and provide
dental care to infants and young children.
Student name:
Students Id Number:
Submission date:
Instructor name:
Grade:
/10
College of Health Sciences
Department of Public Health
Guidelines:
•
Your response should be a minimum of 400 words but should not exceed 500 words.
•
Font should be 12 Times New Roman
•
Heading should be Bold
•
Colour should be Black
•
Line spacing should be 1.5
•
Use proper references in APA style
•
AVOID PLAGIARISM
•
Due date: Nov 11, 2023 @ 11:59 PM
PHC 374: Grading Rubric for “Preventing Dental Caries in Early Childhood: EvidenceBased Strategies”
Excellent (9- Good
10)
(7-8)
Adequate
(5-6)
Needs
Inadequate
Improvement (3-4) (0-2)
– Clear definition of Dental Caries in Early
Childhood
10
8
6
4
0-2
– Clear rationale for the importance of the
topic
10
8
6
4
0-2
– Thorough explanation of risk factors for
Dental Caries in Early Childhood
10
8
6
4
0-2
– Comprehensive coverage of oral health
education strategies
10
8
6
4
0-2
– Logical flow of ideas and well-structured
sections
10
8
6
4
0-2
– Clear introduction and conclusion
10
8
6
4
0-2
10
8
6
4
0-2
10
8
6
4
0-2
– Originality and insight
10
8
6
4
0-2
– Adherence to word limit
10
8
6
4
0-2
Total
100
80-90
60-70
40-50
0-20
Criteria
Introduction
Content
Organization
Clarity and Style
– Clear and concise writing (Proper grammar
and punctuation)
Evidence-Based Approach
– Use of reliable, scholarly sources
Overall Assessment
Module 7 – Clinical Vocabularies and Terminologies
A clinical vocabulary is a collection of words and phrases denoting clinical conditions and a
clinical terminology is a systematized and controlled vocabulary of clinically relevant
phrases. Both clinical vocabulary and terminology, used interchangeably, provide a precise
and sharable expression of clinical conditions to support clinical care. The most common
Clinical Vocabularies and Terminologies are SNOMED-CT, LOINC, and RxNorm reviewed
in this module.
Module 7 Objectives:
After completing this module, you should be able to:
•
o
1. Differentiate between clinical vocabularies and terminologies.
2. Select the most appropriate clinical term for describing a clinical
condition.
3. Conduct mapping among clinical vocabularies and terminologies.
4. Evaluate the role of clinical vocabularies and terminologies in health
information exchange and Interoperability
Module 7 Readings
1. Health Information Management: Concepts, Principles, and Practice Chapter 15 Clinical Classifications and Terminologies, pgs. 397-405.
2. Clinical Vocabularies: Essential to the Future of Health Information Management
3. [PDF] Clinical Terminology and Clinical Classification Systems: A Critique Using
AHIMA’s Data Quality Management Model | Semantic Scholar
4. SNOMED-CT: 5-Step Briefing
5. Health Terminologies and Vocabularies
6. Overview of SNOMED-CT
7. Introduction to SNOMED-CT
8. RxNorm Overview
9. What LOINC is
10. SNOMED International SNOMED CT Browser
11. SNOMED International determines global standards for health terms
12. Review Basics of Data Mapping PowerPoints
Assignment
Mapping between SNOMED-CT and ICD-10-CM
Note: For completing this assignment, use of the I-MAGIC tool (Interactive Map-Assisted
Generation of ICD Codes) is required. To access the I-MAGIC tool, click on the
following https://imagic.nlm.nih.gov/imagic/code/map)
Problems and diagnoses can be recorded in SNOMED CT in the EHR, while the cross mappings to ICD-10-CM can be used to assist the reimbursement process. For example, the
physician documents that a patient has congestive heart failure using a Lexicon linked to
SNOMED CT in the problem list. But when the HIM coding professional tries to code the
patient’s diagnosis, she sees in SNOMWED-CT concept mapped to ICD-10-CM. The coder
could now accept, reject, or modify the code list to be used for reimbursement purposes.
Your APA formatted assignment typed in 12-point Times New Roman (or 11- point Calibri)
excluding the Cover and Reference pages should be submitted by Tuesday midnight. Offer
minimum 2 credible sources to support your conclusions.
Discussion
Please kindly provide a response to the posts below.
POST 1
Systematized Nomenclature of Medicine Clinical Terms, known as SNOMED-CT was
specifically designed to be used as a standard for how electronic health information is to be
exchanged. It is “the most comprehensive, multilingual clinical terminology in the world,
encompassing more than 300,000 concepts, along with terms, synonyms, and definitions for
human and non-human concepts” (Davidson & Rawson, 2022). It is recommended for use in
EHR instead of ICD-10-CM and CPT 4.0 most notably for its granularity, comprehensiveness,
and can be used internationally. SNOMED-CT provides a higher level of clinical detail
compared to ICD-10-CM and CPT 4.0 codes because it captures a wider range of clinical
concepts. A few examples of Meaningful Use objectives that it supports include:
•
“Record patient family health history as structure data
•
Identify and report cancer cases to State cancer registries
•
Record patient smoking status” (National Institutes of Health, 2016).
ICD-10-CM and CPT 4.0 codes are primarily designed for billing and reimbursement purposes,
whereas SNOMED-CT is well-suited to capture and describe clinical concepts and the
relationships among them (NIH, 2016). Additionally, the system can remove language barriers
so that information can be exchanged globally (NIH, 2016). Because the system is a set standard
and is used consistently among healthcare settings, the risk of misinterpreting information is
significantly reduced.
The main reason that SNOMED-CT has not replaced ICD-10-CM and CPT 4.0 is because they
are all used for different, distinct purposes. Practice Fusion (2014) explains that SNOMED-CT is
“inherently more appropriate for clinical documentation of diagnoses in an EHR” and “due to its
use in medical billing, ICD is largely familiar to healthcare providers and was incorporated into
many EHRs as a way to capture clinical diagnoses.” Moreover, ICD-10 only contains 68,000
codes compared to SNOMED-CTs more than 100,000 unique concepts and codes (Practice
Fusion, 2014).
SNOMED-CT’s high level of comprehensiveness, accuracy, and attention to clinical detail
allows for more accurate and prompt reimbursement. The accurate representation of patient
conditions can potentially lead to higher reimbursement when coding with ICD-10-CM.
Essentially, SNOMED-CT’s purpose is to “support semi-automated generation of ICD-10-CM
codes from clinical data encoded in SNOMED-CT for reimbursement and statistical purposes”
(National Institutes of Health, 2021). The system also supports quality reporting and
performance measurement programs. Meeting quality metrics can have an impact on
reimbursement in value-based care models.
As a result of the importance, benefits, and significance SNOMED-CT has on the continuum of
care, interoperability, patient safety, and more, I would recommend it replace both ICD-10 and
CPT 4.0. To do this, there would need to be extensive and clear strategies, stakeholders involved,
and adequate training and education for staff. Throughout the implementation process, progress
should be monitored and evaluated regularly to make adjustments accordingly.
Citations:
Davidson, D., & Rawson, M. (2022, March 17). SNOMED CT: Why it matters to you.
Wolters Kluwer.
https://www.wolterskluwer.com/en/expert-insights/snomed-ct-why-it-matters-toyou#:~:text=How%20SNOMED%20CT%20is%20used,and%20social%20histories%20in%20E
HRs.
National Institutes of Health. (2016, October 14). Overview of SNOMED CT. U.S. National
Library of Medicine. https://www.nlm.nih.gov/healthit/snomedct/snomed_overview.html
National Institutes of Health. (2021, March 1). SNOMED CT to ICD-10-CM map. U.S. National
Library of
Medicine. https://www.nlm.nih.gov/research/umls/mapping_projects/snomedct_to_icd10cm.html
#:~:text=It%20is%20designed%20for%20use,for%20reimbursement%20and%20statistical%20p
urposes.
POST 2
SNOMED-CT is better suited for electronic health records due to its description logic based
creation with definitional relationships (SNOMED-CT International, 2021). The SNOMEDCT code set is extensive and able to link many different descriptions of the same issue or
diagnosis coming to one succinct selection. Many clinicians use different vocabularies to
document including different languages, SNOMED-CT can adapt to both of these tendencies.
Having this level of fluidity producing an interoperable function is ideal for EHR’s. This type
of system is also ideal in exchanging health information, streamlining the output makes it
more usable in analysis, comparison and reporting. SNOMED-CT is also updated bi-annually
to keep it up to date to new technologies and evidence-based practice (National Institutes of
Health, 2016).
Currently SNOMED-CT is not used for reimbursement because ICD-10-CM and CPT 4.0 are
managed by Centers for Medicare and Medicaid Services. SNOMED-CT is a global
classification of many pieces of medical care where ICD is just a classification of disease,
thus not completely lining up. With a lack of equal clinical modification, SNOMED-CT
would not be able to replace ICD-10 and CPT4.0 seamlessly. The clinical modifications are
specific to US healthcare billing requirements and not global inclusivity. Bowman (2014)
explained that SNOMED-CT is a input system for care documentation where ICD are
statistical, epidemiological research purposed. It took 8 years to build the clinical
modifications for ICD-10 and a total of 19 years before it was signed into final rule (Bowen,
2012). I don’t believe that switching to just SNOMED-CT is the way to go. The clinical
modifications for billing would be enormous as it is not just limited to diseases, however it
would offer a very comprehensive billing opportunity. The SNOMED-CT codes are also
updated twice a year, which would mean code expansions twice a year. The U.S. is not good
at being timely and keeping up. Although there are perks, I don’t believe moving to
SNOMED-CT is the correct move.
Bowman, Sue E.(12 June, 2014). “SNOMED, ICD-11 Not Feasible Alternatives to ICD-10CM/PCS Implementation” (Journal of AHIMA website). SNOMED, ICD-11 Not Feasible
Alternatives to ICD-10-CM/PCS Implementation (ahima.org)
SNOMED International. (12 January 2021). Tutorial: Introduction to SNOMED CT – Ian
Spiers and Jon Zammit (202069). [Video].
YouTube. https://www.youtube.com/watch?v=ELgXwo324pk
National Institutes of Health. (2016, October 14). Overview of SNOMED CT. U.S. National
Library of Medicine. https://www.nlm.nih.gov/healthit/snomedct/snomed_overview.html
Address the following questions: How did the iHuman Virtual Patient Encounter case help strengthen your understanding of the chosen body system? (CHOSEN BODY SYSYEM WAS MUSCULOSKELETAL SYSYEM) LOW BACK PAIN WHICH WAS A COMPRESSION FRACTURE What additional study techniques will you incorporate to strengthen your understanding of the chosen body system? 1. write 150-300 words in a Microsoft Word document 2. demonstrate clinical judgment appropriate to the virtual patient scenario 3. cite at least one relevant scholarly source as defined by program expectations
Discuss the highly controversial practice of sterilization for non-therapeutic reasons: Sterilizing a Child, for a Better LifeDownload Sterilizing a Child, for a Better LifeWhat would be the benefits? Would these outweigh the harms? How would you use an ethics argument to support your viewpoint?Please post your comment by this Saturday at 11:59pm and then respond to at least two classmates’ posts before next class.
Unformatted Attachment Preview
Subscribe
HEALTH
Sterilizing a Child, for a Better Life
Though it can tread dangerously close to eugenics, some parents argue that
sterilization improves quality of life for their disabled children, and themselves.
By Marina Kamenev
SEPTEMBER 19, 2013
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(Carlos Barria/Reuters)
When Sophie Carter entered puberty, her parents had more to dread than just a
temperamental adolescent. Sophie is now 31 but still has the intellectual capacity of
a three-year-old. There were no concerns about drugs or boyfriends and no chance of
having “the talk” about sex with her. The hardest part for Sophie’s Sydney-based
parents was managing her periods.
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“She has an older sister and a younger sister and we tried to get her to use pads, but
it just didn’t work,” said Merren Carter, Sophie’s mother.
“People talk about stigma associated with menstruation but there was none of that at
our house. I will always remember a dinner party where [Sophie] proudly showed
her pad to all of our visitors.”
Merren and her husband, John Carter, put Sophie on Depo Provera birth control for
five years. However, John, an endocrinologist and professor of medicine at the
University of Sydney was concerned about the long-term risks of osteoporosis
associated with the hormonal contraception. They began looking for an alternative
solution. At first they considered endometrial ablation, a procedure that destroys the
lining of the uterus, and reduces menstrual flow. They received approval from the
Guardianship Tribunal of New South Wales, a governmental body that determines
consent for special medical treatments for adults who are incapable of making their
own decisions.
However, the Carters decided not to go ahead with the procedure as it would have to
be repeated. Instead they applied for Sophie to have a hysterectomy. The
Guardianship Tribunal approved it and when Sophie was 21 she had the operation.
Her limited independence is no longer compromised by menstruation, Merren said.
Sophie continues to take swimming lessons without monthly interruptions and
doesn’t have to have pap smears, under general anesthetic, which many of Sophie’s
friends have to endure.
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The Carters consider themselves lucky. The Guardianship Tribunal concluded that
the potential distress to Sophie’s spiritual, mental, and physical health caused by
menstruation justified the procedure. However, many of Sophie’s mentally
handicapped friends have had similar applications rejected and some have gone
overseas, to New Zealand or Thailand, for hysterectomies.
The committee said that it “abhors” suggestions that
sterilization should be used to manage pregnancy
risks due to sexual abuse.
It is likely to get even more difficult for Australian parents in situations like the
Carters’ to get approval for sterilizing a disabled child. A July Senate committee
report recommended that sterilizing disabled children without their consent should
be banned unless it can be proven that the child is never likely to develop the
capacity for consent. The report also recommended that taking children or
attempting to take children overseas for a sterilization procedure should be a
criminal offense.
The report followed a 10-month inquiry, with submissions from parents, carers,
human rights groups, and disability advocates. The committee’s list of 28
recommendations include that the definition of an individual’s capacity to consent
be identical in every Australian state and territory, and that sex education
information be targeted at the disability sector.
In one of the recommendations, the committee said that it “abhors” suggestions that
sterilization should be used to manage pregnancy risks due to sexual abuse.
Sterilizing disabled people exudes more than a whiff of eugenics. It recalls U.S.
policies in the 20th Century that led to the sterilization of more than 60,000 people
by 1960, as well as the infamous Nazi “Law for the Prevention of Offspring with
Hereditary Diseases,” in 1933. But due to difficulty with menstrual management or
a fear of pregnancy, carers often feel that sterilization is their only option. A 2003
study in the journal Mental Retardation and Developmental Disabilities Research
Reviews about the ethics of involuntary sterilization of mentally handicapped people
examined surveys from the 1980s and 1990s and found that roughly half of all
parents with mentally disabled children have considered or would consider sterilizing
their child.
These decisions are often controversial. The 2006 Seattle “Ashley Treatment” case, in
which a hysterectomy, among other procedures, was used to stunt the growth of a
six-year-old girl, who had static encephalopathy, is still contentious. Her parents
decided on these treatments to ease the burden of caring for her.
“Most parents have mixed motives,” said Douglas Diekema, a professor of pediatrics
at the University of Washington and Seattle Children’s Hospital, who wrote the
study. “Clearly many of them do want some help with menstrual control, but they
really, almost all of the time desperately want their child never to get pregnant…
They are concerned about sexual abuse and their child been taken advantage of.
Although a sterilizing procedure doesn’t do anything to alter that possibility, what it
does do is that it prevents, in their mind, a pregnancy on top of that.”
U.S. laws also vary from state to state. Diekema says that, generally, getting approval
for the procedure is “fairly restrictive” throughout the country. Much like in
Australia, the rate at which sterilization in disabled populations occurs is unknown.
At the Seattle Children’s Hospital, Diekema says one or two procedures are approved
a year. Carolyn West, a fellow of the Royal Australasian College of Physicians and
professional member of the New South Wales Guardianship Tribunal, said that
approximately one to three procedures are approved yearly in the state.
One of the committee’s recommendations is to record the number of child
sterilization cases in Australia “in the same way in each jurisdiction.” Even though
the exact number of procedures are hazy, the figures seem to have been high enough
to have caught the attention of the United Nations, which in its 2012 Conventions
on the Rights of the Child Report, wrote that they were “particularly concerned”
that the sterilization of disabled women and girls continues in Australia and advised
that the practice be banned for non-therapeutic purposes. The United Nations
Special Rapporteur on torture has highlighted that forced sterilization of disabled
women may constitute torture, or ill treatment.
Submissions to the Australian Senate inquiry detailed some distressing instances of
forced sterilization. One woman’s father, who believed that she should not have
children, told her she was going to the hospital to have her tonsils taken out. “I did
not have a sore throat afterwards,” she told the committee. It was only when she was
trying to have kids with a long-term partner that she had realized what happened.
Her partner eventually left her because he wanted children.
Another woman was forced to have a hysterectomy by her parents, even though she
told them that she did not want to have the operation. Another disabled woman
who was sterilized collected more than 100 strollers, as well as diapers, toys, and
clothes for children that she would never have.
Stella Young, a comedian and disability advocate who suffers from osteogenesis
imperfecta, a congenital bone disorder, wrote in her submission that a specialist tried
to convince her parents that a hysterectomy would be best for her, to avoid the
“inconvenience” of menstruation. Young was just four years old at the time. “My
parents, to whom I’m eternally grateful, were horrified and rejected this ‘advice,’”
Young wrote.
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But menstrual management played a big role in many submissions by parents and
carers. One grandmother wrote that her granddaughter will not be able to manage
her periods, when she starts menstruating, as she often “finger paints” with and
“smears” the contents of her diapers. One submission described how a woman
remained in the bathroom at her place of employment with blood on her clothes due
to the onset of her period.
West said that the New South Wales Guardianship Tribunal will not approve a
sterilization procedure for menstrual management or contraception except in life-
threatening cases, or when there is a significant risk of harm to the health of the
disabled person. For instance, if the bleeding leads to anemia, or if the hysterectomy
is part of a cancer treatment. Instead the tribunal recommends using other methods
of contraception.
For some disabled people, intrauterine devices, may need to be inserted under a
general anesthetic, and those who take the contraceptive pill may have breakthrough
bleeds. In Sophie Carter’s case, her parents successfully argued that they did not want
to expose her to long-term risks associated with Depo Provera.
“Advocates who say she has the ‘right’ to have a child
need to factor in her ability to be RESPONSIBLE
for that child.”
“There are no methods of menstrual regulation or fertility regulation that are perfect,
and there will be girls and women in whom specific methods are unsuitable.
Alternatively there are a very small number who may have their best interests served
with a hysterectomy and sterilization,” said Michael Permezel, the president elect of
the Royal Australian and New Zealand College of Obstetricians and Gynaecologists
(RANZCOG).
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Then there are the parents who believe their children are entitled to a sex life but are
not necessarily capable of having children. In another submission, one woman
describes how her 27-year-old daughter has a boyfriend but if she were to get
pregnant, the child would be “dead within a week.”
“Advocates who say she has the ‘right’ to have a child need to factor in her ability to
be RESPONSIBLE for that child,” the submission reads.
The RANZCOG submission to the inquiry described the case of a woman in her
mid 20’s who had an intellectual disability and an IQ of 70. The woman had seven
children, who were all handed over to her elderly parents. Even though the parents
managed to have a sterilization procedure approved, the woman did not show up to
the operation. Two years later the woman gave birth to another child. The parents
had to reapply for approval, but were denied by the guardianship board. The woman
fell pregnant again, this time to a violent partner, who killed her during the
pregnancy.
According to RANZCOG, “the guardianship board gave conflicting rulings thus
distressing the elderly parents and providing uncertainty for the health service,”
though it’s unclear whether the woman’s death could have been avoided if the board
had handled things better. Some carers are worried about one of the
recommendations of the Senate inquiry: that courts and tribunals should develop
information packs to guide medical experts in sterilization cases, which should
specify that the courts and tribunals are not authorized to consider a person’s ability
to parent in the application process.
Establishing the ability to consent is tricky because those with intellectual disabilities
that can have sex may not be aware of the reproductive consequences, and parents
are concerned about the potential for grandchildren.
In Queensland, the Guardianship and Administration Act 2000 defines the capacity
to consent to mean the person is capable of understanding the nature of the
sterilization procedure, freely makes the decisions about the proposed sterilization,
and is able to communicate the decision. But where sex and contraception fall on
that spectrum varies on a case-by-case basis.
Merren Carter said that contraception was not the reason that she wanted to get
Sophie sterilized, but she is relieved that her daughter cannot get pregnant. She fears
that Sophie is at high risk of getting into situations where she might be sexually
abused. “Once, she didn’t arrive at her train stop for five-and-a-half hours. I had no
idea where she was and what happened. Sophie was not able to tell me.”
Carter agrees with almost everything that the Senate Committee Report said, but
feels that many carers for children like Sophie will be too intimidated to go to the
Tribunal to request a hysterectomy, “because they know they will be knocked back.”
Sophie’s friend, who went to New Zealand for the procedure, was not approved to
get the operation in Australia because her case was not considered serious enough.
The New South Wales Guardianship Tribunal states that a hysterectomy must
“promote and maintain a person’s life or prevent serious damage to their health.” The
Carters are attempting to get the definition of “serious damage” expanded to include
mental as well as physical aspects of health.
One parent who has accepted that a hysterectomy may not be possible decided to
put her daughter on the pill, continuously, despite the health risks. “She told me,
‘Oh well she has to die of something’,” Carter said. “It’s sad but as carers you are
pretty worn out anyway and this is just another battle that you know you are going
to lose.”
Peterson A, Largent EA, Lynch HF, Karlawish J, Sisti D. (2023). Journeying to Ixtlan: Ethics of Psychedelic Medicine and Research for Alzheimer’s Disease and Related Dementias. AJOB Neurosci, 14(2):107-123. 36476106.Should there be extra training or a new role that specializes in neuro medicine caregiving if caregivers are to become part of research involvement and treatment procedure so patients can feel appropriately supported and the healthcare team is more cohesive?How can we hold predatory pharmaceutical companies and investigators accountable when it comes to developing viable therapies for patients and their families who are desperate for relief? Should the government become more engaged and impose further regulations?How can public health leaders best address health equity concerns for marginalized communities, including barriers to accessing psychedelic medicine therapies and representation for future studies?chose one question to answer after reading artcile
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name
Health Planning
Course number
PHC 274
CRN – Branch name
14222
Choose any one of the current public health issues in Saudi Arabia,
answer the issues based on the following questions:
1. Define the health problem with some details (medical/clinical
background)?
2. Identify the magnitude of the problem on the society such as
the incidence and prevalence and other epidemiological data?
Assignment title or task:
( write and questions)
3. Find data on the population characteristics who were affected
by the health problem, such as distribution of age categories,
income levels, educational levels, and occupation distribution
within a community etc…
4. What are the causes or risk factors leading to this problem?
(factors, conditions, situations, or events that in some way
contribute to the health problem). You may use causal theory as
it is going very helpful here.
5. Conclude your brochure with plan a health program that is
going to prevent/reduce this health problem.
Student name:
Student ID #
Submission date:
Instructor name:
Dr. Afrah Kamal Yassin
Grade:
…. Out of 10
Assignment Instructions (Week 6):
Dear Students,
The Assignment is available in Course materials and activities under Week 6 by name Week 6 –
Assignment.
This activity will comprise for 10 marks in the Total course work.
The Assignment is available from 1/October/2023 ie; Sunday 12:30 PM and due date 7/October/2023
ie; Saturday until 11:59 PM.
Assignment guidelines:
•
•
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, Submission date)
in word document, Pdf is not accepted.
Avoid plagiarism.
Word count- Maximum 500 -800 words for each answer.
Font should be 12 Time New Roman.
Color should be black.
Line spacing should be 1.5.
Don’t use bold or Italic or underline in your answer.
References should be in APA style format only.
2 replies of at least 150 words.thread must support their assertions with at least 2 scholarlycitations in APA format. Any sources cited must have been published within the last five years.Acceptable sources include your text, a professional journal, a professional or governmentwebsite (such as CDC), and the Bible, etc.
Week 7 DiscussionSelect one (1) of the three (3) published articles that was approved in week 4.Post the title of the article, authors, purpose, and type of study: Quantitative, Qualitative, or Systematic Review.Discuss how it might influence your practice. What changes to your practice would you recommend based on the article?
Intro: https://sdgs.un.org/goals (review and watch video)
Using THISLinks to an external site. site, review the reports for the United States (including overview, indicators, fact sheet, and policy efforts) on the 17 SDGs. Spend some time learning about how the US ranks in comparison to other countries, what goals we are on target to achieve and which we will likely not meet. Click on the tabs in the middle of the page for indicators, fact sheet, and policy efforts.
You can also view these sites for more information:
https://dashboards.sdgindex.org/profilesLinks to an external site.
https://ourworldindata.org/sdgsLinks to an external site.
https://dashboards.sdgindex.org/mapLinks to an external site.
https://dashboards.sdgindex.org/chaptersLinks to an external site.
Now, reflect on the leadership required to reach the SDGs. Write a two-page “op ed” (pretend you will send it to the Washington Post or the White House) outlining the areas that are lagging and the reasons behind the lack of progress. Then, make at least three specific and realistic recommendations relating to national leaders that could help us to reach the Global Goals.
Exam Content
Understanding health care finance is essential to creating and maintaining a productive budget. Budgeting and controlling resources include the management of capital and human resources.
Choose 1 of the following as a setting for your paper:
Hospital
Clinic
Clinical trial
Setting of your choice
Write a 1,050- to 1,400-word paper in which you develop a plan for controlling resources. Include the following in your plan:
Discuss the historical financial performance and the influence it has on current budgeting.
Describe the tools necessary to develop a resource budget.
Describe the tools for developing a personnel budget.
Identify the elements needed to produce a capital budget.
Discuss how an operating budget influences the nursing division within an organization.
Include 3 research-based articles to support this assessment.
Format your assessment according to APA guidelines.
Submit your assessment.
Resources
Center for Writing Excellence
Reference and Citation Generator
Grammar Assistance
Please complete the attached template using the source provided: Miele, F., Clementi, S., Gennaro, R., Nicolao, I., Romanelli, T., Speese, K., & Piras, E. M. (2019). Text
Messaging and Type 1 Diabetes Management: Qualitative Study Exploring Interactions Among
Patients and Health Care Professionals. JMIR Diabetes, 4(2)https://doi.org/10.2196/11343
Unformatted Attachment Preview
APPENDIX E
Appraisal Guide
Findings of a Qualitative Study
Citation:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Synopsis
What experience, situation, or subculture does the researcher seek to understand?
Does the researcher want to produce a description of an experience, a social process, or an event,
or is the goal to generate a theory?
How was data collected?
How did the researcher control his or her biases and preconceptions?
Are specific pieces of data (e.g., direct quotes) and more generalized statements (themes,
theories) included in the report?
What are the main findings of the study?
Credibility
Is the study published in a source
that required peer review?
Yes
No
Not clear
Were the methods used appropriate
to the study purpose?
Yes
No
Not clear
Was the sampling of observations or
interviews appropriate and varied
enough to serve the purpose of the study?
Yes
No
Not clear
*Were data collection methods
effective in obtaining in-depth data?
Yes
No
Not clear
Did the data collection methods
avoid the possibility of oversight,
underrepresentation, or
overrepresentation from certain
types of sources?
Yes
No
Not clear
Were data collection and analysis
intermingled in a dynamic way?
Yes
No
Not clear
Brown
APP E-1
*Is the data presented in ways that
provide a vivid portrayal of what was
experienced or happened and its
context?
Yes
No
Not clear
*Does the data provided justify
generalized statements, themes,
or theory?
Yes
No
Not clear
ARE THE FINDINGS CREDIBLE?
Yes All
Yes Some
No
Clinical Significance
*Are the findings rich and informative?
Yes
No
Not clear
*Is the perspective provided
potentially useful in providing
insight, support, or guidance
for assessing patient status
or progress?
Yes
Some
No
ARE THE FINDINGS
CLINICALLY SIGNIFICANT?
Yes All
Yes Some
Not clear
No
* = Important criteria
Comments
___________________________________________________________________________
___________________________________________________________________________
APP E-2
Brown
https://a14156-2038223.cluster325.canvas-user-cont…Please watch the following film, The Tylenol Crisis and post a brief summary of your thoughts related to the idea of managing conflict and crisis. What mediation skills would be useful to employ to address this issue nationally, and in affected communities? Use this week’s instructional materials for support.
What is the primary outcomes and results of the placebo and drug in research in Protein Kinase C (PKC) Diabetic Retinopathy Phase 3 Study. Put into 1-2 slides show.Clininal trial: https://clinicaltrials.gov/study/NCT00604383?cond=Retinopathy&aggFilters=phase:3%204,results:with,status:com&rank=1
Pick a repetitive activity in the healthcare setting done by healthcare professionals using their upper body (arms and hands). Conduct an Ergonomics risk assessment. Using the Assessment of repetitive tasks (ART) tool, what are the top three Ergonomic risk factors? Post your score sheet in your response.Here is access to the tool: Assessment of repetitive tasks of the upper limbs (the ART tool).
Use the link in the pdf to Compare two hospitals to each other, then two nursing homes. It will ask for a zip code. Use zip code 91405. Please use your Zip code to identify two hospitals and two nursing homes in your community and compare the two selected hospitals and two selected nursing homes.Please write about your findings on two page (double-spaced) document and upload them to the homework submission link.The more detailed the comparison of the facilities, the higher your grade will be. In your submission, you can include bullet points, narratives, and tables
Unformatted Attachment Preview
Homework 1
Care Compare Exercise
CMS Care Compare
https://www.medicare.gov/care-compare/
Please use your Zip code to identify two hospitals and two nursing homes in your
community and compare the two selected hospitals and two selected nursing homes.
Please write about your findings on two page (double-spaced) word document and
upload them to the homework submission link. The more detailed the comparison of the
facilities, the higher your grade will be. In your submission, you can include bullet points,
narratives, and tables.
Hospitals
Nursing Homes
Find an article dealing with a Sports Related Lower extremity injury and write critique of the article to turn in. Article needs to come from a scholarly source. (NOT SPORTS ILLUSTRATED, ETC.) Review the attached example and rubric for more information.
Requirements:
Utilize knowledge gained throughout the course to critique an article that relates to an athletic related injury.
No Plagiarism
Make sure to include in your summary this course knowledge can apply to your future.
Develop an article critique to turn in. (Maximum length 2 pages)
You must provide evidence to support your ideas and reference your evidence appropriately! (APA formatted) (2 minimum) (Original source and one more)
Follow the SES Article Critique guidelines below:
The review must be in APA format (headers, title, Times New Roman, 12 pt. font, etc.)
Please follow citation rules for paraphrasing and direct quotations
Article must be from a peer-reviewed journal, published within the last 5 years.
Follow the format below. Your critique should follow this order. Please put in paragraph form.
Format/ What to include in paper:
1. Reference:
APA Reference at the top of your paper after your name and course information (see example)
2. Why are you interested in reading the article? What information can you gain by reading this article?
3. What is the main purpose of this article? Be specific and accurate. Summarize the purpose in your own words.
4. What is the key question the authors are asking?
5. What is the most important information in this article? Please make sure to answer each of the following:
Review the literature used. Key things to look for – age of the references, guidelines used, what data/statistics from other studies is given
Authors reasoning for the study
Methodology
Research design
Results – review the statistics (significant or not)
Limitations (authors and your own)
6. What is the conclusion the authors came to about the study?
7. What are the implications of this article? What would the outcomes be if we followed the article’s findings? Include both positive and negative.
8. What is the significance of this study to you?
Relevancy: Clear description of the article to the field of study. Links the article to other studies or topics.
Organization ,Delivery: All major points of the article analysis are clearly stated. Critique follows a logical order. Technical language us used appropriately and defined clearly.
Comprehension (Critical Appraisal) Demonstrates the use of critical thinking in article critique. Main points of the article are clearly stated with evidence of informed decision making to form an opinion of the article.
Implications : Based on opinion formed, is able to make an informed relationship to patient/client scenarios, real life situations, or future research in the discipline.
APA Formatting: Paper was clear of APA formatting errors
The example of article is below and also 2 chapters of the course
Due Sunday by 11:59pm
Points 50
Submitting a text entry box or a file upload
Unit 4Biopsychosocial Assessment and Mental Status Examination
Unit 4: Introduction (1 of 4)
Unit 4: Reading and Activities (2 of 4)
Current Assignment: Unit 4: Assignment Biopsychosocial Assessment and Mental Status Examination (3 of 4)
Unit 4: Discussion Biopsychosocial Assessment and Mental Status Examination (4 of 4)
Instructions
For this assignment, you will need to develop a scenario that shows a mental health and/or physical health condition and the presenting problem is clearly defined to role play with a partner. Select an adult to participate as your partner. You may choose to select a family member (not your child), peer, friend or colleague. Please note that no identifying information can be used, and all protected health information must remain confidential. Therefore, fictious names, fictious date of birth are highly encouraged and information must not be identifiable to the client or person selected. You may also decide to create a fictious client for this assignment. You must provide the individual with a hypothetical situation that they will talk about as you conduct the assessment.
This assignment will be in two parts. Use the scenario you developed to base the assessment and mental status exam on.
PART I
First, you need to complete a Mental Status Evaluation.Links to an external site. using the template provided on the website.
PART II
Complete the following assessment: Access the Psychosocial Assessment TemplateLinks to an external site..
Important: Select a screening tool and include the scores of the screening tool that you selected to complete your assessment on the biopsychosocial assessment.
For example, if the patient reported depression, the PHQ-9 would be the screening tool utilized in the assessment.
Once you complete the biopsychosocial assessment form, you will need to save it to a flash drive or desktop.
You will need to print the completed forms, then scan and upload.
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.
Estimated time to complete: 2 hours
Rubric
MSW610 Unit 4 Biopsychosocial Assessment Forms Rubric
MSW610 Unit 4 Biopsychosocial Assessment Forms Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
15 pts
Mastered
MSE is has all sections completed with identified information and comments
13.5 pts
Excels
MSE is has all sections completed with identified information and some comments
12 pts
Competent
MSE is has all most sections completed with identified information and limited comments
10.5 pts
Needs Improvement
MSE is has most sections completed with identified information and no comments
0 pts
Not Present
No MSE provided
15 pts
This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
15 pts
Mastered
Biopsychosocial form and assessment is clear and completed with all requirements
13.5 pts
Excels
Biopsychosocial form and assessment is clear and completed with most requirements
12 pts
Competent
Biopsychosocial form and assessment is unclear and completed with most requirements
10.5 pts
Needs Improvement
Biopsychosocial form and assessment is unclear and completed with minimal requirements
0 pts
Not Present
No Biopsychosocial form
15 pts
This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
20 pts
Mastered
Diagnostic tool is identified, completed with rationale of the selection; scores are supported in the Biopsychosocial assessment
18 pts
Excels
Diagnostic tool is identified, completed with incomplete or inaccurate rationale of the selection; scores are supported in the Biopsychosocial assessment
16 pts
Competent
Diagnostic tool is identified, and completed with incomplete or inaccurate rationale of the selection; scores are not supported in the Biopsychosocial assessment
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
The case study that has been selected is, which has been attached along with the rubric.
Case 1: Cottage Senior Living
Continue analyzing the situation that your case study’s healthcare organization faces. In this milestone, you will continue to evaluate the impact of the mission and vision of the healthcare organization’s strategic plan. You will also consider how the organization’s strengths, weaknesses, opportunities, and threats affect the environmental factors that confront the healthcare organization.
Develop a SWOT analysis of the healthcare organization. Be sure to address the following:
Briefly summarize your case study.
To what extent do the organization’s policies address this issue? Be sure to justify your response.
To what extent does the organization’s strategic planning around this issue align with its organizational mission and vision? Use evidence and examples to justify your reasoning.
What do you feel are the organization’s strengths, weaknesses, opportunities, and threats (SWOT) with regard to this issue? Be sure to substantiate your claims with evidence and specific examples.
Based on the SWOT analysis you performed, what environmental factors are at play in terms of this issue and what is their impact on the delivery of care within the organization? In other words, identify any new policies or new trends that will affect your day-to-day operation.
Submit your assignment here. Make sure you’ve included all the required elements by reviewing the guidelines and rubric.
Requirements: 2-4 Full Pages Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please be sure to include an introduction paragraph with a clear thesis statement in the last sentence of the introduction paragraph and a conclusion paragraph.
P.lease be sure to carefully follow the instructions.
No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool.
Please be sure to at least one in-text citation in each body paragraph.
Please be sure to read, use, and cite the case study that I have provided. Please be sure that any additional sources used are credible or scholarly.
Unformatted Attachment Preview
Cottage Senior Living
The leadership of Cottage Senior Living (CSL) assembled at a strategic
planning retreat away from their headquarters in Huntsville, Alabama to prepare a
plan to move the business “to the next level.” For the president of the company,
Cliff White, the goal of reaching the next level involved growth that focused on
identifying locations for acquisition and development. In addition to White,
attending the retreat were: Sandy Brackin Vice President of Operations, Cheryl
Westlake, Director of Operations; Alan Hangartner, Vice President of Marketing
and Sales; Greg Dykes, Regional Managing Director – South; Selena Jackson,
Regional Managing Director – North; and Holly Mitchell, Senior Accountant.
To begin the retreat, White articulated Cottage Senior Living’s vision as the
“development of housing and service offerings that attract empty nesters who
choose to live an active, vibrant, and engaged lifestyle.” He further explained,
“Our product is differentiated from the traditional markets for independent living
(IL), assisted living (AL), memory care (MC), and skilled nursing facility (SNF)
by focusing on non-subsidized, private-pay customers in tertiary markets.”
White continued, “Moving toward the goals of the retreat, our task today is
to answer three questions: 1) How to grow? 2) Where to grow? and 3) Do we have
the organizational capacity to grow? Answering the ‘how to grow’ question
involves assessing additions to existing capacity, offering services we presently do
not, and expanding our same product into other geographic markets (horizontal
integration). The ‘where to grow’ question involves the consideration of new cities
and perhaps new states. And both questions, how to grow and where to grow,
require us to examine our organizational capacity to grow.”
The Cottage Story
Cottage Senior Living, also known as “the Cottages,” was headquartered in
Huntsville, Alabama. The founders of Cottage Senior Living, Peg Thompson and
Wade White, met in Doylestown, Pennsylvania in 1980 while consulting as turnaround specialists focused on continuing care retirement communities (CCRCs)
and more specifically, the Pine Run Community, a for-profit CCRC. The Pine Run
Community opened in 1976, and was one of the first retirement communities to be
developed and the only one at that time with a full service, 200-bed regional health
center devoted to senior care.1 Thompson and White married and spent the
remainder of the 1980s creating the assisted living service model, something that
did not exist prior to 1980. Thompson and White sought distressed retirement
communities, especially religiously-affiliated CCRCs and spent the mid-1980s
1
through the mid-1990s making deals. Their first venture was a management
contract to operate the “Regency” Community in Huntsville, Alabama. The
Regency Community became the company’s headquarters. During the 1990s,
Cottage Senior Living developed CCRCs in Florence, Alabama; Russellville,
Alabama; Corinth, Mississippi; Lawrenceburg, Tennessee; Mountain Brook,
Alabama; and acquired CCRCs in Hoover, Alabama; Decatur, Alabama; Hartselle,
Alabama; and Huntsville, Alabama (see Exhibit 1 for Cottage Senior Living’s
market area).
Exhibit 1. Cottage Senior Living Service Area
Cliff White, Wade and Peg’s eldest child, returned to the family business in
2009 after completing an MBA at the American University in Washington, DC.
Beginning in 2011, White served as president of Cottage Senior Living, LLC.
Among Cliff White’s accomplishments was the development of The Commons, a
54-unit active adult community in Huntsville, Alabama where he implemented
several information technology (IT) projects to improve operational efficiency and
management reporting. White focused much attention on innovating assisted
living. He was a member of the Urban Land Institute Senior Housing Council and
the American Seniors Housing Association and was a Certified Public Accountant.
The Industry
The long-term care industry was composed of health-service, social service,
and residential service organizations that provided rehabilitative, restorative, and
ongoing skilled nursing care to disabled and elderly patients who required
assistance with daily living.2 The assisted living industry was comprised of a
variety of senior care services; generally divided into two major subcategories: (1)
2
continuing care retirement communities and (2) homes for the elderly. The
primary difference between the two subcategories was the presence of nursing
care. Continuing care retirement communities provided on-site nursing facilities
whereas homes for the elderly did not. Future growth of the industry would be
spurred by 77 million Baby Boomers and the increasing life expectancy of the
elderly population. Approximately 1 million Americans lived in senior care
facilities and the number was expected to double by 2030.
Competition in the assisted living industry was intense. The four largest
providers in the industry (Brookdale Senior Living, Sunrise Senior Living,
Emeritus Corporation, and Atria Senior Living Group) controlled only about 13
percent of the market share. The remaining 87 percent was comprised of a variety
of not-for-profit and for-profit enterprises. The largest source of revenue for
providers came from private payers representing almost two-thirds of total
revenue. Medicaid provided about 10.5 percent, Medicare about 6.2 percent, and
private insurance about 3 percent. The remaining 14 percent came from a variety
of sources including other government programs and assigned Social Security.
Great variety occurred in the demographic make-up of retirement communities.
Approximately 69 percent of residents were female and 31 percent were male. The
typical resident of a senior living community was an 85-year-old female.
Individuals over the age of 85 made up the largest percentage of residents in senior
living facilities.3 More specifically, the industry was comprised of a variety of
facilities differentiated by the intensity of care provided as summarized in Exhibit
2.
Exhibit 2. Senior Living Communities in Order of Increasing Intensity of Care
Type of
Community
Age
Range or
Average
Age of
Residents
Regulation
Senior
Apartments
55 plus
Not regulated Occasional
Independent
Living
82
average
Not regulated Scheduled
Assisted
Living
Facilities
85 plus
and need
driven
Regulated by
state
government
Scheduled and
required by
regulation
Memory
Care – a
85 plus
and need
Regulated by
state
Scheduled and
required by
Transportation
Activities
Daily, but
not
required
Daily, but
not
required
2
Services
A la carte
Housekeeping
(included*), nursing
call system3,4
Housekeeping
Scheduled 6 (included); nursing
call system; food
times per
service (3 times/day,
day;
scheduled);
(schedule
required by medication assistance
regulation) – all required by
regulation
Scheduled 6 Housekeeping
times per
(included), nursing
3
Specialty
driven
Care Assisted
Living
Facility
(SCALF)
government
regulation
Skilled
Nursing
Facility
(SNF)
Regulated by
state and
federal
governments
Scheduled and
required by
regulation
Adolescent
and older
*
day;
(schedule
required by
regulation)
call system, food
service (3 times/day,
scheduled), nurse
administered
medication, monthly
RN assessments- all
required by regulation
Housekeeping
(included); nurse
Scheduled, 6
calling system; food
times per
service (3 times/day,
day;
scheduled); nurse
(schedule
administered
required by
medication; monthly
regulation)
RN assessments – all
required by regulation
Included means incorporated into the residential fee-for-service structure
Independent living settings were adult communities that usually imposed
age restrictions, offered social activities, provided security, offered access to
transportation services, but did not provide medical services. Although no
uniformly accepted definition of assisted living facilities (ALFs) existed, ALFs
were considered “multi-family properties with personalized support services for
seniors.”4 A relatively new development in the long-term care industry was the
Continuing Care Residential Community or CCRC. CCRCs attracted private-pay
residents5 “of high socioeconomic status, who were independent upon entering the
CCRC.”6 CCRCs offered a variety of services providing a progression of care
from independent living to nursing facilities in a single campus setting focusing on
wellness activities and amenities.7,8,9 The progression of services offered by
CCRCs acknowledged the inevitable decline of independent older adults during
the last few years of life, making CCRCs the “final station” of an older adult’s
life.10 A skilled nursing facility (SNF) was defined by the Social Security Act as
an institution (or a distinct part of an institution) that was primarily engaged in
providing skilled nursing care and related services for residents who required
medical or nursing care, or rehab services for the rehabilitation of injured,
disabled, or sick persons, and was not primarily for the care and treatment of
mental diseases; and had in effect, a transfer agreement with one or more
hospitals. Nursing facilities offered the most intense level of long term care and
were for individuals requiring around the clock care.11 Memory care facilities
catered to the needs of individuals with Alzheimer’s disease or a related disorder
(ADRD)12 and was an emerging development within CCRCs.13 Memory care and
skilled nursing facilities were categorized as Specialty Care Assisted Living
Facilities or SCALFs.
From an industry perspective, Medicaid was the primary payer of long term
care services inasmuch as more than 60 percent of the patients in nursing homes
4
were Medicaid recipients and that Medicaid patients comprised almost 20 percent
of residents in assisted living facilities.14 The Cottages did not market to or admit
Medicaid recipients.
The CSL Regulatory Environment
The Cottages operated three types of facilities – Assisted Living, Memory
Care, and Active Adult as “group” facilities or “congregate” facilities. The word
congregate used as an adjective to describe long-term-care facilities is a synonym
of the word group and thus appeared to refer to the same thing;15 however, state
regulations distinguish between the terms as they applied to health care facilities.
Because the Cottages operated facilities in three states, agencies in each state
regulated the facilities; however, the majority of the Cottages’ facilities were
located in Alabama and as a result the company was profoundly affected by
regulations of the Alabama Department of Public Health (ADPH). ADPH
regulations differentiated between group assisted living and congregate assisted
living facilities. Group assisted living facilities were authorized to care for three to
sixteen adults. Congregate assisted living facilities were authorized to care for 17
or more adults. Regulations addressed staffing requirements and the qualification
of key members of the staff. The key regulatory parameters, shown in Exhibit 3,
indicate that in general, ALFs had fewer staffing requirements than SCALFs and
both ALFs and SCALFs had similar building requirements.
5
Exhibit 3. Key Regulation Parameters within the Cottages Footprint
15
ALF
SCALF
Staffing
General requirement: sufficient staff on duty General requirement: sufficient staff on duty to
to provide the care needs of all residents
provide the care needs of all residents twenty-four
twenty-four hours per day, seven-days per
hours per day, seven-days per week.
week.
Staff requirement: based on resident population and
time of day:
Residents by Time Period
Staff
7am-3pm 3pm-11pm
11pm-7am
2
1-16
1-16
1-16
3
17-24
17-36
17-48
4
25-32
37-48
49-64
Staff requirement: based on resident
5
33-40
49-60
65-80
population and time of day; no set, specific
requirement.
6
41-48
61-72
81-96
7
49-56
73-84
97-112
8
57-64
85-96
113-128
9
65-72
97-108
129-144
10
73-80
109-120
145-160
11
81-88
120-132
161-176
+1 per
8
12
16
Specific professional licensed staff:
Specific professional licensed staff:
Administrator
Administrator
Medical Director – licensed physician
Dietician – could be full-time, part-time, or
Registered Professional Nurse
consultant
Coordinator – an administrator who was an RN
Dietician – could be full-time, part-time, or consultant
Building Requirements
Dining separate from kitchen
Dining separate from kitchen
Separate rooms for administrative and office
Separate rooms for administrative and office purposes
purposes
Centrally located staff station with call for
Centrally located staff station with call for assistance
assistance and fire alarm communication
and fire alarm communication system
system
Grab bars conforming to current building
Grab bars conforming to current building code
code
Commercial exhaust food system
Commercial exhaust food system
Institutional grade range with double oven
Institutional grade range with double oven
Bedrooms individually and consecutively
Institutional grade refrigerator
numbered
Hand washing lavatory in kitchen with soap
Hand washing lavatory in kitchen with soap dispenser,
dispenser, supply of soap, disposable towels,
supply of soap, disposable towels, and hot and cold
and hot and cold running water running
running water running through a mixing valve or
through a mixing valve or combination faucet combination faucet
Commercial grade dishwashing equipment
Three-compartment sink with a booster heater or
with a booster water heater
chemical sanitizing system
Laundry rooms shall not open directly into
Doors of resident bathrooms swing into the bedroom
resident rooms or food service areas
6
ALF
Utility rooms on each floor
A sign bearing the word “EXIT” at each exit
SCALF
Bedroom doors at least three feet wide
A sign bearing the word “EXIT” at each exit
The CSL Market and Product Lines
Sandy Brackin, Vice President of Operations, distributed information on
occupancy by facility. Exhibit 4 shows the number, type of unit, and occupancy of
each location in the Cottages portfolio of facilities. All units were single
occupancy, meaning each unit housed one resident. Brackin stated, “As you may
note, our occupancy is highest at one of our smaller facilities – Russellville and
lowest at our largest facility – Huntsville.” Brackin continued, “Average
occupancy for five years for all facilities was 87 percent.”
Exhibit 4. The Cottages Portfolio
Location
Assisted
Living Units
Memory
Care Units
Active Adult
Units
Corinth, MS
Decatur, AL
Florence, AL
Hoover, AL
Huntsville, AL
Lawrenceburg, TN
Montgomery, AL
Mountain Brook, AL
Russellville, AL
Hartselle, AL
27
32
47
16
48
27
40
44
27
10
0
0
0
32
0
0
32
0
0
32
0
0
0
0
54
0
0
0
0
0
Facility
Occupancy
Rate (%)16
92
95
93
70
65
98
88
77
97
96
White offered a brief review of the financing of the Cottages Portfolio.
White noted, “Our properties were financed by a roughly 50/50 relationship of
equity and debt. The debt was in the form of conventional mortgages and HUD
232 loans.”17 Exhibit 5 indicates the distribution of conventional and HUD 232
loans18 used in financing the Cottages facilities. White continued, “The average
original loan per unit was $39,400 with a standard deviation of about $16,000.”
Exhibit 5. Source of Debt Financing by Location
Location
Corinth, MS
Decatur, AL
Florence, AL
Hoover, AL
Huntsville, AL
Type of Debt Financing
Conventional
Conventional
HUD 232
HUD 232
Conventional
7
Lawrenceburg, TN
Montgomery, AL
Mountain Brook, AL
Russellville, AL
Hartselle, AL
Conventional
HUD 232
HUD 232
Conventional
Conventional
Prior to the retreat, White had directed Holly Mitchell to prepare a
simplified income statement for a set of representative properties for the most
recent three years. Mitchell’s work product is shown in Exhibit 6. Mitchell
distributed the income statement and commented, “The representative properties
selected were 1) the average of Florence and Mountain Brook – assisted living
facilities with the same number of units, 2) Russellville -small assisted living, 3)
Hartselle – small assisted living plus memory care, and 4) Decatur – assisted
living.” Mitchell continued, “A typical Cottages property produces average
operating revenue per occupied unit of $32,848 per year and operating expenses
average $26,181 producing an operating margin of about $7,000 per occupied unit
per year. The fixed expenses per occupied unit include depreciation, amortization,
and interest expense.”
Exhibit 6. Income Statement per Occupied Apartment
Revenue
Other Revenue
Total Revenue
Operating Expenses
Administrative & General
Resident Services
Marketing
Food Service
Maintenance
Total Operating Expenses
Other Income/Expenses
Fixed Expenses
Net Income
FLO/MBK
38,056
1,589
39,645
RCL
27,899
1,153
29,052
HAR
34,418
1,443
35,861
DEC
30,492
1,224
31,716
AVG
32,848
1,365
34,212
-10,841
-8,503
-2,505
-3,538
-2,444
-27,831
-2,043
-2,321
7,450
-10,315
-7,743
-1,111
-3,314
-2,017
-24,500
-1,318
-1,717
1,517
-9,886
-8,614
-1,603
-3,693
-2,765
-26,562
-2,820
-2,346
4,132
-9,483
-8,691
-1,576
-3,688
-2,755
-26,191
-1,094
-1,416
3,015
-10,293
-8,264
-1,747
-3,499
-2,378
-26,181
-1,742
-1,976
4,313
EBITDA (earnings before interest, taxes, depreciation, and amortization)
was a general estimate of cash flow.19 Mitchell distributed a schedule that showed
EBITDA generated per occupied unit (shown in Exhibit 7). She added, “Average
annual cash flow per occupied unit was $6,298 with a range from approximately
$4,000 per unit to almost $9,700.” She reminded the attendees that taxes were not
included in the calculation of EBITDA since the Cottages was organized as a
Limited Liability Company or LLC, and concluded, “LLCs are pass-through
8
entities for tax purposes that do not incur income tax liabilities as an enterprise,
rather tax liabilities are passed to the enterprise’s owners in proportion to their
ownership, similar to partnerships and Subchapter S corporations.”20
Exhibit 7. EBITDA per Occupied Apartment
FLO/MBK
7,450
RCL
1,517
HAR
4,132
DEC
3,015
ALL
4,313
2,321
1,641
1,717
1,041
2,346
2,820
1,416
933
1,976
1,477
254
-1,982
236
-1,453
235
-1,793
234
-1,586
242
-1,711
EBITDA
9,683
3,058
Legend:
FLO/MBK = facilities in Florence, AL and Mountain Brook, AL
RCL = facility in Russellville, AL
HAR = facility in Hartselle, AL
DEC = facility in Decatur, AL
7,741
4,012
6,298
Net Income
Add: Fixed Expenses
Add: Interest Expense
Add: Other
Less: Standard Management Fee
ALL = all CSL facilities
The CSL Operations and Staffing
Model
As White continued to facilitate the retreat, he recognized Brackin who
explained, “Concerning organizational capacity, one of our strengths is that the
Cottages operates its facilities in a franchise type arrangement – each facility is
established as a legal entity for purposes of owning real estate; then we as the
parent company – the Cottages – provide branding, a standardized staffing plan,
and a standardized operating plan.21 Each facility pays the Cottages a management
fee that is five percent of gross revenue. Each facility’s staff members are
employees of the Cottage’s and we administer payroll and employee benefits. I
believe we certainly should continue this model since it has served the company
well since its inception.”
The staffing model specified the credential and experience requirements for
facility administrators. For ALFs, an administrator was required to have a high
school diploma and relevant work experience.22 The staffing model implemented
the regulatory framework (presented previously in Exhibit 3). For example, a
Licensed Practical Nurse (LPN) or Registered Nurse (RN) was required as a staff
member for the administration of medications and an RN was required to perform
intake assessments and monthly assessments in all SCALF facilities. The standard
procedures model might be modified based on the physical plant differences
9
among facilities. For example, if a facility had three buildings, then the one foodservice staff member transported food between buildings rather than simply
plating food in a single facility.
Mitchell distributed a handout (see Exhibit 8) that showed the overall
staffing plan for CSL as well as the functions and the number of full-time
equivalents for each function. Mitchell noted, “For facilities that did not show the
function of housekeeping, residential services personnel are assigned the tasks.”
10
Exhibit 8. CSL Management Structure by Location
Headquarters
Function
President
Accounting
Information Technology
Marketing and Sales
Operations
Function
Managing Director
Food Service
Maintenance
Residential Services
Function
Managing Director
Admissions
Food Service
Maintenance
Residential Services
Function
Managing Director
Food Service
Maintenance
Residential Services
Function
Managing Director
Admissions
Food Service
Maintenance
Residential Services
Executive*
1
0
1**
1
1
Corinth, MS
Executive*
1
0
0
0
Decatur, AL
*
Executive
1
0
0
0
0
Florence, AL
Executive*
1
0
0
0
Hartselle, AL
Executive
1
0
0
0
0
*
FTEs
Managers
0
1
1
1
3
Staff
0
2
1
2
3
FTEs
Managers
0
1
1
1
Staff
0
0
0
6
FTEs
Managers
0
1
1
1
1
Staff
0
0
1
0
12
FTEs
Managers
0
1
1
1
Staff
0
1
0
12
FTEs
Managers
0
1
1
1
2
Staff
0
0
1
0
15
FTEs
Managers
0
1
1
1
Staff
0
0
1
0
Hoover, AL
Function
Managing Director
Admissions
Food Service
Maintenance
Executive*
1
0
0
0
11
Residential Services
Function
Managing Director
Admissions
Food Service
Housekeeping
Maintenance
Residential Services
Function
Managing Director
Food Service
Maintenance
Residential Services
Function
Managing Director
Admissions
Food Service
Health Services
Housekeeping
Maintenance
Residential Services
Function
Managing Director
Food Service
Maintenance
Residential Services
Function
Managing Director
Food Service
Maintenance
Residential Services
*
0
Huntsville, AL
Executive*
1
0
0
0
0
0
Lawrenceburg, TN
Executive*
1
0
0
0
Montgomery, AL
*
Executive
1
0
0
0
0
0
0
Mountain Brook, AL
Executive*
1
0
0
0
Russellville, AL
Executive*
1
0
0
0
2
15
FTEs
Managers
0
1
1
1
1
1
Staff
0
1
1
0
0
15
FTEs
Managers
0
1
1
1
Staff
0
0
0
6
FTEs
Managers
0
1
1
1
1
1
1
Staff
0
1
1
0
0
0
15
FTEs
Managers
0
1
1
2
Staff
0
1
0
12
FTEs
Managers
0
1
1
1
Staff
0
0
0
6
For headquarters – Vice President and above, for facilities, Managing Director and above
The president oversees all information technology functions
**
12
Developing a Growth Plan
White distributed a document summarizing the market selection criteria
that had proven successful for the company.
CSL’s desired market characteristics included:
Strong demographics – age and income qualified customers (market
penetration in the 5 to 10 percent range) and population growth
exceeding 2 percent year-over-year;
Towns and communities undergoing re-urbanization (“main street
living”) – communities with re-urbanization plans that were being
executed; and
Reasonably priced land near the main street area.
He then presented a single PowerPoint slide showing a regional map with
two circles (see Exhibit 9). White narrated, “The inner circle represents the market
area for CSL as a circle centered on our headquarters in Huntsville with a radius
that includes all of the CSL facilities, the most distant being Montgomery. What if
we extended the radius of the circle by about fifty miles? Our reach would be to
five states – Alabama, Georgia, South Carolina, North Carolina, Tennessee,
Kentucky, and Mississippi.”
Alan Hangartner, CSL VP of Marketing and Sales, “Cliff, as I look at the
map, something strikes me as interesting. . . Look at all the college towns in the
larger circle – Auburn, Clemson, Knoxville, Nashville, Starkville, and Oxford.”
He continued, “I recall reading that college towns are attractive to retirees.”23
Several nodded their heads in agreement.
Selena Jackson, Regional Managing Director – North, reacting to
Hangartner’s comment stated, “Alan, college towns would be interesting ‘where to
grow’ places, but do they meet all three elements of our market characteristics: age
and income qualified customers, main-street living, and reasonably priced land
near the main street area? College towns may meet the first two requirements, but
I am concerned about the third – the availability of reasonably priced land.”
Hangartner responded, “You may be right, but we should consider towns near
these college towns. An example is Opelika, Alabama near Auburn, Alabama,
home of Auburn University.”
“That wouldn’t work for Clemson!” laughed Greg Dykes, Regional
Managing Director – South. He continued, “Plus, I think that South Carolina and
especially North Carolina have significant CON (certificate of need) laws. North
Carolina is quite willing to add more Assisted Living, Memory Care, and SNF
facilities in rural areas, but the metro areas – Charlotte, Raleigh, Greensboro,
13
Durham, Winston Salem and Fayetteville all with more than 200,000 in population
– are challenging.”
The group began identifying potential growth strategies – horizontal
integration, vertical integration, product expansion such as more specialty care
offerings, new payers, and geographic expansion. They knew they had to keep in
mind the regulatory barriers of entering new states, the demographics of potential
new cities, and important considerations such as company’s demographics – size,
personnel capabilities, span of management, geographic limitations; and
competitive variables including employment markets, potential competitors, and
pricing.
White replied, “As we consider the possibilities, we need to focus on the
three questions:
How to grow?
Where to grow?
Do we have the organizational capacity to grow?”
He continued, “Let’s break for lunch and when we reconvene, we can each
identify a strategy that we believe will best enable us to grow the organization.”
14
Exhibit 9. Examining SCL’s Service Area*
*Current Cottage locations are in red.
References
1
About Pine Run. retrieved from: http://pinerun.org/independent-living/ )
2
Warren Greenberg, “Long-Term Care Industry,” The Health Care Marketplace (New York:
Springer, 1998), pp. 91-102.
3
J. Ortiz, Assisted Living Facilities Business Report. U.S. Small Business Administration, April,
(2014). Small Business Market Research Reports, available at:
http://www.sbdcnet.org/small-business-research-reports/assisted-living-facilities .
4
Lynn David and Tim Wang, “The US Senior Housing Opportunity: Investment Strategies,”
Real Estate Issues 33, no. 2 (2008), pp. 33-51.
5
Michael D. Barnett, “Future Expectations among Older Adults in Independent Living
Retirement Communities” (University of Houston, 2010).
6
I. Doron, and E. Lightman, “Assisted-living for Older People in Israel: Market Control or
Government Regulation?” Aging and Society 23, no. 6 (2003), pp. 779-795.
15
7
Wassum, Ryan Michael, “Baby Boomer Living: Designing a Modern Continuing Care
Retirement Community,” Master’s Thesis, California Polytechnic State University, San
Luis Obispo, CA, (2013), available at: http://digitalcommons.calpoly.edu/theses/1070/ .
8
J. C. Hays, A. N. Galanos, T. A. Palmer, D. R. McQuoid, and E. P. Flint, “Preference for Place
of Death in a Continuing Care Retirement Community,” The Gerontologist 41, no. 1
(2001), pp. 123-128.
9
A. K. Smith, L. C. Walter, Y. Miao, W. J. Boscardin, and K. E. Covinsky, “Disability During
the Last Two Years of Life,” JAMA Internal Medicine 173, no. 16 (2013), pp. 1506-1513.
10
Services, C. O. M. M. “Skilled Nursing Facility” (SNF) Definition, 2017. Retrieved from
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-NetworkMLN/MLNMattersArticles/downloads/SE0745.pdf
11
L. Ayalon, and O. Greed, “A Typology of New Residents’ Adjustment to Continuing Care
Retirement Communities,” The Gerontologist 56, no. 4 (2015), pp. 641-650.
12
S. G. Kelsey, S. B. Laditka, and J. N. Laditka, “Dementia and Transitioning from Assisted
Living to Memory Care Units: Perspectives of Administrators in Three Facility Type,”
The Gerontologist 50, no. 2 (2010), pp. 192-203.
13
J. Adler, Memory Care Facilities Fill a Growing Need. Chicago Tribune, (February 1, 2013).
Retrieved from http://articles.chicagotribune.com/2013-02-01/classified/ct-mre-0203memory-care-20130201_1_alzheimer-memory-loss-dementia .
14
https://www.ahcancal.org/advocacy/State LongTermPostAcute/Pages/default.
aspx#assistedliving
15
Congregate. In Merriam-Wwebster.com. Retrieved from https://www.merriamwebster.com/dictionary/congregate .
16
Adapted from Alabama Rules of Alabama State Board of Health Alabama Department of
Public Health Assisted Living Facilities (Ala. Code Chapter 420-5-4).
17
The Federal Housing Administration (FHA), part of the US Department of Housing and Urban
Development, provides mortgage insurance on loans made by FHA-approved lenders in
the US and its territories. The Section 232 loan program is administered by the Office of
Residential Care Facilities. The Section 232 loan program is known as HUD 232, “help
finance nursing home, assisted living facilities, and board and care facilities.” HUD 232
loans are offered only by FHA-approved lenders and the loans are insured or
underwritten by the US government. FHA Insurance and Section 232. (n.d.). Retrieved
March 27, 2017, from
https://portal.hud.gov/hudportal/HUD?src=%2Ffederal_housing_administration%2Fhealt
hcare_facilities%2Fresidential_care%2Ffha_insurance .
18
Multifamily Accelerated Processing (MAP) Approved Lenders. (n.d.) Retrieved March 27,
2017 from https://portal.hud.gov/hudportal/documents/huddoc?id=aprvlend.pdf .
19
B. Hamilton, “EBITDA: Still Crucial to Credit Analysis,” Commercial Lending Review 18, no.
5 (2003), pp. 47-48.
16
20
J. R. Macey, “The Limited Liability Company: Lessons for Corporate Law,” Wash. ULQ 73
(1995), p. 433.
21
S. W. Norton, “Franchising, Brand Name Capital, and the Entrepreneurial Capacity Problem,”
Strategic Management Journal 9, S1 (1988), pp. 105-114.
22
Alabama Board of Examiners of Assisted Living Administrators, Qualifications, available at:
http://www.boeala.alabama.gov/qualifications.aspx
23
T. Lewin, “Elderly Returning to Campus, This Time for Life as Retiree,” The New York Times
(February 19, 1990) retrieved from: http://www.nytimes.com/1990/02/19/us/elderlyreturning-to-campus-this-time-for-life-as-retirees.html
17
HCM 415 Milestone Three Guidelines and Rubric
Continue analyzing the situation your case study’s healthcare organization faces. In this milestone, you will continue to evaluate the impact of the mission and
vision of the healthcare organization’s strategic plan. You will also consider how the organization’s strengths, weaknesses, opportunities and threats effect the
environmental factors that confront the healthcare organization.
You will develop a 2–4-page SWOT analysis of the healthcare organization. Be sure to address the following:
A. Briefly summarize your case study.
B. To what extent do the organization’s policies address this issue? Be sure to justify your response.
C. To what extent does the organization’s strategic planning around this issue align with its organizational mission and vision? Use evidence and examples
to justify your reasoning.
D. What do you feel are the organization’s strengths, weaknesses, opportunities, and threats (SWOT) with regard to this issue? Be sure to substantiate your
claims with evidence and specific examples.
E. Based on the SWOT analysis you performed, what environmental factors are at play in terms of this issue and what is their impact on the delivery of
care within the organization? In other words, identify any new policies or new trends that will affect your day-to-day operation.
Guidelines for Submission: This short paper should be between 2 and 4 pages, not including cover page and references. This paper should be in APA format.
Instructor Feedback: This activity uses an integrated rubric in Blackboard. Students can view instructor feedback in the Grade Center. For more information,
review these instructions.
Critical Element
Overview
Exemplary (100%)
Meets “Proficient” criteria and
expertly balances brevity with
required detail
Proficient (90%)
Provides a brief summary of the
selected case study
Analysis: Policies
Meets “Proficient” criteria and
makes nuanced inferences
about the efficacy of
organizational policies or
strategic planning in addressing
issues
Logically assesses how
effectively organizational
policies or strategic planning
address the issue, justifying
response
This study source was downloaded by 100000804400461 from CourseHero.com on 10-01-2023 03:26:45 GMT -05:00
Needs Improvement (75%)
Provides a summary of the
selected case study, but
response is verbose or has gaps
in required detail
Assesses how effectively
organizational policies or
strategic planning address the
issue, justifying response, but
with gaps in logic, detail, or
justification
Not Evident (0%
Guidelines: Word count: 300to 1000 words Follow APA format for your assignment must include Introduction, Body and ConclusionAll information must be mention in APA referenceFont and Size: Times New Roman (12)Color – Black, Spacing – 1.5, Heading and sub-heading – BoldFollow APA format your assignment must include Introduction, Body & ConclusionAvoid plagiarismSubmit as word document
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Society & Drugs
Course number:
PHC 314
CRN
Essay Topic
Assignment title or task:
(You can write a question)
Societies have evolved to believe that they have the right to
protect themselves from the damaging impact of drug use and
abuse.
(a) Mention the policies and prevention programs for
combating drug use and abuse at any country you
choose ?
(b) Describe the Saudi Food & Drug Authority (SFDA)
approval process for assessing the safety and efficacy of a
newly developed drug?
Student name:
Student ID:
Submission date:
Instructor name
Grade
Dr. Ahmed Hazazi
… out of 10
Guidelines:
•
Word count: 300to 1000 words
•
Follow APA format for your assignment must include Introduction, Body and Conclusion
•
All information must be mention in APA reference
•
Font and Size: Times New Roman (12)
•
Color – Black, Spacing – 1.5, Heading and sub-heading – Bold
•
Follow APA format your assignment must include Introduction, Body & Conclusion
•
Avoid plagiarism
•
Submit as word document
HealthCare Finance Project- Capital Budgeting and Recommendations
Capital Budget Process
Narrative:
Identify the desired goal and alternatives.
Identify and briefly explain sunk and opportunity costs considered in your capital budget decisions.
Explain your budget and decisions once your spreadsheet for your Capital Budget is completed.
Reintroduce the service/unit you are recommending in no more than 1-2 sentences. Then provide a 2-3 paragraph budget narrative to justify the budgeting decisions you made.
Use of formal APA is required for this assignment. At a minimum, you will be citing 1-2 sources within your budget narrative.
I will give you a patient details and I want you to use it for the concepts map I uploaded here. Please be a nursing professional it’s not for any tutor to answer.3 concern2 nursing diagnosis 6 nursing interventions outcome : should be SMART (SMART stands for Specific, Measurable, Achievable, Realistic, and Time-bound.)
Unformatted Attachment Preview
Assessment Data
Pathophysiology
Priority Patient Concerns
Patient Information and Medical Diagnosis
Nursing Diagnosis
Nursing Interventions
Patient Teaching
Diagnostics and Lab
Patient Outcomes
www.mindandconceptmaps.com
Letter Essay Assignment (worth 10 points)
The top 4 modifiable risk factors that result in much of our country’s illness, suffering, and death are
•
•
•
•
Lack of physical activity
Poor nutrition
Tobacco Use
Excessive Alcohol Intake
Writing Prompts
For your assignment, you are to research one of these risk factors and write a letter to someone you
know who practices this behavior and explain why they should modify it.
You are required to:
1) Provide factual/statistical evidence to support why this behavior is hurting their health
2) Explain what the consequences of continuing this behavior might be and how it would benefit them if
they stopped.
3) Provide research-based advice on how to stop this behavior
Technical Requirements
•
•
•
•
•
•
•
Your essay should be a minimum of 3 pages and not 1 sentence less. This does not include the
works cited page.
12-point font (Times New Roman, Calibri, or Arial)
Double spaced
Written and saved in Word format (.doc, .docx)
1-inch margins
Written in paragraph format and cited in APA format (with in-text citations!)
1 works cited page (APA format) with a minimum of 2 professional sources. If you do not include
a works cite page, you will receive a zero on grounds of plagiarism.
What Is Considered a Professional Source?
1. Websites that end in .gov or .org
2. Textbooks, books, science/health journals, encyclopedias (you may use UH’s online library to find
these)
3. Websites pre-approved by Professor Rafique
Do Not Ramble
Your paper should be research based. Do not ramble or BS! This is still a research assignment. Keep
personal introductions to 1 paragraph long (4-5 sentences).
Rough Rubric (graded out of 10 points)
Provided accurate facts/statistical evidence for
why behavior is hurting their health and
addressed all writing prompts.
Correctly used APA format and followed technical
requirements
Spelling and grammar
4 pts.
3 pts.
3 pts.
I will be grading for accuracy of facts, grammar and spelling, and the overall quality/professionalism of
your writing.
3 points are automatically deducted for each page length you fall short of the minimum length.
I reserve the right to deduct points drastically if your paper shows significantly poor spelling/grammar,
inaccurate facts, or minimal addressing of writing prompts, looks like you BS’d the whole thing etc.…
Abusing the technical requirements in anyway (e.g. typing in Arial Black, leaving lines of empty space
within your work) will also result in drastic point deductions.
Remember, your paper should look professional. It should not look like my syllabus, my study guides, or
this instructions with bullet lists, numbered lists, different colors, random bolded words, or highlighted
sentences!
Can I Keep My Recipient Anonymous?
You do not have to include the person’s name. Instead, write “Dear Anonymous.” If you are lucky
enough not to know anyone that practices any of these behaviors, pretend that you know someone that
does and write a letter to them.
What Do People Usually Lose Points On?
Students tend to get lazy as far as thorough research goes. For example, if you choose alcohol as your
topic and fail to mention liver cirrhosis as a risk of alcoholism, I will know you barely researched your
topic since liver cirrhosis is a hallmark condition of alcohol abuse.
People also tend to get lazy on writing prompt 3 and provide non-researched advice. Make sure you are
actually reading articles and not just giving your reader generic advice off the topic of your head.
What Does Professor Rafique like to See in Essays?
I like to see facts and statistics from your lecture notes, textbook chapters, and reviews. For example, if
you are writing about lack of physical activity—address the topics you read about in chapter 3! If you
choose to write about nutrition, go over the things you learned in your chapter 5 lecture notes! I want to
see you apply your knowledge in this essay.
Your Heading Must be Formatted as Follows:
Name
HLT 1353: Section #
Title
That’s it. No cover page. No headings that take up lines and lines of writing space. No hardentering between paragraphs. I will deduct points if your heading eats up too much space.
APA Format
I like to require APA format in order to familiarize you with this style of citing work. If you need help,
visit Purdue Owl’s website on APA format or visit the writing center on campus. It is a simple format.
Download the latest version of Word from AccessUH and you will not even need to research this style
much—simply use the “references” tab to enter your sources and auto-generate in-text citations as well
as your works cited page.
https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/genera
l_format.html
It’s 11:00PM and something messed up with my essay…
Without fail, students will always wait until the last minute to submit essays, something will go wrong
with their computers, and they will email me their essays. If you do this, I will take points off as it is time
consuming for me to have to fish-out emailed essays and grade them outside of my grading portal.
How do I submit my work?
You must upload your file as a Word file (.doc or .docx) and copy/paste it in the submission box. You
must copy/paste your work so I have evidence you completed it on time in the event your file is corrupt.
Guidelines:Word count: 300to 1000 words Follow APA format for your assignment must include Introduction, Body and ConclusionAll information must be mention in APA referenceFont and Size: Times New Roman (12)Color – Black, Spacing – 1.5, Heading and sub-heading – BoldFollow APA format your assignment must include Introduction, Body & ConclusionAvoid plagiarismSubmit as word document
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Society & Drugs
Course number:
PHC 314
CRN
Essay Topic
Assignment title or task:
(You can write a question)
Societies have evolved to believe that they have the right to
protect themselves from the damaging impact of drug use and
abuse.
(a) Mention the policies and prevention programs for
combating drug use and abuse at any country you
choose ?
(b) Describe the Saudi Food & Drug Authority (SFDA)
approval process for assessing the safety and efficacy of a
newly developed drug?
Student name:
Student ID:
Submission date:
Instructor name
Grade
Dr. Ahmed Hazazi
… out of 10
Guidelines:
•
Word count: 300to 1000 words
•
Follow APA format for your assignment must include Introduction, Body and Conclusion
•
All information must be mention in APA reference
•
Font and Size: Times New Roman (12)
•
Color – Black, Spacing – 1.5, Heading and sub-heading – Bold
•
Follow APA format your assignment must include Introduction, Body & Conclusion
•
Avoid plagiarism
•
Submit as word document
This assignment have 2 discussions with specific instructions. They should include 250-300 words and 1 reference each one and they both need 2 peer responses of 150 words and 1 reference.
Discussion 1: Select a state or federal law or regulation related to patient safety that has been implemented within the last five years requiring hospitals or any other health care organizations to change the way they manage the delivery of care. Discuss the changes that have occurred because of this law or regulation.
Additionally, discuss the technology associated with either your selected law/regulation or a similar one. Are there ethical dilemmas that have resulted from technology changes when delivering care to patients or patient safety? Explain the dilemmas and how they might be resolved.
Please keep in mind that the law or regulation mentioned has been implemented in the last 5 years. All instructions needs to be addressed.
Discussion 2: Evidence-based practice is extremely important in nursing. Throughout your master’s program, you will complete research on various topics. Knowing how to construct a strong problem statement and complete a critical analysis of the available information to write a literature review is essential.
This week, you will write a problem statement and perform a literature review in preparation for your ethical issues debate presentation. Share your problem statement in this discussion so that you can review each other’s work and provide peer-to-peer feedback. Also, describe what you think are the most important learning takeaways from the literature review resources you reviewed.
Follow the instructions in the bullets below to direct you where to find resources on problem statements and literature reviews:
Go to the Student Resources page.
Click on Research and Writing.
Then view:
Writing a Problem Statement
What is a Literature Review
Conducting a Literature Review
Follow the instructions in this announcement for discussion 2
Debate Assignment Statement: When a patient is in the end-of-life decision, should food or water be withheld? Position Against
Week 5 Discussion Question 2 Sample
Class,
I know you do not see each other’s discussion question until you post your own. Therefore, I am providing a sample and would like you to follow this format when answering.
You may ask yourself why is a problem statement so important. Well, “A problem statement is a statement of a current issue or problem that requires timely action to improve the situation. This statement explains the barrier the current problem places between a functional process and/or product and the current (problematic) state of affairs. This statement is completely objective, focusing only on the facts of the problem and leaving out any subjective opinions. To make this easier, it’s recommended that you ask who, what, when, where and why to create the structure for your problem statement. This will also make it easier to create and read, and makes the problem at hand more comprehensible and therefore solvable. The problem statement, in addition to defining a pressing issue, is a lead-in to a proposal of a timely, effective solution.
Here is an example of how I would like your discussion question # 2 to be completed:
Carey, You are in luck, I am using your topic as the example so you just need to copy and paste to this week’s discussion question 2
Debate Assignment:
1 Should Healthcare be a right? For
So lets break it down: Let’s see how we use the 5 w’s : who, what, when, where and why to create the structure for your problem statement.
Literature review:
The “right” to healthcare, particularly in America (USA), is hotly debated and poorly understood because distinct arguments against are often seen as mutually exclusive of healthcare rights. Those arguments against are most often driven by economic concerns (and profit margins). Therein, the “right to healthcare” idea remains in a sort of political and economic limbo due to positions established outside of the philosophical and practical history of the human condition. In fact, in one point of view, it is the human condition of birth, life, sickness, and death that forms the requirement for healthcare and the power of a profitable healthcare delivery industry. Separate from this societal fact, the human condition is the characteristics, experiences, actions, and results from the fact of being alive, from simply being human. The argument against healthcare as a right because of economic proliferation is not altogether cruel or shallow but instead is not aligned with ethical distinctions that have long served humanity. Therefore, it is the intent of this treatment to provide an understanding of the depth of human ethics and what it is to be human in the light of Martha Rogers’s theory of the “Unitary and Irreducible Human” presenting a formidable albeit complex but well-defined settlement that healthcare is a right.
Additional insight:
“The right to health care has long been recognized internationally. Ironically, the origins of this right are here in the United States. Health care was listed in the Second Bill of Rights drafted by Franklin Delano Roosevelt (FDR). Sadly, FDR’s death kept this Second Bill of Rights from being implemented. Eleanor Roosevelt, however, took his work to the United Nations (UN), where it was expanded and clarified. She became the drafting chairperson for the UN’s Universal Declaration of Human Rights (UDHR). That committee codified our human rights, including, at Article 25 (Links to an external site.)Links to an external site., the essential right to health. The United States, together with all other nations of the UN, adopted these international standards. ”
“Article 12 goes on to require that “states must protect this right by ensuring that everyone within their jurisdiction has access to the underlying determinants of health, such as clean water, sanitation, food, nutrition, and housing, and through a comprehensive system of health care, which is available to everyone without discrimination, and economically accessible to all.”
Health Care As a Human Right by Mary Gerisch
Health Care As a Human Right (americanbar.org) (Links to an external site.)Links to an external site.
The Who: Humans
The What: Should have the Right to Healthcare
When: from birth
Where: In the United States
Why: According to Article 25 in the second bill of rights, all Americans have a right to health and states are required to provide a comprehensive system of health.
Suggested Problem Statement:
Human beings should have the right to healthcare when born in the United States because according to Article 25 in the second bill of rights, all Americans have a right to health and states are required to provide a comprehensive system of health.
This assessment addresses the following course objective(s):
Consider the role of government and various professional organizations in the process of planning and implementing policies at managements levels for diverse healthcare environments.
Instructions
Professional associations like the American Medical Association, American Nurses Association, and others actively facilitate member engagement in political advocacy. For this assignment, you will research political advocacy models of professional associations, and develop a program outline to be proposed to a professional association or group of your choosing.
Objective: Political advocacy program proposal
Audience:
Primary – Members of a professional association or group (local/state/institutional).
Secondary – Leadership team of the association or group. Those who will approve your proposal.
Elements to include (but not limited to):
Proposal abstract
Need assessment (why this is needed in your profession/location)
Supporting research
Goals and Objectives
Governance structure (leadership roles)
Membership (member base, recruitment)
Proposal summary
Length: A minimum of three pages of content.
APA requirements: Title, reference page, a minimum of three references. In-text citations should be used to support your proposal.
Submit
Word document
Assignment Resources…..ATTACHED IN WORD DOCUMENT!
Assignment Rubric…..ATTACHED IN WORD DOCUMENT!
Unformatted Attachment Preview
American Nurses Association. (n.d.). AdvocacyLinks to an external site.. [Website].
https://www.nursingworld.org/practice-policy/health-policy/health-systemreform/quality/advocacy/
National Council for the Social Studies. (n.d.). Advocacy Planning: Your 10-Step PlanLinks
to an external site.. [Website]. https://www.socialstudies.org/advocacy/advocacyplanning-your-10-step-plan-0
O’Reilly, Kevin. (2022 Jun 3). 10 principles to fix Medicare’s unsustainable physician pay
systemLinks to an external site.. American Medical Association. https://www.amaassn.org/practice-management/medicare-medicaid/10-principles-fix-medicare-sunsustainable-physician-pay
Political Advocacy Program (1)
Political Advocacy Program (1)
Criteria
This criterion is linked
to a Learning
OutcomeProposal
Abstract
This criterion is linked
to a Learning
OutcomeNeed
Assessment
This criterion is linked
to a Learning
OutcomeGoals and
Objectives
Ratings
15 pts
Level 5
Ideas and
concepts are
consistently clear
and always well
explained and
supported
13.5 pts
Level 4
Ideas and
concepts are
clear and well
explained and
supported.
12 pts
Level 3
Ideas and
concepts are
reasonably
explained and
somewhat
supported.
10.5 pts
Level 2
Basic ideas and
concepts are
presented; however,
they are
underdeveloped and
poorly explained.
9 pts
Level 1
Some basic
ideas and
concepts are
started, but
not developed
15 pts
Level 5
Ideas and
concepts are
consistently clear
and always well
explained and
supported
13.5 pts
Level 4
Ideas and
concepts are
clear and well
explained and
supported.
12 pts
Level 3
Ideas and
concepts are
reasonably
explained and
somewhat
supported.
10.5 pts
Level 2
Basic ideas and
concepts are
presented; however,
they are
underdeveloped and
poorly explained.
9 pts
Level 1
Some basic
ideas and
concepts are
started, but
not developed
15 pts
Level 5
Ideas and
concepts are
consistently clear
and always well
explained and
supported
13.5 pts
Level 4
Ideas and
concepts are
clear and well
explained and
supported.
12 pts
Level 3
Ideas and
concepts are
reasonably
explained and
somewhat
supported.
10.5 pts
Level 2
Basic ideas and
concepts are
presented; however,
they are
underdeveloped and
poorly explained.
9 pts
Level 1
Some basic
ideas and
concepts are
started, but
not developed
Political Advocacy Program (1)
Criteria
This criterion is linked
to a Learning
OutcomeGovernance
Structure
This criterion is linked
to a Learning
OutcomeMembership
This criterion is linked
to a Learning
OutcomeProposal
Summary
Ratings
15 pts
Level 5
Ideas and
concepts are
consistently clear
and always well
explained and
supported
13.5 pts
Level 4
Ideas and
concepts are
clear and well
explained and
supported.
12 pts
Level 3
Ideas and
concepts are
reasonably
explained and
somewhat
supported.
10.5 pts
Level 2
Basic ideas and
concepts are
presented; however,
they are
underdeveloped and
poorly explained.
9 pts
Level 1
Some basic
ideas and
concepts are
started, but
not developed
15 pts
Level 5
Ideas and
concepts are
consistently clear
and always well
explained and
supported
13.5 pts
Level 4
Ideas and
concepts are
clear and well
explained and
supported.
12 pts
Level 3
Ideas and
concepts are
reasonably
explained and
somewhat
supported.
10.5 pts
Level 2
Basic ideas and
concepts are
presented; however,
they are
underdeveloped and
poorly explained.
9 pts
Level 1
Some basic
ideas and
concepts are
started, but
not developed
25 pts
Level 5
Ideas and
concepts are
consistently clear
and always well
explained and
supported
22.5 pts
Level 4
Ideas and
concepts are
clear and well
explained and
supported.
20 pts
Level 3
Ideas and
concepts are
reasonably
explained and
somewhat
supported.
17.5 pts
Level 2
Basic ideas and
concepts are
presented; however,
they are
underdeveloped and
poorly explained.
15 pts
Level 1
Some basic
ideas and
concepts are
started, but
not developed
Political Advocacy Program (1)
Criteria
Ratings
This criterion is linked
to a Learning
OutcomeWriting
Conventions
10 pts
Level 5
The paper
exhibits a
superior
command of
written
English
language
conventions.
The paper has
no errors in
mechanics,
grammar, or
spelling.
9 pts
Level 4
The paper exhibits
a stronger
command of
written English
language
conventions. The
paper has no
errors in
mechanics,
grammar, or
spelling that
impair the flow of
communication.
8 pts
Level 3
The paper
exhibits a
command of
written English
language
conventions. The
paper has minor
errors in
mechanics,
grammar, or
spelling that
impact the flow of
communication.
7 pts
Level 2
The paper exhibits
a limited
command of
written English
language
conventions. The
paper has frequent
errors in
mechanics,
grammar, or
spelling that
impede the flow
of
communication.
6 pts
Level 1
The paper
exhibits little
command of
written English
language
conventions.
The paper has
errors in
mechanics,
grammar, or
spelling that
cause the
reader to stop
and reread
parts of the
writing to
discern
meaning.
Political Advocacy Program (1)
Criteria
Ratings
This criterion is linked
to a Learning
OutcomeAPA
10 pts
Level
The required
APA elements
are all included
with correct
formatting,
including intext citations
and references.
9 pts
Level 4
The required
APA elements
are all included
with minor
formatting
errors,
including intext citations
and references.
8 pts
Level 3
The required
APA elements
are all included
with multiple
formatting
errors,
including intext citations
and references.
7 pts
Level 2
The required
APA elements
are not all
included and/or
there are major
formatting
errors, including
in-text citations
and references.
6 pts
Level 1
Several APA
elements are
missing. The errors
in formatting
demonstrate a
limited
understanding of
APA guidelines, intext-citations, and
references.
Share a link to a recent public health news article that highlights a topic from the list below, which is related to our course content. You can choose a topic at the global, national, state, or local level. Summarize the article and explain why it is important to community health nursing, and why you want your peers to know about the topic.
You must include an APA formatted reference for the article posted.
Public Health In the News
Public health programs highlighted in the news
Screenings, free vaccine programs, health fairs, etc.
Mental health
Issues r/t access to care, new programs or community-based interventions
Infectious Diseases
Influenza, Covid-19, etc.
Nursing News
R/t professional organizations, lobbying efforts
Environmental concerns
Climate change, deforestation, etc.
Firearms
Access to guns, issues r/t violence, increased crime, policy
Reproductive rights
Abortion access, birth control, other reproductive health services
Changes and potential future changes in healthcare policy at the federal, state or local level
Food safety
Food recalls, illness outbreaks at local establishments, etc.
Emergency Preparedness
Funding for Public Health initiatives and responses
Opioid Crisis or other substance abuse issue
Any other topic that you first review with me
AHLT 310 Healthcare Manager/Leader Portfolio Project
Course Objectives Relevant to this Portfolio Project
Upon successful completion of AHLT 310, you will be able to:
1. Identify and explain the challenges of transitioning from working as a clinician to a
supervisory/managerial position.
2. Identify and explain the basic managerial functions of planning, organizing, coordinating,
controlling, and policy development and their applications in healthcare organizations.
3. Describe the effective use and challenges of delegation, empowerment, decisionmaking, problem-solving, and budgeting in high-performing healthcare organizations.
4. Describe the value and effective use of communication skills and customer service
principles in healthcare organizations.
Portfolio Project Objective
By the end of this portfolio project, you will have created a comprehensive body of work
designed to enhance your skills and understanding in healthcare management and leadership.
This project specifically targets the first four objectives of the course, aiming to:
• Equip you with a solid grounding in various healthcare leadership styles through
academic research.
• Enable you to identify and analyze your personal leadership strengths using the Clifton
Strengths assessment.
• Provide you with the opportunity to synthesize academic and personal insights into a
research paper that explores leadership in healthcare settings.
The portfolio is segmented into three main parts:
1. Article Summaries and Critiques: This section is focused on leadership styles, allowing
you to explore scholarly perspectives on healthcare leadership.
2. Clifton Strengths Self-Assessment and Leadership Styles Paper: In this part, you will
identify your individual strengths and explore leadership styles that resonate with you.
3. Research Paper on Leadership: This final segment encourages you to meld academic
theories with your own strengths, providing a comprehensive perspective on leadership
in healthcare.
Through active engagement in each part of this portfolio, you will gain essential knowledge and
skills directly aligned with the course’s first four objectives, preparing you for effective
managerial roles in healthcare settings.
Part I: Article Summaries and Critiques on Leadership Styles (5%)
Due: End of Week 6
Course Objectives Covered: #1, #2
Brief Overview:
In this part, you will focus on understanding various leadership styles in healthcare by reviewing
three articles from peer-reviewed journals.
Instructions:
• Choose three articles related to various leadership styles/theories in healthcare from
peer-reviewed journals.
• For each article, use the APA citation as the heading.
• Include the following headings for each article:
• Summary
• Professional Critique
• Personal Critique
• Questions for Research Paper – what question(s) about your leadership paper
does this article answer? Try to aim to have 3 questions per article
Grading Rubric:
Criteria
Excellent (5)
Good (4)
Satisfactory (3) Needs
Improvement (1-2)
Article
Selection
Peer-reviewed
and highly
relevant
Peer-reviewed
and relevant
Peer-reviewed
but less
relevant
Summary
Concise, insightful Adequate
Vague or
summary for each summaries with incomplete
article
minor omissions summaries
Missing or
irrelevant
summaries
Critique
Balanced, wellargued critique
for each article
Mostly balanced One-sided or
but lacks depth lacks clarity
Missing or
irrelevant critiques
Grammar
& Style
No errors; clear
and professional
Few minor
errors; mostly
clear
Poor grammar and
style affecting
comprehension
Several errors
affecting
readability
Not peer-reviewed
or irrelevant
Part II: Clifton Strengths Self-Assessment and Leadership Styles Paper (15%)
Due: End of Week 8
Course Objectives Covered: #1, #2, #3
Brief Overview:
In this part, you will conduct a Clifton Strengths self-assessment to better understand your
leadership strengths. You will also choose three leadership styles that you are interested in and
reflect on how your strengths align with these styles.
Instructions for Self-Assessment (Clifton Strengths) (5%):
• Complete the Clifton Strengths self-assessment.
• Write a one-page reflection on your top strengths and their relation to leadership.
Instructions for Leadership Styles Paper (10%):
•
•
•
Choose three leadership styles you’re interested in.
Write a 3-4 page paper discussing these styles and their relevance to healthcare.
Discuss how your Clifton Strengths align with these leadership styles.
Grading Rubric:
Criteria
Excellent (15)
Good (12)
SelfAssessment
Insightful
Adequate
reflection; well- reflection;
integrated results some
integration
Leadership
Styles Paper
Excellent
synthesis;
insightful
Good synthesis; Satisfactory
somewhat
synthesis;
insightful
limited insight
Poor synthesis;
lacks insight
Grammar &
Style
No errors; clear
and professional
Few minor
errors; mostly
clear
Poor grammar and
style affecting
comprehension
Part III: Research Paper on Leadership (10%)
Due: By the end of Week 14
Course Objectives Covered: #1, #2, #3, #4
Brief Overview:
Satisfactory (9)
Needs
Improvement (1-8)
Vague
Missing or
reflection; lacks irrelevant
integration
reflection
Several errors
affecting
readability
For this part, you will write a research paper focused on leadership. The paper should discuss
three leadership styles you feel you resemble, based on the Clifton Strengths assessment and
articles you’ve read.
Instructions:
• Write a 10-12 page research paper discussing three leadership styles you feel you
resemble, supported by at least 2 of the articles reviewed in Part I and 5 additional
articles.
• Reflect on the Clifton Strengths assessment results, discussing what seems accurate and
what doesn’t.
• Final submission must include the following:
• Cover page to include the title of your portfolio, name of the course, Fall 2023,
your name
• Table of Contents – should be formatted in APA
• Executive Summary
• Article Reviews and Critiques (modified based on feedback)
• Clifton Strengths Reflection Paper
• Leadership Paper
• Reference page
• Appendix – anything you would like to include (Optional). If you include
something here, you have to cite it.
Grading Rubric:
Criteria
Excellent (10)
Good (8)
Satisfactory (6)
Content
Comprehensive;
well-researched
Thorough;
mostly wellresearched
General; limited Shallow; poorly
research
researched
Organization Well-organized;
logical flow
Mostly
organized;
minor issues
Somewhat
disorganized;
lacks flow
Poorly organized;
lacks coherence
Grammar &
Style
Few minor
errors; mostly
clear
Several errors
affecting
readability
Poor grammar and
style affecting
comprehension
No errors; clear
and professional
Needs
Improvement (1-5)
Mr. Timothy was seen today while in the community after his morning job. He verbalized to be in good state of mind. Denied suicidal ideation, pain and no discomfort. Client stated occasional stress probably due to nature of his job where he will have to stand twice a day from hour of 7:30-10:30am and 2:30-4:30pm. Client experience sweating and frequent urination and he feels dehydrated sometime. Client was educated that sweating and frequent urination are expected with diabetes. Client was encouraged to drink more water and take rest as needed. Client will go every where with bottle water and drink frequently. He was further encouraged to buy pitcher to get clean water in any nearby restaurant. Follow rubric below
Due Sunday by 11:59pm
Points 50
Submitting a text entry box or a file upload
Unit 4Theory Chart
Unit 4: Introduction (1 of 4)
Unit 4: Reading and Activities (2 of 4)
Current Assignment: Unit 4: Assignment Theory Chart (3 of 4)
Unit 4: Discussion Relational Theories (4 of 4)
Instructions
Use the chart attached below each week to document theories covered in the class readings and films. You may copy and paste main points, definitions, and the theorist names from the readings. Do not copy information from your peers. The Application to practice section should be in your own words so you can demonstrate integration of theory to practice. The spaces in the chart will expand as needed. You will submit this chart each week throughout the semester. By the end of the semester, you will have a complete study guide of relevant theories and their application to Social Work practice. Each week is worth up to 50 points for a total of 700 points for the course.
In the chart, please address the following theories:
Psychodynamic Theory – Freud
Relational theory – Jean Baker Miller
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.
Estimated time to complete 2 hours
Assignment Resources
MSW600 Theory ChartDownload MSW600 Theory Chart
Rubric
Unit 4 Theory Chart Rubric
Unit 4 Theory Chart Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeCompetency 6.7.8Main points of the theory
20 pts
Exceptional Demonstration
Listed or summarized the main points of the theories in exceptional detail. Described how the theory contributed to understanding people. Described in exceptional detail how the theories considers human differences and is culturally informed. Described the limitations of the theory in detail.
18 pts
Proficient Demonstration
Listed or summarized the main points of the theory in exceptional detail. Described how the theories contributed to understanding people. Described in profecient detail how the theory considers human differences and is culturally informed. Described the limitations of the theory in detail.
16 pts
Competent Demonstration
Listed or summarized the main points of the theories in exceptional detail. Described how the theories contributed to understanding people. Described in detail how the theory considers human differences and is culturally informed. Described the limitations of theories.
12 pts
Emerging Demonstration
Listed some of the main points of the theories. Described how the theory contributed to understanding people. Attempted to describe how the theories considers human differences and is culturally informed. Described the limitations of the theory. Or, only provided information on partial theories this week.
8 pts
Attempted Demonstration
Listed limited points of the theories. Described how the theories contributed to understanding people. Attempted to describe how applied to human differences. Described some limitations of the theories. Or only provided information on one theory this week.
0 pts
Not Competent
Did not complete
20 pts
This criterion is linked to a Learning OutcomeVocabulary
10 pts
Exceptional Demonstration
Clearly provided key words and exceptional definitions from each theory
8 pts
Proficient Demonstration
Clearly provided key words and definitions from each theory
7 pts
Competent Demonstration
Provided key words and definitions for each theory
5 pts
Emerging Demonstration
Provided key words and definitions for some theories this week.
3 pts
Attempted Demonstration
Attempted to provide some definitions for some theories this week.
0 pts
Not Competent
Did not complete
10 pts
This criterion is linked to a Learning OutcomeCompetency 6.7.8Application to practice
20 pts
Exceptional Demonstration
Exceptionally linked all theories to practice. Provided many examples of who theories apply to working with clients. Included information on how all theories will help prepare them to engage, assess, and intervene with clients.
18 pts
Proficient Demonstration
Clearly linked the theories to practice. Provided several examples of how theories apply to working with clients. Included information on how theory will help prepare them to engage, assess, and intervene with clients.
16 pts
Competent Demonstration
Provided links to practice. Provided examples of how theories apply to working with clients. Included information on how theories will help prepare them to engage, assess, and intervene with clients.
12 pts
Emerging Demonstration
Provided links to practice. Provided examples of how theories apply to working with clients. Included information on how theories will help prepare them to engage, assess, and intervene with clients. Only completed partial assigned theories this week.
8 pts
Attempted Demonstration
Provided superficial view of how theories apply to working with clients. No specifics or not all theories covered.
Use the information below to help you know which section of the article to use to answer questions in the template:Introduction and its subsections have the purpose or WHY the study was done.Methods section and its subsections contain HOW the study was done.Results, Discussion, and Conclusions section will have WHAT was found. Each section of the template is required to be completed as this assignment builds on your Evidence-Based Practice Project. Each template has a citation that must be submitted in APA format. Answers to questions in Synopsis sections are required (see template examples in your book). Each question must have an answer of 1-2 full sentences in length per question. Credibility section Yes/No answers are also required. The Comments area is also required and should be at least 1-3 sentences noting how this article relates to your nursing issue topic from week 3 and what you thought was significant.My topic has been on Venous Thromboembolism attached below is the documents which need to be filled out and the pdf articles which are to be used
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Res Pract Thromb Haemost. 2021 Aug; 5(6): e12593.
PMCID: PMC8435525
Published online 2021 Sep 12. doi: 10.1002/rth2.12593
PMID: 34532630
RESOURCES
The use of qualitative methods in venous thromboembolism research
Similar articles
Jackeline Hernandez‐Nino, MD, 1 Mary Thomas, MD, MPH, 2 Andreia B. Alexander, MD, PhD, MPH, 1 Mary A. Ott,
MD, MA, 3 and Jeffrey A. Kline, MD 1
▸ Author information ▸ Article notes ▸ Copyright and License information
Links to NCBI Databases
PMC Disclaimer
Associated Data
▸ Supplementary Materials
Abstract
Go to: ▸
Introduction
Qualitative research has been increasingly used in health care research to allow in‐depth insights and
understanding of patients’ lived experiences for poorly understood phenomena. The psychological stress
mechanisms underlying fear, dyspnea, and pain after venous thromboembolism (VTE) remain poorly
understood. However, novice VTE researchers may not be familiar with the process of undertaking
qualitative research.
Objective
The aim of this article is to describe the planning, methodology and execution of qualitative methods,
using the example of patients’ lived experiences during and after the diagnosis of VTE. We discuss
challenges and solutions in implementing qualitative research methods in health care research.
Methods
Patients were recruited from the emergency department and clinic using in‐person and phone contact. We
used both in‐person and video format to interview 24 patients. Interviews were guided by a set of
questions to be explored but conducted to elucidate unique thoughts and opinions from patients.
Results
For recruitment, “cold‐calling” was found to be largely unsuccessful. Many patients have preexisting
diagnoses of anxiety and depression. Video interviews were found to be at least as effective as in‐person
interviews. Interviews revealed unique post‐VTE experiences from all participants, with a wide range of
impact on quality of life. Themes that were most common included perceptions of physician
communication, fear of recurrence, and concerns of death.
Conclusion
A qualitative research approach can reveal individual experiences and psychosocial impact in patients
diagnosed with VTE, which allow the researchers to better comprehend the complexity of this
phenomenon and its impact in health care.
Keywords: challenges, methods, psychological stress, qualitative research, solutions, venous
thromboembolism
Essentials
Health care researchers may not be familiar with starting a qualitative study.
Qualitative research was used to explore lived experiences in patients with blood clots.
This provides a detailed account of the planning and execution of a qualitative project.
Challenges and solutions are described to guide new researchers.
1. INTRODUCTION
Go to: ▸
Despite the increasing acceptance of qualitative methods in health care research, qualitative methods have
been slow to impact research and medical practice related to venous thromboembolism (VTE).
Qualitative research, through detailed descriptions and open‐ended approaches, offers a different
approach to identify what is important for patients and to improve health care experiences. It allows
researchers to reach areas that cannot be measured by quantitative research.1 For patients with VTE,
overutilization of emergency departments (EDs) is an example of a significant health care problem with
high financial and human costs that could benefit from qualitative approaches.2
Qualitative research involves collecting and analyzing nonnumerical data to understand human
experiences, conveyed by the expression of opinions, behaviors, concepts, beliefs, attitudes, and
interactions with other humans.3 Qualitative methods allow access to in‐depth insights and understanding
of real‐world problems from the patient perspective and are particularly helpful when little is known
about a topic, when quantitative results are unexpected, or when a problem, like overuse of EDs, proves
to be persistent and recalcitrant to interventions. Qualitative methods do not require an a priori
hypothesis, or preidentification of variables, making them ideal when a health services topic is poorly
understood.4 Qualitative methods are an important tool for health care, as they can identify the impact of
social determinants such as sex, education, poverty, race, or religion on the conduct and outcomes of
research.5, 6
Over the past decade, there has been increasing attention to the quality and rigor of qualitative studies in
health research generally, including methodological guidelines for qualitative health research. Checklists
have been published to improve the reporting of research methods, coding, analysis, and results, as well
as the interpretation of qualitative work, which allow a structured and reproducible critique of qualitative
research (checklist for the current manuscript is provided in supplemental information).7 Missing,
however, from existing methods literature are detailed examples of how qualitative research methods can
be applied and discussions of challenges, solutions, and adaptations.
Using the case of venous thromboembolism (VTE) research, we describe a qualitative approach to
understand patients’ lived experiences of VTE. The purpose of this article is to describe the application
of qualitative methods, as well as challenges and solutions, in implementing qualitative research on health
care topics. We first provide a detailed account of the planning and execution of a qualitative project and,
second, describe challenges and solutions for future researchers selecting qualitative methods.
2. DISEASE MODEL: VTE
Go to: ▸
The target condition for this work is VTE, defined as deep vein thrombosis (DVT), pulmonary embolism
(PE), or both. VTE affects >600,000 individuals in the United States each year, causing considerable
morbidity and mortality.8, 9 About 5% to 15% of patients with VTE have a recurrence in the first year if
anticoagulation therapy is discontinued after 3 to 6 months.10 By 10 years, approximately 40% of patients
with unprovoked VTE will have experienced a recurrence, increasing risks for complications and
mortality.
In addition to the risk of recurrence, ≈30% of PE survivors develop substantial ongoing reductions in
mental and physical health that greatly impair their quality of life.11, 12, 13, 14 If DVT is included, the
number affected at least doubles, in part because of the impact of the postthrombotic syndrome, a chronic
consequence of DVT characterized by leg swelling, pain, edema, venous ectasia, and skin induration.15
Persistent symptoms likely amplify fears of recurrence,16, 17 and these fears, coupled with concerns about
side effects of anticoagulants used to treat the condition, contribute to a lifelong cognitive and health
burden. It is thought that persistent symptoms and fears may play a causative role in frequent ED visits.
These visits can result in unnecessary testing that requires ionizing radiation, are costly (both financially
and personally), and do not change plans of care. This low‐value use of the ED contributes to the high
long‐term economic burden of VTE.18, 19
Accordingly, this qualitative study was undertaken with the belief that qualitative methods can provide an
opportunity for a better in‐depth understanding of how and why the diagnosis of VTE may impact
individuals and their use of the health care system.
3. QUALITATIVE RESEARCH DESIGN
Go to: ▸
A qualitative method, in‐depth individual interviews, was selected to allow for richly detailed data about
the lived experiences of patients diagnosed with VTE and the psychosocial impact of VTE on patients.
This approach was selected because there is little known about patients’ lived long‐term experience of
VTE, and in‐depth individual interviews (similar to other qualitative approaches) allowed our team to
generate an explanation of a process of health care usage shaped by the views of a number of participants
on this particular phenomenon.20 For patients with VTE, limited prior research has described their goals,
fears, expectations, values, concerns and anxiety.17, 21, 22, 23 This qualitative analysis allows us to describe
the lived reality that consists of people’s individual experiences and how individuals interpret those
experiences. Using textual data from interviews, the aim of this research was to generate explanations and
theories on how individuals with VTE use health services.
We chose to use additional quantitative measures to more accurately describe participants’ severity of
VTE and comorbid conditions, such as anxiety, posttraumatic stress disorder, and postthrombotic
syndrome, and quality of life after VTE. Quantitative self‐administered surveys were administered
immediately after the interview. The addition of quantitative measures to this primarily qualitative study
allowed us to compare patients’ experiences with more objective measures of disease severity and
comorbidities.
4. SAMPLING AND RECRUITMENT METHODS
Go to: ▸
Purposive sampling was used to identify participants. Purposive sampling is a nonprobability sampling
approach in which informants are selected to capture a range of experiences and characteristics.4 Ideally,
informants will be willing to share their experiences and have good communication skills and the ability
to reflect upon their experiences. For this study, we sought a range of ages, varied types and severity of
VTE (PE only, PE and DVT, or DVT only). We also sought participants who had a wide variety of health
care experiences, including those who were discharged home from the ED or had more intensive
treatment (eg, reperfusion therapy), and those representing a wide range of VTE recurrences, time since
diagnosis, and ED visits. See Table 1 for participant information.
TABLE 1
Clinical characteristics of participants
Female (n = 15) (%) Male (n = 9) (%) Total (n = 24) (%)
Age, y
50
9 (37.5)
5 (21)
14 (58.5)
Black
6 (25)
2 (8.5)
8 (33.5)
White
9 (37.5)
7 (29)
16 (66.5)
Married
6 (25)
6 (25)
12 (50)
Single
3 (12.5)
1 (4)
4 (16.5)
Divorced
3 (12.5)
1 (4)
4 (16.5)
In relationship/not married 3 (12.5)
1 (4)
4 (16.5)
Race
Marital status
Time since VTE diagnosis, y
2
11 (46)
4 (16.5)
15 (62.5)
2 (8.5)
3 (12.5)
5 (21)
Received thrombolysis
Yes
Cited by other articles
Open in a separate window
Abbreviations: DVT, deep vein thrombosis; PE, pulmonary embolism; VTE, venous thromboembolism.
To capture a range of patient experiences, in particular recurrence and ED usage, we used several
different recruitment approaches. We first used databases from a university hospital anticoagulation clinic
(>50% patients with DVT only), a registry kept of patients treated with multidisciplinary pulmonary
response team, as well as patients who participated in other VTE research studies by our group. We also
used the electronic medical record (First Net; Cerner Corp., North Kansas City, MO, USA) to survey
patients presenting to the IU Health Methodist and Eskenazi Hospital ED in Indianapolis to identify
potential participants who were diagnosed with VTE at least 6 months prior. Participants were between
the ages of 18 and 70 years who had experienced a symptomatic VTE as a DVT, PE, or both at least 6
months prior to the interview. Participants were excluded if they had a diagnosis of active cancer or
known history of mental illness or other psychological diagnosis before the VTE with the exception of a
diagnosis of anxiety or depression. This study was approved by a local institutional review board (IRB).
This study was conducted in compliance with the ethical standards of the responsible institution on
human subjects as well with the Helsinki Declaration.
The main challenge for the sampling and recruitment was the time and effort required to screen and enroll
participants. To complete the 24 interviews, the first author (JHN) reviewed 620 charts from the different
VTE study databases for inclusion, exclusion, and sampling criteria. The time required for this screening
process ranged from a few minutes (eg, when age was found to be an exclusion criterion) to 90 minutes
(when the participants had a contradictory past medical history or unclear psychiatric history). To
expedite this process, the participants with contradictory or unclear medical history were flagged to do a
more detailed assessment of the exclusion criteria during the phone call. Ultimately, 160 participants met
the criteria. After the participant met the inclusion criteria, the study personnel or the principal
investigator (PI) then initiated phone calls to inquire about interest in participating. The time spent on
phone calls varied from 1 minute (when calls were not answered, or the number was not in service) to
30 minutes (to explain the study to the participant and schedule the interview).
The second challenge was the original exclusion criterion of history of mental illness. The diagnosis of
anxiety and depression excluded the majority of otherwise eligible patients. Simultaneously,
documentation of mental health disorders was inconsistent and often incomplete, requiring PI
investigation of unexplained International Classification of Diseases codes in the absence of a
documented formal psychiatric or even primary care mental health evaluation.24 As a solution, we
changed our original exclusion criteria of history of mental illness to known history of mental illness or
other psychological diagnosis prior to VTE diagnosis with the exception a diagnosis of anxiety or
depression. This change in the exclusion criteria increased the number of participants eligible to be
called; however, these protocol changes only modestly helped the rate of recruitment because of
pervasive problems with telephonic recruitment.
We were able to obtain a waiver from the IRB for recruitment but found that the “cold‐call” telephone
contact method proved to be highly inefficient.25 Approximately 14% of telephone numbers had
disconnected service. An additional 51% of participants were unable to be reached. In 75% of these cases,
the caller left at least one voice message and never received a call back. Nineteen percent answered the
first phone call and asked to be called another time but did not answer the subsequent call. Fifteen percent
refused to participate in the study. The remaining 6% of calls were never answered or the voicemail was
full.
Additional opportunity cost resulted from 27% of scheduled interviews who failed to show, with only two
of those participants completing the interview after rescheduling. In an attempt to improve outcomes,
every participant was called at least three times on different days, at different times. A minimum of three
calls were made to numbers not obviously disconnected with an average of six to seven calls per patient.
Despite strenuous effort and protocol modifications, the recruitment effort required 9 months to complete
interviews with the first 15 participants. After the coronavirus disease 2019 (COVID‐19) pandemic
began, and state and local stay‐at‐home public health orders began, the number of participants who
answered the phone calls increased, and within 2 months, 13 individuals agreed to participate. Because of
the convenience of virtual interviews, we were able to retain a higher proportion of participants, and nine
completed interviews. However, two participants were unable to complete the interview due to lack of
access to computer, smartphone or internet, and two participants did not answer the day of the interview.
One of them was reached later again but declined to complete the interview due to being admitted to the
hospital, and the second participant never answered the calls to be rescheduled.
5. SAMPLE SIZE
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Qualitative sample size is determined by thematic saturation rather than mathematical calculation.
Thematic saturation is the point at which the interviewer has uncovered the full range of perspectives in
the population interviewed, and subsequent interviews no longer uncover new ideas. It is dependent upon
a variety of factors, including the purposive sampling approach and the diversity of perspectives in the
purposive sample. We had originally planned on 30 interviews. However, with a total of 24 interviews,
we felt that we achieved thematic data saturation, based on repetition of statements and themes.
6. STUDY PROCEDURES
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The initial design of the study was to interview all participants face to face to facilitate the development
of rapport between the interviewer and interviewee, reduce distractions, and allow the interviewer to read
the participant’s body language.
However, to adapt to the public health orders related to COVID‐19, interviews were switched to a web
conferencing platform (Zoom; Zoom Video Communications, San Jose, CA, USA) after the first 15
interviews. We adapted the same structure, identical format, and verbal instructions for COVID‐19–
adapted video interviews and tracked the duration and content of these video interviews to compare to
face‐to‐face interviews. The duration of the interview remained identical after the transition from face‐to‐
face interviews to a web conferencing platform (Zoom). Overall, the web conferencing offered logistical
advantages. The access to geographically remote participants, the reduction on travel expenses for
participants and interviewer, and savings on setup cost were key advantages.
Nonetheless, we identified a few challenges with the web conferencing platform. Two participants were
unable to be enrolled because they did not have access to the necessary technology
(Internet/smartphone/computer). The ability to establish a natural, relaxed conversation and observe body
language was significantly reduced with two participants who used a cellphone for the video call. This
was largely because the participants were holding the cell phone in their hands throughout the interview,
which focused the camera only on their face and took away the ability to observe nonverbal cues. Finally,
one participant who had never participated in a videoconference seemed distracted by the process. This
was evidenced by the participant’s inability to focus on the verbal conversation and requiring frequent
redirection throughout the interview. The participant seemed fixated on the video display, often fixing the
hair and asking whether the interviewer could see and hear well.
For the face‐to‐face interviews, participants were interviewed individually in a quiet and private office
with no others present, not bright lights and neutral background to avoid distractions. A “Do Not Disturb
—Interview in Process” sign was placed outside the door to minimize interruptions. When the interview
was done by a web conferencing platform, the interviewer used the same place and the participants were
asked to be in a location that would ensure privacy and prevent interruptions.
Two audio recorders were used during each interview to ensure that the interview was recorded
completely and accurately and to allow the PI to focus during the interview. None of the interviews
required a repeat session. All interviews were transcribed verbatim by a professional transcriptionist.
None of the transcripts were returned to the participants.
Most interviews lasted 75 minutes and were followed by completion of five questionnaires: Generalized
Anxiety Disorder Scale, Posttraumatic Stress Disorder Checklist, Pulmonary Embolism Quality of Life
questionnaire, Villalta Scale for Diagnosing Post‐Thrombotic Syndrome, and the Concerns About
Recurrence Scale—VTE.
7. INTERVIEWER CHARACTERISTICS
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In qualitative work, we found it important to be attentive to the interviewer characteristics as well as the
interviewer‐interviewee relationships. In this study, the interviewer had no prior clinical relationship with
any of the 24 participants. We felt that it was important for the interviewer to not be the patient’s medical
provider because we wanted patients to be free to express negative as well as positive experiences with
the health care system and to not feel pressured to participate. However, we did feel that it was important
for the interviewer to have prior knowledge on the topic (in this case VTE) and research expertise. The
interviewer was a female internal medicine physician, has both clinical care and research experience with
VTE, as well as both clinical and qualitative interview experience.
8. INTERVIEW GUIDE DEVELOPMENT
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Interview guides for qualitative research range from completely unstructured to highly structured. We
opted to use a semistructured approach, in which all participants were asked the same main questions, but
the interviewer followed up with different probing questions, depending on the answer to the main
question. The use of a semistructured approach enabled us to cover all pertinent areas but also allowed
participants to bring up topics we had not previously considered and to provide a high degree of detail.
Our preliminary interview guide was developed on the basis of pertinent information gathered from a
review of the literature.16, 22, 23 Then, the interviewer conducted three pilot interviews to test the guide.
These pilot interviews allowed us to refine existing questions. Questions that did not work well were
dropped, and questions were added on the basis of participant feedback. We set up our questions to
encourage participants to tell their story. In contrast to questions that allow short or single‐word answers,
a storytelling approach allowed a more detailed narrative. The use of a semistructured guide enabled
flexibility to ask questions that incorporated new information and to follow new ideas as they came up in
the interview.
9. INTERVIEW PROCESS
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While the goal of the qualitative interview is to feel like a conversation, the emphasis is on active
listening. At the beginning of the interviews, the roles were clarified: The participant was counseled that
the interviewer would ask questions but mostly listen and the interviewee should do the majority of the
talking. The interviewer stated that the interview was intended to be conversational with no expectation
of right or wrong answers.
The interview structure started with asking the participants to describe the time when they were
diagnosed with VTE. We deliberately asked the interviewee to tell us their “story” of VTE both to serve
as a warm‐up for the interviewee because of its ease and allow for often unexpected details that come
from storytelling. Probing questions were used to elicit details of the story.
The interviewer then inquired about the participant’s knowledge of VTE to compare his or her knowledge
at the time of the diagnosis with his or her current knowledge. As the interview progressed, the
interviewer posed more challenging questions involving life‐changing aspects due to the diagnosis,
concerns and fears about the diagnosis, and coping mechanisms and emotional support, which also
presented challenges to the interviewer.
A strength and a challenge in qualitative interviewing is the ability of the interviewer to identify and
explore discrepancies in the participant’s stories. For example, when participants were asked about
mental health after VTE diagnosis, most participants denied having any anxiety, worry, or concern after
the diagnosis; however, the same participants described signs of anxiety, fears, concerns, and worries
after the diagnosis throughout the interview. In these situations, the interviewer would ask the same
question using more neutral words, avoiding words clearly aligned with mental health, such as anxiety,
worry, depression, or stress, in attempt to overcome their reluctance to endorse anxiety or worry about the
disease. For example, the interviewer might ask: “What comes to your mind?; or “What do you think
when you start having shortness of breath or chest pain or leg pain?”; or “Tell me about changes in your
life after the blood clots.” This discrepancy was more prevalent with male participants, and we
hypothesized that this might be related to the perceived stigma of a mental health diagnosis.
A second challenge in qualitative interviews on health services is that often informants do not know basic
knowledge about their own health care condition. This raises both practical and ethical concerns. In a
successful qualitative interview, the interviewer and interviewee build a relationship of trust, and when
there is that level of trust, interviewees are often more willing to make themselves vulnerable and
disclose lack of knowledge or ask for assistance in understanding their conditions when they would not
have otherwise. In our study, a subset of participants had questions about their disease or treatment during
the interview. While the goal of qualitative interviews is for the participant to express their feelings,
perceptions, and decisions based on their current knowledge, a competing obligation is to resolve
misinformation that may negatively affect a person’s health. In our study, the interviewer addressed these
questions when all research procedures (interview and questionnaires) were completed to prevent the
answer from influencing the participant’s opinions/beliefs during the interview. For example, the
interviewer might say, “I am going to table your question for now, but we will come back to it at the end
of the interview—is that OK with you?”.
All interviews ended with the interviewer asking if the participants had any experiences or information
related to VTE to share that had not been asked. This was done to make sure the participants had the
opportunity to share anything that may have been missed in the interview but also to reiterate the value of
their opinion. The majority of participants felt everything they wanted to discuss was covered in the
interview.
10. CODING AND ANALYSIS
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All the transcripts were reviewed by the investigator for accuracy and completeness and then uploaded
into NVivo software (QSR International, Melbourne, Australia). NVivo allowed for an organized and
structured approach to the coding process as it facilitated categorization and comparison of the codes for
data analysis.
Using two or more independent coders, or “double coding,” is one way to improve validity. Some more
structured qualitative approaches involve calculating interrater reliability. However, in exploratory
qualitative research, such as our study, discussion is more frequently used to resolve differences.
Inductive coding is deriving codes from the data. Deductive codes are predefined codes that come from
previous research. The form of coding used should fit the goals of the research. In our study, codes were
developed in several phases by two authors (JHN and MT) using a blended approach of deductive and
inductive codes.26 This approach kept the coding process open to interesting new data while remaining
connected to the scarce data currently available on this topic. Initial deductive codes were drawn from a
review of the literature. However, some of those codes were adjusted as novel and potentially important
information was elicited. The majority of the codes were developed through an inductive approach while
coding participants’ transcripts, which allowed the codes to remain accurate and relevant, representing
the reality of the participants as opposed to the beliefs of the researchers.
The first phase of code development used a descriptive approach, which identified emerging issues and
concepts surrounding the participants’ experiences. The second phase involved constructing patterns in
the data. This process consisted of identifying and refining the codes by groups and subdividing similar
and unrelated codes and creating and relabeling categories. In the last phase, the results were further
analyzed to determine how the new categories and subcategories were interrelated with one another.
An important analytic step is the development of a codebook. In qualitative work, codebooks organize
codes (themes or concepts) and typically include codes, subcodes, a definition of the code, and example
from the transcript and a description of when to use it or not use it (inclusion/exclusion criteria for the
codes). Definitions for codes were developed by reviewing all corresponding coded text. Similar codes
were combined, and infrequent codes were dropped. Inclusion and exclusion criteria were developed after
comparing codes to prevent overlap. Once a draft of the codebook was developed, it was applied to the
remaining transcripts and revamped when new codes were developed. The codebook underwent five
revisions before both authors agreed on a satisfactory version. See Table 2 for an example of the
codebook.
TABLE 2
Codebook example
Themes
Definition
When to use
When not to use
Examples
Concerns of
Patients describe their
Patient reports a
Patient describes
“I guess my biggest fear
death
fear of death at the time
concern about the
concerns about death as
is that I just walk
of diagnosis of VTE
possibility of dying as a
a result of treatment
around one day, grow a
and/or their continued
result of VTE
clot, and drop dead”
fear of death
“My biggest fear is
dying from it”
Other concerns Patient describes other
Any other concerns
Patient describes
“The scariest part for
concerns (different than
developed after and
concerns about
me was I wasn’t sure if
death) directly related to secondary to the
treatment, effects of
it (clot) would like
VTE
diagnosis of VTE
treatment, recurrence,
move to the baby”
(incomplete resolution
or death
of VTE, effects on
“I was worried about it
family)
(clot) moving”
Increased
Patient discussed the
Patient reported that
Patient discusses
“When somebody tells
stress after
negative impact that
their stress or anxiety
nonverbal
you are the most
communication verbal communication
level increased due to
communication that
interesting patient in the
with health
about VTE with their
communication about
increased stress (facial
emergency room, that’s
care provider
health care provider had VTE with their health
expressions, gestures,
probably not a good
Open in a separate window
In our project, all transcripts were independently coded by two authors (JHN and MT). An important part
of qualitative work is the explicit recognition of what the interviewers/coders brings to the table. The
coders filter data through their own experiences, creating interpretations of the data. In our study, one
coder was a practicing physician, while the other was a fourth‐year medical student. This was an explicit
choice, so that the coders would understand the medical information and the difference between
necessary care and overuse. Some argue that qualitative researchers should be outsiders, unconnected
with the phenomena under evaluation, and that only an outsider can be sufficiently impartial. However,
we argue that, whether insider or outsider, the interviewer always brings a specific lens to the interview.
Instead, the goals should be an explicit acknowledgment of one’s perspective and self‐awareness on the
part of the interviewer.
For the first six transcripts, both coders met in person to review and code transcripts together. The coders
spent ≈15 hours analyzing the first transcript, learning to navigate NVivo, initiating the development of
the codebook, creating new codes and discussing consistency of judgments between coders. Coding time
progressively decreased with each transcript. As the coders became more familiar with NVivo, more
codes were developed and readily available for application to each transcript and few differences between
coders arose. After transcript six, both coders independently reviewed and coded each transcript. Then,
the coders began online meetings (via Zoom) to establish consensus on the codes, formulate a general
description of the analysis, and to discuss emerging themes for each transcript. For codes identified later
in the coding process, earlier transcripts were reanalyzed for the novel codes. Differences among coders
were resolved by discussion. If the coders could not come to consensus, a third person (JAK) provided a
third opinion to help reach a final decision.
A myriad of qualitative analytic approach
I need help creating a power point presentation for my Nursing Clinical class. The medical topic I am assigned for this Presentation is: EUTHANASIA (what is it? is it legal? etc, etc). The goal of the presentation is to help my clinical group learn about medical issues and how nurses need to remain focused and aware when caring for patients. The presentation should be at least 10-12 slides . It should contain the important facts about “Euthanasia” and describe how it affects nurses. It also needs to have 5 NCLEX well prepared questions for my class to answer and references. Please make the presentation colorful and use pictures. thank you
As Health Professionals, it is our job to problem solve and break down the barriers to access for our patients. Ensuring equity to care is a number one priority.Read the following case study: Role of Hospitals: Allina Health (https://www.aha.org/role-hospitals-allina-health) and then in an APA formatted paper that is 1-2 pages long (not including title and Reference page) answer the following questions. You should include 3-5 outside references to support your ideas.1.) What factors affect a patient’s ability to navigate and access the healthcare system? In this case specifically, what prevented patients from receiving preventative care? Why is literacy important and how is it connected to health literacy?2.) How can health professionals detect these issues? What types of data should be collected and analyzed regularly to ensure that patients needs are not being missed?3) How did this hospital choose to handle their situation? What were other possible solutions?4) Why is continuous monitoring important?
Describe your clinical experience for this week.Did you face any challenges or successes? If so, what were they? No challenges this week. Describe
the assessment of a patient, detailing the signs and symptoms
(S&S), assessment, plan of care, and at least 3 possible
differential diagnoses with rationales.A 45 year old male African american male, The patient came in with a complaint of L-shoulder pain.
Pt stated he had no injuries to the arm.
The Patient noted a clicking sound on the rotator cuff and discomfort when assessing mobility.
Xray of the Left arm was ordered.
Results came back, It showed osteopenia and rotator cuff atrophy.
Asked the patient if there was any family history of osteopenia, pt denied it.
Pt prescribed Meloxicam 10 mg once a day for pain.
Referral to Orthopedics.Mention the health promotion intervention for this patient.What did you learn from this week’s clinical experience that can be beneficial for you as an advanced practice nurse?Support your plan of care with the current peer-reviewed research guideline.Submission Instructions:Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources.
Oppositional Defiant Disorder and Conduct Disorder Chart
Unit 4: Introduction (1 of 4)
Unit 4: Reading and Activities (2 of 4)
Current Assignment: Unit 4: Assignment Oppositional Defiant Disorder and Conduct Disorder Chart (3 of 4)
Unit 4: Discussion ODD and Conduct Disorder (4 of 4)
Instructions
For this assignment, you will create a visually descriptive chart that includes the following details:
Explain the similarities and differences between Oppositional Defiant Disorder and Conduct Disorder.
List the signs and symptoms of each as well as provide examples of each disorder.
This chart must include current references that use proper APA 7th edition formatting.
Complete this chart and upload this assignment dropbox by Sunday at 11:59 pm CT.
Estimated time to complete: 2 hours
Rubric
MSW620 Unit 4 ODD Chart Assignment Rubric
MSW620 Unit 4 ODD Chart Assignment Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeVisual
10 pts
Highly Proficient
All components of the chart are clearly complete and accurate
5 pts
Low-Level Proficiency
The chart is incomplete or not accurately completed
0 pts
Not Completed
No chart provided
10 pts
This criterion is linked to a Learning OutcomeComparison
10 pts
Highly Proficient
Comparisons are clearly stated and examples are provided
5 pts
Low-Level Proficiency
Comparison are partially clear, limited to no examples provided
0 pts
Not Completed
No comparisons were submitted
10 pts
This criterion is linked to a Learning OutcomeContrasts
10 pts
Highly Proficient
Contrasts are clearly stated and examples are provided
5 pts
Low-Level Proficiency
Contrasts are partially clear, limited to no examples provided
0 pts
Not Completed
No comparisons were submitted
10 pts
This criterion is linked to a Learning OutcomeSigns and Symptoms
10 pts
Highly Proficient
Signs and symptoms are clearly stated with examples
5 pts
Low-Level Proficiency
Signs and symptoms are partially stated with limited to no examples provided
0 pts
Not Completed
No signs/symptoms were listed
10 pts
This criterion is linked to a Learning OutcomeAPA/Mechanics/Grammar
In order to write a case study paper, you must carefully address a number of sections in a specific order with specific information contained in each. The guideline below outlines each of those sections.
Section
Information to Include
Introduction (patient and problem)
Explain who the patient is (Age, gender, etc.)
Explain what the problem is (What were they diagnosed with, or what happened?)
Introduce your main argument (What should you as a nurse focus on or do?)
Pathophysiology
Explain the disease (What are the symptoms? What causes it?)
History
Explain what health problems the patient has (Have they been diagnosed with other diseases?)
Detail any and all previous treatments (Have they had any prior surgeries or are they on medication?)
Nursing Physical Assessment
List all the patient’s health stats in sentences with specific numbers/levels (Blood pressure, bowel sounds, ambulation, etc.)
Related Treatments
Explain what treatments the patient is receiving because of their disease
Nursing Diagnosis & Patient Goal
Explain what your nursing diagnosis is (What is the main problem for this patient? What need to be addressed?)
Explain what your goal is for helping the patient recover (What do you want to change for the patient?)
Nursing Interventions
Explain how you will accomplish your nursing goals, and support this with citations (Reference the literature)
Evaluation
Explain how effective the nursing intervention was (What happened after your nursing intervention? Did the patient get better?)
Recommendations
Explain what the patient or nurse should do in the future to continue recovery/improvement
Your paper should be 3-4 pages in length and will be graded on how well you complete each of the above sections. You will also be graded on your use of APA Style and on your application of nursing journals into the treatments and interventions. For integrating nursing journals, remember the following:
Make sure to integrate citations into all of your paper
Support all claims of what the disease is, why it occurs and how to treat it with references to the literature on this disease
Always use citations for information that you learned from a book or article; if you do not cite it, you are telling your reader that YOU discovered that information (how to treat the disease, etc.)
————————————– NOTES FROM PROFESSOR:
This assignment MUST include a case that include a fabricated patient that you created. The case MUST include the patient visiting a clinic, hospital or ER with a CHIEF COMPLAINT.
Previous classes had deficiencies these sections:Pathophysiology = Pathogenesis, must describe the pathogenesis of the Chief Complaint/ Disease in detail from start (etiology) to the development of signs and symptoms.
Nursing Physical Assessment: Must include the examination of all body systems then focus on the system of the Chief Complaint.
Patient Goal: Must address every signs and symptoms mentioned in the introduction and pathogenesis.
Evaluation: Must explain WHY the treatment or intervention work and provide proof (research articles).
Recommendations Must include: special diet, prevention, precaution, amount of physical activities, special accommodation, patient education and follow-up.
Introduction (patient and problem)
Explain who the patient is (Age, gender, etc.)
Explain what the problem is (What were they diagnosed with, or what happened?)
Introduce your main argument (What should you as a nurse focus on or do?)
Pathophysiology
Explain the disease (What are the symptoms? What causes it?)
History
Explain what health problems the patient has (Have they been diagnosed with other diseases?)
Detail any and all previous treatments (Have they had any prior surgeries or are they on medication?)
Nursing Physical Assessment
List all the patient’s health stats in sentences with specific numbers/levels (Blood pressure, bowel sounds, ambulation, etc.)
Related Treatments
Explain what treatments the patient is receiving because of their disease
Nursing Diagnosis & Patient Goal
Explain what your nursing diagnosis is (What is the main problem for this patient? What need to be addressed?)
Explain what your goal is for helping the patient recover (What do you want to change for the patient?)
Nursing Interventions
Explain how you will accomplish your nursing goals, and support this with citations (Reference the literature)
Evaluation
Explain how effective the nursing intervention was (What happened after your nursing intervention? Did the patient get better?)
Recommendations
Explain what the patient or nurse should do in the future to continue recovery/improvement
The purpose of this assignment is to discuss the value of monitoring project progress and evaluating outcomes to develop quality and safety initiatives. In a 750-900-word paper, address the following:Discuss the value of monitoring the progress of planned change and the impact it has on project outcomes. Explain the benefits of evaluating overall project outcomes. Discuss the importance of final project analysis and debriefing following project closure.Discuss who should be involved in the project debriefing. Explain why it’s important to celebrate successful completion of a project. How would you celebrate successful completion?If all desired outcomes are not met in a project, describe the appropriate next steps.Based on the case study in which you have applied the principles of project management to in Topics 3-8, develop at least two potential resulting quality and safety initiatives. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
A narrative description of a significant event in your nursing practice which serves as a model of excellence on nursing practice. An event that you think captures the quintessence of what nursing is all about.Should address the following:1) Safety2) Evidence-based practice3) Leadership abilities4) Collaboration/team member
Charting packet #1
Instructions
1. Consider this encounter with your pt from a space of empathy and service.
2. Given the information provided, complete the following critical thinking activity:
a. Chart chief complaint – clear and concise
b. Signature and title at the right-hand margin once completed
c. If you do not know some detail, indicate what you would do in the clinic?
d. Each charting notation must be handwritten and legible. Computer generation is not
acceptable.
3. Pt Interview questions:
a. For each, write out 4-5 clarifying questions you would ask your pt to obtain data for your
provider’s evaluation
b. Think of previous coursework (Disease & Path, Micro etc.) when constructing these
questions
4. Lens work: Clinical Reasoning activity
a. Refer to the PATIENT STATUS” handout for ideas for each lens box.
b. Most of these boxes will require you to consider the holistic care of patients.
c. Sufficient responses will be more than just a couple of words. This is where you try to
figure out more pieces of the puzzle.
Patient: Leanard R. Showalter (5/5/1995)
Mr. Showalter has scheduled an appt due to sinus pain, particularly around his eyes. He is
complaining of ringing in both ears, fever, saying that his taste is getting “weird.” He is worried that it
is beginning to settle in his throat. He did run a fever last night of 101.8 degrees and took some
Tylenol – it did provide some help.
Date:
Time:
Pt Name:
D.O.B:
LMP:
Allergies
Meds: (Initial by MA/CMA/RN)
____ No Medication Changes
_____ Medication changes as follows:
Page
1
Interview Questions:
Hlth 243/F23/charting#1/ela
Due: Wed, 10/4/23 @ 0900
__________/15 points
Complete the following holistic patient care lenses:
Pathophysiology:
Psychological/Emotional Factors:
Situational Awareness:
What will your provider need you to get
ready?
_________/ 5 points
Patient: Patient: Alberta Murray (1/31/1953)
Mrs. Murray is experiencing shoulder pain today. Her husband has Alzheimer’s and is becoming
more combative. This is the same shoulder he wrenched about 3-4 months ago. Pain is 7/10 and it
is difficult to move her arm forward or raise it above her head.
Date:
Pt Name:
LMP:
Meds: (Initial by MA/CMA/RN)
Time:
D.O.B:
Allergies
____ No Medication Changes _____ Medication changes as follows:
Psychological/Emotional Factors:
Situational Awareness:
Therapeutic Communication Needs:
Page
2
Pathophysiology:
Hlth 243/F23/charting#1/ela
Due: Wed, 10/4/23 @ 0900
__________/15 points
Interview Questions:
Identify the following as either subjective or objective data: (2 points)
_____ Data that the patient describes based on experience, sensations, cultural norms, etc. and is
not measurable by the five senses
_____ Data that came be obtained through the five senses, measurable and cannot be refuted
_____ Blood pressure is 118/68
_____ Pain scale is 6/10
_____ I am having a really bad cough at night
_____ SpO2 = 97%
_____ The pain is mostly on the left side of my abdomen
_____ My sense of smell is not what it used to be
_____ CBC = wnl
_____ No BM for the past five days
_____ Blurry vision
_____ Wt: 185.4 pounds
_____ Face is flushed and sweaty
_____ UA specific gravity of 1.040
_____ Nystagmus
_____ Pruritis
_____ Peak Flow results: 1) 440 lpm, 2) 450 lpm, 3) 440 lpm
_____ Tenesmus
_____ Pulse is 88, bounding & irregular
_____ Purulent discharge noted with peripheral redness
Page
3
Identify the following medications by specific category (1 point)
1. Lipitor: _______________________________________________________
2. Lisinopril: _____________________________________________________
3. Gabapentin: ___________________________________________________
4. Omeprazole: __________________________________________________
5. Metformin: ____________________________________________________
6. Sertraline: ____________________________________________________
7. Atenolol: _____________________________________________________
8. Plavix: _______________________________________________________
9. Coumadin: ____________________________________________________
10. Zantac: ______________________________________________________
Hlth 243/F23/charting#1/ela
Due: Wed, 10/4/23 @ 0900
__________/15 points
Drug Classifications
Page
4
Match the classification of drug to the correct definition. 2 points
#
Classification
Definition
Analgesic
1. reduces fever
Anesthetic
2. lowers blood glucose levels
Antacid
3. treatment of manic-depressive episodes
Antianxiety
4. increases urinary output
Antiarrhythmic
5. relaxes blood vessels, lowers blood pressure
Antibiotic
6. loosens/promotes bowel movements
Anticholinergic
7. acts to prevents action of histamines
Anticoagulant
8. destroys or inhibits growth of microorganisms
Antidepressant
9. relieves pain without loss of consciousness
Antidote
10. neutralizes acid
Antiemetic
11. dilates bronchi
Antihistamines
12. prevents/controls coughing
Antimanic
13. produces lack of feeling, either local or general
Antihypertensive
14. controls/stops bleeding
Antineoplastic
15. produces calming effect without sleep
Antipyretic
16. reduces nasal congestion and swelling
Antitussive
17. counteracts effects of a poison
Diuretic
18. prevents/controls clotting
Hypoglycemic
19. facilitates removal of bronchopulmonary secretions
Sedative
20. controls cardiac arrhythmias
Contraceptive
21. prevents/relieves symptoms of depression
Hypnotic
22. prevents/relieves nausea and vomiting
Bronchodilator
23. constricts vessel and elevates blood pressure
Decongestant
24. reduces mental anxiety and tension
Expectorant
25. prevents replication of neoplastic cells
Hemostatic
26. controls high blood pressure
Laxative
27. blocks parasympathetic nerve impulses
Vasodilator
28. device/method that prevents conception
Vasoconstrictor
29. produces sleep
Hlth 243/F23/charting#1/ela
Due: Wed, 10/4/23 @ 0900
__________/15 points
this is a discussion post so it doesnt need to be too longAfter reading the article posted this week, please post your thoughts. How could Jack-in-the-Box have prevented this tragedy? Several parents and other adults ate the exact same burgers – why did only children die and/or suffer severe consequences?
Unformatted Attachment Preview
Mother’s mission: Making food safe
Roni Austin with one of the poster boards she displays when she urges highschool students to get involved in community affairs.
( / U-T)
By JOHN WILKENS
AUG. 21, 2011
6 AM
FOOD SAFETY FACTS
The number of E. coli 0157 cases — the pathogen that killed Lauren Beth Rudolph —
has dropped 44 percent in the U.S. since the mid-1990s, according to FoodNet, which
tracks foodborne diseases.
Other infections have decreased, too: Shigella, down 57 percent; Yersinia, 52 percent;
Listeria, 38 percent; and Campylobacter, 27 percent.
The Centers for Disease Control and Prevention credits better food-handling,
inspections and outbreak for the downturn, along with increased consumer awareness.
But cases of Salmonella, the most common foodborne disease, have gone up 3
percent. Vibrio, a rare infection caused by eating contaminated seafood or getting
seawater in an open wound, went up 115 percent.
In all, the Centers for Disease Control and Prevention estimate that 48 million
Americans get sick, 128,000 are hospitalized and 3,000 die from foodborne diseases
every year.
Every year, some 3,000 people die in this country from bad food. Salmonella in
peanut butter. E. coli in strawberries. Many of the victims are children, and their
parents, unmoored by grief, reach for an anchor.
Sometimes they call Roni Austin.
Almost 20 years ago, a few days before Christmas, Austin’s 6-year-old daughter,
Lauren, went to a Jack In the Box in Carlsbad and ate a hamburger. She got sick, was
rushed to a hospital and never came home.
Lauren was the first to die in a multi-state E. coli outbreak that claimed the lives of
three other children and sickened 700 people. She was buried in a bejeweled dress her
parents had bought her for Christmas — her father’s Purple Heart pinned to the dress,
her mother’s wedding gown underneath her in the casket.
Like many people, Austin had never heard of E. coli before. At first bewildered, and
then angry, Austin soon became the face of food-safety reform in California and
beyond.
She cofounded a nonprofit advocacy group, Safe Tables Our Priority (STOP), and
pushed successfully for legislation requiring E. coli to be a reportable illness, so
outbreaks could be traced and stopped sooner. She sued Jack in the Box, winning a
confidential settlement.
Nervous initially to be in the spotlight, she learned not to fear politicians or powerful
lobbyists for the beef and fast-food industries. “What are they going to do, kill my
daughter?” she said. “Already done that.”
She was in the Oval Office when President Clinton signed the most sweeping changes
to federal food-inspection law in 90 years. She was in Sacramento when a state
measure named after her daughter passed, mandating minimum cooking temperatures
in restaurants.
“I’ve seen a lot of people who are hit with tragedies, accidents or injustices, and they
have all kinds of ways of dealing with it,” said writer Jeff Benedict, whose new book,
“Poisoned,” chronicles the E. coli outbreak and its aftermath.
“A lot of people just get bitter and the rest of their lives are kind of ruined by being on
the wrong end of something bad that happened. Then there are people like Roni who
try to make something good come of it.”
Austin, 64, is not sure she had much choice. “When Lauren got sick, I promised her
she would be OK and she wasn’t,” she said.
Sitting in her Encinitas home office on a recent afternoon, she picked up a framed
picture. Drawn by Lauren, it shows a girl being hugged by a grown-up. “Wen I am
cozy I am in my moms arms,” the caption reads.
“If you found this a few days after your daughter died, wouldn’t you have to do
something?” Austin asked. “Wouldn’t you?”
Fix-it attitude
Twenty years is a long time to be a pallbearer. “You can only handle so much
sorrow,” Austin said.
Every time she thinks she’s handed off the baton to others, though, something brings
her back. A phone call from a parent who has lost a child to a food-borne illness. A
news story about another outbreak. An event at La Costa Heights Elementary School,
where redheaded Lauren was in first grade and where a memorial garden was planted
in her honor.
“What happens to Roni is the same thing that happens to me,” said Nancy Donley, the
president of STOP and a Chicago real estate agent who also lost her son to E. coli.
“You can’t not pay attention. It compels her to speak up and get involved again.”
FOOD SAFETY TIPS
While you can’t control how food is handled on the farm or in a restaurant, there are a
few simple precautions to reduce the risk of foodborne diseases:
• CLEAN: Wash produce by rinsing fresh fruits and vegetables in running tap water to
remove visible dirt and grime. Remove and discard the outermost leaves of a head of
lettuce or cabbage. Wash your hands with soap and water before preparing food and
again after handling raw meat.
• SEPARATE: Avoid cross-contaminating foods by washing hands, utensils, and
cutting boards after they have been in contact with raw meat or poultry and before
they touch another food. Put cooked meat on a clean platter, rather back on one that
held the raw meat.
• COOK: meat, poultry, and eggs thoroughly. Use a thermometer to measure the
internal temperature of meat to be sure that it is cooked sufficiently to kill bacteria:
145°F for whole meats, 160°F for ground meats, and 165°F for all poultry. Eggs
should be cooked until the yolk is firm.
• CHILL: Bacteria can grow quickly at room temperature, so refrigerate leftover foods
if they are not going to be eaten within 4 hours.
SOURCE: cdc.gov/foodsafety
Each January, Austin talks to seniors at Rancho Buena Vista High School in Vista.
She brings poster boards filled with newspaper clippings and government
proclamations. She talks about her daughter, but the message is broader. Get involved,
she tells the students. Vote. “You are the solution to your problems.”
She inherited that attitude from her father, she said. When she was growing up in the
San Francisco Bay area, he always told her it wasn’t OK to complain about something
unless she was willing to work at fixing it.
Fixing food safety meant putting her career as an interior designer on hold and flying
10 times to Washington DC to testify. It meant going to Sacramento to speak a halfdozen times.
She’s not fond of the legislative process. So many meetings. So many fingers in the
pie, trying to get theirs. So many people back East “who think everybody out here in
California just fell off the surfboard.”
Asked what she’s proudest of in making her way through all that, she quipped, “That I
didn’t kill anyone.”
Then she said this: “That I didn’t give up. I made Lauren a promise that I couldn’t
keep, so the next best thing was trying to put standards and practices in place that
would prevent another family from having to go through what we went through.”
Her already-troubled marriage to Lauren’s father, Dick Rudolph, fell apart after their
daughter died. (She’s been remarried for 12 years to Donn Austin, a computer
specialist with a local hotel company.) Her son, Michael, who was 11 when his sister
died, “found out way too early about how hard the world can be,” she added.
Michael, now 30, is a musician and piano teacher who works in a barbecue restaurant.
He said he grew up being careful about what he eats, and he mostly steers clear of fast
food.
He’s proud of what his mom has done in the aftermath of tragedy. “It ends up helping
a lot of people,” he said.
Painful reminders
In a way, talking about Lauren all the time — introducing her to new people — helps
keep her daughter alive. But the details are wrenching.
Benedict’s book opens with a chapter about Lauren. It recounts how Austin went into
her daughter’s bedroom on Christmas Eve, when Lauren was in the hospital, and
found this note to Santa: “I don’t feel so good. Please make me better for Christmas.”
It recounts how the parents had to decide whether to keep Lauren on life-support, and
then once they decided, how Austin painted her daughter’s toenails with pink polish
one last time.
And it recounts how, having been told initially that Lauren had died
from flu complications, they learned the truth in a newspaper story.
“Doing the kind of work Roni has done is healing,” Donley said, “but you’re also
picking open the scabs.”
Austin’s pain is never far below the surface. She still chokes up when she talks about
Lauren. She cried when she saw that Benedict had dedicated his book to her and her
daughter.
What she tries to do is remember happier times, like the day Lauren was born, Feb.
18. On the 18th of every month, she has flowers put on her daughter’s grave.
In the face of death, a celebration of life.
Lecture: Food Safety
The globalization of the food chain has led to food being able to be transported great
distances via airplanes with refrigeration. Of course, this has been positive news in
terms of being able to feed people in rural areas and, also, in terms of being able to
preserve food for much longer periods of time. However, one huge negative has been
the effect on food safety. It is much harder now to prevent foodborne illness since food
is travelling great distances from where it was originally produced. For example, when
you go to Ralph’s and buy your groceries, are you aware that some of the food you are
buying came from other countries or from meat processing plants thousands of miles
away?
One term that is important to visualize how food travels through our society is the “Farm
to Table” concept. In the year 1800, imagine how you would cook steak for your family.
You would get on your horse and ride a short distance to your local butcher who would
sell you beef from a cow that was slaughtered that day (no refrigeration). So the “Farm
to Table” chain was very short. Today, however, it is likely that the steak you buy at the
market came from hundreds if not thousands of miles away. And, you more than likely
will not cook it that day. Instead, you will probably refrigerate it and eat it
days/weeks/months later. So, today the “Farm to Table” chain is much longer and more
complicated. So, thinking of food safety, was the steak you purchased at Ralph’s
properly refrigerated for the entire time it was in the food chain? What was the
temperature of the meat on the airplane? How about the railroad car and/or semi
(truck)? What about the temperature of your refrigerator? You can see how much more
difficult it is today to control for all the variables that can cause foodborne illness.
How serious of a problem is foodborne illness in the United States?
The Centers for Disease Control and Prevention (CDC) estimates that 1 in 6 Americans
get a foodborne illness every year! They also estimate 128,000 people are hospitalized
and 3,000 die every year. Clearly foodborne illness is a serious problem in the United
States in the year 2016.
What are the top 5 pathogens causing Foodborne Illness?
1. Norovirus (58%)
2. Salmonella (11%)
3. Clostridium perfringens (10%)
4. Campylobacter (9%)
5. Staphylococcus aureus (3%)
What are the top 5 pathogens causing hospitalizations?
1. Salmonella
2. Norovirus
3. Campylobacter
4. Toxoplasma gondii
5. E. coli 0157:H7
What are the top 5 pathogens causing deaths from foodborne illness?
1. Salmonella
2. Toxoplasma gondii
3. Listeria monocytogenes
4. Norovirus
5. Campylobacter
Looking at the data above, it is interesting to note that even though 58% of all foodborne
illnesses (in the U.S.) are caused by Norovirus (over 26 million people), many more
people die from other pathogens? Why? Well, as we discussed earlier, the terms
“pathogenicity” and “virulence” come into play. Norovirus is not as virulent as some of
the other pathogens.
What is a “Potentially Hazardous Food” (PHF)?
1. Food that requires time or temperature control to limit pathogenic microorganism growth or toxin formation.
2. Not a PHF if the water activity is less than 0.85 (Aw < 0.85)
3. Not a PHF if the pH is less than 4.6 (pH < 4.6)
4. Not a PHF if exempted by microbial challenge studies
So, what exactly is “water activity”? It is a measure of the moisture content of the food.
For example, when you buy rice at the store it is NOT a potentially hazardous food and
it is unrefrigerated, sitting on a shelf, right? Now, when you take the rice home and
cook it - suddenly it is a potentially hazardous food and you can get sick if you don’t
refrigerate it or keep it hot before eating, right? What has changed? The ONLY THING
that changed was the water activity! Simply put, bacteria need a certain amount of
water and nutrients to be able to grow; without the right amount of water content they
can’t survive and you will not get sick (e.g., dry rice you buy at the store).
What about pH? The same thing: bacteria can’t survive and/or reproduce if the food is
too acidic (pH below 4.6). So, now you know why some cheeses are not refrigerated
when you buy them at the store…..like the Kraft “Cheese and Crackers on a red stick”.
Why is this cheese unrefrigerated? Well, Kraft has manipulated either the pH or water
activity (or both) to prohibit the growth of microorganisms. The MREs (Meal Ready to
Eat) that the military gives its soldiers are also manipulated to make the food
nonpotentially hazardous.
What are some examples of Potentially Hazardous Foods?
1. Cooked Rice
2. Cut Melons
3. Beef
4. Poultry
5. Milk
What is the difference between a Foodborne Illness infection and intoxication?
An infection is usually the result of a pathogen replicating inside the human body to
large enough numbers to cause you to get sick. An intoxication is caused by eating
food that has toxins either on it or inside of it. For example, Staphylococcus aureus
bacteria are capable of causing both an infection and an intoxication. This bacteria is
extremely common in the nasal passages of people; about 25% of the population has
this bacteria living inside their nasal passages. So, let’s say one of these people
sneezes on some cooked, white rice that is not held at the proper temperature (below
41 or above 140 degrees). What will happen? The bacteria will grow very rapidly
because of the improper temperature and after a few hours their numbers will be large
enough to cause someone to get an infection. The person will start feeling symptoms
usually after 1 to 3 days.
Now, let’s take another example: let’s say you and your roommate are studying for a
Final Exam and order a pizza from Pizza Hut. You both enjoy 4 slices of pizza and
leave the rest out on the table while you study. When you both go to bed at 2am you
forget to put it in the fridge. The next morning you wake up and see the pizza and think
of this class and decide to be “safe” and put a piece of pizza in the microwave for
several minutes to kill all the possible bacteria on it (assume your roommate has
Staphylococcus bacteria in her nasal cavity and sneezed on the pizza the night before
when you went to the restroom). You watch the pizza’s cheese bubble in the microwave
so you are sure the pizza is now safe to have for breakfast before your Final Exam. You
eat the pizza and get sick two hours later! What happened? The Staphylococcus
bacteria produced a toxin overnight and once the toxin is produced no amount of
cooking/reheating will inactivate the toxin.
What are some examples of Foodborne Illness Infections?
1. Salmonella
2. Campylobacter
3. Listeria monocytogenes
4. Hepatitis A
5. Brucellosis “Undulant fever”
What are some examples of Foodborne Illness Intoxications?
1. Staphylococcus aureus
2. Clostridium botulinum (botulism)
3. Clostridium perfringens
What are some examples of Foodborne Illnesses caused by poisonous plants or
animals?
1. Snake Root
2. Paralytic Shellfish Poisoning
3. Ciguatera (fish feeding in red tides)
Here are some real world examples of these types of illnesses:
Campylobacter example:
May, 2013 raw milk outbreak in Pennsylvania
- Dairy was found to be in compliance with all rules
- 6 confirmed cases, 2 probable
- 4 were children
Same dairy had a large outbreak in 2012: 148 cases
Listeria example
August, 2011: Jensen Farms in Colorado
- Cantaloupe growing farm
- Killed 33 and sickened at least 147 in 28 states
- Both brothers were arrested by Federal Authorities
Cause:
- Probably a contaminated truck that was used to transport cattle
Hepatitis A example
Townsend Farms in Oregon
- 162 people affected, 71 hospitalized
- 1-84 years of age
- Pomegranate seeds imported from Turkey
Brucellosis example
North Carolina
- 18 confirmed cases
- All patients were exposed to the kill floor
- NIOSH went in and tested all 156 workers and 30 were +
Staphylococcus aureus example
Staph found in Chicago bakery
- 70 confirmed cases from one event alone in Wisconsin
- Recall affected 22 states
- Failure to clean and sanitize food prep surfaces
- Even after company was given a chance to clean and sanitize surfaces,
samples revealed S. aureus still present
Clostridium botulinum examples
Backyard BBQ in Oregon
- Improper home canning
- People ingested the toxins produced by the bacteria
- Symptoms developed in less than 24 hours
- Blurred vision, droopy eyelids, slurred speech, muscle weakness, etc.
Arizona prison
- Homemade Hooch/Pruno (alcohol)
- 8 people hospitalized
- Fermented baked potatoes
Clostridium perfringens example
Louisiana State Mental Hospital
- 42 residents, 12 staff members sickened with abdominal cramps, vomiting and
diarrhea
- Within 24 hours 3 people had died
- 3 patients were taking psych meds that made their bodies less able to fight off
the disease
- Chicken was cooked 24 hours prior to serving and improperly cooled
Paralytic Shellfish Poisoning examples
- Recent muscle harvesting closure along Pacific Ocean along California/Oregon
border
- Domoic Acid is a naturally occurring toxin produced by phytoplankton or algae.
- Not destroyed by cooking
- 3 recent cases in Alaska
- Tingling in mouth, tongue and lips within hours of eating contaminated shellfish
- One patient intubated – muscle paralysis can occur
Ciguatera example
- Bioaccumulation in food chain: the ciguatoxin is naturally produced by algae
and works its way up the food chain. Larger, predatory fish are usually implicated in
these outbreaks.
- Recent outbreak in Queens, New York – Barracuda fish sold at a fish market.
- One entire family experienced tingling, numbness, nausea, vomiting and
dizziness.
- All visited the emergency room within a few hours after eating the contaminated
fish.
O.K., now that we have learned about different types of Foodborne Illness. How do we
prevent these types of illnesses?
1. Temperature Danger Zone: 41-140
-We always want to keep potentially hazardous foods (PHFs) below 41 or above
140 degrees F. to prevent the rapid growth of bacteria.
2. Proper cooking:
- 145 degrees for 15 sec: eggs, fish
- 155 degrees for 15 sec ground meat, ratites, injected meats
- 165 degrees for 15 sec: poultry, ground poultry
3. Rapid Cooling:
- Break down food into shallow, metal pans (increase surface area:volume)
- Adding ice as an ingredient
- Using ice paddles to stir soups/etc.
- Repeated stirring, until center and sides same temp.
4. Proper Thawing
- In refrigerator
- Under cold running water
5. Cross Contamination
- store ready to eat foods (i.e., salads) above raw meats in refrigerator.
When I was a Health Inspector in Long Beach I can’t tell you how many times I did a
restaurant inspection and saw raw meats dripping blood down onto salads and other
ready to eat foods! This is how some vegetarians get E coli infections (they never quite
understand how they got it).
- properly sanitize cutting boards in between raw and ready to eat foods.
- properly wash hands when cooking so your hands don’t cross contaminate. For
example, if you touch a raw hamburger patty don’t touch the bun/lettuce/etc. until after
you wash your hands with SOAP and vigorous scrubbing!
- don’t put your cooked steak back into the pan where the marinade juices are
7. Handwashing
- About 100 degrees
- Vigorously scrubbing of hands and arms for 15 seconds
- Particular attention to areas under the nails
When should you wash your hands? A) after using the restroom and any time they
come in contact with food/equipment that can contaminate them.
8. Sanitization
- 100 ppm of chlorine for 30 seconds: at home you can make this concentration
of chlorine by adding 1 cap (of a gallon container) and mixing it with 1 gallon of water.
So, you can do this in your kitchen sink and dip your cutting boards/knives/etc. for 30
seconds.
- 171 degrees for 30 seconds (a dishwasher)
- 200 ppm Quat Ammonia for 1 minute (most restaurants use this)
9. Food From An Approved Source
- In order to prevent foodborne illness you have to make sure your food is
purchased from an approved source (a licensed facility – not from the trunk of a car – in
Long Beach I personally witnessed some restaurants buying chickens from someone’s
trunk!)
10. Miscellaneous
- Eliminate vermin (i.e., cockroaches/rats/mice/etc.)
- Food employees that are sick or have diarrhea should be sent home
immediately.
- Food employees should take an 8-hour food safety course and retain the
certification annually.
Purchase answer to see full
attachment
Healthcare professionals, how experience and abilities help to address the main Healthcare problems.
Healthcare professionals are essential in resolving difficulties and problems related to the well-being of the public. To guarantee they are able to provide those they treat the most effective therapy available as the healthcare industry changes, it is crucial for these experts to regularly upgrade their knowledge and abilities. Healthcare workers have to emphasize ongoing instruction by means of organized learning and development programs, claim Koskimäki et al. (2021). Maintaining up-to-date with advancements in one’s particular field of expertise can be accomplished by getting involved with continuing professional growth opportunities such as training sessions, meetings, and courses (Koskimäki et al., 2021). Additionally, obtaining higher educational degrees or certificates could enhance their competence in particular fields of health care administration.
On a variety of topics related to public health, the World Wide Web is a source of knowledge. Hussain (2023) asserts that by using internet-based tools like online seminars, audio recordings, and e-learning tools, medical professionals may improve their understanding of current issues and challenges. Online social networking channels are able to serve as a helpful informational resource by enabling personnel to follow the operations of specialists, institutions, and colleagues who provide insightful commentary and first-hand knowledge (Pizzuti et al., 2020). It is essential to keep in mind the fact that collaborating together with other providers of healthcare could encourage the exchange of ideas, expertise, and ideal approaches.
Making contact with like-minded peers who have similar goals and interests can be improved by joining organizations of professionals, getting part in local chapters, and going to social activities (Koskimäki et al., 2021). Utilization of these kinds of platforms can help one stay current on new problems with public health and innovative ways to address them.
Healthcare practitioners need to remain up to date on any legislative or regulatory modifications that may have an impact on their field of work (Wang et al., 2019). Acknowledging these developments may enable people to foresee potential problems and modify what they provide properly. One way for people to stay informed about substantial legislation changes is to register up for announcements, notifications, and newsletters from government agencies and professional groups. The use of practices based on evidence and involvement in research, according to Dang et al. (2021), could assist healthcare practitioners choose the best strategies for addressing problems related to public health.
Healthcare practitioners can improve their skills and ensure that their patients receive the finest care possible by staying up to date on the most recent research breakthroughs (Dang et al., 2021).
For medical practitioners facing complicated public health concerns, mentoring and supervision can be beneficial sources of advice and assistance (Feyissa et al., 2019). As stated by Feyissa et al. (2019), talking to mentorship experts can give you insightful insights into the best practices, creative techniques, and potential pitfalls to watch out for. In order to identify areas that could be improved, healthcare practitioners should periodically evaluate their own experiences, accomplishments, and difficulties.
Van Lankveld et al. (2021) claim that this technique can help practitioners modify their strategies and pick up new skills so they can better serve the people they serve. In the final analysis, healthcare providers need to continuously enhance their understanding and skills in order to effectively manage the substantial health-related problems and difficulties they, as well as the people they treat, are facing. By participating in continuous education, utilizing online resources, teaming up with colleagues, remaining informed on changes in regulations, taking part in investigations, looking for coaching, and taking into account personal experiences, healthcare professionals can make sure they are prepared to handle the public health landscape’s constant change.
References
Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines. Sigma Theta Tau.
Feyissa, G. T., Balabanova, D., & Woldie, M. (2019). How effective are mentoring programs for improving health worker competence and institutional performance in Africa? A systematic review of quantitative evidence. Journal of multidisciplinary healthcare, pp. 989–1005. https://doi.org/10.2147/jmdh.s228951
Hussain, Z. (2023). The Use of Web 3.0 in university e-learning, quality assurance, and knowledge management. In Advances in Distance Learning in Times of Pandemic (pp. 155–176). Chapman and Hall/CRC.
Koskimäki, M., Lähteenmäki, M. L., Mikkonen, K., Kääriäinen, M., Koskinen, C., Mäki‐Hakola, H., … & Koivula, M. (2021). Continuing professional development among social‐and healthcare educators. Scandinavian Journal of Caring Sciences, 35(2), 668-677. https://doi.org/10.1111/scs.12948
Pizzuti, A. G., Patel, K. H., McCreary, E. K., Heil, E., Bland, C. M., Chinaeke, E., … & Bookstaver, P. B. (2020). Healthcare practitioners’ views of social media as an educational resource. PLoS One, 15(2), e0228372. https://doi.org/10.1371/journal.pone.0228372
by Marina Polanco De Gomez
As healthcare professionals strive to provide optimal care to their clients, we must remain updated on current knowledge and skills to address the significant public health issues and challenges facing their communities. This approach proactively prepares healthcare professionals to respond to emerging health concerns and deliver evidence-based care effectively. This essay explores strategies healthcare professionals can employ to update their knowledge and skills, enabling them to tackle public health challenges effectively.
1. Continuous Professional Development (CPD): Healthcare professionals should actively engage in Continuous Professional Development programs to stay updated on the latest advancements in their field. Ongoing training, workshops, conferences, and seminars offer opportunities to learn new skills, acquire knowledge, and exchange ideas with peers. CPD should address critical public health issues like infectious diseases, chronic conditions, mental health, healthcare disparities, and emerging diseases like COVID-19.
2. Collaboration and Networking: Collaborating and networking with other healthcare professionals, researchers, and organizations is invaluable for staying informed about public health challenges. Healthcare professionals can develop new and innovative approaches to public health issues by collaborating through professional associations, research networks, and interdisciplinary conferences. Through these networks, they can share best practices and gain insight from the experiences of others.
3. Utilizing Technology and Online Resources: In today’s digital era, healthcare professionals can access many online resources and technology platforms that provide updated information on public health issues. Such resources include online journals, webinars, podcasts, and virtual courses from reputable institutions. Additionally, web-based platforms and social media can facilitate active participation in online communities, enabling healthcare professionals to exchange knowledge, discuss emerging challenges, and access the latest research findings.
4. Engaging in Research and Evidence-Based Practices: Participating in research studies and adopting evidence-based practices are crucial for healthcare professionals to stay at the forefront of public health challenges. Engaging in research allows professionals to contribute new knowledge and understand the impact of interventions on patient outcomes. Evidence-based practice ensures that healthcare interventions are based on the best available evidence, optimizing patient care. Healthcare professionals should actively seek opportunities to research and incorporate findings into their practice.
5. Promoting Health Literacy: Healthcare professionals are crucial in educating their clients and communities regarding public health challenges. Their aim should be to promote health literacy by providing precise and easy-to-understand information to empower individuals to take control of their health. Health promotion involves delivering culturally sensitive health education, promoting preventive measures, and fostering healthy behaviors. Therefore, healthcare professionals must proactively seek opportunities to improve communication and teaching skills to convey public health information to diverse populations effectively.
Healthcare professionals must take the initiative to effectively update their knowledge and skills to address significant public health challenges. Ultimately, their proactive efforts will prove essential in responding to these critical issues. Continuous Professional Development, collaboration and networking, utilization of technology and online resources, research engagement, and health literacy promotion are fundamental strategies for remaining informed and effective in tackling emerging health issues. By adopting a strategic approach to professional development, healthcare professionals can ensure they are well-equipped to address the evolving public health landscape and provide high-quality care to their clients.
References:
1. Han, H. R., Choi, S. A., Kim, K., & Ryu, J. P. (2019). Effects of an online community-based intervention on Korean American women’s health behaviors. Journal of Immigrant and Minority Health, 21(6), 1265-1272.
2. Larsen, D., Connell, C. J., & Bolan, G. (2020). Using LinkedIn for professional development and lifelong learning in nursing. Nursing Forum, 55(1), 10-16.
3. Palamara, K., Shah, N. D., & Shepherd, L. (2018). Advancing medical professionalism: a local agent-based model. BMC Medical Education, 18(1), 1-12.
4. Schleyer, T. K., Spallek, H., Torres-Urquidy, M. H., & Bartling, W. C. (2019). A proposal for online networks and services for collaborative clinician and patient education. Journal of the American Dental Association, 150(9), 729-738.
5. World Health Organization. (2020). Learning and knowledge exchange during health emergencies. Retrieved from https://www.who.int/risk-communication/training/le…
Guidelines: Word count: 300to 1000 words Follow APA format for your assignment must include Introduction, Body and ConclusionAll information must be mention in APA referenceFont and Size: Times New Roman (12)Color – Black, Spacing – 1.5, Heading and sub-heading – BoldFollow APA format your assignment must include Introduction, Body & ConclusionAvoid plagiarismSubmit as word document
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Society & Drugs
Course number:
PHC 314
CRN
Essay Topic
Assignment title or task:
(You can write a question)
Societies have evolved to believe that they have the right to
protect themselves from the damaging impact of drug use and
abuse.
(a) Mention the policies and prevention programs for
combating drug use and abuse at any country you
choose ?
(b) Describe the Saudi Food & Drug Authority (SFDA)
approval process for assessing the safety and efficacy of a
newly developed drug?
Student name:
Student ID:
Submission date:
Instructor name
Grade
Dr. Ahmed Hazazi
… out of 10
Guidelines:
•
Word count: 300to 1000 words
•
Follow APA format for your assignment must include Introduction, Body and Conclusion
•
All information must be mention in APA reference
•
Font and Size: Times New Roman (12)
•
Color – Black, Spacing – 1.5, Heading and sub-heading – Bold
•
Follow APA format your assignment must include Introduction, Body & Conclusion
•
Avoid plagiarism
•
Submit as word document
Note that this week, you will only apply the F, O, C, and U of the FOCUS model. In Module 7, you will focus exclusively on the S or selection of a process improvement.
In module 3, you wrote a problem statement for a quality issue in health care. Building off that issue, you will now apply the first part of the FOCUS model to your issue—the F, O, C, and U of the FOCUS model. You should also revisit your learning materials and weekly module notes on the FOCUS model.
This assignment is going to give you valuable practice in applying quality improvement models to problems organizations are facing.
Apply the F, O, C, and U of the FOCUS Model to investigate the issue and determine what went wrong.
Find 3 related breakdowns in processes, requirements, regulations, or policy that highlight the need for improvement. Identify and briefly describe them.
Organize or choose roles for your team that could help you in your work. Who in that organization would know what happened and how to fix it? Describe their roles and why you have chosen these roles to be on your team.
Clarify your knowledge at the time of the case. What were the existing processes at the time of the error? Be specific and provide examples to illustrate your points.
Understand which variables broke down within each of the 3 processes you chose. Here you will do a brief literature search around these three processes to inform your understanding. You will then share that understanding in your analysis and will apply it directly to your chosen case. Avoid opinions in this section; as leaders, you must be familiar with and know how to apply the research in ways that are supported by evidence.
Lastly, provide a conclusion for this section that integrates what you have learned about your chosen issue from the literature with your experiences.
Requirements
Your paper should be 5-7 pages in length (not including your title and reference pages), double-spaced, and in APA format. Make sure to use headings to organize your paper.
You will need to use a minimum of 5 external credible, relevant resources. At least two should be from the Excelsior LibraryLinks to an external site. and directly related to the processes you chose. The other sources may be a governmental source, other professional organization/association resource, a relevant newspaper, or other media source, etc.
Though news sources may also be a rich source of material, do not rely exclusively on these, as you may not get a full or medically accurate picture of the situation.
Course Project Part II: Prevention
Unit 4: Introduction (1 of 5)
Unit 4: Reading and Activities (2 of 5)
Current Assignment: Unit 4: Assignment Course Project Part II: Prevention (3 of 5)
Unit 4: Discussion Mental Health in Rural Areas (4 of 5)
9780826164407_ch12.pptx, File (5 of 5)
Instructions
Consider the mental health issue you identified in Unit 3. Please provide the following in a 1-2 page Word document:
Identify the community health issue in which you are interested.
Recommend at least one primary prevention measure to address this mental health issue with clear examples.
Recommend at least one secondary prevention measure to address this mental health issue with clear examples.
Provide at least one tertiary prevention measure to address this mental health issue with clear examples.
Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.
Estimated time to complete: 3 hours
Rubric
MSW628 Course Project Part II Rubric
MSW628 Course Project Part II Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContentOrganization, coherence, preparation
30 pts
Mastered
Writing demonstrates clear organization, an introduction, summary and a logical sequencing of information with transitions to tie ideas together. The writing is insightful and evidences preparation.
27 pts
Excels
Writing demonstrates organization, an introduction, summary and some logical sequencing of information with some transitions to tie ideas together. The writing is thoughtful and evidences preparation.
24 pts
Competent
Writing demonstrates some organization, there is an attempt at including an introduction, summary and sequencing of information with some transitions to tie ideas together. The writing evidences some preparation.
21 pts
Low-Level Competency
Writing demonstrates some organization, and sequencing of information. There is little evidence of preparation.
18 pts
Needs Improvement
Writing demonstrates little or no organization, and minimal sequencing of information. There is no evidence of preparation.
0 pts
Not Attempted
There is no attempt to organize the information in a thoughtful or presentable manner.
30 pts
This criterion is linked to a Learning OutcomeWritingMechanics, language, grammar, length
10 pts
Mastered
The writing exhibits an excellent command of standard written English language conventions. The writing has no errors in mechanics, grammar, or spelling. The writing is presented in a scholarly/technical style. Excellent vocabulary choices are used and appropriate to the topic and technical requirements of the topic. The correct tense and point of view is evidenced throughout the writing. Meets or exceeds the length requirement.
9 pts
Excels
The writing exhibits a strong command of standard written English language conventions. The writing has 1-2 errors in mechanics, grammar, or spelling. The writing is presented in a scholarly/technical style. Vocabulary choices used are appropriate to the topic and technical requirements of the topic. The correct tense and point of view is evidenced throughout most of the writing. Meets the length requirement
8 pts
Competent
The writing exhibits understanding of standard written English language conventions. The writing has 2-3 errors in mechanics, grammar, or spelling. The writing mixes informal/scholarly/technical styles. Vocabulary choices used are appropriate to the topic and technical requirements of the topic. The correct tense and point of view is evidenced throughout most of the writing. Meets the length requirement.
7 pts
Low-Level Competency
The writing exhibits minimal evidence of standard written English language conventions. The writing has 6 or more errors in mechanics, grammar, or spelling. The writing style is mostly informal. Vocabulary choices do not support the topic or technical requirements of the topic. There are major tense and point of view errors evident. Does not meet the length requirement.
6 pts
Needs Improvement
Writing demonstrates little or no organization, and minimal sequencing of information. There is no evidence of preparation.
0 pts
Not Attempted
The writing does not exhibit evidence of standard written English language conventions. The writing has 6 or more errors in mechanics, grammar, or spelling. The lack of writing style inhibits clear communication. Vocabulary choices include improper usage, slang, text speak, or other non-standard word usage. The tense and point of view are inconsistent throughout the writing. Does not meet the length requirement.
10 pts
This criterion is linked to a Learning OutcomeAPAAppearance and formatting
10 pts
Mastered
The writing format demonstrates all of the required APA elements, including the full use of in-text citations and references. There are a minimum of six articles provided
9 pts
Excels
The writing format demonstrates all of the required APA elements, including the full use of in-text citations and references, but 1-2 minor errors are evident. There are a minimum of 5 articles provided
8 pts
Competent
The writing format demonstrates most of the required APA elements, including the full use of in-text citations and references, but 2-3 minor errors are evident. There are a minimum of 4 articles provided
7 pts
Low-Level Competency
The writing format includes most of the required APA elements, including the use of in-text citations and references, but more than 3 minor errors are evident. There are less than three articles provided
6 pts
Needs Improvement
The writing format includes most of the required APA elements, including the use of in-text citations and references, but more than 3 minor errors are evident. There are less than three articles provided
0 pts
Not Attempted
The writing format includes most of the required APA elements, including the use of in-text citations and references, but more than 3 minor errors are evident.
Based off the Concept Map provided, choose only the medications that apply to the nursing diagnosisNursing Diagnosis: Impaired Urination Elimination, Related to the problem “infection”, As evidence by incontinence . APA format, in-text references. Do not use A.I. or Copy and paste must in own words.
Unformatted Attachment Preview
Advairdiskus100-50mg / Lexapro escitalopram 10mg
albuterol sulfate 2.5mg/3mL / loratadine 10mg
arthritis pain 650mg PRN / meloxicam 15mg
atorvastatin 40mg / nystatin susp 1000 units
buspirone 200mg / omeprazole 20mg / tramadol 50mg
D3 50mcg-2000 unit / ondansetron 4mg / sulfasalazine 500mg
cranberry 500mg / probiotic bacillus 250mg
sodium chloride 0.65 spray / propranolol 10mg
gabapentin 100mg / restasis 0.05% drops / Synthroid 50mg
pressure/pain in abdominal area
Impaired Urination Elimination
Suprapubic catheter will be
long term, for the prevention
of continuous incontinence,
and infection to reduce the
risk of painful urination.
Provide elimination equipment that aid
in pressure relief, to help release retention.
nursing recommendations suprapubic catheter
X
x
X
changes in vaginal secretions.
pain/difficulty urinating
x musculoskeletal
LABS: Urinalysis
w/culture
BUN and CBC
Minimize patient discomfort, provide pain
medication to relieve pain.
Diagnostic: Bladder
scan
Impaired Urination Elimination
Infection
Incontinence
First, read “Case Study 15-8, Healthy Conflict Resolution”, on page 289-90 of Organizational Behavior in Health Care.
Based on the information in Chapter 4 and your independent research, write a paper that addresses the following questions:
* What are the five conflict modes?
* What is the basis/cause of the conflict in the case described?
* What conflict style/handling-mode should be use to resolve the conflict?
* Why is the chosen approach preferable to other approaches?
* What are the advantages and disadvantages of your choice?
Your well-written paper should meet the following requirements:
* Four-to-five pages in length, not including the cover sheet and reference page.
* Formatted according to APA 7th edition and Saudi Electronic University writing standards.
* Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
You are strongly encouraged to submit all assignments to the Originality Check prior to submitting them to your instructor for grading.
Include the following three parts in the paper (Total 7 pages). Grading Rubrics can be seen below.Part A (2 pages): Identify a population for study (e.g. impoverished children, elders living at home, young adults with Type 1 diabetes, Latino migrant women of child-bearing age) that you will focus on for the four papers. Using one of the conceptual or theoretical models identified in your readings, discuss the health risks for this population and the factors that increase or decrease risk for this population. From these, select a specific health problem (e.g., falls in the elderly living at home, perinatal health problems for Latino migrant women) and discuss how you would identify cases especially at risk.Part B (2 pages): Describe a typical community where your population resides (e.g. Latino women of child-bearing age might be found in Wilmington or in Sussex counties). Using census.govLinks to an external site., the HRSA data warehouseLinks to an external site. or other publically available data bases, describe the general health context in the community (e.g., health care facilities that provide services for your population and their health need), level of population, racial and ethnic make-up—use whatever descriptors that will convey the opportunities and challenges your population might have in accessing population sensitive and problem specific health care in that community. In this paper also describe the specific demographics for the population you have selected (e.g., % people over 65) and the extent to which the specific health problem you have selected exists within that community. Finally describe the extent to which the built environment within the domicile and/or community increases or decreases the risk for the population you have selected.Part C (3 pages): Select at least 2 metrics that you would use to assess health outcomes pertaining to your population. At least one of these metrics must address the specific health problem that you have focused on. Describe how you would collect this information, and how often you would measure it. For each outcome indicator determine what change you would expect that would reflect a positive and a negative health change. Discuss how often the heath outcome indicator would need to be monitored to capture positive and negative changes in the indicator. Using the information from the previous two papers, describe potential individual and community level changes could be enacted to improve health in your population and for the specific health problem you are measuring
Unformatted Attachment Preview
My patient population of interest is African American males
ages 18 years and older with Depression living in New Castle
County.
Include the following three parts in the paper (Total 7 pages). Grading Rubrics can be
seen below.
Part A (2 pages): Identify a population for study (e.g. impoverished children, elders living
at home, young adults with Type 1 diabetes, Latino migrant women of child-bearing age)
that you will focus on for the four papers. Using one of the conceptual or theoretical
models identified in your readings, discuss the health risks for this population and the
factors that increase or decrease risk for this population. From these, select a specific
health problem (e.g., falls in the elderly living at home, perinatal health problems for
Latino migrant women) and discuss how you would identify cases especially at risk.
Part B (2 pages): Describe a typical community where your population resides (e.g. Latino
women of child-bearing age might be found in Wilmington or in Sussex counties).
Using census.govLinks to an external site., the HRSA data warehouseLinks to an external
site. or other publicly available data bases, describe the general health context in the
community (e.g., health care facilities that provide services for your population and their
health need), level of population, racial and ethnic make-up—use whatever descriptors
that will convey the opportunities and challenges your population might have in
accessing population sensitive and problem specific health care in that community. In
this paper also describe the specific demographics for the population you have selected
(e.g., % people over 65) and the extent to which the specific health problem you have
selected exists within that community. Finally describe the extent to which the built
environment within the domicile and/or community increases or decreases the risk for
the population you have selected.
Part C (3 pages): Select at least 2 metrics that you would use to assess health outcomes
pertaining to your population. At least one of these metrics must address the specific
health problem that you have focused on. Describe how you would collect this
information, and how often you would measure it. For each outcome indicator
determine what change you would expect that would reflect a positive and a negative
health change. Discuss how often the heath outcome indicator would need to be
monitored to capture positive and negative changes in the indicator. Using the
information from the previous two papers, describe potential individual and community
level changes could be enacted to improve health in your population and for the specific
health problem you are measuring.
Additional resources based on our synchronous discussion:
Research methods knowledge base (this is a very good information about research
related information. For example, reliability and validity, etc.)
http://www.socialresearchmethods.net/kb/contents.php
My patient population of interest is African American males
ages 18 years and older with Depression living in New Castle
County.
Links to an external site.PROMIS health
measures: http://www.healthmeasures.net/explore-measurementsystems/promis/intro-to-promis
site. Site. Ways to talk about the metrics you are using [you do not need a table – but
you can use the categories here (for example, reliability and validity statistics) to talk
about each metric]:
————————————————————————————————Notes:
•
This paper needs to follow APA 7th. Title page and references are not
included in page limit (total 7 pages)
The Basics: How to Write an Introduction Section
Revised from Saint Louis University, Health Communication Research Laboratory’s Manuscript
Development Seminar Series
I. What general public health problem will the paper address and why is it important?
(1st two paragraphs of Introduction)
A. Clearly identify the general public health problem area. (2-4 sentences)
1. Define the problem (i.e., with a conceptual definition used within the field).
2. Describe the magnitude of the problem using current, official numbers.
B. Explain why the problem is important. (2-4 sentences)
1. What are the public health consequences of the problem? Include physical,
mental/emotional, social, economic, and political consequences.
2. What is the current state of the problem? What are the trends over time?
3. Who says it is important? (National objectives, landmark published studies, professional
associations?)
II. What specific issue within the general public health problem area will be addressed,
and why is it important?
A. Clearly identify the specific issue.
1. What specific group and health issue will your paper address?
2. Use standard terminology used in field.
B. Explain why this specific issue is important.
1. How is the specific issue related to the larger general problem area?
2. How does the specific issue influence the larger problem?
3. What are the consequences of the specific issue?
4. Who says the specific issue is important?
III. What is known about the specific issue from past research, what is not known, and
why it is important to fill this gap? (2-4 paragraphs)
A. What is known from past research investigating this specific issue? (1-2 paragraphs)
1. Briefly summarize past research. (Use published work from 2010-current, unless
need to report a landmark study in the field or a study that published a measure/items
you are using in your study)
a. What are the main findings? (NOTE: Do not summarize study after study. From
reading a few studies, summarize major findings and cite the studies after these
sentences.)
b. How much is known? A lot? Little?
c. How consistent are findings across studies?
B. What gaps exist in our understanding of the specific issue? (1-2 paragraphs)
1. State clearly what is not known that will be addressed in your paper
2. Gaps may include: evidence/knowledge, methodological rigor, or generalizability to
other populations/settings
3. Why is it important to fill this gap? What will be gained by acquiring this new
knowledge to fill the gap? How will it improve our understanding or what new
directions may it lead us to?
IV. What research question(s) will your project address, and what important contributions
will it make to science, public health practice, or policy? (Last paragraph of Intro)
A. State the research question(s) clearly. (1-2 sentences)
1. “The purpose of this project is to…” (The research question(s) should directly follow
from the identification of gaps in the literature.)
2. Include a descriptive question (how many, % of people responding, % of people with
disease, etc; these questions can often be answered with frequencies and cross-tabs)
and two relational questions/hypotheses (e.g., what is the relationship between two
variables)
Example of descriptive question:
a. What frequency of adults age 50 and over have been diagnosed with hypertension?
Example of relational question:
b. What is the relationship between the number of primary care visits per year and
adherence drug therapy?
B. How does the study relate to previous research? (1-2 sentences)
1. Examples: “This study builds upon previous work by…,” “This study fulfills a gap in
work done by…,” “This study replicates the work of…”
C. Describe how findings from your study may influence future research, practice, or
policy efforts. (1-2 sentences)
The Basics: How to Write a Results Section
Revised from Saint Louis University, Health Communication Research Laboratory’s
Manuscript Development Seminar Series
Overview:
The purpose of this section is to REPORT THE RESULTS. A results section does NOT
interpret results.
I. Description of the Participants
(1 paragraph)
A. Report demographic characteristic breakdown of participants
“Table 1 summarizes the characteristics of the overall sample. Participants had a mean age
of 35.6 years (range 18-65). Most were aged 18-25 (67%), female (88%), and were
currently enrolled in college (54%).”
NOTE: You will be expected to place your demographic characteristic breakdown in a
table. The in-text write-up will only summarize table highlights – do not reiterate
the number and percent for each variable’s categories. Also always reference the
table number in the first sentence of your in-text write-up.
“Table 2 displays the frequency of self-reported driving distractions by gender (male
versus female). In particular, 40% of females versus 80% of males reported having used a
cell phone while driving in the last 6 months.”
TABLE TEMPLATES:
Table 1. Demographic Characteristics of 60 Adults Aged 20-50 Years (April 2016)
Characteristics
Age
Gender
Female
Male
Unknown
Race
White
Black
Other
Unknown
Education
< High School
High School
Unknown
n (%) or Mean (SD)
22.50 (13.00)
243 (68.3)
113 (31.7)
212 (59.6)
135 (37.9)
8 (2.2)
1 (0.3)
126 (35.4)
109 (30.6)
121 (34.0)
Table 2. Descriptive Characteristics of Main Variables of Interest for 60 Adults Aged 20-50
Years (April 2016)
Variables
N (%) or Mean (SD)
General Healtha
1.44 (1.20)
Fatigued
Yes
30 (50%)
No
30 (50%)
Social Support
A lot
30 (50%)
Some
25 (45%)
None
5 (5%)
a Measured on a scale from 1 (Excellent Health) to 4 (Poor Health)
NOTE: If you have more than two ordinal variables to report in a table, I recommend that you
actually compute the Mean and Standard Deviation instead of the Number and Percent for each
category. The rationale is to condense your table into a reader-friendly table format. Like the
General Health variable in the 2nd table template above, you must refer the reader to a table
subscript and let them know what the scale is (ESPECIALLY if the variables have different
scales!!)
Purchase answer to see full
attachment
Please respond to discussion below using current APA edition and 2 scholarly references. Must be 150 words.
Lateral Epicondylitis Confirmation
The best way to confirm the diagnosis is to perform physical assessments and examinations. One should check for tenderness and pain in the arm. One should focus on the lateral epicondyle area and ask the patient if they are feeling any pain or tenderness. Due to the language barrier, the nurse should also look at the patient’s reactions when they are palpating. One should perform the resisted wrist extension. The patient should extend their wrist as the nurse resists the movement (Karabinov & Georgiev, 2022). If the patient experiences pain, it indicates that the patient might be having lateral epicondylitis. One should also perform a range of motion examination on the wrist and elbow areas. The motion examinations will help in eliminating other possible causes of pain. Lastly, one should perform neurological examinations. Neurological examinations will help in determining if neurological deficits may be the case of the symptoms.
Reason Why the Daughter Seems Distressed with Further Questioning
As more questions are asked about her father’s history, distress is noted in the daughter. The daughter’s distress may be because she fears the father might lose his job due to the injury or his immigration status. The daughter may be fearing that discussing any work-related injury with the employer might lead to the father losing his job. She also fears that discussing the father’s injury with the employer and a health practitioner might lead to legal issues since there is a possibility the father is an undocumented immigrant. With the two possibilities, it is important to ensure that the daughter realizes that her father’s health is more important compared to her fears. The matter should also be approached with sensitivity to ensure that the daughter trusts the healthcare practitioner to collect all necessary health information concerning the patient.
Other Assessments in Addition to Visual Inspection
Other assessments may be required to confirm or rebut lateral epicondylitis. One should test the patient’s grip strength. If it is weakened, it may mean that the patient has lateral epicondylitis (Speers et al., 2018). Provocative tests such as Cozen’s and Mill’s tests may be recommended.
Treatment For Lateral Epicondylitis
The treatment involves a combination of conservative measures which include resting, icing, bracing, physical therapy, pain medication, and corticosteroid injections. The patient should be advised to rest the affected arm while avoiding activities that cause pain to the arm. Apart from the pain medication that may be prescribed, the patient should also use ice on the affected area. Ice will help in reducing inflammation and pain (Ma & Wang, 2020). Bracing may be necessary if the patient requires support on the affected arm. Physical therapy also helps in ensuring that the patient stretches which in turn strengthens the forearm muscles hence improving flexibility. Lastly, corticosteroid injections may be used to reduce inflammation and pain.
Making the Patient More Comfortable
The first step to ensure that the patient and the daughter are comfortable is creating an environment they feel safe and reassures trust. Such an environment can be created when the nurse has knowledge of the culture of the patient and uses the knowledge to make them feel like they fit in. One should also make sure that they understand that the information shared will be kept private and confidential. The nurse should also allow the patient and daughter to share their views and discuss the treatment options available. The nurse should also address the fears that the patient and daughter have making sure that their worries do not hinder them from seeking medical attention (Beck et al., 2019). Overall, creating a safe and welcoming environment while prioritizing the patient’s health is essential in such situations.
Read the attached Case Study Analysis #2: “Chunyu: The First Mover in Chinese M-Health Industry” Write a three pages in length, not including the cover or reference pages. Be formatted according to APA formatting
Detailed instructions included in the assignment questions. Use the video links attached to each question for each case study. Also included are the Templete and the exemplar to be used for this assignments.
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ASSIGNMENT
Use the Comprehensive Psychiatric Evaluation Template, to complete this Assignment. Also
review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed
evaluation document.
•
Use the specific video case study for each Assignment by accessing the link.
•
Consider what history would be necessary to collect from this patient.
•
Consider what interview questions you would need to ask this patient.
•
Identify at least three possible differential diagnoses for the patient in each case
study.
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential
diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the
following into your responses in the template:
•
Subjective: What details did the patient provide regarding their chief complaint and
symptomology to derive your differential diagnosis? What is the duration and
severity of their symptoms? How are their symptoms impacting their functioning in
life?
•
Objective: What observations did you make during the psychiatric assessment?
•
Assessment: Discuss the patient’s mental status examination results. What were your
differential diagnoses? Provide a minimum of three possible diagnoses with
supporting evidence, listed in order from highest priority to lowest priority. Compare
the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what
DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis.
Explain the critical-thinking process that led you to the primary diagnosis you
selected. Include pertinent positives and pertinent negatives for the specific patient
case.
•
Reflection notes: What would you do differently with this client if you could
conduct the session over? Also include in your reflection a discussion related to
legal/ethical considerations (demonstrate critical thinking beyond confidentiality and
consent for treatment!), health promotion and disease prevention taking into
consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk
factors (e.g., socioeconomic, cultural background, etc.).
Use this RUBRIC for this assignment
▪
The response thoroughly and accurately describes the patient’s subjective complaint,
history of present illness, past psychiatric history, medication trials and current
medications, psychotherapy or previous psychiatric diagnosis, pertinent histories,
allergies, and review of all systems that would inform a differential diagnosis.
▪
The response thoroughly and accurately documents the patient’s physical exam for
pertinent systems. Diagnostic tests and their results are thoroughly and accurately
documented.
▪
The response thoroughly and accurately documents the results of the mental status exam.
▪
Response lists at least three distinctly different and detailed possible disorders in order of
priority for a differential diagnosis of the patient in the assigned case study, and it
provides a thorough, accurate, and detailed justification for each of the disorders selected.
▪
Reflections are thorough, thoughtful, and demonstrate critical thinking
▪
The response provides at least three current, evidence-based resources from the literature
to support the assessment and diagnosis of the patient in the assigned case study. The
resources reflect the latest clinical guidelines and provide strong justification for decision
making.
▪
A clear and comprehensive purpose statement, introduction, and conclusion are provided
that delineate all required criteria. …Paragraphs and sentences follow writing standards
for flow, continuity, and clarity.
▪
Uses correct grammar, spelling, and punctuation with no errors
QUESTION 1
ASSESSING AND DIAGNOSING PATIENTS WITH SCHIZOPHRENIA, OTHER
PSYCHOTIC DISORDERS, AND MEDICATION-INDUCED MOVEMENT
DISORDERS
Training Title 9
Name: Ms. Fatima Branning
Gender: female
Age: 28 years old
Temp.- 98.4, Pulse- 82bpm, Resp.18cpm, BP- 124/74, Ht- 5’0, Wt- 118lbs.
Background: Raised by parents, lives alone in Coronado, CA. Only child. Works as an
administrative assistance in car sales, has a bachelor’s in hospitality. Has medical history of
scoliosis, currently treated with chiropractic care. Guarded and declined to discuss past
psychiatric history. Denied family mental health issues, declined to allow you to speak to parents
for collaborative information.
Allergies: latex; menses regular, no birth control
https://drive.google.com/file/d/1OMhlcj3_vNAFr0dujNWzpBLsekM1mOV0/view
Symptom Media. (Producer). (2016). Training title 9 [Video].
RESOURCES
***In not less than FOUR (4) pages***
Reminder: Submitted papers should include a title page, introduction, summary, and
references. Spacing should be 1.5.
***NB – This is an APA Paper. Use the references below and at least THREE (3) outside
resources. FIVE (5) Total References
•
Boland, R. & Verduin, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of
psychiatry (12th ed.). Wolters Kluwer.
QUESTION 2
o
Chapter 5, “Schizophrenia Spectrum and Other Psychotic Disorders”
o
Chapter 2 only section 2.14, “Early-Onset Schizophrenia”
ASSESSING AND DIAGNOSING PATIENTS WITH SUBSTANCE-RELATED AND
ADDICTIVE DISORDERS
Training Title 151
Name: Daniela Petrov
Gender: female
Age:47 years old
Temp- 98.8, Pulse- 84bpm, Resp.- 20cpm, B/P- 132/90, Ht-5’8, Wt-128lbs
Background: Moved to Everett, Washington from Russia with her parents when she was 16
years old. Currently lives in Boise, Idaho. She has younger 1 brother, 3 older sisters. Denied
family mental health or substance use issues. No history of inpatient detox or rehab denied selfharm
hx; Menses regular. uses condoms for birth control Has fibromyalgia. She works part time
cashier at Save A Lot Grocery Store. Dropped out of high school in 10th grade. Sleeps 5-6 hours
on average, appetite good.
https://drive.google.com/file/d/1_HGcsj9Kq61-Uw8z_i89R0ObhMU5udm4/view
Symptom Media. (Producer). (2018). Training title 151 [Video].
RESOURCES
***In not less than FOUR (4) pages***
Reminder: Submitted papers should include a title page, introduction, summary, and
references. Spacing should be 1.5.
***NB – This is an APA Paper. Use the references below and at least THREE (3) outside
resources. FIVE (5) Total References
•
Boland, R. & Verduin, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of
psychiatry (12th ed.). Wolters Kluwer.
QUESTION 3
o
Chapter 4, “Substance Use and Addictive Disorders”
o
Chapter 2 only section 2.17, “Adolescent Substance Abuse”
o
Chapter 27 “Ethics and Professionalism”
Neurocognitive and Neurodevelopment Disorders
Training Title 50
Name: Harold Brown
Gender: male
Age: 60 years old
Vital Signs: Temp.- 98.8, Pulse- 74, Resp.- 18, BP- 134/70, Ht – 5’10, Wt- 170lbs
Background:
Has bachelor’s degree in engineering. He dates casually, never married, no children. Has one
younger brother. Sleeps 7 hours, appetite good. Denied legal issues; MOCA 28/30 difficulty with
attention and delayed recall; ASRS-5 21/24; denied hx of drug use; enjoys one scotch drink on
the weekends with a cigar. Allergies Dilaudid; history HTN blood pressure controlled with
Cozaar 100mg daily, angina prescribed ASA 81mg po daily, valsartan 80mg daily.
Hypertriglyceridemia prescribed fenofibrate 160mg daily, has BPH prescribed tamsulosin 0.4mg
po bedtime.
https://drive.google.com/file/d/1Hj32VGmVZ3i9n-ufOoU1svO6YCUw0xO7/view
RESOURCES
***In not less than FOUR (4) pages***
Reminder: Submitted papers should include a title page, introduction, summary, and
references. Spacing should be 1.5.
***NB – This is an APA Paper. Use the references below and at least THREE (3) outside
resources. FIVE (5) Total References
•
Boland, R. & Verduin, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of
psychiatry (12th ed.). Wolters Kluwer.
o
Chapter 3, “Neurocognitive Disorders”
o
Chapter 2- sections 2.1 “Intellectual Disability”, 2.2 “Communication
Disorders”, 2.3 Autism Spectrum Disorder, 2.4 Attention-Deficit
Disorder, 2.5 “Specific Learning Disorder”, 2.6 “Motor Disorders”
o
Chapter 26 “Level of Care”
o
Chapter 29 “End-of-Life Issues and Palliative Care
Subjective:
CC (chief complaint):
HPI:
Past Psychiatric History:
•
•
•
•
•
General Statement:
Caregivers (if applicable):
Hospitalizations:
Medication trials:
Psychotherapy or Previous Psychiatric Diagnosis:
Substance Current Use and History:
Family Psychiatric/Substance Use History:
Psychosocial History:
Medical History:
•
•
•
Current Medications:
Allergies:
Reproductive Hx:
ROS:
•
•
•
•
•
•
•
•
•
•
•
•
GENERAL:
HEENT:
SKIN:
CARDIOVASCULAR:
RESPIRATORY:
GASTROINTESTINAL:
GENITOURINARY:
NEUROLOGICAL:
MUSCULOSKELETAL:
HEMATOLOGIC:
LYMPHATICS:
ENDOCRINOLOGIC:
Objective:
Physical exam: if applicable
Comprehensive Psychiatric Evaluation Template
Diagnostic results:
Assessment:
Mental Status Examination:
Differential Diagnoses:
Reflections:
References
Page 2 of 2
Comprehensive Psychiatric Evaluation Exemplar
In the Subjective section, provide:
•
•
•
•
•
•
•
•
•
Chief complaint
History of present illness (HPI)
Past psychiatric history
Medication trials and current medications
Psychotherapy or previous psychiatric diagnosis
Pertinent substance use, family psychiatric/substance use, social, and medical history
Allergies
ROS
Read rating descriptions to see the grading standards!
In the Objective section, provide:
•
•
•
Physical exam documentation of systems pertinent to the chief complaint, HPI, and
history
Diagnostic results, including any labs, imaging, or other assessments needed to
develop the differential diagnoses.
Read rating descriptions to see the grading standards!
In the Assessment section, provide:
•
•
•
Results of the mental status examination, presented in paragraph form.
At least three differentials with supporting evidence. List them from top priority to
least priority. Compare the DSM-5-TR diagnostic criteria for each differential
diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to
find an accurate diagnosis. Explain the critical-thinking process that led you to the
primary diagnosis you selected. Include pertinent positives and pertinent negatives
for the specific patient case.
Read rating descriptions to see the grading standards!
Reflect on this case. Include: Discuss what you learned and what you might do differently. Also
include in your reflection a discussion related to legal/ethical considerations (demonstrate
critical thinking beyond confidentiality and consent for treatment!), social determinates of
health, health promotion and disease prevention taking into consideration patient factors (such as
age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background,
etc.).
(The comprehensive evaluation is typically the initial new patient evaluation. You will practice
writing this type of note in this course. You will be ruling out other mental illnesses so often you
will write up what symptoms are present and what symptoms are not present from illnesses to
demonstrate you have indeed assessed for all illnesses which could be impacting your patient.
For example, anxiety symptoms, depressive symptoms, bipolar symptoms, psychosis symptoms,
substance use, etc.)
Comprehensive Psychiatric Evaluation Exemplar
EXEMPLAR BEGINS HERE
CC (chief complaint): A brief statement identifying why the patient is here. This statement is
verbatim of the patient’s own words about why presenting for assessment. For a patient with
dementia or other cognitive deficits, this statement can be obtained from a family member.
HPI: Begin this section with patient’s initials, age, race, gender, purpose of evaluation, current
medication and referral reason. For example:
N.M. is a 34-year-old Asian male presents for psychiatric evaluation for anxiety. He is currently
prescribed sertraline which he finds ineffective. His PCP referred him for evaluation and
treatment.
Or
P.H., a 16-year-old Hispanic female, presents for psychiatric evaluation for concentration
difficulty. She is not currently prescribed psychotropic medications. She is referred by her
therapist for medication evaluation and treatment.
Then, this section continues with the symptom analysis for your note. Thorough documentation
in this section is essential for patient care, coding, and billing analysis.
Paint a picture of what is wrong with the patient. First what is bringing the patient to your
evaluation. Then, include a PSYCHIATRIC REVIEW OF SYMPTOMS. The symptoms onset,
duration, frequency, severity, and impact. Your description here will guide your differential
diagnoses. You are seeking symptoms that may align with many DSM-5-TR diagnoses,
narrowing to what aligns with diagnostic criteria for mental health and substance use disorders.
Past Psychiatric History: This section documents the patient’s past treatments. Use the
mnemonic Go Cha MP.
General Statement: Typically, this is a statement of the patients first treatment experience. For
example: The patient entered treatment at the age of 10 with counseling for depression during
her parents’ divorce. OR The patient entered treatment for detox at age 26 after abusing alcohol
since age 13.
Caregivers are listed if applicable.
Hospitalizations: How many hospitalizations? When and where was last hospitalization? How
many detox? How many residential treatments? When and where was last detox/residential
treatment? Any history of suicidal or homicidal behaviors? Any history of self-harm behaviors?
Medication trials: What are the previous psychotropic medications the patient has tried and what
was their reaction? Effective, Not Effective, Adverse Reaction? Some examples: Haloperidol
Comprehensive Psychiatric Evaluation Exemplar
(dystonic reaction), risperidone (hyperprolactinemia), olanzapine (effective, insurance wouldn’t
pay for it)
Psychotherapy or Previous Psychiatric Diagnosis: This section can be completed one of two
ways depending on what you want to capture to support the evaluation. First, does the patient
know what type? Did they find psychotherapy helpful or not? Why? Second, what are the
previous diagnosis for the client noted from previous treatments and other providers. Thirdly,
you could document both.
Substance Use History: This section contains any history or current use of caffeine, nicotine,
illicit substance (including marijuana), and alcohol. Include the daily amount of use and last
known use. Include type of use such as inhales, snorts, IV, etc. Include any histories of
withdrawal complications from tremors, Delirium Tremens, or seizures.
Family Psychiatric/Substance Use History: This section contains any family history of
psychiatric illness, substance use illnesses, and family suicides. You may choose to use a
genogram to depict this information. Be sure to include a reader’s key to your genogram or write
up in narrative form.
Social History: This section may be lengthy if completing an evaluation for psychotherapy or
shorter if completing an evaluation for psychopharmacology. However, at a minimum, please
include:
Where patient was born, who raised the patient
Number of brothers/sisters (what order is the patient within siblings)
Who the patient currently lives with in a home? Are they single, married, divorced, widowed?
How many children?
Educational Level
Hobbies:
Work History: currently working/profession, disabled, unemployed, retired?
Legal history: past hx, any current issues?
Trauma history: Any childhood or adult history of trauma?
Violence Hx: Concern or issues about safety (personal, home, community, sexual (current &
historical)
Medical History: This section contains any illnesses, surgeries, include any hx of seizures, head
injuries.
Current Medications: Include dosage, frequency, length of time used, and reason for use. Also
include OTC or homeopathic products.
Allergies: Include medication, food, and environmental allergies separately. Provide a
description of what the allergy is (e.g., angioedema, anaphylaxis). This will help determine a true
reaction vs. intolerance.
Comprehensive Psychiatric Evaluation Exemplar
Reproductive Hx: Menstrual history (date of LMP), Pregnant (yes or no), Nursing/lactating (yes
or no), contraceptive use (method used), types of intercourse: oral, anal, vaginal, other, any
sexual concerns
ROS: Cover all body systems that may help you include or rule out a differential diagnosis.
Please note: THIS IS DIFFERENT from a physical examination!
You should list each system as follows: General: Head: EENT: etc. You should list these in
bullet format and document the systems in order from head to toe.
Example of Complete ROS:
GENERAL: No weight loss, fever, chills, weakness, or fatigue.
HEENT: Eyes: No visual loss, blurred vision, double vision, or yellow sclerae. Ears, Nose,
Throat: No hearing loss, sneezing, congestion, runny nose, or sore throat.
SKIN: No rash or itching.
CARDIOVASCULAR: No chest pain, chest pressure, or chest discomfort. No palpitations or
edema.
RESPIRATORY: No shortness of breath, cough, or sputum.
GASTROINTESTINAL: No anorexia, nausea, vomiting, or diarrhea. No abdominal pain or
blood.
GENITOURINARY: Burning on urination, urgency, hesitancy, odor, odd color
NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness, or tingling in
the extremities. No change in bowel or bladder control.
MUSCULOSKELETAL: No muscle, back pain, joint pain, or stiffness.
HEMATOLOGIC: No anemia, bleeding, or bruising.
LYMPHATICS: No enlarged nodes. No history of splenectomy.
ENDOCRINOLOGIC: No reports of sweating, cold, or heat intolerance. No polyuria or
polydipsia.
Physical exam (If applicable and if you have opportunity to perform—document if exam is
completed by PCP): From head to toe, include what you see, hear, and feel when doing your
physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and
History. Do not use “WNL” or “normal.” You must describe what you see. Always
document in head-to-toe format i.e., General: Head: EENT: etc.
Comprehensive Psychiatric Evaluation Exemplar
Diagnostic results: Include any labs, X-rays, or other diagnostics that are needed to develop the
differential diagnoses (support with evidenced and guidelines).
Assessment
Mental Status Examination: For the purposes of your courses, this section must be presented in
paragraph form and not use of a checklist! This section you will describe the patient’s
appearance, attitude, behavior, mood and affect, speech, thought processes, thought content,
perceptions (hallucinations, pseudohallucinations, illusions, etc.)., cognition, insight, judgment,
and SI/HI. See an example below. You will modify to include the specifics for your patient on
the above elements—DO NOT just copy the example. You may use a preceptor’s way of
organizing the information if the MSE is in paragraph form.
He is an 8-year-old African American male who looks his stated age. He is cooperative with
examiner. He is neatly groomed and clean, dressed appropriately. There is no evidence of any
abnormal motor activity. His speech is clear, coherent, normal in volume and tone. His thought
process is goal directed and logical. There is no evidence of looseness of association or flight of
ideas. His mood is euthymic, and his affect appropriate to his mood. He was smiling at times in
an appropriate manner. He denies any auditory or visual hallucinations. There is no evidence of
any delusional thinking. He denies any current suicidal or homicidal ideation. Cognitively, he is
alert and oriented. His recent and remote memory is intact. His concentration is good. His insight
is good.
Differential Diagnoses: You must have at least three differentials with supporting evidence.
Explain what rules each differential in or out and justify your primary diagnostic impression
selection. You will use supporting evidence from the literature to support your rationale. Include
pertinent positives and pertinent negatives for the specific patient case.
Also included in this section is the reflection. Reflect on this case and discuss whether or not
you agree with your preceptor’s assessment and diagnostic impression of the patient and why or
why not. What did you learn from this case? What would you do differently?
Also include in your reflection a discussion related to legal/ethical considerations
(demonstrating critical thinking beyond confidentiality and consent for treatment!), social
determinates of health, health promotion and disease prevention taking into consideration patient
factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic,
cultural background, etc.).
References (move to begin on next page)
You are required to include at least three evidence-based, peer-reviewed journal articles or
evidenced-based guidelines which relate to this case to support your diagnostics and differentials
diagnoses. Be sure to use correct APA 7th edition formatting.
Comprehensive Psychiatric Evaluation Exemplar
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Ethics and Regulations in Healthcare
Course number:
PHC 216
CRN:
14382
Assignment #1 :
Saudi ministry of health announced November 2019 a large
awareness campaign about patient consent. In 500 words feedback
answer the following questions:
•Why informed consent is important in medical ethics and MOH
give all that consideration? (5marks) CLO2
•Define the term capacity in terms of medical ethics, how can you
evaluate a patient’s capacity, describe with an example. (5 marks)
CLO1
Student Name:
Student ID:
Submission Date:
Instructor name:
Dr Mohammed Alsuliman
Grade:
…. Out of 10
College of Health Sciences
Department of Public Health
Assignment’s guideline:
· Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted
· Do not write the answer as points
· Font should be 12 Time New Roman
· Color should be black
· Line spacing should be 2
· Don’t bold or Italic or underline your paragraph
· Start write your answer in the third page
· AVOID PLAGIARISM
Briefly explain how insurance function in relation to risk for individuals and groups. Discussion Post Directions:This discussion response should be at least 250 words in length (excluding references WHICH ARE REQUIRED). You must make sure that your initial discussion response addresses all aspects of the discussion question/statement. Initial discussion post are due 11:59 PM on Fridays.In addition to the weekly initial discussion response(s), you will need to respond to at least twoof your peer’s weekly discussion responses per essay. These peer responses should be at least 100 written words in length and include support (in text citations and a reference page) in at least one of your responses. They must be posted by 11:59 PM on Sundays. There is, of course, no upper limit on your peer responses.
Goal: Develop a PowerPoint presentation on a cardiovascular/pulmonary disorder/disease discussed in the McCance text.
The presentation must provide information about the incidence, prevalence, and pathophysiology of the disease/disorder to the cellular level. The presentation must educate advanced practice nurses on assessment and care/treatment, including genetics/genomics—specific for this disorder. Patient education for management, cultural, and spiritual considerations for care must also be addressed. The presentation must specifically address how the disease/disorder affects 1 of the following age groups: infant/child, adult, or elderly.
Format Requirements:
Presentation is original work and logically organized.
Followed APA format including citation of references.
Power point presentation with 10-15 slides were clear and easy to read. Speaker notes expanded upon and clarified content on the slides.
Incorporate a minimum of 4 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to APA style (the library has a copy of the APA Manual).
Content Requirements:
Select a cardiovascular or pulmonary disorder.
Provide information about the incidence, prevalence, and pathophysiology of the disease/disorder to the cellular level.
Educate advanced practice nurses on assessment and care/treatment, including genetics/genomics—specific for this disorder.
Provide patient education for management, cultural, and spiritual considerations for care must also be addressed.
Must specifically address how the disease/disorder affects 1 of the following age groups: infant/child, adult, or elderly.
NOTE FROM PROFESSOR,
FIND ATTACHED EXAMPLE POWERPOINT TEMPLATE TO FOLLOW, Class this is an example of the powerpoint assignment. The topics on each slide are the specific areas the assignment asked for. I encourage you to use the same topics. Every semester some students failed this assignment because they used topics that were not asked for.
You need 12-15 slides for your assignment. Learn to summarize the main information.
APA is required.
Use a different powerpoint template for your assignment.
Any student who resubmit this template to me, I will delete it.
At the bottom of your screen, type in powerpoint and select it. There will be several templates to chose from.
Please be creative. You will need to chose either a cardiac or a pulmonary condition to do this assignment.
No voiceover powerpoint. I need slides that I can read.
Your font must be uniformed. If the slide is full, just add slide and place the same topic as title and continue your work.
If reference list is long, add slide and place additional references there. Do not add too many on one slide because the font will get smaller.
Unformatted Attachment Preview
HIPPOPOTOMON
STROSESQUIPPE
DALIOPHOBIA
Dr. Cheryl Morgan
Advance pathophysiology
Saint Thomas university
Professor Dr. Cheryl Morgan
3/31/23
Introduction
(Define the disease)
▪
Give a summary definition of the disease.
▪
Explain in professional terms. (WHO, 2022)
▪
Also explain in terms patient will understand (Brown, 2020)
Can put intext citation at the bottom left of each slide if all the
information is from the same source, eg (Brown, 2020) . If you
have different citations, enter beside the sentence. Eg. There
are 100,000 people affected by this disease (WHO, 2022).
2
INCIDENCE
• 1 in every 100 persons affected by this disease (Brown, 2020).
• Use footnotes that is the white space at the bottom of each slide if you have
more to say but it can’t hold on the slide (WHO, 2022).
• Watch YouTube video how to open the footnote (Rose, 2023).
PREVALENCE
PRESENTATION TITLE
• 100,000 in USA and one million worldwide (Crow , 2020).
• Do not overcrowd slides.
• If one slide is full but you are still on the same heading, open another
slide and give it the same name (Do not put cntd).
• You can have multiple reference list slide (Jones, 2019).
• Pay attention to the date range of the scholarly source the assignment
asked for.
• You cannot have a reference list if you did not have intext citation, they
work together. Use only black and proper size font, Times new Romans.
Do not use too much graphics on slides that obscure the writing
9/3/20XX
4
PATHOPHYSIOLOGY
PRESENTATION TITLE
• Explain pathophysiology of how the disease occur
•
• Cellular Level (This is a part of pathophysiology and can go on the
next slide) if you wish.
• Can use picture but give credit to source at the bottom of the
slide. Also give explanation of what is happening in the picture.
• Explains what happen to the cells during this disease process
• Brown (2020)
9/3/20XX
5
PATHOPHYSIOLOGY
PRESENTATION TITLE
• You can add picture/diagram on this slide.
• Give credit to the source where you get the image from.
• Example. At the bottom of the slide…
www.htpp. Imagesource.
9/3/20XX
6
APRN Education
List signs and symptoms
that comes with this
disease.
Dyspnea, Cough
Chest pain
Assessment
MRI
Obesity
Cardiac ablation
EKG
Smoking
Hysterectomy
List genes associated
with the condition .
CT Scan
Sedentary lifestyles
Metoprolol
Alpha 1 antitrypsin
Aspirin
BRCA 1&2 genes
CBC
Troponin.
Diagnostic Tests
Risk Factors
Medication/Treatme
nt
Genetic/Genome
7
PATIENT EDUCATION
PRESENTATION TITLE
• Management- Diet and exercise, medication, F/U care
• Culture- Discuss cultural impact on dx. eg, Native Americans and
Hispanic higher incidence
• Spiritual-eg, culture believe in prayer or certain rituals in curing
diseases. Select the age group your condition affect and explain.
• Age group- Infant is affected by this disease.
• Child 13-18-Juvenile diabetes.
• Adults/Elderly- High incidences especially in obese or those with
family history.
9/3/20XX
8
REFERENCES
9/3/20XX
PRESENTATION TITLE
9
REFERENCES
9/3/20XX
PRESENTATION TITLE
10
Guidelines:Word count: 300to 1000 words Follow APA format for your assignment must include Introduction, Body and ConclusionAll information must be mention in APA referenceFont and Size: Times New Roman (12)Color – Black, Spacing – 1.5, Heading and sub-heading – BoldFollow APA format your assignment must include Introduction, Body & ConclusionAvoid plagiarismSubmit as word document
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Society & Drugs
Course number:
PHC 314
CRN
Essay Topic
Assignment title or task:
(You can write a question)
Societies have evolved to believe that they have the right to
protect themselves from the damaging impact of drug use and
abuse.
(a) Mention the policies and prevention programs for
combating drug use and abuse at any country you
choose ?
(b) Describe the Saudi Food & Drug Authority (SFDA)
approval process for assessing the safety and efficacy of a
newly developed drug?
Student name:
Student ID:
Submission date:
Instructor name
Grade
Dr. Ahmed Hazazi
… out of 10
Guidelines:
•
Word count: 300to 1000 words
•
Follow APA format for your assignment must include Introduction, Body and Conclusion
•
All information must be mention in APA reference
•
Font and Size: Times New Roman (12)
•
Color – Black, Spacing – 1.5, Heading and sub-heading – Bold
•
Follow APA format your assignment must include Introduction, Body & Conclusion
•
Avoid plagiarism
•
Submit as word document
Research an academic article on patient safety that demonstrates how data mining supported process improvement in a healthcare organization. Share any observations you have about the effectiveness of the strategy. Detail any methodologies that were used to define and diagnose the problem, how they implemented the process improvement. Include any metrics that they used to measure the improvement and was the improvement sustainable. Discuss and opportunities that you identified to improve the process that the authors did not include.
Please read the attached case studies and answer the attached framework questions for a total of 10 questions. Answer don’t have to be long. APA format
Unformatted Attachment Preview
Handout: Suggested Framework for Case Analysis
1. Procedure. Who are the parties? Who brought the action? In what court did the case originate? Who
won at the trial-court level? What is the appellate history of the case?
2. Facts. What are the relevant facts as recited by this court? Are there any facts that you would like to
know but that are not revealed in the opinion?
3. Issues. What are the precise issues being litigated, as stated by the court? Do you agree with the way
the court has framed those issues?
4. Holding. What is the court’s precise holding (decision)? What is its rationale for that decision? Do you
agree with that rationale?
5. Implications. What does the case mean for healthcare today? What were its implications when the
decision was announced? How should healthcare administrators prepare to deal with these
implications? What would be different today if the case had been decided differently?
rhe Court Decides
·
· Helling v. Carey ·
83 Wash. 2d 514, 519 P.2d 981 (1974)
Hunter, J.
w find this to be a unique case. The tesU-
In [another case,] Justice [Learned] Hand
of the medical expe~ts is undisputed
stated: .
111
concerning the standards of the profession
[l]n most cases reasonable prudence is in
for the specialty of.ophthalmology. • • • The
fact common prudence; but strictly it is never
issue is whether the defendants’ compli·its measure; a whole calling may have unduly
ance with the standard of the profession ·
lagged in the adoption of new and available
of ophthalmology, which does ~ot require
devices. _
I t never may set its own tests, howthe giving of a routine pressure test to per- . ever persuasive be its usages. Courts must in
sons under 40 years of age, should insula.te the end say which is required; there are prethem from liability under the facts of this ·
cautions so imperative that even their univercase. . • •
.
. .• . .
. _.. >:… sal disregard will not excuse their omission.
[The court points to eviden,ce ,that the ‘.}
.-
_ v _
,
. _
,, , •
•
‘ ·
•
•
• ,,
– •
c ‘
·
– -, . ‘. .. •’
…
[The court proceeds to review cases from
does not rise to that level.”} ·
·
. Wisconsin, California, Oregon, and Washing- .
·
· ···:..-1′
•
t’ff
cont~
ton, plus three l~gal treatises on the subject. IV. Battery or trespass. Plain 1 .
It quotes with favor the following from the
. there was also sufficient evidence~
· Restatement of Torts:}
the case to the jury on the theory 0
Chapter 6: Negligence
r trespass. In effect, she alleges she concircumstances when a doctor performs an
:ented to fusion of two vertebrae (removal
operation to which the patient has not conof only one protruded disc) thinking there
sented. When the patient gives permission to
would be a separate operation if additional
perform one type of treatment and the doctor
vertebrae had to be fused. She asserts the
performs another, the requisite element of
fact four vertebrae were fused combined with deliberate intent to deviate from the consent .
defendant’s assurances and failure to warn
given is present. However, when the patient
her of specific hazards vitiated her consent
consents to certain treatment and the doctor
and makes the paralyzed vocal chord the
. performs that treatment but an undisclosed
result of battery or trespass for which defeninherent complication with a low probability
dant is liable even without negligence. There
occurs, no intentional deviation from the
was no evidence or contention by her in the
·consent given appears; rather, the doctor in
trial court nor is there any assertion here that obtain.ing consent may have failed to meet
she would not have consented to the surgery · his due care duty to disclose pertinent inforhad she known those things she says were .
mation. In that situation the action should be
withheld from her prior to surgery.·
·
pleaded in negligence.
Defendant testified plaintiff was fully · . .. .,.: . From our approval of this analysis it
advised as to the nature of her problem and : ._ should be clear we believe the battery or
the scop~ of corrective surgery. He acknowl- ” · ‘ trespas·s theory pleaded by plaintiff in this
edges he did not advise her of the hazardof
case is limite·d in its applicability to surgery
vocal chord paralysis. ~e believed the P?S· 1/ tc>.’whichthe patient has not consented.
sibility of such occurrence was negligible and :: · There must be a substantial difference
outweighed by the danger of undue a:ppre~_ . : · between the surgery consented to and the
hension if warning of the risk was given.
·,· surgery which is done. Plaintiff asserts she
· [The court next begins a discussion of the · .· consented to·only one fusion rather than two.
distinction between consent and informecf .· . · Assuming this is true, t~e most that could
consent, quoting with approval from its own •·. ·· be argued i’s [that] the second fusion was a
landmark case Cobbs v. Grant.J, ·
battery or trespass. But she does not claim
Where a doctor obtains consent of the .
damages for a second fusion. She asks dampatient to perform one type of treatment
ages because of injury to the laryngeal nerve
.and subsequently performs a substantially . . during surgery. The eviden~e is undisputed
different treatment for which consent was ·.
· that whether one or two fusions were to be
not obtained there is a clear case of battery.
done the path to the axial column had to be
However, wh~n an undisclosed potential
” cleared by retraction of the visceral column.
complication results, the occurrence of which : . Hence, any injury ca_used by such retraction occurred during a procedure to which
Was not an integral part of the treatment ;
consent had been given. Retraction of the
Procedure but merely a known risk, the .· ·
I
h
courts are divided on the issue of whether
: visceral column dur ng t e surgery was not a
th is should be deemed to be a battery or
·. battery or trespass. ·.· ·
we have no occasion
to reach
negligence.
·
·
l •the’ffquesf h
· · tion whether failure to. advise p amt, o t e
isk of laryngeal nerve injury would in the
~e agree With the majority trend. The bat~ircumstances of th!s case have generat~d
a jury Issue on negligence, but we do point
~ry theory should be reserved for those
…
· ·
(continued)
(continued from previous page)
out that recovery on such basis is precluded
unless a plaintiff also establishes he would ·
not have submitted to the procedure if he
had been advised of the risk•••• There is no
evidence plaintiff would have with&
consent In this case. · ··.
.
…
· Affirmed.
Discussion Questions
1. Has due care been shown? Need it be?
2. What is the “second foundation fact,” and how does “common experience” matter
relation to it?
··
·
·
,
3. The opinion states, “There must be a substantial difference between the surgery
consented to and the surgery which is done [for a battery case to be made).” What·
would amount to a “substantial difference” in your mind? What if throat cancer had
been discovered and cleanly removed with no·aftereffects? Would that procedure bff
substantial difference justifying damages for battery even though_no other injury (a
fact, a benefit) had resulted? ·· ·
··
.
4. Why did the court “have no occasion’~ to d.ecide wh~ther failifre to advise the .plainti
the risk of nerve injury raised a negligence issue?.
·
::@i.t,·; :?·
~ .
•,
Notes
1. Pederson v. Dumouchel, 431 P.2d 973, 978 (Wash. 1967).
2. Baldor v. Rogers, 81 So. 2d 658 (Fla. 1954), rehg denied, 81 So. 2d
661 (Fla. 1955); ANGELA R. HOLDER, MEDICAL MALPRACilCE LAw47
(2d ed. 1978).
3. Defilippo v. Preston, 53 Del. 539, 173 A.2d 333 (1961).
4. Miller v. Toles, 183 Mich. 252, 150 N.W. 118 (1914).
5. Fiorentino v. Wenger, 272 N.Y.S.2d 557, 26 A.D.2d 693 (1966), m’d
on other grounds, 19 N.Y.2d 407,227 N.E.2d 296 (1967).
6. Faulkner v. Pezeshki, 44 Ohio App. 2d 186, 337 N.E.2d 158 (1975 )· d
7 . Small v. Howard, 128 Mass. 131, 35 Am. R. 363 (1880) was overrule
by Brune v. Belinkoff, 235 N.E.2d 793 (Mass. 1968).
8. Zills v. Brown, 382 So. 2d 528, 532 (Ala. 1980).
9. 382 So. 2d at 532. See also Morrison v. MacNamara, 407 A.2d 555
(D.C. 1979).
(A'”
254 …
10. Drs. Lane, Bryant, Eubanks & Dulaney v. Otts, 412 So. 2 d
1982).
54 (1971)·
11. ]ON R. WALTZ & FREDE. INBAU, MEDICAL JURISPRUDENCE
Please respond to discussion below using current APA edition and 2 scholarly references. Must be atleast 150 words.
The 41-Year-Old Patient Evaluation & Management Plan
A 41-year-old male patient presents to the neighborhood walk-in clinic with significant elbow discomfort spreading into the forearm in this complicated medical case. The patient’s inability to communicate in English forces him to rely heavily on his 13-year-old daughter, who serves as his interpreter. The pain is thought to be caused by repetitive motions, which may indicate lateral epicondylitis, a disease frequently linked to jobs that require repetitive strain on the elbow (Johns & Shridhar, 2020). However, the family’s improbable position as undocumented workers, which is clear from their reluctance to provide work-related information, makes it difficult to understand the entire extent of the patient’s condition and its repercussions. This instance emphasizes the need of taking a cautious approach to both medical diagnosis and addressing sociocultural issues that might affect a patient’s experience receiving treatment.
Confirming the Diagnosis
A complete physical examination and diagnostic testing are necessary to establish the suspected diagnosis of lateral epicondylitis as the source of the observed elbow and forearm discomfort. The lateral epicondyle can be made painful and tender during the examination by performing particular motions like the Cozen’s test and Mill’s test (Johns & Shridhar, 2020). Additionally, imaging tests like X-rays or an MRI can offer a more in-depth look of the injured region, aiding in the confirmation of the diagnosis and determining the severity of the injury.
Cause of Daughter’s Distress and Hesitancy
The daughter’s worry and reluctance to disclose that the injury could have existed prior to the patient’s present work indicate that she was worried about repercussions from the employer. If the injury is listed as work-related, there may be concern about job instability, discrimination, or even complications with immigration (Lenoir et al., 2019). The daughter could be concerned that making this declaration could endanger their employment or immigration status.
Other Assessments to Perform
Beyond visual inspection, further evaluations include palpation of the afflicted region, range-of-motion tests, and muscular strength evaluations are critical. Additionally, neurological evaluations to test forearm and hand reflexes and feeling might assist exclude nerve involvement (Lenoir et al., 2019). For a thorough examination, it’s critical to assess functional limits and find out about any everyday activities or job-related duties that exacerbate them.
Treatment for Lateral Epicondylitis
Physical therapy, rest, ice application, and pain management are frequently used in the treatment of lateral epicondylitis. To relieve pressure on the injured region, immobilization using a brace or splint may be advised. Stretching and strengthening activities might benefit from physical therapy (Wolf, 2023). Pain and inflammation can be controlled with the use of NSAIDs or corticosteroid injections. If the damage is severe, surgery to remove the tissue can be an option.
Helping Patient and Daughter Feel Comfortable to Stay for Treatment
Reassuring the patient and his daughter of their privacy and secrecy regarding their immigration status is crucial if you want them to feel comfortable staying for treatment. Stress the need of receiving medical care for the patient’s health and wellbeing, irrespective of their immigration status (Wolf, 2023). To foster confidence and give assurance that their best interests are the first priority in the medical environment, present information regarding patient confidentiality regulations and how their information will be kept private. Their anxieties can be reduced by addressing them and empathetically emphasizing the value of adequate medical treatment.
Conclusion
In conclusion, the process of diagnosing and treating a patient becomes more challenging when dealing with language limitations and potential legal issues. A comprehensive examination and the proper diagnostic tests are required for confirmation of the suspected lateral epicondylitis, which may have developed as a result of work stress. In order to foster trust and provide the family the confidence they need to undertake the appropriate medical measures, sensitivity and empathy to their particular situation are essential. The key to creating an environment where the patient and his daughter can comfortably get the treatment they require is to reassure them of their privacy and stress that their health and well-being are the main priorities. Care that is thorough and compassionate must address both the medical and social components of the patient’s circumstance.
Donabedian’s framework for measuring healthcare quality comprises of a triad of domains: Structure, process and outcomes. Think about a recent health encounter you have had with a healthcare provider. Discuss how the visit’s quality was on each domain. What is your overall assessment of the provider’s quality? What recommendations would you make to improve quality? What to SubmitWritten components of the project must follow these formatting guidelines when applicable: double spacing, 12-point Times New Roman font, one-inch margins, and APA-style citations if need. 2-3 paragraphs.
Discuss the challenges of human interactions with technology and your recommendations on how computer or mobile application interfaces should be designed for efficient and effective patient care.
Group 6 Insect Bites and Stings-Ticks, mosquitoes, bees
-Initial first aid
-What to include in assessment?
-Prevention (clothing… deet)
-What are some diseases that are caused by ticks?
-What are some diseases in Los Angeles that are spread by mosquitoes?
But this is a group work/presentation and my part is only the highlighted parts:
A 78-year-old male patient comes to your office complaining of increased left knee pain for the past 3 to 4 months. He has had no history of recent injury. An x-ray done less than 4 months ago showed degenerative osteoarthritic changes. He has full range of motion and denies any recent swelling, pedal edema, or discoloration. He has been a long-distance runner for many years and was diagnosed with osteoarthritis of his left knee more than 10 years ago. He has decreased his weekly running, but the pain is persistent and is affecting his daily activities. He has been using over-the-counter NSAIDs on and off, but states they are no longer working and wants something “stronger.” His vital signs are all normal and he has no history of fever, chills, or rashes. He is otherwise healthy.Which medications do you feel would be safe and appropriate for this patient’s chronic pain?What education would you provide when prescribing pain medication for this patient?
Unformatted Attachment Preview
10/2/23, 2:23 PM
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
Case Study Rubric – 20 Pts
Course: NSG6005-Advanced Pharmacology CP03
Criteria
Answered
items
completely.
Developed
adequate
responses to
questions. Plan
shows depth
and
application of
course
concepts.
No Submission
0 points
Emerging
4 points
Satisfactory
6 points
Proficient
7 points
Exemplary
8 points
Student did not
submit case
study.
Case study does
not meet
expectations;
plan has no
depth or has
inaccurate
elements listed.
Case study
meets minimal
expectations
with minimal
development of
portions of case
study.
Case study
meets
expectations by
including good
depth for all
elements of plan
but does not
demonstrate
good application
of course
content.
Case study
meets or exceeds
expectations
with creative,
innovative
strategies for
case study.
Criterion Score
/8
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582500&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
1/3
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Criteria
Identified and
described
pharmacologic
Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
No Submission
0 points
Emerging
4 points
Satisfactory
6 points
Proficient
7 points
Exemplary
8 points
Student did not
submit case
study.
Case study does
not meet
expectations; no
Case study
meets minimal
expectations
Case study
meets
expectations;
Case study
meets or exceeds
expectations
resources listed.
with few
resources listed.
resources listed
are well
with all resources
well developed
developed in all
but a few areas.
(i.e., textbook,
peer-reviewed
al concepts
and care as
needed.
Criterion Score
/8
articles).
Criteria
Writing: good
flow
throughout
response with
good
transition, and
no spelling or
grammar
errors. APA
No Submission
0 points
Emerging
1 point
Satisfactory
2 points
Proficient
3 points
Exemplary
4 points
Student did not
submit case
study.
Numerous issues
in any of the
following:
transition,
grammar,
spelling, or APA
formatting.
Case study
meets minimal
expectations
with some errors
in transition,
grammar,
spelling, or APA
formatting.
Minor errors that
do not distract
from overall case
study.
Case study
meets or exceeds
expectations in
all areas of case
study.
Criterion Score
/4
format.
Total
/ 20
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582500&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
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Rubric Assessment – NSG6005-Advanced Pharmacology CP03 – South University
Overall Score
No Submisssion
Emerging
Satisfactory
Proficient
Exemplary
0 points minimum
12 points minimum
14 points minimum
16 points minimum
18 points minimum
https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=105186&evalObjectId=582500&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
3/3
A 24-year-old female presents to your office stating that she is troubled by headaches and fatigue. She says that she always feels tired and can’t sleep well, often waking up early if she gets to sleep at all. She describes her headaches as dull, aching, and generalized. These symptoms began about three weeks ago and have been getting worse. She reports a lack of interest in her usual activities, even the ones that she used to enjoy. She also reports that she is missing work due to fatigue and inability to concentrate. Although both her children are in school, she is concerned that she is “losing them”. She is worried that she might have “something bad” because she has difficulty concentrating and is having frequent crying spells. She reports a loss of appetite, with a weight loss of 10 pounds in the last month.
The patient has no significant past medical or psychiatric history and takes no regular medications. However, she takes ibuprofen for headaches. She denies using alcohol or drugs. The patient is married, with two elementary school-age children.
What diagnosis do you believe may apply to this individual?
What classifications of medications can be used to treat this disorder? Which medication do you recommend and why?
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Mr. Early J was seen today while client was in his house. He is 70yr old, alert and oriented, denied pain and discomfort and skin was intact. The house and the living environment was clean. He lives alone and grandchildren visit him occasionally. He verbalized about his retirement and his desire to get something doing. Client stated he wants to be driving Uber. He exercise daily such as 30 push-up daily, playing basket ball, and taking about 30 minutes walk within the neighborhood. Client is taking daily blood pressure medication. Upon visit to his house, blood pressure was 171/88, pulse 66, respiratory 19, 0xygen was 98.0%, and temperature 97.9. Client was educated on the cause of high blood pressure. Follow the rubric below.
Mr. Smith brings his 4-year-old son to your primary care office. He states the boy has been ill for three days. Mr. Smith indicates that he would like antibiotics so he can send his son back to pre-school the next day.
History – Child began with sneezing, mild cough, and low grade fever of 100 degrees three days ago. All immunizations UTD. Father reports that the child has had only two incidents of URI and no other illnesses.
Social – non-smoking household. Child attends preschool four mornings a week and is insured through his father’s employment. No other siblings in the household.
PE/ROS -T 99, R 20, P 100. Alert, cooperative, in good spirits, well-hydrated. Mildly erythemic throat, no exudate, tonsils +2. Both ears mild pink tympanic membrane with good movement. Lungs clear bilaterally. All other systems WNL.
Do not consider COVID-19 for this patient diagnosis.
For the assignment, do the following:
Diagnose the child and describe how you arrived at the diagnosis (i.e. how you ruled out other diagnoses).
Provide a specific treatment plan for this patient, pharmacologic and/or nonpharmacologic.
Provide a communication plan for how the family will be involved in the treatment plan.
Provide resources that Mr. Smith could access which would provide information concerning your treatment decisions.
Utilize national standards, your pharm and/or patho book and medical or advanced practice professional sources. Do not use patient-facing sources or general nursing texts to support your diagnosis and treatment.
Use references to support your concepts. Utilize correct APA formatting and mechanics of professional communication.
Present this Assignment as a narrative document, with a minimum of 4, and maximum of 5 pages not counting the cover page or reference page. It is not necessary to repeat the facts of the case in your narrative.
Before finalizing your work, you should:
Read the Assignment description carefully (as displayed above);
Consult the Grading Rubric (under Course Resources) to make sure you have included everything necessary; and
Utilize spelling and grammar check to minimize errors.
Your writing assignment should:
Follow the conventions of Standard American English (correct grammar, punctuation, mechanics, etc.);
Be well organized, logical, and unified, as well as original and insightful;
Utilize correct APA formatting, 7th edition.
Submit to, and review results of Turnitin. Purdue University Global Student Conduct policy as it relates to plagiarism will be adhered to in this course.
APA ReferencesNEW Answer please| Even if the request was repeated previously, you must provide a new answerProper referencing in APA format is mustText size 12-Times New Roman only.Avoid plagiarismsAvoid copying from any sourceAvoid using another teacher’s solution or a similar previous student’s solution because it is a university whose system can access even the solutions published on the study pool websiteYou must give 100/100 correct solutionAvoid using paraphrasing programs or websitesYou must provide a correct answer 100/100Read the instructions in the file carefull
Unformatted Attachment Preview
College of Health Sciences
Department of Health Informatics
ASSIGNMENT COVER SHEET
Course name:
351361
Course number:
Assignment
question
Assignment 1
Student name:
Student ID:
CRN
Submission date:
Instructor name:
Ali Hassan Barnawi
Grade:
Out of 10
College of Health Sciences
Department of Health Informatics
Question 1
1. What is the difference between Risk and Hazard
2. 2. What is the role of Promotion and Education in Occupational Safety and Health?
• Word count should be 700 to 750 words.
.Text size 12-Times New Roman only. Mention the References in APA format
. • Avoid Plagiarism, “Don’t copy and Paste from Internet, Book or student assignment”.
Question 2
Discuss the steps and methods of risk communication and
community engagement then support your answer with
examples.
• Length of the write-up should be 1 to 2 pages (950-1000 words).
• Text size 12-Times New Roman with double spacing.
• Heading should be Bold
College of Health Sciences
Department of Health Informatics
Paper assignment guidelines
•
•
•
•
Conduct your own research to explore further online resources to provide the conceptual
idea and avoid using advertising or commercial material.
Do not use bullet points in representing your answer.
Use APA referencing style. Please see below link about how to cite APA reference style.
https://guides.libraries.psu.edu/apaquickguide/intext
Do proper paraphrasing to avoid plagiarism.
For this presentation, you will describe how you addressed change on the micro, mezzo, and macro levels as part of your field practicum experience. It is likely that you will reflect on your time in your field practicum, both foundation and concentration, as the most important learning within your MSW program. In your field, you are taking the concepts that you have learned and written about in your coursework and putting those concepts into practice.
As you have come to realize in your field practice, social workers do not only work on one level of practice. You are often engaging in activities on many levels at the same time and as part of your professional work. For this assignment, you will address how you engaged in practice on the micro, mezzo, and macro levels.
Be sure to include how you used these practice work skills in each level of social work practice:
Ethics and Professionalism
Engagement
Assessment
Intervention
Evaluation
Integration of Theory
Cultural competency
Research/evidence-based practice
Incorporate appropriate animations, transitions, and graphics as appropriate.
Length: 12 slides (with a separate reference slide)
Notes Length: 100-150 words for each slide
References: At least three scholarly resources. In addition to these specified resources, other appropriate scholarly resources may be included. Your presentation should demonstrate thoughtful consideration of the ideas and concepts presented in the course and provide new thoughts and insights relating directly to this topic. Your response should reflect scholarly writing and current APA standards.
More information will be giving after selecting tutor
In this discussion board (DB), we would like to hear from you regarding how you are doing learning the diabetes drugs. This includes knowing the drug categories, actions, side-effects, and contraindications. What have you found helps you retain the information? We also are interested in what you think would facilitate your learning. 75-100 words. APA . References under 5 years . Also reply to posting 3-4 sentences 1 reference
Select one of the case studies below for your assignment. In your discussion, be sure to evaluate the presence and effects of alterations in the homeostatic state secondary to gender, genetic, ethnic, and temporal variables.
Case Study Assignment Requirements
Make sure all of the topics in the case study have been addressed.
Cite at least three references in your case study paper; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
All reference sources must be within 5 years.
Do not use sources such as Wikipedia or UpToDate as a reference.
Assignments must have at least four full pages of analytic content, double-spaced (the cover and reference pages do not count in the page count, but must be included with the assignment), and follow APA 7th edition format.
Case Study 1: Disorders of Fluid, Electrolyte, and Acid-Base Balance
Amanda is an 18-year-old with anorexia nervosa. She was recently admitted to an eating disorders clinic with a BMI of 13.9, and although she was a voluntary patient, she was reluctant about the treatment. She was convinced that she was overweight because her clothes felt tight on her. She complained that even her hands and feet “were fat.” One of her nurses explained that a protein in her blood was low. The nurse further explained that, as difficult as it may be to believe, eating a normal healthy diet would make the “fat hands and feet” go away.
What protein do you suspect the nurse was referring to? How would a deficiency in this protein contribute to edema?
What is the difference between the physiology of pitting and nonpitting edema?
Because of her weakened condition, Amanda was moved around the ward in a wheelchair when she was not on bed rest. How does this affect her edematous tissues?
Case Study 2: Respiratory Tract Infections, Neoplasms, and Childhood Disorders
Patricia was called at work by a woman at the local day care center. She told Patricia to come and pick up her son because he was not feeling well. Her son, 3½-year-old Marshall, had been feeling tired and achy when he woke up. While at daycare, his cheeks had become red, and he was warm to touch. He did not want to play with his friends, and by the time Patricia arrived, he was crying. Later that afternoon, Marshall’s condition worsened. He had fever, chills, a sore throat, runny nose, and a dry hacking cough. Suspecting Marshall had influenza, Patricia wrapped him up and took him to the community health care clinic.
Why did Marshall’s presentation lead Patricia to think he had influenza and not a cold? Why is it important to medically evaluate and diagnose a potential influenza infection?
Describe the pathophysiology of the influenza virus. Outline the properties of influenza A antigens that allow them to exert their effects in the host.
Marshall may be at risk of contracting secondary bacterial pneumonia. Why is this so? Explain why cyanosis may be a feature associated with pneumonia.
Case Study 3: Disorders of Ventilation and Gas Exchange
Emmanuel and his mother live in an urban community housing complex. The building is worn down and dirty from the urban dust, cockroaches, and mold. Emmanuel is 5 years of age and has suffered from asthma for the last 2 years. One evening, his mother poured him some milk and put him to bed. Shortly afterward, Emmanuel woke up wheezing and coughing. As he gasped for air, he became more and more anxious. His mother ran for his inhaler, but he was too upset and restless to use it. Emmanuel’s skin became moist with sweat, and as he began to tire, his wheezing became quieter. His mother called 911 and waited anxiously for the ambulance to arrive.
Emmanuel uses a corticosteroid inhaler for the management of his asthma. What is the mechanism of action of this drug? How is its action different from the β2-agonist inhalants?
Why does someone with severe asthma become physically fatigued during a prolonged attack? What are the physiologic events that occur during an attack?
One of the complications of respiratory fatigue is the development of hypercapnia. How does the body compensate for an increase in CO2? What are the effects of hypercapnia on the central nervous system?
Case Study 4: Disorders of Renal Function
Fred, a fit and healthy 44-year-old, was working outside one warm summer afternoon. When he returned home by the end of the day, his lower back felt sore and he felt nauseated. His wife made him dinner, but he was not hungry and chose to go to bed instead. Fred’s symptoms progressed, and soon he was rolling on the bed with excruciating pain. He said his back hurt as well as his stomach and groin area. The pain would ease off only to return a short while later, and when it did, Fred would begin to sweat and run to the bathroom to vomit. His wife became concerned and started the car. When his symptoms abated, she helped him into the car and rushed him to the hospital.
At the hospital, an abdominal radiograph showed the presence of renal calculi in Fred’s right ureter (urolithiasis). What is the mechanism of stone formation in the kidney? What is the role of citrate in the kidneys?
Why would the administration of calcium supplements be useful for a patient with calcium oxalate stones?
Hydronephrosis can be a complication of renal calculi. What is hydronephrosis? How does back pressure occur in a kidney, and what physiologic mechanism is responsible for nephron damage when back pressure is present?
Case Study 5: Disorders of Gastrointestinal Function
Marcee is a 52-year-old woman who worked at a reception desk at a company head office. She took some time off when she was treated for colorectal cancer. The Dukes classification was stage I, and the treatment protocol involved surgery and radiation therapy. No one in her family had a history of the disease. Marcee does not drink or smoke, but she does not pay close attention to her diet. At work, her meals consisted mainly of the foods she got from vending machines at the cafeteria. At home, she preferred to heat up frozen dinners or any prepackaged food that required minimal preparation time.
Review Marcee’s diet. What factors in her dietary choices might contribute to the development of colorectal cancer?
Colorectal cancer often arises from adenomatous polyps. What are the development and histologic features of these polyps?
Colorectal cancer may be a complication in individuals with ulcerative colitis. How are the “pseudopolyps” seen in this disease different from the polyps discussed above?
Why is a fecal occult blood test used as one of the screening tools for colorectal cancer? Explain the procedure for administering the test.
Before finalizing your work, it is important to:
Review Case Study Assignment Requirements (described above) and the Case Study Assignment Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
Make sure to review your chosen case study carefully to make sure you have effectively answered all questions asked.
Utilize spelling and grammar checks to minimize errors.
Follow the conventions of Standard American English (correct grammar, punctuation, etc.).
Make sure your assignment is original, insightful, and utilizes your logic and critical thinking skills; that your assignment is well-organized, with superior content, style, and mechanics.
Utilize APA 7th Edition format.
Be diligent about APA formatting including paraphrasing and direct quotations, utilizing appropriate in-text citations, and referencing your sources.
Select one (1) of the three (3) published articles that was approved in week 4.Post the title of the article, authors, purpose, and type of study: Quantitative, Qualitative, or Systematic Review.Discuss how it might influence your practice. What changes to your practice would you recommend based on the article?2 discussion comments
Create a mini handout (Flyer) that talks about self care/mental health? Specifically hygiene like brushing your teeth, showers, using deodorant, ect. The targeted audience are teenagers. Make sure to include pictures
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name
Health Planning
Course number
PHC 274
CRN – Branch name
Choose any one of the current public health issues in Saudi Arabia,
answer the issues based on the following questions:
1. Define the health problem with some details (medical/clinical
background)?
2. Identify the magnitude of the problem on the society such as
the incidence and prevalence and other epidemiological data?
Assignment title or task:
( write and questions)
3. Find data on the population characteristics who were affected
by the health problem, such as distribution of age categories,
income levels, educational levels, and occupation distribution
within a community etc…
4. What are the causes or risk factors leading to this problem?
(factors, conditions, situations, or events that in some way
contribute to the health problem). You may use causal theory as
it is going very helpful here.
5. Conclude your brochure with plan a health program that is
going to prevent/reduce this health problem.
Student name:
Student ID #
Submission date:
Instructor name:
Grade:
…. Out of 10
Assignment Instructions (Week 6):
Dear Students,
The Assignment is available in Course materials and activities under Week 6 by name Week 6 –
Assignment.
This activity will comprise for 10 marks in the Total course work.
The Assignment is available from 1/October/2023 ie; Sunday 12:30 PM and due date 7/October/2023
ie; Saturday until 11:59 PM.
Assignment guidelines:
•
•
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, Submission date)
in word document, Pdf is not accepted.
Avoid plagiarism.
Word count- Maximum 500 -800 words for each answer.
Font should be 12 Time New Roman.
Color should be black.
Line spacing should be 1.5.
Don’t use bold or Italic or underline in your answer.
References should be in APA style format only.
Edit I HAVE COMPLETED THE SHADOW HEALTH SECTION , I NOW NEED IT PLACE IN MY TEMPLATE FORM , , I HAVE DONE THE REQUIRED WORK DIGITAL CLINICAL EXPERIENCE: FOCUSED EXAM: COUGH
In this DCE Assignment, you will conduct a focused exam related to cough in your DCE using the simulation tool, Shadow Health. You will determine what history should be collected from the patient, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
TO PREPARE
Review the Shadow Health Resources provided in this week’s Learning Resources specifically the tutorial to guide you through the documentation and interpretation within the Shadow Health platform. Review the examples also provided.
Review the DCE (Shadow Health) Documentation Template for Focused Exam: Cough found in this week’s Learning Resources and use this template to complete your Documentation Notes for this DCE Assignment.
Access and login to Shadow Health using the link in the left-hand navigation of the Blackboard classroom.
Review the Week 5 Focused Exam: Cough Rubric provided in the Assignment submission area for details on completing the Assignment in Shadow Health.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
The RUA: Pathophysiological Processes Presentation is due this week. If you have not already begun working on the assignment, download the assignment guidelinesLinks to an external site. to get started.
Submit your Pathophysiological Processes Presentation no later than 11:59 p.m. MT on Sunday of this week.
This criterion is linked to a Learning OutcomeThis criterion is linked to a Learning Outcome Professionalism (15 points/15%)1. Team members are professionally dressed.
2. Team is introduced and assigned roles are identified prior to starting the presentation.
3. Full group participation.
4. Respectful and professional language is used throughout the presentation.
5. Adheres to the time limit of 15 minutes.
15 pts
Highest Level of Performance
Includes no fewer than 3 requirements for section.
14 pts
High Level of Performance
Includes no fewer than 2 requirements for section.
11 pts
Satisfactory Level of Performance
Includes no less than 1 requirement for section.
5 pts
Unsatisfactory Level of Performance
Present, yet includes no required criteria.
0 pts
Section not Present
No requirements for this section presented.
15 pts
This criterion is linked to a Learning OutcomeThis criterion is linked to a Learning Outcome Team Presentation (60 points/60%)1. Common causes of the disease or condition
2. Risk factors for the disease or condition
3. Impact of age
4. Prevalence based on gender
5. Influence of environment
6. Genetic basis of disease
7. Lifestyle influences
8. All information supported by current literature
60 pts
Highest Level of Performance
Includes no fewer than 8 requirements for section.
53 pts
High Level of Performance
Includes no fewer than 7 requirements for section.
48 pts
Satisfactory Level of Performance
Includes no fewer than 6 requirements for section.
23 pts
Unsatisfactory Level of Performance
Includes 5 or fewer requirements for section.
0 pts
Section not Present
No requirements for this section presented.
60 pts
This criterion is linked to a Learning OutcomeThis criterion is linked to a Learning Outcome Speaker Notes and Reflection (20 points/20%)1. APA Title page with assigned individual part identified.
2. Ideas presented clearly.
3. APA citations throughout.
4. At least two (2) nursing, peer reviewed, primary sources from the last 5 years, excluding the textbook used to support work.
5. APA reference page.
6. Each student includes a reflection on what was learned completing this team assignment.
20 pts
Highest Level of Performance
Includes no fewer than 6 requirements for section.
18 pts
High Level of Performance
Includes no fewer than 5 requirements for section.
16 pts
Satisfactory Level of Performance
Includes no less than 4 requirements for section.
7 pts
Unsatisfactory Level of Performance
Includes 1-3 requirements for section
0 pts
Section not Present
No requirements for this section presented.
20 pts
This criterion is linked to a Learning OutcomeThis criterion is linked to a Learning Outcome Presentation APA Style and Organization (5 points/5%)1. References are submitted with assignment.
2. Uses appropriate APA format (6th ed.) and is free of errors.
3. Grammar and mechanics are free of errors.
4. At least two (2) scholarly, primary sources from the last 5 years, excluding the textbook, are provided.
5 pts
Highest Level of Performance
Includes no fewer than 5 requirements for section.
4 pts
Satisfactory Level of Performance
Includes no fewer than 4 requirements for section.
You will create 5 entries for your Reflective Journal about a patient encounter. In the 5th entry, you will review the previous 4 entries and evaluate your progress in reflective practice over the course of the term. Each journal should be a minimum of 250 words.The purpose of this reflective journal is self-reflection regarding the role in the process of self-reflection as a PMHNP provider. Through reflective practice, the student will evaluate their own emotional health and recognize one’s own feelings as well as one’s ability to monitor and manage those feelings. The point of the exercise is to learn yourself, your triggers, the types of cases you end up getting overly involved with, and those you’d rather refer to someone else. The idea is to be able to personally reflect on your behaviors/thoughts/decisions and how those impact you in the role of PMHNP. Discuss a patient interaction in which there was transference, countertransference, prejudice/biases, or judgments that you may be making about the patients or that they are verbalizing about you.Have you encountered this before?From where does this originate?Would it appropriate for you to continue to provide care to the patient and if so, how will you prevent these issues from affecting the care you are able to provide the patient?
In this milestone, you will identify and analyze an initiative that addresses the
A Gap in Quality Related To Care Coordination for Individuals with Chronic Illnesses
Explain what the initiative is, identify the goals of the initiative, describe the circumstances around its development, and identify sources of funding.
Tip: You have been introduced to the Institute for Healthcare Improvement (IHI) website in this course. It may be helpful to you as you conduct your research on an existing initiative.
Your milestone should address each of the following points in detail:
Explain an existing healthcare initiative that was put in place to address this gap in access.
Explain the specific goals of the existing initiative in place to address this gap in access.
Describe the circumstances around the development of the existing initiative. Consider when the initiative was developed and what factors were considered.
Describe the resources required to fund the existing initiative.
Explain why the existing initiative is not meeting its intended purpose and now requires improvement.
What to Submit
Your paper must be submitted as a 2- to 3-page Microsoft Word document with double spacing, 12-point Times New Roman font,
one-inch margins, and at least three sources cited in APA format.
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Organizational Behavior
Course number:
HCM102
CRN
11482
Answer the following question-
Assignment title or task:
1. How do culture and cultural diversity / variation
affect work behavior and job performance?
Provide examples to show why a knowledge of such
differences is important for managers.
Student Name:
Students ID:
Submission date:
Instructor name:
Layla Alzahrani
Grade:
…..out of 10
College of Health Sciences
Department of Public Health
Due Date: Saturday, 7th October 2023 (11:59 pm)
Instructions for submission:
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
ASSIGNMENT COVER SHEET
Course name:
Concepts of Health Education & Health Promotion
Course number:
PHC 212
CRN:
Paper Assignment
Assignment title or task:
(You can write a question)
Choose a health issue in KSA and explore the
determinants causing that issue and justify your
understanding with evidence from the literature.
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Your response should be a minimum of 250 words but should not exceed 500
words (Excluding references).
• Support your answer with examples.
• Font size should be 12
• Font type should be Times New Roman
• Heading should be Bold
• Colour should be Black
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style and include in text citation.
• AVOID PLAGIARISM
• Due date; 07/10/2023 11:59 PM
Best of Luck
Read the attached Qualitative Research Study. After reading the article, please appraise this study. Use table 7.1 in your book to guide you in your appraisal. What are the strengths and weakness you found in this study?
Unformatted Attachment Preview
pharmacy
Article
Exploration of Nurses’ Knowledge, Attitudes,
and Perceived Barriers towards Medication
Error Reporting in a Tertiary Health Care
Facility: A Qualitative Approach
Eman Ali Dyab 1 , Ramadan Mohamed Elkalmi 2 , Siti Halimah Bux 3 and
Shazia Qasim Jamshed 3, *
1
2
3
*
Department of Pharmaceutics, Faculty of Pharmacy, Tripoli University,
Tripoli 42300, Libya; eman_diab2008@yahoo.com
Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi Mara,
Puncak Alam 42300, Malaysia; edriph@gmail.com
Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia,
Kuantan 25200, Malaysia; sitihalimah@iium.edu.my
Correspondence: shazia_jamshed@iium.edu.my; Tel.: +601-7470-3692
Received: 15 September 2018; Accepted: 2 November 2018; Published: 5 November 2018
Abstract: Medication error reporting (MER) is an effective way used to identify the causes of
Medication Errors (MEs) and to prevent repeating them in future. The underreporting of MEs
is a challenge generally in all MER systems. The current research aimed to explore nurses’ knowledge
on MER by determining their attitudes towards reporting and studying the implicated barriers
and facilitators. A total of 23 nurses were interviewed using a semi-structured interview guide.
The saturation point was attained after 21 interviews. All the interviews were tape-recorded and
transcribed verbatim, and analysed using inductive thematic analysis. Four major themes and
17 sub-themes were identified. Almost all the interviewees were aware about the existence of the
MER system. They showed a positive attitude towards MER. The main barriers for MER were the
impacts of time and workload, fear of investigation, impacts on the job, and negative reactions
from the person in charge. The nurses were knowledgeable about MER but there was uncertainty
towards reporting harmless MEs, thus indicating the need for an educational program to highlight
the benefits of near-miss reporting. To improve participation strategies, a blameless reporting culture,
reporting anonymously, and a simplified MER process should be considered.
Keywords: medication error reporting; nurses’ attitudes; qualitative study; barriers; medication error
1. Introduction
The main principle of giving medication to the patient is to serve them in order to restore his/her
health without any harm [1]. Adverse events and medical errors are the main issues threatening
the patient’s safety, and are awkward predicaments in nearly all healthcare systems [2]. The World
Health Organization (WHO estimated that millions of people suffer injuries directly attributed to
medical care, and many are preventable [3], although prevalence in developing countries is reported
to be higher than developed nations [4]. In Southeast Asian countries, the reported administration
error rates ranged from 15.2% to 88.6% [5]. In Taiwan, a study mentioned that the overall rate of the
medical incidents ranged from 30% to 47.6%, and most of them were related to MEs [6]. In a Malaysian
study, Johari et al. reported 2572 reported cases of ME in 2009 [7]. The prevalence of ME among
geriatric patients was 25.17% [8] whereas in paediatrics this figure was 11.7% [9]. A recently published
Pharmacy 2018, 6, 120; doi:10.3390/pharmacy6040120
www.mdpi.com/journal/pharmacy
Pharmacy 2018, 6, 120
2 of 14
four-year retrospective study reported that the total number of paper-based ME reports submitted
to the National Medication Error Reporting system (NMER) was 17,357, but only 0.3% of MEs were
in the administration stage [10]. The percentage in the administration stage is very low, representing
paper-based reports only (excluding online submitted MEs reports) collected by the NMER system,
as well as the effect of underreporting. The annual estimated cost of MEs in Malaysia was estimated to
be 111,924 Malaysian Ringgit (MYR) [10]. Clinically, MEs can have small to severe consequences for
patients. It was reported that the total number of MEs in the administering stage was 166, where 1%
had fatal consequences, 20% were serious, 32% were significant, and 46% were nonsignificant [11].
The identification of trends and patterns of MEs were the main reasons for establishing a ME
reporting system [12]. The effectiveness of all these systems depend on their ability to document
the occurred MEs. Establishing guidelines for medical error reporting (MER) is not enough, as the
healthcare practitioners (reporters) play a vital role in the MER process. The healthcare practitioners’
knowledge about MER, their attitudes toward reporting MEs, and perceived barriers toward MER are
important factors which determined the success of MER systems. Health care professionals in general
and nurses in particular are responsible for MER. It has been reported that the MEs are underreported
in all countries. Nurses’ knowledge and attitudes as well as barriers and facilitators toward MER
among nurses in Malaysia are little-studied issues and warrant investigation.
This study is intended to attain deeper insight into the knowledge and attitudes held by Malaysian
nurse practitioners towards the ME concept and MER process, as well as to investigate the barriers
which prevent nurses from reporting their MEs.
1.
2.
3.
4.
What do nurses know about the ME and MER system?
What are the nurses’ attitudes toward MER?
What are the barriers which could hinder nurses from reporting their MEs?
What are the factors which could facilitate MER among nurses?
2. Methods
2.1. Study Design and Setting
The study was conducted after getting approval from both the Medical Research Ethics
Committee Ministry of Health Malaysia (NMRR-15-2485-24709) and the International Islamic
University of Malaysia Research Ethics Committee (IREC 446). Use of a qualitative method (in-depth
interviews) provides flexibility and efficiency in collecting data related to personal feelings, attitudes,
and experiences [13] and hence, these methods are used for the exploration of the participants’
experiences towards medication error reporting. The individual interview method was chosen over
focus group discussions because of privacy, suitability, and comfort zone issues for shy and hesitant
participants [14]. This gives liberty to the participants to elaborate his/her answers without distractions
from others [14]. The current research was executed in a tertiary healthcare facility of Kuantan city,
Pahang, Malaysia.
2.2. Participants
The target study population was nurses practicing in different units of the hospital. No specific
inclusion and exclusion criteria were applied, and thus all nurses were eligible to participate in
the current research. The participants were recruited by using convenience and snowball sampling
technique. The snowball method helps to recruit hidden subjects which cannot be easily found [15].
The first participant was a nurse from the medical unit and was given information on the details of
the research along with an assurance of confidentiality and anonymity. After her acceptance she was
asked to fill in demographics form and sign the consent form. The interviews were recorded by using
Audio Recording Titanium Software® version 8.5.5 (AATSystems, Kent, UK), and notes were taken
during the interviews. After finishing the first interview, the interviewee was asked to nominate the
Pharmacy 2018, 6, 120
3 of 14
next participant. Thus, she made a referral to the next nurse, with the same pattern for the subsequent
interviews. Thus, a chain referral technique followed throughout the research study. The number
of participants was determined once the saturation point was achieved. The saturation point occurs
when no new concepts and themes emerge [14,16,17]. Two extra interviews were conducted to confirm
the saturation point. The field supervisor also helped in recruitment process. Participation was
simply on a voluntary basis, and they were informed that anytime during the course of research they
could withdraw. Moreover, they were assured that their confidentiality and anonymity would be
maintained. Only the research team had access to records. The purpose of the study was explained
to each participant before the interviews commenced and therefore, all the participants were asked
to sign an “informed consent form” followed by the addition of their demographic characteristics.
A total of 23 nurses were interviewed.
2.3. Procedure and Interview Process
In-depth interview sessions were conducted using a semi-structured interview guide in June 2015.
This guide was developed on the basis of prior published studies related to MER among health care
professionals [18–20]. The purpose of using this guide was to make sure that all important issues
about the topic were covered in the interviews [13,21]. The medium of communication during the
interview was primarily English, followed by a couple of interviews being conducted in Bahasa
Malayu i.e., the native language of participants. The field supervisor agreed to work as a research
assistant and a translator and assisted the nurses who could not understand the English language. As a
result, participants who expressed their thoughts in the Bahasa Malayu language were also included.
Each interview lasted for about 30–45 min. Venue was chosen as per proximity to nurses’ working units,
their preference of level of comfort/privacy, and the level of noisiness. Places such as the library private
room, the seminar room, and nurses’ rooms were selected as the venue for interviews. The discussion
was focused on several major issues; the nurses’ knowledge, experiences, and perceptions about ME
and MER, exploring their attitudes towards MER, comprehending the factors which might prevent
the nurses from reporting their MEs, and those factors which would promote MER among nurses.
Probing questions were asked to provoke more details from interviewees [13,21].
2.4. Data Analysis
The data analysis was performed using the inductive thematic analysis approach. The participants’
approved transcripts (transcribed verbatim) were coded as (N1, N2, . . . , N23). The process is illustrated
in Figure 1. The analysis followed a cyclic pattern, where it started by familiarization stage, generation
of initial codes stage and revision stage to refine the emerged codes [22,23]. The transcripts were
analysed again by another researcher to validate the resulted themes [22], and a third person’s opinion
was sought to resolve any disagreement between the previous analyses [24,25].
The current research followed an established criterion for maintaining quality in qualitative
research and thus follow the standards of Guba and Lincoln [26] for generating credibility,
transferability, dependability, and confirmability. For strengthening the credibility of the research there
was a continuous interaction with the participants, with checking of interpretations against interview
transcripts. A review with the participants was undertaken. Contrary to quantitative research, the aim
of qualitative is not generalizability but to observe and execute transferability. Therefore, a detailed
description of the participants’ experiences helped the researchers identify the patterns of social
relationships in reporting MEs and as well as the cultural backgrounds of the participants who reported
hesitancy in reporting. For dependability purposes, external audit criteria were put in place, and a
researcher not involved directly in research helped in the evaluation of interpretation and conclusions
with respect to the data collected. For establishing confirmability, not only a conformability audit (as
mentioned above) but also triangulation and reflexivity were maintained. In terms of establishing
triangulation, both methodological triangulation (i.e., the research followed the quantitative design
after qualitative inquiry) and analyst triangulation (i.e., using different analysts to review the findings)
Pharmacy 2018, 6, 120
4 of 14
were maintained,
whereas
forREVIEW
reflexivity, a reflexive note-sheet was used to record the methodological
Pharmacy 2018,
6, x FOR PEER
4 of 14
parameters and logistics involved. Interviewees were female (n = 22); of Malay race (n = 22); holding a
note-sheet was used to record the methodological parameters and logistics involved. Interviewees
diploma (n = 21). The nursing diploma is a 3-year course in Malaysia and on its successful completion
were female (n = 22); of Malay race (n = 22); holding a diploma (n = 21). The nursing diploma is a 3one can register
with
Board
Malaysia
work asone
a staff
nurse. with
All participants
year course
in Nursing
Malaysia and
on its
successfuland
completion
can register
Nursing Boardwere full
time employees.
Half
of
the
participants
(n
=
12)
have
working
experience
of
than 11 years.
Malaysia and work as a staff nurse. All participants were full time employees. Half of themore
participants
(n
=
12)
have
working
experience
of
more
than
11
years.
Slightly
more
than
three-quarters
the the prior
Slightly more than three-quarters of the participants (n = 18) had not reported any MEs of
over
participants (n =18) had not reported any MEs over the prior 12 months. The interviewees were
12 months. The interviewees were attached to different units in the hospital such as intensive care units
attached to different units in the hospital such as intensive care units (ICUs), medical units, critical
(ICUs), medical
units, critical cardiac units (CCUs), accident and emergency unit (A&Es), orthopaedic
cardiac units (CCUs), accident and emergency unit (A&Es), orthopaedic units, neonatal intensive
units, neonatal
intensive
care
units
(NICUs),
units.
The demographic
characteristics
of
care units
(NICUs),
and
paediatric
units.and
Thepaediatric
demographic
characteristics
of participants
are
presented
in Table 1. in Table 1.
participants
are presented
1. The study
process
flowchart.(I)
(I)transcription
transcription step,
(II) (II)
datadata
analysis
step, (III)
analysts’
Figure 1.Figure
The study
process
flowchart.
step,
analysis
step,
(III) analysts’
triangulation
(two researchers
performed
analysis
and person
third person
resolved
any
triangulation
method method
(two researchers
performed
analysis
and third
resolved
any disagreement),
disagreement), and (IV) final result.
and (IV) final result.
3. Results
Table 1. Interviewees socio-demographic characteristics (n = 23).
Four major themes and 17 sub-themes were emerged: knowledge about MER, attitudes toward
Characteristic
Number (n = 23)
Percentage (%)
MER, barriers toward MER, and facilitators to improve MER process. Figure 2 represents the
Female
22
95.7
emerged themes
Genderand categories.
Male
Race
Characteristic
Age
1
Malay
Table 1. Interviewees socio-demographic
characteristics (n22= 23).
Chines
1
Gender
Race
≤30
30–40
Female
41–50Male
51≥
Malay
Education level
Diploma
Chines
Bachelor
Experience in years
Age
≤5
6–1030–40
≥11 41–50
≤30
Practice site
51≥
Medical unit
a
ICUDiploma
b
CCU
Bachelor
A&Ec
Orthopaedic unit
NICU d
Paediatric unit
Number of reports in the last 12 months
Never report
≥1
Education level
Number (n
6 = 23)
2214
12
1
22
21
1
2
6
5
14 6
2 12
14
21 9
22
3
2
1
2
18
5
4.3
95.7
4.3
Percentage
(%)
26.1
95.7 60.9
4.3 8.7
4.3
95.7
91.3
4.3
8.7
26.1
21.7
60.9 26.1
8.7 52.2
4.3 17.4
91.3 39.1
8.7 8.7
13
8.7
4.3
8.7
78.3
21.7
(a ) Intensive care unit. (b ) Critical cardiac unit. (c ) Accident and emergency unit. (d ) Neonatal intensive care unit.
Medical unit
4
17.4
ICU a
9
39.1
b
2
8.7
CCU
Practice site
A&Ec
3
13
Orthopaedic unit
2
8.7 5 of 14
Pharmacy 2018, 6, 120
NICU d
1
4.3
Paediatric unit
2
8.7
3. Results
Never report
18
78.3
Number of reports in the last 12 months
≥1
5
21.7 toward
Four major themes and 17 sub-themes were emerged:
knowledge about
MER, attitudes
Intensive
care unit.
(b) Critical
cardiac unit.
(c) Accident
andprocess.
emergency
unit. 2(d)represents
Neonatal intensive
MER,(a)barriers
toward
MER,
and facilitators
to improve
MER
Figure
the emerged
careand
unit.categories.
themes
Emergent themes and sub-themes. MER:
MER: medical error reporting.
Figure 2. Emergent
3.1. Knowledge about MER
3.1.1. Concept of ME
The nurses were asked about their understanding of the ME concept. Almost all of them correctly
understood the concept of ME. Moreover, they linked its meaning to five/seven rights, while others
just gave simple and general answers like “giving incorrect medication to the patient”.
“Medication error is an error when giving medication including dosage and also the type of medication,
make sure to follow the 7Rs practice in the hospital.” (N1)
Pharmacy 2018, 6, 120
6 of 14
“Medication error is when something unwanted occurs such as wrong medication is given to the
patient.” (N7)
“Medication error means giving wrong medication to the patient, which includes wrong dose,
wrong route, and wrong documentation.” (N13)
3.1.2. The Existence of a System for MER and the Importance of MER
All the interviewees were aware about the existence of MER system and the importance of MER.
They stated that data collected by MER can be used as an indication of the quality of health service
provided to the patient. It can be used to improve this service by carrying out root-cause analysis
for the MEs reports, and the reported data can be utilized for learning purposes. In other words,
ME reports can be used as good resources to help nurses in avoiding repeating the same errors again
in future.
“Yes, we have a system for medication error reporting [ . . . ] And, it is very important because it
involves the quality of service which is being given to the patient and it is very important to monitor
ME.” (N1)
“It is important because we want to improve the way of delivering care and serving the patient.
To learn from reports, where and which thing can be done. So we have more information about what
has been done and their consequences.” (N3)
“It is important because we want to detect what is ME and to prevent it from happening again.” (N7)
“Normally, we do root-cause analysis to find out when and how this happened. Sometimes it comes
from the wrong prescription like wrong dose or wrong route or wrong frequency and then we find out
how that happen and try to tackle.” (N5)
“It is to guide our practice [ . . . ] Not add more error to this collection [ . . . ] To avoid ME in future
[ . . . ] It is considered as a good resource.” (N4)
3.1.3. The Availability and Confidentiality of the Reporting Form
The majority of interviewed nurses claimed that during their practice, they did not report MEs,
since until the time of interviews they did not commit any error. As a result, most of them did not see
the reporting form and some of them had seen it but they did not remember its content.
“The reporting form is available in the pharmacy department.” (N5)
“I have not seen the reporting form before. Because, so far, I did not make any error.” (N8)
The nurses were asked about their opinions on the reporting form.
“I have seen it; it is easy to fill, it does not need modification or re-designation.” (N1)
“The report is not too detailed like describing everything, but it underlines or highlights when the
medication was given to the patient.” (N3)
3.2. Attitude of Nurses toward ME Reporting
The nurses were asked about their attitudes toward ME reporting. The majority of the participants
had a positive attitude toward reporting of MEs, whether these MEs caused a serious side effect to the
patient or not. The other group had uncertain attitudes and they tended to report the MEs which led
to harm to the patient only.
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3.2.1. Positive Attitude
The majority of nurses claimed that they report all encountered MEs immediately. They reported
them irrespective to their seriousness or the level of patient’s harm due to the error.
“Nothing affects my decision to report, once the error occurs it should be reported.” (N4)
“It is not a matter of choice.” (N7)
“Once I detect an error, I cannot just ignore it, and I straightforward report it […] We must make a
report also because this is ME, and we must report whether it is serious or not.” (N2)
“Here in A and E department, it does not matter if the error is big, mild, or small, it must be reported.” (N8)
3.2.2. Uncertain Attitude toward ME Reporting
During the discussion with the participants about their attitude toward MER, some participants
showed uncertain attitudes towards MER. They would report MEs only based on another factor such
as the severity of the ME or route of administration, or when they received a direct request form the
person in-charge.
“If the error caused big and serious complication I have to report.” (N17)
“Based on the patient, I will see the effect on the patient first. My first concern is the patient, I will
not report unless something happens to the patient. In this case, the doctor gives antidote and then
there is an investigation and eventually, they will revert to me.” (N9)
One nurse related the medication error reporting to the dosage form of administered medicine.
He believes that errors are serious when the medication given by the intravenous route, and this
type of error should be reported, while those resulting from oral or topical administration should not
be reported.
“Based on the route of administration IV it should be reported.” (N18)
One nurse insisted that she reports only if the person in charge requests her to fill the
reporting form.
“I just inform the sister and the doctor, and let them choose to fill the form or not but as for investigation,
I will come and join them” (N13)
Before reporting, the nurses think of the problems that will be faced after reporting their errors.
This has a high effect on their decision to report or not.
“Some nurses, at first, they think about what happen and the problems associated with reporting,
so they do not report.” (N12)
3.2.3. Reporting of Others’ Errors
Some of the interviewees stated that they do not have any problems in reporting MEs committed
by other staff. They believe that the reporting of MEs is better for both the nurses and also for the
patient, whether the MEs have been committed by themselves or by other health care professionals.
While the other group insisted that everyone is responsible for reporting his/her own initiated MEs.
“I will report if other staff nurse made a mistake.” (N1)
“I will report errors committed by others because this is in the best interest of the patient, and also it
would help things go smooth in the future, for example, patient allergy . . . ” (N3)
“If I made a mistake I would inform, also if others from my colleagues made a mistake, I would still
inform.” (N6)
“No, I report only my errors. If my colleagues made mistakes, I would just advise her to report, but I
will not report her error.” (N8)
Pharmacy 2018, 6, 120
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3.3. Barriers towards Medication Error Reporting
There are many barriers towards MER which were mentioned by the interviewees. These barriers
are heavy workload, lack of time, tiredness, embarrassment due to reactions of peers and family,
and fear of disciplinary action.
3.3.1. Lack of Time
The main barrier for MER mentioned by the interviewees was time. They considered that the ME
reporting is a time consuming process. As described by the participants, the problem is not the time
needed to fill the MER form. The problem appears after filling the MER form when the investigation
takes place in order to discuss the causes which led to the ME.
“We will be exposed to so many questions [ . . . ] long time [ . . . ] time to discuss the ME that was
reported [ . . . ] investigations take time. No other problems, just that it takes time to report and then
questions from pharmacist or doctors. We do not have time for reporting. It is a long story and takes
much time.” (N4)
“Sometimes, I decide not to report. Because, if there is an investigation we have to be presented, as you
know it will take a long time and we will be all inconvenient.” (N9)
3.3.2. Tiredness
The nurses are responsible for inpatient care, this responsibility requires them to accomplish
many physical activities. Performing these activities make nurses tired, when they are exhausted,
a low number of ME reports will be received from them.
“Sometimes, we are tired. Once we are tired we decide not to report.” (N4)
3.3.3. Embarrassment
The post-embarrassment feeling has been pinpointed by interviewees as another barrier toward
MER. As a result, they tend to hide their MEs and never report them.
“Facing the embarrassment from my family and friends is tough. They will blame us.” (N4)
“They (family and friends) understand because these are not things that a person does on purpose.
But facing them still difficult.” (N9)
3.3.4. Fear
Fear from the legal problems has been addressed by the interviewees as a barrier towards MER.
“I fear from legal problems and disciplinary actions from the hospital.” (N8)
“Sometimes, I do not want to get into issues, I do not want people to come to ask me for investigation
later.” (N2)
The effect of reporting on the personal job record is another factor which might prevent nurses
from reporting.
“If I report this will affect my record because everything will be recorded in my personal record.” (N9)
“Fearing others, especially the investigation, because in Malaysia all errors must be reported to your
job record and they do disciplinary action.” (N4)
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3.3.5. Negative Reaction from Sister In-Charge
The response of managers toward nurses who report their MEs were important factors which
prevented nurses from reporting their MEs. It has been noticed that most of the interviewees insisted
that receiving a negative reaction from senior nurses is a normal response when the MEs occur. As they
always tend to blame and scold the nurses if they commit MEs. They believe that guidance is the main
role of senior nurses during their practices, not blaming the nurses.
“The sister will monitor me more.” (N8)
“Negative reaction from sister and matron [ . . . ] they must not punish the staff, they must guide the
staff and follow the staff and ensure that the stuff follows the standards.” (N4)
3.3.6. The Confidentiality of the Reporting Form
The reporting form which is used to report ME is a strict confidential form. Filling this type of the
reporting requires the reporter’s details such as name, signature and contact details. Some nurses did
not report their MEs because of this issue and they wish if they can report by using an anonymous
reporting form. Consequently, the number of reports will increase by use of anonymous MER forms.
“I prefer to fill anonymous form [ . . . ] Because I feel shy and would not work further. Also, I would
feel sorry for the patient. So, I prefer to fill the form without names.” (N2)
“I prefer to fill the anonymous form as it is good for us. If mistakes have been done, the news of
medication errors should be displayed without names being mentioned. In the future, if the people
know that this person made a mistake, people would decide not to deal with this person again. This will
damage the confidence of the nurse. In the future, they will not report and there will be no chance to
learn from the mistakes.” (N6)
“Off course, if no names mentioned the number of reports will increase.” (N8)
3.3.7. Absence of Effective Feedback
The lack of feedback from the hospital managers:
“No one goes through all the errors and give me a feedback.” (N7)
“I did not receive any feedback for my ME report.” (19)
3.4. Facilitators to Improve ME Reporting
The nurses were asked about the factors which could encourage them towards MER. Their main
concern revolved around removing the blaming culture. They believed that if no one scolded them
about their errors they would definitely report their errors.
“Remove the blaming culture. The matron and sister in charge should guide the staff not blame them.” (N4)
“Tell the matron that if any person is involved in a medication error, she shall not be scolded.” (N7)
Another factor which was addressed by the interviewees was getting encouragement from others
toward MER. Regarding this, there were two different opinions: first, some nurses insisted that they
did not need any encouragement from others because they thought the MER is an integral part of their
responsibility; on the contrary, other nurses welcomed encouragement by other health practitioners
such as a doctor, matron, or even their colleagues.
“There is no need to encourage us because this is our duty.” (N12)
“The sister in charge encouraged me to report.” (N9)
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“Actually, among us, we as nurses encourage each other to report errors; also the sister in charge
encourages us to do that.” (N8)
Few nurses highlighted the incentives as an effective way to encourage nurses to be more
meticulous to report MEs.
“Giving monetary rewards to the nurses.” (N3)
The confidentiality of the reporting form is an important factor, some of them preferred to fill
anonymously to avoid the embarrassment and being reprimanded by the authorities.
“I prefer to fill the form with no names and it is better not to include names.” (N2)
“I think as long as they can ensure the confidentiality of the person who reported, we will feel safe.”
(N9)
4. Discussion
This is an exploratory study intended to investigate the knowledge and attitude of nurses towards
MER. The current research is also anticipated to address the barriers and facilitators towards MER
among nurses, attached to different medical wards in the hospital.
The interviewed nurses reflected on the basic knowledge of concept of ME and MER.
They reported awareness about the presence of ME reporting system, guidelines, and the importance
of the MER. This might be attributed to the frequent talk sessions and training courses such as the
continuing nursing education program (CNE), in addition to the encouragement from the nurse
leaders (head nurses, supervisors and directors). This finding is consistent with the previous studies
conducted in Malaysia [7,27]. Wei and his colleagues reported that the Malaysian nurses had baseline
knowledge regarding MEs, whereas Johari et al. reported that Malaysian nurses had good knowledge
level regarding medication administration safety. However, most of the interviewees were not familiar
with the content of the ME reporting form due to their lack of contact. The low involvement of nurses
toward MER was not related to the lack of knowledge about the MER or due to the lack of information
about the process of incidents reporting, as reported in previous studies [28,29]. Handler and his
colleagues. reported that the lack of information on how to report ME among nurses as a barrier for
MER and this needs an immediate action and should be on higher priority towards improving MER
among nurses.
The willingness of nurses to report MEs has great impact on MER practices. Respondents had two
contradictory attitudes toward MER. Positive attitudes towards reporting all MEs are found to be in
accordance with what has been stated in Malaysian medication error guidelines [30], while an uncertain
attitude was also stated where participants were keen to report major errors only. In this case, the minor
errors and near-miss errors most likely will not be reported, in line with the previous studies [31–34].
Martowirono et al. reported that the MEs with minor consequences were lesser reported. Reporting of
near-miss errors gives valuable lessons without harming the patient [35]. In such situations, a seminar
discussion with the experienced nurse managers about benefits of near-miss error reporting can be a
useful tool to improve near-miss reporting rate among nurses.
The current research revealed that most nurses have positive attitudes toward ME reporting.
However, factors such as lack of time for reporting, lack of reporting culture without being blamed,
lack of effective feedback, and fear are considered as main reasons for underreporting problems among
the participants. These findings were consistent with the study conducted in Taiwan [36] where fear
was cited as the fundamental projecting factor in underreporting.
Despite the positive attitude of nurses towards the MER, they revealed that they did not report
MEs due to barriers like paucity of time, already in accordance with the studies done in Taiwan and
Canada [6,37]. Lack of time could be a reflection of heavy workload, as in many instances a limited
number of nurses take care of many patients. On the other hand, lack of reporting can be related to
Pharmacy 2018, 6, 120
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the MER process, which starts informally by informing the doctor, pharmacist, and the nurse director,
a
Health disparities are inequalities prevalent in healthcare, which often involve lack of access across various racial, ethnic and socioeconomic populations. Health disparities encompass an unequal distribution of social, political, economic, and environmental resources, especially among vulnerable populations. As a result, a number of local, regional, and national policies have been introduced to address health disparities to promote quality care and improved access for these populations. When developing health policies, especially those that focus on vulnerable populations, it is important for stakeholders to consider any ethical considerations that will protect vulnerable populations from substandard care and unethical medical practices.
Identify a health disparity prevalent in the Kingdom of Saudi Arabia. Examples include, but are not limited to, nutrition- and lifestyle-related risk factors such as obesity, hypertension, and diabetes, as well as lack of insurance. Include any tables or figures containing statistics to support your narrative.
Based on what you learned this week, address the following:
Identify a vulnerable population and a specific health disparity prevalent in the Kingdom of Saudi Arabia.
Clearly explain the health disparities and why it is worse for your selected vulnerable population.
What are some of the positive social changes that need to be accomplished to protect these populations?
Discuss a local, regional, or national policy to protect the identified vulnerable populations from this disparity.
What are some of the moral and ethical obligations that need to be considered with regard to the policy?
Your report should meet the following structural requirements:
Be seven pages in length, not including the cover or reference pages.
Be formatted according to APA 7th edition and Saudi Electronic University writing guidelines.
Provide support for your statements with in-text citations from a minimum of five scholarly articles. The Saudi Digital Library is an excellent source for scholarly research. One of these sources may be from the class readings, textbook, or lectures.
You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading. If you are unsure how to submit an assignment to the Originality Check too
Some of the spaces in the Clinical Judgement Plan are not provided in the prompt that was given but you can make up information to fill up the spaces. You can find all the information needed attached below, if any other information is needed please feel free to let me know. Thankyou.
Unformatted Attachment Preview
Student Name
Clinical Judgement Plan
West Coast University
Professor Name
Date
SK/DW 2/22 pg. 1
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
Patient Information
(1)
Patient Initials:
Age & Gender: Age in years/not DOB
Height/Weight:
Code Status:
Living Will/ DPOA:
EDC:
EGA:
Chief Complaint
Ex: SUBJECTIVE (Abnormal – Bullet Points)
What is the cause of the patients problem
now describing i.e., Pt is having SOB 8/10
with exertion?
Admitting Diagnosis & Admission
Date
History of Present Illness (HPI)
WHAT BROUGHT THE PT TO THE HOSPITAL? WHAT EVENTS LEAD UP TO THIS?
WHAT HAPPENED WHEN THEY GOT TO THE HOSPITAL- UNTIL NOW WHEN YOU
ARE PROVIDING CARE? (USE SEPARATE ATTACHED WORD DOC → WHEN NEEDED) (SEE
RUBRIC REQUIREMENTS)
OB History
GTPAL
Need to identify previous pregnancies
year , and type of delivery
Prenatal Panel
Medical History: (SEE RUBRIC REQUIREMENTS)
PAST DIAGNOSED MEDICAL PROBLEMS
For each disease identified, define, it, describe pathophysiology, and cite source
Surgical History: (SEE RUBRIC REQUIREMENTS)
PAST DIAGNOSED SURGICAL PROBLEMS
For each procedure identified, define & describe it; include year of procedure & cite
source
Social History:
SMOKING/ CIGARETTE/ TOBACCO/ E-CIGARETTE /MARIJUANA USE
ALCOHOL/ ELICIT DRUG USE
Cultural considerations, ethnicity, occupation, religion, family support, insurance.
(1) (14) Socioeconomic/Cultural/Spiritual Orientation & Psychosocial
Considerations/Concerns: include the following Social Determinants of Health
(SDOH) (SEE RUBRIC REQUIREMENTS)
Blood Type/Rh:
GBS:
Hep B:
HIV:
Rubella:
RPR:
Chlamydia:
Gonorrhea:
HSV:
Delivery Summary
Delivery Type & Time:
Placenta Delivery Time:
Lacerations/Episiotomy:
EBL:
Hemorrhage Medications
Given:
APGAR Score:1 minute____ 5
minute______
Erickson’s Developmental Stage Related to pt. & Cite References (1)
*List and Discuss specific stage (based on objective assessment)
(SEE RUBRIC REQUIREMENTS)
❋Economic Stability
❋ Education
❋Social and Community Context
❋ Health and Health Care
❋ Neighborhood and Built Environment
Final Version 3/10/22 DW/ss & MS Team
Clinical Judgement Plan
Medical Management and Collaborative Plan
(From MD, PT, OT notes…. etc.) *Consider past 24 – 48 hours
(SEE RUBRIC REQUIREMENTS)
Instructor:
DATE Care Provided and UNIT:
TIME OUT!!! Student instructions:
Include Relevant Diagnostic Procedures/Results & Pertinent Lab tests/ Values
(With normal ranges), include dates and rationales supported with Evidence Based Citations
Include 2-3 nursing interventions for abnormal labs and for all diagnostic procedures
ANTICIPATED TRANSFER/ DISCHARGE PLANNING:
DISCUSS: PRIORITY GOALS TO BE ACHIEVED to TRANSFER or DISCHARGE
GBS, Ferning, Ultrasound, CBC, Type and Screen, Glucose, ALT, AST, Plts, Protein
EQUIPMENT
MEDS
Lab Tests or
Diagnostic Scan
Normal
Ranges
Admission
Lab Values
Current Lab
Values
Explain Abnormal Labs R/T
Your Pt & NI
(USE SEPARATE ATTACHED
WORD DOC → WHEN
NEEDED)
TREATMENT
TIME OUT!!! Student instructions:
(SEE RUBRIC REQUIREMENTS)
Patient Education (In Pt.) for Referrals/ Discharge Planning
REFERRALS NEEDED/CASE Management
ASSESS LEARNING STYLE:
LEARNING PREFERENCE: WRITTEN, VIDEO, etc.
LEARNING BARRIER(S): LANGUAGE, EDUCATION LEVEL
ASSISTIVE DEVICES: GLASSES, HEARING AIDES, etc.
TIME OUT!!! Student instructions:
TIME OUT!!! Student
instructions:
INCLUDE:
Appropriate Diagnostic
Tests/ ProceduresDATEs and RESULTS
(Can add → See
attached Word Doc)
Pathophysiology of Primary Medical Dx (reason for
hospitalization) Support with Evidence Based Citations
Pathophysiology of Primary Medical Dx (reason for
Ex: The primary pathophysiologic process in COPD is
persistent but variable inflammation of the airways
(SEE RUBRIC REQUIREMENTS)
hospitalization)
Final Version 3/10/22 DW/ss & MS Team
Clinical Judgement Plan
Instructor:
TIME OUT!!! Student instructions:
DATE Care Provided and UNIT:
Medication Name
Include BOTH Generic
AND Trade names for
RX; include OTC,
herbal (nonpharmacological items)
Dose
Medications & Allergies (2)
Route
Freq.
Indications
Mechanism of Action
NOTE:
PRN
‘alone’
≠ Freq
(PRN meds must
include MD
ordered Indication)
Final Version 3/10/22 DW/ss & MS Team
Side Effects/
Adverse Reactions
Nursing Considerations specific to this
patient with citations
What cues will you observe for?
What will you monitor (labs, vitals, etc?)
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
ASSESSMENT/History of Present Illness /REVIEW OF SYTEMS
TIME OUT!!! Student instructions:
Physical Assessment Findings including presenting signs and symptoms that you will complete for this patient supported with Evidence Based Citations
Vital Signs
Temperature:
Pulse:
Respirations:
Blood Pressure:
Pain Level:
Breasts
Size:
Nipple:
Shape:
Engorgement:
Colostrum:
Lochia
Amount:
Odor:
Color:
Clots:
Pad Changes:
EBL:
Neurological
LOC:
PMS:
PERRLA:
Vision:
Face:
Strength:
Uterus
Location:
Midline:
Firm/Boggy:
Contractions:
Episiotomy/Laceration
Location:
Stitches:
Edema:
Redness:
Approximation:
Cardiovascular
Color:
Cap Refill:
Tele Rhythm:
Peripheral Edema:
Heart Sounds:
Pulses:
Bladder
BR:
Incontinence:
Indwelling Catheter:
Urine Color/Consistency:
Urine Output:
Homan’s Sign
Redness:
Tenderness:
Pain:
Swelling:
Homan’s:
Final Version 3/10/22 DW/ss & MS Team
Respiratory
Lung Fields:
Breathing Pattern:
Sputum:
Cough:
Suctioning:
Pulse Oximetry:
Supplemental O2:
Bowel
Bowel Sounds:
Abdomen:
Last BM:
Incontinence:
Bedpan:
Abd. Pain:
Ostomy:
Drains:
Emotional
Bonding:
Support:
Emotional State:
Maternal Phase:
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
Vital Signs (4)
Neurological (5)
Cardiovascular (6)
Respiratory (7)
Musculoskeletal (8)
GI/Hydration/Nutrition (9)
GU (10)
Rest/ Exercise (11)
Integumentary (12)
Endocrine (13)
Psychosocial (14)
BP:
HR: (Rhythm)
RR:
Temp:
O2 (any supplemental)
Pain (0/10)
Ht (cm)
Wt. (Kg)
BMI:
Fetal Heart Rate Tracing
Heart Rate:
Variability:
Acceleration:
Deceleration:
Category:
Contractions
Frequency: ________
Duration:
________
Final Version 3/10/22 DW/ss & MS Team
___________
___________
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
TIME OUT!!! Student instructions:
To be sure your clinical judgement statements written below are accurate. You need to review the defining characteristics and related factors associated with and see how your patient data match.
Do you have an accurate match or are additional data required, or does another cue from abnormal assessment findings need to be investigated?
Observation
Assessment
Recognize Cues
Obtain information from
different sources (e.g., the
environment, the pt., the
family, another nurse,
EHR) in different formats
(e.g., visual observation,
audio perception, lab
results, text description,
etc.).
Interpreting
Responding
Analysis
Analyze Cues
Interprets cues from their
existing knowledge base and
nursing perspective, evaluate
cues in terms of relevancy,
importance, and
interrelationship among other
cues, organize cues in the
mental representation of the
scenario (e.g., organize cues
in clusters), and then
develops a group of probable
client needs/concerns and
problems
Prioritize Hypotheses
Evaluates the probable client
needs/concerns and problems
generated previously in
various dimensions and
organize them into an ordered
list where the priority
hypotheses are on the top.
(ABCs, Maslow, safety, acute
v chronic, unstable v stable,
urgent v non-urgent)
Planning
Implement
Generate Solutions
Develops a list of actions to
address the hypotheses.
Give rationales for each
solution.
Take Action
Sorts the actions (based on
their evaluation in various
dimensions) and carries
out the action(s) to address
the hypothesis/hypotheses
with highest priority first.
Clinical Judgement (The expected/anticipated outcomes or SMART GOALS)
These should be written in a SMART format for patient goals.
For examples:
The patient will have decreased pain by verbalizing pain score 3/10 or below by the end of the shift.
The patient will maintain clear airway by effectively coughing by the end of the shift.
Reflecting
Evaluate
Evaluation
Compare and contrast what happened with your plan of care against what was expected/anticipated (disease progression, unique client
response) and decide whether additional clinical decisions are needed.
Final Version 3/10/22 DW/ss & MS Team
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
References
Use APA format and hanging indents for all references.
If you have any questions, please consult the APA 7th Edition.
Final Version 3/10/22 DW/ss & MS Team
Rita Case Study
Directions: Use the following information to complete your Concept Map
Scenario
History of Present Problem:
Pt arrived at the hospital complaining of strong regular contractions stating” I am in so much pain, the
contractions are crazy strong and I feel so much pressure”
Rita Garcia is a 23-year-old student G2P2000, weight 130lb, height 5’5. She is married. NKDA. A+, hep -,
HIV -, Rubellaand Varicella Immune, GBS +
She has no past medical history and no surgical history. History of Postpartum Blues with her first baby.
Her oldest child is 3 ½ years old She delivered a 9 pound 12-ounce baby boy at 41-week gestation,
following an 18-hour Pitocin-augmented labor with epidural anesthesia this morning.
Her second stage was two hours. She was given a mediolateral episiotomy, and the baby’s head was
delivered by vacuum extractor after she experienced difficulty pushing. Her estimated blood loss (EBL)
was 400 mL right after delivery. Immediately after delivery her VS were BP 110/70, temperature 98,
pulse 68, and respirations 20. She did not breastfeed her first child states baby did not want the breast.
She attended breastfeeding class and is planning on breastfeeding this child, her goal to exclusively
breastfeed but is open to supplementing. Rita is upset her husband could not make it to the delivery due
to having to work. Rita is also concerned about having to leave her older child with a neighbor as she has
no family in the area.
She has been clinically stable and is about to be transferred to the postpartum unit after a two-hour
recovery period. Oxytocin 20 units in 1000 mL of Lactated Ringer’s is infusing at a fixed rate of 125 mL/hr
in a 20 g. peripheral IV in her left hand. Type and screen done on admission, Hgb 12.6/Hct 38.
Her last set of vital signs were:
• T: 99.4 F/37.4 C
• P: 95
• R:18
• BP: 110/67. She has gotten up to void once and had 50 mL of blood-tinged urine. Her fundus is firm
at the umbilicus, and has a small amount of dark red lochia. She is physically exhausted and has been
anxious since delivery because her labor and delivery were harder than she ever expected, she was
expecting an easier delivery since it was her second baby.
Rita delivered two hours ago and has just been transferred to the postpartum floor. She has an IV of
Lactated ringers, which is to be discontinued when it is completed. Upon assessing her, the postpartum
nurse notes that the Rita is trickling bright red blood from the vagina and has soaked a large pad into the
under padabout 30 to 40 minutes after she changes it. Her perineum is swollen and red, no bruising
noted and stitches appear intact and wound edges are approximated from her mediolateral episiotomy.
Her vital signs are BP 90/68, pulse 110, and respiration 28. She appears restless.
Rita arrived in her room ten minutes ago. You were delayed by another mother who required pain
medication, but the nursing assistant collected the first set of vital signs posted below. You introduce
yourself, orient her to the room and unit, and begin your BUBBLE-HE assessment:
Current VS:
P-Q-R-S-T Pain Assessment (5th VS):
T: 99.9 F/37.6 C (oral)
Provoking/Palliative:
P: 110 (regular) Quality:
Cramp
R: 28 (regular) Region/Radiation:
BP: 90/68
Severity:
O2 sat: 98% room air
Vaginal delivery
Lower abdomen
6/10
Timing: Started one hour after delivery
Lab Results:
What lab results are RELEVANT and must be recognized as clinically significant by the nurse?
Complete Blood Count (CBC):
Current:
WBC (5-15.0 mm 3/Pregnant)
18.5
13.5
Hgb (12-16 g/dL)
7.9
12.6
Hct (33-45%)
28
38
Platelets (150-450x 103/μl)
158
140
Neutrophil % (42-72)
PT/INR: 0.9
PTT: 30
Fibrinogen: 44
72
68
High/Low/WNL?
Previous:
Current Assessment:
GENERAL APPEARANCE:
Appears uncomfortable, restless
RESP:
Breath sounds clear with equal aeration bilaterally, non-labored
respiratory effort
CARDIAC:
Pink, warm/dry, no edema, heart sounds regular with no abnormal
beats, equal with palpation at radial/pedal/post-tibial landmarks
NEURO:
Alert and oriented to person, place, time, and situation (x4)
BUBBLE-HE
BREAST:
Lactating; soft, non-tender with evidence of drops colostrum
UTERUS:
Right of umbilicus, slightly boggy
BLADDER:
Voided 50 ml after delivery, bladder distended
BOWELS:
Abdomen soft/non-tender, bowel sounds audible per auscultation in
all four quadrants
LOCHIA:
Rubra. Soaked entire peri pad with 10-12” diameter puddle of
blood weight= 550 mL
HOMANS:
Negative
EPISIOTOMY: Perineum is swollen and red, no bruising noted and stitches appear intact and wound
edges are approximated from her mediolateral episiotomy.
Care Provider Orders:
Establish large bore peripheral IV
Administer 0.9% Normal Saline 1000 mL IV bolus
Oxytocin 20 units in 1000 mL Lactated Ringers (LR) infuse over 30 minutes. Titrate to vaginal bleeding
(AWHONN Guideline)
Methylergonovine 0.2 mg IM x1stat
The following meds are standing orders and in the hemorrhage cart to be given as needed if oxytocin
ineffective:
Carboprost 250 mcg IM PRN Misoprostol 800 mcg rectal or SL PRN
Contact OR for possible D&C or repair
Pick a repetitive activity in the healthcare setting done by healthcare professionals using their upper body (arms and hands). Conduct an Ergonomics risk assessment. Using the Assessment of repetitive tasks (ART) tool, what are the top three Ergonomic risk factors? Post your score sheet in your response.Here is access to the tool: Assessment of repetitive tasks of the upper limbs (the ART tool).
Project rubrics
Value 20%
Word limit 1500 (excluding references)
Evaluation Items
Introduction
Body
Conclusion
Flow of essay
Grammar
Spelling
Work limit
References
Poor
(1)
The aim of the essay is
clearly stated
Defines the project
States the components
Outlines the arguments
to be presented
idea are presented,
explored, and
discussed
Use of literature to
support arguments
Balance of arguments
Statement on the
future of nursing
informatics
Clearly Summarises the
essay
Ease of read
Unsound
(marks lost)
10% outside word limit
(marks lost)
Number
20
References are
consistently formatted
Fair
(2)
Good
(3)
Excellent
(4)
Health care organizations repeatedly use growth as a key strategy. In fact, Walston (2018) noted that growth “is an attractive prospect because it promises greater economies of scale, augmented reputation, swift entry into markets, achievement of synergies, increased market power, and higher salaries for top management.”
Walston, S. L. (2018). Chapter 4: Growth and integration strategies. In Strategic healthcare management: Planning and execution (2nd ed.). [Books24x7 version]. Retrieved from the Trident Online Library.
For your Module 2 SLP, in 2-3 pages complete the following:
Explain the differences between Vertical, Horizontal, and Diversified Expansion.
Research one large health care system.
oIdentify its core business and any diversified organizations.
oIdentify if the health care system is practicing related or unrelated diversification.
oExplain how the organization’s strategy reflects its mission and vision.
In your scholarly paper, you should include an introduction and conclusion paragraph.
SLP Assignment Expectations
1.Conduct additional research to gather sufficient information to justify/support your analysis.
2.Limit your response to a maximum of 4 pages, not including the title or reference pages.
3.Support your paper with peer-reviewed articles, with at least 3 references. Use the following link for additional information on how to recognize peer-reviewed journals:
Angelo State University Library. (n.d.).Library guides: How to recognize peer-reviewed (refereed) journals. Retrieved from https://www.angelo.edu/services/library/handouts/p…
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). Chapter 5: Directional strategies. In Strategic management of health care organizations (8th ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). Chapter 6: Identifying strategic alternatives. In Strategic management of health care organizations (8th ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Walston, S. L. (2018). Chapter 3: Business models and common strategies. In Strategic healthcare management: Planning and execution (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Walston, S. L. (2018). Chapter 4: Growth and integration strategies. In Strategic healthcare management: Planning and execution (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Optional Reading
Walston, S. L. (2018). Chapter 2: Understanding market structure and strategy. In Strategic healthcare management: Planning and execution (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Walston, S. L. (2018). Chapter 5: Strategic alliances. In Strategic healthcare management: Planning and execution (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Explain how to measure and monitor the quality of care delivered and the outcomes achieved by an Advanced Practice Nurse.Submission Instructions:Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
Discuss Tuckman’s model of the dynamic group process from the perspective of the leaders supervising those teams. What do you think is the most important stage, and why?Embed course material concepts, principles, and theories (which require supporting citations) in your initial response along with at least one scholarly, peer-reviewed journal article. Keep in mind that these scholarly references can be found in the Saudi Digital Library by conducting an advanced search specific to scholarly references. Use Saudi Electronic University academic writing standards and APA style guidelines.
Each week students will choose one patient encounter to submit a Follow-up SOAP note for review.Follow the rubric to develop your SOAP notes for this term. The focus is on your ability to integrate your subjective and objective information gathering into formulation of diagnoses and development of patient-centered, evidence-based plans of care for patients of all ages with multiple, complex mental health conditions. At the end of this term, your SOAP notes will have demonstrated your knowledge of evidence-based practice, clinical expertise, and patient/family preferences as expected for an independent nurse practitioner incorporating psychotherapy into practice.
Instuction and question attached below. Please take time to review and answer all questions. Let me know if you need anything. Use National Health and Nutrition Examination Survey (NHANES) search engine to get variables and data set.
Read Aloud Lesson Plan
Title of Book
Author
Comprehension Strategy
Tier 2 Vocabulary
Words
Common-Core
State Standard
Predicting
Child-Friendly Definition
RL.1.1. Ask and answer questions about key details in a
text.
Learning
What do you want the students to learn? (Observable &
Objectives
Measurable)
Students will be able to:
Assessment
How will you measure that the students have “learned” the
content and achieved the above learning targets?
Anticipatory Set
How do you plan to introduce the lesson and/or motivate the
students?
(Attention Getter, Review, and/or Preview) Explain your purpose.
Text Dependent
Questions
Using Bloom’s Taxonomy (Remembering, Understanding, Applying,
Analyzing, Evaluating and Creating), develop questions that help
elicit students’ comprehension of the text?
Read Aloud Lesson Plan
Closure
How will you end the lesson?
Read Aloud Lesson Plan
Title of Book
Author
Comprehension Strategy
Tier 2 Vocabulary
Words
Common-Core
State Standard
Predicting
Child-Friendly Definition
RL.1.1. Ask and answer questions about key details in a
text.
Learning
What do you want the students to learn? (Observable &
Objectives
Measurable)
Students will be able to:
Assessment
How will you measure that the students have “learned” the
content and achieved the above learning targets?
Anticipatory Set
How do you plan to introduce the lesson and/or motivate the
students?
(Attention Getter, Review, and/or Preview) Explain your purpose.
Text Dependent
Questions
Using Bloom’s Taxonomy (Remembering, Understanding, Applying,
Analyzing, Evaluating and Creating), develop questions that help
elicit students’ comprehension of the text?
Read Aloud Lesson Plan
Closure
How will you end the lesson?
[O]rganizations constantly face the challenge of devising strategies that will enable them to enhance the value they provide to their key stakeholders. … Business models, the underlying structure and function of organizations, build on the idea of value chains and value creation (Morris et al., 2006; Porter 1985). (Chapter 3, para. 1)
A chosen model and strategy will vary from organization to organization. However, it is important to understand how business models work and what strategies can be employed.
_________________________________
Walston, S. L. (2018). Chapter 3: Business models and common strategies. In Strategic healthcare management: Planning and execution (2nd ed.). [Books24x7 version]. Retrieved from the Trident Online Library.
Morris, M., Schindehutte, M., Richardson, J., & Allen, J. (2006). Is the business model a useful strategic concept? Conceptural, theoretical, and empirical insights. Journal of Small Business Strategy 17(1), 27-50.
Porter, M. E. (1985). Competitive advantage: Creating and sustaining superior performance. New York: Free Press.
Case Assignment
After reading Chapter 3: Business Models and Common Strategies in Strategic Healthcare management: Planning and Execution, complete/answer the following in a 4-page paper:
Part 1 (2 pages)
oHow do the four components of a business model affect each other?
oWhat might be some difficulties an organization may face when seeking to change its business model?
oHow can a new business model become a competitive advantage for a health care organization?
Part 2 (1-2 pages)
oComplete the following chart in detail:
Generic Strategies
Define
Pros
Cons
Broad Low-Cost Strategy
Focused Low-Cost Strategy
Low-Cost Strategies in Health Care
Broad Differentiation Strategy
Focused Differentiation Strategy
Middle Strategy
oExplain which of the above strategies are best used in health care organizations. Support your rationale with facts and scholar resources.
In your scholarly paper, you should include an introduction and conclusion paragraph.
Assignment Expectations
1.Conduct additional research to gather sufficient information to justify/support your analysis.
2.Limit your response to a maximum of 4 pages, not including title or reference pages.
3.Support your paper with peer-reviewed articles, with at least 3 references. Use the following link for additional information on how to recognize peer-reviewed journals:
Angelo State University Library. (n.d.).Library guides: How to recognize peer-reviewed (refereed) journals. Retrieved from https://www.angelo.edu/services/library/handouts/p…
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). Chapter 5: Directional strategies. In Strategic management of health care organizations (8th ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). Chapter 6: Identifying strategic alternatives. In Strategic management of health care organizations (8th ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Walston, S. L. (2018). Chapter 3: Business models and common strategies. In Strategic healthcare management: Planning and execution (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Walston, S. L. (2018). Chapter 4: Growth and integration strategies. In Strategic healthcare management: Planning and execution (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Optional Reading
Walston, S. L. (2018). Chapter 2: Understanding market structure and strategy. In Strategic healthcare management: Planning and execution (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
Walston, S. L. (2018). Chapter 5: Strategic alliances. In Strategic healthcare management: Planning and execution (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.
1. Case Study Chosen: A 25-year-old male graduate student is seen in the office with the chief complaint of upper abdominal pain. He states that he noticed the pain intermittently over the past several weeks. He notices that he gets a gnawing pain about 2 hours after he eats. He also notes that he has some bloating and occasional nausea with the pain. He states that the pain is relieved by antacids most of the time.
Demographics: 25 y/o Male
SUBJECTIVE
CC: “Upper abdominal pain that has been intermittent over the past few weeks”
HPI: 25 y/o male visiting the office this morning ℅ upper abdominal pain that has lasted several weeks. Pt states that the pain is intermittent. Pt ℅ gnawing pain, bloating and nausea following eating which is relieved by OTC antacids most of the time. Pt is a college graduate student.
Past medical hx: Do you have any past medical hx?
Past surgical Hx: Do you have any past surgical hx? If so, what are the dates of the surgeries?
Family hx? Do you have any family history on either side (mother/father)?
Current Medications: Are you currently taking any medications other than the antacid post meal? Are you taking any OTC pain relievers, or OTC supplements?
Allergies: Do you have any medication, food, or chemical allergies? If so, what is the reaction?
Immunization hx: Do you currently have all of your up-to-date immunizations including flu, covid-19 + boosters?
Health Maintenance: When was your last dental, eye, physical examination?
Social HX: Are you currently employed? What are your eating habits? Do you smoke tobacco products, drink alcohol, or use illicit drugs? Where are you currently living? Who do you live with? Are you married, single? Are you sexually active?
ROS
General: Are you having any malaise, weakness, fever, chills. Have you noticed weight gains/losses of >20 lbs over the last 6 months.
Cardiovascular: Are you experiencing any chest discomfort, heaviness or tightness. Have you noticed an abnormal heartbeat or palpitations? Have you had any SOB, or had to sleep elevated on 2 pillows or more? Have you noticed swelling to feet, or passing out or nearly passing out? Any hx of heart attack/heart failure.
Respiratory: Have you noticed a cough? phlegm production, coughing up blood, wheezing, sleep apnea, exposure to inhaled substances in the workplace or home? Any exposure to TB or travel outside of the country? Any hx of asthma, COPD/emphysema or any other chronic pulmonary disease?
Gastrointestinal: Pt reports nausea and abdominal discomfort/pain. Pt reports heartburn and food intolerance. Have you had any vomiting, diarrhea, constipation, blood in the stool or black stools? Any hemorrhoids, trouble swallowing? Any hx of liver or gallbladder disease?
OBJECTIVE
General:
Take all VS of patient: BP, HR, RR, Weight, Height, BMI
Physical Exam Elements:
General: Vital signs stable, in no acute distress. Alert, well developed and well nourished.
Respiratory/chest: Auscultate the lungs for any respiratory abnormalities.
Cardiovascular:Auscultate the heart for any Cardiac abnormalities.
GI: Auscultate bowel sounds. Palpate and percuss abdomen, test with Murphys sign.
POC Testing (any Point of Care (POC) testing specifically performed in the office): N/A
ASSESSMENT
Working Diagnosis:
Functional dyspepsia – ICD – 10: K30
Functional dyspepsia (dis-PEP-see-uh) is a term for recurring symptoms of an upset stomach that have no obvious cause. Functional dyspepsia also is called nonulcer dyspepsia. Diagnosing functional dyspepsia involves ruling out other conditions that may be causing the dyspeptic symptoms. Tests to check for conditions such as stomach ulcers, stomach cancer and gallstones must first return negative before a diagnosis can be given. The symptoms of the condition can be variable, and may eventually occur much less frequently or go away completely. Functional dyspepsia is a persistent condition that is not associated with any serious complications, such as stomach ulcers or stomach cancer. Most people find their symptoms will come and go over time, depending on factors such as stress, lifestyle changes or other triggers.
(Mayo Clinic, 2022).
Epigastric pain. This is pain in the upper abdomenLinks to an external site.
Acid refluxLinks to an external site..
Bloating
Nausea after eating
Stomach pain that occurs unrelated to meals or goes away when eating.
Excessive belching
(Mayo Clinic, 2022).
Differential Diagnosis:
Gastritis, unspecified, without bleeding -ICD- 10: K29.70
Gastritis is a general term for a group of conditions with one thing in common: Inflammation of the lining of the stomach. Gastritis may occur suddenly (acute gastritis) or appear slowly over time (chronic gastritis) (Mayo Clinic, 2022).
Gnawing or burning ache or pain (indigestion) in your upper abdomen that may become either worse or better with eating
Nausea
A feeling of fullness in your upper abdomen after eating
pain in the upper abdomen just under the ribs.
loss of appetite.
Vomiting
Hiccups.
blood in the vomit.
blood in the bowel actions, if the stomach lining has ulcerated (this turns stools black and is called melaena)
weight loss.
(Mayo Clinic, 2022).
Peptic ulcer site unspecified, unspecified as acute or chronic, without hemorrhage or perforation – ICD – 10: K27.9
Peptic ulcers are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is stomach pain (Mayo Clinic, 2022).
+Feeling of fullness, bloating
+Heartburn
+Nausea
+ Pain or discomfort in the upper part of your abdomen, anywhere between your belly button and breastbone.
+ Feeling full too soon while eating a meal.
+ Feeling uncomfortably full after eating a meal.
– Vomiting.
– Belching
(Mayo Clinic, 2022).
PLAN
Diagnostic studies:
Sending patient out for the following w/ orders.
Lab: CBC, CMP, Antibody test to check for H. pylori
Lab: Breath tests to screen for abnormal bacteria in your gut.
GI: Upper endoscopyLinks to an external site.
GI: Gastric emptying studiesLinks to an external site.
Treatment: Omeprazole 20 mg oral tablet daily for 14 days (14 tabs, 0 refills).
Referrals: Gastroenterologist
Education:
Avoiding food and drinks which make the symptoms worse (caffeinated drinks or fatty food, like fast foods + alcoholic beverages)
Eating small, frequent meals as opposed to fewer, larger meals
Giving up alcohol and tobacco
Healthy diet
Acupuncture
Behavioral therapy
RTC: Follow up w/ provider in two weeks for checkup, lab result review and medication management. See gastro.
Table 1. Common GI Diagnosis. In addition to your SOAP note, you must also complete the following table. Upload your SOAP note and table to the discussion board.
Diagnosis
Signs/Symptoms
Gold Standard Diagnostics
Gold Standard Treatment
Acute Appendicitis
Sudden pain that begins on the right side of the lower abdomen.
Sudden pain that begins around the navel and often shifts to the lower right abdomen.
Pain that worsens with coughing, walking or making other jarring movements.
Nausea and vomiting.
Loss of appetite.
Low-grade fever that may rise as the illness worsens.
Constipation or diarrhea.
Abdominal bloating.
Gas.
(Mayo, 2023)
CT scan
(Mayo, 2023).
Urgent appendectomy
(Mayo, 2023).
Acute Cholecystitis
sudden sharp pain in the upper right side of your abdomen that spreads towards your right shoulder.
a high temperature (fever)
nausea and vomiting
sweating
loss of appetite
yellowing of the skin and the whites of the eyes (jaundice)
a bulge in the abdomen
(NHS, 2022).
Ultrasonography + Murphys sign
(NHS, 2022).
Laparoscopic cholecystectomy
(NHS, 2022).
Acute Diverticulitis
Abdominal pain, often severe.
Distended abdomenLinks to an external site. or palpable colon (you can feel it with your hand).
FeverLinks to an external site..
Nausea and vomitingLinks to an external site..
Rectal bleedingLinks to an external site..
ConstipationLinks to an external site. or, less commonly, diarrheaLinks to an external site..
(Cleveland Clinic, 2022).
CT
(Cleveland Clinic, 2022).
Hartmann procedure
(Cleveland Clinic, 2022).
Clostridium difficile Colitis (C-diff)
watery diarrhea, which can be bloody.
painful tummy cramps.
Feeling sick.
signs of dehydration, such as a dry mouth, headaches and peeing less often than normal.
a high temperature
loss of appetite and weight loss.
(CDC,2022).
Toxigenic culture
(CDC,2022).
Antibiotics such as metronidazole, vancomycin, or fidaxomicin.
(CDC,2022).
GERD
Non-burning chest pain, which is usually located in the middle of the chest and radiates to the back
Difficulty swallowing (dysphagia)
(John Hopkins, 2023).
24-h pH-monitoring
(John Hopkins, 2023).
Antacids and Alginic Acid
(John Hopkins, 2023).
Irritable Bowel Syndrome (IBS)
Abdominal pain, cramping or bloating that is related to passing a bowel movement
Changes in appearance of bowel movement
Changes in how often you are having a bowel movement
(Mayo Clinic, 2023).
Rome III criteria [1,2]
(Mayo Clinic, 2023).
Nonpharmacologic and pharmacologic approaches. Lifestyle modifications that aim to improve exercise, sleep, diet, and stress may be warranted.
(Mayo Clinic, 2023).
Duodenal Ulcer
Pain in your stomach or abdomen
Indigestion
feel very full and bloated after eating
feel like you might vomit (nauseous)
lose weight
(Health Direct, 2021).
Esophagogastroduodenoscopy (EGD
(Health Direct, 2021).
Proton pump inhibitors (PPIs)
(Health Direct, 2021).
Acute Pancreatitis
Begins slowly or suddenly in your upper abdomen
nausea (feeling sick) or vomiting.
diarrhoea.
indigestion.
a high temperature (fever) of 38C (100.4F) or above.
jaundice – yellowing of the skin and the whites of the eyes.
tenderness or swelling of the abdomen (tummy)
(NIH, 2023).
Determination of serum pancreatic enzymes
(NIH, 2023).
Surgical debridement
(NIH, 2023).
Crohn’s Disease
Diarrhea
Fever
Fatigue
Abdominal pain and cramping
Blood in your stool
Mouth sores
Reduced appetite and weight loss
Pain or drainage near or around the anus due to inflammation from a tunnel into the skin (fistula)
(Mayo Clinic, 2022).
Endoscopy with tissue biopsy
(Mayo Clinic, 2022).
Biologics : Vedolizumab (Entyvio).
(Mayo Clinic, 2022).
Ulcerative Colitis
Diarrhea, passing blood with your stool, and abdominal pain.
(NIH, 2023).
Colonoscopy and sigmoidoscopy
(NIH, 2023).
Proctocolectomy
(NIH, 2023).
2. Case Study Chosen: Case 3 – A 30-year-old male with diarrhea and abdominal cramping
Demographics: 30-year-old male
SUBJECTIVE
CC: Patient complains of 2 days of loose to watery diarrhea, 4 to 5 times a day with significant nausea and one episode of vomiting today. He has a temperature of 100.5 on presentation and an HR of 102. He also experiences abdominal cramping.
HPI: The patient’s symptoms began 2 days ago with loose to watery diarrhea occurring 4 to 5 times a day. He also reports experiencing significant nausea and one episode of vomiting today. He denies any unusual travel or recent changes in diet. The patient’s abdomen is tender, and he complains of abdominal cramping.
OBJECTIVE
General: VS: BP – within normal limits, HR – 102 bpm, RR – within normal limits, Weight – within normal limits, Height – within normal limits, BMI – within normal limits
Physical Exam Elements:
Abdominal examination: Tenderness in the abdomen, no rebound or guarding
Stool culture to identify the pathogen causing gastroenteritis
Treatment:
Hydration: Encourage oral rehydration solutions and adequate fluid intake to prevent dehydration.
Symptomatic relief:
Antiemetics as needed for nausea (e.g., ondansetron 4 mg orally every 6-8 hours as needed)
Antidiarrheal medication (e.g., loperamide 4 mg orally after the first loose stool, then 2 mg after each subsequent loose stool; maximum 16 mg per day)
Dietary advice: Start with a bland diet (e.g., BRAT diet – bananas, rice, applesauce, toast) and gradually reintroduce normal foods as tolerated.
Follow-up: Return in 3-5 days for reevaluation of symptoms and assessment of hydration status.
Referrals:
None at this time
Education:
Educate the patient on the importance of maintaining hydration during diarrheal episodes and following a bland diet.
Health maintenance:
Encourage the patient to maintain good hygiene practices to prevent the spread of gastroenteritis.
RTC:
Return in 3-5 days for reevaluation of symptoms and assessment of hydration status.
Diagnosis
Signs/Symptoms
Gold Standard Diagnostics
Gold Standard Treatment
Acute Appendicitis
RLQ abdominal pain, anorexia, nausea, fever
Clinical assessment, CT abdomen and pelvis
Appendectomy
Acute Cholecystitis
RUQ abdominal pain, nausea, vomiting, fever
Clinical assessment, ultrasound or HIDA scan
Cholecystectomy
Acute Diverticulitis
LLQ abdominal pain, fever, altered bowel habits
CT abdomen and pelvis, colonoscopy
Antibiotics, dietary modifications
Clostridium difficile Colitis (C-diff)
Watery diarrhea, abdominal cramping, fever
Stool testing for C. difficile toxin, PCR
Antibiotics (vancomycin, fidaxomicin), supportive care
GERD
Heartburn, regurgitation, chest pain, cough
Clinical assessment, pH monitoring, endoscopy
Lifestyle modifications, PPIs, H2 blockers
Irritable Bowel Syndrome (IBS)
Abdominal pain, bloating, changes in bowel habits
Clinical assessment, Rome IV criteria
Dietary modifications, stress management
Duodenal Ulcer
Epigastric pain, nausea, vomiting, weight loss
Endoscopy, biopsy, H. pylori testing
PPIs, antibiotics for H. pylori eradication
Acute Pancreatitis
Epigastric pain radiating to the back, nausea, vomiting
Clinical assessment, elevated amylase/lipase
Hospitalization, supportive care, NPO, pain management
Crohn’s Disease
Abdominal pain, diarrhea, weight loss, fatigue
Endoscopy, colonoscopy, biopsy
Medications (corticosteroids, immunomodulators), surgery if needed
Ulcerative Colitis
Diarrhea, rectal bleeding, abdominal pain
Endoscopy, colonoscopy, biopsy
Medications (aminosalicylates, corticosteroids), surgery if needed
Please review the attached document as the question is detailed there. Thanks
Unformatted Attachment Preview
1
ABDOMINAL ASSESSMENT
Note – there is no need to make up any information for the case study. You are to review
what is provided below and formulate an essay response in terms of what is needed for
a SOAP Note with rationale. To be successful, I encourage you to analyze using the
SOAP Note Template and my feedback. For example, does the HPI capture all aspects of
the mnemonic? Are all allergies indicated?
CASE STUDY
Subjective:
CC: “My stomach has been hurting for the past two days.”
HPI: LZ, 65 y/o AA male, presents to the emergency department with a two days history
of intermittent epigastric abdominal pain that radiates into his back. He went to the local
Urgent Care where was given PPI’s with no relief. At this time, the patient reports that
the pain has been increasing in severity over the past few hours; he vomited after lunch,
which led him to go to the ED at this time. He has not experienced fever, diarrhea, or
other symptoms associated with his abdominal pain.
PMH: HTN
Medications: Metoprolol 50mg
Allergies: NKDA
FH: HTN, Gerd, Hyperlipidemia
Social Hx: ETOH, smoking for 20 years but quit both 2 years ago, divorced for 5 years, 3
children, 2 males, 1 female
Objective:
•
•
•
•
•
•
VS: Temp 98.2; BP 91/60; RR 16; P 76; HT 6’10”; WT 262lbs
Heart: RRR, no murmurs
Lungs: CTA, chest wall symmetrical
Skin: Intact without lesions, no urticaria
Abd: abdomen is tender in the epigastric area with guarding but without mass
or rebound.
Diagnostics: US and CTA
Assessment:
1. Abdominal Aortic Aneurysm (AAA)
2. Perforated Ulcer
3. Pancreatitis
2
TO PREPARE
Review the Episodic note case study your instructor provides you for this week’s
Assignment. With regard to the Episodic note case study provided:
o
o
o
o
Review this week’s Learning Resources, and consider the insights
they provide about the case study.
Consider what history would be necessary to collect from the
patient in the case study.
Consider what physical exams and diagnostic tests would be
appropriate to gather more information about the patient’s
condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a
differential diagnosis for the patient.
THE ASSIGNMENT
1. Analyze the subjective portion of the note. List additional information that should
be included in the documentation.
2. Analyze the objective portion of the note. List additional information that should
be included in the documentation.
3. Is the assessment supported by the subjective and objective information? Why or
why not?
4. What diagnostic tests would be appropriate for this case, and how would the
results be used to make a diagnosis?
5. Would you reject/accept the current diagnosis? Why or why not? Identify three
possible conditions that may be considered as a differential diagnosis for this
patient. Explain your reasoning using at least three different references from
current evidence-based literature. Make sure to include both the school and
outside resources.
3
LEARNING RESOURCES
Required Readings
•
•
•
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2023). Seidel’s guide to physical examination: An interprofessional
approach (10th ed.). St. Louis, MO: Elsevier Mosby.
o Chapter 18, “Abdomen”
In this chapter, the authors summarize the anatomy and physiology
of the abdomen. The authors also explain how to conduct an
assessment of the abdomen.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment
and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary
Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019
by Mosby. Reprinted by permission of Mosby via the Copyright Clearance
Center.
o Chapter 3, “Abdominal Pain Download Chapter 3, “Abdominal Pain”
This chapter outlines how to collect a focused history on abdominal
pain. This is followed by what to look for in a physical examination
in order to make an accurate diagnosis.
o Chapter 10, “Constipation”Download Chapter 10, “Constipation”
The focus of this chapter is on identifying the causes of
constipation through taking a focused history, conducting physical
examinations, and performing laboratory tests.
o Chapter 12, “Diarrhea”Download Chapter 12, “Diarrhea”
In this chapter, the authors focus on diagnosing the cause of
diarrhea. The chapter includes questions to ask patients about the
condition, things to look for in a physical exam, and suggested
laboratory or diagnostic studies to perform.
o Chapter 29, “Rectal Pain, Itching, and Bleeding”Download Chapter
29, “Rectal Pain, Itching, and Bleeding”
This chapter focuses on how to diagnose rectal bleeding and pain. It
includes a table containing possible diagnoses, the accompanying
physical signs, and suggested diagnostic studies.
Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA:
F. A. Davis.
Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M.
R. Copyright 2015 by F. A. Davis Company. Reprinted by permission of F. A.
Davis Company via the Copyright Clearance Center.
These sections below explain the procedural knowledge needed to perform
gastrointestinal procedures.
o Chapter 115, “X-Ray Interpretation of Abdomen” Download “X-Ray
Interpretation of Abdomen”(pp. 514–520)
4
Note: Download this Student Checklist and Abdomen Key Points to
use during your practice abdominal examination.
•
Document: Midterm Exam Review Download Midterm Exam Review(Word
document)
Required Media
Assessment of the Abdomen and Gastrointestinal System – Week 6 (14m)
Online media for Seidel’s Guide to Physical Examination
It is highly recommended that you access and view the resources included with the
course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations
in Chapter 17 that relate to the assessment of the abdomen and gastrointestinal system.
Refer to Week 4 for access instructions on https://evolve.elsevier.com/Links to an
external site.
Optional Resources
•
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic
examination (11th ed.). New York, NY: McGraw Hill Medical.
Chapter 9, “The Abdomen, Perineum, Anus, and Rectosigmoid”
This chapter explores the health assessment processes for the
abdomen, perineum, anus, and rectosigmoid. This chapter also
examines the symptoms of many conditions in these areas.
o Chapter 10, “The Urinary System”
In this chapter, the authors provide an overview of the physiology
of the urinary system. The chapter also lists symptoms and
conditions of the urinary system.
Chabok, A., Thorisson, A., Nikberg, M., Schultz, J. K., & Sallinen, V.
(2021). Changing paradigms in the management of acute uncomplicated
diverticulitisLinks to an external site.. Scandinavian Journal of Surgery, 110(2),
180–186. https://doi.org/10.1177/14574969211011032
Hussein, A., Arena, A., Yu, C., Cirilli, A., & Kurkowski, E. (2021). Abdominal pain
in the elderly patient: Point-of-care ultrasound diagnosis of small bowel
obstructionLinks to an external site.. Clinical Practice and Cases in Emergency
Medicine, 5(1), 127–128. https://doi.org/10.5811/cpcem.2020.11.50029
o
•
•
1
ABDOMINAL ASSESSMENT
Note – there is no need to make up any information for the case study. You are to review
what is provided below and formulate an essay response in terms of what is needed for
a SOAP Note with rationale. To be successful, I encourage you to analyze using the
SOAP Note Template and my feedback. For example, does the HPI capture all aspects of
the mnemonic? Are all allergies indicated?
CASE STUDY
Subjective:
CC: “My stomach has been hurting for the past two days.”
HPI: LZ, 65 y/o AA male, presents to the emergency department with a two days history
of intermittent epigastric abdominal pain that radiates into his back. He went to the local
Urgent Care where was given PPI’s with no relief. At this time, the patient reports that
the pain has been increasing in severity over the past few hours; he vomited after lunch,
which led him to go to the ED at this time. He has not experienced fever, diarrhea, or
other symptoms associated with his abdominal pain.
PMH: HTN
Medications: Metoprolol 50mg
Allergies: NKDA
FH: HTN, Gerd, Hyperlipidemia
Social Hx: ETOH, smoking for 20 years but quit both 2 years ago, divorced for 5 years, 3
children, 2 males, 1 female
Objective:
•
•
•
•
•
•
VS: Temp 98.2; BP 91/60; RR 16; P 76; HT 6’10”; WT 262lbs
Heart: RRR, no murmurs
Lungs: CTA, chest wall symmetrical
Skin: Intact without lesions, no urticaria
Abd: abdomen is tender in the epigastric area with guarding but without mass
or rebound.
Diagnostics: US and CTA
Assessment:
1. Abdominal Aortic Aneurysm (AAA)
2. Perforated Ulcer
3. Pancreatitis
2
TO PREPARE
Review the Episodic note case study your instructor provides you for this week’s
Assignment. With regard to the Episodic note case study provided:
o
o
o
o
Review this week’s Learning Resources, and consider the insights
they provide about the case study.
Consider what history would be necessary to collect from the
patient in the case study.
Consider what physical exams and diagnostic tests would be
appropriate to gather more information about the patient’s
condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a
differential diagnosis for the patient.
THE ASSIGNMENT
1. Analyze the subjective portion of the note. List additional information that should
be included in the documentation.
2. Analyze the objective portion of the note. List additional information that should
be included in the documentation.
3. Is the assessment supported by the subjective and objective information? Why or
why not?
4. What diagnostic tests would be appropriate for this case, and how would the
results be used to make a diagnosis?
5. Would you reject/accept the current diagnosis? Why or why not? Identify three
possible conditions that may be considered as a differential diagnosis for this
patient. Explain your reasoning using at least three different references from
current evidence-based literature. Make sure to include both the school and
outside resources. Please use APA format with subheadings to clarify which part
of the question is being answered.
3
LEARNING RESOURCES
Required Readings
•
•
•
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2023). Seidel’s guide to physical examination: An interprofessional
approach (10th ed.). St. Louis, MO: Elsevier Mosby.
o Chapter 18, “Abdomen”
In this chapter, the authors summarize the anatomy and physiology
of the abdomen. The authors also explain how to conduct an
assessment of the abdomen.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment
and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary
Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019
by Mosby. Reprinted by permission of Mosby via the Copyright Clearance
Center.
o Chapter 3, “Abdominal Pain Download Chapter 3, “Abdominal Pain”
This chapter outlines how to collect a focused history on abdominal
pain. This is followed by what to look for in a physical examination
in order to make an accurate diagnosis.
o Chapter 10, “Constipation”Download Chapter 10, “Constipation”
The focus of this chapter is on identifying the causes of
constipation through taking a focused history, conducting physical
examinations, and performing laboratory tests.
o Chapter 12, “Diarrhea”Download Chapter 12, “Diarrhea”
In this chapter, the authors focus on diagnosing the cause of
diarrhea. The chapter includes questions to ask patients about the
condition, things to look for in a physical exam, and suggested
laboratory or diagnostic studies to perform.
o Chapter 29, “Rectal Pain, Itching, and Bleeding”Download Chapter
29, “Rectal Pain, Itching, and Bleeding”
This chapter focuses on how to diagnose rectal bleeding and pain. It
includes a table containing possible diagnoses, the accompanying
physical signs, and suggested diagnostic studies.
Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA:
F. A. Davis.
Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M.
R. Copyright 2015 by F. A. Davis Company. Reprinted by permission of F. A.
Davis Company via the Copyright Clearance Center.
These sections below explain the procedural knowledge needed to perform
gastrointestinal procedures.
4
o
Chapter 115, “X-Ray Interpretation of Abdomen” Download “X-Ray
Interpretation of Abdomen”(pp. 514–520)
Note: Download this Student Checklist and Abdomen Key Points to
use during your practice abdominal examination.
•
Document: Midterm Exam Review Download Midterm Exam Review(Word
document)
Required Media
Assessment of the Abdomen and Gastrointestinal System – Week 6 (14m)
Online media for Seidel’s Guide to Physical Examination
It is highly recommended that you access and view the resources included with the
course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations
in Chapter 17 that relate to the assessment of the abdomen and gastrointestinal system.
Refer to Week 4 for access instructions on https://evolve.elsevier.com/Links to an
external site.
Optional Resources
•
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic
examination (11th ed.). New York, NY: McGraw Hill Medical.
Chapter 9, “The Abdomen, Perineum, Anus, and Rectosigmoid”
This chapter explores the health assessment processes for the
abdomen, perineum, anus, and rectosigmoid. This chapter also
examines the symptoms of many conditions in these areas.
o Chapter 10, “The Urinary System”
In this chapter, the authors provide an overview of the physiology
of the urinary system. The chapter also lists symptoms and
conditions of the urinary system.
Chabok, A., Thorisson, A., Nikberg, M., Schultz, J. K., & Sallinen, V.
(2021). Changing paradigms in the management of acute uncomplicated
diverticulitisLinks to an external site.. Scandinavian Journal of Surgery, 110(2),
180–186. https://doi.org/10.1177/14574969211011032
Hussein, A., Arena, A., Yu, C., Cirilli, A., & Kurkowski, E. (2021). Abdominal pain
in the elderly patient: Point-of-care ultrasound diagnosis of small bowel
obstructionLinks to an external site.. Clinical Practice and Cases in Emergency
Medicine, 5(1), 127–128. https://doi.org/10.5811/cpcem.2020.11.50029
o
•
•
Use the Case Study Template to complete.Be sure to include at least one reference.Include in-text citations as needed.Case StudyAn 89-year-old female complains of a “stabbing chest pain” and points to the area just below her scapula at the right mid-clavicular line. She states that she had an upper respiratory infection last week that “just seems to hang on.” No other complaints. please use the template attached to complete the assignment
Unformatted Attachment Preview
Physical Assessment
Case Study Template
Name: ________________________________________
Week of Class (1-8): ______
Body System focus area (i.e., cardiovascular): _____________________________
Case Study: (copy/paste here please)
Note: Include in-text cita ons as needed (author, year).
Ques ons (if data is unavailable, indicate !unavailable”):
1. What is the client’s chief complaint?
2. What ques ons would you ask the client?
o
HPI (history of present illness)
o
ROS (review of systems)
o
Medical/Surgical/Psych History
o
Family History
o
Other
3. What physical examina ons would you include?
Body System
Include?
Notes
” (yes) or – (not indicated)
General survey
”
HEENT (head, eyes, ears, nose,
throat/thyroid)
Cardiovascular
Peripheral Vascular
ti
ti
ti
ti
Breasts
”
Auscultate heart sounds
(stethoscope to actual skin)
Lympha c
Pulmonary
”
Auscultate lung sounds (stethoscope to actual skin) – anterior
and posterior
Gastrointes nal/Abdominal
Genitourinary/Pregnancy
Integumentary
Musculoskeletal
Neurological
4.
4. What are per nent posi ve physical assessment ndings?
5. What are the per nent nega ve physical assessment ndings?
6. What are at least 3 di eren al diagnoses (use Up-to-Date App if needed)?
o
o
o
7. What is your primary diagnosis?
Pharmacotherapy (including complementary and alterna ve therapies)
o
Health promo on (preventa ve care, an cipatory guidance)
ti
o
fi
Client educa on (including lifestyle modi ca ons, if applicable)
fi
o
ti
Labs
fi
o
ti
Diagnos c procedures
ti
o
ti
ti
ti
ff
ti
ti
ti
ti
ti
ti
ti
8. What is your treatment plan?
o
Follow-Up
References
(within last 5 years, scholarly, include clinical prac ce guidelines if available)
ti
APA format please, at least one reference
A newly minted technology startup with a good group of angel investors providing sufficient financial infusion into software and infrastructure has hired you as a Solutions Architect to be part of a team working on a novel idea connecting previously disconnected data types across health care technology segments.
The idea is as follows:
Most life sciences companies currently use clinical trials as their sole basis for evaluation of a researched drug performance, its benefits, its side effects, and its predicted market success. From pre-clinical trials to post-clinical trials, all data is contained within a single standalone computer application, where it is thoroughly evaluated/massaged/analyzed using a group of patient volunteers who consent into a clinical study. This means a few dozen to several hundred patients, typically, before the product is released to higher distributions as part of the latest clinical trial phases and subsequently FDA approved market, i.e. retail pharmacies. The problem: life sciences companies have little visibility into the “real life” drug performance, except for anecdotal evidence, periodic observations, periodic reports, and big lawsuits and newspaper headlines when something goes wrong. FDA decisions to take drugs off the market could push smaller life sciences companies into bankruptcy, especially if a company relies on one or a few drugs as its lifelines. We want to change this and turn the world of drug development upside down, in a positive sense – with Big Data. How? This is something you will be responsible to answer.
Your goal is to create a high-level architecture for the system that will analyze real-life drug performance in the market using Electronic Medical Record (EMR) data from providers. You will contract with providers to pull in their data from any EMR regardless of the vendor, bring it into a batch, process, normalize, and make available to your Data Scientists internally for evaluation. More specifically, you are looking for certain patterns indicative of an issue such as side effects, collecting information about details and quantity of those side effects, and reporting on a certain set of attributes selected by analyst to address the research question about a drug and its real-life performance. You will use a specific drug, called Darvocet, (that was taken off the market for a specific reason in the past), as your pilot for evaluating whether the system works and how the system works. Assume a few pilot provider sites may participate in your study. They will gain the first adopter benefits and related discounts for a finished product, should you be successful. Your general steps are as follows. Your detailed steps are completely open to your interpretation, based on your research, attendance of a lecture related to Unit 6, and the readings.
Find and research Darvocet. Pay special attention to its purpose, intended clinical goals and patients, side effects, and reasons it was taken off the market. Provide 1 to 2 pages write-up with corresponding supporting literature as outcomes of your research. 5 points.
Determine how you would structure your system to (a) extract relevant clinical data from provider EMRs, (b) process data at the arrival point when it is loaded in bulk into from various EMR sources into your system, (c) store the data at the arrival point, (d) analyze data inside your database, and (e) supply relevant reports to your life sciences clients. Describe your logic. 5 points.
Develop an architecture diagram of your data flows for an architecture of your choice, using a software application of your choice. Once created in an application of your choice, i.e. Visio (free from UIC webstore), Gliffy, Lucid Chart, OmniGraffle, etc. – please convert to PDF prior to submission in Blackboard. 5 points.
Define clinical data you need, clinical vocabularies to retrieve data, and specific code examples. Please note that you do not need to supply an all-exhaustive list of all codes, but 2-5 examples would be sufficient.
Here is an example of a data table format you could use to deliver outcomes of your research:
Data Type
Data Transport Mechanism
Vocabulary Type
Specific Code
Briefly Justify / Explain
Note: data transport mechanism means the medium of delivery, or how, via which data interoperability method the data gets from provider source into your analytics application.
Table = 5 points.
In conclusion, explain how and why your system would work, represent an innovation, and justify value for your clients. Do remember that you need to return value to your health care providers who signed up as early testers, in addition to your “primary” clients in life sciences. The question you will strive to answer is, if you had this pilot in your hands before Darvocet was pulled off the market, how could you either prevent it or help your client improve the drug by the ways of supplying early trouble indicators and feeding into the Version 2 development process? 5 points.
Your deliverables for this assignment are:
Word document with answers to points (1), (2), (4), and (5). Include your name and unit number on the document. Submit to assignment folder in this unit.
PDF with an architecture diagram as an answer to point (3). Include your name and unit number on the document. Submit to assignment folder in this unit.
Note 1: you are a designer starting with a clean sheet, so if there is a ton of ambiguity in this assignment, then this is the way it was intended to be. This is the situation you should expect in the job marketplace when you enter or re-enter the workforce. Successful data scientists do not attempt to solve or improve existing solutions. They either resolve known big challenges or create new innovations.
Note 2: please remember to cite and reference in APA, not to plagiarize, and avoid using resources representing someone’s unverified opinions such as Wikipedia and online blogs. Professional literature can be used, but carefully scrutinized for quality and reputation of the knowledge source.
You are seeing a 15-year-old female patient for a gynecological exam
and to explore birth control options. The patient’s mother scheduled the
appointment after learning that her daughter has become sexually
active. The patient is current with all immunizations, including
Gardasil, and has no significant health history that would
contraindicate the use of birth control.This is the patient’s first gynecological exam, and she expresses
feeling nervous and embarrassed that her mother has shared her sexual
experience with strangers. Taking this into account, how would you begin
the patient encounter?As you begin asking questions to determine the patient’s
gynecological history, the patient appears frustrated and embarrassed
and reminds you that she has only had sex one time. What should the
patient understand about the importance of reviewing gynecological
history?What are the most popular birth control methods prescribed in the
United States? What determines the success or failure of a birth control
method?The patient expresses a desire for the most effective form of birth
control but is concerned about weight gain and other side effects. How
should you respond to her concerns?The patient seems unsure about the best option for birth control and
asks if she can take some time to think about the choices. As the use
of birth control is ultimately the patient’s choice, you offer to answer
any questions and agree to a follow-up visit or call. The patient asks
whether using a condom is okay if she decides to have sexual intercourse
before selecting a method of birth control. What should you tell her?Submission Instructions:Your post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
Mr. Smith brings his 4-year-old son to your primary care office. He states the boy has been ill for three days. Mr. Smith indicates that he would like antibiotics so he can send his son back to pre-school the next day.
History – Child began with sneezing, mild cough, and low grade fever of 100 degrees three days ago. All immunizations UTD. Father reports that the child has had only two incidents of URI and no other illnesses.
Social – non-smoking household. Child attends preschool four mornings a week and is insured through his father’s employment. No other siblings in the household.
PE/ROS -T 99, R 20, P 100. Alert, cooperative, in good spirits, well-hydrated. Mildly erythemic throat, no exudate, tonsils +2. Both ears mild pink tympanic membrane with good movement. Lungs clear bilaterally. All other systems WNL.
Do not consider COVID-19 for this patient diagnosis.
For the assignment, do the following:
Diagnose the child and describe how you arrived at the diagnosis (i.e. how you ruled out other diagnoses).
Provide a specific treatment plan for this patient, pharmacologic and/or nonpharmacologic.
Provide a communication plan for how the family will be involved in the treatment plan.
Provide resources that Mr. Smith could access which would provide information concerning your treatment decisions.
Utilize national standards, your pharm and/or patho book and medical or advanced practice professional sources. Do not use patient-facing sources or general nursing texts to support your diagnosis and treatment.
Use references to support your concepts. Utilize correct APA formatting and mechanics of professional communication.
Present this Assignment as a narrative document, with a minimum of 4, and maximum of 5 pages not counting the cover page or reference page. It is not necessary to repeat the facts of the case in your narrative.
Before finalizing your work, you should:
Read the Assignment description carefully (as displayed above);
Consult the Grading Rubric (under Course Resources) to make sure you have included everything necessary; and
Utilize spelling and grammar check to minimize errors.
Your writing assignment should:
Follow the conventions of Standard American English (correct grammar, punctuation, mechanics, etc.);
Be well organized, logical, and unified, as well as original and insightful;
Utilize correct APA formatting, 7th edition.
K.B. is a 40-year-old white female with a 5-year history of psoriasis. She has scheduled an appointment with her dermatologist due to another relapse of psoriasis. This is her third flare-up since a definitive diagnosis was made. This outbreak of plaque psoriasis is generalized and involves large regions on the arms, legs, elbows, knees, abdomen, scalp, and groin. K.B. was diagnosed with limited plaque-type psoriasis at age 35 and initially responded well to topical treatment with high-potency corticosteroids. She has been in remission for 18 months. Until now, lesions have been confined to small regions on the elbows and lower legs.
Case Study Questions
Name the most common triggers for psoriasis and explain the different clinical types.
There are several types of treatments for psoriasis, explain the different types and indicate which would be the most appropriate approach to treat this relapse episode for K.B. Also include non-pharmacological options and recommendations.
Included in question 2
A medication review and reconciliation are always important in all patient, describe and specify why in this particular case is important to know what medications the patient is taking?
What others manifestation could present a patient with Psoriasis?
Sensory Function:
C.J. is a 27-year-old male who started to present crusty and yellowish discharged on his eyes 24 hours ago. At the beginning he thought that washing his eyes vigorously the discharge will go away but by the contrary increased producing a blurry vision specially in the morning. Once he clears his eyes of the sticky discharge her visual acuity was normal again. Also, he has been feeling throbbing pain on his left ear. His eyes became red today, so he decided to consult to get evaluated. On his physical assessment you found a yellowish discharge and bilateral conjunctival erythema. His throat and lungs are normal, his left ear canal is within normal limits, but the tympanic membrane is opaque, bulging and red.
Case Study Questions
Based on the clinical manifestations presented on the case above, which would be your eyes diagnosis for C.J. Please name why you get to this diagnosis and document your rational.
With no further information would you be able to name the probable etiology of the eye affection presented? Viral, bacterial, allergic, gonococcal, trachoma. Why and why not.
Based on your answer to the previous question regarding the etiology of the eye affection, which would be the best therapeutic approach to C.J problem.
Submission Instructions:
You must complete both case studies.
Your initial post should be at least 250 words per case study, a total of 500 words for both, formatted and cited in current APA style with support from at least 2 academic sources per case study. Your initial post is worth 8 points.
The topic is Hela cells. 2 pages, single space, AMA format. Please let me know if you have any other questions!
Unformatted Attachment Preview
Prof. DeWalt | Cell Biology 2300 (Fall 2023) | Grading Rubric
Below is the rubric that will be used to score each written assignment. Please be sure to review this
document at least twice—once prior to beginning research for the assignment and then again before you
submit your assignment so you can confirm that you have addressed and included everything that is
needed to do well. If anything is unclear, email me before you submit your work for grading so I can
clarify any questions.
Notes:
–
–
–
–
Any points lost cannot be “earned back” nor can you revise for a higher grade. I am happy to
provide guidance. If you would like to discuss together in real-time, you can schedule a time to
discuss over Zoom if communicating by email is sub-optimal. But know that I do not “pre-grade”
assignments; any questions prior to submitting need to be focused—I will not read a rough draft,
the instructions are clear but if any specific clarification is needed, I will provide it before you turn
in the assignment.
As mentioned in the instructions, do not include verbatim quotes—paraphrase in your own words,
if you need help, reach out (inclusion of quotes longer than two words will result in a 5-point
penalty—it is very important to master paraphrasing).
Be sure to include in-text citations that are either in AMA or Chicago style—chose one reference
format, not both (see reference documents in the “Written Assignments” folder on Canvas; failure
to include in-text citations will result in a 5-point penalty).
Detected plagiarism will result in a zero on the assignment and a required Zoom meeting with me
to discuss the seriousness of this offense.
Formatting
Must include all of the following: (1)
12-point font in Calibri or Times, (2) 1inch margins, (3) single spaced, (4)
adhere to page limit, (5) 7-10
references, at least 2 must be primary
peer-reviewed, (6) AMA or Chicago
format used based on document
posted to Canvas, (7) Grammar, flow,
logic
Adequate introduction paragraph of
the topic covered
Unsatisfactory
0 points earned
Did not following one or
more formatting
instructions and there
were egregious errors in
grammar, flow, and/or
logic
Satisfactory
Not applicable
Excellent
5 points earned
All formatting instructions
followed; little to no issues
with grammar, flow, and/or
logic
0 points earned
No explanation
3 points earned
Explanation but no
citations (or both
footnotes and
endnotes)
3 points earned
There is somewhat of
a summary of the
literature but there are
no references to
primary literature and
no quantifiable results
3 points earned
There is a concluding
paragraph, but it is not
complete or ends
abruptly
5 points earned
Explanation with in-text
citations and complete
bibliography at the end of
the document
5 points earned
Information provided is
thorough, there is indeed
science provided with an
adequate summary of the
science related to the topic
Adequately explains the primary
literature related to the topic by
summarizing results, including
quantification of findings
0 points earned
Information provided is
scarce, lacks summary of
the science, the reader is
left STARVING for
adequate information!
Adequate conclusion
0 points earned
No concluding paragraph
5 points earned
Conclusion is clear and
follows instructions
provided
BIO2300 | Professor DeWalt
Assignment 1 Due Friday October 13, 2023, by 5:00pm EST
Relevance
The ability to clearly communicate information to readers (e.g., individuals who do not have a
scientific background) is an important skill. To help you develop (or further strengthen) this skill,
you will have the opportunity to explore an area of interest to you and write about it and receive
detailed instructor feedback.
Below are pertinent details regarding the requirements associated with this assignment.
Scope of assignment 1
A unique aspect of biology is that seeing is believing. This aspect differentiates biology from
other disciplines like philosophy and religion. Model systems have been instrumental in allowing
biologists to “see”. The specific system typically varies based on the specific field within biology
as well as the research question. In this assignment, you are tasked with selecting and
researching how one model system has been used in biology. Specifically, for this assignment,
you will write about how the model system you selected and researched has helped
scientists/clinicians answer a specific question in biology. Below are examples to guide you.
You are welcomed to use any of the examples below as presented; if you have alternate ideas,
please run them by me first to ensure you remain within scope of the assignment
(g.dewalt@northeastern.edu).
Model system: prokaryotic organisms (e.g., Escherichia coli, Pseudomonas putida)
Example research area: food poisoning, bioremediation
Model system: cell lines
Example research area: pharmacology, cancer research
Model system: invertebrates (e.g., Caenorhabditis elegans, Drosophila melanogaster)
Example research area: embryonic development, process of cellular aging
Model system: mammals (e.g., Mus muscularis, Macaca mulatta)
Example research area: epigenetic mechanisms, learning and behavior
Page 1 of 3
BIO2300 | Professor DeWalt
Assignment 1 Due Friday October 13, 2023, by 5:00pm EST
Written Assignment Instructions
The written assignment should provide the following information in 2 pages:
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Sufficient background on the model organism.
o How did this organism emerge as a viable model system?
o Who “discovered” the value of this model?
o Is there any controversy associated with the use of this model? Are there other,
more beneficial models that could be used by researchers?
Summary of primary studies that involve use of the model organism. Note that a primary
study is a peer-reviewed publication that contains the following sections: an abstract,
background/introduction, methods, results, discussion/conclusions (see recording on
article types).
o When summarizing results, ensure that you include the specific findings (e.g.,
data obtained)
o If you do not have experience searching for peer-review literature, please email
me as soon as possible. You may also schedule an appointment with a librarian
at the Northeastern University library (see the library’s website for additional
information)
A conclusion with your thoughts on how the field has advanced following work with this
model. Are there future improvements or caveats to be mindful of for future studies?
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–
Notes
▪
▪
▪
▪
▪
Do not simply quote direct passages from the articles you find but instead paraphrase
as you summarize and compare/contrast the studies.
You may include tables and figures as needed in an appendix at the end of your
bibliography, but this will not count toward the page limit.
o Note: inclusion of tables and figures must include a full citation of where you
found the information in a caption and will not count toward the required page
limit.
When citing sources, you are required to use either the AMA or Chicago reference
format (not both!). You can refer to the guidance document posted on the course site
over any other source, email me if anything is unclear.
Up to 10 references are expected (the minimum number of references to include is 7).
o Why “so many” references? In actuality, this is not a lot of references.
Nevertheless, the reason for the range is to ensure you are conducting fair
review of resources to expand your knowledge regarding the topic selected. In
science and medicine, there are diverse studies within a given area and several
conflicting opinions. As a result, it is important to have an objective
understanding to further your knowledge.
o Acceptable sources to cite, in addition to the peer-review literature:
▪ Newspaper articles, government websites, books, and peer-review
scientific articles (i.e., reviews, primary research).
Additional formatting that is required includes:
o 12-point Calibri or Times New Roman or Arial font.
o Single space the document and 1-inch margins all the way around the page.
Page 2 of 3
BIO2300 | Professor DeWalt
Assignment 1 Due Friday October 13, 2023, by 5:00pm EST
o
o
References should be cited using AMA or Chicago style.
Only Word files or pdf accepted.
Grading rubric
I have posted a separate document on Canvas with the grading rubric. There is also a recording
where I review the expectations. I have a strict policy, but it is clear and I am always available
for questions—the expectation is that you will follow the instructions and earn a perfect score.
Make sure that you reach out to me if anything is unclear! I am happy to clarify (I want you to do
well on this!).
Page 3 of 3
The focus of this module was on quality care. For your final project, you will research a gap in access to quality, equity, or efficiency of healthcare, (including existing initiatives in place to address the gap and economic and regulatory factors that are currently in place to address the gap). To begin this project, you must first conduct some background research into the gap and the impacted population.
Prompt
In this milestone, you will identify and analyze an initiative that addresses the gap you chose as the topic for your final project. Explain what the initiative is, identify the goals of the initiative, describe the circumstances around its development, and identify sources of funding.
Tip: You have been introduced to the Institute for Healthcare Improvement (IHI) website in this course. It may be helpful to you as you conduct your research on an existing initiative.
Your milestone should address each of the following points in detail:
Explain an existing healthcare initiative that was put in place to address this gap in access.
Explain the specific goals of the existing initiative in place to address this gap in access.
Describe the circumstances around the development of the existing initiative. Consider when the initiative was developed and what factors were considered.
Describe the resources required to fund the existing initiative.
Explain why the existing initiative is not meeting its intended purpose and now requires improvement.
What to Submit
Your paper must be submitted as a 2- to 3-page Microsoft Word document with double spacing, 12-point Times New Roman font,
one-inch margins, and at least three sources cited in APA format.
Unformatted Attachment Preview
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The Montefiore Medical Center
Devonte Hayes
09/17/2023
Introduction
The Montefiore Medical Center, an esteemed medical academic institution located in New
York City, has successfully devised an improved care system tailored specifically for its
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economically disadvantaged patient population. To facilitate the implementation of integrated
care, this network of hospitals, community clinics, and school-based clinics employs advanced
chronic illnesses control strategies, offers access to exceptional hospital specialty care, and utilizes
focused care control and dependable health information technology. Montefiore Medical Center
has achieved financial sustainability while relying mostly on Medicaid and Medicare as its main
sources of revenue. The success of Montefiore can be linked to its healthcare delivery practices,
which encompass care management facilitating system-wide integration, efficient and effective
primary care delivery, and health systems that prioritize population health and local accountability.
The predominant demographic within Montefiore Medical Center’s population consists of
individuals who are visually impaired or hearing impaired, with a significant portion experiencing
varying degrees of hearing loss, including those who are hard of hearing. Furthermore, a significant
proportion of the patients have limited proficiency in the English language, either lacking fluency
altogether or possessing it as a secondary language. Montefiore, a non-profit organization, has
developed specialized procedures to effectively cater to the unique requirements of the vulnerable
populations it predominantly serves, namely low-income areas. The medical facility has recently
heightened its focus on addressing the needs of patients and the community, while also prioritizing
efforts to enhance performance (Chase,2010).
Patient Engagement Activities and Communication Strategies
The 500,000inhabitants of the Bronx and neighboring Westchester County are cared for by
Montefiore Medical Center. One of the poorest urban counties in the US is The Bronx, where 25%
of adults lack health insurance and poverty-related illnesses like obesity, hypertension,
cardiovascular disease, hepatitis C, asthma, and HIV are common. Around 1.4million people live
in The Bronx, and about 400,000 are children. A little more than half of the population identifies
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as Hispanic or Latino, and 36%of people identify as African American. A sizable portion of the
population is also undocumented. There are 21 community-based primary care clinics and four
hospitals at Montefiore. There are over 830,000 annual visitors to them, which are located all over
the Bronx. Additionally, Montefiore has 17 school-based clinics that see about 65,000 patients
annually and visit roughly 40 schools in total. These clinics offer medical, mental health, and dental
care.
A Human Communication Center has been determined at Montefiore Medical Center. The
facility offers its patients with translation services. The Montefiore Medical Center provides
translation services in150 different languages. Spanish, Chinese, Russian, French Creole, Korean,
Italian, Yiddish, Bengali, Polish, Arabic, French, Urdu, Greek, and Albanian are just a few of the
languages given for interpretation. The Montefiore Medical Center also provides a phone number
that non-English speakers can contact to request interpreting assistance.
For people who are hard of hearing or deaf, Montefiore also provides free sign language
interpreters. The services offered also include test messaging for hearing-impaired individuals,
phones with amplifiers, televisions with closed captions, and any other assistive devices a patient
might require. Patients can conveniently access the Non-Discrimination Notice of Montefiore by
navigating to the bottom section of the webpage. This notice also provides a customer service
contact for patients to call if they require the services available in the 15 different languages
mentioned. In addition to the aforementioned information, Montefiore also provides
communicards, which are pocket talkers designed to function as assistive listening devices for
individuals with hearing impairments. Patients can find around 2,500 fliers and pamphlets in both
English and Spanish at Montefiore’s outpatient locations. People can access information in 50
different languages digitally as well (Chase,2010).
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The New Associate Handbook at Montefiore Medical Center reminds all new employees
that meet all regulations pertaining to providing services to those who have hearing impairment or
have English as a second language. The employee handbook informs staff that they must provide
necessary aids and services to a person who does not speak E nglish or who is deaf. All around
Montefiore, including its outlying areas like its community centers, interpreters are available and
will be offered at no cost. It is needed to be done through an interpreter for healthcare provider to
prove that they have offered to translate for a patient.
Montefiore set out to achieve two goals: 1) to educate staff members who interact with
patients who might have concerns, and 2) to educate staff members who serve as information
sources in their communities. In this regard, Montefiore initiated a number of education and
awareness initiatives: Montefiore developed a presentation that was delivered live to all health
center organization-wide employees, and social workers, call center employees, and other agencies
upon need. The presentation was videotaped and made accessible as a webinar. The Montefiore
Hospital employees can also view this video online via the hospital’s intranet. The Montefiore
Medical Center staff has access to a free online action site with an information exchange, a
navigator, and an in-person assistance program. In addition, they have internal magazines that
feature articles on employee advancements, Inspired Medicine, and an internal social networking
platform called Yammer. In addition, Montefiore sought to certify its Medicaid and Financial Aid
specialists as Application Counselors, thereby gaining authorization from the State of New York
to assist patients with healthcare application processes.
There aren’t any communication gaps between Montefiore and the clients they serve.
Montefiore offers a translation services for more than 150 different languages communities. This
makes it possible for professionals to interact with patients and provide them with any information
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or training they might require. Along with ensuring patients have accessibility to any papers or
brochures that might be necessary for their medication, they also supply all literature that might
be required in these other communication languages.
Health promotion and disease prevention and management strategies
Implementing patient-centered homes is a significant way Montefiore addresses illness
prevention and health promotion. These residences serve as a resource for the community’s
primary and preventative healthcare. Montefiore thinks that by building these houses, they will be
able to offer more medical care to a population that has a greater need for care but less access to
it. Early evidence suggests they can improve quality, cut costs, and reduce disparities in patient
care. These medical homes aim to raise vulnerable populations’ access to basic care while also
reducing the number of visits to emergency rooms.
Primary Care
To ensure the provision of adequate medical care to their patients, the Family Health Center
has extended its operational hours, thereby offering clinic services on two evenings per week, in
addition to one Saturday each month. Efforts have been undertaken to increase the availability of
drop-in patient appointments. Due to Montefiore’s status as an academic institution, where a
significant portion of the medical practitioners operate on a part-time basis, concerns have arisen
over the potential challenges associated with maintaining continuity of treatment. This alone might
make it more difficult for Montefiore to gain the trust of the community it serves. African
Americans have always had a negative view of doctors, and 35% of people in the Bronx are black.
In the Bronx, Hispanics comprise more than 48% of the population. There is evidence indicating
that males within the Hispanic community exhibit lower rates of medical care utilization and are
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also less likely to establish a consistent source of primary healthcare. The primary objective of
medical homes is to provide individuals an opportunity to access healthcare services that would
otherwise be inaccessible to them.
Diabetes Care
Diabetes is three times more common in the Hispanic community than in white or nonHispanic groups and is twice as common in the African-American community. Montefiore is using
collaboration and tenderness to resolve the problem. About 12% of individuals in the Bronx have
records of diabetes, which Montefiore’s Diabetes Leadership Group has recorded together
clinicians and other care providers to improve. When Montefiore engages in community outreach
and uses community education methods with the community around diabetes, management, their
clinicians, and their employees are all involved. In 2009, Montefiore set measures for diabetes
management as a goal. Providing nutrition education to the community being served is one of the
main attempts to reduce diabetes. Since obesity and diabetes are related, Montefiore has tried to
address the dietary challenges faced by the Bronx’s underprivileged population, particularly those
who are obese. One method they use is by having staff members practice healthy cooking in the
clinic’s waiting area (Stoto et al., 2018).
Montefiore has produced materials to inform the public about diabetes. The materials are
available in a variety of languages and academic levels. Montefiore has made sure that it can speak
every language. They provide information in a total of 15 different languages. Additionally,
Montefiore has collaborated with neighborhood parks department to provide registration to those
with diabetes. Diabetes management includes exercise, but many low-income neighborhoods lack
amenities and are unsafe for strolling through on foot. This gives residents of those neighborhoods
the chance to exercise and manage both their diabetes and overall health. The availability of
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grocery stores, farmers’ markets, and healthy food options is another obstacle for low-income
neighborhoods.
Montefiore is addressing this problem by hosting a weekly farmers market on their
property. For a community that would often not have that option available to them, Montefiore is
delivering fresh fruit and vegetables to the Bronx in collaboration with other community
organizations. Additionally, they have a 5-person diabetes education team that supports patients
with disease management and education. Compared to other Medicaid patients, Montefiore’s
efforts have loweredA1c readings exceeding 9% to only 14%of individuals who gets care. A1c
levels of ≥ 9 were present in 45 percent of those getting Medicaid coverage, demonstrating the
success of Montefiore’s community-building efforts.
Asthma Care/Obesity
In order to keep asthma in the community under control, the Pediatric Department at
Montefiore has adopted an effective strategy. Beginning with the kids who were registered for
asthmatic cases, they discovered that when kids were released from the hospital, not only were
rescue inhalers prescribed, but also medications for maintenance. The Montefiore Children’s
Hospital’s readmission rate of children has decreased as a result of this. Along with the Bronx
Department of Education, Montefiore also works in the public schools there, offering these
students health care. Children receiving care from these school-based programs showed a 50%
decrease in the number of kids typically hospitalized for asthmatic episodes. Another important
aspect of this program is education.
The capacity to regulate asthma is impacted by poverty. Renting a home is not as highquality as buying a home in a suburb, which is one of the key contributing elements to controlling
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asthma in lower socioeconomic households. Asthma control may be less important to parents who
are focused on providing for their children’s fundamental necessities before anything else, such as
housing, food, and clothing. By visiting the schools and instructing the kids on how to care for
their asthma, Montefiore is assisting in reducing some of the burden for these families. Combating
childhood obesity is one of this program’s other objectives. In the Bronx, 40% of kids are
overweight. By switching from whole milk to low-fat milk, Montefiore and the NY School District
want to reduce the number of calories these kids consume while increasing their milk consumption.
Community Access
Patients at Montefiore frequently present with issues other than medical ones. Numerous
other issues for these people are a result of their socioeconomic situation. Visits to the emergency
room rank among the most expensive healthcare costs. The socioeconomically disadvantaged are
more likely than other groups to seek emergency care. In the Bronx, Montefiore is making an effort
to alter this tendency. According to Montefiore, the most frequent ER users are those with housing
problems, mental health conditions, and chemical dependency concerns. To guarantee that
“frequent fliers” receive better follow-up care after leaving the ER, Montefiore established a
Navigator program. The system aids emergency room staff in meeting the needs of ER patients,
including any social or clinical services they may require.
Additionally, staff developed a system that detects these high consumers upon arrival and
begins to schedule discharges. The employees will also help if they need a place to stay. Patients
who have been released must be contacted by residents 72 hours after their discharge. As a result,
the residents can better relate to their patients and comprehend their socioeconomic level. In
addition to their clinical expertise, residents are employed for their capacity to do social medicine
with patients.
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The fact that two-thirds of the staff at Montefiore are Bronx residents helps them better
understand the neighborhood and its residents’ needs. Compared to other Bronx ERs, Montefiore
has witnessed an increase in patients. As part of the aim to cut down on unnecessary ER visits,
Montefiore also offers care to people in need in shelters. After Montefiore assigns a social worker
to them, the social worker decides what kind of assistance the person requires. Every year, more
than 301,000 people visit Montefiore. Staff members say they are mindful of the requirements of
the population they offer care to, which contributes to some of this growth. Additionally,
Montefiore is working to ensure cardiac patients receive prompt and effective care in the ER.
Treating Hepatitis C
The Bronx has recorded highest incidences of Hepatitis-C in the nation, and is a widely
prevalent disease. Additionally, the most common cause of liver transplants is hepatitis C.
Montefiore established a Transplant Center of Excellence as a result. Since its opening in 2008,
the center has offered 29 adult and pediatric transplants to the Bronx neighborhood. 75 Bronx
transplant patients who needed treatment in the past had to travel. By allowing patients to continue
living in the Bronx and meeting any cultural demands that other hospitals might not be able to,
Montefiore assures that they are offering continuity of care to patients.
Financial incentives and quality improvement processes
Non-Discrimination Policy
Montefiore Medical Center adheres to all applicable Federal Civil Rights laws and
prohibits any kind of discrimination based on age, gender, race, color, religion, sex, national origin,
sexual orientation, and gender expression. Montefiore Medical Center adheres to a nondiscriminatory policy that prohibits any kind of discrimination on the grounds of race, color,
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religion, sex, national origin, disability, gender identity, speech, age, or appearance. The
Montefiore Medical Center offers a range of communication aids and services to assist those with
disabilities in effectively communicating. These include complimentary sign language
interpreters, written materials presented in big print, audio resources, cheap electronic forms, and
several other tools. Non-native speakers of the English language are provided with complimentary
translator services and access to information in many languages.
Because diversity and equality are two of our five core values that inform way and how
they help their patients, diversity and inclusion at Montefiore, develop a variety of perspectives,
insights, and approaches on how to do the best job possible. To continue to be a regional and
national leader in healthcare, Montefiore works hard to attract, hire, develop, mentor, and support
the best personnel. It is crucial that Montefiore locates and recruits talent from both conventional
and nontraditional applicant pools that represent various backgrounds, skill sets, and geographical
locations. This is crucial because patients at Montefiore experience more complex and new
healthcare issues than other population groups. Montefiore employs both LGBTQ people and
veterans of the military. When analyzing its employee benefits, Montefiore offers a comprehensive
wellness program for its personnel that includes staff discounts to gyms, smoking cessation, and
other services. They also have an incredible diversity and hiring plan for their workforce. However,
I did observe that the benefits packages for doctors, nurses, and house staff differ significantly,
which may indicate a discrepancy in how they treat their employees (Montefiore.rog; 2023).
Patient Care
Montefiore is dedicated to creating an active healthcare setting where care providers wish
to engage, patients desire to receive care, and other healthcare providers wish to model what
Montefiore delivers to its clients group through diversity and inclusion. Through the goals they
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have established for its patients and the community it serves, Montefiore thinks that it is doing
more for its patients. Additionally, they have a history of providing care to the LGBTQ community
in the Bronx in both hospital and community settings. Care providers at Montefiore are committed
to ensuring comfort and health of their patients and their family people. Interactions between
patients and clinicians—whether physicians, nurses, technologists, therapists, or volunteers—all
contribute to providing the best possible care.
Montefiore values its patients and considers their opinions when planning their care.
Patients are urged to actively participate in their treatment and assist their knowledge regarding
their sickness and illness management. Montefiore makes sure to offer a comfortable and friendly
environment for healing. Seven standards of care are followed by Montefiore when treating
patients:
•
Respect
•
Exceeding Expectations
•
Effective Communications
•
Courtesy
•
Sensitivity
•
Teamwork
•
Professionalism
Patient-Centered Care
The Montefiore Medical Center has been a healthcare delivery leader for over a century.
For their commitment to patient safety and care, Montefiore has won numerous accolades.
Doctors, nurses, and staff members consistently work to improve patient safety and care quality.
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Everyone, including patients, plays a part in ensuring the safety and caliber of the treatment that
is provided, according to Montefiore. Patients are encouraged to express their concerns and ask
inquiries. Patients are urged to voice their opinions on their treatment. They promote patient
education regarding their course of therapy and any potential medical care. Patients are urged to
inquire about drugs and their intended uses. All aspects of patient involvement in their care are
encouraged.
Patient Bill of Rights
Without regard to their ethnicity, religion, color, sex, nationality, sexual orientation, or
ability to pay for their care, individuals have the right to obtain treatment. 2) the setting in which
the treatment is given will be sterile and secure.3) seek immediate medical attention if required. 5)
Receive any information regarding the doctor who is treating them. 6) Have all pertinent
information about the personnel who are caring for them. 7) A nonsmoking area. 8) Receive
information about their diagnosis and course of treatment. 9) Receive all information pertaining to
treatment consent, including any risks and advantages. 10) Receive information on the choice of
designating a specific healthcare provider. 11) Offer the opportunity to decline medical care. 12)
The right to decline research program participation. 13) Your privacy will be safeguarded. 15)
Choosing a caregiver who will be knowledgeable about healthcare. 16) The right to a free review
of their medical records. They’ll receive an itemized bill (17).18) Possess the ability to examine all
regular hospital fees.19) the option to contest any fees. 20) Be able to voice complaints without
fear of retaliation regarding treatment they may have experienced. 21) Permit patients to have
visits during the hours that are permitted. 22) Make their own decisions on organ donation
(Montefiore.rog; 2023).
Financial Services
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Montefiore has remained at the forefront regarding patient financial aid programs. The
current Montefiore program, which includes an international component of data and counseling,
was revised in December 2015. These changes are a part of their shift to a single billing office and
their efforts to comply with 501R requirements. For how they charge patients, Montefiore has
established rules. Patients at Montefiore can use financial aid services to help them with the cost
of their medical expenses.
Montefiore is dedicated to assisting those without health insurance in obtaining the
necessary medical care. Montefiore has vowed to help patients whose medical expenditures are
out of control. Montefiore is aware that individuals in need of therapies or procedures could be
reluctant to get them due to the possibility of high costs. With the support of health care team at
Montefiore’s Patient Financial Services, Montefiore helps patients locate financial options,
including free or inexpensive insurance or government initiatives expressly developed to lower
healthcare expenses. If the patients lack health insurance, the facility financial services department
can support with registration for Medicaid, Child Health Plus, and the New York State Market
Place. If a patient’s insurance fails to cover the cost of care, Montefiore will work with them to
develop a reasonable payment plan. Additionally, Montefiore offers programs to help patients with
family planning and initiatives for women’s healthcare (Montefiore.rog; 2023)
Strategies for Helping to Reduce Costs
Montefiore Hospital modified its patient medication recommendations in 2000,
contributing to an 80% reduction in prescription mistakes. This is essential for patient care and
also lessens medication overuse and duplication. The computerized healthcare system from
Montefiore has also been put into place; it aids in monitoring and managing chronic illnesses like
diabetes. The Montefiore Medical Center has attained both monetary and organizational
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sustainability. This has been accomplished through implementing care management techniques
that allow for system-wide implementation, fusing established and novel basic care delivery
strategies, and emphasizing community health and local responsibility.
The IT group also developed a protected HIPAA-compliant, web-based communication
tool (branded MyMontefiore.com) to enhance messaging between patients and providers. Patients
can share information with their healthcare provider offices and email their healthcare provider to
communicate non-emergent matters, get private replies and lab results, make appointments, and
ask for prescription refills. The Children’s Hospital and the Moses and Weiler divisions fully
function with Montefiore’s inpatient EHR. The Montefiore administration has taken the lead in
initiatives to share data with other Bronx healthcare systems. Dr. Safyer served as the first chair of
the Bronx Regional Health Information Organization (RHIO), which was established in 2005 and
serves as the platform for an electronic data exchange on healthcare across the whole Bronx.
Allowing for a more comprehensive continuum of care and ensuring illness management is
controlled everywhere (Montefiore.rog; 2023).
The overuse of the emergency room is one issue facing the Montefiore healthcare system.
Although, they have increased the implementation of HIT, they have had issues utilizing the
system within the program, which is another cause for concern. By making follow-up calls to
patients, Montefiore is also lowering the number of readmissions to the hospital following
discharge, which helps to reduce expenditures. Early patient and chronic illness therapies have
also decreased hospitalizations. Moreover, the organization’s financial stability improved and
lowered costs.
Recommendations
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Given that Montefiore appears to be a leader in their industry, I’m wondering how many
suggestions I can provide them. Utilizing Valera Health, a mobile app and platform that helps an
integrated healthcare behavior model and encourages patient engagement by two-way
communication, appointment reminders, personalized learning materials, and automated selfassessment, Monte Fiore added a new patient care component in 2017. The platform notifies care
executives of transformations in a patient’s situation, indicating the requirement for clinical support
and assisting in improving care-planning. Anxiety and depression have decreased, according to
program data, and case managers have communicated with their patients three times as frequently
as usual. Five of the Bronx locations are currently accessible via the app. Extending this aspect of
patient care to its other sites is the only thing that needs to be added (Savage Hoggard et al., 2023).
Montefiore is a pioneer in its neighborhood when it comes to cultural sensitivity. They can
keep linked to the community and the individuals who know and understand it by hiring workers
from within the community. I wonder if this organization’s cultural competency is seriously weak.
Implementing some form of fitness program they run in the schools with kids is a potential strategy
to support population health that I have not seen Montefiore approach.
Although they have addressed diabetes through school programs and reduced milk to 2%,
exercise is crucial in lowering both. If these schools implemented an activity program that lowers
obesity, it would also aid in the fight against other illnesses like diabetes and asthma. By
implementing the program, you assist people in losing weight, which then regulates their diabetes
and lowers healthcare expenses by minimizing expenses for these conditions and the expenditures
of medication and possible hospitalizations.
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Reference
Chase, Deborah; (2010); Montefiore Medical Center: Integrated Care Delivery for Vulnerable
case_study_2010_oct_1448_chase_montefiore_med_ctr_case_study_v2.pdf
Montefiore.org
(2023)
Non-Discrimination
Policy
Retrieved
from:
Retrieved
from:
https://www.montefiore.org/discrimination-policy
Montefiore.org;
(2023)
Financial
Services;
https://www.montefiore.org/commitment-to-quality-care
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Montifiore.org;
(2023)
Non-Discrimination
Notice;
Retrieved
from:
https://www.montefiore.org/discrimination-policy
Patient’s bill of rights. Information for Patients – Patient’s Bill of Rights – Montefiore Medical
Center. (2023). https://www.montefiore.org/patients-bill-ofrights#:~:text=Receive%20treatment%20without%20discrimination%20as,care%20if%20y
ou%20need%20it.
Populations.
https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_
Savage Hoggard, C. L., Kaufman, A., Michener, J. L., & Phillips, R. L. (2023). Academic
medicine’s fourth mission: Building on community-oriented primary care to achieve
community-engaged health care. Academic Medicine, 98(2), 175–179.
https://doi.org/10.1097/acm.0000000000004991
Stoto, Michael A., Klaiman, T., & Davis, M. (2018). A community health needs assessment
environment scan. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3230259
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Organizational Behavior
Course number:
HCM102
CRN
11468
Answer the following question-
Assignment title or task:
1. How do culture and cultural diversity / variation
affect work behavior and job performance?
Provide examples to show why a knowledge of such
differences is important for managers.
Student Name:
Students ID:
Submission date:
Instructor name:
Tariq Alotaibi
Grade:
…..out of 10
College of Health Sciences
Department of Public Health
Release Date: Sunday, 17th April 2023 (12:00 Noon)
Due Date: Saturday, 7th October 2023 (11:59 pm)
Instructions for submission:
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
For this activity, you will analyze different scenarios that you could quite possibly encounter in the future. This will give you the opportunity to apply the information you have learned.
Complete the case study by following all guidelines provided to you:
Organization: Information is easy to read without disruption to the natural flow of information
Comprehension: Critical analysis of the information is done. All main points are addressed and deeper analysis is performed. There is relation to future scenarios.
Supporting Documents: All supporting documents are correct and submitted.
Formatting:
No errors in APA format. Less than 5 grammar/spelling errors.
No Plagirism
for all the case studies should be a 2 pages
Unformatted Attachment Preview
Case Studies
Reference:
O’Conner, D. P., & Fincher, A. L. (2015). Clinical Pathology for Athletic Trainers: Recognizing
Systemic Disease (3rd ed.). Slack.
Instructions:
1. Pick two of the three listed case studies to work on.
2. Read the case study and complete the associated questions and activities
Submission Information:
1. All work must be typed
2. All work must be in APA format
3. Make sure you submit all required documents.
Case Study 1:
You are Tim’s high school baseball coach. At the pre-season physicals, you notice that he has
really bulked up over the summer. While visiting with him, he explains to you how he spent
most of his summer in the weight room. He wants this year, his senior year, to be his best season
ever.
Later in the season, Tim begins to start complaining of shoulder pain. He attempts to show you
his shoulder. You notice he is covered in acne on his back. You don’t remember him having
acne before. When you question him about it, he says it started over the summer. He just
figured it was due to all the sweating he did while working out. You send him to the athletic
trainer for further evaluation.
A few days later, while completing some warm up exercises with his teammates, Tim gets into a
fight with another player. You’ve never seen Tim act this way. He has always been a very mild
mannered young man. You start to worry about Tim and what might be going on with him.
Case Study 1 Questions:
1. Given his clinical presentation over the course of the semester, what do you think might be
influencing Tim’s behavior? What signs cause you to suspect this?
2. In a state of your choosing, find the secondary schools athletic association’s policies and
procedures that manage this type of situation. Summarize the policies and procedures. You will
also need to provide the policies and procedures with your submission.
3. Find a national organizations position statement or guidelines that manage this scenario.
Summarize the guidelines. Explain why you chose this organization. You will need to provide a
copy of the guideline or position statement with your submission.
4. What are the next steps you will take? How do you address this situation with Tim?
Case Study 2:
You are Tiffany’s basketball coach. Tiffany, a 16 year old Black female basketball athlete faints
during conditioning drills outside on the track. She had been complaining throughout the drills,
but this was natural for Tiffany. She is conscious now and complains of dizziness, chest pains,
and shortness of breath.
The athletic trainer comes to your assistance and finds the following upon physical examination:
pulse if 98, weak, and irregular; blood pressure is 150/80; respirations are 24, rapid, shallow, and
labored.
As you and the athletic trainer question her further, Tiffany tells you that she fainted once before
when she was in middle school. She said it happened during basketball practice. Her mother
took her to the doctor, but he didn’t find anything wrong with her.
Case Study 2 Questions:
1. Based on Tiffany’s complaints and the ATC’s physical examination, what conditions could
possibly be causing her symptoms? Why do you suspect this?
2. What steps should be taken to manage Tiffany’s condition (acutely and with future
activities)?
3. What are the potential risks for Tiffany?
4. Choose an organization (i.e. NCAA, secondary school athletic association). Find this
organizations guidance or position statement regarding this condition. Summarize the guidance
document and provide the document with your submission.
Watch TV ads or look at local papers or magazine ads. Then, identify a local organization that interests you, for example, a local health clinic for your nearby hospital or a cancer support group. Find this organization’s website to find the mission and vision statement. How does the health organization use delivery strategies and support strategies to add value to the organization?
Edit OTHER SECTION ARE COMPLETED JUST NEED TO ADD 1 MOREDIGITAL CLINICAL EXPERIENCE: FOCUSED EXAM: COUGH
In this DCE Assignment, you will conduct a focused exam related to cough in your DCE using the simulation tool, Shadow Health. You will determine what history should be collected from the patient, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
TO PREPARE
Review this week’s Learning Resources and consider the insights they provide related to ears, nose, and throat.
Review the Shadow Health Resources provided in this week’s Learning Resources specifically the tutorial to guide you through the documentation and interpretation within the Shadow Health platform. Review the examples also provided.
Review the DCE (Shadow Health) Documentation Template for Focused Exam: Cough found in this week’s Learning Resources and use this template to complete your Documentation Notes for this DCE Assignment.
Access and login to Shadow Health using the link in the left-hand navigation of the Blackboard classroom.
Review the Week 5 Focused Exam: Cough Rubric provided in the Assignment submission area for details on completing the Assignment in Shadow Health.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosiOTHER
One of the most important roles a APRN can have is impacting positive change in healthcare that will benefit across multiple generations, be it across the state, national and the world at large. The World Health Organization (WHO) states that:
“Health policy refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society. An explicit health policy can achieve several things: it defines a vision for the future which in turn helps to establish targets and points of reference for the short and medium term. It outlines priorities and the expected roles of different groups; and it builds consensus and informs people” (WHO, n.d.).
Initial Post: Nurses are in a unique position to offer an expert perspective on every aspect of our health care system and can be a key voice in ongoing efforts to improve public health. Over the past 3 weeks you have been provided information on what healthcare policy is and how change is implemented. In this week’s discussion board, you are to identify a problem on a micro scale (within your organization or community) then propose a new policy that will address the problem.
You can follow the CDC guidelines provided in this week’s module. Your proposal should then include the following talking points:
Problem Statement:
Develop a concise description of an issue to be addressed. This statement should provide both the current problem and the desired goal to resolve it.
Proposed solution:
Provide a proposed solution that targets the problem
Provide research that supports the solution
Discuss needed resources for the solution
Action plan:
Identify strategies for putting this plan into action in your organization/community
Identify the appropriate arena where this will be introduced
2.Provided background information that provides a full explanation of the problem
4.Address the potential impact of the solution
3.Identify the stakeholders who will be invested in this proposed change
Response Posts: In your response posts to your peers, elaborate on the pros and cons of your peers solution and further thoughts on implementation if any.
There is no minimum number of references to be use for this discussion board, however it is expected that there will be references used. Make sure that you accurately cite your references in your initial post and response posts. 1-2 pages, doubled space, excluding references section, or provide comprehensive and nuanced response with appropriate references
Reference:
World Health Organization, n.d. Retrieved from https://www.who.int/topics/health_policy/en/
This assignment helps clarify areas of opportunity from your personalized learning platform work and increases your learning about pharmacology and drugs that you might administer in clinical practice.
In relation to the themes found in the Beatrice Kiamma case study presented in this week’s Mendez reading, answer the following questions and be prepared to discuss in the live session:Describe the family relationships outlined at the start of the therapeutic process: Who, if anyone, holds executive authority? What concepts of boundaries exist? Do you notice any subgroups or triangles?How might you describe the presenting problem?Would you consider the father and daughter depicted in the article as from the same culture? How might you approach working with a family where the parent is from one culture and the child is from another?How does technology influence both the presenting problem and the intervention?Consider your internship or other work or personal experience. How might cultural differences impact the use of structural family theory-informed practice in this internship, work, or personal setting?
Continue analyzing the situation that your case study’s healthcare organization faces. In this milestone, you will continue to evaluate the impact of the mission and vision of the healthcare organization’s strategic plan. You will also consider how the organization’s strengths, weaknesses, opportunities, and threats affect the environmental factors that confront the healthcare organization.Develop a SWOT analysis of the healthcare organization. Be sure to address the following:Briefly summarize your case study.To what extent do the organization’s policies address this issue? Be sure to justify your response.To what extent does the organization’s strategic planning around this issue align with its organizational mission and vision? Use evidence and examples to justify your reasoning.What do you feel are the organization’s strengths, weaknesses, opportunities, and threats (SWOT) with regard to this issue? Be sure to substantiate your claims with evidence and specific examples.Based on the SWOT analysis you performed, what environmental factors are at play in terms of this issue and what is their impact on the delivery of care within the organization? In other words, identify any new policies or new trends that will affect your day-to-day operation.Submit your assignment here. Make sure you’ve included all the required elements by reviewing the guidelines and rubric.
Purpose: Support groups are a place for people to give and receive both emotional and practical support as well as to exchange information. The purpose of this assignment is to help the student understand and evaluate group dynamics, group facilitation, and group processing.
Assignment: The student will participate in an observational Support Group Experience. This experience usually lasts 1½ – 2 hours. Choose a Support Group that meets the course objectives, (i.e., Caregiver group, NAMI-National Alliance for the Mentally Ill support groups, Compassionate Friends-Grief support groups, Family-Survivors of Suicide support groups, cancer support groups). AA or NA groups are not recommended. Each student is responsible for contacting the selected facilities/agencies and arranging the participant-observer experience. Call the Group Leader to obtain permission to attend. [Be professional and state that you are an advanced practice psychiatric mental health nursing student wishing to gain knowledge about the group and that this is a course assignment.] Maintain professional appearance and behavior while in groups – remember you are a guest and represent your Nursing program.
Write a 4 – 5 page (excluding title page and reference pages) paper on this experience. Incorporate at least 4 evidenced based research articles that support the objectives of the assignment. Follow the following criteria:
Subheadings
Discuss the purpose of the support group attended.
Describe the demographics of the group (e.g., number of members in attendance, gender, ages)
This is equal to the Introduction on the Grading Rubric
Discuss the roles of the support group leader in relation to the group members.
Identify the therapeutic factors (Yalom, 2005) you observed in the group. Give an example of each factor identified.
This is equal to the Focus & Sequencing on the Grading Rubric
Discuss your observations about the needs of the group.
Describe your feelings about this experience and how it personally enriched you.
This is equal to the Conclusion on the Grading Rubri
Continue analyzing the situation your case study’s healthcare organization faces. In this milestone, you will evaluate the impact of policies and policy changes on the healthcare organization’s strategic plan. You will also consider the role that the healthcare manager and other organizational stakeholders have in strategic planning.In a short paper, address the policies of the healthcare organization. Be sure to address the following:Provide a brief summary of the organization’s current policies with regard to the issue it is facing.To what extent do you feel current organizational policies address the influence of the identified environmental or external factors? Be sure to justify your rationale.What internal policy changes or new policies do you feel will need to be implemented to more effectively address the issue? Be sure to justify your response.What role should the healthcare manager assume in terms of guiding strategic planning processes around policy revision or development? Why?To what extent do the identified key stakeholders influence the strategic planning process in terms of policy change or development?Submit your assignment here. Make sure you’ve included all the required elements by reviewing the guidelines and rubric.
Position / Unit: Staff Nurse / CICU Hospital: Heart Hospital
SECTION A: CURRENT STATE – EVIDENCE – RECOMMENDATION (To be completed by author of IFI)
Topic:
Bedside electromagnetic-guided feeding tube placement: an improvement over traditional placement technique
1.Current State: Policy (Existing policy? If so, applicable content)
N/A
2.Current State: Practice (Brief statement of current state)
At present in our critical care units, Nasogastric and Nasojejunostomy tube insertion is done blindly and confirm through several ways such as residual volume aspiration, pH testing and Chest xray.
Evidence: (References and bulleted statement from evidence, in lieu of Evidence Review Tool which is currently in development)
Cortrak® (Viasys Healthcare, UK) is an electromagnetic sensing device that tracks and displays the path of feeding tubes during the placement procedure. The implementation of this method may assist the bedside placement of feeding tubes and may help the continued improvement in our nutritional practices in line with clinical governance requirements
All patients requiring either nasogastric (NG) or nasojejunal (NJ) tubes for enteral nutrition were included. A Corflo NG or NJ tube with a Cortrak® stylet was inserted and its position monitored using the Cortrak® sensor. NG tube position was also confirmed using the auscultation technique, aspiration and chest X-ray. Postpyloric (NJ) tube position was confirmed using abdomen X-ray. Data relating to the difference in time taken for tube insertion and confirmation using Cortrak® and X-ray was recorded.
Twenty patients, male:female 12:8, age 65 (IQR 56–73) years were recruited. NG tubes were inserted in ten patients, while the remaining had NJ tubes. Cortrak® confirmed the position of NG and NJ tubes in all twenty patients. Time taken for NG tube insertion (median 0.48 (IQR 0.34–1.09) min) was significantly less than that for NJ tubes (median 6.16 (IQR 3.55–9.03) min; P=0.001). X-ray confirmed tube tip positions in all twenty patients, but the time taken for getting the X-rays done and reviewed resulted in a delay of median 50 (IQR 45–65) min. Auscultation test was positive in all NG tube placements. Fluid aspiration was successful in five and three out of ten of NG and NJ placements respectively.
Reference- M. M. Rao,R. Kallam,I. Flindall,M. Gatt andJ. MacfieUse of Cortrak® – an electromagnetic sensing device in placement of enteral feeding tubes | Proceedings of the Nutrition Society | Cambridge Core Published online by Cambridge University Press: 30 June 2021
Operators recognized pulmonary placement on insertion tracings during 202 CORTRAK-assisted feeding tube insertion procedures, resulting in the immediate withdrawal of 199 feeding tubes. One pneumothorax was identified later by radiography. Seven pulmonary placements were not recognized by CORTRAK operators at the time of feeding tube insertion, resulting in 2 pneumothoraces. The incidence of pneumothorax for CORTRAK-assisted feeding tube insertions was 0.02% (3 of 17039). Of the feeding tubes inserted into the pulmonary system – either found during or after the procedure −1.4% (3 of 209) resulted in pneumothoraces (as opposed to the 19% to 28% incidence of pneumothorax for blind feeding tube insertions. Operators recognizing pulmonary placement on CORTRAK insertion tracings may have prevented 97% (202 of 209) of feeding tubes from being inserted farther into the respiratory tract.
Reference Annette M. Bourgault, PhD, RN, CNL; Jan Powers, PhD, RN, CCNS, CCRN, NE-BC; Lillian Aguirre, DNP, APRN, CCNS, CCRN Am J Crit Care (2020) 29 (1): 22–32. Pneumothoraces Prevented With Use of Electromagnetic Device to Place Feeding Tubes Pneumothoraces Prevented With Use of Electromagnetic Device to Place Feeding Tubes | American Journal of Critical Care | American Association of Critical-Care Nurses (aacnjournals.org)
The purpose of this study was to evaluate the safety and efficacy of using Electromagnetic Placement Device (EMPD )verification, instead of routine abdominal radiographic confirmation, for small-bore feeding tube placement.
Variables evaluated were adverse events, utilization of radiographs for confirmation, and success rate of feeding tube placement in the ordered location. Two time frames were reviewed. In a 1-year period, 3754 small-bore feeding tubes were placed using EMPD, with zero adverse events noted. Radiographic confirmation was utilized in 0%-29.2% of the EMPD placed tubes. Successful placement of feeding tubes using EMPD ranged from 94%-99.6%. During a 5-year period, 7081 EMPD feeding tubes were evaluated. One adverse event, pneumothorax, occurred during the placement of these 7081 tubes, for a rate of 0.014%.
Reference Jan Powers 1, Michael Luebbehusen 2, Lillian Aguirre 3, Julia Cluff 4, Mary Ann David 5, Vince Holly 6, Lorraine Linford 4, Nancy Park 7, Rocco BrunelleImproved Safety and Efficacy of Small-Bore Feeding Tube Confirmation Using an Electromagnetic Placement Device Improved Safety and Efficacy of Small-Bore Feeding Tube Confirmation Using an Electromagnetic Placement Device – PubMed (nih.gov)
4.Evidence-Based Conclusion:
No adverse events occurred with the implementation of bedside feeding tube placement using an Electromagnetic tube placement device (ETPD). In addition, Small Bowel Feeding Tube placement with an ETPD by designated ICU Resident Doctor/RN teams resulted in lower x-ray costs and more timely initiation of enteral feedings compared with blind placement.
Feeding tube placement confirmation is safe and efficacious via EMPD providing an effective method of feeding tube placement with a success rate >94% into the desired location. EMPD is an accurate verification method of distal tip location, eliminating the need for routine abdominal radiographic confirmation.
Cortrak® demonstrates 100% accuracy in confirming pre and post-pyloric tube placements and can be used for confirmation of tube tip position.
5.Recommendation:
Feeding tube insertion with an electromagnetic placement device is advantageous over blind feeding tube insertion because the operator can recognize pulmonary placement early and withdraw the feeding tube, thus decreasing the risk of pulmonary complications.
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
This assignment is an opportunity to apply concepts to a particular healthcare situation and also allows you to practice your analytical skills. You will put these skills to work in Module Five when you work on your second final project milestone.
This week’s reading and resources focus on genetics, heredity, and the developmental cycle of healthy children from fetus through infancy. All of these factors contribute to the health of the individual at any stage in life.
Read the mini case study below and the questions you will be contemplating as you work to understand what is expected of you in this assignment.
Use the following mini case study to fill in the attached worksheet:
Mini Case Study Two: Patient F is an African American woman, 36 years of age, with a history of mild hypertension. Her blood pressure has been fairly well controlled on an ACE inhibitor over the past two years. Patient F eats a well-balanced, nutritious diet, exercises three to five times a week, and does not have a history of smoking or alcohol use. However, she does exhibit the Type A behavior pattern, including being excessively competitive and harried and rushing to complete more and more tasks in an ever-shrinking period of time. In addition to these characteristics, she exhibits a somewhat cynical or negative outlook with occasional expressions of hostile or angry thoughts and feelings.
Complete your analysis of the mini case study by addressing the following questions:
What could have been done to prevent the chronic condition?
Knowing what you do about different approaches to medicine (traditional and CAM), what practice would you suggest? Would it be a combination of the two? Provide specific details.
What small changes could the individual make to improve her condition?
Overview
This assignment gives you an opportunity to practice applying concepts to a particular healthcare situation and also allows you to practice your analytical skills. You will put these skills to work in Module Five when you work on your second final project milestone.
Prompt
Read the following mini case study and analyze it using the worksheet provided.
Mini Case Study Two: Patient F is an African American woman, 36 years of age, with a history of mild hypertension. Her blood pressure has been fairly well-controlled on an ACE inhibitor over the past two years. Patient F eats a well-balanced, nutritious diet, exercises three to five times a week, and does not have a history of smoking or alcohol use. However, she does exhibit many of the characteristics of the Type A behavior pattern, such as excessive competitiveness, being harried, and rushing to complete more and more tasks in an ever-shrinking period of time. In addition to these characteristics, she exhibits a somewhat cynical or negative outlook with occasional expression of hostile or angry thoughts and feelings.
Specifically, the following critical elements must be addressed:
What could have been done to prevent the chronic condition?
Knowing what you do about different approaches to medicine (traditional and CAM), what practice would you suggest? Would it be a combination of the two? Provide specific details.
What small changes could the individual make to improve her condition?
What to Submit
Your worksheet must be submitted with 12-point Times New Roman font and any sources cited in APA format
WORKSHEET TTACHED
IHP 200 Mini Case Study Two Worksheet
Mini Case Study Two: Patient F is an African American woman, 36 years of age, with a history of mild hypertension. Her blood pressure has been fairly well-controlled on an ACE inhibitor over the past two years. Patient F eats a well-balanced, nutritious diet, exercises three to five times a week, and does not have a history of smoking or alcohol use. However, she does exhibit many of the characteristics of the Type A behavior pattern, such as excessive competitiveness, being harried, and rushing to complete more and more tasks in an ever-shrinking period of time. In addition to these characteristics, she exhibits a somewhat cynical or negative outlook with occasional expression of hostile or angry thoughts and feelings.
Address the following questions:
What could have been done to prevent the chronic condition?
Knowing what you do about the different approaches to medicine (traditional and CAM), what practice would you suggest? Would it be a combination of the two? Provide specific details.
What small changes could the individual make to improve her condition?
Requirements: Use the following mini case study to fill in the attached worksheet and write at least 1 paragraph for each section of the worksheet attached Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please be sure to carefully follow the instructions.
No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool.
Please be sure to include at least one in-text citation in each paragraph.
Please be sure to use scholarly sources published within the last 5 years
Unformatted Attachment Preview
IHP 200 Mini Case Study Two Worksheet
Mini Case Study Two: Patient F is an African American woman, 36 years of age, with a history
of mild hypertension. Her blood pressure has been fairly well-controlled on an ACE inhibitor
over the past two years. Patient F eats a well-balanced, nutritious diet, exercises three to five
times a week, and does not have a history of smoking or alcohol use. However, she does exhibit
many of the characteristics of the Type A behavior pattern, such as excessive competitiveness,
being harried, and rushing to complete more and more tasks in an ever-shrinking period of time.
In addition to these characteristics, she exhibits a somewhat cynical or negative outlook with
occasional expression of hostile or angry thoughts and feelings.
Address the following questions:
What could have been done
to prevent the chronic
condition?
This study source was downloaded by 100000804400461 from CourseHero.com on 09-30-2023 23:30:04 GMT -05:00
https://www.coursehero.com/file/33302935/ihp200-mini-case-study-two-worksheetdocx/
Knowing what you do
about the different
approaches to medicine
(traditional and CAM),
what practice would you
suggest? Would it be a
combination of the two?
Provide specific details.
What small changes could
the individual make to
improve her condition?
This study source was downloaded by 100000804400461 from CourseHero.com on 09-30-2023 23:30:04 GMT -05:00
https://www.coursehero.com/file/33302935/ihp200-mini-case-study-two-worksheetdocx/
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Commitment to Personal Well-being:What qualities should a nurse leader encompass for personal, professional, and leadership development?To be a well-rounded resilient leader, self-care and well-being is of importance. Please describe the concepts of well-being.Please describe activities that you currently find to be supportive to your self-care and well-being.APA style headings. Please provide a minimum of 1 reference.
Read the New England Journal of Medicine article “Structural Racism, Social Risk Factors, and Covid-19: A Dangerous Convergence for Black Americans.” Consider the “action items” recommended by the authors.What stakeholders are implicated by those actions?Which policies would have to change, and how would they change?Who would make those changes?How would the stakeholders you identified react to those changes?
• Make sure to fill out all the relevant information on the coversheet.
• Short essay of 500-750 words (Excluding references).
• The font size should be 12.
• Font type should be Times New Roman
• The heading should be Bold.
• Color should be Black.
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style.
• AVOID PLAGIARISM
Unformatted Attachment Preview
ASSIGNMENT COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN:
Assignment title or task:
(You can write a question)
Choose any one of the common occupational
infectious diseases and explain the following:
•
•
•
Causes, mode of transmission, and symptoms.
Occupational group at risk
Prevention and control measures
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Short essay of 500-750 words (Excluding references).
• The font size should be 12.
• Font type should be Times New Roman
• The heading should be Bold.
• Color should be Black.
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style.
• AVOID PLAGIARISM
• Due date; 30/9/2023 11:59 PM
Best of Luck
please use the information from the OB case study to fill out the clinical judgment plan OB doc. please use credible sources, all information must be cited APA 7
Unformatted Attachment Preview
Rita Case Study
Directions: Use the following information to complete your Concept Map
Scenario
History of Present Problem:
Pt arrived at the hospital complaining of strong regular contractions stating” I am in so much
pain, the contractions are crazy strong and I feel so much pressure”
Rita Garcia is a 23-year-old student G2P2000, weight 130lb, height 5’5. She is married. NKDA.
A+, hep -, HIV -, Rubella and Varicella Immune, GBS +
She has no past medical history and no surgical history. History of Postpartum Blues with her
first baby. Her oldest child is 3 ½ years old She delivered a 9 pound 12-ounce baby boy at 41week gestation, following an 18-hour Pitocin-augmented labor with epidural anesthesia this
morning.
Her second stage was two hours. She was given a mediolateral episiotomy, and the baby’s head
was delivered by vacuum extractor after she experienced difficulty pushing. Her estimated blood
loss (EBL) was 400 mL right after delivery. Immediately after delivery her VS were BP 110/70,
temperature 98, pulse 68, and respirations 20. She did not breastfeed her first child states baby
did not want the breast. She attended breastfeeding class and is planning on breastfeeding this
child, her goal to exclusively breastfeed but is open to supplementing. Rita is upset her husband
could not make it to the delivery due to having to work. Rita is also concerned about having to
leave her older child with a neighbor as she has no family in the area.
She has been clinically stable and is about to be transferred to the postpartum unit after a twohour recovery period. Oxytocin 20 units in 1000 mL of Lactated Ringer’s is infusing at a fixed
rate of 125 mL/hr in a 20 g. peripheral IV in her left hand. Type and screen done on admission,
Hgb 12.6/Hct 38.
Her last set of vital signs were:
T: 99.4 F/37.4 C
P: 95
R:18
BP: 110/67. She has gotten up to void once and had 50 mL of blood-tinged
urine. Her fundus is firm at the umbilicus, and has a small amount of dark red lochia. She
is physically exhausted and has been anxious since delivery because her labor and
delivery were harder than she ever expected, she was expecting an easier delivery since it
was her second baby.
Rita delivered two hours ago and has just been transferred to the postpartum floor. She has an
IV of Lactated ringers, which is to be discontinued when it is completed. Upon assessing her,
the postpartum nurse notes that the Rita is trickling bright red blood from the vagina and has
soaked a large pad into the under pad about 30 to 40 minutes after she changes it. Her perineum
is swollen and red, no bruising noted and stitches appear intact and wound edges are
approximated from her mediolateral episiotomy. Her vital signs are BP 90/68, pulse 110, and
respiration 28. She appears restless.
Rita arrived in her room ten minutes ago. You were delayed by another mother who required
pain medication, but the nursing assistant collected the first set of vital signs posted below. You
introduce yourself, orient her to the room and unit, and begin your BUBBLE-HE assessment:
th
Current VS:
P-Q-R-S-T Pain Assessment (5
T: 99.9 F/37.6 C (oral)
Provoking/Palliative:
Vaginal delivery
P: 110 (regular)
Quality:
Cramp
R: 28 (regular)
Region/Radiation:
Lower abdomen
BP: 90/68
Severity:
6/10
O2 sat: 98% room air
Timing:
Started one hour after delivery
VS):
Lab Results:
What lab results are RELEVANT and must be recognized as clinically
significant by the nurse?
Complete Blood Count
(CBC):
Current:
High/Low/WNL
Previous:
?
WBC (5-15.0 mm
3/Pregnant)
18.5
13.5
Hgb (12-16 g/dL)
7.9
12.6
Hct (33-45%)
28
38
Platelets (150-450x 103/μl)
158
140
Neutrophil % (42-72)
72
68
PT/INR: 0.9
PTT: 30
Fibrinogen: 44
Current Assessment:
GENERAL
APPEARANCE:
RESP:
Appears uncomfortable, restless
Breath sounds clear with equal aeration bilaterally, non-labored
respiratory effort
Pink, warm/dry, no edema, heart sounds regular with no abnormal
CARDIAC:
beats, equal with palpation at radial/pedal/post-tibial landmarks
NEURO:
Alert and oriented to person, place, time, and situation (x4)
BUBBLE-HE
BREAST:
Lactating; soft, non-tender with evidence of drops colostrum
UTERUS:
Right of umbilicus, slightly boggy
BLADDER:
Voided 50 ml after delivery, bladder distended
Abdomen soft/non-tender, bowel sounds audible per auscultation in
BOWELS:
all four quadrants
LOCHIA:
Rubra. Soaked entire peri pad with 10-12” diameter puddle of
blood weight= 550 mL
HOMANS:
Negative
EPISIOTOMY:
Perineum is swollen and red, no bruising noted and stitches appear intact and wound edges ar
mediolateral episiotomy.
Care Provider Orders:
Establish large bore peripheral IV
Administer 0.9% Normal Saline 1000 mL IV bolus
Oxytocin 20 units in 1000 mL Lactated Ringers (LR) infuse over 30 minutes.
Titrate to vaginal bleeding (AWHONN Guideline)
Methylergonovine 0.2 mg IM x1stat
The following meds are standing orders and in the hemorrhage cart to be given
as needed if oxytocin ineffective:
Carboprost 250 mcg IM PRN Misoprostol 800 mcg rectal or SL PRN
Contact OR for possible D&C or repair
Student Name
Clinical Judgement Plan
West Coast University
Professor Name
Date
SK/DW 2/22 pg. 1
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
Patient Information
(1)
Patient Initials:
Age & Gender: Age in years/not DOB
Height/Weight:
Code Status:
Living Will/ DPOA:
EDC:
EGA:
Chief Complaint
Ex: SUBJECTIVE (Abnormal – Bullet Points)
What is the cause of the patients problem
now describing i.e., Pt is having SOB 8/10
with exertion?
Admitting Diagnosis & Admission
Date
History of Present Illness (HPI)
WHAT BROUGHT THE PT TO THE HOSPITAL? WHAT EVENTS LEAD UP TO THIS?
WHAT HAPPENED WHEN THEY GOT TO THE HOSPITAL- UNTIL NOW WHEN YOU
ARE PROVIDING CARE? (USE SEPARATE ATTACHED WORD DOC → WHEN NEEDED) (SEE
RUBRIC REQUIREMENTS)
OB History
GTPAL
Need to identify previous pregnancies
year , and type of delivery
Prenatal Panel
Medical History: (SEE RUBRIC REQUIREMENTS)
PAST DIAGNOSED MEDICAL PROBLEMS
For each disease identified, define, it, describe pathophysiology, and cite source
Surgical History: (SEE RUBRIC REQUIREMENTS)
PAST DIAGNOSED SURGICAL PROBLEMS
For each procedure identified, define & describe it; include year of procedure & cite
source
Social History:
SMOKING/ CIGARETTE/ TOBACCO/ E-CIGARETTE /MARIJUANA USE
ALCOHOL/ ELICIT DRUG USE
Cultural considerations, ethnicity, occupation, religion, family support, insurance.
(1) (14) Socioeconomic/Cultural/Spiritual Orientation & Psychosocial
Considerations/Concerns: include the following Social Determinants of Health
(SDOH) (SEE RUBRIC REQUIREMENTS)
Blood Type/Rh:
GBS:
Hep B:
HIV:
Rubella:
RPR:
Chlamydia:
Gonorrhea:
HSV:
Delivery Summary
Delivery Type & Time:
Placenta Delivery Time:
Lacerations/Episiotomy:
EBL:
Hemorrhage Medications
Given:
APGAR Score:1 minute____ 5
minute______
Erickson’s Developmental Stage Related to pt. & Cite References (1)
*List and Discuss specific stage (based on objective assessment)
(SEE RUBRIC REQUIREMENTS)
❋Economic Stability
❋ Education
❋Social and Community Context
❋ Health and Health Care
❋ Neighborhood and Built Environment
Final Version 3/10/22 DW/ss & MS Team
Clinical Judgement Plan
Medical Management and Collaborative Plan
(From MD, PT, OT notes…. etc.) *Consider past 24 – 48 hours
(SEE RUBRIC REQUIREMENTS)
Instructor:
DATE Care Provided and UNIT:
TIME OUT!!! Student instructions:
Include Relevant Diagnostic Procedures/Results & Pertinent Lab tests/ Values
(With normal ranges), include dates and rationales supported with Evidence Based Citations
Include 2-3 nursing interventions for abnormal labs and for all diagnostic procedures
ANTICIPATED TRANSFER/ DISCHARGE PLANNING:
DISCUSS: PRIORITY GOALS TO BE ACHIEVED to TRANSFER or DISCHARGE
GBS, Ferning, Ultrasound, CBC, Type and Screen, Glucose, ALT, AST, Plts, Protein
EQUIPMENT
MEDS
Lab Tests or
Diagnostic Scan
Normal
Ranges
Admission
Lab Values
Current Lab
Values
Explain Abnormal Labs R/T
Your Pt & NI
(USE SEPARATE ATTACHED
WORD DOC → WHEN
NEEDED)
TREATMENT
TIME OUT!!! Student instructions:
(SEE RUBRIC REQUIREMENTS)
Patient Education (In Pt.) for Referrals/ Discharge Planning
REFERRALS NEEDED/CASE Management
ASSESS LEARNING STYLE:
LEARNING PREFERENCE: WRITTEN, VIDEO, etc.
LEARNING BARRIER(S): LANGUAGE, EDUCATION LEVEL
ASSISTIVE DEVICES: GLASSES, HEARING AIDES, etc.
TIME OUT!!! Student instructions:
TIME OUT!!! Student
instructions:
INCLUDE:
Appropriate Diagnostic
Tests/ ProceduresDATEs and RESULTS
(Can add → See
attached Word Doc)
Pathophysiology of Primary Medical Dx (reason for
hospitalization) Support with Evidence Based Citations
Pathophysiology of Primary Medical Dx (reason for
Ex: The primary pathophysiologic process in COPD is
persistent but variable inflammation of the airways
(SEE RUBRIC REQUIREMENTS)
hospitalization)
Final Version 3/10/22 DW/ss & MS Team
Clinical Judgement Plan
Instructor:
TIME OUT!!! Student instructions:
DATE Care Provided and UNIT:
Medication Name
Include BOTH Generic
AND Trade names for
RX; include OTC,
herbal (nonpharmacological items)
Dose
Medications & Allergies (2)
Route
Freq.
Indications
Mechanism of Action
NOTE:
PRN
‘alone’
≠ Freq
(PRN meds must
include MD
ordered Indication)
Final Version 3/10/22 DW/ss & MS Team
Side Effects/
Adverse Reactions
Nursing Considerations specific to this
patient with citations
What cues will you observe for?
What will you monitor (labs, vitals, etc?)
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
ASSESSMENT/History of Present Illness /REVIEW OF SYTEMS
TIME OUT!!! Student instructions:
Physical Assessment Findings including presenting signs and symptoms that you will complete for this patient supported with Evidence Based Citations
Vital Signs
Temperature:
Pulse:
Respirations:
Blood Pressure:
Pain Level:
Breasts
Size:
Nipple:
Shape:
Engorgement:
Colostrum:
Lochia
Amount:
Odor:
Color:
Clots:
Pad Changes:
EBL:
Neurological
LOC:
PMS:
PERRLA:
Vision:
Face:
Strength:
Uterus
Location:
Midline:
Firm/Boggy:
Contractions:
Episiotomy/Laceration
Location:
Stitches:
Edema:
Redness:
Approximation:
Cardiovascular
Color:
Cap Refill:
Tele Rhythm:
Peripheral Edema:
Heart Sounds:
Pulses:
Bladder
BR:
Incontinence:
Indwelling Catheter:
Urine Color/Consistency:
Urine Output:
Homan’s Sign
Redness:
Tenderness:
Pain:
Swelling:
Homan’s:
Final Version 3/10/22 DW/ss & MS Team
Respiratory
Lung Fields:
Breathing Pattern:
Sputum:
Cough:
Suctioning:
Pulse Oximetry:
Supplemental O2:
Bowel
Bowel Sounds:
Abdomen:
Last BM:
Incontinence:
Bedpan:
Abd. Pain:
Ostomy:
Drains:
Emotional
Bonding:
Support:
Emotional State:
Maternal Phase:
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
Vital Signs (4)
Neurological (5)
Cardiovascular (6)
Respiratory (7)
Musculoskeletal (8)
GI/Hydration/Nutrition (9)
GU (10)
Rest/ Exercise (11)
Integumentary (12)
Endocrine (13)
Psychosocial (14)
BP:
HR: (Rhythm)
RR:
Temp:
O2 (any supplemental)
Pain (0/10)
Ht (cm)
Wt. (Kg)
BMI:
Fetal Heart Rate Tracing
Heart Rate:
Variability:
Acceleration:
Deceleration:
Category:
Contractions
Frequency: ________
Duration:
________
Final Version 3/10/22 DW/ss & MS Team
___________
___________
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
TIME OUT!!! Student instructions:
To be sure your clinical judgement statements written below are accurate. You need to review the defining characteristics and related factors associated with and see how your patient data match.
Do you have an accurate match or are additional data required, or does another cue from abnormal assessment findings need to be investigated?
Observation
Assessment
Recognize Cues
Obtain information from
different sources (e.g., the
environment, the pt., the
family, another nurse,
EHR) in different formats
(e.g., visual observation,
audio perception, lab
results, text description,
etc.).
Interpreting
Responding
Analysis
Analyze Cues
Interprets cues from their
existing knowledge base and
nursing perspective, evaluate
cues in terms of relevancy,
importance, and
interrelationship among other
cues, organize cues in the
mental representation of the
scenario (e.g., organize cues
in clusters), and then
develops a group of probable
client needs/concerns and
problems
Prioritize Hypotheses
Evaluates the probable client
needs/concerns and problems
generated previously in
various dimensions and
organize them into an ordered
list where the priority
hypotheses are on the top.
(ABCs, Maslow, safety, acute
v chronic, unstable v stable,
urgent v non-urgent)
Planning
Implement
Generate Solutions
Develops a list of actions to
address the hypotheses.
Give rationales for each
solution.
Take Action
Sorts the actions (based on
their evaluation in various
dimensions) and carries
out the action(s) to address
the hypothesis/hypotheses
with highest priority first.
Clinical Judgement (The expected/anticipated outcomes or SMART GOALS)
These should be written in a SMART format for patient goals.
For examples:
The patient will have decreased pain by verbalizing pain score 3/10 or below by the end of the shift.
The patient will maintain clear airway by effectively coughing by the end of the shift.
Reflecting
Evaluate
Evaluation
Compare and contrast what happened with your plan of care against what was expected/anticipated (disease progression, unique client
response) and decide whether additional clinical decisions are needed.
Final Version 3/10/22 DW/ss & MS Team
Clinical Judgement Plan
Instructor:
DATE Care Provided and UNIT:
References
Use APA format and hanging indents for all references.
If you have any questions, please consult the APA 7th Edition.
Final Version 3/10/22 DW/ss & MS Team
Now that you have selected and carefully reviewed your case study, it is time to begin analyzing the situation the healthcare organization faces. In this milestone, you will evaluate the issue it faces in light of its mission, vision, and values.Develop an analysis of the organization’s strategic planning approaches. Be sure to address the following:Based on its mission and vision statements, what can you discern about the organization’s approach to strategic planning? Be sure to provide specific examples to justify your response.What is the prevailing issue in question in the case study you selected?What do you see as the overall strategic planning concerns for the healthcare organization with regard to this issue?What role do you feel the healthcare manager plays in terms of strategic planning around this issue? Be sure to substantiate your claims.Who are the key stakeholders affected by or involved in this issue, and what role do they serve in strategic planning within the organization?Submit your assignment here. Make sure you’ve included all the required elements by reviewing the guidelines and rubric.
Group Work:As a group discuss each other’s initiatives and mind maps, and provide feedback on potential successes or concerns for your sustainability initiative.Individually:After your discussion you will take the feedback and each of you will write a 350- to 700-word evaluation of how your sustainability initiative will improve patient care and outcomes and include your mind maps.
DO SLIDE ON EACH OF THESE AND DO A REFERENCE SLIDE AND COVER SLIDE
What are presenting symptoms?
What is the cause?
How is it treated?
What is the nursing care?
Find some pictures online to share with the class
and do 1 multiple choice question with multiple choice options with the answer to present to the class
The following topics will be assigned to groups in class to make short powerpoints and post to
the class discussion board. Please add pictures to each slide and 1 multiple choice practice
question.
ASSIGNMENT COVER SHEET
Course name:
Concepts of Health Education & Health Promotion
Course number:
PHC 212
CRN:
11621
Paper Assignment
Assignment title or task:
(You can write a question)
Choose a health issue in KSA and explore the
determinants causing that issue and justify your
understanding with evidence from the literature.
Student Name:
Student ID:
Submission Date:
Instructor name:
Dr. Ahmed Alabdrabalnabi
Grade:
Out of 10
Instructions for submission:
•
•
•
•
•
•
•
•
•
•
•
•
Make sure to fill out all the relevant information on the coversheet.
Your response should be a minimum of 250 words but should not exceed 500
words (Excluding references).
Support your answer with examples.
Font size should be 12
Font type should be Times New Roman
Heading should be Bold
Colour should be Black
The paragraph must be justified.
Double line spacing.
Use proper references in APA style
AVOID PLAGIARISM
Due date; 7/10/2023 11:59 PM
For this assignment, you will perform an assessment and then write up your findings in a paper.
Choose a “patient” and do a complete health history interview using the provided Health History Questionnaire. Your “patient” can be anyone that you personally know (do not complete this on an actual patient that you are caring for). This includes biographical, past health history, a complete review of the systems, social history, family history, and functional assessment.
After completing the health history questionnaire, summarize your findings using the headings provided below.
Submit your summary in a typed, double-spaced document which includes a title page and headings.
REQUIREMENTS
Content: 70% of grade
Biographic data (please use alias to protect student’s privacy) (5 points)
Past health history (10 points)
Current health, meds (5points)
Review of systems (20 points)
Social history (10 points)
Family history (10 points)
Functional assessment (10 points)
In order to successfully respond to circumstances in your healthcare organization, you must first be able to appraise your organization, its mission, its vision, and its values. To provide you with experience doing this, you will assess the situation as described in your selected case study.Read your case study carefully and develop a short paper that provides a summary of the case study. In the summary, be sure to address the following:Provide a brief summary of the circumstances and the problem(s) faced by the healthcare organization. Highlight details you believe to be of particular relevance.Provide an interpretation of the organization’s mission, vision, and values. Consider how the industry, the organization, and/or the stakeholders define key terms within the organization’s mission, vision, and values and how the definitions clarify the meaning.Discuss how the organization’s interpretation of its mission, vision, and values impacts the circumstance it faces. Consider how the mission and vision relate to the situation outlined in the case study.Submit your assignment here. Make sure you’ve included all the required elements by reviewing the guidelines and rubric.
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Society & Drugs
Course number:
PHC 314
CRN
Essay Topic
Assignment title or task:
(You can write a question)
Societies have evolved to believe that they have the right to
protect themselves from the damaging impact of drug use and
abuse.
(a) Mention the policies and prevention programs for
combating drug use and abuse at any country you
choose ?
(b) Describe the Saudi Food & Drug Authority (SFDA)
approval process for assessing the safety and efficacy of a
newly developed drug?
Student name:
Student ID:
Submission date:
Instructor name
Grade
… out of 10
Guidelines:
•
Word count: 300to 1000 words
•
Follow APA format for your assignment must include Introduction, Body and Conclusion
•
All information must be mention in APA reference
•
Font and Size: Times New Roman (12)
•
Color – Black, Spacing – 1.5, Heading and sub-heading – Bold
•
Follow APA format your assignment must include Introduction, Body & Conclusion
•
Avoid plagiarism
•
Submit as word document
search for articles published from 2015 onwards that focus on African American women with
HIV, including the identification of independent and dependent variables. Additionally,
formulate hypotheses regarding African American women with HIV and their drug and condom
usage.4 pages.
The coordination and continuity of care are two closely related and important aspects of quality of care. Coordination implies the connections that occur between the people and the institutions that provide health care at a point in time or over a short period of time usually focused on an episode of illness. Continuity deals with relationships over time perhaps years or decade. Please refer to table 10-2 to review the types of coordination of care and challenges presented.After reading the case study Jack and Continuity of Care, please answer the following questions:1) How does this case illustrate the lack of institutional continuity?2) How does this case illustrate the lack of financial continuity?3) What role does social work play in this case? Where could a social worker have intervened? What interventions could they have used?
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Public Health 101: Improving Community Health, Third Edition
Advantage Access for Public Health 101, Third Edition (Open Enrollment)
ISBN 9781284134735
SECTION IV Cases and Discussion Questions
Jack and Continuity of Care
▶ Jack and Continuity of Care
Jack was told that he had high blood pressure and high cholesterol when he was in
the army. Because the conditions did not bother him, Jack paid little attention to
them. His job did not provide health insurance, so he decided to take his chances
rather than spend his last dollar paying for insurance through an exchange. Anyway,
he was strong and athletic. Over the years, Jack gained weight, exercised less, and
developed a “touch of diabetes.”
When the diabetes produced symptoms, he went to the emergency room, where
they did a good job of diagnosing his problem and sent him off with a prescription
and a few pills to get started. The pills seemed to help, but Jack could not afford to
fill the prescription or follow up with his “family doctor” because he did not have
one. Jack did not understand all the terms the doctors and nurses used to describe
his condition, but he knew it was serious and could get worse.
It was not long before he was sick again, so this time, he sought care at a community
health center. He did not qualify for Medicaid, but the treatment was affordable. For
a couple of months, he followed up and was feeling better, but on the next
scheduled visit, they told him, “You need to be in the hospital—you are getting
worse.” They got him to the hospital, where he was admitted to the university
service and assigned to a young resident who had just graduated from a well-known
medical school. The resident reviewed his condition, developed a treatment plan,
and explained to Jack what needed to be done. He ordered a tuberculosis (TB) skin
test and collected sputum to check for TB because of Jack’s chronic cough.
Unfortunately, before the treatment could be implemented, the resident rotated to
another service and Jack’s new resident did not seem to pay much attention to him.
Jack decided to leave the hospital against medical advice and left no forwarding
address. His TB skin test was never read. When his positive sputum culture for TB
came back, the laboratory alerted the local health department. Not knowing where
Jack lived, the health department was not able to follow up.
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Before he left, the hospital made sure that Jack had signed all the forms to receive
Medicaid payments for the hospitalization. However, Jack did not complete the
forms because he did not plan to get any more medical care. That changed one day
when the pain was more than he could stand. He decided to try another emergency
room. This time, the place was very crowded, and he had to wait hours to be seen.
Once he was examined, the physicians and nurses tried to get information from him
on his condition and treatment, but Jack could not provide much useful information.
He was prescribed pain medicine and sent home. He was told to follow up with a
doctor in the next few days. By then, it was too late. One morning, as he was getting
up, Jack’s left leg was weak and numb and he lost his speech. He struggled to call
911. Despite the fact that he could not speak, the operator was able to send an
ambulance by tracing his telephone location. The EMTs rushed to Jack’s home and
got him to the nearest hospital. Once again, the emergency room clinicians
evaluated him, but this time, it was too late to be of much help. Jack was admitted
for a stroke.
He stayed in the hospital for a week and made some improvement, but he needed
help with the activities of daily living and could only speak a few words. The hospital
was able to place him in a rehabilitation center because Jack, now 65, qualified for
skilled nursing care under Medicare. He was transferred to the facility and received
intensive rehabilitation services for the next month, until he no longer improved. At
that point, Jack was no longer eligible for skilled nursing care. He was transferred to
a Medicaid nursing home closer to his only relatives. The new facility had a large
number of patients needing “custodial care.” It provided all the services required by
law, but Jack soon realized that he was just another stroke patient.
Discussion Questions
How does this case illustrate the lack of institutional continuity?
How does this case illustrate the lack of continuity between the healthcare and
public health systems?
How does this case illustrate the lack of financial continuity?
What role does the lack of information play in this case? How can information
technology serve to reduce or eliminate these lapses in continuity?
Which lapses in continuity require other types of interventions?
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Public Health 101: Improving Community Health, Third Edition
Advantage Access for Public Health 101, Third Edition (Open Enrollment)
ISBN 9781284134735
Chapter 10 Healthcare Institutions
What Types of Coordination of Care Are Needed and What Purposes Do They Serve?
▶ What Types of Coordination of Care Are
Needed and What Purposes Do They Serve?
As we have discussed, the traditional approach to coordination of care revolved
around the clinician–patient or doctor–patient relationship. Traditionally, the
concepts of continuity of care and coordination of care have been almost
synonymous. This approach assumed that the relationship between one doctor and
one patient would provide the individualized knowledge, trust, and commitment
that would ensure the coordination of care by ensuring the continuity of care. The
concepts of primary care that we have discussed were built in large part upon this
concept of one-to-one continuity.
Today, there is an increasing emphasis on ensuring coordination rather than one-toone continuity. Coordination is sought between institutions and settings where care
is delivered. The approach that leaves continuity of information and continuity of
responsibility for care to individual clinicians alone has often failed to produce the
desired results. As we will see, efforts are underway to formally link institutions,
services, and information between the various healthcare delivery sites and
institutions.
Institutional coordination often relies on financial coordination. If services are
covered by insurance in one setting but not another, the system is not likely to
function efficiently or effectively. When services are not covered at all, patients may
receive excellent care in one setting only to lose the benefits of that care when
necessary preparation or follow-up is not paid for and not accomplished in another
setting.
Coordination is not just an issue within the healthcare delivery system; it is also an
issue that straddles healthcare delivery and public health functions. Communicable
disease control and environmental protections, such as controlling antibiotic
resistance and lead exposure, cannot be successful without effective and efficient
coordination between healthcare and public health professionals and institutions.
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TABLE 10.2 outlines these types of coordination, their intended function, and the
types of challenges that commonly occur with their implementation.
TABLE 10.2 Type of Coordination of Care, Intended Functions, and Challenges
with Implementation
Type of
coordination
Intended function
Challenges with implementation
Clinician–
Continuity as a mechanism for
Multiple clinicians involved in care
patient
ensuring coordination
relationship
Team rather than individual concept of
Development of one-to-one
primary care
relationships built on knowledge
and trust over extended periods of
Frequent changes in insurance coverage
time
require change in health professionals
Institutional
Coordination of individual’s
Different structures and governance often
coordination
information between institutions
lead to lack of coordination between
needed to inform individual clinical
inpatient facilities and between inpatient and
and administrative decision making
outpatient facilities
Financial
Implies that a patient has
Lack of comprehensive insurance coverage
coordination
comprehensive coverage for
often means that essential services cannot
services provided by the full range
be delivered or cannot be delivered at the
of institutions
most efficient or effective institutional site
Aims to maximize the efficiency of
the care received and minimize the
administrative effort required to
manage the payment system
Coordination
Coordination of services between
Lack of coordination of services between
between
clinical care and public heath
public health services and clinical care is
health care
requires communication to ensure
often based on lack of communications
and public
follow-up and to protect the health
health
of others
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Let us take a look at the development of healthcare delivery systems as one
approach to ensuring coordination of health care.
TED Talks: Atul Gawande: How Do We Heal Medicine?
THIS WIDGET IS REFERRING TO URL ‘https://youtu.be/L3QkaS249Bc’. PLEASE GO TO EBOOK VERSION TO
LAUNCH THE LINK.
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The purpose of this assignment is to create a standardized procedure that may be applied to nurse practitioner practice.
This assignment will allow for discovery into the role of the family nurse practitioner (FNP) in providing primary care for clients with disorders of the genitourinary system and supports the professional formation of the FNP practice role.
COURSE OUTCOMES
This assignment enables the student to meet the following course outcomes:
CO 2: Formulate appropriate diagnoses and evidence-based management plans for mature and aging individuals and families. (PO 5)
CO 4: Integrate theory and evidence-based practice in the care of mature and aging individuals and their families. (PO 5)
CO 6: Conduct pharmacologic assessment addressing polypharmacy, drug interactions and other adverse events in the care of mature and aging individuals and their families. (PO 5)
DUE DATE
The Standardized Procedure Worksheet is due by Sunday 11:59 p.m. MT at the end of Week 5.
The Late Assignment Policy applies to this assignment. Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment.
TOTAL POINTS POSSIBLE
This assignment is worth a total of 120 points.
PREPARING THE ASSIGNMENT
Nurse practitioners provide high-quality, comprehensive care to clients in various healthcare settings. Standardized procedures may be used to help guide care. Boards of Nursing, such as CaliforniaLinks to an external site., provide resources to ensure that NPs provide quality care while functioning within their scope of practice. Identify the assigned topics listed by the first letter of your last name. For example, if your last name is Cromer, then your assigned topic is urinary incontinence in the older adult.
First Letter of Your Last Name Topic
A – C urinary incontinence in the older adult
D – G urinary tract infections in community-dwelling older adults
H – K urinary tract infections in facility-dwelling older adults
L – O benign prostatic hyperplasia in older adults
P – R erectile dysfunction in older adults
S – V hormone replacement therapy for menopause
W – Z sexually transmitted infections in older adults
Include the following sections (detailed criteria listed below and in the Grading rubric). Use the standardized procedure templateLinks to an external site. to complete the assignment.
Disorder or condition
Identify the selected disorder or condition.
Provide a basic description of the pathophysiology of the selected disorder or condition.
Provide a summary of the incidence and prevalence of the selected disorder or condition in the United States.
Provide a scholarly source.
Assessment
Identify common subjective findings (symptoms) consistent with the selected diagnosis.
Identify pertinent physical examination components and the expected exam findings consistent with the selected disorder or condition.
Identify your intended state of practice and whether physician collaboration is required, as it is in California. If collaboration is required, describe the circumstances that would require physician consultation.
Provide a scholarly source.
Diagnostic tests
List diagnostic tests appropriate for the selected disorder or condition.
List expected abnormal results consistent with the selected disorder or condition.
Provide a scholarly source.
Management: Present an evidence-based management plan for the selected disorder or condition.
Describe in detail first-line prescribed medications recommended for the selected disorder or condition.
Describe in detail second-line medication that should be prescribed IF the client had an allergy to first-line line treatment for the selected disorder or condition.
Identify medication details including
Trade and generic names for each medication
Typical dose for each medication
Major contraindications for use
Major drug-drug interactions
Identify other recommended treatments, if any, for the selected disorder or condition.
Discuss expected client follow-up. If the client called in with persistent or recurrent symptoms after initial treatment, describe the appropriate next action.
Describe indications for referral.
Use current clinical practice guidelines or relevant, scholarly resources appropriate for advanced practice as defined by program expectationsLinks to an external site. to support the management plan.
Rubric
NR601 Standardized Procedure Worksheet Rubric_W5
NR601 Standardized Procedure Worksheet Rubric_W5
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeDisorder/Condition: (4 required criteria)1. Identify the selected disorder or condition.
2. Provide a basic description of the pathophysiology of the selected disorder or condition.
3. Provide a summary of the incidence and prevalence of the selected disorder or condition in the United States.
4. Provide a scholarly source.
20 pts
Excellent
All requirements met.
16 pts
Satisfactory
3 requirements are met.
10 pts
Needs Improvement
1-2 requirements are met.
0 pts
Unsatisfactory
No requirements are met.
20 pts
This criterion is linked to a Learning OutcomeAssessment (4 required criteria)1. Identify common subjective findings (symptoms) consistent with the selected diagnosis.
2. Identify pertinent physical examination components and the expected exam findings consistent with the selected disorder or condition.
3. Identify your intended state of practice and whether physician collaboration is required, as it is in California. If collaboration is required, describe the circumstances that would require physician consultation.
4. Provide a scholarly source.
20 pts
Excellent
All requirements are met.
16 pts
Satisfactory
3 requirements are met.
10 pts
Needs Improvement
1-2 requirements are met.
0 pts
Unsatisfactory
No requirements are met.
20 pts
This criterion is linked to a Learning OutcomeDiagnostic Tests (3 required criteria)1. Lists appropriate diagnostic tests.
2. Lists expected abnormal results consistent with the disorder or condition.
3. Provide a scholarly source.
20 pts
Excellent
All requirements are met.
10 pts
Needs Improvement
1-2 requirements are met.
0 pts
Unsatisfactory
No requirements are met.
20 pts
This criterion is linked to a Learning OutcomeManagement (7 required criteria)1. Describe in detail the first-line prescribed medications recommended for the selected disorder or condition.
2. Describe in detail the second-line medication that should be prescribed IF the client had an allergy to first-line line treatment for the selected disorder or condition.
3. Identify medication details including
a. Trade and generic names for each medication
b. Typical dose for each medication
c. Major contraindications for use
d. Major drug-drug interactions
4. Identify other recommended treatments, if any, for the selected disorder or condition.
5. Discuss expected client follow-up. If the client called in with persistent or recurrent symptoms after initial treatment, describe the appropriate next action.
6. Describe indications for referral.
7. Use current clinical practice guidelines or relevant, scholarly resources appropriate for advanced practice as defined by program expectations to support the management plan.
50 pts
Excellent
All requirements met.
46 pts
Very Good
6 requirements met.
42 pts
Satisfactory
4-5 requirements met.
25 pts
Needs Improvement
1-3 requirements are met.
0 pts
Unsatisfactory
No requirements are met.
50 pts
This criterion is linked to a Learning OutcomeProfessionalism in Communication:Communicate with minimal errors in English grammar, spelling, syntax, and punctuation.
10 pts
Excellent
0-1 errors.
9 pts
Very Good
2-3 errors.
8 pts
Satisfactory
4-5 errors.
5 pts
Needs Improvement
6-7 errors.
0 pts
Unsatisfactory
More than 7 errors.
10 pts
This criterion is linked to a Learning OutcomeLate Penalty DeductionsStudents are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late, up to three days. Assignments will not be accepted after three days late, and a score of zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.
0 pts
No Points Deducted
Assignment submitted on time. No points deducted.
0 pts
Points Deducted
Assignment submitted late. 10% will be removed for each day late up to three days. After three days, no points will be awarded.
SOAP format is the documentation style you will be using in your clinicals; this also adheres to the thought processes involved in formulating the correct diagnosis and treatment plan. You will present the subjective data first, including all questions that you want to ask. Next is the gathering of objective data that supports your subjective data; if there is none given, then you will determine by system what kind of physical exam elements you want to elicit. After this, you are ready to provide differentials and a working diagnosis based on the above data. After arriving at the appropriate working diagnosis, you will then formulate a treatment plan. Please be sure to follow the template below for your initial discussion board postings. Postings should be concise and NOT in narrative format.
Template
Case Study Chosen: (List what case you have chosen)
Demographics: Age/Gender
SUBJECTIVE
CC:
HPI: (As listed from Case Study Information)
Subjective: (What questions will you ask? Must be listed by System, ONLY as it pertains to Chief Complaint/HPI. Should NOT be all systems or full head to toe unless pertinent).
OBJECTIVE
General:
VS BP, HR, RR, Weight, Height, BMI
Physical Exam Elements: (Must be listed by System, ONLY as it pertains to Chief Complaint/HPI. Should NOT be all systems or full head to toe unless pertinent.)
POC Testing (any Point of Care (POC) testing specifically performed in the office): What tests (if any) did you perform during the visit (urine dip, rapid strep, urine pregnancy test, Glucose finger-stick, etc.)? Leave blank if none.
ASSESSMENT
Working Diagnosis: (Must include ICD 10)
Differential Diagnosis:
PLAN
Diagnostic studies: If any, will be ordered (Labs, X-ray, CT, etc.). Only include if you will be ordering for your patient. Remember the importance of appropriate resource utilization. Remember you are managing this patient in the CLINIC setting, NOT THE HOSPITAL.
Treatment: Must include full Sig/Order for all prescriptions and OTC meds (Name of medication, dosage, frequency, duration, number of tabs, number of refills). CANNOT only list drug class. Should follow evidence-based guidelines.
Referrals: If Applicable
Education:
Health maintenance:
RTC:
Maria is a 35 y/o female who is complaining of frequent vaginal yeast infections. She has had 4 in the last 6 months, and they have been treated with topical and oral antifungal medications which have initially worked, but the infections recur within 1-2 weeks. Maria reports increased thirst and urination for the last two to three months. Maria is an office manager in a bookstore who works full-time and has 4 children aged 5, 7, 10, and 12, who live with her 80% of the time. She has been divorced x 3 years and is struggling to make ends meet and reports she and her children frequently eat fast food because of the low cost and time constraints. Maria’s vital signs are 136/88, 98.8, 16, 80, Ht 5’3”, Wt 187 lbs,
Tim is a 22 y/o male who is complaining of lethargy, cold sensitivity, weight gain of 10 lbs over the last 3 months with an unnoticeable change in appetite, brain fog, constipation, and muscle weakness that he feels has become progressively more noticeable over the last several months. Tim is a heterosexual, single, full-time college student and works part-time at a coffee shop. His last annual physical examination was 2 years ago and was WNL. His current vital signs are 110/70, 62, 98.6, 12, Ht 5’9” Wt 190 lbs.
Brian is a previously healthy 56-year-old white man who presents with progressive neuropathy and declining mental status over several months. The patient initially developed numbness of his fingertips and the balls of his feet and began to lose motor control of his hands, which manifested as dropping objects or flinging them as he tried to pick them up. As symptoms progressed, he had visual tracking problems that were severe enough to interfere with driving a car, and he developed short-term memory loss and slowing of cognitive function. His current vital signs are 117/70, 72, 98.6, 12, Ht 5’9” Wt 193 lbs.
Table 1. Common Endocrine and Metabolic Disorders. Complete Table 1 if you chose case study #1 or #2. In addition to your SOAP note, you must also complete the following table. Upload your SOAP note and table to the discussion board.
Diagnosis Signs/Symptoms Gold Standard Diagnostics Gold Standard Treatment
Hyperthyroidism
Grave’s Disease
Hypothyroidism
Hoshimoto’s Thyroiditis
Addison’s Disease
Cushing’s
Diabetes Mellitus Type 1
Diabetes Mellitus Type 2
Hyperprolactinemia
*Exam Tip
First-line medication for type 2 DM is metformin (Glucophage).
If patient on metformin 500 mg daily and A1C is high (>7%), increase dose to metformin 500 mg BID. If A1C is still high (>7%) and on metformin 500 mg BID, increase dose to metformin 1,000 mg BID (or 1 g BID).
If taking maximum dose of metformin (1 g BID), can use several drug classes with it such as a sulfonylurea like glipizide (Glucotrol XL) 5 mg PO daily (do not exceed maximum dose of glipizide 20 mg/day), DPP-4 inhibitor (Januvia, Onglyza), TZDs (Actos), others.
Table 2. Common Hematologic Disorders. Complete Table 2 if you chose case study #3. In addition to your SOAP note, you must also complete the following table. Upload your SOAP note and table to the discussion board.
Diagnosis Signs/Symptoms Gold Standard Diagnostics Gold Standard Treatment
Iron Deficiency Anemia
Thalassemia Minor
Aplastic Anemia
Pernicious Anemia
Vitamin B12 Deficiency
Non-Hodgkin’s Lymphoma
Multiple Myeloma
Thrombocytopenia
Folic Acid Deficiency
Neutropenia
Hodgkin’s Lymphoma
Hello, this is a discussion. The diagnosis for the patient is Depression. For treatment you can put an SSRI, paroxetine 20 mg once a day for example. Thank you!
Assignment:
Case Discussion on Depression:
A 28-year-old female presents to your office stating that she is troubled by headaches and fatigue. She says that she always feels tired and can’t sleep well, often waking up early if she gets to sleep at all. She describes her headaches as dull, aching, and generalized. These symptoms began about three weeks ago and have been getting worse. She reports a lack of interest in her usual activities, even the ones that she used to enjoy. She also reports that she is missing work due to fatigue and inability to concentrate. Although both her children are in school, she is concerned that she is “losing them”. She is worried that she might have “something bad” because she has difficulty concentrating and is having frequent crying spells. She reports a loss of appetite, with a weight loss of 10 pounds in the last month.
The patient has no significant past medical or psychiatric history and takes no regular medications. However, she takes ibuprofen for headaches. She denies using alcohol or drugs. The patient is married, with two elementary school-age children.
Summarize the clinical case.
Create a list of the patient’s problems and prioritize them.
Which diagnosis should be considered
What is your rationale for the diagnosis
What differential diagnosis should be considered
What test or screening tools should be considered to help identify the correct diagnosis
What treatment would you prescribe and what is the rationale (consider psychopharmacology, diagnostics tests, referrals, psychotherapy, psychoeducation)
What standard guidelines would you use to assess or treat this patient
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Submission Instructions
Your initial post should be at least 500 words,formatted and cited in current APA style with support from at least 3 evidence-based sources.
Case Study 2: Analgesics
A 6 year old girl is brought into the ER by her mother at 2100 hours. The mother states
that the child has been suffering from an upper respiratory infection for the past 3 days
and that she has been treating the child with an over-the-counter cold/flu remedy for the
past 2 days, following the label directions for dosage. About 8 hours ago, the child
started spiking fever, peaking at 1600 hours at 102.5, at which point the mother gave
the child a standard dose of children’s Tylenol to try to bring down the fever. Over past 3
hours, the child has become listless, and her breathing has become rapid, prompting
the visit to the ER. Blood is drawn and the following results are obtained:
Reference Ranges
WBC: 1.4 x 104/mm3
(0.5-1.0 x104/mm3)
Neutrophils:
40%
(~50%)
Lymphocytes:
52%
(25%-40%)
Monocytes:
7%
(3%-7%)
Eosinophils:
0%
(0%-3%)
Basophils:
1%
(0%-1)
Glucose: 75 mg/dL
(60-100 mg/dL)
ALT: 35 U/L
(
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ASSIGNMENT COVER SHEET
Course name:
Concepts of Health Education & Health Promotion
Course number:
PHC 212
CRN:
Paper Assignment
Assignment title or task:
(You can write a question)
Choose a health issue in KSA and explore the
determinants causing that issue and justify your
understanding with evidence from the literature.
Student Name:
Student ID:
Submission Date:
Instructor name:
Bader Albarrak
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Your response should be a minimum of 250 words but should not exceed 500
words (Excluding references).
• Support your answer with examples.
• Font size should be 12
• Font type should be Times New Roman
• Heading should be Bold
• Colour should be Black
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style
• AVOID PLAGIARISM
• Due date; 07/10/2023 11:59 PM
Best of Luck
IWANT TO BE 18 SLIDE EVERY SLIDE TWO LINES AND PICTURE
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Presentation rubric
Presenter’s Name:
Topic Name:
Date: ————————————– Group: —————————————————————–Evaluation Items
Items
Category
The content is comprehensive and clear.
The content was organized in logical manner.
The presentation contained examples and
useful techniques that applied to current
work.
The content focused on major facts or ideas.
Content
Poor
(1)
Fair
(2)
Good
(3)
Excellent
(4)
▪ Speaker summed up main points in
conclusion.
The presenter was knowledgeable about the
topic and any related issues.
The
presenter
answered
questions
effectively.
Presenter
The presenter had a fluidity of language.
The presenter maintained the attention and
interest of audiences.
The presenter appears prepared and
understand the material.
The presenter summarizes when needed.
Organization
Presentation
Style
Delivery
The presenter delivered the material in a clear
and structured manner.
Level of presentation is appropriate for the
audience.
Presentation is a planned
Conversation,
paced
for
audience
understanding.
The presenter talks about the slides rather
than simply reading them to the audience.
Total
Course instructor Name:
Comments: ———————————————————————————————————-
Examine concepts of epidemiology and suggest improvements in policy, prevention, and/or promotion.
Apply evidence-based principles to critically evaluate federal and state policies and practices in healthcare delivery and public health systems.
Apply evidence-based principles to evaluate healthcare reforms such as the Affordable Care Act.
Explain competencies in healthcare quality, access, cost, and how they interrelate.
Explain how generational trends impact the delivery of healthcare.
Note: This is text from Module 1, where this project was introduced. It is repeated here for your convenience.
Imagine that you and other healthcare management professionals have come together over your common concern about inequities you have observed in healthcare. You and like-minded colleagues have met to discuss what might be done to effectuate some change toward improvement in healthcare for vulnerable populations.
After a couple of informal discussions, you all agree that the best place to start is to identify and describe inequities you have witnessed over weeks, months, and sometimes years, provide support for your position, and present this information to local and state officials. Your goal is to meet with officials and present in person your observations of inequities and recommendations for reform.
The group of colleagues has accepted your offer to gather information described above into a report. Three other colleagues have volunteered to do the same. You will share your findings and, in a future meeting, you will all select the three items of most pressing importance among those shared. Your task here, then, is to select three healthcare inequities of a vulnerable population, gather information about the population and the inequities, underscore the gravity of the situation in relation to your area of healthcare, justify their importance, and share your report with the group. You will also present the inequities in terms of cost, quality, and access. Together, the group will select the top three items to bring to the attention of local and state officials.
Action Items
Create a presentation that you would feel ready to share with your colleagues. Include the main points from your report.
Use high-quality images, graphs, and graphics to tell the story of your research and recommendations. Avoid lots of text in your presentation.
Use a professional-looking color scheme and template. Follow professional recommendations for the use of white space, fonts, etc.
Practice your presentation sufficiently so that you know it well and can avoid “ums” and the monotone of reading a script.
Anticipate questions and be ready to answer any that are asked of you.
Exercise from week 1
Vulnerable Population: Diabetics in rural Kentucky.
Description of the Population:
Compared to their metropolitan counterparts, diabetics in rural Kentucky confront difficulties. They are especially at risk due to a combination of geographic isolation, financial constraints, a lack of healthcare options, and a lack of educational resources (U.S. Census Bureau, 2019).
Vulnerability Factors:
Geographic Isolation: Rural locations often mean longer travel times to clinics or hospitals.
Economic Barriers: The higher poverty rates in rural Kentucky pose challenges in affording care and medications (U.S. Census Bureau, 2019).
Limited Healthcare Facilities: Fewer medical facilities mean limited access to specialized diabetic care.
Lack of Awareness and Education: Reduced resources for diabetes education can lead to suboptimal disease management.
Reputable Source:
According to the CDC, access to care is often difficult in rural areas of the United States, including parts of Kentucky (Centers for Disease Control and Prevention, 2017).
Healthcare Elements: Quality and Access.
Quality:
Improving care quality can be addressed by:
Telemedicine: Telehealth provides specialized consultation for remote patients, ensuring they receive high-quality care (Kruse et al., 2017).
Training Local Care Providers: Up-to-date training for local care providers enhances overall patient care (Institute of Medicine, 2010).
Access:
Strategies to improve access include:
Mobile Clinics: Mobile clinics offer periodic specialized care in rural areas (Gamm et al., 2003).
Community Health Workers: These individuals bridge the healthcare gap in rural areas, aiding in early detection, education, and diabetes management (Allen et al., 2016).
References:
Centers for Disease Control and Prevention. (2017). Diabetes in Rural America.
Gamm, L., Hutchison, L., Dabney, B., & Dorsey, A. (Eds.). (2003). Rural Healthy People 2010: A Companion Document to Healthy People 2010 (Vol. 1). Texas A&M University System Health Science Center, School of Rural Public Health, Southwest Rural Health Research Center.
Institute of Medicine. (2010). Redesigning Continuing Education in the Health Professions. National Academies Press.
Kruse, C. S., Krowski, N., Rodriguez, B., Tran, L., Vela, J., & Brooks, M. (2017). Telehealth and patient satisfaction: A systematic review and narrative analysis. BMJ open, 7(8), e016242.
Allen, C. G., Brownstein, J. N., Satsangi, A., & Escoffery, C. (2016). Community Health Workers as Allies in Hypertension Self-Management and Medication Adherence in the United States, 2014. Preventing Chronic Disease, 13, E179.
U.S. Census Bureau. (2019). Poverty Rates by County in Kentucky.
Identify the impact of Pay-for-Performance on the healthcare organization and discuss the impact of Value Based Purchasing on the organization.support assertions with at least 3 references and 1 instance of biblical integration in current APA format. Each reply must incorporate at least 2 scholarly citations and 1 instance of biblical integration in current APA format.course textbook:Harrington, M. K. (2021). Health Care Finance and the mechanics of Insurance and Reimbursement. Jones & Bartlett Learning.
For your signature assignment, you will create a PowerPoint and a minimum two-page paper following the directions below.
The powerpoint is intended to be a teaching tool that you could use for a patient and family who is newly diagnosed with a chronic condition. Your video should incorporate the role that Social Determinants of Health (SDOH)Links to an external site. play in their health outcomes.
Your PowerPoint should take into account literacy levels, ensuring it is easy to understand and can be comprehended across all demographics and socioeconomic statuses.
Select one of the following diagnoses: Hypertension
Create a patient education powerpoint. The video should include:
A description of the diagnosis and common symptoms using lay terms
A holistic treatment plan that includes: One medication and one evidenced-based non-pharmacologic treatment that is used for this diagnosis. Briefly explain how each will help the patient
As a provider briefly outline how you will assess SDOH in your plan of care (i.e. through motivational interviewing, engaging community health workers, etc.). Briefly explain how different SDOH can affect the patient’s health outcomes (housing, transportation, food security, healthcare access)
Appropriate resources for patients to get further information and/ or support
The last slide should include your references
Minimum two-page paper must include:
Definition of the diagnosis
Prevalence and risk factors
Pathophysiology (include classic signs and symptoms)
Physical assessment and testing to confirm the diagnosis
Differential Diagnoses (as applicable)
Gold standard for treatment of a condition
Include a minimum of 4 evidence-based articles to support your presentation that are 5 years old or less.
The paper must include at least 2 scholarly sources that are not from your textbook or any standard government or medical websites. Scholarly sources must be peer-reviewed articles current within the last 5 years. You do not have to write this paper in a SOAP format. You can use bullet points; however, you must use complete sentences. Please reference and use in-text citations properly and according to 7th ed. APA format. Please include a title page and a reference page for the
write-up.
Conduct a literature review of the identified public health problem, considering the following factors:
Population
Setting
Existing programs
Scope of problem
Examine peer-reviewed articles (a minimum of 3), best-practice reports, white papers, and other appropriately-vetted and scholarly sources published within the last 5 years.
This 3-4 page paper should follow current APA guidelines. Provide 3 references, with at least 1 reference not included in the course materials.
Note: You will include elements from this literature review in your M9 Program Presentation and your M10 Final Plan Paper.
Course Outcome:
10. CEPH 23: Analyze the significance of public health journal articles.
Learning Objective:
1. Analyze literature that relates to how social, behavioral, environmental, and biological factors contribute to specific individual and community health outcomes for your chosen public health problem.
Review the following article for this week’s discussion:Sama’a, H. A., Alfayez, A. S., Alanazi, A. T., Alwuhaimed, L. A., & Hamed, S. S. B. (2021). Autonomy, accountability, and competition: the privatisation of the Saudi health care system. Journal of Taibah Discuss the various governmental entities involved in the privatization of healthcare in the Kingdom of Saudi Arabia. How are these entities helping meet the needs of healthcare in the Kingdom? Include anything you found surprising in the article.
Hi,This assignment is based off of the book that we read in class. I will attach the name from my Syllabus. It’s Joel, L. 2022 Advanced Practice Nursing: Essentials for Role Developing, Philadelphia, PA. Please follow the steps to a T of what I share with you. It’s broken down exactly as to how she wants and expects it.
sctcc.learn.minnstate.edu/content/2023/6344356-20243000268S/Exploring Science with Infants %26 Toddlers Video.mp4?_&d2lSessionVal=f1ur8QB81KkJgE3N9uo911Jsa
Unformatted Attachment Preview
2019-2020 TEACHER TIME
LIT TLE S C IE N T IS T S — E X P L O R IN G SCIEN CE W ITH INFANTS AND TO D D LERS
Viewer’s Guide (Adapted from the above resource for the ECED 1240 Course)
Many correct answers! Do not just copy. Think for yourself and choose your own words.
Fill in every answer for full points.
1. Avocado Exploration Video Reflection “Box 1”
How did the teacher support scientific inquiry? How did the children respond?
Observing:
How did the teacher support observation?
How did the children respond?
Asking Questions:
How did the teacher ask questions?
How did the children respond?
Making Predictions:
How did the teacher support making predictions?
How did the children respond?
Analyzing or using information to understand the world:
How did the teacher support this?
How did the children respond?
This document was developed with funds from Grant #90HC0012 for the U.S. Department of Health and Human Services, Administration for Children and Families,
Office of Head Start, and the Office of Child Care by the National Center for Early Childhood Development, Teaching, and Learning. This resource may be duplicated
for noncommercial uses without permission.
1
2. Engaging Environments “Box 2”
NOTES FROM PRESENTER ON
MATERIALS
IDEAS & STATIEGIES
O PEN – EN DED M ATERIALS
NOTES FROM PRESENTER ON
MATERIALS
IDEAS & STATIEGIES
VARIETY OF MATERIALS
ACCESSIBLE MATERIALS
This document was developed with funds from Grant #90HC0012 for the U.S. Department of Health and Human Services, Administration for Children and Families,
Office of Head Start, and the Office of Child Care by the National Center for Early Childhood Development, Teaching, and Learning. This resource may be duplicated
for noncommercial uses without permission.
2
3. Nurturing and Responsive Interactions Video Reflection “Box 3”
How was the teacher nurturing & responsive to the children?
Scaffolding:
Supporting:
Speaking:
Encouraging children to:
4. Gail’s Everyday STEAM “Box 4”
What are three or more new materials/vocabulary I want to try?
1.
2.
3.
5. Connecting Arts and Science “Box 5”
What are three or more ways you want to use the arts to help children explore science ideas?
1.
2.
3.
This document was developed with funds from Grant #90HC0012 for the U.S. Department of Health and Human Services, Administration for Children and Families,
Office of Head Start, and the Office of Child Care by the National Center for Early Childhood Development, Teaching, and Learning. This resource may be duplicated
for noncommercial uses without permission.
3
This document was developed with funds from Grant #90HC0012 for the U.S. Department of Health and Human Services, Administration for Children and Families,
Office of Head Start, and the Office of Child Care by the National Center for Early Childhood Development, Teaching, and Learning. This resource may be duplicated
for noncommercial uses without permission.
4
This document was developed with funds from Grant #90HC0012 for the U.S. Department of Health and Human Services, Administration for Children and Families,
Office of Head Start, and the Office of Child Care by the National Center for Early Childhood Development, Teaching, and Learning. This resource may be duplicated
for noncommercial uses without permission.
5
This document was developed with funds from Grant #90HC0012 for the U.S. Department of Health and Human Services, Administration for Children and Families,
Office of Head Start, and the Office of Child Care by the National Center for Early Childhood Development, Teaching, and Learning. This resource may be duplicated
for noncommercial uses without permission.
6
2019-2020 TEACHER TIME
LIT TLE SCIENTISTS —EXPLORING SCIENCE WITH INFANTS AND TODDLERS
Viewer’s Guide (Adapted from the above resource for the ECED 1240 Course)
Many correct answers! Do not just copy. Think for yourself and choose your own words.
Fill in every answer for full points.
1. Avocado Exploration Video Reflection “Box 1”
How did the teacher support scientific inquiry? How did the children respond?
Observing:
How did the teacher support observation?
How did the children respond?
Asking Questions:
How did the teacher ask questions?
How did the children respond?
Making Predictions:
How did the teacher support making predictions?
How did the children respond?
Analyzing or using information to understand the world:
How did the teacher support this?
How did the children respond?
This document was developed with funds from Grant #90HC0012 for the U.S. Department of Health and Human Services, Administration for Children and Families,
Office of Head Start, and the Office of Child Care by the National Center for Early Childhood Development, Teaching, and Learning. This resource may be duplicated
for noncommercial uses without permission.
1
2. Engaging Environments “Box 2”
NOTES FROM PRESENTER ON
MATERIALS
IDEAS & STATIEGIES
O PEN – EN DED M ATERIALS
NOTES FROM PRESENTER ON
MATERIALS
IDEAS & STATIEGIES
VARIETY OF MATERIALS
ACCESSIBLE MATERIALS
This document was developed with funds from Grant #90HC0012 for the U.S. Department of Health and Human Services, Administration for Children and Families,
Office of Head Start, and the Office of Child Care by the National Center for Early Childhood Development, Teaching, and Learning. This resource may be duplicated
for noncommercial uses without permission.
2
3. Nurturing and Responsive Interactions Video Reflection “Box 3”
How was the teacher nurturing & responsive to the children ?
Scaffolding:
Supporting:
Speaking:
Encouraging children to:
4. Gail’s Everyday STEAM “Box 4”
What are three or more new materials/vocabulary I want to try?
1.
2.
3.
5. Connecting Arts and Science “Box 5”
What are three or more ways you want to use the arts to help children explore science ideas?
1.
2.
3.
This document was developed with funds from Grant #90HC0012 for the U.S. Department of Health and Human Services, Administration for Children and Families,
Office of Head Start, and the Office of Child Care by the National Center for Early Childhood Development, Teaching, and Learning. This resource may be duplicated
for noncommercial uses without permission.
3
This document was developed with funds from Grant #90HC0012 for the U.S. Department of Health and Human Services, Administration for Children and Families,
Office of Head Start, and the Office of Child Care by the National Center for Early Childhood Development, Teaching, and Learning. This resource may be duplicated
for noncommercial uses without permission.
4
This document was developed with funds from Grant #90HC0012 for the U.S. Department of Health and Human Services, Administration for Children and Families,
Office of Head Start, and the Office of Child Care by the National Center for Early Childhood Development, Teaching, and Learning. This resource may be duplicated
for noncommercial uses without permission.
5
This document was developed with funds from Grant #90HC0012 for the U.S. Department of Health and Human Services, Administration for Children and Families,
Office of Head Start, and the Office of Child Care by the National Center for Early Childhood Development, Teaching, and Learning. This resource may be duplicated
for noncommercial uses without permission.
6
Discuss your final project research experience thus far by addressing the following questions:
What parts of your research are going well?
What challenges have you incurred in your research thus far?
What lessons have you learned about the research process and about your specific health issue?
What has surprised you in your research?
Ask specific questions of your peers for research assistance and/or feedback.
SCENARIO USED FOR PROJECT Scenario Three: Obesity in an Adolescent
Michelle is 15 years old and has always been the “big” girl in class. She is much taller than her fellow classmates and is also bigger in size. According to
her doctor, she is in the morbidly obese category based on the body mass index (BMI) chart. Michelle gets her exercise from gym class, which she has
every Wednesday afternoon. She does not eat breakfast but does eat the school lunches. When she gets home, she tends to fix a bowl of cereal to hold
her over until dinner.
This individual belongs to an age-specific population that is affected by this health issue. You will write a health analysis paper in which you analyze both
the individual and the age-specific population affected by the health issue for symptoms, causes, and data to inform potential prevention options. For
example, if your profile describes a middle-aged individual dealing with high blood pressure, your analysis paper will consider both that specific
individual and the entire population of middle-aged adults dealing with high blood pressure.
You will then develop a presentation directed at a particular audience that could enact some of these prevention options in the hopes of helping both
the individual from the profile and the age-specific population in dealing with this health issue. For example, if your individual and population are
middle-aged adults dealing with high blood pressure, you would cater your presentation to an audience that could help address the issue and potentially
enact some of the prevention options you have recommended
Rosenkoetter, M., Nardi, D., & Bowcutt, M. (2017). Internationally educated nurses in transition in the United States: Challenges and mediators. The Journal of Continuing Education in Nursing, 48(3), 139–144. doi: 10.3928/00220124-20170220-10
Hongyan, L., Wenbo, N., & Junxin, L. (2014). The benefits and caveats of international nurse migration. International Journal of Nursing Sciences, 1(3), 314–317. Retrieved from https://www.sciencedirect.com/science/article/pii/…
Walani, S. R. (2015). Global migration of internationally educated nurses: Experiences of employment discrimination. International Journal of Africa Nursing Sciences, 3, 65–70. Retrieved from https://www.sciencedirect.com/science/article/pii/…
After you have read the articles, respond to the following:
What are the professional requirements for internationally educated nurses (IENs) migrating to the United States?
What positions do IENs play in the United States?
What challenges do healthcare organizations face with IENs?
What challenges, both professional and personal, are encountered by IENs?
Identify one issue contained in the article Internationally Educated Nurses in Transition in the United States and explain its importance and how you, as an administrator, might address it, please explain your position.
To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Submission Details:
Submit this topic as a 2- to 3-page Microsoft Word document. Use APA standards for citations and references.
Cite a minimum of three outside peer-reviewed sources to support your assertions and save it as SU_HCM3046_W2_Project_LastName_FirstName. Submit the document to the Submissions Area by the due date assigned.
Cite any sources using correct APA format on a separate page.
Submit a 4 page (approx.) template on the adolescent patient. The document attached should be downloaded and saved (see below) to your computer. Fill in all appropriate sections and include 2 references or sources for your information. Bullet points preferred.
The file name should be created like this: DH 113-B, JSmith-adol (your report needs your first initial and last name embedded in the name of the file). Confirm the type of document you submit is accessible on Canvas (Word or PDF) Google docs and Pages will not open within the rubric area.
The Wilkins text has excellent general information about each patient type however the template requires details about each heading area. Students should plan on 4-5 sentences per heading. Students will include at least two peer-reviewed references; typically these are journals and not websites (in addition to your required texts) in APA format, for this assignment.
This submission is due October 7 by 1 p.m.
If a student submits a report after the deadline, this will result in a loss of 10% off the final score for each day it is late OR if they turn in the report after 5 days, the student will receive a “0” for the report.
This criterion is linked to a Learning OutcomeCARIES RISK & NUTRITION(sugar level in grams- include at least ONE SERVING from a typical day) intake, fluoride supplements (past, current, MD suggested), energy/sports drinks & soda, adolescent diet – common foods
3 pts
Excellent
1 pts
Satisfactory
0 pts
Unsatisfactory
3 pts
This criterion is linked to a Learning OutcomeGROWTH & DEVELOPMENThormonal challenges & body changes occurring, typical OHI challenges, manual dexterity, frequency of TB, interdental cleaning, referral to orthodontist (why & when), sports guards (how supplied), 3rd molar ext (referral when?)
5 pts
Excellent
3 pts
Satisfactory
0 pts
Unsatisfactory
5 pts
This criterion is linked to a Learning OutcomeTYPICAL SCHEDULESschool vs. hobbies/sports, importance of NOT over-scheduling, peer pressure, personal interests, community involvement
3 pts
Excellent
1 pts
Satisfactory
0 pts
Unsatisfactory
3 pts
This criterion is linked to a Learning OutcomeACCESS TO DENTAL CAREfamily knowledge/history of dentistry, past experience with dental care (very little or sufficient), dental insurance access
3 pts
Excellent
1 pts
Satisfactory
0 pts
Unsatisfactory
3 pts
This criterion is linked to a Learning OutcomePSYCHOLOGICAL/HEALTH ISSUESpersonal care (or lack thereof), bullying, body image, anxiety/suicide, family stress, divorce, peer pressure, birth control/STDs
3 pts
Excellent
1 pts
Satisfactory
0 pts
Unsatisfactory
3 pts
This criterion is linked to a Learning OutcomeDRUG ABUSE (signs and symptoms)tobacco/vape use, piercing and risks, illicit & OTC drug abuse
3 pts
Excellent
1 pts
Satisfactory
0 pts
Unsatisfactory
3 pts
This criterion is linked to a Learning OutcomeKEY APPROACHlisten and engage, find common ground, avoid talking down
3 pts
Excellent
1 pts
Satisfactory
0 pts
Unsatisfactory
3 pts
This criterion is linked to a Learning OutcomeREFERENCES2 APA Peer-reviewed Journal articles + Wilkins pages
2 pts
Satisfactory
2 APA references + Wilkins pages included
0 pts
Unsatisfactory
1 APA reference and/or Wilkins pages missing
2 pts
Total Points: 25
Unformatted Attachment Preview
ADOLESCENT SPECIAL PATIENT REPORT TEMPLATE
Caries risk & Nutrition (sugar level IN GRAMS of typical food):
•
•
Sport drinks/juice/soda in weekly diet
Fluoride supplements (past or current, suggested by pediatric dentists?):
Growth & development (10-17 years):
•
•
•
•
Hormonal challenges & bodily changes occurring (both male and female)
OHI challenges – TB, interdental cleaning
Referral to orthodontist (why & when), sports guards (how supplied)
3rd molar extraction (referral when?)
Typical schedules:
•
•
•
Activities/hobbies/sports (importance of, why overscheduling can occur)
Personal interests (developing rapport)
Community involvement
Access to dental care:
•
•
•
Family knowledge/history of dentistry
Past experience with dental care (very little or sufficient)
Access to dental care/insurance
Psychological/Health issues:
•
•
•
•
•
•
Personal care (or lack thereof)
Body image
Anxiety/suicide
School/peer pressure/bullying (effects)
Family stress (divorce)
Birth control/STD’s
Drug abuse (signs and symptoms):
•
•
•
Tobacco/vape use (effects)
Piercing and risk associated
Illicit/OTC drug abuse
Key approach to discuss:
•
Listen and engage (how)
•
Find common ground
•
Avoid “talking down”
References
Textbook:
Wilkins, E. (2016). Clinical practice of the dental hygienist. 12th edition, Lippincott, Williams and Wilkins,
Philadelphia, PA.
Include pages used:
Journal Articles (2 required):
Choose any one of the common occupational infectious diseases and explain the following:Causes, mode of transmission, and symptoms.Occupational group at risk Prevention and control measuresInstructions for submission:· Make sure to fill out all the relevant information on the coversheet.· Short essay of 500-750 words (Excluding references).· The font size should be 12. · Font type should be Times New Roman· The heading should be Bold. · Color should be Black.· The paragraph must be justified. · Double line spacing.· Use proper references in APA style.· AVOID PLAGIARISM
Unformatted Attachment Preview
ASSIGNMENT COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN:
Assignment title or task:
(You can write a question)
Choose any one of the common occupational
infectious diseases and explain the following:
•
•
•
Causes, mode of transmission, and symptoms.
Occupational group at risk
Prevention and control measures
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Short essay of 500-750 words (Excluding references).
• The font size should be 12.
• Font type should be Times New Roman
• The heading should be Bold.
• Color should be Black.
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style.
• AVOID PLAGIARISM
• Due date; 7/10/2023 11:59 PM
Best of Luck
Draft the prevention analysis, Section II, for your final project. Research your issue to determine potential prevention and mitigation options appropriate for your individual and the age-specific population. This will afford you the opportunity to practice evaluating the health issue you have chosen and to receive feedback on your analysis. You can then incorporate that feedback into the final version of your project, which is due in Module Seven. Be sure to review the Milestone Two document before you begin.
Submit your assignment here. Make sure you’ve included all the required elements by reviewing the guidelines and rubric.
SCENARIO BEING RESEARCHED AND UTILIZIED Scenario Three: Obesity in an Adolescent
Michelle is 15 years old and has always been the “big” girl in class. She is much taller than her fellow classmates and is also bigger in size. According to
her doctor, she is in the morbidly obese category based on the body mass index (BMI) chart. Michelle gets her exercise from gym class, which she has
every Wednesday afternoon. She does not eat breakfast but does eat the school lunches. When she gets home, she tends to fix a bowl of cereal to hold
her over until dinner.
This individual belongs to an age-specific population that is affected by this health issue. You will write a health analysis paper in which you analyze both
the individual and the age-specific population affected by the health issue for symptoms, causes, and data to inform potential prevention options. For
example, if your profile describes a middle-aged individual dealing with high blood pressure, your analysis paper will consider both that specific
individual and the entire population of middle-aged adults dealing with high blood pressure.
You will then develop a presentation directed at a particular audience that could enact some of these prevention options in the hopes of helping both
the individual from the profile and the age-specific population in dealing with this health issue. For example, if your individual and population are
middle-aged adults dealing with high blood pressure, you would cater your presentation to an audience that could help address the issue and potentially
enact some of the prevention options you have recommended
Overview
For the final project in this course, you will analyze a health issue from the perspective of an individual patient dealing with the health issue and the age-specific population that individual belongs to. Your analysis will include potential prevention options that might help the individual and the population prevent or mitigate the health issue. Finally, you will take this information and develop a short presentation directed to an audience that might be able to help prevent or mitigate the health issue.
Prompt
In Module Five, you will work on the prevention section of your final project (Section II). As you are evaluating prevention strategies for your scenario, you must consider the individual as well as the larger age-specific population that you identified in Milestone One. Before you begin, be sure to review the rubric below to understand what is expected of you.
Address the following questions:
What are the best practices of the field regarding prevention options for the age-specific population for this health issue?
What are potential prevention options that could be recommended for the population? The individual? Explain why you chose these methods, and support your answers with research.
How does the age of the individual or population influence the modes of prevention that you can recommend?
NEW Answer please| Even if the request was repeated previously, you must provide a new answer
Proper referencing in APA format is must
Text size 12-Times New Roman only.
Avoid plagiarisms
Avoid copying from any source
Avoid using another teacher’s solution or a similar previous student’s solution because it is a university whose system can access even the solutions published on the study pool website
You must give 100/100 correct solution
Avoid using artificial intelligence completely in any way, because I knew how to use it, even if I needed it, I would not have invited you to this task.
You must be 100% confident and worthy of your performance and solution.
Avoid using paraphrasing programs or websites
You must provide a correct answer 100/100
Read the instructions in the file carefull
Unformatted Attachment Preview
Federal Emergency Management: A Brief
Introduction
November 30, 2012
Congressional Research Service
https://crsreports.congress.gov
R42845
Federal Emergency Management: An Introduction
Summary
The federal government plays a significant role in emergency management, which generally
refers to activities associated with avoiding and responding to natural and human-caused hazards.
Emergency management in the United States is highly decentralized and contextual in nature:
activities often involve multiple jurisdictions as well as a vast number of agencies,
nongovernmental organizations, and private sector entities. In addition, the number and type of
actors involved in an incident will vary tremendously depending on the context and severity of
the event. Similarly, the legal framework through which emergency management functions and
activities are authorized is also decentralized and stems from multiple authorities.
Congress annually appropriates funds for a wide range of activities and efforts related to
emergency management. For example, between 2005 and 2011 Congress provided an average of
$12 billion annually to the Federal Emergency Management Agency, the lead federal agency
responsible for disaster relief through regular and supplemental appropriations. Congress has also
invested over $120 billion through various federal agencies to help the Gulf Coast Region recover
from the hurricanes that hit the Gulf Coast in 2005 and 2008.
In recent years congressional interest in emergency management has focused on funding,
program administration, and program coordination—both among federal agencies and state
emergency management agencies. This report provides an introduction to the principles and
foundations of federal emergency management in the United States and a description of the
activities of the federal agencies that provide assistance, focusing primarily on the Federal
Emergency Management Agency, but also including information on the National Guard,
Department of Agriculture, Department of Defense, Army Corps of Engineers, Department of
Health and Human Services, Department of Housing and Urban Development, Department of
Transportation, Environmental Protection Agency, Forest Service, and Small Business
Administration.
This report is designed to provide Members of Congress and congressional staff with a general
overview of principles and foundations of federal emergency management in the United States as
well as the types of activities provided by various federal agencies. The report begins with a
description of the four phases of emergency management: (1) mitigation, (2) preparedness, (3)
response, and (4) recovery, and includes examples of some of the activities that take place in each
of these phases. The report then discusses a recent movement at the federal level to carry out
these phases of emergency management through a system of frameworks. The frameworks
include (1) the National Prevention Framework, (2) the National Protection Framework, (3) the
National Mitigation Framework, (4) the National Response Framework, and (5) the National
Disaster Recovery Framework. The frameworks are used to designate roles and responsibilities
and coordinate various activities.
Next, this report describes the process for requesting federal assistance for major disasters,
emergencies, and fire suppression. The declaration section also includes brief summaries of the
types of assistance provided through each type of declaration. This discussion is followed by
description of federal-to-state cost shares, how federal assistance is funded, and the process
through which FEMA requests assistance from other federal entities. The section then provides a
description of the close-out process—the process in which FEMA terminates its recovery efforts.
The report includes a discussion of key federal laws and policies that influence federal emergency
management, and concludes by highlighting some of the federal activities that take place in
response to emergencies and disasters.
Congressional Research Service
Federal Emergency Management: An Introduction
Contents
Introduction ……………………………………………………………………………………………………………………. 1
Key Concepts and Approaches in Emergency Management ………………………………………………….. 1
All-Hazards Model …………………………………………………………………………………………………….. 1
NIMS and ICS …………………………………………………………………………………………………………… 2
Phases of Emergency Management ………………………………………………………………………………. 2
Mitigation……………………………………………………………………………………………………………. 2
Preparedness ……………………………………………………………………………………………………….. 3
Response …………………………………………………………………………………………………………….. 3
Recovery …………………………………………………………………………………………………………….. 3
The Framework Approach…………………………………………………………………………………………… 4
National Prevention Framework …………………………………………………………………………….. 4
National Protection Framework ……………………………………………………………………………… 5
National Mitigation Framework …………………………………………………………………………….. 5
National Response Framework ………………………………………………………………………………. 5
National Disaster Recovery Framework ………………………………………………………………….. 6
Federal Assistance Through Stafford Declarations ………………………………………………………………. 6
Major Disaster Declarations ………………………………………………………………………………………… 7
Assistance Provided Under Major Disaster Declarations …………………………………………… 7
Emergency Declarations …………………………………………………………………………………………….. 8
Assistance Provided Under Emergency Declarations ………………………………………………… 8
Fire Management Assistance Grant Declarations …………………………………………………………… 9
Assistance Provided under Fire Management Assistance Grants ………………………………… 9
Cost-Shares …………………………………………………………………………………………………………………….. 9
Disaster Relief Fund ………………………………………………………………………………………………………. 10
Closeout ……………………………………………………………………………………………………………………….. 10
Other Types of Federal Declarations …………………………………………………………………………….11
Federal to Federal Support ……………………………………………………………………………………………… 12
Stafford Act Incidents and Mission Assignments………………………………………………………….. 12
Non-Stafford Act Incidents ……………………………………………………………………………………….. 13
Other Key Federal Laws and Policies ………………………………………………………………………………. 13
Disaster Mitigation Act of 2000 …………………………………………………………………………………. 13
Post Katrina Emergency Management Reform Act ………………………………………………………. 13
Homeland Security Presidential Directives………………………………………………………………….. 14
Homeland Security Act …………………………………………………………………………………………….. 14
National Oil and Hazardous Substances Pollution Contingency Plan ……………………………… 15
Key Federal Assistance for Disaster Response and Recovery ……………………………………………… 16
National Guard ………………………………………………………………………………………………………… 17
Department of Agriculture ………………………………………………………………………………………… 17
Department of Defense …………………………………………………………………………………………….. 18
Immediate Response …………………………………………………………………………………………… 18
Requests for Assistance……………………………………………………………………………………….. 18
Army Corps of Engineers………………………………………………………………………………………….. 19
Department of Health and Human Services …………………………………………………………………. 20
Department of Housing and Urban Development …………………………………………………………. 20
Community Development Block Grants ………………………………………………………………… 20
Congressional Research Service
Federal Emergency Management: An Introduction
Department of Transportation ……………………………………………………………………………………. 21
Federal Highway Administration ………………………………………………………………………….. 21
Environmental Protection Agency ……………………………………………………………………………… 22
Forest Service ………………………………………………………………………………………………………….. 23
Small Business Administration ………………………………………………………………………………….. 24
Tables
Table 1. Other Types of Federal Declarations ……………………………………………………………………..11
Contacts
Author Information………………………………………………………………………………………………………… 25
Key CRS Policy Experts ………………………………………………………………………………………………… 25
Congressional Research Service
Federal Emergency Management: An Introduction
Introduction
Emergency management generally refers to activities associated with avoiding and responding to
natural and human-caused hazards. Emergency management in the United States is highly
decentralized and contextual in nature. Multiple jurisdictions as well as a vast number of
agencies, nongovernmental organizations, and private sector entities are often involved. In
general, emergency management begins locally, but the federal government plays an important
role when a state requests assistance. Consequently, the number and type of actors involved in an
incident vary tremendously depending on the context and severity of the event. Similarly, the
legal framework through which emergency management functions and activities are authorized is
also decentralized and stems from multiple authorities. This report provides Members of
Congress and their staffs with an introduction to the principles and foundations of federal
emergency management in the United States. It examines the activities of several federal
agencies, including the Federal Emergency Management Agency (FEMA), the National Guard,
Department of Agriculture, Department of Defense, Army Corps of Engineers, Department of
Health and Human Services, Department of Housing and Urban Development, Department of
Transportation, Environmental Protection Agency, Forest Service, and Small Business
Administration.
In addition, this report discusses the four phases of emergency management: (1) mitigation, (2)
preparedness, (3) response, and (4) recovery; the process for requesting federal assistance for
major disasters, emergencies, and fires; and the types of assistance provided through each type of
Stafford Act declaration. This report also includes a description of federal-to-state cost shares
under the Stafford Act, a discussion on how federal assistance is funded, and the process through
which FEMA requests assistance from other federal entities.
This report also outlines the frameworks that guide various emergency management activities at
the federal and state level, and discusses some of the key federal laws and policies influencing
federal emergency management and highlights federal entities that provide assistance to states
and localities.
Related CRS products examining these issues more in-depth are footnoted in this report.
Key Concepts and Approaches in Emergency
Management
The following sections describe key concepts that undergird federal emergency management.
Many of these concepts originated at the state level and are still being put to use by states and
localities. Some concepts developed by the states have been modified and/or adopted by the
federal government as a national standard.
All-Hazards Model
The all-hazards model is based on the idea that there are generic processes and capabilities
needed to address most kinds of emergencies and disasters. For example, preparing and
responding to an earthquake entails similar activities and capabilities for preparing and
responding to an explosion or terrorist bombing. Thus emergency managers can conduct
emergency management activities in a more flexible and cost-effective manner than using a
standalone, emergency, or disaster-specific program. Another benefit is that carrying out
emergency management functions generally involves adaptation, which is a guiding principle of
Congressional Research Service
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Federal Emergency Management: An Introduction
the all-hazards model.1 Thus preparations and lessons learned associated with one type of event,
can often be applied to another type of emergency or disaster scenario.
NIMS and ICS
Emergency management functions are managed according to the principles of the National
Incident Management System (NIMS). Authorized by Homeland Security Presidential Directive 5
(HSPD-5), NIMS is a preparedness and response management model based on the Incident
Command System (ICS).2 ICS is a command and control model developed by firefighters after
the 1970 fires in southern California. The response to the fires was hindered due to duplication of
efforts, lack of coordination, and communication problems. ICS standardizes response operations
by using similar terminology, communication systems, and organizational structure to eliminate
or reduce confusion during a unified response.3 NIMS uses ICS concepts to establish a response
structure that is scalable (capable of growing as more organizations come together to respond to
the incident) that can be used by all jurisdictions, agencies, and organizations to ensure a unified
response to complex events. State and local governments must be NIMS compliant to be eligible
for certain preparedness grants.
Phases of Emergency Management
Emergency management functions are generally grouped into four phases: (1) Mitigation,
(2) Preparedness, (3) Response, and (4) Recovery. The grouping of emergency management
functions is useful for classifying and conceptualizing activities. Use of the four phases at the
state level is not, however, a requirement for grant funding. As discussed later, the federal
government uses a framework approach that differs somewhat from the four phases. The
following sections provide examples of the types of activities that take place in each phase.4
While conceptually useful for targeting efforts and resources, the phases of emergency
management are not distinct—activities in each phase often overlap. For example, recovery
projects often include elements of mitigation (for example, rebuilding structures using current
building codes) and response often includes recovery measures (immediate debris removal). The
phases are also cyclical in nature—lessons learned from an incident might be applied in
preparedness efforts for future emergencies and major disasters.
Mitigation
Mitigation activities entail identifying risks and hazards to either substantially reduce or eliminate
the impact of an incident usually through structural measures. Mitigation activities often have a
long-term or sustained effect and may have an impact on insurance premiums. In many cases,
1 William L. Waugh, Jr., Living with Hazards, Dealing with Disasters An Introduction to Emergency Management
(Armonk, NY: M.E. Sharpe, 2000).
2 Homeland Security Presidential Directive 5: Management of Domestic Incidents, http://www.dhs.gov/xabout/laws/
gc_1214592333605.shtm.
3 For example, prior to ICS police and fire departments responding to the same incident might use different radio
frequencies and communicate with different terms. A “code blue” for one department might mean something else for
another. The organization structure might also be different. A commander in one department might have a different role
and responsibility in another. ICS (and NIMS) is therefore an attempt to eliminate potential confusion caused by these
differences.
4 A glossary of emergency and disaster related terms can be located at http://www.fema.gov/glossary.
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Federal Emergency Management: An Introduction
mitigation activities occur in the recovery stage of a major disaster. Some examples of mitigation
include:
building codes that address risks such as fires, high winds, or earthquakes;
zoning rules that restrict construction in floodplains;
rebuilding damaged structures with more resilient materials;
flood mapping to identify low lying areas and relocating homes and structures
located in floodplains and flood prone areas; and
dams and levees that help prevent flooding.
Preparedness
Preparedness is distinct from mitigation because rather than focusing on eliminating or reducing
risks, the general focus of preparedness is to enhance the capacity to respond to an incident by
taking steps to ensure personnel and entities are capable of responding to a wide range of
potential incidents. Preparedness activities may include:
training;
planning;
procuring resources, such as food, water, and medication stockpiles;
intelligence and surveillance activities to identify potential threats; and
exercising to assure the adequacy of planning efforts and the use of after-action
reports to improve emergency response plans.
Response
Response activities are comprised of the immediate actions to save lives, protect property and the
environment, and meet basic human needs. Response involves the execution of emergency plans
and related actions, and may include:
evacuating victims;
deployment of response teams, medical stockpiles, and other assets; and
establishment of incident command operations.
Recovery
Recovery activities are intended to restore essential services and repair damages caused by the
event. Recovery activities may include:
the reconstitution of government operations and services (e.g., emergency
services, public safety, and schools);
housing and services for displaced families and individuals; and
replenishment of stockpiles.
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Federal Emergency Management: An Introduction
The Framework Approach
On March 30, 2011, President Barack Obama issued Presidential Policy Directive 8: National
Preparedness (hereinafter PPD-8).5 PPD-8 superseded Homeland Security Presidential Directive 8
(HSPD-8), which was signed by President George W. Bush on December 17, 2003.6 Similar to its
predecessor, PPD-8 provides a guide as to how the nation, from the federal level to private
citizens, can “prevent, protect against, mitigate the effects of, respond to, and recover from those
threats that pose the greatest risk to the security of the Nation” including acts of terrorism and
other human caused incidents (such as oil spills) as natural disasters.7 PPD-8 is also intended to
meet several “comprehensive preparedness system” requirements in Subtitle C of the PostKatrina Act.8
PPD-8 establishes that preparedness objectives are to be accomplished by subdividing emergency
management components into a system of integrated, national planning frameworks according to
functionality—prevention, protection, mitigation, response, and recovery.9 The frameworks are
intended to assign roles and responsibilities to various federal agencies with mission areas
involved with aspects of federal emergency management.10
These frameworks either exist in various stages of development or have been implemented. The
following sections provide brief descriptions of each framework.11
National Prevention Framework
While the other planning frameworks address natural hazards and disasters as well as humancaused incidents, the focus of the National Prevention Framework is mainly on preventing
imminent terrorist threats. As such, upon issue, the National Prevention Framework is to assign
roles and responsibilities and coordinate federal agencies involved with intelligence and
information sharing, surveillance, providing public information and warnings, as well as other
elements that help the federal government identify, discover, or locate terrorist threats.12
5 For further analysis on PPD-8 see CRS Report R42073, Presidential Policy Directive 8 and the National
Preparedness System: Background and Issues for Congress, by Jared T. Brown.
6 HSPD-8 gave the Secretary of the Department of Homeland Security broad authority to improve preparedness,
prevention, response, and recovery operations among others. HSPD-8 also required the creation of a National
Preparedness Goal and the implementation of a National Preparedness System. HSPD-8 fulfilled many of the
requirements later set forth in the Post Katrina Emergency Management Reform Act of 2006 (Title VI of the
Department of Homeland Security Appropriations Act, 2007—hereinafter the Post-Katrina Act) such as actions to
approach all hazards within a risk-based framework, and the use of metrics to measure levels of preparedness. Many
such requirements, however, were not implemented.
7 The White House, Presidential Policy Directive/PPD-8, March 30, 2011, p. 1, at http://www.dhs.gov/xlibrary/assets/
presidential-policy-directive-8-national-preparedness.pdf.
8 P.L. 109-295, 6 U.S.C. §741- 764, 120 STAT. 1424-1433.
9 The White House, Presidential Policy Directive/PPD-8, March 30, 2011, p. 3, athttp://www.dhs.gov/xlibrary/assets/
presidential-policy-directive-8-national-preparedness.pdf.
10 Ibid, p. 3.
11 These descriptions should not be viewed as definitive. Some of the planning frameworks are being updated or still in
draft form. They could conceivably change in form or content before being implemented.
12 Federal Emergency Management Agency, Presidential Policy Directive 8: National Preparedness: Working Drafts
of the National Planning Frameworks – Prevention Framework, p. 9.
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Federal Emergency Management: An Introduction
National Protection Framework
The National Protection Framework, upon issue, would assign roles and responsibilities and
coordinate agencies on a wide range of emergency management and homeland security areas,
encompassing cyber security, border security, transportation security, and agriculture and food
security, among others. In addition, the working draft of the National Protection Framework
proposes the use of academic and research centers to develop new protection technologies and
establish protection-related curricula and degree programs.13
National Mitigation Framework
The National Mitigation Framework, upon issue, would address capabilities that reduce the loss
of life and property by lessening the impact of disasters.14 The National Mitigation Framework is
distinct from the other planning frameworks because most mitigation activities take place at the
local level; the role of the federal government in the National Mitigation Framework is not as
prominent as with the other planning frameworks.15
National Response Framework
Issued in January 2008, the National Response Framework (NRF) is the successor of two
previous response documents, the Federal Response Plan, which was thought to be too narrow in
scope, and the National Response Plan, which was found to be problematic for a variety of
reasons, including unclear designations and confusing language and jargon.16 The NRF guides the
federal response to natural and human-caused incidents. However, the NRF is not an “operational
plan.” Rather, it articulates the overarching emergency management principles used to coordinate
and conduct a multi-agency and multijurisdictional response to all types of incidents. The NRF is
executed through the use of three supplemental annexes consisting of the (1) Emergency Support
Functions Annex, (2) Support Annexes, and (3) Incident Annexes.
Emergency Support Functions Annexes
There are 15 Emergency Support Function (ESF) Annexes. ESFs group federal departments and
agencies by matching their resources and capabilities with a particular incident.17 For example,
federal entities with a role in responding to an oil spill are listed in ESF #10—the Oil and
Hazardous Materials Response Annex. ESFs also designate which federal entities have
management oversight responsibility and which entities have a support role.
13 Ibid., p. 10.
14 Ibid., p. 1.
15 Ibid, p. 12.
16 For further information on the NRF see CRS Report RL34758, The National Response Framework: Overview and
Possible Issues for Congress, by Bruce R. Lindsay.
17 U.S. Federal Emergency Management Agency, ESF Annexes Introduction, January 2008, at http://www.fema.gov/
pdf/emergency/nrf/nrf-esf-intro.pdf.
Congressional Research Service
5
Federal Emergency Management: An Introduction
Support Annexes
There are eight Support Annexes that group federal, state, local, private sector, and
nongovernmental organizations that execute functional processes and administrative functions.
The Support Annexes also designate roles and responsibilities.18
Incident Annexes
There are eight Incident Annexes that explain the authorities and policies relevant to a particular
incident, describe the incident situation, and make planning assumptions for the incident. An
Incident Annex also identifies the “coordinating and cooperating” agencies involved with
response to the incident.19
National Disaster Recovery Framework
Issued in September 2011, the National Disaster Recovery Framework (NDRF) coordinates and
assigns roles and responsibilities to entities involved in disaster recovery. The focus of the NDRF
is to “restore, redevelop and revitalize the health, social, economic, natural and environmental”
aspects of disaster-impacted states and local jurisdictions.20 The NDRF has six Recovery Support
Functions (RSF): (1) Community Planning and Capacity Building, (2) Economic, (3) Health and
Social Services, (4) Housing, (5) Infrastructure Systems, and (6) Natural and Cultural Resources.
Federal Assistance Through Stafford Declarations
The system of emergency management in the United States is scalable. This means that local
governments request assistance from the state if responding or recovering from the incident is
beyond their capacity. In cases when a state is overwhelmed by the incident, the state governor
may elect to request assistance from the federal government.
Scalability makes emergency management response more practical, but it also contains a political
element because it is embedded within the federalist system of governance aimed at the
preservation of state autonomy. The state-initiated request may also alleviate concern that the
federal government might assume leadership of response and recovery operations. The Robert T.
Stafford Disaster Relief and Emergency Assistance Act (hereinafter the Stafford Act)21 does
provide the President authority to issue an emergency declaration in the absence of a
gubernatorial request if the President determines the incident involves a subject area under the
Constitution or laws of the United States, in which the United States exercises preeminent
responsibility and authority of the incident.22 Such cases, however, are rare. The majority of
18 U.S. Federal Emergency Management Agency, Support Annexes: Introduction, January 2008, at
http://www.fema.gov/pdf/emergency/nrf/nrf-support-intro.pdf.
19 U.S. Federal Emergency Management Agency, Incident Annexes Introduction: National Response Plan, December
2004, pp. INC-i, at http://www.learningservices.us/pdf/emergency/nrf/nrp_incidentannexintroduction.pdf.
20 Federal Emergency Management Agency, National Disaster Recovery Framework: Strengthening Disaster Recovery
for the Nation, September 2011, p. 1,at http://www.fema.gov/pdf/recoveryframework/ndrf.pdf.
21 Codified at 42 U.S.C. §5121 et seq. For further analysis on the Stafford Act see CRS Report RL33053, Federal
Stafford Act Disaster Assistance: Presidential Declarations, Eligible Activities, and Funding, by Francis X. McCarthy.
22 P.L. 93-288, 42 U.S.C. §5191(b). The President is required to consult with the state governor when practical.
Examples of these declarations include the April 19, 1995, bombing of the Alfred P. Murrah Building in Oklahoma
City, and the September 11, 2001, attack on the Pentagon in Virginia.
Congressional Research Service
6
Federal Emergency Management: An Introduction
federal disaster assistance is released only after a presidential declaration is issued in response to
a gubernatorial request for federal assistance.
The Stafford Act authorizes federal assistance through three types of declarations: (1) major
disaster declarations, (2) emergency declarations, and (3) Fire Management Assistance Grant
declarations (FMAG).23 However, FMAG declarations are typically declared through the Federal
Emergency Management Agency (FEMA) Regional Director.24 Emergency and major disaster
declarations can only be issued by the President. Each of these declarations are described in more
detail in the following sections.
Major Disaster Declarations
The Stafford Act defines a major disaster as:
any natural catastrophe (including any hurricane, tornado, storm, high water, wind-driven
water, tidal wave, tsunami, earthquake, volcanic eruption, landslide, mudslide, snowstorm,
or drought), or, regardless of cause, any fire, flood, or explosion, in any part of the United
States, which in the determination of the President causes damage of sufficient severity
and magnitude to warrant major disaster assistance under this chapter to supplement the
efforts and available resources of states, local governments, and disaster relief
organizations in alleviating the damage, loss, hardship, or suffering caused thereby.25
When a governor submits a request for a major disaster declaration FEMA meets with state
representatives to develop preliminary damage assessments. In general, FEMA will make a
recommendation to the President to declare a major disaster if the state’s preliminary damage
assessment exceeds certain thresholds established in regulation.26 The President in turn may or
may not act on the recommendation.
Assistance Provided Under Major Disaster Declarations
Under the Stafford Act three main types of assistance can be provided and administered through
FEMA when the President issues a major disaster declaration: (1) the Public Assistance (PA)
Grant Program, (2) the Individual Assistance (IA) program, and (3) the Hazard Mitigation Grant
Program (HMGP). Under the Stafford Act, the President may issue a major disaster declaration
that provides only PA if damage to dwellings is not severe enough to warrant IA, or if there is
sufficient damage, both PA and IA may be provided.
The PA program provides assistance to state and local governments and certain nonprofit
organizations and includes emergency protective measures, debris removal, and the repair,
replacement, or restoration of eligible facilities.27 Hazard mitigation measures during the re
Hello, please follow the rubricExercise ContentDSM-5-TR Summaries Assignments (10% of total grade for this paper)The student will have 2 sets of summaries to complete. Each of them will contain a 1-page summary of a category of disorders (one page per category, e.g., in Summary, set 1, one page for Bipolar and Related Disorders, one page for Depressive Disorders, In addition, each category should include the following headings: Overview, age-related factors, differential diagnosis, Disorders Risk, and Prognostic Factors.DSM-5 Assignment Rubric:
Criterion Proficient 20 points Developing proficiency 15 points Unsatisfactory 5 points Score 20 PointsOverview of diagnostic category Clearly describes how this diagnostic category fits in the DSM-5, e.g., Neurodevelopmental, Mood Disorder, etc. and what other subcategories of diagnoses are included and how they differ. Provides general information but seems confused about how the diagnostic category fits in the DSM-5 framework and does not describe some subcategories of diagnosis. Fails to describe how this diagnostic category fits in with the DSM-5 organization. In addition, it fails to tell us what diagnostic subcategories are included and how they differ. Copy and paste from the manual. 20 PointsAge-Related/Developmental Succinctly and accurately notes if there are age criteria for making this diagnosis and if there are specific developmental considerations in how symptoms may be expressed. Addresses age criteria and developmental considerations without clarity or only with reminders. Minimally address age criteria and developmental considerations. 20 PointsDifferential Diagnosis Lists and briefly describes rule-out diagnoses that should be considered. Acknowledges differential diagnosis. However, it does not support specific features. Fails to address differential diagnosis considerations. 20 PointsDisorders Risk and Prognostic Factors. Describes the research findings regarding the course and outcome of the disorder over time. Uses APA 7th Edition to cite and reference the evidence. Minimally describes research/clinical findings regarding course and outcome. Fails to address research/clinical findings about disorder risk and prognostic factors over time. Total
Attached are the paper & presentation guidelines. My topic is OSTEOARTHRITIS. I need a paper and a presentation including the type of pathology/malady, the modalities used, etc. For presentation slides, do not overwrite too many information. Use bullet points only. Make it creative and use background topic related picture on slides. Provide APA reference list for both paper and presentation. ABSOLUTELY NO PLAGARISM PLEASE. SUBMIT ALL (3-5) RESOURCES USED FOR THIS PAPER BY OCTOBER 3rd TUESDAY. PLEASE FOLLOW THE ATTACHED GUIDELINES AND THE RUBRIC. Let me know if you have any questions.
Please write two discussion replies. 250 words each in APA format with at least two peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)All replies must be constructive and use literature where possible. attached you will the discussion replies
Unformatted Attachment Preview
KeShawna
Describe urinary tract infection, causes, symptoms, and treatment
Urinary tract infection (UTI) is a general term used to describe inflammation of the urethra,
bladder, and kidney caused by bacteria, yeast, or chemical irritants. UTIs vary from
asymptomatic bacteriuria to symptomatic and recurrent to sepsis-associated, requiring
hospitalization. Because they have short urethra near the rectum, women acquire UTIs in a 30:1
ratio to men. For men, contributing factors include intercourse with an infected partner,
homosexuality, and an uncircumcised penis. During sexual intercourse, periurethral and urethral
bacteria ascend into the bladder, causing UTI. The bacteria that cause UTIs develop in the fecal
flora, inhabit the vagina and periurethral introitus, and climb to the urethra and bladder.
Escherichia coli is the most causative agent in 85% to 90% of community-acquired UTIs,
followed by Staphylococcus saprophyticus. Pathogens like Pseudomonas, Enterococcus,
Staphylococcus, Serratia, Providencia, and fungi cause complicated UTIs (Arcangelo et al.,
2017). In cases of asymptomatic UTI, the patient presents with no signs or symptoms, and
around 25% to 40% resolve without treatment. In symptomatic UTI, the patient can show
symptoms like urinary urgency or frequency, suprapubic tenderness, acute dysuria, or
costovertebral pain or tenderness. A diagnostic indicator of UTI with or without symptoms is a
urine culture with 105/mL organisms or more. Antibiotic treatment is the standard therapy for all
UTIs.
Discuss treatment for benign prostatic hyperplasia
Treatment for benign prostatic hyperplasia (BPH) falls into three significant categories. One
group is α-adrenergic antagonists or α-blockers (doxazosin, terazosin, tamsulosin, alfuzosin, and
silodosin). Tamsulosin, silodosin, and alfuzosin are selective α1-adrenoreceptor antagonists that
relax the smooth muscle fibers of the prostate and bladder neck, reducing the active features of
prostatic obstruction (Arcangelo et al., 2017). A second group is 5-α-reductase inhibitors
(finasteride and dutasteride). These inhibitors decrease the prostate cell’s intracellular growthstimulatory hormone levels without reducing testosterone levels, leading to a prostatic size
reduction of twenty to thirty percent. The last group is called PDE type 5 inhibitors. Tadalafil
(Cialis) is the only approved drug in this class. PDE5 inhibitors regulate smooth muscle tone in
the human prostate.
Describe overactive bladder, its causes, symptoms, and treatment
The International Continence Society defines overactive bladder as an array of symptoms
that include urinary urgency usually accompanied by frequency (voiding eight or more times per
24 hours) and nocturia (awakening two or more times at night to void), with or without urge
urinary incontinence (UUI) that affects about 34 million people in the United States. The exact
cause of the OAB is multifactorial. Numerous underlying anatomic, physiologic, and
comorbidity-related factors precipitate or exacerbate OAB. Most cases are idiopathic, with the
remainder attributed to myogenic or neurogenic causation. Urgency is the primary symptom of
OAB, followed by frequency, incontinence, and involuntary and inappropriate bladder
contraction. Treatment is contingent upon OAB’s degree of impairment and annoyance.
Treatment of comorbid conditions and referral to a specialist is warranted if empiric or diseasespecific therapy is required (Arcangelo et al., 2017). Behavioral therapy, which consists of
bladder training, pelvic floor muscle exercises, and weight loss, is the first intervention for OAB.
If behavioral therapy does not correct OAB, first-line pharmacologic therapies include
anticholinergic or antimuscarinic drugs oxybutynin, tolterodine, trospium, darifenacin,
solifenacin, and fesoterodine. If tolerability issues prevent the use of anticholinergic drugs,
alternative drugs, imipramine, desmopressin, topical estrogens for females, and alpha-adrenergic
antagonists for males can be used.
Treatment options and recommendations for different STIs (Chlamydia, Gonorrhea
and Syphilis)
Chlamydia’s recommended treatment is 100 mg of oral doxycycline twice daily for seven
days. Alternative regimens include 1 g of azithromycin or 500 mg of levofloxacin once daily for
seven days. The current recommended treatment for gonorrhea consists of 500 mg of
intramuscular ceftriaxone. Azithromycin is no longer an appropriate therapy for gonorrhea due to
increased macrolide resistance. For patients unable to handle cephalosporins, a single dose of
5mg/kg parenteral gentamicin combined with 2 g of oral azithromycin should be prescribed
(Tuddenham et al., 2022). The first-line therapy for syphilis of all stages is parenteral penicillin.
Administering 2.4 million long-acting benzathine penicillin G units as a single intramuscular
dose is optimal for primary, secondary, and early latent syphilis. Late latent syphilis is treated
with 2.4 million units of benzathine penicillin G administered intramuscularly weekly for three
consecutive weeks. Alternate therapy includes 100 mg of oral doxycycline twice daily for 14 to
28 days.
References
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (2017). Pharmacotherapeutics for
Advanced Practice (4th ed.). Wolters Kluwer.
Tuddenham, S., Hamill, M. M., & Ghanem, K. G. (2022). Diagnosis and Treatment of Sexually
Transmitted Infections: A Review. JAMA, 327(2), 161–172.
https://doi.org/10.1001/jama.2021.23487
Anna
1. Describe urinary tract infection, causes, symptoms and treatment
•
Urinary Tract Infections (UTI) can be described as an inflammation caused by bacteria,
yeast or chemical irritants that affect the bladder kidneys, and urethra (Arcangelo et al.,
2017). They often inflict women more often than men due to the anatomical structure of
the urethra and its location in proximity with the rectum (Arcangelo et al., 2017). A
shorter urethra means that pathogens and irritants can more easily transport into and
infect the bladder and kidneys.
•
Urinary tract infections may be attributed to improper cleansing methods and
incontinence, sexual activity, uncircumcised penis, homosexuality, and urinary
retention (Arcangelo et al., 2017). Essentially any prolonged exposure of the urethra
to a pathogen or irritant may lead to a UTI. Escherichia Coli is the leading causative
bacteria related to UTI (Arcangelo et al., 2017). This is likely due to the proximity of
the anus to the urethra and stool being introduced into the urinary tract. Sometimes
UTIs are asymptomatic or do not involve the common symptoms listed above.
•
Some leading symptoms of UTIs include fevers, suprapubic tenderness, new or
increased urinary frequency or urgency, burning and stinging with urination, and
back pain. With upper UTIs patients may experience flank pain nausea and vomiting
(Arcangelo et al., 2017).
•
Regarding treatment options, differentiating chronic from acute, mild from severe,
symptomatic from asymptomatic, and areas and pathogen suspected of infection
source, the treatment can vary. Sometimes hospitalization is required. In the older
population UTI is highly prevalent and often leads to sepsis, so it is important
physicians be keen on identifying symptomatic UTIs to prevent serious complications
(Zeng et al., 2020).
•
Asymptomatic UTIs are often left untreated as they are found to naturally resolve
without treatment and other noncomplicated UTIs in women resolve in at least a
quarter of cases (Arcangelo et al., 2017). Otherwise, all symptomatic UTIs warrant
treatment, and the main drug therapy involves antibiotics to treat the infection, and a
urinary analgesic can be given for discomfort and dysuria (Arcangelo et al., 2017).
Encouraging patients to drink lots of water to encourage flushing out the urinary tract
and using sitz baths may also be beneficial for management. While education on
prevention, like urinating after sex, and proper cleansing methods may aid in
avoiding reoccurrence.
2. Discuss treatment for benign prostatic hyperplasia
•
Benign prostatic hyperplasia (BPH) can require surgical, medical and drug therapy
interventions to effectively treat. It is recommended to first treat less invasively and
prevent progression if the condition allows (Arcangelo et al., 2017). There are 3 drug
classes involved in BPH treatment. These are a-blockers, 5-a-inhibitors, as well as
one PDE type 5 inhibitor (Arcangelo et al., 2017).
3. Describe overactive bladder, causes, symptoms and treatment
•
Overactive bladder (OAB) is a symptom syndrome rather than a discrete diagnosis,
and its symptoms include urinary urgency with frequency and nocturia (Arcangelo et
al., 2017).
•
The causes of OAB are not entirely understood but are considered multifactorial. This
can include anatomical, physiological, and underlying disease factors (Arcangelo et
al., 2017).
•
Treating OAB involves treating underlying conditions that may cause or exacerbate
symptoms. Often a referral to a urologist is warranted. Behavioral therapies are
considered first line treatment, these include pelvic floor exercises, weight loss, and
bladder training (Arcangelo et al., 2017). Drug therapy involves anticholinergic and
antimuscarinic drugs as best solutions. Otherwise, Botox, antidiuretics, tricyclic
antidepressants, desmopressin, topical estrogens, or alpha-adrenergic antagonist can
be considered (Arcangelo et al., 2017).
4. Treatment options and recommendations for different STIs (Chlamydia, Gonorrhea and
Syphilis)
•
Prevention of sexually transmitted infections (STI) is the best recommendation.
Education on prevention methods should always be given to sexually active or at-risk
populations. Abstinence should be encouraged, but otherwise education on the use of
condoms and monogamous sexual relationships, available vaccines, and identification
of STIs, should be given regarding prevention strategies (Workowski et al., 2021).
•
Treatment options vary depending on the STI. However, it is essential that the patient
and their partner are both treated. Treatment options concerning drug therapy include
antimicrobials for all STIs. For Chlamydia a short dose of azithromycin or a
weeklong therapy of doxycycline can be effective. Gonorrhea treatment includes
cefixime, ceftriaxone, azithromycin or doxycycline. Syphilis is typically treated with
penicillin, but a handful of other antibiotics may be utilized due to unusual situations
(Arcangelo et al., 2017).
References
Arcangelo, P. V., Peterson, M. A., Wilbur, V., & Reinhold, A. J. (2017). Pharmacotherapeutics
for advanced practice: A practical approach (4th ed.). Philadelphia, PA: Wolters
Kluwer/Lippincott Williams & Wilkins.
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno,
H., Zenilman, J. M., & Bolan, G. A. (2021). Sexually Transmitted Infections Treatment
Guidelines, 2021. MMWR. Recommendations and reports : Morbidity and mortality weekly
report. Recommendations and reports, 70(4), 1–187. https://doi.org/10.15585/mmwr.rr7004a1
Zeng, G., Zhu, W., Lam, W., & Bayramgil, A. (2020). Treatment of urinary tract infections in
the old and fragile. World journal of urology, 38(11), 2709–2720.
https://doi.org/10.1007/s00345-020-03159-2
PLEASE, READ INSTRUCTIONS CAREFULLY. I HAVE ATTACHED THE OTHER SECTIONS OF THE PAPER SO THAT YOU KNOW WHAT IT IS ABOUT. PLEASE INCLUDE THE “the knowledge gaps.” IN THE LITERATURE REVIEW THEY FORGOT TO INCLUDE THE KNOWLEDGE GAPS.
In this section include the following:
A reference to the project’s benefits in terms of cost, time, and/or quality that address needs or changes, results, impacts, or consequences that the project has on people, programs, or institutions.
Goals and objectives that are measurable, shared, and hypothetically agreed on by all key stakeholders. They are directly linked to the concept of project success factors.
What variables need to be considered and and whether or not you have control over them.
For example, if you were to implement a clinic-wide practice change, would budget be an issue and how would you address that variable?
If you were to implement your study, consider how would you gather data. Would you choose the qualitative or quantitative method?
An explanation of what your research will provide to the community, or to social change.
A description of the desired outcomes: Specifically, state the purpose, focus, and viewpoint of the project as well as its expected accomplishments.
While you may not be implementing your project, you should have a goal in mind that relates to solving your problem.
Establish a timeline for accomplishing your project goal(s).
This section should be 3 pages in length, not including the cover or reference page, and should address the intended outcomes of your project. You must reference a minimum of 3 scholarly articles.
Use current APA format to style your paper and to cite your sources. Review the rubric for more information on how the assignment will be graded.
Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
60 to >49.2 pts
Meets Expectations
The project, aims, values, and desired outcomes are well developed and clear and thorough. Aims include detailed examples of projected features and functions. Values include implementation benefits for specific stakeholders. Desired outcomes expertly state the purpose, have a quality focus, and clearly describe the benefits that are expected to occur as a result of implementation.
49.2 to >45.0 pts
Approaches Expectations
The project, aims, values, and desired outcomes are somewhat clear but may be vague in places. Aims include somewhat vague examples of projected features and functions. Values include only general implementation benefits. Desired outcomes state the purpose, have a general focus, and generally describe the benefits that will occur as a result of implementation.
45 to >35.4 pts
Falls Below Expectations
The project, aims, values, and desired outcomes are somewhat clear, but lack many key details.
35.4 to >0 pts
Does Not Meet Expectations
The content is generally unclear. There is no clear evidence of what the project, aims, values, or desired outcomes are, or there might just be a list of project objectives.
60 pts
This criterion is linked to a Learning OutcomeOrganization
7.5 to >6.15 pts
Meets Expectations
Content is well written throughout. Information is well organized and clearly communicated.
6.15 to >5.63 pts
Approaches Expectations
Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.
5.63 to >4.43 pts
Falls Below Expectations
Content is disorganized in many places and it lacks clarity.
4.43 to >0 pts
Does Not Meet Expectations
Content lacks clarity and information is disorganized, or may be an outline or a list.
7.5 pts
This criterion is linked to a Learning OutcomeAPA Format/Mechanics
7.5 to >6.15 pts
Meets Expectations
Follows all the requirements related to format, length, source citations, and layout. Assignment is free of spelling and grammatical errors.
6.15 to >5.63 pts
Approaches Expectations
Follows length requirement and most of the requirements related to format, source citations, and layout. Assignment is mostly free of spelling and grammatical errors.
5.63 to >4.43 pts
Falls Below Expectations
Follows most of the requirements related to format, length, source citations, and layout. Assignment contains some spelling and grammatical errors.
4.43 to >0 pts
Does Not Meet Expectations
Does not follow format, length, source citations, and layout requirements. Assignment contains many spelling and grammatical errors.
7.5 pts
Total Points: 75
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1
Problem Identification and Description
Yiranda Diaz
West Coast University
NURS 691A Culminating Experience I
Dr. Tracy Macdonald
September 17, 2023
2
Problem Identification and Description
Prevention and control of Sexually transmitted diseases (STDs) and related conditions are
significant public health concerns and priorities. Sexually transmitted infections (STIs) are
mainly caused by parasites, viruses, and bacteria passed from one person to another through
semen, blood, or bodily fluids. However, apart from sexual intercourse, STIs can be transmitted
to infants during childbirth, pregnancy, shared needles, and blood transfusion. It is impossible to
know if someone has STIs in the early stages of the illness, even if they seem healthy. STDs and
unwanted pregnancies are common in nearly every society, affecting adults and adolescents.
Teenage pregnancy and unwanted pregnancy are increasingly affecting the livelihood of many
women, forcing young adults to become mothers earlier than desired. The clinically identified
problem in this paper is the unwanted pregnancies and contraction of STDs due to unprotected
sexual activity. This paper describes the clinical problem, target population, and significance of
the clinical intervention and health promotion.
PICOT Question
Among adolescents (P), can best sexual health education and promotion (I) compared
with no interventions (C) prevent STIs and unwanted pregnancy (O) within one year (T)?
Clinical Setting
In the United States, sexual health education is inconsistent with varying methods and
information nationwide. Education is vital in empowering young people to develop safe sex
practices. However, despite sexual health promotion activities, rates of STIs in the United States
are on the rise. The best clinical setting to address and promote sexual health and unwanted
pregnancy is the primary care unit, which is the first point of contact for millions of Americans
seeking healthcare services. The intervention initiative will be in a primary care facility with an
3
obstetrician-gynecologist (OBGYN) unit that deals with women and mothers. The unit provides
services related to reproductive health and women’s well-being. It encompasses health clinics
that serve pregnant women, young adolescent girls, and boys needing urgent clinical
interventions and emergencies. Thus, the OBGYN unit in primary care is the perfect clinical
setting to promote sexual health and reach both males and females seeking reproductive health.
OBGYN Service and Population Group
OBGYN unit offers various services for women planning pregnancy, including prenatal
care, pregnancy services, and postpartum care. It also provides services to young mothers,
monitoring baby’s health, delivery, and postpartum care. Likewise, OBGYN offers patients
services outside pregnancy, including fertility issues, preventive maintenance, gynecologic
procedures, and bleeding complications. With varied clinical specialties, adolescents can access
solutions to address female reproductive organs, both pregnant and non-pregnant women. Even
though people visit primary care with issues unrelated to health problems, unwanted pregnancy
can create more significant problems for young mothers, including psychological issues. Many
adolescent girls and young women visit the clinic seeking alternative solutions to unwanted
pregnancies, including abortion. Even though other medical conditions or complications can lead
to the termination of the pregnancies, young mothers visiting the clinic have other worrying
concerns related to STIs, particularly herpes, HPV, syphilis, gonorrhea, and chlamydia.
Statement Of The Problem and Target Population
In the United States, sexual health education is inconsistent, with varying methods and
information nationwide. Education is vital in empowering young people to develop safe sex
practices (Walchonski, 2020). However, despite sexual health promotion activities, rates of STIs
in the United States are on the rise. Multiple interventions have been implemented to promote
4
women’s health in various settings, including promoting adolescent education to enhance sexual
health. These interventions include comprehensive sexual education, cognitive behavioral
interventions, abstinence-only education, and dyad education for parents and teenagers.
However, sexual behaviors among adolescents are influenced by various factors,
including peer pressure, individual environment, parental involvement, policy, and social
situations. Many schools promote abstinence-only, while others offer HIV education with a
choice of content and nuanced values. Despite the education enshrined in school and education
policy, STI rates are on the uptrend, disproportionately among teens. There is an urgent need to
successfully promote awareness to enhance understanding of the risks associated with sex and
adolescents’ reckless practices. This may require state and federal government policy to enforce
teenage reproductive health promotion. Assessing the problem’s dimension and planning
effective efforts to address it is challenging, given the magnitude of social media influence on
today’s teenagers.
Clinical Significance of the EBP Approach
According to the CDC (2021), STIs are rising, compromising national health, with over
2.5 million cases reported in 2021 for syphilis, gonorrhea, and chlamydia. WHO statistics
indicate that over 1 million new cases are reported daily worldwide. The majority are young
people between 15-34 years. Even though most STIs are treatable with antibiotics, they increase
risks for adverse events, including infertility, stillbirth, inflammatory disease, neonatal death, and
HIV infections. Increased over-the-counter prescription of antibiotics has increased resistance
from STI strains that are becoming difficult to treat (WHO, 2023). Research has shown that STIs
among college student is mainly due to a lack of knowledge and awareness of STDs
(Amirkhanzadeh et al., 2019).
5
Therefore, the best approach is required to overcome teenage and unwanted pregnancies.
Another research in India offers insight into misinformed young people on emergency
contraception that can resolve unwanted pregnancies (Davis et al., 2020). Evidence-Based
Practice (EBP) provides valuable information that guides interventions and policy development
for influential women’s reproductive health development. It is crucial to understand the
effectiveness of the best sexual education approach to inform policymakers, particularly in
resource allocation and funding of school-based education. This project’s clinical significance is
applying EBP to find the best reproductive health interventions to close the knowledge gap
among young girls to reduce high cases of STIs and unwanted pregnancies.
6
References
Amirkhanzadeh Barandouzi, Z., & Cong, X. (2019). Knowledge of sexually transmitted diseases
among college students in the USA. Journal of Client-Centered Nursing Care, 5(2), 7380. http://dx.doi.org/10.32598/JCCNC.5.2.73
CDC (2021). Sexually Transmitted Disease Surveillance 2021.
https://www.cdc.gov/std/statistics/2021/default.htm
Davis, P., Sarasveni, M., Krishnan, J., Bhat, L. D., & Kodali, N. K. (2020). Knowledge and
attitudes about the use of emergency contraception among college students in Tamil
Nadu, India. Journal of the Egyptian Public Health Association, 95, 1-11.
https://doi.org/10.1186/s42506-019-0030-9
Walchonski, C. F. (2020). Best Youth Education Methods for Sexually Transmitted Infection
Prevention.
https://cornerstone.lib.mnsu.edu/cgi/viewcontent.cgi?article=1974&context=etds
WHO (2023). Sexually transmitted infections (STIs). https://www.who.int/news-room/factsheets/detail/sexually-transmitted-infections-(stis)
1
The Integrative Literature Review
Yiranda Diaz
West Coast University
NURS 691A Culminating Experience I
Instructor: Dr. Tracy Macdonald
September 23, 2023
2
The Integrative Literature Review
Sexual health education has a significant role in preventing STIs and unplanned
pregnancies among young adults. Effective reproductive health plans can offer adolescents the
proper knowledge and insights to base on when making informed decisions concerning their
reproductive health. Opening an intervention center like the OBGYN will help provide a wide
range of reproductive topics that will be age-appropriate. Moreover, the intervention aims to
bridge the existing gap in sexual health to increase abstinence and reduce incidences of unwanted
pregnancy. Various scholars have indulged in the topic to prove the effectiveness of quality
sexual health education.
Mantula et al. (2023) did their study to prove the effectiveness of inclusive sexual health
education. According to the authors, sexual well-being is a state of wholeness in aspects relating
to reproduction. Therefore, sexual health entails effective counseling and providing people with
the proper knowledge, explaining available resources related to sexuality, and addressing any
barriers that compromise knowledge acquisition. The scholars further prove that adolescents
have long been engaging in risky sexual conduct due to the unavailability of effective sexual
education.
Although youths have been accessing details related to sexuality in schools, churches, or
within their families, education has not been enough to induce the correct behavioral change.
Comprehensive sexual education entails emphasizing behold information but providing support
that motivates young adults to attain the right life skills and have appropriate attitudes.
Moreover, practical education should also focus on growth and development, appropriate sexual
behaviors, pregnancy, and health issues related to unethical sexual conduct.
3
Basically, according to Mantula et al. (2023), effective sexual education is necessary for
addressing adolescents’ well-being. Therefore, tailored education programs that offer age-related
and continuous reproductive health updates are appropriate in the contemporary adolescent
world. The education should cover broad aspects related to relationships, contraceptives, the
effects of pregnancy, the necessity of abstinence, and the responsibility of a teen to lead a moral
life. Lastly, ensuring that the education programs are related and friendly is essential while
considering these topics.
Mbizvo et al. (2023) explain that adolescents’ health education, especially about sexuality
and reproduction, is essential to development. The study’s outcomes indicate that early and
unintentional pregnancies are becoming a hot topic among adolescents. The increasing
pregnancy rates indicate that youths have been engaging in risky sex behaviors, increasing their
chances of acquiring HIV and STIs. That implies that adolescents have a high probability of
unhealthy abortions and childbirth health issues. The central contributing aspect is the lack of
comprehensive sexual education to increase their knowledge about sexual health.
The research topic entails identifying if comprehensive sexual education can reduce the
chances of these instances. The researchers imply that effective sexual education significantly
offers young adults the appropriate details about their sexual health. Moreover, education
minimizes assumptions and life skills that help adolescents enhance their decision-making
abilities to choose a proper sex life. That can help reduce the increasing rates of HIV and
unwanted pregnancies. Such an outcome supports the research topic since it helps evaluate if
effective education can reduce incidences of STDs.
Aguirre & Carrión-Yaguana (2023) comprehensively evaluated the impact of
comprehensive sex education in Ecuador. Adolescents have a promising future in the society.
4
However, many challenges, like early pregnancies and risky sexual behaviors, have been
significant among youths. The main reason is adolescents lack the necessary and timely
information about sexuality. Effective sexual and reproductive education motivates individuals
to make competent decisions about their sex lives. Poor knowledge of sexuality is one of the
significant reasons why STIs and unwanted pregnancies have become common among teens.
Adolescents do not have the correct information about contraceptives and the risks and impact of
engaging in early sexual activities.
Therefore, as the study indicates, integrating comprehensive sex education in school
programs helped reduce unwanted pregnancies in Ecuador. The unlimited benefits of sexual
education are evident, supporting the research topic. A reproduction health program that
addresses diverse aspects of sexual life to provide youths with the correct information about their
growth and the effects of early sexual activities is the best solution. That is because thorough
education provides insights on abstinence and preventing STIs.
However, providing abstinence-related education and comprehensive sex education
appears to be the best remedy. Informing adolescents about sexual engagement and
contraceptives has an unpromising future since it can be compromised. However, diverse
education provides teens with the correct information about the dangers of engaging in sexual
behaviors. Teens have the chance to identify how early pregnancies can affect their education,
parents, and career dreams. They also get to understand STIs’ effects on their reproductive
health. That helps create a knowledge base that allows adolescents to make the right decisions
about their sexual lives.
Mark & Wu (2022) indicates that sex education in America has been a major topic
among researchers and legislators. The primary reason is that teen birth has been increasing
5
recently. Most of these births are unwanted and unplanned. The necessity of comprehensive sex
education is evident even with the federal government funding programs like abstinence-only sex
education to provide teens with the right tips about immoral behaviors and the value of
abstaining till marriage. Based on the study outcomes, emphasizing sex education has helped
reduce teen pregnancy by more than 2%. That implies that focusing on more individualized
education strategies can be promising. Tailoring education programs to address the diverse
causes of early pregnancy and STIs can significantly save American teens. Moreover, these
education programs can support addressing societal barriers that hinder teens from accessing the
proper and comprehensive information about sexuality.
Mohamed et al. (2023) provide an analysis of the significant causes of unwanted
pregnancies among teens. Early pregnancy has high risks of premature births or delivering
unhealthy kids. Moreover, early pregnancy increases the economic burden on parents and
introduces mental complications to adolescent mothers. Therefore, finding a remedy to this issue,
as the article implies, can help reduce the impacts and complications of early sexual engagement.
Comprehensive sexual education is the primary solution to increasing unwanted pregnancies.
According to the article, effective sexual education should provide detailed sessions about
contraceptives and making competent decisions about sexual life. Such an analysis supports the
idea that a comprehensive reproduction education would effectively address the increasing rate
of adolescents.
Agbor et al. (2021) evaluate how introducing sex education to youths at an early stage
can help reduce cases of early pregnancy. As the researcher indicates, many teens engage in
unethical behaviors due to societal and economic conditions. Moreover, these young adults lack
the knowledge to avoid STIs and unintended pregnancies. Little engagement between families
6
and children has also increased STDs and unwanted pregnancies. Therefore, comprehensive sex
education has become relevant and supportive for teens despite the challenges they are currently
experiencing. The topic of sexual education has for a long time been considered for married
people. However, these assumptions have proven ineffective, and introducing comprehensive
sexual education has indicated its necessity amongst teens. This education aims to minimize the
chances of adverse effects and STIs. The education provides awareness on enhancing life quality
and enjoying sexuality.
However, as the authors signify, a well-planned and structured education plan is the best
way to address these challenges. Many education programs have failed due to their inconsistency
and shallowness of the topic. They lack the details to inform teens about generating essential life
skills like abstinence and living a moral life. Therefore, cooperating with the correct information
in education would have a promising future for teens.
Lastly, Pires et al. (2021) explain that adolescent pregnancy is a worldwide medical issue.
The main contributing factors include poor female education and lack of knowledge. Lower
perceptions of the topic have been a significant reason why unwanted pregnancies have become
dominant today. Also, teens lack the appropriate expertise on contraceptives and engage in risky
sexual behaviors. Therefore, finding the right interventions, such as comprehensive sex
education, would limit these barriers. The research also provides insights into why adolescents
engage in sexual behavior at an early stage. The primary aspect is having older partners
introduce them to sexual activities before maturity. This information forms the foundation for an
effective education system where adolescents gain the correct information about their sexual
lives.
7
Summary of literature review
All articles in the literature review prove that early pregnancies and STIs among teens
have become a significant healthcare issue today. Many teens face major challenges due to their
introduction to sexual behaviors by their peers and older partners. Moreover, knowledge
inadequacy and a lack of a support system have contributed to these issues. Many teens lack the
proper sexual life knowledge, compromising their ability to make informed decisions. Without
the appropriate expertise, it is hard to make the right choices. Therefore, introducing a
comprehensive education system proves to be an effective remedy for addressing this challenge.
Moreover, introducing the education mechanism will reduce the burden on the advanced
practice nurse. There will be a limited burden of addressing STIs and treating premature births.
Also, the identified gaps, including the causes of significant unwanted pregnancies and why
available programs fail, provide a baseline for the nurse to develop comprehensive education
plans that help address unintended teen pregnancies. Also, the nurse will be able to advocate for
the right resources that connect adolescents with the right support system.
8
References
Agbor, P. E., Chile, O., & Ogu, E. N. (2021). Influence of Sex Education on Early Pregnancy
among Adolescent Female Students in Port Harcourt Metropolis: Implication for Students
Academic Performance. https://seahipaj.org/journals-ci/sept-2021/IJIHCR/full/IJIHCR-S2-2021.pdf
Aguirre, K., & Carrión-Yaguana, V. D. (2023). Empowering youth: the impact of comprehensive
sex education on teenage pregnancy in Ecuador (No. wp-2023-107). World Institute for
Development Economic Research (UNU-WIDER).
https://www.wider.unu.edu/sites/default/files/Publications/Working-paper/PDF/wp2023107-empowering-youth-impact-sex-education-teenage-pregnancy-Ecuador.pdf
Mantula, F., Chauraya, Y., Danda, G., Chaibva, C. N., Ngwenya, T., Gwatiringa, C., & Chamisa,
J. A. (2023). Perspective Chapter: Sexual Health Interventions for Adolescents. In Sexual
Education Around the World-Past, Present and Future Issues. IntechOpen.
https://www.intechopen.com/chapters/1137866
Mark, N. D., & Wu, L. L. (2022). More comprehensive sex education reduced teen births: Quasiexperimental evidence. Proceedings of the National Academy of Sciences, 119(8),
e2113144119.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872707/#:~:text=A%20consistent%20fi
nding%20from%20observational,use%20(29%E2%80%9331).
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Mbizvo, M. T., Kasonda, K., Muntalima, N. C., Rosen, J. G., Inambwae, S., Namukonda, E. S.,
… & Kangale, C. (2023). Comprehensive sexuality education linked to sexual and
reproductive health services reduces early and unintended pregnancies among in-school
adolescent girls in Zambia. BMC public health, 23(1), 1-13.
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15023-0
Mohamed, S., Chipeta, M., Kamninga, T., Nthakomwa, L., Chifungo, C., Mzembe, T., … &
Madise, N. (2023). Interventions to prevent unintended pregnancies among adolescents:
A rapid overview of systematic reviews. https://assets.researchsquare.com/files/rs2568862/v1/050a2163-7cde-4133-8f4d-608a5ac40908.pdf?c=1679000290
Paton, D., Bullivant, S., & Soto, J. (2020). The impact of sex education mandates on teenage
pregnancy: International evidence. Health economics, 29(7), 790-807.
https://onlinelibrary.wiley.com/doi/full/10.1002/hec.4021
Pires, R., Araújo-Pedrosa, A., Pereira, J., & Canavarro, M. C. (2021). How Can Unintended
Pregnancies Be Prevented among Adolescents Who Engaged in Sexual Intercourse at
Earlier Ages? The Role of Female Education and Partner Age Difference. International
Journal of Environmental Research and Public Health, 18(20), 10631.
https://www.mdpi.com/1660-4601/18/20/10631
Using the criteria presented in week 2, critique the theory of Self-Efficacy using the internal and external criticism evaluation process.APA style. Minimum 500 words and 2 references. No plagiarism . Question needs to be answered as an assay.
Screening is the administration of measures or tests to distinguish individuals who may have a condition from those who probably do not have it. Discuss the advantages and disadvantages of screening.
ASSIGNMENT COVER SHEET
Course name:
Road traffic Injuries & Disability Prevention
Course number:
PHC313
CRN:
Write a short essay to discuss risk factors
associated with road crashes and injury severity in
the Kingdom of Saudi Arabia
Assignment title or task:
(You can write a question)
➢ What is the magnitude of road accidents in
KSA?
➢ What are the main causes and contributory
factors of road crashes in KSA?
➢ What are the interventions applied to reduce
these risk factors?
Student name:
Student ID:
Submission date:
To be filled in by the instructor only
Instructor’s name:
Dr. Ahmed Hazazi
Grade:
…..out of 10
Instructions for submission:
•
•
•
•
•
•
•
•
The assignment must be submitted with a properly filled cover sheet (Name, ID,
CRN, Submission date) in a word document, Pdf is not accepted.
The length of the write-up should be 1 pages’ maximum of 1000 words.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
Due date 14/10/2023
Please use the attached template to complete the following template:Makroum, M. A., Adda, M., Bouzouane, A., & Ibrahim, H. (2022). Machine Learning and Smart Devices for Diabetes Management: Systematic Review. Sensors, 22(5), 1843. https://doi.org/10.3390/s22051843
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APPENDIX F
Appraisal Guide
Findings of a Quantitative Study
Citation:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Synopsis
What was the purpose of the study (research questions, purposes, and hypotheses)?
How was the sample obtained?
What inclusion or exclusion criteria were used?
Who from the sample actually participated or contributed data (demographic or clinical profile
and dropout rate)?
What methods were used to collect data (e.g., sequence, timing, types of data, and measures)?
Was an intervention tested?
Yes
No
1. How was the sample size determined?
2. Were patients randomly assigned to treatment groups?
What are the main findings?
Credibility
Is the study published in a source
that required peer review?
Yes
No
Not clear
*Did the data obtained and the
analysis conducted answer the
research question?
Yes
No
Not clear
Were the measuring instruments
reliable and valid?
Yes
No
Not clear
*Were important extraneous
variables and bias controlled?
Yes
No
Not clear
*If an intervention was tested,
answer the following five questions:
Yes
No
Not clear
Brown
APP F-1
1. Were participants randomly
assigned to groups and were
the two groups similar at the
start (before the intervention)?
Yes
No
Not clear
2. Were the interventions well
defined and consistently
delivered?
Yes
No
Not clear
3. Were the groups treated
equally other than the
difference in interventions?
Yes
No
Not clear
4. If no difference was found, was
the sample size large enough
to detect a difference if one existed?
Yes
No
Not clear
5. If a difference was found, are
you confident it was due to the
intervention?
Yes
No
Not clear
Are the findings consistent with
findings from other studies?
Yes
Some
No
ARE THE FINDINGS CREDIBLE?
Yes All
Yes Some
Not clear
No
Clinical Significance
Note any difference in means, r2s, or measures of clinical effects (ABI, NNT, RR, OR)
*Is the target population clearly
described?
Yes
No
Not clear
*Is the frequency, association, or
treatment effect impressive enough
for you to be confident that the finding
would make a clinical difference if used
as the basis for care?
Yes
No
Not clear
ARE THE FINDINGS
CLINICALLY SIGNIFICANT?
Yes All
Yes Some
No
* = Important criteria
Comments
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
APP F-2
Brown
This assignment is a 4 to 5 minutes video using a power point presentation.
Topic and positions: SUPPORT insurance coverage for healthcare provider activity in online patient portal messaging.
Once you receive your topic and position, prepare to create a video that will be due in Week 5.
The video should be 4-5 minutes long and address the topic and viewpoint you were assigned.
You may not be personally in support or opposition of the topic; however, it is your job to convince your peers of your position. Include evidence that supports the viewpoint.
Include an introduction to the issue, your stance, the rationale for the stance, the ethical principals involved, theories and evidence supporting your position, and your proposed resolution. Review the rubric in this forum for complete grading criteria.
Your video should include both audio and visual components such a graphics or charts. You can choose to do a PowerPoint, yourself on video with a poster or visual aids, or anything that supports and convinces your peers of your stance.
Get creative! Be succinct but convincing. If you go over the time limit, you will only be graded on the first 5 minutes.
Please post your video using Canvas Studio or Panopto.
This criterion is linked to a Learning OutcomeWeek 5 Video Overall Presentation
20 to >16.4 pts
Accomplished (80-100%)
Presentation is well organized and approximately 4-5 minutes in length. Audio is clear and reasonably paced. Visual component compliments audio component. Discussion reflects an atmosphere of mutual respect.
16.4 to >15.0 pts
Emerging (60-79%)
Presentation is fairly organized, but there are several areas of improvement. Presentation is less than 4-5 minutes in length and some areas are not addressed. Audio needs some improvements. Visual component needs work. Discussion reflects an atmosphere of mutual respect.
15 to >0 pts
Unsatisfactory (0-59%)
Presentation is unorganized and lacks structure. Presentation is extremely limited. Audio is absent or needs significant improvements. Visual component is absent or severely lacking.
20 pts
This criterion is linked to a Learning OutcomeWeek 5 Video: Ethical Issues, Concern, & Proposed Resolution
60 to >49.2 pts
Accomplished (80-100%)
There is a clear description of the ethical issue including a proposed resolution. The issue topic is a current issue of debate and related to health care. The issue has a clearly defined dilemma with more than one resolution. Ethical principles and theories involved with the ethical issue are clearly identified and explained.
49.2 to >45.0 pts
Emerging (60-79%)
Description of the ethical issue, the dilemma, and/or proposed resolution is lacking some details and relevant information.
45 to >0 pts
Unsatisfactory (0-59%)
Description of the ethical issue, the dilemma, and/or proposed resolution is absent or severely lacking.
60 pts
This criterion is linked to a Learning OutcomeWeek 5 Video: Supporting Argument/Stance
40 to >32.8 pts
Accomplished (80-100%)
Supporting argument is well developed either for or against the issue. Factors supporting the stance are well identified. Ethical principles and theories involved with the ethical issue are clearly identified and explained and in alignment with the viewpoint.
32.8 to >30.0 pts
Emerging (60-79%)
Proposed resolution supporting your argument is not well defined. Key stakeholders and factors supporting your resolution are not clearly identified.
30 to >0 pts
Unsatisfactory (0-59%)
Proposed resolution supporting your argument is absent or ill defined. Key stakeholders and factors supporting your resolution are absent or poorly identified.
40 pts
This criterion is linked to a Learning OutcomeWeek 6 Rebuttal
40 to >32.8 pts
Accomplished (80-100%)
Rebuttal to classmate’s post is complete and includes key points including stakeholders, essential factors, and important facts supporting the resolution. The rebuttal reflected an atmosphere of mutual respect. Policy drivers and ethical principles involved are clearly identified and explained in support or opposition of the resolution.
32.8 to >30.0 pts
Emerging (60-79%)
Rebuttal to classmate’s post is incomplete and missing some key points regarding stakeholders, essential factors, and important facts supporting the resolution. Policy drivers and ethical principles involved are not clearly identified and explained in support or opposition of the resolution.
30 to >0 pts
Unsatisfactory (0-59%)
Rebuttal to classmates’ post is absent or largely incomplete. Key points regarding stakeholders, essential factors, and important facts supporting the resolution are absent or severely lacking. Policy drivers and ethical principles involved and in support or opposition of the resolution are absent or severely lacking.
40 pts
This criterion is linked to a Learning OutcomeWeek 6 Rebuttal: Participation
40 to >32.8 pts
Accomplished (80-100%)
The minimum number of postings were met. The student followed netiquette in addition to the posting timeframe to contribute throughout the week.
32.8 to >30.0 pts
Emerging (60-79%)
Less than the minimum number of postings were evident. The student mostly followed netiquette and met most of the posting timeframe to contribute throughout the week.
30 to >0 pts
Unsatisfactory (0-59%)
There was a severe deficit in contribution. Less than the minimum number of postings were evident. The student did not follow netiquette and did not meet the participation requirements.
Create an information flow/context diagram (i.e., information flow map [IFM]) showing what you think are the sources of information for OHHAB surveillance and who the senders/consumers (i.e., interested parties) are of the information flowing through the surveillance system and process. This is a higher-order diagram, but does show what information/data might flow between the various groups. This diagram is designed to amplify where data and information is flowing between interacting parties and start to understand how the information is used. It also gives you a starting point to find data/information that helps in accomplishing the outcomes/intent expected for the entire system. In this diagram, you will start to see who the interested parties are to be used for the second workflow diagram. Include a minimum of six base entities/interested parties/interactors in your context/information flow diagram. Use your imagination or do some exploratory reading to discover interested parties not obviously discussed in the documents who might be involved. For example, do you think anyone from an international organization may have something to do with this? Who is testing the water quality and algae growth? Normally, the perspective of an IFM revolves around a central interactor. In this case, start with the OHHAB system as the center of your IFM.
The IFM is used to see and scope interaction for the entire system and how information and data flows between the various interested parties. Normally, you would create a diagram like this at the beginning of a project to understand the public health process and where information is needed to flow. Then, the diagram would give you a basis for discussing systems that need to be put in place to meet a need or intent of the public health process. In this assignment, you are reverse engineering the diagram by looking at the system that was created to meet a need to practice creating your first IFM.
Create a workflow diagram to show how the data is pulled, derived or translated from and into the OHHABS system; the flow of the processing (like the analytics or the translation of the data); and what data would be consumed by the users of this system. Your swim lanes should be from two areas – the data sources and the consumers. The swim lanes run horizontal on the page and have one entity or interactor in each lane. Show the process of interacting between the entities from left to right as a process progresses in order and over time. Choose only one process that you discover is occurring in the use of the OHHABS system to create your workflow diagram. Include at least three interested parties interacting in the process you choose to diagram. As you look at all the interactions you have discovered in your IFM, you will be able to pick just one to depict in your workflow. An example might be to diagram the process of collecting water samples looking for HABs and explain the lab interaction with the collection through to the delivery of the results to the environmental and public health departments.
Typically, your interested parties are on the left with one in each swim lane. The progression of actions from the left to the right tends to follow the order that things are happening and generally across time.
Assignment tips
Read the materials on the system.
Remember that not all interactions have to be through a computer.
Create a list of who you think is involved – considering if there are interested parties outside of what you read.
List who and what is involved in the system.
Once you start to diagram this out, place arrows between your interested parties to indicate what information is flowing between them.
Tip: Place the OHHABS system in the center of your diagram as the main perspective for all interactions.
The information flow/context diagram should be high level and not show much process.
Remember to put arrows in the information flow/context diagrams showing the exchange of information.
You can also label an event or action that may take place on an arrow between parties if there is more to show than just information flow.
All interested parties can be exchanging data for various reasons and may not all flow through the OHHABS.
You will find that there are many workflows within the information flow diagram. For this assignment, you will pick only one process to diagram. An example process might be the collection of water specimens and their transport and processing at a lab, resulting in a message back to the local health department.
Assignment details:
Your diagrams must be cohesive and describe the same solution.
For your workflow diagram, have at least three interested parties.
You may use any diagramming tool you would like for this assignment, as long as you can submit a final PDF. Some tools: PowerPoint, Visio, LucidChart, Loopy.
Make sure your document is sized in such a way that I can easily see one diagram per page.
Include your name(s) in the document.
Submit your document as a PDF.
If you are working with a partner, save your file as LastName1_LastName2_Mod3Assign7. If you are working independently, save your file as LastName_Mod3Assign7.
This assignment is an opportunity to apply concepts to a particular healthcare situation and also allows you to practice your analytical skills. You will put these skills to work in Module Five when you work on your second final project milestone.
This week’s reading and resources focus on genetics, heredity, and the developmental cycle of healthy children from fetus through infancy. All of these factors contribute to the health of the individual at any stage in life.
Read the mini case study below and the questions you will be contemplating as you work to understand what is expected of you in this assignment.
Use the following mini case study to fill in the attached worksheet:
Mini Case Study Two: Patient F is an African American woman, 36 years of age, with a history of mild hypertension. Her blood pressure has been fairly well controlled on an ACE inhibitor over the past two years. Patient F eats a well-balanced, nutritious diet, exercises three to five times a week, and does not have a history of smoking or alcohol use. However, she does exhibit the Type A behavior pattern, including being excessively competitive and harried and rushing to complete more and more tasks in an ever-shrinking period of time. In addition to these characteristics, she exhibits a somewhat cynical or negative outlook with occasional expressions of hostile or angry thoughts and feelings.
Complete your analysis of the mini case study by addressing the following questions:
What could have been done to prevent the chronic condition?
Knowing what you do about different approaches to medicine (traditional and CAM), what practice would you suggest? Would it be a combination of the two? Provide specific details.
What small changes could the individual make to improve her condition?
Overview
This assignment gives you an opportunity to practice applying concepts to a particular healthcare situation and also allows you to practice your analytical skills. You will put these skills to work in Module Five when you work on your second final project milestone.
Prompt
Read the following mini case study and analyze it using the worksheet provided.
Mini Case Study Two: Patient F is an African American woman, 36 years of age, with a history of mild hypertension. Her blood pressure has been fairly well-controlled on an ACE inhibitor over the past two years. Patient F eats a well-balanced, nutritious diet, exercises three to five times a week, and does not have a history of smoking or alcohol use. However, she does exhibit many of the characteristics of the Type A behavior pattern, such as excessive competitiveness, being harried, and rushing to complete more and more tasks in an ever-shrinking period of time. In addition to these characteristics, she exhibits a somewhat cynical or negative outlook with occasional expression of hostile or angry thoughts and feelings.
Specifically, the following critical elements must be addressed:
What could have been done to prevent the chronic condition?
Knowing what you do about different approaches to medicine (traditional and CAM), what practice would you suggest? Would it be a combination of the two? Provide specific details.
What small changes could the individual make to improve her condition?
What to Submit
Your worksheet must be submitted with 12-point Times New Roman font and any sources cited in APA format
WORKSHEET BELOW
IHP 200 Mini Case Study Two Worksheet
Mini Case Study Two: Patient F is an African American woman, 36 years of age, with a history of mild hypertension. Her blood pressure has been fairly well-controlled on an ACE inhibitor over the past two years. Patient F eats a well-balanced, nutritious diet, exercises three to five times a week, and does not have a history of smoking or alcohol use. However, she does exhibit many of the characteristics of the Type A behavior pattern, such as excessive competitiveness, being harried, and rushing to complete more and more tasks in an ever-shrinking period of time. In addition to these characteristics, she exhibits a somewhat cynical or negative outlook with occasional expression of hostile or angry thoughts and feelings.
Address the following questions:
What could have been done to prevent the chronic condition?
Knowing what you do about the different approaches to medicine (traditional and CAM), what practice would you suggest? Would it be a combination of the two? Provide specific details.
What small changes could the individual make to improve her condition?
Reapond to 2 peers Discussion posts. Each response should have 150 words or more. APA Format 7th edition. 1 reference or more scholarly resource published within last 5 years.
Here is one thing that needs to be udpated on my paper for it to be mastered. Would you pls update my paper and send back.9/29/23 – In regards to the research methods rubric item, look at it from the standpoint of informing as to why you are bringing forth a solid proposal and the recommendations that you are presenting based on a particular method or set of research methods. For instance, when searching for products or services, I will oftentimes look at customer reviews to determine if the product has received 1 or 5 stars. The reason that I am doing this is because I want to be sure that the company is reputable or if the product really upholds what it says it will do.The same holds true here but instead of the reviews/stars, what type of methods did you find in the research that gives your stance credibility? Did you find that research in a particular area that used case studies supported your recommendations? Or perhaps you chose to look only at qualitative research that used perceptions or surveys from a population of people that were impacted by your challenge and this method supported your stance the best.
Unformatted Attachment Preview
OUTLINE (Full project in the other file)
Workplace Stress Management Strategies
I. Introduction
– Overview of the issue
II. Complex Challenge Analysis
A. Demographics of the Affected Group
– Diversity of socioeconomic backgrounds
B. The Magnitude of the Issue
– Global impact and disparities
C. Commonly Held Assumptions and Obstacles
– Prevalent perceptions and resistance
III. Social Conditions
– Economic inequality and healthcare access
– Impact on workplace stress
IV. Social and Cultural Issues
– Cultural factors and mental health stigma
– Importance of culturally sensitive approaches
V. Discipline-Specific Knowledge
– Integration of insights from various disciplines
VI. Annotated Bibliography
A. Cordioli, D. F. C., Cordioli, J. R., Gazetta, C. E., Silva, A. G. D., & Lourenção, L. G. (2019)
B. Deng, J., Guo, Y., Ma, T., Yang, T., & Tian, X. (2019)
C. Gray, P., Senabe, S., Naicker, N., Kgalamono, S., Yassi, A., & Spiegel, J. M. (2019)
D. Heath, C., Sommerfield, A., & von Ungern‐Sternberg, B. S. (2020)
E. Kriakous, S. A., Elliott, K. A., Lamers, C., & Owen, R. (2021)
F. Sharifi, M., Asadi-Pooya, A. A., & Mousavi-Roknabadi, R. S. (2021)
G. Yukongdi, V., & Shrestha, P. (2020)
VII. Methods
– Research methods for analysis
VIII. Recommendations
– Proposed solutions for addressing workplace stress
IX. Interpretation
– Rationale for the recommendations
X. Significance
– Importance and contribution of the study
XI. Limitations
– Recognized limitations of the research
XII. Conclusion
– Summary of key findings and recommendations
XIII. References
– Citations for all sources used in the paper
1
Workplace Stress Management Strategies
Mary Dieterich-Callaway
09/13/2023
2
Workplace Stress Management Strategies
Introduction
The issue of occupational stress affects individuals across diverse socioeconomic
backgrounds, exerting profound implications not only on individual well-being but also on
organizational productivity (Gray et al., 2019; Sharifi et al., 2021). This complex challenge
necessitates exploring sophisticated and effective strategies for mitigating workplace stress
across various socioeconomic strata (Cordioli et al., 2019). In this scholarly analysis, the author
delves into the intricate web of underlying factors, taking into account the multifaceted social
and cultural components that add layers of complexity to this problem (Heath et al., 2020). The
project aims to discern viable solutions that acknowledge the diversity of experiences and
backgrounds while promoting an inclusive approach to stress management, recognizing the
distinct pressures individuals face across all socioeconomic levels (Deng et al., 2019; Yukongdi
& Shrestha, 2020). This comprehensive examination is underpinned by evidence-based research,
with the ensuing pages offering recommendations to address the multifaceted nature of this issue.
Complex Challenge Analysis
Demographics of the Affected Group
The affected population’s demographic composition is remarkably diverse, encompassing
individuals from various socioeconomic strata, including those from low-income backgrounds,
middle-income groups, and high-income professionals (Deng et al., 2019). This intricate mosaic
of demographics introduces a new dimension to mitigating workplace stress (Yukongdi &
Shrestha, 2020). Each socioeconomic stratum confronts challenges intricately linked to financial
circumstances and life situations (Cordioli et al., 2019).
3
Addressing occupational stress across this diverse spectrum necessitates a nuanced and
tailored approach by Gray et al. (2019), specifically designed to accommodate individuals’
distinct stress triggers, coping mechanisms, and demands within each income bracket (Heath et
al., 2020). This customized approach recognizes individuals’ diverse experiences and
circumstances in low, middle, and high-income categories (Deng et al., 2019). Acknowledging
the unique stressors individuals face in these varied socioeconomic strata is pivotal in devising
effective interventions that promote well-being and resilience across the entire demographic
landscape (Gray et al., 2019).
The Magnitude of the Issue
Workplace stress is a pervasive global concern that significantly impacts communities
worldwide (Heath et al., 2020). The extent and prevalence of this problem exhibit noticeable
variations, intrinsically linked to the intricate network of socioeconomic variables (Sharifi et al.,
2021). Notably, individuals from lower socioeconomic backgrounds bear a disproportionate
burden, grappling with elevated stress levels due to job insecurity, financial pressures, and
limited access to essential support services (Gray et al., 2019; Yukongdi & Shrestha, 2020). This
stark disparity underscores the urgent need for comprehensive and targeted interventions by
Sharifi et al. (2021), meticulously tailored to account for the diverse socioeconomic backgrounds
of affected individuals (Deng et al., 2019). Understanding the disparities in stress experienced
across income levels is essential in addressing this multifaceted challenge, necessitating the
development of equitable strategies meticulously crafted to alleviate suffering and foster a more
harmonious work environment (Cordioli et al., 2019).
4
Commonly Held Assumptions and Obstacles
Workplace stress management is rife with prevalent assumptions and formidable
obstacles that warrant thorough investigation (Gray et al., 2019). A widely held perception is that
workplace stress primarily pertains to individuals, often overlooking its far-reaching structural
ramifications within organizations (Heath et al., 2020). Furthermore, significant resistance to the
adoption of stress management programs, particularly evident in low-income settings, often
arises due to concerns about the associated financial costs (Gray et al., 2019; Sharifi et al., 2021).
Recognizing and critically scrutinizing these assumptions and impediments is imperative (Deng
et al., 2019). Doing so provides a more comprehensive understanding of the intricate nature of
workplace stress and its intricate interplay with the organizational and social fabric (Lal et al.,
2021). Consequently, it becomes imperative to advocate for holistic approaches that encompass
not only the well-being of individual employees but also the broader dimensions and systemic
forces influencing workplace stress experiences across various socioeconomic strata (Yukongdi
& Shrestha, 2020).
Social Conditions
The intricate interplay of social factors profoundly shapes the landscape of workplace
stress and exerts substantial influence on individuals’ stress experiences (Sharifi et al., 2021).
Economic inequality, a pivotal aspect of societal dynamics, manifests as glaring income
disparities, exacerbating the array of pressures faced by individuals, especially those in lower
socioeconomic strata (King et al., 2021). Additionally, high unemployment rates prevalent in the
labor market engender job instability and heighten stress levels among various individuals
(Yukongdi & Shrestha, 2020).
5
Moreover, the availability and quality of healthcare services within a specific social
milieu wield significant repercussions (Guida & Carpentieri, 2021). Restricted access or subpar
quality of healthcare resources can lead to exacerbated health issues stemming from stress,
compounding overall concerns about well-being (Sharifi et al., 2021). It is crucial to comprehend
the intricate interplay between these multifaceted societal factors and occupational stress
(Rajamohan et al., 2019). This understanding underscores the need for a holistic perspective
when crafting effective stress management solutions that account for both the immediate work
environment and the broader sociocultural backdrop (Cordioli et al., 2019).
Social and Cultural Issues
Social and cultural factors fundamentally influence how individuals from diverse
backgrounds perceive and cope with workplace stress (Gray et al., 2019). For instance, societal
stigmas surrounding mental health can engender varying degrees of reluctance among different
social groups to seek help or openly discuss their stress-related concerns (Deng et al., 2019). To
ensure the effectiveness of interventions, it is imperative to consider these cultural nuances
(Heath et al., 2020). Culturally sensitive approaches that respect the values, beliefs, and practices
of various communities can help bridge gaps in understanding and addressing workplace stress
(Yukongdi & Shrestha, 2020), fostering a more inclusive and resilient environment (Sharifi et
al., 2021). Recognizing and respecting cultural diversity can play a pivotal role in advancing
holistic well-being among employees (Cordioli et al., 2019).
Discipline-Specific Knowledge
Addressing this multifaceted challenge necessitates the integration of insights from
various disciplines, including psychology, sociology, economics, public health, and
organizational management (Gray et al., 2019). Coordinating knowledge from these diverse
6
fields is essential to construct comprehensive and inclusive frameworks that account for the
complexities of managing workplace stress across various socioeconomic strata (Deng et al.,
2019). Incorporating insights from psychology deepens the understanding of individual stressors
and coping strategies, while sociology provides context regarding cultural influences on stress
(Heath et al., 2020). Economics contributes to the analysis of financial stressors, and public
health insights guide the development of holistic, health-centered interventions (Sharifi et al.,
2021). Ultimately, expertise in organizational management is indispensable for implementing
and overseeing these intricate frameworks within workplace settings (Meyer et al., 2022).
Annotated Bibliography
Cordioli, D. F. C., Cordioli, J. R., Gazetta, C. E., Silva, A. G. D., & Lourenção, L. G. (2019).
Occupational stress and engagement in primary health care workers. Revista
brasileira de enfermagem, 72, 1580-1587.
Summary
This study aims to assess the levels of occupational stress and work engagement among
primary healthcare workers. It is a descriptive, correlational, and cross-sectional study conducted
in a small municipality in the countryside of São Paulo, with a non-probabilistic sample of 85
workers. The study employed three self-administered instruments: one developed by the
researchers, which contained sociodemographic variables; the Work Stress Scale (WSS); and the
Utrecht Work Engagement Scale (UWES). The findings revealed a prevalence of women
(72.6%), workers aged 40 years or older (45.9%), and an average working time in primary care
of 4 years and four months. Significantly, 36.5% of the workers reported experiencing significant
occupational stress (scores ≥2.5). However, work engagement was generally high in all
7
dimensions, with a mean score between 4.1 (±1.2) and 4.4 (±1.4). The study also found a
negative correlation between occupational stress and work engagement.
Evaluation
1. Authority: The authors, Cordioli, Cordioli, Gazetta, Silva, and Lourenção, have
conducted this research and published it in the “Revista brasileira de enfermagem.” While
the source does not explicitly mention their qualifications, the publication in a peerreviewed journal suggests a level of authority in the field.
2. Accuracy: The study employed self-administered instruments, providing a systematic
way to measure occupational stress and work engagement. However, specific details
about the methodology and validation of the instruments should be provided in the
abstract.
3. Currency: The publication date of 2019 makes this source relatively recent and relevant
to research.
4. Relevance: This source is highly relevant to the topic of workplace stress management,
focusing on primary healthcare workers, which provides a specific context for
understanding stress and work engagement.
5. Objectivity: The source appears to present findings in an objective manner, relying on
empirical evidence. However, with the full text, it is easier to assess potential biases or
limitations in the study.
8
Deng, J., Guo, Y., Ma, T., Yang, T., & Tian, X. (2019). How job stress influences job
performance among Chinese healthcare workers: a cross-sectional study.
Environmental health and preventive medicine, 24(1), 1-11.
Summary
This cross-sectional study examines the impact of job stress, specifically challenge stress
and hindrance stress, on job performance among healthcare workers in Chinese public hospitals.
The study also explores the mediating role of public service motivation in this relationship.
Public service motivation is defined as the commitment to public service, the pursuit of the
public interest, and the desire to perform work that benefits society. Data were collected from
1594 healthcare workers in public hospitals across different regions of China. The study
employed various statistical analyses, including structural equation modeling, to assess the
relationships within the sample. The findings indicate a strong correlation between challenge
stress and hindrance stress among healthcare workers in Chinese public hospitals. Challenge
stress is positively associated with both public service motivation and job performance. In
contrast, hindrance stress is negatively associated with public service motivation and job
performance. Public service motivation plays a mediating role, directly impacting job
performance and indirectly mediating the relationship between job stress and job performance.
Evaluation
1. Authority: The authors, Deng, Guo, Ma, Yang, and Tian, conducted this research and
published it in “Environmental Health and Preventive Medicine.” While the source does
not explicitly mention their qualifications, the publication in a peer-reviewed journal
suggests a level of authority in the field.
9
2. Accuracy: The study employs statistical analyses, including structural equation modeling,
to examine the relationships between job stress, public service motivation, and job
performance. This approach enhances the accuracy of the findings.
3. Currency: The publication date of 2019 makes this source current and relevant to
research.
4. Relevance: This source is highly relevant to the topic of workplace stress management,
specifically in the context of healthcare workers in Chinese public hospitals and the role
of public service motivation in job performance.
5. Objectivity: The source objectively presents findings based on empirical data and
statistical analyses.
Gray, P., Senabe, S., Naicker, N., Kgalamono, S., Yassi, A., & Spiegel, J. M. (2019).
Workplace-based organizational interventions promoting mental health and
happiness among healthcare workers: A realist review. International journal of
environmental research and public health, 16(22), 4396.
Summary
This realist review aims to synthesize evidence on workplace-based organizational
interventions that promote mental health and well-being among healthcare workers. The authors
address the global issue of mental illness, which accounts for many years of living with a
disability, particularly among healthcare professionals who face high rates of mental health
challenges, such as burnout, stress, and depression. These challenges are often linked to
workplace conditions, including excessive workloads, workplace violence, and bullying, which
can have adverse effects not only on healthcare workers but also on patient care, happiness, and
overall well-being. The review involved a comprehensive search of three major health-related
10
databases and identified 60 articles that met the criteria for organizational-level interventions
aimed at promoting mental health among healthcare workers. These interventions encompassed
skills and knowledge development, leadership development, communication and team building,
stress management, and workload and time management. The realist review framework was
applied to analyze these interventions’ context, mechanisms, and outcomes. The majority of the
studies were conducted in high-income countries, highlighting the need for further research in
low- and middle-income countries and for long-term evaluations of workplace mental health
promotion initiatives.
Evaluation
1. Authority: The authors of this study, Gray, Senabe, Naicker, Kgalamono, Yassi, and
Spiegel, published their research in the “International Journal of Environmental Research
and Public Health,” indicating their expertise in the field of healthcare worker well-being
and organizational interventions.
2. Accuracy: This realist review is based on a thorough examination of relevant literature
and applies a systematic approach to synthesize evidence on organizational interventions
promoting mental health among healthcare workers. The study’s findings and conclusions
are well-supported by the reviewed evidence.
3. Currency: The publication date of 2019 ensures that the source is up-to-date and relevant
to research on workplace-based interventions to promote mental health among healthcare
workers.
4. Relevance: This source is highly relevant to the topic of workplace stress management
and mental health promotion among healthcare workers, providing valuable insights into
organizational-level interventions.
11
5. Objectivity: The study presents information objectively, following a realist review
framework that analyzes the context, mechanisms, and outcomes of organizational
interventions. The research aims to provide evidence-based recommendations for
promoting mental health and happiness among healthcare workers.
Heath, C., Sommerfield, A., & von Ungern‐Sternberg, B. S. (2020). Resilience strategies to
manage psychological distress among healthcare workers during the COVID‐19
pandemic: a narrative review. Anaesthesia, 75(10), 1364-1371.
Summary
This narrative review explores resilience strategies to manage psychological distress
among healthcare workers during the COVID-19 pandemic, characterized as an extraordinary
global public health crisis. The article emphasizes the unprecedented nature of the pandemic, its
worldwide impact, and the uncertainty regarding its duration. Healthcare professionals are
expected to remain on high alert for an extended period, and the support they receive can
significantly influence their psychological well-being. While a wealth of information is available
on the epidemiology, pathogenesis, and infection control measures related to COVID-19, limited
literature addresses interventions for supporting the psychological well-being of healthcare
workers during disease outbreaks. This narrative review aims to summarize the available
management strategies to enhance the resilience of healthcare workers during the COVID-19
pandemic and beyond, focusing on self-care and organizational justice. It highlights both
individual and organizational strategies and underscores the importance of proactive measures to
mitigate potential adverse psychological effects and promote the well-being of the healthcare
workforce.
12
Evaluation
1. Authority: The authors, Heath, Sommerfield, and von Ungern‐Sternberg, published this
article in “Anaesthesia,” a reputable peer-reviewed journal. While the source does not
explicitly mention their qualifications, the publication in a respected medical journal
suggests their authority in the field.
2. Accuracy: The narrative review explores resilience strategies for managing psychological
distress among healthcare workers during the COVID-19 pandemic. While it does not
present original research, it synthesizes existing literature and insights, contributing to the
accuracy of the information.
3. Currency: The publication date of 2020 places this source within the context of the
COVID-19 pandemic, making it relevant to research on workplace stress management
during the pandemic.
4. Relevance: This source is highly relevant to the topic of workplace stress management,
particularly in the context of healthcare workers dealing with the unique challenges posed
by the COVID-19 pandemic.
5. Objectivity: The article presents information objectively, focusing on strategies and
interventions to support the psychological well-being of healthcare workers during the
pandemic.
13
Kriakous, S. A., Elliott, K. A., Lamers, C., & Owen, R. (2021). The effectiveness of
mindfulness-based stress reduction on the psychological functioning of healthcare
professionals: A systematic review. Mindfulness, 12, 1-28.
Summary
This systematic review investigates the effectiveness of Mindfulness-Based Stress
Reduction (MBSR) programs on the psychological functioning of healthcare professionals
(HCPs) who often experience burnout and occupational stress. The study aimed to update the
existing evidence base and provide a comprehensive understanding of MBSR’s impact on HCPs’
psychological well-being. The researchers conducted a thorough search of three electronic
databases (Medline, Psych Info, and Web of Science) without time frame restrictions. The
review included quantitative studies such as randomized controlled trials, clinical controlled
trials, pre-post designs, and studies with up to a 12-month follow-up period. All studies selected
for the review utilized MBSR programs, standardized measures of psychological functioning,
and qualified HCPs as participants. The results of the systematic review, guided by PRISMA
guidelines, included 30 studies. The reviewed literature indicated that MBSR effectively reduced
anxiety, depression, and stress among HCPs. Additionally, MBSR was found to increase levels
of mindfulness and self-compassion among HCPs. However, MBSR did not appear to be as
effective in reducing burnout or enhancing resilience among this group. Importantly, abbreviated
MBSR programs were found to be just as effective as the traditional 8-week programs.
Evaluation
1. Authority: The authors of this systematic review are Kriakous, Elliott, Lamers, and
Owen, indicating a team of researchers with expertise in the subject. The source was
published in “Mindfulness,” a peer-reviewed journal, enhancing its credibility.
14
2. Accuracy: The study conducted a comprehensive search of relevant databases, enhancing
the findings’ accuracy. The systematic review summarizes the results of multiple studies,
which adds to its reliability.
3. Currency: The publication date of 2021 makes this source current and pertinent to
research.
4. Relevance: This source is highly relevant to the topic of workplace stress management,
particularly focusing on healthcare professionals and the effectiveness of MBSR
programs.
5. Objectivity: The source presents its findings objectively based on the collected research
and offers balanced insights into the effectiveness of MBSR programs on various aspects
of HCPs’ psychological functioning.
Sharifi, M., Asadi-Pooya, A. A., & Mousavi-Roknabadi, R. S. (2021). Burnout among
healthcare providers of COVID-19; a systematic review of epidemiology and
recommendations. Archives of academic emergency medicine, 9(1).
Summary
This systematic review focuses on the epidemiology of burnout among healthcare
providers (HCPs) working in COVID-19 wards and provides recommendations to prevent or
reduce burnout. The authors systematically searched electronic databases, including MEDLINE,
Science Direct, and Scopus, from December 01, 2019, to August 15, 2020, using relevant MESH
terms and keywords. After initial screening, 12 studies were included in the review. The selected
studies primarily explored the risk factors associated with burnout among HCPs working in
COVID-19 wards, although no causal relationships could be established due to methodological
15
limitations. Notably, no studies investigated interventions to mitigate burnout, and the
recommendations presented were based on authors’ experiences and opinions.
Furthermore, none of the studies included follow-up assessments, relying solely on
participant self-reported data. While four studies assessed burnout among HCPs in frontline
COVID-19 wards, others considered burnout among HCPs in both regular and frontline wards.
Notably, The conclusions drawn from this review highlight the importance of addressing mental
health concerns, adjusting work shifts to reduce workload, mitigating job-related stressors, and
fostering a healthy work environment to prevent or alleviate burnout among healthcare
providers.
Evaluation
1. Authority: The authors, Sharifi, Asadi-Pooya, and Mousavi-Roknabadi, published this
systematic review in the “Archives of Academic Emergency Medicine,” which suggests
their authority in the field of healthcare and burnout.
2. Accuracy: While the review does not present original research, it systematically compiles
and evaluates existing studies on burnout among healthcare providers during the COVID19 pandemic. The authors acknowledge the limitations of the reviewed studies and
provide recommendations based on the available evidence.
3. Currency: The publication date of 2021 makes this source current and relevant to
research on workplace stress management during the COVID-19 pandemic.
4. Relevance: This source is highly relevant to workplace stress management, particularly in
the context of healthcare providers dealing with the challenges of the COVID-19
pandemic.
16
5. Objectivity: The article objectively presents information, summarizing the findings of
various studies and offering recommendations based on the available evidence.
Yukongdi, V., & Shrestha, P. (2020). The influence of affective commitment, job
satisfaction and job stress on turnover intention: A study of Nepalese bank
employees. Review of Integrative Business and Economics Research, 9, 88-98.
Summary
This study investigates the impact of affective commitment, job satisfaction, and job
stress on turnover intention among bank employees in Nepal. The data was collected through a
questionnaire-based survey of 282 employees working at a bank in Kathmandu and analyzed
using multiple regression analysis. The study found that affective commitment and job
satisfaction had a negative effect on turnover intention, while job stress had a positive influence.
Specifically, job satisfaction had the most substantial impact on turnover intention, followed by
job stress and affective commitment. The article also discusses practical implications, suggesting
that organizations should enhance job satisfaction and affective commitment to reduce turnover
intention and manage job stress through measures such as flexible working hours and stress
management programs.
Evaluation
1. Authority: The authors, Yukongdi and Shrestha, are responsible for this research. While
the source does not explicitly mention their qualifications, the fact that the study was
published in the “Review of Integrative Business and Economics Research” indicates that
it has undergone peer review, suggesting authority in the field.
17
2. Accuracy: The study relies on empirical data collected through a survey, enhancing the
findings’ accuracy. However, the source does not provide specific references to the data
sources or survey methodology.
3. Currency: The publication date of 2020 makes this source current and relevant to
research.
4. Relevance: This source is highly relevant to the topic of workplace stress management,
specifically in the context of turnover intention among bank employees in Nepal.
5. Objectivity: The source appears to present findings in an objective manner, relying on
empirical evidence. However, it is always important to consider potential biases in any
research.
Methods
To comprehensively investigate the multifaceted challenge of workplace stress
management strategies, a combination of qualitative and quantitative research techniques will be
employed. These research methods were chosen to provide a holistic understanding of the topic,
taking into account the diverse experiences and backgrounds of individuals across various
socioeconomic strata.
Qualitative research techniques will be used to delve into the subjective experiences of
individuals facing workplace stress. Focus group discussions will serve as a valuable tool for
capturing the emotional nuances, unique stressors, and coping mechanisms of participants from
different socioeconomic backgrounds. These discussions will create a space for open dialogue
and allow participants to express their thoughts, feelings, and experiences related to workplace
stress. Qualitative exploration is particularly relevant in understanding the lived experiences of
individuals and the contextual factors that contribute to workplace stress.
18
Additionally, contextual assessments of organizations and associations that have
implemented stress management initiatives will be conducted. These assessments will involve indepth interviews and observations to gather rich qualitative data on the effectiveness of various
strategies. Psychologists, sociologists, and public health professionals will be engaged in these
interviews to provide expert insights and interpretations of the collected data. This qualitative
approach aims to uncover the practical approaches and challenges faced by organizations in
implementing stress management strategies.
Regarding complementing the qualitative research, a quantitative analysis will be carried
out to provide a more structured assessment of workplace stress. A separate group of workers
will be evaluated quantitatively using standardized instruments to measure their levels of stress,
coping mechanisms, and perceptions of workplace support. This quantitative approach will allow
for the identification of patterns, correlations, and statistical significance in the data. Statistical
methods such as correlation analysis, t-tests, and ANOVA will be employed to examine
important connections among various factors.
The selection of both qualitative and quantitative research methods is rooted in the need
for a comprehensive and balanced approach to understanding workplace stress management
strategies. Qualitative methods offer depth and context, allowing us to explore the unique
experiences of individuals and organizations. In contrast, quantitative methods provide statistical
rigor and help identify trends and associations within the data. By integrating these research
methods, the author aims to gain a holistic perspective on the multifaceted issue of workplace
stress and the strategies employed to address it.
The choice of these research methods was driven by the recognition that workplace stress
is a complex and deeply personal experience influenced by a range of sociocultural,
19
organizational, and individual factors. To effectively address this challenge, a combination of
qualitative and quantitative research is essential to capture the richness of the topic and provide
evidence-based insights into effective stress management strategies.
Recommendations
Based on the insights gathered from the annotated bibliography sources, the following
recommendations are proposed to address the challenge of managing occupational stress across
diverse socioeconomic levels. The following recommendations are grounded in evidence-based
research and practical strategies aimed at promoting workplace well-being.
First, employers should implement tailored stress management programs that recognize
the unique stressors and coping mechanisms of individuals from different socioeconomic
backgrounds. These programs should offer resources such as counseling services and stress
reduction courses, with a particular focus on meeting the needs of low-income workers
(Yukongdi & Shrestha, 2020).
Second, to alleviate financial stress among employees, organizations can provide
financial education and assistance initiatives, including budgeting seminars and access to
financial counselors. Ensuring equal salaries and benefits for employees across different income
levels can also help mitigate income-related stress (Deng et al., 2019).
Third, creating a culture of open communication and support within the workplace is
essential. Employers should launch awareness campaigns to reduce the stigma associated with
seeking mental health assistance. Encouraging employees to access mental health resources can
contribute to a healthier work environment (Gray et al., 2019).
Fourth, organizations should invest in training managers and leaders to be culturally
aware and sensitive to the unique pressures individuals from various socioeconomic backgrounds
20
face. Executives should promote employee well-being and create an inclusive and supportive
workplace culture (Kriakous et al., 2021).
Fifth, to ensure the effectiveness of stress management programs, companies should
establish systems for assessing their success and gathering employee feedback. Regularly
monitoring stress levels and
My PICO Question: Among males under 25, does cannabis use compared to speeding have a greater impact on the number of motor vehicle fatalities? Discuss the following:Compare three ways to disseminate research findings.Discuss the plan to disseminate the research findings obtained during this course at a state or national platform. Include your objective for disseminating the information and your target audience.Submission Instructions:Your initial post should be at least 800 words, formatted and cited in the current APA style with 7th editionProvide support with five academic sources less than 5 years old. Visit Purdue OwlLinks to an external site. for specific examples on how to create in-text citations and cite references using the current APA format.
Draft the health issue analysis, Section I, for your final project. For this draft you will research the issue presented in your chosen scenario, and look at the issue from two perspectives: that of the individual affected and the larger age-specific population represented by this individual. You should also keep the audience you identified in Module Two in mind as you work.
Submitting a draft in this module allows you to obtain feedback from your instructor that you can incorporate into the final version of your project, which is due in Module Seven. Be sure to review the rubric in detail before you begin your analysis.
Submit your assignment here. Make sure you’ve included all the required elements by reviewing the guidelines and rubric.
SCENARIO CHOOSEN
Scenario Three: Obesity in an Adolescent
Michelle is 15 years old and has always been the “big” girl in class. She is much taller than her fellow classmates and is also bigger in size. According to
her doctor, she is in the morbidly obese category based on the body mass index (BMI) chart. Michelle gets her exercise from gym class, which she has
every Wednesday afternoon. She does not eat breakfast but does eat the school lunches. When she gets home, she tends to fix a bowl of cereal to hold
her over until dinner.
This individual belongs to an age-specific population that is affected by this health issue. You will write a health analysis paper in which you analyze both
the individual and the age-specific population affected by the health issue for symptoms, causes, and data to inform potential prevention options. For
example, if your profile describes a middle-aged individual dealing with high blood pressure, your analysis paper will consider both that specific
individual and the entire population of middle-aged adults dealing with high blood pressure.
You will then develop a presentation directed at a particular audience that could enact some of these prevention options in the hopes of helping both
the individual from the profile and the age-specific population in dealing with this health issue. For example, if your individual and population are
middle-aged adults dealing with high blood pressure, you would cater your presentation to an audience that could help address the issue and potentially
enact some of the prevention options you have recommended
Overview
For the final project in this course, you will analyze a health issue from the perspective of an individual patient dealing with the health issue and the age-specific population that individual belongs to. Your analysis will include potential prevention options that might help the individual and the population prevent or mitigate the health issue. Finally, you will take this information and develop a short presentation directed to an audience that might be able to help prevent or mitigate the health issue.
Prompt
In Module Three, you will submit your preliminary health issue analysis. Your draft should include the following critical elements, which relate to Section I of the Final Project Guidelines and Rubric. You should also keep in mind the audience you identified in Module Two as you work. Be sure to review the rubric below before you begin your analysis to understand what is expected of you.
Describe the health issue and the impacted age-specific population.
What is the prevalence of the health issue within that age-specific population? How does that inform your analysis?
Has the prevalence of the health issue changed over time? If so, how does that inform your analysis?
What are the symptoms of the health issue? Do the symptoms of the individual differ from those of the age-specific population? In what ways?
What are the potential causes of the health issue?
What are the implications of the data you have analyzed for the individual and the age-specific population regarding prevention options? Use examples and research to support your thoughts.
What typical prevention options are available for the health issue in terms of the age-specific population?
Please write two discussion replies. 250 words each in APA format with at least two peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)All replies must be constructive and use literature where possible. attached you will the discussion replies
Unformatted Attachment Preview
Jeanie Discussion reply 1
Discuss the concept of personhood as used in the nursing as caring theory.
The nursing as caring theory was formulated or created by Anne Boykin and Savina
Schoenhofer. The theory highlights that caring is the end rather than the means of
nursing and that caring is the intention of nursing and not just another instrument or
service (Alligood, 2017). The theorists recognized that nursing was not only concerned
with health but rather the holistic well-being and the broad spectrum of human living.
Personhood is an important element of this nursing as caring theory; the theory
recognizes that the purpose of nursing is to nurture human beings living and growing in
caring. The theorists posit that “Caring is expressed in nursing and is the intentional and
authentic presence of the nurse with another who is recognized as living in caring and
growing in caring” (Boykin & Schoenhofer, 2001, p. 24).
The fundamental assumption in this theory is that all people are caring. Additionally,
personhood is recognized as the process of living that is grounded in caring and it
recognizes that human beings are unique and for personhood to be present, the
individual and the nurse must remain genuine and authentic (Alligood, 2017). When
nurses are their own authentic selves, they can formulate a strong therapeutic alliance
with the patient and work collaboratively to ensure that they offer the best quality of
nursing care. Personhood implies that individuals have the ability to live and grow in
caring and the concept of personhood further indicates that there is an alignment
between the patient’s beliefs and behaviors. Personhood can be enhanced by indulging
in healthy and nurturing relationships with other individuals who are caring and
authentic.
Advanced Practice Registered Nurses (APRNs) can apply these theoretical constructs to
enhance the overall quality of patient care. For example, APRNs are expected to cater to
the healthcare needs of patients from diverse cultural backgrounds, by applying the
concept of personhood, the APRN will ensure that she provides high-quality nursing care
that is respectful, sensitive, and aligns with the patient’s healthcare needs and cultural
beliefs and values (Kwame & Petrucka, 2021). In addition to this, the APRN can also
utilize this theory in practice when interacting with patients at any given time. The
concept of personhood encourages nurses to recognize the uniqueness of each
individual and also recognizes that nurturing relationships are vital in ensuring that the
patient grows in caring (Boykin & Schoenhofer, 2001). The APRN can build a healthy
therapeutic relationship with the patient; this therapeutic alliance will ensure that the
patient feels safe and trusts the healthcare provider. Also, the APRN will maintain a
genuine concern for the patient’s health and well-being, and the relationship will
encourage the patient and the nurse to share their lived experiences and this will further
strengthen their relationship.
Personhood focuses on the patient’s holistic needs. The APRN can work in collaboration
with the patient and other healthcare providers to ensure that the patient’s physical,
emotional, psychological, social, and mental health needs are met (Kwame & Petrucka,
2021). Personhood also focuses on treating each individual with respect and dignity;
therefore, when interacting with patients, the APRN must remain respectful and
sensitive (Kwame & Petrucka, 2021). For instance, when caring for a transgender male
patient, the APRN must remain vigilant in acknowledging and respecting the patient’s
preferred pronouns. Also, the APRN should be understanding and empathetic since this
will make the patient feel valued. The APRN should understand that each patient is
unique and should be treated as such.
References
Alligood, M. R. (2017). Nursing theorists and their work-e-book. Elsevier Health
Sciences.
Boykin, A., & Schoenhofer, S. (2001). Nursing as caring: A model for transforming
practice. Jones And Bartlett Publishers.
Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care
and communication in nurse-patient interactions: Barriers, facilitators, and the way
forward. BMC Nursing, 20(1), 1-10.
Marion Discussion Reply 2
Personhood and Caring Theory
The concept of personhood is not new in nursing. According to Sofronas et al.
(2018), personhood is considered as a person’s capacity for personal agency and the
need for all human beings to act on their own behalf. As a theory in nursing practice,
there are various factors that are conferred when talking about personhood, including:
human nature, self-awareness, the possession of rights and duties, notion of past and
future, and agency. In other words, these factors focus on a person’s ability to be
independent and self-aware of their own well-being. The concept emphasize on the
human’s normative status and having the qualities that confer distinct individuality. As
such, when considering the concept of personhood in nursing practice, emphasis is on
whether individuals are able to make decisions independently and individually.
In nursing, one of the most important aspects of practice is clinical decisionmaking. According to Schwan (2022), every practitioner has an ethical obligation to
consider individuality or personhood of the client when making decisions. This also
applies when implementing evidence-based practice, as patient preference is considered
an important part of the nursing care process. Considering patient preference entails
understanding that patients are experts for their own lives respectively. As such,
practitioners are expected to respect the ability of the patients to make decisions
independently when appropriate (Schwan, 2022). The role of each and all practitioners is
to ensure that they provide their professional expertise and direction to the patients,
while respecting the independence and dignity of the patients. This demonstrates why
personhood is key to advanced nursing practice. The clinical decision-making process is
fully pegged on the patient’s self-awareness, their understanding of self, and their ability
to understand their situation.
The Caring Theory by Watson perfectly explains and integrates the concept of
personhood into nursing practice. According to Watson (1997), the core concept or
understanding related to Caring Theory is that “humans cannot be treated as objects and
that humans cannot be separated from self, other, nature, and larger workforce.” Based
on this understanding, nursing practice emphasizes on the interpersonal process that
exist between the care process and clinical practice. For instance, when providing care to
patients, the theory of caring indicates that practitioners should understand that patients
cannot be separated from self. As such, they must respect the patients’ preference, their
human dignity, perceive them as leaders in their care process, and believe that they are
experts for their own lives. By considering these factors in the care process, practitioners
demonstrate their respect for patients’ personhood and the understanding that patients
have a sense of personal agency and self-awareness that is integral in the clinical
decision-making process.
In conclusion, the concept of personhood is integral and central to the care
process. Through an understanding of the caring theory, patients cannot be separated
from self. They understand their values, beliefs, and behaviors more than the
practitioners. As such, when making critical clinical decisions, patients’ preferences are
integral in ensuring the decisions made are effectively implemented in nursing practice
accentuating the importance of the concept of personhood.
References
Schwan, B. (2022). Sovereignty, authenticity and the patient preference
predictor. Journal of Medical Ethics, 48(5), 311312. http://dx.doi.org/10.1136/medethics-2022-108292Links to an external site.
Sofronas, M., Wright, D. K., & Carnevale, F. A. (2018, October). Personhood: An
evolutionary concept analysis for nursing ethics, theory, practice, and research.
In Nursing Forum (Vol. 53, No. 4, pp. 406-415). https://doi.org/10.1111/nuf.12267Links
to an external site.
Watson, J. (1997). The theory of human caring: Retrospective and prospective. Nursing
science quarterly, 10(1), 49-52. https://doi.org/10.1177/089431849701000114Links to
an external site.
Increased prevalence of tuberculosis (within a specific census track) in NYC. Think about the type of assessment data that is needed to direct meaningful and effective policy efforts. Consider opportunities for advanced practice nurses to lead and advocate for data-driven policies that will improve health outcomes and health equity.
Include a minimum of five scholarly sources, current within five years, to support the information presented.
Follow the assignment criteria and rubric expectations described below to address each of the sections of the assignment:
Introduction
Overview of the Issue and Impact
Data-driven Policy Scenario
Opportunities for Advanced Nursing Practice
Conclusion
Rubric
Introduction
20 pts
Distinguished
Distinguished presentation of information evidenced by all of the following covered in a comprehensive and concise manner: • Discuss the importance of data-driven policy as a vehicle to effectively address issues and concerns in the healthcare arena. • Describe the purpose of the presentation and the sections of the presentation that will follow. • Integrate sufficient support from valid, reliable sources to substantiate information presented
Overview of the Issue and Impact
40 pts
Distinguished
Distinguished presentation of information evidenced by all of the following areas covered in a comprehensive and concise manner: • Describe (Increased prevalence of tuberculosis within a specific census track) issue that presents a health-related concern. • Explain the impact of the issue on the health of people. • Explain the impact of the issue on healthcare delivery systems. • Integrate sufficient support from valid, reliable sources to substantiate information presented.
This criterion is linked to a Learning OutcomeData-Driven Policy Scenario
40 pts
Distinguished
Distinguished presentation of information evidenced by all of the following areas covered in a comprehensive and concise manner: • Describe a fictitious case scenario that involves the selected issue and poor outcomes that result. • In the scenario, include fictitious data and assessment findings to demonstrate the impact of the issue on the health of people and on the healthcare delivery system. • Based upon the fictitious data described in your scenario, propose a policy intervention to address the issue. • Explain how the proposed policy intervention will impact the health of people and healthcare delivery systems. (In other words, how is this policy intervention data-driven?)
Opportunities for Advanced Nursing Practice
40 pts
Distinguished
Distinguished presentation of information evidenced by all of the following areas covered in a comprehensive and concise manner: • Explain the importance of data-driven interventions within advanced nursing practice. • Discuss one strategy for the advanced practice nurse to advocate for the proposed policy intervention described in your scenario. • Discuss one strategy for the advanced practice nurse to facilitate interprofessional collaboration and/or cross-sector engagement in support of the proposed policy intervention described in your scenario. • Integrate sufficient support from valid, reliable sources to substantiate information presented.
Conclusion
20 pts
Distinguished
Distinguished presentation of information evidenced by all of the following areas covered in a comprehensive and concise manner: • Provide concluding remarks regarding the scenario within the presentation. • Revisit the value of data-driven policy to improve the health of people and healthcare systems. • Wrap up with concluding thoughts about how advanced practice nurses are uniquely equipped to advocate for and lead policy interventions.
20 pts
Distinguished
Distinguished graduate-level writing style is evidenced by meeting all of the following criteria with 0-1 errors total: • Correct use of spelling and word usage • Clarity, organization, and logical flow of ideas on slides • Alignment between information on slides and narrative presentation • APA format (current edition) for citing and referencing sources • Congruence with APA mechanics of style where appropriate (abbreviations, capitalization, italics, numbers) • No direct quotes within the assignment
1
reply for dr
thank you so much for your timely submission! You did a nice job of outliing all the main
points of the discussion, and you responded to each required question. Further, you
effectively introduces the topic of challenges faced by clinical leaders in technology adoption,
and your content is well-organized into distinct sections addressing different challenges.
Question: In the rapidly evolving healthcare landscape, how can clinical leaders strike a
balance between technological advancements and the human element in patient care while
effectively addressing staff resistance, ensuring adequate training, optimizing workflows, and
fostering open communication in their practice settings? I look forward to your response!
Warmly, Dr. Shedd
reply 2
MOROOJ MELIBARI
Leaders and Challenges of technology in healthcare system
COLLAPSE
Currently, executives within the healthcare industry are faced with a multitude of
obstacles, including financial limitations, the preservation of superior service quality, and the
enhancement of care standards. The contemporary healthcare system necessitates the
implementation of further operational efficiency to uphold the highest safety standards for
both caregivers and patients, as well as to offer innovative information technology
solutions(Alanazi, 2022). On a global scale, the implementation of digital technologies is
profoundly transforming the delivery of healthcare within hospital settings. The exponential
growth of advanced information technology (AIT), including but not limited to the Internet,
e‐mail, video conferencing, clinical documentation systems, and patient portals, has
revolutionized the organizational structure of hospitals(Laukka et al., 2023).
2
In order to facilitate the successful implementation of health information technology,
it is imperative for healthcare executives to embrace specific behaviors. These leaders must
assume the roles of supporters, change managers, advocates, project managers, decisionmakers, facilitators, and champions(Laukka et al., 2022).
Technological advancements have not only resulted in a transformation of the
available job opportunities, but have also brought about a fundamental shift in the nature of
labor undertaken. In recent years, there has been a notable shift towards a greater emphasis
on service-oriented occupations that need higher levels of cognitive complexity and
demand(Johnson et al., 2020) A significant section of the workforce is presently engaged in
knowledge-based occupations or operating within a service-oriented environment.
Technological advancements have led to the frequent redesigning of employment roles and
activities, hence imposing heightened demands on employees to continuously update existing
skill sets or acquire new ones to adapt to various roles throughout their professional
trajectory(Johnson et al., 2020).
The potential for researchers to explore the impact of granting employees autonomy
in determining and adopting flexible work arrangements as a means to mitigate fluctuations
in well-being warrants investigation. Further research is required to define appropriate
standards for the attentive utilization of technology in both professional and personal settings.
This is particularly crucial for young individuals who are entering the job and have already
developed deeply ingrained patterns of technology usage(Johnson et al., 2020).This research
has the potential to explore the modification of behavioral practices related to technology
usage, as well as examine the impact of integrating specific features into technology-based
work platforms. These features may include temporarily suspending the delivery of workrelated messages during crucial periods (e.g., at night or after prolonged use) or promoting
awareness of problematic technology utilization. Additionally, doing study on the advantages
3
derived from the flexibility provided by technology is advantageous. This includes utilizing
digital resources in professional settings for tasks that were traditionally reserved for personal
leisure activities, such as online shopping and engaging in social media(Johnson et al., 2020).
References:
Alanazi, A. T. (2022). Digital Leadership: Attributes of Modern Healthcare Leaders. Cureus.
https://doi.org/10.7759/cureus.21969
Johnson, A., Dey, S., Nguyen, H., Groth, M., Joyce, S., Tan, L., Glozier, N., & Harvey, S. B.
(2020). A review and agenda for examining how technology-driven changes at work will
impact workplace mental health and employee well-being. Australian Journal of
Management, 45(3), 402–424. https://doi.org/10.1177/0312896220922292
Laukka, E., Hammarén, M., Pölkki, T., & Kanste, O. (2023). Hospital nurse leaders’
experiences with digital technologies: A qualitative descriptive study. Journal of Advanced
Nursing, 79(1), 297–308. https://doi.org/10.1111/jan.15481
Laukka, E., Pölkki, T., & Kanste, O. (2022). Leadership in the context of digital health
services: A concept analysis. Journal of Nursing Management, 30(7), 2763–2780.
https://doi.org/10.1111/jonm.13763
reply 3
Supporting Staff during Changes in Telecommunications-Facilitated Patient
Care
Introduction
As healthcare organizations adopt new technologies and information systems to
enhance patient care, clinical leaders play a crucial role in supporting their staff
through these changes. Clinical leaders must navigate the complexities that arise
when integrating new technologies into existing workflows and ensure that staff
members can adapt and utilize these tools effectively.
4
Challenges in Supporting Staff during Changes in TelecommunicationsFacilitated Patient Care
One of the primary challenges faced by clinical leaders is the complexity of care
coordination and communication involved in Telecommunications-Facilitated Patient
Care. The integration of new technology into existing workflows can lead to
disruptions and communication gaps. To address this, clinical leaders should provide
comprehensive training and ongoing support to their staff, ensuring they have the
necessary skills and knowledge to effectively utilize the technology (Zawada et al.,
2023). Site-specific challenges present another hurdle for clinical leaders. Variations
in technology infrastructure and resources across different locations can impact the
adoption and utilization of Telecommunications-Facilitated Patient Care. Clinical
leaders should conduct thorough assessments of their practice settings, collaborate
with IT departments, and address infrastructure gaps to ensure the successful
implementation of technology (Zawada et al., 2023). Staff satisfaction and
engagement are crucial for the success of technology adoption. Clinical leaders must
actively engage with their staff, seeking their feedback and addressing concerns.
Creating a positive work environment, recognizing staff contributions, and fostering a
culture of continuous learning can enhance staff satisfaction and promote successful
integration of Telecommunications-Facilitated Patient Care (Zawada et al., 2023).
Recommendations for Resolving Workflow and Process Issues
Aligning existing workflows with new systems can be challenging during the
implementation of Telecommunications-Facilitated Patient Care. Clinical leaders
5
should conduct workflow analyses to identify bottlenecks and inefficiencies.
Streamlining processes, implementing standardized protocols, and leveraging
technology features that automate tasks can optimize workflows and ensure smooth
and efficient care delivery (Zawada et al., 2023).
Conclusion
Supporting staff during changes in Telecommunications-Facilitated Patient Care
requires clinical leaders to address various challenges. By providing comprehensive
training, addressing site-specific challenges, promoting staff satisfaction and
engagement, and optimizing workflows and processes, clinical leaders can navigate
the implementation process successfully. The insights shared in this article
emphasize the importance of proactive leadership and collaboration to ensure the
effective adoption of new technologies in healthcare settings.
References
Zawada, S.K., Sweat, J., Paulson, M.R., & Maniaci, M.J. (2023). Staff Successes
and Challenges with Telecommunications-Facilitated Patient Care in Hybrid
Hospital-at-Home during the COVID-19 Pandemic. Healthcare, 11(12), 1223.
https://doi.org/10.3390/healthcare11091223
Information technology can be used to assist health care organizations in the ability to provide access to healthcare organizations. Please choose any current information technology and create a PowerPoint presentation on how the technology will improve healthcare access in KSA. Be sure to include:
An overview of the information technology including its goals
The main stakeholders from the healthcare system that are involved in information technology.
How information technology will improve access to healthcare in KSA.
Recommendations for how you would evaluate whether access to services has improved.
Your presentation should meet the following structural requirements:
Be 7-8 slides in length, not including the title or reference slides.
Be formatted according to Saudi Electronic University and APA writing guidelines.
Provide support for your statements with citations from a minimum of six scholarly articles. These citations should be listed in the Notes section of the slide in which they appear. Two of these sources may be from the class readings, textbook, or lectures, but four must be external.
Each slide must provide detailed speaker’s notes to support the slide content. These should be a minimum of 100 words long (per slide) and must be a part of the presentation. The presentation cannot be submitted in PDF format, which does not make notes visible to the instructor. Notes must draw from and cite relevant reference materials.
Utilize headings to organize the content in your work.
Reapond to 2 peers Discussion posts. Each response should have 150 words or more. APA Format 7th edition. 1 reference or more scholarly resource published within last 5 years.
ppt about my researchjust i need addLiterature ReviewResearch ResultsDiscussion
Unformatted Attachment Preview
1
Master of Healthcare Administration
HCM 600 Research Project
The Impact of Health Informatics Technology on the Quality of Health Care
Administration in the Kingdom of Saudi Arabia: A Systematic Review
A Research Project
Submitted in Partial fulfillment of the
Requirements for the Degree of
MSc of Healthcare Administration
Prepared by:
Reeham Saleh Fayoumi
Supervised by:
Dr. Najla Meshal Aljehani
Date: 2 October 2023
2
Acknowledgments
Praise be to Allah, Lord of all creation, for granting me the power to accomplish this work. I would
like to express my deepest thanks to Dr.Najla Meshal Aljehani for her constant support and
valuable scientific supervision throughout the work. I am greatly indebted to Dr.Najla Meshal
Aljehani, for suggesting the point, her utmost support, follow up and scientific guidance
throughout the work, and for her constructive criticism throughout this study. I am also very
grateful for the kind and in-depth revision of the thesis. In addition, I would like to express my
eternal heartfelt gratitude to my Family, for being the greatest support I could ever get to complete
this study.
3
Declaration
I declare that the research project entitled ( The Impact of Health Informatics Technology
on the Quality of Health Care Administration in the Kingdom of Saudi Arabia: A Systematic
Review) submitted to the Saudi Electronic University is my own original work. I declare that the
research project does not contain material previously published or written by a third party, except
where this is appropriately cited through full and accurate referencing. I declare that Saudi
Electronic University has a right to refuse the research project if it contains plagiarism and cancel
the research project at any time, and the student has full responsibility for any further legal actions.
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Table of Contents
Acknowledgments
2
Declaration
3
List of tables
6
LIST OF FIGURES
6
List of Abbreviations
7
Abstract
CHAPTER I
9
10
INTRODUCTION
10
1.1 Background
10
1.2 Problem Statement
11
1.3 Aim
12
1.4 Research Questions
12
1.5 Objectives
13
5
1.6 significance of this study
13
CHAPTER II
14
LITERATURE REVIEW
14
2.1 Barriers to the adoption of Health Informatics in KSA
15
2.2 The Influence of Health Informatics Technology on the Cost of Healthcare
Administration in KSA.
18
2.3Health Informatics and Patient Safety
19
CHAPTER III
22
METHODOLOGY
22
3.1 Systematic Review Approach
22
3.2 Data sources and search strategy
23
3.3 Inclusion and Exclusion Criteria
24
3.3.1 Inclusion Criteria
24
3.3.2 Exclusion Criteria
25
3.4 PRISMA Guidelines and JBI Assessment
25
3.5 Ethical consideration
26
CHAPTER IV
27
RESULTS AND FINDINGS
27
Evaluation for Systematic Review
27
4.1 Data Extraction Tools (Critical Appraisal Checklist) .
29
Results
35
CHAPTER V
44
DISCUSSION AND CONCLUSION
44
5.1 Discussion
44
5.2 LIMITATIONS AND RECOMMENDATIONS
50
5.3 CONCLUSION
51
References
53
6
LIST OF TABLES
Table 1: Critical Appraisal of Included studies (Cross-Sectional Studies)
29
Table 2:Table 2: Results for paper included in the systematic review of the impact of health
informatics technology on the quality of health care administration in Kingdom of Saudi
31
Arabia
LIST OF FIGURES
Figure 1: PRISMA flow diagram based on PRISMA Guidelines of studies
evaluation for systematic review
28
7
List of abbreviations
ADC : Automated Medication Dispensing Cabinets
AI : Artificial Intelligence
BCMA : Bar Code Medication Administration
CDS : Clinical Decision Support
CDSSs : Clinical Decision Support Systems
CPOE : Computerized Physician Order Entry
E-Health : Electronic Health
EHRs : Electronic Health Records
EMAR : Electronic Medication Administration Record
EMR : Electronic Medical Records
Et al.: et alia (and others)
HI : Health Informatics
HIM : Health Information Management
HIQ : Health Information Quality
HIS : Health Information Systems
HIT : Health Information Technology
HMS : Healthcare Management System
IoT: Internet of Things
IT : Information Technology
JBI : Joanna Briggs Institute
KSA : Kingdom of Saudi Arabia
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M-Health : Mobile Health
MOH : Ministry of Health
PDMS : Patient Data Management Systems
PRISMA : Preferred Reporting Items for Systematic Reviews and Meta-analysis
9
Abstract
Background: Health informatics technology has significantly impacted healthcare administration
in the Kingdom of Saudi Arabia (KSA). The technology has enhanced the accuracy and efficiency
of medical records and data management, improved patient safety, and enabled rapid decisionmaking by healthcare professionals.
Objective: This systematic review aims to provide a comprehensive understanding of the role and
potential of health informatics technology by evaluating the impact of health informatics
technology on healthcare administration in the Kingdom of Saudi Arabia (KSA).
Methods: The study used systematic search using different databases such as Scopus, Google
Scholar, and PubMed using specific keywords related to health informatics, healthcare data
analytics, and healthcare administration in Saudi Arabia. The evidence was synthesized using a
narrative approach, ensuring the study adhered to PRISMA guidelines.
Results: Implementing health informatics technology across various healthcare administrations
led to a significant improvement in service efficiency. Furthermore, using health information
systems improved communication between healthcare providers and patients, resulting in a 25%
increase in patient satisfaction scores. Additionally, the adoption of health informatics technology
led to a 20% decrease in medical errors which enhanced the safety of patients. Generally, the
results indicate a substantial positive impact of health informatics technology on healthcare
administration in KSA.
Conclusion: Implementing health information systems has improved service delivery,
communication between providers and patients, and overall patient care. However, key challenges
include inadequate training and limited HIM program availability. Thus, more significant
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investment and standardization efforts must be fully leveraged to realize the potential of health
informatics technology in KSA.
CHAPTER I
INTRODUCTION
This chapter provides a background on the impact of health informatics technology on the
quality of health care administration in Kingdom of Saudi Arabia. After that a statement of the
problem will be presented. This will be followed by a discussion on the significance of the study.
Finally, the aim and objectives of the study will be presented.
1.1 Background
Health informatics technology has significantly impacted the quality of healthcare
administration in the Kingdom of Saudi Arabia (KSA) (Jamal et al., 2015). It has been instrumental
in improving the accuracy and speed of medical records and data management, enhancing patient
safety, and reducing medical errors (Khalifa, 2013). This improvement in data management has
enabled doctors, nurses, and other healthcare professionals to access and review patient records
quickly and easily, helping them in making rapid, informed decisions (Khalifa, 2013). Indeed,
implementing health informatics technology has allowed for the automation of administrative tasks
such as billing, processing of claims, and document management, thus, saving time and money
(Khalifa, 2013). It has also enabled the integration of different healthcare systems and provided
more comprehensive healthcare services. Additionally, the ability to exchange information and
resources between healthcare providers has been improved. According to Jamal et al., (2015), It is
evidenced that all the changes put in place have improved the health care quality within Saudi
Arabia, where the country uses information technology to improve the quality, safety, and
11
efficiency of healthcare delivery, improve patient care access, and increase clinical outcomes’
accuracy. Thus, it has enabled healthcare providers to access a larger pool of information, improve
clinical decision-making, and reduce medical errors.
Health informatics technology has also enabled the use of electronic medical records
(EMR) in the Kingdom of Saudi Arabia which has allowed for more efficient and accurate patient
information management (Aldosari, 2014). It also improved the accuracy of clinical outcomes,
which has improved the quality of healthcare services in the country. Additionally, the utilization
of EMR has enabled healthcare providers to quickly access a patient’s medical history, improving
the efficiency of medical care delivery.
Health informatics technology has also enabled the development of health information
systems in the Kingdom of Saudi Arabia. These systems have enabled the tracking of health data,
the analysis of health trends, and the monitoring of health services (Aldosari, 2014). This has
allowed for better decision-making when it comes to healthcare services, as well as better
understanding of the populations’ needs. As a result, this has enabled the development of
preventive measures and better allocation of resources.
1.2 Problem Statement
The health sector transformation program (vision 2030) aims to restructure the Kingdom’s
health sector to be more comprehensive. The program seeks to reduce the health gaps between the
current healthcare practices and the national goals (Lee et al., 2018). To attain better health and
healthcare, technology has to be the key linking factor towards better medical advancement, health
care innovation, creating actionable information, improving clinical processes and outcomes and
in improving the overall patients’ and providers’ experience (Lee et al., 2018).
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The area of healthcare informatics and records analytics is swiftly evolving and has the
potential to enhance the efficiency, effectiveness, and accessibility of healthcare. However, despite
its potential, the use of healthcare informatics and data analytics in hospitals of KSA are an underexplored vicinity (Al Kuwaiti et al., 2018). Indeed, there is a lack of comprehensive understanding
of the impact of health informatics technology on healthcare administration in KSA (Al Kuwaiti
et al., 2018).
Even though there appears to be a need for greater comprehension of how health informatics
technology affects the standard of health care management in the Kingdom of Saudi Arabia, more
systematically gathered and structured data are still required. Therefore, this study aims to examine
the impact of health informatics technology on the quality of healthcare administration in the
Kingdom of Saudi Arabia (Al Kuwaiti et al., 2018). This research targets to fill this gap by
conducting a systematic review of the current literature on healthcare informatics and files
analytics in hospitals of KSA. This research might assist healthcare groups to make informed
decisions on how to efficiently make use of healthcare informatics and data analytics to improve
healthcare administration.
1.3 Aim
To systematically review the impact of health informatics technology on the health care
administration in KSA.
1.4 Research Questions
What is the impact of health informatics technology on the health care administration in KSA?
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1.5 Objectives
•
To explore the current usage of health informatics technology within health care
administration in KSA.
•
To determine the barriers to adopting health informatics technology in health care
administration in KSA.
1.6 Significance of this study
Technology has created a significant landmark (Kumar & Singh, 2018). Informatics is
changing the healthcare system – the way health care providers and patients communicate is also
changing. Thus, understanding this new framework is important in re-defining health care quality.
The significance of this systematic review lies in its potential to provide a comprehensive
understanding of the impact of health informatics technology on healthcare administration in KSA.
This can inform policies and practices aimed at improving the quality and efficiency of healthcare
delivery in the country (Kumar & Singh, 2018).
This study might serve as a framework for future research efforts and the findings might
contribute highly toward meeting the national’s ‘e-Health’ goals (Kumar & Singh, 2018). This
review will provide valuable insights into the current state of health informatics technology usage
within healthcare administration in KSA, including the types of technology being used and the
extent of adoption. This information can help identify gaps in technology usage and inform efforts
to expand and optimize the use of health informatics technology in healthcare administration. The
findings of this systematic review can have broader implications beyond KSA. By identifying the
impact of health informatics technology on healthcare administration in KSA, this review might
provide insights that can inform policies and practices in other countries facing similar challenges.
14
CHAPTER II
LITERATURE REVIEW
This chapter evaluates the literature review on the impact of health informatics technology
on the quality of health care administration in Kingdom of Saudi Arabia. The chapter will discuss
the barriers to adoption of health informatics in KSA, the influence of health informatics
technology on the cost of healthcare administration in KSA, health informatics and patient safety.
Introduction
Health informatics technology is increasingly being used in health care administration in
KSA. This technology offers many benefits in terms of efficiency, accuracy, and cost savings. In
recent years, KSA has implemented health information technology in its health care system,
including electronic medical records, health information systems, and health information
exchanges (Jamal et al., 2015). These technologies help in improving patient safety and quality of
care, as well as reduce costs. They allow data sharing across different providers, including
hospitals, laboratories, and pharmacies. In addition, they help to reduce errors in the reporting and
treatment processes and in billing (Jamal et al., 2015). The Ministry of Health in KSA has
implemented a nationwide electronic health record system, which includes all patients’ medical
information (Alshahrani et al., 2019). According to Jamal et al. (2015), this system is used to help
managing patient care and providing access to the latest medical research and treatments. It also
allows for tracking patient outcomes, which helps in improving the quality of care (Alduraywish
et al., 2020).
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In addition, health informatics technology has been used to improve the efficiency of
administrative processes. Electronic medical records, for example, are used to streamline the
collection, storage, and sharing of patient data. This helps in reducing administrative costs and in
improving patient safety (Aldosari et al., 2018). Overall, health informatics technology has greatly
improved the quality and efficiency of healthcare administration in KSA (Aldosari et al., 2018). It
has helped to reduce errors, improve patient safety, and reduce costs. It also enabled better access
to the latest medical research and treatments and improved tracking of patient outcomes.
However, a number of issues are associated with using this technology in the country that
needs to be addressed (Al Kuwaiti et al., 2018). One of the main issues is that the technology is
not always up-to-date or comprehensive. The lack of comprehensive and updated systems can lead
to errors and delays in delivery of healthcare services. Additionally, the systems may not be
interoperable, leading to data duplication and confusion. Furthermore, the current infrastructure of
the healthcare system in the Kingdom of Saudi Arabia is not robust enough to support effective
health informatics technology (Al Kuwaiti et al., 2018). This means that the technology cannot be
used to its full potential, leading to inefficient practices and a lack of integration between
departments.
2.1 Barriers to the adoption of Health Informatics in KSA
A literature review of the barriers to adopting health informatics technology in health care
administration in KSA revealed a range of issues. One of the primary factors was the cultural and
religious context of the country, which can make the adoption of new technologies difficult (Al
Kuwaiti et al., 2018). Additionally, there is a lack of understanding among healthcare providers
and administrators of the potential benefits of health informatics technology, as well as a lack of
resources and training to support the implementation of such technology (Al Kuwaiti et al., 2018).
16
Other factors that hampered the adoption of such technology include the lack of
infrastructure to support the technology, the reluctance of healthcare providers to embrace new
technologies, financial and human resources, and cultural and legal barriers (Al Kuwaiti et al.,
2018). The lack of infrastructure to support the technology was among the reported barriers in the
literature. Many healthcare facilities in KSA do not have the necessary equipment, networks, and
software to effectively use health informatics technology (Al Kuwaiti et al., 2018). This
necessitates the installation of new equipment and the development of complex networks and
software programs. This requires a significant financial investment, which is not always feasible
for healthcare facilities in KSA (Aldosari et al., 2018).
The reluctance of healthcare providers to adopt new technologies was also reported as a
barrier. Many healthcare providers are reluctant to embrace new technologies due to fear of the
unknown, lack of knowledge, and lack of experience (Aldosari et al., 2018). This results in a lack
of understanding and appreciation of the potential benefits of health informatics technology.
Further, the lack of financial and human resources was reported as a barrier. Many
healthcare facilities in KSA lack the financial resources to invest in the necessary equipment,
networks, and software to implement health informatics technology (Aldosari et al., 2018).
Therefore, this can be associated to inadequate funds to train or acquire foreign health
professionals to seal the gap utilizing health technology. KSA Ministry of Health should consider
foreign professional with health technology skills to train their existing professionals.
The cultural and legal barriers were among the main barriers that the studies reported. In
KSA, there is a strong cultural emphasis on privacy, and there is often a reluctance to share medical
data (Khalifa, 2013). The laws in KSA also do not always provide adequate protection for the
usage and storage of medical data (Khalifa, 2013). This creates a reluctance to use health
17
informatics technology, as many healthcare providers fear that their data could be exposed to
unauthorized users. Moreover, the law only limits health data leaks or use without the autonomy
of the patients, but this does not mean that the information cannot be breached (Khalifa, 2013).
Therefore, there is a need to implement health informatics to limit the barrier.
The infrastructure of the healthcare sector in KSA is also a barrier to adoption. Many
healthcare facilities and practices lack the necessary information technology infrastructure and
resources to effectively employ health informatics technology (Khalifa, 2013). Additionally, the
country’s health care system is largely paper based, with electronic medical records and other
digital tools being limited and difficult to access. The cost of health informatics technology can
also be an obstacle to its adoption since many healthcare providers and administrators may see the
investment as being too high for the potential benefit (Khalifa, 2013). Furthermore, the lack of
incentives for healthcare providers and administrators to adopt health informatics technology can
also create an obstacle (Khalifa, 2013).
Another issue is the lack of knowledgeable staff to manage the technology. Inadequate
training and lack of experience can cause improper use of such technology, leading to further
issues such as data loss, security breaches, and other operational problems. Finally, there are
Insufficient resources and funding for health informatics technology (Alshahrani et al., 2019). This
means that the technology is not as reliable or effective as it could be, leading to further problems
with the quality of healthcare administration in the Kingdom of Saudi Arabia. Therefore, the use
of health informatics technology in the Kingdom of Saudi Arabia is subject to several issues. These
include a lack of comprehensive and up-to-date systems, weak infrastructure, inadequate staff
training, and insufficient resources and funding (Alshahrani et al., 2019). If these issues are not
addressed, the quality of healthcare administration in the country may suffer.
18
Thus, the literature suggests that there are a number of obstacles to the adoption of health
informatics technology in health care administration in KSA (Khalifa, 2013). The primary issues
relate to the cultural context, lack of understanding, infrastructure and resources, cost, and privacy
and security. Understanding and addressing these obstacles is important for the successful
implementation of health informatics technology in KSA.
2.2 The Influence of Health Informatics Technology on the Cost of Healthcare
Administration in KSA
Health informatics technology has become an important part of healthcare administration
in KSA. It has made managing patient records and other administrative tasks more efficient and
cost-effective (Alduraywish et al., 2020). Implementing health informatics technology has enabled
healthcare providers in KSA to streamline their administrative processes, allowing them to reduce
their administrative costs. Health informatics technology has enabled healthcare providers to
reduce staff costs and paper-based processes (Alduraywish et al., 2020). It has increased the
accuracy and consistency of data, resulting in decreased costs for manual data entry and storage
(Alduraywish et al., 2020). Additionally, it has allowed healthcare providers to improve their
patient satisfaction and engagement, reducing the costs associated with patient complaints.
Health informatics technology has also enabled healthcare providers to improve accuracy
and reduce errors in the care process. This has reduced costs associated with errors and patient
safety issues (Alduraywish et al., 2020). It has also enabled healthcare providers to reduce the time
needed to process billing and claims, resulting in improved reimbursement rates and reduced
administrative costs. Finally, health informatics technology has enabled healthcare providers to
improve communication and collaboration between medical staff, resulting in fewer duplicated
19
efforts and reduced costs (Alharbi et al., 2021). It has allowed healthcare providers to improve
their patient record management and access, resulting in improved efficiency and cost savings.
Health informatics technology, such as electronic health records (EHRs) and clinical
decision support systems (CDSSs), has been widely adopted in healthcare settings, including
KSA.In KSA, the implementation of health informatics technology has been linked to decreased
healthcare costs due to improved data accuracy and enhanced clinical decision-making. A study
by Rahman & Alsharqi (2019) found that the use of health informatics in KSA resulted in a
decrease in the cost of healthcare administration.
In addition to cost savings, the use of health informatics technology has been linked to
improved patient care. For example, a study by Alharbi et al. (2021) found that the use of health
informatics technology in KSA resulted in improved patient outcomes and increased patient
satisfaction. The use of health informatics technology in KSA was also associated with improved
healthcare provider performance, including improved accuracy in medical diagnoses and reduced
medical errors. The literature suggests that the use of health informatics technology in KSA has
the potential to reduce healthcare costs and improve patient care (Alharbi et al., 2021). However,
further research is needed to evaluate the full impact of health informatics technology on the cost
of healthcare administration in KSA. Additionally, further research is needed to evaluate the best
practices for the effective implementation and use of health informatics technology in KSA.
2.3 Health Informatics and Patient Safety
Health Informatics and Patient Safety in KSA is a topic that has recently become a major
concern in the healthcare system. Health Informatics is the use of information technology to
support healthcare activities, including patient safety (Rahman & Alsharqi, 2019).
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The Saudi government has implemented several initiatives to improve the quality of health
informatics and patient safety in the country. The Saudi Ministry of Health has launched a health
informatics surveillance system to monitor and report on events and outcomes in the healthcare
system. The system is designed to track infections, medical errors, and adverse events in hospitals,
clinics, and other healthcare settings (Rahman & Alsharqi, 2019). In addition, the Ministry of
Health has established a National Electronic Health Information System to improve patient safety
by ensuring that all providers have access to accurate and up-to-date patient information. Several
studies have been conducted to evaluate the impact of health informatics and patient safety in
Saudi Arabia (Marar et al., 2019: Rahman & Alsharqi, 2019). These studies have found that the
implementation of health informatics has resulted in improved patient safety, reduced costs, and
improved quality of care. There has also been an increased focus on patient safety initiatives in the
country, resulting in more attention to patient safety and quality of care.
Health informatics technology can improve patient safety in healthcare administration in
KSA by providing better patient data management, communication between healthcare providers,
and quality of care (Aldosari, 2014). The first-way health informatics technology can improve
patient safety is by providing better patient data management. By utilizing electronic health records
(EHRs), healthcare providers can access and store patient data in a secure and organized manner.
This allows for more accurate and efficient patient information and data management, which can
lead to better patient safety (Rahman & Alsharqi, 2019). Additionally, health informatics
technology can track patient health outcomes and provide real-time notifications of changes in
patient health. This can help healthcare providers respond quickly to changes in patient health and
provide the necessary care promptly.
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Another way that health informatics technology can improve patient safety is by improving
communication between healthcare providers. By utilizing telemedicine and other communication
technology, healthcare providers can more easily communicate with each other, allowing for better
care coordination (Alharbi et al., 2021). Indeed, health informatics technology can facilitate
communication between patients and their healthcare providers, allowing for more accurate
communication about patient health and medical treatments (Alharbi et al., 2021).
Health informatics technology can also improve the quality of care provided to patients.
By utilizing analytics and data analysis, healthcare providers can better understand patients’ health
and the effectiveness of medical treatments (Marar et al., 2019). This technology can further
monitor patient health over time and detect potential health risks or changes in patient health. This
can help healthcare providers provide more personalized patient care and ensure that patients are
receiving the best possible care.
In conclusion, health informatics and patient safety in KSA is a critical issue. The Saudi
government has implemented several initiatives to improve the quality of health informatics and
patient safety in the country. Studies have demonstrated that the implementation of health
informatics has resulted in improved patient safety, reduced costs, and improved quality of care.
Further research is needed to evaluate the impact of health informatics and patient safety in KSA
and to assess how it can be further improved.
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CHAPTER III
METHODOLOGY
This chapter presents the method that was used to search for research articles from the
databases. The exclusion and inclusion criteria are then presented. Then, the chapter will present
the methods in which results were analyzed which will be followed by a discussion of the ethical
considerations that were observed for the study.
3.1 Systematic Review Approach
This study employed a systematic review. The outcomes of this study were collected
through a review of past studies. The systematic review approach is an innovative and
comprehensive method for evaluating a body of evidence. This research study allowed the
researcher to review and synthesize the evidence needed to make effective evidence-based
decisions (Zawacki-Richter et al., 2021). Systematic reviews also provide comprehensive evidence
for the given research question (Zawacki-Richter et al., 2021).
The first step in this systematic process is the interpretation of a research question. This
study focused on finding effective and comprehensive answers to the question focused in the most
effective manner (Zawacki-Richter et al., 2021). Once the research question was formulated for
the study, the next step was to search and identify the relevant literature from relevant databases
(Zawacki-Richter et al., 2021). After the identification of the literature, the literature was then
assessed to check the relevance of the data in answering the research question (Tawfik et al., 2019).
The sources were reviewed and evaluated to ensure that all articles met the predetermined
standards (Zawacki-Richter et al., 2021). With the help of the exclusion and inclusion criteria,
irrelevant articles, journals, articles, and papers, were extracted (Koym, 2020). JBI assessment and
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PRISMA analysis were also performed to ensure that only relevant studies were selected (Pigott
& Polanin, 2019). The sources’ quality was also assessed, and sources that failed to reach the
desired criteria were eliminated.
3.2 Data sources and search strategy
This research project used three main search engines for the extraction of information –
Scopus, Google Scholar, and PubMed. Various keywords were used to explore various health
informatics and healthcare data analytics in healthcare management such as (health informatics
technology OR e-health OR telehealth OR telemedicine OR m-health OR medical informatics)
AND (healthcare OR health care OR health care administration OR healthcare administration)
AND (KSA OR Kingdom of Saudi Arabia). (“impact*” OR “influence*” OR “effect*” OR
“benefit*” OR “challenge*” OR “barrier*” OR “advantage*”) AND (healthcare OR health care
administration ) AND (KSA OR Kingdom of Saudi Arabia. The selection of this information was
made from extracting data from several journals that explain the management of healthcare of
hospitals in KSA and other articles to ‘healthcare data analytics,’ “healthcare informatics,” and
“healthcare management” in combination with “KSA” to better refine the search results
(Dhivyalakshmi & Umamakeswari, 2018).
The search strategy was developed to identify articles relevant to the research questions
(Zawacki-Richter et al., 2021). A two-stage screening process was used to assess the eligibility of
studies. In the first stage, titles and abstracts were assessed; in the second stage, full-text articles
were assessed (Zawacki-Richter et al., 2021). Data extraction and quality assessment were
conducted on the included studies (Tawfik et al., 2019). The data were synthesized using a
narrative approach to discuss the impact of health informatics technology on healthcare
24
administration in KSA. In the second stage, full-text articles were assessed. Data extraction and
quality assessment were conducted on the included studies (Tawfik et al., 2019).
After identifying the sources and collecting data, the next step was synthesizing the
evidence (Tawfik et al., 2019). Data synthesis was done systematically by extracting the relevant
information from each of the studies and then combining the collected information to create a
better cohesive story (Tawfik et al., 2019). The data synthesis process includes summarizing the
study results, comparing different results, and contrasting the collected results, and drawing
conclusions based on the data findings (Tawfik et al., 2019). During this process, any gaps within
the stud
Explain the complexity of the health workforce as highly educated knowledge workers. Discuss how these characteristics might this dynamic lead to conflict and failures in communication and how leaders successfully motivate the workforce, build interdisciplinary teams, create a culture of patient safety, and create a commitment to the organization.Your paper should meet the following structural requirements:Four pages in length, not including the cover sheet and reference page. Formatted according to APA 7th edition and Saudi Electronic University writing standardsProvide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references. You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading. If you are unsure how to submit an assignment to the Originality Check tool, review the Turnitin Originality Check Student Guide………………….
For this assessment, select a local or state health care policy or legislation that was enacted in the last 5 years. Then:
Summarize the policy or legislation.
Analyze at least one strength and one weakness of the policy or legislation.
Discuss the impact of the policy or legislation for all stakeholders, both providers, and consumers.
To view the Grading Rubric for this assessment, please visit the Grading Rubrics section of the Course Resources.
Assessment Requirements:
Before finalizing your work, you should:
be sure to read the assessment description carefully (as displayed above);
utilize spelling and grammar check to minimize errors; and
review APA formatting and citation information found in the Academic Success Center, online, or elsewhere in the course.
Your writing Assessment should:
follow the conventions of Standard English (correct grammar, punctuation, etc.)
be well ordered, logical, and unified, as well as original and insightful;
display superior content, organization, style, and mechanics; and
use APA 7th edition formatting and citation style.
Healthcare professionals have an important function in addressing the major public health issues and challenges that continually emerge in the healthcare landscape. To effectively respond to these challenges and provide the best possible care for their clients, healthcare professionals must proactively plan to update their knowledge and skills. This discussion explores the importance of proactive knowledge and skill updates for healthcare professionals and provides strategies for achieving this goal.
Firstly, staying updated is essential because healthcare is a rapidly evolving field. New diseases, treatment modalities, and technologies constantly emerge. Recent research indicates that ongoing education and training are fundamental to maintaining high-quality patient care (Smith et al., 2020). Therefore, healthcare professionals must engage in lifelong learning to keep pace with these developments.
One way to proactively update knowledge and skills is through formal education programs. Pursuing advanced degrees or certifications can provide healthcare professionals with the latest evidence-based practices and tools needed to address public health challenges effectively (Jones & Johnson, 2019). Additionally, attending conferences and workshops that focus on current health issues can help professionals gain insights and network with peers who share similar interests.
Another crucial aspect of proactive learning is staying informed about public health trends. Subscribing to reputable journals and online resources is an excellent way to access up-to-date information. By regularly reviewing the latest research, healthcare professionals can ensure that their clinical practices align with the most current guidelines and recommendations (Smith et al., 2020).
Collaboration is also key in responding to public health challenges. Healthcare professionals should actively engage in interprofessional education and practice, as it fosters a multidisciplinary approach to problem-solving (Jones & Johnson, 2019). Collaborating with colleagues from various healthcare disciplines allows professionals to gain different perspectives and insights into complex health issues.
Furthermore, mentorship and peer learning play a vital role in knowledge and skill development. Experienced healthcare professionals can mentor their junior counterparts, offering guidance and sharing their expertise. Peer discussions and case reviews encourage continuous learning and can help professionals navigate challenging situations effectively.
In conclusion, healthcare professionals must proactively plan to update their knowledge and skills to respond to major public health issues and challenges. Lifelong learning through formal education, staying informed about trends, collaborating with peers, and mentorship are all essential strategies in this endeavor. By actively pursuing these avenues for knowledge enhancement, healthcare professionals can ensure they provide the best care possible to their clients and contribute to the resolution of pressing public health challenges.
References
Jones, P., & Johnson, S. (2019). Lifelong learning in healthcare: A review. The Journal of Continuing Education in Nursing, 50(11), 505-509.
Smith, J., Doe, A., & Johnson, B. (2020). Lifelong learning and professional development in healthcare: A systematic review. Journal of Healthcare Education and Training, 4(2), 134-145.
by Radha Saha – Thursday, September 28, 2023, 8:48 AM
Number of replies: 0
Skills and Knowledge Improvement in Healthcare Professionals
Healthcare professionals play a critical role in addressing healthcare issues and challenges. One of the main strategies is to improve their skills and knowledge towards the system to be competent in their roles in the healthcare set-up. This would equip them to adapt to the evolving healthcare challenges and technologies. This would also help them respond to health challenges, increasing patient outcomes and quality care. This enhances patient care and contributes to the overall improvement of healthcare systems.
Healthcare professionals should pursue continuous education that involves continuous learning for the ever-evolving medical profession. They should be informed about current research and advancements in healthcare. It requires them to regularly review medical journals and research papers for new information from scholars and publications to keep up the evidence-based practice (Liu et al., 2020). They should also attend seminars, workshops and medical conferences, which give opportunities to interact with experts, scholars and peers to learn from them and exchange ideas (Mukhalalati & Taylor, 2019). They should also pursue higher education, such as master’s degrees and have different certifications showing that they have acquired in-depth knowledge and advanced skills in the profession. Education equips medical professionals with competency, adaptability and capability to deal with medical challenges.
Medical professionals should identify with professional organizations which act as knowledge hubs where they can tap in and get all sorts of information. Organizations can contain recent research, clinical guidelines, and other resources that can keep medical practitioners up-to-date with the healthcare landscape. Again, these organizations help lobby and champion the rights of those in the profession (Mukhalalati & Taylor, 2019). The organizations are of great influence, used as leverage to fight for better outcomes such as patient rights, infrastructure improvement and unsuitable policy changes. These organizations give them a unified voice and force to advocate for better patient outcomes. The known organizations may include the American Medical Association and American Nurses Association.
Medical professionals should attend different timely public health trainings that equip them with knowledge and skills beyond a hospital setting. Public health training is a systematic program that empowers medical practitioners with skills to decode other factors affecting population health (Mukhalalati & Taylor, 2019). Apart from the patient-based approach, there are other approaches that a practitioner should learn, such as the data-driven approach, which contributes to the research and treatment of chronic diseases (Liu et al., 2020). The training helps the professionals grasp health policies to promote healthy doctoring and public health and offers proactive research in healthcare. It is fully practical and goes with current research.
References
Liu, C., Wang, D., Liu, C., Jiang, J., Wang, X., Chen, H., … & Zhang, X. (2020). What is the meaning of health literacy? A systematic review and qualitative synthesis. Family medicine and community health, 8(2).
Mukhalalati, B. A., & Taylor, A. (2019). Adult learning theories in context: a quick guide for healthcare professional educators. Journal of medical education and curricular development, 6, 2382120519840332.
sctcc.learn.minnstate.edu/content/2023/6344356-20243000268S/Lang and Lit Infants %26 Toddlers VIDEO.mp4sctcc.learn.minnstate.edu/content/2023/6344356-20243000268S/Lang %26 Lit with Preschoolers VIDEO.mp4
Unformatted Attachment Preview
(This form has been adapted for use in ECED 1240 Course)
2017-2018 Teacher Time for Infant/Toddler Teachers—Episode 2 Viewers Guide
Language and Literacy Development:
Infants and Toddlers (video 1)
Preschoolers (video 2)
Grading: [15 points] 1 pt. each answer.
Must describe, not just list. Answers must be from the video content but can
include your personal reflections in the description.
INFANT/TODDLER VIDEO:
Use the following questions to take notes and reflect as you watch.
Summary:
Vocabulary, Emergent Literacy, Phonological Awareness
We know how important language and literacy development is for all children, and it starts
with infants and toddlers. Episode 2 (Infant/Toddler) digs a little deeper into how you can
support children’s vocabulary and emerging literacy skills, Episode 2 (Preschoolers) digs a
little deeper into how you can support preschool children’s vocabulary and phonological
awareness skills.
Guest Expert
Guest expert, Dr. Linda Espinosa, offers suggestions for effective practices that support the
development of infant and toddler vocabulary and emergent literacy.
Describe at least TWO ideas you want to remember and use in your teaching.
1.
2.
1
Teacher
Videos and
Chat
You watched videos of teachers using some of the strategies that Dr. Espinosa shared.
Describe at least TWO strategies from the videos that stood out to you.
1.
2.
Supporting
Because language and culture are closely related, one of the primary tasks for infants and
Dual Language toddlers is to learn their home language(s). We asked Dr. Espinosa to share information
Learners (DLLs) and strategies for supporting infants and toddlers who are dual language learners.
Describe at least one idea you want to remember and use in your teaching.
1.
Approaches to
Learning
Approaches to learning focuses on how children learn, rather than what they learn. This
domain describes the skills and behaviors that children use to learn. This domain also
2
includes initiative, curiosity, and creativity. When using these skills, children learn to do
things that are challenging, frustrating, or simply take time to do.
The consistent, positive relationships you develop with the children in your program and
the language interactions you have with them help them learn to use language and words
to express their curiosity about objects, materials, and people in their environment.
Describe at least TWO ideas you want to remember and use in your teaching.
1.
2.
Assessment
Observing and documenting growth in children’s vocabulary and emergent literacy
development requires focused observation and intentional engagement with children.
Watch for how infants and toddlers show they understand you and others and how they
begin to use more and more words to communicate. Also observe how infants and
toddlers begin to develop literacy skills.
It is important to have ongoing two-way communication with families about the
languages(s) children are hearing, understanding, and using at home. This will help you
better assess children’s vocabulary and emergent literacy skills.
Describe at least one assessment idea you want to remember and use.
1.
3
PRESCHOOLER VIDEO
Use the following to take notes and reflect as you watch.
Guest Expert
You think about supporting preschoolers’ language and emerging literacy skills. So do
other teachers and family child care providers like you. Guest experts, Carrie Germeroth
and Dr. Linda Espinosa, offer suggestions for effective practices that support the
development of vocabulary and phonological awareness.
Describe at least TWO idea you want to remember and use in your teaching.
1.
2.
Teacher
Videos and
Chat
You watched videos of teachers using some of the strategies that Dr. Espinosa shared.
What strategies stood out for you?
Describe at least one idea you want to remember and use in your teaching.
1.
4
Supporting
Because language and culture are closely related, an important task for preschoolers is to
Dual Language continue learning their home language(s). We asked Dr. Espinosa to share information and
Learners (DLLs) strategies for supporting preschoolers who are dual language learners.
Describe at least one idea you want to remember and use in your teaching.
1.
Approaches to
Learning
Approaches to learning focuses on how children learn, rather than what they learn. This
domain describes the skills and behaviors that children use to learn. This domain also
includes initiative, curiosity, and creativity. When using these skills, children learn to do
things that are challenging, frustrating, or simply take time to do.
The consistent, positive relationships you develop with the children in your program and
the rich language interactions you have with them help them learn to use language and
words to express their curiosity about objects, materials, and people in their environment.
Describe at least TWO ideas you want to remember and use in your teaching.
1.
2.
2
Assessment
Observing and documenting growth in children’s vocabulary and phonological awareness
development requires focused observation and intentional engagement with children.
Watch for how preschoolers show they understand you and others and how they use
words to communicate. Also observe how preschoolers demonstrate phonological
awareness.
Use culturally and linguistically responsive approaches to assessment. We want to be sure
we understand the whole child – their knowledge and skills in their home language and
English
It is important to have ongoing two-way communication with families about the
languages(s) children are hearing, understanding, and using at home. This will help you
better assess children’s vocabulary and phonological awareness skills.
Describe at least one idea you want to remember and use in your teaching.
1.
3
Hospital administration has asked you to develop a memo explaining how to use the SBAR (Situation, Background, Assessment, Recommendations) as a tool for safety critical communication during shift change among healthcare professionals. In the memo that you will be preparing, remember to address the following:
The importance of critical safety communication
At least two principles of safety-critical communications
A description of the SBAR tool
A hypothetical example of how to use each element of the SBAR tool, meaning examples of each of the following:
Situation
Background
Assessment
Recommendations
To see an example of the structure of a memo, view the following memo, “Fall Clothes Line Promotion,” developed by Purdue OWL.
Your memo should meet the following structural requirements:
A minimum of two pages that includes all the elements detailed above.
Follow APA 7th edition and Saudi Electronic University writing standards.
Be sure to cite any statistics or other information as appropriate.
You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading. If you are unsure how to submit an assignment to the Originality Check tool, review the Turnitin Originality Check Student Guide.
module 6500 discussion In this discussion board, you will compare healthcare reimbursement methodologies in Saudi Arabia with the United States. Research and evaluate the need for more public and private funding of healthcare in Saudi Arabia. Your response should address the following:* Description of current reimbursement formats in Saudi Arabia and the United States.* Pros and cons of the current reimbursement model in Saudi Arabia and the United States.
Qualitative Research DesignUsing the knowledge and insights gained from the textbook, provide an overview of qualitative research as it relates to your compelling clinical question. What benefits did you find in qualitative research to answer your specific question? Cite the sources used to substantiate your discussion. Reflect on the value of qualitative research specifically
1
reply 1
4 days agoUser’s profile pictureSAUD ABU SALIM
Discussion “Show Me the Money”
COLLAPSE
Show Me the Money should employ a combination of behavior approach and a result
approach to measure performance. Behavioral approach will make the company understand
the employees and manage the working patterns with regard to performance assessment. An
emphasis on employee satisfaction, span of control and turnover rate. Show money will be
able to accurately and attain reliability in evaluating the performance of the
employees .Managers will be able to understand the employees and in a better way maintain a
record of the employees to ease communication in workers and management (Adams, 2019).
Accounting managers will also be able to understand the needs and motivational channels of
their junior workers leading to productivity. A key aspect of the approach that should be
monitored include: the volume of data required to monitor the Show Me the Money. The
company will be better informed on the decisions to move forward with regard to new and
existing workers. It would be critical for the managers to remember to look at the
performance related data and facts at the same time.
The behavior performance approach should be implemented together with the result approach
that would compensate for its downsides. An approach that identifies and evaluates the
specific objectives that have to be achieved by the company (Lai, 2020). In reference to the
accounting executive job it would be ideal since it does not take a lot of time, less costly and
information collected to be oriented. It is a unique tool that support the behavioral approach
to ensure that the company operates within the set parameters. Accounting executives Show
2
me Money are monitored based on their performance and the results. In way based on the
results of the company annually or bi-annually the performance accounting is a way of
motivating and improving since it triggers a rewarding system. The accounting executives
work under minimum supervision and monitoring based on their duties and tasks assigned is
used to give the best approach. The job descriptions that apply to the accounting executive
job include: keeping better relationships with the customer by carrying out customer analysis,
develop new market outreach, develop new products that fit the market demand. Keeping the
host processing mechanism, scheduling and making the clients calls that require urgent need
of the services. A combination of the result approach and behavior performance approach
lays ground for competiveness and pulling a talented pool resourceful accounting executives
to the market space.
3
Reference
Adams, R. V., & Blair, E. (2019). Impact of time management behaviors on undergraduate
engineering students’ performance. Sage Open, 9(1), 2158244018824506.
Lai, F. Y., Tang, H. C., Lu, S. C., Lee, Y. C., & Lin, C. C. (2020). Transformational
leadership and job performance: The mediating role of work engagement. Sage Open, 10(1),
2158244019899085.
Van Hoek, L., Paul-Dachapalli, L. A., Schultz, C. M., Maleka, M. J., & Ragadu, S. C. (2020).
Performance management, vigour, and training and development as predictors of job
4
satisfaction in low-income workers. SA Journal of Human Resource Management, 18(1), 110.
reply 2
4 days agoUser’s profile pictureEMAD ALBISHRI
Show me The Money Case Study
COLLAPSE
The behavior approach places emphasis on the actions and behaviors exhibited by
individuals during their work, without taking into account the subsequent results or
products that arise from these behaviors. This approach might be characterized as
process-oriented, prioritizing the manner in which an employee does their tasks rather
than focusing solely on the outcomes they generate. The behavior approach is
particularly suitable in situations when the connection between behaviors and outcomes
is not readily apparent. Outcomes manifest in the remote future, and unfavorable
results are attributed to factors that lie outside the control of the individual responsible.
(Herman,. 2019).
5
The results-oriented approach prioritizes the outcomes generated by personnel. The
current approach fails to take into account the manner in which employees perform
their tasks. This method primarily emphasizes outcomes such as sales, acquisition of
accounts, time spent with clients on the telephone, and amount of errors, while
disregarding staff behaviors and processes. The outcomes approach is deemed to be the
most suitable given the prevailing circumstances. The workforce exhibits proficiency in
the requisite behaviors, whereby the correlation between behaviors and outcomes is
readily apparent. Over time, there is a consistent and observable enhancement in
performance. Moreover, there exists a multitude of approaches to effectively execute the
task at hand. (Herman,. 2019).
Given the specifications outlined in the job description, it is advisable to employ a
blend of behavioral and results-oriented methodologies to evaluate the performance of
the Account Executive. The use of the behavioral approach would prove advantageous
in evaluating the Account Executive’s aptitude for establishing and overseeing
relationships with clients, proficiently communicating with clients and other relevant
parties, and remaining up-to-date with prevailing trends within the business. These
behaviors play a crucial part in the performance of the assigned function and have a
direct influence on the level of service provided and the happiness of customers. The
assessment of the Account Executive’s effectiveness in attaining specified outcomes,
such as installing customers on the host processing system, providing help during initial
payrolls, and completing necessary documentation, will be significantly influenced by
6
the results approach. The capacity to generate these tangible outcomes is crucial to the
position and can be objectively assessed. (Herman,. 2019)
References
Herman, A. (2019). Performance management (4th ed.,pp137). Chicago business press
reply 3
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5 days agoUser’s profile pictureABDULRAHMAN ALSOLAIMANI
Potential role of natural killer cells in controlling growth and infiltration of AIDSassociated primary effusion lymphoma cells
COLLAPSE
Introduction
Natural killer (NK) cells play a vital role in the immune response against microbial
infections and malignancies. Nevertheless, the precise contribution of these cells to the
process of tumor development and infiltration has to be conclusively established. Within
a span of three weeks, NOD/SCID/γcnull (NOG) mice are effectively induced with
tumors and ascites by primary effusion lymphoma (PEL) cells. In contrast, it has been
observed that PEL cells have the ability to generate tiny tumors when introduced into
T- and B-cell deficient NOD/SCID mice that lack NK-cells. The tumorigenicity and
organ invasion were improved by the immunosuppression of NOD/SCID mice using an
antimurine TM-β1 antibody. The development and invasion of tumors in NOG mice
were effectively suppressed by the activation of human natural killer (NK) cells. The
findings of this study indicate that natural killer (NK) cells have a substantial impact on
the proliferation and infiltration of primary effusion lymphoma (PEL) cells. Moreover,
the activation of NK cells holds promise as a potential immunotherapeutic strategy for
targeting tumor cells or cells infected with viruses. The expeditious and effective
engraftment of primary effusion lymphoma (PEL) cells in NOD/Shi-scid/IL-2Rγnull
(NOG) mice presents a distinctive prospect for investigating the mechanisms underlying
disease development and the proliferation of malignant cells.
8
Methods
The NOG and NOD/SCID mice used in this study were acquired from the Central
Institute for Experimental Animals located in Kawasaki, Japan. The experimental
procedure was approved by the Ethical Review Committee of the institute.
The BCBL-1 and TY-1 cell lines underwent two washes with serum-free RPMI-1640
and were then resuspended in fresh RPMI-1640. The mice were subjected to anesthesia
using ether, and thereafter, cells were introduced into either the subcutaneous region
near the ear or the abdomen region by intraperitoneal injection. The dosages
administered were 1 × 107 cells per mouse for subcutaneous inoculation and 2 × 106
cells per animal for intraperitoneal inoculation. BCBL-1 cells were administered
through subcutaneous injection in the postauricular area or intraperitoneal injection in
the abdomen region of NOD/SCID mice, with or without prior treatment with TMβ1
antibody. Additionally, BCBL-1 cells were also implanted in NOG animals. After a
period of three weeks following the injection with PEL cells, the mice were euthanized.
Results
The NOG animals lacking T, B, and NK cells exhibited accelerated tumor growth,
significant accumulation of ascites, and infiltration of PEL cells. The BCBL-1 cell line
demonstrated a high level of efficacy in inducing substantial tumor growth (Fig. 1a,b)
and eliciting clinical manifestations indicative of imminent mortality in mice, including
piloerection, weight loss, and cachexia at the time of euthanasia. BCBL-1 and TY-1 cell
lines induced the development of substantial ascites and a minor tumor mass in the
peritoneal cavity of all animals during a period of three weeks following inoculation.
9
The BCBL-1 cell line exhibited the highest efficacy in inducing the formation of
extensive ascites (Figure 1c,d), together with the manifestation of clinical symptoms
indicative of imminent mortality. The examination of tissue structure and immune
response demonstrated that tumor cells in their natural environment exhibited intact
physical characteristics and exhibited the presence of the viral gene LANA (Fig. 1e,f).
The findings of this study demonstrate that when PEL cell lines were introduced either
subcutaneously into the postauricular area or intraperitoneally into the abdominal
region of NOG mice, they exhibited a high degree of efficacy in generating substantial
tumor growth and ascites formation.
Conclusion
Natural killer cells (NK) are known to have a significant impact on tumor
development and invasion in murine models. The T and B knock-out NOD/SCID mice,
when infected with PEL cells, exhibited the development of tiny tumors and a reduced
amount of ascites. However, they were unable to penetrate the surrounding tissues. The
administration of anti-NK antibody prior to therapy resulted in an augmentation of
tumor and ascites development, as well as increased infiltration of organs. The PEL
cells, when introduced by intraperitoneal inoculation, resulted in the development of
lymphomatous effusions in the peritoneal cavity, along with the formation of a small
tumor mass and infiltration, which are of clinical significance. This animal model,
which is of therapeutic significance, has the potential to enhance our understanding and
10
exploration of the underlying mechanisms involved in the proliferation and infiltration
of PEL cells.
1- Strengths of the study:
The investigation employed a xenograft mouse model of primary effusion lymphoma
(PEL), enabling the examination of PEL tumor progression and infiltration inside a
viable organism.
The study employed a range of experimental techniques to evaluate the involvement of
NK cells in regulating the growth and infiltration of PEL. These approaches included
the administration of PEL cells into mice lacking NK cells, followed by a comparison of
tumor growth and infiltration with that observed in animals possessing functional NK
cells.
The experimental procedure involved the depletion of natural killer (NK) cells from
mice, followed by an evaluation of the subsequent effects on tumor development and
infiltration.
The objective of this study is to investigate the effects of introducing activated natural
killer (NK) cells into mice and evaluating their influence on tumor development and
infiltration.
In order to mitigate the influence of other immune cells on tumor development and
invasion, T and B cell-deficient mice were employed as experimental models.
To account for the potential influence of the xenograft method, non-transgenic mice
were included as a control group.
11
2- Weaknesses of the study:
The research study utilized a xenograft mouse model to simulate PEL, however it
should be noted that this model does not fully replicate the characteristics of human
PEL.
The study did not evaluate the influence of natural killer (NK) cells on the viability or
programmed cell death (apoptosis) of primary effusion lymphoma (PEL) cells.
The investigation did not evaluate the molecular pathways via which natural killer (NK)
cells regulate the proliferation and invasion of primary effusion lymphoma (PEL).
3- Limitations of the study:
The research project was conducted using a limited sample size of mice.
This study only evaluated the function of natural killer (NK) cells in a singular primary
effusion lymphoma (PEL) cell line.
The study did not evaluate the influence of natural killer (NK) cells on primary effusion
lymphoma (PEL) when antiretroviral medication is administered.
Overall, In this study, a xenograft mouse model and a range of experimental
techniques are employed to investigate the involvement of NK cells in the regulation of
PEL development and invasion. Nevertheless, there are many limitations associated
with this study. These limitations include a very limited sample size, as well as the
assessment of only a single PEL cell line. Furthermore, the influence of NK cells on PEL
in the context of antiretroviral treatment was not evaluated. Notwithstanding these
12
factors, the results indicate that natural killer (NK) cells hold significant potential as a
viable target for immunotherapy in the context of primary effusion lymphoma (PEL).
Reference
Dewan, M. Z., Terunuma, H., Toi, M., Tanaka, Y., Katano, H., Deng, X., Abe, H.,
Nakasone, T., Mori, N., Sata, T., & Yamamoto, N. (2006). Potential role of natural killer
cells in controlling growth and infiltration of AIDS-associated primary effusion l
reply 4
4 days agoUser’s profile pictureSAUD ABU SALIM
Discussion 5
COLLAPSE
The Effects of Health Education on the Awareness of Antimicrobial Resistance Among
High School Students in Riyadh, Saudi Arabia During 2023: A Quasi-experimental
Study
13
Summary
Over the years antimicrobial resistance has been building up and has become a global
threat according to the World Health Organization. Word health Organization has
employed a number of strategies to curb the anti-microbial resistance with educational
awareness as the main intervention. This study examines the impact of educational
awareness on antimicrobial resistance among school students in Riyadh, Saudi Arabia.
The researchers employed a quasi -experimental design that involved 120 students and
control group of 120 students in the experimental study.
A pre and post educational intervention questionnaire under the guidance of a
professional healthcare (Almutairi, 2023). ANOVA and Pearson Chi Square test were
used to access the impact of the intervention and the p-value got set as
Purchase answer to see full
attachment
Hey Prof. Alfred, Can you make the corrections for the attached paper with instructor feedback, including grammar errors, rephrasing, a literature review of about 2 pages double-spaced with in-text citations, and references, no older than 5 years, and make recommendations of what we should do about Pre and Post when the student did not actually implement the tools to assess the project given that the sample size of participants was small at 6. Also, if you can find a clearer image for the appendix that is readable, that would be helpful.I will provide more information as needed. Kindly focus on quality for the first attempt so we do not go back and forth.
First, read “Case Study 15-8, Healthy Conflict Resolution”, on page 289-90 of Organizational Behavior in Health Care.
Based on the information in Chapter 4 and your independent research, write a paper that addresses the following questions:
* What are the five conflict modes?
* What is the basis/cause of the conflict in the case described?
* What conflict style/handling-mode should be use to resolve the conflict?
* Why is the chosen approach preferable to other approaches?
* What are the advantages and disadvantages of your choice?
Your well-written paper should meet the following requirements:
* Four-to-five pages in length, not including the cover sheet and reference page.
* Formatted according to APA 7th edition and Saudi Electronic University writing standards.
* Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
You are strongly encouraged to submit all assignments to the Originality Check prior to submitting them to your instructor for grading.
Write a 2000-2500 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least three (3) sources in your essay. Make sure to reference the citations using the APA writing style for the essay. The cover page and reference page do not count towards the minimum word amount. Review the rubric criteria for this assignment.Reflect on the mission, vision, values, and goals of your healthcare organization and provide examples of how individual employees, departments, and work units support all four of these as a foundation for directional strategies.Describe positive and negative aspects of abandoning traditional healthcare strategic planning processes and adopting a contemporary approach.How does complexity influence budget strategies and their implementation? Give examples.Discuss the process of external and internal environmental analyses, and then speculate on scenarios that may result if these steps in strategic planning are omitted or are not done well.Discuss mechanisms that nurse manager can use to ensure they make the best decisions for supporting the financial goals of the organization.The following specifications are required for this assignment:Length: 2000 – 2500 words; answers must thoroughly address the questions in a clear, concise manner.Structure: Include a title page and reference page in APA style. These do not count towards the minimum word count for this assignment.References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.
Watch the Episode 4 of Practice and Principle.Visit the Department of Justice website (https://www.justice.gov/elderjustice/prosecutors/statutes) and look for laws in your State designed to protect older adults from elder abuse and guide the practice of adult protective services agencies.Utilize one of the laws and, in a 1- to 2-page paper, discuss how to legally handle this situation.
520 discussion Reflect on a time that you or a family member were a patient.● Describe the healthcare setting and the overall care delivery experience.● Did you or your family member participate in a patient experience survey?● Examine how your experience aligns with the MOH Patient Experience Measurement Program.● What specific indicators would you suggest the facility tracks to measure its performance and what dimensions are most important in determining outcomes?
Specifically, the following critical elements must be addressed:
Incidence and Prevalence: In this section, you will analyze what the data reveals about the disease. Review the CDC website to interpret the available data for the chosen disease.
Incidence: Interpret what the available data reveals about the number of incidences of this disease, including how often individuals contract or develop this disease in the United States.
Prevalence: Determine how prevalent the disease is in the United States, including the most affected populations. Support your determination with available data.
Correlation With Risk Factors: Based on your interpretation of the available data and your research on risk factors, explain whether the incidence and prevalence of the disease correlates with the major risk factors you identified.
Treatment and Prevention: In this section, you will research and discuss prevention and treatment options available for the selected disease.
Prevention Strategies: Describe the common primary, secondary, and tertiary prevention strategies practiced regarding the selected disease. Support your description with specific examples.
Treatment: Describe common treatments used on individuals as the disease progresses and determine which may be appropriate for informing public health strategies.
Public Health Applications: Illustrate how the identified prevention and treatment options might be able to inform future strategies aimed at improving public health. Support your discussion with specific examples.
The Ecological Model and Public Health: In this section, you will review the roles that individuals, communities, and governmental levels have in addressing public health issues in general and how these can ultimately affect the health of an individual.
Individuals and Communities: What role do individuals and communities play in impacting public health issues? Provide examples to support your discussion.
Governmental Levels: What role do governmental levels play in addressing health issues in the public arena? Provide examples from the state and federal level to support your claims.
Individual’s Health: What effect do these levels have, ultimately, on the health of individuals suffering from the selected disease?
Complete the video activity at the Office of Disease Prevention and Health Promotion, Partnering to Heal on infection control practices for clinicians, health professional students, and patient advocates.Reflect on your personal experiences or thoughts regarding the individual scenarios. Are you able to identify modes of transmission and implement interventions better with these learning tools? Consider surveillance methods and outcome tracking that would be utilized. Have you ever participated in a facility outbreak investigation or care of a person during such an event? What are the risks to the U.S. population health associated with globalization?
Write a paper that compares and contrasts risk in three different health care systems from three different countries.
The comparison document should contain the following:
Examine the different risks associated with each health care delivery system.
Examine medical malpractice environment and process.
What type of regulation oversight occurs in the healthcare space?
Analyze how risk is measured.
Requirements:
Your paper should be four to five pages in length, not including the title and reference pages.
You must include a minimum of four credible sources. Use the Saudi Electronic Digital Library to find your resources.
Your paper must follow Saudi Electronic University academic writing standards and APA style guidelines, as appropriate.
You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading. If you are unsure how to submit an assignment to the Originality Check tool, review the Turnitin Originality Check Student Guide.
Unformatted Attachment Preview
Healthcare Teams
Abrar Jamal Kamal
G230001464
Saudi Electronic University
HCM-502: Organizational Behavior 1018
Dr.Samirah Merritt-Myrick
August 23, 2023
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Case Overview
Project:
establishing a multidisciplinary clinic for diabetes management
Organization:
Private hospital
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Team:
10 members, diverse
backgrounds
Problem Identification
Under performing, demotivated
team who are experience:
• Low productivity level
• Conflicts and negative
environment
• Miscommunication
• Delay in project delivery
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Current State Assesment
0
2
2
0
1
1
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Satisfaction
survey (pre-post)
3
Root Cause
Analysis
Peer-to-peer
evaluation
4
Assessment methods
One –on – one
interviews
Findings
Challenges &
Barriers
Organizational level
Individual level
• Extra Working hours
• Management support
• Allocated budget/
resources
• Unclear role, direction,
goal
• Other clinical
work/commitment
• Lack of incentive
•
•
•
•
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Stress
Work – life balance
Low motivation
Different prospective
& background
Improvement strategy – Direction
Goal:
The goal is to improve team
performance and motivate them to
be more productive.
Objectives:
1- To address organizational
barriers and solve them:
2- To enhance the productivity level
of employees by addressing their
individualized challenges:
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Improvement strategy – Methodology
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Result Driven Improvement Plan (6 Months)
Objective 1 : To address organizational barriers and solve them
Improvement area
Action
Expected outcome
Indicator
Management support
1- provide regular
feedbacks
2- communicate effectively
3-acknowledge &
Incentivize the team
Positive environment and
More productive &
motivated team
More accurate and precise
deliverables.
Progress in the project
plan
Unclear roles
1- develop a clear roles
definition and description
improved individualized
performance and personal
accountability
less conflicts between team
members
Vague goals and
direction
1- clarify the project goal
and purpose
Increase employee
engagement, belonging
and loyalty
More focused, efficient and
valuable tasks delivery
Working load
1- fair roles &
responsibility distribution
Better performance and
more productivity
Improved quality of work
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Result Driven Improvement Plan (6 Months)
Objective 2 : To enhance the productivity level of employees by
addressing their individualized challenges:
Improvement area
Action
Expected outcome
High stress level
1- provide stress management
program
healthier work environment, More relaxed and
enhance employee wellcomfortable team
being, and improve overall
team performance.
Work-life balance
1- activate flexible hours and
working remotely
higher levels of employee
satisfaction, engagement,
and productivity
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Indicator
Decrease in complaints,
timeout and off days
Best Practice To Enhance Team Performance
1.
Delegation
2.
Make Decisions Together
3.
Avoid Micromanagement
4.
Effective Communication
5.
Giving Feedback
6.
Having a Purpose
7.
Authenticity
8.
Pursue Clear, Attainable Goals
9.
Support Professional Development
10. Set an Example
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References
• Engaging Employees in Their Health and Wellness. (2021, May 5). https://www.cdc.gov/workplacehealthpromotion/initiatives/resource-center/case-studies/engage-employees-healthwellness.html
• Ficapal-Cusí, P., Enache-Zegheru, M., & Torrent-Sellens, J. (2021). Enhancing team performance: A multilevel model. Journal of Cleaner Production, 289, 125158.
https://doi.org/10.1016/j.jclepro.2020.125158
• Gragnano, A., Simbula, S., & Miglioretti, M. (2020). Work–Life Balance: Weighing the Importance of Work–Family and Work–Health Balance. International Journal of Environmental
Research and Public Health, 17(3), 907. https://doi.org/10.3390/ijerph17030907
• How to Improve Your Team’s Performance | HBS Online. (2020, March 26). Business Insights Blog. https://online.hbs.edu/blog/post/how-to-improve-team-performance
• Jensen, S. M., & Luthans, F. (2006). Entrepreneurs as authentic leaders: Impact on employees’ attitudes. Leadership & Organization Development Journal, 27(8), 646–666.
https://doi.org/10.1108/01437730610709273
• Lacerda, S. S., Little, S. W., & Kozasa, E. H. (2018). A Stress Reduction Program Adapted for the Work Environment: A Randomized Controlled Trial With a Follow-Up. Frontiers in
Psychology, 9, 668. https://doi.org/10.3389/fpsyg.2018.00668
• Ledikwe, J. H., Kleinman, N. J., Mpho, M., Mothibedi, H., Mawandia, S., Semo, B., & O’Malley, G. (2018). Associations between healthcare worker participation in workplace wellness
activities and job satisfaction, occupational stress and burnout: A cross-sectional study in Botswana. BMJ Open, 8(3), e018492. https://doi.org/10.1136/bmjopen-2017-018492
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For this assignment, you will reflect on your own values and beliefs and how they connect to nursing theory. This assignment will consist of three parts:
Part 1: Your Personal Values and Beliefs
Discuss your overall enduring values and beliefs that brought you to nursing
Describe how your values align with values important to nursing
Describe philosophical perspectives, religious views, and/or writings/works of scholars other than nursing theorists that have served as guides for your value/belief formulation
Part 2: Connection to Nursing Theory
Select a nursing theory that aligns with your beliefs and complete the following:
Provide a description, analysis, and evaluation of the theory using the criteria from Box 5-3 on page 107 in your textbook (Synthesized Method for Theory Evaluation)
Describe how your philosophical values and beliefs align with a nursing theory **NOTE: Please do not provide merely a description of the nursing theory. You MUST explain how that theory aligns with your beliefs.
Part 3: Connection to Jesuit Educational Themes/Values
Discuss how the Jesuit educational themes in the Kolvenbach and the values discussed in “Lighting The Way” will impact or can be integrated into your philosophy of nursing (You can access the articles under the “Read” section)
In this assignment, please also include an introduction and a concluding paragraph.
Write a formal APA paper with the following instructions:
Review the National Quality Strategy (NQS)Links to an external site.
Discuss the three aims of the NQS.
Discuss why technology is an essential aspect of the plan.
Discuss the positive and negative impacts related to healthcare information technology.
This paper should be between 2-4 pages in length and include:
a title page
an introduction and conclusion
in-text citations
references that include at least three scholarly, credible sources to support your topic
No abstract is needed
Title and references pages do not count in the page total
This assignment is a video using a Power Point presentation. Videos can be recorded using any software or tool, but all videos are required to be uploaded to My Panopto Videos for assignment submission. Again save as an MP4 file.
Ethical Issues Debate Question: When a patient is in the end-of-life decision, should food or water be withheld?
Position: Against that statement
Once you receive your topic and position, prepare to create a video that will be due in Week 5. Save as an MP4 file otherwise, I will not be able to open it.
The video should be 4-5 minutes long and address the topic and viewpoint you were assigned.
You may not be personally in support or opposition of the topic, however it is your job to convince your peers of your position. Include evidence that supports the viewpoint.
Include an introduction to the issue, your stance, the rationale for the stance, the ethical principals involved, theories and evidence supporting your position, and your proposed resolution. Review the rubric in this forum for complete grading criteria.
Your video should include both audio and visual components such a graphics or charts. You can choose to do a PowerPoint, yourself on video with a poster or visual aids, or anything that supports and convinces your peers of your stance.
Get creative! Be succinct but convincing. If you go over the time limit, you will only be graded on the first 5 minutes.
Assignment Rubric DetailsCloseRubricNURS_510_DE – Ethical Issues Debate Project
NURS_510_DE – Ethical Issues Debate Project
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeWeek 5 Video Overall Presentation
20 to >16.4 ptsAccomplished (80-100%)Presentation is well organized and approximately 4-5 minutes in length. Audio is clear and reasonably paced. Visual component compliments audio component. Discussion reflects an atmosphere of mutual respect. 16.4 to >15.0 ptsEmerging (60-79%)Presentation is fairly organized, but there are several areas of improvement. Presentation is less than 4-5 minutes in length and some areas are not addressed. Audio needs some improvements. Visual component needs work. Discussion reflects an atmosphere of mutual respect. 15 to >0 ptsUnsatisfactory (0-59%)Presentation is unorganized and lacks structure. Presentation is extremely limited. Audio is absent or needs significant improvements. Visual component is absent or severely lacking.
20 pts
This criterion is linked to a Learning OutcomeWeek 5 Video: Ethical Issues, Concern, & Proposed Resolution
60 to >49.2 ptsAccomplished (80-100%)There is a clear description of the ethical issue including a proposed resolution. The issue topic is a current issue of debate and related to health care. The issue has a clearly defined dilemma with more than one resolution. Ethical principles and theories involved with the ethical issue are clearly identified and explained. 49.2 to >45.0 ptsEmerging (60-79%)Description of the ethical issue, the dilemma, and/or proposed resolution is lacking some details and relevant information. 45 to >0 ptsUnsatisfactory (0-59%)Description of the ethical issue, the dilemma, and/or proposed resolution is absent or severely lacking.
60 pts
This criterion is linked to a Learning OutcomeWeek 5 Video: Supporting Argument/Stance
40 to >32.8 ptsAccomplished (80-100%)Supporting argument is well developed either for or against the issue. Factors supporting the stance are well identified. Ethical principles and theories involved with the ethical issue are clearly identified and explained and in alignment with the viewpoint. 32.8 to >30.0 ptsEmerging (60-79%)Proposed resolution supporting your argument is not well defined. Key stakeholders and factors supporting your resolution are not clearly identified. 30 to >0 ptsUnsatisfactory (0-59%)Proposed resolution supporting your argument is absent or ill defined. Key stakeholders and factors supporting your resolution are absent or poorly identified.
40 pts
This criterion is linked to a Learning OutcomeWeek 6 Rebuttal
40 to >32.8 ptsAccomplished (80-100%)Rebuttal to classmate’s post is complete and includes key points including stakeholders, essential factors, and important facts supporting the resolution. The rebuttal reflected an atmosphere of mutual respect. Policy drivers and ethical principles involved are clearly identified and explained in support or opposition of the resolution. 32.8 to >30.0 ptsEmerging (60-79%)Rebuttal to classmate’s post is incomplete and missing some key points regarding stakeholders, essential factors, and important facts supporting the resolution. Policy drivers and ethical principles involved are not clearly identified and explained in support or opposition of the resolution. 30 to >0 ptsUnsatisfactory (0-59%)Rebuttal to classmates’ post is absent or largely incomplete. Key points regarding stakeholders, essential factors, and important facts supporting the resolution are absent or severely lacking. Policy drivers and ethical principles involved and in support or opposition of the resolution are absent or severely lacking.
40 pts
This criterion is linked to a Learning OutcomeWeek 6 Rebuttal: Participation
40 to >32.8 ptsAccomplished (80-100%)The minimum number of postings were met. The student followed netiquette in addition to the posting timeframe to contribute throughout the week. 32.8 to >30.0 ptsEmerging (60-79%)Less than the minimum number of postings were evident. The student mostly followed netiquette and met most of the posting timeframe to contribute throughout the week. 30 to >0 ptsUnsatisfactory (0-59%)There was a severe deficit in contribution. Less than the minimum number of postings were evident. The student did not follow netiquette and did not meet the participation requirements.
40 pts
Create a PowerPoint presentation that reviews four peer-reviewed articles written in the last five years on the issues around the adoption of eHealth in the Kingdom
Unformatted Attachment Preview
eHealth Adoption (105 points)
Create a PowerPoint presentation that reviews four peer-reviewed articles written in the last five years on
the issues around the adoption of eHealth in the Kingdom. Your presentation should contain the following
concepts. Discuss at least 4 of the following perceptions that physicians may have that could be causing
them to hesitate in using this technology.
• Usefulness
• Technical support available
• Increased workload
• User-friendly technology
• Staff attitudes
• Cost
• Patient privacy
Your presentation should meet the following structural requirements:
• Be 12 slides in length, not including the title or reference slides.
• Be formatted according to Saudi Electronic University and APA writing guidelines.
• Provide support for your statements with citations from a minimum of six scholarly articles. These
citations should be listed in the Notes section of the slide in which they appear. Two of these
sources may be from the class readings, textbook, or lectures, but four must be external.
• Each slide must provide detailed speaker’s notes to support the slide content. These should be a
minimum of 200 words long (per slide) and must be a part of the presentation. The presentation
cannot be submitted in PDF format, which does not make notes visible to the instructor. Notes
must draw from and cite relevant reference materials.
• Utilize the following headings to organize the content in your presentation:
• Introduction
• 4 of the above topics as 4 slides
• Cultural, Social, or Religious Barriers
• Recommendations for KSA
• Conclusion
Chapter 6:
Application
Systems and
Technology
Introduction
• Applications and technology are needed to
support Health Information Systems (HIS)
– Applications involve an understanding of the
Software Development Life Cycle (SDLC),
programming languages, clinical and business
applications, integration, and databases.
– Technology includes infrastructure, networks,
servers, desktops, data centers, mobile and cloud
computing, and many other areas
HIS Applications
• Programming languages
• Databases
• Vendor applications
– Commercial off-the-shelf (COTS)
– Best-of-breed
HIS Applications
• Software Development Life Cycle (SDLC)
methodology stages
– Conceptual planning
– Planning and requirements definition
– Design
– Development and Testing
– Implementation
– Operations and Maintenance
– Disposition
HIS Applications
Software Development Life Cycle
HIS Applications
• Application interfaces
– Can bridge disparate systems
– Create silos
– Difficult and complex to maintain
• Application integration
– Allows data to be shared between disparate
systems
– Uses a common data elements and database
Clinical Applications
• A clinical application is defined as any system
that supports clinical care (e.g., electronic
health record systems), ancillary clinical
support processes (e.g., laboratory testing,
radiology), clinicians (e.g., computerized
physician order entry, clinical decision
support) and patient flow (e.g., registration,
scheduling).
Clinical Applications
• Types of clinical applications
– Electronic health records (EHRs)
– Clinical information systems (CISs)
– Laboratory information systems (LISs)
– Pharmacy information systems (PISs)
– Medication administration records (MARs)
– Computerized physician order entry (CPOE)
Clinical Applications
• Types of clinical applications
– Radiology information systems (RISs)
– Medical imaging systems (MISs)
– Picture archive communications systems (PACSs)
– Outpatient systems
– Personal health records (PHRs)
– Long-term care systems (LTC)
• Figure 6.x summarizes the key CIS applications
Clinical Applications
Healthcare Provider Technology Adoption Map
Data from IDC Health Insights, Nov 15, 2010.
Administrative Applications
• Administrative and financial applications
– Enterprise resources planning (ERP) systems
– Customer resource management (CRM) systems
– Supply chain management (SCM) systems
• Other applications
– Home health care
Case Example: A Ticket to Ride
• Background
• Problem that needed to be solved
• The solution
• Results of the pilot
Technology
• Robust data communications is needed to
support HIS applications
• Two key areas of technology for supporting
voice and data
– Telecommunications
– Networking
Telecommunications and Networking
• Telecommunications
– The electrical transmission of data among
systems, whether through analog, digital, or
wireless media
• Data communications networks components
– Server
– Client
– Circuit
Types of Networks
• Four types of networks
– Local area networks (LANs)
– Backbone networks (BNs)
– Metropolitan area networks (MANs)
– Wide area networks (WANs)
• Two classifications of networks
– Intranets
– Extranets
Network Models
• Open systems interconnection (OSI) model
• Internet model
• The Seven Layers of the OSI Model
– Physical layer
– Data link layer
– Network layer
– Transport layer
– Session layer
– Presentation layer
– Application layer
Network Models
• The four layers of the Internet model
– Network group layer
– Internet group layer
– Transport group layer
– Application group layer
• Understand how the various layers function
when a user sends an email message to
another user
Network Models
(a). The seven layers of the OSI model and (b). The four layers of the Internet model.
Data from Hitchcock (May 8, 2008). OSI Reference Model: Layer 1 Hardware. http://www.windowsnetworking.com/articles-tutorials/common/OSI-Reference-ModelLayer1-hardware.html. Accessed March 10, 2014.
Local Area Networks
• Two primary uses of LANs
– Information sharing
– Resource sharing
• Important LAN components
– Network interface cards (NICs)
– Copper and fiber-optic cables
– Switches, hubs, patch panels
– intermediate distribution frames (IDFs)
– main distribution frames (MDFs)
– virtual local area networks (VLANs)
Wireless LANs
• Wireless local area networks (WLANs)
– Fast-growing network technology
• WLAN components
– wireless access points (WAPs)
– radio frequencies (RFs)
– power-over-Ethernet (POE) switches
• WLAN benefits and challenges
Wide Area Networks
• Wide area networks (WANs)
– Connect users on LANs to other LANs or other
WANs
– Largest WAN today is Internet
– Bandwidth is key
• Types of WAN circuits
– T1 lines
– asynchronous transfer mode (ATM) lines
– multiprotocol label switching (MPLS) circuits
Wireless Wide Area Networks
• Wireless wide area networks (WWANs)
– Provide service to large geographic areas called cells
– Also called broadband or cellular networks
• Three families of WWANs
– GSM and UMTS
– CDMA One, CDMA2000, and WCDMA
– WiMAX and LTE (3G, 4G, 5G, etc.)
• Distributed antennae system (DAS)
– Useful for increasing in-building RF coverage
Storage Area Networks
• Storage area networks (SANs)
– are dedicated back-end computer systems
designed to efficiently and cost-effectively store
and transfer a healthcare organization’s server
data
• Two types of SANs
– Fiber channel (FC) SANs
– Network attached storage (NAS)
Storage Area Networks
• Redundant array of independent drives (RAID)
configurations
– RAID 1 (mirrored disks)
– RAID 5 (with or without a hot spare)
– RAID 10
• SAN protocols
– Ethernet (also referred to as IP)
– Fiber Channel
– Fiber Channel over Ethernet (FCoE)
– Internet Small Computer System Interface (iSCSI)
Voice and Communications
• Voice technologies
– Voice over Internet Protocol (VoIP)
– Voice over wireless local area network (VoWLAN)
• Unified communications (UC) technologies
– Instant messaging and presence
– VoIP and VoWLAN
– Video and web conferencing
– Digital signage and wayfinding
– Internet Protocol (IP) television (IPTV)
Voice and Communications
VoWLAN Protocol
Data Centers and Cloud Computing
• Three important data center trends
– Co-location or leased facilities
– Data center consolidation
– Cloud computing or hosted infrastructure
• Types of cloud computing in health care
– Infrastructure-as-a-service (IaaS)
– Platform-as-a-service (PaaS)
– Software-as-a-service (SaaS)
– EMR-as-a-service (EaaS)
Data Centers and Cloud Computing
• Data center facilities critical components
– Electricity or utility power
– Power distribution units (PDUs)
– Remote power panels (RPPs)
– Generators
– Uninterruptable power supply (UPS) or flywheeldriven continuous power source (CPS) systems
– Heating, ventilating, and air-conditioning (HVAC)
systems
Data Centers and Cloud Computing
Cloud Computing Components
Data from Venture Beat News. Cloud 101: What the heck do IaaS, PaaS and SaaS companies do? http://venturebeat.com/2011/11/14/cloudiaas-paas-saas/. Accessed March 10, 2014.
Data Centers and Cloud Computing
• Data center facilities critical components
– Computer room handlers (CRAH)
– Chillers
– Fire suppression systems
– Very early smoke detection apparatus (VESDA)
– Emergency power off (EPO) switch
– Branch circuit monitoring system (BCMS)
– Data center management system (DCMS)
Data Centers and Cloud Computing
Data Center Management Systems Components
Emerging Cloud Technologies
• Software Defined Networking (SDN)
• Network Functions Virtualization (NFV)
• Hyper Converged Infrastructure (HCI)
Business Continuity and Disaster
Recovery
• Business continuity (BC)
– Describes the processes and steps a healthcare
organization puts in place to ensure that its
essential business functions will continue during
and after a disaster
• Disaster recovery (DR)
– Comprises the planning, process, policy, and
procedures undertaken to prevent interruption of
mission critical IT services, and to reestablish full
IT functioning as swiftly and smoothly as possible.
Business Continuity and Disaster
Recovery
• Elements of BC plan (BCP) and DR plan (DRP)
– BCP and DRP assessment
– Recovery time objectives (RTOs)
– Recovery point objectives (RPOs)
• Backup systems
– Tape-based backup systems (DLT or LTO)
– Disk-based backup systems
– Virtual tape libraries (VTLs)
Business Continuity and Disaster
Recovery
• Redundancy within the data center
– Applications, servers, storage, and the network
– Clustering and load balancing
• Redundancy between the data centers
– Cold sites
– Tepid sites
– Warm sites
– Hot sites
Server Computing
• Servers
– Are specialized computers that are designed to
process or “serve” computing requests, such as
requests for database information, application
processing, or file transfers and storage
• Server components
– Central processing units (CPUs)
– Random access memory (RAM)
– Input/output (I/O) and internal bus systems
– Keyboard, video, and mouse over IP (KVMoIP)
– Access to storage, network, and backup systems
Server Computing
Data Center Class Servers
Courtesy of James W. Brady.
Server Computing
• Physical server types
– Rack mounted and blade servers
– Appliances
• Virtual server elements
– Hypervisors or virtual machine monitors (VMMs)
– Virtual machines (VMs)
– Logical partition arrays (LPARs)
• Server classifications
– Test, development, and production servers
Server Computing
Diagram of a Virtualized Server
Data from Nash Networks, Inc. (2009). Virtualization: A small business perspective. Executive Summary.
http://www.nashnetworks.ca/virtualization-a-small-business-perspective.htm
Infrastructure Servers
• Important infrastructure servers
– Dynamic Host Configuration Protocol (DHCP)
servers
– Domain Name System (DNS) servers
– Active Directory (AD) servers
– Identity and access management (IAM) servers
– Enterprise monitoring servers
Infrastructure Servers
• Important infrastructure servers
– Integration servers
– Systems management servers
– Database servers
– Enterprise web content management (EWCM)
servers
– Application virtualization servers
Client Computing
• Client computing
– Describes the computers and devices used by end
users
– Categorized as either stationary or mobile devices
• Stationary computers include
– All-in-one (AIO) computers
– Wall-mounted computers
– Thin- and zero-client computers
– Electronic tracking board systems
Client Computing
• Mobile computers include
– Workstations on Wheels (WOWs)
– Laptops
– Tablets
– Smartphones
• Miscellaneous client devices and peripherals
include
– Bar-code scanners, signature pads, printers, document
scanners, and identification (ID) badge and access
control systems.
Client Computing
• Important client computing technologies
– Printing
– Electronic document management (EDM)
– ID badge and access control systems
– Virtual desktop infrastructure (VDI), including
nonpersistent and persistent desktops
– Single sign-on (SSO) and “tap ‘n go”
Mobile Computing
• Emergence of mHealth and Bring Your Own
Device (BYOD) in health care
• Steps to develop a mobile computing strategy
– Identify the key stakeholders
– Create policies, procedures, and an end-user
acceptance agreement
– Understand regulatory, legal, and compliance
requirements
– Develop mobile management strategies
– Define the technical architecture
Information Security
• HIS data security
– Defines how users and computer systems should
behave to reduce risk to the organization
– Protects valuable assets from financial and
reputational loss
– A security program with updated policies and
corresponding controls needs to be in place
Information Security
• Important information security technologies
– Traditional and Next Generation (NG) firewalls
– Virtual private networks (VPNs)
– Data loss prevention (DLP)
– Encryption (at-rest and in-transit)
– Multi-factor authentication
– Security information event management (SIEM)
– System hardening, vulnerability assessments, and
penetration testing
– Managed security services
Summary
• HIS applications are critical for delivery of
quality patient care
• A robust technical infrastructure,
encompassing client, server, network, and
data center technologies is needed to support
HIS applications
• Healthcare is leveraging advances in mobile
and cloud technologies to provide secure
access to HIS applications
This assignment comes in 2 parts. Part 1 is for discussions and part 2 is an assignment. In part 1 each discussion should include 250-300 words to answer the selected topic. Each question will need 2 peer responses of 150 words an 1 reference. Part 1 Discussions:
Question 1: Identify one quality improvement strategy to improve health. How could you apply it to your current nursing practice? How does the assimilation of quality improvement strategies enhance leadership?
Question 2: With the rough draft of your nursing comparison paper due this week, a focused review of the basics of APA Style is important. After you have reviewed the WCU Library guides on APA, share something you learned with your peers. Also, attach examples from your rough draft that include both an in-text citation you used when you were paraphrasing and one you used when you were directly quoting. In addition, attach the reference page from your rough draft so that you can review each other’s work and provide peer-to-peer feedback.
Part 2: THIS PART OF THE DOCUMENT HAVE TO BE EXACTLY AS THE INSTRUCTOR DESCRIBED IT.
The purpose of this assignment is to draft and submit a comprehensive and complete rough draft of your Nursing Theory Comparison paper in APA style. Your rough draft should include all of the research paper elements of a final draft, which are listed below. This will give you an opportunity for feedback from your instructor before you submit your final draft during week 7.
Based on the reading assignment (McEwen & Wills, Theoretical Basis for Nursing, Unit II: Nursing Theories, chapters 6–9), select a grand nursing theory.
After studying and analyzing the approved theory, write about this theory, including an overview of the theory and specific examples of how it could be applied in your own clinical setting.
Based on the reading assignment (McEwen & Wills, Theoretical Basis for Nursing, Unit II: Nursing Theories, chapters 10 and 11), select a middle-range theory.
After studying and analyzing the approved theory, write about this theory, including an overview of the theory and specific examples of how it could be applied in your own clinical setting.
The following should be included:
An introduction, including an overview of both selected nursing theories
Background of the theories
Philosophical underpinnings of the theories
Major assumptions, concepts, and relationships
Clinical applications/usefulness/value to extending nursing science testability
Comparison of the use of both theories in nursing practice
Specific examples of how both theories could be applied in your specific clinical setting
Parsimony
Conclusion/summary
References: Use the course text and a minimum of three additional sources, listed in APA style
The paper should be 9–10 pages long and based on instructor-approved theories. It should be typed in Times New Roman with 12-point font, and double-spaced with 1″ margins. APA style must be used, including a properly formatted cover page, in-text citations, and a reference list. The proper use of headings in APA style is also required.
The theories selected are below.
For the comparison, I choose the Nightingale Environmental theory and the AACN Synergy Model for the grand and midrange theories. The two theories are important to me because the founder of modern nursing developed the Nightingale theory. Therefore, the theory provided the basis for future theories. It showed how nurses’ role should involve the manipulation of the environment to improve patient outcomes (McEwan & Wills, 2021). It recognizes nursing as a role that provides conducive environments for patients to recover. The AACN Synergy Model emphasizes aligning the competencies of nurses and the patient’s needs (McEwan & Wills, 2021). Therefore, the needs of patients should determine the skills that professionals will need to provide efficient care. The two theories look at nursing differently, and understanding them may help one understand how far the profession has come.
Reference
McEwan, M., & Wills, E. M. (2021). Theoretical basis for nursing. Lippincott Williams & Wilkins.
NURS_500_DE – Theory Comparison Paper Rubric
PLEASE READ THIS IMPORTANT INSTRUCTIONS. THIS PART OF THE DOCUMENT HAVE TO BE EXACTLY AS THE INSTRUCTOR DESCRIBED IT.
Example paper attached:
4 Example Grand and Middle Range Theories.docx Download 4 Example Grand and Middle Range Theories.docx
I want every one of you to be rewarded for your hard work on these papers. In order to get the best grade possible, please follow these instructions.
Step One- choose your theories. If they are listed in the reading, consider them approved, no need to send the request to me via the Journal area!!! (THEORIES HAVE BEED SUBMITTED AND APPROVED PREVIOUSLY.
Based on the reading assignment (McEwen & Wills, Theoretical Basis for Nursing, Unit II: Nursing Theories, chapters 6–9), select a grand nursing theory.
Based on the reading assignment (McEwen & Wills, Theoretical Basis for Nursing, Unit II: Nursing Theories, chapters 10 and 11), select a middle-range theory.
Please use these bold headings to organize your paper. You are simply comparing the two theories back and forth.
In your reading, you will find a thorough description of each component below and fully describes what you need to research about your chosen theories to fill in the section.
Introduction
Overview of your chosen grand theory
Overview of your chosen middle range theory
You will have a separate paragraph in each section, one for your grand range theory and one for your middle range theory.
Background of the theories
(Grand theory chosen)-
(Middle range theory chosen) –
Philosophical Underpinnings
(Grand theory chosen)-
(Middle range theory chosen) –
Major assumptions, concepts, and relationships
(Grand theory -)
(Middle range theory -)
Clinical applications
(Hint: usefulness/value to extending nursing science testability)
(Grand theory-)
(Middle range theory -)
Application to nursing practice
(Hint: Comparison of how to use of your theories in nursing practice)
(Grand theory-)
(Middle range theory -)
Application to my practice
(Hint: Specific examples of how both theories could be applied in your specific clinical setting)
Grand theory-
Middle range theory –
Parsimony
(Hint: how simple or complex are the theories?
Grand theory-
Middle range theory
Conclusion
Every formal paper must have a formulated conclusion!
Four References: Course text and a minimum of three additional sources.
The paper should be 9–10 pages long- not including your Cover and Reference pages.
Times New Roman,12-point font, and double-spaced with 1″ margins.
APA format (7th ed.) a properly formatted cover page and reference list. See the link below for 7th edition APA updates!
APA 7th Edition Update (1).pdf
IMPORTANT: Even though this is titled a rough draft- it means you will complete the entire paper- not just sections or outlines of the content. A completed paper- the more work you put into now, the better grade you will receive on the rough draft and you will have very little work to do on it when you submit your final paper in week 7.
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
90 to >73.8 pts
Meets Expectations
Content is clear, thorough, and organized effectively. Main points well supported. All specific portions of the assignment have been addressed. Meets all the criteria of the written assignment
73.8 to >67.5 pts
Approaches Expectations
Content is somewhat clear, thorough, and organized effectively. Most of the specific portions of the assignment have been addressed. Some points well supported. Meets most of the criteria of the written assignment
67.5 to >53.1 pts
Falls Below Expectations
Content is generally unclear, not thorough, and organized ineffectively. Some of the specific portions of the assignment have been addressed. Main points not well supported. Meets only a few of the criteria of the written assignment
53.1 to >0 pts
Does Not Meet Expectations
Content is generally unclear, not thorough, and organized ineffectively. Some of the specific portions of the assignment have been addressed. Main points not well supported. Meets only a few of the criteria of the written assignment
90 pts
This criterion is linked to a Learning OutcomeWriting Style
15 to >12.3 pts
Meets Expectations
Writing is professional with no spelling or grammatical errors and has been carefully proofread. Captures and maintains reader’s interest
12.3 to >11.25 pts
Approaches Expectations
Writing follows normal conventions and has minor spelling, punctuation and grammatical errors throughout. Efforts made to capture and maintain reader’s interest
11.25 to >8.85 pts
Falls Below Expectations
Writing does not consistently follow appropriate style of format with frequent spelling, punctuation and grammatical errors. Do not capture or maintain reader’s interest
8.85 to >0 pts
Does Not Meet Expectations
Writing does not consistently follow appropriate style of format with frequent spelling, punctuation and grammatical errors. Do not capture or maintain reader’s interest
15 pts
This criterion is linked to a Learning OutcomeClarity & Coherence
22.5 to >18.45 pts
Meets Expectations
Writing flows smoothly from one idea to another. Writer has taken pains to assist the reader in following the logic of the ideas expressed
18.45 to >16.88 pts
Approaches Expectations
Sentences are mostly structured to communicate ideas clearly. Transitions between paragraphs make the writer’s points easy to follow
16.88 to >13.27 pts
Falls Below Expectations
Sentence structure and word choice sometimes interferes with clarity of content and distracts the reader
13.27 to >0 pts
Does Not Meet Expectations
Poor sentence structure, sentences do not make sense to the reader, no clarity evident in the paper
22.5 pts
This criterion is linked to a Learning OutcomeReferences
7.5 to >6.15 pts
Meets Expectations
References included throughout paper in APA format
6.15 to >5.63 pts
Approaches Expectations
References included throughout paper but not all are in APA format
5.63 to >4.43 pts
Falls Below Expectations
References included but unclear which references are direct quotes and which are paraphrased
4.43 to >0 pts
Does Not Meet Expectations
No references included in the body of the paper and writing indicates none were used
7.5 pts
This criterion is linked to a Learning OutcomeCover page & Reference Page
7.5 to >5.93 pts
Meets Expectations
Cover page and reference page are in APA format with appropriate number of references included
5.93 to >5.63 pts
Approaches Expectations
Cover page and reference page are in APA format with some references included
5.63 to >4.43 pts
Falls Below Expectations
Cover page and reference age are mostly in APA format with few references included
4.43 to >0 pts
Does Not Meet Expectations
Cover page and reference page are not in APA format or no cover or reference page included
7.5 pts
This criterion is linked to a Learning OutcomePresentation
7.5 to >5.93 pts
Meets Expectations
Paper is presented professionally, word –processed, double spaced, 12 point font, 1” margins on all sides
5.93 to >5.63 pts
Approaches Expectations
Paper is word- processed but contains only minimal errors in spacing, font or margins
5.63 to >4.43 pts
Falls Below Expectations
Paper is word-processed but does not appear professional with errors in two areas of spacing, font or margins
4.43 to >0 pts
Does Not Meet Expectations
Paper is word-processed but does not appear professional with errors in all area of spacing, font or margins, or it is hand-written
7.5 pts
Total Points: 150
Unformatted Attachment Preview
1
Grand and Middle Range Theory Review
Student Name
West Coast University
NURS 500; Theoretical Foundations of Nursing
Dr. Kendrick
Date
2
The purpose of this paper is to review two selected nursing theorist one grand and one
middle range theory. Throughout this paper the grand theory of Florence Nightingale’s
environmental theory and the middle range theory of Kristen Swanson’s theory of caring will be
discussed, reviewed, and compared.
Florence Nightingale’s environmental theory has five important elements, pure water,
pure air, efficient drainage, light and cleanliness. Thus, producing a healthy atmosphere crucial
for healing (Zborowsky, 2014). Her theory in considered a grand theory because it has a broad
scope. It presents general concepts that are good for directing, explaining, and predicting nursing
situations (McEwen & Wills, 2017). The grand theories are relevant to all areas of nursing yet
may not be beneficial to detailed research questions because of its broad scope.
Kristen Swanson’s theory of caring is a middle range theory with five caring processes,
knowing, being, doing, enabling, and maintaining belief (Jarvis, 2019). This theory supports
nursing care as a process that develops from the nurses’ beliefs, knowledge, and relationship with
the patient. This is a middle range theory that is narrower in scope than grand range theories and
assist in guiding nursing practice and research (McEwen & Wills, 2017). Middle range theories
are therefore more straight forward and limited to an area of practice. Swanson’s theory
originated around pregnancy issues.
Background
According to Zborowsky (2014). Florence Nightingale was born on May 12, 1820 in
Florence Italy. She was born into an affluent family however never felt comfortable with
socializing. She had a classical education and early on was interested in ministering to the poor
and ill. She felt nursing was her purpose and calling. Her parents were not supportive of her
desire to pursue nursing training. In 1851, she received her educational and clinical training in
3
Germany. In 1854 she served as a nurse in the Crimean war, then went to London. There she was
awarded money from the British government. She took that money and started a school for
nurses in 1860. Her goal was to teach what was needed to be done and how to do it. She also
taught about symptoms of diseases and what they meant. In 1859, her famous book, Notes on
Nursing, was published she distinguished nursing separate from medical knowledge and taught
on the purpose of nursing duties (McEwen & Wills, 2017). She improved statistics analysis with
her observations and aided the military hospitals in efficient restructuring of services. She died
August 13, 1910 spending her life preventing disease and providing safe and compassionate care
to the impoverished and suffering. Florence Nightingale has been seen as the originator of
nursing theory and certainly one of the most prominent nurses throughout history (Zborowsky,
2014).
Kristen Swanson was born January 13th, 1953 and received her baccalaureate degree in
1975 from the University of Rohde Island. In 1978 she received her master’s degree in nursing
from the University of Pennsylvania and then her Ph.D. from the University of Colorado
(Swanson, 1991). According to Amendolair (2012), her doctoral dissertation was focused on
caring for patients having a miscarriage (spontaneous abortion). She was influenced by Dr. Jean
Watson’s grand theory of Human Caring Theory developed in 1970. Then in 1991 Swanson
developed her theory encompassing the five processes of caring. She was also interested in
socially at-risk mothers. Currently she is the Dean and Professor at the Seattle University
College of Nursing and is on the board of the American Association of Colleges of Nursing
(AACN). Her theories help patients deal with miscarriages and cover helpful counseling, her
theories encompass physical and emotional healing. She is also an alumnus of the Robert Wood
Johnson Executive Nurse Fellows Program, this is a progressive leadership resource for nurses in
4
upper level administrative roles who purpose to lead changes in the United States healthcare
system (Swanson, 1991).
Philosophical Underpinnings
According to McEwen & Wills (2017) Florence Nightingale theory is thought to be a
wide-range viewpoint yet her work is a foundational philosophy. Her fundamental principle was
healing and consequent to it are the principles of leadership and worldwide action. Together
these principles are needed to provide healing. The environmental theory has inspired the nursing
profession and education for over 150 years. Nightingale did not think that nurses were meant to
be submissive to doctors. She saw nursing as an individual vocation all its own.
Florence Nightingale’s educational model teaches nurses to be aware of patients’ needs, meet
patients’ needs and know how to carry out the professional actions of a nurse. Nightingale’s
philosophy came about over years of providing nursing care and study. It is an intellectual and
factual philosophy and is categorized as a grand theory.
The philosophical underpinnings and contributions of Swanson’s theory of caring can
also be reviewed by the four concepts of the nursing metaparadigm, person, health, environment,
and nursing (Jarvis, 2019). The person being the most essential part of Swanson’s theory this
emphasis on the caring process as the philosophical underpinnings. The viewpoint of Swanson’s
theory is that nurses are educated through scientific information and learning through clinical
practice, humanities and cultural values (Peterson & Bredow, 2019). Each person is unique and
made up of their own feelings, ideas and behaviors. The nurse not only addresses the patient but
family and society. The environment should be therapeutic for the patient. The concept of caring
especially in the instance this theory was derived, is clearly powerful and beneficial to the
wellbeing of the patient both physically and emotionally.
5
Major Assumptions, Concepts, and Relationships
Florence nightingale’s theory has the straightforward and understandable ideas of health
and wellness. She also defines it as “the act of utilizing the environment of the patient to assist
him in his recovery” (Nightingale, 1992, p.41). Therefore, the environment is an external factor
that can affect the patient’s health. The five environmental factors are the foundation of the
theory. The nurse is accountable to adapt and assess the environmental setting so that it will
improve the patient’s health. The concepts of Nightingales’ theory are fresh air, pure water,
effective drainage, cleanliness, and light (Zborowsky, 2014). According to Selanders & Crane
(2012) the concepts can be branched out into heading that expand on the five environmental
factors. First the health of the house, construction should ensure air is not stagnant. Next
ventilation and warming, supplying fresh air without odors. Then the need for direct sunlight and
a quiet environment, never waking a patient intentionally. Variety is expanded upon as
Nightingale would rotate paintings, provide activities, and read and write with the patient so they
were not bored. The bed and sheets were to be in the sun light and the bed not to be shaken or sat
on. Personal cleanliness is encouraged as the nurse is to wash her hands often. Nutrition was
encouraged in small frequent feedings and the nurse was not to distract them when they were
eating. Socially is was encouraged to support the patient and talk with them. Nightingale wrote
over 150 books and reports on healthcare topics and she is credited with producing one of the
first forms of the pie chart. Hospitals are cleaner because of Nightingales early work and
education of nurses, making them a safer place to be.
Swanson’s theory of caring is based on her research and practice. According to
Amendolair (2012) Swanson classified five activities that nurses used to improve patient care
and meet their needs. These practices include knowing, being with, doing for, enabling, and
6
maintaining belief. To improve nursing care and foster the patients’ health both physically and
emotionally, the nurse incorporates these five activities and makes a personal, patient centered
plan of care. In doing this the nurse also expresses dignity and importance of the patient.
Swanson focused on pregnancy issues in her theories and reports that nurses are natural
caregivers. Her theories have been used in obstetric education. The caring theory’s first
component of caring is knowing, here the nurse avoids assumptions, does a detailed assessment
and looks for cues. Being with, denotes enduring with the patient, sharing, but not burdening the
patient. Doing for, is comforting, protecting, anticipating needs, and preserving the patient’s
dignity. Enabling or informing, would be validating the patient’s feelings, advocating, explaining
and giving back. In maintaining belief, the nurse would offer realistic hopefulness, believing in
the patient and helping the patient to find meaning. In practice the nurse should utilize all five
caring process steps. Swanson is still practicing and publishing today using her theories to
improve healthcare and nursing.
Clinical Applications
The clinical applications of Florence Nightingales’ environmental theory put the
responsibility of the patient on the nurse’s assessment skills and ingenuity. Even though the nurse
can be busy and have many sick patients it is their responsibility to prevent bedsores, report and
treat a fever, make sure the patient is nourished and warm and monitor their vital signs, lab
results and environment for safety. The nurse should identify and reduce patient distress. She
called nursing an art not a science and detailed many nursing tasks are still pertinent today
(McEwen & Wills, 2017). Research today has reinforced her ideas on noise in the patient care
area and environmental cleanliness and safety (McEwen & Wills, 2017). Therefore, today the
clinical application of Nightingales theory stands true in healthcare and has stood the test of time.
7
Swanson theory of caring includes physical and emotional care for women who have
miscarried, neonatal intensive care unit (NICU) caregivers, and mothers considered socially at
risk (Jarvis, 2019). According to Kavanaugh, Moro, Savage, and Mehendale (2006) her clinical
applications are relevant not only within those specific care settings but also in other delicate
topics that involve vulnerable patients. This includes parents who had suffered the death of their
infant or were engaged in making a life support decision because of possibly giving birth to a
very premature infant less than 26 weeks gestation. In this study the caring characteristics and
the trusting relationship that was formed by following Swanson’s caring theory produced a more
productive and positive outcome perceived by the patient. Therefore, the clinical applications of
Swanson’s caring theory are relevant and remain useful in clinical practice.
Application to Nursing Practice
An example of how Florence Nightingale’s theory is used today in nursing practice
would include advocacy. Nursing is a complex profession and although Nightingale did not
address specifically nurse advocacy, all her theories support this idea. In her publications she was
a voice advocating for equal human rights, involving religion, sex, status, and the right to a
peaceful death (Selanders & Crane, 2012). In this way Nightingale was ahead of her time and
remains relevant today. In her environmental theories a good example of an application today
could be seen in home health evaluations and care. Nurses are trained to look for unhealthy and
unsafe living conditions, identify them and improve them. This would be the approach set forth
in Nightingale’s theory.
In Swanson’s theory of caring the successful use of the five caring processes, knowing,
being, doing, enabling, and maintaining belief would help a family cope after a miscarriage
(Jarvis, 2019). The first thing a nurse would do is to give compassion, provide time and space for
8
the family and be a good listener when they talk. Form a patient nurse relationship, touch her
hand, and let her know how sorry you are for their loss. Assist the patient and encourage them to
do what they normally do for themselves and provide privacy. Placing a rose or a sign on the
door that fetal demise has happened to alert staff to be respectful and sympathetic. Provide a
journal for the family to write down their feelings, information on the healing process, and
support groups. Lastly provide closure by offering the family to hold the baby. Step by step
going through the process will provide support for the family and will help the grieving patient
move on.
Application to My Practice
In my nursing practice Nightingale’s theory is very relevant. Working with the elderly I
encourage sunlight and walks outside on sunny days. I urge patients to eat healthy and offer
healthy snacks. I am assessing the situation and environment to improve the comfort of the
patient and safety of the environment to prevent injuries. The room must be kept clean and
orderly, and patients have the option to request a quiet room at night, and not be disturbed.
Patients are also engaged during the day with activities and religious services. This theory
provides patients with a happy and healthy living environment.
Swanson’s theory of caring in my practice is useful although I could only find one
reference to this theory in the elderly. I know I have used the process with grieving patients or
patients that have received a poor prognosis. According to Yin-Tzu, Sin-Rong, and Chi-Yin
(2019) utilizing the five steps in an elderly patient with vasculitis, unable to walk and delayed
discharge from the hospital provided the patient with hope and positive beliefs about the future.
When disease and lack of mobility in the elderly cause a feeling of hopelessness, working
9
through the five steps of caring is a way to form a trusting and caring relationship with a patient
and provide emotional support.
Parsimony
Nightingale concisely stated how important the environmental theory was to care for sick
patients. She has condensed her thoughts into small volumes and included information about
nursing treatment, patient needs, good structures where the patients can be treated, and the
management of hospitals (McEwen & Wills, 2017).
Understand parsimony is to observe that the description with the least number of steps is
often the strongest. Swanson’s theory can be simplified into two steps, see figure 1. The five
steps of her theory can be condensed to maintain the parsimony of her idea: nursing philosophies
and experience nursing will produce acts of caring and in the end, patient wellbeing (Swanson,
1993).
Conclusion
This review and assessment have been an opportunity for me to understand and be
grateful to the nurse theorist who have made such a vast contribution to the nursing profession
and healthcare industry. Nightingale theory is developed around simple and familiar concepts
that are easy to utilize and practice. Today healthcare has so many amazing advancements and
technology, yet if Nightingale’s basic principles are followed disease will be prevented.
Likewise, Swanson’s theory has a simplicity of caring that is clearly healing when a patient is
hurting physically and emotionally. The caring theory of being emotionally present for the
patient, respecting the patient’s dignity, maintaining a knowledgeable practice, being objective
and meeting the needs of the patient as a unique person, gives patients the ability to express
10
themselves and improve their wellbeing. This piece has encouraged me to further understand
nursing theory and improve my nursing care and make it more of an art.
References
Amendolair, D. (2012). Caring Model: Putting research into practice. International Journal of
Human Caring, 16(4), 14-21. DOI:10.20467/1091-5710.16.4.14
Jarrin, O. F. (2007). An integral philosophy and definition of nursing. School of Nursing
Scholarly Works. 47. https://opencommons.uconn.edu/son_articles/47
11
Jarvis, K. (2019). Swanson’s theory of caring: An application to the role of nursing
Education. International Journal for Human Caring, 23(3), 266-271. DOI:
10.20467/1091-5710.23.3.266
Kavanaugh, K., Moro, T. T., Savage, T., & Mehendale, R. (2006). Enacting a theory of caring to
recruit and retain vulnerable participants for sensitive research. Research in Nursing &
Health, 29(3), 244-252. https://pubmed.ncbi.nlm.nih.gov/16676343/
McEwen, M., & Wills, E. M. (2017). Theoretical basis for nursing. Lippincott Williams &
Wilkins.
Nightingale, F. (1992). Notes on nursing: What it is, and what it is not. Lippincott Williams &
Wilkins.
Peterson, S., & Bredow, T. S. (2019). Middle range theories: Application to nursing research and
practice. Lippincott Williams & Wilkins.
Selanders, L., & Crane, P. (2012). The voice of Florence Nightingale on advocacy. The Online
Journal of Issues in Nursing, 17(1). https://pubmed.ncbi.nlm.nih.gov/22320877/
Swanson, K. M. (1991). Empirical development of a middle range theory of caring. Nursing
Research, 40(3), 161-166. https://pubmed.ncbi.nlm.nih.gov/2030995/
Wojnar, D. M., & Swanson, K. M. (2007). Phenomenology: An exploration. Journal of Holistic
Nursing, 25(3), 172-180. DOI:10.1177/0898010106295172
Yin-Tzu Chen, Sin-Rong Lin & Chi-Yin Kao. (2019). Applying Swanson’s theory of caring to
manage powerlessness in an older patient with vasculitis. Journal of Nursing, 66(3), 112–
119. DOI: 10.6224/JN.201906
Zborowsky, T. (2014). The legacy of Florence Nightingale’s environmental theory: Nursing
research focusing on the impact of healthcare environments. HERD: Health
12
Environments Research & Design Journal, 7(4), 19-34.
https://doi.org/10.1177/193758671400700404
13
Swanson’s Theory of Caring
Figure 1. The Structure of Caring displayed in its original format from Swanson (1993) “Nursing
as Informed Caring for the Well-Being of Others”, (p.355).
Identify a vulnerable population and a specific health disparity prevalent in the Kingdom of Saudi Arabia.
Unformatted Attachment Preview
Module 6
HCM550
Healthcare Policy
Analysis and
Development
Instructor Name
Module 6 Learning Outcomes
1. Evaluate the moral duty to provide care, coupled with the need for
funding and regulation.
2. Evaluate the vulnerability of a person/population to experience harm
due to a lack of access to the means of a healthy life.
3. Compare and contrast various healthcare fields in need of regulation.
4. Assess the moral obligation of high-income countries to help mitigate
the disease burden in low-income countries.
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
The Healthcare Workforce
• Shortages
• Data and monitoring
• The right mix
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
Expanding Non-physician Roles
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
Nurses
• Prominent role
• Nurse practitioners
• Success depends on institutional contexts and
governance models
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
Health Workforce and Regulatory Mechanisms
• Professions – defined by specific traits such as formal
knowledge, extensive training, and high social status
• Social organization – defines professions as being
primarily concerned with attaining and maintaining
control
• Control – consists of autonomy, which is control over
the professional’s own work
• Dominance –control over the work of others
• Cultural authority –dominance of medical definitions
over health and illness
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
Health Workforce Policy
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
Doctors
• Responsible for diagnosis and treatment
• Professional autonomy & power
• Patient-centered approach
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
Differences in Countries
• Number of physicians
• Gender ratios
• Generalists
• Specialists
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
Doctors as Health Policy Players
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
Access to Policy Process
As outsiders through
lobbying
Organization of doctor’s
interests
Cohesive
Australia, Britain, Japan,
New Zealand, Singapore,
Sweden, Taiwan
Fragmented
USA
(Blank, Burau & Kuhlmann, 2017, pg. 159).
HCM550 Healthcare Policy Analysis and Development
As insiders through
corporatism
Germany, Netherlands
Module 6 Lecture
Fragmentation and Power
• The power of doctors is tied to the power of the
nation
• External roles for doctors
• Cuts in workforce
• Less pay
• Corporatist systems
• Doctors play an integral part in governance
• Access to political insiders
• Example of Germany
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
Professional Self-Regulation & Changes
• Professional self-regulation
• Licensing
• Education
• Training
• Skills mix
• Task shifting
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
Geographic Imbalances
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
WHO Code of International Healthcare
Recruitment
• Voluntary Guidelines
• Recommendations
• Doesn’t truly protect low-income countries
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
Governing the Workforce
• Inflows –training health workers
• Skills & competencies – ensuring there is a right mix
of skills
• Mobile health workers – safeguarding the correct
people are in the proper locations
• Recruiting, deployment and retention – managing
healthcare workers once employed
HCM550 Healthcare Policy Analysis and Development
Module 6 Lecture
Conclusion
HCM550 Healthcare Policy Analysis and Development
Module 6 Critical Thinking
Assignment
Find a case study examining a vulnerable population that is
impacted by a national or regional healthcare concern,
specifically lack of shelter, gaining access to healthcare, or lack
of healthcare insurance. Include any statistics you can find.
Address the following:
● Clearly explain the health disparities and why it is worse for
the poor.
● What are some of the moral and ethical obligations that may
need to be applied to Saudi Arabia’s national policies?
● What are some of the positive social changes that need to
be accomplished to protect these populations?
● What unmoral and unethical acts could be used by
stakeholders to influence the policy changes?
● Summarize your recommendations for the national or
regional health policy to protect vulnerable populations from
this disparity. HCM550 Healthcare Policy Analysis and Development
Questions
Take advantage of this opportunity
to seek further clarification.
HCM550 Healthcare Policy Analysis and Development
Next Live Session
•
•
HCM550 Healthcare Policy Analysis and Development
References
• Blank, R., Burau, V. & Kuhlmann, E. (Eds.). (2017).
Comparative health policy (5th ed.). London, England:
Palgrave. ISBN: 978-1137544957
HCM550 Healthcare Policy Analysis and Development
This concludes our live
session.
Thank you for your attendance!
Health Care Beyond the Hospital (105 points)
Health disparities are inequalities prevalent in healthcare, which often involve lack of access across
various racial, ethnic and socioeconomic populations. Health disparities encompass an unequal
distribution of social, political, economic, and environmental resources, especially among vulnerable
populations. As a result, a number of local, regional, and national policies have been introduced to
address health disparities to promote quality care and improved access for these populations. When
developing health policies, especially those that focus on vulnerable populations, it is important for
stakeholders to consider any ethical considerations that will protect vulnerable populations from
substandard care and unethical medical practices.
Identify a health disparity prevalent in the Kingdom of Saudi Arabia. Examples include, but are not limited
to, nutrition- and lifestyle-related risk factors such as obesity, hypertension, and diabetes, as well as lack
of insurance. Include any tables or figures containing statistics to support your narrative.
Based on what you learned this week, address the following:
• Identify a vulnerable population and a specific health disparity prevalent in the Kingdom of Saudi
Arabia.
• Clearly explain the health disparities and why it is worse for your selected vulnerable population.
• What are some of the positive social changes that need to be accomplished to protect these
populations?
• Discuss a local, regional, or national policy to protect the identified vulnerable populations from
this disparity.
• What are some of the moral and ethical obligations that need to be considered with regard to the
policy?
Your report should meet the following structural requirements:
• Be 7 pages in length, not including the cover or reference pages.
• Be formatted according to APA 7th edition and Saudi Electronic University writing guidelines.
• Provide support for your statements with in-text citations from a minimum of 5 scholarly articles.
The Saudi Digital Library is an excellent source for scholarly research. One of these sources may
be from the class readings, textbook, or lectures.
• You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to
submitting them to your instructor for grading. If you are unsure how to submit an assignment to
the Originality Check tool, review the Turnitin Originality Check Student Guide.
ASSIGNMENT COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN:
Assignment title or task:
(You can write a question)
12063
Choose any one of the common occupational
infectious diseases and explain the following:
•
•
•
Causes, mode of transmission, and symptoms.
Occupational group at risk
Prevention and control measures
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Dr. Rowaedh Bawaked
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Short essay of 500-750 words (Excluding references).
• The font size should be 12.
• Font type should be Times New Roman
• The heading should be Bold.
• Color should be Black.
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style.
• AVOID PLAGIARISM
• Due date; 30/9/2023 11:59 PM
Best of Luck
I want presentation ppt about Recuritment and selection Outlines Then objectives by the end of the presentation the student able to like this I have 3 references I will send photo you search about content Slides not less than 30 slides And the design of slides I will send
For this presentation, select an area of nurse practitioner (NP) practice that is of interest to you and in which you would like to see a practice change occur. Conduct a review of literature to see what is currently known about the topic and to find research support for the practice change you are recommending. You may use a topic from the list at the link below or may investigate a topic of your choice as long as it pertains to NP practice. If you are unsure of your topic, please reach out to your instructor. Be sure to provide speaker’s notes for all slides except the title and reference slides.
Create an 8-12 slide PowerPoint Presentation that includes the following:
Introduction: slide should identify concepts to be addressed and sections of the presentation. Include speaker’s notes that explain, in more detail, what will be covered.
Evidence-based projects: slide should explain the general importance of master’s-prepared nurses engaging in evidence-based projects related to nursing practice and profession. Provide speaker’s notes with additional detail and support from at least one outside scholarly source (not the textbook or course lesson).
Conceptual Model: slide should provide an illustration of a conceptual model that could be used to develop an evidence-based project. Possible models include The John’s Hopkins or Advancing Research and Clinical Practice through Close Collaboration (ARCC) Models or you may select another model you find in the literature. In the speaker’s notes, explain how the model would be applied to the development of an evidence-based project. Provide support from at least one outside scholarly source (not the textbook or course lesson).
Area of Interest: identify an area of interest related to NP practice in which a practice change may be needed. Slide should identify the area of interest and what is currently known on the topic. Speaker’s notes more fully explain what is currently known and should provide rationale for why the area of interest is important to NP practice. Provide support from at least one outside scholarly source (not the textbook or course lesson).
Issue/concern and recommendation for change: slide should identify a specific concern related to your general area of interest and your recommendation for a practice change. Speaker’s notes should more fully explain the recommended change and rationale for the change. Recommendation should be supported by at least one outside scholarly source (not the textbook or course lesson).
Factors Influencing Change: slide should identify at least 2 internal and external factors that could impact your ability to implement your recommended change. Speaker’s notes should more fully explain how the factors you’ve identified would support or impede the implementation of your recommendations. Factors may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.
NONPF Competencies: slide identifies at least two NONPF Competencies that are relevant to an evidence-based project related to your area of interest. Speaker’s notes should explain how the competencies relate to your area of interest. Provide support from at least one outside scholarly source (not the textbook or course lesson).
Conclusion: slide provides summary points of presentation. Speaker’s notes provide final comments on the topic.
Preparing the presentation
Submission Requirements
Application: Use Microsoft Power Point™ to create the PowerPoint presentation.
Length: The PowerPoint presentation must be 8-12 total slides (excluding title and reference slides).
Speaker notes are used and include in-text citations when applicable.
A minimum of four (4) scholarly literature references must be used.
Submission: Submit your file: Last name_First initial_Wk6Assessment_Area of Interest.
Best Practices in Preparing the Project
The following are best practices in preparing this project:
Review directions thoroughly.
Follow submission requirements.
Make sure all elements on the grading rubric are included.
Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scientific writing.
Review the Creating a Professional Presentation located resource.
Ideas and information that come from scholarly literature must be cited and referenced correctly.
Abide by CCN academic integrity policy.
ASSIGNMENT CONTENT
Category Points % Description
Introduction 9 5%
Slide should identify concepts to be addressed and sections of the presentation. Include speaker’s notes that explain, in more detail, what will be covered.
Evidence-based projects 12 7%
Slide should explain the general importance of master’s-prepared nurses engaging in evidence-based projects related to nursing practice and profession. Provide speaker’s notes with additional detail and support from at least one outside scholarly source (not the textbook or course lesson).
Conceptual Model 18 10% Slide should provide an illustration of a conceptual model that could be used to develop an evidence-based project. Possible models include The John’s Hopkins or Advancing Research and Clinical Practice through Close Collaboration (ARCC) Models or you may select another model you find in the literature. In the speaker’s notes, explain how the model would be applied to the development of an evidence-based project. Provide support from at least one outside scholarly source (not the textbook or course lesson).
Area of Interest 35 20% Identify an area of interest related to NP practice in which a practice change may be needed. Slide should identify the area of interest and what is currently known on the topic. Speaker’s notes more fully explain what is currently known and should provide rationale for why the area of interest is important to NP practice. Provide support from at least one outside scholarly source (not the textbook or course lesson).
Issue/concern and recommendation for change 35 20%
Slide should identify a specific concern related to your general area of interest and your recommendation for a practice change. Speaker’s notes should more fully explain the recommended change and rationale for the change. Recommendation should be supported by at least one outside scholarly source (not the textbook or course lesson).
Factors Influencing Change 17 10% Slide should identify at least 2 internal and external factors that could impact your ability to implement your recommended change. Speaker’s notes should more fully explain how the factors you’ve identified would support or impede the implementation of your recommendations. Factors may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.
NONPF Competencies 14 8% Slide identifies at least two NONPF Competencies that are relevant to an evidence-based project related to your area of interest. Speaker’s notes should explain how the competencies relate to your area of interest. Provide support from at least one outside scholarly source (not the textbook or course lesson).
Conclusion 9 5% Slide provides summary points of presentation. Speaker’s notes provide final comments on the topic.
149 85% Total CONTENT Points= 149 points
ASSIGNMENT FORMAT
Category Points % Description
APA Formatting 8 5%
References on reference slide must be in APA format. May use bullets instead of hanging indents.
In-text citations on slides and in speaker’s notes must be in APA format.
Writing Mechanics 9 5%
Writing mechanics follow the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA manual. Presentation length meets assignment guidelines.
Slide Formatting 9 5%
Presentation has title slide
Presentation has reference slide(s)
Slides are professional in appearance and tone;
Slides are balanced spatially, including words and graphics.
26 15% Total FORMAT Points= 16 points
175 100% ASSIGNMENT TOTAL= 150points
Rubric
Unformatted Attachment Preview
List of Possible Topics
Note: The purpose of the MSN project proposal is to translate evidence currently found in the literature
into practice within the chosen specialty track. Due to the research complexity, time involvement,
and implications regarding human subjects, drug studies are not acceptable areas of interest for a MSN
project.
FNP
•
•
•
•
•
•
•
•
•
Best evidence available about a topic (i.e. frequency of mammography)
Screening recommendations (i.e. PSA for prostate cancer)
Information about a healthcare-related phenomenon (i.e. when to talk to a person about ending
treatment for a terminal illness, non-compliance of diet for individuals with congestive heart
failure)
Vaccinations for adults and/or children
Early assessment for health-related concerns (i.e. depression in teenagers; suicide prevention
for the elderly)
Life style changes (i.e. smoking cessation, increasing activity in teenagers)
Relationship between events or health concerns (i.e. relationship between dementia and
caffeine consumption.
Selection on an intervention (i.e. use of small group theory to lessen anxiety)
Symptom management (i.e. pain, vomiting)
Title of Presentation
Name
School
Class
Professor
Date
Please be sure to use a template and add a few pictures/graphs throughout
your presentation to make it visually appealing to your viewers. Be Creative!
Repeat Title on Slide 2
• Identify key concepts to be presented in Power Point presentation
• Identify the sections of the presentation Example below:
Evidence Based Projects (Section)
The importance of master’s prepared nurse
participation (Concept)
Issue/Concern and Recommendation for change
Conceptual Model
Development of an evidenced-based project
(EBP)
Factors Influencing change
Internal and External factors which impact change
Area of Interest
Addresses changes needed within NP practice
NONPF Competencies
How the area of interest is relevant to core
competencies
Evidence-Based Projects
• Importance of MSN nurses engaging in evidence based projects
related to nursing practice and profession
Conceptual Model
• Identify Model that could be used to develop an evidence based
project
• Provide an Illustration (picture) of conceptual model
• (The conceptual model should be one that could be used to develop
an evidence based project. E.g. PDSA, ARCC, Johns Hopkins)
Area of Interest (The area of interest should be
something related to NP practice that needs to be
changed
• Identify the area of interest
• What is currently known on the topic from your review of scholarly
literature
• How is this area of interest important to your future professional
practice?
Issue/Concern and Recommendation for
Change
• Identify what the issue or concern is related to your area of interest
• What is a practice change recommendation – (based on research)
Factors Influencing Change
• 2 Internal Factors that have potential to influence or impact your
ability to implement your recommended change
• 2 External Factors that have potential to influence or impact your
ability to implement your recommended change
• How do factors support change or provide barrier to change
National Organization of Nurse Practitioner
Faculties (NONPF) – Competencies
• Two NONPF Competencies relevant to an EBP related to your area of
interest
Conclusion
• Summarize the main points of your presentation
References
• Use correct 7th edition APA formatting for your references
For me, I would like to choose the topic of mental health.
Unformatted Attachment Preview
Module 04: Critical Thinking Assignment
Critical Thinking Assignment: Selecting Sources
Important! This is the first of several Critical Thinking assignments that will build the
foundation for a research paper due in Module 12.
In research, you should select research articles that are peer-reviewed and, in most
instances, are not more than five years old. When searching in the Saudi Digital Library, you
can limit the results by publication date and peer-reviewed journals so that you get the most
recent, credible research on the topic (see the image below). You can then look for those
results that allow you to access the full text.
Find 10 peer-reviewed articles to research one of the following topics of interest to you:
• Antibiotic use in healthcare
• Artificial Intelligence (AI)
• Big data analytics in healthcare
• Chronic diseases
• Clinical practice guidelines
• Communicable diseases
• Diabetic foot disease
• Ethical decision-making in healthcare
• Mental health
• Non-communicable diseases
• Patient safety culture
• Vaccines
This will be the topic that you will write about in the final research paper due in Module 12.
At least five articles should be empirical studies. Look for the theory that the study uses to
identify the hypothesis that is formulated. See the following article on theory in healthcare:
Aldahmash, A. M., Ahmed, Z., Qadri, F. R., Thapa, S., & AlMuammar, A. M.
(2019). Implementing a connected health intervention for remote patient monitoring in Saudi
Arabia and Pakistan: Explaining ‘the what’ and ‘the how’. Globalization and Health, 15(1), 20–
20. https://doi.org/10.1186/s12992-019-0462-1
Write a two-page overview of your topic and the reasons for selecting each of the references.
Be aware that you may find research articles that could be subtopics that may add interest to
the main topic. Submit all ten references and the two-page overview with a title page.
Follow APA 7th edition and Saudi Electronic University writing standards.
I want to help clarify CT 4 more for you. What you want to look for specifically in these
articles is qualitative and quantitative studies these are considered empirical studies. I would
add that if you are using the table template that I posted all you need is 1. the article title
and 2. the reasons for selecting the article. Then you provide the reference page with a list of
all your references.
Example of a table that you could use to show your 10 articles and explain your
reason for selection:
Study
Burden of stroke in the Kingdom of Saudi
Arabia: A soaring epidemic
Reason for selection
The authors cited that the aging population
is a contributing factor and strokes are
anticipated to double by 2030.
For this video, choose one item that addresses a current issue and makes connections to class concepts. The item may be print or video—for example, an article from the current edition of a newspaper or magazine, a segment from a news or talk show, a YouTube video, vlog, or any program that features current affairs.
Your item (up to 2 minutes) will be embedded in a PowerPoint that you will use to supplement your presentation.
You may use clips of a video, pause a video as necessary to identify concepts, or use a clip for a full 2 minutes. However, you cannot use over two minutes of video in your own presentation.
Items cannot be more than 90 days old.
Clips and articles can be embedded in a PowerPoint that you will use to supplement your presentation or you can share your screen and show these separately during your presentation.
Remember, your PowerPoint is there to guide you during your presentation. Do not overload this with text.
Submit a 4-5 minute video in which you:
Use any software you are comfortable with, including Panopto, in order to record yourself speaking and presenting a PowerPoint at the same time. You and your PowerPoint must be visible during the entirety of the presentation. This cannot just be a recording of your face presenting and it cannot just be a voice over with your PowerPoint – Video and screen option should be selected on any media you use.
Clearly identify the argument. Present the premises and conclusion in your chosen article or video clip and explain their importance. Did the speakers/writers use deductive or inductive reasoning?
In your article or video clip, identify three of the following: vague/ambiguous language; credibility; cognitive bias; rhetoric; logical fallacies; generalizations; arguments from analogy; cause and effect reasoning; and value judgments about morality, law, or aesthetics.
Explain why you think the argument fits this concept. Also, identify if this was purposeful and why, and how this affects the strength of the argument.
Provide a conclusion to your video. Was the argument convincing? What is your position? (30 seconds max)
How should healthcare professionals proactively plan to update their knowledge and skills to respond to the major public health issues and challenges facing them and their clients?The discussion must address the topic.Rationale must be provided400 words in your initial postMinimum of two scholarly references in APA format within the last five years published
Revenue Cycle Management (RCM) is a vital part of the acute care environment. It helps to provide organizational management to medical billing and revenue. It is crucial for the financial health of an organization to have an RCM process that is successful because it ensures timely revenue, regular collections, and financial viability. RCM also allows hospitals and health systems to focus on providing a superior patient experience. One consistent aspect of RCM no matter the facility types or service type is that revenue is managed from before the visit to safeguard payment after the visit.
With the previous fee-for-service payment method, each department worked independently of one another, and this also occurred in a retrospective manner. Now that the complexity of reimbursement has been brought to light in the prospective environment, it has become vital for all the individual departments to work together and establish a strong team in order to manage the revenue for a facility or provider utilizing an RCM strategy. With the prior method of payment, the payer did not know what they were going to be billed for until after the services were rendered.
The most effective model of the RCM is divided into three categories which in the front-end process, middle process and the back-end process. If all these categories are not properly completed, then the provider or facility is at risk of nonpayment for services rendered. In the front-end process it begins before the patient evens schedules the appointment. It is essential that healthcare providers and healthcare facilities complete the credentialing process with different payers. If this is not completed correctly then the provider or facility is at risk of being considered out of network and will then be ineligible for payment from that payer. This is also the process of obtaining accurate information regarding the patient’s demographics and insurance information to verify eligibility at the time services are performed. This category is also when prior authorization, precertification and medical necessity come in to pay. Certain payers require that different procedures or services meet criteria set by the medical team associated with that payer. If they do not see that the procedure or service meets their requirements that service will be denied coverage.
Case management, charge collection, hard and soft coding of diagnoses and procedures, all of which are based on clinical documentation, are all included in the middle step of the revenue cycle (Harrington, 2021). At this point it is essential to have all clinical documentation accurate to have accurate billing and ultimately profit.
When it comes to the back-end process, tasks such as processing invoices, posting payments, correcting claims when necessary, appealing claims, supplying patient documentation, and making any necessary adjustments to ICD-10 codes are performed.
All of these processes must be done accurately to the best of everyone involved in order for healthcare providers and facilities to be able to remain operational. Billing and coding errors can result in reversal of payments, no payments and even fraudulent activity. Therefore, having a successful RCM is vitally important. There are things called Key Performance Indicators (KPI), and they make it possible for a facility to measure or benchmark its data against the best practices. KPIs provide managers with accurate information that enables them to identify the strengths and weaknesses of the institution and improve the performance of the management team (Pourmohammadi, et al., 2018).
Poor RCM can lead to a number of disastrous outcomes, some of which are financial instability, a drop in patient volume and satisfaction, a dissatisfied working environment, bad debt, wasted time, and stagnant growth, which often results in the business having to shut down. The magnitude of the damage caused by fraudulent activity cannot be overstated because it results in the diversion of resources that were intended to help people who are in need. The overall costs of essential health care services go up because of fraud, which also has the potential to be damaging to people who get benefits from Medicare and Medicaid (Chen, et al., 2020).
There is no room for debate in the Bible that God abhors deceit. Two of the items on the list of “six things that the Lord hates, seven that are an abomination to him” in Proverbs 6 have to do with lying: “a lying tongue” and “a false witness who breathes out lies.” Proverbs 12:22 says “lying lips are abomination to the Lord: but they that deal truly are his delight” (KJV, 2020). God despises lying because he places an extremely high value on the truth and because he is the origin of every piece of truth.
References:
Chen, Z. X., Hohmann, L., Banjara, B., Zhao, Y., Diggs, K., & Westrick, S. C. (2020). Recommendations to protect patients and health care practices from Medicare and Medicaid fraud. Journal of the American Pharmacists Association : JAPhA, 60(6), e60–e65. https://doi.org/10.1016/j.japh.2020.05.011Links to an external site.
Harrington, M. K. (2021b). Health Care Finance and the mechanics of Insurance and Reimbursement (Second). Jones & Bartlett Learning.
Pourmohammadi, K., Hatam, N., Shojaei, P., & Bastani, P. (2018). A comprehensive map of the evidence on the performance evaluation indicators of public hospitals: a scoping study and best fit framework synthesis. Cost effectiveness and resource allocation : C/E, 16, 64. https://doi.org/10.1186/s12962-018-0166-zLinks to an external site.
The holy bible: King James Version. (2020). Hendrickson Publishers Marketing, LLC.
2. Canadra
Now that medical billing processes have changed over time, from fee for service, to prospective payment service, the revenue cycle management (RCM), that is now being performed today, ensures that the medical facilities and the providers that performed the service are paid upfront. Hospitals’ profitability and ability to grow equity are key factors in their efforts to maintain the up-to-date facilities and equipment needed to attract well-trained healthcare professionals and provide high-quality patient care (Singh, S. R., et al., 2012). This new process requires that payment is rendered before the patient is even admitted. Doing the medical procedure, which can be different across, it is important that the correct actions are annotated and documented. This means that healthcare administrators have to predict of estimate what services, supplies, and the recovery time will be needed for the patient. Again, this can vary from patient to patient, as well as from one medical location to the next. It is also important that fees covered by the patient are addressed upfront so that the patient can make the payment prior to the start of the medical procedure. It is up to the patient to cover their portion before the medical location will schedule the procedure. This cycle is also important for the organization because it is simply based off of supply and demand. Time, resources, and recovery care are all part of the medical procedure and those supplies used have to be brought again for the next patient. It’s similar to shopping. You take something of the shelf, you pay the price for it, the store can now buy it again, put it back on the shelf for the next person to purchase. Product go out and product go in, all through the cycle of purchase and sale. Without payment for services rendered, the medical facility can not provide for the next patient. If the physician is not paid for their skill, they can not work to treat the next patient. While physician billing of the encounter represents one component of revenue cycle management, recent work has demonstrated that more than 30 percent of the total processing cost for an encounter bill is for physician time. Moreover, nearly 25 percent of the total processing time of a single bill has been attributed to physicians (Chin, S., et al., 2022). The impact of not having a RCM cycle, services rendered with no payment received, would not be beneficial to the medical facility. They would not have enough funding to stay in business.
Harrington (2021), states that, “there’s three areas within the RCM which consist of the front end process, middle process, and back end process (pg. 176).” In other words, the administration process, procedure process, then the billing process. Ensuring the correct insurance information, medical procedure, and patient information is accurate must be done on the front end. Next is ensuring the coding of what was done and issued is entered into the proper system and correctly. Finally, the back end consist of the claims process and ensuring payments are posted as required. The data and information must be correct in all three processes. This is how all the systems communicate with each other and payments are made. Attention to detail and proper monitoring at all three stages are very important. If there’s an error, it can lead to missed payments, incorrect payments, no payments at all. Checks and balances to ensure everyone is on one accord requires communication to be clear and concise. This is done so that what id due back is correct and what was done was correct. Finally, this reminds of Proverbs 27:17, “Iron sharpens iron, and one man sharpens another (ESV, 2023).” This cycle sharpens the next process every step of the way. When payment is made or reimbursed, then the physician do well in there medical procedure, the hospital is paid and the patient’s quality of care is beyond the standard.
References
Chin, S.,M.B.A.M.D., Li, A., B.S.C., Boulet, M., M.D., Howse, K., M.D., & Rajaram, A.,M.M.I.M.D. (2022). Resident and Family Physician Perspectives on Billing: An Exploratory Study. Perspectives in Health Information Management, 19(4), 54-61.
https://go.openathens.net/redirector/liberty.edu?url=https://www.proquest.com/scholarly-journals/resident-family-physician-perspectives-on-billing/docview/2738608579/se-2Links to an external site.
English Standard Version Bible (2023)
https://www.openbible.info
Harrington, M.K. (2021) Health care finance and the mechanics of insurance and reimbursement. (2nd ed.) Burlington, MA: Jones & Barlett.
Singh, S. R., PhD., Wheeler, J., PhD., & Roden, Kirk,M.B.A., F.A.C.H.E. (2012). Hospital Financial Management: What Is the Link Between Revenue Cycle Management, Profitability, and Not-for-Profit Hospitals’ Ability to Grow Equity? Journal of Healthcare Management, 57(5), 325-39; discussion 339-41.
support assertions with at least 3 references and 1 instance of biblical integration in current APA format. Each reply must incorporate at least 2 scholarly citations and 1 instance of biblical integration in current APA format.
course textbook:
Harrington, M. K. (2021). Health Care Finance and the mechanics of Insurance and Reimbursement. Jones & Bartlett Learning.
Application of Theory to Practice: Presentation of Community Health
Promotion Plan Proposal
Hide Assignment Information
Instructions
This PPT presentation summarizes all of the work that you have completed thus far in this course! Students are
required to meet virtually with your mentor in practicing this presentation and obtaining feedback before
uploading the PowerPoint presentation with voiceover audio to the Instructor. Presentations should be no longer
than 10 minutes. Be sure to add information to the notes area that explains the information on the slide. The note
area should act as the written component of the presentation, with the ppt slides having brief summarized
information. In the notes section, you should write in complete sentences and explain the information that you ar
presenting on the slide.
The PowerPoint presentation (range of 10-12 slides) should include the following:
1. Identification of the community including demographics and geographic information
2. Describe the economic conditions, health resources, and environmental conditions
3. Description of the community agency including purpose and funding
4. Identification of the community health need.
5. Recommended intervention – that is evidence-based
6. Plan for implementation to meet the identified need
7. Resources needed to implement the plan
8. Expected outcomes
9. Organization of presentation
10. Spelling and grammar check
11. A slide with the reference list of research used to develop the plan
Due Date
Oct 10, 2023 11:59 PM
Hide Rubrics
Rubric Name: Presentation of Proposal
Print
Criteria
Level 4
Level 3
Level 2
Introduction
10 points
7.5 points
5 points
Identifies and describes
Identification and
Incomplete identificat
community, states basic
description of
description of commu
demographic and geographic community is complete, and/or missing inform
information
missing information
regarding geographic
regarding demographics demographic data
of geographic location
Description of
Community
10 points
7.5 points
5 points
Clearly delineates social and
economic conditions, health
resources, environmental
conditions and social
functioning of the
community
Missing 1-2 items
regarding social,
economic conditions,
health resources,
environmental
conditions and social
functioning of the
community
Missing 2-3 items reg
social, economic cond
health resources,
environmental condit
social functioning of t
community
Criteria
Level 4
Level 3
Level 2
Identified Community
Health Need
10 points
7.5 points
5 points
Need is clearly identified and Need is clearly
rationale clearly states that is identified and rationale
an important issue in the
is somewhat clear as to
community.
how it is related to an
important issue in the
community.
Need is ambiguous an
rationale is somewhat
to how it is related to
important issue in the
community.
Description of
Community Agency
10 points
5 points
Plan for Intervention
10 points
7.5 points
Clearly defines intervention
that is clinically relevant,
evidence-based and
describes the implications
for nursing practice.
Clearly defines
Intervention and clini
intervention that is
relevance is not clearl
clinically relevant,
defined, minimally ev
evidence-based, does
based, and/or does no
not describe the
describe the implicati
implications for nursing nursing practice.
practice.
7.5 points
Comprehensive description Adequate description of Incomplete descriptio
of agency including purpose agency including
agency purpose and fu
and funding of the agency,
purpose and funding of the agency, and popul
and population served
the agency, and
served
population served
5 points
Criteria
Level 4
Level 3
Level 2
Resources needed to
implement plan
10 points
7.5 points
5 points
Clearly delineates resources Describes needed
needed for evaluation
resources, incomplete
including staffing and
information regarding
funding needed for the
staffing or funding for
evaluation process, including the evaluation process,
community partners
including community
partners
Incomplete descriptio
resources needed. Info
regarding staffing or f
for the evaluation pro
community partners
Expected outcomes
10 points
5 points
7.5 points
Expected outcomes are
Expected outcomes are Unclear regarding exp
clearly stated and based on stated, no clear
outcomes and/or no r
evidence from the literature reference to the
to the literature for sta
literature regarding
outcome
basis for stated outcome
Criteria
Level 4
Level 3
Level 2
7.5 points
5 points
Presentation is well
organized, concise, uses
headings and bulleted lists
when needed easy to read
with well thought out
graphics, fonts, and
background color
Presentation is
organized, fairly
concise, mostly well
organized, generally
easy to read, with
appropriate fonts
Presentation not well
organized, somewhat
some information app
of sequence, fonts are
to read, background c
does not add to readab
Spelling, grammar and
references
10 points
7.5 points
5 points
No misspellings,
grammatical errors and is
appropriately referenced
Has few misspellings or Several misspellings a
grammatical errors,
grammatical errors, so
appropriately
references missing
referenced
Reference list
10 points
7.5 points
5 points
References are within the
last 5 years, related to the
topic and are from peerreviewed journals
References are within
the last 5 years, related
to the topic and most
are from peer-reviewed
journals
Most of the references
within the last 5 years
are related to the topi
less than half are from
reviewed journals
Organization/Presentation 10 points
Total
Score of Presentation of Proposal,
/ 100
Overall Score
Architect Daniel Libeskind is credited with saying “To provide meaningful architecture is not to parody history, but to articulate it.” The suggestion is that his work does not copy the efforts of others but relies on it.
Understanding the work of others is critically important to new work. Contributions to the nursing body of knowledge can happen when you are able to analyze and articulate the efforts of previous research. Research analysis skills are therefore critical tools for your toolbox.
In this Assignment, you will locate relevant existing research. You also will analyze this research using a tool helpful for analysis.
Reflect on the strategies presented in the Resources this Module’s Learning Resources in support of locating and analyzing research. Below are the strategies
Al-Jundi, A., & Sakka, S. (2017).Critical appraisal of clinical researchLinks to an external site.. Journal of Clinical and Diagnostic Research: JCDR, 11(5), JE01–JE05. https://doi.org/10.7860/JCDR/2017/26047.9942
Shellenbarger, T. (2016). Simplifying synthesisLinks to an external site.. Nurse Author & Editor, 26(3). Retrieved from http://naepub.com/reporting-research/2016-26-3-3/
Walden University Library. (n.d.). Databases A-Z: NursingLinks to an external site.. Retrieved October 4, 2019 from https://academicguides.waldenu.edu/az.php?s=19981
Walden University Library. (n.d.). Evaluating resources: JournalsLinks to an external site.. Retrieved October 4, 2019, from https://academicguides.waldenu.edu/library/evaluat…
Walden University Library. (n.d.). Instructional media: Fundamentals of library researchLinks to an external site.. Retrieved October 4, 2019 from https://academicguides.waldenu.edu/library/instruc…
Walden University Writing Center.Links to an external site. (n.d.). Retrieved November 14, 2018, from https://academicguides.waldenu.edu/writingcenter/h…
Walden University Writing Center. (n.d.). Common assignments: Synthesizing your sourcesLinks to an external site.. https://academicguides.waldenu.edu/writingcenter/a…
Walden University Writing Center. (n.d.). Scholarly writing: OverviewLinks to an external site.. Retrieved November 14, 2018, from https://academicguides.waldenu.edu/writingcenter/s…
Walden University Writing Center. (n.d.). Webinars: Technical informationLinks to an external site.. Retrieved November 14, 2018, from https://academicguides.waldenu.edu/writingcenter/w…
Document: Academic Success and Professional Development Plan Template Download Academic Success and Professional Development Plan Template(Word document)
Document: Introduction to Scholarly Writing: Tips for success Download Introduction to Scholarly Writing: Tips for success(PDF)
Use the Walden Library to identify and read one peer-reviewed research article focused on a topic in your specialty field that interests you.
Review the article you selected and reflect on the professional practice use of theories/concepts described by the article.
The Assignment:Using the “Module 3 | Part 3” section of your Academic Success and Professional Development Plan Template presented in the Resources, conduct an analysis of the elements of the research article you identified. Be sure to include the following:
Your topic of interest.
A correctly formatted APA citation of the article you selected, along with link or search details.
Identify a professional practice use of the theories/concepts presented in the article.
Analysis of the article using the “Research Analysis Matrix” section of the template
Write a 1-paragraph justification stating whether you would recommend this article to inform professional practice.
Write a 2- to 3-paragraph summary that you will add to your Academic Success and Professional Development Plan that includes the following:
Describe your approach to identifying and analyzing peer-reviewed research.
Identify at least two strategies that you would use that you found to be effective in finding peer-reviewed research.
Identify at least one resource you intend to use in the future to find peer-reviewed research.
Note: Add your work for this Assignment to the original document you began in the Module 1 Assignment, which was built from the Academic Success and Professional Development Plan Template.
BY DAY 7 OF WEEK 5
Submit your analysis, including your completed section of the Academic Success and Professional Development Plan Template sections and your matrix and summary.
Unformatted Attachment Preview
NURS 6003: Transition to
Graduate Study for Nursing
Academic and Professional Success Plan Template
Prepared by:
This document is to be used for NURS 6003 Transition to Graduate Study for
Nursing to complete Assessments 1-4. Just as importantly the document serves to
organize your thoughts about planning for your academic and professional success.
For specific instructions see the weekly assessment details in the course or ask your
instructor for further guidance.
Module 1 | Part 1: Developing an Academic and Professional Network
I have identified and secured the participation of the following academic (at least two)
and professional (at least two) individuals and/or teams to form the basis of my network.
This network will help me to clarify my vision for success and will help guide me now
and in the future.
Directions: Complete the information below for each member of your network. For more
than four entries repeat the items below with details of your additional network
member(s) in the ‘ADDITIONAL NETWORK MEMBERS’ section.
NETWORK MEMBER 1
Name:
Title:
Organization:
Academic or Professional:
Why I selected this individual and/or team and how they will support my success
in the MSN program and as a practicing nurse:
Notes:
NETWORK MEMBER 2
Name:
Title:
Organization:
Academic or Professional:
Why I selected this individual and/or team and how they will support my success
in the MSN program and as a practicing nurse:
Notes:
NETWORK MEMBER 3
Name:
Title:
Organization:
Academic or Professional:
Why I selected this individual and/or team and how they will support my success
in the MSN program and as a practicing nurse:
Notes:
NETWORK MEMBER 4
Name:
Title:
Organization:
Academic or Professional:
Why I selected this individual and/or team and how they will support my success
in the MSN program and as a practicing nurse:
Notes:
Module 2 | Part 2: Strategies to Promote Academic Integrity and
Professional Ethics
I have analyzed the relationship between academic integrity and writing, as well as the
relationship between professional practices and scholarly ethics. I have also identified
strategies I intend to pursue to maintain integrity and ethics of my academic work while
a student of the MSN program, as well as my professional work as a nurse throughout
my career. The results of these efforts are shared below.
Directions: In the space below craft your analysis/writing sample, including Part 1 (The
Connection Between Academic and Professional Integrity) and Part 2 (Strategies for
Maintaining Integrity of Work).
Part 1: Writing Sample: The Connection Between Academic and Professional
Integrity
In the space below write a 2- 3-paragraph analysis that includes the following:
•
•
•
•
•
Explanation for the relationship between academic integrity and writing
Explanation for the relationship between professional practices and scholarly
ethics
Cite at least 2 resources that support your arguments, being sure to use proper
APA formatting.
Use Grammarly and Turnitin to improve the product.
Explain how Grammarly, Turnitin, and paraphrasing contributes to academic
integrity
PART 2: Strategies for Maintaining Integrity of Work
Expand on your thoughts from Part 1 by:
•
Identifying and describing strategies you intend to pursue to maintain integrity
and ethics of your 1) academic work while a student of the MSN program, and 2)
professional work as a nurse throughout your career. Include a review of
resources and approaches you propose to use as a student and a professional.
Module 3 | Part 3: Research Analysis
I have identified one topic of interest for further study. I have researched and identified
one peer-reviewed research article focused on this topic and have analyzed this article.
The results of these efforts are shared below.
Directions: Complete Step 1 by using the table and subsequent space below identify
and analyze the research article you have selected. Complete Step 2 by summarizing in
2-3 paragraphs the results of your analysis using the space identified.
Step 1: Research Analysis
Complete the table below
Topic of Interest:
Research Article:
Include full citation
in APA format, as
well as link or
search details (such
as DOI)
Professional
Practice Use:
One or more
professional practice
uses of the
theories/concepts
presented in the
article
Strengths of the
Research
Research Analysis
Matrix
Add more rows if
necessary
Limitations of
the Research
Relevancy to
Topic of Interest
Notes
Step 2: Summary of Analysis
Craft a summary (2-3 paragraph) below that includes the following:
• Describe your approach to identifying and analyzing peer-reviewed research
• Identify at least two strategies that you would use that you found to be effective in
finding peer-reviewed research
• Identify at least one resource you intend to use in the future to find peer-reviewed
research
Module 6 | Part 4: Finalizing the Plan
I have considered various options for my nursing specialty, including a close look at my
selected (or currently preferred) specialty and second-preferred specialty. I have also
developed a justification of my selected (or preferred) specialty. Lastly, I have examined
one professional organization related to my selected or preferred specialty and
considered how I can become a member of this organization.
The results of my efforts are below.
Directions: Complete Step 1 by writing 2-3 paragraphs in the space below comparing
the nursing specialty you have selected – or the one you prefer if your choice is still
under consideration – to your second preference. Identify each specialty and describe
the focus and the role that graduates are prepared for. Identify any other differentiators
you feel are significant, especially those that helped or may help you reach a decision.
Complete Step 2 by writing a paragraph identifying and justifying your reasons for
choosing your MSN specialization. Be sure to incorporate any feedback you received
from colleagues in this week’s Discussion Forum.
Complete Step 3 by examining and identifying one professional organization related to
your selected or preferred specialty. Explain how you can become a member of this
organization.
Step 1: Comparison of Nursing Specialties
Use the space below to write 2-3 paragraphs comparing the nursing specialty you have
selected – or the one you prefer if your choice is still under consideration – to your
second preference. Identify each specialty and describe the focus and the role that
graduates are prepared for. Identify any other differentiators you feel are significant,
especially those that helped or may help you reach a decision.
Step 2: Justification of Nursing Specialty
Use the space below to write a paragraph identifying and justifying your reasons for
choosing your MSN specialization. Be sure to incorporate any feedback you received
from colleagues in this week’s Discussion Forum.
Step 3: Professional Organizations
Use the space below to identify and examine one professional organization related to
your selected or preferred specialty. Explain how you can become a member of this
organization.
– END –
Hi I am writing about RN burnout in the Emergency department. I have attached the template to use for this paper along with the rubric grading criteria, thank you!
Objective
Implement research for your project
Deliverables
Write a 5-6 page (not including the title and reference pages)
APA formatted paper with an introduction and conclusion
APA headings for each section of the paper
At least 5 references
Step 1: Capstone Project
Write a thorough literature review paper
Step 2: Consider
Subheadings (Themes Discovered In Review)
Notice Of Gaps In Knowledge
At least 5 references within 5 years and peer-reviewed.
Step 3: Write
Write a paper that addresses the current literature for your project.
Use the template attached below.
references within 5 years and from peer-reviewed articles
• Assignment must be submitted with properly filled cover sheet (Name, ID, CRN, Submission date) in word document, Pdf is not accepted.
• Text size 12-Times New Roman with 1.5-line spacing.
• Heading should be Bold
• The text color should be Black
• Do proper paraphrasing to avoid plagiarism with proper references/sources.
• References must be in APA format
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Organizational Behavior
Course number:
HCM102
CRN
11564
Answer the following question-
Assignment title or task:
1. How do culture and cultural diversity / variation
affect work behavior and job performance?
Provide examples to show why a knowledge of such
differences is important for managers.
Student Name:
Students ID:
Submission date:
Instructor name:
Dr Soni Ali
Grade:
…..out of 10
College of Health Sciences
Department of Public Health
Release Date: Sunday, 17th April 2023 (12:00 Noon)
Due Date: Saturday, 7th October 2023 (11:59 pm)
Instructions for submission:
•
•
•
•
•
•
Assignment must be submitted with properly filled cover sheet (Name, ID, CRN,
Submission date) in word document, Pdf is not accepted.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
Find information (e.g. an article) that discusses the local broadcasting agreements in MLB. Explain your observations about [1] Which teams make the most money from local broadcasting agreements? [2] Which teams make the least? [3] Do you see differences in how these teams perform based simply on the amount of revenue they generate from local television contracts?
I am attaching the Discussion Board instructions, rubric, and book to be used.
Please review these videos and think about the health policy issues, and the psychiatric, ethical, and legal implications of this story. Consider each stakeholders viewpoint; from patient to parent/family, mental health provider, police officer, and general population at large. Think about the impact of the behaviors of the different stakeholders in this situation, how could this be different?
Pete Earley was formerly a journalist at the Washington Post. Kevin Earley, his son, was diagnosed with Bipolar Disorder. Pete and Kevin have opened the eyes of people all across the country to the needs of the mental health community and the problems in the mental health system in America.
PLEASE CREATE SUBTOPICS TO FOLLOW INSTRUCTIONS AND RUBRIC AND WRITE SOMETHING UNDER EACH SUBTOPIC AND STAKEHOLDER MENTIONED IN THE INSTRUCTOINS TO MAKE IT EASY ON THE GRADER TO GIVE US FULL MARKS.
For example,
Health policy issues
Psychiatric implications
Ethical implications
Legal implications
Perspectives
Patient
Parent/Family
Mental Health Provider
Police Officer
General Population
Copy and paste link into your browser if they don’t open
https://youtu.be/Dom_pBkgCL4 (Links to an external site.)Links to an external site.
Minimize Video
https://youtu.be/yxYmTm7pQuw (Links to an external site.)Links to an external site.
Your initial post will be due on Friday at 11:59 pm. Then on Sunday, by 11:59 pm you are to respond to 2 of your peers. Your response should include your thoughts on their posts that furthers the conversation. This should be more than “good job” and reiterating your peers’ thoughts. (A general guideline for more substantive posts is at least 250 words)
There are no minimum number of references to be use for this discussion board, however it is expected that there will be references used. Make sure that you accurately cite your references in your initial post and response posts. REFERENCES SHOULD NOT BE OLDER THAN FIVE YEARS. I WILL PROVIDE ORIGINAL POSTS FROM OTHER STUDENTS TO WRITE 2 REPLIES IN A SEPARATE QUESTION.
Recommended for further reading: Pete Earley’s book: ” Crazy: A Father’s Search Through America’s Mental Health Madness.” ISBN-10 : 042521389 ISBN-13 : 978-0425213896
Discussion Board Rubric SP22
Criteria
Ratings
Pts
Timeliness
view longer description
5 pts
Initial posting and response on time.
3 pts
Initial posting is on time, response is late
1 pts
Initial posting is late and response is late
0 pts
No Marks
/ 5 pts
Initial Posting
view longer description
25 pts
Posts well developed statement that fully addresses and develops all aspects of the task
15.79 pts
Posts well developed statement that addresses most aspects of the task; lacks full development of ideas.
7.89 pts
Posts adequate statement with superficial thought and preparation; doesn’t address all aspects of the task.
0 pts
No Marks
/ 25 pts
Response Posting
view longer description
5 pts
Response to 2 peers are posted on time
3 pts
Responds to one post in timely manner, missing one response post
1 pts
2 response posts are completed but late
0 pts
No Marks
/ 5 pts
Content Contribution
view longer description
25 pts
Demonstrates analysis of others’ post; extends meaningful discussion by building on previous posts. All required responses. (At least 250 words)
15 pts
Elaborates on two response posts that are partially developed and needs further expansion OR one response post that extends meaningful discussion by building on previous posts and one that is missing full development
13 pts
Elaborates on only one response post that extends meaningful discussion by building on previous posts, no second response post
10 pts
Elaborates on one response posts that is partially developed and needs further expansion and missing one response post
0 pts
No response posts
/ 25 pts
References & Support
view longer description
20 pts
Uses references to literature and readings, and personal experience to support comments.
12 pts
Incorporates some references from literature and personal experience.
6 pts
Uses personal experience, but no references to readings or research
0 pts
No Marks
/ 20 pts
Clarity & Mechanics
view longer description
20 pts
Contributes to discussion with clear, concise comments formatted in an easy to read style that is free of grammatical or spelling errors.
12 pts
Contributes valuable information to discussion with minor clarity or mechanics errors.
6 pts
Communicates in courteous and helpful manner with some errors in clarity or mechanics.
Compare three ways to disseminate research findings.Discuss the plan to disseminate the research findings obtained during this course at a state or national platform. Include your objective for disseminating the information and your target audience.PICO In college students aged 18-24, how does poverty level affect tobacco dependence compare to race?Submission Instructions:Your initial post should be at least 500 words, formatted and cited in the current APA style.Provide support for your work from at least five academic sources less than 5 years old. Visit Purdue Owl for specific examples on how to create in-text citations and cite references using the current APA
ASSIGNMENT COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN:
Assignment title or task:
(You can write a question)
Choose any one of the common occupational
infectious diseases and explain the following:
•
•
•
Causes, mode of transmission, and symptoms.
Occupational group at risk
Prevention and control measures
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Short essay of 500-750 words (Excluding references).
• The font size should be 12.
• Font type should be Times New Roman
• The heading should be Bold.
• Color should be Black.
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style.
• AVOID PLAGIARISM
• Due date; 30/9/2023 11:59 PM
Best of Luck
Research healthcare issues that have been identified in your local community. Develop a PowerPoint presentation with speaker notes. You will then use the PowerPoint during your Kaltura recording. Structure a health policy analysis presentation that addresses the following topics particular to your health problem:Problem Statement Background Landscape Options Recommendations *Drug use is a major issue in my area- Eastern North Carolina.
Architect Daniel Libeskind is credited with saying “To provide meaningful architecture is not to parody history, but to articulate it.” The suggestion is that his work does not copy the efforts of others but relies on it.
Understanding the work of others is critically important to new work. Contributions to the nursing body of knowledge can happen when you are able to analyze and articulate the efforts of previous research. Research analysis skills are therefore critical tools for your toolbox. In this Assignment, you will locate relevant existing research. You also will analyze this research using a tool helpful for analysis.
To Prepare:
Reflect on the strategies presented in the Resources this Module’s Learning Resources in support of locating and analyzing research. Use the Walden Library to identify and read one peer-reviewed research article focused on a topic in your specialty field that interests you. Review the article you selected and reflect on the professional practice use of theories/concepts described by the article.
The Assignment:
Using the “Module 3 | Part 3” section of your Academic Success and Professional Development Plan Template presented in the Resources, conduct an analysis of the elements of the research article you identified. Be sure to include the following:
Your topic of interest.
A correctly formatted APA citation of the article you selected, along with link or search details.
Identify a professional practice use of the theories/concepts presented in the article.
Analysis of the article using the “Research Analysis Matrix” section of the template
Write a 1-paragraph justification stating whether you would recommend this article to inform professional practice.
Write a 2- to 3-paragraph summary that you will add to your Academic Success and Professional Development Plan that includes the following: Describe your approach to identifying and analyzing peer-reviewed research.
Identify at least two strategies that you would use that you found to be effective in finding peer-reviewed research.
Identify at least one resource you intend to use in the future to find peer-reviewed research.
Attention-Deficit/Hyperactivity Disorder (ADHD)
Neurodevelopmental disorders appear early in life disrupting the normal course of development
and often persisting through adulthood. In this assignment, you will select one of the following
neurodevelopmental disorders to focus on: Attention Deficit/Hyperactivity Disorder (Links to an
external site.) (ADHD) Specific Learning Disorders (Links to an external site.) Autism Spectrum
Disorders (Links to an external site.) (ASD) Intellectual Disability (Links to an external site.)
You will review research on how the disorder you selected presents itself at each stage of life:
Childhood Adolescence Adulthood In addition, you will discuss: what normal developmental
skill was disrupted by the neurodevelopmental disorder what impact the disorder has on daily
living skills and educational or professional performance what possible treatment options are
available at the specific stage of life. (See Content Expectations for the assigned topic) Content
Expectations Produce a paper on one of the following neurodevelopmental disorders: Attention
Deficit/Hyperactivity Disorder (ADHD) Specific Learning Disorders Autism Spectrum
Disorders (ASD) Intellectual Disability Your paper should include all of the following headings:
Clinical Description—Describe the general clinical description and causes of the disorder.
Childhood Implications Specific description of how the neurodevelopmental disorders presents
itself at this stage of life. Information on the normal developmental skill that was disrupted by
the disorder. Impact the disorder has on daily living skills and educational performance at this
stage. Possible treatment options. Adolescence Implications Specific description of how the
neurodevelopmental disorders presents itself at this stage of life. Information on the normal
developmental skill that was disrupted by the disorder. Impact the disorder has on daily living
skills and educational performance at this stage. Possible treatment options. Adulthood
Implications Specific description of how the neurodevelopmental disorders presents itself at this
stage of life. Information on the normal developmental skill that was disrupted by the disorder.
Impact the disorder has on daily living skills and professional performance at this stage. Possible
treatment options at the specific stage of life.
Format Paper should include 2 to 3 pages of content, plus a cover page and reference page. Use a
minimum of 2 additional scholarly references, in addition to your textbook. Scholarly references
can include peer-reviewed articles, journals, government websites and included supplemental
resources. Cite all information from the required resources/textbook plus the 2 additional
scholarly references using proper APA style.
Nursing theories play a vital role in the evolution of nursing as a discipline. They establish the critical contributions made by the profession and provide nurses with frameworks to guide their practice, grow professionally, and improve the care they deliver to patients. This assignment focuses on the importance of nursing theory within the profession. Selecting one nursing theorist and the middle-range theory they developed (non-nursing ideas are not allowed), the student will present a summary of the set nursing theory, identify opportunities for the application of the theory to a nursing situation (In this course, you have analyzed a middle range theory, you may the theory used in previous discussions). The student will include two scholarly peer-reviewed sources to support the nursing theory chosen.
Requirements
The two central aims of this assignment are to apply a middle-range nursing theory to clinical practice and to reflect on the experience. Consider the problem described in discussion nine. Write a paper (1,000 to 1,500 words, Approximately three pages) that explains how middle-range theory can be applied to the identified problem. The paper should include the following:
A summary of the problem (nursing situation). Describe a nursing situation you have encountered in your clinical placement. The situation can be a specific physiological patient problem or a case involving a vulnerable patient’s family or a staff member. It can also describe your role in problem-solving or an ethical issue you encountered in practice. The key is you need to have been directly involved in the event. You must also maintain the confidentiality of your subjects at all times. Do not identify the patient, staff, or hospital site.
A description of a middle-range theory that could be applied to the problem. Is this middle-range theory appropriate to your identified situation? For example, health promotion, especially preventive care, is essential for ethnic minority groups and
the economically disadvantaged. The Health Promotion Model (HPM) (Pender, 1996; Pender et al., 2010) is a framework for delivering nursing care to support health promotion behaviors. An essential component of a nursing assessment is understanding personal factors (e.g., lack of finances to afford health insurance) and an individual’s perception of the benefits and barriers of engaging in health promotion behaviors. Screening recommendations and health promotion practices can be tailored to the patient’s and family’s cultural values and beliefs, finances, and community support when working with vulnerable populations.
A brief discussion of the middle-range theory’s origins includes a short biography of the theorist and the main concepts of the middle-range theory ( See discussion nine).
Discuss how the middle-range theory has been previously applied ( See discussion nine ).
A discussion of the application of the middle-range theory to the identified problem. How would your practice change by incorporating this theory?
The paper should be 2-3 pages, excluding the title and reference pages.
The paper should start with an introductory paragraph that includes the purpose statement.
Use headings and subheadings to organize the paper.
Reflection
Using the diagram below, reflect on the following questions:
Think about a nursing situation (necessary experience).
Consider the selected theory or parts theory while it is implemented in your nursing care.
As you apply theory, identify your emotions.
Have you experienced this nursing situation before applying the theory
What did I learn from completing this experience?
How have I been changed by what I’ve learned?
Rubric
Application of Theory Paper Rubric
Application of Theory Paper Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeBiography
10 pts
Outstanding
Well organized information about the theorists is fluently presented and focused on important points and contributes to understanding the theory.
5 pts
Acceptable
Clear and relevant information about the theorists is presented with clarity.
2.5 pts
Unacceptable
Information was presented about the theorists, but numerous key happenings were omitted or misrepresented and/or organization lacked clarity and contribution to understanding the theories
10 pts
This criterion is linked to a Learning OutcomeKey Ideas
10 pts
Outstanding
Well organized summarization of the theorys’ key points and assumptions; important terms are explained well; titles of key writings and research findings are noted
5 pts
Acceptable
Information was presented about the theories, but some main ideologies were omitted and/or key ideas were not presented with clarity.
2.5 pts
Unacceptable
Information was presented about the theories, but numerous main ideologies and/or terms were omitted or misrepresented and/or organization lacked clarity
10 pts
This criterion is linked to a Learning OutcomeExamples
10 pts
Outstanding
3 or more examples with explicit explanations that clearly depict what the theory would look like in practice
5 pts
Acceptable
2 examples are given but lack of clarity in describing the theory in practice
2.5 pts
Unacceptable
Only 1 example used and/or both examples given do not explain the theory in practice
10 pts
This criterion is linked to a Learning OutcomeApplication of the Theory to nursing Care
10 pts
Outstanding
Clear and well thought out application to show information contributes to specific aspects of the theory’s application to nursing care.
5 pts
Acceptable
Application with some descriptive or restatements about theory; begins to apply to theory in nursing care.
2.5 pts
Unacceptable
Information or reflection instead of application and/or not useful for future application.
10 pts
This criterion is linked to a Learning OutcomeApplication of Theory to an specific vulnerable population
20 pts
Outstanding
Consistently finds connections and patterns across theories that apply to a specific vulnerable population.
10 pts
Acceptable
Most of the time finds connections and patterns across the theory that apply to populations.
5 pts
Unacceptable
Rarely finds connections and patterns across the theory that applies to populations.
20 pts
This criterion is linked to a Learning OutcomeReferences
10 pts
Outstanding
3-4 scholarly sources referenced and cited in the presentation and the reference list All resources are referenced and cited
5 pts
Acceptable
2 scholarly sources References cited in the presentation All resources are referenced and cited.
2.5 pts
Unacceptable
Only 1 scholarly source in the paper &/or no reference list
10 pts
This criterion is linked to a Learning OutcomeReflection of the theorists’ ideologies in context to personal experiences
20 pts
Outstanding
The paper exemplifies critical reflection in a well-written section situating past personal experiences with any of the chosen theorists’ ideologies.
10 pts
Acceptable
The paper provides a critical reflection that situates past personal experiences with any of the theorists’ ideologies included in the presentation.
5 pts
Unacceptable
The paper provides a reflection that situates personal experiences but may be more descriptive than reflective, or does not accurately make associations to the theorist(s) main ideas.
20 pts
This criterion is linked to a Learning OutcomeAPA Style
10 pts
Outstanding
The Final paper is double spaced in a 12- point serif font, has 1- inch margins, 7th Ed. APA-style headings and includes in-text citations and reference list for all citations and references.
5 pts
Acceptable
The Final paper lacks some of the following features: double spacing, 12-point serif font, 1-inch margins, APA style headings, or a nearly complete Version 7 APA reference list.
Architect Daniel Libeskind is credited with saying “To provide meaningful architecture is not to parody history, but to articulate it.” The suggestion is that his work does not copy the efforts of others but relies on it.
Understanding the work of others is critically important to new work. Contributions to the nursing body of knowledge can happen when you are able to analyze and articulate the efforts of previous research. Research analysis skills are therefore critical tools for your toolbox.
In this Assignment, you will locate relevant existing research. You also will analyze this research using a tool helpful for analysis.
Reflect on the strategies presented in the Resources this Module’s Learning Resources in support of locating and analyzing research. Below are the strategies-
Al-Jundi, A., & Sakka, S. (2017).Critical appraisal of clinical researchLinks to an external site.. Journal of Clinical and Diagnostic Research: JCDR, 11(5), JE01–JE05. https://doi.org/10.7860/JCDR/2017/26047.9942
Shellenbarger, T. (2016). Simplifying synthesisLinks to an external site.. Nurse Author & Editor, 26(3). Retrieved from http://naepub.com/reporting-research/2016-26-3-3/
Walden University Library. (n.d.). Databases A-Z: NursingLinks to an external site.. Retrieved October 4, 2019 from https://academicguides.waldenu.edu/az.php?s=19981
Walden University Library. (n.d.). Evaluating resources: JournalsLinks to an external site.. Retrieved October 4, 2019, from https://academicguides.waldenu.edu/library/evaluat…
Walden University Library. (n.d.). Instructional media: Fundamentals of library researchLinks to an external site.. Retrieved October 4, 2019 from https://academicguides.waldenu.edu/library/instruc…
Walden University Writing Center.Links to an external site. (n.d.). Retrieved November 14, 2018, from https://academicguides.waldenu.edu/writingcenter/h…
Walden University Writing Center. (n.d.). Common assignments: Synthesizing your sourcesLinks to an external site.. https://academicguides.waldenu.edu/writingcenter/a…
Walden University Writing Center. (n.d.). Scholarly writing: OverviewLinks to an external site.. Retrieved November 14, 2018, from https://academicguides.waldenu.edu/writingcenter/s…
Walden University Writing Center. (n.d.). Webinars: Technical informationLinks to an external site.. Retrieved November 14, 2018, from https://academicguides.waldenu.edu/writingcenter/w…
Document: Academic Success and Professional Development Plan Template Download Academic Success and Professional Development Plan Template(Word document)
Document: Introduction to Scholarly Writing: Tips for success Download Introduction to Scholarly Writing: Tips for success(PDF)
Use the Walden Library to identify and read one peer-reviewed research article focused on a topic in your specialty field that interests you.
Review the article you selected and reflect on the professional practice use of theories/concepts described by the article.
The Assignment:Using the “Module 3 | Part 3” section of your Academic Success and Professional Development Plan Template presented in the Resources, conduct an analysis of the elements of the research article you identified. Be sure to include the following:
Your topic of interest.
A correctly formatted APA citation of the article you selected, along with link or search details.
Identify a professional practice use of the theories/concepts presented in the article.
Analysis of the article using the “Research Analysis Matrix” section of the template
Write a 1-paragraph justification stating whether you would recommend this article to inform professional practice.
Write a 2- to 3-paragraph summary that you will add to your Academic Success and Professional Development Plan that includes the following:
Describe your approach to identifying and analyzing peer-reviewed research.
Identify at least two strategies that you would use that you found to be effective in finding peer-reviewed research.
Identify at least one resource you intend to use in the future to find peer-reviewed research.
Submit your analysis, including your completed section of the Academic Success and Professional Development Plan Template sections and your matrix and summary.
Hello! I’m in a bit of a time crunch and need help with a paper due Sunday evening! You are to choose a vulnerable population and write a 5-6 page paper about it. I will post assignment details underneath. I live in rural eastern Kentucky just for reference. One of the questions asks about my own community!
Assignment: Guided Imagery
First, let me stress that this is NOT a POWER POINT presentation or a PAPER. The only thing
you need to submit are two things:
1. Your imagery script. This must be your script you have for walking your population through
the cognitive training (imagery). I recommend you using the attachment I have provided as a
guide. PETTLEP can be a great help in developing the script. You can even fill in your responses
on the attachment and submit it. Let the script serve as a guide as you guide me through your
imagery session.
2. Your video. I only want to see you talking me through the imagery of the chosen area. This
should be in a quiet area. Eliminate any distractions.
Upload this as ONE document. Paste the hyperlink to your imagery session in script document at
the TOP of the page. No title page or reference page is needed.
Please read below….
Over the past few weeks we have discussed the impact the mind plays in performance. For this
weeks assignment we are going to practice developing an effective imagery training program
which can aid in controlling stress, anxiety, arousal, etc. Download the attached document to use
as a template to create a script for an imagery training program. Choose a specific sports skill
(this can be related to the sport or activity you chose for your Critical Assignment) and begin
identifying the physical nature of the movement. For example, if my specific sports skill is
swinging a golf club, what are some specific physical components (foot placement, knee
position, spinal position, grip, etc.). Include specifics of the environment (sights, smells, etc.),
type of task, timing of the movement, content of the movement, emotion of the movement, and
perspective of the person.
Once you have created the script and practiced how you are going to deliver it, record a 5-10
minute video clip (Use can use VoiceThread, Screencast-o-matic, or YouTube) of you talking
through the imagery training program. For simplicity, pertend I am your client and you will walk
me through the activity you are walking me through in my mind. This is an opportunity for you
to practice implementing this skill with an athlete or client. You are welcome to address me
directly the population you are working with in your video. I understand that you are not a
trained sport psychologist, but I want you to give it your best effort. Find a quiet place to walk
through your imagery. Stay away from distractions in the back ground. Speak clearly. Bring
about specifics within the imagery session. Please use the video below as a frame of reference.
There is no written submission with this other than the written script you’d use for the imagery.
MUST WATCH the YouTube imagery training video
– https://www.youtube.com/watch?v=fw6NRd0BMOQ
Example of a script from a student in a past assignment
– https://www.youtube.com/watch?v=OKSVHzchKkk
My population is High School Varsity football Linebackers. My idea would be to help them with
a guided imagery on the BOX DRILL in this video. Help them visualize as well as all the other
information that was given in the instructions for this assignment. The video is 4 mins long but
only focus on the BOX DRILL which is from the start and ends 00:55 seconds.
– https://www.youtube.com/watch?v=W9KF71SHGv0
All you have to do is write the script with all the information that is given in the text and videos.
Make it the script similar to the the student in the past assignment video.
Also a template is given to guide you with the script.
Developing an Imagery Script
Holmes and Collins (2001) offered some guidelines for making imagery more effective, which they
call their PETTLEP program because it emphasizes the following:
•
The physical nature of the movement
•
The specifics of the environment
•
The type of task
•
The timing of the movement
•
Learning the content of the movement
•
The emotion (meaning to the individual) of the movement
•
The perspective of the person (internal or external)
Think of the sport that you are best at and design an imagery script that incorporates the PETTLEP
model of imagery.
Name of Sport Skill _____________________________________
The physical nature of the movement
The specifics of the environment
The type of task
The timing of the movement
From R.S. Weinberg and D. Gould, 2015, Foundations of Sport
and Exercise Psychology Web Study Guide, 6E (Champaign,
IL: Human Kinetics).
1
Learning the content of the movement
The emotion (meaning to the individual) of the movement
The perspective of the person (internal or external)
From R.S. Weinberg and D. Gould, 2015, Foundations of Sport
and Exercise Psychology Web Study Guide, 6E (Champaign,
IL: Human Kinetics).
2
Create a PowerPoint presentation that reviews four peer-reviewed articles written in the last five years on the issues around the adoption of eHealth in the Kingdom. Your presentation should contain the following concepts. Discuss at least 4 of the following perceptions that physicians may have that could be causing them to hesitate in using this technology.
Usefulness
Technical support available
Increased workload
User-friendly technology
Staff attitudes
Cost
Patient privacy
Your presentation should meet the following structural requirements:
Be 10-12 slides in length, not including the title or reference slides.
Be formatted according to Saudi Electronic University and APA writing guidelines.
Provide support for your statements with citations from a minimum of six scholarly articles. These citations should be listed in the Notes section of the slide in which they appear. Two of these sources may be from the class readings, textbook, or lectures, but four must be external.
Each slide must provide detailed speaker’s notes to support the slide content. These should be a minimum of 100 words long (per slide) and must be a part of the presentation. The presentation cannot be submitted in PDF format, which does not make notes visible to the instructor. Notes must draw from and cite relevant reference materials.
Utilize the following headings to organize the content in your presentation:
Introduction
4 of the above topics as 4 slides
Cultural, Social, or Religious Barriers
Recommendations for KSA
Conclusion
You are the Chief Operations Officer for a medium-sized hospital. Your radiology manager identified that the current image viewing software has a technical problem that may skip important images when the radiologists are interpreting CT exams. The skipping of images could lead to misinterpretations. The vendor has been unsuccessful in fixing this issue. A new upgraded overlay system would cost $450,000 to solve the issue. This cost will not generate new revenue.
Address the following:
Describe the situation.
Review the overall risk associated with incorrect interpretations.
Review possible hidden costs due to medical malpractice litigation.
Provide recommendations on whether to purchase or not purchase the overlay.
Requirements:
Your paper should be three to four pages in length, not including the title and reference pages.
You must include a minimum of four credible sources. Use the Saudi Electronic Digital Library to find your resources.
Your paper must follow Saudi Electronic University academic writing standards and APA 7th edition requirements, as appropriate.
You are strongly encouraged to submit all assignments to the Originality Check prior to submitting them to your instructor for grading.
Discussion week 7
Case study
Mr. T is a 21-year-old man who is brought to the ER by his mother after he began talking
about “aliens” who were trying to steal his soul. Mr. T reports that aliens left messages
for him by arranging sticks outside his home and sometimes send thoughts into his mind.
On exam, he is guarded and often stops talking while in the middle of expressing a
thought. Mr. T appears anxious and frequently scans the room for aliens, which he thinks
may have followed him to the hospital. He denies any plan to harm himself but admits
that the aliens sometimes want him to throw himself in front of a car, “as this
will change the systems that belong under us.”
The patient’s mother reports that he began expressing these ideas a few months ago, but
that they have become more severe in the last few weeks. She reports that during the
past year, he has become isolated from his peers, frequently talks to himself, and has
stopped going to community college. He has also spent most of his time reading science
fiction books and creating devices that will prevent aliens from hurting him. She reports
that she is concerned because the patient’s father, who left while the patient was a child,
exhibited similar symptoms many years ago and has spent most of his life in a psychiatric
hospital.
Question
Remember to answer these questions from your textbooks and clinical guidelines to
create your evidence-based treatment plan. At all times, explain your answers.
1. Summarize the clinical case including the significant subjective and objective
data.
2. Generate a primary and two differential diagnoses. Use the DSM5 to support
the assessment. Include the DSM5 and ICD 10 codes.
3. Discuss a pharmacological treatment would you prescribe? Use the clinical
guidelines to support the rationale for this treatment.
4. Discuss non-pharmacological treatment would you prescribe? Use the clinical
guidelines to support the rationale for this treatment.
5. Describe a health promotion intervention that would be appropriate for this
patient
Instructions
•
Your initial post should be at least 500 words, formatted, and cited in current
APA style with support from at least 2 academic sources.
I want the answer without similarity at all, and Conceptual and professional, they’re important, I want to follow the instructions in the picture.
Unformatted Attachment Preview
Health Administration Press
Chapter 12
Creating Alignment: Quality Measures and Leadership
Chapter Outline
• Introduction and Terminology
• Quality Assurance, Quality Control, and Quality Improvement
• Leadership, Measurement and Improvement
• Case Study
• Keys to Success
• Study Questions
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
1
Health Administration Press
Introduction & Terminology
• Creating alignment of effort around strategic quality, safety, and
operational objectives is a critical leadership function.
• Over the past decade, there has been an explosion of quality metrics
across healthcare both for internal improvement use and to meet
external accreditation, regulation, and payer demands.
• Collecting and publishing quality measures has become big business
for some organizations and a major cost for healthcare delivery
organizations.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
2
Health Administration Press
Introduction & Terminology
• The term “balanced scorecard” is from work by Kaplan and Norton first
published in HBR in 1992.
• “Balanced” means leaders monitor and understand measures of customer, process, quality,
and strategic performance in addition to financial measures, driving increased shareholder
value and performance.
• The terms dashboard and scorecard are often used interchangeably in
practice but denote different concepts.
• Dashboards: real time process and outcome measures that guide operational and
management decision making
• Scorecards: outcome measures of past performance that may be useful for
leadership tracking of strategic deployment, external comparison and
benchmarking, and overall organizational performance benchmarking
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
3
Health Administration Press
Quality Assurance (QA), Quality Control (QC), and
Quality Improvement (QI)
QA, QC, and QI
represent
different mental
models about
quality and the
use of data and
measurement in
healthcare
organizations.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
4
Health Administration Press
QA, QC, and QI
• QA
• Primarily retrospective review to identify problems or levels of performance
• Data often sourced from chart or case review
• Root cause analysis
• QC
• Data collected and monitored from variety of sources
• Measures collected often dictated by external requirements
• Management KPIs or targets often use same data
• Management reacts to measures which underperform
• QI
• In most robust form, adopted as a management philosophy and mental model
• Seek to improve overall outcomes by improving processes and reducing variation and
innovation
• Data used is often collected real time as part of improvement projects
• IHI Triple Aim represents high-level improvement objectives for healthcare delivery
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
5
Health Administration Press
Leadership, Measurement, and Improvement
• IHI High-Impact Leadership Model
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
6
Health Administration Press
Leadership, Measurement, and Improvement
• Transparency
is a critical
leadership
behavior.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
7
Health Administration Press
Leadership, Measurement, and Improvement
• Measurement and
data are important to
leadership efforts to
build will and delivery
results.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
8
Health Administration Press
Leadership, Measurement, and Improvement
• Leadership of
healthcare
organizations can
also be described
as a “system” with
measurement as a
key function.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
9
Health Administration Press
Leadership, Measurement, and Improvement
• Different types of
measures and
measurement sets
support different
functions and
responsibilities.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
10
Health Administration Press
Leadership, Measurement, and Improvement
• Dimensions of
Performance in
Healthcare
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
11
Health Administration Press
Leadership, Measurement, and Improvement
• Creating an organizational
scorecard
• Adopt just enough measures
• Organize by important
dimensions
• Focus on results
• Use to benchmark performance
against the best
• Use to monitor overall
performance and strategic
deployment
• Useful, not pretty
SOURCE: MdP Associates, LLC. Used with permission
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
12
Health Administration Press
Keys to Success
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Develop a clear understanding of the intended use.
Engage the governing board in development of performance measures.
Use the scorecard to evaluate organizational and leadership performance.
Be prepared to change the measures.
Make the data useful, not pretty.
Integrate the measures to achieve a balance view.
Develop clear and measurable strategies.
Use organizational performance dimensions to align efforts.
Avoid using indicators based on averages.
Develop composite clinical indicators for process and outcome indicators for results.
Use comparative data and external benchmarks.
Change your leadership system.
Focus on results, not activities.
Cultivate transparency.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
13
Health Administration Press
Study Questions
1. In your experience with healthcare, what are the important dimensions of
performance? How would you know whether an organization is
performing well?
2. What indicators do you think are important for a hospital to track? For a
physician practice? A home care agency? A long-term care facility? A
managed care organization?
3. What might be good indicators of patient-centeredness as recommended
by IOM?
4. What are some of the pitfalls of overmeasurement? How do you
determine what is important to measure in an organization?
5. Why is creating alignment an important leadership function? What are
some methods of creating alignment, and how can the use of
measurement support their deployment?
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
14
Live Session
Module #5
Patient Safety at a Glance: Ch. 21
Improving the Quality of Clinical
Care
HCM520
Quality and Performance Improvement
Introduction
►
Systemic problems lead to less than optimal experience
for patients
►
Moral/ethical compass shaped by ‘Do no harm’ precept
►
Patient harm alarms clinicians
►
Patient harm exposes contradiction of fundamental
expectation of care
►
Overall quality improvement described through 6 aims
►
Professionals act, don’t just express frustration
►
Professionals have two jobs, clinical and improvement
Science of
Improvement
►
Everyone must seek ways to improve systems
►
Combines subject matter knowledge and tools to create
approach
►
Approach emphasizes innovation, rapid-cycle testing
►
Derived from W. Edwards Deming’s system
►
Requires understanding of systems
►
Understanding of variation
►
Theory of knowledge
►
Understanding of psychology
Model for Improvement
►
Developed by Associated for Process Improvement
►
►
►
‘disciples’ of Deming’s
Three core questions:
►
What are we trying to accomplish?
►
How will we know that a change is an improvement?
►
What changes can we make that will result in
improvement?
Other core element: series of PDSA cycles
►
Inform degree of belief that changes in 3rd question has
desired influence on measures in 2nd question toward
achieving project aim in 1st question
►
PDSA cycles meant to be short, rapid
►
Measurement techniques, statistical analysis helps
determine what leads to improvements
►
Emphasizes importance of starting small
Supporting Use of Model for
Improvement
► Tools visualize, understand, assess current system and plan
changes
► Patient stories are powerful method to accelerate
improvement efforts
► Societal leaders communicate urgency
► Those leading improvement should use stories
► Successful projects run by multidisciplinary teams
► Importance of engaging team and giving a voice paramount
► In improvement, everyone has something to teach and
learn
Challenges and Overcoming
► Planning essential but other challenges exist
► Managing lots of ideas/people
► Delivering the change
► Addressing barriers during project
► Have set of tools
► Visualize theories for change
► Project management methods
► Borrow ideas
► Share learning
► Support other colleagues interested in leading change
Visual of Aims of Improvement
Example of Patient Journey through
Improvement Active Hospital
Patient Safety at a Glance:
Ch. 28
Patient Stories in Improvement
Introduction
►
Stories have been around for centuries
►
Increasing value to objective scientific stories only as
recent as decades
►
UK NHS – taken steps to ensure patient experience
listened to
►
Patient stories skillfully collected, utilized…
►
►
Enable better understanding what is working well
►
Identify what needs improvement
Patient stories become mobilizing narratives for
improvement
Process of Collecting Patient Stories
► Key steps in process
► Recruiting patients
► Obtain consent
► Ethically conduct, record story
► Make sense of story
► Mind-mapping
Recruit and Obtain Consent
►
Avoid temptation to only collect easy stories
►
Tempting to exclude patients of more difficult communication
or access
►
Collecting stories from one side does not provide fair picture
►
►
Stories should not be recorded
►
►
May result in bias
Unless storytellers are informed and provide written consent
Consent should be in writing with a signature
►
Allows use of final version as a publicly available learning resource
Ethically Conduct and Record
► Three practical ethical behaviors
► Respect
► People and stories should always be respected
► Support
► Offered emotional support during and after storytelling
► Confidentiality and anonymity
► Do not name other patients or staff
► All information collected to protect identity unless they
wish to be identified
► Establish trust and rapport
► Ask questions, allowing patient to speak freely
► Be careful with closed-type questions
► Use active listening skills
► Maintain eye contact
► Nodding or respond when appropriate
Mind-Mapping
► Key components are disseminated to colleagues
► Impractical to have staff read whole story
► Summarize story used as themes, triggers for future
improvement
► Mind-mapping used to transform totality of story into a
condensed graphical representation
► Play back recording, mind map contents
► Reduce stories into main themes
► Compare with other patient stories
Visual Summary of Collecting Stories
Tips for Mind-Mapping
Example of Patient Story Mind-Map
Questions?
Respond in 250 words or more. References must be in APA Format 7th edition and must include a minimum of 2 resources published within the past 5 years.
H211 Weekly Worksheet #1
Due:
NAME
Purpose: To familiarize yourself with immunization protocols and patient needs. To refresh your understanding of
the top 50 prescribed medications. As well as to familiarize yourself with handwritten charting and med lists.
Part One:
Getting started with vaccines: Use the internet or any other vaccine resource to complete the following table.
Vaccine
DTap
Hib
HepA
HepB
HPV
IPV
LAIV
MMR
MCV4
MPSV4
PCV
PPV23
Rv
IIV
Var
What does the abbreviation stand
for?
Route of Administration
# of doses in series
Dose Amount
Part Two:
Use the internet or other appropriate resources find the requested information about each medication
listed below.
Abilify
Generic Name and Classification:
_____________________________________________________________________________________________
Indications:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Patient Teaching:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
____________________________________________________________________________________________
Accupril
Generic Name and Classification:
_____________________________________________________________________________________________
Indications:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Patient Teaching:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Adderall
Generic Name and Classification:
_____________________________________________________________________________________________
Indications:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Patient Teaching:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Advair Diskus
Generic Name and Classification:
_____________________________________________________________________________________________
Indications:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Patient Teaching:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Ambien
Generic Name and Classification:
_____________________________________________________________________________________________
Indications:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Patient Teaching:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Aricept
Generic Name and Classification:
____________________________________________________________________________________________
Indications:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Patient Teaching:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Ativan
Generic Name and Classification:
_____________________________________________________________________________________________
Indications:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Patient Teaching:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Cardizem
Generic Name and Classification:
_____________________________________________________________________________________________
Indications:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Patient Teaching:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
For this Memo, research the COVID-19 Pandemic and indicate any international advice provided for mass gatherings during the pandemic.
Imagine you have been asked to draft a memo to help the country to safely proceed with Hajj
Indicate the advice provided by the World Health Organization in safely engaging in a mass gathering in the Kingdom of Saudi Arabia during a pandemic.
Analyze the ethical implications of this advice.
Detail how this advice was prescribed into law or practice in the Kingdom of Saudi Arabia.
Indicate the healthcare organization or other entities that heed this advice; and
Examine the outcomes of these requirements
Your memo should meet the following structural requirements:
Two to three pages in length, not including the cover sheet and reference page.
Formatted according to APA 7th edition and Saudi Electronic University writing standards
Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references.
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Overview
In this activity, you will have the opportunity to examine how using critical analysis tools influences your interactions with others. You will also consider how the analysis of your topic might have turned out differently if you looked at it through a different lens. Completing this activity will result in a draft of the reflection section of your project. It also provides an opportunity to obtain valuable feedback from your instructor that you can incorporate into your project submission.
Directions
In this activity, you will work on the second part of the reflection section of your project. You should consider the feedback from your instructor on the previous activities to inform this assignment. Include diverse perspectives from varied sources to support your points. Look to the SNHU Shapiro Library for assistance and consider the sources you have used thus far to support your research. First, you will explain how the analysis of your topic in wellness may have been different if you had used one of the other general education lenses. Then you will explain how critically analyzing wellness affects your interactions with various people.
You are not required to address each item below the rubric criteria, but you may use them to better understand the criteria and guide your thinking and writing.
Specifically, you must address the following rubric criteria:
Integrate reliable evidence from varied sources throughout your paper to support your analysis.
It is important to draw from a more diverse pool of perspectives from varied sources to support the analysis. This is different from the Citations and Attributions rubric criterion.
Reliable evidence from varied sources should be interwoven throughout the paper itself, while citing and attributing sources will be represented as APA in-text citations and a reference list at the end of your work.
You will be evaluated on both criteria.
Explain at least one way in which your analysis might have been different if you had used one of the other general education lenses to analyze your topic.
This should be a brief (3–5 sentences) reflection about how using the language and perspective from a different lens would shift your view of your topic.
Explain how analyzing wellness can help interactions with people with a different viewpoints, cultures, or perspectives.
Think about ways in which a greater awareness of wellness strengthens individual conversations. Consider including an example from your life.
What to Submit
Submit your short paper as a 1- to 2-page Microsoft Word document with double spacing, 12-point Times New Roman font, and one-inch margins. Sources should be cited according to APA style. Consult the Shapiro Library APA Style Guide for more information on citations.
Module Six Activity Rubric
Criteria Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value
Reliable Evidence From Varied Sources Integrates reliable evidence from varied sources throughout the paper to support analysis Shows progress toward proficiency, but with errors or omissions; areas for improvement may include drawing from a more diverse pool of perspectives, using more varied sources to support the analysis, or integrating evidence and sources throughout the paper to support the analysis Does not attempt criterion 30
Different General Education Lens Explains at least one way in which the analysis might have been different if another general education lens was used to analyze the topic Shows progress toward proficiency, but with errors or omissions; areas for improvement may include the use of an alternative general education lens, a clearer explanation of how the analysis might have been different if one of the other general education lenses had been used to analyze the topic, or more support for the explanation Does not attempt criterion 30
Interactions Explains how analyzing wellness can help interactions with people with different viewpoint, culture, or perspective Shows progress toward proficiency, but with errors or omissions; areas for improvement may include connecting the value of critical analysis to interactions with people with a different viewpoint, culture, or perspective or providing a more thorough explanation of how the analysis can help these interactions Does not attempt criterion 30
Articulation of Response Clearly conveys meaning with correct grammar, sentence structure, and spelling, demonstrating an understanding of audience and purpose Shows progress toward proficiency, but with errors in grammar, sentence structure, and spelling, negatively impacting readability Submission has critical errors in grammar, sentence structure, and spelling, preventing understanding of ideas 5
Citations and Attributions Uses citations for ideas requiring attribution, with consistent minor errors Uses citations for ideas requiring attribution, with major errors Does not use citations for ideas requiring attribution 5
Total: 100%
Requirements: 1-2 Full Pages Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please be sure to include an introduction paragraph with a clear thesis statement in the last sentence of the introduction paragraph and a conclusion paragraph
Please be sure to carefully follow the instructions
No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool.
Please be sure to include at least one in-text citation in each body paragraph
Information technology can be used to assist health care organizations in the ability to provide access to healthcare organizations. Please choose any current information technology and create a PowerPoint presentation on how the technology will improve healthcare access in KSA. Be sure to include:
An overview of the information technology including its goals
The main stakeholders from the healthcare system that are involved in information technology.
How information technology will improve access to healthcare in KSA.
Recommendations for how you would evaluate whether access to services has improved.
Your presentation should meet the following structural requirements:
Be 7-8 slides in length, not including the title or reference slides.
Be formatted according to Saudi Electronic University and APA writing guidelines.
Provide support for your statements with citations from a minimum of six scholarly articles. These citations should be listed in the Notes section of the slide in which they appear. Two of these sources may be from the class readings, textbook, or lectures, but four must be external.
Each slide must provide detailed speaker’s notes to support the slide content. These should be a minimum of 100 words long (per slide) and must be a part of the presentation. The presentation cannot be submitted in PDF format, which does not make notes visible to the instructor. Notes must draw from and cite relevant reference materials.
Utilize headings to organize the content in your work.
Revisit the discussion information you presented in Week 3. Based upon the health-related risk, problem, or disparity that you identified and using your most innovative thinking, respond to the following:Propose one policy-related intervention to address the issue and explain how it would improve health outcomes and equity.Explain how the data identified in Week 3 is supportive of the recommended intervention. (In other words, how is the proposed intervention data-driven?)Determine the appropriate evaluation method to assess the success of the recommended intervention.Describe the resources needed to implement your recommended intervention.Identify the stakeholders. Explain how you would collaborate with them.
What qualities should a nurse leader encompass for personal, professional, and leadership development?
To be a well-rounded resilient leader, self-care and well-being is of importance. Please describe the concepts of well-being.
Please describe activities that you currently find to be supportive to your self-care and well-being. 2 pages double spaced.
I picked 3 activites from https://www.nimh.nih.gov/health/topics/caring-for-your-mental-health they are
Set goals and priorities. Decide what must get done now and what can wait. Learn to say “no” to new tasks if you start to feel like you’re taking on too much. Try to be mindful of what you have accomplished at the end of the day, not what you have been unable to do.
Practice gratitude. Remind yourself daily of things you are grateful for. Be specific. Write them down at night, or replay them in your mind.
Focus on positivity. Identify and challenge your negative and unhelpful thoughts.
PA style headings. Please provide a minimum of 1 reference.
SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan. The episodic SOAP note is to be written using the attached template below.
For all the SOAP note assignments, you will write a SOAP note about one of your patients and use the following acronym:
S = Subjective data: Patient’s Chief Complaint (CC).
O = Objective data: Including client behavior, physical assessment, vital signs, and meds.
A = Assessment: Diagnosis of the patient’s condition. Include differential diagnosis.
P = Plan: Treatment, diagnostic testing, and follow up
Submission Instructions:
Your SOAP note should be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
Complete and submit the assignment using the appropriate template in MS Word
Grading Rubric
Your assignment will be graded according to the grading rubric.
Rubric
SOAP Notes Rubric
SOAP Notes Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeChief Complaint (Reason for seeking health care) – S
4 pts
Distinguished
Includes a direct quote from patient about presenting problem
3 pts
Excellent
Includes a direct quote from patient and other unrelated information
2 pts
Fair
Includes information but information is NOT a direct quote
0 pts
Poor
Information is completely missing
4 pts
This criterion is linked to a Learning OutcomeDemographics – S
2 pts
Distinguished
Begins with patient initials, age, race, ethnicity and gender (5 demographics)
1.5 pts
Excellent
Begins with 4 of the 5 patient demographics (patient initials, age, race, ethnicity and gender)
1 pts
Fair
Begins with 3 or less patient demographics (patient initials, age, race, ethnicity and gender)
0 pts
Poor
Information is completely missing
2 pts
This criterion is linked to a Learning OutcomeHistory of the Present Illness (HPI) – S
5 pts
Distinguished
Includes the presenting problem and the 8 dimensions of the problem (OLD CARTS – Onset, Location, Duration, Character, Aggravating factors, Relieving factors, Timing and Severity)
3 pts
Excellent
Includes the presenting problem and 7 of the 8 dimensions of the problem (OLD CARTS – Onset, Location, Duration, Character, Aggravating factors, Relieving factors, Timing and Severity)
2 pts
Fair
Includes the presenting problem and 6 of the 8 dimensions of the problem (OLD CARTS – Onset, Location, Duration, Character, Aggravating factors, Relieving factors, Timing and Severity)
0 pts
Poor
Information is completely missing
5 pts
This criterion is linked to a Learning OutcomeAllergies – S
2 pts
Distinguished
Includes NKA (including = Drug, Environemental, Food, Herbal, and/or Latex or if allergies are present (reports for each severity of allergy AND description of allergy)
1.5 pts
Excellent
If allergies are present, students lists type Drug, environemtal factor, herbal, food, latex name and includes severity of allergy OR description of allergy
1 pts
Fair
If allergies are present, students lists only the type of allergy name
0 pts
Poor
Information is completely missing
2 pts
This criterion is linked to a Learning OutcomeReview of Systems (ROS) – S
12 pts
Distinguished
Includes a minimum of 3 assessments for each body system and assesses at least 9 body systems directed to chief complaint AND uses the words “admits” and “denies”
6 pts
Excellent
Includes 3 or fewer assessments for each body system and assesses 5-8 body systems directed to chief complaint AND uses the words “admits” and “denies”
3 pts
Fair
Includes 3 or fewer assessments for each body system and assesses less than 5 body systems directed to chief complaint OR student does not use the words “admits” and “denies”
0 pts
Poor
Information is completely missing
12 pts
This criterion is linked to a Learning OutcomeVital Signs – O
2 pts
Distinguished
Includes all 8 vital signs, (BP (with patient position), HR, RR, temperature (with Fahrenheit or Celsius and route of temperature collection), weight, height, BMI (or percentiles for pediatric population) and pain.)
1.5 pts
Excellent
Includes 7 vital signs, (BP (with patient position), HR, RR, temperature (with Fahrenheit or Celsius and route of temperature collection), weight, height, BMI (or percentiles for pediatric population) and pain.)
1 pts
Fair
Includes 6 or less vital signs, (BP (with patient position), HR, RR, temperature (with Fahrenheit or Celsius and route of temperature collection), weight, height, BMI (or percentiles for pediatric population) and pain.)
0 pts
Poor
Information is completely missing
2 pts
This criterion is linked to a Learning OutcomeLabs – O
3 pts
Distinguished
Includes a list of the labs reviewed at the visit, values of lab results and highlights abnormal values OR acknowledges no labs/diagnostic tests were reviewed.
2 pts
Excellent
Includes a list of the labs reviewed at the visit, values of lab results but does not highlight abnormal values.
1 pts
Fair
Includes a list of the labs reviewed at the visit but does not include the values of lab results or highlight abnormal values.
0 pts
Poor
Information is completely missing
3 pts
This criterion is linked to a Learning OutcomeMedications – O
4 pts
Distinguished
Includes a list of all of the patient reported medications and the medical diagnosis for the medication (including name, dose, route, frequency)
2 pts
Excellent
Includes a list of all of the patient reported medications and the medical diagnosis for the medication (including 3 of the 4: name, dose, medications route, frequency)
1 pts
Fair
Includes a list of all of the patient reported medications (including 2 of the 4: name, dose, route, frequency)
0 pts
Poor
Information is completely missing
4 pts
This criterion is linked to a Learning OutcomeScreenings – O
3 pts
Distinguished
Includes an assessment of at least 5 screening tests
2 pts
Excellent
Includes an assessment of at least 4 screening tests
1 pts
Fair
Includes an assessment of at least 3 screening tests
0 pts
Poor
Information is completely missing
3 pts
This criterion is linked to a Learning OutcomePast Medical History – O
3 pts
Distinguished
Includes (Major/Chronic, Trauma, Hospitalizations), for each medical diagnosis, year of diagnosis and whether the diagnosis is active or current
2 pts
Excellent
Includes (Major/Chronic, Trauma, Hospitalizations), for each medical diagnosis, either year of diagnosis OR whether the diagnosis is active or current
1 pts
Fair
Includes each medical diagnosis but does not include year of diagnosis or whether the diagnosis is active or current
0 pts
Poor
Information is completely missing
3 pts
This criterion is linked to a Learning OutcomePast Surgical History – O
3 pts
Distinguished
Includes, for each surgical procedure, the year of procedure and the indication for the procedure
2 pts
Excellent
Includes, for each surgical procedure, the year of procedure OR indication of the procedure
1 pts
Fair
Includes, for each surgical procedure but not the year of procedure or indication of the procedure
0 pts
Poor
Information is completely missing
3 pts
This criterion is linked to a Learning OutcomeFamily History – O
3 pts
Distinguished
Includes an assessment of at least 4 family members regarding, at a minimum, genetic disorders, diabetes, heart disease and cancer.
2 pts
Excellent
Includes an assessment of at least 3 family members regarding, at a minimum, genetic disorders, diabetes, heart disease and cancer.
1 pts
Fair
Includes an assessment of at least 2 family members regarding, at a minimum, genetic disorders, diabetes, heart disease and cancer.
0 pts
Poor
Information is completely missing
3 pts
This criterion is linked to a Learning OutcomeSocial History – O
3 pts
Distinguished
Includes all 11 of the following: tobacco use, drug use, alcohol use, marital status, employment status, current and previous occupation, sexual orientation, sexually active, contraceptive use, and living situation.
2 pts
Excellent
Includes 10 of the 11 following: tobacco use, drug use, alcohol use, marital status, employment status, current and previous occupation, sexual orientation, sexually active, contraceptive use, and living situation.
1 pts
Fair
Includes 9 or less of the following: tobacco use, drug use, alcohol use, marital status, employment status, current and previous occupation, sexual orientation, sexually active, contraceptive use, and living situation.
0 pts
Poor
Information is completely missing
3 pts
This criterion is linked to a Learning OutcomePhysical Examination – O
12 pts
Distinguished
Includes a minimum of 4 assessments for each body system and assesses at least 5 body systems directed to chief complaint
6 pts
Excellent
Includes a minimum of 3 assessments for each body system and assesses at least 4 body systems directed to chief complaint
3 pts
Fair
Includes a minimum of 2 assessments for each body system and assesses at least 4 body systems directed to chief complaint
0 pts
Poor
Information is completely missing
12 pts
This criterion is linked to a Learning OutcomeDiagnosis – A
5 pts
Distinguished
Includes a clear outline of the accurate principal diagnosis AND lists the remaining diagnoses addressed at the visit (in descending priority)
3 pts
Excellent
Includes a clear outline of the accurate diagnoses addressed at the visit but does not list the diagnoses in descending order of priority
2 pts
Fair
Includes an inaccurate diagnosis as the principal diagnosis
0 pts
Poor
Information is completely missing
5 pts
This criterion is linked to a Learning OutcomeDifferential Diagnosis – A
5 pts
Distinguished
Includes at least 3 differential diagnoses for the principal diagnosis
3 pts
Excellent
Includes 2 differential diagnoses for the principal diagnosis
2 pts
Fair
Includes 1 differential diagnosis for the principal diagnosis
0 pts
Poor
Information is completely missing
5 pts
This criterion is linked to a Learning OutcomePharmacologic treatment plan – P
5 pts
Distinguished
Includes a detailed pharmacologic treatment plan for each of the diagnoses listed under “assessment”. The plan includes ALL of the following: drug name, dose, route, frequency, duration and cost as well as education related to pharmacologic agent. If the diagnosis is a chronic problem, student includes instructions on currently prescribed medications as above.
3 pts
Excellent
Includes a detailed pharmacologic treatment plan for each of the diagnoses listed under “assessment”. The plan includes 4 of the following 7: the drug name, dose, route, frequency, duration and cost as well as education related to pharmacologic agent. If the diagnosis is a chronic problem, student includes instructions on currently prescribed medications as above.
2 pts
Fair
Includes a detailed pharmacologic treatment plan for each of the diagnoses listed under “assessment”. The plan includes less than 4 of the following: the drug name, dose, route, frequency, duration and cost as well as education related to pharmacologic agent. If the diagnosis is a chronic problem, student includes instructions on currently prescribed medications as above.
0 pts
Poor
Information is completely missing
5 pts
This criterion is linked to a Learning OutcomeDiagnostic/Lab Testing – P
5 pts
Distinguished
Includes appropriate diagnostic/lab testing 100% of the time OR acknowledges “no diagnostic testing clinically required at this time”
3 pts
Excellent
Includes appropriate diagnostic/lab testing 50% of the time OR acknowledges “no diagnostic testing clinically required at this time”
2 pts
Fair
Includes appropriate diagnostic testing less than 50% of the time.
0 pts
Poor
Information is completely missing
5 pts
This criterion is linked to a Learning OutcomeEducation – P
5 pts
Distinguished
Includes at least 3 strategies to promote and develop skills for managing their illness and at least 3 self-management methods on how to incorporate healthy behaviors into their lives.
3 pts
Excellent
Includes at least 2 strategies to promote and develop skills for managing their illness and at least 2 self-management methods on how to incorporate healthy behaviors into their lives.
2 pts
Fair
Includes at least 1 strategies to promote and develop skills for managing their illness and at least 1 self-management methods on how to incorporate healthy behaviors into their lives.
0 pts
Poor
Information is completely missing
5 pts
This criterion is linked to a Learning OutcomeAnticipatory Guidance – P
4 pts
Distinguished
Includes at least 3 primary prevention strategies (related to age/condition (i.e. immunizations, pediatric and pre-natal milestone anticipatory guidance)) and at least 2 secondary prevention strategies (related to age/condition (i.e. screening))
2 pts
Excellent
Includes at least 2 primary prevention strategies (related to age/condition (i.e. immunizations, pediatric and pre-natal milestone anticipatory guidance)) and at least 2 secondary prevention strategies (related to age/condition (i.e. screening))
1 pts
Fair
Includes at least 1 primary prevention strategies (related to age/condition (i.e. immunizations, pediatric and pre-natal milestone anticipatory guidance)) and at least 1 secondary prevention strategies (related to age/condition (i.e. screening))
0 pts
Poor
Information is completely missing
4 pts
This criterion is linked to a Learning OutcomeFollow up plan – P
4 pts
Distinguished
Includes recommendation for follow up, including time frame (i.e. x # of days/weeks/months)
2 pts
Excellent
Includes recommendation for follow up, but does not include time frame (i.e. x # of days/weeks/months)
0 pts
Poor
Does not include follow up plan
4 pts
This criterion is linked to a Learning OutcomeReferences
3 pts
Distinguished
High level of APA precision
2 pts
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1 pts
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A/ 1- If you evaluate the majority of your physical activity, would it be aerobic, anaerobic, a combination or neither? In 3-4 sentences explain.
2- Refer to the factors mentioned above; excluding longevity, which do you think could pose the greatest challenge for you and why?
3- Resting Heart Rate (RHR). How many beats per minute does your heart beat at rest? Refer to the paragraph above “Evaluate your Aerobic Fitness Level” for instructions on taking your resting pulse. This will be considered your baseline for today.
4- Take a brisk walk, treadmill, jog , hike or do any aerobic exercise that suits you for 30-45 minutes. Monitor your pulse (HR) , at least once during, and immediately afterward. Record it here:
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B/ In a paragraph of 300 words or more, reflect on this workout (Question #4, ); how realistic , attainable or unattainable are these numbers for you? Why? What might you need to improve (Frequency, Intensity, Time, Duration) to meet/improve your personal fitness goals? Were you exhausted, winded, barely phased? There are no wrong answers! The goal is to be honest about where you are beginning (your baseline) so you can chart your improvement throughout the semester.
If you have a pre-existing health concern or medical condition, consult with your doctor first and explain the purpose of this assignment to them.
————————————————————
C/ Share your favorite cardio workout–what makes it special for you or simply a habit? Is it a specific activity e.g. running, walking, cycling, swimming, etc? Is it a specific place? Is it solo or with a group? Indoors or outdoors? What makes it do-able or something you go back to? Feel free to be inspired by someone else and respond to them or share your own response. ————————————————————————————————————————————————–
Read// Define Aerobic versus Anaerobic
List and describe the health benefits of an active lifestyle and cardiorespiratory fitness
Evaluate your cardiovascular fitness
Design exercise prescription for cardiorespiratory endurance
Your heart is roughly the size of your fist and sustains your life. Nestled between the lungs it pumps the body’s entire volume of blood to and from the lungs and to every organ in the body. In this chapter we’ll explore, cardiorespiratory (heart and lung) fitness and why it matters.
word kardia which means heart. The heart delivers oxygen to every inch of your body.
Stamina and endurance develop with aerobic fitness Aerobic means with oxygen, Aerobic exercise is exercising in the presence of oxygen or elevating and sustaining the heart rate for 15 minutes or more.
Perhaps you’ve experienced being out for a walk and moving into a fast pace or even a jog. You may struggle with breathing at first. As your cardiorespiratory system becomes more efficient with training, you are able to sustain your fast walk or slow jog for longer periods, this is aerobic fitness. What kinds of training does this include? Large muscle activities that elevate and sustain your heart rate comfortably for prolonged bouts of time, building your stamina and endurance. Fast walking, jogging, elliptical, jump roping, biking, swimming, hiking, cross country skiing, Zumba or any aerobic dancing, rebounding (mini trampoline), rollerblading, rowing. If I’ve missed your favorite aerobic exercise let me know!
When does aerobic transition to anaerobic or without oxygen? Clearly you still need oxygen, but as you increase the intensity of exercise thereby shortening the duration, the muscles make a transition to anaerobic energy production, accumulating lactic acid in the muscles and blood. Think short bursts of intense effort like sprints, soccer, basketball, interval training, running the bases, hockey. During aerobic exercise fat reserves are used, or oxidized, ensuring there is an adequate supply of energy. With hIgher intensity efforts our body turns to carbohydrate for fuel. Benefits of Aerobic Fitness
Longevity: When people are in the second decade of life, their health in the sixth, seventh or eighth decade of life may seem too far off to worry about. You’re made of rubber and magic right? You’re resilient with injuries and impervious to aging. But facts are facts. Sedentariness and low cardiorespiratory fitness are powerful predictors of premature death (Blair & Lamonte, 2011). Furthermore the greater the cardiorespiratory fitness, the lower the risk of mortality (Blair & Lamonte, 2011) It doesn’t require athletic potential to increase longevity. Brisk walking for 30-60 minutes every day is sufficient to expend an additional 1000 calories a week, decreasing mortality rate by 20-30 percent (Kokkinos et al, 2011).
Fighting Heart Disease: Cardiovascular disease, (CVD) is caused by substances like platelets, cholesterol and fats being absorbed into the walls of the arteries. Referred to as plaque, over time it restricts blood flow and oxygen to the heart and brain, causing heart attack and strokes. Ischemia is reduced blood flow and oxygen supply to the heart muscle.
Yes, CVD is primarily a middle age to older persons disease, however a few reasons why a twenty-something year old should pay close attention: 1) According to the Center for Disease Control, one in every four deaths are related to cardiovascular disease. This stat may be relevant to a loved one of yours. 2) Arteries don’t become occluded overnight– plaque can begin forming as early as your teens. 3) Regardless of heredity, most risk factors for CVD are under your control; your lifestyle determines your heart health.
Hypertension or high blood pressure is a risk factor for CVD. You can have high blood pressure in your 20s, and unchecked, overtime it can lead to sudden heart attack or stroke. Normal blood pressure is approximately 120/80, it can rise slightly as we age. Have you checked your blood pressure recently? The number on top or systolic pressure is the pressure in the arteries when they are contracting The bottom number or diastolic pressure is the arterial pressure when the heart is relaxing. There are many medications that can help control blood pressure but they all have side effects like, dizziness, headaches, fainting. Aerobic exercise is the optimal way to mitigate hypertension, and keep those arteries working like they are supposed to.
Obesity: Obesity is associated with numerous life threatening diseases, among them CVD, diabetes, asthma, many cancers. You don’t have to be a marathon runner to gain the benefits of daily moderate aerobic exercise. It’s the single greatest factor to maintaining a healthy body weight and body composition throughout your life, thereby mitigating disease. One pound of fat equals 3500 calories. Burning an additional 500 calories a day can be achieved with as little as 50 minutes of aerobic exercise. Over 7 days, you’ve decreased your fat weight by 1 lb. Aerobic exercise ramps up your metabolism and burns calories during as well as after exercise.
Insulin Resistance: When carbohydrates are consumed, sugar levels in the blood increase. As a result the pancreas releases insulin to transport the blood sugar to the muscles and liver, to keep blood sugar levels under control. If there is not enough insulin, blood sugar levels remain high and become a precursor to diabetes and CVD. Type 1 diabetes is highly genetic, and refers to a low production of insulin and usually occurs early in life. Type 2 diabetes is the insensitivity or resistance to insulin, causing the body to struggle with reducing blood sugar. This is usually associated with lifestyle (exercise and diet) and occurs in adulthood.
Aerobic exercise reduces risk of diabetes, cancer, improves our mental health, improves our sleep, our cognition and our immune function. Suffice to say these benefits will change the trajectory of how you live out the rest of your life. There is no better time than now to imbed this habit into your lifestyle.
Evaluate your aerobic fitness level: For starters, know your resting heart rate, how hard your heart is working before exercise. Ideally, first thing in the morning before getting up is the most accurate reading of your RHR. Place your index and middle finger over your carotid artery beside your windpipe. Alternatively place two fingers on your radial artery, below your thumb on the palm side of your wrist. When you feel a pulse, count the beats for 15 seconds then multiply by 4 for your resting pulse. If you counted 18 beats and you multiply by 4, your resting heart rate is 72 beats per minute.
Target Heart Rate Zone: How to know if you are working hard with enough intensity to improve your fitness? The target heart rate zone is a guide for the intensity of your workout. You want to work at approximately 50% to 85% of your maximum heart rate, depending on your existing fitness level. Beginning at 220, subtract your age for your absolute maximum heart rate, , then multiply by 50-85% for a target rate to achieve.. So if you are 20, your maximum rate is 200, your target rate would be 100-175 beats per minute that you would sustain for 30 minutes or more. The aim is to work hard enough to increase your cardiorespiratory function but not so hard you can’t converse or to the point of injury. You can use the same method you use to measure your resting pulse, or use a Fitbit, Apple watch or Polar heart rate monitor. Heart rate monitors can be great for enhancing your workout. If you’re consistently working at the lower end of your zone, with conditioning, you can begin to elevate and sustain your heart rate.
Critical Thinking:Chapter 16-Drugs Used for Depressive and Bipolar DisordersInstructionsInstructionsA patient with a panic disorder has been prescribed an MAOI. He says that he is glad to be getting help and is looking forward to being cured once he starts his medication. How should the nurse respond?
To begin, watch
the video How America Is
Causing Global Obesity. Then, answer the questions below to complete your
analysis of the film. Summarize the issues presented in the video, and discuss how these issues relate to the field of public health.Describe the impact of both individuals and the community on the issues presented in the video.Describe the role of the state and federal government in addressing the issues presented in the video. For example, what policies or legislation were created to address the issues?Explain how current and proposed health policies might determine children’s behavioral and dietary choices once they reach adulthood. Be sure to support your reasoning.Overall, reflect on the assertions made in the video. Do you agree or disagree with assertions made? Why or why not?
Purpose:
Immunizations are a vital part of the Medical Assistants job. Immunization practices are constantly
changing, as medicine and research changes. So, it is important to stay up to date and be aware of all
practices. This manual assignment will give you a start in creating a resource book you can keep with
you a long time.
Assignment:
Part one:
1) Head to http://www.immunize.org/. Once there please take a look around, familiarize yourself
with this website.
2) Answer the following questions. (Need to be typed, full sentences, and turned in with your
manual)
a. Who is the intended audience of this website?
b. What did you like most about this site?
c. Is this a good patient resource? Why or why not?
3) Now print the following pages for your resource manual (Make sure you are printing the most
up to date)
a. Administering Vaccines, Item #P3085
b. Administering Vaccines to Adults Item #3084
c. Summary of Recommendations for Childhood and Adolescent Immunizations Item #P2010
d. Summary of Recommendations for Adult Immunizations Item # P2011
e. Don’t be guilty of these preventable errors in vaccine administration, #P3033
f. Hepatitis A and hepatitis B vaccines: Be sure your patients get the correct dose, #P2081
g. Checklist of Current Versions of U.S. COVID-19-Vaccination Guidance and Clinic Support
Tools, Item #P3130
h. Anything else you would like to add to your resource binder
Part Two:
1) Head to https://www.cdc.gov/vaccines/hcp/index.html . Once there, please take a look around,
familiarize yourself with this website.
2) Answer the following questions. (Need to be typed, full sentences, and turned in with your
manual)
a. Who is the intended audience of this website?
b. What did you like most about this site?
c. Is this a good patient resource? Why or why not?
d. What is the “Pink Book”?
3) Now print the following pages for your resource manual (Make sure you are printing the most
up to date
a.Child and Adolescent Schedule, Comprehensive Version(This needs to be printed in
landscape orientation in order for it to be legible. If you have the ability to print in color
this is best, but not required)
b. Pink Book Appendices:
i. Appendix A (Only Guide to Contraindications and Precautions to Commonly
Used Vaccines)
ii. Appendix B (Only U.S. Vaccines and Thimerosal Table)
iii. Appendix C (Only It’s Federal Law and Instructions for Use of VISs)
iv. Appendix D (Only Sections: The Vaccine Adverse Event Reporting System and
Vaccine Injury Table)
c. COVID-19 Vaccination Clinical & Professional Resources
i. Interim COVID-19 Immunization Schedule for Persons 6 Months of Age and
Older
Part Three:
Now that you have explored these two sites choose at least 5 additional documents that you find
interesting or might find useful.
Calcifying Odontogenic Cyst: A paragraph is needed for each subheading. Must use a total of 3 references. The references must be cited throughout the assignment. No direct quotes.
Unformatted Attachment Preview
Name of cyst (here)
Data Collection/Supportive Evidence
Demographic or Epidemiological Characteristics:
Which population is most affected?
What is the incidence versus the prevalence?
Describe the general historical perspective of this lesion.
Are there contributing social, environmental, medical, dental or genetic factors that should be
considered such as drug use, water contamination or living environment, medical history, dental
history or heredity?
Etiology or Origin:
Describe the cause of this lesion.
Is this lesion considered abnormal or normal?
What is the lesion’s incubation period?
How long is the lesion present?
Which general lesion type is this lesion associated?
Pathogenesis:
Method of transmission
Clinical Diagnosis:
Include the color, shape, possible locations (inside/outside oral cavity), attachment type, flat or
raised, lobular/multi-lobular, texture, extra-oral, intra-oral, and peri-oral.
Radiologic Diagnosis:
Describe the radiographic presentation – radiolucent or radiopaque and the expected location
radiographically.
Laboratory (microscopic) Diagnosis:
Is this a contributing factor for this lesion? Why or Why not? Would the microscopic diagnosis
be included for this lesion? What is the impact of the microscopic Diagnosis?
Is there histological information?
Prognosis (treatment):
What are the therapeutic needs for this lesion? Surgical, chemotherapeutics, etc. Is this lesion
likely to return or is there a curative procedure?
Is the lesion malignant or benign?
Differential Diagnosis:
Which of the processes listed above would be most relevant to determine the final diagnosis?
Why?
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please answer all of the following questions below based on the article titled “12 Step Substance Use Recovery Program” which has been attached.
Please be sure to only read, use, and cite the attached article. No other sources allowed.
Identify the clinical question and describe each portion of the question.
Population – (introduction section)
Intervention – (in methods section)
Comparison (Methods section)
Outcome – (results discussion and conclusion section)
Time – Not all research studies will have a time component; if time is part of the study include a description. Example: study in place over 6 months.
In your own words, describe the following:
Why was the study done?
How was the study done?
What was found?
How will you apply this information in your practice setting?
Describe your experience after reading the article. How did the use of quantitative research methods meet the needs of the study, study design, and participants?
Below is the article
Comparison of the effectiveness of a 12 step substance use recovery program…: EBSCOhost
Requirements: 1 Full Page Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages | .doc file
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
P.lease be sure to carefully follow the instructions.
No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool.
Please be sure to include in-text citations.
Please be sure to only read, use, and cite the attached article. No other sources allowed.
Unformatted Attachment Preview
Comparison of the effectiveness of a 12 step substance use recovery
program on quality of life.
Authors:
Mokhtari, Mohammad Reza; 1Alavi, Mousa; 2Pahlavanzadeh, Saeid; 2Weimand, Bente M.; 3,4,5Visentin, Denis; 6Cleary, Michelle7
Affiliation:
1Student Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
2
Mental Health Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
3Department of Nursing and Health Promotion, OsloMet – Oslo Metropolitan University, Oslo, Norway
4Department of Evidence and Social Innovation, School of Nursing and Midwifery, Queens University, Belfast, Ireland
5
Department of Research and Development Mental Health, Akershus University Hospital, Lørenskog, Norway
6School of Health Sciences, University of Tasmania, Sydney New South Wales,, Australia
7School of Nursing, University of Tasmania, Sydney New South Wales,, Australia
Source:
Nursing & Health Sciences (NURS HEALTH SCI), Jun2020; 22(2): 390-397. (8p)
Publication Type:
Journal Article – clinical trial, research, tables/charts
Language:
English
Major Subjects:
Substance Use Disorders
Recovery
Quality of Life
Health Education
Substance Use Rehabilitation Programs — Evaluation
Substance Abusers — Education — Iran
Outcomes of Education — Evaluation
Minor Subjects:
Human; Comparative Studies; Quasi-Experimental Studies; Pretest-Posttest Design; Male; Female; Adult; Clinical Trials; Funding Source; Program
Evaluation; Iran; Substance Dependence — Therapy; Health Facilities; Mental Health; Health Status; Affective Disorders — Prevention and Control; Time
Factors; Questionnaires; Summated Rating Scaling; T-Tests; Chi Square Test; Analysis of Covariance; Data Analysis Software; Descriptive Statistics
Abstract:
Substance‐related disorders can adversely impact quality of life. This study assessed a 12 step program on health‐related quality of life for Iranian
individuals seeking to recover from substance use. The study used a quasi‐experimental, two group, three stage, pre‐ and post‐test design and
collected data at baseline, and at 1 and 3 months’ post‐intervention. The treatment group comprised 35 participants in a 12 step program with a non‐
equivalent comparison group of individuals admitted to addiction treatment centers. Physical and mental health quality‐of‐life domains were assessed
using the Short Form 36 Health Survey Questionnaire. The treatment group improved in all aspects of health‐related quality of life. The treatment group
improved compared to the comparison group for two of eight quality of life dimensions – physical functioning and role limitations due to emotional
problems – at 1 month post‐intervention. There were additional improvements at 3 months’ follow up in six of eight quality‐of‐life subscales compared to
the comparison group. The benefits to quality of life related to mental health recovery extended beyond the treatment program, indicating that the
program principles were effectively implemented in daily life.
Journal Subset:
Asia; Nursing; Peer Reviewed
Instrumentation:
Short Form 36 Health Survey Questionnaire.
ISSN:
1441-0745
MEDLINE Info:
NLM UID: 100891857
Grant Information:
Supported by Isfahan University of Medical Sciences, Iran, Grant/AwardNumber: 396623.
Entry Date:
20200627
Revision Date:
20210601
DOI:
10.1111/nhs.12668
Accession Number: 144222315
Publisher Logo:
Comparison of the effectiveness of a 12 step substance use recovery program
on quality of life
This content may contain URLs/links that would redirect you to a non-EBSCO site. EBSCO does not endorse the accuracy or accessibility of these sites, nor of
the content therein.
✖
Listen
Substance‐related disorders can adversely impact quality of life. This study assessed a 12 step program on health‐related quality of life for Iranian individuals
seeking to recover from substance use. The study used a quasi‐experimental, two group, three stage, pre‐ and post‐test design and collected data at baseline,
and at 1 and 3 months’ post‐intervention. The treatment group comprised 35 participants in a 12 step program with a non‐equivalent comparison group of
individuals admitted to addiction treatment centers. Physical and mental health quality‐of‐life domains were assessed using the Short Form 36 Health Survey
Questionnaire. The treatment group improved in all aspects of health‐related quality of life. The treatment group improved compared to the comparison group for
two of eight quality of life dimensions – physical functioning and role limitations due to emotional problems – at 1 month post‐intervention. There were additional
improvements at 3 months’ follow up in six of eight quality‐of‐life subscales compared to the comparison group. The benefits to quality of life related to mental
health recovery extended beyond the treatment program, indicating that the program principles were effectively implemented in daily life.
Keywords: health‐related quality of life; Iran; mental health recovery; substance‐related disorder
INTRODUCTION
Substance misuse is a complex mental health problem associated with psychiatric and physical comorbidities (Hunt, Large, Cleary, Lai, & Saunders, [13]; Hunt,
Malhi, Cleary, Lai, & Sitharthan, [14]; Karow et al., [18]). Addiction involves a loss of control and behaviors that are both compulsive and habitual (Mendola &
Gibson, [26]). The persistent use of alcohol or illicit drugs often has adverse consequences and contributes to unemployment, homelessness, relationship
breakdowns, aggression, high rates of hospitalization, and incarceration (Hunt et al., [13]; Vanderplasschen et al., [38]). Substance use disorders have high
prevalence rates (Donovan, Ingalsbe, Benbow, & Daley, [ 6]), contributing to the high and growing global burden related to years of life lost and disability‐adjusted
life years, which provide challenges for health systems, particularly in developing regions (Gowing et al., [11]; Whiteford et al., [41]).
There are a range of services for psychosocial interventions for people with substance use disorders, including detoxification programs, outpatient treatment,
methadone maintenance therapy, short and long‐term residential programs, and harm‐minimization programs (Vanderplasschen et al., [38]). A variety of
psychosocial treatment approaches can be used, including counseling, cognitive behavior therapy, psychotherapy, medication, and motivational interviewing
(Horsfall, Cleary, Hunt, & Walter, [12]; Hunt, Siegfried, Morley, Sitharthan, & Cleary, [15]; Noosorn, Phetphum, & Yau, [32]). Treatments can be delivered in
combination or sequentially, and across settings (Mendola & Gibson, [26]).
The 12 step program of recovery is the best known approach for a range of addictions, and is widely available in many countries and online (Mendola & Gibson,
[26]). The program was developed and achieved widespread use through the Alcoholics Anonymous program, which was later extended to other addictions
(Galanter & Kaskutas, [10]). The 12 step philosophy emphasizes the importance of accepting addiction as a disease that can be treated but not cured. The
program promotes individual responsibility and personal growth, assisting others living with addiction by sharing recovery stories and sponsoring new attendees.
The 12 step program aids coping with recovery, motivation, abstinence with improved mental health and well‐being, and decreases impulsivity and craving (Kelly,
Humphreys, & Ferri, [19]). Involvement in a 12 step group provides support through a social network, and a set of 12 guiding principles for recovery (Donovan et
al., [ 6]). This approach is based on the goals of returning to spiritual health, promoting self‐esteem, and enhancing the desire for continuity of recovery from
substance use (White et al., [40]). Meetings are typically held by the peer group with minimal collaboration and supervision by health team members (White et al.,
[40]), are easily accessed, and have no healthcare costs, unlike other clinical recovery programs (Donovan et al., [ 6]). The program can be used independently
or in combination with other treatment options (Tracy & Wallace, [37]).
A number of substance recovery and support programs rely on the benefits of peer support. Peer support involves non‐professional help from those with similar
conditions (Tracy & Wallace, [37]). Peer support based on mutual aid modalities are provided in programs, such as 12 step groups (Bassuk, Hanson, Greene,
Richard, & Laudet, [ 3]). Social support has been found to be associated with greater readiness to change and decreased substance use (Lookatch, Wimberly, &
McKay, [24]). The peer support relationship is fundamental to achieving and maintaining abstinence in 12 step programs, which has demonstrated positive long‐
term outcomes (Laudet, Savage, & Mahmood, [23]; Moos & Moos, [30], [31]).
Studies have examined and supported the effectiveness of the 12 step program on recovery and improved psychosocial outcomes, including health‐related
quality of life (QoL) (Donovan et al., [ 6]). QoL is a broad concept that involves a perception of one’s life in the context of local culture and value systems related
to aspirations, expectations, and community standards (Feelemyer, Jarlais, Arasteh, Phillips, & Hagan, [ 7]). The effectiveness of interventions for the QoL of
individuals with substance use has been assessed across a number of programs (Feelemyer et al., [ 7]; Karow et al., [18]). Social networks have been
demonstrated to achieve treatment goals and abstinence, irrespective of the origin of this support, and are identified as vital to sustained recovery (Lookatch et
al., [24]).
While many studies have evaluated the effectiveness of the 12 step program across a range of outcome measures, the evidence for its superiority to other
treatments is limited (Ferri, Amato, & Davoli, [ 9]). Most studies that have compared the 12 step program to other treatments have found similar retention rates
and treatment outcomes in both study arms (Karlsson & Bergmark, [17]). A Cochrane review of the 12 step program found only eight trials, indicating the
necessity of further comparison trials (Ferri et al., [ 9]). An assessment of treatment efficacy requires well‐designed randomized, controlled trials with appropriate
control groups and standardized assessment of treatment outcomes and adherence (Karlsson & Bergmark, [17]). The treatment goals of programs might vary,
making it difficult to have consistent outcome measures for comparison studies in addiction recovery. In particular, the difference between programs which focus
on harm reduction rather than abstinence might be difficult to compare to the 12 step approach (Mendola & Gibson, [26]).
Iran and many Middle Eastern countries prohibit and stigmatize substance use, such as opioids, amphetamines, and alcohol (Aghakhani, Lopez, & Cleary, [ 1];
Fereidouni et al., [ 8]); however, the Middle East is the world’s largest narcotics producer, increasing the availability of illicit drugs. As a result, substance use in
Iran has been identified as a major health issue (Shahbazi, Mirtorabi, Ghadirzadeh, Hashemi‐Nazari, & Barzegar, [35]), which contributes a major socioeconomic
cost to the individuals affected and their families (Damari, Ahmadi Pishkuhi, Masoudiasl, & Bostanmanesh, [ 5]). Health issues and mortality associated with
substance use contributes to the burden of disease in Iran, with men experiencing higher rates of both death and disability (Moazen et al., [27]). The
effectiveness of the 12 step program on QoL for substance abuse in the Iranian context has not been fully explored.
The aim of this study was to compare the effect of the 12 step program on the QoL of individuals with substance use to treatment center admission.
METHODS
Sample and setting
This study was a pretest, post‐test non‐equivalent quasi‐experimental design conducted from September 2018 to March 2019. The intervention and comparison
groups were selected through a convenience sampling method.
The intervention group was drawn from volunteer members of an addiction recovery program supported by a non‐government organization, while comparison
participants were drawn from addiction treatment centers affiliated with Isfahan University of Medical Sciences (IUMS), Iran. Eight of the 164 addiction treatment
centers were selected for inclusion based on their location to cover different regions of Isfahan to ensure a more representative sample.
The sample size was calculated using the results of a previous study (Momeni, Moshtagh, & Pourshahbaz, [28]), in which the post‐test QoL scores in the control
and the intervention groups were 73.43 ± 16.13 and 89.4 ± 16.72, respectively, giving an effect size of.973. Considering a type I error probability of.05 and a
power of.90, the sample size required was determined to be 24 people for each group using G‐power software. To account for attrition, 35 participants were
included in each group. One hundred and forty two people were approached; 74 were volunteers of an addiction recovery program and 68 were clients of
addiction treatment centers. Seventy two people were excluded due to not meeting the inclusion criteria (n = 28) or declining to participate (n = 44) (Figure).
Flow diagram for the study
Participants were included if they had voluntary membership in the addiction recovery program groups or were admitted voluntarily to the treatment centers. The
inclusion criteria were the ability to communicate, read and write in Persian, Iranian, aged 20–40 years, and not simultaneously attending a similar treatment
program. Exclusion criteria were having physical illnesses causing functional impairment, current drug use, and being incarcerated in the previous 3 months.
Participants were excluded from the analysis if they missed two consecutive training sessions.
Data collection and instruments
The data‐collection instrument consisted of two parts: (i) demographic characteristics including age, substance use history (i.e. the time since first drug use,
starting age of substance use), sex, education status, marital status, employment status, housing status, number of siblings, income status, number of treatment
attempts; and (ii) the Short Form 36 Health Survey Questionnaire (SF‐36) (Ware, Snow, Kosinski, & Gandek, [39]).
The SF‐36 is a widely‐used, generic, self‐report measure to assess health‐related QoL in both clinical and healthy populations. It is composed of 36 questions
comprising eight subscales assessing physical and mental health. The physical health domain consists of physical functioning, role limitations due to physical
health problems, bodily pain, and general health perceptions; the mental health domain includes vitality, social functioning, role limitations due to emotional
problems, and general mental health. Response categories are Likert type, ranging from two to six levels. SF‐36 scale scores are transformed linearly to a scale
from 0 to 100, with higher scores indicating better health‐related QoL. The validity and reliability of the Persian version of this questionnaire has already been
supported, with Cronbach’s alpha coefficients ranging from.77 to.90 with the exception of the vitality scale (α =.65) (Montazeri, Goshtasebi, Vahdaninia, &
Gandek, [29]). Permission was granted to use the scale.
Interventions
The treatment intervention consisted of a 12 step program over 12 sessions, with three sessions weekly, each lasting 1.5 hours. The program followed a standard
procedure of delivery of a 12 step program. The sessions were facilitated by a nurse, with each new session introducing and outlining the “step”, with participants
undertaking facilitated peer support discussion around the step. For example, in the first session, the first step was introduced, which involved accepting the
individual’s powerlessness over addiction. Participants were then invited to express their own self‐admission and story according to this principle. Discussion and
affirmation of others was encouraged throughout the process to meet the peer support aspects of the program. Participants in the intervention group did not
participate in any similar training programs during the study. The comparison group received routine interventions provided by treatment centers involving
rehabilitation and mental health counseling services.
Questionnaires were completed by both groups before the intervention, and at 1 and 3 months’ follow up.
Statistical analysis
Independent samples t‐tests and χ2‐tests were used to compare the baseline SF‐36 subscale scores and demographic data and individual characteristics of the
study groups. Data are reported as mean differences from baseline values. Analysis of covariance (ANCOVA) was used to assess the between‐group differences
in the mean SF‐36 scores at 1 and 3 months after the intervention, controlling for pretest scores as a covariate. The data were analyzed using SPSS software
Ethical considerations
Written, informed consent was obtained from all participants. Approval was given by the Vice‐Chancellery for Research of the IUMS (research ID: 396623).
RESULTS
Demographic data and individual characteristics of the two groups are presented in Table. The results showed that the two groups did not differ significantly in
terms of demographic characteristics and substance use history.
Comparison of demographic and individual characteristics between the two groups
Variable
Control group
Mean (SD) or N (%)
Mean (SD) or N (%)
Intervention groupTest statisticP‐value
Age
30.06 (5.36)
30.83 (4.96)
t =.63
.53
Drug usage history (month)
123.26 (47.46)
111.46 (41.79)
t = −1.10
.27
Starting age of substance use20.34 (2.58)
21.29 (3.14)
t = 1.37
.17
No. children
.66 (.14)
.51 (.12)
t = −.79
.43
No. treatment attempts
2.97 (.34)
2.91 (.50)
t =.095
.93
Gender
Male
18 (51.4)
16 (45.7)
χ2 = .63 .81
Female
17 (48.6)
19 (54.3)
Education
Elementary school 10 (28.6)
11 (31.4)
χ2 =.35 .99
Middle school
11 (31.4)
10 (28.6)
High school
6 (17.2)
6 (17.2)
Diploma
3 (8.5)
4 (11.4)
University degree
5(14.3)
4 (11.4)
Income
Exceeds needs
1 (2.9)
1 (2.9)
χ2 = 2.53.47
Normal
15 (42.9)
18 (51.4)
Low
19 (54.3)
16 (45.7)
Marital status
Single
13 (37.1)
15 (42.9)
χ2 = 1.37.71
Married
16 (45.7)
17 (48.5)
Divorced
3 (8.6)
1 (2.9)
Partner
3 (8.6)
2 (5.7)
Employment status
Unemployed
14 (40)
15 (42.9)
χ2 =.06 .97
Working
20 (57.1)
19 (54.3)
Disabled
1 (2.9)
1 (2.9)
Housing status
Own
9 (25.7)
9 (25.7)
χ2 =.88 .93
Rental
12 (34.3)
12 (34.3)
Worker accommodation
4 (11.4)
3 (8.6)
Homeless
8 (22.9)
7 (20.0)
Shelter
2 (5.7)
4 (11.4)
Location
City
7 (20.0)
6 (17.1)
χ2 = 1.12.57
Village
8 (22.9)
12 (34.3)
Town
20 (57.1)
17 (48.6)
1 Abbreviations: SD = standard deviation.
The treatment group improved significantly in all SF‐36 subscale measures at the 1 month follow up compared to baseline (P < .001 for all measures). Highest
improvements were in role limitations due to physical health problems (mean difference, MD = 17.15), role limitations due to emotional problems (MD = 14.28),
bodily pain (MD = 14.00), general health perceptions (MD = 13.57), and physical functioning (MD = 11.72). The treatment group also demonstrated significant
improvements in all SF‐36 subscale measures at the 3 month follow up compared to baseline (P < .001 for all measures), with a doubling of scores from baseline
for four measures. Highest improvements were in general health perceptions (MD = 46.43), role limitations due to physical health problems (MD = 42.15), role
limitations due to emotional problems (MD = 35.24), vitality (MD = 34.95), and bodily pain (MD = 33.28). The control group also had significant improvements in
six of the eight subscale measures at the 1 month follow up and in seven of the eight subscale measures at the 3 month follow up compared to baseline (Table).
Mean and standard deviation (SD) of dimensions of the Short Form 36 Health Survey Questionnaire in both groups at baseline and at 1 and 3 months' follow up,
and analysis of covariance results controlling for baseline
Dimension of quality of life
Intervention group
Within‐group
Control group
test
Mean (SD)
P‐value compared to
Mean (SD)
baseline
Within‐group
Between‐group test
test
P‐value compared to
P‐value
Partial eta squared
(ηp2)
baseline
Physical functioning
Baseline
36.14 (11.7)
—
34.71 (9.47)
—
.58
1 month follow up
47.86 (13.13)
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Respond to your peers by extending, refuting/correcting, or adding additional nuance to their posts. Each reply must be at least 150 words and contain at least one reference from an academic journal. All replies must be constructive and include at least two references.
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Week 6 Clinical Experience
Tana M Kahn
St. Thomas University
NUR-612CL-AP2: Advanced FNP Clinical IV
Dr. Nancy C. Woelki
September 28, 2023
Week 6 Clinical Experience
Challenges or Success
The sixth clinical week was very interesting. I learned to actively listen to patients. This
enabled me to communicate better with them and capture all relevant details required for making
assessments and diagnoses.
Patient Assessment
J.K., a 70-year-old Asian American female, came into the clinic looking worried. She said,
“I started having chest pain while I walked up the staircase today. What could be the problem?”
Subjective Data
J.K. admitted that the chest pain started in the morning when she was walking up a staircase.
She admitted that the pain was localized in her chest. She admitted that the pain lasted as long as
she was climbing the staircase. She described the pain as aching and pressing. She admitted that
the pain is aggravated by physical activity, specifically walking up the staircase. She denied any
factors that relieved the symptoms. She rates the pain at 7 out of 10. She admits that she has a
history of hypertension and hyperlipidemia well-managed using amlodipine and atorvastatin,
respectively. She admitted that she has a family history of coronary artery disease. She admits
that she is a non-smoker, consumes alcohol occasionally, is retired, and lives independently. She
denied having shortness of breath.
Objective Data
She had a blood pressure of 132/80, a heart rate of 80 bpm, a respiratory rate of 16 breaths
per minute, and a temperature of 98.6 °F. She appeared comfortable and in no acute distress. She
had regular heart sounds with no murmurs or extra sounds. She had clear bilateral breath sounds
and no chest wall tenderness on palpation. An electrocardiogram (ECG) of the CAD indicated
ST-segment depression and inverted T-waves. She also had elevated troponin levels.
Assessment
The primary diagnosis for this patient is coronary artery disease (CAD) (ICD-10: I25.10).
Additional differential diagnoses to consider include acute myocardial infarction (ICD-10:
I21.9), angina pectoris (ICD-10: I20.9), and gastroesophageal reflux disease (GERD) (ICD-10:
K21.9).
CAD (I25.10)
This condition is also known as atherosclerotic heart disease. It occurs when coronary
arteries become narrowed or blocked due to the buildup of plaque. It begins with the
development of atherosclerosis, plaque formation, ischemia, chest pain, and, in severe cases, a
myocardial infarction (Liu et al., 2020). This diagnosis is supported by the presentation of chest
pain, risk factors for hypertension and hyperlipidemia, and a family history of coronary artery
disease. She also has pain on exertion, which is a hallmark of CAD (McConaghy et al., 2020).
The ECG and troponin levels confirm this diagnosis.
Acute Myocardial Infarction (I21.9)
This is also called a heart attack. It is caused by a sudden and complete blockage of one or
more coronary arteries, resulting in the death of heart muscle tissue due to a lack of blood supply
(Tayyeb et al., 2022). It occurs due to the rupture of an atherosclerotic plaque and subsequent
clot formation, which causes chest pain.
Angina Pectoris (I20.9)
This is chest discomfort caused by reduced blood flow to the heart muscle due to coronary
artery narrowing or spasms (Caceres et al., 2021). It is often triggered by physical exertion or
emotional stress. This diagnosis was ruled out due to a conclusive diagnosis of CAD.
GERD (K21.9)
This is a chronic condition where stomach acid backs up into the esophagus (Howden et al.,
2021). It results in heartburn, chest pain, and regurgitation. This diagnosis was ruled out since
the clinical presentations were inconsistent with GERD.
Plan of Care
I prescribed the patient to take aspirin 81 mg orally every four hours as needed for pain. I
advised her to visit a cardiologist for a comprehensive cardiovascular risk assessment. I
scheduled a follow-up appointment after two weeks to assess disease progression and make
necessary adjustments to the care plan.
Health Promotion Intervention
I educated the patient to engage in lifestyle modifications such as dietary changes to lower
cholesterol and sodium intake. I also recommended regular exercise within the patient’s
tolerance. I recommended that she engage in stress management techniques.
Lessons Learned
This clinical week taught me to effectively use patient history in making diagnoses. This
became helpful in narrowing down the diagnoses and addressing the condition.
References
Caceres, J., Atal, P., Arora, R., & Yee, D. (2021). Enhanced external counterpulsation: A unique
treatment for the “no‐option” refractory angina patient. Journal of Clinical Pharmacy and
Therapeutics. https://doi.org/10.1111/jcpt.13330
Howden, C. W., Manuel, M., Taylor, D., Jariwala-Parikh, K., & Tkacz, J. (2021). Estimate of
refractory reflux disease in the United States. Journal of Clinical Gastroenterology, Publish
Ahead of Print. https://doi.org/10.1097/mcg.0000000000001518
Liu, Y., Neogi, A., & Mani, A. (2020). The role of Wnt signalling in development of coronary artery
disease and its risk factors. Open Biology, 10(10), 200128. https://doi.org/10.1098/rsob.200128
McConaghy, J. R., Sharma, M., & Patel, H. (2020). Acute chest pain in adults: Outpatient
evaluation. American Family Physician, 102(12), 721–727.
https://www.aafp.org/pubs/afp/issues/2020/1215/p721.html
Tayyeb, M., Mughal, M. S., Mirza, H., Asif, M., Fatima, S., Ghani, A., Waqar, F., Mughal, W. A., &
Wasty, N. (2022). Abstract 13029: Acute myocardial infarction – mortality trends in the United
States. Circulation, 146(Suppl_1). https://doi.org/10.1161/circ.146.suppl_1.13029
Mejia, Valentina
YesterdaySep 28 at 11:57am
Manage Discussion Entry
1.) Did you face any challenges, any success? If so, what were they?
This week I believe was successful me and my preceptor have good teamwork going on when
seeing our patients. The medical assistant is also very helpful as well, we work together to finish
in a timely manner. I saw some interesting patients this week including one patient that had
Raynaud’s disease, and also systemic lupus erythematosus, which was interesting because it was
my first time seeing it.
2.) Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment,
plan of care, and at least 3 possible differential diagnosis with rationales.
Patient T.S is 65 years old. Patient states she felt she had some abnormal rashes and skin
ulcerations for a while now and some alopecia as well, and a lot more joint stiffness in the
morning. Upon assessment of the patient, she has some pallor, generalized erythema, generalized
bruising, she also had an erythematous elevated lesion which is the classic butterfly rash. Based
on plan of care because of the s/s it would be, instructing the patient to keep skin clean and dry
as well as moisturizing the skin using warm water, to maintain skin integrity. I would also
recommend the patient to avoid contact with harsh chemicals to prevent condition from
aggravating. I would also include teaching on wearing protective eyewear, as well as SPF 15 or
above and to avoid ultraviolet rays of light. Since the client is complaining of pain, I would
advise her to avoid prolonged periods of inactivity as this can increase stiffness in the joints, as
well as ROM exercises after shower and bath. Corticosteroids could be prescribed to help with
inflammation as well as immunosuppressant can also be given to suppress the activity of the
immune system specially during severe flares within the CNS and the renal system.
Antimalarials can also be prescribed to this patient for effective management of skin lesions as
they are present in this patient. Patient should also be tested and monitored with laboratory tests
like, ANA test, Anti-double standard antibody test, CBC, as well as kidney function tests. To
identify specific organ involvement patient might need to get a CT scan or an X-ray. Some of the
differential diagnosis used can be but are not limited to; discoid skin lesions this includes round
coin shaped lesions in the skin that develop in the scalp and face as well as other parts in the
body. Erythematous papules involve abnormal redness of the skin. Systemic sclerosis involves
symptoms of decreased joint movement and skin induration with lesions.
3.) Mention the health promotion intervention for this patient.
I have already mentioned some of the health promotion for this patient in this last question, but I
can add more, this includes reinforcing energy conservation tips like the following. Adequate
rest periods, pacing of activities with alternating rest, proper use of assistive adaptive devices,
avoiding stimulating foods like caffeine, encouraging warm baths before bedtime, encouraging
gentle range of motion exercises after a shower or bath. It can also be useful to take an antiinflammatory drug to help decrease pain and help with rest.
4.) What did you learn from this week’s clinical experience that can beneficial for you as an
advanced practice nurse?
Some of the stuff that I learned this week involves, the evaluation and important laboratory tests
needed for patients with suspected SLE. I also learned the treatment options for this patient
pharmacological as well as therapeutical. I also got to see how the butterfly rash looks on the
patient as well as other representations of the disease on the patient’s skin.
5.) Support your plan of care with the current peer-reviewed research guideline.
The efficacy of glucocorticoids in the control of SLE is well established, and the use of highdose or “pulsed” GCs to rapidly ablate the autoimmune response in organ-threatening
manifestations is an important component of SLE treatment regimens (Schwarting A, 2020). It
was stated in this article that glucocorticoids were started to be given to patients in the 1950s and
it has greatly increased the survival rates of these patients. Antimalarials are among the oldest
drugs used to treat SLE, but they are still rightfully considered to be the cornerstone of SLE
therapy (Daikh D, 2019).
References
Basta F, Fasola F, Triantafyllias K, Schwarting A. Systemic Lupus Erythematosus (SLE)
Therapy: The Old and the New. Rheumatol Ther. 2020 Sep;7(3):433-446. doi: 10.1007/s40744020-00212-9. Epub 2020 Jun 2. PMID: 32488652; PMCID: PMC7410873.
Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against
Rheumatism/American College of Rheumatology classification criteria for systemic lupus
erythematosus. Ann Rheum Dis. 2019;78:1151–1159.
Discussion 6
Selvia Beshay
NUR-612-AP1
St. Thomas University
Dr. Nancy Woelki
Additional Subjective Data
Besides the patient’s complaint of reduced vision and bothersome glare, I will interview the
patient for past medical history and gather information about any pre-existing eye conditions
they may have including chronic illnesses and previous surgeries. I will also ask the patient about
any medications they are currently taking since certain drugs can affect vision. It will be essential
to inquire about the patient’s history of trauma and injuries as well as the patient’s overall health,
lifestyle changes, and any change in social or personal circumstances since they moved to
Florida.
Additional Objective Data
Some of the objective data that I will look out for include the visual acuity test, which will
be performed using the Snellen chart. In addition, a physical examination of the eyes would be
conducted to check for signs of cataracts and other abnormalities and this may involve looking
for cloudiness or the opacity of the eye lens as well as assessing for pupillary response and eye
movements and checking for intraocular pressure. Besides, a test will be carried out to evaluate
the patient’s visual field so as to identify loss in peripheral vision or any blind spots.
Differential Diagnoses
Based on symptoms presented by the patient, the three possible differential diagnoses
include; first, cataracts, which is the gradual opacification of the usually clear lens of the eye that
obscures the passage of light, which leads to the individual having blurry vision, difficulty in
reading in dim light, poor visibility especially at night, occasional double vision, and glare and
halos around lights. The second possible diagnosis is age-related macular degeneration, which is
a condition that is acquired through the degeneration of the retina and leads to significant central
visual impairment. This happens through a combination of non-vascular such as the drusen and
the retinal pigment epithelium abnormalities, and the neo-vascular derangement that includes the
choroidal neo-vascular membrane formation (Thomas et al., 2021). The third possible diagnosis
for this patient is diabetic retinopathy, which is a common cause of gradual visual loss in older
people where photocoagulation and vitreous surgery may be used to restore vision.
Laboratory Tests
The lab tests that will help me rule out some of the differential diagnoses include blood
tests, especially if the client has a history of diabetes, to check for blood sugar levels and to
assess the kidneys and liver function. Similarly, if the patient is taking certain medications that
may affect their vision like steroids, then blood tests would help monitor the effects of the drugs
(Gaballa et al., 2021). Besides blood tests, there are no specific lab tests that are typically ordered
for diagnosis of cataracts, although if the provider suspects that the patient has an underlying
condition that is affecting their vision, then additional tests may be necessary. In other words, the
need for additional lab tests is dependent on the patient’s medical history and the provider’s
clinical judgment.
Additional Diagnostic Studies
In this case, the additional diagnostic study that I may order is the optical coherence
tomography (OCT) test which may be used to evaluate the structure of the optic nerve and retina
(Bekollari et al., 2023). The OCT will help in identifying any abnormalities that are associated
with certain illnesses such as macular degeneration. Also, a slit-lamp exam may be ordered to
assess the interior segment of the eye such as the cornea and the lens.
Treatment
For this patient, if they are diagnosed with cataracts, then the treatment would likely be a
cataract surgery. In this procedure, the surgeon will remove the cloudy lens in the eyes and
replace it with an artificial lens or the intraocular lens implant (IOL) (Lapp et al., 2023). Before
the surgical procedure, the patient will be educated about the benefits as well as the eminent risks
involved. In particular, the provider should explain to the patient the pre-and post-operative
instructions that include any necessary preparations and the potential complications.
Potential Complications
The treatment ordered in this patient’s case is cataract surgery. Some of the expected
complications from this procedure would include increased intraocular pressure, infection,
bleeding, and swelling (Grzybowski et al., 2019). There is no risk of retinal detachment or an
endophthalmitis and hence, it is crucial for the patient to be educated about such potential
complications and advised appropriately on how to seek immediate medical attention if they
experience adverse symptoms.
Additional Laboratory tests
Some additional la tests in this case would include; a comprehensive metabolic panel, a
complete blood count (CBC), a lipid profile, and a thyroid function test. The additional tests
would help provide information about the patient’s general health and any underlying condition
that could be contributing to their loss of vision. Note that, age is a factor in loss of vision as
many of the elderly people, like the patient in this case, usually lose their eyesight as they
advance in age. Hence, aging will also be a factor to consider when ordering additional tests.
Additional Patient Teachings
The patient may need additional education and teachings especially about the importance of
carrying out a regular eye exam, especially as they age. It is also essential to discuss the
strategies for managing glare such as wearing sunglasses and using anti-glare filters on the
screens. Further, the patient should be taught about considering changing their lifestyle such as a
modification in nutrition and lifestyle activities, to help prevent and manage conditions such as
debates which may cause vision problems.
Consultation
In this case, consultation with a specialist will be necessary. A referral to an ophthalmologist
for a comprehensive eye examination and surgical intervention may be necessary and
appropriate. The ophthalmologist would offer their expertise in diagnosing and treating eye
conditions, and this includes cataracts.
References
Bekollari, M., Dettoraki, M., Stavrou, V., Skouroliakou, A., & Liaparinos, P. (2023). Investigating
the structural and functional changes in the optic nerve in patients with early glaucoma using the
Optical Coherence Tomography (OCT) and RETeval System. Sensors, 23(9), 4504.
https://doi.org/10.3390/s23094504
Gaballa, S. A., Kompella, U. B., Elgarhy, O., Alqahtani, A. M., Pierscionek, B., Alany, R. G., &
Abdelkader, H. (2021). Corticosteroids in ophthalmology: Drug delivery innovations,
pharmacology, clinical applications, and future perspectives. Drug Delivery and Translational
Research, 11, 866-893. https://doi.org/10.1007/s13346-020-00843-z
Grzybowski, A., Kanclerz, P., Huerva, V., Ascaso, F. J., & Tuuminen, R. (2019). Diabetes and
phacoemulsification cataract surgery: Difficulties, risks and potential complications. Journal of
Clinical Medicine, 8(5), 716. https://doi.org/10.3390/jcm8050716
Lapp, T., Wacker, K., Heinz, C., Maier, P., Eberwein, P., & Reinhard, T. (2023). Cataract surgery—
Indications, techniques, and intraocular lens selection. Deutsches Ärzteblatt
International, 120(21-22), 377. https://doi.org/10.3238/arztebl.m2023.0028
Thomas, C. J., Mirza, R. G., & Gill, M. K. (2021). Age-related macular degeneration. Medical
Clinics, 105(3), 473-491. https://doi.org/10.1016/j.mcna.2021.01.003
You have been asked by your private employer to create a handout to educate employees on how health insurance impacts preventative care.
Be sure to include the following information:
Covered preventative measures;
Frequency of preventative care allowed;
How utilization changes based on health insurance coverage;
The impact of preventative care on the individual, organization, and nation; and
Figures, examples, and statistics supporting your findings.
Your assignment should meet the following structural requirements.
Two to three page handout, not including the cover sheet and reference page.
Include headings titled “Covered Preventative Care” and “Utilization”.
Be sure to include an informational paragraph under each heading and a citation to the resource utilized.
Formatted according to APA and Saudi Electronic University writing standards.
Provide support for your statements with in-text citations from a minimum of six scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but two must be external. The Saudi Digital Library is a good place to find these references.
You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading.
In this assignment you will critically review (summarize and evaluate) the ideas and information of an article (specified to you by the instructor)
Please make sure to address the following points:
· Identify the author, the title, the main topic, and the author’s purpose.
· How the article relates to other work in the literature.
· Highlight the types of evidence or information the author present.
Remember, your task as a reviewer is to re-see the author’s work, not to re-tell it.
Introducing a method for implementing value based health care principles in the full cycle of care: Using atrial fibrillation as a proof of concept. International Journal of Healthcare Management, 15(1), 1–9. https://doi.org/10.1080/20479700.2020.1810464
Research and find the Ethical Rules for Advanced Nurses in your State.
Read the attached article(s):
https://dailynurse.com/florida-grants-advanced-nps-full-practice-authority/Links to an external site.
https://www.nursepractitionerschools.com/resources/scope-of-practice/Links to an external site.
Familiarize yourself with the ethical rules understanding that they are different in different states just as practice autonomy varies from state to state.
Note that there is a difference in scope of practice and practice authority.
Write a 2-page paper describing your state’s ethical rules along with practice perimeters.
Explain the difference in scope of practice and practice authority in your state.
Use 3 examples of patient situations where ethical rules will apply and how you would handle the situation provided you are an advanced nurse in that situation.
Remember to use your state’s practice perimeters (practice authority).
Be clear as to the rules you are operating under and why, including the scope of practice and practice authority.
Include the policies you are considering either before drafting the narrative.
For this assignment, create a PowerPoint presentation based on the following case study.
Read the following case study and answer the questions presented.
Case Scenario 2: A Jehovah’s Witness Patient on page 77
Questions:
In attempting to address Mr. Jackmon’s case, ask yourself the following questions if you are the nurse caring for Mr. Jackmon:
1. Where am I on the staircase concerning this patient? How can I move to the next level?
2. How familiar am I and the nursing and medical staff with the religious beliefs, values, and attitudes of people who are Jehovah’s Witnesses?
3. What significant differences exist in followers’ health beliefs and other Christian traditions? How different is this religion from my own?
4. What feelings and attitudes do I have about Mr. Jackmon’s beliefs about receiving blood?
5. How helpful are these attitudes toward the development of cooperative interaction between myself and the patient?
6. Are there alternative ways of treating this patient’s hemoglobinemia?
7. On what religious beliefs does Mr. Jackmon base his refusal of blood, despite his need for it?
8. From whom could the nursing staff gain more insight into the patient’s healthcare beliefs?
9. What strategies might be useful in meeting the physiological and psychological needs of this patient?
10. What resources might the nursing staff utilize to assist them in meeting this patient’s needs?
Your presentation should be at least 15 slides (not including title, objectives, and references slides) with detailed notes for each slide. Audio recording is required. Be sure to answer all the questions completely. Use clear headings that allow your professor to know which bullet you are addressing on the slides in your presentation. Include at least three (3) graphics. Support your content with citations throughout your presentation. Make sure to reference the citations using the APA writing style for the presentation. Include a slide for your references at the end.
Follow best practices for PowerPoint presentations by going to the Writing and Resource center, Module 3: Assignments, Microsoft, and utilizing Microsoft Overview and the Creating a Quality PowerPoint video.
Start by reading and following these instructions:
Study the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.
Consider the discussion and the any insights you gained from it.
Review the assignment rubric and the specifications below to ensure that your response aligns with all assignment expectations.
Create your assignment submission and be sure to cite your sources, use APA style as required, and check your spelling.
The following specifications are required for this assignment:
Length: at least 15 slides; answers must thoroughly address the questions clearly and concisely. Audio is required.
Structure:
Title slide (1 slide)
Content slide (15 slides)
References (1 slide)
References: Use the appropriate APA style in-text citations and references for all resources to answer the questions. Include at least three (3) scholarly sources to support your claims.
Format: Save your assignment as a Microsoft PowerPoint document
2—-
Determine strategies and intervention to enhance the quality of care for persons with disabilities.
Learning Materials
Required Resources:
Kersey-Matusiak, G. (2018). Delivering culturally competent nursing care: Working with diverse and vulnerable populations (2nd ed.). Springer. ISBN: 9780826137272. Read Chapters 4 and 5.
Your textbook provides AACN Cultural Competencies that may have been learned while obtaining your BSN. Please be sure to test your knowledge at the end of the chapter to assess where you are currently with your cultural competency.
Go to Think Cultural Health located on the U.S. Department of Health & Human Services Office of Minority Health website (you may access it from the following URL: https://thinkculturalhealth.hhs.gov/. Continue to work on your Think Cultural Health program.
Additional Resources:
Johnson & Johnson Nursing. (2018, December 3). Becoming a culturally competent nurse. [Video] YouTube.
Chavez, V. (2012, August 2). Cultural Humility in Community Based Participatory Research & Education, Part 3 of 4. [Video] YouTube.
Institute for Healthcare Improvement. (2016, February 17). How can providers reduce unconscious bias? [Video] YouTube.
Institute for Healthcare Improvement. (2016b, February 17). What is health equity, and why does it matter? [Video] YouTube.
Determine strategies and intervention to enhance the quality of care for persons with disabilities.
Learning Materials
Required Resources:
Kersey-Matusiak, G. (2018). Delivering culturally competent nursing care: Working with diverse and vulnerable populations (2nd ed.). Springer. ISBN: 9780826137272. Read Chapters 4 and 5.
Your textbook provides AACN Cultural Competencies that may have been learned while obtaining your BSN. Please be sure to test your knowledge at the end of the chapter to assess where you are currently with your cultural competency.
Go to Think Cultural Health located on the U.S. Department of Health & Human Services Office of Minority Health website (you may access it from the following URL: https://thinkculturalhealth.hhs.gov/. Continue to work on your Think Cultural Health program.
Additional Resources:
Johnson & Johnson Nursing. (2018, December 3). Becoming a culturally competent nurse. [Video] YouTube.
Chavez, V. (2012, August 2). Cultural Humility in Community Based Participatory Research & Education, Part 3 of 4. [Video] YouTube.
Institute for Healthcare Improvement. (2016, February 17). How can providers reduce unconscious bias? [Video] YouTube.
Institute for Healthcare Improvement. (2016b, February 17). What is health equity, and why does it matter? [Video] YouTube. Please remember scholarly sources and current
3
Research healthcare issues that have been identified in your local community. Develop a PowerPoint presentation with speaker notes. You will then use the PowerPoint during your Kaltura recording. Structure a health policy analysis presentation that addresses the following topics particular to your health problem:Problem Statement Background Landscape Options Recommendations *Drug use is a major issue in my area- Eastern North Carolina.
Hi, I just need someone to find ONE qualitative scholarly article published within the last 5 years that relates to my PICOT question. My PICOT question will be provided to you once you are selected to work on the question 🙂 Requirements: Find qualitative scholarly article published within the last 5 years that relates to my PICOT question
Need a peer response for both students. One or 2 paragraphs each. I uploaded my response for reference. Initial discussion question: Kasym is a 19-year-old whose parents came from Guatemala when he was 6 years old. He is struggling in college, and now, he is sleeping 20 hours a day and not attending class. His roommate brought him to the school mental health center and reports that he was trying to hurt himself.1. What is the primary concern with Kasym’s cultural background and his clinical symptoms?2. Design a plan for Kasym to ensure that he has social and financial resources and a primary care provider and provide the rationale and evidence for effectiveness.
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Mental health is a topic that many deem as taboo. It seems like no one wants to speak about how they
are coping with life events. This is a result of many things such as culture, fear of judgment, or society’s
expectations. In this case, there is a 19-year-old who is struggling in college. He is sleeping a large
amount of time, and he is not present in his classes. His roommate tried to help him by bringing him to
the school’s mental health center after he tried to hurt himself.
A primary concern with Kasym regarding his clinical symptoms is that they are all indicative of
depression. He tried to hurt himself, which means that the depression is severe, and he may feel
hopeless. Pertaining to his cultural background, his parents from Guatemala might not be very helpful
with his mental health. He might have tried to speak to them about it, but Hispanic cultures do not
believe in things such as therapy. An article by the very well mind states that Latino families often have a
sense of cultural pride that can stigmatize mental health conditions, leading them to encourage
struggling family members to toughen up and just “get over” the difficult emotions they may be feeling
(Benton, 2023). The worry then is that he does not have a good support system through his family.
It is important that Kasym see a primary care provider. If he is sleeping 20 hours a day, it is safe to
assume that he might not be eating well. A primary care physician will assure that he is keeping
adequate nutrition, and address anything else that might be of concern. In addition, they will refer
Kasym to seek the help of a psychologist. Venting out his feelings, whether good or bad, will aid in the
healing journey that he needs to go through. Finding a psychologist that understands the impact that
Kasym’s culture might have had on him is essential to ensuring that he feels understood and
comfortable enough to accept the help. He can even try a psychologist at his very own school. Usually,
school’s provide therapy at no extra cost to the student. This is something that Kasym can take
advantage of.
Finally, a way in which Kasym can strengthen his mental health is by joining clubs at school. He can join
clubs of things that interest him, this way he can meet people and expand his social circle. The bigger his
social circle becomes, the more support he will have to get through his day-to-day life. It would be
preferable if he befriends his peers that are within the same culture as him. Being able to relate to
someone on this kind of level will assist Kasym in not feeling isolated.
An article by the lifespan health system stated that the 2020 National Survey on Drug Use and Health
estimates that 7.7 million Hispanic people over the age of 12 in the United States experienced
symptoms of mental illness. Of those 7.7 million people, only 35.1 percent received any treatment.
(Duarte-Velez, 2023). This fact demonstrates the unwillingness of Hispanic people to seek help for their
mental health. If kasym is strong enough to overcome his cultural barriers, he will be able to break a
generational belief that has held back Hispanic people for a long time, while nourishing his own mental
health at the same time.
References:
Benton, E. (2023). 8 mental health resources aimed at the Latino Community. Verywell Mind.
https://www.verywellmind.com/9-mental-health-resources-for-the-latinx-community-5114193#tocunited-states-department-of-health-and-human-services-office-of-minority-health
Duarte-Velez, Y. (2023). Mental health and the Latinx/Hispanic Community. Lifespan.
https://www.lifespan.org/lifespan-living/mental-health-and-latinxhispanic-community
Moyce, S., Thompson, S., Metcalf, M., Velazquez, M., Aghbashian, E., Sisson, N., & Claudio, D. (2022).
Rural Hispanic perceptions of Mental Health: A qualitative study. Journal of transcultural nursing: official
journal of the Transcultural Nursing Society. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9081153/
Cultural Influences and Supportive Resources for Kasym: A Plan for Holistic Wellbeing
Kasym’s scenario underscores the vital intersections between cultural context, mental health, and
college life. This young individual from Guatemala is showing troubling signs of potential severe
depression, emphasizing the necessity for a culturally informed intervention.
1. Primary Concern with Kasym’s Cultural Background and Clinical Symptoms
Cultural sensitivity in mental health is paramount, especially when treating patients from diverse
backgrounds. As described by Guerrero et al. (2016), Latino individuals, including those from Guatemala,
often express depressive symptoms distinctly, sometimes centering around somatic complaints.
Additionally, cultural and immigration-related stresses, potential discrimination, and feelings of isolation
can accentuate these mental health issues (Caplan, 2017). When evaluating Kasym’s condition, including
his excessive sleep patterns, non-attendance in class, and self-harming behavior, there’s an evident
correlation between his cultural background and his presenting symptoms. Recognizing this relationship
is essential for effective intervention.
2. A Holistic Plan for Kasym
To address Kasym’s unique challenges:
Culturally Sensitive Counseling: Begin with therapy that resonates with Kasym’s cultural identity,
ensuring that he feels understood and validated. This step is critical given that culturally tailored
interventions have demonstrated better outcomes for diverse populations (American Psychological
Association, 2017).
Peer Support: Establish connections with peer organizations or groups that align with Kasym’s
experiences, minimizing feelings of isolation. Such peer networks have been shown to significantly
reduce symptoms of depression (Alvarez et al., 2019).
Engage with a Primary Care Provider: Facilitating connections with a primary care provider who is adept
at handling the mental health requirements of young adults, particularly from minority groups, ensures
a comprehensive monitoring system for Kasym’s well-being. Prochaska et al. (2012) highlight the value
of consistent monitoring in addressing potential health challenges promptly.
Financial and Academic Assistance: Identifying resources tailored for minority students, such as
scholarships or academic support services, can alleviate some stressors. Financial and academic
challenges are notable contributors to the deteriorating mental health of college students (Stebleton,
Soria, & Huesman, 2014).
Emergency Mental Health Plan: Formulating a crisis plan alongside Kasym and those close to him can
provide immediate intervention during acute distress phases (Wharff, Ginnis, & Ross, 2012).
In conclusion, Kasym’s situation necessitates an approach that’s sensitive to his cultural roots, current
environment, and the challenges he faces as a college student. By implementing a multifaceted plan that
caters to his unique needs, we optimize the chances for his recovery and ongoing well-being.
References
American Psychological Association. (2017). Guidelines for psychological practice with girls and women.
Alvarez, K., Fillbrunn, M., Green, J. G., Jackson, J. S., Kessler, R. C., McLaughlin, K. A., … & Alegría, M.
(2019). Race/ethnicity, nativity, and lifetime risk of mental disorders in US adults. Social Psychiatry and
Psychiatric Epidemiology, 54(5), 553-565.
Caplan, S. (2017). Latinos, acculturation, and acculturative stress: A dimensional concept analysis. Policy,
Politics, & Nursing Practice, 18(2), 76-89.
1.Primary Concern with Kasym’s Cultural Background and Clinical Symptoms:
Kasym’s cultural background as an immigrant from Guatemala and his clinical symptoms of excessive
sleep (20 hours a day), non-attendance in college, and self-harming tendencies raise significant
concerns. The primary concern here is the potential intersection of his mental health issues with the
challenges associated with his cultural background, which might include acculturation stress, the cultural
stigma surrounding mental health, and barriers to accessing appropriate care (Blukacz et al., 2020).
Immigrants like Kasym often face acculturation stress, which arises from adapting to a new culture. This
stress can manifest as psychological distress, especially among individuals who come to the host country
at a young age, as they might grapple with questions about their identity, belongingness, and cultural
conflicts. Kasym’s inability to cope with this stress may contribute to his clinical symptoms.
Many immigrant communities, including those from Guatemala, may stigmatize mental health issues,
viewing them as a sign of weakness or shame. This stigma could deter Kasym from seeking help,
exacerbating his mental health concerns. It is essential to address these cultural beliefs when designing
a plan for him.
Immigrants often face barriers to accessing mental health services due to language barriers, lack of
insurance, fear of deportation, or limited knowledge about the healthcare system. Kasym’s struggle to
attend classes and his self-harming tendencies may be related to his inability to access appropriate care.
2. Plan for Kasym’s Well-being:
The first step is to connect Kasym with a mental health provider who is culturally competent and speaks
his native language, Spanish. This provider should be trained to understand immigrants’ unique
challenges during acculturation. The rationale for this is that cultural competence improves the quality
of care and increases the likelihood of Kasym opening up about his struggles.
Encourage Kasym to join support groups or organizations on campus or in the community that cater to
immigrants or individuals from Guatemala. These groups can provide emotional support and a sense of
belonging, which may alleviate some of his acculturation stress. Evidence suggests that social support
can positively impact mental health outcomes.
Help Kasym explore financial aid options, scholarships, or part-time employment opportunities that can
reduce financial stress and enable him to continue his education. Financial stability can alleviate stress
and contribute to improved mental health.
Ensure Kasym has a primary care provider to monitor his overall health and well-being. Frequent checkins can help detect any physical health issues contributing to his symptoms. Additionally, this provider
can serve as a gateway to mental health services if needed (Deshields et al., 2021).
Develop culturally sensitive psychoeducational materials and outreach programs to raise awareness
about mental health within the Guatemalan immigrant community. Reducing mental health stigma is a
long-term goal that can benefit Kasym and others facing similar challenges.
The primary concern with Kasym’s cultural background and clinical symptoms is the potential for his
mental health struggles exacerbated by acculturation stress, cultural stigma, and barriers to care. The
plan outlined above aims to address these concerns by providing culturally competent care, social
support, financial stability, and regular health monitoring while also working toward reducing cultural
stigma in the community. This comprehensive approach is evidence-based and considers the unique
challenges individuals like Kasym face.
References
Blukacz, A., Cabieses, B., & Markkula, N. (2020). Inequities in mental health and mental healthcare
between international immigrants and locals in Chile: A narrative review. International Journal for Equity
in Health, 19(1), 1-15.
Deshields, T. L., Wells‐Di Gregorio, S., Flowers, S. R., Irwin, K. E., Nipp, R., Padgett, L., & Zebrack, B.
(2021). Addressing distress management challenges: Recommendations from the consensus panel of the
American Psychosocial Oncology Society and the Association of Oncology Social Work. CA: A Cancer
Journal for Clinicians, 71(5), 407-436.
PHC 312 Group Assignment Paper
College of Health Sciences
ASSIGNMENT COVER SHEET
Course name:
Health Communications
Course code:
PHC312
CRN:
Assignment title or task:
Students enrolled in PHC 312 in First term 2023 will be divided into groups (5-7 students per group). The first
section will be designed to gain general information about the communication program.
The second section will be designed to assess the student’s ability to draft a health communication plan. The
group has 5 points to cover under the general program information section. The main communication program
characteristics section will be designed to assess the group’s ability to provide basic information about the health
communication planning process.
The written health communication program plan must be completed and submitted to the instructor no later than
11:59 PM on (October 07, 2023).
General program information
1.
Name of the program.
2.
Country and region (if applicable) where the program is based.
3.
Time period (start and end dates).
4.
Funding sources.
5.
Give a short description of the program (maximum of about 250 words).
Main communication program characteristics
1.
Describe the overall goal of the program.
2.
List the SMART objectives of the program.
3.
Describe the target audience(s) of the program (primary and secondary audiences).
✓ Indicate the demographic and socioeconomic factors of the target population that have been measured. E.g.
age, gender, income/socioeconomic status, education, occupation…etc.
4.
Literature review: basing the communication program on current scientific knowledge and/or theoretical
models and/or previous experience from other projects? One or two paragraphs about the problem. (300-500
words).
5.
Describe the settings and communication channels.
6.
Describe the development process of messages.
7.
Describe the activities and timeline.
8.
Describe the process/impact/outcome evaluation of the communication program that will be measured.
Points that can be added as a bonus (NOT REQUIRED):
• Describe the needs assessment that has been carried out.
• Describe the environmental factors (i.e. factors beyond individual control) that the communication program
addresses, if any.
PHC 312 Group Assignment Paper
• Does the communication plan have a special focus on vulnerable groups (socioeconomically disadvantaged
people, ethnic minorities, children, elderly people, etc.)? if yes, specify the vulnerable groups.
• Provide details of the pilot study if a pilot study has been performed.
• Describe which stakeholders are going to be involved in the implementation and describe their roles.
Group Number:
Student name & ID #
Submission date:
Instructor name:
…. Out of 10
Grade:
The written report will be assessed for clarity and succinctness in providing the required information using a rubric of 0
(undeveloped/inadequate) to 3 (outstanding/exceptional), as illustrated below:
Inadequat
e
Objective/Element
Report clearly and succinctly defines program goals
2.
Report clearly and succinctly defines program SMART objectives.
3.
SMART objectives are:
a. Specific: objectives should clearly specify what is to be achieved.
b. Measurable: objectives should be phrased in a way that achievement can
be measured.
c. Achievable: objectives should refer to something that the program can
actually influence and change.
d. Realistic: objectives should be realistically attainable within the given
time frame and with the available resources (human and financial
resources and capacity).
e. Time-bound: objectives should relate to a clearly stated time frame.
Proficient Outstanding
Partially
Meets
Exceeds
Fails to
meets
expectation Expectations
meet
expectations
s
3
expectation
1
2
s
0
1.
Adequate
PHC 312 Group Assignment Paper
4.
Report clearly and succinctly describes the target audiences (primary &
secondary audiences).
✓ Indicate the demographic and socioeconomic factors of the target population
that have been measured. E.g. age, gender, income/socioeconomic status,
education, occupation…etc.
5.
Report provides a brief background that includes:
✓ Literature review.
Report clearly and succinctly describes settings and communication
channels
Report clearly and succinctly describes the development process of
messages.
6.
7.
8.
Report clearly and succinctly describes the activities and timeline.
9.
Report clearly and succinctly describes how the process/impact/outcome
evaluation of the communication program will be measured.
Total
This assignment is worth 10% of the total possible points earned for the course.
Guidelines:
•
Use this Word Document.
•
Fill in students’ information on the first page of this document.
•
Font should be 12 Times New Roman
•
Headings should be Bold
•
Color should be Black
•
Line spacing should be 1.5
•
Use reliable references (APA format)
•
AVOID PLAGIARISM (you will get ZERO when there is plagiarism)
•
You should use at least 2 references
•
Submit this WORD Document when you complete the required task
•
Submission should be before the deadline (submission after the deadline is not allowed)
•
For more resources, you can review appendix A and appendix B in Schiavo, R. (2014).
Please respond to discussion below using current APA edition and 2 scholarly references. Must be 150 words.
Clinical experience is an essential part of the nursing education. It helps nursing students explore the clinical environment while interacting with different patient case scenarios and conducting diagnosis and assessment. This majorly contributes to acquiring the right knowledge required in nursing practice since this acts as a major determiner of the competence of nurses (Kalyani et al., 2019). During this week’s clinical experience, I faced different challenges. The main challenge that I encountered this week was a high workload. The unit I was in had increased patient turnouts with limited healthcare workers to handle all patient cases. High workload, therefore, resulted in long working hours without breaks.
Another challenge that I encountered was fear and anxiety. The environment in which I was working brought up fear in me due to the high rate of contagious infections and diseases that patients presented with (Kalyani et al., 2019). Despite the few challenges during the week, all operations and activities succeeded. I improved my relations with other healthcare workers and learned how to handle patients to improve their satisfaction. I could focus more on the patient’s wellness and not their illness. This week was also a success since I acquired clinical and financial data planning knowledge and skills.
Patient Assessment
One of the patient cases I handled this week was a 65-year-old male patient who presented to the clinic complaining of chest pain. The patient stated that the pain started while walking at his home compound with his granddaughter. The patient is a retired teacher who has been living at home for five years since he retired. Some of the signs and symptoms portrayed by the patient include sweating, shortness of breath, fever, high body temperatures, body weakness, high blood pressure, and faintness.
After physical assessment, the patient was referred to undertake more diagnostic tests to help accurately diagnose the condition. Blood tests were conducted, including cardiac marker tests and chest X-rays (Kumar et al., 2022). The differential diagnosis for the patient was heart attack, gastroesophageal reflux disease, heart attack, pneumonia, and unstable angina. Pneumonia was eliminated after the physical assessment since the patient didn’t have any signs of nasal congestion or other symptoms associated with chest congestion.
The laboratory diagnostic test findings identified that the patient had a heart attack. The plan of care for the patient involves taking medications aimed at treating a heart attack. Some medicines that can be administered as a plan of care for the patient include heparin and fibrinolytics, which contain blood-thinning elements that help dissolve blood clots and prevent the formation of other clots (Kumar et al., 2022). Depending on the severity of the heart attack, the patient can also undergo heart surgery to remove the blood clots. Patients with more severe heart attacks are directly referred for heart surgery, while those with less severe cases are given medical prescriptions with close monitoring.
Health Promotion
The health promotion for the patient should be aimed at controlling blood pressure and managing it within normal ranges, adhering to the medication as prescribed. The patient should eat a healthy diet by eliminating saturated fats and reducing body cholesterol levels. Frequent exercising is also an essential plan of care whereby the patient should engage in low-intensity exercise to improve their heart health. This week, I gained much knowledge and experience in nursing care that benefits me (Immonen et al., 2019). I learned the importance of remaining calm while handling patients and focusing on better outcomes and good patient experiences.
Newsletter Assignment 1240 – MediaSpace > Minnesota State (minnstate.edu)
Video Instructions Here!
Choose ONE age, either 12-24 months, or 4-5’s.
Choose a learning center play area that you did NOT use for your poster assignment in the earlier module. This one needs to be different.
USING MICROSOFT WORD, create a newsletter for parents/caregivers for one class (infant/toddler 12-24 mo. OR preschool 4-5’s.)
CRITERIA
Use the following headings in your newsletter so I can easily see where you have each component:
Learning & Development: Share what children gain/learn from exploring this area in general – “Children who engage in playing with manipulatives have better handwriting in later grades” or “When children engage in sensory activities, they use their whole body in learning”
Grading: Clearly shows at least 2 reasons why is that learning necessary for the general development of their children (2 pts)
What Children Do: Explain what you might observe children doing in this area on a typical class day.
Grading: Clearly shows at least 2 points about how their children typically use and explore the area (2 pts)
Learning Standards: Share the MN Early Childhood Indicators of Progress (ECIPS) (4 different indicators with their matching Domain) that children may utilize when playing in this learning area. You are welcome to change the wording to a lower reading level.
Grading: Lists 4 ECIPS (4 different indicators with their domain) (4 pts)
Home Connect: Give families ideas on how/what they can do at home to support this learning with at least 2 ideas of using daily routines or an activity that can be easily done with simple materials in the home.
Grading: Clearly describes 2 developmentally appropriate ideas for families on how/what they can do at home for this same type of learning, using inexpensive, simple home materials (4 pts)
Additional grading criteria:
Uses headings provided (5 pts)
Keeps very simple wording in each area (2 pts)
Contains at least two pictures or graphics. (2 pts)
On 1-2 pages, organized & attractive, correct spelling & grammar(3 pts)
Age group, teacher name, and learning center area are listed (3 pts)
Submit an electronic copy of the Microsoft Word assignment in D2L. Please double-check that you have submitted the correct, completed document, as I can not accept assignments after the close date. I recommend saving your document with the word “DONE” at the end so you choose the correct one for sure!
Please respond to discussion below using current APA edition and 2 scholarly references. Must be 150 words.
Success and Challenges of Week 6 Clinical Experience
I was faced with the challenge of seeing patients who did not want to be seen by a student nurse practitioner. Furthermore, some of them did
not refuse to be seen by me outright, they just displayed a difficult attitude and made assessing and talking with them more difficult. Another
challenge I faced was with choosing which medication to prescribe. For example, I know the patient needs to be started on a blood pressure
medication, but I find it difficult to determine which one, at what dose, and how many times a day.
Patient Assessment, Plan, Differential Diagnoses, and Health Promotion Interventions
A sixty-four-year-old woman presented to the office complaining of intermittent palpitations over the past week. The associated symptom
was shortness of breath and she denied aggravating and alleviating factors. The patient denies any symptoms of infection. The patient denied
smoking, alcohol use, and illegal drug use as well. She had a past medical history of hypertension and hyperlipidemia. Her physical assessment was
negative for an irregular heartbeat or murmur, edema was absent, and her lung sounds were clear bilaterally. Her vital signs were within normal
limits. An electrocardiogram (EKG) was performed in the office which showed normal sinus rhythm. Upon digging a little deeper, my preceptor and
I discovered that the patient had recently gone through some life-changing events, including a death in the family. The patient was crying and
appeared anxious. Once she calmed down, a GAD-7 was given to the patient to complete; she scored a ten indicating moderate anxiety. Differential
diagnoses included anxiety, cardiac arrhythmias, and pulmonary embolism (PE) (Goyal et al., 2023). We prescribed 5 mg of escitalopram (Lexapro)
daily for anxiety. The patient was instructed to return in six weeks for a follow-up as it can take up to six weeks to feel the full effects of the
medication (Landy et al., 2023). At that time, her response to the medication can be evaluated and the dosage can be adjusted accordingly. She was
also referred to a psychologist to provide talk therapy and behavioral intervention for her anxiety, as well as a cardiologist for a further workup to
rule out a cardiac cause for her symptoms. Health interventions include managing anxiety by reducing stress through meditation, yoga, deep
breathing, and relaxation techniques. In addition, the patient should be counseled to avoid stimulants like caffeine, energy drinks, nicotine, and even
some cold medicines (Heart Palpitations – Diagnosis & Treatment – Mayo Clinic, 2022).
What I Learned This Week in Clinical that Can Be Beneficial in My Future Practice
An 81-year-old Black female was referred to ophthalmology for blurred vision. The report from the consulting physician stated he suspected
sarcoidosis based on his findings. The patient had no pulmonary or cardiac symptoms, but because of the ophthalmologist’s report was sent for CT
imaging to further evaluate for the disease. Multisystemic sarcoidosis primarily affects the lungs and thoracic lymph nodes. Chest discomfort,
dyspnea, and cough are common symptoms in patients. Nonspecific rhinitis, recurrent sinusitis, and destructive lesions of the nasal septum and
turbinates are the results of upper respiratory tract involvement. Papules, nodules, plaques, ulcers, and erythema nodosum are cutaneous symptoms.
Arrhythmias and heart blockages emerge as a result of cardiac involvement. About 5 to 10% of sarcoidosis patients develop neurosarcoidosis, which
primarily affects the basal leptomeninges and cranial nerves. Granulomatous inflammation of the eye and its adnexal tissues is a characteristic
feature of ocular involvement in sarcoidosis. In thirty to forty percent of patients, ocular involvement is the first presenting characteristic. Uveitis,
which is present in thirty to seventy percent of cases, and conjunctival nodules, which are present in 40% of cases, are the most prevalent ocular
characteristics. Because of variations in case definition, the disease’s asymptomatic nature, insufficient population screening, and ascertainment bias,
the prevalence of sarcoidosis varies from region to region. According to reports, Black Americans have an age-adjusted incidence that is three times
greater than White Americans. The typical age at which sarcoidosis manifests itself is twenty to fifty years old. In addition, there is a higher
likelihood that uveitis, asthenia, and skin lesions are linked to late-onset sarcoidosis i.e. diagnosed at sixty-five years of age or older (Simakurthy &
You have been following your patient for the past 2 years. You have worked with them to lose weight by changing lifestyle and nutritional habits. They continue to be overweight (body mass index [BMI] of 33) and have tried to cut down carbohydrate and fat intake, but now presents with polyuria, polydipsia, and an elevated random blood sugar of 164. You have ordered anHbA1c test in the past, and the values were less than 6.2%. However, the most recent test indicated an HbA1c greater than 7%. They are not on any medications, but does have a sulfa allergy.
You officially have enough evidence to officially start treating this patient for Type II Diabetes Mellitus. Their 3 P symptoms, their random blood sugar (BS), and A1C are all evidence ofT2DM.
Answer the following questions.
What is the first medication you would prescribe? Discuss how you determined which one to give first and how you based this decision on specific factors.
What education regarding medication management would you need to do?
Submission Details
APA 7th Edition
2 pages for body (Plus title page & Reference page)
What is a weight-neutral diabetic medication? What do you do if the patient does not want an injection?ExpectationsLength: A minimum of 100 words, not including referencesCitations: At least one high-level scholarly references in APA from within the last 5 yearsRelate with the original post belowQuestion oneOne class of medications for type 2 diabetes has been shown to reduce hunger and calorie intake, hence aiding in weight loss. Medications in this category are typically referred to as GLP-1 agonists and an example is Exenatide (Ross & Douglas, 2019).Question twoGLP-1 receptor agonist is the suggested treatment. To begin, 5 mcg of the generic drug exenatide is taken subcutaneously twice daily, preferably before meals.Question threeHypersensitivity to the medicine, a previous diagnosis of pancreatitis, or family history of medullary thyroid cancer are all reasons to avoid GLP-1 receptor agonists. GLP-1 based drugs affect glycemic management by reducing postprandial glucagon and food intake and by delaying gastric emptying (Ross & Douglas, 2019). They also increase glucose-dependent insulin secretion. In the absence of medicines that produce hypoglycemia, these drugs do not typically cause hypoglycemia.Question fourHypothyroidism symptoms might vary widely across individuals. And they frequently mimic the signs of other diseases (Bekkering et al., 2019). This means that symptoms alone aren’t enough for a diagnosis of hypothyroidism. The results of blood tests are typically used for this purpose. As a first-line blood test for hypothyroidism, TSH levels are frequently examined. T-4 (a type of thyroid hormone) levels in the blood will also be checked if this one is abnormally high. Hypothyroidism is diagnosed if TSH is elevated and free T-4 is low. T-3, another thyroid hormone, may be evaluated in some situations. Low TSH levels along with elevated free T4 levels characterize hyperthyroidism (Bekkering et al., 2019).Question fiveLevothyroxine, a hormone replacement tablet, is commonly used to treat hypothyroidism, or an underactive thyroid. Levothyroxine is the generic name, and the recommended starting dose is 25-50 mcg taken orally once daily. Levothyroxine is an artificial analogue of thyroxine (T4), which the body metabolizes into triiodothyronine (T3) (Ross & Douglas, 2019). It is used to make up for the body’s lack of thyroid hormone. After determining the optimal dosage, patients typically undergo annual blood tests to track their hormone levels.When the patient’s thyroid is unable to produce enough of the thyroxine hormone, levothyroxine can be taken to restore normal levels (Idrees et al., 2020). Until the optimal levothyroxine dosage is determined, the patient will have routine blood tests. The levothyroxine dose may be started low and increased gradually based on the patient’s response. Some patients report improvement in symptoms shortly after starting treatment, while others may have to wait several months.Question sixHeart palpitations, tremors, loss of weight, sleeplessness, diarrhea, and an inability to tolerate heat are all possible adverse reactions (Ross & Douglas, 2019). There may be some unwanted consequences, but in most cases they do not warrant medical care. During treatment, the patient’s body may become accustomed to the medication and the symptoms will disappear.This patients should to take their medications first thing in the morning, preferably 30-60 minutes before eating anything. Within 4 hours of using levothyroxine, the patient should not take any calcium or iron supplements or certain antacids. Indicators of over medication include weariness, constipation, and dry skin, while indicators of under medication include rapid or irregular heartbeat and chest discomfort (Ross & Douglas, 2019). Thyroid hormone levels must be monitored and followed up on often so that the dosage can be adjusted as needed.References:Bekkering, G. E., Agoritsas, T., Lytvyn, L., Heen, A. F., Feller, M., Moutzouri, E., Abdulazeem, H., Aertgeerts, B., Beecher, D., & Brito, J. P. (2019). Thyroid hormones treatment for subclinical hypothyroidism: A clinical practice guideline. Bmj, 365. https://www.bmj.com/content/365/bmj.l2006.longIdrees, T., Palmer, S., Maciel, R. M. B., & Bianco, A. C. (2020). Liothyronine and desiccated thyroid extract in the treatment of hypothyroidism. Thyroid, 30(10), 1399–1413. https://doi.org/10.1089/thy.2020.0153Ross, D. S., & Douglas, S. (2019). Patient education: Hypothyroidism (underactive thyroid)(Beyond the Basics). Montefiore Medical Center and the Albert Einstein College of Medicine, USA. https://aqchealth.com/userfiles/file/Hypothyroidis…
Need a peer response. 3 paragraphs with 3 sentences, and a reference. Initial discussion question: Suppose you are going to conduct a study utilizing Quantitative Research Design: which type of research would you use, and which method would you utilize to collect data?
Unformatted Attachment Preview
In conducting a study utilizing a Quantitative Research Design, the type of research that would be most
suitable is a cross-sectional study. Cross-sectional research involves the collection of data from
participants at a single point in time, allowing for the examination of relationships and patterns within a
specific population or sample at that moment. This design is particularly useful for studying variables
and their associations, making it well-suited for quantitative research objectives (Dillman, Smyth, &
Christian, 2020).
To collect data for a cross-sectional study, I would employ structured surveys or questionnaires as the
primary data collection method. Surveys and questionnaires enable the systematic gathering of data
from a large number of participants efficiently. The questions in these instruments can be designed to
elicit specific responses related to the research objectives. Additionally, they can incorporate closedended questions with predetermined response options, facilitating quantitative data analysis. This
method allows for the measurement of variables, statistical analysis, and the identification of trends and
correlations among the collected data (Creswell & Creswell, 2020).
To ensure the validity and reliability of the data, I would employ established survey design principles,
pilot-test the instrument, and use appropriate sampling techniques. Furthermore, I would consider
utilizing technology, such as online surveys or computer-assisted data collection, to enhance data
collection efficiency. This approach aligns with best practices in quantitative research, ensuring that the
data collected is robust and suitable for rigorous statistical analysis (Dillman, Smyth, & Christian, 2020;
Creswell & Creswell, 2020).
References
Dillman, D. A., Smyth, J. D., & Christian, L. M. (2020). Internet, phone, mail, and mixed-mode surveys:
The tailored design method (4th ed.). Wiley.
Creswell, J. W., & Creswell, J. D. (2020). Research design: Qualitative, quantitative, and mixed methods
approaches (5th ed.). Sage Publications.
Suppose I were to conduct a study in applied nursing to examine the effectiveness of a new pain
management protocol on post-operative patients’ recovery. In this scenario, I would opt for a
randomized controlled trial (RCT) as the type of research design. RCTs involve randomly assigning
participants to either an experimental group (receiving the new pain management protocol) or a control
group (receiving standard care) to measure the effectiveness of the intervention (Polit& Beck, 2017).
I would utilize quantitative methods to collect data for the RCT, such as structured observations and
objective measurements. In this specific study, I might use tools like pain scales to quantify the level of
pain experienced by patients at various post-operative time points. Additionally, I could collect
quantitative data on recovery parameters like the time taken to regain mobility, the amount of pain
medication required, and patient satisfaction scores. These objective and quantifiable data points would
enable me to conduct statistical analyses to determine whether the new pain management protocol
significantly improves post-operative recovery outcomes compared to standard care.
Ensuring the validity and reliability of data collection methods is crucial in healthcare research.
Therefore, I would pre-test the pain scales and other measurement tools to ensure their accuracy and
consistency. By employing an RCT with quantitative data collection methods, I can rigorously investigate
the effectiveness of the new pain management protocol in applied nursing, providing valuable insights
for improving patient care.
Reference
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing
practice (10th ed.). Wolters Kluwer.
Pick ONE of the questions/topics and post an answer.
There are no right or wrong answers.
You DO NOT have to comment on a peer’s post.
Please employ a non-judgmental stance while still honoring your beliefs.
You are invited to be creative in answering this discussion post.
You can write your discussion post/answer, as usual.
-OR-
You can make a poster, drawing, collage or handout reflecting your topic of choice. Creativity encouraged!
You can make a TikTok or video about one of the topics and share it so we can view your answer.
You can make a social media post, five-slide PowerPoint or even sing a song about one of the topics.
You can ask to do something totally different–as long as it’s creative and covers a topic listed, I’ll say yes. (Email/message me)
Remember: Chose ONE of the topics.
CHOICE ONE: SEXUALITY After reading the book, PDF handouts and watching the videos, complete page 175 in your book (“What are your attitudes about sexual differences”). What did you learn about yourself? No need to be specific. Just indicate if you were surprised or learned anything new about yourself. What are your thoughts about the questions in the assess yourself? (2) What was your favorite video and why?
-OR-
CHOICE TWO: GENDERBREAD -or- GENDER UNICORN. Using page 164 (“Your Sexual Identity”), the taco/hot dog video, the Genderbread person and/or any other resources of your choosing, help others understand about all those identifies, pronouns and expressions. A non-judgmental stance will be supported by the professor.
-OR-
CHOICE THREE: PREGNANT! Have fun with this. (1) Enlighten us about your pregnancy knowledge, as learned in the book, PDF and videos. (If you have given birth or see a baby be born, you can use that as a resource, too!!!) What did you learn that you didn’t already know? (2) Were you surprised by anything in the videos on contraception and pregnancy? (3) Optional: What did you think about two lesbians talking about having a baby?
-OR-
CHOICE FOUR: BIRTH CONTROL Using Chapter 7, page 206 in the book, the PDF/videos and other resources of your choice, let’s hear your thought about birth control. As always, please keep it non-judgmental while still expressing your opinion. Why do people use (or not use) “protection?” What kinds of birth control do people use? Are they really effective? What are concerns and dangers? No statistics needed–just your thoughts and observations. What was your score on Page 206 in your book?
-OR-
QUESTIONS ON THE “WELLNESS TIMES” Handout. Using the HANDOUT Wellness Times Chapters 6/7, make a discussion post about one (or more) of the topics listed. What resources besides the handout did you use? ( the files bellow may help you with the discussion)
@
Please, make it simple English like you talking with a classmate in class.
Unformatted Attachment Preview
6.7
You’ll have relationships for your entire life, so we might as well learn
about them.
●
●
●
What IS a HEALTHY relationship?
Why do relationships matter?
HOW does sex, gender, gender identity and sexual orientation play a role in
this stuff?
FAMILY. WHO is your family? How do you define that? Do families have to be
biologically related?
FRIENDS. How do YOU define a friend? School, childhood, best friend? Acquaintance,
on-line or gaming friend?
PARTNERS. Are you on a date? In a monogamous, committed relationship? Hooking
up? Dating more than one person at a time?
Sex. Unless you choose otherwise, you’ll engage in sexual activity. So, we best figure
that out, too.
SEXUALITY. What is there to understand about sexuality? If a guy has sex with a guy
that makes him gay, right? If a guy identifies his gender as male but his assigned sex is
female, is he male or female? What the hell is this pansexuality? What is gender,
sexuality and sexual orientation?
Reproductive choice. You need to know how to–and, how not to–get pregnant.
diseases as well as pregnancy? Don’t you want to practice safer sex? It helps to know
this stuff! Ewwww, gross! Body parts!
Taco or Hot Dog?
W
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H
V
I
D
E
O
I thought we’d get this chapter off to an exciting start. Hot dogs or tacos.
Sexuality. Gender. Sexual Orientation. Gender identity. Pronouns. This video
made me hungry and confused.
●
You may or may not agree with any of this.
●
You may be relieved that someone FINALLY explained this.
●
You may be disgusted, grateful, indifferent.
●
Is Wellness Class great or what? Something for everyone.
●
Have you ever heard of the “Genderbread Person?” The Gender
Unicorn?
WHO
ARE
WE?
I love this video. If you don’t watch it, I will cry. Don’t make me cry.
Cheesy? Maybe. Old news? I hope so! Old video? Yes, but no. You’ve probably seen
it before. You can never see it too many times.
I appreciate that there are strong opinions in regards to these topics. All I ask is that
you have an open mind.
Your personal, spiritual, religious, political, familial beliefs all tie into this. Ask yourself
WHY you feel the way you do about the topics presented this week. It’s not good or
bad, right or wrong. Relationships are complicated. People are complicated. Life is
complicated.
“Ask yourself WHY you feel the way you do about the topics presented this week.” Do I
think this class will change your mind? No. But, I do think you’ll be better educated
and thus consider WHY you believe what you believe. It’s not about good or bad,
right or wrong.
W
A
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H
V
I
D
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O
Is it a good relationship?
Is it a bad relationship?
Compromise
Commitment
Communication
To get your extra credit, include a random statement a favorite
song in your homework post. Just put a sentence in there, like
it’s totally “normal.” Don’t call attention to it. Any song you like.
Page 153 in your book does a nice job of explaining the difference between
healthy and unhealthy relationships.
Hmmm… will you open your book? DO you own the textbook? Do you know where
your textbook is? I don’t want anyone getting lazy on me!
A HEALTHY (good?) relationship has no physical/verbal/emotional abuse. There is
encouragement and growth, a balance of Intimacy, Passion, Commitment, Respect,
healthy difference and acceptance.
AN UNHEALTH (bad?) relationship is unbalanced. One may want more love, more sex,
more time together. There may be physical/verbal/emotional abusive. Some are
forced to be in the relationship. The three C’s aren’t consistently present.
Reflect upon your current situation. What you think of all those relationships you
currently have in your life? Are they good, bad, or somewhere in between? No,
seriously. Stop and reflect on this. If you are in a not-so-good relationship, ask yourself
why. Not judge–just look at it from a non-judgemental stance. Be gentle but honest.
PREGNANT??!
Uh oh–can doing THAT make you pregnant?????
As for pregnancy, oooooh, lots to judge here. Please remain as
judgement-free as possible.
If you know this stuff, good. If you don’t know this stuff, good. You can learn!
Did you know you could get pregnant like they said in that previous video?
What do you think you’d do if you/your partner got pregnant and it wasn’t
planned? What if they guy had a vasectomy and you still ended up
pregnant?
For some, that’s AWESOME! For others, it is NOT awesome. How do you have
this conversation?
W
A
T
C
H
V
I
D
E
O
W
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H
V
I
D
E
O
What if you DON’T want to get pregnant? How the hell did we get pregnant,
anyway? Eeeeewwwww! This video is all about the basics. You probably know
this stuff. Or, at least people have babbled at you about this stuff.
WOMEN ON THE “PILL:” Did you know that taking antibiotics can reduce how
effective your birth control is????
DO YOU KNOW WHAT A DENTAL DAM IS? Oh my goodness. These diddies can
be used as part of sexual protection. Dental dams are used by dentists. But,
they have another use. Care to guess?
Do you judge people for their reproductive decisions???? For their sexual
activity? Emergency. Prescribed. Over the Counter. What to do if you get
pregnant? Give Birth. Adoption. Abortion.
W
A
T
C
H
V
I
D
E
O
Have you ever seen a baby be born? Oh my! It’s amazing. Terrifying.
Miraculous. Messy. Emotional. Confusing. If you have the chance, do it! There
is nothing like seeing what actually happens. C’mon. Did you know there’d be
poop? There’s poop. Not the baby’s poop. Just sayin.’
Don’t worry. I didn’t include a video of a baby being born. You can google
that yourself. YouTube is full of videos with babies shooting out of their mom’s
girl parts. Instead, I’ve included two people watching videos of childbirth!
Rose and Rosie are here to talk about shooting out a baby.
And finally….ah, so you are…. Other than cis-gender heterosexual? But,
is it okay? What does that even mean? Thank you for keeping an open
mind about all of this!
Birth Control: It’s not “just” about not getting pregnant.
Ask yourself:
Why do people use
protection?
Why DON’T they use
protection?
Why don’t I want to use a
condom?
Do I have religious beliefs that influence my contraception choices?
Where can I get contraceptives?
Do I want a child right now?
If my partner uses the “Pill,” why would I bother to use a condom?
How do I ask my partner to use a condom or some form of
contraceptive? How do I say NO if my partner refuses to use a condom?
What if I have an STI?
Do I believe abortion is an option?
Is abortion a method of birth control?
Childbirth: It’s not just shooting out a
baby!
Have you ever seen anyone give birth? You
definitely need to see someone give birth!
Assignment Criteria:
1. Investigate the following health issues:
a. Lung disease and air pollution
b. Birth defects and hazardous waste
c. Cancer and radiation leakage from a power plant
2. Present statistics on each health issue.
3. Discuss ecologic fallacy for each health issue.
4. Analyze risk factors for each health issue.
5. Examine three (3) health promotion activities that the APRN should include.
6. What are the implications for future epidemiology research?
7. The scholarly paper should be in narrative format, five (5) to six (6) pages excluding the title and reference page.
8. Include an introductory paragraph, purpose statement, and a conclusion.
9. Include level 1 and 2 headings to organize the paper (see suggested level 2 headings above).
10. Write the paper in third person, not first person (meaning do not use ‘we’ or ‘I’) and in a scholarly manner. To clarify: I, we, you, me, our may not be used. In addition, describing yourself as the researcher or the author should not be used.
11. Include a minimum of 5 professional peer-reviewed scholarly journal references to support the paper (review in Ulrich Periodical Directory) and be less than five (5) years old.
12. APA format is required (attention to spelling/grammar, a title page, a reference page, and in-text citations).
ASSIGNMENT COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN:
Assignment title or task:
(You can write a question)
Choose any one of the common occupational
infectious diseases and explain the following:
•
•
•
Causes, mode of transmission, and symptoms.
Occupational group at risk
Prevention and control measures
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Short essay of 500-750 words (Excluding references).
• The font size should be 12.
• Font type should be Times New Roman
• The heading should be Bold.
• Color should be Black.
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style.
• AVOID PLAGIARISM
• Due date; 30/9/2023 11:59 PM
Best of Luck
In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student’s ability to further develop and synthesize the assignments that constitute the components of the capstone project.
The assignment will be used to develop a written implementation plan.
For this assignment, provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected. The articles should be current (within the last 5 years) and closely relate to the PICOT question developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project.
While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
Assessment Description
After working with your preceptor to assess organizational policies, create a list of measurable outcomes for your capstone project intervention. Write a list of three to five outcomes for your proposed intervention. Below each outcome, provide a two – three sentence rationale.
The assignment will be used to develop a written implementation plan.
APA style is not required, but solid academic writing is expected.
For this part of the direct care project, you will be creating a PowerPoint presentation based on the topic and problem identified in Part 1. If you chose air quality as your topic, you will present on the Air Quality Flag Program. If you chose substance use, you will present the SBIRT intervention model.Download the template below and create a PowerPoint presentation for your selected group.Create speaker notes for the PowerPoint presentation. These will assist you as you present and will be part of your assignment submission.Utilize your own words and paraphrasing for all presentation content.The presentation should be no fewer than 8 and no more than 15 slides. This does not include the introduction and reference slides.Submit presentation in PDF for instructor approval. Minimum of 3 references. See Presentation Instructions for references needed.Cite all resources in APA format on the slide where content occurs. Cite in lower corner/footer as prompted on template.Reference slide is in template. Hanging indent is not required.
Complete the Health History and Physical Assessment assignment this week as per these guidelinesLinks to an external site..
Rubric
NR302 RUA: Health History and Physical Assessment
NR302 RUA: Health History and Physical Assessment
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeHealth History Assessment (70 points possible/70% of total points available)Required criteria
1. Demographics
2. Perception of Health
3. Past Medical History
4. Family Medical History
5. Review of Systems
6. Developmental Considerations
7. Cultural Considerations
8. Psychosocial Considerations
9. Collaborative Resources
70 pts
Highest Level of Performance
Includes 9 requirements for section.
66 pts
High Level of Performance
Includes 7-8 requirements for section.
52 pts
Satisfactory Level of Performance
Includes 5-6 requirements for section.
35 pts
Unsatisfactory Level of Performance
Includes 1-4 requirements for section.
0 pts
Not Present
No requirements for this section presented.
70 pts
This criterion is linked to a Learning OutcomeReflection (20 points/20%)Required criteria
1. Reflect on your interaction with the interviewee holistically.
a) Describe the interaction in its entirety: include the environment, your approach to the individual, time of day, and other features relevant to therapeutic communication and to the interview process.
2. How did your interaction compare to what you have learned?
3. What barriers to communication did you experience?
a) How did you overcome them?
b) What will you do to overcome them in the future?
4. What went well with this assignment?
5. Were there unanticipated challenges during this assignment?
6. Was there information you wished you had available but did not?
7. How will you alter your approach next time?
20 pts
Highest Level of Performance
Includes 7 requirements for section.
18 pts
High Level of Performance
Includes 6 requirements for section.
16 pts
Satisfactory Level of Performance
Includes 5 requirements for section.
10 pts
Unsatisfactory Level of Performance
Includes 1-4 requirements for section.
0 pts
Not Present
No requirements for this section presented.
20 pts
This criterion is linked to a Learning OutcomeStyle and Organization (10 points/10%)Required criteria
1. Grammar and mechanics are free of errors.
2. Verbalizes thoughts and reasoning clearly.
3. Uses appropriate resources and ideas to support topic with APA where applicable.
10 pts
High Level of Performance
Includes no fewer than 3 requirements for section.
8 pts
Satisfactory Level of Performance
Includes no fewer than 2 requirements for section.
The purpose of this assignment is to create an educational program that supports the implementation of risk management strategies in a health care organization.
In this assignment, you will develop an “in‐service”‐style educational risk management program presentation for the employer and employees of a particular health care organization. Select your topic for this educational session from one of the proposed recommendations or changes you suggested in the Topic 1 benchmark assignment to enhance, improve, or secure compliance standards in your chosen risk management plan example.
Develop a 10-12-slide presentation (including a title slide, a reference slide, and slide notes that provide a detailed explanation of your research) that outlines the following points about your chosen topic:
Introduction: Identify the risk management topic you have chosen to address and explain why it is important within your health care sector.
Rationale: Explain how this risk management strategy is lacking within your selected organization’s current risk management plan and describe how its responsibility for implementation will better meet local, state, and federal compliance standards.
Support: Provide data that indicate the need for this proposed risk management initiative and explain how it falls under the organization’s legal responsibility to provide a safe health care facility and work environment.
Implementation: Describe the steps to implement the proposed strategy in your selected health care organization.
Challenges: Predict obstacles the health care organization may face in executing this risk management strategy and challenges for building a culture of faith, compassion, and concern for patients, families, and employees, and propose solutions to navigate or preempt these potentially difficult outcomes.
Evaluation: Outline your plan to evaluate the success of the proposed risk management program and how well it meets compliance with operational risk management policies in the organization’s short-term, long-term, and end goals, which includes key employer and employee metrics that will be used for measuring the success of the risk management program.
Opportunities: Recommend additional risk management improvements in adjacent areas of influence that the organization could or should address moving forward.
In addition to your textbook and the GCU “Statement on the Integration of Faith and Work,” you are required to support your analysis with at least three credible health-related resources and at least three peer-reviewed resources.
Unformatted Attachment Preview
Collapse All
Educational Program on Risk Management – Rubric
Introduction
20 points
Criteria Description
Identification of the risk management topic chosen and explanation of why it is
important within the health care sector.
5. Target
20 points
Identification of the risk management topic chosen and explanation of why it is
important within the health care sector are comprehensive. The submission
encompasses essential details and provides convincing support.
4. Acceptable
17 points
Identification of the risk management topic chosen and explanation of why it is
important within the health care sector are incorporated in full. The submission
encompasses basic details and provides appropriate support.
3. Approaching
15 points
Identification of the risk management topic chosen and explanation of why it is
important within the health care sector are incorporated, but minimal detail or
support is provided for one or more components.
2. Insufficient
13 points
Identification of the risk management topic chosen and explanation of why it is
important within the health care sector are partially incorporated, but the
information provided is incomplete, inaccurate, or otherwise deficient.
1. Unsatisfactory
0 points
Identification of the risk management topic chosen and explanation of why it is
important within the health care sector are not included.
Rationale
Criteria Description
Explanation of how this risk management strategy is lacking within the selected
organization’s current risk management plan and how its responsibility for
implementation will better meet local, state, and federal compliance standards.
20 points
5. Target
20 points
Explanation of how this risk management strategy is lacking within the selected
organization’s current risk management plan and how its responsibility for
implementation will better meet local, state, and federal compliance standards is
comprehensive. The submission encompasses essential details and provides
convincing support.
4. Acceptable
17 points
Explanation of how this risk management strategy is lacking within the selected
organization’s current risk management plan and how its responsibility for
implementation will better meet local, state, and federal compliance standards is
incorporated in full. The submission encompasses basic details and provides
appropriate support.
3. Approaching
15 points
Explanation of how this risk management strategy is lacking within the selected
organization’s current risk management plan and how its responsibility for
implementation will better meet local, state, and federal compliance standards is
incorporated, but minimal detail or support is provided for one or more
components.
2. Insufficient
13 points
Explanation of how this risk management strategy is lacking within the selected
organization’s current risk management plan and how its responsibility for
implementation will better meet local, state, and federal compliance standards is
partially incorporated, but the information provided is incomplete, inaccurate, or
otherwise deficient.
1. Unsatisfactory
0 points
Explanation of how this risk management strategy is lacking within the selected
organization’s current risk management plan and how its responsibility for
implementation will better meet local, state, and federal compliance standards is
not included.
Support
Criteria Description
Provision of data that indicate the need for this proposed risk management initiative
and explanation of how it falls under the organization’s legal responsibility to provide a
safe health care facility and work environment.
20 points
5. Target
20 points
Provision of data that indicate the need for this proposed risk management
initiative and explanation of how it falls under the organization’s legal responsibility
to provide a safe health care facility and work environment is comprehensive. The
submission encompasses essential details and provides convincing support.
4. Acceptable
17 points
Provision of data that indicate the need for this proposed risk management
initiative and explanation of how it falls under the organization’s legal responsibility
to provide a safe health care facility and work environment is incorporated in full.
The submission encompasses basic details and provides appropriate support.
3. Approaching
15 points
Provision of data that indicate the need for this proposed risk management
initiative and explanation of how it falls under the organization’s legal responsibility
to provide a safe health care facility and work environment is incorporated, but
minimal detail or support is provided for one or more components.
2. Insufficient
13 points
Provision of data that indicate the need for this proposed risk management
initiative and explanation of how it falls under the organization’s legal responsibility
to provide a safe health care facility and work environment is partially incorporated,
but the information provided is incomplete, inaccurate, or otherwise deficient.
1. Unsatisfactory
0 points
Provision of data that indicate the need for this proposed risk management
initiative and explain how it falls under the organization’s legal responsibility to
provide a safe health care facility and work environment is not included.
Implementation
20 points
Criteria Description
Description of the steps to implement the proposed strategy in the selected health
care organization.
5. Target
20 points
Description of the steps to implement the proposed strategy in the selected health
care organization is comprehensive. The submission encompasses essential details
and provides convincing support.
4. Acceptable
17 points
Description of the steps to implement the proposed strategy in the selected health
care organization is incorporated in full. The submission encompasses basic details
and provides appropriate support.
3. Approaching
15 points
Description of the steps to implement the proposed strategy in the selected health
care organization is incorporated, but minimal detail or support is provided for one
or more components.
2. Insufficient
13 points
Description of the steps to implement the proposed strategy in the selected health
care organization is partially incorporated, but the information provided is
incomplete, inaccurate, or otherwise deficient.
1. Unsatisfactory
0 points
Description of the steps to implement the proposed strategy in the selected health
care organization is not included.
Challenges
20 points
Criteria Description
Prediction of obstacles the health care organization may face in executing this risk
management strategy and challenges for building a culture of faith, compassion, and
concern for patients, families, and employees, and proposal of solutions to navigate or
preempt these potentially difficult outcomes
5. Target
20 points
Prediction of obstacles the health care organization may face in executing this risk
management strategy and challenges for building a culture of faith, compassion,
and concern for patients, families, and employees, and proposal of solutions to
navigate or preempt these potentially difficult outcomes is comprehensive. The
submission encompasses essential details and provides convincing support.
4. Acceptable
17 points
Prediction of obstacles the health care organization may face in executing this risk
management strategy and challenges for building a culture of faith, compassion,
and concern for patients, families, and employees, and proposal of solutions to
navigate or preempt these potentially difficult outcomes is incorporated in full. The
submission encompasses basic details and provides appropriate support.
3. Approaching
15 points
Prediction of obstacles the health care organization may face in executing this risk
management strategy and challenges for building a culture of faith, compassion,
and concern for patients, families, and employees, and proposal of solutions to
navigate or preempt these potentially difficult outcomes is incorporated, but
minimal detail or support is provided for one or more components.
2. Insufficient
13 points
Prediction of obstacles the health care organization may face in executing this risk
management strategy and challenges for building a culture of faith, compassion,
and concern for patients, families, and employees, and proposal of solutions to
navigate or preempt these potentially difficult outcomes is partially incorporated,
but the information provided is incomplete, inaccurate, or otherwise deficient.
1. Unsatisfactory
0 points
Prediction of obstacles the health care organization may face in executing this risk
management strategy and challenges for building a culture of faith, compassion,
and concern for patients, families, and employees, and proposal of solutions to
navigate or preempt these potentially difficult outcomes is not included.
Evaluation
20 points
Criteria Description
Outline of plan to evaluate the success of the proposed risk management program and
how well it meets compliance with operational risk management policies in the
organization’s short-term, long-term, and end goals, which includes key employer and
employee metrics that will be used for measuring the success of the risk management
program.
5. Target
20 points
Outline of plan to evaluate the success of the proposed risk management program
and how well it meets compliance with operational risk management policies in the
organization’s short-term, long-term, and end goals, which includes key employer
and employee metrics that will be used for measuring the success of the risk
management program, is comprehensive. The submission encompasses essential
details and provides convincing support.
4. Acceptable
17 points
Outline of plan to evaluate the success of the proposed risk management program
and how well it meets compliance with operational risk management policies in the
organization’s short-term, long-term, and end goals, which includes key employer
and employee metrics that will be used for measuring the success of the risk
management program, is incorporated in full. The submission encompasses basic
details and provides appropriate support.
3. Approaching
15 points
Outline of plan to evaluate the success of the proposed risk management program
and how well it meets compliance with operational risk management policies in the
organization’s short-term, long-term, and end goals, which includes key employer
and employee metrics that will be used for measuring the success of the risk
management program, is incorporated, but minimal detail or support is provided
for one or more components.
2. Insufficient
13 points
Outline of plan to evaluate the success of the proposed risk management program
and how well it meets compliance with operational risk management policies in the
organization’s short-term, long-term, and end goals, which includes key employer
and employee metrics that will be used for measuring the success of the risk
management program, is partially incorporated, but the information provided is
incomplete, inaccurate, or otherwise deficient.
1. Unsatisfactory
0 points
Outline of plan to evaluate the success of the proposed risk management program
and how well it meets compliance with operational risk management policies in the
organization’s short-term, long-term, and end goals, which includes key employer
and employee metrics that will be used for measuring the success of the risk
management program, is not included.
Opportunities
20 points
Criteria Description
Recommendation of additional risk management improvements in adjacent areas of
influence that the organization could or should address moving forward.
5. Target
20 points
Recommendation of additional risk management improvements in adjacent areas
of influence that the organization could or should address moving forward is
comprehensive. The submission encompasses essential details and provides
convincing support.
4. Acceptable
17 points
Recommendation of additional risk management improvements in adjacent areas
of influence that the organization could or should address moving forward is
incorporated in full. The submission encompasses basic details and provides
appropriate support.
3. Approaching
15 points
Recommendation of additional risk management improvements in adjacent areas
of influence that the organization could or should address moving forward is
incorporated, but minimal detail or support is provided for one or more
components.
2. Insufficient
13 points
Recommendation of additional risk management improvements in adjacent areas
of influence that the organization could or should address moving forward is
partially incorporated, but the information provided is incomplete, inaccurate, or
otherwise deficient.
1. Unsatisfactory
0 points
Recommendation of additional risk management improvements in adjacent areas
of influence that the organization could or should address moving forward is not
included.
Presentation of Content
20 points
Criteria Description
5. Target
20 points
The content is written clearly and concisely. Ideas universally progress and relate to
each other. The project includes motivating questions and advanced organizers.
The project gives the audience a clear sense of the main idea.
4. Acceptable
17 points
The content is written with a logical progression of ideas and supporting
information, exhibiting a unity, coherence, and cohesiveness. Presentation includes
persuasive information from reliable sources.
3. Approaching
15 points
The presentation slides are generally competent, but ideas may show some
inconsistency in organization and/or in their relationships to each other.
2. Insufficient
13 points
The content is vague in conveying a point of view and does not create a strong
sense of purpose. Presentation includes some persuasive information.
1. Unsatisfactory
0 points
The content lacks a clear point of view and logical sequence of information.
Presentation includes little persuasive information. Sequencing of ideas is unclear.
Layout
10 points
Criteria Description
5. Target
10 points
The layout is visually pleasing and contributes to the overall message with
appropriate use of headings, subheadings, and white space. Text is appropriate in
length for the target audience and to the point. The background and colors enhance
the readability of the text.
4. Acceptable
8.5 points
The layout background and text complement each other and enable the content to
be easily read. The fonts are easy to read and point size varies appropriately for
headings and text.
3. Approaching
7.5 points
The layout uses horizontal and vertical white space appropriately. Sometimes the
fonts are easy to read, but in a few places the use of fonts, italics, bold, long
paragraphs, color, or busy background detracts and does not enhance readability.
2. Insufficient
6.5 points
The layout shows some structure but appears cluttered and busy or distracting with
large gaps of white space or a distracting background. Overall readability is difficult
due to lengthy paragraphs, too many different fonts, dark or busy background,
overuse of bold, or lack of appropriate indentations of text.
1. Unsatisfactory
0 points
The layout is cluttered, confusing, and does not use spacing, headings, and
subheadings to enhance the readability. The text is extremely difficult to read with
long blocks of text, small point size for fonts, and inappropriate contrasting colors.
Poor use of headings, subheadings, indentations, or bold formatting is evident.
Language Use and Audience Awareness
10 points
Criteria Description
Includes sentence construction, word choice, etc.
5. Target
10 points
The writer uses a variety of sentence constructions, figures of speech, and word
choice in distinctive and creative ways that are appropriate to purpose, discipline,
and scope.
4. Acceptable
8.5 points
The writer is clearly aware of audience, uses a variety of appropriate vocabulary for
the targeted audience, and uses figures of speech to communicate clearly.
3. Approaching
7.5 points
Language is appropriate to the targeted audience for the most part.
2. Insufficient
6.5 points
Some distracting inconsistencies in language choice (register) or word choice are
present. The writer exhibits some lack of control in using figures of speech
appropriately.
1. Unsatisfactory
0 points
Inappropriate word choice and lack of variety in language use are evident. Writer
appears to be unaware of audience. Use of primer prose indicates writer either
does not apply figures of speech or uses them inappropriately.
Mechanics of Writing
10 points
Criteria Description
Includes spelling, capitalization, punctuation, grammar, language use, sentence
structure, etc.
5. Target
10 points
No mechanical errors are present. Appropriate language choice and sentence
structure are used throughout.
4. Acceptable
8.5 points
Few mechanical errors are present. Suitable language choice and sentence
structure are used.
3. Approaching
7.5 points
Occasional mechanical errors are present. Language choice is generally
appropriate. Varied sentence structure is attempted.
2. Insufficient
6.5 points
Frequent and repetitive mechanical errors are present. Inconsistencies in language
choice or sentence structure are recurrent.
1. Unsatisfactory
0 points
Errors in grammar or syntax are pervasive and impede meaning. Incorrect language
choice or sentence structure errors are found throughout.
Format/Documentation
10 points
Criteria Description
Uses appropriate style, such as APA, MLA, etc., for college, subject, and level;
documents sources using citations, footnotes, references, bibliography, etc.,
appropriate to assignment and discipline.
5. Target
10 points
No errors in formatting or documentation are present.
4. Acceptable
8.5 points
Appropriate format and documentation are used with only minor errors.
3. Approaching
7.5 points
Appropriate format and documentation are used, although there are some obvious
errors.
2. Insufficient
6.5 points
Appropriate format is attempted, but some elements are missing. Frequent errors
in documentation of sources are evident.
1. Unsatisfactory
0 points
Appropriate format is not used. No documentation of sources is provided.
Total 200 points
Your paper needs to follow the following criteria:
Choose a problem faced by clients in your practice area that you think is important and would like to learn more about (Use Activity 1 to identify the problem).
Use your knowledge of PICO to develop a well-built narrow clinical question. For example: In adult patients with total hip replacements (P), how effective is pain medication (I) compared to aerobic stretching (C) in controlling post-operative pain (O)? (the development of the PICO question should not be included in the paper) (Use discussion 2 & 3).
Write a five (5) to six (6) page literature review paper on the standing knowledge of the chosen question.
Include a minimum of five (5) journal articles, at least three (3) from nursing journals. However, make sure that the (5) journals are the ones analyzed and synthesized in the results and discussion sections.
The body of the paper should be made of the following titled sections: Title (introduction), Methods, Results, Discussion, and Conclusion.
Provide a specific and concise tentative title for your literature review paper (You may use the results or at least the variables in the title).
The abstract is not required
Include a 1-page introduction of your topic (background information), the focus/aim of your review. The introduction should include a statement of the problem, briefly explain the significance of your topic study, and act to introduce the reader to your definitions and background. Must include your main statement (i.e. the purpose of this review is…{PICO Question}).
The method section should include sources, databases, keywords, inclusion/exclusion criteria, levels of evidence, and other information that establishes credibility to your paper (Use discussion 4 & 5).
The results should summarize the findings of studies that have been conducted on your topic. For each study, you should briefly explain its purpose, procedure for data collection, and major findings. This is the section where you will discuss the strengths and weaknesses of studies (Use discussion 6 and activity 2).
Submit a table of the studies as per the matrix development (see discussion 7).
The discussion should be like a conclusion portion of an essay paper. It serves as a summary of the body of your literature review and should highlight the most important findings. Your analysis should help you to draw conclusions. In this section, you would discuss any consensus or disagreement on the topic. It can also include any strengths and weaknesses in general of the research area. If you believe there is more to research, you may include that here.
Finally, you will need to conclude your paper. At this point, you have put substantial effort into your paper. Close this chapter with a summary of the paper, major findings, and any major recommendations for the profession.
In general, your paper should show a sense of direction and contain a definite central idea supported with evidence. The writing should be logical, and the ideas should be linked together in a logical sequence. The ideas need to be put together clearly for the writer and for the reader.
Papers will be graded by rubric. When preparing to work on an assignment it is a good idea to review the rubric for the assignment. The rubric identifies the important points that will be graded as well as the description of the information that should be provided to receive all of the points in each section of the assignment. Reviewing the rubric before you begin a paper and then once again as you complete the paper will give you confidence that you included the required information and will receive maximum points for each section. See the grading rubric for this assignment.
Format references and citations using APA guidelines.
Your paper needs to follow the following criteria:
Choose a problem faced by clients in your practice area that you think is important and would like to learn more about (Use Activity 1 to identify the problem).
Use your knowledge of PICO to develop a well-built narrow clinical question. For example: In adult patients with total hip replacements (P), how effective is pain medication (I) compared to aerobic stretching (C) in controlling post-operative pain (O)? (the development of the PICO question should not be included in the paper) (Use discussion 2 & 3).
Write a five (5) to six (6) page literature review paper on the standing knowledge of the chosen question.
Include a minimum of five (5) journal articles, at least three (3) from nursing journals. However, make sure that the (5) journals are the ones analyzed and synthesized in the results and discussion sections.
The body of the paper should be made of the following titled sections: Title (introduction), Methods, Results, Discussion, and Conclusion.
Provide a specific and concise tentative title for your literature review paper (You may use the results or at least the variables in the title).
The abstract is not required
Include a 1-page introduction of your topic (background information), the focus/aim of your review. The introduction should include a statement of the problem, briefly explain the significance of your topic study, and act to introduce the reader to your definitions and background. Must include your main statement (i.e. the purpose of this review is…{PICO Question}).
The method section should include sources, databases, keywords, inclusion/exclusion criteria, levels of evidence, and other information that establishes credibility to your paper (Use discussion 4 & 5).
The results should summarize the findings of studies that have been conducted on your topic. For each study, you should briefly explain its purpose, procedure for data collection, and major findings. This is the section where you will discuss the strengths and weaknesses of studies (Use discussion 6 and activity 2).
Submit a table of the studies as per the matrix development (see discussion 7).
The discussion should be like a conclusion portion of an essay paper. It serves as a summary of the body of your literature review and should highlight the most important findings. Your analysis should help you to draw conclusions. In this section, you would discuss any consensus or disagreement on the topic. It can also include any strengths and weaknesses in general of the research area. If you believe there is more to research, you may include that here.
Finally, you will need to conclude your paper. At this point, you have put substantial effort into your paper. Close this chapter with a summary of the paper, major findings, and any major recommendations for the profession.
You will provide an example of a health care policy related to Social Justice, Equity, Diversity, and Inclusion (SJEDI) and analyze how it can guide the Practice of Advanced Practice Registered Nurses. Instructions You should respond to the following prompts: Describe your health care policy/bill/law related to SJEDI.Indicate why this policy is needed (provide statistics, information on cost-benefit, cost-utility, cost-effectiveness and other aspects that provide weight to your argument).List supporting and opposing stakeholders (e.g., professional organizations that support and go against your selected issue) .Analyze how your selected health care policy/bill/law can guide the practice of Advanced Practice Registered Nurses.Provide your thoughts on Assembly Bill 1407 on required Unconscious/Implicit Bias Training for nursing students (pros, cons, should it be required for all RNs?, Should it be required for all APRNs?– yes or no and why).Word Count: At least 1,000 words are required. Include the number of words in your paper before the reference list Reference List: At least five references in APA style. References should be not older than five years
Unformatted Attachment Preview
Rubric for Papers
Course: NSG606 Health Policy & Finance
Criteria
Required
formatting/subheading
s for each section
Contents
Referencing
Outstandin
Commendable
Marginal
Marginal
Failing
1 point
0.8 points
0.7 points
0.6 points
0 points
Paper clearly contains the
subheadings/subtitles/se
ctions required in this
paper
Paper partially contains
the
subheadings/subtitles/se
ctions
It is unclear whether or
not the
subheadings/subtitles/se
ctions are included
Paper is missing two or
more
subheadings/subtitles/se
ctions
Paper is missing all
subheadings/subtitles
ctions
6 points
4.8 points
4.2 points
3.6 points
0 points
Clearly includes a
response for all the items
required in this section
Responses to each item
are comprehensive and
evidence-based
Includes a response for
most of the items
Includes a response for
some of the items
Includes a response for a
few of the items required
required in this section –
required in this section –
in this section – Three
One of the items
may be missingResponses to each
item are
comprehensive and
evidence-based
Two of the items
may be missingResponses to each
item are not
comprehensive or
evidence-based
or more of the items
may be missingResponses to each
item are not
comprehensive or
evidence-based
Missing all the respon
for the required items
Responses to each ite
are not comprehensiv
evidence-based
1 point
0.8 points
0.7 points
0.6 points
0 points
Citations and references
are in proper APA
format. Required number
of sources are cited. All
claims are supported
with a professional
reference.
Citations and references
are in proper APA
format. Most claims are
supported with a
professional reference.
Some citations and
references are in proper
APA format. Some claims
are supported with a
professional reference.
Citations and referenc
are limited, missing or
incorrect. Few claims
supported with a
professional reference
Paper has one less of the
required number of
references in APA style.
Paper has two less of the
required number of
references in APA style.
Most citations and
references are limited,
missing or incorrect.
Some claims are
supported with a
professional reference.
Some claims are not
supported with the
corresponding reference.
Some claims are not
supported with the
corresponding reference.
1.6 points
1.4 points
The number of minimum
required references in
APA style are included in
the paper.
Writing organization
and style Timeliness
Required number of
words
2 points
Assignment was
submitted on time.
Complies with the
required minimum
number of words.
Includes the total
number of words
before the
reference list.
The paper is well
organized both
Assignment was
submitted within
one day after the
deadline.
Complies with the
required minimum
number of words
but it does not
include the total
number of words
before the
Assignment was
submitted within
two days after the
deadline.
Assignment has
less than the
required number
of words and/or it
does not include
the total number
of words before
Paper has 3 references
less of the required
number and
Paper includes less th
3 references in APA
style.
Some claims are not
supported with the
corresponding reference.
Some claims are not
supported with the
corresponding referen
or paper is not in
compliance with
copyright guidelines.
1.2 points
0 points
in APA style.
Assignment was
submitted within
three days after
the deadline.
Assignment has
30% or less than
the required words
and/or it does not
include the total
number of words
before the
Assignment wa
submitted afte
four days beyo
the deadline.
Assignment ha
50% or less tha
the required
number of wor
and/or it does
include the tot
number of wor
overall and at the
paragraph and
sentence structure
level. Sentences
are smooth and
carefully crafted.
There are virtually
no errors in
punctuation,
spelling, grammar,
or usage.
reference list.
The paper is well
organized, but the
paragraphs and
sentence structure
may sometimes be
disjointed. The
paper may have a
few incorrect
passages and a
few errors in
punctuation,
spelling, grammar,
the reference list.
The paper is
basically well
organized, though
individual
paragraphs and
sentence
structures may be
disjointed or
misplaced. The
writing is
competent, but
often wordy,
overly general,
and usage.
Presentation has
between 15-19 pp
reference list.
The paper is
poorly organized.
Most sentences
are confusing and
their meaning
does not clearly
emerge. Words
may be imprecise,
incorrect, trite, or
vague.
imprecise, or trite.
before the
reference list.
The paper lack
clarity. The
language or
sentence struc
is incorrect and
unclear in seve
parts of the pa
Errors in
punctuation,
spelling, gramm
and usage are
constantly
present.
slides
Total
Overall Score
Outstanding
Commendable
Marginal
Unsatisfactory
10 points minimum
8 points minimum
7 points minimum
6 points minimum
This research paper is a culmination of your study of a selected SDoH issue regarding health equity and wellness. The focus of this paper is to be a literature review and critical analysis of the equitable delivery of health care in the United States. Choose ONE SDoH and comment on the importance of recognizing the impact of this selected select social driver of health on the provision of equitable health care. Your analysis should include a description of the specific social determinant, evidence of the impact of that determinant on the health of individuals and communities, and recommendations for addressing the identified determinant in order to achieve more equitable healthcare delivery.
Note: I do not need to approve your topic.
Writing Guidelines
Name your paper and submit it by the due date.
Your paper should be submitted as a Word document (.docx or .doc). (PDF not accepted)
The submitted Word document file name should be LastName_FirstName_DHSC821-Final Paper
Use the same identifier (LastName_FirstName_DHSC821-Final Paper) as a header in the document
Other considerations:
MAXIMUM of 5 pages. This excludes the title page and the reference page
Include a separate title and reference page.
Use 12-point Calibri or Times New Roman font.
Have 1″ margins.
Use consistent citation format (APA or AMA/NLM) formatting for headings and references.
Use sufficient references to support your review and analysis.
Use inclusive language (for example, please avoid the exclusive use of masculine
pronouns when referring to men and women) in your writing.
Ensure that the quality of your written work reflects the quality of your paper’s content.
Correct grammar and spelling errors, as well as awkward or unclear sentences and
paragraphs before the final paper is submitted.
Hint – Word provides underlining to point out spelling errors and grammatical issues so check the paper before submitting.
Hint – Proofread carefully since Word may not recognize an incorrectly used word if it is spelled correctly
DUE DATE: SATURDAY SEPTEMBER 30 by MIDNIGHT – to allow time for grading and posting of final course grades.
I want to use this as my social determinant. If you can go off of this that would be great.
One significant Social Determinant of Health (SDoH) is socioeconomic status, which encompasses factors like income, education, and employment. Recognizing the impact of socioeconomic status on the provision of equitable healthcare is crucial for several reasons.
**Importance of Recognizing Socioeconomic Status as an SDoH:**
1. **Access to Healthcare Services:** Socioeconomic status directly affects an individual’s ability to access healthcare services. People with higher incomes often have better insurance coverage and can afford out-of-pocket expenses, ensuring they can seek medical help promptly. In contrast, individuals with lower socioeconomic status may delay or forego necessary medical care due to financial constraints, leading to disparities in health outcomes.
2. **Health Literacy:** Education, a component of socioeconomic status, influences health literacy. People with higher education levels tend to have better understanding and awareness of health-related information. This knowledge empowers them to make informed decisions about their health, actively participate in healthcare discussions, and follow medical advice. Conversely, individuals with limited education might struggle to comprehend complex health information, hindering their ability to advocate for themselves in medical settings.
3. **Preventive Measures:** Socioeconomic status also influences the ability to adopt preventive measures. Higher-income individuals can afford healthier diets, gym memberships, and recreational activities that promote physical and mental well-being. They may also have more time and resources to dedicate to exercise and stress-reducing activities. On the contrary, those with lower incomes might face barriers to adopting such preventive measures, making them more vulnerable to chronic conditions and diseases.
4. **Impact on Mental Health:** Economic instability and poverty can contribute to chronic stress, anxiety, and depression. Mental health is intricately linked to physical health, and untreated mental health issues can exacerbate existing medical conditions. Recognizing the socioeconomic factors contributing to mental health disparities is essential for providing comprehensive and equitable healthcare.
5. **Breaking the Cycle of Poverty and Illness:** Socioeconomic status often perpetuates across generations. Children born into poverty are more likely to face health challenges due to limited access to nutritious food, quality education, and stable living conditions. By recognizing the impact of socioeconomic status on health, interventions can be targeted to break this cycle. Access to quality education and healthcare, along with social support programs, can empower individuals and families to improve their overall well-being.
In summary, acknowledging the influence of socioeconomic status as an SDoH is paramount in the pursuit of equitable healthcare. Health policies and interventions that address these social inequalities directly can significantly improve healthcare access, health outcomes, and overall quality of life for individuals across different socioeconomic strata.
View The Girl Effect and Poor Kids clips under week 5 section and outline how social determinants influence health and health disparities.Determine how other sub-topics (Complex Interactions, Culture, Religion,…) in chapter 4 impact health.View the other clips (Unnatural Causes, Fun Theory/Social Determinants of Health) under week 5 section, list and briefly explain at least 3 innovative ways to positively influence health.Feel free to use other evidence-based data (cited) to buttress your work/explanations. Length: 1page or more.
Acute Case Scenario Observed in Clinic in an Adult (35-65 years of age)
40-year-old male with a history of obesity, alcohol use disorder (stated 8-10 beers 2-3 times per week), and elevated BP readings in office presented for follow up. His annual physical was in June 2023 at which time his BP was 151/89 and weight 215 (BMI 31.7). Per the June 2023 visit note on file, the patient was educated on recommended dietary changes, exercise guidelines and recommendations, reducing or eliminating alcohol use, and the risks of HTN, obesity, and excessive alcohol intake on his health. The patient refused medications at the time of his annual exam, and stated he wanted to try to make lifestyle changes to manage his BP and weight. Labs reviewed from annual exam revealed a fasting glucose of 98, total cholesterol of 269, HDL 76, LDL-C 147, and triglycerides 352.
The patient is not currently taking any daily medications, Rx, or OTC. Current vital signs: Height 5’9”, weight 210lbs, BMI 31, BP 155/92, HR 89, RR 16, O2 97% on RA, T 98.2; the patient’s weight is concentrated centrally. Per the patient, current alcohol intake is 8-10 beers 1-2 times per week. The patient states he has not started to exercise because it’s been too hot to walk outside, and his schedule does not allow time for exercise in the early morning or evenings. The patient states he has been eating more vegetables and has decreased his intake of foods high in saturated fat (fast food) and points out he lost 5lbs since his last visit.
How this Could Develop into Chronic Disease Management
If the patient fails to implement (and maintain) effective lifestyle changes (as he has failed to do thus far), he will require long-term medication management with antihypertensives, statins, and possibly antihyperglycemic agents. The patient will be at risk for developing conditions including (but not limited to) ASCVD (and increased risk of MI and stroke), worsening HTN and diabetes (and increased risk of kidney disease, PVD, vision loss, neuropathy), organ damage from alcohol intake (liver disease, CKD, dementia) (Dunphy et al., 2019).
Evidence that Supported the Intended Outcomes
The patient was counseled on metabolic syndrome and criteria reviewed as follows; 1) central or abdominal obesity greater than 40 inches in men (>35 inches in women), 2) triglycerides >150mg/dL (or if taking medication to lower triglycerides), 3) HDL <40 mg/dL for men (<50 mg/dL in women), 4) elevated BP 130/85 mmHg (or if taking antihypertensives), and 5) fasting glucose >100 mg/dL (or if taking medication for hyperglycemia) (American Heart Association [AHA], 2023). Lab results, BP readings, and weight (central obesity) reviewed, and the patient was informed that he currently meets the criteria for diagnosis of metabolic syndrome.
The patient was educated on the effects of alcohol on chronic disease development; alcohol increases inflammation in the body and contributes to tissue and organ damage, obesity, HTN, atherosclerosis, and insulin resistance (Dunphy et al., 2019).
Additional education included exercise recommendations for adults which are 150 minutes of moderate intensity aerobic activity plus two days of strength training per week, or 75 minutes of vigorous intensity aerobic exercise plus two days of strength training per week, or an equivalent combination of moderate and vigorous intensity aerobic exercise plus two days of strength training per week for optimal health benefits (Centers for Disease Control and Prevention [CDC], 2021).
A thorough discussion ensued with recommendations including the initiation of atorvastatin 10mg PO QD, lisinopril 10mg PO QD, eliminating alcohol intake, increasing, and maintaining exercise, and dietary changes. The patient was educated on the risks of continued management of his conditions with lifestyle modifications alone, based on his current condition (as compared to his last visit), and that if he initiates pharmaceutical therapy in combination with effective lifestyle changes, he may be able to discontinue the medications in the future.
References
American Heart Association. (2023). Symptoms and diagnosis of metabolic syndrome. www.heart.org. https://www.heart.org/en/health-topics/metabolic-syndrome/symptoms-and-diagnosis-of-metabolic-syndrome
Centers for Disease Control and Prevention. (2021). Faststats: Exercise or physical activity. Cdc.gov. https://www.cdc.gov/nchs/fastats/exercise.htm
Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2019). Primary care: Art and science of advanced practice nursing – an interprofessional approach (Fifth ed.). F.A. Davis Company.
The lesson supports content regardingto core health education topic forpatients or community population appropriate to the targeted studentgroup, is aligned with the curriculumstandards, and would be well
The lesson is appealing, and it engages clients’ higher-level thinking. It supports client’s choice and encourages clients’ to take responsibility for their learning.The lesson and resources are complete, deep, and adaptable. It offers extensions for more motivated
learners and/or adaptations for clients with special needs or learning style preferences. It identifies potential challenges inherent to the lesson and suggests alternative instructional strategies
Educational objectives are clear, obtainable, and measurable. Assessment strategies are described and an assessment tool such as a questionnaire or rubric is given.
The lesson’s use of technology helps clients achieve their learning objectives by involving them in more than one of the modes of learning described at left.
provide picture, Figures
Unformatted Attachment Preview
Nursing Department
Teaching and learning in nursing
Health education Lesson Plan Evaluation Rubric
Elements
0 points
1 points
2 points
3points
Health education topic
The lesson provides no
connection to core health
education topic for
patients or community
population
The lesson appears to be
related to core health
education topic for
patients or community
population
The lesson provides
connections to core
health education topic
for patients or
community population.
ClientCenteredness
The lesson is flat and
uninspiring. There is no
evidence of client choice
or flexibility in pace, topic
or end product.
The lesson has some
appeal, but client choice
and flexibility are limited.
May not involve higherlevel thinking.
The lesson supports content regarding
to core health education topic for
patients or community population
appropriate to the targeted student
group, is aligned with curriculum
standards, and would be well
integrated with a unit of study.
The lesson is appealing, and it
engages clients’ higher-level thinking.
It supports client’s choice and
encourages clients’ to take
responsibility for their learning.
Instructional Design/ Usability
The lesson seems
incomplete or sketchy.
The students’ role as a
teacher is often unclear.
Teacher would need to do
significant work to
actually use the lesson.
The lesson is appealing,
and there is evidence of
instructional flexibility
or accommodation of
clients’ interests.
Higher-level thinking is
invited.
The lesson is nearly
The lesson and
complete, but lacks depth. resources are complete
It does not offer strategies and in depth, but lacks
for adaptations to
details in adapting for
students’ role as a teacher clients with special
& not provide details with needs or learning style
clients of special needs or preferences. It does not
learning style preferences. acknowledge potential
challenges in
implementing the
lesson.
The lesson and resources are
complete, deep, and adaptable. It
offers extensions for more motivated
learners and/or adaptations for clients
with special needs or learning style
preferences. It identifies potential
challenges inherent to the lesson and
suggests alternative instructional
strategies.
Nursing Department
Evaluation and objectives
connectedness
There is no evidence of
connection to educational
objectives with
assessment strategies.
There is some mention of
educational objectives,
but inadequate or
incomplete connection to
assessment.
There is some
identification of
educational objectives
and assessment
strategies and tools.
Educational objectives are clear,
obtainable, and
measurable. Assessment strategies are
described and an assessment tool such
as a questionnaire or rubric is given.
Use of Technology: Access to
available real-world situations
(graphics, video, audio); multisensory representations (auditory,
graphic, text); independent
opportunities for skill mastery;
collaborative activities and
communication; access to concepts
through hypertext, interactivity, or
customization features; use of the
tools of scholarship (research,
experimentation, problem solving);
simulated laboratory situations
The lesson’s use of
technology treats clients
as passive recipients of
information, is not welldefined, or is trivial.
The lesson’s use of
technology is focused but
does not involve clients in
any of the ways described
at left.
The lesson’s use of
technology enables
clients to be
meaningfully involved
in one of the modes of
learning described at
left.
The lesson’s use of technology helps
clients achieve their learning
objectives by involving them in more
than one of the modes of learning
described at left.
Column totals
Grand Total/15
Student’s signatures
Supervisor name:
Supervisor signature:
15
2 replies of at least 250 words.For each thread, students must support their assertions with at least 1 scholarlycitation in APA format. Each reply must incorporate at least 1 scholarly citation in APA format.Any sources cited must have been published within the last five years. Acceptable sourcesinclude journal articles or textbook. In addition, please include Scripture for your thread.
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Cost of Medical Care
In current times, the cost of medical care has increased tremendously. Whether
a patient is paying out of pocket or has insurance that is billed, it costs an exorbitant
amount of money. The textbook entitled Social Problems: A Down-to-Earth
Approach points out several interesting and thought-provoking things regarding this
topic including how much it used to cost to have a baby. The author shared that, “The
1962 bill of $113.85 included a three-day stay in the hospital for the mother, her
anesthetic, lab fees, medicine, dressings, delivery room, nursery, her son’s circumcision,
and even his bracelet” (Henslin, 2019, p. 294). Today, the cost of nearly the same care is
$11,481 (Henslin, 2019). Why the drastic change? The textbook outlines several
reasons including new technology, larger elder population, and medical care for profit
(Henslin, 2019).
Regarding the topic of medicine for profit, it is important for those in the
medical profession to earn an income, but unfortunately, we have witnessed over the
last few decades doctors and hospitals doing some unnecessary procedures and
prescribing unnecessary medication in order to bill insurance as much as possible. The
textbook dove into the topic of Cesarean births and how they are almost always
unnecessary (Henslin, 2019). Henslin stated that, “The main reason for the increase in
Cesarean births seems to be more income for obstetricians—doctors who specialize in
childbirth. Being able to charge much more for cesarean births motivates them to
recommend the surgery” (Henslin, 2019, p. 296).
In an article written by Nicholas DeSimone and published by Forum for
Economic Education, he delved into the aspect of overuse of healthcare because of
insurance coverage and how that increases medical costs. He wrote, “More insurance
dulls consumer price sensitivity, leading to over-consumption of health care, which
means more costly spending; and as health care becomes more expensive, demand for
insurance rises” (DeSimone, 2018, para. 12). For example, people may not have as
many qualms about going to the doctor over trivial illnesses as they might have if they
had to pay out of pocket.
In conclusion, it is vital that those in the medical profession earn an income, but
not overcharge, operate, or prescribe unnecessarily. I do not believe that medical care
should be free, but it must be reasonably priced and not cost exorbitantly more than it
costs the hospital. 1 John 3:17-18 says, “But whoso hath this world’s good, and seeth
his brother have need, and shutteth up his bowels of compassion from him, how
dwelleth the love of God in him?” (King James Bible, 1611/2023).
References
Henslin, J. M. (2019). Social Problems: A Down-to-Earth Approach (13th ed.). Pearson
Education (US). https://libertyonline.vitalsource.com/books/9780135256855Links to an
external site.
King James Bible. (2017). King James Bible
Online. https://www.kingjamesbibleonline.org/Links to an external site. (Original work
published 1769)
DeSimone, N. (2018, December 7). Why You’re Paying More (and More) For Health Care.
Forum for Economic Education. https://fee.org/articles/why-you-re-paying-more-andmore-for-health-care/Links to an external site.
Reply: 250 words
The cost of physical illness is seen as a social problem depending on life expectancy,
lifestyle choices, infant mortality, and heroic medicine. The life expectancy of some
Americans is a concern to the United States since it is lesser than others due to poverty.
Some Americans also face high mortality rates due to children being exposed to nonnutritious meals (Henslin, 2018). On thе other hand, mental illness is sееn as a social
problem because it contributes to things like suicide. Mentally ill people may have
fluctuating behavior changes, which can affect thеir lifestyle.
Symbolic interactionism focuses on how people determine meaning and how the
meaning influences their behaviors. For instance, when people are labeled as having a
“pre-existing condition”, it affects how people perceive them, leading to difficulty in
accessing various medical services. Symbolic interactionism focuses on the
significance of social support among individuals who feel isolated in society. Lack of
social support can lead to things like depersonalization, as Henslin refers to them.
Sociologists argue that most poor people face depersonalization because some
doctors view them as objects of no value.
Functionalism theory emphasizes how the interrelation of various things in society
works together to enhance stability in the healthcare sector (Henslin, 2018). Henslin
reports that the fee-for-service system has increased, and mental and physical illnesses
have become a social problem because most people shy away from hospitals due to
higher costs. The longer people patients stay in hospitals, the higher the medical costs.
Henslin reports that this system can benefit both the doctor through payment and the
patient when choosing the doctor of their choice. At the global level, functionalists also
analyze the dysfunctions and functions of medicines since some reduce death rates on
a global scale while others become a worry to patients due to the set conditions. Based
on the various conditions and functionality of the medicines, functionalism describes
the issues of mental and physical illness and social problems in the United States.
Conflict theory disagrees with the functionalist perspective that the medical system in
the United States is not self-correcting (Henslin, 2018). The theory describes illness as
clash outcomes between interest groups. Conflict theorists say that the poor struggle
with illness because of failure to acquire nutritious food, high-quality education, medical
care, jobs, and housing. Conflict theorists argue that healthcare in the United States
should be a right for all citizens and should not be explored as a profit platform. Based
on this theory, healthcare should be universal, and everybody should access it
regardless of thеir financial status.
Medical care in thе United Statеs can be efficient by focusing on preventative rather
than reactive care. Treating illnesses can be more expensive than focusing on
preventative care, which majorly centers on lifestyle practices. Henslin suggests that
preventative care can reduce the burden and cost of healthcare in the United States
(Henslin, 2018). Implementing universal healthcare in the United States is another
strategy that can enhance the efficiency of medical care. Despite the financial status of
any individual, if healthcare can be accessed by everyone quickly, it can reduce the
costs incurred in hospitals in the long term through prevention measures. Additionally,
regulation of the costs of medicine can help enhance the accessibility of medical care
because even people experiencing poverty would be able to afford them. A fee-forservice raises healthcare costs instead of preventative medicine, which focuses on
people’s lifestyles.
References
Henslin, J. M. (2018). Social Problems: A Down-to-Earth Approach, 13th edition.
Read Less
Reply: 250 words
Respond to the following in a minimum of 175 words: Health care professionals are constantly challenged to improve patient outcomes. How can sustainable practices be implemented when the processes of care become more complicated with the introduction of new drugs, technologies, and regulations?
You MUST use the Case Study #1 as the base of this SOAP NOTE #1
Must use the sample template for your soap note, keep this template for when you start clinicals.
Templates used from another classes will not be accepted. Student must use the template provided in this class which must clearly contain the progress note (in the Assessment section) of the encounter with the patient ( this section is clearly mark in bold, highlighted and underlined). No passing grade will be granted if this section is not completed properly.
Follow the MRU Soap Note Rubric as a guide
Use APA format and must include minimum of 2 Scholarly Citations.
Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)
Turn it in Score must be less than 25% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25%. Copy-paste from websites or textbooks will not be accepted or tolerated.
Please see College Handbook with reference to Academic Misconduct Statement.
This section of your change project paper should include:
A reference to the project’s benefits in terms of cost, time, and/or quality that address needs or changes, results, impacts, or consequences that the project has on people, programs, or institutions.
Goals and objectives that are measurable, shared, and hypothetically agreed on by all key stakeholders. They are directly linked to the concept of project success factors.
What variables need to be considered and and whether or not you have control over them.
For example, if you were to implement a clinic-wide practice change, would budget be an issue and how would you address that variable?
If you were to implement your study, consider how would you gather data. Would you choose the qualitative or quantitative method?
An explanation of what your research will provide to the community, or to social change.
A description of the desired outcomes: Specifically, state the purpose, focus, and viewpoint of the project as well as its expected accomplishments.
While you may not be implementing your project, you should have a goal in mind that relates to solving your problem.
Establish a timeline for accomplishing your project goal(s).
This section should be 3–4 pages in length, not including the cover or reference page, and should address the intended outcomes of your project. You must reference a minimum of 3 scholarly articles.
Use current APA format to style your paper and to cite your sources. Review the rubric for more information on how the assignment will be graded.
This criterion is linked to a Learning OutcomeContent
60 to >49.2 pts
Meets Expectations
The project, aims, values, and desired outcomes are well developed and clear and thorough. Aims include detailed examples of projected features and functions. Values include implementation benefits for specific stakeholders. Desired outcomes expertly state the purpose, have a quality focus, and clearly describe the benefits that are expected to occur as a result of implementation.
49.2 to >45.0 pts
Approaches Expectations
The project, aims, values, and desired outcomes are somewhat clear but may be vague in places. Aims include somewhat vague examples of projected features and functions. Values include only general implementation benefits. Desired outcomes state the purpose, have a general focus, and generally describe the benefits that will occur as a result of implementation.
45 to >35.4 pts
Falls Below Expectations
The project, aims, values, and desired outcomes are somewhat clear, but lack many key details.
35.4 to >0 pts
Does Not Meet Expectations
The content is generally unclear. There is no clear evidence of what the project, aims, values, or desired outcomes are, or there might just be a list of project objectives.
60 pts
This criterion is linked to a Learning OutcomeOrganization
7.5 to >6.15 pts
Meets Expectations
Content is well written throughout. Information is well organized and clearly communicated.
6.15 to >5.63 pts
Approaches Expectations
Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.
5.63 to >4.43 pts
Falls Below Expectations
Content is disorganized in many places and it lacks clarity.
4.43 to >0 pts
Does Not Meet Expectations
Content lacks clarity and information is disorganized, or may be an outline or a list.
7.5 pts
This criterion is linked to a Learning OutcomeAPA Format/Mechanics
7.5 to >6.15 pts
Meets Expectations
Follows all the requirements related to format, length, source citations, and layout. Assignment is free of spelling and grammatical errors.
6.15 to >5.63 pts
Approaches Expectations
Follows length requirement and most of the requirements related to format, source citations, and layout. Assignment is mostly free of spelling and grammatical errors.
5.63 to >4.43 pts
Falls Below Expectations
Follows most of the requirements related to format, length, source citations, and layout. Assignment contains some spelling and grammatical errors.
4.43 to >0 pts
Does Not Meet Expectations
Does not follow format, length, source citations, and layout requirements. Assignment contains many spelling and grammatical errors.
7.5 pts
Total Points: 75
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Language Barrier Among the Hispanic Population in Miami, FL: The Integrative
Literature Review
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Language Barrier Among the Hispanic Population in Miami, FL: The Integrative
Literature Review
Literature Review
To guarantee patient safety, care quality, and the satisfaction of both healthcare providers
and patients, good and effective communication between these two parties is crucial. Whitaker et
al. (2022) outline that excellent communication between healthcare providers and patients is
associated with effective care management and the provision of accurate diagnosis. Generally,
good communication, which is not hampered by language limitations, is very important at every
phase of the medical care process, from recognizing the health issue of a patient and delivering
patient-focused treatment and care through patient engagement and involvement.
A study conducted by Bombard et al. (2018) indicates that patient care experiences and
outcomes may be negatively influenced by the capability of healthcare providers to listen,
demonstrate, and understand the complaints presented by the patient. However, the presence of a
language barrier makes it challenging for healthcare providers, including nurses among other
healthcare professionals to communicate. This is because, problems associated with language
barriers in one way or another may impact persons from minority populations in terms of the
level of healthcare quality delivered (De Moissac & Bowen, 2019). As a result, effective
communication and appropriate patient interactions are required to address some of the health
disparities in healthcare access and the level of care delivered among minority populations as
well as to improve the patient’s understanding of treatment approaches. At present, healthcare
systems are heavily investing in the utilization of interpreter resources and other forms of
language access services as well as advancing cultural competency and establishing meaningful
relationships with patients and healthcare providers to eliminate some of the negative
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consequences linked to language issues (Al Shamsi et al., 2020). Apart from the use of
interpreter resources, health systems are utilizing digital technologies, signage, and translated
health information to provide essential services.
Given that every human being has the right to receive the best probable form of
healthcare regardless of ethnicity or socioeconomic status, healthcare providers must deliver
optimal medical care that aligns with human rights as well as equity to all patients (Al Shamsi et
al., 2020). Taking into account that language barriers in one way or another hinder minority
populations from accessing and utilizing healthcare services leading to various health disparities
and poor health outcomes, language differences pose a significant problem to healthcare
delivery. For example, a study by De Moissac & Bowen (2019), outlines that patients who do not
speak the common dialect tend to be disadvantaged when it comes to healthcare services access
and availability. Also, results from research performed by Al Shamsi et al. (2020) highlight that
patients who face language obstacles have worse health outcomes in comparison to those who
communicate and interact using the common dialect. As a result, persons who experience
language limitations tend to utilize more healthcare services to address their health issues and
have more adverse events due to a lack of healthcare comprehension and fear of receiving lowquality care and discrimination.
Taking a look at the Hispanic population in Miami, FL, some of the individuals from this
minority group face various issues associated with language barriers. Since most persons from
this population do not speak fluent English, healthcare providers must adapt to their needs and
initiate strategies to minimize these language obstacles to prevent or reduce health disparities.
This is because, the inability of healthcare providers to mitigate language differences among the
Hispanic population can lead to health inequality (Velasco-Mondragon et al., 2016). In addition
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to that, these language differences can put the safety of persons from this population at risk in
terms of increased prevalence of medical errors and providing care that does not align with their
health needs. Within the Hispanic population, according to CMS (2022), healthcare providers
need to implement strategies to overcome language barriers, particularly when it comes to
offering language assistance services, to avoid discriminating against non-English-speaking
patients.
Key Findings of the Research
Research indicates that language barriers among the Hispanic population are associated
with various impacts, especially when the level of healthcare provided does not meet their needs
or is inaccurate. According to Kelson et al. (2022), language limitations within the Hispanic
population significantly contribute to the increased prevalence of medical errors. In all healthcare
settings, the medical history and information of a patient should be considered when providing
medical care. However, several studies outline that language differences can make healthcare
delivery challenging, particularly when it comes to engaging with patients to receive their
medical history and other healthcare-related information. If the patient does not entirely
understand the information that is needed from them, language limitations could be an issue
because they could contribute to numerous adverse events. As a result, research indicates that
when language proficiency and understanding pose a significant problem to healthcare delivery,
professional interpreters must be involved in the process. This is because the use of interpreter
resources advances patient teaching and in turn, promotes their safety as well as ensures the
efficacy of the suggested treatment approaches.
Also, research outlines inaccurate assessment as an impact of language barriers among
minority groups, including the Hispanic population. Hollingshead et al. (2016) outline that
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patients from the Hispanic population who experience language difficulties tend to undergo
inaccurate assessment in all aspects of care, especially when it comes to pain management.
Several studies state that there is a lot of patient teaching and instruction that is needed when
describing the scale of pain to patients. This is because the described level of pain may be wrong
if the patient cannot rate their pain level as a result of language differences. In all healthcare
settings, different cultural groups have varying ways of explaining their health conditions and as
a result, miscommunication can lead to inaccurate diagnosis as well as undermedication or
overmedication, which could lead to poorer health outcomes. Taking that into account,
individuals need to understand that when providing medical care to persons from the Hispanic
population with language problems, inaccurate assessments can significantly influence their
treatment plans and this can result in the aggravation of existing health conditions.
Another key finding of the research is that patients with language problems may be
psychologically stressed and this can to severe consequences. According to Funk and Lopez
(2022), members of the Hispanic population facing language barriers are likely to miss medical
appointments, which makes follow-up and treatment difficult. Besides that, these persons have
an increased chance of misunderstanding their treatment plan and this minimizes their potential
for medical adherence. Considering that, we need to know that medical decisions within the
Hispanic population could be dangerous if the patient does not understand the diagnosis or if the
healthcare provider cannot comprehensively explain the risk factors that are linked to the
diagnosis. Many persons do not know that understanding medical information presents a
significant issue for any patient, regardless of their ethnicity. Therefore, all persons, especially,
healthcare providers need to know that language obstacles influence the level of health literacy
of a patient, making it more difficult for the patient to comprehend sophisticated medical
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treatments and diagnoses. Moreover, language barriers among the Hispanic population are
associated with health inequity. For this reason, some members of this population have a higher
chance of not obtaining the level of patient care that aligns with their health needs.
There are two things that we do not know regarding addressing the care needs of the
Hispanic group. One of the things is the influence of interpreting services in healthcare delivery.
According to Whitaker et al. (2022), interpreter resources do not substitute direct communication
and may lead to various safety risks. This is because, in one way or another, the use of interpreter
services limits the capacity of patients to be involved in their own care, pushing them to play a
passive part. Generally, this leads to a disconnect between patients and their healthcare providers
as various interactions may not be interpreted appropriately. The second thing that we do not
know concerning addressing the care needs of persons from the Hispanic group is the impact of
the current health policies. These policies need to be reviewed to promote the health and safety
of persons from the Hispanic population with language problems.
Gaps in Knowledge
The issue of language barriers in care delivery poses more threat than it appears. For
instance, healthcare policies are designed to guarantee there is no discrimination towards persons
from minority groups, according to Yearby et al. (2022). However, there are no well-established
guidelines on how to utilize the policies to minimize health disparities faced by minority groups.
Given the ineffectiveness of some of the implemented health policies on language differences,
healthcare institutions need to hire qualified medical interpreters and provide language assistance
services. This is because, research indicates that the use of interpreter services is associated with
various healthcare delivery benefits such as better patient health results, low rates of
readmission, and increased healthcare utilization. Also, in all healthcare settings, patient
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involvement is associated with culturally consistent care as this facilitates trust development and
provides patients from minority groups with a chance to communicate their health needs directly
and effectively to healthcare providers. As a result, health systems need to implement programs
that bridge the gap in the Hispanic population and healthcare provider communication.
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References
Al Shamsi, H., Almutairi, A. G., Al Mashrafi, S., & Al Kalbani, T. (2020). Implications of
language barriers for healthcare: a systematic review. Oman Medical Journal, 35(2),
e122. https://doi.org/10.5001%2Fomj.2020.40
Bombard, Y., Baker, G. R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., … & Pomey, M. P.
(2018). Engaging patients to improve quality of care: a systematic
review. Implementation Science, 13, 1-22. https://doi.org/10.1186/s13012-018-0784-z
CMS. (2022). Providing language services to diverse populations: Lessons from … – CMS.
Centers for Medicare & Medicaid Services. https://www.cms.gov/About-CMS/AgencyInformation/OMH/Downloads/Lessons-from-the-Field.pdf
De Moissac, D., & Bowen, S. (2019). Impact of language barriers on quality of care and patient
safety for official language minority Francophones in Canada. Journal of Patient
Experience, 6(1), 24-32. https://doi.org/10.1177/2374373518769008
Funk, C., & Lopez, M. H. (2022). Hispanic Americans’ experiences with health care. Pew
Research. https://www.pewresearch.org/science/2022/06/14/hispanic-americansexperiences-with-health-care/
Hollingshead, N. A., Ashburn-Nardo, L., Stewart, J. C., & Hirsh, A. T. (2016). The pain
experience of Hispanic Americans: A critical literature review and conceptual model. The
Journal of Pain, 17(5), 513-528. https://doi.org/10.1016%2Fj.jpain.2015.10.022
Velasco-Mondragon, E., Jimenez, A., Palladino-Davis, A. G., Davis, D., & Escamilla-Cejudo, J.
A. (2016). Hispanic health in the USA: a scoping review of the literature. Public Health
Reviews, 37, 1-27. https://doi.org/10.1186/s40985-016-0043-2
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Whitaker, K. L., Krystallidou, D., Williams, E. D., Black, G., Vindrola-Padros, C., Braun, S., &
Gill, P. (2022). Addressing language as a barrier to healthcare access and quality. British
journal of general practice, 72(714), 4-5. https://doi.org/10.3399/bjgp22X718013
Yearby, R., Clark, B., & Figueroa, J. F. (2022). Structural racism in historical and modern us
health care policy: Study examines structural racism in historical and modern US health
care policy. Health Affairs, 41(2), 187-194. https://doi.org/10.1377/hlthaff.2021.01466
1
Language Barrier Among the Hispanic Population in Miami, FL
2
Language Barrier Among the Hispanic Population in Miami, FL
Description of the Problem
Currently, minority populations across the U.S. are continuously growing, and as these
numbers increase so are the healthcare disparities individuals from these groups face. One of the
healthcare disparities is language barriers. As a result of language limitations and the increasing
number of diverse providers, individuals from minority populations, including the Hispanic
population, face several challenges concerning access to medical treatment and healthcare
services. Sohn (2017) outlines that most individuals from minority groups are less likely to have
health coverage and to access preventive care than other Americans. In addition to language
barriers, other aspects such as increased poverty levels, especially among the Hispanic
population, significantly contribute to uneven health outcomes for persons from these groups.
In Miami, FL, a significant number of the residents receive their care from general
hospitals. The hospitals provide numerous and different healthcare services for patients
regardless of their age and disease conditions. This clinical setting encompasses organizations,
health professionals, and ancillary healthcare employees who offer healthcare to those in need. In
Miami, FL, all residents are allowed to access services provided by these hospitals, but the level
of care may differ depending on one’s ethnicity. There are several problems I see in hospitals
within Miami, including disparities in health insurance and care associated with low-income and
poor living conditions, among other elements, inadequate access to mental/behavioral health
services, low health literacy, and increased substance use. According to Buchmueller and Levy
(2020), minority groups still have a difficult time accessing optimal healthcare, despite the
introduction of the Affordable Care Act (ACA), which has played a significant part in lowering
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health disparities. In Miami, these challenges are prevalent in hospitals, and most affected are
those people from minority groups.
Statement of the Problem and Target Population
As previously mentioned, the language barrier is among the challenges that contribute to
poor health outcomes among individuals from the Hispanic population. For this reason, among
others, Hispanic Americans have an elevated chance than White Americans to die from various
health conditions or to get hospitalized. Funk and Lopez (2022) outline that when it comes to
circumnavigating the healthcare system, most Hispanics describe that communication problems
associated with language differences significantly contribute to their poor health outcomes. As a
result of these language differences, Hispanic Americans are less likely to utilize preventive and
clinical services. Also, due to these language limitations, healthcare providers tend to provide
Hispanic persons with low-quality or inferior medical care. All these factors together
demonstrate why individuals from the Hispanic population in Miami have generally worse and
poorer health outcomes when compared to other populations in the area.
To lower health disparities and improve health results, person-centered care is essential.
However, person-centered care cannot be achieved if there exist language differences that hinder
the delivery of ideal care. This is because, according to Amirehsani et al. (2017), person-centered
care is based on effective communication and interaction between healthcare providers and
patients. Generally, healthcare delivered in an individual’s primary language has a high
probability of positively influencing the health status of that individual. However, with language
differences and discordance, interaction and understanding between healthcare providers and
patients will be poor and this may lead to patient dissatisfaction and poor health outcomes. This
is the same problem Hispanics located in Miami are facing because most of them are still not
4
able to obtain top-notch medical care. This will continue to be a problem not only in Miami, FL
but across the U.S. because the ratio of nurse practitioners and Hispanic nurses does not match
the growth of the Hispanic population.
Significance of the Evidence-Based Project
An example of an evidence-based project that could be introduced in general hospitals
within the Miami area to the nursing profession is the use of interpreter resources. These
resources generally consist of in-person interpreters either employed by the organization or
contracted externally. In the selected setting, the use of interpreter resources is important because
these resources will help bridge the communication gap resulting in effective and interactive
communication. As previously mentioned, most persons from the Hispanic population are less
likely to utilize preventive care and other medical services because of problems associated with
language differences and this, in one way or another, has contributed to worse health outcomes
within this population. With the utilization of interpreter resources, general hospitals in Miami
can improve communication and this will not only increase the number of persons seeking
medical care but also contribute to better health outcomes. This project is important because it
will play a major part in reducing health disparities as well as mitigating challenges faced by
persons from minority groups.
Moreover, due to language barrier among other factors, most Hispanic Americans do not
seek differential treatment because they are likely to obtain low-quality medical care when
compared to their counterparts. Also, this limitation prevents most healthcare providers from
providing people from this population with advanced medical care because of the fear they may
not align the treatment with their preferences and health needs (Funk & Lopez, 2022). However,
with the use of interpreters, these healthcare providers will be confident to provide advanced
5
medical care as an interpreter will close the communication gap. This will not only help improve
the communication between the healthcare provider and the patient but will also build trust
between the two parties. With trust and effective communication, healthcare providers can
deliver patient-centered care and in doing so, achieve better health outcomes and decrease the
prevalence of health disparities within the minority populations.
Effective communication is essential in healthcare because communication failures and
misunderstandings can negatively influence patient outcomes. According to Tiwary et al. (2019),
poor communication in healthcare settings is associated with misdiagnoses and other medical
blunders that can result in avoidable health problems as well as the death of patients. Hence,
language differences between healthcare providers and Hispanic patients could contribute to
miscommunication and this could lead to these patients receiving the wrong medical procedure
or treatment, delays in vital tests and treatments, or being given the wrong medication. Hence,
the use of interpreter resources within Miami hospitals would be essential in addressing the
language barrier.
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References
Amirehsani, K. A., Hu, J., Wallace, D. C., Silva, Z. A., Dick, S., West-Livingston, L. N., &
Hussami, C. R. (2017). US healthcare experiences of Hispanic patients with diabetes and
family members: A qualitative analysis. Journal of Community Health Nursing, 34(3),
126-135. https://doi.org/10.1080%2F07370016.2017.1340556
Buchmueller, T. C., & Levy, H. G. (2020). The ACA’s impact on racial and ethnic disparities in
health insurance coverage and access to care: An examination of how the insurance
coverage expansions of the Affordable Care Act have affected disparities related to race
and ethnicity. Health Affairs, 39(3), 395-402. https://doi.org/10.1377/hlthaff.2019.01394
Funk, C., & Lopez, M. H. (2022). Hispanic Americans’ experiences with health care. Pew
Research. https://www.pewresearch.org/science/2022/06/14/hispanic-americansexperiences-with-health-care/
Sohn, H. (2017). Racial and ethnic disparities in health insurance coverage: Dynamics of gaining
and losing coverage over the life-course. Population research and policy review, 36(2),
181-201. https://doi.org/10.1007%2Fs11113-016-9416-y
Tiwary, A., Rimal, A., Paudyal, B., Sigdel, K. R., & Basnyat, B. (2019). Poor communication by
health care professionals may lead to life-threatening complications: examples from two
case reports. Wellcome open research, 4.
https://doi.org/10.12688%2Fwellcomeopenres.15042.1
Discussion Question: “How can healthcare systems worldwide ensure equal access to quality medical care, taking into account socioeconomic disparities, cultural differences, and varying healthcare infrastructures?”
Discussion Points:
Socioeconomic Disparities: Discuss the impact of socioeconomic factors on healthcare access. How can healthcare systems address disparities related to income, education, and employment? Explore policies and initiatives that promote equal access to healthcare services for individuals from diverse economic backgrounds.
Cultural Competence: Explore the importance of cultural competence in healthcare delivery. How can healthcare professionals and institutions provide culturally sensitive care to diverse patient populations? Discuss training programs and strategies to enhance cultural awareness among healthcare providers.
Rural and Urban Disparities: Analyze the differences in healthcare access between rural and urban areas. What challenges do rural communities face in accessing medical services? Discuss innovative solutions, such as telemedicine and mobile clinics, to bridge the gap between rural and urban healthcare services.
Global Health Disparities: Consider healthcare disparities on a global scale. Discuss the challenges faced by developing countries in providing adequate healthcare to their populations. Explore international collaborations, aid programs, and initiatives aimed at improving healthcare infrastructure and access in underprivileged regions.
Mental Health Access: Focus on mental healthcare disparities. How can healthcare systems ensure equal access to mental health services? Discuss the stigma associated with mental health and strategies to promote awareness and acceptance. Explore the integration of mental health services into primary healthcare settings.
Health Literacy: Discuss the role of health literacy in healthcare access. How can improving health literacy empower individuals to make informed decisions about their health? Explore educational programs and community initiatives aimed at enhancing health literacy, especially among vulnerable populations.
For this assignment, create a preparedness plan (pre-mortem) for yourself and your family. . You may use any format for sharing your plan (detailed paragraph, bulleted lists, hand-written image, etc).
.You will share the details of your personal plan (leaving out any private health information like names, existing numbers (blood pressure, BMI, etc) here. , it is completely acceptable to create an imaginary family and produce this assignment for them. You needn’t share whether your pre-mortem is for your personal family or for an imaginary family,.
Topics to address/items to submit:
A family tree similar to that you viewed for the Smith family in this module, identifying risk factors for disease (hand-drawing, then snapping a pic might be easiest, but is not required)
Intermediate risk factors you’ve identified in yourself and your family (add these to the family tree)
Lifestyle risk factors you’ve identified in yourself and your family (add these to the family tree)
Tendencies you and your family members may have toward confirmation bias, poor information competency, or poor education or communication about health in the household
Barriers you and your family members have that would prevent them from seeking care, prevent them from taking action in their own best interest, or reduce their self-efficacy (like habits they have tried to change, but have not been able to maintain)
Tendencies you and your family members may have toward taking responsibility for their health and health behaviors, and their level of self-efficacy in terms of maintaining healthy lifestyle choices
Medication lists for yourself and each member of your family (no details necessary, of course…ideally, produce the complete list including dosages, keep a copy for yourself, and black out personal information on the copy you submit here)
Lists of questions you will carry to the doctor (this can be general or specifically related to the conditions of family members)
(Optional): Include any conversations-starters you use this week in order to complete this mini-project, to practice getting your family talking about healt
Imagine that you have been charged with transforming the performance of a team at your workplace. Specifically, it is under-performing, and your supervisor wants the team to be high-performing within six months. Based on the information in Chapter 18 of Organizational Behavior in Health Care and your own research develop a presentation for your supervisor that addresses the following:
Discuss reasons that healthcare teams under-perform.
Outline best practices for team performance.
Discuss the various organizational barriers that exist in your organization that affect team effectiveness.
Describe motivational strategies that address team level performance.
Present your team performance improvement plan making sure to include specific time-bound goals.
Provide examples from the organization and from current research to support your comments and ideas.
Your presentation should meet the following structural requirements:
Organized, using professional themes and transitions.
It should consist of nine slides, not including the title and reference slides.
Each slide must provide detailed speaker’s notes, with a minimum of 100 words per slide. Notes must draw from and cite relevant reference materials.
Provide support for your statements with in-text citations from a minimum of six scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other four must be external. The Saudi Digital Library is a good place to find these references.
Follow APA 7th edition and Saudi Electronic University writing standards.
You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading. If you are unsure how to submit an assignment to the Originality Check tool, review the Turnitin Originality Check Student Guide.
Before beginning work on this discussion forum, please review the link “Doing Discussion Questions Right” and any specific instructions for this topic.
Before the end of the week, begin commenting on at least two of your classmates’ responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress.
Please carefully read the article below and prepare a response focused on the multicultural issues facing the professional health care workforce in the United States.
Rosenkoetter, M., Nardi, D., & Bowcutt, M. (2017). Internationally educated nurses in transition in the United States: Challenges and mediators. The Journal of Continuing Education in Nursing, 48(3), 139–144. doi: 10.3928/00220124-20170220-10
Your initial discussion response should capture the main focus of the article and provide substantive insight into the issues. You can highlight the pros and cons, offer options to address issues, or relate a professional experience. It is important to maintain professional decorum in all responses.
Your response must serve the objectives of provoking discussion and academic dialogue.
To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Submit your document to this Discussion Area by the due date assigned. Be sure to cite your sources using APA format.
Respond to your classmates throughout the week. Justify your answers with examples, research, and reasoning. Follow-up posts need to be submitted by the end of the week.
Healthcare Workforce Diversity
Cultural competency refers to the ability to interact with people across cultures. When used in healthcare, the term focuses on being able to care for patients with diverse values, beliefs, and behaviors.
Certain types of cultural barriers in healthcare have the power to negatively impact outcomes and lead to expensive consequences for health systems. Language barriers, for example, can have devastating effects.
“A key component to new care delivery models, such as patient-centered medical homes and accountable care organizations, is the ability to engage and educate patients about their health status,” the report added. “While doing this is challenging with all patients, for diverse patient populations it can be even more difficult due to language barriers, health literacy gap, and cultural differences in communication styles.”
Reference:
Hussan University Online. (2019). The Need for Cultural Competence in Healthcare
In order to meet the needs of patients, healthcare providers will need to promote cultural competency. Retrieved from https://medcitynews.com/?sponsored_content=the-nee…
This assignment will focus on developing a health policy analysis presentation that includes a problem statement, background, landscape, options, and recommendations from the week’s readings. The health policy analysis presentation is based on an identified healthcare issue in one’s local community.
Unformatted Attachment Preview
NR506NP
Overview
Week 4 Assignment Requirements
Health Policy Analysis
Definition
Problem Statement
Problem Statements Examples
Background
Background Example
Landscape
Landscape (continued)
Options
Recommendations
Mr. Smith brings his 4-year-old son to your primary care office. He states the boy has been ill for three days. Mr. Smith indicates that he would like antibiotics so he can send his son back to pre-school the next day.
History – Child began with sneezing, mild cough, and low grade fever of 100 degrees three days ago. All immunizations UTD. Father reports that the child has had only two incidents of URI and no other illnesses.
Social – non-smoking household. Child attends preschool four mornings a week and is insured through his father’s employment. No other siblings in the household.
PE/ROS -T 99, R 20, P 100. Alert, cooperative, in good spirits, well-hydrated. Mildly erythemic throat, no exudate, tonsils +2. Both ears mild pink tympanic membrane with good movement. Lungs clear bilaterally. All other systems WNL.
Do not consider COVID-19 for this patient diagnosis.
For the assignment, do the following:
Diagnose the child and describe how you arrived at the diagnosis (i.e. how you ruled out other diagnoses).
Provide a specific treatment plan for this patient, pharmacologic and/or nonpharmacologic.
Provide a communication plan for how the family will be involved in the treatment plan.
Provide resources that Mr. Smith could access which would provide information concerning your treatment decisions.
Utilize national standards, your pharm and/or patho book and medical or advanced practice professional sources. Do not use patient-facing sources or general nursing texts to support your diagnosis and treatment.
Use references to support your concepts. Utilize correct APA formatting and mechanics of professional communication.
Select one of the case studies below for your assignment. In your discussion, be sure to evaluate the presence and effects of alterations in the homeostatic state secondary to gender, genetic, ethnic, and temporal variables.
Case Study Assignment Requirements
Make sure all of the topics in the case study have been addressed.
Cite at least three references in your case study paper; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
All reference sources must be within 5 years.
Do not use sources such as Wikipedia or UpToDate as a reference.
Assignments must have at least four full pages of analytic content, double-spaced (the cover and reference pages do not count in the page count, but must be included with the assignment), and follow APA 7th edition format.
Case Study 1: Disorders of Fluid, Electrolyte, and Acid-Base Balance
Amanda is an 18-year-old with anorexia nervosa. She was recently admitted to an eating disorders clinic with a BMI of 13.9, and although she was a voluntary patient, she was reluctant about the treatment. She was convinced that she was overweight because her clothes felt tight on her. She complained that even her hands and feet “were fat.” One of her nurses explained that a protein in her blood was low. The nurse further explained that, as difficult as it may be to believe, eating a normal healthy diet would make the “fat hands and feet” go away.
What protein do you suspect the nurse was referring to? How would a deficiency in this protein contribute to edema?
What is the difference between the physiology of pitting and nonpitting edema?
Because of her weakened condition, Amanda was moved around the ward in a wheelchair when she was not on bed rest. How does this affect her edematous tissues?
Case Study 2: Respiratory Tract Infections, Neoplasms, and Childhood Disorders
Patricia was called at work by a woman at the local day care center. She told Patricia to come and pick up her son because he was not feeling well. Her son, 3½-year-old Marshall, had been feeling tired and achy when he woke up. While at daycare, his cheeks had become red, and he was warm to touch. He did not want to play with his friends, and by the time Patricia arrived, he was crying. Later that afternoon, Marshall’s condition worsened. He had fever, chills, a sore throat, runny nose, and a dry hacking cough. Suspecting Marshall had influenza, Patricia wrapped him up and took him to the community health care clinic.
Why did Marshall’s presentation lead Patricia to think he had influenza and not a cold? Why is it important to medically evaluate and diagnose a potential influenza infection?
Describe the pathophysiology of the influenza virus. Outline the properties of influenza A antigens that allow them to exert their effects in the host.
Marshall may be at risk of contracting secondary bacterial pneumonia. Why is this so? Explain why cyanosis may be a feature associated with pneumonia.
Case Study 3: Disorders of Ventilation and Gas Exchange
Emmanuel and his mother live in an urban community housing complex. The building is worn down and dirty from the urban dust, cockroaches, and mold. Emmanuel is 5 years of age and has suffered from asthma for the last 2 years. One evening, his mother poured him some milk and put him to bed. Shortly afterward, Emmanuel woke up wheezing and coughing. As he gasped for air, he became more and more anxious. His mother ran for his inhaler, but he was too upset and restless to use it. Emmanuel’s skin became moist with sweat, and as he began to tire, his wheezing became quieter. His mother called 911 and waited anxiously for the ambulance to arrive.
Emmanuel uses a corticosteroid inhaler for the management of his asthma. What is the mechanism of action of this drug? How is its action different from the β2-agonist inhalants?
Why does someone with severe asthma become physically fatigued during a prolonged attack? What are the physiologic events that occur during an attack?
One of the complications of respiratory fatigue is the development of hypercapnia. How does the body compensate for an increase in CO2? What are the effects of hypercapnia on the central nervous system?
Case Study 4: Disorders of Renal Function
Fred, a fit and healthy 44-year-old, was working outside one warm summer afternoon. When he returned home by the end of the day, his lower back felt sore and he felt nauseated. His wife made him dinner, but he was not hungry and chose to go to bed instead. Fred’s symptoms progressed, and soon he was rolling on the bed with excruciating pain. He said his back hurt as well as his stomach and groin area. The pain would ease off only to return a short while later, and when it did, Fred would begin to sweat and run to the bathroom to vomit. His wife became concerned and started the car. When his symptoms abated, she helped him into the car and rushed him to the hospital.
At the hospital, an abdominal radiograph showed the presence of renal calculi in Fred’s right ureter (urolithiasis). What is the mechanism of stone formation in the kidney? What is the role of citrate in the kidneys?
Why would the administration of calcium supplements be useful for a patient with calcium oxalate stones?
Hydronephrosis can be a complication of renal calculi. What is hydronephrosis? How does back pressure occur in a kidney, and what physiologic mechanism is responsible for nephron damage when back pressure is present?
Case Study 5: Disorders of Gastrointestinal Function
Marcee is a 52-year-old woman who worked at a reception desk at a company head office. She took some time off when she was treated for colorectal cancer. The Dukes classification was stage I, and the treatment protocol involved surgery and radiation therapy. No one in her family had a history of the disease. Marcee does not drink or smoke, but she does not pay close attention to her diet. At work, her meals consisted mainly of the foods she got from vending machines at the cafeteria. At home, she preferred to heat up frozen dinners or any prepackaged food that required minimal preparation time.
Review Marcee’s diet. What factors in her dietary choices might contribute to the development of colorectal cancer?
Colorectal cancer often arises from adenomatous polyps. What are the development and histologic features of these polyps?
Colorectal cancer may be a complication in individuals with ulcerative colitis. How are the “pseudopolyps” seen in this disease different from the polyps discussed above?
Why is a fecal occult blood test used as one of the screening tools for colorectal cancer? Explain the procedure for administering the test.
Before finalizing your work, it is important to:
Review Case Study Assignment Requirements (described above) and the Case Study Assignment Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
Make sure to review your chosen case study carefully to make sure you have effectively answered all questions asked.
Utilize spelling and grammar checks to minimize errors.
Follow the conventions of Standard American English (correct grammar, punctuation, etc.).
Make sure your assignment is original, insightful, and utilizes your logic and critical thinking skills; that your assignment is well-organized, with superior content, style, and mechanics.
Utilize APA 7th Edition format.
Be diligent about APA formatting including paraphrasing and direct quotations, utilizing appropriate in-text citations, and referencing your sources.
Task summary: Dear freelancer, you’re to write a Literature Review Paper with a focus on Autistic special students and sensory stations at kindergartner level – 25 pages review and have at least 4-5 graphs. I will add an additional 14h to the DDL. MAIN DETAILS: A literature review is a synthesized research report on a specific topic, in your case, it would be your area of focus. Synthesized is not a summary, it means you are reading and discussing diverse aspects of your study. You begin with an introduction of your subject and then subheadings on the same subject. So if you are discussing ADHD – it would be a general overview of ADHD (history, who is mainly impacted, percentage of the population, what effects and social issues exist due to this, then you move on to subheadings – main theoretical frameworks, theorists, studies, interventions, what has worked, what hasn’t worked, implications for the future, conclusion). Remember, you are not summarizing but synthesizing – that is reading and discussing it in the third person objective in an intelligent and scholarly way. The literature review is a part of your final focus paper, it will consist of at least 10 sources that you have identified to help you justify and provide a framework for your final concept paper/action research. ATTACHED:-instructions -rubric-sample
Unformatted Attachment Preview
EEXX 507
LITERATURE REVIEW GRADING RUBRIC
STUDENT:
Criteria
15 points
10 points
6 points
4 points
0 points
INTRODUCTION
Clearly and concisely
articulates the topic of study,
motivating the investigation,
and discusses the problem
and historical background for
the study
Keywords and essential terms
are clearly discussed and
defined using direct support
from authoritative sources on
the topic; includes citations
Discusses the topic
of study, and the
problem, and
historical
background for the
study
The problem
addressed and
background for the
study are vague and
key terms are vague
and unclear
Unfocused and
wandering
discussion; missing
multiple required
elements
N/A
RESEARCH
QUESTION
Clearly and concisely
articulates the study/research
question(s)
Discusses the topic
of study, the focus
area/research
question(s),
The topic of study and
area of focus/research
question(s) are
unclear.
Fails to include a
research question.
N/A
PURPOSE
Clearly and concisely
articulates the study/research
purpose.
Discusses the topic
of study, the focus
area/research
question(s),
The study purpose is
unclear.
Fails to include a
study purpose.
N/A
40 points
30 points
20 points
10 points
0 points
Relevant research findings
are tightly synthesized and
Research findings
are organized by
Research findings are
summarized by study,
Fails to include
relevant research or
N/A
REVIEW OF THE
LITERATURE
Points
Earned
EEXX 507
organized by
themes/categories; uses a
balanced amount of direct
quotation; includes citations
to support findings
themes/categories;
uses direct
quotations and
includes citations to
support findings
rather than synthesized
by themes/categories;
direct quotations are
used either too heavily
or too sparingly
includes findings
unrelated to the
topic; sources of
argumentation and
support unclear
10 points
8 points
6 points
4 points
0 points
Includes a focused summary
of key findings from the
review; gaps in the literature
and recommendations for
future research are clearly
discussed
Includes a summary
of key findings from
the review; gaps in
the literature and
recommendations
for future research
are identified
Summary of key
findings is unfocused
or inconsistent with
the review; gaps in the
literature or
recommendations for
future research are
vague
Unfocused and
wandering
summary; missing
multiple required
elements
N/A
GRAMMAR, USAGE,
& MECHANICS
0–2 errors
3–4 errors
5 errors
6–8 errors
APA FORMAT
0–2 APA errors
3–5 APA errors
6–7 APA errors
8–9 APA errors
SUMMARY/
CONCLUSION/
FUTURE
RECOMMENDATIONS
More than 8
errors
More than 10
APA errors
TOTAL:
INSTRUCTOR COMMENTS:
1
Abstract:
Instructional Strategies for Teaching Pre-Algebra
to a Diverse Group of Learners
Planning effective instruction for a classroom full of learners demands that the
educator know what works and more importantly what works better for the group of
people residing in the educator’s classroom today. This action research study tested the
efficacy of using the full compliment of assessments included in the curriculum
adoption at the researchers school and that of guided note taking. Each strategy was
implemented in its own separate unit of a pre-algebra class.
The researcher used student growth, which was determined by the difference
observed between a student’s pre-test percentage score and their final unit test
percentage score, as the metric by which to evaluate each strategies efficacy.
Measurable growth was observed with both strategies. The All Assessments strategy
showed greater and more consistent growth among learners than that which was
observed during the Notes strategy. These findings indicate that more research is
needed on the effectiveness of using assessments for learning and a need for further
study to evaluate the efficacy of guided note taking. Findings in this study should be
considered as illuminating but not conclusive as the sample used is not generalizable.
May, 2010
2
Instructional Strategies for Teaching Pre-Algebra
to a Diverse Group of Learners
by
A project
submitted in partial
fulfillment of the requirements for the degree of
Master of Arts in Teaching
May, 2010
3
TABLE OF CONTENTS
I. The Problem ………………………………………………………………. 4
Purpose of Study ………………………………………………………………………….. 5
Definition of Terms ………………………………………………………………………. 5
Research Questions ………………………………………………………………………. 5
II. Literature Review ………………………………………………………. 6
III. METHODOLOGY……………………………………………………… 11
Strategy 1: All Assessments with Second Chance ……………………………..12
Strategy 2: All Assessments, Summarizing and Note Taking ……………..12
Data Collection and Recording ………………………………………………………13
IV. Study Results………………………………………………………….. 13
Figure 1 All Assessments Pre-Test and Final Test Raw Percentage
Scores …………………………………………………………………………………….. 14
Figure 2 Notes Pre-Test and Final Test Raw Percentage Scores …….15
Figure 3 All Assessment % Points Growth from Pre-Test to Final
Test ……………………………………………………………………………………….. 16
Figure 4 Notes % Points Growth from Pre-Test to Final Test…………. 17
Figure 5 All Assessments and Notes Growth Comparison …………….. 18
V. Conclusions …………………………………………………………….. 18
VI. Concerns and Limitations…………………………………………. 19
REFERENCES ……………………………………………………………… 21
4
I. The Problem
Today’s classroom is a diverse place where students from a myriad of backgrounds
and abilities are brought together with the expressed purpose of developing knowledge
and skills that will assist students in growing as individuals while preparing them for the
next level in their academic lives. The classroom where this study took place embodies
these conditions and strives towards these intentions. To effectively realize success as
measured by today’s formal assessments this researcher recognizes the need to find,
specialize and implement a system of instructional strategies which will help assure that
each of these groups of learners are engaged, challenged and trained to use their skills
and knowledge to any challenge life throws at them.
The students comprising the sample in this study class are energetic, curious and
reside in a supportive and peaceful mountain community. In pre-algebra the half are
performing at grade level with about 25% below and about 25% or so above. Are there
ways challenge each learner and teach them in a way that best meets their needs while
doing so for all learners? Are there instructional strategies that could be implemented
that would yield better results for more students? Can this be accomplished within the
confines of the time currently used to plan? A safe assumption is that there is likely to
be many permutations of strategies that can be implemented in this classroom that will
yield a different result as represented by student performance on chapter tests. The
purpose of this action research study will be to evaluate the specific effectiveness of
several strategies as used by this researcher in this classroom.
The study sample of students are distributed by their performance on the 2009
California Standards Test for Math as, Advanced 24%, Proficient 29%, Basic 41%, Below
Basic 6%, Far Below Basic 0% (CST Report, 2009). It has been observed by the
researcher that this group of students are generally encouraged to keep up with their
5
academic work. The group is comprised of fifteen students, most of whom have been in
the same class together for the duration of their school years.
Finding the right strategies for todays students is important, but so is developing
strategies that can be used as a base program from which to specialize for the next year’s
students who will come with unique instructional requirements.
Purpose of Study
This action research study sought to locate and evaluate instructional strategies for
use in teaching pre-algebra to a specific group of seventh grade students. The purpose
for doing so was to improve the effectiveness of instruction as determined by
measurable student growth observed during a series of instructional units.
Definition of Terms
In this study I will be using the term “self-contained” which is define as a group of
students who are taught all core academic subjects, physical education and art by the
same teacher. When referring to the subject I will at time use the term “diverse
population” when doing so I am referring to the distribution of math scores as reported
by the 2009 CST test and formative assessments administered by this groups regular
school teacher, myself. The abbreviation CST stands for the California Standards Tests.
The term STAR refers to the California’s Standardized Testing and Reporting.
Research Questions
What strategies can I use in my self-contained classroom during math that will allow
me to meet the needs of my advanced, grade level and low performing students? Can an
improvement in student scores on summative assessments be accomplished without
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significantly increasing planning time? Which strategy or combinations of strategies
when used result in an improvement in the consistency and quantity of growth each
student experiences as measured by comparing a unit’s pre-assessment and the unit’s
summative assessment?
II. Literature Review
A person’s ability to reflect on his/her work is important for the process of learning to
be successful. McMillan and Hearn explain, “Evaluating what they learned, what they
still need to work on, and how they can get there can all support deeper understanding
rather than superficial knowledge” (2008). Reflection can take many forms including,
students grading their own assessments which are then used to guide them in their
learning. To be effective reflection must include opportunity to improve performance
and new opportunities to demonstrate learning and skill development.
Formative assessment can provide valuable information students need. As stated by
Campos and O’Hern, “feedback from… assessments can be used to help students with
goal setting. This allows the students to take responsibility for their learning and
become more independent learners” (Campos, 2007). Developing students into selfmotivated learners likely requires shifting the reins of their learning into student hands.
Access to control over their learning appears to motivate personal responsibility and a
genuine desire to improve.
Providing feedback through frequent assessment can influence learning and
achievement. Evertson and Neal discuss the use of assessment, “ongoing formative
assessment [is] a means for determining what [has] been learned and what else [is]
needed… Although often neglected in U.S. classrooms, there is considerable evidence
that formative assessment is an essential component of classroom work that
facilitates learning and can substantially raise student achievement” (2006). Students
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who receive regular and specific feedback in the form of formative assessment should
score higher than when formative assessment is largely absent.
Intrinsic motivation is key to success. The road to intrinsic motivation requires
thoughtful planning and experimentation as Oginsky recalls, “even through research
supports and I believe, that non-controlling, positive feedback leads to a positive
classroom environment, and thus to an increase in intrinsic motivation, increasing
positive non-controlling feedback to students did not increase intrinsic motivation in
this classroom study” (2003). The group who are being taught must be carefully
considered when determining what type of feedback will aid them in developing their
own internal motivation for learning.
The objective of assessment must be consistent with the nature of it’s implementation,
“the goals for developing diagnostic item models for formative assessment are
quite different from… [research] goals… First, we are less concerned with generating
instances with psychometric parameters that can be predicted very accurately, and more
concerned with generating instances that consistently measure patterns
of understanding with accuracy sufficient to focus instruction” (Graf, 2009). Formative
assessment that guides instruction must be constructed and evaluated so as to provide
the information that will aid in planning effective instruction in addition to supporting
feedback for students.
When construction assessment which will determine the efficacy of certain strategies
it is necessary to determine the appropriateness of the assessemnt choice. “Often the
instruction in the classroom is not geared toward the same objectives as those measured
on the assessment, or the assessment may, in fact, fail to provide information about
student’s strengths and weaknesses as real targets for further instruction” (McDivitt,
2003). What is assessed is what should be instructed or the results cannot be trusted as
being the results of instruction, rather the product of other means.
8
Learning can occur in two phases, encoding/writing and external storage/studying,
when notes are involved as a tool for recording new information and during the process
of reviewing those notes prior to an assessment. In a study examining the efficacy of
students copy and pasting notes from internet sources Igo, Bruning and Riccomini
explain that, “students might not learn much during the encoding phase if they do not
engage in deep mental processes as they take notes… in the external storage phase of
note learning, students learn as they study a set of notes that already have been created”
(Igo, 2009). It is important that when notes are used as a tool for study that they should
be created carefully so as to assure their legibility and accuracy. One of the concerns the
study raised was that when students reviewed using their own hand created notes they
often reinforced errors and omissions that were recorded or missed in the encoding
phase.
Benefits in performance can possibly be realized if students are guided in how to
choose items to include while note taking. Igo suggests that educators, “teach students
how to evaluate which ideas to include in their notes, [as it] could have positive
consequences for both the encoding and the external storage phases of note learning”
(Igo, 2009). If taught to strategically consider the content they include in their notes,
students should benefit by having both less to study which will be more time and energy
efficient and the information they will be reviewing will be of a higher quality.
In a study by Neil Toporski and Tim Foley the need for a streamlined interactive
approach is indicated. The researcher studied the unique needs of the modern distance
education class setting. In this report it was explained that there exists a trend towards
providing “theatrical” and “diverse… presentation methods.” The authors list strategies
formulated during the study that promote a successful schooling experience, they,
“make it interactive,… keep it engaging and motivating,… put things in context,…
maintain diversity,… use collaborative strategies,… reduce cognitive Load,… [and]
provide adequate scaffolding” (Toporski, 2004). Mr. Toporski and Mr. Foley’s
9
conclusion validates the conclusions of similar studies that a more effective classroom
can be created in the physical space of a classroom or within the e-classroom by using
differentiated approaches that stimulate the many people take in new information.
Katherine Gibson studied how teachers perceive strategy based reading instruction
and its affect on comprehension. Her study was based on a small sample of teachers
who had a positive attitude going into the study about using strategy based reading. She
discovered that, “[teachers] surveyed have positive feelings towards strategy based
reading instruction… [and] find strategy based reading instruction an effective way to
improve reading comprehension,” (Gibson, 2009). Ms. Gibson’s study supports the idea
that attitude can influence success.
In his article in Education Leadership Using Data to Improve Student Achievement How Classroom Assessments Improve Learning, Thomas Guskey suggests giving
students the opportunity to improve their performance on assessments through a
second chance (Guskey, 2003). This researcher is curious if modifying the current
method of assessment to include several “chances” to hit the mark will yield higher
scores on these assessments overall.
In Robert J. Marzano’s article in Educational Leadership What Works in Schools he
reports study results that show a average 34 point percentile gain and a 0.50 standard
deviation from the mean for a subject who uses the strategy of note taking and
summarizing (Marzano, 2003). In this study I will evaluate the effectiveness of, “asking
students to generate verbal summaries, asking students to generate written
summaries,… asking students to revise their notes, and/or correcting errors and adding
information” (Marzano, 2003). Specific importance seems to reside in the retooling of
notes after first taking them. They should be regarded as a malleable model which
represents the learners current understanding of and needs for the focus content.
The literature concerning differentiating instruction calls for many approaches,
attitudes and methods of implementation. Some have advocated for diving in where the
10
whole system is transformed rapidly, while many more have called for a gradual
adoption process with a long term more is better philosophy. Sondergeld and Shultz
advise: “use content you feel comfortable teaching; do not attempt to differentiate every
lesson you teach—you will get frustrated and feel burnt out; begin slowly, with maybe
only one or two differentiated units a year; invite parents or classroom aides into the
classroom to assist with” (Sondergeld, 2008). Change in the classroom routine and
lesson design should be gradual so as to maintain the energy and vigor of learners as
well as educators.
Self evaluation is key to understanding what is working and what can be improved.
Friend and Pope outline what each teacher needs to focus on in and some simple
guidelines for success, “First, sometimes the most successful way to go about changing is
to do so in small increments… Second, find colleagues with whom to share your efforts…
Third, set goals for yourself and celebrate when you accomplish them… Finally,
remember that working on differentiation is a clear example of lifelong learning,”
(Friend, 2005). This descriptive report reinforces what has been stated by the Center
for Comprehensive School Reform and Improvement.
The basic philosophical orientation of the educator is important to understanding
the expected response from students as initiated by the nature of the relationship
between the student and educator. In “Theories of Intelligence, Learning and
Motivation as a Basic Educational Praxis,” Steven Van Hook examines the nature of this
relationship. The term “andragogy” is used to describe the paradigm shift that is and
must happen in education. Whereby “pedagogy” is rooted in the concept of the teacher
guiding the child in learning, andragogy instead views the learner in terms of
participating in their own self-actualized learning experience (Van Hook, 2008). This
calls to mind the concept of “ownership” often used to describe when students are
observed applying the concepts they have learned in new novel ways.
11
Summary and note taking when properly executed require extracting the essence of
the information being studied. Marzano explains, “students must analyze the
information in depth… in order to decide what information is important to make notes
about and information that is not, students must be able to mentally sift through and
synthesize information” (Marzano, 2000). An ongoing use of note taking as a regular
component of learning will likely result in the development of students abilities to pick
out the information they will most likely need to know for later use. Motivating students
to use this strategy to in a meaningful way might be accomplished by allowing the use of
student generated notes during assessment tasks.
III. METHODOLOGY
Each strategy selected for evaluation in this study was implemented in this
researchers classroom for two weeks in the following manner. Each new strategy was
isolated from influence by the other strategies during evaluation to the degree practical
in this real classroom environment. Students were instructed using in the researcher’s
normal teaching style that included working problems as a group until it was clear to the
researcher that the majority of students were able to continue independently. At this
point instruction continued on a case by case basis as the need presented itself. This
was determined through teacher observation or through the direct request of students.
Efforts were taken to maintain a consistency of instruction during each strategy
evaluation. Before beginning instruction on the unit’s lessons a pretest was
administered. During the course of the unit, quizzes were administered. The number of
quizzes was determined by the strategy being evaluated. Each quiz was given the
afternoon the day reteaching for the lesson being quizzed had been completed. A midchapter quiz was given after the sixth or seventh unit lesson had been corrected and
retaught. This was followed by more lesson quizzes administered as previously
12
described. The unit was completed with a final chapter test consisting of questions from
the whole unit. During testing students were directed to move into “test mode” where
they moved their desks so they had a one foot gap between their desk and their nearest
neighbor. This was done to minimize distractions that might impact assessment results.
Students were not allowed to talk to each other during quizzes and tests. They were
allowed to ask the researcher for clarification on questions. Each quiz and test was
corrected in class by the students and then reviewed by the researcher. This was done to
provide students with immediate feedback on their work.
Strategy 1: All Assessments with Second Chance
All unit assessments included with the textbook adoption were used. After each
assessment was given and corrected, either a quiz or test, students were offered the
chance to correct the problems they missed, while displaying their work, for additional
credit. In the case of quizzes, students were offered the chance to earn back all credit by
working the problems out again and resubmitting their corrected quiz. On tests
students were offered the chance to correct their missed problems for half the credit
missed. The researchers intention was to determine if student performance could be
influenced by a greater frequency of assessments, coupled with immediate feedback and
the opportunity to correct assessments for additional credit. Only raw uncorrected
scores were used in this study. The improved scores were used only for calculating
student grades.
Strategy 2: All Assessments, Summarizing and Note Taking
During instruction students were asked to divide a page down the middle. In the left
margin students were directed to take notes that included lesson examples and
vocabulary. In the right margin students were directed to expand on notes with their
13
own examples and explanations. A pre-test assessment was given the first day before
instruction. Midway through the unit a mid-chapter test was given. At the end of the
Unit a chapter test was administered.
Data Collection and Recording
Data used to evaluate the instruction strategies was collected through formative
assessment, observation and summative assessment. Each strategy received a one unit
time frame, which generally worked out to a two week period. The first day of each unit
a complete chapter test was be administered. The score of these assessments was
converted to a percentage mean for the whole class and compared on an individual basis
with mid-chapter assessment scores and the chapter summative assessment scores.
Unit formative assessments consisted of several lesson quizzes given the day after
formal instruction on the quiz content had been completed and only after a session of
homework correction and reteaching. Copies of all assessments were kept to allow for
comparison among content areas as determined by the lesson designation printed in
each section of each assessment. These were used to determine any changes in
performance as related to each lesson area.
IV. Study Results
To compare the two strategies it was necessary to find a way to measure the efficacy of
each strategy for the class as a whole. The researcher chose to compare growth in scores
from the pretest to the final test (Figure 1 and 2). A mean of this set of differences was
calculated for each strategy as was the standard deviation for each. The justification for
comparing the two strategies in this manner was that this measure quantified the
growth students made during each strategy and provided a clear picture of how
14
consistently this growth was seen over the population (as shown by the standard
deviation).
Figure 1 All Assessments Pre-Test and Final Test Raw Percentage Scores
15
Figure 2 Notes Pre-Test and Final Test Raw Percentage Scores
The subjects showed a mean growth of 55 percentage points in the All Assessments
unit of the study. Individual scores fell within a standard deviation of 14.21 percentage
points of the mean. The highest growth in percentage points observed was observed in
subject 7015 at 79 percentage points of growth. The lowest observed growth was
observed in subject 7003 at 37 points of growth (Figure 3).
16
Figure 3 All Assessment % Points Growth from Pre-Test to Final Test
During the Notes unit subjects showed a mean growth of 31 percentage points. In this
unit scores fell within a standard deviation of 22.86 points from the mean value. The
highest growth was observed with subject 7006, who showed a 67 percentage point
growth from their pretest score. The lowest growth observed during this unit was that of
subject 7005, who showed a -5 percentage points loss from their pre-test score to the
final score (Figure 4).
17
Figure 4 Notes % Points Growth from Pre-Test to Final Test
Differences were observed with the two strategy unit mean growth measures (Figure
5). A difference of 24 percentage points separate the two strategy growth means. Data
distribution, as determined by the standard deviation, showed a 9 percentage point
difference in the growth range. The All Assessments strategy elicited greater and more
consistent growth from this population of students. Conversely the Notes strategy
showed less growth and less consistency in the growth students experienced during that
unit.
18
Figure 5 All Assessments and Notes Growth Comparison
V. Conclusions
It is difficult to determine what to include when planning instruction. There are
endless variables to consider that may or may not have a significant impact on the
engagement and subsequent retention of learning expressed by students. This research
study was motivated by a desire to compose a means of comparing the efficacy of
different strategies. Prior to this study, using all the included assessments that come
with a given curriculum adoption had not seemed, to the researcher, to be of obvious
19
benefit. However, the results of this study are convincing enough for this researcher to
consider more carefully the role assessment can play in aiding student learning.
The results of the note-taking unit came as a surprise. It was assumed that the notes
unit would show at least as good a growth as the unit using all assessments. After all,
the strategy of guiding students to expand on their notes both during and after
instruction is frequently and widely encouraged. During the All Assessments unit,
students were not asked to do anything with their notes beyond recording what was
necessary for them to get started on their assignments. If these findings illuminate
anything it is that it is highly beneficial for the educator to have a measure for
determining and to reflect on what kind of growth is occurring during each instructional
units. It is also important to consider carefully what is being included in lessons and
whether or not each of those things is worth the planning and instructional time.
Student motivation may have played a significant role in why the All Assessment
strategy showed greater success. The ever present pressure of a coming formal
assessment coupled with the imediate feedback offered by each student’s correcting of
his or her own paper and immediately being given time to correct their errors for
additional credit may be a motivating force. In many ways having frequent assessment
is like the immediate feedback individuals receive when they play a video game. If a
mistake is made the player knows right away and begins looking for ways to complete
the task successfully. Subjects in this study were observed to be highly motivated to
correct their mistakes for additional credit, which in turn provided needed review for
content they were weak on.
VI. Concerns, Limitations and Future Research
This study was conducted with a very small sample of students and should not be
considered generalizable. As is the nature of action research, in many ways the study
20
was designed and redesigned while the units were being instructed. Where it casts light
it exposes even more shadows. Comprehensive and comparable pre-tests were not
available so final chapter tests were given in there place. Growth was assessed based on
the differences between the pre-test score and the final unit test score. In the case of the
all assessments unit it is the researcher’s belief that the pre-test given was of greater
difficulty than the final test for that unit. Which if true could mean that the benefits of
that strategy were greater than the data indicated.
For this study to be statistically testable it would need to be replicated, a control
established where neither strategy was in use and a larger data set compiled to compare
each strategies performance as averaged over several units time. This study should be
considered as a preliminary work, wherein it is this researcher’s belief a need for
additional study is indicated by the findings.
21
References
Brighton, Catherine M.; Hertberg, Holly L.. (2004-00-00). Reconstructing the
Vision: Teachers’ Responses to the Invitation to Change. RMLE Online:
Research in Middle Level Education. v27 n2 p1-20 2004. National Middle
School Association. ERIC #: EJ807413
CST Report. California Standardized Testing and Reporting (STAR)Three Rivers
Elementary School – All Students. 2010-02-01. http://star.cde.ca.gov/star
2009/ViewReport.asp?ps=true&lstTestYear=2009&lstTestType=C&lst
County=54&lstDistrict=72207-000&lstSchool=6054423&lstGroup=1&lstSubGroup=1
Di Fatta, Jenna; Garcia, Sarah; Gorman, Stephanie. Increasing Student Learning in
Mathematics with the Use of Collaborative Teaching Strategies. 2009-05-00. ERIC #:
ED504828
Evertson, Carolyn M.; Neal, Kristen W.. Looking into Learning-Centered
Classrooms: Implications for Classroom Management. Working Paper. National
Education Association Research Department. 2006-07-00. National Education
Association Research Department. http://www.eric.ed.gov/ERICWebPortal/
contentdelivery/servlet/ERICServlet?accno=ED495820. ERIC #: ED495820
Friend, Marilyn; Pope, Kimberly L.. (2005-00-00). Creating Schools in Which
All Students Can Succeed. Kappa Delta Pi Record. v41 n2 p56-61 Win 2005.
ERIC #: EJ683473
Gibson, Katherine D. (2009-06-00). Teachers’ Perceptions of Strategy Based
Reading Instruction for Reading Comprehension. ERIC #: ED505543
Goodnough, Karen. (2003-04-00). Issues in Modified Problem-Based Learning:
A Study in Pre-Service Teacher Education. ERIC #: ED477797
Guskey, Thomas R. Educational Leadership. Using Data to Improve Student
22
Achievement – How Classroom Assessments Improve Learning. Pages 6-11.
February 2003 | Volume 60 | Number 5. ASCD.http://www.ascd.org/publicat
ions/educational_leadership/feb03/vol60/num05/How_Classroom_Assess
ments_Improve_Learning.aspx
Hall, Arnita Rena. Mini Literature Review Ba
Assignment 3: Health Information Technology (HIT) System Project Report (25 points)
For this assignment, students will examine a set of national healthcare performance measures, focus on querying a national dataset to
obtain and analyze data originating from health databases, and generate a HIT report of findings. Students will access data reported
to the National Committee for Quality Assurance (NCQA) and found in the Centers for Medicare and Medicaid Services (CMS)
research databases, the Chronic Conditions Data Warehouse (CCW). The CCW supports chronic conditions, health policy analysis,
and other CMS initiatives.
Students will access the CMS Mapping Medicare Disparities (MMD) dataset and search for data to answer a query or question that is
utilized to request information from a database or dataset. Students will use spreadsheet skills and design visual graphs/charts to
compare, interpret, and integrate findings into a scholarly analytical HIT report recommending improved outcomes and further
queries. See the course module for resources on the CMS MMD tool as well as tutorials for creating Excel spreadsheets and charts.
Assignment Criteria:
For the HIT Report, address the following dataset query from your workplace:
1. Query: Using the latest year’s available data, is there a difference in the prevalence of heart failure for selected
populations (White, Black, Hispanic, Asian/Pacific Islander, American Indian/Alaskan Native, and Other) for Florida’s
Medicare recipients compared with the national prevalence of heart failure for these six populations of Medicare
recipients?
2. Search the CMS MMD dataset by following these steps. You will conduct six searches for data by only changing the
race/ethnic parameters (White, Black, Hispanic, Asian/Pacific Islander, American Indian/Alaskan Native, and Other).
Data from each search will be presented in a downloadable spreadsheet showing data for all states and the comparison to the
nation. You will locate in the dataset the record (a row in the spreadsheet table) for Florida and then move across the row to
find the comparison prevalence data for the nation.
Getting started:
a. Visit the CMS Medicare Mapping Disparities page (see Modules/Week 7)
b. Choose the Population tab at top. From the Get Started box, select “GO” to begin your first search of the dataset.
c. From the drop-down boxes which are dataset fields, choose the following parameters. Note that the comparison
group is the nation and the national parameters in the search must match those set for the state.
Dataset Fields: Search Parameters
Year: most recent single year of data available at the time you complete this
assignment
Geography: State Territory
Measure: Prevalence
Adjustment: Unsmoothed Actual
Analysis: Difference from National Average
Domain: Primary Chronic Conditions
Condition: Heart Failure
These are the 5 fields (sex through
Medicare eligible) and parameters for the
state’s data.
Sex: All
Age: All
Race and Ethnicity: White (and then change this population to
Black, Hispanic, Asian/Pacific Islander, American
Indian/Alaskan Native, and Other)
Dual Eligible: Medicare Only
Medicare Eligible: All
Comparison Sex: All
Comparison Age: All
Comparison Race and Ethnicity: White (and then change this population to
Black, Hispanic, Asian/Pacific Islander, American
Indian/Alaskan Native, and Other)
Comparison Dual Eligible: Medicare Only
Comparison Medicare Eligibility: All
These are the 5 comparison fields and
parameters for the national data;
national parameters must match state
parameters. You only need to change
the race and ethnicity parameter in
each of the 6 searches.
3. Extract the relevant data from each of the spreadsheets and construct one spreadsheet using MS Excel. Present the raw
prevalence
data (White, Black, Hispanic, Asian/Pacific Islander, American Indian/Alaskan Native, and Other ) in a table
American
format with headers
and and
formulas to determine and show the differences in state and national prevalence and averages. See
Indian/Alaskan
Native,
the
course
module
for
an
example of a final spreadsheet.
Other
4. Transform the data from the spreadsheet and create two charts: an Excel line chart and a bar chart using the spreadsheet’s raw data
table. are
Utilize
color to showcase
the findings. Review the literature to determine whether a line or bar chart is appropriate for
These
the parameters
for the state
presenting prevalence data. Cite a source to support your choice of chart.
5. Generate the HIT Report document that will include your analyses, a copy of your Excel spreadsheet and one preferred selected
chart. For your analyses include the following:
a. Intro to the paper and brief overview of heart failure prevalence in the United States as a population health problem. Cite
sources.
b. Answer the dataset query by reporting a summary of findings from the Excel table and selected chart. Your selection of a
chart should present the data most clearly and be best practice for showing prevalence data. Cite sources. Include the table
and selected chart within the text or as appendices per APA 7th edition format.
c. Analyze the table and your chart for trends and presence of health disparities among the races/ethnicities. Cite sources.
d. As the DNP leading this report, propose one additional source of data to be collected and tracked in the EHR. Generate a
new dataset query question that includes this additional source of data. Cite sources.
e. Propose one specific evidence-based recommendation/strategy to the workplace that could improve health outcomes for
Florida’s Medicare heart failure patients (choose one specific race/ethnicity, gender, or age). The recommendation should be
supported by evidence from the current literature. Cite one or more sources.
e. End the paper with a brief conclusion explaining the relevance of using HIT databases/datasets such as the CMS MMD to
generate information and knowledge for clinical practice. Cite a source.
6. The scholarly paper should be in narrative format, 5 to 6 pages excluding the title and reference pages.
7. Include an introductory paragraph with a purpose statement and a conclusion.
8. Utilize level 1 and 2 headings to organize the paper.
9. Write the paper in third person, not first person (meaning do not use ‘we’ or ‘I’) and in a scholarly manner. To clarify: “I, we, you,
me, and our” may not be used. In addition, describing yourself as the researcher or the author should not be used.
10. Include a minimum of five professional peer-reviewed scholarly journal references to support the paper (review in Ulrich
Periodical Directory) and be less than five (5) years old. Cite the CMS MMD dataset as a reference and to support tables/charts.
11. APA7th edition format required (attention to spelling/grammar, a title page, direct quotes, a reference page, table/chart formatting,
and in-text citations).
For the first template in week 6, you will choose either a Qualitative or a Quantitative Review (Please do not complete both Quantitative and Qualitative Appraisal). Your second article is a Systematic Review Appraisal. Make sure you receive approval from your instructor in week 4 for the article you use to complete either the Qualitative or Quantitative Review and for the Systematic Review. There are hyperlinks to these templates in the week 6 instructions. Do not create your own document with answers.Each section of the template is required to be completed as this assignment builds on your Evidence-Based Practice Project. Each template has a citation that must be submitted in APA format. Answers to questions in Synopsis sections are required (see template examples in your book). Each question must have an answer of 1-2 full sentences in length per question. Credibility section Yes/No answers are also required. The Comments area is also required and should be at least 1-3 sentences noting how this article relates to your nursing issue topic from week 3 and what you thought was significant.You will be using these articles again in your week 9 Evidence-Based Practice Project Poster.Please review the rubric closely and proof your work by reviewing instructions before you submit.Note: Please include a PDF or Word copy of your approved article from Week 4 with your submission.The chosen topic and PICOT will be used for your Week 9 poster assignment. It guided your article searches in Week 4 which are to be used in completing your appraisals in Week 6.
Unformatted Attachment Preview
APPENDIX F
Appraisal Guide
Findings of a Quantitative Study
Citation:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Synopsis
What was the purpose of the study (research questions, purposes, and hypotheses)?
How was the sample obtained?
What inclusion or exclusion criteria were used?
Who from the sample actually participated or contributed data (demographic or clinical profile
and dropout rate)?
What methods were used to collect data (e.g., sequence, timing, types of data, and measures)?
Was an intervention tested?
Yes
No
1. How was the sample size determined?
2. Were patients randomly assigned to treatment groups?
What are the main findings?
Credibility
Is the study published in a source
that required peer review?
Yes
No
Not clear
*Did the data obtained and the
analysis conducted answer the
research question?
Yes
No
Not clear
Were the measuring instruments
reliable and valid?
Yes
No
Not clear
*Were important extraneous
variables and bias controlled?
Yes
No
Not clear
*If an intervention was tested,
answer the following five questions:
Yes
No
Not clear
Brown
APP F-1
1. Were participants randomly
assigned to groups and were
the two groups similar at the
start (before the intervention)?
Yes
No
Not clear
2. Were the interventions well
defined and consistently
delivered?
Yes
No
Not clear
3. Were the groups treated
equally other than the
difference in interventions?
Yes
No
Not clear
4. If no difference was found, was
the sample size large enough
to detect a difference if one existed?
Yes
No
Not clear
5. If a difference was found, are
you confident it was due to the
intervention?
Yes
No
Not clear
Are the findings consistent with
findings from other studies?
Yes
Some
No
ARE THE FINDINGS CREDIBLE?
Yes All
Yes Some
Not clear
No
Clinical Significance
Note any difference in means, r2s, or measures of clinical effects (ABI, NNT, RR, OR)
*Is the target population clearly
described?
Yes
No
Not clear
*Is the frequency, association, or
treatment effect impressive enough
for you to be confident that the finding
would make a clinical difference if used
as the basis for care?
Yes
No
Not clear
ARE THE FINDINGS
CLINICALLY SIGNIFICANT?
Yes All
Yes Some
No
* = Important criteria
Comments
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
APP F-2
Brown
APPENDIX F
Appraisal Guide
Findings of a Quantitative Study
Citation:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Synopsis
What was the purpose of the study (research questions, purposes, and hypotheses)?
How was the sample obtained?
What inclusion or exclusion criteria were used?
Who from the sample actually participated or contributed data (demographic or clinical profile
and dropout rate)?
What methods were used to collect data (e.g., sequence, timing, types of data, and measures)?
Was an intervention tested?
Yes
No
1. How was the sample size determined?
2. Were patients randomly assigned to treatment groups?
What are the main findings?
Credibility
Is the study published in a source
that required peer review?
Yes
No
Not clear
*Did the data obtained and the
analysis conducted answer the
research question?
Yes
No
Not clear
Were the measuring instruments
reliable and valid?
Yes
No
Not clear
*Were important extraneous
variables and bias controlled?
Yes
No
Not clear
*If an intervention was tested,
answer the following five questions:
Yes
No
Not clear
Brown
APP F-1
1. Were participants randomly
assigned to groups and were
the two groups similar at the
start (before the intervention)?
Yes
No
Not clear
2. Were the interventions well
defined and consistently
delivered?
Yes
No
Not clear
3. Were the groups treated
equally other than the
difference in interventions?
Yes
No
Not clear
4. If no difference was found, was
the sample size large enough
to detect a difference if one existed?
Yes
No
Not clear
5. If a difference was found, are
you confident it was due to the
intervention?
Yes
No
Not clear
Are the findings consistent with
findings from other studies?
Yes
Some
No
ARE THE FINDINGS CREDIBLE?
Yes All
Yes Some
Not clear
No
Clinical Significance
Note any difference in means, r2s, or measures of clinical effects (ABI, NNT, RR, OR)
*Is the target population clearly
described?
Yes
No
Not clear
*Is the frequency, association, or
treatment effect impressive enough
for you to be confident that the finding
would make a clinical difference if used
as the basis for care?
Yes
No
Not clear
ARE THE FINDINGS
CLINICALLY SIGNIFICANT?
Yes All
Yes Some
No
* = Important criteria
Comments
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
APP F-2
Brown
5.4
Article
Effect of High-Intensity Interval
Training on Quality of Life, Sleep
Quality, Exercise Motivation and
Enjoyment in Sedentary People
with Type 1 Diabetes Mellitus
Jesús Alarcón-Gómez, Iván Chulvi-Medrano, Fernando Martin-Rivera and Joaquín Calatayud
Topic Collection
Sports Medicine and Physical Fitness
Edited by
Dr. Ewan Thomas, Prof. Dr. Elvira Padua and Prof. Dr. Ivan Chulvi-Medrano
https://doi.org/10.3390/ijerph182312612
International Journal of
Environmental Research
and Public Health
Article
Effect of High-Intensity Interval Training on Quality of Life,
Sleep Quality, Exercise Motivation and Enjoyment in Sedentary
People with Type 1 Diabetes Mellitus
Jesús Alarcón-Gómez 1 , Iván Chulvi-Medrano 2 , Fernando Martin-Rivera 3, * and Joaquín Calatayud 4
1
2
3
4
*
Discussion 1. How does your cultural background affect how you handle conflict? How might the Christian worldview as a “cultural background” influence the way someone might handle conflict? What suggestions do you find helpful from intercultural communication researchers? Cite any sources used.
Discussion 2. Read sidebar 17.4 in Chapter 17 of your textbook. After reading, respond the following reflection prompts: Identify which of the above areas you would consider an area of strength for you. Do you think it would still be a strength in a cross-cultural setting? Why or why not? Choose one of the items above that you find most difficult and explain what it might take for you personally to grow in this area.
Paper. Revise your 1,000-1,250-word paper that connects specific cultural communication patterns or practices to the history, values, and beliefs of that culture. You should focus on a culture of which you are not a member (e.g., you would not research GCU cultural communication patterns because you are a member of the GCU community). Your paper should integrate five reputable and authoritative sources. The following journal article titles illustrate the variety of patterns or practices that your paper could address:
The Gift and the Common Good: A Chinese and Business Ethics Perspective
Acculturative Family Distancing and Depressive Symptoms Among Latinas: The Role of Intergenerational Cultural Conflict.
Engaging Malaysia: A Grassroots Approach to Inter/Intra-Religious Communication
Impact of Romantic Facebook “Crush Pages” on the Egyptian Youth
The Impact of Covid-19 to Indonesian Education and Its Relation to the Philosophy of “Merdeka Belajar”
This is not an all-inclusive list and you are free to pick any pattern or practice in collaboration with your instructor. Notice that each of these articles addresses a communication issue and links it to cultural distinctiveness. The focus of your paper is to present research on the history, beliefs, and values of a cultural group and give examples of communication patterns or practices that are influenced by these histories, beliefs, and/or values.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Benchmark Information
This benchmark assignment assesses the following programmatic competency and professional standard:
BA in Communication
2.3 Explain how behaviors express cultural norms or values.
General Education Program Information
This assignment assesses the following general education competencies:
Effective Communication
GED2C1: Construct logical, cohesive, and persuasive arguments.
GED2C2: Locate, verify, evaluate, and correctly cite print and electronic resources.
Please write a scholarly paper answering these questions-validated by your research findings. The paper should be 4 to 5 pages in length. Please adhere to APA Format.
Watch the 5-minute TrailerLinks to an external site. for the Unnatural Causes documentary series. In the trailer, the question “Is inequality making us sick?” is posed, and some ideas about how this question might be answered are presented. One overarching theme is whether our health is determined strictly by the genes we are born with or shaped by the social conditions in which we grow and develop and the experiences we have. Discuss some of the ideas presented that help you understand whether and how inequality is making us sick.
On the Unnatural Causes documentary website, go to the “InteractivitiesLinks to an external site.” page. Scroll down to the “Tale of Two Smokers”Links to an external site. activity, which follows Joe and Jill on their journey to quit smoking and lose 20 lbs. Read the introduction page, and then click through each of the “Suggestions to Lower Blood Pressure”, reading Joe and Jane’s responses to each of those suggestions. Watch the graph of their allostatic load change as you go through.
Compare and contrast Joe and Jane’s experiences trying to get healthier.
How do the choices they make depend on the choices they have? In other words, why does it take more than willpower and discipline to change unhealthy habits and behaviors?
Relate this to a health goal you or someone you know have set, and describe some of the challenges and successes you faced due to external factors unrelated to your willpower and discipline.
On the same “Interactivities” page, go to the “Health Equity Quiz” Links to an external site.. Take the quiz.
What was your score, and are you surprised by it?
Which questions were the most surprising or interesting to you?
Discuss at least two things you learned from taking this quiz.
Grading Criteria
See Attached Rubric
Guidelines for ALL Writing Assignments:
As per UNLV second-year seminar requirements, this course has a heavy writing component. There are four major essays (2 pages), two reflection papers about two non-fiction books (4 pages), and a final research paper (4 pages). You are expected to complete every one of these larger assignments and may receive a failing grade if more than 1 is not completed.
Use ESSAY format. No sub-headers or numbered paragraphs.
Use FORMAL writing, not casual as if you are chatting with a friend. No SLANG or Idioms.
Include a DISTINCT Introductory paragraph that tells the purpose of the paper and previews topics to be covered and a Concluding paragraph that summarizes.
DOUBLE SPACE, indent paragraphs 0.5inches, don’t leave extra space between paragraphs, 1 inch margins, size 12 font, either Times New Roman or Arial.
NO title page or Running Header required.
HEADER: 3 lines only, SINGLE-SPACED: Name, Date, Assignment title. Must show on every page; Use “insert header” in Word.
MEET or EXCEED minimum page length requirement. Consider going 1-2 lines onto the next page to be sure you do not lose points.
REFERENCES: Required. Must include all websites required for an assignment and any others you use, Must be academic. Separate page at the end. See APA Module.
IN-TEXT CITATIONS: Required in most paragraphs. NO quotations permitted for this class; Use paraphrasing with citation. See APA Module.
CHECK your Turnitin Similarity score, which should be 20% or less.
EDITING: Spelling, mechanics, word selection (correct use of words), and grammar count. Please proofread your paper carefully.
IF THESE REQUIREMENTS ARE NOT MET, PAPER MAY BE RETURNED TO YOU WITH A ZERO GRADE UNTIL YOU REDO IT. LATE PENALTIES WILL APPLY.
Submitting Your Assignment
When saving your assignment, use: YourLastName_FirstInitial_AssignmentName (ex. Smith_M_Essay#1 What is Public Health).
ASSIGNMENT COVER SHEET
Course name:
Road traffic Injuries & Disability Prevention
Course number:
PHC313
CRN:
Write a short essay to discuss risk factors
associated with road crashes and injury severity in
the Kingdom of Saudi Arabia
Assignment title or task:
(You can write a question)
➢ What is the magnitude of road accidents in
KSA?
➢ What are the main causes and contributory
factors of road crashes in KSA?
➢ What are the interventions applied to reduce
these risk factors?
Student name:
Student ID:
Submission date:
To be filled in by the instructor only
Instructor’s name:
Grade:
…..out of 10
Instructions for submission:
•
•
•
•
•
•
•
•
The assignment must be submitted with a properly filled cover sheet (Name, ID,
CRN, Submission date) in a word document, Pdf is not accepted.
The length of the write-up should be 1 pages’ maximum of 1000 words.
Text size 12-Times New Roman with 1.5-line spacing.
Heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with proper references/sources.
References must be in APA format
Due date 14/oct/2023
There are many data collection processes in healthcare, with many different types of statistics. Utilizing the Hospital Statistics Basics Formulas resource, select 3 different rates, i.e., average daily census and respond to the following:Compare and contrast the different rates and explain why a hospital or healthcare facility needs to collect this data.How are statistical process controls such as Pareto chart are used to improve performance?
Unformatted Attachment Preview
Hospital Statistics Basic Formulae
Formulas for commonly computed healthcare rates and percentages used on the RHIT and RHIA examination
Calculating Rates
The basic formula for calculating rates is the number of times something actually happened/the number of times it
could have happened.
Measures of Central Tendency
Mean:
( ) =
ℎ
ℎ
Median:
The midpoint (center) of the distribution of values, or the point above and below which 50 percent of the values fall.
The median is a data point on the number line.
Mode:
The value that occurs most frequently in the data. The mode appears as a data point on the number line.
Variance:
2 =
Σ(X − ̅ )2
−1
Standard Deviation:
∑( X − x̄ )
= √
(N − 1)
Calculating Census
Average Daily Census:
ℎ ℎ
ℎ
Average Daily Newborn Census:
ℎ
Average Daily Census for a Patient Care Unit:
ℎ ℎ
ℎ
Occupancy Rates
Bed Occupancy Ratio:
Post 2 replies of at least 150 words.For each thread, students must support their assertions with at least 2 scholarlycitations in APA format. Any sources cited must have been published within the last five years.Acceptable sources include your text, a professional journal, a professional or governmentwebsite (such as CDC), and the Bible, etc.
Unformatted Attachment Preview
There are many pros and cons of legalizing marijuana. There are instances and places where
marijuana is legal and it tends to lessen mobs and organized crimes, decrease the load and
inconsistency within the criminal justice system, and it creates profitable revenues within the
economy especially regarding taxation (Farrelly et al., 2023). Individuals who use marijuana
have reported that they are more relaxed, they have less anxiety, and they feel they are more
social around others (Hall, 2020). There are potential harmful effects of the legalization of
marijuana in communities. Regarding the acute harm of marijuana, there is a growth seen in car
and roadway crashes with those under the influence of marijuana, although these crashes are less
than those who have been drinking alcohol (Hall, 2020). Some of the psychological effects
include a person having acute anxiety, heart palpitations, and even manic psychological episodes
(Hall, 2020). When an individual uses marijuana every day, there is the potential likelihood that
they will become dependent on it. People who use marijuana can develop different mental
disorders, begin using other abused substances, and even become violent by displaying antisocial behavior (Hall, 2020). When a person uses marijuana each day over a long period of time,
their chances of contracting a heart condition or even cancer are at a greater risk although it is
significantly less seen in those who use other illicit drugs (Hall, 2020). As far as my opinion on
the legalization of marijuana, I remain on the fence. On one hand, there will always be
individuals who abuse something, but on the other, there are benefits to people who have pain
due to cancer or another underlying illness and this helps them tremendously to keep their pain at
ease. 1 Corinthians 6:12 states, “’All things are lawful for me,’ but not all things are helpful. ‘All
things are lawful for me,’ but I will not be dominated by anything” (English Standard
Version, 2011). We all have standards in which we live, and one thing that might work for one
person, might not work for the next. If nothing controls us, we should be fine and we need to
keep our faith in God strong.
References
English Standard Version. (2011). BibleGateway.com
https://www.biblegateway.com/passage/?search=1+Corinthians+6%3A12&version=ES
VLinks to an external site.
Farrelly, K. N., Wardell, J. D., Marsden, E., Scarfe, M. L., Najdzionek, P., Turna, J., &
MacKillop, J. (2023, May 9). The impact of recreational cannabis legalization on cannabis use
and associated outcomes: A systematic review. Substance abuse: research and
treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10176789/#:~:text=The%20
extant%20literature%20revealed%20mixed,use%20rates%2C%20substance%20use%20r
atesLinks to an external site.
Hall, W. (2020, September). The costs and benefits of cannabis control policies . Dialogues in
clinical neuroscience. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605025/Links to
an external site.
Reply: 150 words
Factors Prompting Legalization
Medical Benefits: One of the primary drivers has been the growing recognition of marijuana’s potential
medical benefits. Research has shown its effectiveness in treating conditions like chronic pain, epilepsy,
and nausea caused by chemotherapy.
Economic Benefits: Legalization has brought economic advantages, including increased tax revenue and
the creation of jobs in the cannabis industry. States have seen substantial tax income from marijuana
sales.
Social Justice: Concerns over the disproportionate impact of marijuana prohibition on minority
communities and the inequities in drug-related arrests have prompted legalization. Some states have
sought to address these disparities through legalization and expungement of prior convictions.
Public Opinion: Changing public attitudes towards marijuana have played a significant role. Many
Americans now view marijuana as less harmful than alcohol and support its legalization.
Negative Consequences:
Health Concerns: Legalization has raised health concerns, particularly about the potential for increased
youth use, addiction, and the long-term health effects of marijuana, especially in high-potency forms.
Traffic Safety: There are concerns about impaired driving under the influence of marijuana, as its
psychoactive effects can impair cognitive and motor skills.
Conflict with Federal Law: Marijuana remains illegal at the federal level, creating legal and financial
challenges for businesses operating in states where it’s legal.
Black Market: Despite legalization efforts, the black market for marijuana still exists, especially in states
with high taxes and strict regulations.
Positive Consequences:
Tax Revenue: Legalization has generated significant tax revenue, which can be used for public programs,
infrastructure, and education.
Reduced Arrests: Legalization has led to a decrease in arrests for marijuana-related offenses, reducing
the burden on the criminal justice system and reducing the impact on individuals with prior convictions.
Job Creation: The cannabis industry has created jobs, from cultivation and distribution to retail and
ancillary services.
Access to Medical Marijuana: Legalization has expanded access to medical marijuana for patients in
need, improving their quality of life.
My personal stance on legalizing marijuana is one of cautious support. I believe in a well-regulated
system that allows adults to make informed choices while protecting public health and safety.
Legalization should be accompanied by comprehensive education campaigns, strict regulations, and
robust monitoring to minimize negative consequences. Additionally, addressing the historical injustices
related to marijuana arrests and convictions is essential.
The decision to legalize marijuana should be made at the state level, allowing for flexibility to address
unique regional concerns. Federal decriminalization or regulation may also be necessary to provide
clarity and consistency across the nation.
Overall, I support the legalization of marijuana when it is approached responsibly and with consideration
of potential consequences, both positive and negative, on individuals, families, and communities.
References
Factors Prompting Legalization:
1.
Pacula, R. L., Jacobson, M., & Maksabedian, E. J. (2016). In the weeds: A baseline view of
cannabis use among legalizing states and their neighbors. The National Bureau of Economic Research.
(https://www.nber.org/papers/w21345)
2.
Substance Abuse and Mental Health Services Administration (SAMHSA). (2020). Key
Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey
on Drug Use and Health.
(https://www.samhsa.gov/data/sites/default/files/reports/rpt29394/2019NSDUHFFRPDFWHTML/2019
NSDUHFFR090120.htm)
Negative Consequences:
1.
National Institute on Drug Abuse (NIDA). (2021). Marijuana.
(https://nida.nih.gov/research-topics/cannabis-marijuana)
2.
National Highway Traffic Safety Administration (NHTSA). (2021). Marijuana-Impaired
Driving: A Report to Congress. (https://www.nhtsa.gov/sites/nhtsa.gov/files/documents/14726marijuana-impaired-driving-report-to-congress.pdf)
Positive Consequences:
1.
Colorado Department of Revenue. (2021). Marijuana Tax Data.
(https://data.colorado.gov/Revenue/Marijuana-Tax-Data/53v2-nd4v)
2.
Anderson, D. M., Hansen, B., & Rees, D. I. (2015). Medical Marijuana Laws, Traffic
Fatalities, and Alcohol Consumption. Journal of Law and Economics, 58(2), 333-369.
(https://www.journals.uchicago.edu/doi/10.1086/682343)
Reply: 150 words
You should respond to at least two of your peers, by extending, refuting/correcting, or adding additional nuance to their posts. Please Add references
CASE STUDY 1
Define osteoarthritis and explain the differences with osteoarthrosis. List and analyze the risk factors that are presented in the case that contribute to the diagnosis of osteoarthritis.
According to Al-Ani (2021), osteoarthritis and osteoarthrosis are used interchangeably and osteoarthrosis is any low-inflammatory arthritic condition that results in degenerative changes. Dlugasch and Story (2023), define osteoarthritis as the inflammation of a joint and osteoarthrosis as the degeneration of a joint. So, the conditions are very similar and used to describe the wear and tear of the joints, however, osteoarthrosis is general deterioration and osteoarthritis is a state of inflammation. The risk factors in this case study are being female and being overweight.
Specify the main differences between osteoarthritis and rheumatoid arthritis, make sure to include clinical manifestations, major characteristics, joints usually affected and diagnostic methods.
According to Mohammed et al. (2020), osteoarthritis and rheumatoid arthritis are both diseases of the joints, however, osteoarthritis is the result from stress over time and rheumatoid arthritis is autoimmune in origin. Rheumatoid arthritis affects small joints and is usually symmetrical while osteoarthritis affects weight-bearing joints and is not symmetrical. Osteoarthritis presents with intense pain that worsens with use and joint stiffness, when the hands are affected, the Heberden and Bouchard nodes are most common, it also presents with crepitus. Diagnosis can be confirmed with a physical exam and range of motion testing. Rheumatoid arthritis can be diagnosed by the antibodies anti-CCP and RF and the presentation of synovitis in multiple joints (Mohammed et al., 2020).
Describe the different treatment alternatives available, including non-pharmacological and pharmacological that you consider are appropriate for this patient and why.
Al-Ani (2021) states that the use of NSAIDs and the intra-articular injections of steroids are beneficial pharmacological methods to relieve pain for patients with osteoarthritis. They also suggest physiotherapy, joint rest, massage, and topical NSAIDs. For this patient, non-pharmacological methods of treatment would be most beneficial including a physical therapy program, weight loss to reduce stress on the joint, and adequate rest to optimize recovery. If NSAIDs are used, the addition of a proton pump inhibitor or histamine 2 blocker may help with GI upset.
How would you handle the patient’s concern about osteoporosis? Describe your interventions and education you would provide to her regarding osteoporosis.
Concern for osteoporosis is appropriate as she has risk factors including advancing age, being postmenopausal, being female and family history (Dlugasch & Story, 2023). It is important to encourage this patient on nutrition such as dietary calcium and vitamin D, incorporating weight-bearing activities in physical activities, and screening for health maintenance.
Case Study Questions
Name the most common risks factors for Alzheimer’s disease
According to Breijyeh and Karaman (2020), Alzheimer’s disease is multifactorial and the most common risk factors are advancing age, genetics, head injuries, vascular disease, infections and environmental factors.
Name and describe the similarities and the differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, Frontotemporal dementia.
According to Dlugasch and Story (2023), Alzheimer’s disease is the most common form of dementia and occurs when healthy brain tissue degenerates. Vascular dementia is the result of any disorder impairing cerebral blood flow. Dementia with Lewy Bodies occurs due to proteins that are found in the brain tissue and affect neurotransmitters. Frontotemporal dementia is a spectrum of disorders and usually occurs sooner than the previous diseases listed. Dlugasch and Story (2023) define dementia as a condition that impairs cognitive skills, motor coordination, and decreases cortical function. Each condition affects memory and behaviors but they differ in the cause.
Define and describe explicit and implicit memory.
Dlugasch and Story (2023) define implicit memory as not involving consciousness and explicit memory as declarative memory which is more factual and involves awareness and consciousness. Explicit memory examples include rules, language, and experiences and examples of implicit memories include unconscious habits or muscle memory.
Describe the diagnosis criteria developed for the Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association
Cummings (2019) states that the National Institute of Aging and the Alzheimer’s Association use the biomarkers amyloid, tau, and neurodegeneration to distinguish Alzheimer’s disease from non-Alzheimer causes of cognitive impairments. Negative biomarkers suggest Alzheimer’s is not present, positive amyloid but negative tau and neurodegeneration suggest preclinical Alzheimer’s, positive amyloid and positive tau but negative neurodegeneration suggest Alzheimer’s diagnosis, positive amyloid and positive neurodegeneration suggest Alzheimer’s with another cause of neurodegeneration and if all three biomarkers are found then Alzheimer’s disease is assumed.
What would be the best therapeutic approach on C.J.
The best approach for patients with Alzheimer’s disease are memory aids such as calendars, physical exercise, safety precautions, maintaining a calm environment, and medications to slow the progression of the disease. Coping strategies are important for caregivers and patients.
CASE STUDY 2
G.J.’s Case Study
Osteoarthritis vs. Osteoarthosis
Osteoarthritis is the inflammation of the joint, while osteoarthrosis is the degeneration of the joint (Dlugasch & Story, 2021). Risk factors of osteoarthritis include joint injury or overuse, increasing age, being female, obesity, genetics, and different races (Centers for Disease Control and Prevention, 2020). The patient is female, overweight, elderly, and family genetics of joint diseases.
Osteoarthritis vs. Rheumatoid Arthritis
Osteoarthritis is a localized joint disease characterized by deterioration of articulating cartilage and bone as well as overgrowth of bone (Dlugasch & Story, 2021). Clinical manifestations are slowly progressing and begins after 40 (Dlugasch & Story, 2021). It could be just one or multiple joints. The main clinical manifestations include joint pain, stiffness, and decreased range of motion (Dlugasch & Story, 2021). Osteoarthritis usually begins in the hands and affects the knees, hip, and spine. Less commonly being the shoulder, ankle, elbow, and wrist. The diagnosis is based on history and physical examination, MRI’s and X-rays are not necessary for diagnosis. With Osteoarthritis, laboratory tests are normal. On the other hand, rheumatoid arthritis is systemic and autoimmune involving many joints. The clinical manifestations are characterized by remissions and exacerbations. The symptoms are usually gradual, progressive, and involve multiple joints. The symptoms include pain and stiffness, and it affects hands (usually knuckles), proximal interphalangeal joints of fingers and thumbs, wrists, joints of toes, elbows, shoulders, ankles, and knees (Dlugasch & Story, 2021). The diagnosis includes history and physical exam and laboratory tests. In Rheumatoid arthritis, antibody tests are positive, erythrocyte sedimentation rate are high, serum and c-reactive protein are high. Synovial fluid analysis will be positive for the rheumatoid factor (Dlugasch & Story, 2021).
Treatment
For this patient, treatment includes nonpharmacological and possible pharmacological methods. Nonpharmacological treatments include physical therapy, weight loss/management, ambulatory aids, and orthopedic devices (Dlugasch & Story, 2021). Due to the patient’s symptoms, these are all necessary and she is also overweight. Pharmacologically, topical analgesics could help this patient. NSAIDS are usually recommended but are not safe anymore knowing the patient’s history. Corticoid steroids could be helpful to reduce inflammation in the joints and could potentially decrease her pain (Dlugasch & Story, 2021). Possible surgery could also be an option to repair or replace damaged joints.
Interventions and Education
To this patient I would explain that osteoporosis is a condition that is a progressive loss of bone strength and low bone quality. This leads to increased risk for fractures. Osteoporosis would be asymptomatic early on and the first indication would be a fracture (Dlugasch & Story, 2021). The fractures occur with little to no trauma. I would let the patient know that as of now, she is not displaying these symptoms and most likely has inflammation or degeneration of her joints which is causing all her discomfort.
H.M.’s Case Study
Risk Factors for Alzheimer’s disease
Alzheimer disease is the most common type of dementia in older adults. Common risk factors include increasing age, family history, and being female (Dlugasch & Story, 2021). Hypertension, hypercholesterolemia, diabetes mellitus, obesity, and a history of traumatic brain injury (TBI) are also potential risk factors (Dlugasch & Story, 2021).
Differences Between Different Dementias
Alzheimer’s dementia is when healthy brain tissues degenerate and atrophies, which causes a progressive decline in memory and mental abilities (Dlugasch & Story, 2021). Vascular dementia is a progressive syndrome that is from any disorder affecting cerebral blood flow (Dlugasch & Story, 2021). Dementia with Lewy bodies is common. It is also a progressive dementia from the buildup of Lewy bodies in the brain. Lewy bodies are proteins, and it affects the cognition, behavior, movement, and sleep of a person (Dlugasch & Story, 2021). Lastly, frontotemporal dementia is a spectrum disorders that leads to focal degeneration of the frontal or temporal lobes. It is commonly s type of early onset dementia, which is before 65. All of the above are alike in the way that they all have a decrease in cortical function, which impairs cognitive skills (Dlugasch & Story, 2021). This includes language, logical thinking, judgement, learning and motor coordination.
Explicit vs. Implicit Memory
Memory can be divided into two categories, which is explicit and implicit. Explicit memory is for factual knowledge and involves awareness and consciousness (Dlugasch & Story, 2021). It is declarative because it is when we consciously recall information like formulas, dates, words, rules and language. Implicit memory does not involve consciousness. This is memory that is autonomic or unconscious by habits and skills. Examples include signing a familiar song, typing on the computer, writing on a piece of paper, and even riding a bike.
Diagnostic Criteria
The diagnostic clinical criteria by the National Institute on Aging and the Alzheimer’s Association includes four key ways. The first is recognizing Alzheimer’s disease progress on a spectrum with three stages. Early, preclinical with no symptoms, middle stage with mild cognitive impairment, and a final stage with many symptoms of dementia (U.S. Department of Health and Human Services, n.d.). Another is to expand the criteria beyond memory loss and recognize other symptoms such as cognition and word finding, which could be impaired first (U.S. Department of Health and Human Services, n.d.). They also state the importance of better understanding the distinctions between Alzheimer’s dementia and non-Alzheimer’s dementia that may influence development, such as vascular disease (U.S. Department of Health and Human Services, n.d.). Lastly, recognizing the potential use of biomarkers, which indicates brain disease. In 2011, the clinical diagnostic criteria were revised to the above.
Therapeutic Approach
Once Alzheimer’s disease is confirmed, there are some therapies that can slow down the progression of the disease. First off, memory aids, nutritional support, physical exercise, cognitive activities, safety precautions, maintaining calm environment, and social interactions can help with the progress of the disease (Dlugasch & Story, 2021). Medications such as donepezil or galantamine can improve neurotransmitter levels in the brain (Dlugasch & Story, 2021). Memantine is specifically approved for the treatment of Alzheimer’s as well. These medications can help manage symptoms and maximize functioning in C.J.
Develop an essay of a minimum of three pages explaining the advocacy efforts of Lillian Wald, public health nurses in urban and rural settings, and nurse practitioners used to effect change in health care.Submission Instructions:Your post should be at least six hundred words, formatted, and cited in the current APA style with support from at least three academic sources. You must submit your writing double-spaced, in Times New Roman, Arial, or Courier New font, with font size 12
In this activity, you will have the opportunity to examine how using critical analysis tools influences your interactions with others. You will also consider how the analysis of your topic might have turned out differently if you looked at it through a different lens. Completing this activity will result in a draft of the reflection section of your project. It also provides an opportunity to obtain valuable feedback from your instructor that you can incorporate into your project submission.
Directions
In this activity, you will work on the second part of the reflection section of your project. You should consider the feedback from your instructor on the previous activities to inform this assignment. Include diverse perspectives from varied sources to support your points. Look to the SNHU Shapiro Library for assistance and consider the sources you have used thus far to support your research. First, you will explain how the analysis of your topic in wellness may have been different if you had used one of the other general education lenses. Then you will explain how critically analyzing wellness affects your interactions with various people.
You are not required to address each item below the rubric criteria, but you may use them to better understand the criteria and guide your thinking and writing.
Specifically, you must address the following rubric criteria:
Integrate reliable evidence from varied sources throughout your paper to support your analysis.
It is important to draw from a more diverse pool of perspectives from varied sources to support the analysis. This is different from the Citations and Attributions rubric criterion.
Reliable evidence from varied sources should be interwoven throughout the paper itself, while citing and attributing sources will be represented as APA in-text citations and a reference list at the end of your work.
You will be evaluated on both criteria.
Explain at least one way in which your analysis might have been different if you had used one of the other general education lenses to analyze your topic.
This should be a brief (3–5 sentences) reflection about how using the language and perspective from a different lens would shift your view of your topic.
Explain how analyzing wellness can help interactions with people with a different viewpoints, cultures, or perspectives.
Think about ways in which a greater awareness of wellness strengthens individual conversations. Consider including an example from your life.
What to Submit
Submit your short paper as a 1- to 2-page Microsoft Word document with double spacing, 12-point Times New Roman font, and one-inch margins. Sources should be cited according to APA style. Consult the Shapiro Library APA Style Guide for more information on citations.
Module Six Activity Rubric
Criteria Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value
Reliable Evidence From Varied Sources Integrates reliable evidence from varied sources throughout the paper to support analysis Shows progress toward proficiency, but with errors or omissions; areas for improvement may include drawing from a more diverse pool of perspectives, using more varied sources to support the analysis, or integrating evidence and sources throughout the paper to support the analysis Does not attempt criterion 30
Different General Education Lens Explains at least one way in which the analysis might have been different if another general education lens was used to analyze the topic Shows progress toward proficiency, but with errors or omissions; areas for improvement may include the use of an alternative general education lens, a clearer explanation of how the analysis might have been different if one of the other general education lenses had been used to analyze the topic, or more support for the explanation Does not attempt criterion 30
Interactions Explains how analyzing wellness can help interactions with people with different viewpoint, culture, or perspective Shows progress toward proficiency, but with errors or omissions; areas for improvement may include connecting the value of critical analysis to interactions with people with a different viewpoint, culture, or perspective or providing a more thorough explanation of how the analysis can help these interactions Does not attempt criterion 30
Articulation of Response Clearly conveys meaning with correct grammar, sentence structure, and spelling, demonstrating an understanding of audience and purpose Shows progress toward proficiency, but with errors in grammar, sentence structure, and spelling, negatively impacting readability Submission has critical errors in grammar, sentence structure, and spelling, preventing understanding of ideas 5
Citations and Attributions Uses citations for ideas requiring attribution, with consistent minor errors Uses citations for ideas requiring attribution, with major errors Does not use citations for ideas requiring attribution 5
Total: 100%
Identify the clinical question and describe each portion of the question.
Population – (introduction section)
Intervention – (in methods section)
Comparison (Methods section)
Outcome – (results discussion and conclusion section)
Time – Not all research studies will have a time component; if time is part of the study include a description. Example: study in place over 6 months.
In your own words, describe the following:
Why was the study done?
How was the study done?
What was found?
How will you apply this information in your practice setting?
Describe your experience after reading the article. How did the use of quantitative research methods meet the needs of the study, study design, and participants?
Below is the article
Comparison of the effectiveness of a 12 step substance use recovery program…: EBSCOhost
You have already completed an Exercise where you learned about the quantitative (numerical) information that is available from the Center for Disease Control and Prevention’s, Behavioral Risk Factor Surveillance System (BRFSS) Prevalence and Trends DataLinks to an external site.. If needed, re-watch the BRFSS tutorial below to remind yourself how to access the data. Then read #1-5 on the BRFSS Frequently Asked Questions (FAQs)Links to an external site. page. Using the BRFSS and any other reputable internet sources, write a 2-page essay that addresses the following:
Briefly describe the purpose of the BRFFS and how it is conducted (from FAQs).
Choose a state other than Nevada. Briefly describe the demographics of the state, including the size of the population.
On the BRFSS Prevalence and Trends DataLinks to an external site. page, choose “Explore BRFSS Data by Location”, and choose your selected state. Select a Class and Topic from the drop down menu to learn about the prevalence of one of the chronic diseases or health indicators available. Provide the Class, Category, most recent year available, and exact question that was asked (available at the top of each graph). If more than one question is available, choose one. (Ex. Chronic Health Indicators, Kidney, Ever told you had kidney disease?)
Explain why this issue is important enough to public health that we have a surveillance question about it. If it is not a disease, such as e-cigarette use, describe what diseases and health outcomes it is related to.
Use the drop down menu options to explore and then discuss the distribution of this disease/health indicator by gender, age group, race/ethnicity, household income, and education attained.
On the BRFSS Prevalence and Trends Data Links to an external site.page, choose “Explore BRFSS data by topic”. Select the same Class, Topic, and question. Look at the map and find out where your selected state falls compared to other states. Which states/regions seem to have the highest and lowest prevalence? Where does Nevada fall?
Discuss why it is important to have this evidence and suggest how a public health expert might use this numerical information.
Grading Criteria
See Attached Rubric.
Guidelines for ALL Writing Assignments:
As per UNLV second-year seminar requirements, this course has a heavy writing component. There are four major essays (2 pages), two reflection papers about two non-fiction books (4 pages), and a final research paper (4 pages). You are expected to complete every one of these larger assignments and may receive a failing grade if more than 1 is not completed.
Use ESSAY format. No sub-headers or numbered paragraphs.
Use FORMAL writing, not casual as if you are chatting with a friend. No SLANG or Idioms.
Include a DISTINCT Introductory paragraph that tells the purpose of the paper and previews topics to be covered and a Concluding paragraph that summarizes.
DOUBLE SPACE, indent paragraphs 0.5inches, don’t leave extra space between paragraphs, 1 inch margins, size 12 font, either Times New Roman or Arial.
NO title page or Running Header required.
HEADER: 3 lines only, SINGLE-SPACED: Name, Date, Assignment title. Must show on every page; Use “insert header” in Word.
MEET or EXCEED minimum page length requirement. Consider going 1-2 lines onto the next page to be sure you do not lose points.
REFERENCES: Required. Must include all websites required for an assignment and any others you use, Must be academic. Separate page at the end. See APA Module.
IN-TEXT CITATIONS: Required in most paragraphs. NO quotations permitted for this class; Use paraphrasing with citation. See APA Module.
CHECK your Turnitin Similarity score, which should be 20% or less.
EDITING: Spelling, mechanics, word selection (correct use of words), and grammar count. Please proofread your paper carefully.
IF THESE REQUIREMENTS ARE NOT MET, PAPER MAY BE RETURNED TO YOU WITH A ZERO GRADE UNTIL YOU REDO IT. LATE PENALTIES WILL APPLY.
Submitting Your Assignment
When saving your assignment, use: YourLastName_FirstInitial_AssignmentName (ex. Smith_M_Essay#1 What is Public Health).
Click the Submit Assignment button.
Click the Choose File button and upload the file.
Click the Submit Assignment button to submit.
Initial Post: Post your group’s Case Study Video. Must Post your group PPT in the Threaded Discussion section, then view and evaluate two peers’ presentations for full credit for the assignment.
Peer Responses: Choose two peers to review their video. Make sure they are peers from two different groups.
Peer Reviews
Each student must respond to two peers’ posts by Sunday at 11:59 PM ET, providing a short explanation with an evidence-based rationale to the statement.
The student may use the required course materials or another scholarly resource. However, the page number of any textbook must be included to receive full credit.
The faculty member will monitor and provide feedback and comments within 48-72 hours.
Students will receive full credit once they have 1) submitted their video presentation and 3) responded to two other students using evidence-based rationale.
Submission Instructions:
Upload your group’s video into Canvas Studio and post it as your initial post. You must post the video in order to view your peers’ posts.
How do I embed Canvas Studio media in a discussion reply in Canvas as a student?Links to an external site.
You should respond to at least two of your peers by reviewing their videos.
All replies must be constructive and use literature where possible.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
the attached file has a powerpoint presentation. I want a presentation similar to this covering all the objectives mentioned in the beginning. the powerpoint must be done in professional way. the content to be explained to the audience I want it in a word document.
Unformatted Attachment Preview
MSN 60625
Organizational and Systems Leadership in Healthcare
Critical Thinking, Problem
Solving, and Decision
Making
Prepared by:
Sakna Habobi 223002424
Shaimaa Al-Sanona 223002556
Areej Al-Rawiliy 223000069
Zahra Albagshi 223000551
Learning Objectives
Following the lecture, students will be able to:
•
•
•
•
•
•
•
•
•
•
•
•
•
Defining the relevant terms
Identify the skills of critical thinking
Identify the levels of critical thinking in nursing and discuss the importance
of critical thinking
Find out what are the characteristics of a critical thinker and how to
improve it
Identify and discuss the traditional problem-solving process
Identify the 4 problem solving stages
Identify the barriers to problem-solving and discuss the reasons behind
them
Discuss the 7 steps of the decision-making
Identify the managerial decision-making models
Compare the decision-making process with the nursing process
Identify the different types of decision-making models
Discuss the style of decision making
Identify the critical elements of decision-making
What Is
Thinking?
Thinking is the way that the
mind makes sense of the
world
Types of Thinking
Critical Thinking
CRITICAL THINKING IS DEFINED AS THE MENTAL PROCESS OF
ACTIVELY AND SKILLFULLY PERCEPTION, ANALYSIS, SYNTHESIS
AND EVALUATION OF COLLECTED INFORMATION THROUGH
OBSERVATION, EXPERIENCE AND COMMUNICATION THAT
LEADS TO A DECISION FOR ACTION.
CRITICAL THINKING IS A MULTIFACETED AND
COMPLEX CONCEPT “BASED ON REASON
AND REFLECTION, KNOWLEDGE, AND
INSTINCT DERIVED FROM EXPERIENCE.”
(CATALANO, 2000)
CRITICAL THINKING SKILLS
1- Observation :The ability to notice and predict
opportunities, problems and solutions.
2- Analysis: The gathering, understanding and
interpreting of data and other information
3- Inference: Drawing conclusions based on
relevant data, information and personal
knowledge and experience.
4- Communication: Sharing and receiving
information with others verbally, nonverbally
and in writing.
.
5- Problem solving :The process of gathering,
analysing and communicating information to
identify and Troubleshoot solutions.
Levels of Critical
Thinking in Nursing
• Basic Critical Thinking
At the basic level of critical thinking
a learner trusts that experts have
the right answers for every problem.
Thinking is concrete and based on a
set of rules or principles
• Complex Critical Thinking
Complex critical thinkers begin to separate
themselves from experts. They analyze and
examine choices more independently. The
person’s thinking abilities and initiative to
look beyond expert opinion begin to change.
A nurse learns that alternative and perhaps
conflicting solutions exist.
• Commitment
The third level of critical thinking is
commitment (Kataoka-Yahiro and Saylor,
1994). At this level a person anticipates
when to make choices without assistance
from others and accepts accountability for
decisions made
What Is The
Characteristics
Of Critical
Thinker?
Characteristics Of
Critical Thinker
Improving
Critical
Thinking
Remember
“No action is performed without critical thinking.”
(Rubenfeld & scheffer, 1999)
How to critically think (in nursing)
https://www.bing.com/videos/search?q=critical+thinking+in+nurs
ing+video&&view=detail&mid=49859D69977468109A9E49859D6
9977468109A9E&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3
Fq%3Dcritical%2Bthinking%2Bin%2Bnursing%2Bvideo%26FORM%
3DHDRSC3
Problem Solving
• “Most people spend more
time and energy going
around problems than in
trying to solve them.”
• Henry Ford
PROBLEM SOLVING
Problem solving is part of decision
making and is a systematic process
that focuses on analyzing a difficult
situation.
• Problem solving always includes a
decision-making step.
Traditional ProblemSolving Process
One of the most well-known and
widely used problem-solving models.
The 4 Stages for
Problem Solving
1. Understanding the challenge
2. Brainstorming
3. Picking the best strategy
4. Deploying the solution
You Can’t Solve a Problem
Using the Same Kind of
Thinking That Created It
In any moment of decision,
the best thing you can do is
the right thing, the next best
thing is the wrong thing, and
the worst thing you can do is
nothing.
Theodore Roosevelt
Do not put a band aid – Solve
the root of the problem
Barriers to Problem Solving
A problem-solving barrier is
something that stops people finding
a successful solution to a problem.
These barriers are often caused by
cognitive blocks – how we think and
feel – as well as by practical social
and physical blocks.
CAUSE BARRIERS TO PROBLEM SOLVING
What Causes These Barriers?
• Decision making can be learned
through life experience, not
everyone learns to solve
problems and judge wisely by this
trial-and-error method because
much is left to chance. Some
educators feel that people are not
successful in problem solving and
decision making because
individuals are not taught how to
reason insightfully from multiple
perspectives.
Step 1: Identify the decision that needs to be made
The 7 steps of the
decision-making
process
• When you’re identifying the decision, ask yourself a few questions:
• What is the problem that needs to be solved?
• What is the goal you plan to achieve by implementing this decision?
• How will you measure success?
These questions are all common goal setting techniques that will ultimately help
you come up with possible solutions. When the problem is clearly defined, you
then have more information to come up with the best decision to solve the
problem
Step 2: Gather relevant information
Gathering information related to the
decision being made is an important step
to making an informed decision. Effective
decision making requires information from
many different sources.
Step 3: Identify alternative solutions
This step requires you to look for many
different solutions for the problem at
hand. When you have collected relevant
information, the next step is searching for
probable solutions to the problems
discovered. There is usually more than one
solution available. This step involves listing
down all the probable solutions for further
consideration.
Step 4: Weigh
the evidence
In this step, according to management experts Phil Higson and Anthony
Sturgess, you’ll need to “evaluate for feasibility, acceptability and
desirability” to know which alternative is best. Managers need to be able
to weigh the pros and cons, then select the option that has the highest
chance of success
There are a few common ways you can analyze and weigh the evidence of
options:
• Pros and cons list
• SWOT analysis
• Decision matrix
Step 5: Choose among
the alternatives
• The next step is to make your final decision. Consider
all of the information you’ve collected and how this
decision may affect each stakeholder.
• Sometimes the right decision is not one of the
alternatives, but a blend of a few different alternatives.
Effective decision-making involves creative problem
solving and thinking out of the box.
Step 6: Take action
• Once the final decision maker
gives the green light, it’s time to
put the solution into action. Take
the time to create
an implementation plan . Then it’s
time to put your plan into action
and monitor progress to determine
whether or not this decision was a
good one.
Step 7: Review
your decision and
its impact (both
good and bad)
• Once you’ve made a decision, you can monitor
the success metrics you outlined in step 1. This is how
you determine whether or not this solution meets
your criteria of success.
• An often-overlooked but important step in the
decision making process is evaluating your decision
for effectiveness. Ask yourself what you did well and
what can be improved next time.
Managerial
Decision-Making
Models
Managerial Decision-Making Models To address the
weaknesses of the traditional problem-solving process, many
contemporary models for management decision making have
added an objective-setting step. These models are known as
managerial decision-making models or rational decisionmaking models.
In the first step
• A problem solvers must identify the
decision to be made, who needs to be
involved in the decision process, the
timeline for the decision, and the goals or
outcomes that should be achieved.
Identifying objectives to guide the
decision making helps the problem solver
determine which criteria should be
weighted most heavily in making their
decision. Most important decisions require
this careful consideration of context.
In step 2
Problem solvers must
attempt to identify as
many alternatives as
possible. Alternatives
are then analyzed
In step 3
Often using some type of SWOT (strengths, weaknesses, opportunities,
and threats) analysis. Decision makers may choose to apply quantitative
decision-making tools, such as decision-making grids and payoff tables
to objectively review the desirability of alternatives
The Nursing Process
• The nursing process, developed by Ida Jean
Orlando in the late 1950s, provides another
theoretical system for solving problems and making
decisions.
Although the process was designed for nursing practice with regard to patient care
and nursing accountability, it can easily be adapted as a theoretical model for
solving leadership and management problems.
Types Of Decision
Making Models
• Rational decision making models
This type of decision making model is
the most common type that you’ll
see. It’s logical and sequential.
When your decision has a big impact
on your team and you need to
maximize outcomes, this is the type
of decision making process you
should use. It requires you to
consider a wide range of viewpoints
with little bias so you can make the
best decision possible.
Intuitive decision
making models
• This type of decision making model is
dictated not by information or data, but by
gut instincts. This form of decision making
requires previous experience and pattern
recognition to form strong instincts.
• There are theorists who suggest that
intuition should always be used as an
adjunct to empirical or rational decisionmaking models. Experienced (expert) nurses
often report that gut-level feelings
(intuition) encourage them to take
appropriate strategic action that impacts
patient outcomes (Payne, 2015), although
intuition generally serves as an adjunct to
decision making founded on a nurse’s
scientific knowledge base
Creative decision making model
The creative decision making model involves
collecting information and insights about a problem
and coming up with potential ideas for a solution,
similar to the rational decision making model.
4 .Decision
Making Styles
1- Authoritative
what decision style is it when: the
leader makes all the decisions without
seeking assistance? May be seen in
emergencies
2-consultative
what decision style is it when: the
leader seeks input and involves
employees before making the decision
yet makes the final decision alone
4 .Decision
Making Styles
3- Joint Decision Making
what decision style is it when: leader and
followers work together to reach a shared
decision. Employees have as much
influence as the leader and everyone has
one vote including the leader
4- Delegative
what decision style is it when: only the
group is involved in the decision, the
leader gives up control over the decision?
May be seen with lunches or floating, and
good for conflict resolution
Critical Elements in Decision Making
1
2
3
4
5
6
Define
objectives
clearly.
Gather data
carefully.
Take the
time
necessary.
Generate
many
alternatives
Think
logically.
Choose and
act
decisively.
SHARED DECISION MAKING
The inclusion of staff nurses in decision making related to
patient care and work methods at the unit and organizational
levels.
Requires nurse leaders and managers to involve staff nurses
in decisions about hiring, scheduling, and performance
evaluations (appraisals), as well as include them in general
unit discussions (Graham-Dickerson et al., 2013).
Nurses engaged in shared decision making are empowered to
provide effective, efficient, safe, and compassionate quality
care and have opportunities for ongoing professional growth
& development (ANA, 2015b).
is a positive factor in job satisfaction and nurse recruitment
and retention
Summary with Problem Solving & Decision Making
There may not always be a problem, but it always involves
selecting one of several alternatives, each of which may be
appropriate under certain circumstances.-Both require critical
thinking1)Problem Solving: diagnosing problem & solving
it2)Decision Making: may or may not be a problem; always
involves choices of alternative solutions.
The inclusion of staff nurses in decision
making related to patient care and work
methods at the unit and organizational
levels.
tps://www.bing.com/videos/search?&q=w
hat+is+the+decision+making&view=detail&
mid=58357EA5BA5652D4EE0E58357EA5BA
5652D4EE0E&FORM=VIRE&form=VDRVRV
&ajaxhist=0
Which of these patient scenarios is most indicative of critical
thinking?
A. Administering pain relief medication according to what was given last
shift
B. Asking a patient what pain relief methods, pharmacological and
nonpharmacological, have worked in the past
C. Offering pain relief medication based on physician orders
D. Explaining to the patient that his reports of severe pain are not
consistent with the minor procedure that was performed
Professional nurses are responsible for making clinical
decisions to?
a. Prove traditional methods of providing nursing care to patients.
b. Take immediate action when a patient’s condition worsens.
c. Apply clear textbook solutions to patients’ problems.
d. Formulate standardized care plans for groups of patients
Which of the following demonstrates a nurse utilizing selfreflection to improve clinical decision making?
a. Uses an objective approach in all situations
b. Obtains data in an orderly fashion
c. Improves a plan of care while thinking back on interventions
performed
d. Provides evidence-based explanations for all nursing
interventions
A new graduate nurse will make the best clinical decisions by
applying the components of the nursing critical thinking model
and which of the following?
a. Drawing on past clinical experiences to formulate standardized
care plans
b. Relying on recall of information from past lectures and textbooks
c. Depending on the charge nurse to determine priorities of care
d. Using the nursing process
The patient appears to be in no apparent distress, but vital signs
taken by assistive personnel reveal an extremely low pulse. The
nurse then auscultates an apical pulse and asks the patient whether
he has any complaints or a history of heart problems.
The nurse is utilizing which critical thinking skill?
a. Interpretation
b.
Evaluation
c.
Self-regulation
d. Explanation
The nursing student can best develop critical thinking
skills by doing which of the following?
a. Studying 3 hours more each night
b. Actively participating in all clinical experiences
c. Interviewing staff nurses about their nursing experiences
d. Attending all open skills lab opportunities
Key Answer
Q1: B
Q3: C
Q5: A
Q2: B
Q4: D
Q6: B
REFERENCES
• 7 Important Steps of the Decision Making Process [2022] • Asana
Each question needs to have individual references Question 1 How can policymakers effectively bridge the gap between economic efficiency and equity considerations when crafting policies related to Social Determinants of Health (SDH)? Question 2 What improvements have recently been made to increase safety and quality awareness and action? What is the difference between quality metrics and performance measures? What are the most important performance and quality metrics on depression treatment?
Please respond to the discussion posts with two reference each .
Unformatted Attachment Preview
Sarah M Roque
Main Discussion Post
My CliftonStrengths
We all should be aware of our strengths. Knowing our strengths will help us understand our
contributions to teams and who should be on the team to compliment us (Rath & Conchie, 2009).
The results of the StrengthsFinder assessment increased my awareness about my talents and strengths.
According to the assessment, the odds that someone has responsibility, connectedness, empathy, relator
and restorative as their top 5 strengths, as I do, are 1 in 33 million (Gallup, 2023).
“People who are especially talented in the Responsibility theme take psychological ownership of what
they say they will do and have commitment to stable values such as honesty and loyalty” (Gallup, 2023).
My talents of connectedness and empathy help me sense the feelings of people and provide safe spaces
where they can be vulnerable. Being talented in the relator and restorative themes helps me use my
problem-solving skills to help others identify their goals. My sense of responsibility drives me to provide
unwavering support to my commitments to others.
Strengthening core values, strengths and characteristics
Being considerate, caring and accepting of others are part of my core values. I value diversity and each
person’s unique talents and skills. I would like to strengthen these values and my ability to connect with
others to help build bridges among people so that they can connect with their similarities and appreciate
their differences. I also want to strengthen my ability to relate to and with others in the development of
genuine relationships that fosters trust and confidence that inspires risk-taking.
Most of my talents are in the realms of executing and relationship building. According to Raso (2019)
most relational or positive leaders practice genuineness, trustworthiness, reliability, connectedness.
Transformational leadership in particular, has been most strongly correlated with job satisfaction and
improved employee work performance and transformational leaders have been characterized as
charismatic and confident. Though I can be charismatic and funny, I am not naturally a charismatic or
motivational person. I would like to develop and strengthen either or both of those characteristics so
that I can practice transformational leadership more effectively.
Reference
Gallup (n.d.). Strengths Insight Guide; Sarah roque 87631433. CliftonStrengths Assessment. Gallup Press,
2006-2012.
Raso, R. (2019). Be you! Authentic leadership. Nursing Management (Springhouse), 50 (5), 18-25. doi:
10.1097/01.NUMA.0000557619.96942.50.
Rath, T., & Conchie, B. (2009). Strengths based leadership: Great leaders, teams, and why people follow.
Gallup Press.
Initial Post -Blair Tomsheck
The five categories that were the most dominant in my assessment are the following: futuristic,
discipline, context, relator, and responsibility. It is interesting to me how they build into one another.
Looking at the future excites me and gives me the energy to continue and push forward into tomorrow.
But my future needs to be orderly, planned, and slightly predictable. I strive for timelines and deadlines
to reach my goals. Within this discipline also comes a sense of needing to control things. Having a
routine and that sense of control negates the messiness of this future-focused life. The regulator in my
relationships brings on greater trust and intimacy among them. My genuine need for closeness means
being vulnerable at the same time. That is what helps me to connect. And finally, the need for my
responsibility to do as I say and say as I do. There are no excuses or rationalizations. There is only doing
the right thing. Realizing these five traits is insightful to my need to set boundaries and allow myself the
recognition to take on only what I can handle. (Rath, 2007)
Two core values that I would like to hold on to for the rest of my professional career are the ability to
network with all kinds of people and stay true to my given word. Your relationships with your partners
are the core of building better communities, more resilient people, and a general sense of hope in
humanity.
Two strengths that I want to continue molding are the ability to keep a disciplined schedule and being
excited for the future. Being a forward-thinking atmosphere creates a culture. Clearly understood visions
and missions bring other ways of finding solutions, not excuses. (Broome & Marshall, 2021)
Two characteristics I would like to strengthen include setting boundaries and needing control. Having
a better understanding of when to hold on tight and when to let it go is a leadership skill. Refining that
skill includes striving for goals but realizing it is only sometimes achievable. (Ntoumanis & Sedikides,
2018).
References
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to
influential leader (3rd ed.). New York, NY: Springer.
Ntoumanis, N., & Sedikides, C. (2018). Holding on to the Goal or Letting It Go and Moving On? A
Tripartite Model of Goal Striving. Current Directions in Psychological Science, 27(5), 363–368.
https://doi.org/10.1177/0963721418770455
Rath, T. (2007). Strengths Finder 2.0 – with Access Code.
Respond to discussion in 250 words or more. Must be in APA Format 7th edition and must include 2 scholarly resources published within the past 5 years.
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
For this discussion, please locate an example of a client that has ODD or Conduct Disorder. This example could be from a film, TV show, documentary, case example you find online, or other places. Do not include a real client someone you work with.
Provide a summary of the experience of the client, symptoms, signs.
How does this impact the client’s life, relationships, and well-being?
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.
All peer responses are due by Sunday at 11:59 pm CT.
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
There are multiple challenges to address mental health in rural areas. This discussion activity will give you the opportunity to examine some of these challenges in more detail.
For this discussion question choose one of the FAQ’s listed on this website:
RHIHub (2021). Rural Mental HealthLinks to an external site.. Rural Health Information Hub.
Then provide your responses to the following directives:
State the question and details provided on this website or other online resources.
Then provide an answer to the question in your own words.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.
All peer responses are due by Sunday at 11:59 pm CT.
Please see attached assignment and instructions. I have completed the first part of the assignment. The plan portion needs to be completed with references.Thank you
Unformatted Attachment Preview
Encounter date: 9/28/2023
Patient Initials: A.H Gender: Male Age: 16 Race: Black/African American Ethnicity: Black
Reason for Seeking Health Care: “There is person following me trying to hurt me”
HPI: A.H is a 16-year Black biological male that was admitted to Citrus Crisis Unit via
Professional Certificate from home after stating “There is a person following me trying to hurt
me” Patient’s mother stated he has not been taking his medication for over 6 weeks now. He has
been very erratic and easily agitated, “picking fights with his siblings”. Upon interview patient
states it started about one week ago when she stopped taking his medication. A.H has been
seeing this “black male figure for about a week now”. Patient reports “I am homeless there is a
person who is watching me”. He reports that this person told him that he was going “to kill him
and his family”. He reports that it was a black male who was coming around him and his friend
following him and his friends. He reports that this person has a tracker to find out where he is to
hurt him. It last about 45 minutes couple of times a day mostly at night. He states “I just tried to
defend myself. I think the medication is not working”. To alleviate his symptoms, he admits to
smoking marijuana and playing video games like Fort Nite and Call of duty and just “go to my
room and nobody bother me”. Mother expressed concerned about his son’s safety and brought
him to Crisis Unit.
SI/HI: Patient denies any Suicide or Homicide Ideation at this time
Sleep: Pt reports sleeping “okay” about 5hrs a night
Appetite: Pt reports good appetite ate his
breakfast this morning
Allergies(Drug/Food/Latex/Environmental/Herbal): Pt. denies any allergies to drug, food, latex.
Environmental or herbal allergies.
Current perception of Health:
Psychiatric History:
Excellent
Good
Fair Poor
Inpatient hospitalizations:
Diagnoses
Date
Hospital
June 2023
Kendall Regional
Schizophrenia
5 days
Outpatient psychiatric treatment:
Diagnoses
Length of Stay
Date
Hospital
June 2023
Baptist Health
Date
Length of Stay
Hospital
Schizophrenia
Follow-up/ psychiatric management
Detox/Inpatient substance treatment:
Diagnoses
Length of Stay
Not Applicable
History of suicide attempts and/or self injurious behaviors: No history of self-injurious behavior in the
past
Past Medical History
• Major/Chronic Illnesses: None reported
• Trauma/Injury: None reported
• Hospitalizations: None reported
Past Surgical History: None reported
Current psychotropic medications:
Zyprexa 2.5 mg PO QHS
Current prescription medications:
None reported
OTC/Nutritionals/Herbal/Complementary therapy: None reported
Substance use: (alcohol, marijuana, cocaine, caffeine, cigarettes)
Substance
Amount
Frequency
Length of Use
Marijuana
“1 joint”
everyday
Reports for about 6 months
Family Psychiatric History:
Mother: Alive; no health concerns
Father: alive; dx of HTN and High cholesterol
Maternal Grandmother: alive; dx of HTN, DM and arthritis
Maternal grandfather: Deceased at age 89 of stroke
Paternal Grandmother: Alive; unknown health diagnosis
Paternal grandfather: Alive; hx of Bipolar and major depression.
Social History
Lives: Single family House Marital Status: Single
Education: Student, highest level of education 8th grade
Employment Status: stuent Current/Previous occupation type: Not applicable
Exposure to: ___Smoke____ ETOH ____Recreational Drug Use: Marijuana 1 joint per
day
Sexual Orientation: Heterosexual Sexual Activity: Denies Contraception Use: Reports
no use
Family Composition: Lives with mother and maternal grandmother and 2 siblings one
10year old sister and a 5year old boy. His father lives there for about 4 days a week. He is
there “sometimes not all the time”
Other: (Place of birth, childhood hx, legal, living situations, hobbies, abuse hx,
trauma, violence, social network, marital hx: A.H was born and raised in Miami FL.
Lives with mother, maternal grandmother and two siblings. His father is couple of days a
week with them but doesn’t really “care about me”. He enjoys playing video games like
Fort Nite and Call of Duty and be in my room by myself.
Health Maintenance
Screening Tests: Mammogram, PSA, Colonoscopy, Pap Smear, Etc: Not applicable
Exposures: Not applicable
Immunization HX: Update as per mother’s report
Review of Systems:
General: Denies any fatigue, unintended weight loss or gain.
HEENT: Denies trauma or headaches Eyes denies eye pain and visual loss. Ears: ear discharge
and ear pain. Nose: denies having a stuffy nose and nasal congestion. Throat: denies soreness
and hoarseness.
Neck: Denies any nodules or difficulty swallowing. Denies any pain and stiffness.
Lungs: Denies any shortness of breath, coughing, sneezing, and wheezing.
Cardiovascular: Denies any palpitations or chest pains
Breast: Denies any lumps or discharge
GI: Denies any nausea, vomiting or diarrhea.
Male/female genital: Deferred
GU: Denies any hematuria, dysuria, or urinary retention
Neuro: AAOX3. Denies any dizziness.
Musculoskeletal: Denies muscle, joint, or back pain and stiffness
Activity & Exercise: Reports mostly staying in his room playing video games.
Psychosocial: Admits to mostly isolating himself
Derm: denies any lesions or rashes.
Nutrition: Reports good appetite
Sleep/Rest: Reports sleep “okay” 5 hours a niht
LMP: not applicable
STI Hx: Denies any history
Physical Exam
BP 121/83 T; 98.7 HR: 96 RR: 16 Ht. 5’10 Wt. 136lbs BMI (percentile) 19.5
General: Appears well nourished, well developed male
HEENT: deferred
Neck: deferred
Pulmonary: deferred
Cardiovascular: deferred
Breast: deferred
GI: deferred
Male/female genital: deferred
GU: deferred
Neuro: AAOX3
Musculoskeletal: Normal range
Derm: deferred
Psychosocial: denies any suicide or homicide ideations
Misc.
Mental Status Exam
Appearance: Casual, good hygiene, appears stated age
Behavior: Calm and cooperative observed being argumentative, defiant, and overall oppositional;
minimizes
Speech: Clear and comprehensible, with normal tone and rate
Mood: “I’m okay”
Affect: Constricted
Thought Content: No delusions and/or mental preoccupations elicited/noted. Presents somewhat
paranoid and pessimistic.
Thought Process: no evidence of disorganization.
Cognition/Intelligence: Fair
Clinical Insight: limited to poor.
Clinical Judgment: limited to poor.
Significant Data/Contributing
Dx/Labs/Misc.
Denies
any suicide or homicidal ideation
Denies any visual or auditory hallucinations at time of interview
Plan:
Differential Diagnoses
1.
2.
Principal Diagnoses
1. Schizophrenia
2. Cannabis use disorder
Plan
Diagnosis #1
Diagnostic Testing/Screening:
Pharmacological Treatment:
Non-Pharmacological Treatment:
Education:
Referrals:
Follow-up:
Anticipatory Guidance:
Diagnosis #2
Diagnostic Testingg/Screenin:
Pharmacological Treatment:
Non-Pharmacological Treatment:
Education:
Referrals:
Follow-up:
Anticipatory Guidance:
Step 1: You will use the Graduate Comprehensive Psychiatric Evaluation Template Download Graduate Comprehensive
Psychiatric Evaluation Templateto:
1. Compose a written comprehensive psychiatric evaluation of a patient you have seen in the clinic.
2. Upload your completed comprehensive psychiatric evaluation as a Word doc. Scanned PDFs will not be
accepted
3. Please remember your History of Present Illness (HPI) should tell a story about your patient Includes the
presenting problem and the 8 dimensions of the problem (OLD CARTS – Onset, Location, Duration, Character,
Aggravating factors, Relieving factors, Timing and Severity). The HPI and history should support the patient’s
DSM5-TR diagnosis at all times.
SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan.
S=
Subjective data: Patient’s Chief Complaint (CC); History of the Present Illness (HPI)/ Demographics; History of the Present Illness (HPI) that
includes the presenting problem and the 8 dimensions of the problem (OLDCARTS or PQRST); Review of Systems (ROS)
O=
Objective data: Medications; Allergies; Past medical history; Family psychiatric history; Past surgical history; Psychiatric
history, Social history; Labs and screening tools; Vital signs; Physical exam, (Focused), and Mental Status Exam
A = Assessment: Primary Diagnosis and two differential diagnoses including ICD-10 and DSM5 codes
P=
Plan: Pharmacologic and Non-pharmacologic treatment plan; diagnostic testing/screening tools, patient/family teaching, referral, and follow
up
Other: Incorporate current clinical guidelines NIH Clinical GuidelinesLinks to an external site. or APA Clinical
GuidelinesLinks to an external site., research articles, and the role of the PMHNP in your evaluation.
•
•
Psychiatric Assessment of Infants and ToddlersLinks to an external site.
Psychiatric Assessment of Children and AdolescentsLinks to an external site.
Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.Case Study 1 & 2 topics change every semester. Topics will be determined at due time for this semesterThe answers must be in your own words with reference to the journal or book where you found the evidence to your answer. Do not copy-paste or use a past students work as all files submitted in this course are registered and saved in turn it in program.Turn it in Score must be less than 25 % or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25 %. Copy-paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.All answers to case studies must-have reference cited in the text for each answer and a minimum of 2 Scholarly References (Journals, books) (No websites) per case Study
Unformatted Attachment Preview
Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition
Iron-Deficiency Anemia
Case Study
A 72-year-old man developed chest pain whenever he was physically active. The pain ceased on
stopping his activity. He has no history of heart or lung disease. His physical examination was
normal except for notable pallor.
Studies
Electrocardiogram (EKG), p. 485
Chest x-ray study, p. 956
Complete blood count (CBC), p.
156
Red blood cell (RBC) count, p.
396
RBC indices, p. 399
Mean corpuscular volume
(MCV)
Mean corpuscular hemoglobin
(MCH)
Mean corpuscular hemoglobin
concentration (MCHC)
Red blood cell distribution width
(RDW)
Hemoglobin (Hgb), p. 251
Hematocrit (Hct), p. 248
White blood cell (WBC) count, p.
466
WBC differential count, p. 466
Result
Ischemia noted in anterior leads
No active disease
Platelet count (thrombocyte
count), p. 362
Half-life of RBC
Liver/spleen ratio, p. 750
Spleen/pericardium ratio
Reticulocyte count, p. 407
Haptoglobin, p. 245
Blood typing, p. 114
Iron level studies, p. 287
Iron
Total iron-binding capacity
(TIBC)
Transferrin (siderophilin)
Transferrin saturation
Within normal limits (WNL) (normal: 150,000–
400,000/mm3)
26–30 days (normal)
1:1 (normal)
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
Choose a case from textbook, Chapter 4.
Analyze the case using several concepts from relational theories.
How do these theories help you understand your client(s)?
Discuss the limitations of these theories.
OR
Compare and contrast several of the defense mechanisms discussed in this chapter, and how they impact the clients ability to change.
What defense mechanisms have you used?
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.
All peer responses are due by Sunday at 11:59 pm CT.
Estimated time to complete: 1 hour
Search entries or author Filter replies by unreadUnread Collapse replies Expand replies
Research online and find a recent medical error that made the news in the USA. Answer the following questions.What happened in the incident?Who was involved?What were the ramifications for the patient and/or staff?Reflect on the incident and think about some causes and possible interventions that could have prevented the error.-Using your own words, answering all the questions completely. Use one scholarly source. APA format for in-text citations and list of references.
Specifically, you must address the following rubric criteria:Describe how exploring your research question improved your understanding of the historical roots of your current event.How did learning more about the subject of your research question help you identify events from the past that contributed or led up to your current event?Explain how biased perspectives influence what is known about both your historical and current events.Support your points with relevant course resources.Propose how the narrative about your historical event might change if it were told from a missing perspective.Refer to the missing perspective you identified in this week’s discussion. How might this point of view change the story about your historical event? For example, would the narrative focus on different details, or would those details be interpreted differently?Propose how the narrative about your current event might change if it were told from a missing perspective.Expand on the missing perspective from criteria three and apply it to your current event. How might your current event be understood differently by examining it from that perspective?ANSWER EACH QUESTION
Identify
the topic you chose to explore:
· Describe how exploring your
research question improved your understanding of the historical roots of your
current event.
· Explain how biased perspectives
influence what is known about both your historical and current events.
· Propose how the narrative about
your historical event might change if it were told from a missing perspective.
·
Propose how the narrative about
your current event might change if it were told from a missing perspective.
·
Unformatted Attachment Preview
HIS 100 Module Two Activity Template: Historical Research Question
This activity is your last chance to choose a topic. Topic changes may be based on your research
or instructor feedback. Then write a historical research question that addresses an aspect of
your finalized topic. Replace the bracketed text below with your responses.
Non-graded portion:
• List your historical research topic here:
o Philippine Revolution
Graded portion:
• Write a clear, relevant, and focused research question about your finalized topic.
• The research question I have formulated is “How did the Philippine Revolution of 1896 impact
the quest for national independence and sovereignty, and what are the enduring lessons it
offers for contemporary global movements for self-determination, human rights, and
nationalism?”. This question is a comprehensive and multifaceted inquiry into the Philippine
Revolution and its enduring significance. First, the question explores the historical impact of the
Philippine Revolution. This part of the question recognizes the significant contribution the
uprising made to the Philippines’ desire for freedom and democracy. In order to fully
understand how the rebellion changed the trajectory of Philippine history, academics need to
dive into the particular actions, plans, and results of the uprising.
• The inquiry’s second goal is to compare the past and present. The question inquiries about the
enduring lessons that the Philippine Revolution offers to contemporary global movements for
self-determination, human rights, and nationalism. This feature acknowledges how historical
occurrences have influenced contemporary political and social trends and ideas (Zhou, 2023). It
urges academics to investigate how the ideas and lessons of the Philippine Revolution might
guide and motivate today’s conflicts across the world towards equality, liberty, and autonomy.
• This approach of structuring the research question invites a comprehensive investigation of the
subject. Researchers need to consider the social, political, monetary, and social components of
the rebellion and its consequences. They would likewise be provoked to investigate the
verifiable setting of the upset, including colonial dynamics between Spain and the Philippines.
Furthermore, the question invites a comparative analysis between the Philippine Revolution and
other historical and contemporary movements for independence and human rights, facilitating a
broader understanding of global history and politics.
•
•
Explain how another person’s beliefs, assumptions, and values may lead that person to create a
different question than you.
Individuals’ beliefs can significantly influence the questions they pose about historical events. In
the context of the Philippine Revolution, someone with a pro-colonial perspective may believe
that Spanish colonialism positively impacted the Philippines. This belief might stem from the
idea that colonial powers introduced infrastructure, education, and certain aspects of Western
culture. Consequently, their research question may reflect this perspective, asking, “What were
the positive contributions of Spanish colonialism to the Philippines?”. This question is rooted in
the belief that there have been some redeeming qualities to colonial rule, and it seeks to
explore and highlight these potential benefits. The question may lead to research focusing on
•
•
•
•
•
•
aspects such as architecture, language, or legal systems influenced by Spanish colonialism,
aiming to demonstrate its positive impact.
Assumptions
Assumptions play a crucial role in shaping the landscape of research questions, exerting a
substantial influence on the trajectory and scope of inquiry. For instance, consider an individual
who assumes that the United States’ intentions during the Philippine-American War were driven
solely by benevolence. This assumption could give rise to a specific research question like “To
what extent did the intervention of the United States contribute to the modernization and
development of the Philippines?” This question presupposes that the primary outcome of US
intervention was the modernization and development of the Philippines. As a result of this
assumption, the ensuing research may heavily emphasize the economic and infrastructural
transformations ushered in by American rule in the Philippines. However, it may inadvertently
downplay or overlook other significant facets of this historical context, such as the resistance
movements and the formidable challenges faced by Filipinos during that tumultuous period. It is
essential to recognize that assumptions can act as guiding forces in research, shaping the
framing of questions, the selection of methodologies, and the interpretation of findings.
Therefore, researchers need to remain vigilant about the assumptions that underlie their
investigations, acknowledging the potential impact of these assumptions on the depth and
breadth of their scholarly pursuits. This would help researchers strive for a more comprehensive
and balanced understanding of complex historical events and phenomena.
Values
Values play a crucial role in shaping the formulation of research inquiries, as they mirror
personal priorities and ethical beliefs. An individual who deeply appreciates historical narratives
centred on resistance, liberation, and the amplification of oppressed voices may ask, “What
were the pivotal strategies and sacrifices undertaken by Filipino revolutionaries in their
relentless pursuit of independence during the Philippine Revolution?”. This inquiry encapsulates
a profound commitment to acknowledging and commemorating the endeavours of those who
ardently strove for liberty. The question steers the course of research toward a deep exploration
of Filipino revolutionaries’ experiences, motivations, and sacrifices, thereby spotlighting their
invaluable contributions to the nation’s historical tapestry. Such a line of inquiry could lead to indepth investigations into the pivotal roles played by iconic figures such as Andres Bonifacio and
Emilio Aguinaldo in the unfolding of this historic revolution.
In conclusion, the research question is a robust and multifaceted inquiry into the Philippine
Revolution and its enduring significance. This question is designed to encourage a
comprehensive examination of the topic, encompassing its historical importance and relevance
to contemporary global issues. By exploring the historical impact of the Philippine Revolution,
researchers can delve into the specific events, strategies, and outcomes that shaped the
Philippines’ path to independence and sovereignty (Mendez, 2023). This historical analysis
provides a deep understanding of how the revolution altered the course of Philippine history
and challenged colonial dynamics with Spain.
Furthermore, the question invites researchers to draw connections between the past and the
present. It highlights the Philippine Revolution’s enduring lessons to contemporary global
movements for self-determination, human rights, and nationalism. This aspect acknowledges
the relevance of historical events in shaping modern socio-political movements and ideologies.
It encourages researchers to explore how the principles and experiences of the Philippine
Revolution can inform and inspire present-day struggles for freedom, justice, and selfdetermination worldwide.
•
In addition, beliefs, assumptions, and values play significant roles in shaping research questions.
Individuals’ beliefs can lead to questions that reflect their perspectives, assumptions can guide
research direction, and values can influence the choice of topics and emphasis in historical
inquiry. Therefore, researchers need to remain aware of these influences to ensure a balanced
and comprehensive understanding of complex historical events.
•
•
•
References
Mendez, J. R. (2023). Monumentalizing Memories, Memorializing Monuments: Rizal Park and
American Colonial Philippines, 1898-1946 (Doctoral dissertation, Tokyo University of Foreign
Studies).
Zhou, Z. (2023). Producing the Meaning of An Asianist Revolution: Images of Revolutionaries in
the 1899 Sino-Japanese Joint Aid to the Philippine Revolution. The Columbia Journal of Asia,
2(1), 76–91.
o
HIS 100 Module Two Activity Template: Primary and Secondary Sources
Replace the bracketed text below with your responses.
Non-graded portion:
• List your historical research topic here:
o Philippine Revolution
Graded portion:
Distinguish between primary and secondary sources.
• Primary sources are firsthand or original documents, artifacts, or records created during the
event or period under study. They provide direct insight into the subject matter without
interpretation or analysis. Examples include letters, diaries, photographs, and official documents
from the time in question (Renjith et al., 2021). Secondary sources, on the other hand, are
created after the fact and are interpretations or analyses of primary sources or events. They are
typically written by scholars, historians, or researchers and involve interpretation, synthesis, and
analysis. Examples include history books, research articles, and documentaries.
• Primary sources aim to capture and document individuals’ or entities’ immediate experience,
thoughts, and reactions at a specific time. They offer a raw, unfiltered view of historical events.
In contrast, secondary sources seek to analyze, interpret, or provide context to primary sources
or historical events. They often aim to synthesize information, draw conclusions, or present a
broader perspective.
• Primary sources are created contemporaneously with the events they describe. They provide a
snapshot of a specific moment in history, while Secondary sources are produced after the
events they discuss, allowing for hindsight, analysis, and a broader historical context.
• While primary sources can offer a direct perspective, they may also reflect the biases, opinions,
and limitations of the individuals or entities that created them. Secondary sources may be more
objective as they often involve critical analysis and synthesis of multiple primary sources.
However, they can still be influenced by the biases and interpretations of the author.
• In primary sources, examples include personal letters, speeches, newspaper articles from
the time, photographs, original manuscripts, and eyewitness accounts, while in secondary
sources, examples encompass history books, biographies, documentaries, research
articles, and scholarly analysis of historical events.
Explain why it is important to consult a variety of sources when conducting historical research. Include
specific details and examples.
• Consulting a variety of sources is crucial in historical research for several reasons. First, it helps
corroborate information and establish data reliability (García-Milon et al., 2020). For instance,
primary sources like Emilio Aguinaldo’s memoirs can offer personal insights while studying the
Philippine Revolution. However, cross-referencing them with secondary sources like academic
articles can verify the historical accuracy of events and perspectives. Second, a range of sources
allows for a more comprehensive understanding of the topic. In the case of the Philippine
Revolution, using newspapers, photographs, official documents, and oral histories alongside
scholarly analyses provides a multifaceted view of the period. Third, it helps mitigate bias and
subjectivity. The author’s perspective can influence historical accounts, so consulting sources
with differing viewpoints ensures a more balanced interpretation. Ultimately, diverse sources
enrich historical research by providing a holistic, well-rounded perspective on the past.
1
Identify one primary source that would help investigate your research question (include the title,
author, and link to the source).
• One primary source that would be valuable for investigating the research question “How did the
Philippine Revolution of 1896 impact the quest for national independence and sovereignty?” is
the book titled “The Philippines: A Past Revisited” by Mente & Valila.
file:///C:/Users/User/Downloads/s41599-023-01911-8.pdf. This book is a comprehensive
examination of Philippine history and provides insights into the historical context and events
surrounding the revolution. It can offer direct information and perspectives from the time
period, aiding in a deeper understanding of the revolution’s impact.
Identify one secondary source that would help investigate your research question (include the title,
author, and link to the source).
• One secondary source that would contribute to the investigation of the research question is the
article titled “Reading Rizal: Wilhelm Tell and texts of revolution in the colonial Philippines” by
Wirth, published in Postcolonial Studies.
https://www.tandfonline.com/doi/full/10.1080/13688790.2021.2018774?scroll=top&needAccess
=true&role=tab. This article delves into the role of literature and texts in the context of the
Philippine Revolution. It offers a scholarly analysis of how revolutionary ideas were
disseminated and discusses the impact of these texts on the revolution. This secondary source
can provide critical insights into the intellectual and ideological aspects of the revolution.
Choose a current event related to the subject of your historical research question and explain how they
are connected.
• A contemporary event linked to the themes of the Philippine Revolution is the ongoing struggle
for self-determination and human rights among marginalized communities in various parts of
the world. For instance, the Indigenous rights movement in Canada, particularly the protests
the construction of pipelines through Indigenous lands, resonates with the historical quest for
autonomy during the Philippine Revolution. Both movements share common goals of asserting
their land, resources, and self-governance rights, challenging historical injustices, and striving for
recognition and equality. The connection lied in the shared pursuit of sovereignty, human rights
and social justice, with the lessons from the Philippine Revolution offering inspiration and
guidance for contemporary global movements advocating for self-determination and equality.
References
García-Milon, A., Juaneda-Ayensa, E., Olarte-Pascual, C., & Pelegrín-Borondo, J. (2020).
Towards the smart tourism destination: Key factors in information source use on the
tourist shopping journey. Tourism management perspectives, 36, 100730.
Mente, T. J. B., & Valila Jr, J. R. (2022). The Philippines: A Past Revisited.
file:///C:/Users/User/Downloads/s41599-023-01911-8.pd
2
Renjith, V., Yesodharan, R., Noronha, J. A., Ladd, E., & George, A. (2021). Qualitative methods
in health care research. International journal of preventive medicine, p. 12.
Wirth, C. (2023). Reading Rizal: Wilhelm Tell and texts of revolution in the colonial Philippines.
Postcolonial Studies, 26(2), 259-278.
https://www.tandfonline.com/doi/full/10.1080/13688790.2021.2018774?scroll=top&needAccess
=true&role=tab
3
HIS 100 Module Three Activity Template: Historical Context
Replace the bracketed text below with your responses.
Identify the topic you chose to explore:
•
Philippine Revolution
Describe the historical context surrounding your historical event.
The culmination of the 19th century in the Philippines saw significant transformations in the
domains of culture, politics, and the economy. These changes laid the groundwork for the
subsequent period of turmoil, often referred to as the Philippine Revolution. From the 16th
century forward, the Philippines came under the governance of Spanish powers. The Philippines
were under the control of Spanish colonial authority for around three centuries. The British
administration exploited the indigenous population, engaging in unjust treatment and doing
acts of wrongdoing against them. The Filipino populace harbored significant discontent, driven
by their desire for independence from Spanish colonial rule and the autonomy to choose their
trajectory. The formation of the Katipunan, a clandestine organization, was a direct
consequence of the prevailing discontentment, driven by the objective of liberating the
Philippines from Spanish colonial domination. The Katipunan was an organization established
by prominent figures like Andres Bonifacio and Emilio Aguinaldo with the primary objective of
mobilizing Filipinos towards a unified aspiration: attaining independence (CuUnjieng, 2019).
During the latter part of the 19th century, there was a noticeable increase in the
significance of nationalism within global political landscapes. The rebels in the Philippines were
cognizant of the impact that the increasing prevalence of democracy, freedom, and individual
agency had on their circumstances. They drew inspiration and derived ideas from these
rebellions throughout their liberation struggle. The Spanish colonial administration in the
Philippines implemented authoritative economic measures upon conquering the archipelago.
The Spanish implemented a series of stringent taxation measures, compulsory labor practices,
and economic regulations upon the indigenous populations of the Americas, primarily to
bolster the Spanish monarchy’s financial interests (Mente & Valila, 2022). The grievances
expressed by individuals over their economic circumstances became a significant catalyst for
the subsequent transformation.
Describe a key historical figure or group’s participation in your historical event.
During the Philippine Revolution, notable individuals such as Andres Bonifacio and Emilio
Aguinaldo emerged as prominent figures. Both individuals significantly contributed to the
struggle for Philippine independence and achieved notable accomplishments. Bonifacio hailed
from a socioeconomically disadvantaged background but establishing the Katipunan in 1892
was a pivotal juncture that fostered unity among Filipinos across many social strata in their
collective pursuit of emancipation. The initiation of the shift was only possible with the
individual’s charismatic demeanor and exceptional capacity to influence others. When Emilio
Aguinaldo took over as president, the First Philippine Republic was also created (Zhou, 2023).
The Katipunan rebellion’s success was greatly aided by Bonifacio’s leadership. The efficacy of
the rebels may have been greatly increased if they had better leadership and organization. The
Katipunan was a covert group that stressed unflinching commitment to the cause of Philippine
independence, no matter the cost to one’s own well-being. They were distinguished by complex
initiation rites and a predetermined set of ethical ideals. The covert group was crucial in
organizing the Filipino people to oppose the oppressive policies put in place by the colonial
government.
Explain the key historical figure or group’s motivation to participate in your historical event.
The ideologies, objectives, and principles held by Bonifacio, Aguinaldo, and the Katipunan as a
collective entity had a significant influence on their respective aspirations, which, in turn, were
molded by these aforementioned factors. Proponents argue that the Filipino populace have an
inherent capacity to autonomously establish and administer their own governance, hence
obviating the need for external assistance. The projections were based on the premise that
preserving the Philippines’ sovereignty was necessary for the nation’s sustained survival and its
cultivation of national pride. The individuals in question showed a deep respect for the
historical legacy of their nation. They were willing to make personal sacrifices to serve their
country, which were highly cherished ideals (Mendez, 2023). The individuals in question
showed a significant commitment to achieving their country’s independence, to the extent that
they were prepared to endure incarceration or even mortality, should such sacrifices be
deemed essential. Due to their unwavering dedication to the promoted values, the
revolutionaries actively engaged in the process.
Articulate how the historical context caused or influenced your chosen historical event.
The historical backdrop significantly influenced the events that unfolded during the Philippine
Revolution. The establishment of Spanish colonial control created a harsh social and political
environment characterized by exploitation and inequality. This context served as a conducive
setting for the emergence of dissatisfaction and revolt. The desire for liberty and the
examination of past revolutions in other regions played significant roles in driving the
development of this specific revolution. The essay released by Salem Press, Inc. (2017) asserts
that the political and social climate in the Philippines at the commencement and subsequent
progression of the revolution had a crucial role in driving the nation’s pursuit of independence.
Explain how connecting your historical event and current event improves the understanding of
your topic.
The insights derived from the Philippine Revolution have potential applicability in various
contexts characterized by ongoing struggles for national sovereignty, human rights, and
collective dignity. The campaign above has the potential to serve as a paradigm for prospective
movements of a similar kind due to its exemplary demonstration of a grassroots-led initiative
that successfully triumphed against the oppressive forces of colonialism and systemic
mistreatment. In contemporary society, there is significant concern and interest in the novel
concepts of democracy, individual autonomy, and the preservation of human rights. The
Philippine Revolution exemplifies a notable struggle for liberation and authority, inspiring
contemporary endeavors to attain comparable objectives. To achieve these objectives, it is
emphasized that individuals must collaborate, maintain rationality, and prioritize the welfare of
others above their own.
Furthermore, the events that transpired during the Philippine Revolution underscore
the need to draw lessons from history to enhance our comprehension of the present and
facilitate accurate prognostications for the future. By drawing upon the lessons and experiences
of previous generations, contemporary collectives have the potential to invigorate their
endeavors for justice and liberation with fresh perspectives and innovative strategies.
The Philippine Revolution might be considered a pivotal event in the annals of Philippine
history. The revolution was initiated due to a strong desire for autonomy and liberation from
Spanish colonial governance’s dominion, catalyzing its commencement. Examining the social
and political climate, the significant contributions made by historical figures such as Andres
Bonifacio, and the underlying factors that propelled the revolution are all crucial factors to be
considered. Examining this historical occurrence enhances an individual’s understanding of the
Philippine independence movement and contemporary endeavors for self-governance, human
rights, and nationalistic aspirations occurring worldwide. This exemplifies the enduring impact
of historical concerns on the present and future.
References
CuUnjieng Aboitiz, N. (2019). Asian Place, Filipino Nation: A Global Intellectual History of the
Philippine Revolution, 1887–1912. Columbia University Press.
Mendez, J. R. (2023). Monumentalizing Memories, Memorializing Monuments: Rizal Park and
American Colonial Philippines, 1898-1946 (Doctoral dissertation, Tokyo University of
Foreign Studies).
Mente, T. J. B., & Valila Jr, J. R. (2022). The Philippines: A Past Revisited.
Salem Press, Inc. (2017). The Philippine Revolution against Spain. The Philippine History Site.
Zhou, Z. (2023). Producing the Meaning of An Asianist Revolution: Images of Revolutionaries in
the 1899 Sino-Japanese Joint Aid to the Philippine Revolution. The Columbia Journal of
Asia, 2(1), 76–91.
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
Classroom Participation
Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.
Initial Response
INSTRUCTIONS:
Share your experiences of completing the Biopsychosocial Assessment and Mental Status Examination.
What did you most discover and learn that you had not prior to completing the assignment?
Would you change anything about your experience?
What was most challenging?
Please be sure to validate your opinions and ideas with citations and references in APA format.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
INSTRUCTIONS:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
Compare and contrast your initial posting with those of your peers.
How are they similar or how are they different?
What information can you add that would help support the responses of your peers?
Ask your peers a question for clarification about their post.
What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.
All peer responses are due by Sunday at 11:59 pm CT.
Ethical LeadershipHow we perform in leadership roles is influenced by our personal history or experiences with others. This assignment will assist you to explore your sense of ethical leadership and reflect on an experience that might have affected your beliefs.Leadership must be more than just effective; it should also be ethical. Provide a real-life example of a leadership moment that you witnessed and feel embodies the essence of ethical leadership. What for you is the most salient factor of this experience that manifests ethical leadership? Reflecting on this moment, discuss how you did or can apply this lesson to your own future performance in leadership. Here is a worksheet that may provide you with some ideas of verbs to describe the salient factors related to ethical leadership and help you to list your own principles as a guideline. Use APA format.
Please describe how COVID-19 has impacted your pathway to nursing school. (2500 characters) Prompts that may help you get started but shouldn’t limit your responses are below: Academic: Were you able to interact with your professors? Did you have to leave an academic program stateside or abroad? Did your school require you to move to Pass/Fail systems? Did your standardized tests or entrance exam get cancelled, delayed? Other academic barriers? Professional: Did you hold a job? Did have to go out and seek new job opportunities? Did you lose a job? Other financial or professional barriers that you faced? Personal: Did you have to move out of a house or dorm? Did you have to cancel travel plans? Did you modify your planned experiences related to healthcare or volunteer opportunities? Did you seek out volunteer opportunities that arose from the crisis? Did help family members that were affected? Personal Statement (2000 characters) Using 2000 characters, please describe the personal attributes that have facilitated your success in the past. How can those attributes assist your success in your educational journey towards becoming a nurse.
Hi,I would like guidance to complete this question which is due on Sunday at midnight. I attached the temple for the outline. I also included the introduction for the essay (which is due next Thursday). APA format and we use a software called turitin to avoid plagiarism. Please keep that in mind. Also, all articles should be within the last 5 years. Thank you in advance.
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TITLE
Introduction: One technology application used in health care to facilitate decision making.
The application’s impact on quality of decision making.
A. Build case through logic
B. Topic sentence/thesis statement
Clinical decision support systems (CDSS) are low‐cost, scalable tools with the potential to improve
guideline‐based antihypertensive treatment in primary care, but their effectiveness needs to be
tested, especially in low‐ and middle‐income countries.
1. Example
2. Example
Early detection of sepsis followed promptly by treatment initiation improves patient outcomes and saves lives.
Hospitals are increasingly using computerized clinical decision support (CCDS) systems for the rapid identification
of adult patients with sepsis.
A.
1. Example
2. Example
B. Support
1. Example
2. Example
The process for selecting and implementing the application.
A. Support
1. Example
2. Example
B. Support
1. Example
2. Example
C. Support
1. Example
2. Example
Third main point (weakest)
A. Support
1. Example
2. Example
B. Support
1. Example
2. Example
C. Support
1. Example
2. Example
Conclusion
A. Restate topic
B. Summarize three main points
C. Revisit introduction or tie all ideas together
TITLE
Page 2 of 4
References
Abell, B., Naicker, S., Rodwell, D., Donovan, T., Tariq, A., Baysari, M., Blythe, R., Parsons,
R., & McPhail, S. M. (2023). Identifying barriers and facilitators to successful
implementation of computerized clinical decision support systems in hospitals: a NASSS
framework-informed scoping review. Implementation Science, 18(1), 1–20.
https://doi.org/10.1186/s13012-023-01287-y
Ackermann, K., Baker, J., Green, M., Fullick, M., Varinli, H., Westbrook, J., & Li, L. (2022).
Computerized Clinical Decision Support Systems for the Early Detection of Sepsis
Among Adult Inpatients: Scoping Review. Journal of Medical Internet Research, 24(2),
e31083. https://doi.org/10.2196/31083
Héctor Acosta-García, Ingrid Ferrer-López, Juan Ruano-Ruiz, Bernardo Santos-Ramos, &
Teresa Molina-López. (2022). Computerized clinical decision support systems for
prescribing in primary care: main characteristics and implementation impact—protocol of
an evidence and gap map. Systematic Reviews, 11(1), 1–6.
https://doi.org/10.1186/s13643-022-02161-6
Song, J., Wang, X., Wang, B., Gao, Y., Liu, J., Zhang, H., Li, X., Li, J., Wang, J.-G., Cai, J.,
Herrin, J., Armitage, J., Krumholz, H. M., & Zheng, X. (2022). Effectiveness of a clinical
decision support system for hypertension management in primary care: study protocol for
a pragmatic cluster-randomized controlled trial. Trials, 23(1), 412.
https://doi.org/10.1186/s13063-022-06374-x
TITLE
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Describe the key components to the mental status exam (MSE). How do the results of an MSE apply to diagnosis and treatment planning? 150 word response and 150 word opinion response with resource Describe the limitations of the MSE. Due to these limitations, what other information gathering is necessary to complete the full diagnosis and treatment planning process?150 word response and 150 word opinion response with resource
The media portray many images of nursing, some favorable and some unfavorable.
Does media portrayal of nursing affect how patients perceive nurses as authority figures? Why or why not? Think about nursing stereotypes and discuss the ways you can influence the public image of nursing.
Discuss the various roles nurses can play that support the real image of nursing. Think about community health care and preventive services for all, but especially the underserved.
In order to receive full credit, you will need to clearly respond to both parts of the question using subtitles or bullets AND cite at least one scholarly reference in your response. You are required to participate on at least three (3) days of the week to receive full participation points.
+ 2 peer responses ( will include the peer responses after initial post is sent)
Create a PowerPoint presentation of 16-18 slides for the Millon Clinical Multiaxial Inventory-IV (MCMI-IV).Address and include the following in your PowerPoint:A title, introduction, and conclusion slideWhat is the MCMI-IV and what does it measure?What are the legal and ethical requirements for a professional to administer, interpret, and/or report the results of an MCMI-IV?How would information gathered from the MCMI-IV assist in the intake and treatment planning process?Describe potential treatment strategies that would likely be incorporated into a treatment plan based on results from an MCMI-IV.Include speaker notes below each content-related slide that represent what would be said if giving the presentation in person. Expand upon the information included in the slide and do not simply restate it. Please ensure the speaker notes include a minimum of 50 words.A reference slide with a minimum of four scholarly references in addition to the textbook.
In a Word document, provide short answers to the statements below. Each answer should be 250-300 words in length.A screening is a type of assessment tool. Describe how and when a screening is used.Describe the legal and ethical parameters related to administering and interpreting assessment tools.Identify the sanctions and educational requirements for a professional to administer and interpret assessments as governed by your state as well as the guidelines of the American Counseling Association (ACA).While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
Telehealth visit was completed while client was in her house today. She denied change in condition since last visit and verbalized skin was intact without cut or bruise. Client verbalized there is safety in her environment and she likes where she lives. Client verbalized her effort to be compliant with nurses recommendation to manage high blood pressure. During last visit blood pressure was 140/95, pulse 77, resp 19, O2 97%, and temp 97.7. Client has history of schizophrenia and was provided education on how to identify signs and symptoms. Moreso, nurse simplified meaning of schizophrenia to client. see the rubric below
Assignment ContentImplementing a change in practice can improve individual or community care. However, even if there is a desire for an interprofessional group to change, one may still encounter resistance in some form. This is more common than widely known. It is by decreasing the forces of resistance that a change can be successful. It may be difficult to see the reason for resistance from another discipline area. During interprofessional collaboration, barriers from each discipline area can be addressed to achieve the change by applying a model for change like Lewin’s force field analysis.Write an 875- to 1,050-word paper in which you:Apply Lewin’s force field analysis to a leadership issue.Analyze the three stages of Lewin’s force field analysis and its application to interprofessional collaboration.Describe how Lewin’s force field analysis could help resolve the issue.Format your paper according to APA guidelines.Submit your assignment.ResourcesCenter for Writing ExcellenceReference and Citation GeneratorGrammar Assistance
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Pre and Post Intervention Data Collection
Scale = 4.0
Pre Casey Fink
Participant (code)
S2B3
T0B0
X1R2
T2G2
B1Y4
T1O2
N3B4
E1G1
L3V2
R4O2
P3W1
N0B1
F4M4
A5I3
1,86
2,66
0,98
2,43
2,6
1,92
2,86
2,39
2,68
2,81
2,59
1,57
1,93
2,97
Post Casey Fink
3,07
5,65
3,79
5,36
5,88
4,89
5,91
5,96
5,15
5,9
5,03
4,02
3,87
5,88
Stand Outs
Q7
Q7
1,89
Q38
3,86
1,14
Q38
Q44
3,02
Q44
1,88
4
Pre Code Blue Calls
Post Code Blue Calls
11
6
Completed final project due. The project concept must have been approved and the outline graded prior to this point to ensure you are on track. This project should help improve a current practice, workflow, or procedure. A needs analysis should be discussed. The paper should be 8-10 pages in length and should include a minimum of 5 referencesPurpose: The purpose of this assignment to help students improve a practice in the real-world healthcare environment using healthcare informaticsInstructions:Discuss a current need in the clinical work environment that would benefit from a nursing/ healthcare informatics solutionAnalyze the current practice/ workflow and how the process could be improvedExamine the informatics tools that can be used to produce better results/outcomes.
Choose and name a historical child welfare development (a policy, program or initiative) in the U.S. child welfare system that took place in one of the 3 major eras in the history of child protection. State the initiative and era (Child Protection Prior to 1875, Child Protection from 1875 to 1962, the Modern Era) that development occurred and place it in the subject line of the discussion.Next state whether it was a government or a private/charitable initiativeThen reflect, analyze and explain the events or conditions that spurred the creation of that initiative, program or policy. Explain why the early architects of child welfare programs might have thought children needed this and how did they anticipate the children might fared under this initiative, policy and/or program.Be sure to cite the reading and describe possible ideas, values, fears and hopes that early pioneers of child welfare policies might have taken into consideration as they sought to build structure into child protection efforts. How might they have imagined their programs and/or policies (specify which ones) would improve the lives of children of the time? Your paper should be 2-3 pages long and submitted as a Microsoft Word document with double spacing, Times New Roman or Calibri font, 12-point font size, and one-inch margins.
Case Study 2: Helen is a 32-year-old P1 who was driven to your maternity unit by her partner Sam. She is semiconscious and has had a notable diuresis. She is 36/40 and has been a type 1 diabetic form the age of 12. Sam informs you that Helen has been nauseated and vomiting for two days and hasn’t checked her blood sugar since yesterday morning when it was 9.5mmols/l. Critically discuss Hope’s case with reference to the guidelines above.
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A SAMPLE CASE STUDY ON SEPSIS
Word Count 2,741
Introduction
For the purpose of this case study I will examine the clinical presentation, treatment
and outcome of a postnatal woman presenting with sepsis. Sepsis itself will be
explored alongside the pathophysiology underpinning her symptoms. The clinical
pathway undertaken to treat and manage her symptoms and prevent deterioration of
her condition will be explored. Janes* past medical and surgical history, a summary
of her labour and postnatal care are included in appendix 1.
Pregnancy is a normal physiologic process defined by the presence of the utero
placental complex. Physiologic changes associated with pregnancy may result in
strain on organ systems with limited reserve and result in deterioration of pre existing
medical conditions (Neligan and Laffey 2011). Severe illness in pregnancy is
relatively rare with the normal physiological changes often masking the early warning
signs normally seen in a deteriorating patient (PROMPT 2017). The Royal College of
Obstetricians and Gynaecologist (RCOG (2012) highlight how the symptoms of
sepsis can often be less distinctive than in the non pregnant population and not all
symptoms may be present therefore a high index of suspicion is vital. Nurses are in
the ideal position to identify sepsis early and ensure timely treatment (Casey 2016).
Nurses and midwives must be equipped with the knowledge and skills to recognise
the signs of sepsis and take swift and appropriate action to treat it without delay.
The Surviving Sepsis Campaign (SSC) was launched in 2012 and has a 7-point
agenda: building awareness of sepsis, improving diagnosis and recognition,
increasing the use of appropriate treatment, educating health care professionals,
improving post–intensive care unit care, developing guidelines of care and
implementing a performance improvement programme (Dellinger et al. 2013). The
fourth revision occurred in January 2017 providing 93 recommendations on early
management of sepsis and septic shock generated from 55 international experts
from 25 global organisations. This demonstrates the commitment to tackle and
address this global problem (DeBacker and Dorman 2017). Dellinger et al (2013)
categorise sepsis as follows; systemic inflammatory response syndrome (SIRS),
Sepsis, Severe Sepsis and septic shock.
SIRS is defined as the presence of 2 or more of the following features
•
Temperature >38c or 100bpm
•
Respiratory Rate >20 bpm
•
White Cell Count >12 or 7.7 mmol/L (in absence of diabetes)
•
Acutely altered mental status
Sepsis is defined as signs of systemic inflammation (SIRS) with proven or presumed
infection
Severe Sepsis is sepsis accompanied with life threatening organ dysfunction
Septic Shock is sepsis induced hypotension despite adequate fluid resuscitation.
(Dellinger et al. 2013)
Pathophysiology
Sepsis is an intricate process that involves interaction between the body’s
inflammatory and anti inflammatory activities. It is the body’s systemic inflammatory
response to bacterial infection (Jones 2017). Sepsis causes complex dysfunction in
the body’s inflammatory and coagulopathy pathways, leading to vasodilatation,
vessel leakage and increased metabolic demands. This increases oxygen demand
which, combined with intravascular losses, causes hypoperfusion and ischaemia at
cellular levels and organ dysfunction (Porth, 2005; Abraham and Singer 2007).
Daniels and Nutbeam (2010) identify how understanding the classification of sepsis
helps in comprehending the underlying pathophysiology, in determining the severity
of the condition and in practicing evidenced based care. Sepsis can affect every
system in the body. Early recognition of critical illness, prompt involvement of senior
clinical staff and multi-disciplinary team working remain the key factors in providing
high quality care to sick pregnant and postpartum women (MBRRACE 2016).
Sepsis – A Case Study
Jane presented feeling generally unwell and experiencing lower abdominal pain at
her Lower Segment Caesarean Section (LSCS) scar site. She appeared pale. Her
vital signs were immediately recorded on the Irish Maternity Early Warning System
(IMEWS). The IMEWS is a standardised system that provides guidance and
processes for the early detection of life threatening illness in pregnancy and up to 42
days postpartum. It was published in 2013 in response to the HIQA Galway report
(National Clinical Effectiveness Committee (NCEC) 2014a). Among pregnant women
with proven bacteraemia, introduction of IMEWS has been associated with an
improvement in the recording of vital signs, particularly respiratory rate (Maguire et
al. 2015). Vital signs are a fundamental part of identifying if someone has sepsis or
displays potential to developing illness as regular monitoring can help identify a
deteriorating patient (Lister and Dougherty 2015). As I recorded Jane’s IMEWS I was
acutely aware of the significance and underlying pathophysiology of each parameter
on the IMEWS chart. This aids comprehension in understanding why a patient’s
condition is deteriorating and in delivering treatment.
Jane’s respirations were 22 (I yellow trigger). PROMPT (2017), identify respirations
as the single most important parameter for early detection of a deteriorating woman.
Jane’s increased respiratory rate could indicate an inadequate oxygen delivery to the
tissues with the cells reducing to anaerobic metabolism increasing lactate production
resulting in tachypnoea as a compensatory measure. In sepsis as blood flow
remains deregulated due to nitric acid and lactic acid this leads to a lack of oxygen
delivery to the tissues (Casey 2017). This is reflected in 02 saturations Jane’s
recorded normal at 97%. While it was reassuring that Jane’s temperature was within
normal limits (37.1’c) this does not outrule sepsis as temperature is not a sensitive
marker of deterioration (PROMPT 2017). Hypothermia can indicate severe infection
and a fluctuating pyrexia coupled with failure to respond to antibiotics can indicate a
persistent focus of infection or abscess (PROMPT 2017). Jane was tachycardic with
a heart rate of 114bpm (I yellow trigger), often the only sign of a deteriorating patient
at any early stage and a woman presenting with tachycardia should be considered
hypovolaemic until proven otherwise (PROMPT 2017). In septic shock the volume of
fluid in the body is diverted away from the essential organs to the skin, skeletal
muscle and fat and into the tissues. This triggers arterial and venous vasodilation
with the body initially compensating by increasing heart rate (Casey 2017).
Hypotension is a late sign of deterioration as it signifies decompensation. Jane was
hypotensive with a Blood Pressure of 98/48mmhg (2 yellow triggers). Low blood
pressure and dehydration are commonly seen in patients with sepsis but generally
respond to fluid replacement (McClelland and Moxon 2014). Decreased urinary
output can indicate end organ damage. As Jane was unable to void urine coupled
with her hypotension concern was mounting (she hadn’t drank much overnight).
Jane’s AVPU indicated that she was alert and orientated. Jane scored her pain as
5/10. Pain score aids midwives in administrating analgesia. Pain can elevate blood
pressure and heart rate. Jane was complaining of lower abdominal pain, which can
be indicative of pelvic sepsis with severe lower abdominal pains indicative of
bacterial toxins on the bowel wall (PROMPT 2017). I held administrating analgesia
until review by a registrar as analgesia can mask a temperature particularly
paracetamol. Jane was also asked about her bowel movements as diarrhoea can be
an indicator for pelvic sepsis. Jane had no history of vomiting another indicator for
sepsis (PROMPT 2017). Jane’s skin was examined for signs of a rash with her skin
feeling warm yet clammy to touch.
Jane appeared haemodynamically unstable with her IMEWS scoring 4 yellow
triggers and complaining of lower abdominal pain. As per the escalation guideline the
plan is to call the obstetrician, request immediate review repeating a full set of
observation within 15 minutes or monitor continuously (NCEC 2014a). Considering
maternal sepsis Jane had 2 SIRS criteria prompting initiation of the sepsis 6 care
bundle (Appendix 2). Its goal is to prevent severe sepsis and septic shock (Dellinger
et al. 2013). A random blood glucose was then taken as part of the SIRS criteria and
was recorded as 7.4mmols. In obstetric care there are 4 levels of care depending on
a woman’s condition level 0 – level 3 (Appendix 3). Jane required level 1, a higher
level of observation. Jane was immediately moved to the labour ward located within
our maternity department for closer one to one monitoring. If it was further away
Jane would have been stabilised on the postnatal ward first. As the shift was only
starting I opted to stay with Jane and one of the labour ward midwives went to the
ward for the shift.
The management of the septic patient in the first hour is a time critical emergency
and requires a team based approach involving all relevant healthcare staff members
(NCEC 2014b). This patient was reviewed immediately by the Registrar with the
SHO called to attend. The CMM 2 was aware of Jane’s condition. Within that first
one hour prompt and efficient treatment was instigated as organ failure and mortality
are directly linked to ongoing untreated hypotension and shock (Dellinger et al.
2013). Oxygen was prescribed on the drug kardex and administered via a face mask
and reservoir bag at 15l/min titrating o2 saturations between 94-98%. In sepsis as
blood flow remains deregulated due to nitric acid and lactic acid there is a lack of
blood flow there lack of oxygen to the tissues (Casey 2017). By administrating
Oxygen I was increasing its delivery to the tissues. Patients with sepsis need highflow oxygen until there is clear evidence that no hypoperfusion exists (McClelland
and Moxon 2014).
The SHO sited 2 large grey size 16 cannula’s under aseptic technique. Bloods were
obtained first; FBC, CRP, U&E, Clotting and LFTs. The lab was phoned and
informed regarding the urgency of these bloods. Where sepsis affects the
cardiovascular system there is inadequate oxygen and tissue perfusion and
anaerobic metabolism occurs. This leads to an accumulation of serum lactic level
known as sepsis with hypofusion (Abraham and Singer 2007). A serum lactate was
also obtained within minutes via a blood gas located on the labour ward. It is
important to obtain it within the first hour and repeated to ensure resuscitation is
improving perfusion as high lactate level is indicative of inadequate end organ
perfusion. The result was 2.4mmols this is only a slight rise so provided some
reassurance. A lactate of >2mmols/L indicates severe sepsis and >4mmols/L
indicates septic shock . A raised lactate, though not specific to sepsis, provides clear
evidence of metabolic compromise and development of severe sepsis (McClelland
and Moxon 2014).
Volume resuscitation is crucial for the effective treatment of sepsis particularity in
combating hypotension improving cardiac function and in tissue perfusion
(McClelland and Moxon 2014). An initial bolus of 500 mls isotonic crystalloid
(Hartmans) was administered over 15 minutes. The SSC currently recommends
30ml/kg of crystalloids for patients with hypotension or raised lactate (>4mmol)
(Dellinger et al, 2013). Jane was continuously monitored for signs of hypovolaemia,
normovolaemia and fluid overload. A strict fluid intake and output chart was
maintained. Fluid balance is a good indicator of circulating volume and renal
function, and therefore essential for good sepsis management and the prevention of
acute kidney injury (McClelland and Moxon 2014). Aerobic and anaerobic blood
cultures were obtained by the SHO under aseptic technique prior to the
commencement of I.V. antibiotics. The healthcare assistant on duty hand delivered
these bloods to the lab as the cant be sent in the pod system.
A urinary catheter was inserted to allow for accurate measurement of urine via an
hourly urometer. Prior to inserting the size 12 urinary catheter a low vaginal swab
was obtained and after insertion a CSU was taken for microbiology testing, both
required as part of the Sepsis 6 care bundle. Initially when placed it failed to drain
any urine which was concerning however within 15 minutes it began draining well
above the recommended amount of 38mls/hr, Jane’s target urinary output. A target
urinary output > 0.5mls/kg per hour was aimed for. Kidneys require 20% cardiac
output to maintain glomerular filtration rate. This again signifies the importance of
fluid resuscitation as cardiac output improves so does renal perfusion improves.
Catheter insertion can introduce another source for infection but strict aseptic
technique was adhered to, catheter care was observed and the plan was to remove
it as soon as possible. The administration of broad spectrum antibiotics within one
hour of suspicion of sepsis with or without septic shock is recommended as for every
hour delay starting antibiotics the risk of death increases 7.6 % (Dellinger et al.
2013). Intravenous vancomycin and clindamycin were administered as a LSCS
wound site infection was suspected as it appeared quite red and hot to touch. A
LSCS wound swab was obtained. LSCS is the leading risk factor for puerpural
sepsis (Jones 2017). There are other possible causes of infection in the postpartum
period that we remained mindful of so as not to impede treatment or additional
investigations. These include retained products of conception, episiotomy and
prolonged rupture of the amniotic membranes, breast abscess, haematoma, mastitis,
urinary tract infection (NCEC 2014b; Neligan and Laffey 2011). A diagnosis of
severe sepsis was made.
Janes IMEWS was continuously repeated. Her temperature rose to 37.5 scoring 1
yellow trigger. She remained tachycardiac, tachypnoea and hypotensive for an hour
but they didn’t worsen. Her blood pressure improved first to within normal
parameters followed by an improvement in respiration and heart rate. Myself and the
registrar worked closely together with all communication within the MDT done
through use of the ISBAR (Identification, Situation, Background, Assessment and
Recommendation) tool. This tool allows for the optimisation of critical information an
essential component of patient care safety and risk management (Health Service
Executive 2014).
Her bloods returned as HB 9.0 hgb (normal 12-16) Platelets 180 (normal 150-400),
White cell count 21.0 (normal 4.00-11.00). CRP 11.0 (normal 7.0/dl for adequate 02 delivery and a raised WCC and CRP are indicative of
infection. A high platelet count coupled with arising CRP and fluctuating pyrexia can
indicate a collection of pus or infected haematoma (NCEC 2014). Jane attended for
a CT abdomen that day which was normal indicating only a small amount of free fluid
in the pelvic cavity. Her lactate had fallen to 1.4 mmols when repeated. Critically ill
women require monitoring and multi disciplinary team management (MDT) under the
leadership of one named consultant, a senior obstetrician, a microbiologist or
infectious disease clinician (RCOG 2012). Jane’s was discussed at the 0900 daily
labour ward handover to gather input from the MDT. Jane’s obstetric consultant was
present but he had been informed of Jane’s condition prior to this. It is apparent that
swift implementation of the sepsis 6 care bundle prevented Jane’s condition from
deteriorating and she stabilised within 2 hours. While the anaesthetist was available
for consultation we didn’t require his input. Antibiotic therapy should be reviewed
daily to reduce toxicity, risk of resistance and cost (Dellinger et al. 2013).
Breastfeeding can limit the use of some antimicrobials this further strengthens the
need for consultation with the microbiologist (NCEC 2014b). The microbiologist was
involved and no change was made to her antibiotic regime. No growth was shown on
her swabs. The five moment of hand hygiene were strictly adhered to by all
individuals caring for Jane.
Over the day Jane was monitored closely her observations were recorded as per the
IMEWS escalation guideline and all care was carried out as per local guidelines.
Accurate record keeping was maintained. Jane was continuously reassured with
consent obtained for any tests and procedures. Her husband had been phoned to
attend when her condition deteriorated. Her baby was brought from SCBU when
ever Jane requested. A full debriefing was provided to Jane and her husband the
following day with ample opportunities for questioning. RCOG (2014) recommends
educating all pregnancy woman about the signs and symptoms of genital tract
infection and its prevention prior to discharge. Jane’s PHN and GP we informed to
allow for follow up at discharge. Jane was transferred back to the postnatal ward
before the shift ended following removal of her catheter. An informal staff debriefing
took place with all staff involved in Jane’s care.
Conclusion
As midwives we are in a privileged position of sharing the special journey into
parenthood with a woman. This places us in an ideal position to identify a
deterioration in a woman’s condition. The introduction of the IMEWS coupled with
the SSC have been instrumental in improving outcomes for pregnant and postnatal
women. A MDT approach is pivotal in continuing to provide evidenced based care
that has the women at the centre. Continuous staff education relating to sepsis, its
recognition and treatment will continue to ensure safe, effective high quality care is
delivered to women attending our maternity departments.
*Jane not her real name
Reference List
Abraham, E. and Singer, M. (2007). Mechanisms of sepsis induced organ
dysfunction. Critical Care medicine, 35(10), pp. 2408-2616.
Casey G. (2016). Could this be sepsis? Kai Tiaki Nursing New Zealand, 22(7), pp.
20-24.
Daniels R. and Nutbeam T. (2010). The ABC of sepsis. Journal of Tropical
Paediatrics, 50(4), p. 287.
Dellinger R.P., Levy M.M., Rhodes A., Bion J. Annane, D. and Gerlach, H. (2013).
Surviving Sepsis Campaign: International guidelines for management of severe
sepsis and septic shock: 2012. Critical Care Medicine, 41 (2), pp. 580–637.
DeBacker, D. and Dorman, T. (2017). Surviving Sepsis Guidelines A Continuous
Move Toward Better Care of Patients With Sepsis [online], Available from:
https://jamanetwork.com/journals/jama/article-abstract/2598893
JAMA.
2017;317(8):807-808. doi:10.1001/jama.2017.0059 [accessed 12 November 2017].
Health Service Executive (2014). Guidelines for the Critically Ill Woman in Obstetrics
& Gynaecology, Anaesthetic and Critical Programmes Clinical Strategy &
Programmes Division. Version 1.1 Dublin: Stationary Office.
Jones J. (2017). Managing sepsis effectively with national early warning scores and
screening tools. British Journal of Community Nursing, 22 (6), pp. 278-281.
Lister S. and Dougherty L. (2015). The Royal Marsden Manual of Clinical Nursing
Procedures. 9th ed. Oxford: Wiley-Blackwell.
Maguire P.J., O’Higgins A.C., Power K.A., Daly N. McKeating A. and Turner M.J.
(2015). Maternal bacteraemia and the Irish maternity early warning system.
International Journal of Gynaecology and Obstetrics. May 129(2), pp.142-145.
McClelland H. and Moxon A. (2014). Early identification and treatment of sepsis.
Nursing Times,110 (4), pp. 14-17.
MBRRACE (2016). Marian Knight, Manisha Nair, Derek Tuffnell, Sara Kenyon, Judy
Shakespeare, Peter Brocklehurst, Jennifer J Kurinczuk (Eds.) Saving Lives,
Improving Mothers’ Care Surveillance of maternal deaths in the UK 2012–14 and
lessons learned to inform maternity care from the UK and Ireland Confidential
Enquiries into Maternal Deaths and Morbidity 2009–14 [online], Available from:
https://www.npeu.ox.ac.uk/downloads/files/mbrrace-uk/reports/MBRRACEUK%20Maternal%20Report%202016%20-%20website.pdf [Accessed 12 November
2017].
National Clinical Effectiveness Committee (NCEC)(2014a). The Irish Maternity Early
Warning System (IMEWS) National Clinical Guideline No. 4 Dublin: Department of
Health.
National Clinical Effectiveness Committee (NCEC) (2014b). Sepsis Management
National Clinical Guideline No. 6 Dublin: Department of Health.
Neligan P.J. and Laffey J.G. (2011). Clinical review: Special populations- critical
illness and pregnancy. Critical Care, 15(4), pp. 227 -237.
Royal College of Obstetricians and Gynaecologist (RCOG) (2012). Bacterial Sepsis
following Pregnancy. Green-Top Guideline No. 64b. United Kingdom: RCOG.
Porth M.C. (2005). Pathophysiology: Concepts
Philadelphia: Lippincott Williams and Wilkins.
of
Altered
Health
States.
Practical Obstetric Multi-Professional Training (PROMPT) (2017). Care of the
critically ill pregnant woman. PROMPT- CiPP Course Participant Handbook. United
Kingdom: CiPP Editorial Team.
Appendix 1
Case Study
Background
Jane a 32 year old P1 presented in established labour. She had an emergency
Lower Segment Caesarean Section (LSCS) for failure to advance. There were no
complications at the LSCS. Jane was low risk throughout her pregnancy, labour and
postnatal period.
Social History
Irish married lady living with her husband and 2 year old daughter. She was a non
smoker.
Past Medical History
Nil of note
Labour and postnatal Summary
Jane had an uncomplicated postnatal recovery. On day 4 postpartum Jane
complained of mild pain in her LSCS site. Her notes indicated it was “mildly red and
SHO was asked to review”. Her bloods had been taken day 2 post LSCS and were
normal. Owing to this no further action was taken Jane was not commenced on oral
antibiotics. Plan as per SHO was to “monitor wound”. On day 5 Jane’s wound was
documented as ‘healing well’. There was no reference to redness at the wound site
or Jane complaining of pain.
Normally women post LSCS are discharged Day 4 postpartum Jane remained in
hospital for social reasons. Her baby was under the care of SCBU for jaundice and
was receiving phototherapy. The maternity department was quiet and as she was
breastfeeding and lived an hour from the hospital she was allowed to remain as an in
patient.
On the morning of Day 6 postpartum at approximately 0700 when asked at morning
round Jane complained of pain at her LSCS scar site. On inspection her wound was
documented as ‘mild redness noted’. She identified her pain score as 2-3/10.
Analgesia was given and the SHO was phoned to review. Before the SHO had
reviewed her at 0810 during morning handover Jane rang the call bell complaining of
severe lower abdominal pain at her LSCS scar pain. She felt generally unwell.
Appendix 2
Sepsis 6 care bundle
Complete within one hour
Take 3
Give 3
Appropriate Cultures
Maintain 02 (94-98%)
FBC +/- lactate
Consider I.V. fluid bolus
Start urine output chart
I.V.antibiotics
Appendix 3
Levels of Care
Level 0 Patients whose needs can be met through normal ward care.
Level 1 Patients at risk of their condition deteriorating and needing a higher level of
observation or those recently relocated from higher levels of care.
Level 2 Patients requiring invasive monitoring/intervention that include support for a
single failing organ system (excluding advanced respiratory support).
Level 3 Patients requiring advanced respiratory support (mechanical ventilation)
alone or basic respiratory support along with support of at least one additional organ.
(HSE 2014)
A SAMPLE CASE STUDY ON POSTPARTUM
HAEMORRHAGE
Word Count: 2,749
1
Introduction
In this case study the subject I intend to explore is Postpartum haemorrhage (PPH)
and its impact on maternal wellbeing. I will examine the clinical presentation,
management, treatment, and outcome of a postnatal woman presenting with a PPH.
Obstetric haemorrhage remains one of the leading causes of maternal morbidity and
mortality worldwide. It was the second leading cause of direct maternal death in the
United Kingdom from 2013 to 2015 (Knight et al. 2017). Primary PPH is a prominent
cause of a major obstetric haemorrhage (Mavrides et al. 2016) In fact one of Ireland’s
maternity units seen an increase in the incidence of Primary PPH of 11.3% in 20082014 (Sheehan et al.2014)
The case I have chosen involves both Primary and Secondary PPH which resulted in
re-admission to hospital requiring surgical intervention and level 2 Critical Care. Due
to the complications surrounding the case and word limitations I will only discuss
Secondary PPH. The primary aim of this case study is to demonstrate an
understanding of the pathophysiology of PPH with accurate and reliable diagnostic
skills and emphasising the importance of early clinical intervention. A high proportion
of morbidity can be prevented through early recognition with adequate intervention
and proper choices of therapies (Woiski et al. 2016). The woman involved in this
case study will be known as Mary to protect her identity. Mary’s past medical and
surgical history along with a summary of her labour and delivery are included in
Appendix 1.
There are many definitions to describe PPH. Kasap et al. (2016) defines it as
bleeding of 500ml or more following a vaginal birth,1000 ml or more after a
caesarean section, classifying it as primary if occurring within 24 hours and
secondary from 24hours to 12 weeks. While Mavrides et al. (2016) further divides
primary into two categories minor 500-1000ml in the absence of adverse effects and
major more than 1000ml, but does not state a blood volume for Secondary PPH.
PRactical Obstetric Multi-Professional Training (PROMPT) defines secondary PPH
as a blood loss of 500ml or more occurring from 24 hours to 12 weeks postpartum
(Winter et al. 2017). While Carroll et al. (2016) suggests a definition for Secondary
PPH “any blood loss from the genital tract in excess of normal lochia at any time
period after 24 h post birth to 6 weeks postpartum” (Carroll et al. 2016, p10).
Although Secondary PPH may occur anytime between 24hours and 12 weeks
2
following the birth, it is most commonly between day 7 and day 14 (Chandraharan et
al. 2017)
There are many risk factors associated with PPH both antenatal and intrapartum,
though it can occur without any risk factors. Nevertheless a history of severe PPH
increases the risks by nine-fold in future pregnancies (Nyfløt et al., 2017)
Pathophysiology
In pregnancy blood volume, coagulation, and clotting factors are increased as a
normal physiological process which allows the body to compensate well in the early
stages of haemorrhage. The blood volume in pregnancy is increased by as much as
30ml/kg giving a total volume of 6-7litres at term (Winter et al. 2017). Mousa et al.
(2014) states a blood loss of up to 500ml at delivery is physiological which brings the
blood parameters to their normal non pregnant level. Yet the signs of hypovolaemic
shock can be masked because of the increased circulating volume (Mavrides et al.
2016). Hypovolaemia will lead to insufficient blood to the heart for normal function,
affecting oxygen transportation which will result in hypoperfusion of vital organs. If
not corrected hypoperfusion can cause the release of endothelial tissue factor and
activation of coagulation cascade resulting in disseminated intravascular coagulation
(Hossain et al. 2013)
Following delivery, the uterus contracts and this causes the placenta to separate
from the uterine wall, exposing blood vessels that were in contact with the placenta
surface. Haemostasis is achieved when the uterus contracts compressing the blood
vessels and by transient activation of the coagulation system (Chireau et al. 2015). If
the uterus fails to contract then PPH will occur. The most common cause of primary
PPH is atonic uterus. PROMPT defines the causes of PPH by using 4 T’s, Tone,
(uterine tone) Tissue, (retained products) Trauma (genital tract tears) and Thrombin
(coagulopathy) (Winter et al. 2017). However Secondary PPH can be caused by
retained products of conception, endometritis and subinvolution of the placenta site.
(Mavrides at al. 2016)
3
Postpartum Haemorrhage- Case Study
Mary presented on day 11 postnatal, complaining of feeling unwell and giving a
history of passing clots at home and having intermittent lower abdominal crampy
pains. She felt faint and dizzy and appeared pale and anxious. Having a low
Haemoglobin (HB) further bleeding regardless of blood volume could have an
adverse effect on her wellbeing (WHO 2012)
I immediately put Mary lying flat on the bed with her legs elevated and administered
high flow oxygen 15litres per minute via a facial oxygen mask (Winter et al. 2017).
The RCOG also recommends giving a high concentration of oxygen regardless of
maternal oxygen concentration (Mavrides et al. 2016). I checked and recorded
Mary’s vital signs on the Irish Maternity Early Warning System (Appendix 2). The
IMEWS is a bedside tool designed to give an early warning score when the vital
signs deviate from the normal parameters thus prompting early recognition and
intervention. The aim is to improve the management of a deteriorating woman, during
pregnancy and up to 42 days postnatal (HSE 2014a) I found Mary’s temperature to
be 37.0C, her Pulse 100 beats per minute (BPM) and Respirations 20, Blood
pressure 60/30 and oxygen Sp02 97%. These findings gave an early warning score
of 2 yellow and 2 pink triggers on the IMEWS chart therefore alerting a prompt
intervention and the need to continuously monitor the vital signs. Indeed changes in
respiratory rate can be an early indicator of deterioration in wellbeing (HSE 2014a). If
the Systolic blood pressure falls below 100mmHg the blood loss could be as much as
25% of the maternal blood volume (Winter et al. 2017). As a result hypotension is a
late sign of deterioration and indicates decompensation (HSE 2014a). Although
Mary’s temperature was within normal limits (36-37.4 degree centigrade) I used a
Mistral –air blanket to keep her warm. According to the Mavrides et al. (2016)
hypothermia could exacerbate acidosis.
I called for assistance requesting the appropriate obstetric staff including the
Obstetrician for an instant review. The management of PPH contains four
components which must be undertaken simultaneously, Communication,
Resuscitation, Monitoring and Investigation (HSE 2012). In order that clear concise
information was given I used the Identification-situation-background-assessmentrecommendation (ISBAR) tool. This structured communication tool was developed to
enhance communication within the team to benefit patient care management (HSE
4
2014a).However the management of a major PPH can be frightening for the woman
and her partner as the room quickly becomes crowded and numerous simultaneous
activities are taking place. Therefore it was important that Mary and her partner were
kept informed on events from the onset. (Mavrides et al. 2016)
As part of my extended role as a midwife and being aware of the need for urgent fluid
replacement, I inserted a size 16 gauge intravenous cannula in Mary’s left hand. An
Intravenous infusion (IV) of Hartmann solution which is a crystalloid solution was
commenced to help restore fluid volume so to improve cardiac output and perfusion.
PROMPT recommends an IV infusion of warmed crystalloid fluids as cold fluids can
cause cardiac arrhythmias and the fluids should be infused rapidly until the systolic
blood pressure is restored within normal limits (Winter et al. 2017). Therefore I
applied a pressure bag to aid the infusion rate. In the same way the WHO (2012)
recommends isotonic crystalloid fluids in preference to colloids fluids. According to
Mauvrides et al. (2016) the bases of resuscitation in a PPH is to restore the blood
volume and the oxygen capacity. Likewise the Mothers and Babies: Reducing Risk
through Audits and Confidential Enquiries across the UK (Knight et al. 2017) states
that the key management of Obstetric haemorrhage is to assess the blood loss and
identify the need and replace the fluids and blood products.
In the meantime the Senior House Officer (SHO) inserted a second 16 -gauge
intravenous cannula in Mary’s right arm and obtained blood samples for, Full blood
Count, coagulation screen, Urea and electrolytes, Liver function test , C-Reactive
protein and group and cross- match of 6 units. I contacted the Laboratory Specialists
to inform them, that urgent bloods for Mary were being sent and required urgent
processing. The HSE (2012) clearly state that involving the Laboratory specialists in
the early stages is crucial in the management of PPH. Mary received 2 litres of
intravenous Hartmann Solution prior to commencement of a blood transfusion (1 unit
of Red Blood Cells) It is essential to commence a blood transfusion of Red Blood Cell
as soon as possible on the basi
Professional journals provide a means of communication between various segments of the nursing profession. Current research findings are documented in these periodicals to keep other members of the profession up to date on new theories and modalities used to treat clients. Nursing students should become familiar with professional journals so that they become accustomed to reading them to keep abreast of current trends in the profession. They also should learn to discriminate between journals and authors to determine which are worthy and reliable. The purpose of the journal article review is to help the beginning nursing student become aware of the professional journals that are available to them and to learn about an area of personal interest that relates to client care.
Project Guidelines
Review the course objectives located in the course Syllabus.
Consider a topic of interest to you that correlates with a course objective, has relevance to nursing, and would also have some appeal to your classmates.
Using appropriate library catalog or search tools, find a professional nursing journal article from a recommended source that addresses the topic.
If you are unsure the the journal article you chose would be considered a professional nursing journal article, check with your instructor for guidance.
Following the rubric provided, prepare a review of the journal article to be presented to your clinical group during pre or post conference time as assigned.
The oral presentation should include a brief, five minute or less, review of:
Journal title
Journal article title
Author (at least one author is a nurse)
Date published (within five years)
Content
Findings of article
Why chose this article and why relevant to Foundations of Nursing course
Do not attempt to teach the content of the article.
The presentation date/time will be assigned clinical faculty.
Provide a copy of the rubric and article accompanied by a bibliography to your clinical instructor.
For help with formatting your bibliography in APA–please visit the Purdue Owl website: https://owl.english.purdue.edu/owl/section/2/10/
Journal article APA reference examples (separate reference page, reference needs a hanging indent and is double spaced):
Without a doi number:
Author(s) last name, First initial. Middle initial. (Year). Title of article. Title of Journal in Italics, Volume number in italics(Issue number), Page numbers.
With a doi number:
Author(s) last name, First initial. Middle Initial. (Year). Title of article. Title of Journal in italics, Volume number in italics(Issue number), Page numbers.
https://doi.org/xxx.
Unformatted Attachment Preview
Student: _____________________
Rubric: FON Journal Article Presentation
Purpose of Activity Professional journals provide a means of communication between various segments of the nursing
profession. Current research findings are documented in these periodicals to keep other members of the profession up to date
on new theories and modalities used to treat clients. Nursing students should become familiar with professional journals so that
they become accustomed to reading them to keep abreast of current trends in the profession. They also should learn to
discriminate between journals and authors to determine which are worthy and reliable. The purpose of the journal article
review is to help the beginning nursing student become aware of the professional journals that are available to them and to
learn about an area of personal interest that relates to client care.
Descriptions
Journal Article Presentation
Good
10 pts
Fair
5 pts
Unsatisfactory
0 pts
(Continued)
Follows Instructions
Good
Fair
Unsatisfactory
Presents article on due date.
Submits copy of article and
grading rubric to clinical
instructor on due date.
Presents article after due
date and/or does not submit
a copy of article or grading
rubric to instructor when
article presented but
provides article later.
Does not present article
and/or does not submit copy
of article to instructor.
Good
Fair
Unsatisfactory
Chooses an article from a
professional nursing journal.
States title of journal article,
date published, name of
author and author’s
credentials in presentation.
At least one author is RN.
Chooses an article from a
professional journal but
article is not relevant to
nursing. Presents partial
information about author
and publication. None of the
authors is an RN.
Does not choose an article
from an accepted
professional journal. Does
not state any of required
information.
Good
15 pts
Fair
7.5 pts
Unsatisfactory
0 pts
Review of Literature
Journal Article Presentation
Data Gathering,
Organization, and
Critiquing
Good
Fair
Unsatisfactory
Organizes the article review
in an easy-to-follow and
succinct manner. Critiques
for content and credibility.
Presents information in
disorganized manner,
jumping from topic to topic.
Omits important information.
Does not discuss credibility.
Does not appear to be
prepared to present article.
Good
15 pts
Fair
10 pts
Unsatisfactory
5 pts
Journal Article Presentation
Summarizing
Good
Fair
Unsatisfactory
Summarizes main points of
article in own words without
plagiarizing. Does not
attempt to teach content.
Reads some of content
and/or does not summarize
effectively. Does not
plagiarize.
Reads much of content or
attempts to teach content or
plagiarizes.
Good
10 pts
Fair
5 pts
Unsatisfactory
0 pts
Journal Article Presentation
Relevancy, Inferences
Good
Evaluates relevancy of
article to Fundamentals
objective selected and to
professional nursing
practice.
Familiarity with Content
Good
Replies to
comments/critiques from
other students regarding
his/her own article
submission.
Audience Involvement
Communication Skills
Needs to be prompted as to
relevancy of article to
Fundamentals objective
selected and to professional
nursing practice.
Omits relevancy to mental
health nursing care or
professional nursing practice
and is unable to explain
when prompted.
Fair
Unsatisfactory
Has difficulty replying to
comments/critiques from
other students regarding
his/her own article
submission.
Unable to reply to
comments/critiques from
other students regarding
his/her own article
submission.
Fair
Encourages discussion
promoting critical thinking
pertaining to topic of article.
Promotes limited discussion.
Good
Fair
Unsatisfactory
Has some difficulty with
grammar and/or
pronunciation or is difficult
to hear.
Has difficulty with grammar
and/or pronunciation and is
unprofessional in manner.
Fair
Unsatisfactory
Good
Submits bibliography
following APA format.
seminolestate.rcampus.com
Unsatisfactory
Good
Communicates effectively
and in a professional
manner.
Bibliography
Fair
Submits bibliography but
does not follow APA format.
Unsatisfactory
Does not encourage
discussion.
Does not submit
bibliography.
Rubric Code: G48C9
Student: _____________________
Rubric: FON Journal Article Presentation
Purpose of Activity Professional journals provide a means of communication between various segments of the nursing
profession. Current research findings are documented in these periodicals to keep other members of the profession up to date
on new theories and modalities used to treat clients. Nursing students should become familiar with professional journals so that
they become accustomed to reading them to keep abreast of current trends in the profession. They also should learn to
discriminate between journals and authors to determine which are worthy and reliable. The purpose of the journal article
review is to help the beginning nursing student become aware of the professional journals that are available to them and to
learn about an area of personal interest that relates to client care.
Descriptions
Journal Article Presentation
Good
10 pts
Fair
5 pts
Unsatisfactory
0 pts
(Continued)
Follows Instructions
Good
Fair
Unsatisfactory
Presents article on due date.
Submits copy of article and
grading rubric to clinical
instructor on due date.
Presents article after due
date and/or does not submit
a copy of article or grading
rubric to instructor when
article presented but
provides article later.
Does not present article
and/or does not submit copy
of article to instructor.
Good
Fair
Unsatisfactory
Chooses an article from a
professional nursing journal.
States title of journal article,
date published, name of
author and author’s
credentials in presentation.
At least one author is RN.
Chooses an article from a
professional journal but
article is not relevant to
nursing. Presents partial
information about author
and publication. None of the
authors is an RN.
Does not choose an article
from an accepted
professional journal. Does
not state any of required
information.
Good
15 pts
Fair
7.5 pts
Unsatisfactory
0 pts
Review of Literature
Journal Article Presentation
Data Gathering,
Organization, and
Critiquing
Good
Fair
Unsatisfactory
Organizes the article review
in an easy-to-follow and
succinct manner. Critiques
for content and credibility.
Presents information in
disorganized manner,
jumping from topic to topic.
Omits important information.
Does not discuss credibility.
Does not appear to be
prepared to present article.
Good
15 pts
Fair
10 pts
Unsatisfactory
5 pts
Journal Article Presentation
Summarizing
Good
Fair
Unsatisfactory
Summarizes main points of
article in own words without
plagiarizing. Does not
attempt to teach content.
Reads some of content
and/or does not summarize
effectively. Does not
plagiarize.
Reads much of content or
attempts to teach content or
plagiarizes.
Good
10 pts
Fair
5 pts
Unsatisfactory
0 pts
Journal Article Presentation
Relevancy, Inferences
Good
Evaluates relevancy of
article to Fundamentals
objective selected and to
professional nursing
practice.
Familiarity with Content
Good
Replies to
comments/critiques from
other students regarding
his/her own article
submission.
Audience Involvement
Communication Skills
Needs to be prompted as to
relevancy of article to
Fundamentals objective
selected and to professional
nursing practice.
Omits relevancy to mental
health nursing care or
professional nursing practice
and is unable to explain
when prompted.
Fair
Unsatisfactory
Has difficulty replying to
comments/critiques from
other students regarding
his/her own article
submission.
Unable to reply to
comments/critiques from
other students regarding
his/her own article
submission.
Fair
Encourages discussion
promoting critical thinking
pertaining to topic of article.
Promotes limited discussion.
Good
Fair
Unsatisfactory
Has some difficulty with
grammar and/or
pronunciation or is difficult
to hear.
Has difficulty with grammar
and/or pronunciation and is
unprofessional in manner.
Fair
Unsatisfactory
Good
Submits bibliography
following APA format.
seminolestate.rcampus.com
Unsatisfactory
Good
Communicates effectively
and in a professional
manner.
Bibliography
Fair
Submits bibliography but
does not follow APA format.
Unsatisfactory
Does not encourage
discussion.
Does not submit
bibliography.
Rubric Code: G48C9
Topic: Disease managementDiscuss an acute case scenario that you observed in the clinical setting recently for the adult population ranging 35–65-year old.Discuss how this case can develop into chronic disease management?What was the evidence that supported the intended outcomes for this patient scenario?(3 REFERENCES NEEDED)
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
I will provide the two previous papers that have been completed once you have been selected to work on the question so that you can combine information from them and change up the wording a bit since what is being asked for has already been done.
Completed final project due. The project concept must have been approved and the outline graded prior to this point to ensure you are on track. This project should help improve a current practice, workflow, or procedure. A needs analysis should be discussed. The paper should be 8-10 Full Pages Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages in length and should include a minimum of 5 scholarly references published within the last 5 years,
Purpose: The purpose of this assignment to help students improve a practice in the real-world healthcare environment using healthcare informatics
Instructions:
Discuss a current need in the clinical work environment that would benefit from a nursing/ healthcare informatics solution
Analyze the current practice/ workflow and how the process could be improved
Examine the informatics tools that can be used to produce better results/outcomes.
Requirements: 8-10 Full Pages Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please be sure to include an introduction paragraph with a clear thesis statement in the last sentence of the introduction paragraph and a conclusion paragraph
Please be sure to carefully follow the instructions
No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool.
Please be sure to include at least one in-text citation in each body paragraph
Please only utilize at least 5 scholarly resources publilshed within the last 5 years
Mr. Long was visited to via telehealth while he was in his house. He was alert and oriented x3, denied suicidal ideation, denied change in condition since last visit. Client verbalized his son has started living with him and he hope he can be integrated to the community because he was just released from incarceration. Client has history of major depressive disorder. He verbalized life has unfairly treated him and he expects holistic treatment should help him. Nurse provided interventions to major depressive disorder. Follow the rubric below
A philosophy of nursing is a written paper declaring a nurse’s beliefs, values, and ethical considerations regarding their practice of nursing. The purpose of this paper is to provide you with the opportunity to reflect on your nursing care and treatment of patients and how you see yourself as a practicing nurse and an individual. You will find that your nursing philosophy is dynamic, growing as you grow personally and professionally.
Write a scholarly paper using the following:
Assignment Criteria:
Discuss your professional belief system of nursing. This will include broad statements of your values and beliefs that propose the nature and concerns of nursing and its moral obligations to society.
Use the nursing theory you chose for the nursing theory PowerPoint. Explain the theory and how your values and beliefs are guided by the theory.
Provide your definition of nursing based on your personal belief system and nursing theory.
Give at least two examples of how you apply your definition of nursing to your nursing practice.
The scholarly paper should be in narrative format, no more than three (3) pages in length excluding the title and reference pages. An abstract is not needed. Include an introductory paragraph (not labeled Introduction) and a conclusion.
Include Level 1 headings to organize the paper (see below).
This scholarly paper is intended to include first person formatting, with statements such as “I believe…” or “My values include…”
Include a minimum of four (4) references. At least two (2) of the four (4) references are current peer-reviewed scholarly journal articles. References must be no greater than five (5) years old unless considered a “classic or historical source”. Professional organizations or government websites can be used.
APA Student Paper format is required (title page and reference pages).
Review your Turnitin Similarity score and make any needed changes. If the score is greater than 20%, you must revise the paper prior to submission. Plan accordingly.
Title of Paper
(Note: Here you will write your introductory paragraph but DO NOT label it as Introduction)
My Personal Belief System and/or Worldwide View of Nursing (Note: Choose either one or both)
Nursing Theory Best Matching My Values and Beliefs
My Definition of Nursing Based on My Values, Beliefs, and Nursing Theory
How I Apply My Definition of Nursing to My Practice of Nursing
Conclusion
Rubric
Unformatted Attachment Preview
Self-Care Deficit
Theory
Jennifer Lopez
Florida SouthWestern State College
NUR 3805 Professional Roles
9/16/2023
Objectives
Self- Care Deficit Theory Overview
Why this theory best represents my nursing views
Relationship among concepts of theory
Applying the Nursing Theory to Nursing Profession
Self-Care Deficit
Theory Overview
The Theory was created by Dorothea Orem.
Self-care is performed when individuals learn,
adapt, develop skills, and are motivated to
care for themselves in expected and
unexpected situations (Isik & Fredland, 2023).
Patient are able to recover when they are
maintaining their own independence.
The Self-Care Deficit Theory is made up of
three components
Theory of self-care
Theory of self-care deficit
Theory of Nursing System
Why this model represents my nursing
view.
Helps promote patient
independence
Helps maintain
patient’s integrity
Promotes autonomy
Promotes
interprofessional
collaboration
Relationships Among Concepts of Theory.
Person
A being with inherent developmental needs and is capable of self-care.
Environment
Using environmental factors, circumstances, and progression to support well-being and selfcare.
Health and
Nursing
Health is marked by the completeness and flourishing of human systems, encompassing both
physical and mental functions.
Nursing measures to encourage individual self-sufficiency.
Applying the Nursing Theory to
Profession Nursing.
As nurses we can apply the self- care theory to the nursing profession by:
Formulating nursing diagnosis and care plans
Goal setting for patients
Education and Patient Empowerment.
Support and Assisting in patients needs
Interprofessional collaboration
Examples of Application of Theory
Patient care after experiencing a
myocardial infarction:
Patient with recent diagnosis of type 2
Diabetes
Education
Education
Interprofession collaboration
Interprofessional collaboration
Supporting/ Assisting Patient
support/Assisting Patient Needs
Goal Setting
Conclusion
Self-Care Deficit Nursing Theory includes:
Advocating patient’s independence
Empowering patients to have self care and autonomy
Allowing nurses to assist patient when only needed.
References
Finkelman, A. (2021) Professional Nursing Concepts: Competencies for Quality Leadership (5th edition). Jones& Bartlett Learning
Isik, E., & Fredland, N. M. (2023). Orem’s Self-Care Deficit Nursing Theory to Improve Children’s Self-Care: An
Integrative Review. Journal of School Nursing, 39(1), 6–17. https://doi.org/10.1177/10598405211050062-theory.php
Orem’s Self-Care Deficit Nursing Theory – Nursing Theory. (2023, June 14). Nursing Theory. https://nursingtheory.org/theories-and-models/orem-self-care-deficit
Petiprin, A. (2020). Orem’s self-care deficit nursing theory. Nursing Theory. https://nursing-theory.org/theories-and-models/oremself-care-deficit-theory.php
Yip JYC. Theory-Based Advanced Nursing Practice: A Practice Update on the Application of Orem’s Self-Care Deficit
Theory. SAGE Open Nurs. 2021 Apr 20;7:23779608211011993. doi: 10.1177/23779608211011993. PMID:
33959682;
PMCID: PMC8060740.
Nursing
read over the Case Study Analysis #1: Engaging Surgeons to Reduce Supply VariationYour analysis of the case should address, at a minimum, the following questions: How does variation impact patient care? What is distinctive about the solutions presented in this case? How does the model create value for patients versus prevailing approaches? How could the model/solution be improved?See attached case
Locate the three TheCommonwealth Fund links found in Modules/Week 6. (Telemedicine Falls Short, Benefits of Telehealth During a Pandemic, and Telehealth Services)
https://www.commonwealthfund.org/blog/2020/benefit…
Select one topic from the Topics section. The Tools and Data Resources provide the data analyses.
Explain how the masters prepared nurse can use this data to develop an educational program to reduce health risks
Mr. Irving was seen today via telehealth while in his house. He remained alert and oriented, denied pain and discomfort. Client verbalized he now daily check his blood pressure where he works. Client stated he works about 30hrs a week. He try to cope with work stress and society demands. Although he has hsitory of anxiety and coping skill is what he lacks. Client was interviewed on the possible cause of anxiety. He said his aim is to go to school or learn something that can create good future for him. Nursing will continue to follow up with client.
14 hours ago
TALAL ALSHAMMARI
The Effects of a New Online Learning Platform on Student Achievement in Mathematics
COLLAPSE
The Effects of a New Online Learning Platform on Student Achievement in
Mathematics
The study’s main aim was to determine if a new online learning platform would positively
impact student achievement in mathematics. The researchers hypothesized that students who used
the online learning platform would perform better on a standardized mathematics test than those
who used traditional instruction methods (Smith et al., 2023).
The study used a non-randomized control group design. Students in the treatment group were
given access to a new online learning platform, while students in the control group received
instruction using traditional methods. Both groups were given the same pre- and post-test in
mathematics.
Strengths and Weaknesses
The study’s strengths used a quasi-experimental design, which is stronger than a correlational
design, as it allows for a causal relationship to be inferred. The study also used a pre-and post-test
design, which allowed for assessing change over time (Cook et al., 1979).
The study’s weaknesses did not use random assignment, a limitation of quasi-experimental
designs. This means that it is possible that the treatment group differed from the control group in
other ways that could have affected the results.
Role of 2-group tests, regression analysis, and time-series analysis
2-group tests, such as the t-test and ANOVA, can be used to compare the means of two groups.
In this study, the t-test was used to compare the mean scores of the treatment and control groups
on the post-test.
Regression analysis: Regression analysis can be used to control confounding variables in quasiexperimental designs. In this study, regression analysis could have been used to control differences
between the treatment and control groups regarding their pre-test scores and other relevant factors.
Time-series analysis: Time-series analysis can examine trends over time. In this study, timeseries analysis could have been used to examine the trends in student achievement in mathematics
in the treatment and control groups over time.
Challenges and limitations
The study did not use random assignment, a limitation of quasi-experimental designs. The study
was conducted in a single school, limiting the findings’ generalizability. Also, the study was
relatively short-term, so it is impossible to say whether the effects of the online learning platform
would persist over time.
In conclusion, the study provides evidence that the new online learning platform can improve
student achievement in mathematics. However, the study has some limitations, such as the lack of
random assignment and the short-term nature of the study. Future research should replicate the
study using a larger sample and a longer-term design to confirm the findings and assess the longterm effects of the online learning platform (Smith et al., 2023).
References
Cook, T. D., & Campbell, D. T. (1979). Quasi-experimentation: Design and analysis issues for
field settings. Houghton Mifflin.
Smith, J. D., & Jones, B. F. (2023). The effects of a new online learning platform on student
achievement in mathematics. Journal of Educational Research, 116(3), 253-265.
3 hours ago
OMAR AL ABBASI
The Effect of 4 Weeks of High-Intensity Interval Training and 2 Weeks of Detraining on
Cardiovascular Disease Risk Factors in Male Adolescents
COLLAPSE
The Effect of 4 Weeks of High-Intensity Interval Training and 2 Weeks
of Detraining on Cardiovascular Disease Risk Factors in Male Adolescents
The study aimed to investigate the effects of a 4-week High-Intensity Interval Training
(HIIT) program followed by a 2-week detraining period on vascular function and traditional
cardiovascular disease (CVD) risk factors in adolescent boys. The study included 19 male
adolescents, with 10 in the training group (TRAIN) and 9 in the control group (CON). The
participants in TRAIN completed HIIT sessions for 4 weeks, while CON did not undergo any
specific training. Vascular function, body composition, and blood biomarkers were assessed
before the training intervention (PRE), 48 hours after the last training session (POST), and after
2 weeks of detraining (DT).
Methods and analyses
– Group Comparison (Independent t-test): The study compared participant characteristics,
including age, height, and body mass, between the TRAIN and CON groups using independent ttests.
– Linear Mixed Model (LMM) Analysis: The LMM analysis was employed to assess the effects
of training and detraining on various outcome measures, including vascular function
(macrovascular and microvascular), body composition (e.g., BMI, fat mass, fat-free mass), and
blood biomarkers (e.g., glucose, insulin, cholesterol levels). This analysis considered the pretraining (PRE) and post-training (POST) measurements as covariates.
Strengths of the study design
– The study used a randomized controlled trial (RCT) design, which is considered a strong
method for assessing cause-and-effect relationships.
– The inclusion of a detraining period allowed for the investigation of how changes in vascular
function and CVD risk factors persisted or reversed after cessation of training.
– The use of both macrovascular (flow-mediated dilatation) and microvascular (peak reactive
hyperemia) function assessments provided a comprehensive view of vascular health.
Weaknesses of the study design
– The relatively small sample size may limit the ability to generalize the findings to a broader
population.
– Lack of control for physical activity outside the study introduces the potential for confounding
variables that could influence the observed outcomes.
– Missing data, particularly in post-training blood lipid measurements, may affect the accuracy
and reliability of the results, potentially introducing bias.
Limitations of the study
– Limited Generalizability: Participants in the current study were adolescent males aged 12–14
years old. Consequently, the results may not directly translate to other demographic groups, such
as female adolescents. While previous research by Bond et al. (2015c) demonstrated no
significant differences in vascular function between sexes following an acute bout of exercise,
future studies involving female adolescents undergoing chronic exercise interventions are
warranted to assess potential gender-specific effects.
– Restricted to Healthy and Fit Youth: All participants, except one, in the present investigation
exhibited fitness levels exceeding the 60th percentile for their age. Therefore, the findings are
primarily applicable to a healthy and fit youth population. It remains uncertain how HIIT may
impact individuals with lower fitness levels or those with specific health conditions.
– Incomplete Post-Training Blood Lipid Data: Post-training blood lipid data were incomplete,
with missing values from three participants in both the TRAIN and CON groups. While Linear
Mixed Model (LMM) analysis was chosen to accommodate missing data, the presence of
missing values could potentially introduce bias or limit the precision of the analysis.
– Uncontrolled Physical Activity Outside the Study: The study was unable to control for physical
activity levels outside the research setting, a challenge shared with the broader literature on
exercise interventions. Although participants were instructed and regularly reminded to maintain
their usual exercise routines throughout the study, variations in external physical activity levels
could have influenced the study outcomes and introduced additional variability.
In summary, the study design’s strengths include its RCT nature and comprehensive
assessment of vascular function, while limitations include the small sample size and potential
confounding factors related to physical activity outside the study. The use of LMM analysis
helped address some of these limitations by accommodating missing data and assessing the
effects of training and detraining over time. However, further research with larger and more
diverse populations is needed to confirm and extend these findings (Kranen et al., 2023).
Reference
Kranen, S. H., Oliveira, R. S., Bond, B., Williams, C. A., & Barker, A. R. (2023). The effect of 4
weeks of high-intensity interval training and 2 weeks of detraining on cardiovascular
disease risk factors in male adolescents. Experimental Physiology, 108(4), 595–
606. https://doi.org/10.1113/EP090340.
14 hours ago
TALAL ALSHAMMARI
Performance Management Approach
COLLAPSE
Whether Show Me the Money should use a behavior approach, a results approach, or a
combination of both to measure performance for account executives depends on several factors,
including the specific goals of the performance measurement system, the job duties of account
executives, and the organization’s culture (Latham & Locke, 1979).
In the case of Show Me the Money, a combination approach is likely to be most effective. This
is because the job duties of account executives are complex and involve various behavioral and
results-oriented activities. For example, account executives need to be able to build relationships
with clients, identify and qualify for new opportunities, develop, and deliver proposals, and close
deals. They also need to be able to provide customer service and support to existing clients.
A combination approach would allow Show Me the Money to measure account executives’
behaviors and results. For example, they could track the number of calls and emails made weekly,
the number of meetings held monthly, and the number of new clients acquired per quarter. They
could also track customer satisfaction scores and revenue generated per account executive (DeNisi
& Murphy, 2017).
By tracking both behavior and results metrics, Show Me the Money can get a more complete
picture of the performance of each account executive. This information can be used to identify and
reward high-performing account executives, provide feedback to underperforming account
executives, and develop training programs to help all account executives improve their
performance (Aguinis – 2013 – Performance Management.Pdf, n.d.).
Overall, a combination approach to performance measurement is likely to be most effective for
Show Me the Money, given the complex job duties of account executives and the need to measure
both behaviors and results.
References
Aguinis—2013—Performance management.pdf. (n.d.). Retrieved September 26, 2023, from
http://elibrary.gci.edu.np/bitstream/123456789/805/1/MBA763%20Performance%20Management.pdf
DeNisi, A. S., & Murphy, K. R. (2017). Performance appraisal and performance management: 100
years
of
progress? Journal
of
Applied
Psychology, 102(3),
421–433.
https://doi.org/10.1037/apl0000085
Latham, G. P., & Locke, E. A. (1979). Goal setting—A motivational technique that
works. Organizational Dynamics, 8(2), 68–80. https://doi.org/10.1016/0090-2616(79)90032-9
19 hours ago
OMAR AL ABBASI
Performance Management Approach
COLLAPSE
Show Me the Money
Based on the provided job description of the account executive at Show Me the Money, a
combination of both the behavior and results approach to measure performance would be most
appropriate (Aguinis, 2019; Kadak & Laitinen, 2023). The behavior approach is suitable because
account executives have specific responsibilities that involve observable behaviors. For example,
they must perform client needs analysis, establish clients on the host processing system, and
complete necessary documentation. These tasks require adherence to specific processes and
procedures, making it important to evaluate the quality of these behaviors (Aguinis, 2019).
Additionally, account executives are responsible for training new account executives and
networking in relevant industries. These activities, such as attending trade shows and meetings,
are also behavior-driven and should be assessed to ensure they are carried out effectively (Kadak
& Laitinen, 2023). The behavior approach is especially relevant when it comes to client
interactions and training responsibilities, where consistency and adherence to best practices are
essential.
On the other hand, the results approach is equally important for measuring the
performance of account executives. Their roles involve achieving specific outcomes, such as
successful client conversions, client satisfaction during the first few payrolls, and providing
support during the conversion process. Furthermore, they play a role in client calls and
supporting sales representatives in presales efforts, which contribute directly to sales outcomes.
Their responsibility to stay informed about industry trends and regulatory changes is also vital
for the overall success of the company (Aguinis, 2019; Kadak & Laitinen, 2023).
Turning to the specific job descriptions for account executives at Show Me the Money, it
becomes evident that both behavior and results approaches are applicable (Aguinis, 2019; Kadak
& Laitinen, 2023). All the listed job descriptions involve a combination of behaviors, such as
establishing clients, completing documentation, and making client calls, as well as results,
including client satisfaction, successful conversions, and staying updated with industry changes.
Therefore, a balanced approach that considers both the behaviors required to perform the job
effectively and the results achieved in terms of client satisfaction, conversions, and sales growth
is the most suitable way to measure performance for account executives at Show Me the Money.
In conclusion, adopting a performance measurement approach that combines the
evaluation of behaviors and results is the most effective way to assess the performance of
account executives in a complex role like this one. This approach ensures that employees not
only follow the correct procedures and behaviors but also achieve the desired outcomes,
ultimately contributing to the success of Show Me the Money in providing payroll and HR
solutions to their clients.
References
Aguinis, H. (2019). Performance management. 5th ed. Upper Saddle River, NJ: Pearson
Prentice Hall.
Kadak, T., & Laitinen, E. K. (2023). How different are performance management systems?
Empirical typology of performance management systems. Journal of Business Economics
and Management, 24(2), 368-386.
Thank you very much for your thoughtful reply to DQ4! According to Buswell (2023), as you know, “The level of services for mental healthcare in Saudi Arabia has developed over the past 30 years. In addition, the country created a national Mental Health Policy in 2006. Those with mental health problems are treated at the primary care level through health centers in the first instance. Serious or persistent problems, on the other hand, are referred to psychiatric hospitals, community residential facilities, or outpatient treatment.” If you were to explain this to someone in terms of private vs. public facilities, how would you do so? Thanks,Dr. Ide ReferencesBuswell, G. (2023, July 27). The healthcare system in Saudi Arabia. Expatica. https://www.expatica.com/sa/healthcare/healthcare-…
Unformatted Attachment Preview
1
Public and Private Healthcare Facilities
Name of Student
Institutional Affiliation
Course
Date
2
Public and Private Healthcare Facilities
Introduction
Healthcare facilities in the Kingdom of Saudi Arabia cover a wide range, with both
public and private organizations playing important roles in the healthcare system (Alumran et
al., 2021). King Faisal Specialist Hospital (private) and King Abdulaziz Medical City
(public) are two separate instances that provide important insights into the distinctions and
similarities between these various healthcare facilities.
The Difference and Similarities
As a private institution, King Faisal Specialist Hospital is distinguished for its
plentiful amenities and expert medical care (Isbister & Al Sanea, 2001). In comparison to
public hospitals, it frequently has shorter waiting times for a variety of medical treatments
and surgical procedures. The hospital’s financial stability, which allows it to invest in stateof-the-art medical technology and draw top-tier medical experts, is supported by patient fees
and private investments (Isbister & Al Sanea, 2001). Because they believe they will receive
better care and more individualized attention at private hospitals like King Faisal Specialist
Hospital, patients frequently choose them. However, the price of services might often be
much higher, which may restrict some people’s access to healthcare.
King Abdulaziz Medical City, on the other hand, is a government-funded and run
public healthcare centre. It focuses on delivering basic healthcare to a larger population,
giving Saudi nationals and residents care at reduced costs or occasionally free (Al-Rowaily,
2010). Due to its larger size and higher patient traffic, this public hospital frequently has
longer wait times. Although it might not have as many opulent amenities as private
institutions, it is nonetheless essential in ensuring that all population groups have fair access
to healthcare.
3
How The Law Impacts the Operation of These Facilities
The legal system in Saudi Arabia has a big impact on how these institutions work.
The Ministry of Health’s rules and policies are primarily responsible for overseeing the
nation’s healthcare system. Private hospitals like King Faisal Specialist Hospital are required
to abide by stringent licensing and accreditation requirements to ensure a minimal level of
quality and safety (Isbister & Al Sanea, 2001). In order to avoid price gouging and guarantee
accessibility, they are also subject to restrictions regarding insurance coverage and pricing.
Government funding supports public hospitals like King Abdulaziz Medical City,
which are also governed by national healthcare regulations aimed at making healthcare
services accessible and cheap for all inhabitants and citizens (Al-Rowaily, 2010). These
facilities must work within their budgetary restrictions because they are funded by the state
budget, which occasionally results in resource shortages and lengthier wait times.
Conclusion
In conclusion, Saudi Arabia’s public and private healthcare facilities have diverse
functions within the healthcare system. Public hospitals place a higher priority on
accessibility and affordability of healthcare services than private healthcare institutions,
which may provide more opulent amenities and specialized treatment. These hospitals’
activities are heavily influenced by Saudi Arabian law, which also ensures that they adhere to
particular criteria and support the country’s broader healthcare goals.
4
References
Al-Rowaily, M. A. (2010). Prevalence of refractive errors among pre-school children at King
Abdulaziz Medical City, Riyadh, Saudi Arabia. Saudi Journal of
Ophthalmology, 24(2), 45-48. https://doi.org/10.1016/j.sjopt.2010.01.001
Alumran, A., Almutawa, H., Alzain, Z., Althumairi, A., & Khalid, N. (2021). Comparing
public and private hospitals’ service quality. Journal of Public Health, 29, 839-845.
https://doi.org/10.1007/s10389-019-01188-9
Isbister, W. H., & Al Sanea, N. (2001). The cutting seton: an experience at King Faisal
Specialist Hospital. Diseases of the colon & rectum, 44, 722-727.
https://doi.org/10.1007/BF02234574
The application of a theory and/or model to address population-based health problems is a skill developed through continual practice. For this Assignment, you will gain familiarity with the process of asking questions and taking the first steps to applying a theory/model to an identified issue. In practice, you would not be doing this alone but as part of a team. However, going through the process in the context of this Assignment will assist in gaining familiarity and confidence with the general process.
To Prepare:
Based on the public health issue you identified in Week 1, think about how you might apply one of the theories/models from this week’s Learning Resources to develop interventions for the public health issue. Topic is on obesity
The Assignment:
Write a 2- to 3-page paper that includes following: Rubric Attached
Identify a public health theory or model that you think is the most appropriate model to apply to the public health issue you selected in Week 1.
Justify why this public health theory or model is the most appropriate choice for this public health issue.
Explain how you might apply the public health theory or model to the public health issue you selected.
Explain what you learned about the public health issue you selected by applying the selected public health theory or model to the issue.
Unformatted Attachment Preview
1
Current Issues in Public Health
Name
Institution
Course
Instructor
Date
2
Current Issues in Public Health
There are several public health issues across the globe and they impact the health of
communities, families, and nations in various ways. One of the current issues in public health is
obesity. An individual whose weight exceeds what is considered the normal weight for a
particular height is defined as having obesity or being overweight. Obesity is a significant issue
in public health as it affects approximately more than two in five adults and approximately one in
five children and adolescents, according to NIH (2021). This health condition also is a major
issue in public health as it is associated with numerous health issues, particularly chronic
illnesses including heart disease, diabetes, cancer, and depression among others. In addition to
that, obesity can result in gestational diabetes among pregnant women and is also associated with
infant mortality. To put it into perspective, around 4 million people die annually as a result of
obesity and the medical costs for individuals with obesity in the U.S. are about 30% – 40%
higher than for those without the condition (Laurence, 2023).
Obesity arises when an individual’s energy intake is much greater than the energy used,
particularly from engaging in physical activity. Hence, according to Temple (2022), the origin of
the obesity epidemic can be attributed to a decrease in physical activity and excess energy intake
from food or a combination of both. With that in mind, it can be deduced that obesity emerged as
a result of changes in the American diet. Currently, some of the food individuals consume
including dietary fat, sugar and sugar-sweetened drinks, and ultra-processed foods, are associated
with weight gain, a hallmark of obesity. Apart from changes in diet, a decrease in physical
activity also contributed to the emergence of obesity. This can be attributed to a decrease in
manual labor as well as increased access to public transport and cars.
3
Several efforts have been initiated to address obesity. One of these efforts is a priority
strategy targeting early care and education and healthy weight programs. According to the CDC
(2022), the U.S. has prioritized implementing policies and activities that not only improve
physical activity and nutrition but also sustain healthy weight programs for all age groups. Other
efforts to address obesity include working with communities to make it easier for individuals to
eat healthily and be more physically active, measuring obesity trends and related risk factors,
supporting children and families who have a high chance of having obesity through various
services, and funding programs and providing resources for initiatives that advance physical
activity, healthy eating, and food security. In my opinion, these efforts have significantly reduced
the prevalence of obesity. For instance, through early care and education weight programs,
children gain knowledge about healthy living and this has a positive impact on their health and
well-being.
A nurse with public health expertise can intervene to address the obesity epidemic in
various ways. One of these ways is measuring the weight, BMI, and height of their patients and
in turn, counsel and educate them on how to sustain a healthy weight and its role in obesity
prevention. Also, a nurse with public health experience can help reduce obesity incidence by
teaching and instructing individuals about physical activity and nutrition among other factors
associated with obesity development. Additionally, a nurse with public health expertise can
intervene to address obesity by assisting in screening children and adults for obesity and
overweight. After screening, the nurse can refer those with the health issue or at risk of
developing the condition to various programs, including weight programs and obesity prevention
programs. Moreover, a nurse with public health knowledge can connect at-risk persons and those
with obesity with community services to aid them in eating healthily and becoming more active.
4
References
CDC. (2022b, May 17). Adult obesity facts. Centers for Disease Control and Prevention.
https://www.cdc.gov/obesity/data/adult.html
Laurence, E. (2023, June 13). Obesity statistics. Forbes.
https://www.forbes.com/health/body/obesity-statistics/
NIH. (2021). Overweight & Obesity Statistics – Niddk. National Institute of Diabetes and
Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/healthstatistics/overweight-obesity
Temple, N. J. (2022). The origins of the obesity epidemic in the USA–Lessons for
today. Nutrients, 14(20), 4253. https://doi.org/10.3390%2Fnu14204253
USW1_NURS_6710_week05_Assignment_Rubric
USW1_NURS_6710_week05_Assignment_Rubric
Criteria
Ratings
Quality of Work
Submitted: The
extend of which work
meets the assignned
criteria and work
reflects graduate level
critical and analytic
thinking.
30 to >26.0 pts
26 to >23.0 pts
Excellent
Good
Assignment
exceeds
expectations.
All topics are
addressed with
a minimum of
75% containing
exceptional
breadth and
depth about
each of the
assignment
topics.
Assignment
meets
expectations.
All topics are
addressed
with a
minimum of
50%
containing
good breadth
and depth
about each of
the
assignment
topics.
Quality of Work
Submitted: The
purpose of the paper
is clear.
Pts
23 to
>20.0 pts
Fair
Assignment
meets most of
the
expectations.
One required
topic is either
not addressed
or
inadequately
addressed.
5 to >4.0 pts
4 to >3.5 pts
Excellent
Good
A clear and
comprehensive
purpose statement
is provided which
delineates all
required criteria.
Purpose of the
assignment is
stated, yet is
brief and not
descriptive.
3.5 to
>3.0 pts
Fair
Purpose of
the
assignment is
vague or off
topic.
20 to >0 pts
Poor
Assignment
superficially
meets some of
the
expectations.
Two or more
required
topics are
either not
addressed or
inadequately
addressed.
30 pts
3 to >0 pts
Poor
No purpose
statement
was
provided.
5 pts
USW1_NURS_6710_week05_Assignment_Rubric
Criteria
Ratings
Assimilation and
Synthesis of Ideas:
The extend to which
the work reflects the
student’s ability
to:Understand and
interpret the
assignment’s key
concepts.
10 to >8.0 pts
8 to >7.0 pts
7 to >6.0 pts
6 to >0 pts
Excellent
Good
Fair
Poor
Demonstrates
the ability to
critically
appraise and
intellectually
explore key
concepts.
Demonstrates
a clear
understanding
of key
concepts.
Shows some
degree of
understanding
of key
concepts.
Shows a lack of
understanding
of key
concepts,
deviates from
topics.
20 to >17.0 pts
17 to
>15.0 pts
15 to
>13.0 pts
13 to >0 pts
Good
Fair
Integrates
specific
information
from 1
credible
outside
resource and
2-3 course
resources to
support major
points and
point of view.
Minimally
includes and
integrates
specific
information
from 2-3
resources to
support
major points
and point of
view.
Assimilation and
Synthesis of Ideas:
The extend to which
the work reflects the
student’s ability
to:Apply and integrate
material in course
rsources (i.e. video,
required readings,
and textook) and
credible outside
resources.
Excellent
Demonstrates
and applies
exceptional
support of major
points and
integrates 2 or
more credible
outside sources,
in addition to 2-3
course resources
to support point
of view.
Pts
10 pts
Poor
Includes and
integrates
specific
information
from 0 to 1
resoruce to
support
major points
and point of
view.
20 pts
USW1_NURS_6710_week05_Assignment_Rubric
Criteria
Assimilation and
Synthesis of Ideas:
The extend to which
the work reflects the
student’s ability
to:Synthesize
(combines various
components or
different ideas into a
new whole) material
in course resources
(i.e. video, required
readings, textbook)
and outside, credible
resources by
comparing different
points of view and
highlighting
similarities,
differences, and
connections.
Ratings
20 to >17.0 pts
Excellent
Synthesizes
and justifies
(defends,
explains,
validates,
confirms)
information
gleaned from
sources to
support major
points
presented.
Applies
meaning to the
field of
advanced
nursing
practice.
Pts
17 to
>15.0 pts
Good
Summarizes
information
gleaned from
sources to
support
major points,
but does not
synthesize.
15 to >13.0 pts
Fair
Identifies but does
not interpret or
apply concepts,
and/or strategies
correctly; ideas
unclear and/or
underdeveloped.
13 to
>0 pts
Poor
Rarely or
does not
interpret,
apply, and
synthesize
concepts,
and/or
strategies.
20 pts
USW1_NURS_6710_week05_Assignment_Rubric
Criteria
Written Expression
and
FormattingParagraph
and Sentence
Structure: Paragraphs
make clear points that
support well
developed ideas, flow
logically, and
demonstrate
continuity of ideas.
Sentences are clearly
structured and
carefully focused-neither long and
rambling nor short
and lacking
substance.
Written Expression
and FormattingEnglish
writing standards:
Correct grammar,
mechanics, and
proper punctuation
Ratings
Pts
5 to >4.0 pts
4 to >3.5 pts
3.5 to >3.0 pts
3 to >0 pts
Excellent
Good
Fair
Poor
Paragraphs
and sentences
follow writing
standards for
structure,
flow,
continuity and
clarity
Paragraphs
and sentences
follow writing
standards for
structure, flow,
continuity and
clarity 80% of
the time.
Paragraphs
and sentences
follow writing
standards for
structure, flow,
continuity and
clarity 60%79% of the
time.
Paragraphs
and sentences
follow writing
standards for
structure, flow,
continuity and
clarity < 60%
of the time.
5 to >4.0 pts
4 to >3.5 pts
Excellent
Good
3.5 to
>3.0 pts
Uses correct
grammar,
spelling, and
punctuation
with no
errors.
Contains a
few (1-2)
grammar,
spelling, and
punctuation
errors.
Fair
Contains
several (3-4)
grammar,
spelling, and
punctuation
errors.
5 pts
3 to >0 pts
Poor
Contains many (≥
5) grammar,
spelling, and
punctuation
errors that
interfere with the
reader’s
understanding.
5 pts
USW1_NURS_6710_week05_Assignment_Rubric
Criteria
Written Expression
and FormattingThe
paper follows correct
APA format for title
page, headings, font,
spacing, margins,
indentations, page
numbers, running
head,
parenthetical/in-text
citations, and
reference list.
Ratings
Pts
5 to >4.0 pts
4 to >3.5 pts
3.5 to >3.0 pts
3 to >0 pts
Excellent
Good
Fair
Poor
Uses correct
APA format
with no errors.
Contains a few
(1-2) APA
format errors.
Contains
several (3-4)
APA format
errors.
Contains many
(≥ 5) APA
format errors.
5 pts
Mr. Kelton is a 45 yr old man that lives in the district. He is alert and oriented x3, verbalized skin was intact without cut or bruise. Client cannot remember last medical appointment visit. Client denied suicidal ideation or homicide. He has history of post traumatic stress disorder and schizoaffective bipolar type. Presently, client verbalized he was homeless and performed activities of daily living in a shelter or friends house. Client verbalized to be stable until his mother died. Nurse provided education on hygiene due to homelessness. Follow the rubric below.
W5: Interactive Activity
W5: Interactive ActivityRead the following:- Combining end-user recruitment methods for usability testing of eTriage Service- Blockchain Technology in Healthcare: A Comprehensive Review and Directions for Future Research
Watch the following video(s):
Usability testing
Ensuring digital accessibility and employability for persons with disabilities in Singapore
Interactive Activity 4
Purpose
The purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos.
Action Items
What is blockchain? give some exmaple of using this technology in the healthcare industry?
Mr. Harrold telehealth visit was completed today while he was in the community. He verbalized no change in condition since last visit. Client stated skin was intact, well hydrated, no bruise or cut. He likes what he does daily. Followed rules and regulations that binds him both at work and community as whole. Client further stated he cooked his food and eat healthy. He stated he needed help to ease separation anxiety disorder. client explained he fear that loved one’s may leave him and this will severely increase his anxiety. Nurse educates client on intervention to separation anxiety disorder. Follow the rubric below
Read a Scholarly Article about CQ: For this discussion, each student will need to select a scholarly journal article about CQ in a specific professional discipline. Note that a variety of articles have been provided in the Discussion Thread: CQ in the Marketplace Assignment Resources area below to relate to a large selection of degree fields and professional interests; however, if a student does not find an article that matches their interests, they can do their own research to find a different article. You should send the article to your professor and get prior approval before using an article if it is different than the ones provided.Once you have read your article please answer the following questions in your thread: (Questions in parenthesis are suggestions to help guide your writing).Briefly summarize the article. (What were the researchers studying? What was the primary thesis of the article? How did they conduct their research? What were the results?)Using this article as well as other course materials, discuss the implications of Cultural Intelligence in your chosen professional field. (What cross-cultural challenges exist in your profession? How will having high CQ help to address those challenges? What other research needs to be done in order to develop high CQ in your field?)Imagine you were creating a professional development seminar on cultural intelligence for professionals in your chosen field. Aside from simply defining CQ, what topics would you focus on? How would you help your attendees practically apply CQ to your field?Remember to include a citation for your article and any other sources you use at the bottom of your thread. THE CQ ARTICLE: https://www.emerald.com/insight/content/doi/10.1108/ITP-04-2016-0099/full/html
Learning Activities
Read the following:
“Informatics of Toxicology and Environmental Public Health”
Interactive Activity 4
Purpose
The purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos.
Action Items
Name at least four systems designed to assist toxicologists and environmental health professionals in protecting the public. Describe the function of each?
SOAP format is the documentation style you will be using in your clinicals; this also adheres to the thought processes involved in formulating the correct diagnosis and treatment plan. You will present the subjective data first, including all questions that you want to ask. Next is the gathering of objective data that supports your subjective data; if there is none given, then you will determine by system what kind of physical exam elements you want to elicit. After this, you are ready to provide differentials and a working diagnosis based on the above data. After arriving at the appropriate working diagnosis, you will then formulate a treatment plan. Please be sure to follow the template below for your initial discussion board postings. Postings should be concise and NOT in narrative format.
Template
Case Study Chosen: (List what case you have chosen)
Demographics: Age/Gender
SUBJECTIVE
CC:
HPI: (As listed from Case Study Information)
Subjective: (What questions will you ask? Must be listed by System, ONLY as it pertains to Chief Complaint/HPI. Should NOT be all systems or full head to toe unless pertinent).
OBJECTIVE
General:
VS BP, HR, RR, Weight, Height, BMI
Physical Exam Elements: (Must be listed by System, ONLY as it pertains to Chief Complaint/HPI. Should NOT be all systems or full head to toe unless pertinent.)
POC Testing (any Point of Care (POC) testing specifically performed in the office): What tests (if any) did you perform during the visit (urine dip, rapid strep, urine pregnancy test, Glucose finger-stick, etc.)? Leave blank if none.
ASSESSMENT
Working Diagnosis: (Must include ICD 10)
Differential Diagnosis:
PLAN
Diagnostic studies: If any, will be ordered (Labs, X-ray, CT, etc.). Only include if you will be ordering for your patient. Remember the importance of appropriate resource utilization. Remember you are managing this patient in the CLINIC setting, NOT THE HOSPITAL.
Treatment: Must include full Sig/Order for all prescriptions and OTC meds (Name of medication, dosage, frequency, duration, number of tabs, number of refills). CANNOT only list drug class. Should follow evidence-based guidelines.
Referrals: If Applicable
Education:
Health maintenance:
RTC:
Week 4 GI Discussion Prompts: Choose 1 discussion
A 25-year-old male graduate student is seen in the office with the chief complaint of upper abdominal pain. He states that he noticed the pain intermittently over the past several weeks. He notices that he gets a gnawing pain about 2 hours after he eats. He also notes that he has some bloating and occasional nausea with the pain. He states that the pain is relieved by antacids most of the time.
A 34-year-old female presents with the complaint of sudden excruciating pain in her back and points to her flank area on the right side. She rates the pain as 10 on a scale of 1 to 10, with 10 being the worst. She also complains of nausea with the pain. She states that she has never had anything like this before, and the pain is subsiding a little now.
A 30-year-old male comes in complaining of 2 days of loose to watery diarrhea, 4 to 5 times a day with significant nausea and one episode of vomiting today. He has a temperature of 100.5 on presentation and an HR of 102. His skin is slightly pale, and he is complaining of abdominal cramping. He states that he was in his usual state of health prior to the diarrhea and denies any unusual travel or food. His abdomen is generally tender with no rebound or guarding.
Table 1. Common GI Diagnoses. In addition to your SOAP note, you must also complete the following table. Upload your SOAP note and table to the discussion board.
Levels of Evidence Project
Author(s)
Smith, A.L., Cazzell, M. &
Holland, J.
Title / Topic
Year
Publication
Type of Research
Psychometric Evaluation of
a Tool for Assessment of
Clinical Development in
Newly Licensed Registered
Nurses
2019
Journal of Nursing
Measurement, 27 (1) E-1 – E16.
Quantitative
Methodology
Summary of Findings re: @ Concept
Concepts & Theoretical /
Operational Definitions
Scored self-report survey
Concept: Clinical Development
Clinical development to the level of
using numerically scored
Theoretical Definition – Process of competent does not appear to require the
levels of nursing
acquiring knowledge, skills, and two years’ of experience suggested by
competence, and
attitudes in clinical nursing
Benner (1984); rather with support of a 12observational performance practice.
month, nationally accredited residency can
report by preceptors
Operational Definition – Elements be accomplished in about six months. Based
followed by statistical factor of Clinical Development
on the factor analysis, the concept of
analysis.
Assessment (CDA) including
Clinical Developmen t is a single concept
scoring of patient assessment,
composed of the nine elements of clinical
health history, diagnostic studies, performance tested.
nursing interventions, patient
education, critical thinking,
communication, service
excellence and , safety.
Concept: Novice
Theoretical Definition (Benner)
complete basic components of
the patient care element, with
guidance distinguishing normal
and abnormal.
Operational Definition – score
between zero (unsafe) and
five(expert). This is a sample;
there are other concepts in the
article. In your assignment,
identify all concepts.
Level of Evidence
Level III – evidence obtained
from a well-designed
controlled trial without
randomization.
Levels of Evidence Project
Author(s)
Title / Topic
Year
Publication
Type of Research
Methodology
Concepts &
Theoretical/Conceptual
Operational Definitions
Concept:
Theoretical/Conceptual
Definition:
Operational Definition:
Concept:
Theoretical/Conceptual
Definition:
Operational Definition:
Concept:
Theoretical/Conceptual
Definition:
Operational Definition:
Concept:
Theoretical/Conceptual
Definition:
Operational Definition:
Concept:
Theoretical/Conceptual
Definition:
Operational Definition:
Concept:
Theoretical/Conceptual
Definition:
Operational Definition:
Concept:
Theoretical/Conceptual
Definition:
Operational Definition:
Concept:
Theoretical/Conceptual
Definition:
Operational Definition:
Concept:
Theoretical/Conceptual
Definition:
Operational Definition:
Concept:
Theoretical/Conceptual
Definition:
Operational Definition:
Concept:
Theoretical/Conceptual
Definition:
Operational Definition:
Concept:
Theoretical/Conceptual
Definition:
Operational Definition:
Concept:
Theoretical/Conceptual
Definition:
Operational Definition:
Summary of Findings re: @ Concept
Level of Evidence
1
Midwestern State University
Wilson School of Nursing
Nursing 5023: Nursing Research
Module III
Course Objective: Evaluate the appropriateness of selected quantitative and qualitative
research designs relative to research problems, purposes, questions, and/or hypotheses.
Explore:
Access the website NIH Library | NIH Library
Check out the list of resources
•
Search for keywords in the Journal Articles listed below:
o Rye M, Torres EM, Friborg O, Skre I, Aarons GA. The Evidence-based Practice
Attitude Scale-36 (EBPAS-36): a brief and pragmatic measure of attitudes to
evidence-based practice validated in US and Norwegian samples. Implement Sci.
2017;12(1):44. Published 2017 Apr 4. doi:10.1186/s13012-017-0573-0
o Beebe, S.L., McKague, D.K. & Wallington, S.F. (2022). COVID-19 on New Primary
Care Nurse Practitioners: A Qualitative Exploration. The Journal for Nurse
Practitioners, 18(6) doi.org/10.1016/j.nurpra.2022.02.026
o Hagle M, Dwyer D, Gettrust L, Lusk D, Peterson K, Tennies S. Development and
Implementation of a Model for Research, Evidence-Based Practice, Quality
Improvement, and Innovation. J Nurs Care Qual. 2020;35(2):102‐107.
doi:10.1097/NCQ.0000000000000422
•
What type of research is reflected in each of these articles?
o Rye, M. et al. (2017)
o Beebe, S.L., McKague, D.K. & Wallington, S.F. (2022).
o Hagle, M. et al. (2020)
2
•
What conclusions were drawn from that research?
o Rye, M. et al. (2017)
o Beebe, S.L. et al. (2022)
o Hagle, M. et al. (2020)
Use your available resources to locate the following study:
Powers, J. (2020). Increasing capacity for nursing research in Magnet-designated organizations’
organizational model to promote nursing research. Applied Nursing Research,
https://doi.org/10.1016/j.apnr.2020.151286
•
What type of research is reflected in this article?
o Powers, J. (2020)
•
What conclusions were drawn from that research?
o Powers, J. (2020)
Use the MSU Library Database to locate the following article:
Pittman, J., Cohee, A., Storey, S., LaMothe, J., Gilbert, J., Giorgos, B., Ofner, S. & Newhouse, R.
(2119). A multisite health system survey to assess organization context to support
evidence-based practice. Worldviews on Evidence-Based Nursing, 16(4) 271-280.
•
What type of research is reflected in this article?
•
What conclusions were drawn from that research?
3
Read:
Gray, J. R., Grove, S. K. (2021). Burns and Grove’s The practice of nursing research: Appraisal,
synthesis, and generation of evidence (9th Ed.). St. Louis, MO: Elsevier. ISBN: 978-0-323673174; p. 234-257, 261-272 & 369-392.
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare
(4th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. ISBN: 978-1-4511-9094-6; (p.
124-215).
Learning Activity:
Select two of the articles provided in Module III on D2L and decide how would you explain to a
classmate your criteria for determining rigor / whether or not you consider the research
effective (and applicable to practice) or ineffective (and therefore less useful in guiding
practice)?
Authors
Effective / Ineffective
Rationale
If a qualitative article is chosen, rigor is
demonstrated in trustworthiness,
confirmability, transparency, transferability, etc.
If a quantitative article is chosen, rigor is
demonstrated by values for the reliability of
measurement tools, and various types of
validity of measurement tools.
Complete the Levels of Evidence Project on the EXCEL spreadsheet provided and submit it in
the course Dropbox by the due date on the course calendar.
When the assignment is completed drop the ENTIRE completed assignment sheet into the
course Dropbox.
Middle-range theories are narrower in scope than grand theories and deal with some parts of a discipline’s concerns related to particular topics. Because of a middle-range theory’s more limited scope and specificity, it is more readily useable and testable in research projects. For example, Madeline Lenninger’s Culture Care theory can guide nurses with specific actions to provide appropriate and meaningful care preservation and maintenance to restore health and prevent disparities. Dr. Lenninger’s theory explores meaningful and experiential patient experiences while employing the concept of ethnicity, race, and culture as integral to understanding the individual patient experience within a specific population.
Assignment Objectives:
1. Describe how middle-range theories in nursing apply to vulnerable populations.
2. Choose a middle-range theory that has been instrumental in preventing health disparities.
3. Provide at least one research example that uses a middle-range theory that can be used to address health disparities.
Directions:
1. Conduct a brief literature review of the middle range theory, concentrating mainly on their relationships. Please gather the theoretical foundations of the middle range theory as a model to prevent health disparities (It is often difficult to explain such relationships in words. On this occasion, make notes during your review, but use these to produce a figure or diagram showing the relationships in theory).
2. Think about vulnerable populations concerning social determinants of health and how a specific middle-range theory can be used to analyze a plan of care that maximizes their health potential.
3. How can this theory be used in your current practice area (education, executive, clinical practice, informatics, or healthcare policy) to address equitable health outcomes among various populations?
4. The post should be 300 words or less. Observe APA style 7th edition
Middle Range Theories Examples
Patricia Benner: Benner’s Model of Skill Acquisition in Nursing
From Novice to Expert (Nursing-Theory.org)Links to an external site.
Madeleine Leininger: Cultural Care Diversity and Universality Theory
Leininger’s Theory of Culture Care Diversity and Universality (nursology.net)Links to an external site.
Nola Pender: Health Promotion Model
Health Promotion in Nursing Practice (nursology.net)Links to an external site.
Afaf Ibrahim Meleis: Transitions Theory
Transitions Framework / Transitions Theory (nursology.net)Links to an external site.
The Synergy Model
The Synergy Model (nursology.net)Links to an external site.
Mishel’s Uncertainty in Illness Theory
Mishel’s uncertainty in illness theory: Informing nursing diagnoses and care planningLinks to an external site.
Kolcaba’s Theory of Comfort
Kolcaba’s Comfort Theory (nursology.net)Links to an external site.
A practical application of Katharine kolcaba’s comfort theory to cardiac patientsLinks to an external site.
Lenz and Colleagues’ Theory of Unpleasant Symptoms
Theory of Unpleasant Symptoms (nursology.net)Links to an external site.
Reed’s Self-Transcendence Theory
Self-transcendence Theory (nursology.net)Links to an external site.
Eakes, Burke, and Hainsworth’s Theory of Chronic Sorrow
Overview of the Theory of Chronic Sorrow (chapter from Nursing Theories: A Framework For Professional Practice)Links to an external site.
Cheryl Beck: Beck’s Postpartum Depression Theory
Middle Range Theory of Traumatic Childbirth: The Ever Widening Ripple Effect (nursology.net)Links to an external site.
Ramona Mercer: Conceptualization of Maternal Role Attainment/Becoming a Mother
Mercer’s Maternal Role Attainment Theory (Nursing-Theory.org)Links to an external site.
AACN Synergy Model for Patient Care
https://www.aacn.org/nursing-excellence/aacn-standards/synergy-model
Create one Word documents containing all parts of the assignment.
Format your document with one-inch margins and 12-point Times New Roman font.
One page, double-spaced for each part.
Instructions: Part 1: A Personal Negotiation
1. Describe a recent negotiable you were involved in (we all negotiate every day, even it is negotiating with a family member, friend, purchasing a product or service, or with a boss at work.). Include answers to the following questions:
What was the issue(s) being negotiated? Provide adequate background.
What was the outcome you desired? How did you determine this outcome desired?
What was the outcome you obtained?
Based on what you learned on negotiation in this topic, what TWO negotiating strategies you would have utilized to gain a maximum desired outcome?
Instructions: Part 2: New Managed Care Analyst….You!
1.Read the following scenario:
As the new managed care analyst at XYZ internal medicine in Fairfax, VA the practice administrator has asked you to begin preparations for a managed care contract negotiation with Cigna Health Plan.
2. In addition to reimbursement rates, identify four additional items with a brief explanation of each, which you will address/research on behalf of the medical practice
Instructions: Part 3(ARTICLE ATTACHED)
Please review the article ” Get Higher Paying”…list three concepts your learned when you are put in the position of negotiating with a managed care plan
Instructions:Thinking about your work area, elaborate on a case study with any specific issue you face daily.Implement a transformational change to solve this situation and describe the possible forces that help and/or oppose the changes.Include a potential policy to implement in an attempt to solve the problem involving quality and safety in this patient’s healthcare.Your case study must be original work and logically organized. You may follow the current APA format, including citation of references.You must incorporate a minimum of 3 current (published within the last five years) scholarly journal articles or primary legal sources to support your paper. All of them should be referenced according to APA style
You are the Administrator of the Happy Valley Nursing Home. Your facility has 60 private rooms and accepts patients that need care with basic daily functions such as dressing, bathing, mobility. You and your staff also provide mental, physical, and social activities to the residents such as music, games etc.
Mission of Happy Valley Nursing Home: Achieve the Best Outcomes
Vision of Happy Valley Nursing Home: To be the choice for long-term care in the community
For this assignment, write goals and objectives for your facility by focusing on:
State one goal that you would like for your facility regarding the daily function care for your residents and then write one objective for that goalthat is measurable, observable, and attainable and timely.
State one goal that you would like for your facility regarding the mental, physical, and social activities for your residents and then write one objective for that goal that is measurable, observable, and attainable and timely.
An applicant’s professional history and qualifications are outlined in a resume. A cover letter is a way for the applicant to make a professional introduction to the hiring manager and demonstrate an interest in the company.
Develop a current resume and create a formal cover letter for a position for which you would like to apply. Create both the cover letter and resume using a professionally accepted format provided on the Resume-Resources website, located in the topic Resources.
Include the following:
Resume: Detail your overall education, credentials, and professional experience, such as licenses, earned degrees, certifications, professional experiences, previous positions held, membership in professional organizations, publications, and skills.
Write a one-page double spaced introductory cover letter in which you explain your professional objectives, professional interests, and strengths as an applicant.
Prior to submission, share your resume with a colleague and obtain feedback. Revise your resume as needed
While APA style format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Unformatted Attachment Preview
Resume and Cover Letter – Rubric
LISTGRID
PRINT TO PDF
Rubric Criteria
Collapse All Rubric CriteriaCollapse All
Introductory Cover Letter
29.6 points
Criteria Description
Introductory cover letter of no more than one-page double spaced explaining professional objectives,
professional interests, and strengths of the applicant. Cover letter is formally written using a
professionally accepted format.
5. Excellent
29.6 points
The cover letter includes all components as indicated by the assignment instructions. Explanation of
professional objectives, professional interests, and strengths of the applicant is written in a clear and
concise manner. Cover letter has a professional appearance.
4. Good
26.34 points
The cover letter includes all components as indicated by the assignment instructions, including no
more than one-page double spaced professional objectives, professional interests, and strengths of the
applicant.
3. Satisfactory
23.38 points
The cover letter includes all components as indicated by the assignment instructions, including no
more than one-page double spaced professional objectives, professional interests, and strengths of the
applicant.
2. Less than Satisfactory
22.2 points
The cover letter is missing one of the components indicated by the assignment instructions, including
no more than one-page double spaced explaining professional objectives, professional interests, and
strengths of the applicant; or letter is not in a professionally accepted format.
1. Unsatisfactory
0 points
No cover letter is provided or is missing more than one of the components as indicated by the
assignment instructions.
Resume is formally written using a professionally accepted format.
29.6 points
Criteria Description
Resume is formally written using a professionally accepted format.
5. Excellent
29.6 points
The resume includes all components as indicated by the assignment instructions detailing license(s),
earned degree(s), certification(s), professional experiences, previous positions held, membership in
professional organizations, publications, and skills. Resume is offered in a detailed yet concise
manner. The resume has a professional appearance.
4. Good
26.34 points
The resume includes all components as indicated by the assignment instructions detailing license(s),
earned degree(s), certification(s), professional experiences, previous positions held, membership in
professional organizations, publications, and skills. Resume is offered in a detailed yet concise
manner.
3. Satisfactory
23.38 points
The resume includes all components as indicated by the assignment instructions, detailing license(s),
earned degree(s), certification(s), professional experiences, previous positions held, membership in
professional organizations, publications, and skills.
2. Less than Satisfactory
22.2 points
The resume is missing one of the components indicated by the assignment instructions, including the
detailing license(s), earned degree(s), certification(s), professional experiences, previous positions
held, membership in professional organizations, publications, and skills.
1. Unsatisfactory
0 points
No resume is provided, or resume is missing more than one of the components as indicated by the
assignment instructions.
Language Use and Audience Awareness (includes sentence construction, word choice, etc.)
7.4 points
Criteria Description
Language Use and Audience Awareness (includes sentence construction, word choice, etc.)
5. Excellent
7.4 points
The writer uses a variety of sentence constructions, figures of speech, and word choice in distinctive
and creative ways that are appropriate to purpose, discipline, and scope.
4. Good
6.59 points
The writer is clearly aware of audience, uses a variety of appropriate vocabulary for the targeted
audience, and uses figures of speech to communicate clearly.
3. Satisfactory
5.85 points
Language is appropriate to the targeted audience for the most part.
2. Less than Satisfactory
5.55 points
Some distracting inconsistencies in language choice (register) or word choice are present. The writer
exhibits some lack of control in using figures of speech appropriately.
1. Unsatisfactory
0 points
Inappropriate word choice and lack of variety in language use are evident. Writer appears to be
unaware of audience. Use of primer prose indicates writer either does not apply figures of speech or
uses them inappropriately.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
7.4 points
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5. Excellent
7.4 points
Writer is clearly in command of standard, written, academic English.
4. Good
6.59 points
Prose is largely free of mechanical errors, although a few may be present. A variety of sentence
structures and effective figures of speech are used.
3. Satisfactory
5.85 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct
sentence structure and audience-appropriate language are used.
2. Less than Satisfactory
5.55 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice
(register), sentence structure, or word choice are present.
1. Unsatisfactory
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate
word choice or sentence construction is used.
For this assignment, you will produce a professional 4–7 minute audio–video presentation on your chosen topic.
Your presentation must:
Explain the processes or concepts in your own words using references to support your explanations.
Include all necessary physiology and pathophysiology in your explanation.
Use detailed explanations with master’s level terminology to teach or explain. Your classmates and professional colleagues are your audience.
Include audio narration with at least one type of visual aid in your presentation, such as PowerPoint slides, diagrams, whiteboard use, etc.
Use APA format to style your visual aids and cite your sources.
Cite at least two references verbally or with on-screen citations. You may cite your e-text as a source.
Include a reference list in your visual aid or at the end of your slide set.
NURS 530 Video Presentation Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
25 to >21.75 pts
Meeting Expectations
The introduction gets your attention and lays out the topic well. It establishes a strong framework for the rest of the presentation. The conclusion is comprehensive and compelling. Presentation contains accurate and complete information. Ideas, facts, and information demonstrate a strong, confident understanding of the material.
21.75 to >18.75 pts
Approaching Expectations
The introduction lays out the topic. It establishes some framework for the rest of the presentation. The conclusion is clear. Presentation contains accurate and complete information. Ideas, facts, and information demonstrate an understanding of the material.
18.75 to >14.75 pts
Falling Slightly Below Expectations
The minimal introduction establishes a vague framework for the rest of the presentation. The conclusion is abrupt or unclear. Presentation contains some inaccurate and incomplete information. Ideas, facts, and information demonstrate little understanding of the material.
14.75 to >0 pts
Not Meeting Expectations
Introduction is missing. No framework is established for the presentation. The conclusion is missing. There may be multiple instances of inaccurate or incomplete information. No understanding is demonstrated.
25 pts
This criterion is linked to a Learning OutcomeOrganization
15 to >13.05 pts
Meeting Expectations
Information is presented in a clear, logical order with an apparent beginning, middle, and end. The speaker introduces the topic and identifies it skillfully.
13.05 to >11.25 pts
Approaching Expectations
Information is generally presented in a clear, logical order with an apparent beginning, middle, and end. The speaker introduces the topic.
11.25 to >8.85 pts
Falling Slightly Below Expectations
Information is presented in a way that shows little organization or order. The speaker fails to introduce the topic or does so in a way that is confusing.
8.85 to >0 pts
Not Meeting Expectations
Information is not presented in a logical, cohesive order. Topic is unclear.
15 pts
This criterion is linked to a Learning OutcomeNarration (audio)
15 to >13.05 pts
Meeting Expectations
The speaker speaks clearly and articulately without a lot of pauses, “ums,” and “ahs.” Information is presented in a confident, rehearsed manner. The speaker presents with a tone and manner appropriate for an academic audience. Audio is clear and free from background noise distractions. The length of presentation is within the assigned time limits.
13.05 to >11.25 pts
Approaching Expectations
The speaker speaks clearly and articulately for most of the presentation but may lapse occasionally with several pauses, “ums,” and “ahs.” Information is presented in a somewhat confident, casually rehearsed manner. The speaker generally presents with a tone and manner appropriate for an academic audience. Audio is generally clear and free from background noise with a few distractions. The length of presentation is slightly outside the assigned time limits.
11.25 to >8.85 pts
Falling Slightly Below Expectations
There are numerous lapses in audio or multiple background distractions. Speaker demonstrates little preparation. Tone may be inappropriate for the audience. The length of presentation is far outside the assigned time limits. Some audio is missing or difficult to hear. The length of presentation is well outside the assigned time limits.
8.85 to >0 pts
Not Meeting Expectations
It is difficult to follow the speaker due to many pauses, starts and stops, and other factors suggesting the speaker is not practiced or rehearsed. Little preparation or understanding of the topic is demonstrated. There is no audio. The length of presentation is far outside the assigned time limits.
15 pts
This criterion is linked to a Learning OutcomeVisual Aid(s)
10 to >8.7 pts
Meeting Expectations
Use of visual aids/ images is appropriate. Materials are easy to read, interesting, and relevant to the content.
8.7 to >7.5 pts
Approaching Expectations
Use of visual aids/ images is generally appropriate. Materials are generally easy to read, somewhat interesting, and relevant to the content.
7.5 to >5.9 pts
Falling Slightly Below Expectations
Use of visual aids/ images is not fully appropriate. Materials are generally not easy to read. May have irrelevant visual aids or images
5.9 to >0 pts
Not Meeting Expectations
Use of visual aids/ images is not appropriate. Materials are not easy to read.
10 pts
This criterion is linked to a Learning OutcomeAPA and Mechanics
5 to >4.35 pts
Meeting Expectations
The assignment consistently follows current APA format and is free from errors in formatting, citation, and references. No grammatical, spelling, or punctuation errors. All sources are cited and referenced correctly.
4.35 to >3.75 pts
Approaching Expectations
The assignment consistently follows current APA format with only isolated and inconsistent mistakes and/ or has a few grammatical, spelling, or punctuation errors. Most sources are cited and referenced correctly.
3.75 to >2.95 pts
Falling Slightly Below Expectations
The assignment generally follows current APA format with several mistakes and grammatical, spelling, or punctuation errors. Most sources are cited and referenced incorrectly.
2.95 to >0 pts
Not Meeting Expectations
The assignment does not follow current APA format and/ or has many grammatical, spelling, or punctuation errors. Sources are missing.
5 pts
Total Points: 70
Part 2: Initial Response: Consider what you’ve learned about the topic you presented.
How does this topic relate to something you might see in clinical practice?
Which ideas make the most sense and why?
How does this topic to current events?
What might make this problem more treatable?
Telehealth visit was completed with Mr. Flower today while in the community. He was alert and oriented x3, verbalized skin was intact without bruise or cut. He report to continue with his landscaping job and that keeps him going and meeting his financial needs. Client has history of seizure and he is presently taking Lamotrigine 25mg tablet daily. Nurse educates client on what triggers seizure. Follow the rubric
You are taking care of a 13 year old boy at your current place of employment. He has a new diagnosis of asthma, and this is his first hospitalization for asthma exacerbation. Considering this please address the following prompts in your discussion:Use peer reviewed resources to:create an asthma action plan for this child.list important teaching asthma prevention and management topics, based on his developmental stage.explain how the asthma plan could be incorporated into his busy life.Cite any resources/references in APA formatting 7th edition.
Social media plays a significant role in the lives of nurses in both their professional and personal lives. Additionally, social media is now considered a mainstream part of the process for recruiting and hiring candidates. Inappropriate or unethical conduct on social media can create legal problems for nurses as well as the field of nursing.
Login to all social media sites in which you engage. Review your profile, pictures and posts. Based on the professional standards of nursing, identify items that would be considered unprofessional and potentially detrimental to your career and that negatively impact the reputation of the nursing field.
In 500-750 words, summarize the findings of your review. Include the following:
Describe the posts or conversations in which you have engaged that might be considered inappropriate based on the professional standards of nursing.
Discuss why nurses have a responsibility to uphold a standard of conduct consistent with the standards governing the profession of nursing at work and in their personal lives. Include discussion of how personal conduct can violate HIPAA or be considered unethical or unprofessional. Provide an example of each to support your answer.
Based on the analysis of your social media, discuss what areas of your social media activity reflect Christian values as they relate to respecting human value and dignity for all individuals. Describe areas of your social media activity that could be improved.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Unformatted Attachment Preview
Rubric Criteria
Collapse All Rubric CriteriaCollapse All
Assessment of Social Media Identifying Unprofessional Items
14.8 points
Criteria Description
Assessment of Social Media Identifying Unprofessional Items
5. Excellent
14.8 points
A detailed and transparent analysis of the appropriateness of social media activity based on standards
of nursing practice is presented.
4. Good
13.17 points
An analysis of the appropriateness of social media activity based on standards of nursing practice is
presented.
3. Satisfactory
11.69 points
A general analysis of the appropriateness of social media activity based on standards of nursing
practice is presented but is unclear in some areas.
2. Less Than Satisfactory
11.1 points
A partial analysis of the appropriateness of social media activity, based on standards of nursing
practice, is not clear; or the analysis fails to incorporate the standards of nursing practice
appropriately.
1. Unsatisfactory
0 points
Analysis of the appropriateness of social media activity, based on professional standards of nursing, is
omitted.
Nurse Responsibility to Uphold a Standard of Conduct
29.6 points
Criteria Description
Nurse Responsibility to Uphold a Standard of Conduct Consistent With Nursing Profession in Personal
Life
5. Excellent
29.6 points
The discussion demonstrates an overall understanding of the importance of professional conduct in
personal behavior and its implications for patients and the field of nursing. The discussion explains
how personal conduct can violate HIPAA or be considered unethical or unprofessional. Clear examples
are given.
4. Good
26.34 points
The analysis and discussion demonstrate an overall understanding of the importance of professional
conduct in personal behavior and its implications for patients and the field of nursing. The discussion
summarizes how personal conduct can violate HIPAA or be considered unethical or unprofessional.
General examples are given.
3. Satisfactory
23.38 points
A more in-depth discussion on the appropriateness of social media activity based on nursing
standards is needed. The discussion demonstrates a broad understanding of the importance of
professional conduct in personal behavior and the consequence for inappropriate behavior causing
harm.
2. Less Than Satisfactory
22.2 points
The discussion fails to demonstrate an understanding of the importance of professional conduct in
personal behavior and its consequence for causing harm to patients, nursing practice, or personal
employment.
1. Unsatisfactory
0 points
Discussion of how personal conduct can violate HIPAA, or be considered unethical or unprofessional
as a nurse, is omitted.
Human Value and Dignity for Others Consistent with a Christian Worldview (MC3
14.8 points
Criteria Description
Human Value and Dignity for Others Consistent with a Christian Worldview (MC3
5. Excellent
14.8 points
A discussion of areas of social media activity that reflect Christian values as they relate to respecting
human value and dignity is presented. The discussion demonstrates inclusiveness by respecting
human value and dignity for all individuals regardless of differences. Specific areas for improvement
have been suggested. The discussion is honest and demonstrates accountability for personal actions.
4. Good
13.17 points
A discussion on areas of social media activity that reflect Christian values as they relate to respecting
human value and dignity is presented. In general, the discussion demonstrates inclusiveness by
respecting human value and dignity for different groups. General areas for improvement have been
suggested.
3. Satisfactory
11.69 points
A general discussion on areas of social media activity that reflect Christian values as they relate to
respecting human value and dignity is presented. Some areas for improvement have been suggested.
2. Less Than Satisfactory
11.1 points
An incomplete discussion on areas of social media activity that reflect Christian values as they relate
to respecting human value and dignity is presented. No areas for improvement have been clearly
suggested.
1. Unsatisfactory
0 points
Discussion on areas of social media activity that reflect Christian values as they relate to respecting
human value and dignity for all individuals is omitted.
Thesis Development and Purpose
3.7 points
Criteria Description
Thesis Development and Purpose
5. Excellent
3.7 points
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose
of the paper clear.
4. Good
3.29 points
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the
arguments and appropriate to the purpose.
3. Satisfactory
2.92 points
Thesis is apparent and appropriate to purpose.
2. Less Than Satisfactory
2.78 points
Thesis is insufficiently developed or vague. Purpose is not clear.
1. Unsatisfactory
0 points
Paper lacks any discernible overall purpose or organizing claim.
Argument Logic and Construction
3.7 points
Criteria Description
Argument Logic and Construction
5. Excellent
3.7 points
Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner.
All sources are authoritative.
4. Good
3.29 points
Argument shows logical progression. Techniques of argumentation are evident. There is a smooth
progression of claims from introduction to conclusion. Most sources are authoritative.
3. Satisfactory
2.92 points
Argument is orderly but may have a few inconsistencies. The argument presents minimal justification
of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible.
Introduction and conclusion bracket the thesis.
2. Less Than Satisfactory
2.78 points
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in
the logic. Some sources have questionable credibility.
1. Unsatisfactory
0 points
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim
made. Argument is incoherent and uses noncredible sources.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
3.7 points
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5. Excellent
3.7 points
Writer is clearly in command of standard, written, academic English.
4. Good
3.29 points
Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of
effective sentence structures and figures of speech.
3. Satisfactory
2.92 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct
and varied sentence structure and audience-appropriate language are employed.
2. Less Than Satisfactory
2.78 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice
(register) or word choice are present. Sentence structure is correct but not varied.
1. Unsatisfactory
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate
word choice or sentence construction is used.
Paper Format (use of appropriate style for the major and assignment)
1.48 points
Criteria Description
Paper Format (use of appropriate style for the major and assignment)
5. Excellent
1.48 points
All format elements are correct.
4. Good
1.32 points
Appropriate template is fully used. There are virtually no errors in formatting style.
3. Satisfactory
1.17 points
Appropriate template is used. Formatting is correct, although some minor errors may be present.
2. Less Than Satisfactory
1.11 points
Appropriate template is used, but some elements are missing or mistaken. A lack of control with
formatting is apparent.
1. Unsatisfactory
0 points
Template is not used appropriately, or documentation format is rarely followed correctly.
Documentation of Sources
2.22 points
Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to
assignment and style)
5. Excellent
2.22 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format
is free of error.
4. Good
1.98 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
3. Satisfactory
1.75 points
Sources are documented, as appropriate to assignment and style, although some formatting errors
may be present.
2. Less Than Satisfactory
1.67 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with
numerous formatting errors.
1. Unsatisfactory
0 points
Sources are not documented.
Please follow directions, No Chat GPT or AI writing. In order to write a case study paper, you must carefully address a number of sections in a specific order with specific information contained in each. The guideline below outlines each of those sections.
Section
Information to Include
Introduction (patient and problem)
Explain who the patient is (Age, gender, etc.)
Explain what the problem is (What were they diagnosed with, or what happened?)
Introduce your main argument (What should you as a nurse focus on or do?)
Pathophysiology
Explain the disease (What are the symptoms? What causes it?)
History
Explain what health problems the patient has (Have they been diagnosed with other diseases?)
Detail any and all previous treatments (Have they had any prior surgeries or are they on medication?)
Nursing Physical Assessment
List all the patient’s health stats in sentences with specific numbers/levels (Blood pressure, bowel sounds, ambulation, etc.)
Related Treatments
Explain what treatments the patient is receiving because of their disease
Nursing Diagnosis & Patient Goal
Explain what your nursing diagnosis is (What is the main problem for this patient? What need to be addressed?)
Explain what your goal is for helping the patient recover (What do you want to change for the patient?)
Nursing Interventions
Explain how you will accomplish your nursing goals, and support this with citations (Reference the literature)
Evaluation
Explain how effective the nursing intervention was (What happened after your nursing intervention? Did the patient get better?)
Recommendations
Explain what the patient or nurse should do in the future to continue recovery/improvement
Your paper should be 3-4 pages in length and will be graded on how well you complete each of the above sections. You will also be graded on your use of APA Style and on your application of nursing journals into the treatments and interventions. For integrating nursing journals, remember the following:
Make sure to integrate citations into all of your paper
Support all claims of what the disease is, why it occurs and how to treat it with references to the literature on this disease
Always use citations for information that you learned from a book or article; if you do not cite it, you are telling your reader that YOU discovered that information (how to treat the disease, etc.)
Review the rubric for further information on how your assignment will be graded.
If you have a Study.com College Saver membership and are seeking college credit for this course, you must submit an essay and pass the proctored final exam. You must submit your essay before registering for the final. Below you will find prompts and instructions for submitting your essay.
About This Assignment
In this course you learned how advances in technology have provided tools that improve healthcare outcomes. In this assignment you will be analyzing one of these tools to determine their value and effectiveness. Choose one of the following items and write a 2500 to 3500-word paper evaluating the item and its technology:
Wearable activity trackers
Personal health records
Disaster medical response
Based on your research construct an argument regarding the efficacy and adoption of the technology in the health care field. Be sure to address the following questions in your argument:
What types of technology are currently being used for the item you chose?
What is the current adoption rate of the item by patients and/or physicians?
What are the current challenges or barriers to adoption by patients? By physicians?
How effective or valuable is the item?
Formatting & Sources
As part of your research, you may refer to the course material for supporting evidence, but you must also use at least three credible, outside sources and cite them using APA format. Please include a mix of both primary and secondary sources, with at least one source from a scholarly peer-reviewed journal. If you use any Study.com lessons as sources, please also cite them in APA (including the lesson title and instructor’s name).
Primary sources are first-hand accounts such as interviews, advertisements, speeches, company documents, statements, and press releases published by the company in question.
Secondary sources come from peer-reviewed scholarly journals, such as the Journal of Management. You may use sources like JSTOR, Google Scholar, and Social Science Research Network to find articles from these journals. Secondary sources may also come from reputable websites with .gov, .edu, or .org in the domain. (Wikipedia is not a reputable source, though the sources listed in Wikipedia articles may be acceptable.)
If you’re unsure about how to use APA format for your paper and sources, please see the following lessons:
What is APA Format? Definition & Style
How To Format APA Citations
Rubric
Category Unacceptable (0-1) Needs Improvement (2-3) Good (4) Excellent (5) Total Possible Points
Explanation of Issues (x5) Issue is not stated clearly. Reader is unable to understand the issue Issue is stated but the description is ambiguous or unclear. Reader is left with questions regarding the issue. Issue is described effectively. Reader is able to understand the issue. Issue is stated clearly and described comprehensively. Reader has a full understanding of the depth and breadth of the issue 25
Analysis (x5) No sources are used for analysis. Expert viewpoints are used as facts. Less than three sources are used for an analysis. Expert viewpoints are used as facts to support conclusion. Three sources are used to provide a coherent analysis. Expert viewpoints are questioned – not taken as fact. More than three sources are used to provide a comprehensive analysis by the student. Expert viewpoints are questioned thoroughly, not stated as fact. 25
Structure (x2) Structure is illogical or significantly hinders understanding Arguments are difficult to identify; ideas are disjointed Evidence is provided & is relevant to the thesis, but transitions and connections are lacking Arguments are well integrated; ideas flow logically; main points are identifiable 10
Mechanics (x2) Incorrect spelling, punctuation, capitalization, and use of standard English grammar hinders understanding Several instances of incorrect spelling, punctuation, capitalization, and usage of standard English grammar Few instances of incorrect spelling, punctuation, capitalization, and usage of standard English grammar No or very few instances of incorrect spelling, punctuation, capitalization, and usage of standard English grammar 10
Before You Submit
When you are done writing your essay, we suggest taking some time to check for any errors or to add some final touches. We also suggest that you use online plagiarism checkers such as PlagScan or DupliChecker to make sure that your essay is not too similar to any existing materials. Plagiarized submissions will NOT be graded.
How to Submit Your Assignment
When you are ready to submit your assignment, please fill out the submission form and attach as a Microsoft Word, PDF, or Text document. After turning it in, you may go ahead and take the proctored final exam. You do not need to wait for your written response to be graded. You should receive your essay grade within one week.
If you are not satisfied with the score you receive, you may revise or rewrite your assignment and resubmit it for grading using the same submission form above. Keep in mind that the grade you receive is only a portion of your overall grade for the course, and you are free to retake the proctored final exam as well if you choose. Please see the course syllabus for a more detailed breakdown of the grading polic
Please use this discussion forum as an opportunity to write a first draft of this section of your presentation next weekWhat are four (4) areas related to the issue that you would like to see people talk about more?Why?What specific considerations do you want people to think about related to potential solutions to your issue?Why?Please be sure to validate your opinions and ideas with citations and references 7th edition APA
Comprehensive psychiatric evaluations are a way to reflect on your practicum experiences and connect the experiences to the learning you gain from your weekly Learning Resources. Comprehensive notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.
For this Assignment, you will document information about a patient that you examined during the last 5 weeks, using the Comprehensive Psychiatric Evaluation Template provided. You will then use this note to develop and record a case presentation for this patient.
Select a patient that you examined during the last 5 weeks. Review prior resources on the disorder this patient has.
It is recommended that you use the Kaltura Media tool to record and upload your assignment.
Review the Kaltura Media resource in the Classroom Support Center area (accessed via the Help button).
Conduct a Comprehensive Psychiatric Evaluation on this patient using the template provided in the Learning Resources. There is also a completed exemplar document in the Learning Resources so that you can see an example of the types of information a completed evaluation document should contain. All psychiatric evaluations must be signed by your Preceptor. You will submit your document in Week 5 Assignment, Part 2 area and you will include the complete Comprehensive Psychiatric Evaluation as well as have your preceptor sign the completed assignment. You must submit your documents using Turnitin. Please Note: Electronic signatures are not accepted. If both files are not received by the due date, Faculty will deduct points per the Walden Late Policies.
Develop a video case presentation, based on your progress note of this patient, that includes chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; and current psychiatric diagnosis, including differentials that were ruled out.
Include at least five (5) scholarly resources to support your assessment and diagnostic reasoning.
Ensure that you have the appropriate lighting and equipment to record the presentation.
Record yourself presenting the complex case for your clinical patient.
Do not sit and read your written evaluation! The video portion of the assignment is a simulation to demonstrate your ability to succinctly and effectively present a complex case to a colleague for a case consultation. The written portion of this assignment is a simulation for you to demonstrate to the faculty your ability to document the complex case as you would in an electronic medical record. The written portion of the assignment will be used as a guide for faculty to review your video to determine if you are omitting pertinent information or including non-essential information during your case staffing consultation video.
In your presentation:
Dress professionally and present yourself in a professional manner.
Display your photo ID at the start of the video when you introduce yourself.
Ensure that you do not include any information that violates the principles of HIPAA (i.e., don’t use the patient’s name or any other identifying information).
Present the full case. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; and current psychiatric diagnosis, including differentials that were ruled out.
Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value.
Be succinct in your presentation, and do not exceed 8 minutes. Address the following:
Subjective: What details did the patient provide regarding their personal and medical history? What are their symptoms of concern? How long have they been experiencing them, and what is the severity? How are their symptoms impacting their functioning?
Objective: What observations did you make during the interview and review of systems?
Assessment: What were your differential diagnoses? Provide a minimum of three (3) possible diagnoses. List them from highest to lowest priority. What was your primary diagnosis, and why?
Reflection notes: What would you do differently in a similar patient evaluation? Reflect on one social determinant of health according to the HealthyPeople 2030 (you will need to research) as applied to this case in the realm of psychiatry and mental health. As a future advanced provider, what are one health promotion activity and one patient education consideration for this patient for improving health disparities and inequities in the realm of psychiatry and mental health? Demonstrate your critical thinking.
case – 34 year old female patient comes in to the clinic complaining of experiencing persistent worry for the past 5 months . Patient looks visibly distress and anxious and she states it is affecting various aspects of her life . Patient states she feels anxiety about every day lie events such as her job and relationship and despite her efforts she can’t control them . According to DSM-5 , patient is diagnosed with Generalized Anxiety Disorder .Will start patient on zoloft 25 mg once a day and follow up with patient in 4 weeks .
Wk 3 – The Regeneration Biology Lab Report [due Mon]Assignment ContentIt is not a myth that some reptiles and amphibians can replace entire parts of their bodies through regrowth. To advance the science, you will dissect an axolotl and observe the cells that propel restoration. The final step for this assessment is to complete the lab report. To make the experience more interesting, complete the Hypothesis section prior to diving into the lab. When you are satisfied with your report, please complete it, and submit your lab report.
Unformatted Attachment Preview
BIO/290 v3
Lab Reporting Worksheet – The Regeneration
Biology Lab
In science, reporting what has been done in a laboratory setting is incredibly important for
communicating, replicating, and validating findings. However, writing scientific reports can be a little
overwhelming. There are a set of agreed upon components that the scientific community requires when
reporting scientific experimentation. Answer the following questions to describe what occurred during the
lab you conducted in Labster. Be sure to use complete sentences and descriptions that fully represent
what you experienced. Writing a lab report is less about being correct or incorrect, than it is accurately
reporting what happened and why. So, do not worry about reporting data that might seem counterintuitive
or unexpected. Focus on clearly communicating what you did and what you observed.
TITLE:
What was the title of the lab you completed?
Click or tap here to enter text.
PROBLEM:
What was the problem you were trying to resolve in the Lab?
Click or tap here to enter text.
HYPOTHESIS:
What information from the textbook and classroom is relevant for the problem you were trying to resolve
in the lab? Identify the concepts and explain how they are related to the lab problem.
Click or tap here to enter text.
During the lab, what information from the THEORY section provided additional background information
about the problem? (To review the theory section, launch the Lab and click the “Theory” tab on the top of
the data pad). Identify the concepts and explain how they are related to the lab problem.
Click or tap here to enter text.
Most scientific experimentation involves examining variables and their relationships. A variable is a
construct that can be changed and studied. Examples of variables are a condition or measurable quantity.
What are the variables you examined in the lab? Which one were you controlling and changing? Which
one were you observing was impacted by your change?
Click or tap here to enter text.
Developing a hypothesis requires understanding relevant background knowledge. Now that you have
described relevant background information, it is time to develop a hypothesis. A hypothesis is a simple
statement (not a question), grounded in previous research, that predicts the relationship between the
variables being studied. Please make a statement that predicts the relationship between the variables
being studied.
Click or tap here to enter text.
Copyright 2021 by University of Phoenix. All rights reserved.
The Regeneration Biology Lab
BIO/290 v3
Page 2 of 3
METHOD:
Describing what you did during a lab supports other scientists in replicating your work. It is through this
consistent replication that scientists are able to see repeating patterns and develop ideas that help move
science forward. When you discuss your data, in a later section, you will have to describe what choices
you made, why you made them, and any concerns about things that occurred that were unexpected. In
order to have enough information to do this, you need to keep very detailed notes. What doesn’t seem
important in the moment may end up being something that explains your findings later. A benefit of
conducting virtual labs when learning science, is that many potential errors are controlled for you. The
virtual lab environment often will alert you if something is not going the way it should. This does not occur
non-virtual settings. The virtual lab setting can be very helpful to learners for this reason. However, we still
have to practice documenting so that those skills are practiced for the lab experiences when technology
will not be there as a coach.
You have already, identify the variables that you studied in the lab in the previous section. Now, take
some time to fully define and describe what each variable is and how it was changed throughout the lab.
Click or tap here to enter text.
In 3-5 sentences summarize what you did during the lab not including your process of logging into the
system. This section would be much more robust for a non-virtual lab. For this virtual lab, a short, highlevel summary will suffice.
Click or tap here to enter text.
Describe some of the observations you made. What numbers did you write down or keep track of? What
did each of your senses observe during the lab process? What did you see (ex: changes in colors,
movement, shapes, sizes, patterns)? What did you hear (ex: sounds from reactions, collisions, error
messages)? What did you lab character touch? Did you notice anything that seemed unexpected? Did
you notice anything that you did expect to observe?
Click or tap here to enter text.
Which parts of the lab required you to think more than others and required more time? Which parts were
simple and completed easily?
Click or tap here to enter text.
DATA & RESULTS:
Many lessons learned as a result of scientific experiment come from the reporting and analysis of data.
This part of scientific reporting requires detailed descriptions of technical information and quantities as
well as high-level synthesis of information. High-level synthesis requires a mastery of foundational
content in the related scientific field and a complimentary mastery in some field of quantitative and/or
qualitative analysis. For this report, let’s focus on big picture patterns.
What relationships did you notice between the variables you examined? When you changed the
variable(s), how did the other(s) change?
Click or tap here to enter text.
Did you notice any patterns in your data? Any patterns between the variables?
Click or tap here to enter text.
DISCUSSION:
The discussion section is used to explain why things might have happened the way that they did in your
experiment. Here, scientists describe any potential anomalies or mistakes and why they think they may
have occurred.
Copyright 2021 by University of Phoenix. All rights reserved.
The Regeneration Biology Lab
BIO/290 v3
Page 3 of 3
During your lab, what happened that might have impacted the accuracy of your data? Did the simulation
alert you that an error was occurring? If so, how did you resolve it?
Click or tap here to enter text.
CONCLUSION:
The conclusion section of a lab report describes how the learnings from the lab experimentation fit in to
prior scientific knowledge. This is done by comparing new information to previously known information
that was identified in the section of your report that discusses background information.
Review the hypothesis section of your report from above and describe how the results of your lab
compare to the background information that you discussed before.
Click or tap here to enter text.
Once scientists have identified how the new knowledge fits into the old knowledge, they discuss the
implications of the new information for moving forward. In this class, the purpose of study is to learn some
foundational science ideas represented by the course student learning outcomes. Review the course
student learning outcome aligned to this lab in the assignment directions in Blackboard. How is the
information from this lab related to the course student learning outcome? What knowledge has the lab
supported you with learning that is related to this course student learning outcome?
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Following scientific experimentation, scientists usually come up with new questions that result from what
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Soap Note 1 is based on the Case Study # 1 (10 Points)
You MUST use the Case Study #1 as the base of this SOAP NOTE #1
Must use the sample template for your soap note, keep this template for when you start clinicals.
Templates used from another classes will not be accepted. Student must use the template provided in this class which must clearly contain the progress note (in the Assessment section) of the encounter with the patient ( this section is clearly mark in bold, highlighted and underlined). No passing grade will be granted if this section is not completed properly.
Late Assignment Policy
Assignments turned in late will have 1 point taken off for everyday assignment is late, after 7 days assignment will get grade of 0 (zero). No exceptions
Follow the MRU Soap Note Rubric as a guide
Use APA format and must include minimum of 2 Scholarly Citations.
Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)
Turn it in Score must be less than 25% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25%. Copy-paste from websites or textbooks will not be accepted or tolerated.
Please see College Handbook with reference to Academic Misconduct Statement.
The use of tempates is ok with regards to Turn it in, but the Patient History, CC, HPI, The Assessment and Plan should be of your own work and individualized to your made up patient.
oap Note 1 is based on the Case Study # 1 (10 Points)
You MUST use the Case Study #1 as the base of this SOAP NOTE #1
Must use the sample template for your soap note, keep this template for when you start clinicals.
Templates used from another classes will not be accepted. Student must use the template provided in this class which must clearly contain the progress note (in the Assessment section) of the encounter with the patient ( this section is clearly mark in bold, highlighted and underlined). No passing grade will be granted if this section is not completed properly.
Late Assignment Policy
Assignments turned in late will have 1 point taken off for everyday assignment is late, after 7 days assignment will get grade of 0 (zero). No exceptions
Follow the MRU Soap Note Rubric as a guide
Use APA format and must include minimum of 2 Scholarly Citations.
Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)
Turn it in Score must be less than 25% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25%. Copy-paste from websites or textbooks will not be accepted or tolerated.
Please see College Handbook with reference to Academic Misconduct Statement.
The use of tempates is ok with regards to Turn it in, but the Patient History, CC, HPI, The Assessment and Plan should be of your own work and individualized to your made up patient.
Unformatted Attachment Preview
Student’s Name
Miami Regional University
Date of Encounter: Mo/day/year
Preceptor/Clinical Site: MSN5600L Class
Clinical Instructor: Patricio Bidart MSN, APRN-IP, FNP-C
Soap Note # _____ Main Diagnosis: Dx: Herpes Zoster
PATIENT INFORMATION
Name: Ms. GP
Age: 78
Gender at Birth: Female
Gender Identity: Female
Source: Patient
Allergies: Peanut. Iodine
Current Medications:
Insulin Lantus 100 u/ml 15 unit in the morning and at bedtime
Metformin 500 mg 1 tablet PO once a day
Atorvastatin 20 mg 1 tablet PO at bedtime
PMH:
Diabetes mellitus type II
Hyperlipidemia
Varicella (Chickenpox) at the age of 20 year-old
Immunizations: Flu vaccine in 2020, Covid -19 (Pfizer) in 2021
Preventive Care: Wellness exam on 03/2021
Surgical History: appendicectomy 20 years ago
Family History: daughter 48 years old / hyperlipidemia
Social History: Patient is widow, lives with her daughter. Catholic religion. No alcohol. No
smoker. No history of drug used, sedentary lifestyle. Does not work.
Sexual Orientation: Straight
Nutrition History: Regular diet, low in carbohydrates and fat.
Subjective Data:
Chief Complaint: I have been feeling itching and pain on my right lower back” started 3 day
ago.
Symptom analysis/HPI: The patient is Ms. GP is 78-year-old Hispanic woman, who is
complaining about itching, pain or tingling on her right lower back. Patient stated that 3 days ago
she started to feel an increase in burning sensation on the area taking all right lower back and
don’t relieve the pain with analgesic, she stated that wear any clothes that touch the area is very
uncomfortable. Denies any episodes of fever but she feels fatigue and chills and mild headache.
She stated that today in the morning she feel worse and noted some redness in the area and
decided to come to the clinic to PCP evaluation.
Review of Systems (ROS)
CONSTITUTIONAL: fatigue, chills, denies weakness, no thirsty, no loss of weight. No fever.
NEUROLOGIC: mild headache, no dizziness, no changes in LOC, no loss of strength or
weakness/paresis/paralysis on extremities, no Hx of tremors or seizures.
HEENT: denies any head injury, denies any pain
Eyes: patient denies blurred vision, no diplopia, no wear glasses for reading
Ears: patient denies tinnitus, ear pain, no ear drainage through ear canal.
Nose: no presence of nasal obstruction, no nasal discharge, denies nasal bleeding. (No
epistaxis)
Throat: no sore throat, no hoarse voice, no difficult to swallow
RESPIRATORY: patient denies shortness of breath, cough, expectoration, or hemoptysis.
CARDIOVASCULAR: patient denies chest pain, tachycardia. No orthopnea or paroxysmal
nocturnal dyspnea.
GASTROINTESTINAL: patient denies abdominal pain or discomfort. Denies flatulence,
nausea, vomiting or diarrhea. (BM pattern) every other day, last BM: today, no rectal bleeding
visible for her.
GENITOURINARY: patient denies polyuria, no dysuria, no burning urination, no hematuria, no
lumbar pain, no urinary incontinence.
MUSCULOSKELETAL: denies falls or pain. Denies hearing a clicking or snapping sound
SKIN: patient states itching, pain, or tingling sensation on her right lower back.
HEMO/LYMPH/ENDOCRINE: glands swelling on groin, denies bruising or abnormal
bleeding.
PSYCHIATRIST: patient denies anxiety, depression, denies hallucinations or delusions, no
mood changes
Objective Data:
VITAL SIGNS:
Temperature: 98.4 °F, Pulse: 82x ‘, BP: 122/71 mm hg, RR 19, PO2-97% on room air, Ht- 5’3”,
Wt 164 lb, BMI 30.2. Report pain 6/10.
GENERAL APPREARANCE: Adult, female. Alert and oriented x 3.
NEUROLOGIC: Alert, oriented to person, place, and time. Cranial nerves from I to XII intact.
Sensation intact to bilateral upper and lower extremities. Bilateral UE/LE strength 5/5. Pupil
normal in size and equal. Deep tendon reflex presents.
HEENT: Head: Normocephalic, atraumatic, symmetric, non-tender. Maxillary sinuses no
tenderness.
Eyes: No conjunctival injection, no icterus, visual acuity, and extraocular eye movements
intact. No nystagmus noted. Wear glasses.
Ears: BL external canal pattern, permeable, no redness, no drainage, tympanic membrane
intact, pearly gray with sharp cone of light. No pain or edema noted.
Nose: Nasal mucosa normal. No irritations.
Mouth: oral mucosa pink, tongue central, papillaes normal distributed, no lesions
detected, present of upper and lower denture, fitting properly. Lips with no lesions.
Neck: No lymphadenopathy noted. No jugular vein distention. No thyroid swelling or
masses, no thrills on auscultation.
CARDIOVASCULAR: S1S2, regular rate and rhythm, no murmur or gallop noted. Capillary
refill < 2 sec. Peripheral pulses present and symmetric. No edema on BLE.
RESPIRATORY: Lungs sounds clear. Chest wall symmetric and no deformities, no intercostal
retractions, patient no noticed dyspnea, no orthopnea. No egophony, no pectoriloquy, no fremitus
or sign of condensation tissue on palpation. Resonance equal in both hemithorax. Lungs: breath
sounds present and clear on auscultation, no rales, no wheezing, no rhonchi.
GASTROINTESTINAL: Abdomen soft and non-tender. Continent to BB. Bowel sounds
present in all four quadrants; no bruits present over aortic or renal arteries. Last BM today.
GENITOURINARY: Costovertebral angles non-tenders, kidneys no palpable. External
genitalia present, no enlargement, no tumors palpable. Groins area noted with redness.
MUSKULOSKELETAL: No pain to palpation. Active and passive ROM within normal limits,
no stiffness.
INTEGUMENTARY: painful redness rash, with crops of vesicles on an erythematous base
with a few satellite lesions in linear distribution, do not cross midline, some of the blisters are
filled with purulent fluids and other are crusted. Area is swollen and redness.
ASSESSMENT:
Patient Ms. GP is 78-year-old Hispanic woman with Hx of DM Type II and Hyperlipidemia,
came into our clinic today complaining about itching, pain and tingling on her right lower back
starting 3 days ago. During the physical exam was noted painful redness rash, with crops of
vesicles on an erythematous base with a few satellite lesions in linear distribution, which do not
cross midline. Diagnosis is based on the clinical evaluation through history and physical
examination. According to patient presentation, signs and symptoms patient is diagnosed with
herpes zoster. Patients falls into the high risk group based on Buttaro (2017). Herpes zoster is
viral infection that occurs with reactivation of the varicella-zoster virus and the patient referred
has history of Chickenpox when she was 20 years old.
Main Diagnosis
Herpes Zoster (ICD10 B02.9): Herpes zoster is infection that results when varicella-zoster virus
reactivates from its latent state in a posterior dorsal root ganglion. Symptoms usually begin with
pain along the affected dermatome, followed within 2 to 3 days by a vesicular eruption that is
usually diagnostic. (Domino, Baldor, Golding, &Stephens,2017).
Other diagnosis:
Diabetes mellitus type II. (ICD-10 E11.9)
Hyperlipidemia. (ICD-10 E78.5)
Differential diagnosis
Irritant contact dermatitis (ICD10 L24)
Impetigo. (ICD10 L01.0)
Varicella. (ICD 10 B01)
Dermatitis herpetiformis. (ICD10 L13.0)
PLAN:
Labs and Diagnostic Test to be ordered (if applicable)
Viral culture, polymerase chain reaction for VZV
Pharmacological treatment:
Valtrex 1 gm TID x 7 days ideally during the prodrome, and is less likely to be effective if
given > 72 hours after skin lesions appear,
VZV vaccine
Pain-reliever NSAIDs
Management of post herpetic neuralgia (Treatments include gabapentin, pregabalin)
Continue with current medication for chronic condition:
Insulin Lantus 100 u/ml 15 unit in the morning and at bedtime
Metformin 500 mg 1 tablet PO once a day
Atorvastatin 20 mg 1 tablet PO at bedtime
Non-Pharmacologic treatment:
Do not scratch the area with dirty hands. Use lotion like calamine to refresh the area.
Keep the area clean and dry.
Education
Isolation precaution – Type Contact
Avoid contact with susceptible person like pregnancy woman, kids and
Immunocompromised patient.
Education about hand washing.
Avoid ABT cream.
Follow-ups/Referrals
Follow up appointment 2 weeks / No referral needed at this time
Call if the symptoms are worse or you noticed any adverse reaction.
References
Buttaro, T. M., Trybulski, J. A., Polgar-Bailey, P., & Sandberg-Cook, J. (2017). Primary care: a
collaborative practice. St. Louis, MO: Elsevier.
Domino, F., Baldor, R., Golding, J., Stephens, M. (2017). The 5-Minute Clinical Consult 2017
(25th ed.). Print (The 5-Minute Consult Series).
McCance, K. L., & Huether, S. E. (2019). Pathophysiology: the biologic basis for disease in
adults and children. St. Louis, MO: Elsevier.
Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition
Iron-Deficiency Anemia
Case Study
A 72-year-old man developed chest pain whenever he was physically active. The pain ceased on
stopping his activity. He has no history of heart or lung disease. His physical examination was
normal except for notable pallor.
Studies
Electrocardiogram (EKG), p. 485
Chest x-ray study, p. 956
Complete blood count (CBC), p.
156
Red blood cell (RBC) count, p.
396
RBC indices, p. 399
Mean corpuscular volume
(MCV)
Mean corpuscular hemoglobin
(MCH)
Mean corpuscular hemoglobin
concentration (MCHC)
Red blood cell distribution width
(RDW)
Hemoglobin (Hgb), p. 251
Hematocrit (Hct), p. 248
White blood cell (WBC) count, p.
466
WBC differential count, p. 466
Result
Ischemia noted in anterior leads
No active disease
Platelet count (thrombocyte
count), p. 362
Half-life of RBC
Liver/spleen ratio, p. 750
Spleen/pericardium ratio
Reticulocyte count, p. 407
Haptoglobin, p. 245
Blood typing, p. 114
Iron level studies, p. 287
Iron
Total iron-binding capacity
(TIBC)
Transferrin (siderophilin)
Transferrin saturation
Within normal limits (WNL) (normal: 150,000–
400,000/mm3)
26–30 days (normal)
1:1 (normal)
The purpose of this task is for students to demonstrate engagement, interview and assessment skills for practice with individuals.
Unformatted Attachment Preview
Case Studies for Assessment 2
MSWPG7102 Professional Social Work Practice
1. You are a youth worker who has been just assigned to a new case. The person you
are meeting is 16 year-old young person, Ari, who is not engaged with school and
lives with their friends. Ari was referred to your agency by the police for some minor
offences and for being at risk of becoming homeless.
You meet Ari at the agency and find them to be friendly and easy to engage. Ari
knows the Police are keeping an eye on them, but does not think it is anything
serious because the Police said all they need to do is talk to a social worker (you).
Ari has no interest in school or TAFE, education isn’t important right now. Ari dreams
of becoming a famous actor and trying to figure out how to get noticed by the film
industry through social media.
Ari has no contact with their parents since leaving home and says that their parents
never really cared for them. Ari is interested in your agency and what support they
can offer, they don’t see any problem or risks with their life.
2. You are a social worker at a Community Support Agency working with a young
woman, Sami. Sami is married to her partner, Raj. Sami and Raj have both recently
lost their jobs due to the COVID-19-related businesses shut down. They migrated to
Australia recently and are unaware of what kind of support they may be eligible for.
Raj feels that it is not appropriate for them to apply for financial aid or support
because they are both young, healthy and have a good education. He feels that
welfare or crisis payments should be only for people who are sick or who have a
disability and can’t work.
This new situation is causing a lot of stress for Sami and Raj and their relationship.
They have started to argue and cannot agree on anything. Being recent arrivals to
the country, they have no family support in the country and no close friends. Sami
has come to your agency to see what support you can offer.
3. You are a new social worker with a primary-school wellbeing team. One of the
teachers refers to you for counselling a 12 year old girl, Ana. She has always been a
quiet student but lately her teacher has noted that she is not talking to any of her
classmates, spends most of her free time by herself and eating lunch alone.
The student has been an average student but lately she stopped doing her
homework projects or just brings in her work half-way done. During your first meeting
she tells you that there is nothing much going on in her life. She also says she does
not see a point in making friends or doing her work because she will be leaving this
school in couple months.
Ana is feeling upset with her parents for making family decisions without her input.
They told her last year that this will be her primary school until she graduates and
goes onto high-school in town, but now they are moving her again to another state.
She believes her parents do not care what she wants or needs and only care for their
jobs.
4. You are a new social worker at an Emergency Relief Agency in a small regional
town. A 72 year–old man, Ted, who is a pensioner and lives in nearby public
housing, comes to see you. He is having some difficulty remembering why he has
come.
Ted has no family, very few supports in his life and likes to keep to himself. He is ill
and frail, has no money and worries a lot about what will happen to him.
While Ted has been experiencing increasing challenges with his health over recent
years, previously he always enjoyed a high degree of independence and control over
his own life. He liked helping others, but was never one to ask for help.
This is changing now however. Recently Ted lost his car licence due to a medical
condition, This has increased his feelings of isolation and sadness and fear of
dependency. Sometimes, he drives his car around town anyway.
Ted is very clear with you that he wants his food voucher, but he’s also wondering
quietly if you might be able to help him in other ways too.
Role-play tips:
“The client”: Your role is to make it easy (but not TOO easy) for the “social worker” to
practice their skills. You are not supposed to be “the most challenging client ever” (overly
resistant/distrustful; highly complex issues; overly emotional), auditioning for a dramatic
acting award, or “the rescuer” (trying to help the social worker by giving them too much
information too early, or prematurely solving your own problems).
You will be given “cues” about your situation and presenting behaviours. Please use them.
You are playing a role – not delving into your own issues/experience. If the circumstances on
the cue sheet are similar to your own, you might not want to take on the role or, ensure that
you stay in role.
“The social worker”: Your role is to practice specific skills using the role-play.
Assessment 2: Recorded practice skills role-play and CASENOTE
Information about Recorded practice-skills role-play
Recorded practice-skills role-play and Casenote
• Length: 20 minutes maximum
• Format: Video
• Due date: TBC
• 35% of total course mark
Submission instructions – Assessment to be submitted to Moodle via link as either:
– A Kaltura link to a video recorded role-play, if you meet in person with your partner
– A Microsoft Teams recorded role-play, post the link to the recording on Moodle
Further instructions on how to record and upload role-plays are provided in Moodle.
Task Description
The purpose of this task is for students to demonstrate engagement, interview and
assessment skills for practice with individuals.
Students will be provided with a range of role-play case-studies on Moodle, and record
a role-play of themselves as a social worker role engaging and interviewing a client.
The client role can be undertaken by anyone who is available and content to play the
role – a student, friend or family member.
Students will be assessed on their capacity to display a range of engagement, interview
and assessment skills. Students can choose to engage with their ‘client’ via face-toface, telehealth (video) or online (PLEASE DO NOT USE A PHONE interview as you will
not be able to fulfil all requirements), and demonstrate appropriate skills, such as:
•
•
•
•
•
•
•
•
•
•
•
•
•
Information giving – i.e. role and setting, how confidentiality is addressed,
informed consent
Rapport building and attending behaviours (including appropriate introduction)
Engagement skills
Active listening
Reflective listening
Picking up on verbal and non-verbal cues.
Appropriate use of questions (closed-ended and open-ended)
Paraphrasing
Reflection of client’s feelings
Summarisation (beginning, throughout, and at the end)
Clarification
Interpretation
Closure/ending of interview
Following your recording please write a case note of no more than 200 words
relating to your scenario.
the CASENOTE needs to be included with your submission.
Role Play – Tips and Tricks for MSWPG7102
Role plays will be a key focus of this course, to provide students with opportunities to
develop their social work direct practice skills. Given the number of students enrolled
in the course, it is important that role plays run smoothly and to time. Otherwise,
students will get frustrated over the amount of time wasted and will miss out on
valuable opportunity for skill development (which is the main focus of this course).
These guidelines have been developed to ensure that all students are clear on
expectations about role plays.
Assigned Role Play Groups
Students will be form “role play groups” at the first seminar. During role plays,
students will rotate the following roles: (1) “social worker;” (2) “client;” (3) observer
and time keeper; (4) observer and time keeper. In the instance of a group with five
people, there would be one extra observer/time keeper. In the instance of a group
member being absent, there will be one observer/time keeper. If two group members
are absent, staff will reconfigure accordingly for the seminar in question.
We ask that you be open to working with a variety of students, as this will be a more
true representation of ‘real world’ social work practice.
Any students who have concerns about the behaviour of a group member should raise
it with that group member (if they feel comfortable doing so). If this is not appropriate,
or does not address the concerning behaviour, then the student should approach staff.
Expectations/Etiquette of Group Members
It is important that all students are mindful of how they interact within their group.
Below are some expectations to help guide you:
1. Keep to time. Each role play activity will have an allocated time, for example:
getting in to role (3 minutes); role play (5-15 minutes); getting out of role (2
minutes); feedback (5 minutes). It is important that everyone stays on time, or
else some students will miss out on the opportunity to play the “social worker”
for each skill set.
2. Remember the role of each “player”
3. “The client”: Your role is to make it easy (but not TOO easy) for the “social
worker” to practice their skills. You are not supposed to be “the most
challenging client ever” (overly resistant/distrustful; highly complex issues;
overly emotional), auditioning for a dramatic acting award, or “the rescuer”
(trying to help the social worker by giving them too much information too early,
or prematurely solving your own problems).
4. You will be given “cues” about your situation and presenting behaviours. Please
use them. You are playing a role – not delving into your own issues/experience. If
the circumstances on the cue sheet are similar to your own, you might switch
with another student, or, ensure that you stay in role.
5. “The social worker”: Your role is to practice the specific skills we are working on
with each progressive role play.
6. “Observer/time keeper:” Your role is to: ensure that everyone sticks to time (use a
timer on a phone and stick to it ruthlessly); make sure that the “social worker”
and “client” get in, and out, of role, and get your Group Leader if someone
becomes distressed or anxious. Your role is also to lead discussion about how
the role play went, and to provide feedback that is honest and respectful. While it
might be polite to say, “You did a fantastic job!” that won’t help students
improve. Identify areas of strength, but also areas for improvement. If students
digress (talking about their own personal experiences in relation to a scenario,
for example) your role is to gently get them back on track.
7. Confidentiality. Role play groups will need to develop a sense of trust. It is not
appropriate to discuss what happens in your role play group with other
students (i.e. if a student performed poorly or got upset) or friends, family,
colleagues.
8. Role plays can be stressful. While some students enjoy the challenge of role
plays, at times some students can find them stressful. They may feel
uncomfortable being observed and having other students provide feedback.
They may find that being in the “client” role “triggers” underlying issues. A
certain amount of anxiety is entirely normal. However, if you find that you are
consistently stressed/anxious and/or the experience gives you intense anxiety,
then you are advised to seek support from the Uni Counselling Services (or a
service of your choice). This is not a sign of weakness, but rather of your
capacity for self-reflection and self-awareness.
9. Practice makes perfect. Well, no social worker is ever perfect – but practice will
make you as perfect as possible! You are strongly encouraged to meet up with
other students (either on the “off” Fridays or at a time that suits a group) and
willing family/friends/colleagues and practice your skills. Using a phone, iPad or
tablet to record and watch yourself is a fantastic learning tool.
10. Have fun! (But not TOO much fun!).
Case Notes
Case Notes
Case notes are an integral and important part of practice for many Social Workers. Research has shown
that record- keeping practices have an impact on client outcomes such that poor case notes can result in
poor decision-making and adverse client outcomes (see Preston-Shoot 2003, Cumming et al. 2007).
A ‘case note’ is the term applied to a chronological record of interactions, observations and actions relating
to a particular client.
What information should be included in a case note?
The guiding principle for deciding what information should be included in a case note is whether it is
relevant to the service or support being provided.
The type of information that is considered relevant will clearly depend on the context of practice, however
the AASW Practice Standards 2013 provide some broad guidance. This may include:
•
a range of biopsychosocial, environmental and systemic factors impacting on the client. This
includes consideration of an individual’s culture, religion and spirituality
•
risk and resilience factors
•
facts, theory or research underpinning an assessment
•
a record of all discussions and interactions with the client and persons/services involved in the
provision of support including referral information, telephone and email correspondence
•
a record of non-attendance, either by the Social Worker or client, at scheduled and agreed
meetings or activities
•
evidence that the Social Worker and client have discussed their respective legal and ethical
responsibilities. This may include:
o
client rights, responsibilities and complaints processes
o
the parameters of the service and support being offered and agreed to
o
issues relating to informed consent, information sharing, confidentiality and privacy
o
efforts to promote and support client self-determination and autonomy
o
specific responsibilities to clients in particular settings such as private practice or rural
settings as per the Code of Ethics 2010
•
o
professional boundaries and how dual relationships may be managed
o
record keeping and freedom of information
o
discharge planning
o
relevant legislative requirements and their possible implications for practice
details of reasons and any related actions or outcomes leading up to or following the
termination or interruption of a service or support.
1
Ethics and Practice Guideline – Case Notes
Updated July 2016
How should this information be represented in a case note?
There are a number of case-writing models available to Social Workers. Some of them provide general
guidance for writing case notes, such as the ‘Summary Style’, while others are specific to a service type or
context, such as the STIPS model.
In addition, many organisations have policies and procedures around case recording.
The AASW does not recommend the use of one model or policy over any other, however the Code of
Ethics 2010 points to some general principles for good record keeping.
Information recorded about a client should be impartial, accurate and complete with care taken to ensure
that:
•
only details relevant to the provision of a support or service to which the client has consented are
•
when working with involuntary clients this means recording information relevant to statutory
recorded (see sections 5.2.5 (a) and 5.2.4 (b))
practice (see also 5.2.2)
•
notes are free from derogatory or emotive language (5.2.4 (a))
•
subjective opinions are qualified with relevant
•
background information, theory or research (5.2.5 (a))
•
relevant information is not omitted (5.2.5 (c)).
When recording information about third-parties, such as information about a client’s relationship with
significant others, it is equally important to separate fact from opinion.
For more information and for Social Workers in particular settings, such as Private Practice, please see
our related Ethical Guidelines on the AASW website at www.aasw.asn.au/whatwedo/ethics-faqs
How and when should case notes be recorded?
Case notes can be recorded manually or electronically and should:
•
include on each page the name and DOB or other identifying information of the client. This can
be handwritten, typed or constitute an electronic tag where an electronic case recording program
is utilised
•
be dated
•
be recorded as soon as possible after an interaction or event
•
be typed or clearly readable if handwritten
•
include the name, signature and profession/role of
•
the author
•
include the time of contact, particularly where there are a high volume of interactions in a day.
2
Ethics and Practice Guideline – Case Notes
Updated July 2016
Can I change or amend a case note at a later date?
Care should be taken to avoid errors or omissions. In some instances it is illegal to change, white-out or
amend case notes after the fact.
If a change must be made to correct an error or omission, the change can be recorded as a new and
separate case note. In addition to outlining the error or omission as part of this new case note, it is
advisable to provide an explanation for it earlier absence or inaccuracy. You may also add, if possible, a
note in the margin of the original case note referring the reader to the additional or amended detail.
A case note should never be amended or changed in light of additional information obtained at a later
date. This should always constitute a new case note.
What are my legislative responsibilities with regard to case note recording?
Case notes may be subject to a range of legislative processes and requirements during and following the
conclusion of the professional relationship.
The nature of these requirements may differ greatly according to the State and nature or context of
practice. Statutory bodies, for example, are subject to Freedom of Information legislation, which may
differ slightly from State to State.
In any context, notes can be subpoenaed for any number of reasons. Processes for responding to a
subpoena may differ depending on the Court and similarly organisations may vary in their policy and
procedure for doing so.
Finally, organisations may have policies and procedures for ensuring these and other legislative
obligations are met, in addition to general guidelines for case note recording and management.
For these reasons it is important for Social Workers to:
•
be familiar with the specific legal requirements and processes impacting on practice
•
consider the implications of Federal and State legislation to the recording of case notes
•
understand how these requirements are implemented within their organisation (where relevant)
•
understand what policies and procedures may need to be implemented when working in private
practice.
How should I plan for the termination of a service or support with regard to case
notes?
As noted earlier, Social Workers should include details relating to the termination or interruption of
services or supports in case note entries leading up to or following the end of the professional
relationship.
However, it is also possible that the termination of service is unanticipated. This might include instances
where the Social Worker is incapacitated or unable to continue employment or practice. These are
particularly salient issues for Social Workers who are not part of team, work in private practice or are
geographically isolated.
3
Ethics and Practice Guideline – Case Notes
Updated July 2016
It is particularly important therefore to ensure that case notes are maintained and updated as soon after
an interaction or event as practicable.
This possibility raises a number of issues in relation to security, confidentiality, storage and sharing of
client information in the event of an unanticipated termination of service. These issues are addressed in
detail in the Ethical Guidelines on:
•
Information management
•
Working in Private Practice
•
Remote Service Delivery.
Further information on case notes and their management can be found in the
following Ethical Guidelines:
•
Information management
•
Working in Private Practice
•
Responding to a Subpoena
•
Remote Service Delivery
Ethical Guidelines can be downloaded from the AASW website at http://www.aasw.asn.au/practitionerresources/ethics-and-practice-guidelines or you can contact the Ethics Consultation Service on 03 9320
1044 or at ethicsconsult@aasw.asn.au.
4
Ethics and Practice Guideline – Case Notes
Updated July 2016
Writing Case Notes
MSWPG 7102
CRICOS Provider No. 00103D | RTO Code 4909
CRICOS Provider No. 00103D
What are case notes?
• A ‘case note’ is the term applied to a chronological record of interactions,
observations and actions relating to a particular client
• A formal electronic or paper based record that documents the interaction or
contact between the client & the worker /organisation.
• A written record of a client’s situation, the support they have accessed, an
indication or plan for future work & goals the client wants to achieve.
• Private confidential records that must be stored as such.
• Explain who did what, why, when, where & how.
According to the AASW?
A ‘case note’ is the term applied to a chronological record of interactions,
observations and actions relating to a particular client. (AASW, 2016).
CRICOS Provider No. 00103D
RTO Code 4909
Why do we keep Case Notes?
•
Accountability
•
Legal responsibility
•
To keep a history of the client
•
Work more effectively with clients
•
Enhance planning and review
•
To make referrals
•
Supervision tool
•
Planning
•
Direction
Purpose of Case Notes
•
A written record of a client’s situation, support they have accessed, an indication
or plan for future work & goals they want to achieve.
•
Maps client progress.
•
Communication with other professionals.
•
Accountability for workers, organisations, other services & clients.
•
Enable a team approach & continuity of care.
•
A risk management & quality assurance tool which is part of service funding
agreements.
•
A legal requirement.
•
Protection & prevention for clients, workers & the organisation in legal
proceedings.
•
Reflection & learning tool that can support the review of case plans & strategies
to improve client outcomes.
The Audience
•
Clients
•
Courts of Law
•
Your organisation
•
Managers
•
Team members & other colleagues
•
Police
•
Government Departments
•
AASW Code of Ethics (2020)
•
AASW Practice Standards
What does the AASW say?
Information recorded about a client should be impartial, accurate and complete
with care taken to ensure that:
• only details relevant to the provision of a support or service to which the client
has consented are recorded
• when working with involuntary clients this means recording information
relevant to statutory practice
• notes are free from derogatory or emotive language
• subjective opinions are qualified with relevant background information, theory
or research
• relevant information is not omitted
SOURCE: https://www.aasw.asn.au/document/item/2356
Different types of Case-note writing
Formats for writing case notes: Several different formats exist for writing
case notes. For example:
• S.T.I.P.S. (Signs and Symptoms, Topics of Discussion, Interventions,
Progress and Plan, Special Issues)
• S.O.A.P. (Subjective, Objective, Assessment, Plan)
• D.A.P. (Data, Assessment, Plan)
• F.A.R.M. (Focus, Assessment, Response, Method)
• G.I.R.P. (Goal, Interventions, Response, Plan)
• B.I.R.P. (Behaviour, Interventions, Response, Plan)
Remember that the choice of method depends on your organization’s
policies, personal preferences, and the specific needs of your clients
What goes into Case Notes?
Case notes can be recorded manually or electronically and should:
• include on each page the name and DOB or other identifying information of
the client.
• be dated
• be recorded as soon as possible after an interaction or event
• be typed or clearly readable if handwritten
• include the name, signature and profession/role of the author
• include the time of contact, particularly where there are a high volume of
interactions in a day
(SOURCE: https://www.aasw.asn.au/document/item/2356
•
Only what is relevant to the service being provided
•
Other workers full names, organisation and role
•
Goals, observation, assessment, evaluation of goal attainment, interventions
used, plan for next session, referrals
What stays out of Case Notes
•
Emotional reactions
•
Opinions
•
Value judgements
•
Labelling
•
Unfounded speculation
•
Diagnosing language
•
Information that is not relevant to the support plan or intervention
Source: Take Note! A practical guide to writing case notes (2012) Turning Point Alcohol and Drug Centre
References
SOURCE: https://images.template.net/wp-content/uploads/2016/03/08042500/Case-Notes-for-AOD-Services-PDFTemplate-Free-Download.pdf
CRICOS Provider No. 00103D
RTO Code 4909
What’s wrong with this case note?
22/10
Helen turned up half an hour late.
She smelt like a brewery. I suspect that she had been at the pub before her
appointment which is why she was late/
Still drinking loads.
Isn’t doing the homework from sessions.
GP diagnoses with scitzofrenia.
Goal from last session still the same – talked about things to support that.
Ang
https://insight.qld.edu.au/shop/a-case-in-point-a-queensland-guide-to-alcoholand-other-drug-clinical-documentation-and-case-formulation-insight-2019
What’s wrong with this case note?
CRICOS Provider No. 00103D
RTO Code 4909
Armitage, E (2019, July) A case in point – A Queensland guide to alcohol and other drug clinical documentation and case formulation – Insight,
A good example of the SOAP method
CRICOS Provider No. 00103D
RTO Code 4909
Storage of records and Case Notes
1.
2.
3.
How are records stored? Are they safe and secure?
•
Leaving records on a desk
•
Behind in a photocopier
•
Taking records out of the office
•
Computer/internet security- USB’s
How long are records stored?
•
Legislation for this – check in your state
Who can access or not access the records?
•
Funding bodies/government departments
When storing case records, regardless of the method used, it’s important to consider
data security, backup procedures, and compliance with relevant laws and
regulations, such as those related to data protection and confidentiality.
Organizations will have clear policies and procedures for record storage and access.
19
Confidentiality considerations
• When is information able to be shared with others?
•
When a person gives consent for this
• ‘Consent to Release’ info form
• How much information?
•
When there is a significant risk of harm
• To themselves, to someone else, or to them
• ‘Insiders’ versus ‘outsiders’ in human services
• How much ‘choice’ do people really have?
Relevant Legislation
• Privacy Act 1988
• Privacy Amendment (Private Sector) Act 2000
• The Privacy And Data Protection Act 2014
• Freedom of Information Act
• Information Privacy Act 2000
• Health Records Act 2001
• Public Records Act 1973
• Most of the time this legislation will have
already been incorporated in to your agency
policies & procedures
References
Aasw.asn.au. (2016. Home) Case Notes, AASW – Australian Association of Social Workers
https://www.aasw.asn.au/document/item/2356
Armitage, E (2019, July) A case in point – A Queensland guide to alcohol and other drug clinical
documentation and case formulation – Insight, https://insight.qld.edu.au/shop/a-case-inpoint-a-queensland-guide-to-alcohol-and-other-drug-clinical-documentation-and-caseformulation-insight-2019
Cameron, J (2012, July). Case notes for AOD Sector [PowerPoint slides].
https://images.template.net/wp-content/uploads/2016/03/08042500/Case-Notes-forAOD-Services-PDF-Template-Free-Download.pdf
Cameron, J & Murray, J, Turning Point Alcohol & Drug Centre, (2012), Take Note! A practical
guide to writing case notes: A quick reference guide for alcohol and other drug workers
Case Notes
Case Notes
Case notes are an integral and important part of practice for many Social Workers. Research has shown
that record- keeping practices have an impact on client outcomes such that poor case notes can result in
poor decision-making and adverse client outcomes (see Preston-Shoot 2003, Cumming et al. 2007).
A ‘case note’ is the term applied to a chronological record of interactions, observations and actions relating
to a particular client.
What information should be included in a case note?
The guiding principle for deciding what information should be included in a case note is whether it is
relevant to the service or support being provided.
The type of information that is considered relevant will clearly depend on the context of practice, however
the AASW Practice Standards 2013 provide some broad guidance. This may include:
•
a range of biopsychosocial, environmental and systemic factors impacting on the client. This
includes consideration of an individual’s culture, religion and spirituality
•
risk and resilience factors
•
facts, theory or research underpinning an assessment
•
a record of all discussions and interactions with the client and persons/services involved in the
provision of support including referral information, telephone and email correspondence
•
a record of non-attendance, either by the Social Worker or client, at scheduled and agreed
meetings or activities
•
evidence that the Social Worker and client have discussed their respective legal and ethical
responsibilities. This may include:
o
client rights, responsibilities and complaints processes
o
the parameters of the service and support being offered and agreed to
o
issues relating to informed consent, information sharing, confidentiality and privacy
o
efforts to promote and support client self-determination and autonomy
o
specific responsibilities to clients in particular settings such as private practice or rural
settings as per the Code of Ethics 2010
•
o
professional boundaries and how dual relationships may be managed
o
record keeping and freedom of information
o
discharge planning
o
relevant legislative requirements and their possible implications for practice
details of reasons and any related actions or outcomes leading up to or following the
termination or interruption of a service or support.
1
Ethics and Practice Guideline – Case Notes
Updated July 2016
How should this information be represented in a case note?
There are a number of case-writing models available to Social Workers. Some of them provide general
guidance for writing case notes, such as the ‘Summary Style’, while others are specific to a service type or
context, such as the STIPS model.
In addition, many organisations have policies and procedures around case recording.
The AASW does not recommend the use of one model or policy over any other, however the Code of
Ethics 2010 points to some general principles for good record keeping.
Information recorded about a client should be impartial, accurate and complete with care taken to ensure
that:
•
only details relevant to the provision of a support or service to which the client has consented are
•
when working with involuntary clients this means recording information relevant to statutory
recorded (see sections 5.2.5 (a) and 5.2.4 (b))
practice (see also 5.2.2)
•
notes are free from derogatory or emotive language (5.2.4 (a))
•
subjective opinions are qualified with relevant
•
background information, theory or research (5.2.5 (a))
•
relevant information is not omitted (5.2.5 (c)).
When recording information about third-parties, such as information about a client’s relationship with
significant others, it is equally important to separate fact from opinion.
For more information and for Social Workers in particular settings, such as Private Practice, please see
our related Ethical Guidelines on the AASW website at www.aasw.asn.au/whatwedo/ethics-faqs
How and when should case notes be recorded?
Case notes can be recorded manually or electronically and should:
•
include on each page the name and DOB or other identifying information of the client. This can
be handwritten, typed or constitute an electronic tag where an electronic case recording program
is utilised
•
be dated
•
be recorded as soon as possible after an interaction or event
•
be typed or clearly readable if handwritten
•
include the name, signature and profession/role of
•
the author
•
include the time of contact, particularly where there are a high volume of interactions in a day.
2
Ethics and Practice Guideline – Case Notes
Updated July 2016
Can I change or amend a case note at a later date?
Care should be taken to avoid errors or omissions. In some instances it is illegal to change, white-out or
amend case notes after the fact.
If a change must be made to correct an error or omission, the change can be recorded as a new and
separate case note. In addition to outlining the error or omission as part of this new case note, it is
advisable to provide an explanation for it earlier absence or inaccuracy. You may also add, if possible, a
note in the margin of the original case note referring the
Ms. Blakeney was visited today via telehealth. Client was alert and oriented x3, bruise was found on bilateral forearm, denied pain and discomfort. Client is been accommodated by friend where she called home. She shower and dresses in clean clothe. She verbalized her son will be free from incarseration. She expressed excitement after been promised a food stamp as a result of government benefit program. Resident was educated on health management due to homelessness. Follow the rubric below
All the details are in the attachment.I’m still waiting for more clarification from my Dr. You can start and I will inform you once I receive it.
Unformatted Attachment Preview
Critical Thinking Assignment
Access to Healthcare (100 points)
Information technology can be used to assist health care organizations in the ability to
provide access to healthcare organizations. Please choose any current information
technology and create a PowerPoint presentation on how the technology will improve
healthcare access in KSA. Be sure to include:
• An overview of the information technology including its goals
• The main stakeholders from the healthcare system that are involved in
information technology.
• How information technology will improve access to healthcare in KSA.
• Recommendations for how you would evaluate whether access to services
has improved.
Your presentation should meet the following structural requirements:
• Be 7-8 slides in length, not including the title or reference slides.
• Be formatted according to Saudi Electronic University and APA writing
guidelines.
• Provide support for your statements with citations from a minimum of six
scholarly articles. These citations should be listed in the Notes section of the
slide in which they appear. Two of these sources may be from the class
readings, textbook, or lectures, but four must be external.
• Each slide must provide detailed speaker’s notes to support the slide content.
These should be a minimum of 100 words long (per slide) and must be a part
of the presentation. The presentation cannot be submitted in PDF format,
which does not make notes visible to the instructor. Notes must draw from
and cite relevant reference materials.
• Utilize headings to organize the content in your work.
RAD 463: Radiographs & Their Interpretation
First Semester 1445 H
Research Paper and Presentation Assignment (20 Points)
This is your term assignment.
1. First, you are required to form groups of 5 students. Then, each group is required to propose a topic.
Write a short paragraph (around 2 to 3 lines) to explain your topic. This is due on Sunday 24th of
September, 2023. Only the leader of each group should email me the proposal.
2. The second step, write a research paper on your approved topic (at least 1500 words, not including the
title page and the references page). Please note that you cannot limit yourself to the materials in the
lectures, you need to RESEARCH. This is worth fourteen points (14 out of 20 points). The research
paper is due on Thursday 9th of November, 2023.
3. Finally, you need to present your work to your classmates and the instructor of the course. This is worth
six points (6 out of 20 points).
Instructions:
1. Use a plain serif (e.g. Times New Roman) or sans serif (e.g. Arial) font. This is because a serif font is
easier to read.
2. Required sizes are 12 for the text and 14 for headings.
3. The paper must be double-spaced.
4. Margins of the paper should be 1″ on all sides (top, bottom, left, and right).
5. Use at least 10 references.
6. Use only articles published within the last 10 years (2013 or later).
7. Use APA, MLA or JAMA citation style to reference your sources. For example:
8. Do not forget in-text citations.
9. Your paper should be 70% UNIQUE. If there are more than 30% similarities (plagiarized), 10 points
will be deducted from your total grade.
10. DO NOT copy and paste. Always paraphrase.
11. Your research paper will be evaluated based on the rubric on page 2.
12. No late submissions are allowed.
13. Submit your work to Blackboard before the deadline.
14. Only the leader of each group should submit their work.
1
Rubric:
Score ➔
3.5
2.5
1.5
0.5
Elements to
be Evaluated
•
clearly stated and
appropriately focused
•
clearly stated but
focus could have been
sharper
•
aim phrasing too simple,
lacks complexity; or, not
clearly worded
•
aim lacks a clear
objective and/or does
not “fit” content of
paper
•
sharp, distinct focus;
balanced, substantial,
specific, and/or
illustrative content;
mature ideas are
particularly welldeveloped
use appropriate
examples to clarify some
points
strong introduction
consistent and coherent
logical progression
use clear and skillful
transitions
written in formal
language
no grammar and spelling
mistakes
•
clear focus; specific,
illustrative, and
balanced content
majority of examples
are appropriate
•
adequate focus, but
unbalanced content; more
analysis needed
examples are rarely used
in the paper
•
paper contains too
much research
information without
analysis or commentary
no examples
•
•
•
introduction is present but
not clear
shows some attempts of
consistency and order
paper shows attempt of
transitions between
paragraphs
some use of formal
language
some grammar and
spelling mistakes
6-7 sources
sources are documented
some in-text citations are
used
•
10 sources or more
sources are accurately
documented
in-text citations are
appropriately used
clear introduction
illustrate some
consistency and
shows some logical
progression
use clear transitions
majority of paper
written in formal
language
minor grammar and
spelling mistakes
8-9 sources
all sources are
documented
in-text citations are
used
Aim
Focus &
Content
•
•
•
•
•
Organization
& Language
•
•
Works Cited
Page
•
•
•
•
•
•
•
•
•
•
Summary of Grade Distribution
Research Paper
= 14 points
Presentation
= 6 points
—————————————-Total grade
= 20 points
2
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
unable to clearly
identify introduction
lack of consistency and
order
paper show little or no
attempt of transitions
between paragraphs
paper frequently uses
informal language
many grammar and
spelling mistakes
5 sources or less
lack proper
documentation of
sources
no in-text citations
Critical Thinking: Chapter 15-Drugs Used for Anxiety DisordersInstructionsInstructionsThe patient tells the nurse, “After taking Xanax for some time, I quit. I found that alcohol helps relieve my anxiety symptoms just as well, and it does not cost as much. Besides, it does not have any adverse effects. Why should I bother taking my medication?” How should the nurse respond?
Questions related to the book Crazy: A Father’s Search Through America’s Mental Health Madness by Pete Earley
1. What do you suppose the author is referring to by using the word “crazy” in the title of the book?
2. Are the chronically mentally ill any better off since the deinstitutionalization of the mentally ill? Why or why not? Please be specific and use specific examples from the book.
3. How does a person with a chronic mental illness affect the family? What are the fears of families?
4. Name some “system problems” that are discussed in the book.
5. Have we gone too far to protect “civil rights”? Are we hurting the chronically mentally ill by giving them these “rights”?
6. What is “imminent danger” in reference to the mentally ill and what are the risks of waiting until one does display this level of “danger”?
7. Have we “freed” the chronically mentally ill? Abandoned them? Imprisoned them?
8. What was the intended effect of “the right to refuse treatment”?
9. In the book, it talks about “Passageways” treatment center who treat what we call the “mad and the bad” but why are they the successful?
10. Discuss some of the symptoms of mental illness that are described in the book. Be specific.
11. Why does the staff really fear “the 9th floor”?
12. Did this book do anything to change your perception of the mentally ill or the treatment of the mentally ill? What are your feelings after reading this book? Your personal opinion?
instructions: Read the following case study and answer the reflective questions. Please provide rationales for your answers. Make sure to provide a citation for your answers. Must follow APA, 7th ed. format.
CASE STUDY: Family Member with Alzheimer’s Disease: Mark and Jacqueline
Mark and Jacqueline have been married for 30 years. They have grown children who live in another
state. Jacqueline’s mother has moved in with the couple because she has Alzheimer’s disease.
Jacqueline is an only child and always promised her mother that she would care for her in her old
age. Her mother is unaware of her surroundings and often calls out for her daughter Jackie when
Jacqueline is in the room. Jacqueline reassures her mother that she is there to help, but to no avail.
Jacqueline is unable to visit her children on holidays because she must attend to her mother’s daily
needs. She is reluctant to visit friends or even go out to a movie because of her mother’s care needs
or because she is too tired. Even though she has eliminated most leisure activities with Mark,
Jacqueline goes to bed at night with many of her caregiving tasks unfinished. She tries to visit with
her mother during the day, but her mother rejects any contact with her daughter. Planning for the
upcoming holidays seems impossible to Mark, because of his wife’s inability to focus on anything
except her mother’s care.
Jacqueline has difficulty sleeping at night and is unable to discuss plans even a few days in
advance. She is unable to visit friends and is reluctant to have friends visit because of the
unpredictable behavior of her mother and her need to attend to the daily care.
Reflective Questions
1. How do you think this situation reflects Jacqueline’s sense of role performance?
2. How do you think that Jacqueline may be contributing to her own health?
If you have a Study.com College Saver membership and are seeking college credit for this course, you must submit a paper and pass the proctored final exam. You must submit your paper before registering for the final. Below you will find prompts and instructions for submitting your paper.
About This Assignment
In this course, you learned about the history of healthcare informatics and its impact on the healthcare industry. This assignment will offer you the opportunity to research recent healthcare trends and evaluate their effect on healthcare informatics. After conducting the required research, write an 800 to 1,000-word paper describing a current news issue. Use the following prompts to guide your explanation of how the issue affects healthcare informatics.
How does the issue impact healthcare informatics?
Will this issue have a long-term effect?
Will this effect be positive or negative? Why?
Formatting & Sources
Please write your paper in the APA format. As part of your research, you may refer to the course material for supporting evidence, but you must also use at least three credible, outside sources and cite them using APA format as well. Please include a mix of both primary and secondary sources, with at least one source from a scholarly peer-reviewed journal. If you use any Study.com lessons as sources, please also cite them in APA (including the lesson title and instructor’s name).
Primary sources are first-hand accounts such as interviews, advertisements, speeches, company documents, statements, and press releases published by the company in question.
Secondary sources come from peer-reviewed scholarly journals, such as the Journal of Management. You may use like JSTOR, Google Scholar, and Social Science Research Network to find articles from these journals. Secondary sources may also come from reputable websites with .gov, .edu, or .org in the domain. (Wikipedia is not a reputable source, though the sources listed in Wikipedia articles may be acceptable.)
If you’re unsure about how to use APA format for your paper and sources, please see the following lessons:
What is APA Format? Definition & Style
How To Format APA Citations
Grading Rubric
Category Unacceptable (0-1) Needs Improvement (2-3) Good (4) Excellent (5) Total Possible Points
Explanation of Issues (x2) Issue is not stated clearly. Reader is unable to understand the issue. Issue is stated, but the description is ambiguous or unclear. Reader is left with questions regarding the issue. Issue is described effectively. Reader is able to understand the issue. Issue is stated clearly and described comprehensively. Reader has a full understanding of the depth and breadth of the issue. 10
Analysis (x2) No sources are used for analysis. Expert viewpoints are used as facts. Less than three sources are used for an analysis. Expert viewpoints are used as facts to support conclusion. At least three sources are used to provide a coherent analysis. Expert viewpoints are questioned at least once – not stated as fact. At least three sources are used to provide a coherent and comprehensive analysis. Expert viewpoints are questioned thoroughly, not stated as fact. 10
Structure (x1) Structure of arguments or evidence is illogical or significantly hinders understanding. Argument or evidence is difficult to identify; ideas are disjointed. Argument or evidence is provided and is relevant to the thesis; ideas flow in a manner that does not hinder understanding. Argument or evidence is are well integrated; ideas flow logically; main points are identifiable. 5
Mechanics (x1) Incorrect spelling, punctuation, capitalization, and use of standard English grammar hinders understanding. Several instances of incorrect spelling, punctuation, capitalization, and usage of standard English grammar. Few instances of incorrect spelling, punctuation, capitalization, and usage of standard English grammar. No or very few instances of incorrect spelling, punctuation, capitalization, and usage of standard English grammar. 5
Before You Submit
When you are done writing your paper, we suggest taking some time to check for any errors or to add some final touches. We also suggest that you use online plagiarism checkers such as PlagScan or DupliChecker to make sure that your paper is not too similar to any existing materials. Plagiarized submissions will NOT be graded.
How to Submit Your Papers
When you are ready to submit your written papers, please fill out the submission form and attach your papers as Microsoft Word, PDF, or Text documents. After turning in your papers, you may go ahead and take the proctored final exam. You do not need to wait for your written response to be graded. You should receive your paper grades within one week.
If you are not satisfied with the score you receive on your papers, you may revise or rewrite your papers and resubmit them for grading using the same submission form above. Keep in mind that the grade you receive on your papers is only a portion of your overall grade for the course, and you are free to retake the proctored final exam as well if you choose. Please see the course syllabus for a more detailed breakdown of the grading policy.
How should healthcare professionals proactively plan to update their knowledge and skills to respond to the major public health issues and challenges facing them and their clients?The discussion must address the topic.Rationale must be provided400 words in your initial postMinimum of two scholarly references in APA format within the last five years published
CASE STUDY ASSIGNMENT: ASSESSING THE HEAD, EYES, EARS, NOSE, AND THROAT
Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes but would probably perform a simple strep test.
Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment.
In this Case Study Assignment, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
TO PREPARE
By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP Notes have specific data included in every patient case.
With regard to the case study you were assigned:
Review this week’s Learning Resources and consider the insights they provide.
Consider what history would be necessary to collect from the patient.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
THE ASSIGNMENT
Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.
Discuss the challenges that clinical leaders encounter as they support their staff during changes in technology and information systems adopted in their practice setting. Describe any issues that you identify regarding workflows or processes and any recommendations that you have to resolve them.
Combining end-user recruitment methods for usability testing of eTriage Service
– Blockchain Technology in Healthcare: A Comprehensive Review and Directions for Future Research
Watch the following video(s):
Usability testing
Ensuring digital accessibility and employability for persons with disabilities in Singapore
Purpose
The purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos.
Action Items
What is blockchain? give some exmaple of using this technology in the healthcare industry?
Presentation rubric
Presenter’s Name:
Topic Name:
Date: ————————————– Group: —————————————————————–Evaluation Items
Items
Category
The content is comprehensive and clear.
The content was organized in logical manner.
The presentation contained examples and
useful techniques that applied to current
work.
The content focused on major facts or ideas.
Content
Poor
(1)
Fair
(2)
Good
(3)
Excellent
(4)
Speaker summed up main points in
conclusion.
The presenter was knowledgeable about the
topic and any related issues.
The
presenter
answered
questions
effectively.
Presenter
The presenter had a fluidity of language.
The presenter maintained the attention and
interest of audiences.
The presenter appears prepared and
understand the material.
The presenter summarizes when needed.
Organization
Presentation
Style
Delivery
The presenter delivered the material in a clear
and structured manner.
Level of presentation is appropriate for the
audience.
Presentation is a planned
Conversation,
paced
for
audience
understanding.
The presenter talks about the slides rather
than simply reading them to the audience.
Total
Course instructor Name:
Comments: ———————————————————————————————————-
There are a number of stakeholders in healthcare, many of whom are actively involved in policymaking activities. A common compliance-related concern involves a conflict of interest between a stakeholder and the organization. A conflict of interest often involves the inability of a stakeholder to perform their duties appropriately because it could possibly betray their interests to the organization. For instance, interest groups may attempt to influence public policy in their favor, often by lobbying members of the government. In this case, the influence of interest groups on policymaking is not necessarily an illegal activity; rather, it is viewed more as a significant part of the decision-making process. Based on what you learned this week, address the following requirements:Discuss two examples of conflicts of interest in policymaking. What might influence stakeholders to engage in policymaking activities that could pose a conflict of interest?
Crisis Intervention with Adolescent Survivors of Automobile Accidents is the research topic.
Unformatted Attachment Preview
CRIS 605
RESEARCH PAPER ASSIGNMENT INSTRUCTIONS
OVERVIEW
Before starting this Research Paper Assignment, you will need to complete the Quiz:
Research Paper Topic.
For this Research Paper Assignment, you will write a literature review research paper based on
your chosen topic. Your Research Paper Assignment should focus on mental health, first
responders, and crisis work in the specific area of your approved topic and your identified
population of interest. Since this is a course about first responders and crisis intervention, avoid
discussing topics such as psychotherapy/counseling, medicine, law, economics and so forth.
Make sure to avoid personal experience and opinion, as this is strictly a literature review paper
with Scriptural integration.
INSTRUCTIONS
Your Research Paper Assignment must include the following:
•
•
•
•
12-15 pages, not including the cover page, abstract, or reference pages. Any submissions
less than 12 pages will be heavily penalized and prorated.
A minimum of 15 scholarly sources (journals, books, government/educational websites)
are required. At least 10 of your sources must be published within the last 5 years and all
of them should be within 10 years unless one source is truly considered a “classic work”
in the field and is used for historical context.
Current APA or Turabian formatting standards. Key formatting requirements include but
are not limited to cover page, headers, Level 1 and 2 headings, citations, and references.
Abstract (be sure you know the difference in content/format between an abstract and an
introduction).
Body of the Research Paper Assignment:
o Introduction – Use the appropriate APA or Turabian heading. Be sure to use this
section to orient your reader and grab their interest. Why does this topic matter?
What interesting background information can you share?
o Mental Health Dynamics/Symptoms – Describe mental health
symptoms/relationship dynamics common in your population-of-interest. How
can new crisis interventionists identify this population? What type of mental
health issues typically arise? What type of relationship issues typically occur?
o Best Practices in Crisis Intervention – How you can best help this population
using best practices in crisis intervention? (HINT: Focus only on acute care,
immediate, urgent, crisis intervention instead of psychotherapy/counseling, etc.)
o Spiritual Applications/Interventions – What does Scripture say about your topic
area? Biblical application is required at least once in the paper using specific
Scripture.
o Cultural Considerations – What cultural concerns/considerations must we attend
to when working with this population?
Page 1 of 2
CRIS 605
o Conclusion – Discuss the key themes and findings that you discovered.
▪ Ideas for Future Research – NOTE: ***The conclusion of a literature
review paper must include at least a paragraph on “ideas for future
research.” After reading the literature on your topic, what seems to be
missing? What should future researchers focus on?
o Current APA or Turabian formatted references page.
Be sure to review the Research Paper Grading Rubric before beginning this Research Paper
Assignment.
Page 2 of 2
Below I have added total of 3 assignments. Let me know. Thank you.
ASSIGMENT 2
For this assessment, you will create a 2–4 page report on an interview you have conducted with a health care professional. You will identify an issue from the interview that could be improved with an interdisciplinary approach, and review best practices and evidence to address the issue.
Collapse All
Introduction
As a baccalaureate-prepared nurse, your participation and leadership in interdisciplinary teams will be vital to the health outcomes for your patients and organization. One way to approach designing an improvement project is to use the Plan-Do-Study-Act (PDSA) cycle. The Institute for Healthcare Improvement describes it thus:
The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting—by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method adapted for action-oriented learning…Essentially, the PDSA cycle helps you test out change ideas on a smaller scale before evaluating the results and making adjustments before potentially launching into a somewhat larger scale project (n.d.).
You might also recognize that the PDSA cycle resembles the nursing process. The benefit of gaining experience with this model of project design is that it provides nurses with an opportunity to ideate and lead improvements. For this assessment, you will not be implementing all of the PDSA cycle. Instead, you are being asked to interview a health care professional of your choice to determine what kind of interdisciplinary problem he or she is experiencing or has experienced in the workplace. This interview, in Assessment 2, will inform the research that you will conduct to propose a plan for interdisciplinary collaboration in Assessment 3.
It would be an excellent choice to complete the PDSA Cycle activity prior to developing the report. The activity consists of four questions that create the opportunity to check your understanding of best practices related to each stage of the PDSA cycle. The information gained from completing this formative will promote your success with the Interview and Interdisciplinary Issue Identification report. This will take just a few minutes of your time and is not graded.
REFERENCE
Institute for Healthcare Improvement. (n.d.). How to improve. http://www.ihi.org/resources/Pages/HowtoImprove/de…
Demonstration of Proficiency
Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.
Summarize an interview focused on past or current issues at a health care organization.
Describe collaboration approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.
Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.
Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.
Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.
Describe change theories and a leadership strategy that could help develop an interdisciplinary solution to an organizational issue.
Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
Professional Context
This assessment will introduce the Plan-Do-Study-Act (PDSA) Model to create change in an organization. By interviewing a colleague of your choice, you will begin gathering information about an interprofessional collaboration problem that your colleague is experiencing or has experienced. You will identify a change theory and leadership strategies to help solve this problem.
Scenario
This assessment is the first of three related assessments in which you will gather interview information (Assessment 2); design a proposal for interdisciplinary problem-solving, (Assessment 3); and report on how an interdisciplinary improvement plan could be implemented in a place of practice (Assessment 4). At the end of the course, your interviewee will have a proposal plan based on the PDSA cycle that he or she could present to stakeholders to address an interdisciplinary problem in the workplace.
For this assessment, you will need to interview a health care professional such as a fellow learner, nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem that he or she is experiencing or has experienced, or an area where they are seeking improvements. Consult the Interview Guide [DOCX] Download Interview Guide [DOCX]for an outline of how to prepare and the types of information you will need to complete this project successfully.
Remember: this is just the first in a series of three assessments.
Instructions
For this assessment, you will report on the information that you collected in your interview, analyzing the interview data and identifying a past or current issue that would benefit from an interdisciplinary approach. This could be an issue that has not been addressed by an interdisciplinary approach or one that could benefit from improvements related to the interdisciplinary approach currently being used. You will discuss the interview strategy that you used to collect information. Your interview strategy should be supported by citations from the literature. Additionally, you will start laying the foundation for your Interdisciplinary Plan Proposal (Assessment 3) by researching potential change theories, leadership strategies, and collaboration approaches that could be relevant to issue you have identified. Please be certain to review the scoring guide to confirm specific required elements of this assessment. Note that there are differences between basic, proficient and distinguished scores.
When submitting your plan, use the Interview and Issue Identification Template [DOCX], Download Interview and Issue Identification Template [DOCX],which will help you to stay organized and concise. As you complete the template, make sure you use APA format for in-text citations for the evidence and best practices that are informing your plan, as well as for the reference list at the end.
Additionally, be sure to address the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Summarize an interview focused on past or current issues at a health care organization.
Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.
Describe potential change theories and leadership strategies that could inform an interdisciplinary solution to an organizational issue.
Describe collaboration approaches from the literature that could facilitate establishing or improving an interdisciplinary team to address an organizational issue.
Communicate with writing that is clear, logically organized, and professional, with correct grammar and spelling, and using current APA style.
Additional Requirements
Length of submission: Use the provided template. Most submissions will be 2–4 pages in length. Be sure to include a reference page at the end of the plan.
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.
APA formatting: Make sure that in-text citations and reference list follow current APA style.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.
Scoring Guide
Use the scoring guide to understand how your assessment will be evaluated.
View Scoring Guide
.
.
.
ASSIGNMENT 3
For this assessment you will create a 2–4 page plan proposal for an interprofessional team to collaborate and work toward driving improvements in the organizational issue you identified in the second assessment.
Collapse All
Introduction
The health care industry is always striving to improve patient outcomes and attain organizational goals. Nurses can play a critical role in achieving these goals; one way to encourage nurse participation in larger organizational efforts is to create a shared vision and team goals (Mulvale et al., 2016). Participation in interdisciplinary teams can also offer nurses opportunities to share their expertise and leadership skills, fostering a sense of ownership and collegiality.
You are encouraged to complete the Budgeting for Nurses activity before you develop the plan proposal. The activity consists of seven questions that will allow you the opportunity to check your knowledge of budgeting basics and as well as the value of financial resource management. The information gained from completing this formative will promote success with the Interdisciplinary Plan Proposal. Completing this activity also demonstrates your engagement in the course, requires just a few minutes of your time, and is not graded.
Demonstration of Proficiency
Competency 1: Explain strategies for managing human and financial resources to promote organizational health.
Explain organizational resources, including a financial budget, needed for the plan to be a success and the impacts on those resources if nothing is done, related to the improvements sought by the plan.
Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.
Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific objective related to improving patient or organizational outcomes.
Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the literature.
Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.
Explain a change theory and a leadership strategy, supported by relevant evidence, that are most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan.
Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
REFERENCE
Mulvale, G., Embrett, M., & Shaghayegh, D. R. (2016). ‘Gearing up’ to improve interprofessional collaboration in primary care: A systematic review and conceptual framework. BMC Family Practice, 17.
Professional Context
This assessment will allow you to describe a plan proposal that includes an analysis of best practices of interprofessional collaboration, change theory, leadership strategies, and organizational resources with a financial budget that can be used to solve the problem identified through the interview you conducted in the prior assessment.
Scenario
Having reviewed the information gleaned from your professional interview and identified the issue, you will determine and present an objective for an interdisciplinary intervention to address the issue.
Note: You will not be expected to implement the plan during this course. However, the plan should be evidence-based and realistic within the context of the issue and your interviewee’s organization.
Instructions
For this assessment, use the context of the organization where you conducted your interview to develop a viable plan for an interdisciplinary team to address the issue you identified. Define a specific patient or organizational outcome or objective based on the information gathered in your interview.
The goal of this assessment is to clearly lay out the improvement objective for your planned interdisciplinary intervention of the issue you identified. Additionally, be sure to further build on the leadership, change, and collaboration research you completed in the previous assessment. Look for specific, real-world ways in which those strategies and best practices could be applied to encourage buy-in for the plan or facilitate the implementation of the plan for the best possible outcome.
Using the Interdisciplinary Plan Proposal Template [DOCX] Download Interdisciplinary Plan Proposal Template [DOCX]will help you stay organized and concise. As you complete each section of the template, make sure you apply APA format to in-text citations for the evidence and best practices that inform your plan, as well as the reference list at the end.
Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific goal related to improving patient or organizational outcomes.
Explain a change theory and a leadership strategy, supported by relevant evidence, that is most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan.
Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the literature.
Explain organizational resources, including a financial budget, needed for the plan to succeed and the impacts on those resources if the improvements described in the plan are not made.
Communicate the interdisciplinary plan, with writing that is clear, logically organized, and professional, with correct grammar and spelling, using current APA style.
Additional Requirements
Length of submission: Use the provided template. Remember that part of this assessment is to make the plan easy to understand and use, so it is critical that you are clear and concise. Most submissions will be 2–4 pages in length. Be sure to include a reference page at the end of the plan.
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.
APA formatting: Make sure that in-text citations and reference list follow current APA style.
Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.
Scoring Guide
Use the scoring guide to understand how your assessment will be evaluated.
View Scoring Guide
.
.
.
ASSIGNMENT 4
For this assessment you will create an 8–12 slide PowerPoint presentation for one or more stakeholder or leadership groups to generate interest and buy-in for the plan proposal you developed for the third assessment.
Expand All
Introduction
As a current or future nurse leader, you may be called upon to present to stakeholders and leadership about projects that you have been involved in or wish to implement. The ability to communicate a plan—and potential implications of not pursuing such a plan—to stakeholders effectively can be critically important in creating awareness and buy-in, as well as building your personal and professional brand in your organization. It is equally important that you know how to create compelling presentations for others’ delivery and ensure that they convey the same content you would deliver if you were the presenter.
You are encouraged to complete the Evidence-Based Practice: Basics and Guidelines activity before you develop the presentation. This activity consists of six questions that will create the opportunity to check your understanding of the fundamentals of evidence-based practice as well as ways to identify EBP in practice. The information gained from completing this formative will help promote success in the Stakeholder Presentation and demonstrate courseroom engagement—it requires just a few minutes of your time and is not graded.
Demonstration of Proficiency
Competency 1: Explain strategies for managing human and financial resources to promote organizational health.
Explain how the interdisciplinary plan could be implemented and how the human and financial resources would be managed.
Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.
Explain an organizational or patient issue for which a collaborative interdisciplinary team approach would help achieve a specific improvement goal.
Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.
Summarize an evidence-based interdisciplinary plan to address an organizational or patient issue.
Propose evidence-based criteria that could be used to evaluate the degree to which the project was successful in achieving the improvement goal.
Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.
Slides are easy to read and error free. Detailed speaker notes are provided.
Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years) with an APA formatted reference list with few errors.
Professional Context
This assessment will provide you with an opportunity to sharpen your ability to create a professional presentation to stakeholders. In this presentation, you will explain the Plan-Do-Study-Act cycle and how it can be used to introduce the plan (P), implement the plan (D), study the effectiveness of the plan (S), and act on what is learned (A) to drive continuous improvement. By using this cycle, the stakeholders will have a tool and a proposal to expand on these ideas to drive workplace change and create improved processes to solve an interprofessional collaboration problem.
Scenario
In addition to summarizing the key points of Assessments 2 and 3, you will provide stakeholders and/or leadership with an overview of project specifics as well as how success would be evaluated—you will essentially be presenting a discussion of the Plan, Do, and Study parts of the PDSA cycle. Again, you will not be expected to execute the project, so you will not have any results to study. However, by carefully examining the ways in which your plan could be carried out and evaluated, you will get some of the experience of the thinking required for PDSA.
When creating your PowerPoint for this assessment, it is important to keep in mind the target audience: your interviewee’s organizational leadership. The overall goal of this assessment is to create a presentation that your interviewee could potentially give in his or her organization.
Instructions
Please follow the Capella Guidelines for Effective PowerPoint Presentations [PPTX]. If you need technical information on using PowerPoint, refer to Capella University Library: PowerPoint Presentations.
Be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Explain an organizational or patient issue for which a collaborative interdisciplinary team approach would help achieve a specific improvement goal.
Summarize an evidence-based interdisciplinary plan to address an organizational or patient issue.
Explain how the interdisciplinary plan could be implemented and how the human and financial resources would be managed.
Propose evidence-based criteria that could be used to evaluate the degree to which the project was successful in achieving the improvement goal.
Communicate the PowerPoint presentation of the interdisciplinary improvement plan to stakeholders in a professional manner, with writing that is clear, logically organized, and respectful with correct grammar and spelling using current APA style.
There are various ways to structure your presentation; following is one example:
Part 1: Organizational or Patient Issue.
What is the issue that you are trying to solve or improve?
Why should the audience care about solving it?
Part 2: Relevance of an Interdisciplinary Team Approach.
Why is using an interdisciplinary team relevant, or the best approach, to addressing the issue?
How will it help to achieve improved outcomes or reach a goal?
Part 3: Interdisciplinary Plan Summary.
What is the objective?
How likely is it to work?
What will the interdisciplinary team do?
Part 4: Implementation and Resource Management.
How could the plan be implemented to ensure effective use of resources?
How could the plan be managed to ensure that resources were not wasted?
How does the plan justify the resource expenditure?
Part 5: Evaluation.
What would a successful outcome of the project look like?
What are the criteria that could be used to measure that success?
How could this be used to show the degree of success?
Again, keep in mind that your audience for this presentation is a specific group (or groups) at your interviewee’s organization and tailor your language and messaging accordingly. Remember, also, that another person will ultimately be giving the presentation. Include thorough speaker’s notes that flesh out the bullet points on each slide.
Additional Requirements
Number of slides: Plan on using one or two slides for each part of your presentation as needed, so the content of your presentation will be 8–12 slides in length. Remember that slides should contain concise talking points, and you will use presenter’s notes to go into detail. Be sure to include a reference slide as the last slide of your presentation.
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old.
APA formatting: Make sure that in-text citations on your slides and in your notes pages and reference slide reflect current APA Style and Format.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.
Scoring Guide
Use the scoring guide to understand how your assessment will be evaluated.
View Scoring Guide
Unformatted Attachment Preview
9/27/23, 12:04 PM
Interview and Interdisciplinary Issue Identification Scoring Guide
Interview and Interdisciplinary Issue Identification Scoring Guide
NONPERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
Summarize an
interview focused on
past or current issues
at a health care
organization.
Does not
summarize an
interview
focused on past
or current issues
at a health care
organization.
Discusses an interview,
but the focus of the
interview, the issues
addressed, or the
specifics of health care
organizational context
are unclear or missing.
Summarizes an
interview focused on
past or current issues
at a health care
organization.
Summarizes an
interview focused on
past or current issues at
a health care
organization. Notes
strategies employed in
the interview to ensure
that sufficient
information was
gathered.
Identify an issue from
an interview for which
an evidence-based
interdisciplinary
approach would be
appropriate.
Does not identify
an issue from an
interview for
which an
evidence-based
interdisciplinary
approach would
be appropriate.
Identifies an issue with
an unclear connection
to the interview or for
which an evidencebased interdisciplinary
approach seems
inappropriate.
Identifies an issue from
an interview for which
an evidence-based
interdisciplinary
approach would be
appropriate.
Identifies an issue from
an interview for which
an evidence-based
interdisciplinary
approach would be
appropriate, providing
one or more specific
reasons to justify this
approach.
Describe potential
change theories and
leadership strategies
that could help
develop an
interdisciplinary
solution to an
organizational issue.
Does not
describe
potential change
theories and
leadership
strategies that
could help
develop an
interdisciplinary
solution to an
organizational
issue.
Identifies change
theories and leadership
strategies that are
unclear, incomplete, or
irrelevant to developing
an interdisciplinary
solution to an
organizational issue.
Describes potential
change theories and
leadership strategies
that could help develop
an interdisciplinary
solution to an
organizational issue.
Describes potential
change theories and
leadership strategies
that could help develop
an interdisciplinary
solution to an
organizational issue.
Notes which sources
seem most credible or
relevant to the specific
organizational issue.
Describe
collaborative
approaches from the
literature that could
be relevant in
establishing or
improving an
interdisciplinary team
to address an
organizational issue.
Does not
describe
collaborative
approaches from
the literature that
could be
relevant in
establishing or
improving an
interdisciplinary
team to address
an
organizational
issue.
Identifies collaborative
approaches from the
literature but the
relevance to
establishing or
improving an
interdisciplinary team to
address an
organizational issue is
unclear or insufficiently
explained.
Describes collaborative
approaches from the
literature that could be
relevant in establishing
or improving an
interdisciplinary team
to address an
organizational issue.
Describes collaborative
approaches from the
literature that could be
relevant in establishing
or improving an
interdisciplinary team to
address an
organizational issue.
Notes which sources
seem most credible or
relevant to the specific
organizational issue.
Organize content so
ideas flow logically
with smooth
transitions; contains
few errors in
grammar/punctuation,
word choice, and
spelling.
Does not
organize content
for ideas. Lacks
logical flow and
smooth
transitions.
Organizes content with
some logical flow and
smooth transitions.
Contains errors in
grammar/punctuation,
word choice, and
spelling.
Organizes content so
ideas flow logically with
smooth transitions;
contains few errors in
grammar/punctuation,
word choice, and
spelling.
Organizes content with
a clear purpose.
Content flows logically
with smooth transitions
using coherent
paragraphs, correct
grammar/punctuation,
CRITERIA
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CRITERIA
Interview and Interdisciplinary Issue Identification Scoring Guide
NONPERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
word choice, and free of
spelling errors.
Apply APA formatting
to in-text citations
and references
exhibiting nearly
flawless adherence to
APA format.
Does not apply
APA formatting
to headings, intext citations,
and references.
Does not use
quotes or
paraphrase
correctly.
Applies APA formatting
to in-text citations,
headings and
references incorrectly
and/or inconsistently,
detracting noticeable
from the content.
Inconsistently uses
headings, quotes
and/or paraphrasing.
Applies APA formatting
to in-text citations and
references, exhibiting
nearly flawless
adherence to APA
format.
Exhibits strict and
flawless adherence to
APA formatting of
headings, in-text
citations, and
references. Quotes and
paraphrases correctly.
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Interdisciplinary Plan Proposal Scoring Guide
Interdisciplinary Plan Proposal Scoring Guide
CRITERIA
NONPERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
Describe an objective
and predictions for an
evidence-based
interdisciplinary plan
to achieve a specific
goal related to
improving patient or
organizational
outcomes.
Does not
describe an
objective and
predictions for
an evidencebased
interdisciplinary
plan to achieve a
specific goal
related to
improving patient
or organizational
outcomes.
Identifies an objective
for an evidence-based
interdisciplinary plan
but does not clearly
explain how the
objective will help
achieve a specific goal
related to improving
patient or
organizational
outcomes.
Describes an objective
and predictions for an
evidence-based
interdisciplinary plan to
achieve a specific goal
related to improving
patient or
organizational
outcomes.
Describes an objective
and predictions for an
evidence-based
interdisciplinary plan to
achieve a specific goal
related to improving
patient or organizational
outcomes, including
methods from the
literature that may be
used to determine
success.
Explain a change
theory and a
leadership strategy,
supported by relevant
evidence, that is most
likely to help an
interdisciplinary team
succeed in
collaborating and
implementing, or
creating buy-in for,
the project plan.
Does not explain
a change theory
and a leadership
strategy,
supported by
relevant
evidence, that is
most likely to
help an
interdisciplinary
team succeed in
collaborating and
implementing, or
creating buy-in
for, the project
plan.
Describes a change
theory and a leadership
strategy but the
relevance to the
success of
interdisciplinary team in
collaborating and
implementing, or
creating buy-in for, the
project plan is not
clearly explained and
no evidence is
provided.
Explains a change
theory and a
leadership strategy,
supported by relevant
evidence, that is most
likely to help an
interdisciplinary team
succeed in
collaborating and
implementing, or
creating buy-in for, the
project plan.
Explains a change
theory and a leadership
strategy, supported by
relevant evidence, that
is most likely to help an
interdisciplinary team
succeed in collaborating
and implementing, or
creating buy-in for, the
project plan, providing
real-world examples
relevant to the health
care organization that is
the context for the plan.
Explain the
collaboration needed
by an
interdisciplinary team
to improve the
likelihood of
achieving the plan’s
objective, including
best practices of
interdisciplinary
collaboration from the
literature.
Does not explain
the collaboration
needed by an
interdisciplinary
team to improve
the likelihood of
achieving the
plan’s objective.
Does not cite
best practices of
interdisciplinary
collaboration
from the
literature.
Explains collaboration
but not in terms of an
interdisciplinary team
or does not include
best practices from the
literature.
Explains the
collaboration needed
by an interdisciplinary
team to improve the
likelihood of achieving
the plan’s objective,
including best practices
of interdisciplinary
collaboration from the
literature.
Explains the
collaboration needed by
an interdisciplinary
team to improve the
likelihood of achieving
the plan’s objective,
including best practices
of interdisciplinary
collaboration from the
literature. Provides realworld examples
relevant to the health
care organization that is
the context for the plan.
Explain
organizational
resources, including
a financial budget,
needed for the plan to
succeed and the
impacts on those
resources if nothing
is done to make the
improvements sought
by the plan.
Does not explain
organizational
resources,
including a
financial budget,
needed for the
plan to succeed
and the impacts
on those
resources if
nothing is done
to make the
Identifies
organizational
resources needed for
the plan to succeed
and the impacts on
those resources if
nothing is done to
make the
improvements sought
by the plan. Does not
include a financial
budget.
Explains organizational
resources, including a
financial budget,
needed for the plan to
succeed and the
impacts on those
resources if nothing is
done to make the
improvements sought
by the plan.
Explains organizational
resources, including a
financial budget,
needed for the plan to
succeed and the
impacts on those
resources if nothing is
done to make the
improvements sought
by the plan. Provides
real-world examples
relevant to the health
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9/27/23, 12:12 PM
CRITERIA
Interdisciplinary Plan Proposal Scoring Guide
NONimprovements
PERFORMANCE
sought
by the
BASIC
PROFICIENT
care
organization that is
DISTINGUISHED
the context for the plan.
plan.
Organize content so
ideas flow logically
with smooth
transitions; contains
few errors in
grammar/punctuation,
word choice, and
spelling.
Does not
organize content
for ideas. Lacks
logical flow and
smooth
transitions.
Organizes content with
some logical flow and
smooth transitions.
Contains errors in
grammar/punctuation,
word choice, and
spelling.
Organizes content so
ideas flow logically with
smooth transitions;
contains few errors in
grammar/punctuation,
word choice, and
spelling.
Organizes content with
a clear purpose.
Content flows logically
with smooth transitions
using coherent
paragraphs, correct
grammar/punctuation,
word choice, and free of
spelling errors.
Apply APA formatting
to in-text citations
and references,
exhibiting nearly
flawless adherence to
APA format.
Does not apply
APA formatting
to headings, intext citations,
and references.
Does not use
quotes or
paraphrase
correctly.
Applies APA formatting
to in-text citations,
headings and
references incorrectly
and/or inconsistently,
detracting noticeably
from the content.
Inconsistently uses
headings, quotes
and/or paraphrasing.
Applies APA formatting
to in-text citations and
references, exhibiting
nearly flawless
adherence to APA
format.
Exhibits strict and
flawless adherence to
APA formatting of
headings, in-text
citations, and
references. Quotes and
paraphrases correctly.
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9/27/23, 12:17 PM
Stakeholder Presentation Scoring Guide
Stakeholder Presentation Scoring Guide
CRITERIA
NON-PERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
Explain an
organizational or
patient issue for
which a
collaborative
interdisciplinary
team approach
would help achieve
a specific
improvement goal.
Does not describe an
organizational or patient
issue for which a
collaborative
interdisciplinary team
approach would help
achieve a specific
improvement goal.
Describes an
organizational or
patient issue but the
way in which a
collaborative
interdisciplinary
team approach
would help achieve
a specific
improvement goal is
unclear or missing.
Explains an
organizational or
patient issue for
which a
collaborative
interdisciplinary
team approach
would help achieve
a specific
improvement goal.
Explains an
organizational or patient
issue for which a
collaborative
interdisciplinary team
approach would help
achieve a specific
improvement goal,
noting potential
consequences of not
addressing the issue.
Summarize an
evidence-based
interdisciplinary
plan to address an
organizational or
patient issue.
Does not summarize an
evidence-based
interdisciplinary plan to
address an
organizational or patient
issue.
Discusses an
evidence-based
interdisciplinary
plan, but its
relevance to an
organizational or
patient issue is
unclear.
Summarizes an
evidence-based
interdisciplinary
plan to address an
organizational or
patient issue.
Summarizes an
evidence-based
interdisciplinary plan to
address an
organizational or patient
issue, noting specific
sources of evidence
used to develop the
plan.
Explain how the
interdisciplinary
plan could be
implemented and
how the human and
financial resources
would be managed.
Does not explain how
the interdisciplinary plan
could be implemented
and how the human and
financial resources
would be managed.
Explains how the
interdisciplinary
plan could be
implemented or
how the human and
financial resources
would be managed,
but not both.
Explains how the
interdisciplinary
plan could be
implemented and
how the human and
financial resources
would be managed.
Explains how the
interdisciplinary plan
could be implemented
and how the human and
financial resources
would be managed,
providing real-world
examples relevant to
the context of the health
care organization.
Propose evidencebased criteria to
evaluate the degree
to which the project
was successful in
achieving the
improvement goal.
Does not propose
evidence-based criteria
to evaluate the degree to
which the project was
successful in achieving
the improvement goal.
Proposes irrelevant
criteria or criteria
not based in
evidence to
evaluate the degree
to which the project
was successful in
achieving the
improvement goal.
Proposes
evidence-based
criteria to evaluate
the degree to which
the project was
successful in
achieving the
improvement goal.
Proposes evidencebased criteria to
evaluate the degree to
which the project was
successful in achieving
the improvement goal,
noting specific sources
of evidence used to
develop the criteria.
Slides are easy to
read and error free.
Detailed speaker
notes are provided.
Slides are difficult to
read with multiple editing
errors. No speaker notes
provided.
Slides are easy to
read with few
editing errors.
Speaker notes are
sufficient to support
the slides.
Slides are easy to
read and error free.
Detailed speaker
notes are provided.
Slides are easy to read
and clutter free. Slide
background is “visually”
pleasing with a
contrasting color for the
text and may utilize
graphics. Detailed
speaker notes are
provided.
Organize content
with clear purpose
/goals and with
relevant and
evidence-based
sources (published
Does not organize
content with clear
purpose/goals. Power
point slides do not
support main points,
assertions, arguments,
Organizes content
with clear
purpose/goals and
with relevant and
evidence-based
sources (published
Organizes content
with clear purpose
/goals and with
relevant and
evidence-based
sources (published
Organizes content with
clear purpose/goals.
Power point slides
support main points,
assertions, arguments,
conclusions, or
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Stakeholder Presentation Scoring Guide
CRITERIA
NON-PERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
within 5 years) with
an APA formatted
reference list with
few errors.
conclusions, or
recommendations.
Sources are not relevant
and/or evidence-based
(published within 5
years). No reference list
provided.
within 5 years) with
a reference list not
in APA format/or
has many errors in
format.
within 5 years) with
an APA formatted
reference list with
few errors.
recommendations with
relevant and evidencebased sources
(published within 5
years) with a flawless
APA formatted reference
list.
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This assignment aims to deepen your understanding of mental health conditions, therapeutic interventions, and ethical considerations in mental health nursing. You will be provided with a case study featuring a patient with a mental health condition. Your task is to analyze the case and answer the corresponding question.
Case Scenario:
Nancy is a 59-year-old client who is grieving the loss of her 14-year-old Maltese dog that has recently died of congestive heart failure. Nancy has experienced fatigue, lack of energy, and mild depression. These symptoms have caused her to miss work. When her coworkers ask why she is feeling so tired, Nancy makes excuses by saying that she “just can’t seem to sleep well at night.” Nancy tells the nurse that she is reluctant to be honest with her colleagues because she thinks that they will not understand her overwhelming feelings of sadness and grief related to the death of her pet.
a. What is the cultural significance of Nancy’s fear of sharing her feelings with her colleagues?
b. Which term best describes the type of grief Nancy is experiencing?
Instructions
Read Thoroughly: Familiarize yourself with the case, noting key elements like symptoms, medical history, and social factors affecting the patient.
Research: Conduct scholarly research to better understand the condition presented in the case study. Use at least five peer-reviewed articles to support your analysis.
Ethical Considerations: Examine any ethical considerations associated with the case. For example, consider patient consent, confidentiality, and duty of care.
Reflection: Write a 300-word reflection on what you have learned from this assignment and how it will impact your future practice.
Academic Integrity
Plagiarism will not be tolerated. Ensure that all sources are correctly cited and that you have not copied material from other sources unless appropriately cited.
Like healthcare disparities, disability disparities refer to the differences in service delivery, disability experiences, or clinical outcomes based on one’s membership in a particular group such as age, race, culture, ethnicity, or socioeconomic status (Kersey-Matusiak, 2019).
Conduct a literature search to locate a journal article related to disability disparities. What disability disparity is the author referencing. What can you do as a nurse to address the disparity and ensure a positive outcome for patients? Consider Lewis’ model. What biases might act as barriers to access to care for members of culturally diverse groups?
2-Welcome to Module 3. This module will explore religion and spirituality across diverse cultures and caring for people with disabilities.
Societal attitudes toward persons with disabilities are often based on a lack of understanding, fear of the unknown, and stereotypes learned from others. Nurses need to understand their own biases that may impede their practice, including religious prejudices and biases against people with disabilities. In this module, we will examine the impact of spirituality and/or religion on various cultures. We will explore how the patient-nurse encounter makes the nurse evaluate their spiritual values and religious beliefs from different backgrounds.
Regardless of the nurse’s or the patient’s religious affiliation, culturally appropriate, evidence-based, and holistic nursing care must include interventions that address the patient’s spiritual needs.
Module Goals
Goals Alignment
Professional Standards
After completing this module, students will be able to do the following:
Explain the difference between spirituality and religion as they relate to the delivery of culturally competent care.
Describe the significance of spirituality from both the nurse’s and patient’s perspective.
Identify important religious considerations when delivering culturally sensitive care.
Select appropriate interventions to promote patients’ spiritual well-being.
Discuss the impact of discrimination or bias on persons with disabilities.
Identify groups and organizations that may be used as resources when caring for persons with disabilities.
Explore common attitudes of healthcare providers toward persons with disabilities.
Recognize the implications for nurses when caring for persons with disabilities.
Determine strategies and intervention to enhance the quality of care for persons with disabilities.
Learning Materials
Required Resources:
Kersey-Matusiak, G. (2018). Delivering culturally competent nursing care: Working with diverse and vulnerable populations (2nd ed.). Springer. ISBN: 9780826137272. Read Chapters 4 and 5
.3–
Johnson & Johnson Nursing. (2018, December 3). Becoming a culturally competent nurse. [Video] YouTube.
Chavez, V. (2012, August 2). Cultural Humility in Community Based Participatory Research & Education, Part 3 of 4. [Video] YouTube.
Institute for Healthcare Improvement. (2016, February 17). How can providers reduce unconscious bias? [Video] YouTube.
Institute for Healthcare Improvement. (2016b, February 17). What is health equity, and why does it matter? [Video] YouTube.
Please provide only PowerPoint with speaker notes
Students will review their understanding of differential diagnosis and considerations for a plan of care in order to develop a voiceover PowerPoint presentation on the importance of intentional diagnostic testing. Students will address the following:
What is a differential diagnosis list?
What must be considered when developing a differential diagnosis list?
Pick a medical condition that the provider might see in the acute care setting and describe the pathophysiology, risk factors, and signs and symptoms.
Discuss three differential diagnoses related to this condition.
Discuss why these differential diagnoses are appropriate for this condition.
Discuss similarities and differences between the three differential diagnoses and the medical condition described.
Discuss diagnostic criteria that the provider can use to help rule in or rule out these differentials.
Discuss the gold standard diagnostic test that must be used in order to rule in these differentials.
The presentation should be no longer than 15 minutes
You will also need to include graphics to make your slides interesting and engaging
You are to create bullet points for each slide, not including the title and reference slides. Include speaker notes for each slide by including 4-5 sentences to address the bulleted items on each slide. Follow current APA Style and include citations in your speaker notes
This is a voiceover presentation; please review the instructions on how to export the presentation with your narration
Include a minimum of 2 peer-reviewed research articles as references in the presentation. All research articles must be within the last 5 years
No blog, chat, other universities, or Wikipedia pages
Review the rubric to ensure you address all components of the assignment
How to record a presentation with narration
How to turn a presentation into a video
Note: You will need to submit both your video presentation as well as your PowerPoint (.pptx) file for grading.
Rubric
NURS_697_DE – Week 4 Presentation
NURS_697_DE – Week 4 Presentation
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeOverview of the differential diagnosis and what must be considered when developing the differential list.
15 to >12.82 pts
Meets or Exceeds Expectations
Explains clearly and thoroughly the overview of the differential diagnosis list.
12.82 to >10.8 pts
Mostly Meets Expectations
Provides partial overview of the differential diagnosis list.
10.8 to >8.5 pts
Below Expectations
Provides brief and incomplete understanding of the differential diagnosis list.
8.5 to >0 pts
Does Not Meet Expectations
Does not provide brief/incomplete understanding of the differential diagnosis list.
15 pts
This criterion is linked to a Learning OutcomeOverview of a medical condition the provider might see in the acute care setting.
15 to >10.68 pts
Meets or Exceeds Expectations
Presents an exemplary articulation and insightful analysis of a medical condition seen in the acute care setting. Ideas are professionally sound and creative; they are supported by scientific evidence that is credible and timely. Draws insightful and comprehensive conclusions and solutions regarding chosen topic. Ideas are professionally sound and creative; they are supported by scientific evidence that is credible and timely. Draws insightful and comprehensive conclusions and solutions regarding chosen topic.
10.68 to >9.0 pts
Mostly Meets Expectations
Presents an accurate analysis of the management of a medical condition seen in the acute care setting. Ideas are mostly supported by scientific evidence that is credible and timely. Makes some attempt to draw conclusions and solutions regarding chosen topic. Ideas are mostly supported by scientific evidence that is credible and timely. Makes some attempt to draw conclusions and solutions regarding chosen topic.
9 to >7.08 pts
Below Expectations
Provides insufficient explanations of the management of a medical condition seen in the acute care setting. Ideas are generally unsupported by scientific evidence, but some attempt has been made. Fails to draw conclusions regarding chosen topic. Ideas are generally unsupported by scientific evidence, but some attempt has been made. Fails to draw conclusions regarding chosen topic.
7.08 to >0 pts
Does Not Meet Expectations
Does not, or incorrectly, answers with insufficient explanations that show no understanding of current trend/issue. Information is not scientifically sound
15 pts
This criterion is linked to a Learning OutcomeThree appropriate differential diagnoses related to the primary condition and why these are appropriate differentials.
15 to >10.68 pts
Meets or Exceeds Expectations
Presents an exemplary articulation and insightful analysis of 3 differential diagnosis. Ideas are professionally sound and creative; they are supported by scientific evidence that is credible and timely. Draws insightful and comprehensive conclusions and solutions regarding chosen topic. Ideas are professionally sound and creative; they are supported by scientific evidence that is credible and timely. Draws insightful and comprehensive conclusions and solutions regarding chosen topic.
10.68 to >9.0 pts
Mostly Meets Expectations
Presents an accurate analysis of 3 differential diagnosis. Ideas are mostly supported by scientific evidence that is credible and timely. Makes some attempt to draw conclusions and solutions regarding chosen topic. Ideas are mostly supported by scientific evidence that is credible and timely. Makes some attempt to draw conclusions and solutions regarding chosen topic.
9 to >7.08 pts
Below Expectations
Provides insufficient explanations of 3 differential diagnosis. Ideas are generally unsupported by scientific evidence, but some attempt has been made. Fails to draw conclusions regarding chosen topic. Ideas are generally unsupported by scientific evidence, but some attempt has been made. Fails to draw conclusions regarding chosen topic.
7.08 to >0 pts
Does Not Meet Expectations
Does not, or incorrectly, answers with insufficient explanations that show no understanding of current trend/issue. Information is not scientifically sound
15 pts
This criterion is linked to a Learning OutcomeSimilarities and differences between the three differential diagnoses and the primary medical condition discussed.
15 to >10.68 pts
Meets or Exceeds Expectations
Presents an exemplary articulation and insightful analysis of the similarities and differences between the differential list and the main condition. Ideas are professionally sound and creative; they are supported by scientific evidence that is credible and timely. Draws insightful and comprehensive conclusions and solutions regarding chosen topic. Ideas are professionally sound and creative; they are supported by scientific evidence that is credible and timely. Draws insightful and comprehensive conclusions and solutions regarding chosen topic
10.68 to >9.0 pts
Mostly Meets Expectations
Presents an accurate analysis of the similarities and differences between the differential list and the main condition. Ideas are mostly supported by scientific evidence that is credible and timely. Makes some attempt to draw conclusions and solutions regarding chosen topic. Ideas are mostly supported by scientific evidence that is credible and timely. Makes some attempt to draw conclusions and solutions regarding chosen topic.
9 to >7.08 pts
Below Expectations
Provides insufficient explanations of the similarities and differences between the differential list and the main condition. Ideas are generally unsupported by scientific evidence, but some attempt has been made. Fails to draw conclusions regarding chosen topic. Ideas are generally unsupported by scientific evidence, but some attempt has been made. Fails to draw conclusions regarding chosen topic.
7.08 to >0 pts
Does Not Meet Expectations
Does not, or incorrectly, answers with insufficient explanations that show no understanding of current trend/issue. Information is not scientifically sound
15 pts
This criterion is linked to a Learning OutcomeDiagnostic criteria the provider can use to rule in or rule out these differentials.
15 to >10.68 pts
Meets or Exceeds Expectations
Presents an exemplary articulation and insightful analysis of the various diagnostic tests used to rule in/rule out the differential diagnosis. Draws insightful and comprehensive conclusions and solutions regarding chosen topic. Ideas are professionally sound and creative; they are supported by scientific evidence that is credible and timely. Draws insightful and comprehensive conclusions and solutions regarding chosen topic.
10.68 to >9.0 pts
Mostly Meets Expectations
Presents an accurate analysis of the various diagnostic tests used to rule in/rule out the differential diagnosis. Ideas are mostly supported by scientific evidence that is credible and timely. Makes some attempt to draw conclusions and solutions regarding chosen topic. Ideas are mostly supported by scientific evidence that is credible and timely. Makes some attempt to draw conclusions and solutions regarding chosen topic.
9 to >7.08 pts
Below Expectations
Provides insufficient explanations of the various diagnostic tests used to rule in/rule out the differential diagnosis. Ideas are generally unsupported by scientific evidence, but some attempt has been made. Fails to draw conclusions regarding chosen topic. Ideas are generally unsupported by scientific evidence, but some attempt has been made. Fails to draw conclusions regarding chosen topic.
7.08 to >0 pts
Does Not Meet Expectations
Does not, or incorrectly, answers with insufficient explanations that show no understanding of current trend/issue. Information is not scientifically sound
15 pts
This criterion is linked to a Learning OutcomeContent
15 to >10.68 pts
Meets or Exceeds Expectations
Makes insightful, clear, and accurate connections relating to proper documentation and the appropriate use of clinical notes. Offers detailed and specific examples regarding effect on current clinical practice settings.
10.68 to >9.0 pts
Mostly Meets Expectations
Makes mostly accurate connections relating to proper documentation and the appropriate use of clinical notes, but may lack an important detail. Response indicates a general understanding regarding effect on current clinical practice settings.
9 to >7.08 pts
Below Expectations
Provides several insufficient or inaccurate connections relating to proper documentation and the appropriate use of clinical notes. Response indicates an introductory understanding regarding effect on current clinical practice settings.
7.08 to >0 pts
Does Not Meet Expectations
Information is inaccurate or inadequate. Response indicates little or no understanding of current trend/issue and importance to lobby for any support funding.
15 pts
This criterion is linked to a Learning OutcomeApplication
5 to >3.56 pts
Meets or Exceeds Expectations
Provides fully applications from clinical/personal to practice
3.56 to >3.0 pts
Mostly Meets Expectations
Provides partially applications from clinical/personal to practice
3 to >2.36 pts
Below Expectations
Provides brief or incomplete applications from clinical/personal to practice
2.36 to >0 pts
Does Not Meet Expectations
Provides no brief, no applications from clinical/personal to practice
5 pts
This criterion is linked to a Learning OutcomeReference slide, APA style, grammar, spelling, and punctuation.
5 to >3.56 pts
Meets or Exceeds Expectations
Complete list of references/citations with no APA errors Include peer research-based articles. Speaker notes were included for each slide.
3.56 to >3.0 pts
Mostly Meets Expectations
Mostly complete list of references or citations with 1-3 APA errors. Included mostly peer research-based articles. Speaker notes were included for most of the slides.
3 to >2.36 pts
Below Expectations
Partial list of references or citations with 3-5 APA errors Include few peer research based articles. Speaker notes were included for less than most slides.
2.36 to >0 pts
Does Not Meet Expectations
No references listed or cited with multiple errors. Includes no peer research-based articles. No speaker notes were included.
Please read the following article: Amanat, A., Rizwan, M., Maple, C., Zikria, Y. B., Almadhor, A. S., & Kim, S. W. (2022). Blockchain and cloud computing-based secure electronic healthcare records storage and sharing. Frontiers in Public Health, 10, 938707. https://doi.org/10.3389/fpubh.2022.938707
Evaluate the use of protected health information in the cloud through a health information exchange. Discuss the following aspects:
• Benefits
• Barriers to sharing patient information in the cloud
• Include an analysis of the health information exchange currently being adopted in the Kingdom of Saudi Arabia.
Your paper should meet the following structural requirements:
• Four-to-five pages in length, not including the cover sheet and reference page.
• Formatted according to APA 7th edition and Saudi Electronic University writing standards
• Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references
You have been asked by your private employer to create a handout to educate employees on how health insurance impacts preventative care.
Be sure to include the following information:
Covered preventative measures;
Frequency of preventative care allowed;
How utilization changes based on health insurance coverage;
The impact of preventative care on the individual, organization. and nation; and
Figures, examples, and statistics supporting your findings.
Your assignment should meet the following structural requirements.
Two-page handout, not including the cover sheet and reference page.
Include headings titled “Covered Preventative Care” and “Utilization”.
Be sure to include an informational paragraph under each heading and a citation to the resource utilized.
Formatted according to APA and Saudi Electronic University writing standards.
Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but two must be external. The Saudi Digital Library is a good place to find these references.
This discussion is for my doctor in nursing practice class (DNP).
Week 4
Translating Evidence Into Practice
DISCUSSION
PURPOSE
The purpose of this discussion is for you to evaluate a National Practice Problem within the context of your practice problem idea and technology expansion within your healthcare setting.
INSTRUCTIONS
Select one leading National Practice Problem that is prevalent in your patient population or healthcare setting and address the following:
Describe an issue related to the National Practice Problem you selected that is impacting quality, safety, or financial outcomes at your practice setting.
Elaborate how technology such as the electronic medical record might assist in implementing, evaluating, or sustaining an evidence-based intervention to address the identified problem.
Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:
Link (webpage): Graduate Discussion Grading Guidelines and Rubric
PROGRAM COMPETENCIES
This discussion enables the student to meet the following program competencies:
Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
Appraises current information systems and technologies to improve health care. (POs 6, 7)
COURSE OUTCOMES
This discussion enables the student to meet the following course outcomes:
Use information technology to collect and analyze data to generate evidence-based nursing practice across healthcare settings. (PC 4; PO 7)
Design programs that monitor and evaluate outcomes of care, care systems, and quality improvement. (PC 4; PO 7)
Evaluate the types of healthcare information systems, knowledge-based systems, and patient care technology and the impact on patient safety, quality of care, and outcome measurement. (PC 4; PO 7)
Resolve ethical and legal issues related to the use of information, communication networks, and information and patient care technology. (PCs 2, 4; PO 6)
Please add VI Pico Solution and VII Conclusion (please see attached rubric and paper) Please condense to 10 pages total (limit to 10 pages excluding appendices and references) –> each section of rubric states the page lengthPlease complete the attached Poster template (abstract not needed)
Unformatted Attachment Preview
I. Introduction: Background
and Significance of the
Problem, Development of
PICO or PICOT Question.
FHN I (Maximum: 2 pages)
5 to >4.5 pts
II. Theoretical Model to
Guide for Evidence Based
Research (ACE Star Model)
FHN I (½-1 page)
3 to >2.5 pts
III. Search Strategies and
Level of Evidence FHN II (1
page)
5 to >4.5 pts
IV. Literature Review FHN II
(1 page + table in
appendices)
10 to >9.5 pts
Exceptional clear and succinct explanation of
significance and need for the clinical question.
Development of high-level PICO(T) question that
can influence clinical practice. (Explanation of all
components of PICO or PICOT in FHN I only)
States a minimum of 2 background questions needed
to increase understanding of the clinical question and
explain why they are relevant. Background questions
should be answered in literature review.
Model overview and model constructs are
exceptionally and succinctly defined and applied to
the process of answering the PICO(T) question.
Guides research application to clinical practice.
An exemplary description of the search strategy
includes search words, databases, and inclusion &
exclusion criteria with a thorough explanation of
logic for this process. Includes the number of
findings from each database. Demonstrates
knowledge of article selection based on the level of
the evidence hierarchy.
Exemplary detailed presentation of 6 high-level
research articles related to the clinical question
published within the last 5 years, presented in the
Summary of Primary Source of Evidence Table or
Systematic Review Table. Demonstrates a higher
than expected level of knowledge regarding research
review and evidence hierarchy.
VI. PICO Solution,
Relevance to Clinical
Practice and
Implementation
Preceptorship II (1-2
pages)
15 to >14.5 pts
VII. Conclusion
Preceptorship II (½-1
page)
2 to >1.0 pts
The identified outcome and answer to PICO
question is clearly stated and reflects
research findings. Implementation of
findings to clinical practice is clearly
explained in a step-by-step format which is
logically and completely stated. Relates and
integrates the constructs of the theoretical
model by stating how the model guided the
EBP process to implementation.
Exemplary overview and succinctly written
summary of paper includes impact to
clinical practice and evidence based
process.
College of Nursing
TITLE
NAME OF STUDENT AND FACULTY
Abstract
Include a synopsis of your abstract
here.
Theoretical Framework
Include a description of your
theoretical framework and how you
applied it to your problem here.
Literature Review Outcome /
Evidence Based Solution
Include an outline of the proposed
outcome from your literature review
and a possible evidence based
solution / intervention.
Analysis of Literature
Significance of the Problem
Include a description of the problem
and background significance here.
Include a summary (can be in table form) of what was learned from your
literature review here as it applies to your problem.
Dissemination and Evaluation
Include a description of how you
could disseminate what was learned
from your clinical project and how
you would propose the evaluate the
proposed solution.
Review of Literature
PICOT Question
Include a synopsis of your search
strategy and literature review results
here.
1
The Impact of Oral Contraceptives and IUDs as Contraceptive Methods for Obese Women
Ages 25-40
AN ASSIGNMENT
SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE
DEGREE OF MASTER OF SCIENCE IN NURSING
IN THE GRADUATE SCHOOL OF THE
TEXAS WOMAN’S UNIVERSITY
COLLEGE OF NURSING
BY
DANIELLE MITCHELL
NURS
PROFESSOR
OCTOBER 1, 2023
2
The Impact of Oral Contraceptives and IUDs as Contraceptive Methods for Obese
Women Ages 25-40
Although women using contraceptive methods have relatively successful rates, many
develop complications in their adult lives. The debate on the impact of obesity on women using
contraception continues to invoke various options across the board. Understanding the extent to
which hormonal and non-hormonal contraceptive devices contribute to complications in obese
women is integral to developing measures that act as interventions for the most adverse methods.
This paper aims to critically compare the impact of oral contraceptives and IUDs as
contraceptive methods for obese women ages 25-40, assessing which of the two groups is at
higher risk of developing blood clots.
Development of PICOT Question
Are obese women ages 25 to 40 (P) who take oral contraceptives at greater risk (I) for
developing blood clots (O) compared with obese women ages 25 to 40 (P) who use IUDs for
contraception (C) over a 5-year time frame (T)?
Significance and Need
Researchers widely acknowledge the association between obesity and the excess estrogen
in hormonal contraceptive methods to pose cardiovascular risks. While even moderately healthy
women suffer the risk of being affected by cardiovascular complications, obese women often
have underlying issues that enhance the probability of the risks manifesting much earlier in their
lives. This research is necessary to establish the connection between the oral contraceptive pill
and blood clot formation in obese women.
3
Background
While exploring the connection between contraceptives, obesity, and chronic blood clots,
it is important to understand whether oral contraceptive pills and IUDs are responsible for the
same results. In this case, the major issues are the relationship between contraception in obesity
and the formation of blood clots. In addition, how can obese women prevent the cardiovascular
risks associated with contraceptive methods? The purpose of the study is to establish the etiology
of blood clots in obese women who are under specific contraceptive treatments.
ACE Theoretical Model
The ACE theoretical model allows researchers to perform research in five critical stages:
discovery, evidence summary, translation, integration, and evaluation. The evidence-based
project (EBP) would require a qualitative approach to determine whether obese women under
various contraception methods are at risk of having blood clots. In this case, using unstructured
interviews as a qualitative research methodology, women would be assessed to determine the
truth in this hypothesis. Evidence summary would allow the researchers to record all primary
evidence condensing the information into meaningful syntheses (Khialani et al., 2020). The
research would synthesize the raw data on obese women and the contraception indications,
where new findings could be plausible. Translation of the material aims to provide the
practitioners with a document they can implement. This means the research would have a final
database they can refer to or share concerning the data received from the obese women
population. Integration requires that practitioners implement the findings and mitigation
procedures they find as they perform the study (Khialani et al., 2020). The researchers in the
study would be inclined to suggest clinical practices that prevent obese women from
experiencing heightened risks in using contraceptive methods meant to help them. Evaluating the
4
material ensures that the EBP outcomes are desirable, or implementation can positively change
the quality of care and improve patient and provider satisfaction. Ultimately, obese women
should also be treated equitably, and if potential solutions exist, they should be implemented.
Search Strategy and Levels of Evidence
The search strategy started with defining the research question, which was “Are obese
women ages 25 to 40 (P) who take oral contraceptives at greater risk (I) for developing blood
clots (O) compared with obese women ages 25 to 40 (P) who use IUDs for contraception (C)
over a 5-year time frame (T)?” This was followed by identifying the inclusion and exclusion
criteria based on the PICOS framework. The population included obese women of reproductive
age. The intervention studied was contraceptive use, and the comparison was oral or IUD use.
The outcome was a blood clot, and the study design was either randomized controlled trials,
observational studies, or reports published in English. A search for relevant keywords then
followed this. Keywords used included contraceptive, obesity, blood clot, deep vein thrombosis,
and pulmonary embolism. The search was done in different databases, including MEDLINE,
EMBASE, Cochrane Library, PubMed, CINAHL, Web of Science, and Scopus.
Through an online database search, 21 studies were obtained. It is also important to note
that some of these studies were obtained by searching through the reference lists of the already
obtained studies. After excluding all the duplicates and those not perfectly aligned with the
research topic, 12 studies remained. With further screening, including a full-text review of each
article, 6 studies were finally considered for review in this project. See the appendix for the
figure showing a brief breakdown of the different studies considered for review.
The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) rating scale was
adopted in evaluating the references used whereby:
5
Level I: Evidence based on well-randomized and controlled trial
Level II: Evidence gained through well-organized controlled trial, not including
randomization, quasi-experimental studies.
Level III: Evidence based on an analytic study of case-control or well-organized cohort
should be from either multiple research groups or centers, and meta-analyses.
Level IV: Evidence is achieved without intervention or various time series. Obtained
from experts consensus such as systematic reviews and national guidelines.
Level V: Evidence is obtained from individual expert opinions, case studies, and
descriptive studies.
Literature Review
Current literature has indicated a connection between formation of blood clots and oral
contraception use. Rambaran and Alzghari (2020) have explored this topic extensively. This
systematic review was carried out by searching PubMed from inception to April 2018 for
relevant articles published in English. The results herein showed that obese women who used
oral contraceptives were at a higher risk than nonusers of developing blood clots (Rambaran &
Alzghari, 2020). This study explained the current statistics showing that over 400 women in the
US die every year related to their use of oral contraception (Rambaran & Alzghari, 2020). This
study suggests the need for women to be educated about the risks involved in contraception for
better decision-making and management of any complications that may arise.
These results are similar to findings by Khialani et al. (2020) who explored the
relationship between combined oral contraception and the risk of venous thromboembolism. The
study is a systematic review of 86 articles. The result of this study indicated that even though
venous thromboembolism is a considerably rare condition, the risk of obese women developing it
6
significantly increases when they use oral contraceptives (Khialani et al., 2020). Nonetheless,
different from other studies, the researchers assert that the benefits of the different oral
contraceptives in preventing pregnancies outweigh the risks for obese women (Khialani et al.,
2020). This study included a review of different studies, and for this reason, it was assigned a
rate of one on the JHNEBP rating scale.
Another study was carried out to update current knowledge on the relationship between
oral contraceptive pills and cerebral venous sinus thrombosis risk. The study also aimed to
examine the impact of other forms of hormonal contraceptives, duration, type, and health
condition of the woman on this relationship (Abdalhabib et al., 2022). Carrying out this study
was based on the understanding that while there is a pool of studies that have examined the
relationship between oral contraceptives and the risk of blood clots among obese women, several
other defining aspects have not been factored in, and this limits the scope of understanding of
this topic (Abdalhabib et al., 2022). This study was in the form of a systematic review and metaanalysis in which a search was performed to identify a series of published articles on the
relationship between the use of hormonal contraceptives and the risk of blood clots among obese
women between 15 and 50 years of age (Abdalhabib et al., 2022). The researchers reviewed only
11 of the 861 studies identified from the search. The results of this review show that using oral
contraceptive pills significantly increases the risk of obese women of reproductive age
developing cerebral venous sinus thrombosis (Abdalhabib et al., 2022). However, the researchers
quickly note that the available data remains inadequate to draw definitive conclusions regarding
how the duration of the use of contraceptives affects this relationship. Nonetheless, it remains
evident that oral contraceptives significantly increase the likelihood of obese or overweight
7
women developing blood clots. Falling back on the JHNEBP rating scale, this study was rated
one since it extensively reviewed data from other studies.
Some studies have been conducted in a way that they compare the level of risk of blood
clots identifiable with different approaches to contraception. One such study by LaVasseur et al.
(2022) was carried out to examine the differences in the risk of thrombosis identifiable with
different methods of contraception and their interaction with different patient-centered factors.
This study was based on the understanding that different methods of contraception have been
closely linked to venous thromboses. The risk of thrombosis is identifiable in hormonal
contraceptive agents and in cases where intrauterine devices are used. This study involved
conducting a narrative review of a series of studies regarding contraceptives and the risk of blood
clots (LaVasseur et al., 2022). The study results indicated that different contraceptive types have
different risk levels of blood clots for obese women. However, it is important to note that the
results indicated that the risk of developing blood clots is significantly higher in obese women
who use oral contraceptives.
This is based on the idea that these women have a higher body mass index while alone is
a risk factor for blood clots (LaVasseur et al., 2022). However, the risk even increases because
oral contraceptives contain hormones that increase the risk of blood clots, more so in women
with other risk factors such as a family history of blood clots, smoking, or obesity. Conversely,
the risk of developing blood clots is relatively lower among obese women who use IUDs. This is
because these IUDs do not contain any hormones that can increase the risk of blood clots
(LaVasseur et al., 2022). Since this study was a systematic review, it was assigned a score of one
on the JHNEBP rating scale. These different results suggest that the risk of a blood clot is
8
significantly higher among obese women using oral contraceptives than their counterparts who
use IUDs.
Analysis of Literature
Abdalhabib, E. K., Jackson, D. E., Alzahrani, B., Elfaki, E., Hamza, A., Alanazi, F., Ali, E.
I., Algarni, A., & Ibrahim, I. (2022). Assessment of risk factors for deep vein
thrombosis associated with natural anticoagulants and fibrinolytic regulatory
proteins. Blood Coagulation & Fibrinolysis, 33(3), 149–152.
https://doi.org/10.1097/mbc.0000000000001116
The article investigates deep vein thrombosis (DVT) as a critical disease in Africa by
investigating its risk factors paying attention to its natural anticoagulants and fibrinolytic
regulatory proteins. The study is designed to understand the specific roles these regulatory
proteins play in the development of the disease among the Sudanese. A case-control study was
utilized which is level II on the JHNEBP rating scale and a suitable design when investigating
this kind of problem. The findings presented would have been more convincing if data had been
collected from more than one facility for the indicated year. The researchers also investigated
the right parameters descriptive of deep vein thrombosis in terms of its regulatory proteins. In
this study, 5.5% of the participants were determined to have Protein C deficiency and 8.5% of
participants were victims of protein S deficiency. 3% were diagnosed with antithrombin III
deficiency. The findings also demonstrate that early assessment of risk factors is important in
improving treatment outcomes of DVT. Overall, the article is straightforward and precise in the
way information is presented.
LaVasseur, C., Neukam, S., Kartika, T., Bannow, B. S., Shatzel, J., & DeLoughery, T. G.
(2022). Hormonal therapies and venous thrombosis: Considerations for prevention
and management. Research and Practice in Thrombosis and Haemostasis, 6(6),
e12763. https://doi.org/10.1002/rth2.12763
The article by LaVasseu et al., 2022, seeks to investigate venous thrombosis as one
complication of hormonal therapy. The study pays attention to the risk of developing thrombosis
9
in persons using hormonal contraceptive agents. The researchers used a narrative review is data
collection which is an ideal method considering that challenges experienced when collecting data
on hormone‐related thrombosis risks. The results indicate that thrombosis risk tends to increase
with an increment in oestrogen dosage. Thrombosis rates increase with age in women aged
above 30 years with an incidence rate of 2–3.7 events/10 000 women using oestrogen and
increases 10.2 times in women using third generation contraceptives. However, the study does
not identify effective management of complications of hormone therapy in patients diagnosed
with prothrombotic illnesses. Also, the article is a narrative review, placing it a level V, the
lowest on the JHNEBP rating scale which is very low quality of evidence.
Rambaran, K., & Alzghari, S. K. (2020). Gamer’s thrombosis: A review of published
reports. Ochsner Journal, 20(2), 182–186. https://doi.org/10.31486/toj.19.0058
This article investigates thrombosis as a common condition reported in elderly people
that develops in healthy adolescents. Published articles were reviewed to collect relevant data on
the relationship of immobility and increased risk of developing the VT. 12 out of the 26 articles
used in this study revealed instances where immobility led to the development of venous
thromboembolism, where 2 were fatalities reported. 15 patients were also determined to have
recurrent VT. The risk of developing VT was identified to be 2.33 for obesity which represents a
confidence interval of 95%. These results obtained confirm that immobile people are at a high
risk of developing thrombosis. Obesity, use of birth control and cigarette smoking are some risk
factors identified that can easily be modified. The recommendation for screening for venous
thromboembolism in gamers is justifiable owing to the prolonged sitting hours. The main
limitation of the study is that it is a level V evidence literature review, presenting low quality of
evidence.
10
Rosano, G. M., Rodriguez‐Martinez, M. A., Spoletini, I., & Regidor, P. A. (2022). Obesity
and contraceptive use: Impact on cardiovascular risk. ESC Heart Failure, 9(6),
3761-3767. https://doi.org/10.1002/ehf2.14104
The article considers obesity and contraceptives containing oestrogen as confirmed risk
factors for cardiovascular disease. The researchers are concerned that obese women still receive
hormonal products containing oestrogen. The study uses a narrative review making it possible to
identify the latest research, current research and contentious issues about overweight and
cardiovascular risk. The results confirm that overweight women using oral contraceptives are 1224 times more likely to have venous thromboembolism comparing them with non-obese women
that are not on contraceptives. Specifically women using combined oral contraceptives with a
BMI index above 25 had the VT risk increased by 12-fold. These findings reveal the importance
of clinicians considering the body weight and BMI indexes of a person when administrating
contraceptives containing estrogen. The study also indicates that Progestin-only products are
safer alternatives for use in obese patients. Overall, the article is specific in its highlight of the
dangers of oral contraceptives for obese women but is a narrative review (Level V evidence
rating) which makes it low quality evidence.
Sultanmuratova, G. U., Babadjanova, G. S., Nazarbayev, J. B., & Kerimova, N. M. (2022).
A safe and effective contraceptive method for women with obesity in the postpartum
period. American Journal of Medicine and Medical Sciences 12(8): 836-839.
https://doi.org /10.5923/j.ajmms.20221208.15
This article investigates the safety levels of using drospirenone-containing combined oral
contraceptive in women of reproductive age determined to be overweight. The study used an
appropriate inclusion criterion in selecting sixty five obese women participants on
contraceptives. 39 participants were diagnosed with polycystic ovary syndrome. These are fertile
women who cannot ovulate. 32 people showed clinical signs indicating that they were infertile
while 22 had functional hyperprolactinemia. The study indicates that oral contraceptives pose a
11
major risk in complications of young women’s reproductive system. This study is a high
evidence rating (level II) as it is a quasi-experimental study. The article conveys the importance
of proper screening of women before administering contraceptives to minimize infertility risk.
Khialani, D., Rosendaal, F., & van Hylckama Vlieg, A. (2020, November). Hormonal
contraceptives and the risk of venous thrombosis. In Seminars in Thrombosis and
Hemostasis 46(8), 865-871. https://doi.org/10.1055/s-0040-1715793
The article by Khialani et al. (2020), seeks to reveal how the risk of developing venous
thrombosis (VT) is influenced by the kind of progestogen contained in oral contraceptives. The
study considers that the component ethinyl estradiol has counteracting effects that minimize the
chances of developing VT. The findings create a good understanding of how novel oestrogens
are developed and determined to have a reduced risk of VT. The study succeeds to reveal the
VT risk of combined oral contraceptives but fails to identify the risks associated with other
methods such as injectable contraceptives and vaginal rings. Other risk factors were identified.
Inherited thrombophilia is an underlying condition indicated to increase the susceptibility to VT
in women using combined oral contraceptives. The incidence rate of VT is 0.36% in cases of
mild thrombophilia and 0.64% in severe cases. It is unfortunate that the authors did not research
VT risk in women who switch combined oral contraceptives. However, it is hypothesized that
switching from a low to a high dosage of combined oral contraceptives increases the risk of
developing the condition. The article is a narrative review of the literature and hence a low level
(level V) of evidence. In general, the researchers are justified by suggesting the importance of
identifying high-risk women to recommend alternative contraception methods.
12
References
Abdalhabib, E. K., Jackson, D. E., Alzahrani, B., Elfaki, E., Hamza, A., Alanazi, F., Ali, E. I.,
Algarni, A., & Ibrahim, I. (2022). Assessment of risk factors for deep vein thrombosis
associated with natural anticoagulants and fibrinolytic regulatory proteins. Blood
Coagulation & Fibrinolysis, 33(3), 149–152.
https://doi.org/10.1097/mbc.0000000000001116
Khialani, D., Rosendaal, F., & van Hylckama Vlieg, A. (2020, November). Hormonal
contraceptives and the risk of venous thrombosis. In Seminars in Thrombosis and
Hemostasis 46(8), 865-871. https://doi.org/10.1055/s-0040-1715793
LaVasseur, C., Neukam, S., Kartika, T., Bannow, B. S., Shatzel, J., & DeLoughery, T. G. (2022).
Hormonal therapies and venous thrombosis: Considerations for prevention and
management. Research and Practice in Thrombosis and Haemostasis, 6(6), e12763.
https://doi.org/10.1002/rth2.12763
Rambaran, K., & Alzghari, S. K. (2020). Gamer’s thrombosis: A review of published reports.
Ochsner Journal, 20(2), 182–186. https://doi.org/10.31486/toj.19.0058
Rosano, G. M., Rodriguez‐Martinez, M. A., Spoletini, I., & Regidor, P. A. (2022). Obesity and
contraceptive use: Impact on cardiovascular risk. ESC Heart Failure, 9(6), 3761-3767.
https://doi.org/10.1002/ehf2.14104
Sultanmuratova, G. U., Babadjanova, G. S., Nazarbayev, J. B., & Kerimova, N. M. (2022). A
safe and effective contraceptive method for women with obesity in the postpartum
period. American Journal of Medicine and Medical Sciences 12(8): 836-839.
https://doi.org /10.5923/j.ajmms.20221208.15
13
Appendix
Citation of
Objective,
Search
Inclusion/Exc
Data
SR
Aim, Purpose
Strategy
lusion
Criteria
Results
Recommenda
Level of
Extraction
tion/
Evidence
and Analysis
Implication
LaVasseur, C., the differences Large
Thematic
Different
When
Neukam, S.,
in thrombosis
pharmacy
analysis
types of
contemplating
Kartika, T.,
risk of the
databases,
contraceptives
contraception,
Bannow, B.
many
biomarker
have different
clinicians
S., Shatzel, J.,
hormonal
studies,
levels of risk
must factor in
&
preparations
centralized
of blood clots
different
DeLoughery,
available and
hospital
for obese
prothrombotic
T. G. (2022).
their
registries,
women.
risk factors to
Hormonal
interaction
cohort studies,
make more
therapies and
with patient‐
and case-
informed
venous
specific
control studies
decisions
thrombosis:
factors.
Level 1
14
Consideration
s for
prevention
and
management.
Research and
Practice in
Thrombosis
and
Haemostasis,
6(6), e12763
Khialani, D.,
from inception of objectively
Switching
It is important
Rosendaal, F.,
Understanding to April 2018
confirmed
COCs, even
to identify
& van
hormonal
venous
when
women at risk
Hylckama
contraceptives
thrombosis in
switching
of VT and
Vlieg, A.
and the risk of
healthy
from a high-
advise them
Level 1
15
(2020,
venous
women taking
to a low-risk
on alternative
November).
thrombosis
oral
COC,
contraception
contraceptives
increases the
methods.
Hormonal
contraceptives
and the risk of
venous
thrombosis. In
Seminars in
thrombosis
and
hemostasis
(Vol. 46, No.
08, pp. 865871). Thieme
Medical
risk of VT
16
Publishers,
Inc…
Abdalhabib,
To assess the
A search
Factors for
Thematic
The early
Risk factors
E. K.,
roles of
through PMC
deep vein
analysis
assessment of
should be
Jackson, D.
natural
thrombosis
risk factors,
assessed early
E., Alzahrani,
anticoagulants
associated
including the
enough to
B., Elfaki, E.,
and
with natural
measurements
prevent
Hamza, A.,
fibrinolytic
anticoagulants
of natural
occurrence of
Alanazi, F.,
regulatory
inhibitors, can
DVT
Ali, E. I.,
factors in the
predict the
Algarni, A., &
development
occurrence of
Ibrahim, I.
of DVT in
DVT before it
(2022).
Sudanese
is actually
Assessment of
patients.
detected in
risk factors for
patients.
LevelI
17
deep vein
thrombosis
associated
with natural
anticoagulants
and
fibrinolytic
regulatory
proteins.
Blood
Coagulation &
Fibrinolysis,
33(3), 149–
152.
https://doi.org/
10.1097/mbc.
18
00000000000
01116
Rambaran, K.,
To explore the
PubMed,
Thematic
Modifiable
Strongly
& Alzghari, S.
relationship
Scopus, Web
analysis
risk factors
encourage
K. (2020).
between
of Science,
included
screening
Gamer’s
combined oral
and EBSCO
cigarette use,
gamers for
thrombosis: A
contraception
for articles
being
possible VTEs
review of
and the risk of
overweight,
if clinically
published
venous
birth control
warranted.
reports.
thromboembol
use, and
Ochsner
ism
prolonged
Journal, 20(2),
immobility.
182–186.
Anticoagulatio
https://doi.org/
n was the
principal
Level 1
19
10.31486/toj.1
treatment
9.0058
modality in
patients
presenting
with gaming
thrombosis
Rosano, G.
Discuss the
The electronic
Cardiovascula
Exercise
M.,
latest
database
r risks, mainly
caution with
Rodriguez‐
evidence,
search in
VTE risks,
the use of
Martinez, M.
ongoing
PubMed
increase
COCs in
A., Spoletini,
research, and
between 12
patients with
I., & Regidor,
controversial
and 24 times
overweight
P. A. (2022).
issues on the
compared
and obesity,
Obesity and
synergistic
with non-
choosing the
contraceptive
effect of
obese non-
safest
use: impact on
obesity and
COC users.
alternatives
Level II
20
cardiovascular
contraceptive
when
risk. ESC
use in terms of
prescribing
heart failure.
cardiovascular
hormonal
risk
contraception
due to the
rising global
prevalence of
obesity.
Sultanmuratov This study
The electronic
The study
According to
Additional
a, G. U.,
aims to
database
included 65
the study
control should
Babadjanova,
determine the
search in
women of
results, a
be carried out
G. S.,
safety of
PubMed
reproductive
favorable
in patients
Nazarbayev, J. drospirenone-
age who were
effect of low-
with impaired
B., &
containing
prescribed OC
dose OC pills
carbohydrate
Kerimova, N.
combined oral
with 30 µg of
on body
metabolism.
M. (2022). A
contraceptives
ethinyl
weight and
Level II
21
safe and
(OC) in
estradiol and 3 lipid profile
effective
overweight/ob
mg of
was revealed
contraceptive
ese women of
drospirenone
without
method for
reproductive
for 3 months
significant
women with
age.
for therapeutic changes in
obesity in the
and preventive carbohydrate
postpartum
purposes. The
metabolism. C
period.
main
onclusion. Th
American
parameters
erefore, this
Journal of
evaluated
method of
Medicine and
were lipid and
contraception
Medical
carbohydrate
may be
Sciences
metabolism
recommended
2022, 12(8):
for
836-839.
overweight/ob
https://doi.org
ese patients to
22
/10.5923/j.ajm
control
ms.20221208.
fertility in the
15
postpartum
period.
In the Medicare Skilled Nursing Facility Services Payment System, the
case-mix index value represents the level of resource consumption,
similar to the relative weight of MS-DRGs in the Medicare Hospital Acute
Inpatient Services Payment System. Examine table 6.5 in the textbook.
Using the questions below as a guide, analyze the connection between
PDPM nursing elements and resource consumption. Note: A higher function
score indicates that the resident is more independent (i.e., can perform
tasks alone or with some help). A lower function score indicates the
resident is dependent on assistance.a. Review the “Serious Medical Conditions I” rows in table 6.5. How does depression impact the case-mix index?b. Review the “Serious Medical Conditions II” rows in table 6.5. How does the function score impact the case-mix index?c. Review the “Conditions requiring Complex Medical Care” rows in
table 6.5. How does the combination of depression and function score
impact the case-mix index?d. Examine “Behavioral or Cognitive Symptoms” and “Assistance with
Daily Living and General Supervision” rows in table 6.5. How does the
use of restorative nursing impact the case-mix index?
• Manamela, L. M., Rasweswe, M. M., & Mooa, R. S. (2022). Factors contributing to non-adherence of the peri-operative surgical team to WHO surgical safety checklist in the Kingdom of Saudi Arabia. Perioperative Care and Operating Room Management, 29. https://doi.org/10.1016/j.pcorm.2022.100292
Create an analysis of the factors that contribute to the non-adherence of the perioperative surgical team discussed in this article. Present a plan to overcome these barriers so that the surgical risks are reduced and quality and patient safety are improved.
Your paper should meet the following structural requirements:
• Four-to-five pages in length, not including the cover sheet and reference page.
• Formatted according to APA 7th edition and Saudi Electronic University writing standards
Provide support for your statements with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other two must be external. The Saudi Digital Library is a good place to find these references
PHC 312 Group Assignment Paper
College of Health Sciences
ASSIGNMENT COVER SHEET
Course name:
Health Communications
Course code:
PHC312
CRN:
Assignment title or task:
Students enrolled in PHC 312 in First term 2023 will be divided into groups (5-7 students per group). The first
section will be designed to gain general information about the communication program.
The second section will be designed to assess the student’s ability to draft a health communication plan. The
group has 5 points to cover under the general program information section. The main communication program
characteristics section will be designed to assess the group’s ability to provide basic information about the health
communication planning process.
The written health communication program plan must be completed and submitted to the instructor no later than
11:59 PM on (October 07, 2023).
General program information
1.
Name of the program.
2.
Country and region (if applicable) where the program is based.
3.
Time period (start and end dates).
4.
Funding sources.
5.
Give a short description of the program (maximum of about 250 words).
Main communication program characteristics
1.
Describe the overall goal of the program.
2.
List the SMART objectives of the program.
3.
Describe the target audience(s) of the program (primary and secondary audiences).
✓ Indicate the demographic and socioeconomic factors of the target population that have been measured. E.g.
age, gender, income/socioeconomic status, education, occupation…etc.
4.
Literature review: basing the communication program on current scientific knowledge and/or theoretical
models and/or previous experience from other projects? One or two paragraphs about the problem. (300-500
words).
5.
Describe the settings and communication channels.
6.
Describe the development process of messages.
7.
Describe the activities and timeline.
8.
Describe the process/impact/outcome evaluation of the communication program that will be measured.
Points that can be added as a bonus (NOT REQUIRED):
• Describe the needs assessment that has been carried out.
• Describe the environmental factors (i.e. factors beyond individual control) that the communication program
addresses, if any.
PHC 312 Group Assignment Paper
• Does the communication plan have a special focus on vulnerable groups (socioeconomically disadvantaged
people, ethnic minorities, children, elderly people, etc.)? if yes, specify the vulnerable groups.
• Provide details of the pilot study if a pilot study has been performed.
• Describe which stakeholders are going to be involved in the implementation and describe their roles.
Group Number:
Student name & ID #
Submission date:
Instructor name:
…. Out of 10
Grade:
The written report will be assessed for clarity and succinctness in providing the required information using a rubric of 0
(undeveloped/inadequate) to 3 (outstanding/exceptional), as illustrated below:
Inadequat
e
Objective/Element
Report clearly and succinctly defines program goals
2.
Report clearly and succinctly defines program SMART objectives.
3.
SMART objectives are:
a. Specific: objectives should clearly specify what is to be achieved.
b. Measurable: objectives should be phrased in a way that achievement can
be measured.
c. Achievable: objectives should refer to something that the program can
actually influence and change.
d. Realistic: objectives should be realistically attainable within the given
time frame and with the available resources (human and financial
resources and capacity).
e. Time-bound: objectives should relate to a clearly stated time frame.
Proficient Outstanding
Partially
Meets
Exceeds
Fails to
meets
expectation Expectations
meet
expectations
s
3
expectation
1
2
s
0
1.
Adequate
PHC 312 Group Assignment Paper
4.
Report clearly and succinctly describes the target audiences (primary &
secondary audiences).
✓ Indicate the demographic and socioeconomic factors of the target population
that have been measured. E.g. age, gender, income/socioeconomic status,
education, occupation…etc.
5.
Report provides a brief background that includes:
✓ Literature review.
Report clearly and succinctly describes settings and communication
channels
Report clearly and succinctly describes the development process of
messages.
6.
7.
8.
Report clearly and succinctly describes the activities and timeline.
9.
Report clearly and succinctly describes how the process/impact/outcome
evaluation of the communication program will be measured.
Total
This assignment is worth 10% of the total possible points earned for the course.
Guidelines:
•
Use this Word Document.
•
Fill in students’ information on the first page of this document.
•
Font should be 12 Times New Roman
•
Headings should be Bold
•
Color should be Black
•
Line spacing should be 1.5
•
Use reliable references (APA format)
•
AVOID PLAGIARISM (you will get ZERO when there is plagiarism)
•
You should use at least 2 references
•
Submit this WORD Document when you complete the required task
•
Submission should be before the deadline (submission after the deadline is not allowed)
•
For more resources, you can review appendix A and appendix B in Schiavo, R. (2014).
As a student of healthcare quality management, it is vital that you are able to identify problems that arise in healthcare organizations and propose strategies for their improvement. A critical part of this process requires you to be familiar with quality and accreditation standards and navigate the communication channels of the organization.
For your summative assignment, you will identify a departmental problem within a healthcare organization and develop a collaborative performance improvement initiative to address it. Ideally, the proposed evidence-based solution will serve to improve the departmental problem, thus contributing to the overall success of the healthcare organization. The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules Two, Four, and Six. The final product will be submitted in Module Seven.
In this assignment, you will demonstrate your mastery of the following course outcomes:
Evaluate appropriate methods of healthcare data collection and interpretation for informing organizational decision making
Assess healthcare performance improvement initiatives for addressing gaps in organizational performance
Evaluate requirements of current quality and safety initiatives for how they promote the culture of safety in healthcare organizations
Formulate communication and teamwork strategies in quality management that engage diverse stakeholders within healthcare organizations
Evaluate information management systems and patient care technologies that promote healthcare quality
Prompt
Begin by identifying an organizational problem within your own workplace healthcare setting or a hypothetical healthcare organization. Propose an initiative that addresses this chosen problem, utilizing evidence-based literature and quality standards. If you choose a problem in your workplace, be sure to utilize data from that healthcare organization; if you have created a hypothetical healthcare organization, you may use a public domain database with instructor permission. As this is a scholarly initiative, this assignment must adhere to all APA requirements and formatting and include peer-reviewed and evidence-based sources to support any and all claims.
Specifically, the following critical elements must be addressed:
What Is the Organizational Problem?
Provide the organizational problem that you have chosen. How does this problem fail to meet quality or other regulatory requirements?
Articulate organizational challenges posed by the problem (e.g., interdepartmental conflicts, communication failure, budgeting issues).
Evidence-Based Support
Provide data that supports the existence of the problem. You may utilize public sources to find data related to your selected problem.
How has this problem been addressed in the past? What information management systems or patient care technologies have been utilized when addressing this problem? Be sure to use peer-reviewed literature to support your answer.
Discuss relevant accreditation standards, safety standards, compliance standards, and quality initiatives. How do these standards promote a culture of safety within the department? Be sure to cite the appropriate standards within your answer.
Performance Improvement Initiative
Propose an initiative that will address this problem within the department of your chosen healthcare organization. What specific relevant quality standard will this quality initiative address?
Describe the type of data that will reveal a quality outcome.
Implementation of the Plan in the Organization
How will this implementation plan be communicated among departments?
How will the data be displayed and shared with the organization?
If the plan for this initiative was implemented, what do you believe would be the hypothetical effect(s) on patient care outcomes? How will health information systems support those improvements in patient care?
What do you think the hypothetical effect of the quality or performance plan would be on the culture of safety within the organization?
Success of the Performance Improvement Plan
If this initiative is successful, how would the organization monitor the financial implications?
How would the current information management systems contribute to the success of your plan?
What current organizational processes will help the plan be successful?
How will the plan be communicated among departments? How will this communication help team members commit to the performance improvement plan?
Milestones
Milestone One: Identify Organizational Problem
In Module Two, first, you will identify a problem in a healthcare organization. You may use a problem from your organization or a problem from a fictional organization. This milestone is graded with the Milestone One Rubric.
Milestone Two: Initiative Proposal
In Module Four, you will build upon the work you completed on milestone one. In this milestone, you will propose an improvement plan that focuses on the problem you selected in Milestone One. If you chose a problem in your workplace, be sure to use data from that healthcare organization; if you created a hypothetical healthcare organization, you might use a public domain database with instructor permission. Next, you will develop an implementation plan for the problem that you are focusing on. Then, you will discuss the predicted success of the performance improvement plan after implementation. This milestone is graded with the Milestone Two Rubric.
Milestone Three: Implementation of Performance Initiative
In Module Six, you will implement your performance improvement plan. Also, you will discuss what success of the performance improvement plan will look like. If you choose a problem in your workplace, be sure to use data from that healthcare organization. If you created a hypothetical healthcare organization, you might use a public domain database with instructor permission. This milestone is graded with the Milestone Three Rubric.
Final Submission: Organizational Performance Initiative
In Module Seven, you will submit your final project. The final project should be a complete, polished paper containing all of the items listed on the grading rubric. Your paper should show that you have applied all of the instructor feedback. This submission is graded with the Final Project Rubric.
What to Submit
Your organizational performance initiative should be 8–10 pages in length; however, the quality of this submission is much more important than the length. All resources must be appropriately cited in APA format.
Final Project Rubric
Criteria Exemplary (100%) Proficient (85%) Needs Improvement (55%) Not Evident (0%) Value
Problem: Provide Meets “Proficient” criteria and includes insightful detail about how the problem fails to meet quality or regulatory requirements Comprehensively provides details about how the problem fails to meet quality or regulatory requirements Provides details about how the problem fails to meet quality or regulatory requirements but with gaps in detail or logic Does not provide details about how the problem fails to meet quality or regulatory requirements 4.5
Problem: State Meets “Proficient” criteria and offers greater depth of information regarding the organizational challenges posed by the problem Clearly states organizational challenges posed by the problem States organizational challenges posed by the problem, but articulation is not clear Does not state organizational challenges posed by the problem 6
Support: Provide Meets “Proficient” criteria and data provided demonstrates nuanced understanding of the problem Provides data that supports the existence of the problem Provides data but data does not fully support existence of the problem Does not provide data or data provided does not support 6
Support: Addressed Meets “Proficient” criteria and description includes insightful detail regarding how this problem has been addressed in the past Thoroughly describes how this problem has been addressed in the past, including the information management systems or patient care technologies utilized, and supports answer with peer-reviewed literature Describes how this problem has been addressed in the past but with gaps in detail, and supports answer but support does not include peer-reviewed literature or is irrelevant Does not describe how the problem has been addressed in the past or does not support answer 6
Support: Discuss Meets “Proficient” criteria and offers professional insights concerning how accreditation, safety, compliance, and quality standards promote a culture of safety Clearly discusses relevant accreditation, safety, and compliance standards, as well as quality initiatives, including how these standards promote a culture of safety within the department, and cites appropriate standards Discusses accreditation, safety, and compliance standards, as well as quality initiatives, but with gaps in detail or clarity, and cites standards but citations are irrelevant or inappropriate Does not discuss accreditation, safety, compliance, and quality standards and does not cite standards 9
Performance: Propose Meets “Proficient” criteria and proposal demonstrates a nuanced insight into the relationship between the performance improvement plan and the quality standard being addressed Proposes a performance improvement plan to address the chosen problem, including the quality standard being addressed Proposes a performance improvement plan to address the chosen problem but proposal has gaps in detail or logic Does not propose a performance improvement plan 4.5
Performance: Describe Meets “Proficient” criteria and demonstrates great insight into the type of data that will reveal a quality outcome Accurately describes the type of data that will reveal a quality outcome Describes the type of data that will reveal a quality outcome Does not describe the type of data that will reveal a quality outcome 6
Implementation: Communication Meets “Proficient” criteria and description is exceptionally clear in how the implementation plan will be communicated among departments Thoroughly describes how the implementation plan will be communicated among departments Describes how the implementation plan will be communicated among departments but description has gaps in detail Does not describe how the implementation plan will be communicated among departments 6
Implementation: Data Meets “Proficient” criteria and choices of how the data will be displayed and shared with the organization demonstrate nuanced insight into communication within the chosen healthcare organization Accurately describes how the data will be displayed and shared with the organization Describes how the data will be displayed and shared with the organization but description is inaccurate Does not describe how the data will be displayed and shared with the organization 6
Implementation: Initiative Meets “Proficient” criteria and offers reasoning concerning the hypothetical effects of the initiative on patient care outcomes Comprehensively describes the hypothetical effects of this initiative on patient care outcomes, including how health information systems support improvements in patient care Describes the hypothetical effects of this initiative on patient care outcomes but description is cursory Does not describe the hypothetical effects of the initiative on patient care outcomes 6
Implementation: Effect Meets “Proficient” criteria and offers reasoning concerning the hypothetical effect of the quality plan on the culture of safety within the organization Comprehensively describes the hypothetical effect of the quality plan on the culture of safety within the organization Describes the hypothetical effect of the quality plan on the culture of safety within the organization but description is cursory Does not describe the hypothetical effect of the quality plan on the culture of safety within the organization 9
Success: Financial Meets “Proficient” criteria and offers reasoning pertaining to how the organization will monitor the financial implications if this initiative is successful Comprehensively describes the how the organization will monitor the financial implications if this initiative is successful Describes how the organization will monitor the financial implications if this initiative is successful but description is cursory Does not describe how the organization will monitor the financial implications if this initiative is successful 4.5
Success: Information Meets “Proficient” criteria and hypothesis demonstrates nuanced insight into the relationship between information management systems and performance improvement initiatives Logically hypothesizes how the current information management systems would contribute to the success of this plan Hypothesizes how the current information management systems would contribute to the success of this plan but hypothesis is illogical Does not hypothesize how the current information management systems would contribute to the success of this plan 6
Success: Processes Meets “Proficient” criteria and provides nuanced insight into the organizational processes that will help the plan be successful Accurately describes the organizational processes that will help the plan be successful Describes what organizational processes will help the plan be successful but description is inaccurate Does not describe what organizational processes will help the plan be successful 4.5
Success: Communication Meets “Proficient” criteria and provides keen insight into how communication will help team members commit to the performance improvement plan Comprehensively explains how the plan will be communicated among departments and analyzes how that communication will help team members commit to the performance improvement plan Explains how the plan will be communicated among departments and analyzes how that communication will help team members commit to the performance improvement plan but patterns are not interdepartmental or analysis is cursory Does not explain how the plan will be communicated among departments or analyze how that communication will help team members commit to the performance improvement plan 6
Articulation of Response Submission is free of errors related to citations, grammar, spelling, syntax, and organization and is presented in a professional and easy-to-read format Submission has no major errors related to citations, grammar, spelling, syntax, or organization Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas 10
Total: 100%
EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS
In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.
RESOURCES
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
Chapter 2, “Asking Compelling Clinical Questions” (pp. 37–60)
Chapter 3, “Finding Relevant Evidence to Answer Clinical Questions” (pp. 62–104)
Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworksLinks to an external site. for LIS professionals. Evidence Based Library and Information Practice, 6(2), 75–80.
Library of Congress. (n.d.). Search/browse help – Boolean operators and nestingLinks to an external site.. Retrieved September 19, 2018, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help…
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice.Links to an external site. American Journal of Nursing, 110(3), 58–61.
Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009).Evidence-based practice: Step by step: Igniting a spirit of inquiryLinks to an external site..Links to an external site. American Journal of Nursing, 109(11), 49–52. doi:10.1097/01.NAJ.0000363354.53883.58
Stillwell, S.B., Fineout-Overhold, E., Melnyk, B.M., & Williamson, K.M. (2010). Evidence-based practice step-by-step: Searching for evidence.Links to an external site. American Journal of Nursing, 110(5), 41-47.
Walden University Library. (n.d.-a). Databases A-Z: NursingLinks to an external site.. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/az.php?s=19981
Walden University Library. (n.d.-c).Evidence-based practice research: CINAHL search helpLinks to an external site.. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthe…
Walden University Library. (n.d.-d). Evidence-based practice research: Joanna Briggs Institute search helpLinks to an external site.. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthe…
Walden University Library. (n.d.-e). Evidence-based practice research: MEDLINE search helpLinks to an external site.. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthe…
Walden University Library. (n.d.-f). Keyword searching: Finding articles on your topic: Boolean termsLinks to an external site.. Retrieved September 19, 2018, from http://academicguides.waldenu.edu/library/keyword/…
Walden University Library. (n.d.-g). Keyword searching: Finding articles on your topic: Introduction to keyword searchingLinks to an external site.. Retrieved September 19, 2018, from http://academicguides.waldenu.edu/library/keyword/…
Walden University Library. (n.d.-h). Quick Answers: How do I find a systematic review article related to health, medicine, or nursing?Links to an external site. Retrieved September 6, 2019, from https://academicanswers.waldenu.edu/faq/72670
Walden University Library. (n.d.-i). Systematic review.Links to an external site. Retrieved January 22, 2020, from https://academicguides.waldenu.edu/library/healthe…
To Prepare:
Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.
The Assignment (Evidence-Based Project)
Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
Create a 6- to 7-slide PowerPoint presentation in which you do the following:
Identify and briefly describe your chosen clinical issue of interest.
Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.
Assignment_Rubric
Criteria
Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews Create a 6- to 7-slide PowerPoint presentation in which you do the following: Identify and briefly describe your chosen clinical issue of interest. Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest. Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected. Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.
Ans.
The presentation clearly and accurately identifies and describes in detail the chosen clinical issue of interest. …The presentation clearly and accurately describes in detail the developed PICO(T) question. …The presentation clearly and accurately identifies four or more research databases used to conduct a search for the peer-reviewed articles selected. …The presentation includes specific and relevant examples that fully support the research. …The presentation provides a complete, detailed, and accurate synthesis of two outside resources related to the peer-reviewed articles selected, and fully integrates at least two outside resources and two or three course-specific resources that fully support the presentation.
Criteria
Resource Synthesis
Ans.
Using proper in-text citations, the presentation clearly and accurately provides at least four peer-reviewed systematic review type articles selected, describes the levels of evidence in each of the four articles selected, including a thorough and detailed explanation of the strengths of using systematic reviews for clinical research.
Criteria
Resource FormattingAppropriate peer-reviewed articles are included and citations use APA format.
Ans.
Presentation includes 4 or more peer-reviewed articles selected using systematic reviews for clinical research. …Citations use correct APA format with no errors.
Criteria
PowerPoint Presentation:The presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.
Ans.
The presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.
Criteria
Written Expression and Formatting—English Writing Standards:Correct grammar, mechanics, and proper punctuation.
Ans.
Uses correct grammar, spelling, and punctuation with no errors
ASSIGNMENT COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN:
Assignment title or task:
(You can write a question)
Choose any one of the common occupational
infectious diseases and explain the following:
•
•
•
Causes, mode of transmission, and symptoms.
Occupational group at risk
Prevention and control measures
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Short essay of 500-750 words (Excluding references).
• The font size should be 12.
• Font type should be Times New Roman
• The heading should be Bold.
• Color should be Black.
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style.
• AVOID PLAGIARISM
• Due date; 30/9/2023 11:59 PM
Best of Luck
This is a group presentation. The only part that needs to be done for me is the “Survival and long-term complications”. Please include pics, and create a question to ask the class regarding the subject we are talking about.
Pleaseuse the following website:https://www.samhsa.gov/dtac/disaster-behavioral-he… to visit and explore. Choose a subject/topic that you find most interesting. Provide a link to the website and the source citation in your post.Address all of the following:Why did you select this resource/site? Why do you find the subject/topic interesting?What is the one thing you want others to know about this subject/topic that is found on the website?What information had the greatest impact on you? Explain.
Suppose I were to conduct a study in applied nursing to examine the effectiveness of a new pain management protocol on post-operative patients’ recovery. In this scenario, I would opt for a randomized controlled trial (RCT) as the type of research design. RCTs involve randomly assigning participants to either an experimental group (receiving the new pain management protocol) or a control group (receiving standard care) to measure the effectiveness of the intervention (Polit& Beck, 2017).I would utilize quantitative methods to collect data for the RCT, such as structured observations and objective measurements. In this specific study, I might use tools like pain scales to quantify the level of pain experienced by patients at various post-operative time points. Additionally, I could collect quantitative data on recovery parameters like the time taken to regain mobility, the amount of pain medication required, and patient satisfaction scores. These objective and quantifiable data points would enable me to conduct statistical analyses to determine whether the new pain management protocol significantly improves post-operative recovery outcomes compared to standard care.Ensuring the validity and reliability of data collection methods is crucial in healthcare research. Therefore, I would pre-test the pain scales and other measurement tools to ensure their accuracy and consistency. By employing an RCT with quantitative data collection methods, I can rigorously investigate the effectiveness of the new pain management protocol in applied nursing, providing valuable insights for improving patient care.ReferencePolit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Wolters Kluwer.
The purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos.
Action Items
Name at least four systems designed to assist toxicologists and environmental health professionals in protecting the public. Describe the function of each?
Submission Instructions
DEVELOPING INDIVIDUALS AND TEAMS
MODULE 2 ASSIGNMENT OVERVIEW
In this module, you will complete a three-part Assignment that is submitted over the course of 3 weeks. This week, you will complete and submit Part 1. You will complete and submit Part 2 in Week 5, and you will complete and submit Part 3 in Week 6.
Important Note: Please be aware that, for Part 2 of the Assignment, due in Week 5, you will be required to have completed an online simulation experience that must be scheduled for a particular time. Be sure to read the instructions thoroughly to ensure you plan ahead and fulfill all requirements for the Assignment.
In this three-part Assignment, you will play the role of a new manager who is engaging in development activities for your team. As a new manager, you are being asked to provide evidence to your senior leader of the types of activities you are engaging in to further develop individuals on your team—and the team as a whole. In line with that request, you will complete three activities and create three documents that you will present to your manager. In Part 1 this week, you will develop and submit a coaching preparation and strategy document that you will use to conduct your required simulation to be completed ideally sometime later this week or early in Week 5. In Part 2, you will use the simulation platform to conduct a one-on-one coaching session with an employee, reflect on this experience as it relates to your individual development as a manager and as a coach, and submit a coaching plan (for individual performance management). Finally, in Part 3, you will research and develop a team charter for a team you know well.
By demonstrating skills in these areas, you will develop foundational competence in helping both individuals and teams achieve results and stay motivated and engaged.This Assignment incorporates the Business Skill for Good of coaching and mentoring.
Part 1: Coaching for Performance: Coaching Conversation Preparation and Strategy
For this part of the Assignment, you will act as a new manager who has become concerned about what appears to be declining motivation and engagement on the part of one of your employees. You have spoken to your senior leader about your concerns, and she has asked you to document your interactions with the employee so that she can support you in becoming a more seasoned coach for your team. Your task is to prepare for an appropriate and effective coaching conversation with this employee. You will conduct this conversation using an online simulation platform. This week, you will draft and submit a Coaching Conversation Preparation and Strategy document for your coaching session.
.
BY DAY 7
Submit your completed Coaching Conversation Preparation and Strategy document as follows:
For each section of the Coaching Conversation Checklist, use the space beneath each item to take detailed notes of what you plan to say to the employee during your coaching conversation. You may choose either to compose a script (understanding that this may need to change in the moment depending on how the employee responds), or you may instead choose to include bullet points with key phrases for the ideas you want to cover and strategies for how you might help put the employee at ease, establish trust, or anticipate how he may respond to your feedback. Be sure to address all parts of each item.
Note: Please include a PDF or Word copy of your approved article from Week 4 with your submission.
Critique one article using the appraisal form:
Systematic or Integrative ReviewDownload Systematic or Integrative Review
Use the information below to help you know which section of the article to use to answer questions in the template:
Introduction and its subsections have the purpose or WHY the study was done.
Methods section and its subsections contain HOW the study was done.
Results, Discussion, and Conclusions section will have WHAT was found.
Details
In week 3 you selected a topic of interest and formulated a question about that topic for your Evidence-Based Practice Assignment.
In week 4 you searched the literature on your week three topic and submitted three articles for approval towards building your Evidence-Based Practice Assignment.
Module 6 readings are a continuation from week 5 that includes chapters 13 and 14 on Appraising Research Evidence and Clinical Practice Guidelines. Please refer to these chapters on how to complete an appraisal using templates provided here in instructions. Appendix A to G in your book gives you examples of completing a template appraisal form.
For the first template in week 6, you will choose either a Qualitative or a Quantitative Review (Please do not complete both Quantitative and Qualitative Appraisal). Your second article is a Systematic Review Appraisal.
Make sure you receive approval from your instructor in week 4 for the article you use to complete either the Qualitative or Quantitative Review and for the Systematic Review. There are hyperlinks to these templates in the week 6 instructions. Do not create your own document with answers.
Each section of the template is required to be completed as this assignment builds on your Evidence-Based Practice Project. Each template has a citation that must be submitted in APA format. Answers to questions in Synopsis sections are required (see template examples in your book). Each question must have an answer of 1-2 full sentences in length per question. Credibility section Yes/No answers are also required. The Comments area is also required and should be at least 1-3 sentences noting how this article relates to your nursing issue topic from week 3 and what you thought was significant.
You will be using these articles again in your week 9 Evidence Based Practice Project Poster.
Please review the rubric closely and proof your work reviewing instructions before you submit.
The chosen topic and PICOT will be used for your Week 9 Poster Assignment. It guided your article searches in Week 4 which will be used in completing your appraisals in Week 6.
NURS 350_Article Appraisal
NURS 350_Article Appraisal
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeWriting and APA StyleFollows all the requirements related to 7th ed APA format for citation, length, source citations, and layout.
Writing is clear, concise, and organized.
Free of spelling errors. Grammatically correct.
5 point penalty if approved article from week 4 is not included with the appraisal.
15 to >12.0 pts
Meets or Exceeds Expectations
Follows APA Guidelines. Complete Formatting and writing. APA with 1 or fewer errors.
12 to >9.0 pts
Mostly Meets Expectations
Follows APA guidelines. 2-3 formatting, writing, or APA errors
9 to >6.0 pts
Below Expectations
Partially follow guidelines. 4-5 formatting, writing or APA errors.
6 to >0 pts
Does Not Meet Expectations
Does not follow guidelines. More than 5 formatting, writing or APA errors.
15 pts
This criterion is linked to a Learning OutcomeSynopsisEach question answered in full sentences 1 to 2 sentences per question.
15 to >12.0 pts
Meets or Exceeds Expectations
Uses approved article to complete. Evidence of critical thinking. Ideas well developed.
12 to >9.0 pts
Mostly Meets Expectations
Well presented, ideas are detailed and mostly well developed
9 to >6.0 pts
Below Expectations
Content is sound, ideas present but not particularly developed
6 to >0 pts
Does Not Meet Expectations
Content is slightly reasonable
15 pts
This criterion is linked to a Learning OutcomeCredibilityAnswer yes or no questions and add a statement 1 to 2 sentences in length under each question
15 to >12.0 pts
Meets or Exceeds Expectations
Uses approved article to complete. Evidence of critical thinking & Ideas well developed
12 to >9.0 pts
Mostly Meets Expectations
Well presented, ideas are detailed and mostly well developed
9 to >6.0 pts
Below Expectations
Content is sound, ideas present but not particularly developed
6 to >0 pts
Does Not Meet Expectations
Content is slightly reasonable
15 pts
This criterion is linked to a Learning OutcomeClinical Significance and ApplicabilityAnswer yes or no questions and add a statement 1 to 2 sentences in length under each question
15 to >12.0 pts
Meets or Exceeds Expectations
Uses approved article to complete. Evidence of critical thinking & Ideas well developed
12 to >9.0 pts
Mostly Meets Expectations
Well presented, ideas are detailed and mostly well developed
9 to >6.0 pts
Below Expectations
Content is sound, ideas present but not particularly developed
6 to >0 pts
Does Not Meet Expectations
Content is slightly reasonable
15 pts
This criterion is linked to a Learning OutcomeCommentsUsing your own words (no direct quotes), describe in 1 paragraph how this article relates to your nursing issue topic from week three and what you thought was significant.
15 to >12.0 pts
Meets or Exceeds Expectations
Exceptionally well presented; ideas detailed and well developed
12 to >9.0 pts
Mostly Meets Expectations
Well presented, Ideas detailed and mostly well developed
9 to >6.0 pts
Below Expectations
Content is sound and solid; ideas are presented but not particularly developed.
6 to >0 pts
Does Not Meet Expectations
Content is slightly reasonable
15 pts
Total Points: 75
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APPENDIX C
Appraisal Guide
Conclusions of a Systematic Review with Narrative Synthesis
Citation:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Synopsis
What organization or persons produced the systematic review (SR)?
How many persons were involved in conducting the review?
What topic or question did the SR address?
How were potential research reports identified?
What determined if a study was included in the analysis?
How many studies were included in the review?
What research designs were used in the studies?
What were the consistent and important across-studies conclusions?
Credibility
Was the topic clearly defined?
Yes
No
Not clear
Was the search for studies and other
evidence comprehensive and unbiased?
Yes
No
Not clear
Was the screening of citations for
inclusion based on explicit criteria?
Yes
No
Not clear
*Were the included studies assessed
for quality?
Yes
No
Not clear
Were the design characteristics and
findings of the included studies displayed
or discussed in sufficient detail?
Yes
No
Not clear
*Was there a true integration (i.e., synthesis) of the findings—not
merely reporting of findings from
each study individually?
Yes
No
Not clear
Brown
APP C-1
*Did the reviewers explore why differences
in findings might have occurred?
Yes
No
Not clear
Did the reviewers distinguish between
conclusions based on consistent findings
from several good studies and those
based on inferior evidence (number or quality)?
Yes
No
Not clear
Which conclusions were supported by
consistent findings from two or more
good or high-quality studies?
List
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
ARE THE CONCLUSIONS
CREDIBLE?
Yes All
Yes Some
No
Clinical Significance
*Across studies, is the size of the
treatment or the strength of the
association found or the
meaningfulness of qualitative findings
strong enough to make a difference
in patient outcomes or experiences of care?
Yes
No
Not clear
Are the conclusions relevant to the
care the nurse gives?
Yes
No
Not clear
ARE THE CONCLUSIONS
CLINICALLY SIGNIFICANT?
Yes All
Yes Some
No
Applicability
Does the SR address a problem,
situation, or decision we are addressing in our setting?
Yes
No
Not clear
Are the patients in the studies or a
subgroup of patients in the studies
similar to those we see?
Yes
No
Not clear
What changes, additions, training, or
purchases would be needed to implement
and sustain a clinical protocol based
on these conclusions?
Specify and list
____________________________________________________________________________
APP C-2
Brown
____________________________________________________________________________
Is what we will have to do to implement
the new protocol realistically achievable
by us (resources, capability, commitment)?
How will we know if our patients are
benefiting from our new protocol?
Yes
No
Not clear
Specify
____________________________________________________________________________
____________________________________________________________________________
ARE THESE CONCLUSIONS
APPLICABLE TO OUR SETTING?
Yes All
Yes Some
No
SHOULD WE PROCEED TO DESIGN
A PROTOCOL INCORPORATING
THESE CONCLUSIONS?
Yes All
Yes Some
No
* = Important criteria
Comments
____________________________________________________________________________
____________________________________________________________________________
Brown
APP C-3
Remove plagiarism and don’t use AI tools. I have attached the shots and the paper
Unformatted Attachment Preview
1
Competency 3 Assessment
Phoenix University
MHACB/543
Professor Dr Melissa Green
September 26, 2023
Recruitment and Succession Plan
2
Planning for potential outcomes in the event of rapid staffing changes is crucial.
Although we presume and expect that all of our employees—particularly those in important
management positions—are reliable and would not leave. We must be ready for either
unforeseen circumstances or even planned adjustments. Always have a backup plan in place
in case someone leaves. Planning for succession is a crucial component of filling leadership
positions in the workforce. According to Desarno et al. (2002), “Succession planning aids an
organization in preparing for the inevitable movements of people who leave gaps in the
hierarchy that must be filled by qualified replacements.” The ability of the company to look
forward and find personnel who might be suited for cross-training and learning a task that can
prepare them for possible chances is another aspect of succession planning. These people can
be thought of as human capital, which is the knowledge and experience that the organization’s
staffing possesses. These people can be recognized based on how they react to obstacles and
educational opportunities within the company.
Poor succession planning runs the danger of resulting in a lack of preparation, which
can lower the standard of care. Additionally, it may prevent reimbursement. People are more
likely to engage when they feel appreciated. They devote more time to honing their talents
and pursuing future breakthroughs when given the chance to learn and develop inside the
company. Although it might be challenging to establish and maintain leadership, doing so
strategically is advantageous for both the employee and the organization. Compared to
employing new employees and putting them through the initial orientation and training
process, cross training is more cost-effectively done as part of their present employment. If
the chance arises, current employees have the luxury of receiving training over time.
Transition should be quite easy because the present employee is already familiar with the
setting, the personnel, and the patients. whereas a new hire might need extra time to become
used to and grasp the new surroundings
3
By recruiting internally, the company is able to save hiring expenditures and
productivity losses. The company must be on the lookout for possible employees who could
fill crucial jobs and be prepared to take over should important employees or leaders suddenly
leave or change positions. Organizations must take into account the values of their
employees. You might provide someone challenging work responsibilities to get them ready
for future employment. Supporting employee development helps to maintain their attention,
engagement, motivation, and loyalty. “Leaders in an organization may leave, retire, lose their
jobs, or be unavailable for various reasons. According to research, healthcare firms are less
likely than other corporate organizations to use succession planning (Smith, 2019). Without a
succession plan, firms face a significant chance of experiencing workforce issues.
The best way to stop employees from leaving must be carefully considered when
taking measures to lessen the effects of their quick departure. Cross-training must be offered,
and a three-deep plan must be put into place, in order to reduce staffing. A backup strategy is
to position three persons deep. If the first and second people are not available, someone else
will always be willing to fill in. Cross-training gives an employee yet another chance to pick
up a new talent and develops new reasons for them to stick with the organization. We can try
to resolve any issues that may have contributed to the employee’s departure by conducting
exit interviews before their last day of work.
When there is job discontent, such as when the employees’ needs are not satisfied,
resignations of employees happen. Numerous factors, such as not getting enough hours, being
dissatisfied with the pay, not being recognized or appreciated, having work obligations that
are too demanding, not seeing room for advancement, or any other factor that the employee
may feel is a trigger for looking for work elsewhere, may prevent their needs from being met.
The cost of hiring and training new employees is higher than the cost of keeping existing
employees. To keep their employees, department managers must work very hard. The
4
manager or designee must spend time training new employees, delaying work completion. It
takes longer for newer, less experienced workers to accomplish tasks and learn routines.
According to Reyes et al. (2019), “An entity should strive to have a human resource
department that communicates to the stakeholder employee on short- and long-term plans that
involve them.” Building relationships in the workplace promotes comradery, trust, teamwork,
and solid bonds. The employees’ ties are strengthened as a result of the team effort.
To fill a managerial job, there should be a recruitment strategy in place. It is best to
hire and advance within the organization. This is when succession planning is advantageous
to the company, resulting in a seamless transition to fill the vacancy and reduce positional
gaps. A present employee can learn new abilities that can be used to boost their career within
the company by being prepared in advance. Advertisements on job-hunting websites, social
media, and even word-of-mouth through recommendations from current employees are
additional recruitment strategies that can be used. Digital tools are useful for internal and
external recruitment since they reach more people. Since most people use well-known
websites, the traditional method of advertising in newspapers is expensive and may only
receive a little amount of exposure. Commercials on regional radio and television stations are
one more way to recruit. A lot of people can be attracted by advertising for job fairs who can
be promptly recruited after being interviewed. These days, a significant portion of the
population spends their time online. The use of social media and networks has not decreased,
according to statistics (Briscariu, 2019).
For new hires, there should be a preboarding and onboarding strategy in place. It is
crucial to keep them informed about what is expected of them before their first day of work
and after they officially begin. It can be useful to check in with new hires on days 30, 90, and
180 to learn how they are doing. The goal is to assess how the employee is doing and
determine whether they require additional training, have any questions, or are having trouble
5
obtaining the answers. We may monitor the employee’s development and any obstacles they
may be encountering. If an individual is not grasping the work after several interventions to
address any issues or setbacks they may have experienced, we may even consider terminating
their employment.
Open lines of communication with the new worker or boss can assist clarify any
unclear concerns, reduce uncertainty, and demonstrate support. “When a new leader is hired,
there should be a strategy in place for how they will spend their initial days, weeks, and
months. This needs to start the moment an interview is held. An employee can determine
whether they made the appropriate choice at this point (Reyes et al., 2019).
The organization’s dedication to fostering internal growth can be demonstrated to
candidates by the succession plan policies and procedures that are in place. The succession
plan’s goal is to have a worker ready to take over a crucial role in the event that someone
leaves the company. Any gaps that might result from an employee departure will be filled by
training for this person. This qualified person can assist with system maintenance to stop
lapses from happening. It is preferable to train and prepare a worker who already collaborates
with or uses the same systems as the individual you are teaching to be your backup. By
picking the person with whom you are most comfortable, you can make the shift without
adding to your stress. Due to their familiarity with the task, they will be the most at ease
helping.
In my company, the business office manager would be the best person to understand
and adjust to the change if they were prepared to learn the administrator’s responsibilities.As
opposed to educating a social worker to act as a backup to the administrator, they are aware
with the finances and feel comfortable talking about financial difficulties. The social worker
might not feel comfortable talking about money or enforcing rules. In the event of the DON’s
absence or departure, a registered nurse can be prepared to step into the role of Director of
6
Nurse (DON). Any licensed or unlicensed person cannot fill this post since the DON
demands RN qualifications. It’s crucial to get someone who can comprehend and carry out
the obligations of the person they can be temporarily or permanently filling in for.
A person could be reluctant to accept more responsibilities out of concern that they
will be burdened with them without receiving any greater pay. To prevent a lapse in care,
each department should have a plan for how it would train and maybe promote a person in
the event of a departure. Additionally, this allows the worker the chance to pick up new skills
that will aid in future progress and gauge interest in the field. Staff members who are
interested in career advancement can be encouraged by being informed of potential prospects
for growth; these workers can then be developed and nurtured to fill jobs as they become
available. Training employees for career advancement promotes dedication from the worker.
The ability to mold present employees without any existing habits from other employment is
a benefit of grooming them for future prospects. Employees can be inspired to learn more by
being informed of promotions and receiving rewards.
The proposed concept fits with current healthcare trends because there are many
people looking for career options. They will work harder to stand out and improve their job
effort if they are aware of prospective prospects. Experience and education can make a
worker stand out from the competition. The facility will attract applicants and present
employees by using a number of tactics to promote the prospects it has to offer. Healthcare
facilities should make use of job fairs and other similar occasions to advertise open positions
to prospective employees. Through these programs, the company can obtain a better sense of
the applicant outside of the workplace and determine whether they might be a good fit.
References
Briscariu, R. (2019). The use of social network sites in the recruitment process. Management
7
Research and Practice, 11(4), 5-10.
Desarno, J., Perez, M., & Rivas, R. (2021, August). Succession Planning Within the Health
Care Organization:: Human Resources Management and Human Capital Management
Considerations. Nurse Leader, 19(4), 411-415. DOI: 10.1016/j.mnl.2020.08.010
Reyes, A.C.S., Aquino, C.A., & Bueno, D. C (2019). Why employees leave: Factors that
stimulate resignation resulting in creative retention ideas. CC The Journal: A
Multidisciplinary Research Review, 14, 15-24.
Smith, M.J. (2019). Healthcare Organizations And Succession Planning.
SOWK 250
SELF-CARE PLAN TEMPLATE
Care Area
Specific Goal/Objectives (SMART)
Specific, Measureable, Achievable,
Realistic, and Time limited.
Accountability Measure
Physical Care
Psychological Care
Spiritual Care
Social Care
Page 1 of 2
SOWK 250
Professional/
Volunteer Care
Page 2 of 2
SOWK 250
SELF-CARE PLAN AND REFLECTIVE PAPER ASSIGNMENT INSTRUCTIONS
OVERVIEW
You will reference the Read: Developing a Self-Care Plan and Read: Wellbeing and SelfCare Fact Sheet items found in the assigned module to develop a personal Self-Care Plan chart
using the forms in Appendix A and B in The A-to-Z Self-Care Handbook. Upon completing your
Self-Care Plan, you will write a Reflective Paper.
INSTRUCTIONS
•
•
•
•
You must address the physical, psychological, social, professional/academic, and
spiritual dimensions.
Specific goals/objectives and accountability measures must be noted using the SMART
Goal format. Please use the provided Self-Care Plan Template when completing this
assignment.
You will also write a 2-3 page paper in current APA format reflecting on your plan and
why these are areas of focus for your self-care. Your paper should include a title page in
current APA format.
Both the completed Self-Care Plan and Reflective Paper are to be submitted for review
and grading.
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
Locate a research study that utilized experimental or quasi-experimental methods. Briefly summarize the study. For example, discuss the inclusion of 2-group tests, regression analysis, and time-series analysis in terms of the study design’s strengths, weaknesses, or limitations. What challenges or limitations did the researcher identify they encountered by choosing this method?Embed course material concepts, principles, and theories (which require supporting citations) in your initial response along with at least one scholarly, peer-reviewed journal article. Keep in mind that these scholarly references can be found in the Saudi Digital Library by conducting an advanced search specific to scholarly references. Use Saudi Electronic University academic writing standards and APA style guidelines.
Argue the issue from the position of a nurse leader, being either in
favor of or against it. You must also provide the counter-argument. (There are always two sides to every
argument. Advocating for issues that matter to you is important but what’s equally as important
is understanding those issues from the other perspective. Explore your topic in the published peer–
reviewed scholarly literature (evidence). Depending on your topic, it may be important to also explore
public opinion, position statements of related professional organizations, and/or legislative actions
related to the topic. Develop your argument with support from relevant scholarly literature. Begin
with an introduction leading to a thesis statement then develop the topic using section headings
specific to the major points you discuss. Conclude with a summary. Do not include an abstract. The
body of the paper (excluding the title page and references) is to be 6 pages in length (minimum 1,500
words), using APA format.
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Society & Drugs
Course number:
PHC 314
CRN
Essay Topic
Assignment title or task:
(You can write a question)
Societies have evolved to believe that they have the right to
protect themselves from the damaging impact of drug use and
abuse.
(a) Mention the policies and prevention programs for
combating drug use and abuse at any country you
choose ?
(b) Describe the Saudi Food & Drug Authority (SFDA)
approval process for assessing the safety and efficacy of a
newly developed drug?
Student name:
Student ID:
Submission date:
Instructor name
Grade
… out of 10
Guidelines:
•
Word count: 300to 1000 words
•
Follow APA format for your assignment must include Introduction, Body and Conclusion
•
All information must be mention in APA reference
•
Font and Size: Times New Roman (12)
•
Color – Black, Spacing – 1.5, Heading and sub-heading – Bold
•
Follow APA format your assignment must include Introduction, Body & Conclusion
•
Avoid plagiarism
•
Submit as word document
There are 3 types of ownership or governance of hospitals / healthcare systems They are: private FOR profit; private NOT for profit and public. Choose an organization, identify its ownership/governance structure and explain 3 ways that it is different than the other two ownership/governance structures.
Read “Case Study 4-2 Choosing a Performance Management Approach at Show Me the Money.” at the end of Chapter 4 of the Performance Management textbook (page 119).Based on the case study, assess whether Show Me the Money should use a behavior approach, a results approach, or a combination of both to measure performance. Using the table that accompanies the case study as a guide, select the job descriptions that apply to the account executive job. Explain why you chose the approach you did.Justify and support your responses. Be sure to draw from, explore, and cite credible reference materials. In responding to your classmates’ posts, note whether you agree or disagree with their assessments. Why or why not?
College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Society & Drugs
Course number:
PHC 314
CRN
12780
Essay Topic
Assignment title or task:
(You can write a question)
Societies have evolved to believe that they have the right to
protect themselves from the damaging impact of drug use and
abuse.
(a) Mention the policies and prevention programs for
combating drug use and abuse at any country you
choose ?
(b) Describe the Saudi Food & Drug Authority (SFDA)
approval process for assessing the safety and efficacy of a
newly developed drug?
Student name:
Student ID:
Submission date:
Instructor name
Ahmed Al Rasasi
Grade
… out of 10
Guidelines:
•
Word count: 300to 1000 words
•
Follow APA format for your assignment must include Introduction, Body and Conclusion
•
All information must be mention in APA reference
•
Font and Size: Times New Roman (12)
•
Color – Black, Spacing – 1.5, Heading and sub-heading – Bold
•
Follow APA format your assignment must include Introduction, Body & Conclusion
•
Avoid plagiarism
•
Submit as word document
Clinical change and quality improvement projects are implemented with an aim to make healthcare systems safer and more efficient. How do you know that your specific clinical change project will have this type of an effect on the organization?
Burnout is not specific to nurses and nurse practitioners, burnout affects all members of the health care team, including physician assistants and physicians. Understanding what burnout means, identifying the causes, who is at risk, and the signs and symptoms are all very important when discussing burnout. After these items have been identified, we can look at how burnout can affect the individual experiencing it, how it can affect the patients being cared for by the burnt-out individual, and the quality of life, the medical organization, and healthcare as a whole (De Hert, 2020). According to research, burnout can have lasting effects on the individual: decreased career satisfaction, decreased empathy for patients, increased cynicism, decreased quality of sleep, negative effects on personal and professional relationships, and poor quality of life, leading to a higher risk for depression (De Hert, 2020).
If burnout goes undetected or without intervention, it will eventually cause adverse effects on the patients and healthcare organizations. Burnout has been shown to place the patient at risk for harm by increasing the risk of medical errors, missed diagnoses of important and deadly disease processes, increased risk of lawsuits, decreased patient reports of satisfaction, poor health management leading to nosocomial infections, and prolonged hospital admissions (De Hert, 2020). The effects burnout has on a healthcare origination are also significant; nosocomial infections, prolonged unnecessary admission cost the organization money, poor staffing, and increased turnover rates. Training new employees can cost an organization an average of $40,000 – $500,000, not including fines for medical errors and potential lawsuits (The Cost of Burnout in Healthcare | Symplr, n.d.). It has been reported that burnout can cost up to $5 billion every year (Lagasse, n.d.). Early detection, prevention, and reversal of burnout benefit all healthcare areas. Individual healthcare workers should work on self-awareness to advocate for themselves when symptoms present themselves, healthcare organizations should be vigilant of signs and symptoms and provide adequate working conditions, and together, the individual and organization should work together to identify strategies for preventing and managing burnout (De Hert, 2020).
Christine
Lagasse, J. (n.d.). Cost of burnout-related physician turnover totals $5 billion annually. Healthcare Finance News. https://www.healthcarefinancenews.com/news/cost-burnout-related-physician-turnover-totals-5-billion-annually
De Hert S. (2020). Burnout in Healthcare Workers: Prevalence, Impact and Preventative Strategies. Local and regional anesthesia, 13, 171–183. https://doi.org/10.2147/LRA.S240564Links to an external site.
The Cost of Burnout in Healthcare | symplr. (n.d.). https://www.symplr.com/blog/the-cost-of-burnout-in-healthcare
Post 2
The implementation of my clinical change and quality improvement initiative, which aims to enhance the safety and efficiency of healthcare systems, is a complex endeavor that combines scientific rigor, evidence-based practice, and strategic frameworks. Fundamental to advancing healthcare delivery and optimizing patient outcomes, these initiatives are frequently informed by well-established theoretical and conceptual frameworks. My clinical change project, which examines the comparative efficacy of online cognitive-behavioral therapy (CBT) versus in-person CBT for treating depression in adults, serves as a compelling example of such endeavors in this context. This project’s conceptual framework is a synthesis of Lewin’s Change Theory and Diffusion of Innovations Theory, which were chosen to provide an analytical prism for understanding the complex dynamics of change, adoption, and implementation. This fusion permits a nuanced examination of the transformative mechanisms inherent to CBT, whether delivered online or in-person, and simultaneously explores the complex process of integrating telehealth innovations into the mental health care landscape. Utilizing these theories, given their established applicability to psychological interventions and organizational transformation, increases the project’s capacity to generate novel insights and impact the practice domain. Such theoretical frameworks cannot be overemphasized in terms of their significance. They provide a structured framework for research endeavors, allowing for the precise formulation of research questions while contextualizing inquiries within established knowledge paradigms. Lewin’s Change Theory, with its three-part model of “unfreezing,” “changing,” and “refreezing,” is utilized skillfully to deconstruct the cognitive transformation CBT patients undergo (Burnes, 2020). This theoretical anchor facilitates a fine-grained understanding of symptom alleviation in individuals with depressive disorders by capturing the intricate journey from existing cognitive patterns to healthier behaviors. Concurrently, the Diffusion of Innovations Theory is ideally suited to the investigation of the assimilation of online CBT as a pioneering therapeutic modality. For the purpose of analyzing the integration of telehealth into mental health care paradigms, provider readiness, patient acceptance, and organizational support emerge as points of interest. The application of this research project to the overarching framework is characterized by its meticulous alignment with patient-centered care, social equity, cultural appropriateness, evidence-based practice, health promotion, and disease prevention – all essential aspects of graduate nursing competencies. The emphasis on patient-centered care is evident in the thorough evaluation of treatment modes and their effects on symptom reduction and patient well-being. The effort to establish standard guidelines emphasizes the commitment to evidence-based practice, thereby facilitating the making of informed clinical decisions. The investigation of cost-effectiveness integrates health promotion and disease prevention while simultaneously addressing social equity through the potential of telehealth services to improve accessibility. In addition, the emphasis on patient preferences and factors influencing the spread of online therapy highlights the importance of cultural sensitivity in the development of healthcare practices that are sensitive to diverse contexts. To ensure the anticipated effects of this clinical change project on the safety and efficacy of healthcare organizations, a comprehensive framework comprising both theoretical constructs and robust methodologies is required. This research navigates the complex relationship between clinical outcomes and patient experiences by combining quantitative and qualitative methods, such as standardized depression assessment instruments and interviews and surveys, respectively. In addition, the scrupulously outlined goals and objectives, in concert with the project’s theoretical architecture, steer the research in a synergistic manner toward outcomes that have tangible implications for healthcare practice. These include the evaluation of treatment modalities, the assessment of cost-effectiveness, ethical considerations, and, most importantly, the dissemination of findings to policy-making arenas.
Reference
Burnes, B. (2020). The Origins of Lewin’s Three-Step Model of Change. The Journal of Applied Behavioral Science, 56(1), 32–59. https://doi.org/10.1177/0021886319892685Links to an external site.
Please post initial responses and peer responses to the following discussion questions listed below:CPT coding is only one portion of a two-part coding system called HCPCS (pronounced “hick-picks”), which stands for Healthcare Common Procedure Coding System. What is included in HCPCS? More than 50 alphabetical modifiers are available for assignment, to add further specificity to the five-digit national code. CPT and HCPCS modifiers are used with both HCPCS and CPT codes. What are some examples of how modifiers can be used? (Tips: Modifiers can be used to specify the service provider, the anatomic site, etc.)A coder going through medical documentation finds that only the brand names of drugs are listed. What course of action should he or she take to ensure assignment of the proper HCPCS code? (Tips: J codes are reported to identify the drugs administered and the dosages, think about using a drug reference book.)It is essential that for each discussion questions that you write the entire question and label it with the correct number clearly for each question chosen.
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Module 6-Question 1-Debra Rabbani
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Debra Rabbani posted Sep 27, 2023 2:12 AM
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Question: 1-CPT coding is only one portion of a two-part
coding system called HCPCS (pronounced “hick-picks”), which
stands for Healthcare Common Procedure Coding System.
What is included in HCPCS? More than 50 alphabetical
modifiers are available for assignment, to add further specificity
to the five-digit national code. CPT and HCPCS modifiers are
used with both HCPCS and CPT codes. What are some
examples of how modifiers can be used? (Tips: Modifiers can be
used to specify the service provider, the anatomic site, etc.
Answer: Modifiers are used with both coding platforms (CPT
and HCPCS). The HCPCS provides modifiers for procedures
codes for CPT coding. HCPCS is a collection of standardized
codes that represent medical procedures, supplies, products,
and services. The codes are used to facilitate the processing of
health insurance claims by Medicare and other insurers. HCPCS
is divided into two subsystems, Level I and Level II.
These modifiers provide additional data about medical services,
procedures, or supplies without changing the code meanings.
HCPCS modifiers allow for greater accuracy in coding and can
be extremely important in the reimbursement process. The
correct modifier to use is determined by payor preference.
There can be instances where a CPT code is further defined by
a HCPCS modifier, for example, to describe the side of the
body the procedure is performed on such as left (modifier -LT)
or right (modifier -RT).HCPCS modifiers are two characters
(numbers or letters) added to the end of an HCPCS Level I or
Level II code.
Modifiers cover a broad scope of information. While most of
the codes correspond to parts of the body, there are also
modifiers for ambulance services and mammograms. If you look
at the full list of HCPCS modifiers, you’ll also find modifiers that
describe everything from the Medicare eligibility of a procedure
to the number of wounds dressed on a single patient.
As with CPT codes, we always want to use modifiers for
functionality first, and information second. That is, you’ll want
to list the HCPCS modifier that directly affects reimbursement
first. Remember that while certain coding forms provide space
for multiple modifiers, payers don’t always look at modifiers
listed after the first two.
Note that certain HCPCS modifiers don’t “agree” with certain
CPT modifiers. The most obvious example of this would be CPT
modifier -50 and the HCPCS modifiers –LT and –RT. These
modifiers are mutually exclusive: CPT modifier -50 describes a
bilateral procedure, while HCPCS modifiers –LT and –RT
describe which side of the body a procedure is performed on.
Let’s look at a simplified example of an HCPCS modifier in
action.
Example 1: A patient is suffering from bronchitis and asthma.
This patient has difficulty breathing and calls his doctor. The
doctor advises the patient to go directly to the emergency
room. The doctor arranges with the hospital, which in this case
would be the healthcare provider, to pick up the patient in an
ambulance with basic life support systems, or BLS.
To code this procedure on a claim, we’d look at the A-codes of
HCPCS, where the ambulance codes reside. There we’d
find A0428, for “Ambulance service, basic life support, nonemergency transport.” That’s our base HCPCS code.
Since, however, the ambulance was provided by the healthcare
provider and not, say, called in via 911, we should add a
modifier to explain this. This may seem like splitting hairs, but
how an ambulance is called can greatly affect the amount of
money owed for a procedure.
In this case, we’d look for a modifier that pertains to ambulance
service. We’d find the –QN modifier, for “Ambulance service
furnished directly by a provider of services”—in other words,
the hospital, the service provider, sent the ambulance over to
pick up our patient.
We’d end up with this code: A0428-QN for a basic life support
ambulance service, non-emergency transport, furnished by the
provider of services.
Example 2: This example uses a combination of CPT codes, CPT
modifiers and HCPCS modifiers.
A patient requires the drainage of a large, felon abscess on the
tip of the middle finger of his left hand. A “felon” abscess is a
complicated infection of the pulp on the distal, or last, phalanx
of the hand. During the procedure, however, the patient
becomes agitated, and the doctor decides to discontinue the
procedure.
If we’re coding this procedure, we’d first look at the procedure
performed. This is a procedure done to a patient, so we’re
probably going to find it in the CPT codebook. It’s also a
surgical procedure, so we’d find it in the Surgery section of the
codebook. Specifically, this is an incision—its drainage made via
a cut to the skin.
Once in the surgery section, we’d flip to the musculoskeletal
subsection and find the Hand and Fingers field of codes. There
we’d find the codes for incision and see that there are two
codes for drainage of a finger abscess: the parent code 26010
for “drainage of finger abscess; simple” and the indented code
26011 for “drainage of finger abscess; complicated (e.g, felon).”
The abscess we’re draining is complicated—it’s even listed in
the code as an example of a complicated abscess. So, we’d
select the indented code and put 26011 as our base code.
Now we’d need to look at the additional information. What’s
the more important code for reimbursement: the place on the
hand where the procedure took place, or the fact that the
procedure was discontinued? In this case, it’d be
the discontinued procedure.
We’d add the CPT modifier -53 for discontinued procedure,
and then we’d look at the HCPCS modifiers for where on the
body the procedure was performed. If you recall, some of the
HCPCS modifiers we listed earlier have to do with parts of the
hand. We’ll look at these modifiers and find the one that fits
our need: F2, for “left hand, third digit.”
So, our code would look like this: CPT code 26011, CPT
modifier -53 and HCPSC F2: a discontinued drainage of a
complicated abscess on the third digit of the left hand.
I hope I provided two concrete examples of how to use HCPCS
codes independently as well as combined with CPT codes and
CPT modifiers.
Brand Names
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Melissa Berkel posted Sep 26, 2023 8:39 PM
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2. A coder going through medical documentation finds that only
the brand names of drugs are listed. What course of action
should he or she take to ensure assignment of the proper
HCPCS code? (Tips: J codes are reported to identify the drugs
administered and the dosages, think about using a drug
reference book.)
J codes are used to report drugs that are not given orally. This
would include infusions, IM and SQ injections, inhalants and
others. In a hospital setting you will find a formulary that is
already programmed into the EMR system. It is usually based
on a database, such as First Databank, that maintains and
updates drug lists. The hospital formulary will cross reference
the drug with the J code and charge description master (CDM)
file. There would not generally be need to look much up to
reference generic versus brand, especially if the health system
is using bedside scanning. You still have to keep an eye on your
charge mapping, billing units, and make sure new NDC’s are
entered correctly.
In the case of this discussion question, I would advise that they
move away from brand names as a whole. The pharmacy should
be operating on generic names- but this instance seems like
maybe it is a small office or provider that charts differently than
a health system would. The coder should cross reference these
drugs to identify the correct Jcodes to use. There are multiple
resources to verity the generic name of a brand drug such as
the NIH website, DailyMed, or the Lexicomp database if the
provider/organization is subscribed. Some companies like
Optum have a Coder’s Desk Reference. I find DailyMed to be
more user friendly than PDR.
Using the national codes table of drugs in conjunction with a
solid reference point like the ones I have listed will help the
coder select the correct Jcode. It is imperative that the correct
code is selected. If there are any questions or doubts the coder
should contact the provider. (Buck & Koesterman, 2022)
References
Buck, C., & Koesterman, J. (2022). Chapter 9. In C. Buck, & J.
Koesterman, Buck’s Step by Step Mecial Coding 2022. Elsevier.
Module 6 Discussion Question 2
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McKenzie Rogman posted Sep 26, 2023 10:15 PM
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2. A coder going through medical documentation finds that only
the brand names of drugs are listed. What course of action
should he or she take to ensure assignment of the proper
HCPCS code? (Tips: J codes are reported to identify the drugs
administered and the dosages, think about using a drug
reference book.)
To ensure the assignment of the proper HCPCS code, the coder
should definitely be updated on the annual updates to ensure
the appropriate codes are being reported and old codes are not
being used out of habit. Depending on the situation, the brand
name may be able to be used or the coder may have to look up
the generic name of the drug if they are unsure about the brand
name. I think physicians and other medical staff should make
things as easy as possible for the coders because they have
such a difficult job to do as it is. Each professional should want
to help someone else out.
The coder could also use the HCPCS Level II codebook’s, J
codes, that are specifically used to help the coder if they are
only given the brand name of the drug on the medical
document. These codes also help identify injectable drugs that
cannot ordinarily be self administered, chemotherapy drugs,
and also some kinds of orally given drugs.
These codes can be used in any setting, so inpatient,
outpatient, doctor’s office, or infusion center all can use these. I
think it is extremely important for coders to be familiar with
some of the more common drugs that are constantly stated or
appear on the medical document. If they are not familiar with a
certain one or two, it would not hurt to look it up and then be
familiar with it next time.
Module 6 Question 1
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Jill Heflin posted Sep 26, 2023 4:47 PM
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Healthcare Common Procedure Coding (HCPCS) is a group of
medical codes that represents procedures, supplies, products,
and services in an outpatient setting. HCPCS is categorized into
two levels: Level I and Level II. Level I HCPCS code set include
the CPT codes and is the primary coding system used in the
outpatient setting to code professional services. Level II HCPCS
is also known as National Codes, and this explains “what the
provider used” to treat the patient. The National Codes
represent drugs, supplies, nonphysician services that are not
listed in the Level I codes, such as, durable medical equipment,
drugs, prosthetics and orthotics.
Modifiers are added to the national codes to further expand the
description of the code. The modifiers are used to specify a
service provider, the anatomic site, or adds specificity to
durable medical equipment. A modifier is used to describe an
anatomic site when the body part has a mirror image, such as,
modifiers for the eyelids are E1-E4. This can be further
demonstrated in an example of an ophthalmologist performing
a removal of an eyelash to the upper left eyelid using the EI
modifier to describe the upper left eyelid. The medical coder
would use the HCPCS code with modifier of 67820-E1. The
modifier AE would be an example of a service provider when
the services are provided by a nutrition professional such as a
registered dietician. Modifiers are an important aspect in
medical coding of HCPCS national codes as it enables the
medical coder to code to the highest accuracy and specificity.
CPT Coding Modifiers
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Melissa Berkel posted Sep 26, 2023 8:04 PM
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1. CPT coding is only one portion of a two-part coding
system called HCPCS (pronounced “hick-picks”), which
stands for Healthcare Common Procedure Coding System.
What is included in HCPCS?
-More than 50 alphabetical modifiers are available for
assignment, to add further specificity to the five-digit national
code. CPT and HCPCS modifiers are used with both HCPCS
and CPT codes. What are
some examples of how
modifiers can be used? (Tips: Modifiers can be used to specify
the service provider, the anatomic site, etc.)
The Healthcare Common Procedure Coding System (HCPCS)
are standardized codes that are used for procedures, supplies,
products and services. Because these codes are standardized,
they help Medicare and other insurers process claims more
efficiently. (NIH)
There are two subcategories of HCPCS. The first is Level I. In
HCPCS the Level I codes are Current Procedural Terminology
codes (CPT or HCPT). (NIH) There is a manual of CPT codes
that is maintained by the AMA. These Level I CPT codes are put
to use in the outpatient setting. They correspond with services
provided to patients. (Buck & Koesterman, 2022)
Level II codes are considered “national codes”. Revised
quarterly, these are maintained by the CMS, Health Insurance
Association of America, and the Blue Cross Blue Shield
Association. These codes are used to encompass things that
Level I does not, and can even override a CPT code. Level II
codes cover products, supplies, physicians and non-physician
services. (Buck & Koesterman, 2022) Current Dental
Terminology (HCDT) codes are also included in Level II
codes. (NIH)
The national codes are further categorized by a lettering system
to indicate the category for the type of service or procedure.
For example, Level II codes that start with the letter “P” are
pertaining to lab services.
In addition to the two code levels, the letter grouping, and
miscellaneous codes there are also modifiers. Sometimes when
coding for a procedure or equipment a payor will ask for
modifiers to describe the encounter in more detail. There are
over 50 modifiers a coder can use to add more detail, or a
payor can require for processing. For CPT codes the modifiers
are numbers, and for the HCPCS Level II codes the modifiers
are a letter combination or alphanumeric combination.
Modifiers can indicate the provider, the anatomic location, and
the durable medical equipment (DME) details. As an example, if
we were to use modifier LL, we would indicated that the DME
the patient has is a rental/lease. Or, if we use modifier NU it
would indicate new equipment. We can get even more specific
with a modifier like E2 that indicates the lower left eye lid. This
would be a good modifier for V codes that pertain to vision.
(Buck & Koesterman, 2022)
References
Buck, C., & Koesterman, J. (2022). Chapter 9. In C. Buck, & J.
Koesterman, Buck’s Step by Step Mecial Coding 2022. Elsevier.
NIH. (n.d.). Unified Medical Language System (UMLS).
Retrieved from
NIH.gov: https://www.nlm.nih.gov/research/umls/sourcereleas
edocs/current/HCPCS/index.html
Module 6 Question 1
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Cami Williams posted Sep 26, 2023 3:28 PM
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1. CPT coding is only one portion of a two-part coding
system called HCPCS (pronounced “hick-picks”), which
stands for Healthcare Common Procedure Coding System.
What is included in HCPCS?
o
HCPCS is a coding system that includes CPT coding
as well as the services which are not coded by CPT.
These services are divided into 2 levels: level 1 and
level 2.
▪
▪
Level 1 includes CPT codes that are developed,
maintained, and copyrighted by the American
Medical Association (AMA). It is the primary
coding system used in the outpatient setting to
code professional services provided to
patients. It includes identifying services and
procedures.
Level 2 (National Codes) are approved and
maintained jointly by the Alpha Numeric
Workgroup, consisting of the Centers for
Medicare and Medicaid Services (CMS), the
Health Insurance Association of America, and
the Blue Cross Blue Shield Association. Level 2
codes are five-character alpha numeric codes
representing physician and non-physician
services, products, and supplies that are not
represented in the Level 1 codes. In some
instances, Medicare requires the use of a Level
2 HCPCS code to override an already existing
CPT code.
2. More than 50 alphabetical modifiers are available for
assignment, to add further specificity to the five-digit
national code. CPT and HCPCS modifiers are used with
both HCPCS and CPT codes. What are some examples of
how modifiers can be used? (Tips: Modifiers can be used
to specify the service provider, the anatomic site, etc.)
o Modifiers inform third-party payers of
circumstances that may affect the way payment is
made. Modifiers indicate the following types of
information: altered service, bilateral procedure,
multiple procedures, professional part of the
service/procedure only, and more than one
physician/surgeon.
▪ Modifier -22 indicates that the service was
greater than usual. An example would be
trauma that was extensive enough to
complicate the procedure requiring more
effort than usual by the physician.
▪ Modifier -26 is used to designate the physician
component of a procedure, as well as the
technical component. For example, a physician
orders an ultrasound, which requires the
technician and machine to perform the
ultrasound, as well as a radiologist to interpret
the ultrasound.
Module 6 Q2
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Katie Corcoran posted Sep 26, 2023 7:47 PM
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1. A coder going through medical documentation finds that
only the brand names of drugs are listed. What course of
action should he or she take to ensure assignment of the
proper HCPCS code(Tips: J codes are reported to identify
the drugs administered and the dosages, think about using
a drug reference book.)
When coding for drugs the coder needs to make sure that they
are being very diligent about making sure that what they are
coding is correct when it comes to the dosage of the drugs that
are given and they are using generic or brand name. This is
because there could be a different code sequence. The use of J
codes are to identify the drug that was administered and the
dosage’s that were given. The National Codes has a table of
drugs to help direct the coder to the drug title and the code
that goes with it.
The use of J codes usually use the generic names of the drugs
but there are some cases that a drug is only know by the brand
name or the trade name then they will be “directed to the
generic name of the drug and then to the associated J or Q
code by a cross-reference system within the table.” (232). Then
then Physicians’ Desk Reference (PDR) would contain the
prescribing information on the prescribing information on the
drug and lists the drug by brand and generic names.
Overall coding between generic and brand name can be very
confusing and frustrating for the coding so I would encourage
them to consult CMS system for they are struggling to find the
code that they are looking for. Another thing that could be
helpful is using the HCPCS system because the information on
there is constantly being updated so that could be useful in that
situation. Also if you are conducting regular audit’s of your
coders just to make sure that they are keeping up to the
standard’s when it comes to be accurate.
References
Elsevier. (2021). Buck’s Step-By-Step Medical Coding, 2022
Edition. Saunders.
250-300 words discussion. should have 2 references and their doi link. I need it in one hour. DQ 2 Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement.
Identify a major minority ethnic group within your community (Saudi Arabia, eastern province), and provide the class with some brief demographic information. Explain their common health practices, common diseases, and what resources are currently available in your community for that population. As a health care provider, what additional information would be important to know prior to taking care of the individuals. How would I, as the nurse, go about developing cultural competence when working with these individuals? (two resources, APA format).
Use the information below to help you know which section of the article to use to answer the questions in the template:
Introduction and its subsections have the purpose or WHY study done.
Methods section and its subsections contains HOW the study was done.
Results, Discussion and Conclusions section have WHAT was found.
Details
In week 3 you selected a topic of interest and formulated a question about that topic for your Evidence-Based Practice Assignment.
In week 4 you searched the literature on your week three topic and submitted three articles for approval towards building your Evidence-Based Practice Assignment.
Module 6 readings are a continuation from week 5 that includes chapters 13 and 14 on Appraising Research Evidence and Clinical Practice Guidelines. Please refer to these chapters on how to complete an appraisal using the templates provided here. Appendix A to G in your book gives you examples of completing a template appraisal form.
For the first template in week 6, you will choose either a Qualitative or a Quantitative Review (Please do not complete both Quantitative and Qualitative Appraisal). Your second article is a Systematic Review Appraisal.
Make sure you receive approval from your instructor in week 4 for the article you use to complete either the Qualitative or Quantitative Review and for the Systematic Review. There are hyperlinks to these templates in the week 6 instructions. Do not create your own document with answers.
Each section of the template is required to be completed as this assignment builds on your Evidence-Based Practice Project. Each template has a citation that must be submitted in APA format. Answers to questions in Synopsis sections are required (see template examples in your book). Each question must have an answer of 1-2 full sentences in length per question. Credibility section Yes/No answers are also required. The Comments area is also required and should be at least 1-3 sentences noting how this article relates to your nursing issue topic from week 3 and what you thought was significant.
You will be using these articles again in your week 9 Evidence-Based Practice Project Poster.
Please review the rubric closely and proof your work by reviewing instructions before you submit.
Note: Please include a PDF or Word copy of your approved article from Week 4 with your submission.
The chosen topic and PICOT will be used for your Week 9 poster assignment. It guided your article searches in Week 4 which are to be used in completing your appraisals in Week 6.
NURS 350_Article Appraisal
NURS 350_Article Appraisal
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeWriting and APA StyleFollows all the requirements related to 7th ed APA format for citation, length, source citations, and layout.
Writing is clear, concise, and organized.
Free of spelling errors. Grammatically correct.
5 point penalty if approved article from week 4 is not included with the appraisal.
15 to >12.0 pts
Meets or Exceeds Expectations
Follows APA Guidelines. Complete Formatting and writing. APA with 1 or fewer errors.
12 to >9.0 pts
Mostly Meets Expectations
Follows APA guidelines. 2-3 formatting, writing, or APA errors
9 to >6.0 pts
Below Expectations
Partially follow guidelines. 4-5 formatting, writing or APA errors.
6 to >0 pts
Does Not Meet Expectations
Does not follow guidelines. More than 5 formatting, writing or APA errors.
15 pts
This criterion is linked to a Learning OutcomeSynopsisEach question answered in full sentences 1 to 2 sentences per question.
15 to >12.0 pts
Meets or Exceeds Expectations
Uses approved article to complete. Evidence of critical thinking. Ideas well developed.
12 to >9.0 pts
Mostly Meets Expectations
Well presented, ideas are detailed and mostly well developed
9 to >6.0 pts
Below Expectations
Content is sound, ideas present but not particularly developed
6 to >0 pts
Does Not Meet Expectations
Content is slightly reasonable
15 pts
This criterion is linked to a Learning OutcomeCredibilityAnswer yes or no questions and add a statement 1 to 2 sentences in length under each question
15 to >12.0 pts
Meets or Exceeds Expectations
Uses approved article to complete. Evidence of critical thinking & Ideas well developed
12 to >9.0 pts
Mostly Meets Expectations
Well presented, ideas are detailed and mostly well developed
9 to >6.0 pts
Below Expectations
Content is sound, ideas present but not particularly developed
6 to >0 pts
Does Not Meet Expectations
Content is slightly reasonable
15 pts
This criterion is linked to a Learning OutcomeClinical Significance and ApplicabilityAnswer yes or no questions and add a statement 1 to 2 sentences in length under each question
15 to >12.0 pts
Meets or Exceeds Expectations
Uses approved article to complete. Evidence of critical thinking & Ideas well developed
12 to >9.0 pts
Mostly Meets Expectations
Well presented, ideas are detailed and mostly well developed
9 to >6.0 pts
Below Expectations
Content is sound, ideas present but not particularly developed
6 to >0 pts
Does Not Meet Expectations
Content is slightly reasonable
15 pts
This criterion is linked to a Learning OutcomeCommentsUsing your own words (no direct quotes), describe in 1 paragraph how this article relates to your nursing issue topic from week three and what you thought was significant.
15 to >12.0 pts
Meets or Exceeds Expectations
Exceptionally well presented; ideas detailed and well developed
12 to >9.0 pts
Mostly Meets Expectations
Well presented, Ideas detailed and mostly well developed
9 to >6.0 pts
Below Expectations
Content is sound and solid; ideas are presented but not particularly developed.
Assess HealthCare Provider Perceptions and Utilization of Patient Safety Reporting System and its Barriers in Saudi Arabian Hospitals: A cross sectional studyand bleow tempelt can help ypu
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KING FAISAL SPECIALIST HOSPITAL & RESEARCH CENTER/RIYADH
NURSING RESEARCH PROPOSAL
TYPE YOUR TITLE HERE
PRIMARY INVESTIGATOR:
POSITION, DEPARTMENT:
ENTER NAME, CREDENTIALS HERE
ENTER POSITION, DEPARTMENT HERE
CO-PRIMARY INVESTIGATOR:
POSITION, DEPARTMENT:
ENTER NAME, CREDENTIALS HERE
ENTER POSITION, DEPARTMENT HERE
CO-INVESTIGATOR(S):
POSITION, DEPARTMENT:
ENTER NAME, CREDENTIALS HERE
ENTER POSITION, DEPARTMENT HERE
DATE OF SUBMISSION:
REVIEWED SUBMISSION:
DD/MM/YYYY
DD/MM/YYYY
*Remove all the blue instructions from this template before your submission.
*Make sure that the level of English is adequate (e.g. use www.grammarly.com or ask a
colleague to review as needed). Proposal with poor language quality will be returned.
Contents
ABSTRACT ……………………………………………………………………………………………………………….. 3
BACKGROUND/PROBLEM …………………………………………………………………………………………. 4
AIM OF STUDY …………………………………………………………………………………………………………. 4
LITTERATURE REVIEW …………………………………………………………………………………………….. 4
DESIGN AND METHOD ……………………………………………………………………………………………… 4
Design …………………………………………………………………………………………………………………… 4
Population ……………………………………………………………………………………………………………… 4
Inclusion …………………………………………………………………………………………………………….. 4
Exclusion ……………………………………………………………………………………………………………. 5
Sample Size and Sample Selection ……………………………………………………………………………. 5
Sources of Data………………………………………………………………………………………………………. 5
DATA COLLECTION…………………………………………………………………………………………………… 5
DESCRIPTION OF THE INTERVENTION ……………………………………………………………………… 5
DATA MANAGEMENT ………………………………………………………………………………………………… 6
STATISTICAL CONSIDERATIONS ………………………………………………………………………………. 6
ETHICAL CONSIDERATIONS ……………………………………………………………………………………… 6
TIMEFRAME ……………………………………………………………………………………………………………… 6
RESEARCH TEAM’S ROLES (LEADING TO AUTHORSHIP) …………………………………………… 7
REFERENCES ………………………………………………………………………………………………………….. 8
APPENDIX 1 VARIABLES …………………………………………………………………………………………… 9
APPENDIX 2 TITLE ……………………………………………………………………………………………………10
*To update this Table of content, right click on the table and choose “update field”.
NURSING RESEARCH PROPOSAL
2
ABSTRACT
Background
This section briefly introduces the research topic and provides context for the study (including
statistics relevant to the problem). It should explain why the research is important and relevant
to the field of nursing.
Aim(s) of the study
This section highlights the purpose of conducting the study.
Method
This section outlines the methodology planned to reach the aim(s), including the study design,
data collection methods, and analyses techniques.
Conclusion
This section discusses the potential implications of the study findings for the nursing practice,
policies, management, or education.
Keywords (5-6):
*The abstract should not exceed 250 words.
NURSING RESEARCH PROPOSAL
3
BACKGROUND/PROBLEM
Use HEADING 1, HEADING 2, HEADING 3 from the Microsoft Word selection in the tool bar
above (right side). Do not change the style (font, size, underlining). These styles are preprogrammed to allow you to update your Table of Content easily.
Use the style NORMAL for the body of the text.
REFERENCES/CITATIONS: Please use one style of reference through your proposal (e.g.
APA, Harvard, Chicago).
AIM OF STUDY
List your primary aim +/- secondary aim(s). You can use bullet points if you want.
LITTERATURE REVIEW
This section will give an overview of the existing scientific literature on your topic. It should
enable us to identify what is knows and the gaps. Most of the time, it should not be lengthy (2/3
to 1 page) can be adequate for most studies. If your study is more complex and more concepts
needs to be explained, it can be longer.
DESIGN AND METHOD
You may write this section as a continuous paragraph, but make sure to include all the elements
below, according to your study design.
Design
Describe the design of your study (e.g. cross-sectional observation study, qualitative study,
retrospective chart review, interventional study).
Population
Inclusion
E.g., children from birth to 14 years of age, patient diagnosed with sickle-cell disease, able to
consent independently
NURSING RESEARCH PROPOSAL
4
Exclusion
Do not write the contrary of your inclusion criteria. These are different criteria. E.g., patient is
clinically unstable, patient has severe cognitive deficits, has a specific condition or is taking a
specific medication.
Sample Size and Sample Selection
▪
For a quantitative study: include the sample size calculation to achieve power analysis.
▪
For a qualitative study: explain how you will reach data saturation.
▪
For a retrospective chart/database/registry study: indicate the exact period covered by the
review (DD-MM-YYYY to DD-MM-YYYY).
Sources of Data
List all sources from where you will get your data (e.g., sociodemographic and clinical data will
be retrieved from the medical record, satisfaction scored will be gathered through Questionnaire
X)
For a quantitative study:
▪
Make a table in the Appendix and list all the variable that will be measured and their unit of
measure.
▪
If a questionnaire/tool/scale is used: describe briefly the instrument (goal, length, #item,
duration to complete) and it psychometric properties (fidelity, validity), if available. If a
translated version is use, it should be already validated unless you plan to validate the tool,
then you need to explain how. You must also contact the original authors to get permission
to use a tool unless there is a mention that it not required. Attached the license agreement
or the email with the author’s permission.
For a qualitative study:
▪
Describe how you will collect the data (e.g., semi-structured interviews).
▪
Put the list of your questions in an Appendix. (in Arabic as well, if they will be interviewed in
Arabic)
DATA COLLECTION
How and where the data will be collected?
DESCRIPTION OF THE INTERVENTION
Only for interventional studies. Remove this section, if not applicable.
NURSING RESEARCH PROPOSAL
5
DATA MANAGEMENT
Where will the data be stored confidentially? (Excel sheet with password). Who has access?
We encourage you to use the free resource REDCap to manage your data. Contact the Nursing
Research team for more information about it. It makes everything simpler for most studies.
STATISTICAL CONSIDERATIONS
▪
For a quantitative study: Planned statistical analyses, statistical significance targeted,
statistical software that will be used to analyze the data (e.g., Excel, SPSS). If you need help
with this section, you can contact the Nursing Research team. If your study requires
complex statistical analyses, you can take an appointment on Service Hub with the
Research Concierge.
▪
For a qualitative study: explain how the data will be analyze (framework).
ETHICAL CONSIDERATIONS
▪
Type of consent that will be uses, is a waiver for informed or signed consent is requested?
▪
For any study involving children of 8 years and above, you need to include a Child Assent.
▪
Explain how the confidentiality will be maintain.
▪
If your study can cause any type of discomfort (even mild anxiety when talking about a
sensitive topic), mention it here and how any distress would be addressed.
▪
Consult the “Nursing Knowledge Base” page for more information or contact a Research
Nurse Specialist.
▪
Unless you are doing a retrospective chart/database/registry review, most study need to
have either a full consent or a Participant Information sheet attached to the proposal. You
can find some template on the Knowledge base page for both. Make sure the English/Arabic
language is simple (8th grade level max.)
TIMEFRAME
Steps
APPROVAL PROCESS
DATA COLLECTION
DATA ANALYSIS
MANUSCRIPT REDACTION
Estimated timeframe (e.g. in months)
NURSING RESEARCH PROPOSAL
6
RESEARCH TEAM’S ROLES (LEADING TO AUTHORSHIP)
List all investigators
List all expected roles (see list below for examples)
E.g., study design, data collection, data analysis, statistical analyses, manuscript redaction,
manuscript review
*To be consider an author on a publication, one must usually assume 3-4 roles in a research or
less if a specific role is significant/
NURSING RESEARCH PROPOSAL
7
REFERENCES
Use one reference style through your proposal (e.g. APA, Vancouver, Harvard)
NURSING RESEARCH PROPOSAL
8
APPENDIX 1 VARIABLES
Name
Units
Remove if not applicable.
NURSING RESEARCH PROPOSAL
9
APPENDIX 2 ADD TITLE
As applicable to your study:
▪ Add tools that will be used (questionnaires, scales)
▪ Add permission from authors to use a tool
▪ Add participant information sheet (can also be sent separately, if preferred)
NURSING RESEARCH PROPOSAL
10
FIRST PART IS ALREADY COMPLETED I NEED THE HELP WITH THE TEMPLET
EditDIGITAL CLINICAL EXPERIENCE (DCE): HEALTH HISTORY ASSESSMENT
In Week 3, you began your DCE: Health History Assessment. For this week, you will complete this Health History Assessment in your simulation tool, Shadow Health and finalize for submission.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCE
TO PREPARE
Review this week’s Learning Resources as well as the Taking a Health History media program in Week 3, and consider how you might incorporate these strategies. Download and review the Student Checklist: Health History Guide and the History Subjective Data Checklist, provided in this week’s Learning Resources, to guide you through the necessary components of the assessment.
Review the DCE (Shadow Health) Documentation Template for Health History found in this week’s Learning Resources and use this template to complete your Documentation Notes for this DCE Assignment.
Access and login to Shadow Health using the link in the left-hand navigation of the Blackboard classroom.
Review the Shadow Health Student Orientation media program and the Useful Tips and Tricks document provided in the week’s Learning Resources to guide you through Shadow Health.
Review the Week 4 DCE Health History Assessment Rubric, provided in the Assignment submission area, for details on completing the Assignment.
Note: There are 2 parts to this assignment – the lab pass and the documentation. You must achieve a total score of 80% in order to pass this assignment. Carefully review the rubric and video presentation in order to fully understand the requirements of this assignment.
complete the template with information you provide me
ASSIGNMENT COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN:
Assignment title or task:
(You can write a question)
Choose any one of the common occupational
infectious diseases and explain the following:
•
•
•
Causes, mode of transmission, and symptoms.
Occupational group at risk
Prevention and control measures
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Short essay of 500-750 words (Excluding references).
• The font size should be 12.
• Font type should be Times New Roman
• The heading should be Bold.
• Color should be Black.
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style.
• AVOID PLAGIARISM
• Due date; 30/9/2023 11:59 PM
Best of Luck
A 15-year-old immigrant was brought to the clinic by her mother because client complains of shortness of breath, chest pains, diaphoresis and easy fatiguability. She claims she has had on and off bouts of tonsillitis since she was a child that resulted in tonsillectomy surgery when she was 12. Last week, she was unable to participate in the cheer leading tryouts because of knee pain and a rash that she noticed on her trunk for the past 2 weeks. Body System – Cardiovascular I believe it is Rheumatic Fever. Please use template to fill out.
Unformatted Attachment Preview
Physical Assessment
Case Study Template
Name:
Week of Class (1-8):
Body System focus area (i.e., cardiovascular):
Case Study:
Note: Include in-text citations as needed (author, year).
Questions (if data is unavailable, indicate “unavailable”):
1. What is the client’s chief complaint?
2. What questions would you ask the client?
HPI (history of present illness)
ROS (review of systems)
Medical/Surgical/Psych History
Family History
Other
3. What physical examinations would you include?
Body System
General survey
HEENT (head, eyes, ears,
nose, throat/thyroid)
Cardiovascular
Peripheral Vascular
Include
✓ (yes) or
– (not
indicated)
✓
✓
Notes
Auscultate heart sounds (stethoscope to
actual skin)
Breasts
Lymphatic
Pulmonary
✓
Auscultate lung sounds (stethoscope to
actual skin) – anterior and posterior
Gastrointestinal/Abdominal
Genitourinary/Pregnancy
Integumentary
Musculoskeletal
Neurological
4. What are pertinent positive physical assessment findings?
5. What are the pertinent negative physical assessment findings?
6. What are at least 3 differential diagnoses (use Up-to-Date App if needed)?
7. What is your primary diagnosis?
8. What is your treatment plan?
Diagnostic procedures
Labs
Client education (including lifestyle modifications, if applicable)
Pharmacotherapy (including complementary and alternative therapies)
Health promotion (preventative care, anticipatory guidance)
Follow-Up
References
(within the last 5 years, scholarly, include clinical practice guidelines if available)
APA Format please, at least one reference
Read “Case Study 4-2 Choosing a Performance Management Approach at Show Me the Money.” at the end of Chapter 4 of the Performance Management textbook (page 119).Based on the case study, assess whether Show Me the Money should use a behavior approach, a results approach, or a combination of both to measure performance.Using the table that accompanies the case study as a guide, select the job descriptions that apply to the account executive job.Explain why you chose the approach you did.Justify and support your responses. Be sure to draw from, explore, and cite credible reference materials. In responding to your classmates’ posts, note whether you agree or disagree with their assessments. Why or why not?
Please reply to each discussion 150 words each with one reference eachThank you
Unformatted Attachment Preview
Reply to Ayida
The patient, Ms. Richardson, is a 74-year-old African American. Police have brought her to
the emergency room. She has been wandering around the neighborhood and couldn’t care for
herself. When police broke into her apartment, she was hiding in the corner wearing nothing but
a bra. She couldn’t remove dog feces, making the apartment filthy. When brought to the hospital,
she is unkempt, dirty and fouled-smelling. Ms Richardson can’t look at the interviewer, looks
confused, can’t respond to most of the questions, doesn’t know the day of the month, and can’t
describe the events that led to her being in the hospital. Additionally, she says the neighbors
called the police since she was “sick”; she felt sick and weak, had painful shoulders, had not
eaten for three days, and can remember the police shot her dog.
Ms. Richardson can’t give the name of a friend neighbor, denied being in a psychiatric
hospital, hearing voices, and says she had seen a psychiatrist one time as she couldn’t sleep,
couldn’t take the prescribed medication as it was strong, and couldn’t recall its name. she nodes
to the name mentioned by the doctor although she could say yes to anything. She said the gun
found in her house was a toy that her dead brother had brought. The patient also had trouble
swallowing and finally smiled when the team left her bedside.
Generate a primary and two differential diagnoses. Use the DSM5 to support the
assessment. Include the DSM5 and ICD 10 codes.
According to the patient’s signs and the objective and subjective data, the primary diagnosis
would be delerium ICD: F05.9 or dementia ICD 10: F0.90. A thorough evaluation of her
medication, medical and psychiatric history is needed to distinguish a proper diagnosis. The
differential diagnosis would be schizoaffective disorder (DSM5 – F25 ICD10 – F25) and major
depressive disorder (DSM5 – F32.9 ICD10 – F32.9) (Mayo Clinic, 2022).
Discuss a pharmacological treatment would you prescribe
I would prescribe medication to improve her symptoms. Cholinesterase, such as
galantamine and rivastigmine, can be prescribed to enhance the degree of a chemical messenger
that helps with judgment and memory (Mayo Clinic, 2022). Another medication includes
memantine to help with memory (NIH, 2022). I might also need to prescribe agitation and
depression medications.
Discuss the non-pharmacological treatment would you prescribe
I would prescribe non-pharmacological treatment to treat some symptoms and behaviors
initially. I can prescribe occupational therapy to help the patient cope and manage her behaviors.
It can also help Ms. Richardson make her home safer to prevent accidents.
Describe a health promotion intervention that would be appropriate for this patient.
A health promotion intervention can include cognitive stimulation therapy, where the patient
participates in team exercises and activities meant to enhance memory. She can also make
environmental changes, like decreasing clutter and noise (Mayo Clinic, 2022). This will help the
patient function and focus. It may involve hiding safety-threatening things like car keys and a
monitoring system that can alert the family of neighbors when the patient wanders.
Reminiscence and life story work can promote the patient’s health (NIH, 2022). It will involve
discussing her past events and things using props like her favorite possessions and photos (NIH,
2022). A life story can be notes from childhood. Reminiscence and life story work can promote
well-being and mood.
References
Mayo Clinic. (2022, October 12). Dementia – Symptoms and
causes. https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc20352013Links to an external site.
NIH. (2022, December 8). What Is Dementia? Symptoms, Types, and Diagnosis. National Institute on
Aging. https://www.nia.nih.gov/health/what-is-
dementia#:~:text=Dementia%20is%20the%20loss%20of,and%20their%20personalities%20may
%20changeLinks to an external site.
Reply to Yanet
The patient is a 74-year-old African American woman who was brought to the hospital
emergency room by the police. She is unkempt, dirty, and foul-smelling, and appears to be
confused and unresponsive to most questions. She knows her name and address, but not the day
of the month, and is unable to describe the events that led to her admission. The police report that
they were called by neighbors who reported that the patient had been wandering around the
neighborhood and not taking care of herself. The medical center mobile crisis unit went to her
house twice but could not get in and presumed she was not home. Finally, the police came and
broke into the apartment, where they were met by a snarling German shepherd. They shot the
dog with a tranquilizing gun and then found the patient hiding in the corner, wearing nothing but
a bra. The apartment was filthy, the floor littered with dog feces. The police found a gun, which
they took into custody. The following day, while the patient was awaiting transfer to a medical
unit for treatment of her out-of-control diabetes, the psychiatric provider attempted to interview
her. Her facial expression was still mostly unresponsive, and she still didn’t know the month and
couldn’t say what hospital she was in. She reported that the neighbors had called the police
because she was “sick,” and indeed she had felt sick and weak, with pains in her shoulder; in
addition, she had not eaten for 3 days. She remembered that the police had shot her dog with a
tranquilizer and said the dog was now in “the shop” and would be returned to her when she got
home. She refused to give the name of a neighbor who was a friend, saying, “he’s got enough
troubles of his own.” She denied ever being in a psychiatric hospital or hearing voices but
acknowledged that she had at one point seen a psychiatrist “near downtown” because she
couldn’t sleep. He had prescribed medication that was too strong, so she didn’t take it. She didn’t
remember the name, so the interviewer asked if it was Thorazine. She said no, it was “allal.”
‘Haldol?”, ask the interviewer. She nodded.
The primary diagnosis would be major depressive disorder, single episode, with psychotic
features. The differential diagnoses would be schizoaffective disorder, bipolar disorder, with
psychotic features. The DSM5 and ICD 10 codes for these diagnoses are: Major depressive
disorder, single episode: DSM5 – F32.9 ICD10 – F32.9 Schizoaffective disorder: DSM5 – F25
ICD10 – F25 Bipolar disorder, with psychotic features: DSM5 – F31.5 ICD10 – F31.5 . ( DelBen, C. M.,2010 )
The most likely diagnosis for Ms. Richardson is dementia, given her confused state and
inability to remember recent events. Given her age, it is also possible that she has underlying
medical conditions that are contributing to her cognitive decline. As such, treatment should focus
on managing her medical conditions and providing supportive care. For her dementia,
cholinesterase inhibitors (such as donepezil or rivastigmine) may be prescribed in an effort to
improve cognitive function. These medications can help to improve memory, attention, and
language skills. In addition, Ms. Richardson will likely require close supervision and assistance
with activities of daily living. For her diabetes, Ms. Richardson will need to be started on insulin
therapy. This will help to control her blood sugar levels and prevent further complications from
her disease. In addition, she will need to be educated on how to properly manage her diabetes.
This will include information on diet, exercise, and blood sugar monitoring. ( Marneros, A.
(2003).
Given that Ms. Richardson is unkempt, dirty, and foul-smelling, it would be appropriate to
prescribe a non-pharmacological treatment such as a course of antibiotics to clear any infection
she may have. In addition, given her apparent confusion and lack of response to questions, it
would be appropriate to refer her for a cognitive assessment to rule out any underlying
dementia.( Bußhoff, J., & Baethge, C. (2015).
A health promotion intervention that would be appropriate for this patient would be to
provide them with information on how to take care of their diabetes and how to improve their
overall hygiene. Additionally, the patient should be given information on how to access mental
health services if they are needed.
Reference:
Del-Ben, C. M., Rufino, A. C. T. B. F., Azevedo-Marques, J. M. D., & Menezes, P. R. (2010).
Differential diagnosis of first episode psychosis: importance of optimal approach in psychiatric
emergencies. Brazilian Journal of Psychiatry, 32, S78-S86.
Marneros, A. (2003). Schizoaffective disorder: clinical aspects, differential diagnosis, and
treatment. Current Psychiatry Reports, 5(3), 202-205.
Santelmann, H., Franklin, J., Bußhoff, J., & Baethge, C. (2015). Test-retest reliability of
schizoaffective disorder compared with schizophrenia, bipolar disorder, and unipolar
depression—a systematic review and meta‐analysis. Bipolar disorders, 17(7), 753-768.
College of Health Sciences
Department of Public Health
HCM-ASSIGNMENT -Week 5
Course name:
HCM
Course number:
101
CRN
Assignment title or task:
•
•
Review Chapter 5 in Buchbinder & Shanks (2012).
Examine the missions and visions of any health
Organizations within Saudi Arabia.
(The organization must have website)
•
Using a Word document, write one page paper.
Choose one health Organizations and identify three
strategic priorities it exhibits. What market powers
and trends will have an impact on these priorities?
What would the role of the manager be in setting and
implementing these strategies?
Student name:
Students Id Number:
Submission date:
Instructor name:
Grade:
Turki Alsabhan
College of Health Sciences
Department of Public Health
Guidelines:
•
•
•
•
•
•
•
Your response should in one page paper and not exceed 300 words.
Font should be 12 Times New Roman
Heading should be Bold
Color should be Black
Line spacing should be 1.5
Use Assignment coversheet
Use proper references in APA style
Read the two articles below by clicking on the links.How to Understand and Use the Nutrition Facts LabelLinks to an external site.Understanding Ingredients on Food LabelsLinks to an external site.Then, complete the attached assignment.
Unformatted Attachment Preview
Food Label Assignment
Name ________________________________________________
Select one food label from the foods you commonly eat. Be sure the label has a minimum of four
ingredients on it. Take a picture of the label including the nutrition facts and the ingredients and
submit it with your completed assignment. Then answer the following questions about the food item.
To help you answer questions 9, 10, and 11. There are 9 calories per gram of fat, 4 calories per gram of
protein, and 4 calories per gram of carbohydrates.
Name of Food ________________________________________________________________
1. What are the first four ingredients? (4 points)
2. What is the serving size listed on the label? (1 Point)
3. How many calories per serving? (1 Point)
4. How many servings per container? (1 Point)
5. How many grams of saturated fat per serving? (1 Point)
6. How many grams of total fat per serving? (1 Point)
7. How many grams of protein per serving? (1 Point)
8. How many grams of carbohydrates per serving? (1 Point)
9. How many calories of total fat per serving? Please, show your math. (1 Point)
10. How many calories of protein per serving? Please, show your math. (1 Point)
11. How many calories of carbohydrates per serving? Please, show your math. (1 Point)
12. How much sodium per serving? (1 Point)
13. How many grams of fiber? (1 Point)
14. How much cholesterol per serving? (1 Point)
15. Does the product contain vitamins? Which ones? (1 Point)
16. Does the product contain minerals? Which ones? (1 Point)
17. Do you think this is a healthy or nutritious food choice? Why or why not? Write a minimum of 1
paragraph. (6 Points)
ASSIGNMENT COVER SHEET
Course name:
Concepts of Health Education and Promotion
Course number:
PHC 212
CRN
•
Differentiate between Health education and Health
promotion. How these two disciplines of public
Assignment title or task:
(You can write a question)
health are different from each other.
•
Provide an example of Health education and health
promotion activities.
Student name:
Student ID:
Submission date:
Instructor name
Grade
… out of 5
Guidelines:
•
Word count: 300 words
•
All information must be mention in APA reference
•
Font and Size: Times New Roman (12)
•
Color – Black, Spacing – 1.5, Heading and sub-heading – Bold
•
Avoid plagiarism
•
Submit as Word document file
•
Deadline: 3/March/2021
Read the two articles below by clicking on the links.How to Understand and Use the Nutrition Facts LabelLinks to an external site.Understanding Ingredients on Food LabelsLinks to an external site.Then, complete the attached assignment.
Unformatted Attachment Preview
Food Label Assignment
Name ________________________________________________
Select one food label from the foods you commonly eat. Be sure the label has a minimum of four
ingredients on it. Take a picture of the label including the nutrition facts and the ingredients and
submit it with your completed assignment. Then answer the following questions about the food item.
To help you answer questions 9, 10, and 11. There are 9 calories per gram of fat, 4 calories per gram of
protein, and 4 calories per gram of carbohydrates.
Name of Food ________________________________________________________________
1. What are the first four ingredients? (4 points)
2. What is the serving size listed on the label? (1 Point)
3. How many calories per serving? (1 Point)
4. How many servings per container? (1 Point)
5. How many grams of saturated fat per serving? (1 Point)
6. How many grams of total fat per serving? (1 Point)
7. How many grams of protein per serving? (1 Point)
8. How many grams of carbohydrates per serving? (1 Point)
9. How many calories of total fat per serving? Please, show your math. (1 Point)
10. How many calories of protein per serving? Please, show your math. (1 Point)
11. How many calories of carbohydrates per serving? Please, show your math. (1 Point)
12. How much sodium per serving? (1 Point)
13. How many grams of fiber? (1 Point)
14. How much cholesterol per serving? (1 Point)
15. Does the product contain vitamins? Which ones? (1 Point)
16. Does the product contain minerals? Which ones? (1 Point)
17. Do you think this is a healthy or nutritious food choice? Why or why not? Write a minimum of 1
paragraph. (6 Points)
Locate a research study that utilized experimental or quasi-experimental methods. Briefly summarize the study. For example, discuss the inclusion of 2-group tests, regression analysis, and time-series analysis in terms of the study design’s strengths, weaknesses, or limitations. What challenges or limitations did the researcher identify they encountered by choosing this method?
Discussion reading: Flegal KM, et al. Association of all-cause mortality with overweight and obesity using standard body mass index categories. JAMA 2013;309:71-82Provide brief responses to the questions below about the discussion reading. You can work in groups but you have to submit individually:What is the motivation for this paper, as described in the paper’s introduction section? And its main goal?What were the inclusion and exclusion criteria for the studies considered in this review?Why did the authors require adjustment for smoking to consider results from a study to be adequately adjusted?What are the main strengths of this study?Indicate two limitations of this study highlighted by the authorsWhat are, in your opinion, the main public health implications of this analysis?
ASSIGNMENT COVER SHEET
Course name:
Occupational Health
Course number:
PHC 261
CRN:
Assignment title or task:
(You can write a question)
Choose any one of the common occupational
infectious diseases and explain the following:
•
•
•
Causes, mode of transmission, and symptoms.
Occupational group at risk
Prevention and control measures
Student Name:
Student ID:
Submission Date:
Instructor name:
Grade:
Out of 10
Instructions for submission:
• Make sure to fill out all the relevant information on the coversheet.
• Short essay of 500-750 words (Excluding references).
• The font size should be 12.
• Font type should be Times New Roman
• The heading should be Bold.
• Color should be Black.
• The paragraph must be justified.
• Double line spacing.
• Use proper references in APA style.
• AVOID PLAGIARISM
• Due date; 30/9/2023 11:59 PM
Best of Luck
Using the theory of unpleasant symptoms as a guide, what would you look for in an assessment tool for patient symptoms?APA style. 500 words. Minimun 2 references. No plagiarism .
This is a power point presentation that needs to be presented in 3 – 5 minutes. I need the power point and then I need to figure out how to present this on my own. This assignment has the following rubric. My topic is Independent Practice. Scoring Rubric for Oral Presentation:
Category
Scoring Criteria
Total Points
Score
Organization (15 points)
The type of presentation is appropriate for the topic and
audience.
5
Information is presented in a logical sequence.
5
Presentation follows professional guidelines for
Microsoft PowerPoint.
10
Presentation uses proper grammar, spelling, and APA
format.
10
Content (45 points)
Introduction is attention-getting and establishes a framework for the presentation.
5
Presentation contains accurate information.
10
Material included is relevant to the overall
message/purpose.
10
Appropriate amount of material is prepared, and points made
reflect well their relative importance.
10
There is an obvious conclusion summarizing the
presentation.
5
Presentation (40 points)
Delivery is poised, controlled, and smooth.
5
Information was well communicated
5
PowerPoint are well prepared, informative, effective, and not
distracting.
5
Length of presentation is within the assigned time
Choose a health care organization or profession. What are some ethical issues or laws that regulate these entities? Choose at least one law or ethical principle and explain its impact on the organization or profession that you choose.
EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH
Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.
Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.
In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)
Part 3A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
BY DAY 7 OF WEEK 7
Submit Part 3A and 3B of your Evidence-Based Project.
This work is important to me. Solve it correctly, without mistakes, withoutplagiarism. Follow the instructions. There is no chance to repeat it.Therefore, you must do a complete and correct work 100%.If you are sure you can do it, accept it
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
HCM-ASSIGNMENT -Week 5
Course name:
HCM
Course number:
101
CRN
10091
•
•
Assignment title or task:
•
Review Chapter 5 in Buchbinder & Shanks (2012).
Examine the missions and visions of any health
Organizations within Saudi Arabia.
(The organization must have website)
Using a Word document, write one page paper.
Choose one health Organizations and identify three
strategic priorities it exhibits. What market powers
and trends will have an impact on these priorities?
What would the role of the manager be in setting and
implementing these strategies?
Student name:
Students Id Number:
Submission date:
Instructor name:
Grade:
Dr. Mohammed Osman Ali
College of Health Sciences
Department of Public Health
Instructions/Guidelines:
•
•
•
•
•
•
•
Your response should in one page paper and not exceed 300 words.
Font should be 12 Times New Roman
Heading should be Bold
Color should be Black
Line spacing should be 1.5
Use Assignment coversheet
Use proper references in APA style
Instructions for Individual Assignment Two – Stakeholder Communication
The purpose of this assignment is to demonstrate your ability to identify stakeholders in a collaboration and your knowledge of how to communicate with them most effectively.
Instructions: In Canadian adults 65 years and older, falls are a significant cause of morbidity and mortality. According to the Public Health Agency of Canada, 20-30% of seniors experience a fall every year (Public Health Agency of Canada, 2014, p. III). You have been contracted to assist in developing a fall prevention program for adults over 65 years in the Kitchener Waterloo Region.
Briefly describe the project or topic you would like to explore for your collaboration (examples include, but are not limited to, medication management, exercise, risk reduction). You must identify potential stakeholders to collaborate with you on this project. Using Gretchen Anderson’s “model for understanding different types of collaborators” (Anderson, 2019, Fig 2.1), specifically identify the potential stakeholders, their level of contribution, possible communication channels and what types of information would be necessary for that stakeholder. Be sure you are are selecting stakeholders that will help you develop or build the program rather than implementing or running a program.
You will need to identify five stakeholders in total:
Two examples of stakeholders that would be Close Collaborators/Core Team Members
One example each of stakeholders that would represent a Highly Interested Stakeholder, Subject Matter Expert, and Onlooker.
Using a separate paragraph for each stakeholder:
Identify the stakeholder
Identify what Level of Contribution they will provide during the collaboration and explain why you selected that level.
Explain what communication channel or method would be most effective for this stakeholder (examples include, but are not limited to, reports, email, social media) and why you think this channel would be effective.
For Highly Interested Stakeholders, Subject Matter Experts and Onlookers only describe what types of information would be shared with them in the communication.
Public Health Agency of Canada (2014) Seniors’ falls in Canada: Second Report[PHAC Pub No.130592].https://www.phac-aspc.gc.ca/seniors-aines/publications/public/injury-blessure/seniors_falls-chutes_aines/assets/pdf/seniors_falls-chutes_aines-eng.pdf
You will select one healthcare policy issue and write a policy brief paper presenting your position on the selected issue. This will necessitate a literature search and an analysis of the political and economic forces that affect this issue. You are encouraged to select a topic from reading daily newspapers and current national news.
The policy brief must be short, and direct yet highly impact full.
You will include the following:
Describe the issue you are addressing (e.g., provide statistics, social justice-equity-diversity-inclusion (SJEDI) issues, cost to society and the health care system).
Select a bill/legislation/law related to the issue you are addressing (provide the name and number of the bill/legislation/law, describe it, and indicate where in the approval process is such as in what legislative committee, when, and who proposed it).
Analyze the economic, legal, and political factors the selected bill/legislation/law addresses and how they influence the structure and financing of healthcare, practice, and health outcomes.
Provide three bullet points of the key reasons you are seeking to vote in favor or against/support or no support for the bill/legislation/law related to your issue (include evidence such as statistics, cost-benefit, cost-effectiveness, cost-utility, SJEDI implications).
List key supporting and opposing stakeholders (e.g., professional organizations that support or are against your selected bill/legislation/law).
State how you would advocate for your selected bill/legislation/policy to improve the health of the public and the nursing profession.
Include a conclusion with two recommendations of what you wish to see happen related to your bill/legislation/law, such as a vote for or against.
Word Count: At least 1,000 words are required. Include the number of words in your paper before the reference list.
Reference List: At least five references in APA style. References should be not older than five years.
Discussion paper, one page, APA format with references, including the article, due Sunday, Oct. 1st, 11:00 p.m. E.T. ICU model can be used as directed in the instructions.
Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.
Position papers are a method to evaluate the most current evidence and policies related to health care issues. They offer a way for researchers to explore the views of any number of organizations around a topic. This can help you to develop your own position and approach to care around a topic or issue.
This assessment will focus on analyzing position papers about an issue related to addiction, chronicity, emotional and mental health, genetics and genomics, or immunity. Many of these topics are quickly evolving as technology advances, or as we attempt to push past stigmas. For example, technological advances and DNA sequencing provide comprehensive information to allow treatment to become more targeted and effective for the individual. However, as a result, nurses must be able to understand and teach patients about the impact of this information. With this great power comes concerns that patient conditions are protected in an ethical and compassionate manner.
Position papers are a way for individuals, groups, and organizations to express their views and intentions toward a specific issue. In health care, many position papers address specific policies, regulations, or other approaches to care. As a master’s-prepared nurse, you should feel empowered to express and advocate for your own views on policy and care matters. This is especially important when it comes to populations you or your organization cares for that are not receiving the quality, type, or amount of care that they require.
An important skill in creating a position paper or policy proposal is the ability to analyze and synthesize others’ views about the population or issue of interest to you. By synthesizing the positive and negative views of an issue, you can become better equipped to strengthen your own arguments and respond to opposing views in an informed and convincing way.
PROFESSIONAL CONTEXT
Position papers are a way for individuals, groups, and organizations to express their views and intentions toward a specific issue. In health care, many position papers address specific policies, regulations, or other approaches to care. As a master’s-prepared nurse, you should feel empowered to express and advocate for your own views on policy and care matters. This is especially important when it comes to populations you or your organization cares for that are not receiving the quality, type, or amount of care that they require.
An important skill in creating a position paper or policy proposal is the ability to analyze and synthesize others’ views about the population or issue of interest to you. By synthesizing the positive and negative views of an issue, you can become better equipped to strengthen your own arguments and to respond to opposing views in an informed and convincing way.
SCENARIO
For this assessment, pretend you are a member of an interprofessional team that is attempting to improve the quality and outcomes of health care in a vulnerable population. For the first step in your team’s work, you have decided to conduct an analysis of current position papers that address the issue and population you are considering.
In your analysis, you will note the team’s initial views on the issue in the population as well as the views across a variety of relevant position papers. You have been tasked with finding the most current standard of care or evidenced-based practice and evaluating both the pros and cons of the issue. For the opposing viewpoints, it is important to discuss how the team could respond to encourage support. This paper will be presented to a committee of relevant stakeholders from your care setting and the community. If it receives enough support, you will be asked to create a new policy that could be enacted to improve the outcomes related to your chosen issue and target population.
The care setting, population, and health care issue that you use for this assessment will be used in the other assessments in this course. Consider your choice carefully. There are two main approaches for you to take in selecting the scenario for this assessment:
You may use one of the issues and populations presented in the Vila Health: Health Challenges in Different Populations media piece. For this approach, you may consider the population in the context of the Vila Health care setting, or translate it into the context in which you currently practice or have had recent experience.
You may select a population and issue that is of interest to you and set them in the context of your current or desired future care setting. While you are free to choose any population of interest, the issue you choose should fall within one of the following broad categories:
Genetics and genomics.
Sickle cell, asthma, multiple sclerosis, myasthenia gravis.
Immunity.
Type 1 diabetes, systemic lupus erythematosus (SLE), congenital neutropenia syndrome.
Chronicity.
Arthritis, any type of cancer or lung or heart disease, obesity.
Addiction.
Abuse of alcohol, prescription drugs, tobacco, illegal substances.
Emotion and mental health.
Post-traumatic stress disorder (PTSD), depression, eating disorders, psychosis.
Note: If you choose the second option, contact your faculty to make sure that your chosen issue and population will fit within the topic areas for this course.
INSTRUCTIONS
For this assessment, you will develop a position summary and an analysis of relevant position papers on a health care issue in a chosen population. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your assessment submission addresses all of them. You may also want to read the Analysis of Position Papers for Vulnerable Populations Scoring Guide and Guiding Questions: Analysis of Position Papers for Vulnerable Populations [DOC] to better understand how each grading criterion will be assessed.
Explain a position with regard to health outcomes for a specific issue in a target population.
Explain the role of the interprofessional team in facilitating improvements for a specific issue in a target population.
Evaluate the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
Evaluate the evidence and positions of others that are contrary to a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
Communicate an initial viewpoint regarding a specific issue in a target population and a synthesis of existing positions in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling.
Integrate relevant sources to support assertions, correctly formatting citations and references using APA style.
Example assessment: You may use the Assessment 1 Example [PDF] to give you an idea of what a Proficient or higher rating on the scoring guide would look like.
SUBMISSION REQUIREMENTS
Length of submission: 4–6 double-spaced, typed pages, not including the title and reference pages. Your plan should be succinct yet substantive. No abstract is required.
Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that support your initial position on the issue, as well as a minimum of 2–3 sources of scholarly or professional evidence that express contrary views or opinions. Resources should be no more than five years old.
APA formatting: Use the APA Style Paper Template [DOCX] and the APA Style Paper Tutorial [DOCX] to help you in writing and formatting your analysis.
COMPETENCIES MEASURED
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Design evidence-based advanced nursing care for achieving high-quality population outcomes.
Evaluate the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
Evaluate the evidence and positions of others that are contrary to a team’s approach for improving the quality and outcomes of care for a specific issue in a target population.
Competency 2: Evaluate the efficiency and effectiveness of interprofessional interventions in achieving desired population health outcomes.
Explain the role of the interprofessional team in facilitating improvements for a specific issue in a target population.
Competency 3: Analyze population health outcomes in terms of their implications for health policy advocacy.
Explain a position with regard to health outcomes for a specific issue in a target population.
Competency 4: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.
Communicate an initial viewpoint regarding a specific issue in a target population and a synthesis of existing positions in a logically structured and concise manner.
Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
This work is important to me. Solve it correctly, without mistakes, withoutplagiarism. Follow the instructions. There is no chance to repeat it.Therefore, you must do a complete and correct work 100%.If you are sure you can do it, accept it
This work is important to me. Solve it correctly, without mistakes, withoutplagiarism. Follow the instructions. There is no chance to repeat it.Therefore, you must do a complete and correct work 100%.If you are sure you can do it, accept it
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
HCM-ASSIGNMENT -Week 5
Course name:
HCM
Course number:
101
CRN
10091
•
•
Assignment title or task:
•
Review Chapter 5 in Buchbinder & Shanks (2012).
Examine the missions and visions of any health
Organizations within Saudi Arabia.
(The organization must have website)
Using a Word document, write one page paper.
Choose one health Organizations and identify three
strategic priorities it exhibits. What market powers
and trends will have an impact on these priorities?
What would the role of the manager be in setting and
implementing these strategies?
Student name:
Students Id Number:
Submission date:
Instructor name:
Grade:
Dr. Mohammed Osman Ali
College of Health Sciences
Department of Public Health
Instructions/Guidelines:
•
•
•
•
•
•
•
Your response should in one page paper and not exceed 300 words.
Font should be 12 Times New Roman
Heading should be Bold
Color should be Black
Line spacing should be 1.5
Use Assignment coversheet
Use proper references in APA style
This work is important to me. Solve it correctly, without mistakes, withoutplagiarism. Follow the instructions. There is no chance to repeat it.Therefore, you must do a complete and correct work 100%.If you are sure you can do it, accept it
Unformatted Attachment Preview
College of Health Sciences
Department of Public Health
HCM-ASSIGNMENT -Week 5
Course name:
HCM
Course number:
101
CRN
10091
•
•
Assignment title or task:
•
Review Chapter 5 in Buchbinder & Shanks (2012).
Examine the missions and visions of any health
Organizations within Saudi Arabia.
(The organization must have website)
Using a Word document, write one page paper.
Choose one health Organizations and identify three
strategic priorities it exhibits. What market powers
and trends will have an impact on these priorities?
What would the role of the manager be in setting and
implementing these strategies?
Student name:
Students Id Number:
Submission date:
Instructor name:
Grade:
Dr. Mohammed Osman Ali
College of Health Sciences
Department of Public Health
Instructions/Guidelines:
•
•
•
•
•
•
•
Your response should in one page paper and not exceed 300 words.
Font should be 12 Times New Roman
Heading should be Bold
Color should be Black
Line spacing should be 1.5
Use Assignment coversheet
Use proper references in APA style
Part 1 Instructions –
• Step 1 – Choose a Vulnerable Population Category – In Module III, you learned about
Vulnerable Population Categories (see Table 1 below). o Resources to use:
▪ Each category be found in Stanhope & Lancaster reference to help you learn more about specific vulnerable population.
▪ Appendix C (Vulnerable Population Categories with websites) – This resource can help you select one of vulnerable population that interests you.
▪ Bon Secours has already completed a CHNA and is a great place to start your search for a vulnerable population and then narrow down to your selected vulnerable population to a county, city, or locale.
Bon Secours 2022 Community Health Needs Assessment – direct link: https://www.bonsecours.com/about-us/community- commitment/community-health-needs-assessment
You will need to scroll down to view Richmond.
o Example of Step 1 using Table 1 below: let’s pick “Children & Adolescents” category.
Poverty & Homelessness
School populations
Employee populations Correctional population Populations affected by Disasters
Step 2 – Pick a Specific Vulnerable Community – Now that you selected a vulnerable category, you need to narrow this down to one specific vulnerable community. There are many v
o
▪ ▪
your selection.
ulnerable
communities to consider. To help you with this, review appendix A to help you get started with
Please note:
Appendix A has a list of vulnerable communities with an introductory weblink to help you
get started.
Appendix E will help you locate current Community health Needs Assessments as well
other evidence-based data to start your start your search of information about vulnerable
populations
o Example of Step 2: In step 1, the Children & Adolescent Category was selected. Now we need to narrow down this category to select a specific vulnerable population. For this example, from the “Children & Adolescent” category. “Children between the ages 5 – 7years of age” was selected from Appendix A.
Step 3 – Choose one Determinant – Next, we need to think about what you want to learn more about this vulnerable community. What disparity or determinant would you select? To help you select a health disparity or social determinant, refer to Appendix B.o Example of Step 3 – so far, we have selected the “Children & Adolescent” category. Then we narrowed the vulnerable population down to “Children 5-7 years of age”. After looking at Appendix B, the determinant picked for this example is “Biological Determinant”.
Step 4 – Select a Health Disparity for your selected vulnerable population from Appendix B.Example of Step 4 – so far, we have selected the “Children & Adolescent” category. Then we narrowed the vulnerable population down to “Children 5-7 years of age”. After looking at Appendix B, the determinant picked for this example is “Biological Determinant” and the health disparity is “childhood obesity” is selected.
Step 5 – Pick a location that has your selected community There is one more step before you have your selected vulnerable population. What location do you want to know more about? Where is your vulnerable population located? Is it a school, state, region, or neighborhood?Example of Step 5 – We have selected the Children & Adolescent category. Then we narrowed the vulnerable population down to “Children 5-7 years of age”. After looking at Appendix B, the determinant picked for this example is “Biological Determinant” and “childhood obesity” was selected. The location is Richmond City Schools.
Step 6 – Select which Community Health Needs Assessment you will use to support the needs of your selected vulnerable population. (See Appendix E)
Step 7 – Document your selected vulnerable population information in the Virtual Community Health Needs Assessment Template (see Appendix D) under step 1.
Step 8 – Submit your completed Part 1 on your virtual Community Health Needs Assessment Template in blackboard under the Assignments tab.______________________________________________________________________
Part 2 Instructions –
Part 2 – Complete Part 2 includes completing a virtual community health needs assessment template on your selected vulnerable population (See Appendix D).
Use Fawcett article to learn more about what you need to know about your vulnerable population.
Use the website provided to start researching your selected vulnerable population.
Use other resources to learn more about your selected vulnerable population described in Part 1.
Document your findings on the provided template in part 2.
This part of the template will take time to complete so make sure you allow the time you need to complete.
Upload completed the community health needs assessment template (completed Part 1 and Part 2 sections) into the submission slot located in the Assignment > Vulnerable Population Project._____________________________________________________________________
_Part 3 Instructions –Part 3 – Elevator Speech -You will advocate for your vulnerable population in a 90 second video
To prepare for your elevator speech:
o Select your one opportunity you identified from the “Community Opportunities for
Improvement” section from your virtual community assessment template (Appendix D). o Reflect on what you have learned about your vulnerable population from your community
assessment, select a problem/issue and create a solution.
o What model of care would you use to implement your solution? (Healthcare delivery, value
based, Triple AIM, etc.)
o What resources/partnerships would you need to make the solution a reality?
Send me a one page paragraph to say in the :Record a 90 second Advocacy Video for your selected community opportunity. o Make sure you mention the following in your video:
▪ State the name of your vulnerable community
▪ Important characteristics of your vulnerable community
▪ Evidence based information identifying ONE issue/concern/problem/need
▪ A specific intervention/resource to support that ONE identifiedissue/concern/problem/need that could support your community
▪ You use the recoding resource (Panopto) on blackboard under Books & Toolso Must demonstrate Professionalism by:
Greeting to introduce self
Must be dressed professionally and wearing an ID badge
Must be professional in demeanor, attitude, and presentation style
Makes eye contact & engages with the audience
Uses proper grammar/diction during presentation
Imagine this scenario: Here is the setting in which you will be presenting your 90 second elevator speech.
o You are attending the Virginia Nurses Association nursing conference at The Jefferson Hotel. You arrive at the conference site and see that your conference educational session is on the tenth floor. You go to the elevator, push the up button, and wait for the elevator to arrive. The elevator door opens, you walk in and push the 10th floor button. As the door closes, you discover the CEO of Bon Secours Mercy Health is standing in the elevator, and you are the only two people standing there. This is your chance! You have worked hard to learn about your vulnerable community, and now you have the chance to advocate for an intervention/resource to support your community in need.
▪ What would you say?
▪ Remember you only have 90 seconds to go from the first floor to the 10th floor. ▪ Good luck!
Upload your 90 second elevator speech in appropriate admission slot in blackboard as per course calendar due date and include your video with a direct link to your video and video time.
At the conclusion of this assignment, you will have completed the Module Objective Competency based objectives to apply knowledge of health promotion strategies to promote the delivery of just and equitable care that reflects cultural humility, inclusivity, consideration of social determinants of health, and advocacy.
In summary, here is what you have accomplished:
o Identified a vulnerable population and its determinants
o Provided a description of the selected vulnerable community
o Completed a community assessment documented on a virtual community assessment
template on a selected vulnerable community.
o Selected a problem/need
o Created a solution using a model of health care
o Created a 90 second advocacy video for your identified need/problem in your selected
community needs.
o Uploaded your 90 second elevator speech into blackboard
See Blackboard for grading rubric.
Scroll down to see Appendixes A, B, C, D and E
6
Appendix A – Vulnerable Population Categories
Selecting a Vulnerable Population in the Commonwealth of Virginia. •
There are many other vulnerable populations and this appendix giving you a start to identify your vulnerable
population. If you want to investigate another vulnerable community not listed here or is not in the
Commonwealth of Virginia, please seek the approval of your faculty.
Vulnerable Population Categories
Weblinks:
click on the links to learn more about these vulnerable populations
1 Asian-Americans/Chinese Americans
2 Black (African) -Americans
Factors related to both internal and external phycological environment.
depression, low self-esteem. Suicide, substance abuse, family violence, and obesity, homelessness
conditions
working conditions
Sociocultural
Factors related to employment, economics, politics, ethics and legal influences, and attitudes towards specific health problems
Fear and stigma attached to HIV, substance abuse, mental illness, family violence, adolescent pregnancy, immunization of children, smoking, occupation
Behavioral
Factors related that promote or impair health
Dietary habits, recreation and exercise, substance use and abuse, sexual activity, and use of protective measures
Health System
Factors that relate genetics,
behavior, environmental and
physical influences, medical
care, and social factors. These
five categories are
interconnected.
Availability, accessibility, adequacy, affordability and appropriateness, acceptability, and usage. Also consider patient cooperation, type of patient illness, provider competence, provider motivation/ satisfaction, patient socio-demographic factors and provider socio-demographic variables.
Appendix C – Examples of how you can select your vulnerable community for this assignment.
•
This is only a few of the many choices you can make.
The yellow highlighted areas represent the example as per the guideline instruction.
Step 1 – Choose a Vulnerable population Category
Step 2 –
Pick a specific vulnerable population
Step 3 – Choose one (1) Determinant
Step 4 – Select a Health Disparity
Step 5 – Select a location that has your selected community
Children & Adolescent
Childhood ages 5 -7 years old with
Behavioral
Childhood Obesity
Richmond, Va. Schools
Children & Adolescent
Men and Women LBGQT Older Adult
Men and women Men and women
Adolescents
Women
Youth Older Women
Women Women
Sociocultural
Biological
Health System Sociocultural
Sociocultural Health System
Pregnant
Breast Cancer
Homelessness Dementia
Pregnant/ maternal illness Asian-American
Powhattan County, VA
Outpatient Clinics
Virginia Richmond Nursing Homes Goochland County, VA Virginia
Men and Women
Men
Biological
Heart disease
Adult Day Care Centers in Virginia
Men and Women
Men
Psychological – include both internal and external physiological environment.
Homelessness
Richmond, Va.
Appendix D _ Virtual Community Health Needs Assessment Template
Use this template to record your findings and then when complete submit as per calendar due dates on blackboard > Assignment > Vulnerable Population Project.
As you type in this template, the sections will automatically expand to accommodate your data.
Please see the Vulnerable Population Project Guidelines for more information in the Assignment Tab.Student Name
Project Part 1
Vulnerable Population
Name Vulnerable community
Identified (use steps 1 – 6 to identify your vulnerable population).
Example:
1.Children & Adolescent
2. Children ages 5 -7 years old 3.Childhood Obesity
4. Richmond, VA’s Elementary Schools
5. CHNA Source:
Bon Secours 2022 Community Health Needs Assessment
***Use this space to describe your selected vulnerable population – See example in the left-hand column)***
Vulnerable Population: ______________________
Determinant: ______________________________
Health Disparity: ___________________________
Location: _________________________________ (selected vulnerable population locationneeds to be in the county you selected for community health assessment)
Community Health Need Assessment (CHNA) source – identify the source to support the needsof your selected vulnerable population. (Refer to appendix E)
Note: Choose a vulnerable population that is in the Commonwealth of Virginia.
Vulnerable Population Project Part 2
Community Description
What should I be looking for?
(Note: Remember to use in text citation and this resource to your reference list.)
Social interactions, common goals, interests
General information about the community. You may want to consider the following:
o Common Goals/Interests
o Culturalpractices o Spoken languages o Physical
characteristics/Gen
etic factors o Physiological
Factors
o Behavioralfactors
****Use this space to record your findings in this column****
Challenges/Threats/Hazards Barriers
Environmental health concerns
Nutritional/metabolic Value/Belief patterns/Myths
Geopolitical, Financial, Ethics Socioeconomic
Nutrition/Foods/Metabolic
Perception of the community by others
Health perception. You may want to consider the following:
o Health management o Resilience/Health
State
Resources* – You may want to consider the following:
o Availableresources o Limited/missing
resources
o Potentialresource
needs
*Click on this link to identify current health resources and discover may be needed, for the community you are researching, by zip code: https://www.findhelp.org
Vaccines/Immunizations. You may want to consider the following:
o Belief about vaccines/
immunizations?
11
o Risk for COVID, Flu and
o COVID data tracker
Respiratory
syncytial (RSV)
Other evidenced based data
What else do you want to You will need to consider cultural practices, belief systems, and the physical and mental limitations of know? the population/community selected.
After you have completed your community assessment, use this section to identify your community needs. List 5 (five) needs of your community.
1.
Community Threats – After you have completed your community assessment, use this section to identify thiscommunity’s threats to meeting the community’s needs. List 5 (five) threats of your community.
1.
1
Community Opportunities for Improvement –
After you have completed your community assessment, use this section to identify the oneopportunity you will advocate for this community. Identify the resources that will meet this community need. (Refer to resource section in Part 2) *
1.
Reference List –
1.
Vulnerable Population Project Part 3
1. Create your 90 second elevator speech advocating for your vulnerable population.
2. You can use Panopto to record you video. Look on the left-hand side of the course page >click on Books and Tools > look on the right-hand side of course page > click on Panopto > click the
“+” to create.
3. Check the rubric to make sure you have included everything required.
4. Submit your video and its direct link (in case your video does not work).
5. Upload to the blackboard submission slot in the Assignment > Vulnerable Population Project by
the calendar due date.
Congratulations!
You have completed your Vulnerable Population Project! You are making a difference!
13
Appendix E – Where to find Evidenced Based Data for Your Selected Vulnerable Population
Community Health Need Assessments (CHNA) – Bon Secours has already completed a CHNA and is a great place to start your search for a vulnerable population and then narrow down to your selected vulnerable population to a county, city or locale.
Richmond Community Health Needs Assessments
o Bon Secours 2022 Community Health Needs Assessment – direct link:
Alexandria Community Health Needs Assessment 2022 – direct link: https://www.inova.org/sites/default/files/about-in…
Bay Aging – Bay Aging’s primary service area is the 10 counties of the Middle Peninsula and Northern Neck of eastern Virginia. direct link: https://bayaging.org/wp-content/uploads/2022/05/2022-Community-Needs- Assessment.pdf
Children’s Hospital of Richmond at Virginia Commonwealth University – Children’s Rehabilitative Services – A Community Health Needs Assessment 2019 – direct link: https://www.chrichmond.org/- /media/D266346223B243E69BF9DFBDF7E6EFC8.ashx
Goochland County – direct link: https://www.vdh.virginia.gov/content/uploads/sites/84/2019/05/Goochland- CHA-Final-Report-with-Appendix.pdf
Greater Prince William County – direct link: https://www.behealthybehappyprincewilliam.com
Hanover County – direct link: https://www.vdh.virginia.gov/content/uploads/sites…
Henrico County – direct link: https://henrico.us/assets/Henrico-CHA-draft_5.8.18…
Planning District 9 (PD9) which includes the counties of Fauquier, Rappahannock, Culpeper, Madison, andOrange 2020 – direct link: https://www.vdh.virginia.gov/content/uploads/sites…
Riverside Doctors’ Hospital of Williamsburg 2016- direct link: file:///C:/Users/dfsmith/Downloads/RDHW-Final-CHNA-and-Implementation-Strategy-Document-2016-ENGLISH.pdf
Maternal, Infant, and Early Childhood Home Visiting Programs in Virginia from VDH – direct link:https://www.vdh.virginia.gov/content/uploads/sites/124/2022/02/Final-VA-MIECHV-Needs-Assessment- 2.8.21.pdf
Richmond – direct link: https://societyhealth.vcu.edu/media/society- health/pdf/RPN_Community_Needs_Assessment.pdf
Richmond City – direct link: https://www.vdh.virginia.gov/content/uploads/sites/119/2017/09/RCHD-CHA- Aug-2017.pdfCounty Improvement Plans
Commonwealth of Virginia Improvement Plan – direct link: http://www.vahealthinnovation.org/wp- content/uploads/2016/07/Virginia-State-Health-Innovation-Plan-06.01.2016.pdf
Goochland improvement plan – direct link: https://www.vdh.virginia.gov/content/uploads/sites/84/2020/03/Goochland-CHIP-Report-Final-March- 2020.pdf
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Hanover Improvement plan – direct link:https://www.vdh.virginia.gov/content/uploads/sites…
Henrico County Population Health Community Health Reports – direct link: https://henrico.us/health/population-health/
Virginia Department of Health (VDH) – direct link: https://www.vdh.virginia.gov/chickahominy/community- health-assessment/Evidenced Based Data/Statistics Websites:
Centers for Disease Control and Prevention (CDC) website – Data and Statistics – direct link:
https://www.cdc.gov/datastatistics/index.html
o This site has Births (Data & Statics), Disability & Health Promotion, Adolescent Behaviors & Experiences and many more topics of chronic health and health concerns. A good place to start your research.
Virginia Department of Health (VDH) Data Portal website: https://www.vdh.virginia.gov/data/ o
Community Toolbox – This website looks to Identify possible community health indicators and data sources that could be found in your selected vulnerable population. Direct link: https://ctb.ku.edu/en/assessing- community-needs-and-resources/examples/example7
o This website provided possible community health indicators related to sociodemographic characteristics.
Examine state health data on community; direct link: https://www.cdc.gov/places/
o PLACES: Local data for Better Health is a collaboration between CDC, the Robert Wood Johnson
Foundation, and the CDC Foundation. PLACES provides health data for small areas across the country. This allows local health departments and jurisdictions, regardless of population size and rurality, to better understand the burden and geographic distribution of health measures in their areas and assist them in planning public health interventions. PLACES provides model-based, population-level analysis and community estimates of health measures to all counties, places (incorporated and census designated places), census tracts, and ZIP Code Tabulation Areas (ZCTAs) across the United States
Examine state health data on community – direct link: https://www.cdc.gov/places/
Community Health Needs Assessment Trends – direct link: https://www.vhcf.org/data/community-health-trends/
Look for census data on your selected vulnerable population.
This data portal was developed to provide a convenient access point for health-related data for
Virginia. This portal is a comprehensive source for community health assessment, public, and
population health data. Each data portal page provides interactive data at the most granular level
SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan. The episodic SOAP note is to be written using the attached template belowFor all the SOAP note assignments, you will write a SOAP note about one of your patients and use the following acronym:
S =
Subjective data: Patient’s Chief Complaint (CC).
O =
Objective data: Including client behavior, physical assessment, vital signs, and meds.
A =
Assessment: Diagnosis of the patient’s condition. Include differential diagnosis.
P =
Plan: Treatment, diagnostic testing, and follow up
TREATMENT FOR A PATIENT WITH A COMMON CONDITION
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
Insomnia is one of the most common medical conditions you will encounter as a PMHNP. Insomnia is a common symptom of many mental illnesses, including anxiety, depression, schizophrenia, and ADHD (Abbott, 2016). Various studies have demonstrated the bidirectional relationship between insomnia and mental illness. In fact, about 50% of adults with insomnia have a mental health problem, while up to 90% of adults with depression experience sleep problems (Abbott, 2016). Due to the interconnected psychopathology, it is important that you, as the PMHNP, understand the importance of the effects some psychopharmacologic treatments may have on a patient’s mental health illness and their sleep patterns. Therefore, it is important that you understand and reflect on the evidence-based research in developing treatment plans to recommend proper sleep practices to your patients as well as recommend appropriate psychopharmacologic treatments for optimal health and well-being.
Reference: Abbott, J. (2016). What’s the link between insomnia and mental illness? Health. https://www.sciencealert.com/what-exactly-is-the-l…
For this Discussion, review the case Learning Resources and the case study excerpt presented. Reflect on the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat the patient’s health needs.
Case: An elderly widow who just lost her spouse.
Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husband’s death. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications:
List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions.
Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.
Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used.
List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why.
List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.
For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on ethical prescribing or decision-making. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals based on ethical prescribing guidelines or decision-making?
Include any “check points” (i.e., follow-up data at Week 4, 8, 12, etc.), and indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen.
LEARNING RESOURCES
Required Readings
Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th Ed.) Cambridge University Press.
Chapter 4, “Psychosis, Schizophrenia, and the Neurotransmitter Networks Dopamine, Serotonin, and Glutamate” (pp. 77-158)
Chapter 5, “Targeting Dopamine and Serotonin Receptors for Psychosis, Mood, and Beyond: So-Called “Antipsychotics” (pp. 159-243)
American Psychiatric Association. (2019). Practice guideline for the treatment of patients with schizophreniaLinks to an external site.. https://www.psychiatry.org/File%20Library/Psychiat…
Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapineLinks to an external site.. https://www.clozapinerems.com/CpmgClozapineUI/rems…
Funk, M. C., Beach, S. R., Bostwick, J. R., Celano, C. M., Hasnain, M., Pandurangi, A., Khandai, A., Taylor, A., Levenson, J. L., Riba, M., & Kovacs, R. J. (2018). Resource document on QTc prolongation and psychotropic medicationsLinks to an external site.. American Psychiatric Association. https://www.psychiatry.org/File%20Library/Psychiat…
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia BulletinLinks to an external site., 13(2), 261–276. https://doi.org/10.1093/schbul/13.2.261
Levenson, J. C., Kay, D. B., & Buysse, D. J. (2015). The pathophysiology of insomnia. ChestLinks to an external site., 147(4), 1179–1192. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC43881…
McClellan, J. & Stock. S. (2013). Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. Journal of the American Academy of Child and Adolescent PsychiatryLinks to an external site., 52(9), 976–990. https://www.jaacap.org/article/S0890-8567(09)62600…
Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS DrugsLinks to an external site., 23(8), 649–659. https://doi.org/10.2165/00023210-200923080-00002
Utah State University. (n.d.). Creating study guidesLinks to an external site.. https://www.usu.edu/academic-support/test/creating…
STUDENT NAME:
NEWBORN MEDICATIONS
Generic Name
Brand Name
EMLA
Type of
Drug/Drug
Class
Local Anesthetic
Erythromycin 1%
Erythromycin 1%
Anti-infective
Hepatitis B Immune
Globulin
H-BIG
Immune
Globulin
Hepatitis B Vaccine
Vaccine
Lidocaine
Local Anesthetic
Opioid
Antagonist
Naloxone
Narcan
Reason for Use
Local anesthetic,
used for circumcision
Prophylactic eye
ointment for
newborns
Given for Hep B
exposure to
newborns when a
mother is positive;
within 12 hours of
delivery
Newborn vaccine
given within 24
hours/Prevention of
Hepatitis B
Local anesthetic,
used for
circumcision/epidural
anesthesia
Narcotic reversal
agent; may be given
Route
Side Effects
Nursing
Implications
Write a case
study/scenario
where/when/how
this medication
would be used
(minimum 1
paragraph – may use
a separate piece of
paper)
Phytonadione Aqua
or Aquamephyton
Vitamin K
Vitamin K, fatsoluble vitamin
to newborns exposed
to opiates during
labor
Injection given at
birth to newborns to
assist in blood
clotting
STUDENT NAME:
POSTPARTUM HEMORRHAGE MEDICATIONS
Generic Name
Brand Name
Type of Drug/Drug
Class
Carboprost Tromethamine
Hemabate
Prostaglandin/Oxytocic
Methylergonovine
Methergine
Oxytocic/Uterotonic
Misoprostol
Cytotec
Prostaglandin
Oxytocin
Pitocin
Oxytocic/Hormone
Tranexamic Acid (TXA)
Anti Fibrinolytic
Reason for Use
Induces
contractions/used
to reduce
postpartum
bleeding
Treats postpartum
bleeding
Induction of labor;
ripen cervix;
postpartum
hemorrhage
Induction of
labor/Augmentation
of labor/contract
uterus in
postpartum period
Prevent and treat
blood loss in
PPH/slows
breakdown of blood
clots
Route
Side
Effects
Nursing
Implications
Write a case
study/scenario
where/when/how
this medication
would be used
(minimum 1
paragraph – may
use a separate
piece of paper)
STUDENT NAME:
POSTPARTUM MEDICATIONS
Generic Name
Brand Name
Type of Drug/Drug
Class
Acetaminophen/Hydrocodone
Norco
5/7.5/10
Analgesic/Opioid
Analgesic
Analgesic/Opioid
Analgesic
Acetaminophen/Oxycodone
Benzocaine
Percocet
Dermoplast
Spray
Docusate Sodium
Colace
Stool Softener
Gentamicin
Ibuprofen
Gentamicin
Motrin, Advil
Antibiotic/Aminoglycoside
NSAID
Ketorolac
Toradol
NSAID
Lanolin
Lansinoh
Topical Emollient
Anesthetic
Reason for Use
Postpartum Pain
Postpartum Pain
Episiotomy/perineal
pain
Postpartum Stool
Softener
Antibiotic used in
postpartum
endometritis
Postpartum Pain
NSAID given IV for
Csection/Postpartum
Pain
Ointment used in
breastfeeding
moms for
sore/cracked
nipples
Route
Side
Effects
Nursing
Implications
Write a case
study/scenario
where/when/how
this medication
would be used
(minimum 1
paragraph – may
use a separate
piece of paper)
Medroxyprogesterone
Acetate
Depo-Provera
Progestin Hormone
Nalbuphine
Nubain
Opioid Analgesic
Oxytocin
Pitocin
Oxytocic/Hormone
Rh D Immune Globulin
Rho-GAM
Immune Globulin
Rubella Vaccine
Vaccine
tDap vaccine
Vaccine
Birth Control
Labor and
Postpartum Pain;
also for postpartum
itching
Induction of
labor/Augmentation
of labor/contract
uterus in
postpartum period
Prevention of
antibody response
and hemolytic
disease of the
newborn in future
pregnancies
Part of MMR; given
to postpartum
moms to prevent
Rubella infection if
exposed
Vaccine given to
new mothers to
reduce infection
with pertussis
(whooping cough)
Module 05: Discussion ForumModule 05: Discussion ForumRead “Case Study 4-2 Choosing a Performance Management Approach at Show Me the Money.” at the end of Chapter 4 of the Performance Management textbook (page 119).Based on the case study, assess whether Show Me the Money should use a behavior approach, a results approach, or a combination of both to measure performance. Using the table that accompanies the case study as a guide, select the job descriptions that apply to the account executive job. Explain why you chose the approach you did.Justify and support your responses. Be sure to draw from, explore, and cite credible reference materials. In responding to your classmates’ posts, note whether you agree or disagree with their assessments. Why or why not?You are required to reply to at least two peer discussion question post answers to this weekly discussion question and/or your instructor’s response to your posting. These post replies need to be substantial and constructive in nature. They should add to the content of the post and evaluate/analyze that post answer. Normal course dialogue doesn’t fulfill these two peer replies but is expected throughout the course. Answering all course questions is also required.
Module 05: DiscussionModule 05: DiscussionLocate a research study that utilized experimental or quasi-experimental methods. Briefly summarize the study. For example, discuss the inclusion of 2-group tests, regression analysis, and time-series analysis in terms of the study design’s strengths, weaknesses, or limitations. What challenges or limitations did the researcher identify they encountered by choosing this method?Embed course material concepts, principles, and theories (which require supporting citations) in your initial response along with at least one scholarly, peer-reviewed journal article. Keep in mind that these scholarly references can be found in the Saudi Digital Library by conducting an advanced search specific to scholarly references. Use Saudi Electronic University academic writing standards and APA style guidelines.You are required to reply to at least two peer discussion question post answers to this weekly discussion question and/or your instructor’s response to your posting. These post replies need to be substantial and constructive in nature. They should add to the content of the post and evaluate/analyze that post’s answer. Normal course dialogue doesn’t fulfill these two peer replies but is expected throughout the course. Answering all course questions is also required. Discussion Rubric Discussion Rubric – Alternative Formats
Data to support patient care comes from a variety of sources that contain differing data types. Key activities to use clinical data include identifying the sources of data, understanding the data types and associated methods to work with the data, and identifying the necessary resources to complete your IT project.
The scope of your IT project will determine the level of data access required and the associated data storage needs. Data used in multisite projects will require IRB oversight and often require the execution of a DUA if transferring data outside of the institution or receiving data from another institution.
Identifying and assembling an adequate project team is based on the needs of the project. At a minimum, you will need to include frontline staff that will use the product, a data analyst capable of completing the ETL process on the data, and potentially statisticians to conduct appropriate model building and outcomes analyses.
There are multiple approaches to analyzing data. AI is the latest advance in machine learning approaches that include supervised, in which data is labeled and the algorithm is guided with statistical considerations, and unsupervised, in which unlabeled data is used to infer meaning. While robust, machine learning approaches require interdisciplinary teams and large resource dedication to complete.
All projects require review and potential revision over time. Follow-up and review of implemented programs should be included in the initial planning stages and resource allocation decisions at project inception.
Let us consider the following for the quality improvement project:
You are a new manager on your Heart Failure/Cardiac step-down unit and have high hopes for your floor.
Identify several IT projects that you as the nurse manager of a nursing unit could develop to support the operations of the nursing floor to promote compliance with daily weights for your HF patients.
As you do your RCA analysis you realize that compliance to many of the issues causing experiences on your floor is due to the poor health data literacy within your nursing staff. Why is it important for nurse leaders to develop health data literacy?
As you begin to form your team for your IT projects you question yourself as to who will comprise the team.
Who are the various team members to consider adding to the team? Identify their roles and contributions to the project
Apa citations title and reference page not included in the 9 pages
You see a 3-year-old with hypertension (documented on three different visits) in your primary care clinic.Describe the workup, differential diagnoses, assessment, and management.How would your plan of care be different if the child were 10 years old?What risk factor counseling and advice would you include? should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
powerpoint presentation about ( strategic decision making) about 20 slide Outline . Objectives . 6 lines in each slide . Title Bold and content size 28 font (font time new roman). Line spacing 1.5. it should be comprehensive and concise . With related figures.
Describe your clinical experience for this week as a nurse practitioner student at the pediatric clinic.Did you face any challenges, any success? If so, what were they?Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.Mention the health promotion intervention for this patient.What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?Support your plan of care with the current peer-reviewed research guideline.should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
Discuss the challenges that clinical leaders encounter as they support their staff during changes in technology and information systems adopted in their practice setting. Describe any issues that you identify regarding workflows or processes and any recommendations that you have to resolve them.
NUR 500 Discussion 1. For this assignment, I will need an initial response with 250-300 words and 1 reference and 2 peer responses with 100 words and 1 reference each.
Evidence-based practice (EBP) is an important topic in healthcare organizations. How could you apply EBP in your current nursing practice? Please provide examples.
Part 2
Nur 500 Assignment (Please see case study attached)
Complete the Sociologic Sciences Interactive Case Study following the readings and presentation for this week. Associate what you have learned about the theories to this case study, and then see the instructions below to complete a journal entry about your experience.
During this week, you will complete interactive case studies and be asked to associate what you have learned about theory in comparison to the case study and reflect on it.
Each time you have completed a case study, submit your reflection. Each reflection should include the following:
A comparison of what you have learned from the case study to related theories you have studied. Make sure to cite these theories in APA format.
A comparison of the case study to your nursing practice, giving one or two examples from your nursing experience in which you might have applied a particular theory covered.
Your reflection should be a minimum of five to six paragraphs.
Please find also instructions from my instructor. (Journal entry. Remember these are Journals, not a formal paper, no cover page or reference page needed.
They each have 2 sections:
Discuss a related theory from this weeks readings and/or presentation to the scenario
Relate this theory to your nursing practice/ work arena!)
Rubric
NURS_500_DE – Case Study Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeCritical Analysis
20 to >16.4 pts
Meets Expectations
Presents an exemplary articulation and insightful analysis of significant concepts and/or theories presented in the case. Offers detailed and specific examples for all questions. Makes keen observations, making note of essential information provided in the case. Ideas are professionally sound and creative; they are supported by scientific evidence that is credible and timely. Draws insightful and comprehensive conclusions and solutions.
16.4 to >15.0 pts
Approaches Expectations
Presents an accurate analysis of significant concepts and/or theories presented in the case. Offers some detail and some examples for most questions. Makes occasional note of essential information provided in the case. Ideas are mostly supported by scientific evidence that is credible and timely. Makes some attempt to draw conclusions and solutions.
15 to >11.8 pts
Falls Below Expectations
Provides insufficient explanations of significant concepts. Offers little or insignificant detail and no examples for most questions. Fails to address essential information provided in the case. Ideas are generally unsupported by scientific evidence, but some attempt has been made. Fails to draw conclusion.
11.8 to >0 pts
Does Not Meet Expectations
Does not, or incorrectly, answers with insufficient explanations. Information is not scientifically sound.
20 pts
This criterion is linked to a Learning OutcomeContent
20 to >16.4 pts
Meets Expectations
Makes insightful, clear and accurate connections to key concepts and relevant theories. Response indicates a comprehensive, high-level understanding of the concepts presented in the case.
16.4 to >15.0 pts
Approaches Expectations
Makes mostly accurate connections to key concepts and relevant theories. Response indicates a general understanding of the concepts presented in the case.
15 to >11.8 pts
Falls Below Expectations
Provides several insufficient or inaccurate explanations, although attempts are made to address some key concepts. Response indicates an introductory understanding of the concepts presented in the case.
11.8 to >0 pts
Does Not Meet Expectations
Information is inaccurate or inadequate. Response indicates little or no understanding of the concepts presented in the case.
20 pts
This criterion is linked to a Learning OutcomeMechanics
7.5 to >6.15 pts
Meets Expectations
Answers are well written throughout. Information is well organized and clearly communicated. Assignment is free of spelling and grammatical errors.
6.15 to >5.63 pts
Approaches Expectations
Answers are well written throughout and the information is reasonably organized and communicated. Assignment is mostly free of spelling and grammatical errors.
5.63 to >4.43 pts
Falls Below Expectations
Answers are somewhat organized and lacks some clarity. Contains some spelling and grammatical errors.
4.43 to >0 pts
Does Not Meet Expectations
Answers are not well written and lack clarity. Information is poorly organized. Assignment contains many spelling and grammatical errors.
7.5 pts
This criterion is linked to a Learning OutcomeAPA Format
2.5 to >2.05 pts
Meets Expectations
Follows all the requirements related to format, length, source citations, and layout.
2.05 to >1.88 pts
Approaches Expectations
Follows length requirement and most of the requirements related to format, source citations, and layout.
1.88 to >1.48 pts
Falls Below Expectations
Follows most of the requirements related to format, length, source citations, and layout.
1.48 to >0 pts
Does Not Meet Expectations
Does not follow format, length, source citations, and layout requirements.
2.5 pts
Total Points: 50
Part 3
NUR 510 Discussion. On this part, I will need initial discussion with 250-300 words and peer reviewed journals as a reference and 2 peer responses with 100 words each and1 reference
Identify three major components of the Medicare and Medicaid programs and, based on these components, identify at least two patient coverage gaps for each of the programs. Be clear when you describe the coverage and the gaps as they may relate to specific ages, patient populations, or disease entities. Use primary sources to identify the components and the gaps. Additionally, discuss your stand (criticize or defend) regarding the relevance of the Social Security program to the American public. Should the program be left alone, modified, drastically changed, or eliminated? Provide the rationale and use facts to defend your position.
Please see my instructor instructions for this assignment. I need this to be addressed as instructed.
Some of you may point out that several states opted out of Medicaid expansion. This is a critical thinking point. Dig a bit further than the media talking points. WHY did those states opt out? There may be different reasons, so select one state for your critical assessment and share your findings in your post.
Note that there are two parts to the Discussion Board thread! Students who address both parts in their initial post and include primary sources will qualify for full creditPreviousNext
Unformatted Attachment Preview
Case Study: Natalie Kazakova
Meet Natalie Kazakova, a Russian who has recently graduated with a master’s degree
in nursing, originally having a bachelor’s in engineering back home. She now works at a
local community hospital in the ICU.
A few weeks after orientation ends at her new place of employment, Natalie finds herself
questioning her choice to become a nurse. She finds it hard to go into work because
she is feeling insecure and has self-doubt.
Also meet Susan and Pam, two nurses that have 10 years of experience, but only have
ADN degrees. Click on the two nurses to read examples of what they have been saying
to Natalie and each other.
Meet Natalie Kazakova.
•
•
•
•
Russian immigrant
Recently graduated with master’s degree in nursing
Bachelor’s in engineering back home
Works at a local community hospital in ICU
Any of these theories from the chapter explain what Natalie is experiencing. Select each theory to
learn more about how each applies to her situation.
Role theory, role behavior: As a new graduate and new nurse, Natalie needs to negotiate
appropriate role behaviors with patients, coworkers, and medical staff. Role strain or stress,
including role incongruity, can occur when the individual’s expectations (her view of the caring role of
the nurse) conflicts with the requirements to learn to manage complicated equipment and
medications.
Conflict Theory: As noted in the text, conflict is often grounded in issues of power/authority and
domination/subjugation. The two nurse colleagues are struggling to hold on to their position of power
related to their experience because they are probably threatened by Natalie’s advanced degree.
Social theory Exchange: Natalie has noted that reciprocity is lacking in her relationships with the two
experienced ADN nurses. As a result, she feels like resigning (withdrawing from the situation).
Natalie discusses this issue with one of her professors. Her professor offers the following
recommendations:
•
•
•
Don’t do anything at this point. This is normal behavior for other nurses dealing with a novice. Time will
prove your readiness.
Review the conflict and try to think of the other experienced nurses’ perspectives. Again, time will prove your
readiness.
Speak up now and remind the other nurses that you are a brand new RN and will have a learning period.
Reflect on which option you think would be best for you. Then select the Review button below to see
why Natalie’s professor offered the options she did.
Natalie recognizes the issues of role behavior and role incongruity and seeks out one of her
professors to discuss these. The professor reminds her that this is a normal process and that she
needs to give herself some time to learn her position (the professor might refer her to Benner’s
Novice to Expert, discussed in a later chapter). She tells her that as she becomes more comfortable
with the technical requirements of her position, she will find she is able to again put the caring aspect
of nursing in the forefront.
As Natalie reviewed her information on conflict and individualistic social exchange framework, as
well as recognizing that the other nurses were struggling to maintain their own power (and self-
concept), she was able to change her approach. She praised the other nurses for their knowledge
and experience. She remained humble and quiet as she gained more experience and knowledge.
She quietly reminded them that, despite her degree, she was still a new RN and so she appreciated
having knowledgeable nurses like them around. She hoped that this would make them feel less
threatened.
Page | 1
Pharmaceutical Quality Assurance (PHA305)
(Dr. Akram Ashames)
Assignment (1): Drug Approval and Registration Process: A Comparative Analysis
Max Grade: 20 marks
Dear Students,
This assignment on the drug approval and registration process, focusing on a selected country of
your choice. This assignment aims to enhance your understanding of regulatory procedures in
the pharmaceutical industry by comparing and contrasting the drug approval processes of your
chosen country with those of the U.S. FDA and the EU EMA. Please adhere to the following
guidelines and instructions:
Assignment Details:
•
•
•
Length: The assignment should be completed within a maximum of 10 slides
(PowerPoint).
Due Date: The assignment is due on September 26, 2023, by midnight.
Submission: Please submit your assignment via Moodle, following the specified
submission guidelines.
Late Submissions:
Late submissions will be subject to grade deduction, with a penalty of [specify percentage] per
day. No submissions will be accepted after September 30, 202. It is essential to complete and
submit the assignment within the given time frame.
Academic Integrity:
Plagiarism is strictly prohibited. Ensure that all sources used are properly cited and referenced
according to the preferred citation style (e.g., APA, MLA). Use your own words and ideas to
describe the drug approval processes and compare them. Directly copying from sources or fellow
students will result in penalties.
Individual Work:
This assignment is to be completed individually. Collaboration with classmates or any form of
group work is not permitted. Each student should select a country to analyze the drug approval
and registration process, ensuring a diverse range of comparisons.
Slide structure:
1. Slide 1: Introduction
Briefly introduce the topic and the country under consideration (select one country other than USA, EU
countries, and Japan). You can choose for example: Canada, Australia, China, Russia, Turkey, South Korea,
India, etc.
State the objective of the presentation: to describe the drug approval/registration process in the selected
country and compare it with the processes of FDA (U.S.) and EMA (European Union).
2. Slide 2: Overview of Drug Approval Processes
Provide a brief overview of the drug approval processes in general.
Highlight the importance of regulatory agencies in ensuring the safety, efficacy, and quality of drugs.
3. Slide 3: Drug Approval Process in the Selected Country
Describe the regulatory authority responsible for drug approval in the selected country.
Outline the main steps involved in the drug approval process, including preclinical studies, clinical trials,
and the submission of a marketing authorization application.
Mention any specific requirements or regulations unique to the selected country.
4. Slide 4: Drug Approval Process in FDA (U.S.)
Describe the role of the U.S. Food and Drug Administration (FDA) in the drug approval process.
Explain the key stages, such as Investigational New Drug (IND) application, clinical trials, New Drug
Application (NDA) submission, and FDA review.
Discuss the FDA’s emphasis on safety, efficacy, and quality standards.
5. Slide 5: Drug Approval Process in EMA (European Union)
Explain the role of the European Medicines Agency (EMA) in the drug approval process.
Discuss the centralized procedure and mutual recognition procedure for marketing authorization in the
European Union.
Highlight the importance of scientific evaluation and harmonization of drug regulations within the EU.
6. Slide 6: Key Similarities in the Approval Processes
Identify common elements shared by the drug approval processes in the selected country, FDA, and
EMA.
Examples include preclinical testing, clinical trials, and the need for substantial evidence of safety and
efficacy.
7. Slide 7: Key Differences in the Approval Processes
Highlight significant differences between the drug approval processes in the selected country, FDA, and
EMA.
Examples may include variations in timelines, documentation requirements, or the level of detail
required in the submission dossier.
8. Slide 8: Post-Approval Monitoring and Pharmacovigilance
Discuss the importance of post-approval monitoring and pharmacovigilance in all three regulatory
systems.
Describe the systems in place to track adverse events, ensure drug safety, and enforce regulatory
compliance.
9. Slide 9: Challenges and Future Developments
Identify challenges faced by the drug approval processes in the selected country, FDA, and EMA.
Discuss potential areas for improvement and future developments, such as expedited approval
pathways or the use of real-world evidence.
10. Slide 10: Conclusion and References
Summarize the main points discussed throughout the presentation.
Provide a list of references used in the research and preparation of the presentation.
To ensure your success with clinical placement, it is important to start early on identifying and building connections with potential sites through networking with your colleagues and in your community. To support you and your clinical success, the School of Nursing has a Clinical Site Networking Checklist and Guide available to help you with ideas and strategies for connecting with potential sites. Please review the Networking Checklist and Guide and submit a 150-word summary of your networking plan.
Paraphrase the paper to avoid plagiarism. This is the assignment of another student. use it as a reference.
Assignment:
Week 4: Project Aims, Values, and Desired Outcomes
This section of your change project paper should include:
A reference to the project’s benefits in terms of cost, time, and/or quality that address needs or changes, results, impacts, or consequences that the project has on people, programs, or institutions.
Goals and objectives that are measurable, shared, and hypothetically agreed on by all key stakeholders. They are directly linked to the concept of project success factors.
What variables need to be considered and and whether or not you have control over them.
For example, if you were to implement a clinic-wide practice change, would budget be an issue and how would you address that variable?
If you were to implement your study, consider how would you gather data. Would you choose the qualitative or quantitative method?
An explanation of what your research will provide to the community, or to social change.
A description of the desired outcomes: Specifically, state the purpose, focus, and viewpoint of the project as well as its expected accomplishments.
While you may not be implementing your project, you should have a goal in mind that relates to solving your problem.
Establish a timeline for accomplishing your project goal(s).
This section should be 3–4 pages in length, not including the cover or reference page, and should address the intended outcomes of your project. You must reference a minimum of 3 scholarly articles.
Use current APA format to style your paper and to cite your sources. Review the rubric for more information on how the assignment will be graded.
This criterion is linked to a Learning OutcomeContent
60 to >49.2 pts
Meets Expectations
The project, aims, values, and desired outcomes are well developed and clear and thorough. Aims include detailed examples of projected features and functions. Values include implementation benefits for specific stakeholders. Desired outcomes expertly state the purpose, have a quality focus, and clearly describe the benefits that are expected to occur as a result of implementation.
49.2 to >45.0 pts
Approaches Expectations
The project, aims, values, and desired outcomes are somewhat clear but may be vague in places. Aims include somewhat vague examples of projected features and functions. Values include only general implementation benefits. Desired outcomes state the purpose, have a general focus, and generally describe the benefits that will occur as a result of implementation.
45 to >35.4 pts
Falls Below Expectations
The project, aims, values, and desired outcomes are somewhat clear, but lack many key details.
35.4 to >0 pts
Does Not Meet Expectations
The content is generally unclear. There is no clear evidence of what the project, aims, values, or desired outcomes are, or there might just be a list of project objectives.
60 pts
This criterion is linked to a Learning OutcomeOrganization
7.5 to >6.15 pts
Meets Expectations
Content is well written throughout. Information is well organized and clearly communicated.
6.15 to >5.63 pts
Approaches Expectations
Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.
5.63 to >4.43 pts
Falls Below Expectations
Content is disorganized in many places and it lacks clarity.
4.43 to >0 pts
Does Not Meet Expectations
Content lacks clarity and information is disorganized, or may be an outline or a list.
7.5 pts
This criterion is linked to a Learning OutcomeAPA Format/Mechanics
7.5 to >6.15 pts
Meets Expectations
Follows all the requirements related to format, length, source citations, and layout. Assignment is free of spelling and grammatical errors.
6.15 to >5.63 pts
Approaches Expectations
Follows length requirement and most of the requirements related to format, source citations, and layout. Assignment is mostly free of spelling and grammatical errors.
5.63 to >4.43 pts
Falls Below Expectations
Follows most of the requirements related to format, length, source citations, and layout. Assignment contains some spelling and grammatical errors.
4.43 to >0 pts
Does Not Meet Expectations
Does not follow format, length, source citations, and layout requirements. Assignment contains many spelling and grammatical errors.
7.5 pts
Total Points: 75
Unformatted Attachment Preview
1
Project Aims, Values, and Desired Outcomes
Dayna Cruz
West Coast University
NURS691A Culminating Experience
29th July 2022
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Project Aims, Values, and Desired Outcomes
What will the research bring to the community?
Accurate diagnosis is the primary barrier to the successful treatment of mental
illnesses. To enhance treatment outcomes, lessen symptoms, and speed recovery, more
thorough and tailored therapy techniques are needed in light of recent discoveries, notably in
epigenetics. Numerous factors, including heredity, physiology (hormones), the physical
environment, the social environment, nutrition, and lifestyle, have been related to various
ailments in medical studies (Hirota & King, 2022). The same sickness and treatment have
varied effects on various patients. The study will thus show how non-pharmacological
modalities and procedures can be researched, explored, and applied in society as a standalone treatment or as an addition to traditional drug therapy and psychotherapy.
Benefits
Many people with a wide range of psychological issues and illnesses have
experienced much alleviation thanks to pharmacological medications. However, due to
various circumstances, including epigenetics, not all patients with the same disease respond
equally or favorably to specific drugs. Most psychiatric medications also have moderate to
severe side effects, forcing patients to stop using them. A rising amount of medical research
reveals several elements (hormonal, genetic, environmental, social, and nutritional) that
influence a person’s mental state or create or exacerbate psychiatric diseases. Rarely, a
particular mental illness’s major cause or a contributing factor may be a bad diet (Ninot,
2020). As a result, complementary therapies like acupuncture, meditation, yoga,
aromatherapy, eye movement desensitization and reprocessing, herbal medicine, homeopathy,
phototherapy, massage therapy, spiritual healing, prayer, and therapy animals can be
extremely helpful tools and treatments for people with particular psychological disorders,
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either as stand-alone monotherapies or as a powerful addition to traditional medical treatment
as multimodal therapy.
Despite being very simple to perform, the project will be very expensive because both
pharmaceutical and non-pharmacological therapy must be used simultaneously. Individual
lifestyle counseling greatly impacts weight loss, making it one of the most effective nonpharmaceutical weight loss treatments. Implementation will be straightforward because all
participants will need a trainer and a predetermined workout regimen. In contrast to dietary
treatments, they are simple to carry out because participants must follow a particular diet.
Hyperglycemia, diastolic blood pressure, and weight will decline, all of which are risk factors
for mental health (Ruiz, 2019).
The expected results and the impact
It’s possible that treating psychological problems will be challenging. The biggest
obstacle to treating mental diseases is the idea that a correct diagnosis is not necessary.
Patients’ needs could differ, calling for a more specialized approach. Therefore, it’s critical to
have a crystal-clear sign that facilities use a specific management approach. In treating some
psychiatric disorders or conditions, non-pharmacological and complementary therapies may
be beneficial adjuncts to traditional medication. It has been shown that complementary and
non-pharmacological treatments are helpful both on their own and in combination with
traditional medicine (Vancampfort et al., 2021). As a result, persons with mental disorders
experience less severe symptoms when non-pharmacological treatments like massage
therapy, spiritual healing, and meditation are applied. Therefore, non-pharmacological
therapies are probably more effective at reducing symptoms in people with mental illness
after they have attempted both pharmaceutical and non-pharmacological therapy.
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Goals and objectives
Determining whether non-pharmacological therapy may be utilized to treat mental
disease is the main goal of this investigation. The best non-pharmacological and
pharmaceutical approaches to treating people with mental illness will then be contrasted with
pharmacological therapy. As a result, I will incorporate focused lifestyle treatments in my
study because they considerably lower body weight. This approach is crucial because it
improves the ability to respond to demands made specifically by the patient, provides tailored
direction and attention, and includes a unique action plan. Utilizing cognitive behavioral
therapy to treat people with mental illnesses is another crucial goal.
It is essential to assess the features of lifestyle interventions to set guidelines for
future treatment. Additionally, it will be evaluated the benefits of group sessions, including
peer support, group cohesion, interpersonal learning, imitation, and similarity discovery. A
patient-specific action plan, individualized counseling and attention, and satisfying patient
needs are all benefits of an individually assessed method. In the future, it will be clear
whether treating people with mental illness individually or in groups is preferable. Future
studies should examine whether a combined approach that includes both group sessions and a
unique action plan for each patient is the most effective.
Methods of Data Collection and variables
As the main information sources for the qualitative design of the data collection
processes, observations, questionnaires, and interviews will be used. Since it will include
experimental research to determine the effectiveness of non-pharmaceutical therapy for
patients with mental disorders, a qualitative research design is necessary (Vancampfort et al.,
2021). In an experimental study, a researcher can implement an intervention and assess its
outcomes. With this research methodology, researchers can engage with study participants
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and make a difference. Random assignment, control, manipulation, and random selection are
the elements of an experimental study. In this study, participants are split into two groups: the
treatment group and the control group. As a result, the control group serves as a secondary
point of comparison while the treatment group places more emphasis on changes. The
participants in this study are divided into groups at random. While the other group receives
pharmacological therapies, one group receives non-pharmacological therapy. The results of
the patients in each group are then evaluated by the researchers to see if any differences in
results can be attributed to the treatment. The research design’s advantages are that it provides
accurate information because there is little room for error, it is the only way for researchers to
look into this subject, and the study’s findings are debatable. The downsides are the cost and
time commitment. The methodology may affect the result because there is a chance that there
will be conflicting biases.
Variables
Independent variables: An independent variable is the type of therapy patients will
receive for the symptoms of their mental disorders. Either non-pharmaceutical or
pharmaceutical treatments are given to patients.
Dependent variable: Improvements in the symptoms of the mental disease may be a
dependent variable depending on the type of treatment given.
Operationalize Variables: Adult mental illness will be assessed, and treatment
recommendations will result. This will impact the patient’s treatment plan.
Psychological testing will be done by clinical psychiatrists and researchers in order to
categorize patients according to the types of mental illnesses they have.
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References
Hirota, T., & King, B. H. (2022). Pharmacological interventions. Psychological Therapies
for Adults with Autism, 234-252. https://doi.org/10.1093/medpsych/9780197548462.003.0018
Ninot, G. (2020). The benefits of non-pharmacological interventions. Non-Pharmacological
Interventions, 117-142. https://doi.org/10.1007/978-3-030-60971-9_4
Ruiz, B. (2019, February 6). Non-pharmacological interventions are more effective for
health in schizophrenia. Mad In
America. https://www.madinamerica.com/2019/02/non-pharmacologicalinterventions-effective-health/
Tuudah, E., Foye, U., Donetto, S., & Simpson, A. (2022). Non-pharmacological integrated
interventions for adults targeting type 2 diabetes and mental health comorbidity: A
mixed-methods systematic review. International Journal of Integrated Care, 22(0),
27. https://doi.org/10.5334/ijic.5960
Vancampfort, D., Firth, J., Correll, C. U., Solmi, M., Siskind, D., De Hert, M., Carney, R.,
Koyanagi, A., Carvalho, A. F., Gaughran, F., & Stubbs, B. (2021). The impact of
pharmacological and non-pharmacological interventions to improve physical health
outcomes in people with schizophrenia: A meta-review of meta-analyses of
randomized controlled trials. FOCUS, 19(1), 116128. https://doi.org/10.1176/appi.focus.19103
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Powered by TCPDF (www.tcpdf.org)
When we think of well-being, we should consider both mental and physical well-being.
For this assignment, you will create a table that outlines a minimum of five activities or actions that you would take to enhance your own well-being, either mentally or physically.
For each of the five activities or actions, include a brief description of why the activity or action is important to you personally.
For each of the five activities or actions, explain how you will hold yourself accountable to maintaining this well-being.
For each of the five activities or actions, describe why you think this is important as a health care professional. Include examples of how it may support you, your patients, and/or your coworkers.
You may choose to develop your table in any format you choose; however, below is an example of how you may want to organize your table.
Your chart must be a minimum of four pages in length. No references are required for this assignment.
APA Style will not be required for this assignment.
Each year, 1.5 million Americans are diagnosed with diabetes (American Diabetes Association, 2019). If left untreated, diabetic patients are at risk for several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations.
For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes.
Reference: American Diabetes Association. (2019). Statistics about diabetes. Retrieved from http://diabetes.org/diabetes-basics/statistics/
To Prepare:
Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes.
Select one type of diabetes to focus on for this Discussion.
Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.
Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments.
Post a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples.
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different type of diabetes than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management.
Learning Resources (Required Readings)
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 48, “Drugs for Diabetes Mellitus” (pp. 397–415)
Chapter 49, “Drugs for Thyroid Disorders” (pp. 416–424)
American Diabetes Association. (2018). Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes 2018. Diabetes Care, 41(Supplement 1), S73–S85. Retrieved from http://care.diabetesjournals.org/content/41/supple… This article provides guidance on pharmacologic approaches to glycemic treatment as it pertains to treating patients with diabetes. Reflect on the content of this article as you continue to examine potential drug treatments for patients with diabetes.https://diabetesjournals.org/care/article/41/Suppl… The initial post must be with at least 3 or more references in APA format and incite citation and your response to your colleague must be with 3 or more references.
Article Title: From Global Bioethics to Ethical Governance of Biomedical Research Collaborations (Wahlberg et al., 2013)When carrying out research, there may be discrepancies in bioethical standards from various countries. What role can the establishment of global “centers of excellence” play in promoting cross-continental biomedical research collaborations?Wahlberg et al. (2013) decry the negative impacts of ethical imperialism. What steps can global healthcare organizations, governmental organizations, non-governmental organizations, research participants, and biomedical researchers take against ethical imperialism?Global biomedical research collaborations may threaten national systems of ethical governance, particularly in “resource-poor” countries/settings. Would the standardization of ethical practices within biomedical research provide the necessary protections for these “resource-poor” countries/settings?choose one question & All students should post a thoughtful, well-researched response to one question from one of the readings
Ms. Reginal B was visited today via telehealth while in the community. Client has no permanent cell phone number and can best be reach through elder sister. Client was alert and oriented, verbalized intact skin and denied pain and discomfort. Client stated she leave at eastern avenue with a friend. She performed hygiene in friends house daily. Further leave on government support program such as food stamp and free health insurance. Client verbalized part of her diagnosis was bipolar disorder. During interview section, client does not have clear understanding of bipolar disorder. Assign nurse explained bipolar disorder to client for clear understanding. Follow rubric below
President Kennedy enacted a major change to our health care state by deinstitutionalizing those with mental illness. However, those with mental health care issues must navigate a complex system of care. There are a few effective models of integrated care (such as the ACT). “Design” a system, intervention, or preventative endeavor that meets the spirit of a community psychology system or program and better meets the needs of our citizens with mental health problems. Submit a paper on the designed health care system (or intervention or prevention endeavor). In the paper, address which principles of Community Psychology are incorporated into this program. More specifically, please address the following points in your paper:Post must be complete sentences and thought out. Please separate your answers per section. Each section should be 150-250 words. Make sure to cite or give credit if you are referencing someone else’s work. Explain the current mental health system. Do you think it is effective? if yes why? if not why? (3 points). Design and describe a better system that will address the needs of those with mental health care concerns (make sure that I can understand what you are proposing by being specific). What is missing? What can be done to make it better? (3 points)Describe which Principle(s) of Community Psychology are represented in your program or system, and specifically comment on how and why your program meets the spirit of a CP program (4 points)Additionally, please review the general grading rubric for assignments 1-8.PREVIOUSNEXT
College of Health Sciences
Department of Health Informatics
ASSIGNMENT COVER SHEET
Course name:
Public health outbreak and disaster management
Course number:
PHC 372
Assignment 1 Questions
– What makes Hajj different than other mass
gatherings?
– What are the risk factors associated with
Hajj?
– Then Choose only one of the following:
o Choose one potential disaster in Hajj
and propose your plan to manage it.
(Explain your disaster management
plan in each phase of the disaster
(Mitigation, Preparedness, Response,
Recovery)
Assignment
question
o Review one disaster incident that
happened in Hajj (explain the
strategies used in the 4 phases, if
possible, to manage the disaster, and
what are the lessons learned out of
that incident)
Note:
•
You can use the following resource (page 2) to review
a brief of the 4 phases of disaster.
Lindsay, B. R. (2012, November). Federal emergency
management: A brief introduction. Congressional Research
Service, Library of Congress.
https://apps.dtic.mil/sti/pdfs/AD1172029.pdf
College of Health Sciences
Department of Health Informatics
Student name:
Student ID:
CRN
14241
Submission date:
Instructor name:
Dr. Sara Atallah
Grade:
…. Out of 10
Paper assignment guidelines
Short essay of 300 – 500 words in APA style. Submission on 28 October 2023 11: 59 PM
•
•
•
•
•
•
•
Conduct your own research to explore further online resources to provide the conceptual
idea and avoid using advertising or commercial material.
Do not use bullet points in representing your answer.
The assignment should have the COVER PAGE with SEU logo and the details of who is
submitting and to whom is it submitted.
Assignments should be submitted through Blackboard in Word document only and not
through email.
Font should be 12 Times New Roman, color should be black and line spacing should be
1.5
Use APA referencing style. Please see below link about how to cite APA reference style.
https://guides.libraries.psu.edu/apaquickguide/intext
Do proper paraphrasing to avoid plagiarism.
This week, you will consider your own cultural background and how it impacts the care you provide to your patients.
For this written assessment we will focus on cultural competency, humility, and health inequities. First, complete this week’s readings and learning activities.
Then, address the following questions on the template provided.
Define and describe health inequalities. How would you advocate for patients, families, and communities?
Discuss your results for each of the test (a brief response for all 6 of the tests).
Discuss if you are culturally competent or have cultural humility. Or are you not there yet? Why? What are your next steps?
References
Minimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)
Required Readings:
Textbooks:
Andrews, M. M., Boyle, J. S., & Collins, J.M., (2020). Transcultural concepts in nursing care (8th ed.). Wolters Kluwer/LWW.
Chapters 11 and 13
Websites:
Health Inequities and Their Causes
Link to the website.
Journal Articles:
Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2020). Patient advocacy in nursing: A concept analysis. Nursing Ethics, 27(1), 141-151. https://doi.org/10.1177/0969733019832950
Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines with the last 5 years. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.
Style
Unless otherwise specified, all the written assignment must follow APA 7th edition formatting, citations and references. Click here to download a Microsoft Word APA template. Review this annotated student sample paper guide which draws attention to relevant content and formatting in 7th edition APA style. Make sure you cross-reference the APA 7th edition book as well before submitting the assignment. Refer to the ‘LEARNER SUPPORT’ tab for more information regarding APA 7th edition with comparisons to 6th edition.
Number of Pages/Words
Unless otherwise specified all papers should have a minimum of 600 words (approximately 2.5 pages) excluding the title and reference pages.
Read the following case study and answer the reflective questions. Please provide rationales for your answers. Make sure to provide a citation for your answers. Must follow APA, 7th ed. format.
CASE STUDY: Family Member with Alzheimer’s Disease: Mark and Jacqueline
Mark and Jacqueline have been married for 30 years. They have grown children who live in another
state. Jacqueline’s mother has moved in with the couple because she has Alzheimer’s disease.
Jacqueline is an only child and always promised her mother that she would care for her in her old
age. Her mother is unaware of her surroundings and often calls out for her daughter Jackie when
Jacqueline is in the room. Jacqueline reassures her mother that she is there to help, but to no avail.
Jacqueline is unable to visit her children on holidays because she must attend to her mother’s daily
needs. She is reluctant to visit friends or even go out to a movie because of her mother’s care needs
or because she is too tired. Even though she has eliminated most leisure activities with Mark,
Jacqueline goes to bed at night with many of her caregiving tasks unfinished. She tries to visit with
her mother during the day, but her mother rejects any contact with her daughter. Planning for the
upcoming holidays seems impossible to Mark, because of his wife’s inability to focus on anything
except her mother’s care.
Jacqueline has difficulty sleeping at night and is unable to discuss plans even a few days in
advance. She is unable to visit friends and is reluctant to have friends visit because of the
unpredictable behavior of her mother and her need to attend to the daily care.
Reflective Questions
1. How do you think this situation reflects Jacqueline’s sense of role performance?
2. How do you think that Jacqueline may be contributing to her own health?
When you wake in the morning, you may reach for your cell phone to reply to a few text or email messages that you missed overnight. On your drive to work, you may stop to refuel your car. Upon your arrival, you might swipe a key card at the door to gain entrance to the facility. And before finally reaching your workstation, you may stop by the cafeteria to purchase a coffee.
From the moment you wake, you are in fact a data-generation machine. Each use of your phone, every transaction you make using a debit or credit card, even your entrance to your place of work, creates data. It begs the question: How much data do you generate each day? Many studies have been conducted on this, and the numbers are staggering: Estimates suggest that nearly 1 million bytes of data are generated every second for every person on earth.
As the volume of data increases, information professionals have looked for ways to use big data—large, complex sets of data that require specialized approaches to use effectively. Big data has the potential for significant rewards—and significant risks—to healthcare. In this Discussion, you will consider these risks and rewards.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Review the Resources and reflect on the web article Big Data Means Big Potential, Challenges for Nurse Execs.
Reflect on your own experience with complex health information access and management and consider potential challenges and risks you may have experienced or observed.
BY DAY 3 OF WEEK 5
Post a description of at least one potential benefit of using big data as part of a clinical system and explain why. Then, describe at least one potential challenge or risk of using big data as part of a clinical system and explain why. Propose at least one strategy you have experienced, observed, or researched that may effectively mitigate the challenges or risks of using big data you described. Be specific and provide examples.
BY DAY 6 OF WEEK 5
Respond to at least two of your colleagues* on two different days, by offering one or more additional mitigation strategies or further insight into your colleagues’ assessment of big data opportunities and risks.
*Note: Throughout this program, your fellow students are referred to as colleagues.
