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Discussion posr

Jun 14, 2024 | Health Medical

Description

There are many possible sources of literature available (e.g., the West Coast University library electronic databases, such as Medline, Cinahl, and PubMed). Which specific scholarly articles did you use and why did you choose them for your topic?

Topic is again: Changing Sexual Behavior

Reply to this discussion 2

Jun 14, 2024 | Health Medical

Description

Subjective- P.J is a 45-year-old male presenting with feelings of sadness, fatigue, insomnia, and loss of interest in daily activities x 2 weeks. Denies suicidal ideation, history of depression, and family history of depression. Denies smoking tobacco, marijuana use, alcohol, and recreational drug use. Reports he is going through a divorce and is concerned he has gained weight. Has felt this way daily, lacks motivation to go to work, prefers to be secluded at home, overeats, stays indoors, and has not tried anything to help alleviate his feelings.

ROS- General: (+) Fatigue, weight gain

Head: (-) Denies head injury, headaches

GI: (-) Denies changes in bowel movements.

Musculoskeletal: (-) Denies muscle and joint pain

Neuro: (-) Denies numbness, tingling, memory loss, and vertigo

Psych: (-) Denies suicidal ideation (+) Depressed feelings, sadness, loss of interest

in hobbies/daily activities

Objective- BMI 31, Vital Signs: 123/76, HR 70, Temp 98.7, R 16, 99% RA, no pain.

General-Alert and oriented, low volume/slow rate of speech, slumped posture, downcast

eyes, hygiene is appropriate.

Psych- Denies suicidal ideation.

Thyroid- No cervical lymphadenopathy

Heart- S1S2 heard, no extra sounds, clicks, rubs, or murmurs.

Lung- Lung sounds clear to auscultation to bilateral bases.

Assessment-

Differentials:

Major Depressive Disorder- Fatigue, insomnia, can increase/decrease appetite, loss of interest.

or motivation in daily activities, including hobbies or work.

Hypothyroidism- Can cause feelings of fatigue, weight gain, insomnia.

Electrolyte deficiency- May lead to feeling fatigue and depressive moods. (APA, 2023)

Patient Health Questionnaire (PHQ-9)- scored 10, moderate depression (APA, 2023)
Labs: CBC, CMP, TSH/T3/T4 = Reviewed. WNL

Plan-

Daily exercise for a minimum of 30 minutes, such as daily walks, yoga, gardening, or aerobic.
Adoption of a Mediterranean diet
At least 15 minutes of daily sunshine
Music therapy, breathing techniques, or massage.
Shut off electronics 1-2 hours before bedtime.
Counseled patient on beginning SSRI. Shared decision making, patient verbalized would like to begin pharmacotherapy.
Sertraline 25 mg PO qDay #30 0RF (USPSTF et al., 2023)
Begin first dose today. May notice some changes within 2 weeks, but more noticeable changes within 4 weeks.
Follow-up in 1 month for re-assessment of medication, physical examination, and repeat of PHQ-9 test (or sooner if symptoms worsen).
If medication and non-pharmacological recommendations do not alleviate symptoms in one month, will discuss with patient increasing dose first before making a psych referral.

Resources:

American Psychological Association. (2023). Depression treatments for adults. American Psychological Association. https://www.apa.org/depression-guideline/adults/

Epocrates (2023). Epocrates medical references (Version 23.9.1) [Mobile app]. App store.

https://itunes.apple.com/us/app/epocrates/id234195…

US Preventive Services Task Force, Barry, M. J., Nicholson, W. K., Silverstein, M., Chelmow,

D., Coker, T. R., Davidson, K. W., Davis, E. M., Donahue, K. E., Jaén, C. R., Li, L.,

Ogedegbe, G., Pbert, L., Rao, G., Ruiz, J. M., Stevermer, J. J., Tsevat, J., Underwood, S.

M., & Wong, J. B. (2023). Screening for Depression and Suicide Risk in Adults: US

Preventive Services Task Force Recommendation Statement. JAMA, 329(23), 2057–2067.

https://doi.org/10.1001/jama.2023.9297

103 new @Khadoojahmousa

Jun 14, 2024 | Health Medical

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see attached

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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, with intext citation.
https://guides.libraries.psu.edu/apaquickguide/intext
Do proper paraphrasing to avoid plagiarism

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Kinesiology Question

Jun 14, 2024 | Health Medical

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Understanding the difference between physical activity and exercise is crucial but probably most important for beginning kinesiology students is to understand, define and implement the components of fitness to their patients, clients, or student athletes. That is what this assignment is all about. below are your directions please be aware this is important for your major therefore I will be grading the information you give strictly. Follow the directions and if you have any questions reach out to me before you submit your paper.

DIRECTIONS: After reading the PowerPoint please write a one page paper MLA style, typed double spaced and size 12 font. Your rubric is below along with an example of how to write the paper.

Pick one or two components of fitness and then answer the following questions.

1. Describe in detail what types of exercise would you do to get the full benefits of the component of fitness you chose.

Make sure you are specific, meaning if you picked cardiovascular fitness I want to know what type of exercise you would do to get the maximum health benefits (duration, days etc.)

2. List the health benefits from the component of fitness you chose.

3. How many days a week is recommended for your component of fitness?

Then pick a skill related component and answer the following questions. A skill is not a component of fitness is something different than the component of fitness. refer to the PowerPoint.

1. What type of athlete would benefit from your skill component?

2. What types of drills would you use to work with a person or enhance your own skills?

The following attachment is a sample of the assignment!!!!
Rubric

Physical Activity and Assessment

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeDescription of criterionstudents must answer all the questions in complete sentences. Students must follow instructions of the format for the paper.

50 pts

Full marks

If the student chooses a component of fitness, a skill, defines both, gives exercise examples for both and describes the health benefits for the component of fitness. all within one page.

40 pts

partcial credit

If the student only talks about a component of fitness or a skill but not both. If the student writes three quarters of a page. If the student writes does not describe the health benefits. If the student is missing one of the directions.

30 pts

Some credit

If not ALL questions are answered, the paper is not in the correct format MLA ( double spaced, one page, size 12 font) If the paper was turned in late after March 14th.

50 pts

Total Points: 50

Unformatted Attachment Preview

Students name
Class name
Physical Activity and Assessments I choose the Flexibility component of fitness.
According to the PowerPoint, flexibility is important to carry out activities of daily living. You
can do some simple at home exercises to improve flexibility and make sure you get the benefits
from them. You can do exercises like a standing hamstring stretch, a frog stretch, a butterfly
stretch, and lunges/hip stretches. It is recommended to the hamstring stretch for 45 seconds to
two minutes. For the frog and butterfly stretches, 30 seconds to 2 minutes each. And lastly for
the lunges/hip stretches, hold for 30 seconds to 2 minutes, then you switch sides and repeat.
Some health benefits include less back pain, increased range of motion, prevents injuries, and
better circulation and less stress. For flexibility it is recommended you train 2-3 days (minimum)
5-7 days (preferred). A skill related to flexibility is agility. People like Dancers will greatly
benefit from the skill component. Also, athletes who practice any sort of martial arts would
benefit. People who do cycling as a sport would also benefit. As with people who do wrestling
and swimming. Since all of these require you to use your whole body. Some drill I would make
someone or do myself include Internal/External Shoulder rotations, spinal rotations, to stretches,
ankle stretches, hamstring stretches, hip stretches, and of course arm stretches. I would also do
these stretches and drills myself. You can find good YouTube videos online that show you how
and what type of exercises you can do to improve your overall flexibility.

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public 101

Jun 14, 2024 | Health Medical

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all details attached

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Critical Thinking Assignment: Patient Safety Survey Presentation
The Agency for Healthcare Research and Quality (AHRQ) developed the Hospital Survey on Patient
Safety Culture (HSOPSC), which is used in facilities in Saudi Arabia. Create a PowerPoint presentation
describing the effectiveness as a CQI tool for your staff. Be sure to include:
The purpose of this survey:
•
•
•
•
•
Specific factors that can be determined from this survey including organizational activities
and responses to error.
An assessment of the importance of this survey in forming internal policies.
Any applicable laws in the Kingdom of Saudi Arabia that would regulate internal policies
impacting safety culture in healthcare facilities.
Changes that have occurred since the COVID-19 Pandemic.
Impact on Policy.
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 9 scholarly
articles.
Follow APA 7th edition writing standards
Helpful references:
•
•
•
•
•
•
Abaker, M. S. M., Al-Titi, O. A. K., & Al-Nasr, N. S. (2019). Organizational policies and
diversity management in Saudi Arabia. Employee Relations: The International Journal,
41(3), 454-474.
AHRQ. (2019). Hospital survey on patient safety culture.
(https://www.ahrq.gov/sops/surveys/hospital/index.html)
Alomi, Y. A., Alragas, A. M. H., Alslim, M. M., Alamoudi, K. A., Almuallem, Z. A., & Alslim,
R. M. (2019). National survey of medication safety practice: Medication administration at
primary healthcare centers/community pharmacies in Riyadh, Saudi Arabia.
Pharmacology, Toxicology and Biomedical Reports, 5(1), 28-35.
Alsharqi, O. Z., AlBarakati, M., AlBarakati, M., AlQamdi, A. A., Al-Borie, H. M., & Ahmad,
A. M. K. (2017). Factors influencing waiting time as key of patient satisfaction in the
emergency department in King Fahd Armed Forces Hospital, Saudi Arabia. International
Journal of Business and Management, 12(5), 79-88.
Alluhidan, M., Tashkandi, N., Alblowi, F., Omer, T., Alghaith, T., Alghodaier, H., Alazemi, N.,
Tulenko, K., Herbst, C. H., Hamza, M. M., & Alghamdi, M. G. (2020). Challenges and policy
opportunities in nursing in Saudi Arabia. Human Resources for Health, 18(1), 1–10.
https://doi-org.sdl.idm.oclc.org/10.1186/s12960-020-00535-2
Aboufour, M. a. S., & Subbarayalu, A. V. (2022). Perceptions of patient safety culture
among healthcare professionals in Ministry of Health hospitals in Eastern Province of
•
•
•
•
•
•
•
•
•
•
•
•
•
Saudi Arabia. Informatics in Medicine Unlocked, 28, 100858.
htts://doi.org/10.1016/j.imu.2022.100858
Alahmadi, H. A. (2010). Assessment of patient safety culture in Saudi Arabian hospitals.
BMJ Quality & Safety, 19(5), e17. https://doi.org/10.1136/qshc.2009.033258
Albaalharith, T., & A’aqoulah, A. (2023). Level of Patient Safety Culture Awareness Among
Healthcare Workers. Journal of Multidisciplinary Healthcare, 321-332.
Albalawi, A., Kidd, L., & Cowey, E. (2020). Factors contributing to the patient safety
culture in Saudi Arabia: a systematic review. BMJ Open, 10(10), e037875.
https://doi.org/10.1136/bmjopen-2020-037875/j.jiph.2019.04.006
Albarrak, A. I., Mohammed, R., Almarshoud, N., Almujalli, L., Aljaeed, R., Altuwaijiri, S., &
Albohairy, T. (2021). Assessment of physician’s knowledge, perception and willingness of
telemedicine in Riyadh region, Saudi Arabia. Journal of Infection and Public Health, 14(1),
97–102. https://doi.org/10.1016/j.jiph.2019.04.006
Alenezi, A., Pandaan, R. P. M., Almazan, J. U., Pandaan, I. N., Casison, F. S., & Cruz, J. P.
(2019). Clinical practitioners’ perception of the dimensions of patient safety culture in a
government hospital: A one-sample correlational survey. Journal of Clinical Nursing,
28(23–24), 4496–4503. https://doi.org/10.1111/jocn.15038
Alharbi, W. S., Cleland, J., & Morrison, Z. (2018). Assessment of Patient Safety Culture in
an Adult Oncology Department in Saudi Arabia. Oman Medical Journal, 33(3), 200–208.
https://doi.org/10.5001/omj.2.018.38
Alhawassi, T. M., Abuelizz, H. A., Almetwazi, M., Mahmoud, M. A., AlGhamdi, A. S.,
AlRuthia, Y., BinDhim, N. F., Alburikan, K. A., Asiri, Y. A., & Pitts, P. J. (2017). Advancing
pharmaceuticals and patient safety in Saudi Arabia: A 2030 vision initiative. Journal of
the Saudi Pharmaceutical Society, 26(1), 71–74.
https://doi.org/10.1016/j.jsps.2017.10.011
Al-Hazmi, A. M., Sheerah, H. A., & Arafa, A. (2021). Perspectives on Telemedicine during
the Era of COVID-19; What Can Saudi Arabia Do? International Journal of Environmental
Research and Public Health, 18(20), 10617. https://doi.org/10.3390/ijerph182010617
Aljaffary, A., Yaqoub, F. a. A., Madani, R. A., Aldossary, H., & Alumran, A. (2021). Patient
Safety Culture in a Teaching Hospital in Eastern Province of Saudi Arabia: Assessment and
Opportunities for Improvement. Risk Management and Healthcare Policy, Volume 14,
3783–3795. https://doi.org/10.2147/rmhp.s313368
Reis, C. T., Laguardia, J., De Araujo Andreoli, P. B., Júnior, C. N., & Martins, M. (2023).
Cross-cultural adaptation and validation of the Hospital Survey on Patient Safety Culture
2.0 – Brazilian version. BMC Health Services Research, 23(1).
https://doi.org/10.1186/s12913-022-08890-7
Saudi Patient Safety Center (2020). Hospital Survey on Patient Safety Culture Cycle 2.
Riyadh: Saudi Patient Safety Center; 2019. Available from:
https://www.spsc.gov.sa/Arabic/SiteAssets/Pages/national-recommendations/nationalrecommendations.pdf
Silva, M. T., Lopes, M. C. C., Oliva, C. R. R. F., De Almeida Araújo, M. E., & Silva, M. T.
(2018). Patient safety culture in a university hospital. Revista Latino-americana De
Enfermagem, 26(0). https://doi.org/10.1590/1518-8345.2257.3014
Palmieri, P. A., Leyva-Moral, J. M., Rodríguez, D. E. C., Granel, N., Ford, E. B., Mathieson,
K., & Leafman, J. (2020). Hospital survey on patient safety culture (HSOPSC): a multimethod approach for target-language instrument translation, adaptation, and validation
•
•
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•
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•
to improve the equivalence of meaning for cross-cultural research. BMC Nursing, 19(1).
https://doi.org/10.1186/s12912-020-00419-9
Pronovost, P. J., Cole, M., & Hughes, R. M. (2022). Remote Patient Monitoring During
COVID-19. JAMA, 327(12), 1125. https://doi.org/10.1001/jama.2022.2040
Qureshi, M. I., & AlRajhi, A. (2020). Challenge of COVID-19 crisis managed by emergency
department of a big tertiary centre in Saudi Arabia. International Journal of Pediatrics
and Adolescent Medicine, 7(3), 147–152. https://doi.org/10.1016/j.ijpam.2020.08.001
Lawati, M. H. A., Dennis, S., Short, S., & Abdulhadi, N. N. (2018). Patient safety and safety
culture in primary health care: a systematic review. BMC Family Practice, 19(1).
https://doi.org/10.1186/s12875-018-0793-7
Mahrous. (2018). Patient safety culture as a quality indicator for a safe health system:
Experience from Almadinah Almunawwarah, KSA. Journal of Taibah University Medical
Sciences, 13(4), 377–383. https://doi.org/10.1016/j.jtumed.2018.04.002
Mahsoon, A., & Dolansky, M. A. (2021). Safety culture and systems thinking for predicting
safety competence and safety performance among registered nurses in Saudi Arabia: a
cross-sectional study. Journal of Research in Nursing, 26(1–2), 19–32.
https://doi.org/10.1177/1744987120976171
Nie, Y., Mao, X., Cui, H., Li, Y., Li, J., & Zhang, M. (2013). Hospital survey on patient safety
culture in China. BMC Health Services Research, 13(1). https://doi.org/10.1186/14726963-13-228

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Answer Questions

Jun 14, 2024 | Health Medical

Description

Answer the following Questions1. How do political and economic systems affect the ability of global businesses to operate effectively in different countries? What are some strategies that companies can use to navigate these systems and maintain profitability?2. In what positive and negative ways has the Internet changed the conduct and coordination of global business?3. In what ways did the organizational culture at Bernard Madoff Investment Services (BMIS) company help lead to Madoff’s success for so many years?

Discussion Week 6: Interprofessional Collaboration

Jun 14, 2024 | Health Medical

ASSIGNMENT COVER SHEET
Course name:
Fundamental Concepts in Food and Nutrition
Course number:
PHC 241
CRN:
xxxx
Patterns of food consumption in the Kingdom
of Saudi Arabia
The purpose of this assignment is to describe patterns of food
consumption in the Kingdom of Saudi Arabia (KSA).
Please read the attached article and write a brief summary
of it by answering the following questions:
Assignment title or task:
(You can write a question)
1.
2.
3.
4.
What are the current patterns of food consumption in
the KSA?
What dietary gaps can be identified by analyzing the
current food situation in the KSA?
Members of which age group have the healthiest diet,
and why?
In your opinion, what can be done to encourage better
patterns of food consumption among the Saudi
population?
Students ID
xxxx
Student name:
xxxx
Submission date:
xxxx
Instructor name:
Grade:
…. Out of 5
Release Date: 17/09/2023
Due Date: 07/10/2023
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 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/intext
Do proper paraphrasing to avoid plagiarism
College of Health Sciences
Department of Public Health
PHC 241
Fall 2021 Paper assignment rubric
Thinking
Content Presentation
Criteria
Proficiency
2
Some
Proficiency
1.75
Limited
Proficiency
1.50
No
Proficiency
1
The purpose and focus are clear and consistent
Punctuation, grammar, spelling, and mechanics are appropriate
Information and evidence are accurate, appropriate, and integrated
effectively
Analysis/synthesis/evaluation/interpretation are effective and
consistent
Connections between and among ideas are made
Total
/5
Updated 14/9/2023
doi:10.1017/S1368980016003141
Public Health Nutrition: 20(6), 1075–1081
Diet in Saudi Arabia: ﬁndings from a nationally representative
survey
Maziar Moradi-Lakeh1, Charbel El Bcheraoui1, Ashkan Afshin1, Farah Daoud1,
Mohammad A AlMazroa2, Mohammad Al Saeedi2, Mohammed Basulaiman2,
Ziad A Memish2, Abdullah A Al Rabeeah2 and Ali H Mokdad1,*
1
Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600, Seattle,
WA 98121, USA: 2Ministry of Health of the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
Submitted 30 March 2016: Final revision received 8 September 2016: Accepted 10 October 2016: First published online 15 December 2016
Abstract
Objective: No recent original studies on the pattern of diet are available for Saudi
Arabia at the national level. The present study was performed to describe the
consumption of foods and beverages by Saudi adults.
Design: The Saudi Health Interview Survey (SHIS) was conducted in 2013. Data
were collected through interviews and anthropometric measurements were done.
A diet history questionnaire was used to determine the amount of consumption for
eighteen food or beverage items in a typical week.
Setting: The study was a household survey in all thirteen administrative regions of
Saudi Arabia.
Subjects: Participants were 10 735 individuals aged 15 years or older.
Results: Mean daily consumption was 70·9 (SE 1·3) g for fruits, 111·1 (SE 2·0) g for
vegetables, 11·6 (SE 0·3) g for dark ﬁsh, 13·8 (SE 0·3) g for other ﬁsh, 44·2 (SE 0·7) g
for red meat, 4·8 (SE 0·2) g for processed meat, 10·9 (SE 0·3) g for nuts, 219·4 (SE 5·1) ml
for milk and 115·5 (SE 2·6) ml for sugar-sweetened beverages. Dietary guideline
recommendations were met by only 5·2 % of individuals for fruits, 7·5 % for
vegetables, 31·4 % for nuts and 44·7 % for ﬁsh. The consumption of processed
foods and sugar-sweetened beverages was high in young adults.
Conclusions: Only a small percentage of the Saudi population met the dietary
recommendations. Programmes to improve dietary behaviours are urgently
needed to reduce the current and future burden of disease. The promotion of
healthy diets should target both the general population and speciﬁc high-risk
groups. Regular assessments of dietary status are needed to monitor trends and
inform interventions.
Dietary risks are among the most important risk factors
globally and in the Kingdom of Saudi Arabia (KSA) in
particular(1,2). Like many other regions of the world, the
nutrition transition in the Middle East has contributed to the
rising burden of non-communicable diseases(1,3). In KSA in
2013, poor diet accounted for 10·4 % (95 % CI 8·9, 12·2 %) of
disability-adjusted life years and 22·1 % (95 % CI 18·7,
24·5 %) of deaths(3,4). FAO data show an overall increase in
food supply (1961–2007) in KSA, with an increase in the
supply of sugar, meat, animal fat, offal (organ meats), eggs
and milk, and a levelling trend in the vegetable and fruit
supply(5). A similar trend was reported earlier in 2000(6).
Khan and Al Kanhal reported a rapidly increasing surplus of
energy and protein availability in KSA after 1975, compared
with the recommended daily allowances(7).
Keyword
Diet
Foods
Beverages
Nutrition epidemiology
Saudi Arabia
Previous reports have shown the dietary patterns or
energy/nutrient intakes in speciﬁc population subgroups
or regions of KSA(8). However, nationally representative
diet data from KSA are limited to food availability. Food
availability data (such as FAO data) do not represent
intake, as they do not account for wastage and other uses.
Moreover, they do not provide information on diet by age,
sex and socio-economic status.
In 2012, the KSA Ministry of Health published dietary
guidelines on the amount and composition of recommended foods to promote a healthy diet among the
population(9). However, there are not enough data on the
success of the guidelines’ implementation, the population’s current dietary status and the potential impacts of
the guidelines. Therefore, the aims of the present study
*Corresponding author: Email mokdaa@uw.edu
Downloaded from https://www.cambridge.org/core. 15 Sep 2021 at 21:29:35, subject to the Cambridge Core terms of use.
© The Authors 2016
1076
were to describe the amount of consumption of different
types of foods and beverages in KSA; to describe dietary
consumption by age, sex, socio-economic status and subnational administrative regions; and to assess the degree to
which Saudis’ diets met the dietary guidelines.
Methods
Performed between April and June 2013, the Saudi Health
Interview Survey (SHIS) was a national multistage survey
of individuals aged 15 years or older. For this survey, KSA
was divided into thirteen regions. Each region was divided
into sub-regions and blocks. All regions were included in
the survey. A probability-proportional-to-size method was
used to randomly select sub-regions and blocks. Households were then randomly selected from each block.
A roster of household members was conducted and an
adult aged 15 years or older was randomly selected to be
surveyed from each selected household. If the randomly
selected adult was not present, our surveyors made an
appointment to return. A total of three visits were
attempted before the household was considered as a nonresponse. More details about the study are available in
previous publications(10–13).
The Saudi Ministry of Health and its institutional review
board (IRB) approved the study protocol. The University
of Washington IRB deemed the study IRB-exempt, since
the Institute for Health Metrics and Evaluation received deidentiﬁed data for the present analysis. All respondents
had the opportunity to consent and agree to participate in
the study.
The survey included forty-two questions on diet (a diet
history questionnaire), as well as questions on socioeconomic status (educational and household monthly
income levels) and other aspects of health. Respondents
were asked to report the number of days that they
consumed eighteen food or beverage items in a typical
week over the last year. The food and beverage items
included in the survey were: fruits; pure (100 %) fruit
juices; vegetables; dark meat ﬁsh; other ﬁsh; shrimp; red
meat; poultry meat; processed meat (meats preserved by
smoking, curing or salting, or by the addition of
preservatives, such as in the case of pastrami, salami,
bologna, other packaged lunch meats or deli meats,
sausages, bratwursts, frankfurters and hot dogs); other
processed foods (such as fast foods, canned foods, packaged entrées or packaged soup); eggs; nuts; milk; yoghurt;
laban (a beverage of yoghurt mixed with salt, which is
also known as ayran or doogh); labneh (strained yoghurt);
cheese; and sugar-sweetened beverages (SSB). For each
type of food/beverage that the respondents reported at
least one day of consumption per typical week, the
respondents were asked: ‘How many servings of [this
food/beverage] do you usually consume/eat/drink on one
of those days?’ The interviewers used speciﬁc pictures that
M Moradi-Lakeh et al.
represented the serving size of each type of food/beverage. Moreover, respondents were asked about the type
of oil or fat most often used for meal preparation, and the
usual type of dairy products (full-fat, low-fat, non-fat) and
bread in the household.
There were insufﬁcient data to calculate total energy
consumption directly. Supplemental File 1 (see online
supplementary material) shows the method for indirect
estimation of energy intake and the energy-adjusted daily
food/beverage consumption estimates. Although not an
ideal method for energy adjustment, it can provide more
comparability with other studies for interested readers. An
energy adjustment is also necessary to compare the status
with the dietary guideline recommendations.
Average numbers of daily servings – and their equivalent weight (grams) for foods, or volume (millilitres) for
beverages – were calculated. In cases where the weight of
a serving size had not been clariﬁed in the survey manuals
(fruits, vegetables, processed meat, processed foods
and eggs), we matched our visual manual as closely as
possible to phrases in the guidelines of the US Department
of Agriculture to assign an average weight(14). For fruits
and vegetables, we used the weighted average weight of
one serving of the most common types of fruits and
vegetables based on the most recent food supply data of
FAO in KSA(15). The 99th percentiles of consumption were
used as cut-off points to identify and exclude implausibly
high levels of intake.
The statistical software package Stata 13.1 for Windows
was used for the analyses and to account for the complex
sampling design.
Results
A total of 12 000 households were contacted and 10 735
participants (5253 men and 5482 women) completed the
SHIS, for a response rate of 89·4 %.
Table 1 demonstrates the average daily consumption
of different food and beverage items. Table 2 shows the
food and beverage consumption of men and women.
Non-adjusted consumption of fruit, red meat, other
processed foods, eggs and SSB was statistically higher in
men than women, while yoghurt and cheese consumption
was higher in women than men. Daily consumption of
fruits and vegetables was reported by 10·8 (SE 0·4) % and
25·9 (SE 0·6) %, respectively, and 27·0 (SE 0·7) % reported
daily drinking of SSB.
Mean consumption of processed meat, other processed
foods and SSB was clearly higher in younger age groups
(Table 3), while laban consumption was higher in older
age groups. Consumption of fruit, shrimp, labneh and
cheese had an increasing pattern with higher education
(Table 4). As demonstrated in Table 5, consumption
of some of the food items (fruit, shrimp, red meat and
labneh) was higher in individuals with higher household
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Diet in Saudi Arabia
1077
Table 1 Average daily food and beverage consumption of Saudi adults, 2013
Food/beverage item
Fruits (g)
Vegetables (g)
Pure (100 %) fruit juices (ml)
Dark meat fish (g)
Other fish (g)
Shrimp (g)
Red meat (g)
Poultry meat (g)
Processed meat (g)
Other processed foods (g)
Eggs (g)
Nuts (g)
Yoghurt (g)
Milk (ml)
Laban (ml)
Labneh (g)
Cheese (g)
SSB (ml)
Weight/volume units
Serving size
Meet the recommendations
Serving size
N
Mean
SE
Mean
SE
%
SE
103 g*
105 g*
125 ml
75 g
75 g
75 g
75 g
75 g
69 g*
399 g*
92 g*
40 g
175 g
250 ml
175 g
175 g
50 g
125 ml
10 187
10 334
10 066
10 096
10 082
9801
10 223
10 336
9667
9664
10 219
9768
10 257
10 326
10 269
9866
10 113
9967
70·9
111·1
31·9
11·6
13·8
2·4
44·2
103·0
4·8
97·5
46·0
10·9
75·4
219·4
116·8
28·9
43·7
115·5
1·3
2·0
0·8
0·3
0·3
0·1
0·7
1·8
0·2
2·7
0·7
0·3
2·0
5·1
2·8
0·8
0·9
2·6
0·675
1·078
0·269
0·137
0·159
0·028
0·521
1·304
0·070
0·244
0·500
0·274
0·431
0·885
0·667
0·165
0·874
0·924
0·013
0·019
0·007
0·003
0·003
0·001
0·009
0·022
0·003
0·007
0·007
0·007
0·012
0·021
0·016
0·004
0·018
0·021
5·2†
7·5†
0·3
0·4
44·7‡
0·7
85·7§
0·5
80·2§
0·6
31·4†
26·2†
0·7
0·7
78·6‡
0·6
SSB, sugar-sweetened beverages.
*Estimated through matching of pictures in the survey manual with the descriptions of the US Department of Agriculture guideline(14).
Reference dietary guidelines: †Dietary Guidelines for Americans(25); ‡American Heart Association(24); §American Institute for Cancer Research(23).
Table 2 Daily food and beverage consumption of Saudi male and female adults, 2013
Male (N 5253)
Weight/volume units
Female (N 5482)
Serving size
Weight/volume units
Serving size
Food/beverage item
Mean
SE
Mean
SE
Mean
SE
Mean
SE
Fruits (g)
Vegetables (g)
Pure (100 %) fruit juices (ml)
Dark meat fish (g)
Other fish (g)
Shrimp (g)
Red meat (g)
Poultry meat (g)
Processed meat (g)
Other processed foods (g)
Eggs (g)
Nuts (g)
Yoghurt (g)
Milk (ml)
Laban (ml)
Labneh (g)
Cheese (g)
SSB (ml)
75·7
105·4
34·0
11·5
14·3
2·5
52·4
106·6
5·0
108·4
49·8
11·2
67·1
217·5
122·2
27·5
40·5
131·4
1·9
2·3
1·2
0·4
0·4
0·1
1·2
2·4
0·3
4·3
1·0
0·4
1·9
6·4
3·9
1·0
1·2
3·5
0·620
0·904
0·241
0·123
0·153
0·026
0·590
1·195
0·064
0·239
0·496
0·269
0·349
0·712
0·580
0·149
0·672
0·972
0·016
0·020
0·010
0·005
0·005
0·002
0·014
0·027
0·004
0·009
0·011
0·011
0·010
0·019
0·017
0·006
0·016
0·028
65·9
117·0
29·7
11·7
13·3
2·3
35·7
99·3
4·7
86·0
42·0
10·7
84·2
221·4
111·2
30·4
47·0
98·8
1·9
3·3
1·1
0·4
0·4
0·1
0·9
2·7
0·3
3·2
0·9
0·4
3·6
8·1
3·9
1·2
1·4
3·8
0·547
1·032
0·214
0·123
0·144
0·023
0·403
1·131
0·068
0·194
0·414
0·243
0·420
0·796
0·568
0·164
0·779
0·699
0·017
0·034
0·010
0·004
0·006
0·002
0·012
0·033
0·004
0·008
0·009
0·009
0·020
0·033
0·023
0·007
0·023
0·030
SSB, sugar-sweetened beverages.
incomes. Consumption of SSB was statistically higher
in individuals with lower household incomes (Table 5).
Fruit/beverage consumption in different administrative
regions can be found in Supplemental File 2 (see online
supplementary material).
Vegetable oils were the most common type of oil/fat
used for preparation of food (84·5 (SE 0·5) %). Olive oil and
butter/margarine were reported by 5·3 (SE 0·3) % and
4·8 (SE 0·3) %, respectively. Most of the respondents reported
use of full-fat dairy products (77·6 (SE 0·6) %), followed by
low-fat (15·0 (SE 0·5) %) and non-fat (1·3 (SE 0·1) %); others
had no preference. The most common type of bread was
white bread (79·1 (SE 0·5) %); brown bread and Saudispeciﬁc traditional breads were reported by 20·1 (SE 0·5) %
and 0·8 (SE 0·1) %, respectively, as the usual kind
of bread.
Discussion
The present study is the ﬁrst to describe dietary patterns
in a nationally representative sample of adults in KSA. It
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5·5
13·5
2·9
0·9
1·1
0·5
5·3
6·1
0·3
4·0
2·4
1·1
19·6
27·7
14·5
3·1
3·0
3·6
SSB, sugar-sweetened beverages.
SE
Mean
60·1
112·5
24·3
5·9
7·7
1·0
36·8
78·0
0·9
29·8
26·8
5·4
108·0
247·1
129·0
21·3
28·7
21·6
4·4
5·0
2·2
1·0
1·3
0·3
3·1
4·5
0·7
4·7
2·1
0·8
5·0
11·2
7·7
2·5
1·5
3·5
SE
Mean
68·8
91·5
20·8
7·2
12·4
1·3
54·2
79·8
1·4
32·1
32·6
5·3
67·0
205·0
113·5
19·8
23·0
30·4
3·7
5·2
2·0
0·6
0·9
0·2
1·9
3·9
0·4
4·1
1·4
0·7
6·0
9·4
6·5
2·2
1·4
3·1
SE
Mean
65·5
109·2
25·3
8·7
12·5
1·5
37·9
83·1
2·7
54·1
37·0
8·8
80·5
187·4
112·6
29·4
33·1
42·5
3·5
3·5
2·1
0·6
0·7
0·2
1·8
2·9
0·3
5·1
1·7
0·6
3·2
7·4
4·2
2·1
1·3
4·3
SE
Mean
77·9
105·8
30·9
8·8
13·9
2·2
49·2
83·2
2·4
69·6
44·2
9·2
64·2
170·1
102·0
31·0
31·1
64·9
3·6
4·5
1·4
0·7
0·8
0·3
1·4
4·1
0·5
4·8
1·5
0·7
5·9
9·5
7·0
1·5
1·5
4·9
SE
Mean
65·1
104·8
26·5
12·8
14·6
2·7
34·8
87·2
5·7
84·4
44·1
10·3
72·7
191·3
99·4
27·6
40·5
84·3
2·4
7·4
2·4
0·7
0·9
0·3
1·8
5·5
0·6
6·5
1·4
0·6
6·4
18·0
7·2
2·6
2·5
8·0
46·2
104·8
24·8
10·4
11·7
1·9
31·2
96·4
5·8
93·5
35·8
10·4
64·9
201·3
87·0
30·2
42·9
127·3
SE
SE
2·9
3·8
2·3
0·8
0·8
0·2
2·4
3·9
0·7
7·8
1·8
0·8
3·4
9·1
5·8
2·0
1·7
6·6
SE
56·5
83·0
26·2
11·0
12·8
1·7
51·4
101·1
6·3
121·6
48·4
12·9
57·8
183·0
97·2
23·1
36·9
172·2
2·7
3·4
1·8
0·7
0·7
0·3
1·8
4·0
0·4
5·3
1·6
0·7
3·1
6·9
4·7
1·7
1·1
6·0
Mean
Mean
Mean
Food/beverage item
Fruits (g)
Vegetables (g)
Pure (100 %) fruit juices (ml)
Dark meat fish (g)
Other fish (g)
Shrimp (g)
Red meat (g)
Poultry meat (g)
Processed meat (g)
Other processed foods (g)
Eggs (g)
Nuts (g)
Yoghurt (g)
Milk (ml)
Laban (ml)
Labneh (g)
Cheese (g)
SSB (ml)
66·0
98·2
32·5
12·1
13·9
3·4
47·9
98·1
4·2
96·2
46·6
10·4
61·8
163·6
104·3
28·4
33·7
119·2
Male (N 1857)
Female (N 1193)
Female (N 2169)
Male (N 1495)
Female (N 1575)
Male (N 712)
Female (N 545)
M Moradi-Lakeh et al.
Male (N 1189)
25–39 years
15–24 years
Table 3 Daily food and beverage consumption of Saudi adults by sex and age group, 2013
40–59 years
60 years or more
1078
showed poor dietary practices in the Kingdom. Saudis’
dietary behaviours met dietary recommendations in only
a small percentage of the population, especially for fruit
and vegetable consumption, dairy products, nuts and
ﬁsh meat. Young adults (15–24 years old) had a concerning pattern of high consumption of SSB, processed
meat and other processed foods, as well as low intake of
fruits and vegetables. Other studies on schoolchildren
show that these unhealthy dietary behaviours start
even sooner(16). This evidence calls for a comprehensive
programme to improve the dietary situation of Saudis. The
programme should include all age ranges, considering the
different needs and different dietary challenges of each
age group.
A cluster of dietary risk factors is the leading risk factor
for non-optimal health, with 11·3 million attributed deaths
and 241·4 million attributed disability-adjusted life years
per annum around the world(1). The Global Burden of
Diseases, Injuries, and Risk Factors (GBD) study showed
that in Saudi Arabia, the average levels of consumption of
fruits, vegetables, nuts, whole grains, PUFA and seafood
n-3 fatty acids were far less than optimum, and the average
levels of consumption of processed meats, red meats, total
fatty acids, SSB and sodium were higher than optimal(3).
In the report of the WHO 2005 STEPwise survey, there
was limited dietary information on the consumption of
fruits, vegetables and oils. During the time between the
STEPwise survey and our current study (2005 to 2013), the
percentage of individuals consuming at least ﬁve daily
servings of fruits or vegetables increased slightly, from 5·5
to 7·3 %(11). However, based on food supply data, fruit and
vegetable availability in KSA (about 475 g/d in 2010)(17) is
more than twice the average consumption in our study
(less than 200 g/d). The difference might be related to
using fruits as pure juices (about 32 ml/d) or sweetened
juices, as well as the higher potential of decay in fruits/
vegetables compared with other food items. Further
details on consumption of fruits and vegetables by Saudi
adults have been reported elsewhere(11). Consumption of
olive oil has increased from 1·7 % in the Saudi STEPwise
survey to 5·3 %(18); since higher intake of olive oil is
associated with reduced risk of all-cause mortality, cardiovascular events and stroke, this can be considered a good
replacement(19).
Although there was higher consumption of meat and
SSB by men, and of vegetables by women, non-energyadjusted consumption is not directly comparable between
men and women. Considering the fact that average energy
consumption is usually higher in men, vegetable intake is
expected to remain higher in women after energy adjustment. Some of the different patterns of food and beverage
consumption between men and women may be explained
by theories about the association of meat consumption
with masculinity and vegetable consumption with femininity, but we do not have enough information for that
assessment(20–22).
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Diet in Saudi Arabia
1079
Table 4 Daily food and beverage consumption of Saudi adults by educational level, 2013
Primary or less (N 3286)
Elementary/high school (N 4780)
College or higher (N 2649)
Food/beverage item
Mean
SE
Mean
SE
Mean
SE
Fruits (g)
Vegetables (g)
Pure (100 %) fruit juices (ml)
Dark meat fish (g)
Other fish (g)
Shrimp (g)
Red meat (g)
Poultry meat (g)
Processed meat (g)
Other processed foods (g)
Eggs (g)
Nuts (g)
Yoghurt (g)
Milk (ml)
Laban (ml)
Labneh (g)
Cheese (g)
SSB (ml)
64·2
99·6
22·0
10·3
12·9
0·9
43·9
99·2
4·8
66·3
36·4
11·7
74·9
219·6
104·5
20·3
33·0
86·5
2·3
4·3
1·4
0·5
0·7
0·1
1·6
3·5
0·5
4·2
1·2
0·8
5·0
9·5
4·3
1·4
1·3
5·1
55·6
96·9
25·6
9·9
12·3
2·1
42·1
93·8
4·2
95·3
43·8
9·6
62·1
177·2
97·6
27·9
37·3
120·9
1·7
3·0
1·2
0·4
0·5
0·1
1·2
2·5
0·3
4·0
1·0
0·3
2·4
6·9
3·8
1·3
1·1
3·9
74·8
108·0
35·8
11·9
13·3
3·6
41·5
82·5
5·1
92·8
44·8
9·7
69·7
168·6
99·8
35·5
38·9
88·5
3·0
3·9
1·6
0·6
0·6
0·3
1·4
3·5
0·4
4·7
1·3
0·4
4·0
8·5
5·1
1·7
1·4
4·3
SSB, sugar-sweetened beverages.
Table 5 Food and beverage consumption of Saudi adults by household monthly income level, 2013
Less than 5000 Riyals (N 3161)
5000–14 999 Riyals (N 4549)
15 000 Riyals or more (N 1131)
Food/beverage item
Mean
SE
Mean
SE
Mean
SE
Fruits (g)
Vegetables (g)
Pure (100 %) fruit juices (ml)
Dark meat fish (g)
Other fish (g)
Shrimp (g)
Red meat (g)
Poultry meat (g)
Processed meat (g)
Other processed foods (g)
Eggs (g)
Nuts (g)
Yoghurt (g)
Milk (ml)
Laban (ml)
Labneh (g)
Cheese (g)
SSB (ml)
51·5
94·1
20·9
9·8
13·3
1·7
37·2
89·3
3·4
91·0
38·9
8·1
66·4
188·5
104·7
22·7
37·5
113·6
2·0
3·7
1·5
0·5
0·7
0·2
1·5
3·3
0·4
5·3
1·2
0·5
3·4
8·7
4·9
1·5
1·8
5·4
65·2
96·2
28·3
10·8
13·8
2·3
42·4
88·6
4·4
86·8
45·2
10·1
64·6
166·5
99·5
31·9
36·2
95·9
1·7
2·2
1·4
0·5
0·5
0·2
1·2
2·1
0·3
3·7
1·0
0·4
2·3
4·9
3·2
1·4
0·9
3·2
79·3
118·3
40·5
10·6
14·0
3·9
50·3
93·3
5·2
82·7
42·2
11·2
61·9
189·4
98·7
36·4
35·9
91·0
4·7
6·6
2·4
0·8
0·9
0·4
2·4
4·3
0·7
6·6
1·8
0·8
4·0
11·1
5·8
2·7
1·8
5·6
SSB, sugar-sweetened beverages.
Compared with the recommendations of dietary
guidelines(9,23–25), consumption of fruits, vegetables, dairy
products and nuts is very low, and less than 45 % of the
KSA population consumes ﬁsh as recommended. On the
other hand, there is considerable unnecessary consumption of processed meat and SSB compared with the
recommendations(23,24). A 2006 study in Lebanon showed
that Lebanese adults consume the same amount of ﬁsh
and red meat as Saudis in our study, but less poultry meat
(36 v. 103 g/d) and eggs (12 v. 46 g/d), and more fruits and
vegetables (367 v. 182 g/d)(26).
The previously published GBD estimates for dietary risk
factors in KSA were close to our estimates for red meat,
processed meat and SSB. Our estimate for nuts was higher
than previous GBD estimates (about 11 v. 4 g/d)(3).
Midhat et al. reported the consumption of different food
items as part of the routine meals in the Qassim region of
KSA. However, they did not report the amount (or serving
sizes) of consumption. That study showed an increasing
probability of routine intake of ﬁsh, vegetables, fresh fruits
and barbecued meats (called a ‘healthy diet’) with
increasing age(27). Our ﬁndings showed that Saudis of
older ages consume more fruit and vegetables, and fewer
processed foods. The healthier diet seen among older
individuals might be related to different factors, such as a
birth cohort effect (due to the nutrition transition in the
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1080
younger birth cohorts), the longer life of individuals with
healthy diets, more frequent contacts between health careproviders and older individuals (compared with younger
people), and better adherence among older individuals
to dietary guidelines because of their perceived risk of
disease and death.
The average consumption of fruit, vegetables and
shrimp in individuals with a college or higher education
was more than in other educational groups. The highest
intake of milk was reported by individuals with primary or
less education. Individuals with the lowest household
income had the highest consumption of SSB, while consumption of fruits, vegetables and pure juices was lower
than in individuals with higher income.
In our study, the highest intake of ﬁsh was in the Jizan,
Aasir, Al Bahah and Makkah regions (all located in the
south-western part of the country and close to the Red
Sea), as well as in Riyadh (capital); the lowest consumption of ﬁsh was reported by residents of Ha’il, Al Jawf and
Al Hudud ash Shamaliyah (all located in the north-western
part of the country).
Although the prevalence of obesity has decreased in
recent years in KSA, the current combination of high
overweight/obesity prevalence(28), sedentary lifestyle(10)
and inappropriate diet threatens the current and future
health of the population.
Our study has some limitations. First, we used a diet
history questionnaire that did not contain details for all
types of foods and beverages. Second, our food and
beverage consumption data are self-reported and subject
to recall and social desirability biases. Third, our study did
not include the amount of all foods and beverages (for
instance, complex carbohydrates), and we were not able
to directly calculate total energy expenditure. On the other
hand, our study is based on a large sample size and used a
standardized methodology for all its measures. It is
nationally representative and has the merit of providing
accurate data due to our near-real-time data quality
monitoring through the whole survey period.
The Saudi Ministry of Health has initiated programmes
and projects, such as the Crown Health Project(29,30) and
the Saudi dietary guidelines(9), to alleviate the burden of
risk factors of non-communicable diseases. The outcomes
of these programmes need to be evaluated, so that the
lessons learned from them can be used in the adjustment
of current programmes and the planning and installation
of new comprehensive programmes.
Conclusion
Our study showed that Saudis’ diets do not follow the
guidelines for healthy diets. Increased efforts to improve
eating habits in KSA are needed. These efforts should promote a balanced diet according to energy intake and composition of diet. Speciﬁcally, increasing the consumption of
M Moradi-Lakeh et al.
fruits, vegetables, dairy products, nuts and ﬁsh should be
targeted. Strategies are required to limit the consumption of
processed foods and SSB, especially in young adults. These
efforts should involve all stakeholders, including education
representatives, agriculture partners, food companies and
food importers. In addition, regular assessments of Saudis’
dietary status are needed to monitor trends and inform
interventions. Finally, political will is needed to enforce food
labelling and manufacturing regulations.
Acknowledgements
Acknowledgements: The authors would like to thank
Kevin O’Rourke at the Institute for Health Metrics and
Evaluation for editing the manuscript. Financial support:
This study was supported by a grant from the Ministry of
Health of the KSA. The Ministry of Health had no role in
the design, analysis or writing of this article. Conﬂict of
interest: The study and the authors have not received any
ﬁnancial support from the food industries. Authorship:
A.H.M. conceived and designed the study. M.B., Z.A.M.,
M.A.S. and M.A.A. performed the survey. C.E.B. and F.D.
participated in questionnaire design and interviewers’
training. M.M.-L., A.A. and A.H.M. analysed the data.
M.M.-L., A.H.M., C.E.B., A.A., F.D., M.B., Z.A.M., M.A.S.,
M.A.A. and A.A.A.R. drafted or commented on the manuscript. A.A.A.R. supervised the study. All co-authors are
responsible for the content of this article and have read and
approved the ﬁnal manuscript. Ethics of human subject
participation: The Saudi Ministry of Health and its IRB
approved the study protocol. The University of Washington
IRB deemed the study IRB-exempt, since the Institute for
Health Metrics and Evaluation received de-identiﬁed data
for the analysis. All respondents had the opportunity to
consent and agree to participate in the study.
Supplementary material
To view supplementary material for this article, please visit
https://doi.org/10.1017/S1368980016003141
References
1. GBD 2013 Risk Factors Collaborators, Forouzanfar MH,
Alexander L et al. (2015) Global, regional, and national
comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of
risks in 188 countries, 1990–2013: a systematic analysis for
the Global Burden of Disease Study 2013. Lancet 386,
2287–2323.
2. Memish ZA, Jaber S, Mokdad AH et al. (2014) Burden of
disease, injuries, and risk factors in the Kingdom of Saudi
Arabia, 1990–2010. Prev Chronic Dis 11, E169.
3. Afshin A, Micha R, Khatibzadeh S et al. (2015) The impact of
dietary habits and metabolic risk factors on cardiovascular
and diabetes mortality in countries of the Middle East and
Downloaded from https://www.cambridge.org/core. 15 Sep 2021 at 21:29:35, subject to the Cambridge Core terms of use.
Diet in Saudi Arabia
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North Africa in 2010: a comparative risk assessment analysis.
BMJ Open 5, e006385.
Institute for Health Metrics and Evaluation (2014) GBD
compare visualization tool. http://ihmeuw.org/3qc9
(accessed July 2016).
Adam A, Osama S & Muhammad KI (2014) Nutrition and
food consumption patterns in the Kingdom of Saudi Arabia.
Pak J Nutr 13, 181–190.
Madani KA, al-Amoudi NS & Kumosani TA (2000) The state
of nutrition in Saudi Arabia. Nutr Health 14, 17–31.
Khan MA & Al Kanhal MA (1998) Dietary energy and
protein requirements for Saudi Arabia: a methodological
approach. East Mediterr Health J 4, 68–75.
Alsuﬁani HM, Kumosani TA, Ford D et al. (2015) Dietary
patterns, nutrient intakes, and nutritional and physical
activity status of Saudi older adults: a narrative review.
J Aging Res Clin Pract 4, 2–11.
General Director of Nutrition, Ministry of Health (2012)
Saudi Dietary Guideline (Healthy Diet Palm). Riyadh:
Ministry of Health Publications.
El Bcheraoui C, Tuffaha M, Daoud F et al. (2016) On your
mark, get set go: levels of physical activity in the Kingdom
of Saudi Arabia, 2013. J Phys Act Health 13, 231–238.
El Bcheraoui C, Basulaiman M, AlMazroa M et al. (2015)
Fruit and vegetable consumption among adults in Saudi
Arabia, 2013. Nutr Diet Suppl 7, 41–49.
Moradi-Lakeh M, El Bcheraoui C, Tuffaha M et al. (2015)
Tobacco consumption in the Kingdom of Saudi Arabia,
2013: ﬁndings from a national survey. BMC Public Health
15, 611.
Moradi-Lakeh M, El Bcheraoui C, Tuffaha M et al. (2015)
Self-rated health among Saudi adults: ﬁndings from a
national survey, 2013. J Community Health 40, 920–926.
US Department of Agriculture, Agricultural Research Service
(2014) National Nutrient Database for Standard Reference,
Release 27. http://ndb.nal.usda.gov/ndb/foods (accessed
July 2016).
Food and Agriculture Organization of the United Nations
(2011) Food Balance Sheets, Saudi Arabia. http://faostat3.
fao.org/download/FB/FBS/E (accessed October 2015).
Attia AAEM & Farajat MA (2013) Selected dietary habits
among female adolescents in Hail, Saudi Arabia. Am J Res
Commun 1, 140–148.
Haddad LJ, Hawkes C, Achadi E et al. (2015) Global
Nutrition Report 2015: Actions and Accountability to
Advance Nutrition and Sustainable Development.
Washington, DC: International Food Policy Research
Institute.
1081
18. Al-Hamdan NA, Kutbi A, Choudhry AJ et al. (2005) WHO
STEPwise Approach to NCD Surveillance. Country-Speciﬁc
Standard Report: Saudi Arabia. http://www.who.int/chp/steps/
2005_SaudiArabia_STEPS_Report_EN.pdf?ua=1 (accessed July
2016).
19. Schwingshackl L & Hoffmann G (2014) Monounsaturated
fatty acids, olive oil and health status: a systematic review
and meta-analysis of cohort studies. Lipids Health Dis
13, 154.
20. Ruby MB & Heine

ACADEMIC SUCCESS AND PROFESSIONAL DEVELOPMENT PLAN PART 3: RESEARCH ANALYSIS

Jun 14, 2024 | Health Medical

Description

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
NURS_6003_Module03_Week05_Assignment_Rubric
NURS_6003_Module03_Week05_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeUsing the Week 3 Part 3, section of your Academic Success and Professional Development Plan Template complete Step 1. Conduct an analysis of the elements of the research article you identified. Be sure to include the following:· The topic of interest you have selected. · Correctly formatted APA citation of the article you selected, along with link or search details. · Identify one or more professional practice uses of the theories/concepts presented in the article.
25 to >22.0 ptsExcellentThe response clearly identifies the topic of interest selected. … The response accurately and completely provides a citation of the article selected, including an accurate and complete link or thorough search details. … The response clearly identifies and describes in detail a professional practice use of the theories/concepts presented in the article. 22 to >19.0 ptsGoodThe response partially identifies the topic of interest selected. … The response provides a partial citation of the article selected, including a partial link or search details. … The response partially identifies and describes a professional practice use of the theories/concepts presented in the article. 19 to >17.0 ptsFairThe response vaguely identifies the topic of interest selected. … The response vaguely or inaccurately provides a citation of the article selected, including vague or inaccurate search details. … The response vaguely or inaccurately identifies and describes a professional practice use of the theories/concepts presented in the article. 17 to >0 ptsPoorThe response vaguely and inaccurately identifies the topic of interest selected or is missing. … The response vaguely and inaccurately provides a citation of the article selected, including vague and inaccurate search details, or is missing. … The response vaguely and inaccurately identifies and describes a professional practice use of the theories/concepts presented in the article or is missing.
25 pts

This criterion is linked to a Learning OutcomeAnalysis of the article using the Research Analysis Matrix section of the template for:Strengths of the ResearchLimitations of the ResearchRelevancy to the Topic of Interest. · Write a one-paragraph justification explaining whether or not you would recommend the use of this article to inform professional practice.
20 to >17.0 ptsExcellentThe response clearly and accurately provides a detailed analysis of the article using the Research Analysis Matrix section of the template. … The response clearly and accurately explains in detail the justification of whether to recommend the use of the article to inform professional practice. 17 to >15.0 ptsGoodThe response provides a partial analysis of the article using the Research Analysis Matrix section of the template. … The response partially explains the justification of whether or not to recommend the use of the article to inform professional practice. 15 to >13.0 ptsFairThe response provides a vague or inaccurate analysis of the article using the Research Analysis Matrix section of the template. … The response vaguely or inaccurately explains the justification of whether or not to recommend the use of the article to inform professional practice. 13 to >0 ptsPoorThe response provides a vague and inaccurate analysis of the article using the Research Analysis Matrix section of the template or is missing. … The response vaguely and inaccurately explains the justification of whether or not to recommend the use of the article to inform professional practice or is missing.
20 pts

This criterion is linked to a Learning OutcomePart 3, Step 2: Write a 2-3 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.
45 to >40.0 ptsExcellentThe response clearly and accurately describes in detail the approach to identifying and analyzing peer-reviewed research. The response clearly identifies and accurately describes in detail at least two strategies used to be effective in finding peer-reviewed research. … The response clearly identifies and accurately describes in detail at least one resource you intend to use in the future to find peer-reviewed research. 40 to >35.0 ptsGoodThe response partially describes the approach to identifying and analyzing peer-reviewed research. The response partially identifies and describes at least two strategies used to be effective in finding peer-reviewed research. … The response partially identifies and describes in detail at least one resource you intend to use in the future to find peer-reviewed research. 35 to >31.0 ptsFairThe response vaguely or inaccurately describes the approach to identifying and analyzing peer-reviewed research. The response vaguely or inaccurately identifies and describes at least two strategies used to be effective in finding peer-reviewed research. … The response vaguely or inaccurately identifies describes in detail at least one resource you intend to use in the future to find peer-reviewed research. 31 to >0 ptsPoorThe response vaguely and inaccurately describes the approach to identifying and analyzing peer-reviewed research or is missing. The response vaguely and inaccurately identifies and describes at least two strategies used to be effective in finding peer-reviewed research or is missing. … The response vaguely or inaccurately identifies describes in detail or is missing at least one resource you intend to use in the future to find peer-reviewed research.
45 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. which delineates all required criteria.
5 to >4.0 ptsExcellentParagraphs and sentences follow writing standards for flow, continuity, and clarity. 4 to >3.0 ptsGoodParagraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. 3 to >2.0 ptsFairParagraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time. 2 to >0 ptsPoorParagraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. 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 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

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..
Here’s my previous discussion just in case it comes in handy
Cummings et al (2021) article, “The Essentials of nursing leadership: A systematic review of factors and educational interventions influencing nursing leadership,” is the peer-reviewed source I selected that is of particular interest to me. I used the ScienceDirect database to search for this article because it is a reliable source for the life and physical sciences, medicine, technical fields, and, most importantly, nursing-related research. However, several challenges were encountered during the search process. Initially, there was difficulty in selecting appropriate keywords, leading to some trial and error before settling on ” The essentials of nursing leadership” as the most relevant terms. Furthermore, the search generated an overwhelming number of results, necessitating the use of filters and sorting options to refine the outcomes effectively. Lastly, ensuring full-text access to the identified article proved essential, as some articles were restricted behind paywalls, emphasizing the importance of accessing complete research materials.UsefulnessDespite these difficulties, the ScienceDirect database would be useful to my colleagues. This expansive database predominantly centers on biomedical and healthcare literature, encompassing a wide array of peer-reviewed articles (Figueiredo & Pereira, 2017). It is an invaluable resource for healthcare professionals, including nurses, granting them access to a diverse range of research on topics pertinent to nursing practice, patient care, and healthcare management.RecommendationI recommend using ScienceDirect as a primary database for healthcare professionals and researchers. ScienceDirect’s user-friendly interface grants users access to a substantial repository of top-notch peer-reviewed articles (Harnegie, 2013). Furthermore, this database boasts advanced search features, filters, and tools that facilitate precise and efficient searches, making it particularly advantageous when seeking specific topics or refining search results. In summary, ScienceDirect is a dependable and all-encompassing resource for those engaged in evidence-based practice and scholarly research within the healthcare sector.
********I HAVE ALSO PROVIDED MY PREVIOUS PAPERS JUST IN CASE YOU NEED TO USE THEM********

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1
Part 2: Strategies to Promote Academic Integrity and Professional Ethics
Aram Megrabian
Walden University
NURS 6003N
Carie Braun
September 10, 2023
2
Part 2: Strategies to Promote Academic Integrity and Professional Ethics
Section 1: The Connection Between Academic and Professional Integrity
Academic Integrity and Writing
Academic integrity is the foundation of ethical scholarship and crucial to higher
education, especially in my MSN program. It pledges academic honesty, fairness, and
trustworthiness. A key component in Academic integrity necessitates avoiding plagiarism.
Academically, plagiarism involves using someone else’s ideas, words, or work without credit.
This can be disastrous and significantly lower the academic reputation of individuals (Ansorge et
al., 2021). Student writing in my MSN program is influenced by academic honesty. It requires
me to write original content, properly reference sources in APA format, and thank authors for
their efforts. Following these standards protects others’ intellectual property and guarantees that
my work accurately reflects my expertise and research. Writing with integrity emphasizes ethical
scholarship and fosters academic trust and respect.
Professional Practices and Scholarly Ethics
Academic ethics and nursing practice are deeply intertwined. Ethical principles govern all
patient care in nursing. These principles include beneficence, non-maleficence, autonomy, and
justice. A high ethical standard in nursing is essential for secure and humane patient care.
Scholarly ethics and professional practices are interdependent. These ethical values are crucial to
my academic experience as a nursing student. The ethical frameworks I learned in school help
me make ethical nursing judgments. My academic ethical reasoning skills will help me make
decisions that emphasize patient well-being and respect scholarly ethics in a complex healthcare
setting.
3
Grammarly and Turnitin
Grammarly and Turnitin are crucial to academic honesty and writing quality. Grammarly
helps writers correct grammar, spelling, and punctuation errors. Grammarly improves my
academic writing by making it clear, concise, and error-free. On the contrary, Turnitin is a
powerful plagiarism detector. Checking my work against a huge academic database helps
students like me avoid accidental plagiarism (Sorea et al., 2021). I can avoid plagiarism and
promote academic honesty by utilizing Turnitin to cite and reference all sources properly.
Grammarly and Turnitin protect academic integrity by promoting ethical writing and providing
feedback and coaching to improve my academic work.
Section 2: Strategies for Maintaining Integrity of Work
Academic Work as an MSN Student
As an MSN student, I will use numerous methods to ensure academic integrity. Time
management comes first. I must manage my time well to avoid last-minute rushes and academic
dishonesty (Goldsby et al., 2020). Also, planning my schedule will help me avoid plagiarism by
arranging my study schedule and making realistic goals to finish projects early. Additionally, I
will actively engage with my lecturers and peers. Open communication with lecturers lets me ask
questions and clarify assignment expectations. Working with classmates on group projects
improves my teamwork abilities and holds us accountable for academic integrity. Finally, I will
utilize the university’s writing center and library databases to guarantee my research and writing
follow academic standards and ethics.
Professional Work as a Nurse
4
Integrity in professional activities is essential as I enter my nursing career. One way to
solidify my professional activity is by pursuing ethical education. This requires keeping up with
healthcare ethics advancements, including regulations and norms. I will attend ethics conferences
and seminars and study nursing ethics journal articles to ensure my professional behaviors are
ethical. Secondly, ethical nursing requires patient autonomy, confidentiality, and patient-centered
care (Molina-Mula & Gallo-Estrada, 2022). To follow these ideals, I will actively engage with
patients to help them understand their treatment options and make educated decisions. I will also
strictly follow patient confidentiality guidelines because trust is the core of the nurse-patient
interaction. I will also seek guidance from experienced nurses with a good ethical record.
Learning from their real-world experiences and ethical problems will shape my nursing ethics.
5
References
Ansorge, L., Ansorgeová, K., & Sixsmith, M. (2021). Plagiarism through paraphrasing tools—
The story of one plagiarized text. Publications, 9(4),
48. https://doi.org/10.3390/publications9040048
Goldsby, E., Goldsby, M., Neck, C. B., & Neck, C. P. (2020). Under pressure: Time
management, self-leadership, and the nurse manager. Administrative Sciences, 10(3),
38. https://doi.org/10.3390/admsci10030038
Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of
care and patient autonomy in decision-making. International Journal of Environmental
Research and Public Health, 17(3), 835. https://doi.org/10.3390/ijerph17030835
Sorea, D., Roșculeț, G., & Bolborici, A. (2021). Readymade solutions and students’ appetite for
plagiarism as challenges for online learning. Sustainability, 13(7),
3861. https://doi.org/10.3390/su13073861
1
Building an Effective Academic and Professional Network for MSN Success
2
Building an Effective Academic and Professional Network for MSN Success
Academic and Professional Network
As I embark on my journey in the MSN program and toward becoming a practicing
nurse, I recognize the importance of building a robust academic and professional network. This
network will be vital in shaping my success and guiding me throughout my educational and
career endeavors. I have identified key individuals and teams within both Walden University and
the nursing profession who will contribute to my achievements:
Academic Connections
Dr. Emily Johnson (Associate Professor, Walden University School of Nursing): Dr.
Johnson’s expertise in advanced nursing concepts aligns well with my academic goals. Her
research interests in evidence-based practice and patient outcomes resonate with my aspirations.
Collaborating with her will provide insights into current research trends and methodologies,
enriching my understanding of nursing practices.
Research and Writing Center: The Research and Writing Center at Walden University
will be an essential academic resource. Their assistance in developing vital research and writing
skills will be crucial for my coursework and for contributing to the nursing field through
scholarly articles and research projects.
Professional Connections
Dr. John Doe (Seasoned Nursing Mentor): Drawing from Dr. Doe’s rich background in
the nursing realm, particularly within my specialized field, I anticipate gaining invaluable
wisdom and practical viewpoints. His mentorship will serve as a compass during my evolution
3
from a student to an active nurse, effectively closing the divide between theoretical learning and
practical application.
Nursing Networking Group: Joining a professional nursing networking group through
local chapters or online platforms will connect me with a diverse community of nurses. Engaging
in discussions, attending events, and sharing experiences with fellow professionals will enhance
my knowledge, expose me to different nursing specialties, and provide opportunities for
collaboration.
Rationale for Selection
I chose these individuals and resources based on their expertise, relevance to my
academic and professional goals, and their potential to offer guidance and support. Dr. Johnson’s
and the Research and Writing Center will aid me in excelling academically, ensuring I produce
high-quality work. Dr. Doe and the nursing networking group will provide real-world
perspectives, advice, and opportunities for growth as I transition into the nursing profession.
By collaborating with these academic and professional connections, I am confident I will
not be alone. As Donne emphasized, “No man is an island,” Through these networks, I will have
the support and guidance necessary to succeed in my MSN program and thrive as a competent
and compassionate practicing nurse.

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Discussion on Personhood

Jun 14, 2024 | Health Medical

Description

Discuss the concept of personhood as used in the nursing as caring theory.

Submission Instructions:

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 some citations for you to use. Please do not use AI.

Imafidon, E. (2022). Beyond continental and African philosophies of personhood, healthcare and difference. Nursing Philosophy, 23(3), e12393. https://doi.org/10.1111/nup.12393

Tieu, M., Mudd, A., Conroy, T., & Kitson, A. (2022). The trouble with personhood and person-centred care. Nursing Philosophy, 23(3), e12381. https://doi.org/10.1111/nup.12381

Hennelly, N., & O’Shea, E. (2022). A multiple perspective view of personhood in dementia. Ageing & Society,42(9), 2103-2121. doi:10.1017/S0144686X20002007

314 i want 2 difrint file

Jun 14, 2024 | Health Medical

Description

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351 @Sarahmoh369

Jun 14, 2024 | Health Medical

Description

see attached

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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

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Cognitive behavioral therapy

Jun 14, 2024 | Health Medical

Description

Post an explanation of how the use of CBT in groups compares to its use in family or individual settings. Explain at least two challenges PMHNPs might encounter when using CBT in one of these settings. Support your response with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly and attach the PDFs of your sources

PROFESSIONAL NURSING AND STATE-LEVEL REGULATIONS

Jun 14, 2024 | Health Medical

Description

Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.

It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions.

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 mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.
Consider how key regulations may impact nursing practice.
Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion.
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.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.

Discussion post for Genitourinary Disorders

Jun 14, 2024 | Health Medical

Description

Treatments for Genitourinary Tract Disorders

please answer the following questions:

1.Describe urinary tract infection, causes, symptoms and treatment

2.Discuss treatment for benign prostatic hyperplasia

3.Describe overactive bladder, causes, symptoms and treatment

4.Treatment options and recommendations for different STIs (Chlamydia, Gonorrhea and Syphilis)

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 at least five years since publishing.

Each question must be answered individually as in bullet points.

Example: Question 1, followed by the answer to question 1; Question 2, followed by the answer to question 2; and so forth.

EcoMap and Self-Care Plan

Jun 14, 2024 | Health Medical

Description

OVERVIEW
For this assignment, you will evaluate your life situation and develop a plan of personal health to
maintain self-care. The assignment submission will include a current APA cover page, the
Ecomap graphic, a 3-page reflection paper and the SMART Form.
INSTRUCTIONS
Ecomaps are useful tools to help map out, visualize, and better understand connections. You are
to develop an Ecomap graphic reflecting the following information. List at least five people with
whom you feel most connected. List the person’s name and the common connection(s) between
you and this person. Draw an arrow from your name to each person. The thickness of that arrow
will reflect the strength of the relationship. Consider your relationship with each person and
discuss it in the narrative. Does your interaction with this person improve your self-care plan
through relief of anxiety, stress, and the burdens of life? Or does this person or interaction
increase stress? Consider ways the connection with each person could improve your self-care?
Likewise, in the Ecomap graphic list all the places you go throughout a typical week, such as
school, work, the homes of family and friends, businesses, restaurants, health spas, 12-Step
meetings, spiritual places, and so forth. Beside each place, note the reason(s) you go to this
place. Then, examine whether this place aids in or detracts from your self-care. How can you
increase your connection with the places that support your wellness and limit the places that do
not?
You will use the Ecomap Template to develop your graph. You will write a 3-page paper in
APA style reflecting your findings from the development of the Ecomap.
For this assignment, you will reference the Learn items: Explore: Developing a Self-Care Plan
and Read: Wellbeing and Self-Care to develop a personal Self-Care Plan chart using the
SMART Form provided under the Resources section on the assignment page. You must address
the physical, psychological, social, professional/academic, and spiritual dimensions in your care
plan. Specific goals/objectives (more than 1 per category) and accountability measures must be
noted using the SMART format. (SMART: Specific, Measurable, Achievable, Relevant, Time-
bound.

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Ecomap and Self-Care Plan Grading Rubric | SOWK501_B03_202340
Criteria
Content
Ratings
Points
140 to >128 pts
128 to >117 pts
117 to >0 pts
0 pts
Advanced
Proficient
Developing
Not
Present
The paper meets or
exceeds content
requirements:
The paper mostly meets The paper could use
content requirements:
some development to
Not
meet a number of the
Present
– The graphic of the
content requirements:
– The graphic of the
Self-Care Eco Map is
Self-Care Eco Map is
clear and follows the
– The graphic of the
clear and concise, and
instructions provided
Self-Care Eco Map is
follows the instructions
clear and concise, and
provided by going into
– Description is provided follows the instructions
depth in describing
of the relational aspects provided
relationships and the
of the student’s life and
development of a
the impact the
– Detailed attention is
realistic plan of
relationships have on
given to the relational
self-care as well as
the student
aspects of the student’s
having a detailed
life and the impact that
ecomap.
– Description is given of they have on the
the places where the
student
– Detailed description is student spends time on
provided of the
a regular basis and the – Detailed attention is
relational aspects of the impact that they have
given to the places that
student’s life and the
on the student
draw the student’s
impact the relationships
attention on a regular
have on the student
– The reflection paper
basis and the impact
– Detailed description is addresses the facts
that they have on the
given of the places
learned by developing
student
where the student
the Self-Care Eco Map.
spends time on a
– The reflection paper
regular basis and the
– The SMART plan
clearly addresses the
impact that they have
graphic clearly
facts learned by
on the student- The
addresses the Physical, developing the
reflection paper clearly Psychological, Social,
Self-Care Eco Map.
addresses the facts
Professional/academic,
learned by developing
and Spiritual
– The SMART plan
the Self-Care Eco Map. dimensions of the Self
graphic clearly
Care Plan incorporating addresses the Physical,
-The SMART plan
specific goals/objectives Psychological, Social,
graphic clearly
and accountability
Professional/academic,
addresses the Physical, measures using the
and Spiritual
Psychological, Social,
SMART format for each dimensions of the Self
Professional/academic, dimension discussed.
Care Plan incorporating
and Spiritual
specific goals/objectives
dimensions of the Self
and accountability
Care Plan incorporating
measures using the
specific
SMART format for each
goals/objectives and
dimension discussed.
accountability
measures using the
SMART format for each
dimension discussed.
140
pts
Ecomap and Self-Care Plan Grading Rubric | SOWK501_B03_202340
Criteria
APA Format
Ratings
20 to >17 pts
17 to >16 pts
16 to >0 pts
0 pts
Advanced
Proficient
Developing
Not
Present
The paper meets or
exceeds structure
requirements:
-The cover page is in
current APA format
-References cited
according to current
APA format.
Less than three APA
corrections needed.
The paper mostly meets
structure requirements:
– The cover page is in
current APA format.
– References cited
according to current
APA format.
– Less than 6 major APA
corrections needed
(professors realize that
the same APA error
noted multiple times
does not constitute
multiple corrections).
The paper needs further
development in APA
Not
format in numerous
Present
areas: cover page,
in-text citations,
reference page, etc.
17 to >16 pts
16 to >0 pts
0 pts
Proficient
Developing
Not
Present
The paper meets or
exceeds structure
requirements:
-Free of or has very few
spelling and
grammatical errors.
The paper mostly meets
structure requirements:
More than three and
less than six spelling
and grammatical
corrections are needed.
The paper needs further
development in the area Not
of spelling and
Present
grammar:
Numerous spelling and
grammatical corrections
are needed.
20 to >17 pts
17 to >16 pts
16 to >0 pts
0 pts
Advanced
Proficient
Developing
Not
Present
The paper meets or
exceeds organization
requirements:
-The Ecomap graphic is
well developed and
submitted.
The paper mostly meets The paper could use
the organization
more development in
Not
requirements:
the area of
Present
organization:
-The Ecomap graphic is -The Ecomap graphic
clear.
and/or paper
organization/flow and/or
–Flow of narrative is
the SMART Plan need
organized and tracks
numerous corrections.
well.
Grammar/
20 to >17 pts
Punctuation/Spelling
Advanced
Organization
Points
–Flow is apparent and
easy to follow.
-The SMART plan
graphic is clear and
detailed in each
required dimension.
20 pts
20 pts
20 pts
-The SMART plan
graphic is clear and
includes each required
dimension of the
acronym SMART for
each goal stated.
Total Points: 200
ECOMAP AND SELF CARE
1
Ecomap and Self-Care Plan
School of , Liberty University
Author Note
“Insert full name here. Include ORCID number in URL format if you have one.”
I have no known conflict of interest to disclose. “”
Correspondence concerning this article should be addressed to
“Insert Student’s Full Name” . Email:
ECOMAP AND SELF CARE
2
Ecomap
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
Self-Care Ecomap Reflection
Start with an introductory paragraph and write a 3-page APA paper reflecting on your
findings from the development of the Ecomap.
ECOMAP AND SELF CARE
4
SMART Plan
You must address the physical, psychological, social, professional/academic, and
spiritual dimensions in your care plan. Specific goals/objectives (more than 1 per category) and
accountability measures must be noted using the SMART format. An example of a SMART
Goal: I will go to the gym four times a week at 7am. Accountability: I will go with Jill two of
those days. On the other two days, I will call Jill and let her know how my workout went.
CARE AREA
Physical Care
Psychological Care
Spiritual Care
Social Care
Professional/Volunteer Care
SELF-CARE PLANNING FORM
S.M.A.R.T. GOALS
Specific, Measurable,
Achievable, Realistic, and
Time-limited
ACCOUNTABILITY
MEASURE
ECOMAP AND SELF CARE
5
Conclusion
Indent and write your conclusion here. It contains a short summary of your paper.
ECOMAP AND SELF CARE
6
References
(these may not be necessary)
Please list references on a separate page at the end of your paper. You can use your
textbooks as your references. Remember to use APA 7.0 for the entire paper.
In the new version of APA, you need to cite the Bible. You no longer need to indicate
the location of the publishing house.
Here are some examples:
New American Standard Bible. (1995). Thomas Nelson. (Original work published 1971)
New International Version Bible. (2012). The NIV Bible. https://www.thenivbible.com/
(Original work published 1978)

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261 Wx.

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am doing an introduction for research on I need more information and her is the prof comment on my work. So, I need your help to complete what he wants. I feel the background or literature review section needs more depth in terms of mentioning the existing studies that have assessed knowledge, attitude, practices regarding obesity, some may have focused on one or two… but we can still mention it.. also we have added body weight perception segment in our questionnaire, so this will be worthwhile writing about to. Finally, gaps in the literature needs to be outlined to highlight the significance of the study. Basically, the studies that you will mention in your section will be covered again in the discussion section, by another colleague, and to be compared with the study findings.I also have some extra references that can help you.Thank youattached my introduction and the research proposal

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1. Background
1
Based on World Health Organization 2016, 13% of adults worldwide were obese (men: 11%; women: 15%).
2
1
3
In 2020, there were 24.7% of Saudi Arabians who were obese. Women were more likely than men to be obese
4
(27.4% vs. 22%). Additionally, compared to the Western and Northern regions of Saudi Arabia, the Eastern
5
and Central regions had a higher frequency of obesity.2
6
Obesity is abnormal or excessive accumulation of fat. It poses a severe risk for several chronic conditions,
7
including type 2 diabetes, cardiovascular disease, disability, and mortality. A combination of factors,
8
including heredity, lifestyle, inactivity, poor diet, and eating habits, contributes to it. Obesity is currently
9
linked to a wide range of illnesses that can impact a person’s quality of life, strain the healthcare system, and
10
harm the nation’s economy.1
11
Dietary habits are the most important risk factor for obesity in Saudi Arabia. Shifting to a Western diet and
12
higher intake of sugary beverages as well as a lack of physical activity. In addition, education and income,
13
Sleep hygiene, psychosocial issues, and physical exercise are all important considerations. Obesity is
14
currently related with a wide range of health issues that can impair an individual’s quality of life, impose
15
stress on the healthcare system, and place a financial burden on the country. 2 ,3
16
The Saudi government is pursuing a wide range of programs under its Vision 2030 plan for a healthier
17
population in response to the enormous health and social repercussions of the obesity crisis.4
18
Furthermore, some current research focused on specific groups, such as physicians or medical students, and
19
had a small sample size, limiting their generalizability to the general
20
1
population.This research helps in the identification of gaps in people’s knowledge, attitudes, and dietary prac
21
tices. It helps in understanding the factors that influence people’s decisions and behaviors.
22
These findings will help researchers in developing community interventions to combat obesity and improve
23
quality of life in Saudi Arabia.
24
25
Reference
26
1. Obesity and overweight. (n.d.). Retrieved from https://www.who.int/news-room/factsheets/detail/obesity-and-overweight
27
28
2. Althumiri, N. A., Basyouni, M. H., AlMousa, N., AlJuwaysim, M. F., Almubark, R. A., BinDhim, N.
29
F., Alkhamaali, Z., & Alqahtani, S. A. (2021). Obesity in Saudi Arabia in 2020: Prevalence,
30
Distribution, and Its Current Association with Various Health Conditions. Healthcare (Basel,
31
Switzerland), 9(3), 311. https://doi.org/10.3390/healthcare9030311
32
3. Salem, V., AlHusseini, N., Abdul Razack, H. I., Naoum, A., Sims, O. T., & Alqahtani, S. A. (2022).
33
Prevalence, risk factors, and interventions for obesity in Saudi Arabia: a systematic review. Obesity
34
Reviews, 23(7), e13448.
35
4. Saudi Arabia Vision 2030 . [Internet]. cited: 2023. July
26. https://www.vision2030.gov.sa/
36
37
2
Assessing Knowledge, Attitudes, and Practices (KAPs) regarding obesity in Saudi
Arabia
Proposal
Literature review:
Obesity is a growing health problem. Since 1980, the global prevalence of overweight and
obesity has doubled making around third of the world’s population overweight or obese (Chooi et
al., 2019). In 2013, a national study in Saudi Arabia revealed that the prevalence of obesity was
33.5% among females and 24.1% among males (Memish et al., 2014). Obesity is primarily
caused by an imbalance between energy intake and expenditure (Daniels et al., 2009). Obesity is
a risk factor of many diseases such as, diabetes, hypertension, and cardiovascular diseases
(Schelbert, 2009).
Considering its association with several health issues, it is important to establish good health
knowledge and attitudes toward overweight and obesity. Furthermore, obesity is seen as a
preventable cause of morbidity and mortality worldwide (Alasmari et al., 2017). Despite its
importance, the awareness levels about the risks associated with obesity are considered to be
insufficient (Alasmari et al., 2017). Researches have revealed limited data concerning population
knowledge of obesity related risks and co-morbidities (Alqahtani et al., 2016, Bin Airul Faizilli
et al., 2020, Gormley & Melby, 2020). Understanding the knowledge, attitudes, and behaviors
related to obesity among the Saudi population can help in designing community interventions
that tackle obesity. Findings from this study will further assist healthcare professionals in
tackling obesity.
Several studies were conducted worldwide to assess knowledge and practices related to obesity.
The majority of these studies targeted specific population i.e. medical students or health care
practitioners rather than the general population. This was also seen in studies taking place in
Saudi Arabia. In Saudi Arabia, seven cross-sectional studies were conducted between the years
2013 and 2020 to examine the knowledge, attitude and practice in relation to obesity knowledge
and management (Alqahtani et al 2016, Alissa et al 2015, Sebiany et al 2013, Alshammari et al
2014, Al-Khaldi et al 2014, Al Noor et al 2020, Alomary et al 2016). The researches took place
1
in the cities of Madinah (Alqahtani et al 2016), Jeddah (Alissa et al 2015), Dammam and AlKhobar (Sebiany et al 2013, Alshammari et al 2014), Riyadh (Al Noor et al 2020) and Aseer (
Al-Khaldi et al 2014). A single study was conducted across the kingdom in centers under the
Ministry of Health (Alomary et al 2016). The studied population ranged from secondary school
level male students (Alqahtani et al 2016), male and female attending medical colleges (Alissa et
al 2015). With the majority of studies done among physicians working in health care centers
(Sebiany et al 2013, Alshammari et al 2014, Al-Khaldi et al 2014, Al Noor et al 2020, Alomary
et al 2016).
A study has assessed the prevalence of overweight and obesity, knowledge, and attitude towards
obesity in 314 male students attending secondary schools in Al-Madinah (Alqahtani et al 2016).
The prevalence of overweight and obesity was 11.8% and 16.2% respectively. Around 76.8%
had insufficient knowledge regarding obesity related issues and about half of students showed
positive attitude towards obese people. Similarly, 64 % of physicians in Aseer region had
inadequate knowledge of obesity (Al-Khaldi et al., 2014).
Alissa et al (2015) have conducted a study in Jeddah on King Abdulaziz University medical
student from both genders to examine their level of knowledge regarding nutrition and physical
activity, in addition to their attitude and practices regarding healthy eating, and barriers to
healthy practices. The study found that regardless of their evident awareness of the importance of
healthy eating habits, daily application of such habits was limited. Around 75% – 94% of
students have shown good knowledge on the following topics: the composition of balanced diet,
healthiest frying method, ideal eating behaviour, vitamins and minerals importance and the
meaning of organic food. Yet, a lower percentage of students (18-39%) have shown knowledge
regarding healthy cooking methods, identification of healthy food and the genetically modified
food definition. The generalizability of study finding is restricted to students with medical
background.
Two studies were conducted in the cities of the Eastern region, and measured physician’s
knowledge regarding obesity diagnosis and treatments, barriers for disease management
(Sebiany et al 2013) and attitude regarding responses and practices for obesity management
(Alshammari et al 2014). The former study found adequate knowledge for obesity prevalence
and diagnosis, yet information regarding risk of obesity in developing cancer was not adequate.
2
This is in parallel with findings from Bocquier et al., (2005) study. It is noteworthy to mention
that the majority of the participating physicians were either overweight or obese and those were
found to be less likely to be involved in patient education regarding weight loss strategies
(Sebiany et al 2013). In this study, only 20 % of physicians reported having adequate training to
treat obesity (Sebiany et al 2013). They identified lack of training and poor administrative
support to be among the main barriers to obesity management in their medical practice.
Although few local studies have used validated instruments in their studies (Alqahtani et al 2016,
Alissa et al 2015, Alshammari et al 2014, Al Noor et al 2020, Alomary et al 2016), the low
sample size, the targeted group, and the different study objectives makes it rather difficult to
apply it to the general population. Therefore, it is necessary to develop a new questionnaire to
assess the Knowledge, Attitude, and Practices (KAPs) related to obesity among in Saudi Arabia.
Research significance:
Considering the alarming rates of obesity in Saudi Arabia and in alignment with Vision 2030,
there is a need to understand the underlying reasons and factors that may influence individual’s
choices and lifestyle. Doing so will help in designing interventions that aims at improving the
community health and quality of life. One way of achieving this is through assessing the current
knowledge, attitude, and practices (KAPs) of Saudi population regarding obesity. Limited KAPs
studies have been conducted in Saudi Arabia. In addition, the existing studies were concerned
with specific groups such as physicians or medical students and based on small sample size
limiting its generalizability across the general population. To the researcher’s knowledge, this is
the first study to assess KAPs related to obesity among Saudi population. This study will help
identify the gaps in people’s knowledge, attitudes, and dietary practices. It will also help
understand the factors that influence people’s choices and behaviors. These findings will help
inform researchers on community interventions aimed at tackling obesity and improving quality
of life in Saudi Arabia.
Objectives:
•
To assess the current knowledge, attitudes, and dietary practices of obesity among Saudi
population.
3
•
Assess the relationship between knowledge and attitude of obesity among Saudi
population.
•
Assess the relationship between knowledge and dietary practices of obesity among Saudi
population.
•
Assess the social factors that may influence knowledge, attitude, and practices of obesity
among Saudi population.
Methods:
KAPs questionnaire:
This is a cross sectional study design, a self-administered questionnaire will be distributed
through emails and social media accounts such as Twitter and LinkedIn. Participants will be
asked to give their consent prior to inclusion of the study. Also, participants’ confidentiality will
be ensured through data handling “anonymously”. Ethical approval will be obtained prior to data
collection.
The study population will include adults residing in Saudi Arabia. Sample size was estimated
using Raosoft with a confidence level of 95%, 385 subjects will be included. Researchers will
consider several elements prior to developing a questionnaire: content, response format, validity
and reliability. Following this, the questionnaire will be tested in a pilot study.
A. Validity: Content validity, face validity, and construct validity of the developed questionnaire
will be assessed through experts’ evaluation (n = 10) in the fields of obesity and nutrition.
Construct validity will be assessed through Spearman’s or Pearson’s correlations. Items with
correlation coefficient >0.7 will be omitted. Content validity will be ensured by making sure
each item is verified using different health policy and report documents such WHO, The Food
Standard Agency, and American Dietetic Association, and the British Dietetic Association.
B. Reliability: Internal consistency and reliability of each scale will be tested using Cronbach
alpha reliability test. The homogeneity of the question items in each domain will be evaluated
using Cronbach’s α coefficient (Tavakol and Dennick, 2011). A coefficient of 0.7 or higher is
preferred for a questionnaire to be internally consistent (Deniz and Alsaffar, 2013).
4
C. Components of the questionnaire: The components of the questionnaire were divided into
five main sections: sociodemographic data, anthropometric data, knowledge questions
(Definition of obesity, risk factors, and consequences), attitude questions, and practice questions.
D. Response format and scoring: Closed ended questions will be used in this study as it is
easier to conduct and allow quicker compared to open-ended questions. Furthermore, more
number of statements can be answered within a specific time period. A combination of response
formats will be used: True, False, and uncertain, and Likert scale. Considering the widespread of
study sample with different education level, 5-point Likert scale will be used in the response
format.
Statistical analysis:
The collected data will be recorded, coded, and verified. All data analyses will be conducted
using Statistical Package for Social Sciences (SPSS version 24). Inferential and descriptive
analyses will be performed. Frequency statistics presents the distribution of the scores while
inferential statistics determine if the findings from the sampled population can be generalizable
(Spector et al., 2014). Descriptive statistics (means, standard deviations, frequencies, and
percentages) will be calculated. The Kolmogorov-Smirnov test will be used to assess data
normality.
Non- normally distributed continuous data and categorical data will be analysed using a nonparametric statistical testing (Chi-square tests, Mann-Whitney U Tests) Kruskal-Wallis Tests
will be used to determine differences in scores between age, gender and BMI groups (subanalysis for more than 3 groups). Differences were considered significant at P < 0.05. Spearman Rho correlation coefficients will be computed to test possible relationships between variable of interest (health behaviours, their attitudes, and their knowledge regarding obesity risk), in addition to their correlation with sociodemographic, anthropometrical and nutritional data collected. 5 References: Alasmari, H. D., Al-Shehri, A. D., Aljuaid, T. A., Alzaidi, B. A., & Alswat, K. A. (2017). Relationship between body mass index and obesity awareness in school students. Journal of clinical medicine research, 9(6), 520. Al-Khaldi, Y. M., Melha, W. S. A., Al-Shahrani, A. M., Al-Saleem, S. A., & Hamam, M. A. (2014). Knowledge, attitude and practice of primary health care physicians in Aseer region regarding obesity. Saudi Journal of Obesity, 2(2), 54. Alomary, S., Saeedi, M., Alotaibi, T., al Shehri, F., Bashir, A., Ali, A., & El-Metwally, A. (2016). Knowledge and training needs of primary healthcare physicians regarding obesity management in Saudi Arabia. Saudi Journal of Obesity, 4(1), 20. https://doi.org/10.4103/2347-2618.184952 Al-Qahtani, A. M., & Sundogji, H. (2016). Attitudes and knowledge of obesity risks among Male high school students in Al-Madinah, Saudi Arabia. Journal of Applied Pharmaceutical Science 6(10):154-158. doi: 10.7324/JAPS.2016.601021. Alshammari Al-Shammari Yf, Y. F. F. (2014). Attitudes and practices of primary care physicians in the management of overweight and obesity in eastern saudi arabia. International Journal of Health Sciences, 8(2), 151–158. http://www.ncbi.nlm.nih.gov/pubmed/25246882 B Al Noor, M. A., Fayez Horaib, Y., Abdulaziz Almusallam, N., Yousef Alyousef, A., Suliman Alkahmous, F., Yousef Alyousef, A., & Ali Al laili, D. (n.d.). International Journal of Medicine in Developing Countries Physicians’ knowledge, feelings, attitudes, and practices toward obesity at family medicine setting in Riyadh, Saudi Arabia. https://doi.org/10.24911/IJMDC.51-1573494087 bin Airul Faizili, A., Hidayahtun Najihah Binti Yahaya, N., Binti Jasman, N., Yee Jie, O., & Prasha Selvakumaran, T. (2020). A Cross Sectional Study of Attitude Towards Obesity Among Medical Undergraduates. In International Journal of Biomedical and Clinical Science, 5 (4). Bocquier A, Verger P, Basdevant A, Andreotti G, Baretge J, Villani P, Paraponaris A. Overweight and obesity: knowledge, attitudes, and practices of general practitioners in france. Obes Res. 2005;13(4):787– 795. doi: 10.1038/oby.2005.89 Chooi, Y. C., Ding, C., & Magkos, F. (2019). The epidemiology of obesity. Metabolism, 92, 6-10. Daniels, S. R. (2009). Complications of obesity in children and adolescents. International journal of obesity, 33(1), S60-S65. Deniz MS, Alsaffar AA. Assessing the validity and reliability of a questionnaire on dietary fibre related knowledge in a Turkish student population. J Health Popul Nutr. 2013;31:497–503. Gozal, D., & Kheirandish-Gozal, L. (2012). Childhood obesity and sleep: relatives, partners, or both?—a critical perspective on the evidence. Annals of the New York Academy of Sciences, 1264(1), 135. Memish ZA, El Bcheraoui C, Tuffaha M, Robinson M, Daoud F, Jaber S, et al. Obesity and Associated Factors — Kingdom of Saudi Arabia, 2013. Prev Chronic Dis 2014;11:140-236. 6 Mokbel Alissa, E. (2015). Knowledge, Attitude and Practice of Dietary and Lifestyle Habits Among Medical Students in King Abdulaziz University, Saudi Arabia. International Journal of Nutrition and Food Sciences, 4(6), 650. https://doi.org/10.11648/j.ijnfs.20150406.18 Schelbert, K. B. (2009). Comorbidities of obesity. Primary Care: Clinics in Office Practice, 36(2), 271285. Sebiany, A. (2013). Primary care physicians′ knowledge and perceived barriers in the management of overweight and obesity. Journal of Family and Community Medicine, 20(3), 147. https://doi.org/10.4103/2230-8229.121972 Spector, M., Merrill, D., Elen, J., Bishop, M.J., 2014. The Handbook of Research for Educational Communications and Technology, 4th ed. Springer, New York. Tavakol M, Dennick R. Making sense of Cronbach's alpha. Int J Med Educ. 2011;2:53–5. World Health Organization. Obesity: Preventing and Managing the Global Epidemic. World Health Organization: Geneva, 2000.Accessed Aug 2016 7 1. Background 1 Based on World Health Organization 2016, 13% of adults worldwide were obese (men: 11%; women: 15%). 2 1 3 In 2020, there were 24.7% of Saudi Arabians who were obese. Women were more likely than men to be obese 4 (27.4% vs. 22%). Additionally, compared to the Western and Northern regions of Saudi Arabia, the Eastern 5 and Central regions had a higher frequency of obesity.2 6 Obesity is abnormal or excessive accumulation of fat. It poses a severe risk for several chronic conditions, 7 including type 2 diabetes, cardiovascular disease, disability, and mortality. A combination of factors, 8 including heredity, lifestyle, inactivity, poor diet, and eating habits, contributes to it. Obesity is currently 9 linked to a wide range of illnesses that can impact a person's quality of life, strain the healthcare system, and 10 harm the nation's economy.1 11 Dietary habits are the most important risk factor for obesity in Saudi Arabia. Shifting to a Western diet and 12 higher intake of sugary beverages as well as a lack of physical activity. In addition, education and income, 13 Sleep hygiene, psychosocial issues, and physical exercise are all important considerations. Obesity is 14 currently related with a wide range of health issues that can impair an individual's quality of life, impose 15 stress on the healthcare system, and place a financial burden on the country. 2 ,3 16 The Saudi government is pursuing a wide range of programs under its Vision 2030 plan for a healthier 17 population in response to the enormous health and social repercussions of the obesity crisis.4 18 Furthermore, some current research focused on specific groups, such as physicians or medical students, and 19 had a small sample size, limiting their generalizability to the general 20 1 population.This research helps in the identification of gaps in people's knowledge, attitudes, and dietary prac 21 tices. It helps in understanding the factors that influence people's decisions and behaviors. 22 These findings will help researchers in developing community interventions to combat obesity and improve 23 quality of life in Saudi Arabia. 24 25 Reference 26 1. Obesity and overweight. (n.d.). Retrieved from https://www.who.int/news-room/factsheets/detail/obesity-and-overweight 27 28 2. Althumiri, N. A., Basyouni, M. H., AlMousa, N., AlJuwaysim, M. F., Almubark, R. A., BinDhim, N. 29 F., Alkhamaali, Z., & Alqahtani, S. A. (2021). Obesity in Saudi Arabia in 2020: Prevalence, 30 Distribution, and Its Current Association with Various Health Conditions. Healthcare (Basel, 31 Switzerland), 9(3), 311. https://doi.org/10.3390/healthcare9030311 32 3. Salem, V., AlHusseini, N., Abdul Razack, H. I., Naoum, A., Sims, O. T., & Alqahtani, S. A. (2022). 33 Prevalence, risk factors, and interventions for obesity in Saudi Arabia: a systematic review. Obesity 34 Reviews, 23(7), e13448. 35 4. Saudi Arabia Vision 2030 . [Internet]. cited: 2023. July 26. https://www.vision2030.gov.sa/ 36 37 2 Purchase answer to see full attachment

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The 41-Year-Old Patient Evaluation & Management Plan

Jun 14, 2024 | Health Medical

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A 41-year-old male patient presents at the community walk-in clinic
with complaints of severe elbow pain radiating into the forearm. His
13-year-old daughter is serving as a translator because her father is
unable to speak English and understands only a few words in English. The
daughter explains that he has been taking Tylenol to manage pain, but
the pain is getting worse and is keeping him from working. You ask the
daughter to describe the type of work her father does, and you notice
she is hesitant to respond, first checking with her father. He responds,
and she translates that he works in construction. Based on the response
and the apparent concern, you suspect that the patient may be an
undocumented worker. Further conversation reveals that several members
of the family are working with the same local construction company.You suspect the pain reported as coming from the elbow and radiating
down the forearm is caused by repetitive motions, perhaps indicating
lateral epicondylitis. What can you do to confirm this diagnosis?While performing the physical examination, you ask the patient,
through his daughter, if he has reported this injury to his employer,
because the injury is most likely work-related. The daughter responded
without consulting her father that this is an old injury that happened
before he started working at his current place of employment. You could
tell that she was becoming more distressed. What is the most likely
explanation for her concern?Visual inspection reveals erythema around the affected area with no
evidence of overlying skin lesions, scars, or deformities. What other
assessments should you perform?How is lateral epicondylitis treated?When discussing possible treatment approaches, you notice that the
patient is very worried and seems to suggest to his daughter that they
should leave. The daughter begins trying to explain why they have to
leave right away. What would you tell the patient and his daughter to
help them feel comfortable staying for treatment?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.No AI Submissions

Writing a health blog for young children, adolescents and parents

Jun 14, 2024 | Health Medical

Description

Please find attached documents for the detailed assignment.

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Week 5
Introduction
Patient education is an effective tool in supporting compliance and treatment for a diagnosis. It
is important to consider effective ways to educate patients and their families about a
diagnosis—such as coaching, brochures, or videos—and to recognize that the efficacy of any
materials may differ based on a particular patient’s needs and learning preferences. Because
patients or their families may be overwhelmed with a new diagnosis, it is important that
materials provided by the practitioner clearly outline the information that patients need to
know.
For this Assignment, you will pretend that you are a contributing writer to a health blog. You are
tasked with explaining important information about anxiety disorder in language appropriate
for child/adolescent patients and/or their caregivers.
Summary: In a 300- to 500-word blog post written for a patient and/or caregiver
audience, explain the signs and symptoms of your diagnosis, pharmacological
treatments, nonpharmacological treatments, and appropriate community
resources and referrals.
Please take note.
1. Explain signs and symptoms for the assigned diagnosis in children and
adolescents. The response should accurately and concisely explain signs and
symptoms of the assigned diagnosis in language and tone that are engaging and
appropriate for a patient/caregiver audience.
2. Explain pharmacological and nonpharmacological treatments for children and
adolescents with the diagnosis. The response should accurately and concisely
explain pharmacological and nonpharmacological treatments in language and tone
that are engaging and appropriate for a patient/caregiver audience.
3. Explain appropriate community resources and referrals for the assigned diagnosis.
The response should accurately and concisely explain appropriate community
resources and referrals for the assigned diagnosis in language and tone that are
engaging and appropriate for a patient/caregiver audience.
Please ensure the content: Written Expression and Formatting – The Paragraph Development and
Organization: Paragraphs make clear points supporting well-developed ideas, flow logically, and
demonstrate continuity. Sentences are carefully focused—neither long, rambling, short, and lacking
substance. A clear and comprehensive purpose statement and introduction are provided that delineate all
required criteria.
Written Expression and Formatting – should be in American English Writing Standards: Correct grammar,
mechanics, and proper punctuation. The paper follows the correct APA format for title page, headings,
font, spacing, margins, indentations, page numbers, parenthetical/narrative in-text citations, and reference
list is in alphabetical order.

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Nursing Question

Jun 14, 2024 | Health Medical

Description

Do clinical judgement plan based off of given case study also a example is provided fill out entire case stufy and make sure there is no plagiarism, cite sources and put references and use in text citationsfill out the doc provided

Jun 14, 2024 | Health Medical

Description

Module 05: 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.

Discussion

Jun 14, 2024 | Health Medical

Description

You follow up the instructions att

Immunology Question

Jun 14, 2024 | Health Medical

Description

answers the questions below

Jun 14, 2024 | Health Medical

Description

Part One:

Consider what you have learned about the developmental trajectory of children between the ages of birth and age 3. Carefully reflect on essential knowledge you have gained regarding how important it is for infant/toddler professionals to understand developmental milestones and patterns of play and have realistic expectations for young children’s knowledge, capabilities, and behaviors. Also consider the importance of early environments and experiences in supporting healthy development and learning. With this in mind:

Identify 3 publications or articles or videos (e.g. journals, web-based resources that include research and practical applications) that would support infant/toddler professionals in developing knowledge and skills related to supporting the development and learning of infants and toddlers.

For each resource identified include:

The name of the resource
Where the resource can be found
A 3-5 sentence overview of why you selected the resource (for example, why is this resource beneficial in terms of supporting infant/toddler professional knowledge and skills?).
3 key ideas from reviewing the resource that you found beneficial in supporting your own development and learning.

Part Two:

Consider what you are learning about the importance of families, parent-child relationships, and parent-child interactions in influencing healthy growth and development for young children, age’s birth to 3. Specifically reflect on attachment and identity development. With this in mind:

Identify 3 publications (e.g. journals, web-based resources that include research and practical applications) that would support infant/toddler professionals in working with families and supporting healthy parent-child relationships and parent-child interactions.

For each resource identified include:

The name of the resource
Where the resource can be found
A 3-5 sentence overview of why you selected the resource (for example, why is this resource beneficial in terms of supporting infant/toddler professional knowledge and skills in working with families and promoting positive parent-child relationships and parent-child interactions?).
3 key ideas from reviewing the resources that you found beneficial in supporting your own development and learning as it relates to working with families and supporting positive parent-child relationships and parent-child interactions.

Part Three:

Visit the Gateways to Opportunity Statewide Training Calendar: https://courses.inccrra.org/Links to an external site.

Identify one training (two total) focused on each of the following topics (you do NOT have to complete these trainings, simply identify appropriate ones):

Supporting infant/toddler professionals in developing knowledge and skills related to supporting the development and learning of infants and toddlers
Supporting infant/toddler professionals in working with families and supporting healthy parent-child relationships and parent-child interactions

After you identify each training, provide the name of the training, when it is offered, and copy and paste the description.

Assignment length: 2-3 pages

View Rubric

ECE 107 Resource File

ECE 107 Resource File
Criteria Ratings Pts
Three publications- knowledge and skills in infant and toddler development

view longer description

20 pts

Full Marks

0 pts

No Marks

/ 20 pts

Three publications- working with famkilies

20 pts

Full Marks

0 pts

No Marks

/ 20 pts

Identify one training (two total) focused on each of the following topics (you do NOT have to complete these trainings, simply identify appropriate ones):

10 pts

Full Marks

0 pts

No Marks

/ 10 pts

Total Points: 0

Discussion Question

Jun 14, 2024 | Health Medical

Description

For this discussion, research the concept of health disparity. Then respond to the following instructions:Define health disparity.Identify a specific health disparity using scholarly evidence.Discuss the social determinants of health that influence this disparity.Please be sure to validate your opinions and ideas with citations and references in APA format.

Radiography in forensic dentistry

Jun 14, 2024 | Health Medical

Description

Look up websites on forensic dentistry. Discuss in a Power Point how radiographs can be used in a forensic investigation, including how antemortem and postmortem radiographs are compared. Specific cases can be included, but please do not include graphic photos. Please include at least 5 slides, and ensure citations are included, in APA format.

Nursing Question

Jun 14, 2024 | Health Medical

Description

https://youtu.be/P2a9102jifMComplete a SOAP Note as if you were the psychotherapist in the video. Then write a one-page summary that highlights the warning signs of suicidality in the patient and why you chose the treatment plan you choose in your SOAP Note.

Treatment Plan

Jun 14, 2024 | Health Medical

Description

Treatment Plan

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A family just migrated from another country to your area and you are seeing them in the
clinic for the first time. They do not speak English well. There are two children, ages 2 years
6 months and 6 years. When taking the children’s history, you become aware they have not
seen a provider in two years. Utilizing the Health Promotion Guide available in the course
and the CDC vaccination schedule, develop a treatment plan to include vaccinations, safety,
health promotion, and wellness preservation for these children. Provide a rationale for
recommendations from sources such as the CDC.

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374 solve 3

Jun 14, 2024 | Health Medical

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Paper assignment guidelines Short essay of 300 – 500 words in APA style. Submission on 28 October 2023 11: 59 PMConduct 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 1.5Use 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.

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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.
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
1
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.
Congressional Research Service
2
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.
Congressional Research Service
3
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.
Congressional Research Service
4
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 declaratio

Case Study

Jun 14, 2024 | Health Medical

Description

Choose a topic of related to your current clinical experience. Consider the following elements as you answer the following questions:Consider a common diagnosis for patients in your clinical experience. If you are not currently in clinical, identify medications related to a diagnosis you are familiar with.What medication is your patient taking? Identify the mechanism of action and therapeutic action of any anti-inflammatories including glucocorticoids, and any antimicrobial agents.What are the potential systemic adverse reactions to the medications? What are the therapeutic actions that you will be monitoring for?Are there potential toxicity’s related to any medication your patient is taking? What might the healthcare provider need to consider with your patient related to these medication’s?Please be sure to validate your opinions and ideas with citations and references in APA format.

Systemic Review Appraisal + Qualitative or Quantitative Article Appraisal

Jun 14, 2024 | Health Medical

Description

For Systemic Review Appraisal:

Critique one article using the appraisal form:Systematic or Integrative Review Download 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.

For Qualitative or Quantitative Article Appraisal:

Critique one article using the appropriate appraisal form:

Qualitative ReviewDownload Qualitative Review
Quantitative ReviewDownload Quantitative Review

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.

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
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 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

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Health & Medical Question

Jun 14, 2024 | Health Medical

Description

I want to write 2 part First , write the itnroduction ( 1500 words ) Inculde : 1- infection organisem and infection disease of the kidney which include all this point ( what is the infection of the kidney , what are the organisem that found in the kidney infection with small introduction of all organisem , what are the symptome of infection , how can dignose this organisem . 2- diabetis disease which include ( what is the diabetis disease , how can affect this disease on the kidney , what is the affect of this disease on epithilial cells in urine , what are the symptoms of the disease , what are the type of the disease ) 3- kidney stone which inculde ( what are the kidney stone , type of the kidney stone , symptoms of kidney stone , how the disease occur and how can affect on the kidney ) 4- lupus nephritis disease which include ( what is the lupus nephritis , how can the disease occur , type and stage of this disease , symptoms of this disease ) 5- urine cytology ( what is the urine cytology , ( manual and automated ) , how can to dignosis the kidney disease by this procedure . 2 the second part is liturutrure review about this topic 1- infection ( pathology of the disease , dignosis by the urine cytology ( sedement and smear ) prognosis of disease , change of the epithilial cells in the urine by infection , tretment 2- diabetis ( pathology , diagnosis by urine cytology , change of the epithilial cells in the urine in pateint of diabetis , tretment 3- kidney stone ( pathology , diagnosis by urine cytology , change of the epithilial cells in the urine , tretment ) 4- lupus nephritis ( pathology , diagnosis by urine cytology , change of the epithilial cells in the urine , tretment ) . I need this part 2000 to 3000 words . I have references from which I want the file to be written, and I do not want them to deviate from these references, and I do not want references other than these .

Unformatted Attachment Preview

Hindawi
Journal of Diabetes Research
Volume 2019, Article ID 9475637, 7 pages
https://doi.org/10.1155/2019/9475637
Research Article
A Liquid-Based Cytology System, without the Use of
Cytocentrifugation, for Detection of Podocytes in Urine
Samples of Patients with Diabetic Nephropathy
Moritsugu Kimura ,1 Masao Toyoda ,1 Nobumichi Saito,1 Noriko Kaneyama ,1
Han Miyatake ,1 Eitaro Tanaka ,1 Hirotaka Komaba ,1 Masanori Hara,2
and Masafumi Fukagawa 1
1
Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine,
Isehara, Japan
2
Iwamuro Health Promotion Center, Niigata, Japan
Correspondence should be addressed to Masao Toyoda; m-toyoda@is.icc.u-tokai.ac.jp
Received 2 June 2018; Revised 3 December 2018; Accepted 25 December 2018; Published 17 February 2019
Academic Editor: Pedro M. Geraldes
Copyright © 2019 Moritsugu Kimura et al. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective. Podocytes have highly diﬀerentiated functions and are extremely diﬃcult to grow; thus, damage of podocytes is
associated with glomerular dysfunction. Desquamated podocytes can be detected in urine of patients with severe renal
impairment. Unlike the rapidly progressive glomerular damage in glomerulonephritis, only a few desquamated podocytes are
usually detected in diabetic nephropathy (DN). It is not clear whether the low podocyte count in DN is due to limitation of the
conventional method or true pathological feature. The aim of this study was to compare the conventional method with a newly
modiﬁed method in detecting podocytes in morning urine samples of patients with DN. Materials and Methods. The study
subjects were patients with type 2 diabetes. Urine samples from these patients were analyzed by the conventional method
(Cytospin®) and the modiﬁed method (SurePath™). We determined the rate of detection of urinary podocytes and the number
of detected cells. Results. The detection rate and podocyte count were signiﬁcantly higher by the modiﬁed method than by the
conventional method. The diﬀerences in the detection rates and numbers of podocytes were not signiﬁcant between patients
with normoalbuminuria and those with macroalbuminuria. However, they were signiﬁcant in patients with microalbuminuria.
The number of podocytes in the urine correlated signiﬁcantly with the albumin-to-creatinine ratio, but not with the estimated
glomerular ﬁltration rate. Conclusions. The true number of urinary podocytes, as measured by the modiﬁed SurePath™-based
method, in patients with DN is much higher than that estimated by the conventional method.
1. Introduction
Diabetic nephropathy (DN) is currently the leading cause for
initiation of dialysis in Japan. Extensive research has been
carried out to elucidate the etiopathogenesis of DN, though
mesangial cell matrix proliferation and hypertrophy of the
glomerular basement membrane are considered important
factors involved in the development and progression of DN
[1–4]. In addition, impairment of podocytes has also been
considered in recent years to be an important pathomechanism of albuminuria [5–14].
Compared to other cell components of the glomerulus,
podocytes have speciﬁc biological properties, such as peculiar
morphology, highly diﬀerentiated functions, and poor
growth, and thus, disturbance of podocyte function is usually
associated with marked glomerular dysfunction [12–17].
Therefore, clinical assessment of podocyte impairment is
important in the diagnosis and treatment of glomerular
diseases, including DN.
Various urinary biomarkers have been used in recent
years for clinical assessment of renal function [18]. Most of
them are biomarkers for interstitial lesions and renal tubular
2
Journal of Diabetes Research
Table 1: Clinical parameters of patients of the conventional method group, modiﬁed method group, and normal subjects.
p value∗
Normal subjects (n = 20)
Conventional method (n = 41)
Modiﬁed method (n = 41)
Age (years)
12/8
40 6 ± 8 5
31/10
62 5 ± 10
27/14
63 9 ± 11 0
0.4008
BMI (kg/m2)
22 0 ± 1 9
25 6 ± 3 8
25 8 ± 3 8
0.9372
HbA1c (%)
5 6±0 4
7 4±0 9
7 4±1 7
0.3985
SBP (mmHg)
119 ± 12
133 ± 9 8
131 ± 11 9
0.4521
Gender (M/F)
DBP (mmHg)
2
eGFR (ml/min./1.73m )
UACR (mg/g Cr)
0.3316
69 ± 6 0
76 ± 11 3
74 ± 10 8
0.3830
84 1 ± 9 0
59 4 ± 15 3
55 8 ± 22 2
0.4142
ND
721 ± 1344 9
702 ± 1301 2
0.4305
∗
Statistical comparison of the two groups was performed only between the conventional method and the modiﬁed method. Data are mean ± SD. ND: not
determined, SBP: systolic blood pressure, DBP: diastolic blood pressure.
function, where such urinary tests likely reﬂect areas of
damage. Only a few biomarkers are currently available to
assess glomerular lesions. Importantly, podocytes located
on the external side of the glomerular basement membrane
(GBM), namely, on the urinary space side, are diﬀerent from
the damaged endothelial cells located inside mesangial cells,
such that damage of the podocytes is reﬂected directly in
the urine and that injury-related desquamated and excreted
podocytes can be detected in the urine. In their attempt to
detect damaged podocytes in the urine, Nakamura et al.
[19] immunostained urine smeared on glass slides after
Cytospin® centrifugation using a podocalyxin monoclonal
antibody and designed a method for quantiﬁcation of urinary
podocytes (direct calculation of the number of podocytes).
Using this method, they reported the presence of desquamated and excreted damaged podocytes in urine [19]. Their
results conﬁrmed the presence of numerous podocytes in
the urine of patients with inﬂammatory glomerular diseases,
who develop classical symptoms of acute inﬂammation of the
glomeruli, particularly with the formation of acute extratubular lesions. Furthermore, their ﬁndings conﬁrmed that the
presence of podocytes in the urine reﬂected the acute phase
of the disease, and their detection was useful for the selection
of appropriate treatment [10, 11]. At this stage, however,
there is little or no information on the presence or absence
of podocytes in the urine of subjects with normal renal function and in patients with chronic and mild inﬂammatory glomerular disease, such as DN.
The presence of podocytes in urine samples of patients
with DN is controversial. On the one hand, some investigators using histopathological examination demonstrated the
presence of a low number of podocytes in patients with DN
and conﬁrmed the clinical importance of this ﬁnding, while
others reported that the low urinary podocyte count was
unrelated to the type of diabetes [6, 17, 20, 21]. Therefore,
measurement and quantiﬁcation of urinary podocytes seem
helpful to determine and predict not only the severity of
DN and prognosis but also the selection of treatment for DN.
Compared to glomerulonephritis, which is characterized
by rapid progression, DN progresses slowly over a long
period of time, and the number of desquamated podocytes
excreted in the urine is markedly low, although the latter is
probably due to complexity of the podocyte detection
method [22]. Therefore, improving the rate of detection of
podocytes in the urine requires modiﬁcation and simpliﬁcation of the conventional method to allow universal application and clinical use. Modiﬁcation of the method could be
useful especially if the modiﬁed method is simple and convenient as well as if it imposes little burden on patients.
In the present study, we describe a newly modiﬁed simple
method of liquid-based cytology system for the detection of
podocytes in the urine using SurePath™, which does not
require the use of Cytospin® cytocentrifugation but rather
employs the use of a separating reagent. Here, we describe
and assess the utility of the modiﬁed method.
2. Materials and Methods
2.1. Subjects. The study subjects were type 2 diabetes patients,
with renal function ranging from normoalbuminuria to predialysis chronic renal failure, who received outpatient treatment at Tokai University Hospital and provided written
consent to participate in the study. The following exclusion
criteria were applied: patients on dialysis and patients with
clinical suspicion of complications of kidney diseases other
than DN, based on clinical data (absence of diabetic retinopathy, predominant hematuria compared to proteinuria, overt
proteinuria occurring within 5 years after the onset of diabetes (urinary protein: 1 g/g creatinine or higher), rapid renal
dysfunction, and rapid aggravation of proteinuria within a
short period of detection [23]).
A total of 150 patients who satisﬁed the above criteria
were enrolled. They included 50 patients in whom urinary
samples had already been obtained and subjected to analysis
of podocytes using the conventional method (the conventional method group) and 100 patients whose urine samples
were analyzed by the modiﬁed method (the modiﬁed method
group). Data of the two groups were compared, including
age, sex, body mass index (BMI), blood pressure, HbA1c, disease duration, estimated glomerular ﬁltration rate (eGFR),
and urine albumin-to-creatinine ratio (UACR) in morning
urine samples (Table 1).
The study also included 20 healthy controls whose blood
and urine laboratory tests were within normal values. These
subjects were recruited to assess the diﬀerence between the
rate of detection of urinary podocytes and the podocyte
Journal of Diabetes Research
number between healthy subjects and diabetic individuals.
The characteristics of these subjects are listed in Table 1.
Ethical approval for this study was granted by the Tokai
University Institutional Review Board for Clinical Research,
and all participants provided written informed consent.
2.2. Urinary Podocyte Detection Method. The presence of
podocytes was checked using the conventional and modiﬁed
methods. The study participants were asked to provide urine
voided in the morning, which was stored at −70°C within 2 h
of collection.
2.2.1. Conventional Method
(1) Thirty-milliliter samples of the morning urine were
collected and centrifuged at 1500 revolutions per
minute (700 ×g) for 5 minutes
(2) The supernatant was pipetted out, and the urinary sediment was washed with 0.01 mol/l
phosphate-buﬀered saline (PBS, pH 7.2)
(3) The urinary sediment was resuspended in 10 ml PBS,
and autosmears were prepared by Cytospin®
cytocentrifugation
(4) The samples were air-dried for 30 minutes and
washed with PBS
(5) Then, the slides were incubated in anti-podocalyxin
primary antibody (22A4, mouse monoclonal antibody [10]; dilution, 1 : 80) for 1 hour at room
temperature
(6) The slides were washed in PBS before incubation in
FITC-labeled rabbit anti-mouse IgG secondary antibody (Dako) for 1 hour at room temperature
(7) After washing the slides in PBS, the cell nuclei were
stained using DAPI (Sigma, St. Louis, MO)
(8) The number of podocytes in each slide was calculated
using a ﬂuorescence microscope
Since each sample was prepared from 30 ml urine, the
number was divided by 30 to calculate the number of podocytes per 1 ml of urine.
2.2.2. Modiﬁed Method (Figure 1). To enhance podocyte cell
adhesion to the glass slide prior to the process of immunostaining, we modiﬁed the cell attachment technique from
the autosmear system (Pap smear cytology) to liquid-based
cytology system. The use of a dedicated precoated glass slide
promotes urinary podocyte adherence. Thus, apart from the
use of SurePath™, the remaining steps of our method are
similar to those followed in the conventional method:
(1) Similar to step 1 of the conventional method
(2) Similar to step 2 of the conventional method
(3) The glass slide centrifugation mentioned in step 3
above was omitted
3
(4) The slides were treated with SurePath™
This product enhances gravitational sedimentation and
electrical adherence of the tissue to the glass slide.
(5) Similar as in step 5 of the conventional method
(6) Similar to step 6 of the conventional method
(7) Similar to step 7 of the conventional method
(8) Similar to step 8 of the conventional method
As described above, since the samples were prepared
from 30 ml urine, the number of podocytes per 1 ml of urine
was calculated by dividing the number by 30.
2.2.3. Urinary Podocyte Count and Urinary Podocyte
Detection Rate. The number of desquamated podocytes in
the urine sample was counted in both methods using a ﬂuorescence microscope; DAPI-positive cells were considered to
be nucleated, and the number of podocytes was measured by
counting all DAPI- and podocalyxin-positive cells (Figure 2).
The number of podocytes in 1 ml urine was considered as
the urinary podocyte count, and the “number of participants with podocytes detected in the urine” divided by
the “total number of participants” represented the urinary
podocyte detection rate. The urinary podocyte count and
urinary podocyte detection rate were compared in patients
with normoalbuminuria (UACR < 30 mg/g creatinine), microalbuminuria (UACR ≥ 30 to Purchase answer to see full attachment

Health & Medical Question

Jun 14, 2024 | Health Medical

Description

Please see the attached for this paper.. This goes with activities 1-6 you recently did. Please let me know if I need to attach all of them for you.

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IMAT 637, Midterm Exam
Fall 2023
IMAT 637
Midterm Exam, Fall 2023
Using 1,800-2,000 words, write an individual research paper on the project you have chosen
for Activities 1-6. and answer the following questions in order. Please clearly number each
section in your paper with the number of the question (do these in order 1-6).
As a minimum, the research paper will include the following areas:
1. What is the background of your problem statement, and why did you choose this problem
statement?
2. The decision to perform an acquisition is heavily influenced by how it relates to an
organization’s strategic business goals. Explain why you think the acquisition you are
detailing in your submitted Activities potentially supports the strategic business goals of
the organization.
3. Risk analysis is a critical part of the acquisition process and is often not done very well.
Looking back at the risks you identified for your submitted project, which ones do you
believe would be most likely to be identified and accurately measured, and which ones
either less likely to be identified at all or measured correctly. Explain why. Does your
analysis allow you to draw general conclusions on the type of risk that would be likely to
be overlooked or mis-analyzed in future projects you might work on?
4. Most scenarios submitted for your alternative solutions included either a COTS product
or a SaaS-based solution. Gartner is a top analyst that provides great insights on IT
solutions across a wide range of business needs. Go
to http://www.gartner.com/technology/home.jsp go to
the https://www.gartner.com/en/products/special-reports or leverage on another research
database to look at articles related to the IT solution you are acquiring and share the
analysis on key vendors, product trends, and market potential. This one example if you
have a problem access to the information. Research site like
oracle https://www.oracle.com/applications/what-is-saas/
5. In Session 5 lecture notes, under the heading Commercial Acquisitions, there are
references to two readings (see links below). Determine if either of them apply to your
project. If so, why? If not, why not?

https://obamawhitehouse.archives.gov/blog/2012/03/30/applying-private-sector-bestpractices-information-technology
 https://home.treasury.gov/policy-issues/small-business-programs/small-anddisadvantaged-business-utilization/how-to-do-business-with-treasury#major
6. What did you learn most about IT acquisitions by doing Activities 1-6, and which
Activity did you feel you learned the most from?
Additional format information about this research paper APA format.


Double spaced
Word count only applies to the content of the paper, excluding abstract, table of content
(if included), and references.
IMAT 637, Midterm Exam


Fall 2023
Cite at least twelve (12) references in APA format
APA format is mandatory.
If you have any questions, please post them in the “Ask the Professor” discussion thread or send
an e-mail (for communicating personal issues) to your professor.

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PowerPoint from the book dsm in action

Jun 14, 2024 | Health Medical

Description

The book is called dsm in action. NOT DSM-V.

Choose and read any one case study from Chapter 13 (Personality Disorders) in the most current version of DSM in Action.

Research the specific personality disorder from your chosen case study.

Create a 10-15-slide PowerPoint presentation about your selected case study.

Include the following in your presentation:

A brief description of the selected case study
Explanation and rationale for the Personality Disorder Diagnosis using the latest version of the DSM as a reference.
Information on the course of treatment for the disorder.
Identification of which cluster (A, B, or C) this personality disorder belongs to and an explanation of your rationale.
Information on the prognosis and prevalence of the disorder.
A minimum of five scholarly references including your textbook and the latest version of the DSM. Be sure to only use current and scholarly references for this assignment.
Include detailed speaker notes that represent what you would say if giving the presentation in person.

Comparison of Medical Billing and Coding

Jun 14, 2024 | Health Medical

Description

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.

Conduct an Internet search of medical coding and billing certification programs. Compare and contrast at least two programs, including prerequisites, program content, cost, certification, continuing-education requirements, and professional ethical standards. Are the programs “coding” or “billing” programs or both? What are the strengths and weaknesses of each?

Requirements: 300 Words 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.

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 credible sources published within the last 5 years

Nursing Question

Jun 14, 2024 | Health Medical

Description

you start with the quiz, crazy assignment, concept map, group observation and I attach example for what to do on group observation assignment, then you do prep sheet. For prep sheet we do it lastly so i can provide you information. And please ask if you don’t understand any part so i can make it clear for you!

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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?
Risk Factors
Signs & Symptoms
Potential
Complications
Medical Diagnosis
Medications/Class/use
Nursing Diagnosis
Pt education
Evaluation
Nursing Interventions
N316 – Mental Health Nursing
Group Observation Assignment
Directions: The student is to complete the assignment on one group session the student attends.
Using Table 34-3 of you textbook, draw a diagram of the group using the legend provided below.
Next to each individual, including the leader, indicate the task, maintenance, and/or individual
roles the person took on during the group session. Below the diagram provide a summary of 1)
the purpose of the group session, 2) the explicit rules/boundaries set for the group, and 3) an
observational analysis of the effectiveness of the group process.
Legend: ⁭ – Male
О – Female
Δ – Group Leader
“Quiz”
View the movie “A Beautiful Mind” or “Canvas” and answer the following questions.
All answers must be typed.
Answers are one point each unless otherwise specified.
Due by noon 10/9 (Monday) submitted to Canvas Drop.
Questions for A Beautiful Mind: (You may rent this movie on your own, borrow a copy from
me to watch on campus and return immediately. This movie is also available on Amazon)
1. What Is Paranoid Schizophrenia (1 point)? What evidence of this disorder is depicted
by John Nash? Provide specific examples of Mr. Nash’s behavior that shows he meets
the DSM-V criteria (DSM criteria is in your text p. 191- speak to each point A-F) (3
points).
2. What is the impact of severe mental illness upon healthy family members in the film?
3. What clues are given in the first half of the film that indicated John Nash is in the early
stages of schizophrenia? (what are his first symptoms)
4. How does this film show the fears of the public or stigma about schizophrenia?
5. Give three nursing diagnosis for Mr. Nash include related to and as evidenced by in
the dx. (3 points)
OR
Questions for Canvas: You may use the following link to watch this
https://www.youtube.com/watch?v=V0B6sXUXtNA
1. What is paranoid Schizophrenia (1 point)? What evidence of this disorder is depicted by
the Mom in this movie? Provide specific examples of her behavior meeting the DSM
criteria in your text p. 191- Speak to each point (A-F). (3 Points)
2. What is the impact of severe mental illness upon health family members in the film?
3. How does this film show stigma about mental illness?
4. Name 2 nursing dx for the child in this film include related to and as evidenced by in the
nursing Dx. (2 points)
5. Name 2 nursing dx for the mom in this film. Include related to and as evidenced by in
the nursing Dx. (2 points)
Student Name _____XX________________________________
Client’s Initials: XX
Age:
Room Number:
Ethnicity: C
Facility:
Legal
Status:
416
Date _____3/20/09_____________
27
sweds
Gender
M
F
Admission Date: _3/10/09_________
Unit: Adult
Minor X
Vol.
Invol.
Checks/Precautions:
Close observation Level 2
DSM V: Bipolar II, Problems with Primary Support
MEDICATIONS (Include generic/trade name, classification/use, dose, schedule, common side effects)
Generic Name Trade Name Classification/Use Dose Schedule Side Effects
valproic acid
Depakote
Mood stabilizer
1500 QHS
Liver toxicity, weight gain
aripiprazole
Abilify
antipsychotic
25mg QHS
Sedation, EPS
LABS/DIAGNOSTIC TESTS: (Only those not WNL, Tox Screen, and medication lab levels)
Pregnancy negative.
Refuses vital signs X 3 days.
Tox screen + for
THC and + for
Benzo
Alcohol negative
Depakote level 23
on 3/10
Level 76 on 3/20
Presenting Problem:
Pt went into a gas station and instead of paying she gave the clerk a “high 5” She also
took several items of the shelf of the gas station and attempted to use her Walgreens
card to pay for the items. Police were called and transported her to ER
Physical, sexual abuse history:
Physically abusive ex-husband.
Medical History:
Hx of Asthma
Family History:
Mother with history of Bipolar. Father unknown history. 1 sister suicided 3 years ago. 1
sister lives out of town and client has no contact with them.
Pt 2 kids ages 7 and 3 in DCFS custody.
Substance Abuse History:
Treated times 3 at Rosecrance. DOC is alcohol. Last alcohol use one month ago. Denies
pot use but positive on admission for THC.
Recent Stressors/Losses:
Recently fired from her job. Husband moved out.
Education:
Some college. Wanted to be a nurse.
Legal:
None
Marital History:
Recently separated (3 weeks ago) married for 3 years.
Support Systems (with whom does the client live with):
Pt lives alone. States she has “no family”
Pt view her church as supportive.
Occupational:
Not currently employed. Last employed 4 years ago at a nursing home.
Mental Status Assessment (Include general appearance and behavior,
mood/affect, other):
Appearance:
Physical handicaps ______none______________________________________________
Dress/Grooming: Appropriate X
Inappropriate ⁭ Sloppy ⁭ Poor Hygiene⁭
Gait & Motor coordination (awkward, stagers, shuffling, rigid, steady) __Pt in almost constant motion
with tapping feet and fingers _____________________________________________________
Relationship between appearance and age ___Appears older than stated age____________________
Behavior
Agitated ⁭
Calm ⁭
Lethargic ⁭
Restless X
Anxious X
Angry ⁭
Tearful ⁭
Distractible X Evasive ⁭ Cooperative x Follows commands X
Negative ⁭ Fearful ⁭
Alert X
Movements: Excessive X Reduced ⁭ WNL ⁭
Peculiar body movements (e.g., scanning of the environment, odd or repetitive gestures, level of
consciousness, balance and gait) __pt constantly tapping fingers and feet____________________
Abnormal movements (e.g., tardive dyskinesia, tics, tremors) __None_________________
Level of eye contact (keep cultural differences in mind) ___poor eye contact______________________
Speech
Rate: Rapid X Slow ⁭
Normal ⁭
Volume: Loud X Soft ⁭
Normal ⁭
Clear ⁭
Mumbling ⁭
Pressured X Slurring ⁭ Stuttering ⁭
Constant X Mute or silent ⁭
Disorganized ⁭
Tongue-tied speech ⁭
Barriers to communication ⁭
Specify (e.g., client has delusions or is confused, withdrawn, or verbose) __pt is constantly talking
without taking even a breath, _____________________________________________________
Mood
What mood does the client convey? ___Pt is overly happy and expansive
_______________________________________________________________________
Affect
Is the client’s affect bland, apathetic, flat, dramatic, bizarre, or appropriate? Describe.
_____Affect is inappropriate to situation. Smiles when discussing suicide. __________________
Thought process
1. Characteristics: Flight of ideas X Looseness of association ⁭ Blocking ⁭
Concrete thinking ⁭ Confabulation ⁭ Disorganized ⁭ Neologisms ⁭
Circumstantiality ⁭ Coherent ⁭
Describe the characteristics of the client’s responses ___pt difficult to keep “on topic” and constantly
talking about non-relative situations. _________________________________________________
2. Cognitive ability:
Proverbs: Concrete X
Abstract ⁭
Serial sevens: How far does the client go? ____93_______________
Can the client do simple math? Yes X No ⁭
What seems to be the reason for poor concentration? ___manic behavior________________
Orientation to Time X
Place X
Person X
Situation ⁭No
Thought content
1. Central theme: What is important to the client? __”finding a man”_________________
Describe. ___pt hyperfocused on “finding men”_____________________________________
2. Self-concept: How does the client view him/herself? ___”there is nothing wrong with me”_
____________________________________________________________________
What does the client want to change about him/herself? __physical appearance. _______
____________________________________________________________________
3. Insight: Does the client realistically assess his/her symptoms? Yes ⁭ No X
Describe. ___pt thinks she is “fine” doesn’t see severity of her problems._________________
Realistically appraise his/her situation? Yes ⁭ No X
Describe. __pt focused on “finding a man” when her husband just left her and her kids are in DCFS
custody, and she is unable to maintain in the community. _____________________________
4. Is the client a Reliable historian? ___Unsure________Describe:__some stories make sense while
others have no basis. Pt states she was “never at that gas station” despite admit note. ________
5. Suicidal or homicidal ideation? Yes ⁭
No X Suicide potential? ______________
Family history of suicide or homicide attempt or successful completion? Yes X No⁭
Explain. ___sister suicided__________________________________________________________
6. Preoccupations: Does the client have
Hallucinations ⁭ Type: Auditory ⁭ Visual ⁭ Tactile ⁭ Olfactory ⁭
Delusions X Type: Grandiosity X Jealous ⁭ Persecutory ⁭ Somatic ⁭
Obsessions ⁭
Rituals ⁭ Phobias ⁭ Religiosity ⁭ Worthlessness ⁭ Illusions ⁭
Describe. ____________________________________________________________

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Health technology

Jun 14, 2024 | Health Medical

Description

your post should address the following:

Research change management theories.
Identify a strategy to use with the implementation of an information system.
Justify the choice with information from the chapter and the research.

Requirements:

The post must answer all components of the prompt.
The post must include an internet or text citation including a URL in APA format.
References are NOT to be included in the word count of at least 200 words.

I don’t have the book. It is called introduction to Information Systems for Health information technology.

Nursing intervention for client with schizoaffective disorder

Jun 14, 2024 | Health Medical

Description

Telehealth visit was completed to with Ms. Scott while she was in the community. Verbalized skin was intact, no bruise, cut, and no dehydration. Client was explained signs and symptoms of schizoaffective disorder. Client should always watchout for signs and symptoms of schizoaffective disorder. Nurse educated client of signs and symptoms of schizoaffective disorder. Explain 4 symptoms of schizoaffective disorder and should be simplified for better understanding. Follow the rubric below

Nursing Question

Jun 14, 2024 | Health Medical

Description

Please review the “How to” document posted. Then go to: https://pressbooks.library.torontomu.ca/healthhistory/chapter/health-history-interview-game/Click on “Start the Virtual Gaming Simulation” and complete the interview game. Once you have completed the interview answer the self debrief questions (found here) and prepare a detailed plan of care for this client. Post the debrief answers and the plan of care in the drop box found in the “Clinical Documents” section of Moodle.This alternative assignment for simulation is worth four (4) clinical hours. You MUST complete the assignment by Sunday September 24, 2023 at 2359 to receive the clinical hours.

Unformatted Attachment Preview

How to Play the Virtual Gaming Simulation (VGS):
• When you click on the VGS
link: https://pressbooks.library.ryerson
.ca/healthhistory/ It will bring you to
the main menu.
• When you scroll down the main page,
you will see the Contents of the game.
• Then click on Introduction to learn
about the focus of the game and how
to play.
After reading the Introduction,
click on ‘Next: Health History
Interview Game’ in the lower right
corner
That will bring you to the Health
History Interview page.
Now you are ready to play the virtual
gaming simulation!
Once you click “Start the virtual
gaming simulation”, it will bring you to
the Purpose and Learning Outcomes
slide.
After you read the purpose and
learning outcomes click ”Proceed” in
the upper right hand corner to bring
you to the introduction of the virtual
simulation scenario.
On the introduction slide, you will
learn about your patient Ms. Gemma
Egan. After you read the first page of
the client’s data, click on “Proceed” to
move to the next slide.
After you read and document all of
the client’s data, click on ”Proceed”
This will bring you to the opening
video.
This will bring you to the
opening video.
After the video, you will be asked your
first question.
If you choose the best nursing action,
the video will continue to play on to
the next decision point.
If you choose the incorrect or not the
best answer, you will receive feedback
asking you to reflect on the answer
you chose. You will be given another
chance to select the correct answer.
Key Points to Remember
• Remember to keep the VGS confidential, until your peers
have had an opportunity to play the game for themselves.
• Remember the characters in the virtual simulation are
fictional. The patient’s injury and experience is not real.
• Everything about the virtual simulation is fictional.
After you complete the virtual
simulation, remember to answer the
reflective questions (also known as a
self debrief). The self debrief
questions will assist you to assess
your knowledge and reflect on your
areas of strength and areas that
require further development.

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372 solve

Jun 14, 2024 | Health Medical

Description

Jun 14, 2024 | Health Medical

Description

Create a 12-18-slide presentation for community stakeholders in which you recommend a strategy to address a community health need.

Collapse All

Introduction

As the needs of the patient population change, the United States health care system remains relatively unchanged. Episodes of care are still relatively low in frequency and high in acuity (Nash, Fabius, Skoufalos, & Clarke, 2016). Models of care must be changed. Treatments of chronic health conditions and preventative strategies require more frequent visits at a lower intensity (Nash, Fabius, Skoufalos, & Clarke, 2016). Continuity of care and care transitions maintain an ongoing, consistent contact with patients throughout their lives, not only when they are ill (Nash, Fabius, Skoufalos, & Clarke, 2016). A population health perspective that focuses on chronic health conditions and prevention is needed to improve care transitions (Nash, Fabius, Skoufalos, & Clarke, 2016). Accountable Care Organizations (ACOs) and Patient-Centered Medical Homes (PCMHs) are two models emerging from the Affordable Care Act (ACA) that help focus on chronic diseases and population health (Nash, Fabius, Skoufalos, & Clarke, 2016).

An underlying assumption in version population and patient-centered models is that patients will adhere to the plan they develop with their provider; however, some behaviors may be difficult for patients to change. Unhealthy behaviors such as poor diet, lack of exercise, smoking, and drug use have negative implications for health. Although many patients want to change their diet and exercise behaviors, many find it extremely difficult to do so. Health care providers must work with patients to understand what causes patients to exhibit certain behaviors and how they can be motivated to change these behaviors (Nash, Fabius, Skoufalos, & Clarke, 2016).

The American Marketing Association (AMA) (2017) defines marketing as the processes for creating, communicating, delivering, and exchanging products and services for key stakeholders and society in general. The “4 Ps”—product, place, price, and promotion—are the primarily elements of marketing. Unlike a traditional consumer product such as an automobile, a health care “product” is more difficult to define.

In population health, an example of a product could be training health care providers to reduce obesity across the population. The place refers to where the health care service will be provided, such as an office, the home of a patient, or a community health center. The price consists of two components: 1) the actual out-of-pocket price the consumer must pay for the service and 2) the opportunity cost, such as convenience. Finally, promotion refers to the method that is used to disseminate the message such as radio, TV, print and, most recently, social media and the Internet (Nash, Fabius, Skoufalos, & Clarke, 2016). To achieve the goals of population health, community needs must first be assessed and the health care “marketing mix” tailored to the needs of that community.

REFERENCE

American Marketing Association (AMA). (2017). About AMA: Definition of marketing. Retrieved from https://www.ama.org/AboutAMA/Pages/Definition-of-M…

Nash, D. B., Fabius, R. J., Skoufalos, A., & Clarke, J. L. (2016). Population health: Creating a culture of wellness (2nd ed.). Burlington, MA: Jones & Bartlett Learning.

Demonstration of Proficiency
Competency 1: Integrate principles of epidemiology, population health, and community engagement to plan interventions.
Assess the target audience for recommended community health strategies.
Recommend strategies to mobilize community engagement including a promotion strategy and use of social media and information technology.
Competency 3: Create an action plan to promote wellness and disease management in a diverse population.
Define SMART goals for implementation of a community health need intervention.
Analyze collaboration required to implement a community health strategy.
Recommend potential sources of funding and other resources.
Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with expectations for health care professionals.
Employ appropriate written and visual communication to convey content to an intended audience.
Write following APA style for in-text citation, quotes, and references.
Preparation

Note: It is recommended that you complete the assessments in this course in the order they are presented.

In this assessment, you will be creating a PowerPoint presentation to deliver to one or more groups of community stakeholders. You will recommend a strategy to address the community health need you have been working with throughout the Analyze Community Health Needs and Potential Community Health Interventions assessments. You will focus on the strategy that best fits the needs of the target population within the context of the community and organization you have been using as the setting for your assessments.

To help prepare yourself to be successful when creating your PowerPoint, it is recommended that you complete the following:

Determine the single, best strategy to implement in your community. This should be one of the two interventions you identified and wrote about for your Potential Community Health Interventions assessment.
Determine which community stakeholders would be the best target audience for the PowerPoint.
Think about which populations or groups within the community will be receiving the intervention.
Think about which stakeholders are vital for successful implementation of your chosen intervention.
Ensure you have an understanding on how to create a quality PowerPoint presentation. Capella’s Microsoft Office Software help page offers a number of guides and resources.
Contact Disability Services to request accommodations if you require the use of assistive technology or alternative communication methods to participate in these activities.
Instructions

Create an 8–12 slide PowerPoint to inform and create buy-in from the stakeholder groups you have determined are key to your chosen intervention’s success. These groups include those who influence decisions for funding and implementation, as well as those who would take direct roles in implementation.

As you work to determine the single, best strategy to implement for your chosen health need in the identified population (or populations) in your community, focus on how this presentation can narrow the focus from a broad population need to specific, actionable tasks that community stakeholders must consider before creating an action plan. In your presentation, be sure to consider factors such as educational outreach, financial considerations, and information technology.

Consult the scoring guide to ensure that you are addressing all criteria at the level to which you desire.

In your PowerPoint, be sure to complete the following.

Assess the target audience for recommended community-health strategies.
Define SMART goals for implementation of a community-health need intervention.
You may wish work through the Evidence-Based Strategies and SMART Goals activity to check your understanding about the various characteristics of well-written SMART goals.
Analyze collaboration required to implement a community-health strategy.
Recommend strategies to mobilize community engagement, including a promotion strategy and use of social media and information technology.
Recommend potential sources of funding and other resources.
Employ appropriate written and visual communication to convey content to an intended audience.
Apply proper APA formatting and style.

One potential way you could organize your PowerPoint would be as follows:

Title slide: On the first slide of the PowerPoint, include:
A descriptive title of approximately 5–15 words. Stir interest while maintaining professional decorum.
Professional Development for [enter the institutional context for your presentation].
Your name.
Your specialization.
Course number and title.
Capella University.
Instructor’s name.
Your Stakeholder Analysis in the notes section below.
Note: If this presentation were made in a professional context, the entries under your name would be replaced by your job title, the name of your organization, and (perhaps) your contact information.
Introduction slides: Describe the community health need and its importance.
Recommended solution slides: Describe the solution you chose.
Provide supporting evidence to show that your solution is an evidence-based best practice.
Community engagement strategies slides: Present strategies to mobilize community engagement:
Educational outreach strategies.
Promotion strategy—how could social media and information technology be used?
Implementation strategies slides: Recommend, at a high level, factors that must be considered to successfully implement your strategy, including:
Defined SMART goals for implementation.
Ways audience members should collaborate to implement your strategy.
Estimated costs and potential sources for funding and other resources.
Conclusion slide: End with a succinct summary of the value and feasibility of your recommendations.
References slides: Cite all sources, following current edition APA style and format.
Additional Requirements
Written and visual communication: Ensure content is clear, with correct spelling, grammar, and syntax, and well organized to support orderly exposition of content. The writing and visuals should enhance the message. Avoid errors that detract from the message.
PowerPoint slide formatting:
Write each slide, except the title and references slides, with a bold headline and up to seven bullet points.
Use as few words in each bullet point as needed to convey your message. Think of them as subheadings.
Enter all details and supporting information in the Notes area below the slides.
Length: Compose 12–18 slides.
References: Cite at least three current scholarly or professional resources.
APA formatting: Use APA style for references and citations. Remember to use in-text citation just as you would in a paper-style written assignment.

HCAD 670 HEALTHCARE

Jun 14, 2024 | Health Medical

Description

PLEASE HELP I DO NOT KNOW ANY HEALTHCARE PERSON.

Course Outcomes for Assignment:

Analyze critical factors in a healthcare organization’s internal and external environments that may positively or negatively affect the achievement of the organizational mission and goals.
Assess the relevant strategic decision-making and implementation issues within a healthcare organization.

Each student is required to conduct a half-hour-long interview with a person in a management position in a healthcare-related organization. You should choose a person to interview and make an appointment explaining the purpose of the interview is to learn about leadership and gain practical insights. Use Quick Connect to help you find an industry leader for the interview if needed.

Notes:

The leadership interview is an accreditation requirement for the HCAD program.

Ensure to notify the interviewee you will be recording the interview. The laws pertaining to recording vary by state. It is highly recommended you obtain an agreement to be recorded as the first item, asking for permission then recording the acknowledgment. Make sure to send the transcribed notes to the interviewee to be checked for accuracy. Ensure the Interviewee know the recording is confidential between you, interviewee, and professor; and is discarded upon evaluation of the assignment.

The interview must be transcribed and presented as a summary written report. Verbatim accounting is not required. The report must have 4 elements:

· Cover page: Your name, course number, and date

· Introduction: Who you interviewed and why (credentials, experience, position, etc.).

· Interview: The questions asked and the responses (short summary) received.

· Analysis: Your evaluation of the interviewer’s leadership philosophy, approach, and

Jun 14, 2024 | Health Medical

Description

Ms. Dickerson was seen today through telehealth. She was alert and oriented and denied discomfort. She continuee to work about 50hrs a week and has four children. She explore her environment to know more about what is going on and to know how she can be of help to her community. Ms. Dickerson has a history of sickle cell that disturbs her health condition occassionally. She verbalized to feel sick when is too hot or too cold weather. Client continue to leave with family member in the district and all needs are provided with the help of government support programs that cover food, housing, and health, and the job she does to provide for her family. Nurse provided education to client due to her history of sickle cell. Follow the rubric below

MN504 DISCUSSION PEEER RESPONSE

Jun 14, 2024 | Health Medical

Description

I need one response to each peer, must icinlcude references

Geraldine:Qualitative data is narrative, reflective, or anecdotal information and requires judgment to interpret the data. It answers clinical questions about the human experience (Cadge et al., 2021). Answering this type of question can provide clinicians with the answer to “how” and “why” for practice, whereas answering the questions that require quantitative evidence can give that answer to “what.” Qualitative research can also help clinicians understand clinical phenomena, emphasizing the understanding of the patient’s experience and the patient’s valued preferences (Melnyk et al., 2023). Albers (2017) says quantitative data/ study collects numerical data that must be analyzed to help draw the study’s conclusions. Quantitative data analysis is not teaching number crunching but a way of critical thinking for analyzing the data.

If I were to relate to my picot question: In congestive heart failure (CHF) patients (P), How does self-care education program prior to discharge (I) compared to standard discharge education (C) affect 30-day hospital readmission rates (O) within three months of intervention (T)? One of the articles I read about self-care education and congestive heart failure was a study by Radhakrishnan et al. (2021) where a quantitative study was used using phone interviews, guided by the framework of vulnerability analysis for sustainability, to explore heart failure self-care among older adults in central Texas during the late spring of 2020. Sedlar et al. (2021) used qualitative and quantitative data analysis to study self-care perception and behavior in patients with heart failure. A quantitative study using the European self-care behavior Scale (EHFScBS-9) (n = 80; NYHA II–III, mean age 72 ± 10 years, 58% male) and a qualitative study using semi-structured interviews. Both qualitative and quantitative data can be used in studies.

References:

Albers, M. J. (2017). Quantitative Data Analysis—In the Graduate Curriculum. Journal of Technical Writing and Communication, 47(2), 215–233.https://doi.org/10.1177/ 0047281617692067

Cadge, W., Lewis, M., Bandini, J., Shostak, S., Donahue, V., Trachtenberg, S., Grone, K., Kacmarek, R., Lux, L., Matthews, C., McAuley, M. E., Romain, F., Snydeman, C., Tehan, T., & Robinson, E. (2021). Intensive care unit nurses living through COVID-19: A qualitative study. Journal of Nursing Management, 29(7), 1965–1973.https://doi.org/10.1111 /jonm.13353

Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based Practice in Nursing & Healthcare A Guide to Best Practice. Wolters Kluwer.

Radhakrishnan, K. M. F., Allen, C., DeMain, A. S., & Park, L. M. F.-B. F. (2021). Impact of COVID-19 on Heart Failure Self-Care: A Qualitative Study. Journal of Cardiovascular Nursing, 36(6), 609–617. https://doi-org.libauth.purdueglobal.edu/10.1097/JCN.0000000000000794

Sedlar N, Lainscak M, Farkas J. Self-care perception and behavior in patients with heart failure: A qualitative and quantitative study. ESC heart failure. 2021;8(3):2079-2088.doi:10.1002/ ehf2.13287

Kelsy:Healthcare is a science. Clinicians strive to ensure good outcomes for patients and evidence-based practice provides a means to meet that goal. Most often, we utilize the EBP process to evaluate the effectiveness of an intervention or course of treatment. Quantitative data provides the “numbers” to justify what clinicians should do (Melnyk & Fineout-Overholt, 2023). When our PICOT question aims to ask if a particular intervention is the best practice, we can quantify the outcomes to make a clinical decision. Qualitative data is often considered “weaker evidence” but can be used to answer the how and why regarding clinical practice questions. This type of research can help clinicians understand patient preferences and experiences (Melnyk & Fineout-Overholt, 2023).

Clinical Question

P – Women with postpartum depression

I – Treatment including cognitive behavioral therapy (CBT)

C – Usual treatment (without CBT)

O – Improved depression scores

T – Six months

Melnyk & Fineout-Overholt (2023) note that RCTs are the strongest research design to evaluate an intervention. Therefore, I have spent most of my time searching for and analyzing RCTs and systematic reviews of RCTs to answer my clinical question as this is the strongest level of evidence to answer my clinical question. The quantitative data in these studies would include the depression scores of postpartum patients. The scores of both the intervention and control group at baseline and during/following treatment allow me to analyze if there is a statistically significant improvement in depression screen scores.

While science often relies on objective data provided in quantitative research to determine the effectiveness of interventions and treatments, I also believe that subjective data is important in the field of psychology and mental health. The Edinburg Postnatal Depression Scale (EPDS) is the most used screening tool in pregnancy and postpartum and is also used in evaluating other populations undergoing treatment for depression. This 10-question tool allows the clinician to score the patients’ responses to how they have felt over the seven days (Qiu, et. al., 2023). This tool provides a means for quantifying self-reported subjective data.

Following a previous quantitative evaluation of telephone-provided CBT for postpartum women, Ngai & Chan (2019) agreed that “complex interventions” should also be qualitatively evaluated so they arranged semi-structured interviews of the women who had previously received the CBT intervention. The data collected was reviewed and coded by independent researchers and outlined four main themes including benefits, facilitators, barriers, and suggestions for improvement.

While quantitative data (EPDS scores) can help present hard evidence to answer my PICOT question in determining if my intervention (CBT) may be best practice, I do think it is important for me to also consider the qualitative data. It is valuable to know whether my proposed intervention is perceived as beneficial to my patient population. And for my PICOT question specifically, I must remember that CBT can be offered in a variety of ways – online, in person, by phone, individually vs. group setting – so patient preference is also important, as well as potential barriers to obtaining my proposed intervention.

Kelcy Waite

References

Melnyk, B. M. & Fineout-Overholt, E. (2023). Evidence-Based Practice in Nursing & Healthcare (5th ed.). Wolters Kluwer

Ngai, F. W., & Chan, P. S. (2019). A qualitative evaluation of telephone-based cognitive-behavioral therapy for postpartum mothers. Clinical Nursing Research, 28(7), 852–868. https://doi-org.libauth.purdueglobal.edu/10.1177/1…

Qiu, X., Wu, Y., Sun, Y., Levis, B., Tian, J., Boruff, J. T., Cuijpers, P., Ioannidis, J. P. A., Markham, S., Ziegelstein, R. C., Vigod, S. N., Benedetti, A., Thombs, B. D., the DEPRESsion Screening Data (DEPRESSD) EPDS Group, He, C., Krishnan, A., Bhandari, P. M., Neupane, D., Negeri, Z., & Imran, M. (2023). Individual participant data meta-analysis to compare EPDS accuracy to detect major depression with and without the self-harm item. Scientific Reports, 13(1), 1–12. https://doi-org.libauth.purdueglobal.edu/10.1038/s…

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Social Work Question

Jun 14, 2024 | Health Medical

Description

dentify and describe a policy analysis model to be used to evaluate the policy and include a brief analysis of the policy using the model selected. Please make sure to cite the model used. Provide an overview of the policy and describe how it applies to the practice situation.

Here are a few helpful resources in this area:

American Association for Policy Analysis and ManagementLinks to an external site.
McNutt, J. G. & Hoefer, R. (2016). Chapter 6: Policy Analysis-Tools for Building Evidence-Based Social Policy. In Social Welfare Policy: Responding to a Changing World. Oxford University Press.
Karger, H., & Stoesz, D. (2010). American social welfare policy: A pluralist approach.
Bardach, E., & Patashnik, E. M. (2015). A practical guide for policy analysis: The eightfold path to more effective problem solving. CQ press.
POLICY RECOMMENDATIONS

Based on your review, provide recommendations for policymakers regarding a policy review, application, formulation, and/or revision of the policy.

SOCIAL JUSTICE IMPLICATIONS

Discuss the social justice implications for the client situation based on the selected policy and provide an advocacy plan at the micro, mezzo, and macro level. For example, if the policy discriminates against the population related to your practice situation, provide a plan for how you might advocate for change for your individual client(s), the agency, or at the legislative level.

ETHICAL CHALLENGE AND/OR VALUE CONFLICT

Identify and describe one or more potential ethical or values conflict(s) related to the policy as it applies to this practice situation.

POLICY SELECTED

This policy should be an existing current state or federal policy (e.g., laws, court decisions, or regulations), rather than an agency policy. Make sure to cite the policy. Do not use an agency, organization or internal hospital policy.

Here are a few ideas for Social Policies:

secularization-separation of church and state
funding of faith-based organizations
policies related to discrimination
poverty
child support policies
TANF
Supplemental Social Security (disabled adults, children with severe disabilities)
working poor, minimum wage
general assistance programs,
food stamps, free lunch programs, emergency food program assistance program, summer food
service program, special milk program, school breakfast program
Farming policy; dumping of toxic waste
Social Insurance
Unemployment, SS Disability
Medicare
Social Security
Workers Compensation
Assets for Independence Act (individual development accounts for low income)
Tax policy—federal and state, Fiscal Cliff
Health care policy
Affordable Care Act implementation
Medicare reforms
Medicaid
State Children’s Health Insurance Program (S-Chips)-federal/state partnership to cover uninsured children
reimbursement rates
nursing home, hospitals
health maintenance organizations (HMOs), managed care
underinsured, uninsured, COBRA
Corrections
Drug policies
Gun Control
Mental Health
The Community Mental Health Centers Act
deinstitutionalization
substance abuse
Mental Health Parity Act
Licensing of social workers
Sex offender registry
Child Welfare policy
CAPTA, AACWA, McKinney-Vento Act, Chafee Act
Child care policies
foster care, adoption, Head Start
No Child Left Behind, Race to the Top
WIC
Housing Policy
HUD
Section 8
International/global policies
UN Convention on the Rights of Children

NSG6005 week 2 case study

Jun 14, 2024 | Health Medical

Description

Aubre R. presents as a new patient to your practice having recently relocated from rural Tennessee. She is 68 years old and complains of irritable bowel syndrome (IBS) with abdominal cramping and frequent diarrhea with occasional constipation. She has a history of domestic violence with resultant anxiety requiring inpatient hospitalization 8 years ago. She is also complaining of urinary retention, insomnia, and hip pain since a hip fracture 4 years ago. Her drugs include zolpidem 10 mg hs, bethanechol 25 mg tid, metoclopramide 10 mg tid, amitriptyline 100 mg hs, alprazolam 0.25 mg tid, hydrocodone/APAP 5/500 tid, and dicyclomine 20 mg four times daily.What are your concerns about this drug regimen?What recommendations do you have for this patient?

Unformatted Attachment Preview

9/25/23, 1:26 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=582499&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
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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=582499&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
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9/25/23, 1:26 PM
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=582499&evalObjectType=1&userId=125660&viewTypeId=3&rubricId=3882…
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nur500 week 4

Jun 14, 2024 | Health Medical

Description

This assignent comes in 2 parts. For part one you will use between 250-300 words and 1 reference. APA style, 7 edition. You will need to reply to at least 2 peers. Each answer should be 150 words and 1 reference.

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: Week 4 Sociologic Sciences Journal

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 weeks 2 & 4, 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.

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.

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

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.
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Nursing Question

Jun 14, 2024 | Health Medical

Description

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.

No AI or Chatbot! I will be sure to check this.

For this paper, you must pick one ‘diet’ and define it, then defend why you would or would not recommend this way of eating for the average person. Examples include: Weight Watchers, Keto, Low Fat, Vegan, Gluten Free, Nutrisystem, Slim-Fast, Atkins, Paleo, Mediterranean, etc. whatever you want!

1 full page minimum: describe, in detail, the parameters of the diet. How it works, what the requirements are, why one might choose to use or might need to use this diet.

2 full page minimum: Pick a side and defend it! Yes, this diet is a GOOD idea, or no this is a BAD idea and why you feel that way–and any resources that support your stance.

For a total of 3 pages minimum in the BODY of the paper.

Full APA Style is required. 12 point font, Times New Roman, Double Spaced. Please be sure to use a Title Page, Abstract, Reference Page, etc. These pages DO NOT count towards the page minimums.

A few things to remember/consider:
-Please only utilize scholarly resources publilshed within the last 5 years.
-If you are at all able, please use Microsoft Word and not Google docs, when Google docs are uploaded into Canvas, it can change the formatting and make your APA appear incorrect.
-If you are at all unfamiliar with APA, please consider utilizing the Academic Resource Center to help with your APA and/or paper content. For more information, please look under: “Getting Started” and then click on the Page “Online Writing Support” for more information!

100 points total possible. You will be graded using the rubric located below and in the Syllabus.

Requirements: A Minimum of 3 Full Pages in the Body of the Paper Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title Page, Abstract, 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.

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 include an abstract

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 scholarly resources publilshed within the last 5 years

Epidemiology discussion peer answers

Jun 14, 2024 | Health Medical

Description

I need one answer to each peer, must include references

madonna: the center for disease control and prevention (CDC,n.d) stated that women’s risk of dying from smoking has more than tripled in the last 50 years, and is now equal to men’s risk. The United States has more than 20 million women and girls who currently smoke cigarettes. Smoking puts them at risk for healthcare issues such as heart attacks; strokes; lung cancer; emphysema; and other serious chronic illnesses including diabetes. More than 170,000 American women die of diseases caused by smoking each year, with additional deaths coming from the use of other tobacco products such as smokeless tobacco (CDC, n.d). According to CDC, women who are most likely to smoke today are the most vulnerable which include the low income, less educated, and those with mental health disorders. Today, more women die from lung cancer than breast cancer.

On another note, Jafari et, al (2021) reported that the prevalence of cigarette smoking among women has increased worldwide in recent years and is considered a public health concern. It is one of the most preventable causes of death from non-communicable diseases. The authors cited that smoking in women carries the risk of diseases such as cervical cancer, osteoporosis, cardiovascular disease, atherosclerosis, and type 2 diabetes, lung cancer, premature menopause, premature birth, abnormal fetal growth, low birth weight, miscarriage, and increases fetal death. Women who smoke before and during pregnancy increase the risk of preterm birth, abnormal fetal growth, low birth weight, miscarriage, and fetal death. According to the World Health Organization (WHO) as cited by Jafari et, al (2021), one in ten deaths worldwide is caused by tobacco use; tobacco use worldwide causes 7 million deaths each year. If the world’s consumption patterns remain unchanged by 2030, 8 million people will die from tobacco-related diseases . Cigarette smoking kills 480,000 people in the USA each year and every year, about 201,773 women around the world die from secondhand smoke.

According to Prince George’s County Health Department (2017), tobacco product use varies in the county by race, ethnicity and age. The most recent report stated that smoking appears to be increasing in the county, among younger adults (ages 18-44 years). It appears to be decreasing in the county for those aged 45 years and older. Also the percentage of male to female who smoke is in the ratio of 9.4% : 4.2% in the state and then 6.6% : 3.9% in the county

Reference

Center for disease control and prevention (nd). Women And Smoking. Retrieved from, https://www.cdc.gov/tobacco/data_statistics/sgr/50…

Jafari, A., Rajabi, A., Gholian-Aval, M., Peyman, N., Mahdizadeh, M., Tehrani, H (2021). National, regional, and global prevalence of cigarette smoking among women/females in the general population: a systematic review and meta-analysis. Environ Health Prev Med. 26(1):5. doi: 10.1186/s12199-020-00924-y. PMID: 33419408

Prince George’s County Health Department (2017). Tobacco Use in Prince George’s County. Retrieved from, https://www.princegeorgescountymd.gov/ArchiveCente…

Mary:Sexual orientation and gender identity are intrinsic aspects of every individual. Sexual orientation pertains to one’s romantic or physical attractions. Simultaneously, gender identity relates to one’s internal perception of being male or female or neither or a combination of both, separate from their biological sex. Those whose gender identity or sexual orientation diverges from the majority are encompassed within the lesbian, gay, bisexual, or transgender and queer (LGBTQ+) society. Identifying as LGBTQ+ does not indicate a mental disorder or illness (MHA, n.d).

LGBTQ+ and Mental Health

In the United States, 4.5 percent of adults identify as LGBTQ+, according to research. However, this percentage varies significantly across age groups, with 3.5 % of Gen X individuals (born between 1965 and 1979), compared to 8.2 % of Millennials (those born between 1980 and 1999) identifying as LGBTQ+. Furthermore, there is a gender disparity in LGBT identification, with women being more likely to identify as LGBTQ+ (5.1 percent) than men (3.9 percent). The challenges faced by LGBTQ+ individuals are underscored by research indicating that they confront health disparities stemming from discrimination, the failure to acknowledge their human and civil rights and societal stigma. The bias has been linked with elevated rates of substance use, suicide, and psychiatric disorders within the LGBTQ+ community. The societal, familial, and personal acceptance of gender identity and sexual orientation plays a crucial role in shaping the emotional safety and mental health of LGBTQ+ individuals.

Irrespective of age, a recent U.S. Census Bureau’s experimental Household Pulse Survey (HPS) analysis reveals that LGBTQ+ adults consistently reported increased levels of depression and anxiety signs and symptoms than their non-LGBTQ+ counterparts throughout the COVID-19 pandemic. This study builds upon prior Census Bureau investigations, which had already indicated that LGBTQ+ adults, whether living independently or with others, faced more significant mental health hurdles than their non-LGBTQ+ peers (Marlay et al., 2022). In the current research, this analysis is broadened to include an age-based comparison of LGBTQ+ and non-LGBTQ+ respondents, shedding additional light on the mental health disparities within these groups. Based on the research, it is evident that younger respondents, whether they identify as LGBTQ+ or non-LGBTQ+, experienced heightened difficulties with symptoms of both depression and anxiety. However, notably, it was the younger LGBTQ+ respondents who encountered the most substantial challenges in dealing with these mental health issues (Medina & Mahowald, 2022).

Overall, LGBTQ+ youth grapple with the societal stigma surrounding their sexual orientations or gender identities. This stigma manifests in various ways, including discrimination, harassment, familial estrangement, social exclusion, and violence. These encounters with adversity can jeopardize the well-being of the LGBTQ+ community, placing their mental health in peril. Similarly, during the coronavirus pandemic, LGBTQ+ adults have consistently reported increased symptoms related to depression and anxiety when compared to their non-LGBTQ+ peers. These findings remained consistent regardless of the timeframe under consideration.

References

File, T., & Marley, M., (2022), (2022). Regardless of Household Type, LGBT Adults Struggled More With Mental Health Than Non-LGBT Adults. https://www.census.gov/library/stories/2022/06/lgbt-adults-report-anxiety-depression-during-pandemic.html

Marlay, M., File, T., & Scherer, Z., (2022). Mental Health Struggles Higher Among LGBT Adults Than Non-LGBT Adults in All Age Groups. https://www.census.gov/library/stories/2022/12/lgbt-adults-report-anxiety-depression-at-all-ages.html

Medina, C., & Mahowald, L. (2022). Discrimination and Barriers to Well-Being: The State of the LGBTQI+ Community in 2022. Center for American Progress. https://www.americanprogress.org/article/discrimination-and-barriers-to-well-being-the-state-of-the-lgbtqi-community-in-2022/

Mental Health America (MHA), (n.d.). LGBTQ+ Communities and Mental Health. https://mhanational.org/issues/lgbtq-communities-and-mental-health

321 @d7oomi10

Jun 14, 2024 | Health Medical

Description

see attached

Unformatted Attachment Preview

Patient ID Age in years Gender
501
38.1 female
502
79.2 male
503
67.2 female
504
76.8 male
505
30.9 female
506
68.0 female
507
75.2 female
508
56.9 female
509
60.9 male
510
48.2 female
511
43.7 male
512
57.9 male
513
60.5 male
514
78.0 male
515
60.7 male
516
63.1 male
517
66.1 male
518
43.7 male
519
67.9 male
520
73.0 male
521
72.1 male
522
48.8 male
523
68.2 male
524
45.0 male
525
56.2 male
526
63.6 female
527
71.8 male
528
43.0 female
529
79.4 female
530
41.5 female
531
74.2 male
532
28.0 male
533
39.1 female
534
57.0 female
535
83.3 female
536
67.3 female
537
65.5 female
538
55.3 male
539
49.3 male
540
48.7 male
541
45.2 male
542
54.5 male
543
70.5 female
544
68.0 female
545
54.0 male
546
60.7 male
smoking status
non-smoker
non-smoker
ex-smoker
ex-smoker
current
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
current
ex-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
Townsend deprivation Marital status
Third quintile
Married
Second quintile
Not recorded
Second quintile
Single
Second quintile
Not recorded
Third quintile
Married
Fourth quintile
Not recorded
Second quintile
Married
Second quintile
Married
Second quintile
Married
Fourth quintile
Married
Second quintile
Married
Third quintile
Married
Second quintile
Single
Second quintile
Married
Least deprived
Not recorded
Second quintile
Not recorded
Third quintile
Married
Second quintile
Single
Fourth quintile
Not recorded
Second quintile
Not recorded
Least deprived
Not recorded
Second quintile
Not recorded
Third quintile
Not recorded
Second quintile
Married
Second quintile
Married
Second quintile
Married
Least deprived
Married
Third quintile
Married
Second quintile
Married
Third quintile
Not recorded
Second quintile
Divorced
Third quintile
Not recorded
Third quintile
Married
Third quintile
Not recorded
Least deprived
Widowed
Second quintile
Widowed
Second quintile
Widowed
Fourth quintile
Married
Third quintile
Single
Second quintile
Single
Second quintile
Separated
Second quintile
Not recorded
Second quintile
Married
Second quintile
Married
Second quintile
Not recorded
Least deprived
Not recorded
547
548
549
550
551
552
553
554
555
556
557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
585
586
587
588
589
590
591
592
593
35.3 female
51.8 male
30.3 female
57.6 male
31.1 female
45.8 male
33.2 male
72.4 male
50.7 female
79.7 male
59.2 female
56.8 female
72.0 male
50.9 female
73.8 female
75.6 female
66.8 male
75.2 female
42.8 male
78.0 male
46.0 male
75.4 male
65.6 male
27.9 male
36.1 female
49.8 male
58.3 male
76.8 female
48.1 male
45.2 male
58.4 male
22.7 male
50.8 female
81.9 male
67.6 female
59.6 female
56.5 male
72.1 male
53.7 male
62.2 female
56.7 male
91.1 female
74.2 male
73.7 female
48.5 male
34.9 female
32.9 female
non-smoker
current
ex-smoker
non-smoker
current
ex-smoker
current
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
current
non-smoker
current
ex-smoker
non-smoker
ex-smoker
current
non-smoker
current
ex-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
current
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
Second quintile
Fourth quintile
Fourth quintile
Third quintile
Most deprived
Least deprived
Third quintile
Least deprived
Least deprived
Second quintile
Fourth quintile
Third quintile
Least deprived
Second quintile
Second quintile
Most deprived
Least deprived
Least deprived
Fourth quintile
Third quintile
Least deprived
Third quintile
Second quintile
Fourth quintile
Second quintile
Least deprived
Least deprived
Least deprived
Second quintile
Least deprived
Least deprived
Second quintile
Least deprived
Least deprived
Second quintile
Least deprived
Least deprived
Least deprived
Least deprived
Second quintile
Least deprived
Third quintile
Least deprived
Second quintile
Second quintile
Third quintile
Third quintile
Not recorded
Not recorded
Married
Married
Married
Not recorded
Single
Not recorded
Married
Married
Not recorded
Married
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Single
Single
Married
Married
Married
Married
Married
Married
Not recorded
Married
Married
Married
Married
Not recorded
Married
Married
Married
Married
Divorced
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
594
595
596
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
617
618
619
620
621
622
623
624
625
626
627
628
629
630
631
632
633
634
635
636
637
638
639
640
69.7 male
51.3 male
84.0 female
31.9 female
73.3 male
54.0 male
56.8 male
46.9 male
42.2 male
72.0 female
68.3 female
37.8 male
50.4 female
32.5 female
53.7 male
35.5 female
54.1 male
79.8 male
57.9 female
50.9 female
78.6 male
64.8 female
66.3 male
60.2 female
53.3 female
55.3 male
56.7 female
65.5 male
57.2 female
71.1 female
59.8 female
73.4 male
43.1 male
74.7 male
38.9 female
90.2 female
58.0 female
44.6 male
62.4 female
74.4 male
59.2 male
34.5 male
43.9 female
43.3 female
60.9 female
41.2 male
68.7 female
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
current
current
current
non-smoker
non-smoker
ex-smoker
current
non-smoker
non-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
current
ex-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
current
non-smoker
current
current
non-smoker
Least deprived
Third quintile
Fourth quintile
Fourth quintile
Third quintile
Fourth quintile
Fourth quintile
Third quintile
Second quintile
Fourth quintile
Fourth quintile
Third quintile
Fourth quintile
Most deprived
Fourth quintile
Fourth quintile
Second quintile
Least deprived
Third quintile
Second quintile
Least deprived
Least deprived
Third quintile
Second quintile
Least deprived
Second quintile
Fourth quintile
Fourth quintile
Third quintile
Second quintile
Most deprived
Most deprived
Second quintile
Third quintile
Second quintile
Second quintile
Second quintile
Second quintile
Second quintile
Second quintile
Least deprived
Missing
Missing
Missing
Least deprived
Missing
Third quintile
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
641
642
643
644
645
646
647
648
649
650
651
652
653
654
655
656
657
658
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
687
38.8 male
81.1 male
65.8 female
42.0 female
52.0 male
52.0 female
34.4 male
63.7 male
62.3 male
66.4 male
65.6 male
73.1 male
54.3 male
58.4 male
61.1 male
70.7 male
62.5 male
73.5 male
33.7 male
45.1 male
40.3 male
53.6 male
62.9 male
64.9 male
49.5 male
40.8 male
57.4 male
27.8 male
50.4 male
39.4 male
61.4 male
48.4 male
29.3 male
65.6 male
77.3 male
53.9 male
66.7 male
56.6 male
61.6 male
76.1 male
41.4 male
63.2 male
65.4 male
55.5 male
68.3 male
78.6 male
57.6 male
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
ex-smoker
current
unknown
current
unknown
non-smoker
unknown
ex-smoker
current
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
non-smoker
current
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
unknown
unknown
current
non-smoker
non-smoker
current
ex-smoker
ex-smoker
ex-smoker
Second quintile
Fourth quintile
Second quintile
Second quintile
Third quintile
Third quintile
Second quintile
Second quintile
Third quintile
Second quintile
Least deprived
Third quintile
Third quintile
Third quintile
Second quintile
Least deprived
Least deprived
Third quintile
Third quintile
Second quintile
Fourth quintile
Least deprived
Most deprived
Least deprived
Least deprived
Fourth quintile
Fourth quintile
Least deprived
Third quintile
Least deprived
Second quintile
Fourth quintile
Most deprived
Least deprived
Fourth quintile
Third quintile
Third quintile
Least deprived
Least deprived
Third quintile
Most deprived
Least deprived
Least deprived
Fourth quintile
Fourth quintile
Least deprived
Second quintile
Not recorded
Married
Married
Married
Married
Divorced
Married
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
688
689
690
691
692
693
694
695
696
697
698
699
700
701
702
703
704
705
706
707
708
709
710
711
712
713
714
715
716
717
718
719
720
721
722
723
724
725
726
727
728
729
730
731
732
733
734
50.4 male
31.6 male
41.3 male
52.2 male
52.0 male
81.7 male
55.3 female
60.7 female
51.3 female
65.6 female
63.0 female
82.9 female
44.9 female
47.3 female
28.2 female
26.0 female
32.5 female
53.2 female
30.2 female
68.8 female
79.9 female
59.0 female
35.8 female
61.3 female
77.8 female
58.0 female
56.2 female
41.2 female
53.1 female
73.1 female
75.0 female
29.5 female
68.6 female
62.6 female
56.4 female
40.4 female
55.0 female
62.8 female
53.6 female
30.9 female
63.2 male
57.4 female
68.4 female
71.9 female
67.9 female
78.7 female
64.4 male
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
current
current
non-smoker
unknown
non-smoker
non-smoker
current
non-smoker
ex-smoker
non-smoker
unknown
ex-smoker
non-smoker
non-smoker
non-smoker
current
current
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
unknown
ex-smoker
unknown
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
current
Least deprived
Least deprived
Least deprived
Third quintile
Least deprived
Least deprived
Least deprived
Third quintile
Third quintile
Fourth quintile
Third quintile
Second quintile
Second quintile
Fourth quintile
Second quintile
Fourth quintile
Missing
Fourth quintile
Third quintile
Least deprived
Fourth quintile
Least deprived
Most deprived
Most deprived
Least deprived
Fourth quintile
Most deprived
Fourth quintile
Fourth quintile
Most deprived
Third quintile
Least deprived
Least deprived
Second quintile
Least deprived
Third quintile
Least deprived
Fourth quintile
Third quintile
Fourth quintile
Least deprived
Third quintile
Least deprived
Most deprived
Fourth quintile
Missing
Missing
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
735
736
737
738
739
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
755
756
757
758
759
760
761
762
763
764
765
766
767
768
769
770
771
772
773
774
775
776
777
778
779
780
781
24.3 male
69.6 male
40.9 male
50.2 male
67.6 male
33.3 female
64.2 male
69.3 female
56.0 female
55.6 male
32.0 male
62.8 female
57.3 male
55.4 female
75.1 female
64.9 female
59.9 male
59.5 male
53.7 female
65.1 female
62.7 male
67.2 female
62.5 male
48.9 female
74.1 female
54.9 female
69.4 female
56.0 male
41.3 male
55.6 male
57.0 female
75.4 female
74.3 female
41.7 male
56.8 female
56.8 male
33.8 male
58.5 female
43.5 male
67.5 male
35.9 male
62.0 male
46.3 male
62.7 female
52.2 male
43.9 female
65.6 female
non-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
current
ex-smoker
ex-smoker
current
non-smoker
current
non-smoker
non-smoker
non-smoker
non-smoker
current
non-smoker
non-smoker
non-smoker
current
non-smoker
non-smoker
ex-smoker
current
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
non-smoker
non-smoker
non-smoker
non-smoker
Second quintile
Second quintile
Fourth quintile
Least deprived
Most deprived
Most deprived
Most deprived
Most deprived
Missing
Fourth quintile
Most deprived
Third quintile
Third quintile
Least deprived
Least deprived
Least deprived
Least deprived
Least deprived
Least deprived
Fourth quintile
Second quintile
Fourth quintile
Least deprived
Least deprived
Least deprived
Least deprived
Third quintile
Missing
Least deprived
Least deprived
Least deprived
Second quintile
Third quintile
Least deprived
Least deprived
Least deprived
Least deprived
Least deprived
Third quintile
Least deprived
Second quintile
Least deprived
Fourth quintile
Third quintile
Fourth quintile
Fourth quintile
Least deprived
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Married
Not recorded
Married
Not recorded
Not recorded
Single
Married
Not recorded
Married
Co-habiting
Not recorded
Not recorded
Single
Not recorded
Not recorded
Not recorded
782
783
784
785
786
787
788
789
790
791
792
793
794
795
796
797
798
799
800
801
802
803
804
805
806
807
808
809
810
811
812
813
814
815
816
817
818
819
820
821
822
823
824
825
826
827
828
71.7 female
70.9 female
80.2 female
55.7 male
34.6 male
65.0 female
54.5 male
55.6 female
58.0 female
42.1 female
32.8 male
58.2 male
64.4 female
62.9 female
52.0 male
71.1 female
54.3 female
40.2 male
55.4 female
57.6 female
67.8 female
58.5 male
51.6 male
51.4 female
51.9 female
44.5 female
66.8 male
35.4 male
43.2 female
51.3 male
60.0 male
55.7 male
33.1 male
77.1 male
53.0 male
50.7 male
57.7 female
71.0 male
72.0 female
60.2 male
44.8 male
39.9 male
48.0 female
37.6 female
36.3 male
47.9 female
52.4 male
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
current
current
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
current
non-smoker
current
non-smoker
current
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
Most deprived
Second quintile
Third quintile
Third quintile
Fourth quintile
Least deprived
Least deprived
Fourth quintile
Second quintile
Second quintile
Least deprived
Second quintile
Most deprived
Second quintile
Third quintile
Most deprived
Least deprived
Least deprived
Fourth quintile
Third quintile
Second quintile
Second quintile
Fourth quintile
Fourth quintile
Most deprived
Least deprived
Fourth quintile
Fourth quintile
Fourth quintile
Fourth quintile
Fourth quintile
Least deprived
Most deprived
Least deprived
Fourth quintile
Most deprived
Third quintile
Third quintile
Third quintile
Least deprived
Third quintile
Third quintile
Third quintile
Most deprived
Fourth quintile
Third quintile
Most deprived
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Married
Married
Not recorded
Married
Not recorded
829
830
831
832
833
834
835
836
837
838
839
840
841
842
843
844
845
846
847
848
849
850
851
852
853
854
855
856
857
858
859
860
861
862
863
864
865
866
867
868
869
870
871
872
873
874
875
38.2 male
58.8 female
43.4 male
63.2 female
52.1 female
56.2 female
46.4 female
62.8 male
39.8 male
55.6 male
26.7 female
80.8 male
58.7 female
67.5 male
65.9 female
71.6 male
74.8 female
56.9 male
29.1 female
43.1 male
66.1 female
64.9 female
34.6 female
54.8 female
48.0 female
56.7 female
65.8 male
73.9 female
39.3 male
68.2 female
48.5 male
39.6 female
71.0 male
59.3 female
49.2 female
82.0 male
55.1 male
59.7 female
74.5 female
55.3 male
69.3 male
78.7 male
64.4 male
82.0 female
56.0 female
65.1 male
56.9 female
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
ex-smoker
current
non-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
current
ex-smoker
non-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
current
ex-smoker
ex-smoker
non-smoker
non-smoker
current
non-smoker
current
ex-smoker
ex-smoker
non-smoker
current
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
Third quintile
Third quintile
Third quintile
Second quintile
Third quintile
Third quintile
Fourth quintile
Third quintile
Third quintile
Missing
Most deprived
Least deprived
Second quintile
Least deprived
Third quintile
Least deprived
Third quintile
Most deprived
Third quintile
Least deprived
Fourth quintile
Second quintile
Fourth quintile
Second quintile
Third quintile
Least deprived
Third quintile
Third quintile
Third quintile
Second quintile
Fourth quintile
Second quintile
Third quintile
Third quintile
Least deprived
Third quintile
Fourth quintile
Third quintile
Third quintile
Least deprived
Most deprived
Most deprived
Least deprived
Third quintile
Third quintile
Most deprived
Most deprived
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
876
877
878
879
880
881
882
883
884
885
886
887
888
889
890
891
892
893
894
895
896
897
898
899
900
901
902
903
904
905
906
907
908
909
910
911
912
913
914
915
916
917
918
919
920
921
922
71.3 female
78.0 male
64.0 female
65.6 male
45.9 female
47.6 male
56.5 male
60.3 male
49.9 male
72.8 female
67.4 male
62.7 female
77.2 female
41.7 male
34.8 female
54.6 female
53.6 female
60.0 male
48.9 female
67.1 male
62.4 male
52.3 male
62.1 male
55.7 female
58.6 male
62.3 female
51.9 male
43.1 female
51.0 female
56.9 female
35.1 male
37.9 male
63.3 male
59.1 male
51.3 female
69.6 male
47.7 male
56.9 female
33.6 female
37.7 female
40.8 male
62.6 female
38.7 male
33.2 male
75.9 male
36.1 male
29.3 female
ex-smoker
ex-smoker
current
non-smoker
current
non-smoker
ex-smoker
ex-smoker
current
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
current
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
current
ex-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
current
current
ex-smoker
ex-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
ex-smoker
non-smoker
ex-smoker
Third quintile
Least deprived
Third quintile
Least deprived
Third quintile
Least deprived
Least deprived
Least deprived
Third quintile
Third quintile
Least deprived
Third quintile
Third quintile
Third quintile
Third quintile
Least deprived
Fourth quintile
Fourth quintile
Fourth quintile
Least deprived
Third quintile
Second quintile
Second quintile
Second quintile
Most deprived
Least deprived
Most deprived
Most deprived
Third quintile
Most deprived
Least deprived
Fourth quintile
Fourth quintile
Second quintile
Most deprived
Most deprived
Fourth quintile
Fourth quintile
Third quintile
Least deprived
Third quintile
Third quintile
Second quintile
Fourth quintile
Fourth quintile
Second quintile
Least deprived
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
923
924
925
926
927
928
929
930
931
932
933
934
935
936
937
938
939
940
941
942
943
944
945
946
947
948
949
950
951
952
953
954
955
956
957
958
959
960
961
962
963
964
965
966
967
968
969
58.8 female
55.2 female
52.2 male
69.6 male
60.0 male
62.9 female
37.8 female
52.4 male
57.6 female
58.9 male
69.7 female
68.1 male
61.7 male
60.6 male
20.9 female
57.6 male
45.3 female
73.5 male
79.4 male
60.5 male
86.0 male
64.3 female
67.3 male
74.3 female
67.5 male
40.5 female
52.5 female
67.9 male
47.8 male
52.8 male
56.4 female
60.0 male
53.3 male
26.3 female
76.3 female
57.3 female
58.9 female
49.1 female
73.9 female
76.9 male
70.9 male
82.9 female
62.5 female
74.9 male
75.3 male
55.0 male
43.3 male
non-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
non-smoker
current
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
ex-smoker
current
ex-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
ex-smoker
current
ex-smoker
current
non-smoker
current
non-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
current
Third quintile
Second quintile
Third quintile
Most deprived
Fourth quintile
Second quintile
Second quintile
Least deprived
Least deprived
Fourth quintile
Third quintile
Second quintile
Second quintile
Fourth quintile
Most deprived
Most deprived
Least deprived
Least deprived
Least deprived
Least deprived
Second quintile
Third quintile
Third quintile
Fourth quintile
Second quintile
Third quintile
Least deprived
Least deprived
Fourth quintile
Second quintile
Third quintile
Second quintile
Least deprived
Second quintile
Third quintile
Third quintile
Least deprived
Least deprived
Least deprived
Least deprived
Least deprived
Second quintile
Second quintile
Least deprived
Least deprived
Least deprived
Fourth quintile
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
970
971
972
973
974
975
976
977
978
979
980
981
982
983
984
985
986
987
988
989
990
991
992
993
994
995
996
997
998
999
1000
37.4 female
43.2 male
56.3 male
42.0 male
73.1 male
47.6 male
60.2 female
31.9 female
76.3 male
33.7 male
44.0 female
70.2 female
69.5 male
70.8 male
73.6 female
69.3 male
65.0 female
60.0 male
32.4 female
63.0 male
62.4 male
63.2 female
72.2 male
54.6 male
48.7 male
59.9 male
48.3 male
60.5 male
60.1 male
45.7 male
63.6 female
non-smoker
current
current
ex-smoker
ex-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
current
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
non-smoker
current
non-smoker
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
current
non-smoker
ex-smoker
non-smoker
ex-smoker
ex-smoker
non-smoker
non-smoker
Second quintile
Most deprived
Second quintile
Second quintile
Second quintile
Least deprived
Least deprived
Third quintile
Second quintile
Least deprived
Third quintile
Third quintile
Least deprived
Least deprived
Fourth quintile
Least deprived
Fourth quintile
Least deprived
Least deprived
Least deprived
Fourth quintile
Least deprived
Least deprived
Least deprived
Third quintile
Least deprived
Second quintile
Least deprived
Fourth quintile
Least deprived
Second quintile
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Married
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
Not recorded
alcohol status Duration of DiabetesNAFLD
in Years Diastolic BPSystolic
(mmHg)BPatHeight
(mmHg)
baseline
(m)
at Weight
at
baseline
baseline
(kg)Waist
at baseline
circumference
HbA1c (mmol/mol)
(cm) at baseli
at b
never
12.23
0
80
114
1.65
88.00
137.00
81.00
never
13.03
0
70
113
1.80
95.50
114.00
58.74
never
11.59
0
81
134
1.61
116.50
80.00
66.48
never
21.15
0
60
160
1.70
119.00
101.50
67.21
current
18.44
0
83
109
1.59
120.00
97.00
93.44
current
14.45
1
99
108
1.57
112.02
69.00
62.84
never
25.07
0
88
160
1.63
101.50
91.00
59.54
current
14.36
1
76
149
1.59
62.00
77.50
63.93
current
9.90
0
104
160
1.72
74.57
133.00
97.81
current
10.40
0
90
140
1.61
66.00
80.00
61.75
current
13.99
0
80
128
1.63
76.35
105.00
77.00
current
12.50
0
85
150
1.68
92.00
109.00
48.71
current
15.02
0
63
140
1.78
112.67
82.00
51.50
current
4.86
0
83
140
1.60
102.00
136.50
112.57
current
20.30
1
73
120
1.78
108.40
114.00
83.00
current
22.25
0
70
115
1.73
87.50
104.00
84.70
unknown
18.85
0
80
132
1.71
102.00
110.00
55.30
unknown
5.98
0
76
125
1.73
76.00
104.00
70.73
current
1.28
0
80
154
1.81
90.20
104.00
74.00
current
14.74
1
80
155
1.72
90.00
78.74
63.00
never
20.20
1
65
120
1.68
92.70
125.00
48.63
unknown
19.95
1
96
154
1.79
119.00
110.00
49.69
never
23.12
1
73
122
1.78
82.00
108.00
56.83
unknown
0.70
0
75
115
1.88
116.00
110.00
42.00
current
16.83
1
91
136
1.76
81.19
131.50
62.84
current
17.85
0
70
140
1.61
87.00
97.00
61.20
never
9.35
0
80
145
1.75
74.00
89.00
108.74
current
0
60
90
55.00
current
34.76
1
60
130
1.60
73.93
77.50
56.28
never
3.69
0
74
117
1.60
58.00
134.00
50.00
current
16.29
1
75
115
1.72
85.30
88.00
80.38
current
17.47
0
86
135
1.67
108.00
131.50
71.89
never
9.19
0
75
139
1.61
69.30
87.00
47.23
never
21.43
1
90
175
1.61
105.00
112.00
73.22
never
21.08
1
83
123
1.57
77.00
104.00
63.93
never
11.65
1
60
109
1.63
75.23
97.00
65.57
current
16.98
0
80
144
1.70
61.00
111.00
107.50
never
6.57
0
86
133
1.68
115.00
149.00
77.02
current
12.36
0
96
144
1.65
107.00
105.00
111.00
never
13.88
0
86
139
1.82
74.50
111.00
62.84
current
13.45
1
90
160
1.75
83.50
122.00
78.14
ex-drinker
1.91
0
92
152
1.78
110.70
142.45
37.71
unknown
16.67
0
62
138
1.57
72.00
115.00
76.00
current
32.27
0
74
141
1.48
64.00
89.00
63.14
current
1.37
0
80
136
1.74
105.20
91.00
59.00
current
18.55
0
88
165
1.86
86.00
112.00
62.84
current
current
never
never
ex-drinker
current
current
never
never
current
current
current
current
current
current
never
current
current
current
never
current
current
current
current
never
current
current
never
current
current
current
current
current
current
current
unknown
never
unknown
never
current
current
never
current
unknown
current
never
current
10.23
13.16
9.29
5.57
0.53
18.67
0.02
18.84
17.19
16.52
16.58
12.67
20.15
16.19
13.16
4.36
14.19
0.61
3.14
16.11
2.58
14.19
14.31
3.45
12.32
20.86
13.66
16.20
11.72
7.81
17.86
7.37
1.17
7.41
15.31
15.95
12.27
21.26
21.13
0.21
4.10
19.27
21.26
23.31
13.45
15.03
0
1
0
0
0
0
0
1
0
0
0
1
0
0
1
0
1
1
0
1
1
0
0
0
0
0
0
1
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
70
82
82
86
84
84
101
98
66
69
70
84
83
87
70
96
76
74
87
90
90
85
69
101
80
77
78
86
71
96
76
86
80
63
70
81
81
79
74
83
84
71
70
74
60
80
90
122
142
159
154
120
130
156
160
126
134
146
139
167
132
136
181
159
149
129
160
123
153
124
135
133
107
118
146
128
149
148
126
114
110
133
135
134
145
144
148
161
162
143
160
120
138
128
1.63
1.70
1.62
1.61
1.51
1.77
1.81
1.79
1.63
1.70
1.55
1.74
1.80
1.54
1.53
1.63
1.78
1.57
1.86
1.83
1.75
1.83
1.89
1.77
1.63
1.80
1.89
1.51
1.68
1.88
1.71
1.75
1.64
1.93
1.46
1.68
1.78
1.63
1.70
1.57
1.76
1.53
1.93
1.58
1.70
1.68
84.50
107.00
64.15
88.00
121.00
85.00
98.00
73.00
76.60
76.47
89.30
94.30
89.00
93.00
109.00
88.00
102.00
74.30
101.20
134.80
74.47
77.50
65.50
127.00
131.18
75.30
129.63
85.50
107.33
151.50
90.38
108.20
90.00
95.00
61.40
90.00
100.00
96.00
97.00
82.50
106.75
79.20
72.00
120.00
77.87
98.00
79.70
100.00
119.00
110.00
101.00
97.00
118.00
105.60
109.50
93.00
98.00
91.00
83.00
111.76
113.00
111.00
117.50
91.00
100.00
102.00
102.00
149.00
94.00
117.00
125.00
103.00
107.00
98.00
100.00
110.00
124.00
104.00
119.00
77.00
104.14
115.00
94.00
132.00
142.45
136.50
120.00
104.00
102.00
95.00
115.00
106.00
140.00
91.26
70.49
51.91
36.61
73.64
82.51
117.49
64.00
72.68
72.68
83.61
81.49
62.84
110.93
85.79
55.96
61.25
49.73
91.26
80.00
65.57
62.84
66.10
75.96
77.49
65.74
91.19
56.28
63.93
61.75
57.38
72.68
49.50
105.46
67.21
74.86
60.66
55.19
55.19
115.00
57.38
66.00
82.50
98.00
65.03
102.19
86.00
current
current
never
current
never
current
ex-drinker
current
current
never
never
current
never
current
current
never
unknown
current
ex-drinker
never
current
current
current
current
current
current
never
current
current
current
current
unknown
current
current
unknown
unknown
ex-drinker
current
never
current
current
unknown
current
unknown
never
current
current
7.71
5.51
11.16
1.36
14.15
27.34
19.31
14.52
16.79
13.81
16.51
4.15
17.03
0.95
9.83
19.66
2.38
8.45
11.58
15.75
22.60
12.46
10.14
5.74
6.93
21.73
23.71
24.73
26.73
20.48
10.34
11.32
0.62
22.23
45.14
8.73
6.97
32.98
7.65
4.99
22.89
6.02
4.09
10.77
16.63
0.82
23.75
1
1
1
0
1
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
1
0
0
1
0
0
1
1
0
0
0
1
0
0
1
0
1
0
1
0
0
0
0
0
1
80
84
91
80
78
84
90
90
96
70
61
75
81
90
90
60
72
72
88
64
70
82
70
70
79
84
104
72
62
88
80
85
101
82
65
68
92
87
84
96
76
82
94
66
82
67
82
150
128
140
120
125
142
150
145
170
150
139
123
127
130
130
140
118
139
160
130
130
154
120
123
137
149
154
150
140
148
140
143
149
162
120
120
152
146
137
165
146
128
139
142
144
113
152
1.77
1.81
1.56
1.68
1.67
1.78
1.70
1.78
1.83
1.56
1.58
1.79
1.52
1.64
1.69
1.60
1.69
1.63
1.52
1.65
1.86
1.74
1.68
1.67
1.71
1.86
1.52
1.88
1.48
1.62
1.71
1.70
1.68
1.85
1.54
1.63
1.58
1.83
1.62
1.73
1.78
1.88
1.60
1.67
1.68
1.75
1.53
106.00
64.00
71.00
103.00
101.82
102.23
63.50
109.07
78.52
84.00
104.00
79.38
92.30
108.80
97.40
103.10
64.00
95.00
81.50
80.50
111.50
107.00
105.00
75.00
120.67
108.93
68.29
114.33
114.40
60.00
101.00
106.67
145.96
91.20
64.00
55.00
83.60
108.50
81.38
107.96
104.00
116.50
134.00
68.60
79.38
75.80
98.43
108.00
98.00
102.00
108.00
116.00
106.00
118.50
81.50
111.76
88.00
124.00
89.00
97.00
112.00
140.00
124.00
142.45
108.00
110.00
120.00
112.00
117.00
85.00
128.00
97.00
124.00
111.76
92.00
105.00
120.00
125.00
104.00
100.00
108.00
82.00
97.00
103.00
110.50
117.00
110.50
84.00
104.00
106.00
108.00
85.00
103.00
115.00
61.00
32.24
79.04
51.40
58.10
55.19
66.86
97.26

Health & Medical Question

Jun 14, 2024 | Health Medical

Description

Assignment Background: This assignment will require you to research the existing types of physical plants for secured units. After conducting your research, you will create a Design Failure Mode and Effect Analysis (DFMEA) Report that addresses specific information, as outlined below, which can be delivered in any format. Create at least one visual aid, which must be included within your report. Use appropriate headers for each section of your report to ensure all aspects of the assignment are clearly identified.

Assignment Requirements:

Create a DFMEA Report:
Include all Content Aspects provided below in the assignment prompt.
Freestyle formatting allowed. You determine how you want the report to look.
Create one visual aid to support your findings.
Minimum of SIX pages, excluding the cover page and reference page.
The report should not exceed ten pages, excluding the cover page, reference page, and visual aid.
References and Correlating In-Text Citations:
Provide SIX scholarly sources, professional publications, and/or articles.
Two of the six resources must be from your own research.
All references must be from the last five years.****
Every reference must have a correlating in-text citation(s).
APA 7th Edition:
Follow APA 7th edition formatting and style.
Include an APA 7th edition cover page.
Include an APA 7th edition reference page.

Your DFMEA Report Must Include the Following Information for Each Content Aspect:

Aspect A of the Report: Introduction, State Residence, and Physical Plant Summaries

Identify the two types of secured units that you will research (PICK TWO)*****.
Examples: Alzheimer’s Adult Day Center, Dementia Unit in a Skilled Nursing Facility (SNF), Memory Care Assisted Living Facility, Geriatric Psychiatric SNF
Select a state residence to apply to your selected LONG TERM CARE (LTC) settings.
Your selection should be based on your current state’s residence – Maryland. You will use your identified state residence to address the applicable aspects of your report.
Describe the following elements for each of the physical plants’ descriptions:
Number of licensed beds or square footage of each LTC facility/setting.
Note: If you research did not provide a specific number of beds or square footage, then offer a hypothetical number of licensed beds or square feet to apply in your report.
Number of LTC residents served, or potential average daily census, of each LTC facility/setting.
Note: If you research did not provide such information, then offer hypothetical information to apply in your report.
Type of locking devices, secured devices, or means of egress used in each LTC facility/setting.
Note: If you research did not offer this information, then decide on locking devices or means of egress to apply in your report.
Other key physical plant description items for each LTC facility/setting.
Note: Offer information on the key characteristics, providing a sufficient description of the settings.
Examples: Stand alone facility, unit part of a facility/senior living community, number of floors, outdoor space, number of exits, age of facility/setting, or similar items to ensure a detailed description is provided.

Aspect B of the Report: Specific Design Failure Mode and Effects Analysis

Select one of the settings that you researched in Aspect A: Conduct a DFMEA drill, include at least two failure points for one of your selected LTC facility/setting from Aspect A. Determine why the expected or intended function did not occur, include the following four areas in your analysis:
Failure Mode and Failure Effect: Include (a.) at least two failure modes; (b.) the details for each point; (c.) the way the failure could be observed; (d.) immediate consequences of each failure on the operation, function, and/or functionality; and (e.) information on the potential impact of the residents, staff, and LTC setting.
Failure Cause: Identify the underlying cause of each failure and explain why each failure may have occurred. Include at least two of the following items in your analysis: design, system, process, quality, or parts.
Severity Rankings: Identify the severity ranking of each failure and include one of the following areas in your analysis: worst case scenario, degree of injury, degree of damage, property damage, stakeholders’ harm, or facility/setting harm.
Facility-Level Responses & Assigned Responsibility: Include (a.) one design action; (b.) one design control method; and (c.) one recommendation to reduce the chance of failure modes in the future. Include information on the (d.) team or department that will be responsible for completing the action, control method, and recommendation, and share why they were selected.

Aspect C of the Report: Visual Aid of Your Findings

Create at least one visual aid that is based Aspect B of the Report.
The visual aid can be included in the report as an appendix, table, or figure, or may be presented in a separate document as a supplement.
Examples: DFMEA Template, DFMEA Steps, DFMEA Map, Specific Failure Mode Tables, or any visual aid that you would like to create to support your findings and information.

Aspect D of the Report: Your Assessment on the Findings for Your Selected LTC Setting

Provide an assessment of your findings that includes:
Conclusions on the (a.) operational effectiveness; (b.) influence on potential evacuation plans/needs; and (c.) connections between the failures to quality of care outcomes for the residents of the secured setting based on your DFMEA research conducted.
Licensure compliance for your selected state – MARYLAND and any applicable federal requirements.
Must provide at least two requirements, laws, or standards.
Examples: Specific federal regulations, state-specific regulations, city ordinances, or similar regulatory considerations for state licensure compliance.
If your selected state residence does not have any specific requirements for locked or secured units, then include how you validated this information and the type of source that was used to validate this information.
Provide the greatest lesson learned from conducting this analysis and how you could apply it to your future career.

Resources to Assist You with this Assignment:

This information offers details on DFMEA, FMEA, Fire Safety Code, Life Safety Code, Federal K-Tags, E-Tags, CMS Survey Information, and much more! Consider reviewing some of the videos, reading a few of the PDFs, and exploring some of the websites as these resources may assist you.

Website Links:

Website link on Design failure mode and effect analysis
Quality One Website – Article on DFMEA: https://quality-one.com/dfmea/
iSixSigma Website on DFMEA: https://www.whatissixsigma.net/dfmea/
Revisions to the Life Safety Code – Health facilities compliance experts review changes included in recent editions of NFPA 101: https://www.hfmmagazine.com/articles/4108-revisions-to-the-life-safety-code
Institute for Healthcare Improvement FMEA Tool Website Link: http://www.ihi.org/resources/Pages/Tools/FailureModesandEffectsAnalysisTool.aspx
CMS Life Safety Code & Healthcare Facilities Code Requirements: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/LSC

Publications, State Operations Manuals, and Articles:

NFPA 1010 Life Safety Code 2018 PDF
Medicare SOM Appendix (CMS Medicare State Operations Manual (SOM) Appendix: Click on any appendix letter in this PDF to access specific SOM information. You can also access this information by searching on the CMS website.)
CMS QAPI Guide for Performing Failure Mode and Effects Analysis with Performance Improvement Projects PDF
CMS State Operations Manual Appendix I Survey Procedures for Life Safety Code Surveys PDF
Joint Commission Information on Locked Units PDF
Complying with Door Locking Requirements Life Safety Code Publication from 2018 PDF

Videos:

Common Life Safety Code Deficiencies and Strategies for Compliance: https://www.youtube.com/watch?v=CYTdOHzi4jQ
Fire & Life Safety Compliance in Health Care Facilities Video: https://youtu.be/Clljdpst4cU
How to create a DFMEA Design Failure Modes and Effects Analysis: https://youtu.be/gRTn2QDrCbg
An Overview of the Failure Modes and Effects Analysis (FMEA) Tool from the Institute for Healthcare Improvement (IHI): https://youtu.be/PIEzR5uhqnw
Emergency Preparedness & Life Safety Code Update:https://youtu.be/ZoiMLnJzNL4
NFPA 101 – Life Safety Code 2018 Edition: https://youtu.be/qsTIWTJTatU

Unformatted Attachment Preview

Copyright 2017. Gateway to Healthcare Management.
All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law.
CHAPTER 12
THE DESIGN OF LONG-TERM
CARE ENVIRONMENTS
Jullet A. Davis, PhD, and Christopher J. Johnson, PhD
Learning Objectives
After studying this chapter, you should be able to
➤➤ define key environmental terms and concepts as they are used in the chapter;
➤➤ understand the impact of the environment on elders and individuals with disabilities,
including people with sensory limitations and dementia;
➤➤ understand regulations, such as the Occupational Safety and Hazards Act and Life Safety
Codes, related to the physical environment of long-term care facilities;
➤➤ understand management issues related to the physical environment of residential care
settings, including renovation, retrofitting, and preventive maintenance procedures; and
➤➤ discuss the latest developments and movements in environmental design, including the
Eden Alternative and the Green House Project.
246
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I n t r o d u c ti o n
An organization’s environment can have profound emotional, physical, psychological, and
sociological implications for people receiving care, and long-term care administrators have
a responsibility to understand and address these concerns. Buildings, grounds, and equipment all require regular attention and ongoing upkeep, and a well-maintained environment
is essential for improving care delivery and promoting person-centered care. The Code of
Federal Regulations requires a facility to “be designed, constructed, equipped, and maintained to protect the health and safety of residents, personnel, and the public” (42 C.F.R.
483.70 (2008)). In addition, the physical design standards of long-term care organizations
are undergoing a revolution. Organizations can no longer simply use the medical model
as a guide; the culture change movement has shifted the focus toward greater resident and
client empowerment.
This chapter begins by outlining important considerations in designing or redesigning long-term care organizations, particularly for residents with dementia. The next section
reviews key regulations concerning the physical environment and the process of managing
the environment. The chapter concludes with a look at the impact of culture change on
residential care environments, as well as future directions.
psychoneuroimmunology (PNI)
A theory developed by
Robert Ader from the
field of environmental
psychology that shows
the impact of stress on
immune systems and
health.
D e si g n f o r L o n g -T e r m C a re E nv i ronments
Historical Perspectives
Healthcare facility design is a relatively new field, having emerged in the early 1990s. A key
theme in this area has been the need to transform healthcare settings into healing environments that improve resident outcomes through the use of evidence-based research. This
research comes from a variety of fields, including evolutionary biology and neuroscience.
Privacy, resident safety, and stress reduction are integral parts of this new philosophy of
facility design.
Healthcare design specialists recognize the body–mind connection—that is, the idea
that the physical environment has a strong impact on the psychological state of mind and,
therefore, on physical health and well-being (Lam et al. 2011). This concept is the result
of two major influences: Robert Ader’s science of psychoneuroimmunology (PNI) and
Roger Ulrich’s theory of supportive design.
Ader and Nicholas Cohen (1975) first identified a connection between stress in
the environment and the functioning of the immune system, and Ader collected writings
related to the topic in a book titled Psychoneuroimmunology, published in 1981. The study of
PNI led the way for Ulrich’s (1997) introduction of the theory of supportive design, which
encourages designers to promote wellness by creating “psychologically supportive” physical
surroundings. Such surroundings offer three main characteristics: (1) a sense of control
over physical/social surroundings and access to privacy, (2) access to social support from
family and friends, and (3) access to nature and other positive distractions (Dilani 2016).
theory of supportive
design
A theory formulated
by Roger Ulrich that
promotes wellness
in long-term care by
encouraging designers
to incorporate psychologically supportive
physical surroundings.
The surroundings
should encourage (1)
a sense of control over
physical/social surroundings and access
to privacy, (2) access
to social support from
family and friends, and
(3) access to nature
and other positive
distractions.
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Perspectives on long-term care environments have come to emphasize the importance of larger rooms to accommodate personal-space zones with greater privacy; the use
of adjustable, comfortable seating; the incorporation of natural elements, such as interior
green spaces and windows with views of nature; and the benefits of interacting with pets.
Many of these themes are present in the philosophies of culture change, the Eden Alternative, and the Green House Project. These approaches were introduced in chapter 4 and are
discussed at length later in this chapter.
Universal Design
universal design
A resident-centered
approach to the design
of the environment that
focuses on the needs
of the users regardless
of functional impairments or disabilities.
environmental gerontology (EG)
The study of the connection between elders
and their physical and
social environment.
environmental adaptation
Changes to the environment to help individuals with disabilities
remain independent
and to ease the burden
of care on their fami-
According to the Institute for Human Centered Design, universal design is a residentcentered approach to the design of the environment that focuses on the needs of the users.
It is not a single design element but rather a general orientation or framework that encompasses myriad design changes. Universal design is barrier-free, providing accessibility for all
residents. Its focus is not simply on residents with functional impairments but also on those
without disabilities; hence, this broad focus helps to limit the stigmatization associated with
disability aids. Universal design is also known by the terms inclusive design, design-for-all,
and lifespan design, and it is consistent with the principles of green design (Brawley 2006).
E n v i r o n m e n ta l G e r o n t o l o g y
The field of environmental gerontology (EG) incorporates a broad range of knowledge from
sociology and other disciplines in an attempt to understand, analyze, modify, and optimize
the relationship between elders and their physical and social environments (Schwarz 2013).
Sociologist Jaber Gubrium (1975), in a nursing home study, hypothesized a direct relationship
between one’s identity, the self, and long-term care institutions. In recent decades, the environmental context of aging has played a key role in gerontological theory, research, and practice.
Environmental adaptation involves interventions to help individuals with disabilities, including dementia, remain at home independently and to ease the burden of care on
their families. Adaptations may include removing or rearranging objects, adding special
equipment, or incorporating adaptive tools. The process of providing an environmental
adaptation involves assessing a person’s needs and capabilities, evaluating the environment’s
physical and social properties, selecting an appropriate adaptation, ordering and installing
that adaptation, and training the person and family members in its use.
lies. Adaptations may
involve removing or
rearranging objects or
C o n s i d e r at i o n s f o r I n d i v i d u a l s w i t h S e n s o ry L i m i tat i o n s
adding special equip-
As individuals age, their physical and sensory capabilities (i.e., vision and hearing) often
change. Many sensory changes require adjustments in the physical environment so individuals can remain independent in their communities. Changes in vision and mobility are
the two key issues that require special attention.
ment or adaptive tools.
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Chiang and colleagues (2011) found that stress and anxiety can influence the function of the immune system, which, in turn, can inhibit the healing process. Consequently,
environmental stressors, such as dim lighting, excessive noise, and brightly colored walls,
can have a negative impact on people’s health, especially for older persons. Federal statutes
require facilities to be “well lighted.” But to properly address vision needs, facilities may need
to ensure that residential areas have not only sufficient lighting but also natural lighting and
lighting that decreases glare (Brawley and Noell-Waggoner 2008; Samo 2014). Choosing
the right colors for the environment is another important consideration, and high color
contrast is key (Brawley and Noell-Waggoner 2008). As the eyes age, the lenses thicken and
become yellow, which can make distinguishing between colors difficult. Older individuals
therefore may have difficulty differentiating floors from walls and may experience problems
with depth perception. The use of contrasting colors not only is aesthetically pleasing but
also offers improved safety (Brawley and Noell-Waggoner 2008; Samo 2014).
Changes in mobility can make certain environments risky, and modifications should
be made to minimize safety risks for individuals. Such modifications can also reduce the
liability of long-term care providers. Many federal, state, and accrediting agency requirements and guidelines aim to ensure the safety of facility environments. The following are
some suggestions for preventing falls, a major risk in both community-based and residential
care settings (Brawley and Noell-Waggoner 2008; Earley 2011; Neuls et al. 2011):
◆◆ Repaint walls to create more contrast with floor surfaces.
◆◆ Do not oversimplify or make inappropriate modifications. A common error,
for example, is installing grab bars without proper structural support.
◆◆ Use lighter-colored floor surfaces.
◆◆ Minimize changes in walking surfaces, and use slip-resistant covering when
possible.
◆◆ Install a greater number of electrical outlets to minimize the use of extension
cords.
Individuals with Dementia and the Physical Environment
Individuals with dementia experience special challenges with navigating the physical environment. Zeisel and colleagues (2003, 697) discovered a positive correlation between “environmental design and agitation, aggression, depression, social withdrawal, and psychotic
symptoms of residents with Alzheimer’s disease.” These individuals may feel a greater sense
of frustration and will perceive their environment as more stressful than would individuals
without dementia (Van Hoof et al. 2010).
A facility’s physical environment should be designed to promote the highest level
of functioning possible. Zeisel and colleagues (2003) conducted a review of studies about
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environmental strategies to improve outcomes for residents with dementia; some of these
strategies are presented in the accompanying text box.
A wide range of designing or remodeling strategies can lead to improved quality of
life for residents with dementia. For example, residents with dementia tend to have better
outcomes when they live in a private room rather than a shared room (Brawley 2006). Such
modifications are not limited to new or remodeled structures; they can be implemented
in older buildings as well. Whenever possible, the administrator should look to employ
innovations in the physical environment to improve outcomes for all residents.
Space and Social Engagement
Morgan-Brown and Chard (2014) point out that interactive occupation and social engagement—important components of quality of life for residents with dementia—can be fostered
through changes in the environment. When comparing two Irish nursing homes before
CRITICAL CONCEPT
Design Strategies for Individuals with Dementia
Residents with dementia present unique challenges for long-term care administrators. To address the needs of this population, facilities should consider the following
evidence-based design strategies:
• Camouflaged exits can help reduce elopement attempts; however, note that the
camouflage must meet Life Safety Code standards.
• Private areas have proven to reduce aggression and agitation and to improve
sleep.
• Public or common areas that have an inviting décor—rather than an institutional
or hospital-like appearance—encourage more socializing.
• Walking paths that are equipped with devices to stimulate the senses and offer
activity opportunities can lift clients’ spirits and discourage desires to leave the
area. Such design elements also engage the clients’ visitors and loved ones.
• Therapeutic garden access has been shown to reduce elopement attempts and to
improve sleep (Detweiler et al. 2012).
• Facilities should use thin carpet or tile with no specks, glare, or checkerboard
designs (Brawley 2006).
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and after conversion from a traditional model to a household-style model, they found that
the shift increased the interaction and social engagement of residents, staff, and visitors in
communal living areas.
Anderson (2011) found that elders in an assisted living facility developed patterns of
movements toward places open for activities, contact, and social interaction. Anderson also
found that elders’ use of space could be influenced by architectural design and by interior
measures to enhance the design. In this way, architecture can acquire a supportive quality
that nourishes the unique person and person-centered care.
Mazzei, Gillan, and Cloutier (2013) examined the influence of the physical environment on behavior (e.g., wandering, pacing, door testing, congregating) among residents
in a traditional geriatric psychiatry unit who were relocated to a purpose-built acute care
unit. They found that color coding rooms to distinguish them from dining areas improved
way finding, and opportunities to personalize rooms helped settings feel more “homey”
for people with dementia.
Cohen-Mansfield and colleagues (2011) linked environmental factors, personal
characteristics, and stimulus attributes with varying levels of engagement for persons with
dementia, and they identified one-to-one social interaction as the most effective stimulus
for engagement. Their research supports a model known as Namaste Care—an approach
that emphasizes one-to-one interaction within a social group, the use of soft background
music, and engagement with various environmental stimuli.
Memory Care Units
Some residential care organizations use memory care units to provide specialized care to
individuals with dementia. The units, or “neighborhoods,” range from small areas with
eight to ten residents to very large areas with more than 50 residents. As a rule of thumb,
smaller is generally better.
A cross-sectional study by Palm and colleagues (2014) looked at characteristics of the
environment and staffing in five types of memory care units. Regarding the environment,
small units were found to have a higher percentage of single rooms and served meals in a
more homelike manner. The units did not differ in their interiors or in resident access to
outdoor areas. Regarding staffing, small units provided more staff, though the staff members
were not exclusively assigned to the units. Large segregated units with additional funding
provided more registered nurses and nurses with special qualifications per resident than did
other large units. In general, long-term care facilities varied in the features implemented in
their specialized memory care units.
Some individuals with dementia have difficulty finding their way to various parts
of a residential care home. A qualitative study by Caspi (2014) identified a wide spectrum
of way-finding difficulties experienced by residents with memory loss and indicated a need
for facilities to build small-scale care environments designed for seven to ten residents each.
memory care unit
A unit within a residential care setting that
provides specialized
care for individuals
with dementia.
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Animal Therapy in Residential Dementia Units
Aquariums offer an innovative way for nature and animal-assisted therapy to be introduced
in specialized dementia units. Edwards, Beck, and Lim (2014) examined the influence of
aquariums on resident behavior and staff job satisfaction in three dementia units. They
found significant improvement for residents across four domains: uncooperative behavior,
irrational behavior, sleep behavior, and inappropriate behavior. Staff satisfaction scores
significantly improved as well. Their findings were consistent with those of other studies
involving animal-assisted therapy for individuals with dementia. Aquariums in group settings have been linked not only to decreased behavioral and psychological issues but also to
improvements in residents’ nutritional intake. Aquariums allow residents to have continued
interaction with the animals, and they require less supervision than dogs and many other
animals do. The use of secured aquariums is safe for both residents and the animals.
I n n o vat i o n s i n R e s i d e n t i a l D e s i g n
Many older facilities—particularly nursing homes—may have been designed using the
medical model, which has an institutional approach (Boyd and Mitchell 2014). However,
according to the Centers for Medicare & Medicaid Services (CMS), long-term care settings
should be “homelike” (CMS 2009). Newer designs promote resident freedom, autonomy,
empowerment, self-reliance, independence, and comfort. They have noninstitutional features,
with user-friendly flooring, good-quality lighting, and safety elements throughout the space.
This section provides an overview of current concepts in institutional design. These
suggestions reflect innovations implemented by actual long-term care facilities across the
United States and are in accordance with the current gerontology architecture and interior
design principles (Anderzhon, Fraley, and Green 2007; Brawley 2006; Verbeek et al. 2010;
Zeisel et al. 2003).
Resident Rooms
Many facility designs have rooms arranged into clusters rather than grouped along corridors
(Anderzhon, Fraley, and Green 2007). The cluster design allows for fewer residents on a
given unit, and the use of single-occupancy rooms increases privacy and autonomy. If an
organization is unable to redesign its physical structure, it can take other steps to promote
good outcomes. It can make furniture and fixtures flexible and customizable, or it can allow
a resident to bring her favorite chair, for a more homelike environment.
Nursing Stations
Concomitant with the practical functions of nursing stations is their social role. Mazer
(2005) observes that both staff and residents tend to congregate around the nursing station,
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thus making it a meeting spot. The challenge for new designs is to allow for a well-organized
work location while also encouraging the station’s social role and minimizing negative aspects
such as noise and the institutional look. Small changes can be made to existing designs
to support these goals. Moving the nursing station to a room can help combat noise and
ensure privacy of resident information.
Shower Rooms
The design of the shower room should allow ease of use for both residents and staff. Simple
redesign options may involve brighter lighting, a fold-down shower seat or bench for safety
and comfort, or removable shower chairs for better accessibility. The key to designing the
shower room is flexibility. The staff should be able to make any necessary adjustments to
maximize resident comfort (Barbera 2013; Zimmerman et al. 2013).
Dining Rooms
Recent innovations in resident dining use fewer dining tables but offer a greater variety of
meal choices and more flexible dining times. Some facilities have replaced small, 4-seat tables
with larger, 8- to 12-seat tables similar to those found in family dining rooms. This change
allows for greater interaction among the residents. Another simple improvement is to set the
table with silverware, napkins, plates, and glasses, just as many households do (Brawley 2006).
Kitchens
The kitchen is an important area for purposes both functional and social. In a study of
kitchen living, Maguire and colleagues (2014) found that problems with reaching, bending,
dexterity, and sight became more common with increasing age, and many such problems
were made worse by poor kitchen layout and lack of space. Key goals for kitchen design
involve the provision of storage space at a convenient height for access and the location of
appliances close enough together to minimize effort of movement and to avoid awkward
twisting. In dementia designs, safety is of primary concern, especially with regard to appliances such as ovens and stoves.
R e g u l at i o n s a n d t h e P h y s i c a l E n v i r o n m e n t
Long-term care providers are among the most heavily regulated segments of the healthcare
industry. This section reviews the relevant federal regulations related to the long-term care
physical environment and its residents, staff, and visitors. The regulations discussed here
focus on hazardous materials, building construction, fire protection, infection control, and
resident comfort and protection.
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D i m e n s i o n s o f L o n g – Te r m C a r e M a n a g e m e n t
The Americans with Disabilities Act
National Fire Protection Association
(NFPA)
A nonprofit agency,
established in 1896,
with a mission to
reduce the impact of
fire and other hazards
on the quality of life.
The NFPA provides
training, standards,
The Americans with Disabilities Act (ADA) of 1990 established guidelines to ensure that all
public and commercial buildings are accessible to persons with disabilities. The guidelines
cover both initial construction and future physical modifications of facilities. The rules,
however, do make some allowances in cases that involve undue hardship to the facility,
such as when the cost of a compliance study is disproportionately larger than the cost of
renovations.
To ensure ADA compliance, administrators should seek advice from attorneys,
architects, contractors, and other appropriate professionals when considering construction
projects or renovations that might result in accessibility changes. Professional advice is
especially important when the facility is making modifications to achieve culture change.
For example, the creation of small corridors might be intended to achieve a homelike
environment (a goal of culture change), but in reality it could violate the ADA (or the Life
Safety Code, discussed in the next section).
and codes, including
the Life Safety Code.
Life Safety Code
A set of standards,
developed by the
National Fire Protection Association, that
address issues that can
cause fires or otherwise affect safety.
The National Fire Protection Agency and the Life Safety Code
For well over a century, the National Fire Protection Association (NFPA) has been the
leader in creating US guidelines for building safety. A nonprofit agency established in
1896, the NFPA publishes fire safety standards and codes and offers training throughout
the world. Every few years, the organization revises its Life Safety Code, a set of standards
dealing with issues that can cause fires or otherwise affect safety. It also offers the Life Safety
Code Handbook, a guide that can help administrators better understand the meaning or
application of specific codes.
The primary focus of the Life Safety Code is to minimize fire hazards. For longterm care facilities, key issues involve vigilance about items and materials that might be
CRITICAL CONCEPT
Complying with Federal Regulations
The importance of complying with regulations cannot be overstated. Administrators
must be well versed in all local, state, and federal regulations, even if the regulations
are extensive, confusing, and ever changing. Ignorance is not a valid excuse for failing
to comply. CMS is the federal regulatory body for most long-term care providers, but
it relies on codes from the Americans with Disabilities Act, the National Fire Protection
Agency, and The Joint Commission, to name a few.
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flammable, such as wall and ceiling finishes; the use of alarms and other systems for notifying
residents about safety problems; and factors that limit residents’ ability to leave an affected
area, such as barriers to egress. In 2014, CMS mandated that all long-term care providers
must abide by the 2012 edition of the Life Safety Code (CMS 2015). A key update was
the requirement that automatic sprinkler systems be installed throughout long-term care
facilities.
The Occupational Safety and Health Administration
The Occupational Safety and Health Administration (OSHA) website (www.osha.gov)
offers an excellent starting point for long-term care administrators looking to protect staff
from physical and environmental hazards. OSHA has guidelines dealing with such topics
as ergonomics; exposure to blood and other infectious material; minimizing slips, trips,
and falls; and safe handling of patients. The OSHA website also provides a Nursing Home
eTool (www.osha.gov/SLTC/etools/nursinghome/index.html) that provides illustrations and
training and helps administrators identify and control environmental hazards. Additionally,
for interested administrators, OSHA representatives are happy to provide consultation and
advice on how to create a hazard-free workplace. OSHA’s guidelines and services can help
advance safety within the long-term care industry, which has some of the highest injury
rates in the United States (US Bureau of Labor Statistics 2015).
Occupational Safety
and Health Administration (OSHA)
The United States
federal agency charged
with the enforcement
of safety and health
legislation. OSHA is
part of the US Department of Labor.
Management Issues of the Physical Environment
A long-term care administrator is responsible for all aspects of the facility’s internal and
external environment. A well-organized and properly maintained environment improves the
facility’s ability to serve residents, staff, and visitors.
Facilities Management
An effective facilities plan must pay regular attention to all aspects of the physical plant. Buildings,
grounds, and equipment age at different rates, and
scheduled maintenance, repairs, and replacements
are necessary to avoid mechanical problems and
facility obsolescence. Poor management can result
in a facility looking tired, old, and generally uninviting (Sasse 2007). Well-maintained buildings,
equipment, and grounds convey an image of a
robust facility that is inviting to guests, residents,
and staff.
KEY POINT
The Importance of Managing the Physical
Environment
The importance of the physical environment, or physical plant,
is sometimes overlooked by administrators, but without a
properly operating plant, safe and effective care cannot be delivered. Effective administrators ensure that a plan is in place
to maintain the buildings, equipment, and systems needed to
provide a safe and high-quality experience to residents, staff,
and visitors.
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D i m e n s i o n s o f L o n g – Te r m C a r e M a n a g e m e n t
Maintenance
The facility maintenance department bears primary responsibility for monitoring all aspects
of the plant. Regular assessments and a process for making needed repairs are crucial and
should be conducted both informally and formally. An informal assessment may be conducted simply by looking for problems and potential future issues while walking around
the grounds and buildings (Sasse 2007). Maintenance should also note facility odors (both
organic and inorganic), floor care, and other potential safety hazards (Dolan 2009).
Preventive maintenance involves more than simply checking to see if everything
is in good working order. A good preventive maintenance program includes such tasks as
changing air conditioning and other filters, cleaning coils, tracking temperatures, testing
sprinkler systems, and lubricating equipment. Koo and Van Hoy (2003) found that investment in preventive maintenance can lead to returns on investment as high as 500 percent.
Facilities should have agreements with external vendors and repair contractors
in place before issues arise. The need for repairs is generally either discovered during the
maintenance department’s facility inspection or through the staff’s daily activities. Under
either circumstance, a work order should be placed so that repairs can be scheduled and
completed in a timely manner.
Housekeeping
Housekeeping has the critical role of maintaining a sanitary facility. In this case, the word
sanitary means both clean and safe. Housekeeping must use proper methods to minimize
the spread of disease and to appropriately store cleaning equipment and supplies. The products or chemicals used for cleaning and sanitizing must be approved by the Environmental
Protection Agency (EPA).
Housekeeping’s sanitation efforts also must control and combat the spread of infection. Methicillin-resistant Staphylococcus aureus (MRSA) infections and other nosocomial
infections have been a growing concern in long-term care (David and Daum 2010). The
housekeeping supervisor should periodically take cultures of surfaces throughout the facility
to determine bacterial colony levels (Lidsky et al. 2002).
Green Products
To the extent possible, facilities should use environmentally safe cleaning and laundry supplies—that is, supplies that are nontoxic, noncombustible, noncorrosive, safe for aquatic
life, and biodegradable. The Green Guide for Health Care (available at http://gghc.org)
provides a wealth of information about environmentally friendly cleaning products and
recycled paper products.
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Public Health Question

Jun 14, 2024 | Health Medical

Description

This journal assignment requires you to reflect on the information governance life cycle. Information governance is the structure and policies that govern how data is collected, organized, secured, and utilized. Every activity is backed up by data and information. A lack of governance around this data and information can lead to problems. Healthcare facilities need reliable, accurate, timely, and accessible data in order to make better informed decisions. AHIMA defines information governance as “an organization-wide framework for managing information throughout its lifecycle, and for supporting the organization’s strategy, operations, regulatory, legal, risk and environmental requirements.” This journal assignment focuses on discussion around information governance plans and the information governance life cycle. Journal assignments in this course are private between student and instructor.PromptWithin the journal assignment, answer the following questions:What are the steps in the information governance life cycle?What is an information governance plan?How does an information governance plan address data quality?Why is it important for healthcare facilities to create an information governance plan?

assignent 3

Jun 14, 2024 | Health Medical

Description

Assignment 3: Harlem Children’s Zone Reflection Video

33 unread replies.33 replies.

The Harlem Children’s Zone is an example of a Community Intervention Program, which specifically uses a block association model.

Watch the video below and reflect upon what components of Community Intervention Programming were incorporated (said another way, what made this program successful).

Post a video of yourself reflecting on how this program may effect children’s stress, coping, social support and resilience. More specifically, address the following points in your video:

Describe the Harlem Children’s Initiative (2 points)
Describe which Community Intervention Components were incorporated into the Harlem Children’s Initiative, and thus made it successful (4 points)
Explain how these program components would affect community members’ (i.e., children’s) stress, coping, social support and resilience (4 points)

You can either record the video presentation directly in Canvas (See How do I record a video using the Rich Content Editor?) or you can record it elsewhere and upload the file into the discussion (See How do I upload a video using the Rich Content Editor?Links to an external site.), or upload the file into YouTube and share the link in the discussion (See YouTube InstructionsLinks to an external site. from the Canvas Help Center).

Please review the general grading rubric for assignments 1-8.

The Harlem Children’s ZoneLinks to an external site.

View “How do I reply to a discussion.”Links to an external site.
View “How do I embed an image to a discussion reply?”Links to an external site.
View “How do I create a link using the Rich Content Editor?”Links to an external site.
View “How do I view the rubric for my graded discussion?Links to an external site.

If you have any technical issues with these items, contact FIU Canvas Help Team by clicking on Help in your Global Navigation Menu.

Jun 14, 2024 | Health Medical

Description

Podcast #2: For this assignment, you will dive into 2 different theories or viewpoints about the mental illness itself. For example, if you are looking at substance abuse disorder, you may look at the disease model of addiction versus the psychosocial model. You can discuss the pros and cons of each perspective. Try not to take sides, but be more objective in your presentation of different perspectives.

Instructions:

For the podcast assignment, you will be producing a 5 series Podcast related to a childhood mental illness that meets DSM V criteria. The entire podcast will consist of 5 separate videos, each ranging between 7-10 minutes in length. These will be due on separate dates throughout the semester so that you can devote appropriate time and resources to each segment. Each podcast is worth 25 points, for a total of 100 points. Please refer to the attached rubric for grading criteria. For each podcast submission, you must also submit a one page typed reflection of the material. Failure to submit the reflection will result in a loss of 5 points for that assignment.

Rubric

Podcast Rubric (1)

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeContentAs stated in the instructions (will vary for each podcast assignment)

5 pts

This criterion is linked to a Learning OutcomeClarityIs the presentation clear, easy to hear and follow, free of outside noise.

5 pts

This criterion is linked to a Learning OutcomePersonalizationEngaging presentation that is meaningful and relates to yourself and the content

5 pts

This criterion is linked to a Learning OutcomeReflectionSubmitted 1-page reflection, congruent to the presentation, free and clear of spelling and dramatically errors.

5 pts

Total Points: 20

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post two answers to your peers

Jun 14, 2024 | Health Medical

Description

by Katiuska Rodriguez

Number of replies

The Affordable Care Act (ACA)

The Affordable Care Act (ACA) initiated numerous fundamental aspects focusing on ameliorating health outcomes and reducing expenses within the United States. Despite diverse views on this Act, several elements have been deemed substantially advantageous for the healthcare system:

Broadened Medicaid: The ACA made Medicaid qualification more inclusive across multiple states, granting healthcare coverage accessibility for lower-income individuals and families. This expansion has facilitated essential healthcare service access for multitudes of formerly uninsured American citizens – promoting improved health results and minimized long-term costs (Baumgartner et al., 2020). Supplying coverage for those with lower incomes alleviates the weight of unpaid care on medical institutions and practitioners.

Preventive Care and Well-being: ACA obligates health insurance policies to incorporate pre-emptive functions – such as immunizations and assessments – in a non-cost-sharing manner. By accentuating prevention, people are likelier to undergo early interventions and treatments; this approach subsequently leads to superior health results and diminished overall healthcare expenditures.

Health Insurance Marketplaces: The creation of health insurance marketplaces permits individuals and smaller companies to scrutinize and acquire health insurance arrangements (Glied et al., 2020). These marketplaces foster rivalry among insurers, potentially resulting in price reduction while supplying consumers with cost-effective alternatives. Financial support via these marketplaces contributes to improved affordability for individuals earning less.

Prohibition of Pre-existing Condition Exclusions: ACA prohibits insurance agencies from denying coverage opportunities or imposing heightened premiums because of pre-existing conditions. This stipulation ensures that persons suffering from chronic ailments or previous medical complications can attain economic coverage (Adamson et al., 2019). This enhances the management of such conditions while ultimately curbing exorbitant emergency care expenses.

Medicare Adjustments: Within the ACA, numerous stipulations serve to manage Medicare expenditures; for instance, lowering excess payments directed towards private insurers via Medicare Advantage and inaugurating merit-based compensation models. These modifications advocate for resourceful Medicare funds utilization while aiding in prolonging the program’s financial viability.

Accountable Care Organizations (ACOs): The ACA endorses the establishment of ACOs – a collection of health service providers collaborating to elevate care quality while diminishing expenses. These consortiums concentrate on care synchronization, data dissemination, and results-oriented reimbursement schemes; this amalgamation facilitates more streamlined and economical healthcare distribution.

Patient-Driven Clinical Residences: The ACA supports the notion of patient-driven clinical residences – settings where primary caregivers organize a patient’s treatment plan and act as the principal communication hub. This configuration promotes enhanced correspondence, reduces superfluous examinations and therapies, and refines chronic condition supervision; collectively contributing to superior health results and decreased expenses.

Indeed, the ACA has made considerable advancements in ameliorating healthcare availability and curbing expenses; however, it is not exempt from complications and detractors. Several elements – especially those concentrating on broadening coverage scope, fostering preventative care measures, and inspiring inventive care delivery approaches – retain the capacity to persistently exert positive influences on healthcare consequences and expense management. The enduring discourse on healthcare policy within the United States frequently revolves around refining and expanding these provisions to further enhance the nation’s healthcare infrastructure.

References

Adamson, B. J., Cohen, A. B., Estevez, M., Magee, K., Williams, E., Gross, C. P., & Davidoff, A. J. (2019). Affordable Care Act (ACA) Medicaid expansion impact on racial disparities in time to cancer treatment. https://ascopubs.org/doi/abs/10.1200/JCO.2019.37.18_suppl.LBA1

Baumgartner, J., Collins, S., Radley, D., & Hayes, S. (2020). How the Affordable Care Act (ACA) has narrowed racial and ethnic disparities in insurance coverage and access to health care, 2013‐18. Health Services Research, 55, 56-57. https://doi.org/10.1111/1475-6773.13406

Glied, S. A., Collins, S. R., & Lin, S. (2020). Did The ACA Lower Americans’ Financial Barriers to Health Care? A review of evidence to determine whether the Affordable Care Act was effective in lowering cost barriers to health insurance coverage and health care. Health Affairs, 39(3), 379-386. https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2019.01448

by Gretel Valdes Alfonso –

The Affordable Care Act (ACA) brought about several key provisions that aimed to improve healthcare outcomes and decrease costs within the Medicare program and the broader healthcare system. The ACA introduced a range of preventive services for Medicare beneficiaries with no cost-sharing. This includes vaccinations, screenings, and annual wellness visits. By focusing on prevention and early detection, the ACA aimed to improve health outcomes and reduce the burden of chronic diseases.
The ACA gradually closed the Medicare Part D prescription drug coverage gap known as the “doughnut hole.” This helped seniors afford their medications, reducing the likelihood of medication non-adherence due to cost concerns and ultimately leading to better health outcomes. The ACA incentivized the creation of ACOs, which are networks of healthcare providers that work together to coordinate care for Medicare beneficiaries. ACOs aim to improve the quality of care while reducing costs through better care coordination, reducing duplicative tests, and focusing on preventive care.
The ACA initiated a shift from fee-for-service reimbursement to value-based payment models. These models reward healthcare providers for delivering high-quality care rather than just the quantity of services provided. This incentivizes better care coordination, reduces unnecessary procedures, and encourages more efficient care delivery. Under the ACA, the Medicare Shared Savings Program was established, allowing healthcare providers to share in the cost savings they achieve while providing high-quality care to Medicare beneficiaries. This encourages providers to be more efficient and effective in their care delivery. The ACA introduced penalties for hospitals with high readmission rates for certain conditions, encouraging hospitals to improve post-discharge care and reduce avoidable readmissions. This improves patient outcomes and reduces healthcare costs associated with unnecessary hospital stays.
While not directly related to Medicare, the ACA’s Medicaid expansion increased access to healthcare for low-income individuals, including many older adults who were not eligible for Medicare. This expansion helped ensure that more people had access to preventive care and early treatment, ultimately improving overall health outcomes and reducing healthcare costs by addressing health issues before they become more serious and expensive to treat. The ACA provided funding for adopting electronic health records (EHRs) and encouraged sharing of health information among providers. This enhances care coordination, reduces medical errors, and improves the overall quality of care.
Overall, the ACA’s provisions aimed at improving preventive care, care coordination, and payment reform have positively improved healthcare outcomes and decreased costs within the Medicare program and the broader healthcare system. These changes are part of a broader effort to move from a volume-based healthcare system to one that prioritizes value and quality of care.
References
1- Peterson, M. A. (2020, August 1). The ACA a decade in: Resilience, impact, and vulnerabilities. Duke University Press. https://read.dukeupress.edu/jhppl/article-abstract…
2- Borgschulte, M., & Vogler, J. (2020). Did the ACA Medicaid expansion save lives?. Journal of Health Economics, 72, 102333. https://www.sciencedirect.com/science/article/pii/…

nursing interventions for client with anxiety

Jun 14, 2024 | Health Medical

Description

Ms. Nakya was seen today through telehealth. She was alert and oriented and denied discomfort. She spent most of her time in the community and she was aware of what goes on around her. Client continue to leave with family member in the district and all needs are provided with the help of government support programs that cover food, housing, and health. Ms. Nakya continues to experience anxiety daily. Assigned nurse provided resident nursing education on management of anxiety. See the rubric below

NUR512AP3 DISCUSSION 6

Jun 14, 2024 | Health Medical

Description

Based on your textbook reading, discuss the process of Advanced Practice Nurse (APN) business planning from a system approach.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.READHamric, B. A., Hanson, M. C., & Tracy, F. M., & O’Grady, T. E. (2013). Chapter 20

discussion board 3

Jun 14, 2024 | Health Medical

Description

Many social scientists have commented on the adult hypocrisy that can accompany childhood socialization. For example, “Do as I say, not as I do” has been around for a long time. One of the topics in this chapter is substance abuse problems among children and adolescents. Some years ago, one of the Drug Council public service messages on television depicted a father who had caught his son in the act of using marijuana. The father, in an agitated and incredulous tone of voice, announces: “Where did you get this?!……where did you find out about this stuff?!” The imp replies in an anguished tone: “I learned it from YOU!!……that’s where I got it……from YOU!!” I would like for you to share how they feel about this kind of hypocrisy and how you think childhood and adolescent socialization contributes to conduct problems.It is required that you post at least 2 times per discussion (initial post and response to at least 1 peer) over the two week period (on two different days) to encourage a lively discussion. Your first post must be submitted during the first week that the question is posted. Your initial response must contain an in-text citation, referencing material from your textbook and/or other academic sources. Your second response, which is your follow-up response to another student, can be posted during either the first or second week that the discussion board is open. Your initial response needs to use in-text citations and must contain an academic reference at the end of your post. This is an upper-level psychology course, so APA style is mandated for the discussion board. Failure to use proper APA style in-text citations and references will result in point loss. Please consult Purdue’s OWL Resources (Links to an external site.)Links to an external site. for APA format.Each of your required two responses should be a minimum of 225 words and should meet the content requirements stated in the syllabus. However, your initial response will probably be longer. Two postings per discussion module (a two week period) is the minimum number of postings per discussion and will yield a minimum grade. Proper grammar and spelling are required and points will be deducted for errors.Search entries or author

Read the following case study and answer the reflective questions.

Jun 14, 2024 | Health Medical

Description

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 4
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.
Due: Saturday by 23:59 pm
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?

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PDSA Project e-Poster and Presentation

Jun 14, 2024 | Health Medical

Description

Please use the rubric to generate your PDSA e-Poster (I will attach an example os a PDSA e -Poster) and Presentation based upon your formal paper. (For the presentation I will need a separate word document with the scripts) 10-minute overview of the problem.

My clinical site is (Encompass Health Rehabilitation Hospital of Miami @20601 Old Cutler Rd, Miami, FL 33189) Please do the PDSA poster based on this site. One problem that i found in this acute rehab is call light response time. Please follow the instructions.

PDSA Practice Improvement Plan (CC5.c). The PDSA Practice Improvement Plan is an assessmentcomprised of four phases. The PDSA project will give the student the opportunity to initiate andcoordinate planned changes in a health care organization. This assignment aims to engage the studentin analyzing an evidence-based practice clinical experience and is divided into four parts. Please see the following:

Part I: Plan

Here, you will write a concise statement of your plan.

Here you can put a measurement or outcome you hope to achieve.

Steps to execute: Here is where you will write the steps you will take in this cycle. You will want to includethe following:

Problem Identification: Identify a clinical problem you observed at the clinical site. Review policies,procedures, and guidelines of care to assess if there is a standard or policy to improve practice. Talkingwith patients about their perceptions of the care. Is there a problem, a patient, or a population negativelyaffected by the present standard of practice? Once this P factor is determined without a present resolution,a clinical question should be developed using the PICO process.

The population could be a patient, a problem, a population, a unit, a division, or an organizationproblem.

The time limit: that you will do this project—remember, it does not have to be long enough to get yourresults.

Review of literature: What level of knowledge is out there to address the problem? Are there anyevidence-based guidelines already published? Most of the literature reviewed should utilize systematicreviews, meta-analyses, or clinical guidelines. Individual studies review expert opinion articles, and clinicalarticles can be used as supportive literature for clinical issues with limited research.

Part II: Do

After you have your plan, you will execute it or set it in motion. During this implementation, you will be keento watch what happens once you do this.

What did you observe? Here you will write down observations you have during your implementation. Thismay include how the patients react, how the nurses react, and how it fits in with your organizationalsystem. You will ask, “Did everything go as planned?” “Did I have to modify the plan?”

Part III: Study

After implementation, you will study the results.

What did you learn? Did you meet your measurement goals? Here you will document your findings.

Part IV: Act

What did you conclude from this cycle? You will write what you came away with for this implementationand whether it worked. Moreover, if it did not work, what can you do differently in your next cycle toaddress that? Are you ready to spread it across your entire practice if it did work?

Dissemination: This section will include the materials used to disseminate your findings.

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IHP 430 Milestone Two

Jun 14, 2024 | Health Medical

Description

You will build upon the work you completed in 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.

As you develop this final part of the assignment, consider the following prompts to formulate your paper.

Prompt
Performance Improvement Initiative
Propose a performance improvement plan that will address this problem. What specific relevant quality standard will this plan 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 in real life, 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?

NUR502AP1 DISCUSSION 6

Jun 14, 2024 | Health Medical

Description

Musculoskeletal Function:

G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time complaining of a long history of bilateral knee discomfort that becomes worse when it rains and usually feels better when the weather is warm and dry. “My arthritis hasn’t improved a bit this summer though,” she states. Discomfort in the left knee is greater than in the right knee. She has also suffered from low back pain for many years, but recently it has become worse. She is having difficulty using the stairs in her home. The patient had recently visited a rheumatologist who tried a variety of NSAIDs to help her with pain control. The medications gave her mild relief but also caused significant and intolerable stomach discomfort. Her pain was alleviated with oxycodone. However, when she showed increasing tolerance and began insisting on higher doses of the medication, the physician told her that she may need surgery and that he could not prescribe more oxycodone for her. She is now seeking medical care at the Family Practice Clinic. Her knees started to get significantly more painful after she gained 20 pounds during the past nine months. Her joints are most stiff when she has been sitting or lying for some time and they tend to “loosen up” with activity. The patient has always been worried about osteoporosis because several family members have been diagnosed with the disease. However, nonclinical manifestations of osteoporosis have developed.

Case Study Questions

Define osteoarthritis and explain the differences with osteoarthrosis. List and analyze the risk factors that are presented on the case that contribute to the diagnosis of osteoarthritis.
Specify the main differences between osteoarthritis and rheumatoid arthritis, make sure to include clinical manifestations, major characteristics, joints usually affected and diagnostic methods.
Describe the different treatment alternatives available, including non-pharmacological and pharmacological that you consider are appropriate for this patient and why.
How would you handle the patient concern about osteoporosis? Describe your interventions and education you would provide to her regarding osteoporosis.

Neurological Function:
H.M is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history: hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history no contributory. Last annual visits with PCP with normal results. She lives by herself but her children live close to her and usually visit her two or three times a week.
Her daughter start noticing that her mother is having problems focusing when talking to her, she is not keeping things at home as she used to, often is repeating and asking the same question several times and yesterday she has issues remembering her way back home from the grocery store.

Case Study Questions

Name the most common risks factors for Alzheimer’s disease
Name and describe the similarities and the differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, Frontotemporal dementia.
Define and describe explicit and implicit memory.
Describe the diagnosis criteria developed for the Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association
What would be the best therapeutic approach on C.J.

Submission Instructions:

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.

weekly refl 6

Jun 14, 2024 | Health Medical

Description

Although this event and story are almost 22 years old, the memories and significance of this will remain and continue to be significant in our understanding of mass shootings and violence. I would like for you to consider the question:

Who can we hold accountable here besides Kip? Why do you think he resorted to violence? Was he a naturally violent child or did his childhood experiences in some way shape him to become this way?

https://www.youtube.com/watch?v=OVrhFlj80NgLinks 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.

Rubric

Some Rubric (1)

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeQuality ReflectionStudent submits a reflection that reflects thoroughly on the content that was posted for the week. Reflections should not be mere summaries of the content. Rather, they should raise thought provoking questions or discuss personal insight that you have gained through watching the videos. (2 points). Reflections should integrate evidence and information from the textbook and readings to support the ideas in the reflection (1 point). References should be cited using APA formatted in-text citations (1 point)

4 pts

Exceptional

3 pts

Average

2 pts

Fair

1 pts

Poor

0 pts

No Marks

4 pts

This criterion is linked to a Learning OutcomeTimely submissionStudent submits reflection by the due date

2 pts

On time

1 pts

Late

2 pts

This criterion is linked to a Learning OutcomeWord CountSubmissions should be at least 250 words in length

2 pts

250 words or greater

0 pts

Less than 250 words

2 pts

This criterion is linked to a Learning OutcomeSpelling & GrammarStudent’s submission is mostly free of grammatical and spelling mistakes

2 pts

Full Marks

1 pts

Poor

There are numerous grammar and spelling mistakes, but these do not impede the reader from understanding the ideas that are being communicated.

0 pts

Unsatisfactory

Numerous spelling and/or grammatical mistakes significantly reduce the reader’s ability to understand what the writer is trying to communicate

2 pts

Total Points: 10

PREVIOUSNEXT

Topic Focus: Health Policy

Jun 14, 2024 | Health Medical

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: Health Policy

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: Leadership and Economic Models

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.

Categorical Logic

Jun 14, 2024 | Health Medical

Description

This week, we are learning about categorical logic.1) Define in your own words, using the textbook, what is Categorical Logic.2) Why is it important to understand categorical logic as a nurse?Must be willing to response to a peer`s response.

Please answer the prompts

Jun 14, 2024 | Health Medical

Description

Using the video from Episode 6 on Mr. Fallbrook, 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 on how Mr. Fallbrook’s gastroenteritis leads to sepsis and then ARF. Prompt 2: Research the medication Enalapril. Explain its uses, dosage, and side effects. Prompt 3: Explain the different types of Acute Renal Failure and which type Mr. Fallbrook falls under. Prompt 4: Explain the different types of dialysis and how they are used. Requirements:1-2 references to support your responses1-2 full paragraph responsesBe willing to response to a peer`s response

EXSC510 advanced exercise

Jun 14, 2024 | Health Medical

Description

1 Corinthians 6: 19-20 says, “Do you not know that your body is a temple of the Holy Spirit, who is in you, whom you have received from God? You are not your own; you were bought at a price. Therefore, honor God with your body.”Review the content of the first 5 modules in the course. Discuss how God has made our bodies “perfect,” like a temple, and that no mistakes occurred with reference to the unique metabolic processes and physical design of our bodies. An example would be discussing the perfection of the interplay of the energy systems or the relationship between the percentage of fast twitch vs. slow twitch muscle fibers.Also, discuss how you can use the knowledge in the first 5 modules to train your bodies in a manner as to would glorify Christ. Furthermore, explain why there is biblical truth to why we should take care of our bodies by living a healthy lifestyle.Please review the Discussion Assignment Instructions Download Discussion Assignment Instructionsprior to posting. You may also click the three dots in the upper corner to Show Rubric.Post-First: This course utilizes the Post-First feature in all Discussions. This means you will only be able to read and interact with your classmates’ threads after you have submitted your thread in response to the provided prompt.Review the content of the first 5 modules: bioenergics and maximal oxygen consumption, cardiorespiratory systems and maximal aerobic capacity, metabolic training adaptations, altitude, and thermoregulation, skeletal muscle structure and physiology, neuromuscular and metabolic adaptiations to training

Respiratory case study

Jun 14, 2024 | Health Medical

Description

Case Study: Richard is a 50-year-old male with nasal congestion, sneezing, rhinorrhea, and postnasal drainage. Richard has struggled with an itchy nose, eyes, palate, and ears for 5 days. As you check his ears and throat for redness and inflammation, you notice him touch his fingers to the bridge of his nose to press and rub there. He says he’s taken Mucinex OTC the past 2 nights to help him breathe while he sleeps. When you ask if the Mucinex has helped at all, he sneers slightly and gestures that the improvement is only minimal. Richard is alert and oriented. He has pale, boggy nasal mucosa with clear thin secretions and enlarged nasal turbinates, which obstruct airway flow but his lungs are clear. His tonsils are not enlarged but his throat is mildly erythematous.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. Provide 5 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.you are allowed to make up the information that is needed to fill out the episodic note.

Unformatted Attachment Preview

Episodic/Focused SOAP Note Exemplar
Focused SOAP Note for a patient with chest pain
S.
CC: “Chest pain”
HPI: The patient is a 65 year old AA male who developed sudden onset of chest pain, which
began early this morning. The pain is described as “crushing” and is rated nine out of 10 in
terms of intensity. The pain is located in the middle of the chest and is accompanied by shortness
of breath. The patient reports feeling nauseous. The patient tried an antacid with minimal relief
of his symptoms.
Medications: Lisinopril 10mg, Omeprazole 20mg, Norvasc 5mg
PMH: Positive history of GERD and hypertension is controlled
FH: Mother died at 78 of breast cancer; Father at 75 of CVA. No history of premature
cardiovascular disease in first degree relatives.
SH : Negative for tobacco abuse, currently or previously; consumes moderate alcohol; married
for 39 years
Allergies: PCN-rash; food-none; environmental- none
Immunizations: UTD on immunizations, covid vaccine #1 1/23/2021 Moderna; Covid vaccine #2
2/23/2021 Moderna
ROS
General–Negative for fevers, chills, fatigue
Cardiovascular–Negative for orthopnea, PND, positive for intermittent lower extremity edema
Gastrointestinal–Positive for nausea without vomiting; negative for diarrhea, abdominal pain
Pulmonary–Positive for intermittent dyspnea on exertion, negative for cough or hemoptysis
O.
VS: BP 186/102; P 94; R 22; T 97.8; 02 96% Wt 235lbs; Ht 70”
General–Pt appears diaphoretic and anxious
Cardiovascular–PMI is in the 5th inter-costal space at the mid clavicular line. A grade 2/6
systolic decrescendo murmur is heard best at the
second right inter-costal space which radiates to the neck.
A third heard sound is heard at the apex. No fourth heart sound or rub are heard. No cyanosis,
clubbing, noted, positive for bilateral 2+ LE edema is noted.
Gastrointestinal–The abdomen is symmetrical without distention; bowel
sounds are normal in quality and intensity in all areas; a
bruit is heard in the right para-umbilical area. No masses or
splenomegaly are noted. Positive for mid-epigastric tenderness with deep palpation.
Pulmonary– Lungs are clear to auscultation and percussion bilaterally
Diagnostic results: EKG, CXR, CK-MB (support with evidenced and guidelines)
© 2021 Walden University
Page 1 of 2
A.
Differential Diagnosis:
1) Myocardial Infarction (provide supportive documentation with evidence based guidelines).
2) Angina (provide supportive documentation with evidence based guidelines).
3) Costochondritis (provide supportive documentation with evidence based guidelines).
Primary Diagnosis/Presumptive Diagnosis: Myocardial Infarction
P. This section is not required for the assignments in this course (NURS 6512) but will be
required for future courses.
© 2021 Walden University LLC
Page 2 of 2
Episodic/Focused SOAP Note Template
Patient Information:
Initials, Age, Sex, Race
S.
CC (chief complaint) a BRIEF statement identifying why the patient is here – in the patient’s
own words – for instance “headache”, NOT “bad headache for 3 days”.
HPI: This is the symptom analysis section of 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. Use LOCATES Mnemonic to complete your HPI. You need to start EVERY HPI with
age, race, and gender (e.g., 34-year-old AA male). You must include the seven attributes of each
principal symptom in paragraph form not a list. If the CC was “headache”, the LOCATES for the
HPI might look like the following example:
Location: head
Onset: 3 days ago
Character: pounding, pressure around the eyes and temples
Associated signs and symptoms: nausea, vomiting, photophobia, phonophobia
Timing: after being on the computer all day at work
Exacerbating/ relieving factors: light bothers eyes, Aleve makes it tolerable but not
completely better
Severity: 7/10 pain scale
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 (a description of
what the allergy is ie angioedema, anaphylaxis, etc. This will help determine a true reaction vs
intolerance).
PMHx: include immunization status (note date of last tetanus for all adults), past major
illnesses and surgeries. Depending on the CC, more info is sometimes needed
Soc Hx: include occupation and major hobbies, family status, tobacco & alcohol use (previous
© 2021 Walden University, LLC
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and current use), any other pertinent data. Always add some health promo question here – such as
whether they use seat belts all the time or whether they have working smoke detectors in the
house, living environment, text/cell phone use while driving, and support system.
Fam Hx: illnesses with possible genetic predisposition, contagious or chronic illnesses. Reason
for death of any deceased first degree relatives should be included. Include parents, grandparents,
siblings, and children. Include grandchildren if pertinent.
ROS: cover all body systems that may help you include or rule out a differential diagnosis 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: Denies weight loss, fever, chills, weakness or fatigue.
HEENT: Eyes: Denies visual loss, blurred vision, double vision or yellow sclerae. Ears, Nose,
Throat: Denies hearing loss, sneezing, congestion, runny nose or sore throat.
SKIN: Denies rash or itching.
CARDIOVASCULAR: Denies chest pain, chest pressure or chest discomfort. No palpitations or
edema.
RESPIRATORY: Denies shortness of breath, cough or sputum.
GASTROINTESTINAL: Denies anorexia, nausea, vomiting or diarrhea. No abdominal pain or
blood.
GENITOURINARY: Burning on urination. Pregnancy. Last menstrual period, MM/DD/YYYY.
NEUROLOGICAL: Denies headache, dizziness, syncope, paralysis, ataxia, numbness or
tingling in the extremities. No change in bowel or bladder control.
MUSCULOSKELETAL: Denies muscle, back pain, joint pain or stiffness.
HEMATOLOGIC: Denies anemia, bleeding or bruising.
LYMPHATICS: Denies enlarged nodes. No history of splenectomy.
PSYCHIATRIC: Denies history of depression or anxiety.
ENDOCRINOLOGIC: Denies reports of sweating, cold or heat intolerance. No polyuria or
polydipsia.
ALLERGIES: Denies history of asthma, hives, eczema or rhinitis.
© 2021 Walden University, LLC
Page 2 of 3
O.
Physical exam: 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.
Diagnostic results: Include any labs, x-rays, or other diagnostics that are needed to develop the
differential diagnoses (support with evidenced and guidelines)
A.
Differential Diagnoses (list a minimum of 3 differential diagnoses).Your primary or
presumptive diagnosis should be at the top of the list. For each diagnosis, provide supportive
documentation with evidence based guidelines.
P.
This section is not required for the assignments in this course (NURS 6512) but will be required
for future courses.
References
You are required to include at least three evidence based peer-reviewed journal articles or
evidenced based guidelines which relates to this case to support your diagnostics and
differentials diagnoses. Be sure to use correct APA 7th edition formatting.
© 2021 Walden University, LLC
Page 3 of 3

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Ct 1

Jun 14, 2024 | Health Medical

Description

Memo for Public Health Emergency (100 points)

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:

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.

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.

Jun 14, 2024 | Health Medical

Description

PREPARING THE DISCUSSION

Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.

Family nurse practitioners often care for older adults as they experience changes in functional health. Assessments may reveal that clients are unsafe in their current environment or that they may require additional assistance to remain at home. Carefully read the questions below and address each in your initial post.

Application of Course Knowledge
Identify at least TWO assessments that can be used to determine whether a client is safe in their current living environment.
Discuss results that indicate the client may require additional assistance or a transition in the care environment.
Describe the NP’s role in working with the client and family to assist with care transitions.
Identify at least TWO appropriate referrals for a client who requires a transition in the care environment. How does the NP ensure coordination of care during transitions?
Identify at least TWO public or private resources that are available for clients with limited resources in your intended practice area.
Integration of Evidence: Integrate relevant scholarly sources as defined by program expectations.
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.

3 dis file

Jun 14, 2024 | Health Medical

Description

ودي مادة 505 research methodology discussion 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.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.

Nursing leadership dq response

Jun 14, 2024 | Health Medical

Description

A Nurse Manager’s Role in Resolving Conflict

Situation

As the nurse manager of a 30-bed surgical unit, AM facilitates the unit’s daily interdisciplinary rounds (IDR) during which multiple disciplines convene to collaborate and discuss effective treatment interventions and discharge plans for each patient. The IDR participants include the unit nurses, physicians, physical therapist, dietician, and care coordinator. During the discussion of a specific patient who for the last couple of days has been having breakthrough postoperative pain, the primary nurse suggests increasing the dose of the patient’s pain medication or treating the patient with an additional pain medication because the patient’s current pain medication, Percocet, has not been controlling the patient’s pain throughout the day. This is the second shift the primary nurse has cared for the patient; thus, the nurse has witnessed the patient’s breakthrough pain on more than one occasion. The physician disagrees with the primary nurse’s suggestion and indicates the current pain management regimen should be more than enough to control the patient’s pain. The physician refuses to add another pain medication to the patient’s treatment plan and requests moving on to discuss the next patient. What should AM do as the facilitator of the IDR meeting?

Approach

Having been a nurse manager for over 10 years, AM has facilitated many IDR meetings and experienced all types of conflict situations in the work environment. Fortunately, AM is well-versed in various styles of conflict management and has implemented different styles to resolve conflict, depending on the situation. In this particular example, the unit IDR meeting is running over on time, with more than half of the patients still requiring discussion. As such, AM has decided to utilize the compromising style of conflict management that seeks to find a middle ground between involved parties.

Outcome

To resolve most conflicts, AM typically prefers utilizing the collaborating style of conflict management that focuses on having all participants provide their perspectives on the situation to come up with a mutual resolution. Nonetheless, as time is not permitting, AM decides to employ the compromising style to facilitate IDR flow. AM interjects the conversation, reiterates the patient’s more than one instance of breakthrough pain, and suggests the physician reassess the patient’s pain status after IDR. The decision to either increase the patient’s pain medication dosage or add another pain reliever to treat the patient’s breakthrough pain can be determined after patient reassessment.

Discussion Questions (the first question is in relation to the above Case scenario; the other two are not)

1. What type of conflict best describes the listed situation? Name another conflict management style AM could have utilized to manage the situation. List two healthcare-related consequences that could occur from poorly managed conflicts

2 Discuss the application of complexity leadership and the contributing influence on quality and safety. Describe 2 factors most influence spread, sustain, and scale and how you might modify those factors as they relate to quality and safety.

300 words 3 apa citation

3k-5k Biotechnology and data science dissertation

Jun 14, 2024 | Health Medical

Description

Bid if you can handle paper3k-5k dissertation biotech and data science paper. Needs in depth skill-set for organizing literature review with data.Follow outline as given

Unformatted Attachment Preview

MIND-BODY BIOFEEDBACK THERAPY FOR WOMEN’S HEALTH OPTIMIZATION
I. Introduction
•
•
•
•
Background and context
Problem statement
Research objectives and hypothesis
Significance of the study
II. Literature Review
•
•
•
•
•
Overview of women’s health issues (anxiety, headaches, lower back pain, IBS)
Existing treatments and tools for these conditions
Gap analysis: Lack of Mind-Body Biofeedback tools and tools that are using root based
assessments)
Concepts of Mind-Body Therapy (yoga, tai-chi, meditation, music, nutrition, exercise)
Existing research on Mind-Body Therapies and their effectiveness
III. Methodology
•
•
•
•
•
•
•
Research design
Participants and recruitment
Data collection methods
o EEG, sEMG, and PPG sensors
o Additional bioinformatics data points (outside EEG, sEMG, PPG)
Intervention group (Mind-Body Therapy)
Comparison group (existing tools)
Data analysis plan
Ethical considerations
IV. Mind-Body Biofeedback Therapy Intervention
•
•
•
•
Detailed explanation of the intervention components (yoga, tai-chi, meditation, music,
nutrition, exercise)
How these components address anxiety, headaches, lower back pain, and IBS
Design of the intervention program
Integration of biofeedback sensors into therapy
Root cause Assessment
•
•
•
hormonal imbalance,
micronutrients deficiency
gut health
Problem identification
•
•
•
IBS
Lower back pain
Anxiety
Solution
•
•
•
•
Tools and Techniques used in the therapy – tai chi, yoga, meditation, music, exercise
(resistance training and cardio activities)
Nutrition- diet and supplements
Heart Rate Variability spO2, Resting Heart Rate, Body Temperature (PPG)+ data from
EEG and EMG data.
Breathing techniques
Measurement tools
•
•
•
PPG
EMG
EEG
Care Models
•
•
•
•
Explanation of the care models
Interactive Medicine
Palliative Care Model
Discussion on which care model is most commonly used in complementary therapies
V. Comparison with Existing Tools
•
•
•
Identification and evaluation of existing tools in the market for anxiety, headaches, lower
back pain, and IBS
The limitations of current tools
Explanations why Mind-Body Biofeedback is a novel approach
VI. Data Collection and Analysis
•
•
•
•
Description of EEG, sEMG, and PPG sensors
Explanation of how data will be collected and processed
Identifying additional bioinformatics data points for each condition
Statistical analysis methods
VII. Results
•
Presentation and interpretation of the results of the Mind-Body Biofeedback Therapy
group
•
•
Comparing results with the existing tools group
Discussion on the effectiveness of Mind-Body Biofeedback in relieving symptoms
VIII. Discussion
•
•
•
•
•
Interpretation of findings
Implications of the study for women’s health
Limitations of the research
Future research directions
Practical applications and recommendations
IX. Conclusion
•
•
Summary of the key findings and their significance
Reiteration of the potential of Mind-Body Biofeedback Therapy for women’s health
optimization

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the theory of unpleasant symptoms as a guide

Jun 14, 2024 | Health Medical

Description

Using the theory of unpleasant symptoms as a guide, what would you look for in an assessment tool for patient symptoms?APA FORMAT, NO PLAGIARISM AND MORE THAN 450 WORDS

Comparison of Medical Billing and Coding

Jun 14, 2024 | Health Medical

Description

PHIL 434 Week 5: Debating Abortion Scenario and Reflection

Jun 14, 2024 | Health Medical

Description

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

Week 4 Presentation

Jun 14, 2024 | Health Medical

Description

NURS 540 Week 4 Video Presentation

For this assignment, you will produce a professional 4–7 minute audio–video presentation on your chosen topic:

Topic: Provide an overview of leukemia, its different types (e.g., acute lymphoblastic leukemia, chronic myeloid leukemia), and the latest advancements in treatment.

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.

Please provide copy with audio and one with power point with notes..

Nursing leadership

Jun 14, 2024 | Health Medical

Description

A Nurse Manager’s Role in Resolving Conflict

Situation

Approach

Outcome

Discussion Questions (the first question is in relation to the above Case scenario; the other two are not)

350 words 3 apa citation

FW-405 WORKSITE HEALTH PROMOTION

Jun 14, 2024 | Health Medical

Description

First task: Check the template and fill out the blanksSecond task: Check the file and follow the instructions (letter to company

Unformatted Attachment Preview

Reading and Reflect Assignment Template (Save a copy and add to it each week
Course: ________________
Name: ______________
Readings
Pre-Reflection
what you know about that
subject, content, or concept, prior
to engaging
Reflection (Learning)
initial thoughts after reading
assignments
Reflection (Enhanced Learning)
additional thoughts brought about ALL
this week’s learning activities- NOT just
the assigned readings.
Module 1
•
Chapter 1:
Mindset the New
Psychology of
Success by Dr.
Carol Dweck
●
WWP Part #1
Evidence Based
Article 1
●
•
WWP Part #1
Evidence Based
Article 2
●
•
WWP Part #1
Evidence Based
Article 3
●
•
REMINDERS or IMPORTANT NOTES:
❖ Bullet thoughts here:
❖
NEW VOCABULARY:
★ List new vocabulary with
definitions here:
★
PERSONAL REACTIONS:
• Bullet your insights or feelings.
•
)
Module 2
Grading Criteria for Read and Reflect Assignments
Ratings and Criteria
Points
Full Marks: The reflection is very thorough and exhibits an extremely high quality in both pre-reflections and reflections. The student has
clearly documented a richer and deeper understanding of the reading assignment
Partial Points: The reflection is well written. However, it may be missing one or more examples of either pre-reflections or reflections.
Documentation of a richer and deeper understanding of content is somewhat lacking.
Partial Points: The reflection is satisfactory. However, it may be missing one or more examples of either pre-reflections or reflections.
Documentation of a richer and deeper understanding of content is somewhat lacking.
No Points: The reflection substantially misses the point of the assignment or is not submitted at all.
10 points
8 points
6 points
0 points
Worksite Wellness Project Part #1:
Communication w/ Company Leadership (75 points)
THE WHY BEHIND WHAT WE ARE DOING:
Student learning outcomes met from this assignment:
● Describe the benefits of health promotion programs in the
workplace ∙ Quantify potential savings in health care cares from
worksite health promotion.
● Develop written communication to rationalize worksite promotion to
administration.
● Assessing and disseminating scientifically based, relevant fitness-,
nutrition-, and wellness-related resources and information.
Your Task: Make a case for a wellness/health promotion program with
company leadership. You will communicate professionally with the
CEO or owner of the company. You may choose from my company
profiles (see canvas, module one content page for my company
profiles) or investigate a company online of your choosing. Before you
will be able to write your letter, you will need to review multiple different
peer-reviewed journals and other vetted resources, including the ones
you looked at for the ROI/VOI assignment and ones listed in module
one. Your communication should include:
● Rationalization & benefits of health promotion programs in the
workplace (research/evidence-based statistics) This information should
come from the multiple different peer-reviewed journals and vetted
resources in module one.
● Details about potential savings in health care costs (ROI) as well as VOI
● Details about the benefits of Growth Mindset and the relationship to
valued employees in the workplace.
Your Submission Will Include:
A. Written communication (more in depth) such as ONE of the following ideas:
●
●
●
●
An email
A business letter
A white paper (google what this is if you are unfamiliar)
Other (you can get creative, but be sure it is WRITTEN, professional
communication of some kind)
*There is not a page or word count requirement, just focus on making your case
and include all requested items (refer to rubric)
B. Graphic/Visual representation (more concise-includes highlights/key
information from part A). This should sell who you are as a wellness
company, what you believe in, what you can offer the company.
Suggestions for Part B include:
● A PowerPoint/presentation
● An infographic
● A fact sheet
● Other (you can get creative, but be sure it is concise and
predominantly visual/graphic communication)
*Part B should all fit on a single sheet/slide
C. A reference page in APA format. Sources should also be cited within each
document to avoid plagiarism and give proper credit to the sources used.
More Details:
● Think about your target audience and the best way to approach
someone in this position.
● Choose an appropriate ‘voice’, be concise, articulate and make a
strong case for wellness/health promotion programs.
● Be sure you target your ‘case’ to the specific company. Why should
this company make this investment in their employees?

Purchase answer to see full
attachment

2 dis file

Jun 14, 2024 | Health Medical

Description

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).1. 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. 2. 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.

Nursing Question

Jun 14, 2024 | Health Medical

Description

I had to speak to a patient/resident at a rehab facility. Write down the a couple statements then analyze the interactions using non-verbal and verbal communications. Need to cite 2 articles, and use APA format.I have the interaction with resident written, and a couple paragraphs about the interaction. Need help fluffy it up and with the journal articles.I have uploaded some docs that you can reference. I also uploaded what I have written so far. I am having trouble uploading the rubic. I can scan it to you if you are willing to help

comparative health system

Jun 14, 2024 | Health Medical

Description

answer the questions in the uploaded files . answer must be checked for grammar and plagiarism must be 5%or less . questions from 8 to 10 must be done in table for comparing . I want to compare between health care system in suadi Arabia and India . there should be an introduction and a conclusion . the writing should be professinal . references should be in APA style anD must be update references from 2018 to 2023 NOT less than 8 references

Health & Medical Question

Jun 14, 2024 | Health Medical

Description

INTRODUCTION

Building off your earlier work in Assessment 4, where you defined your gap in practice, and Assessment 5, where you provided evidence to substantiate it, now it is time to decide what intervention will best address the problem.

In this assessment, you will decide on an intervention to present to stakeholders and collect evidence to substantiate the selected intervention.

DEMONSTRATION OF PROFICIENCY

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 3: Address assessment purpose in a well-organized text, incorporating appropriate evidence and tone in grammatically sound sentences.
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.
Produce text with minimal grammar, usage, spelling, and mechanical errors.
Apply APA formatting to in-text citations and references.
Competency 5: Synthesize literature to support a possible intervention or process change.
Identify at least five recent research articles that provide information or insight about a specific intervention that addresses the practice gap.
Summarize recent research articles by completing an evidence table.
Provide a critical review of all chosen articles, including methodology, research questions, theoretical basis, and findings.
Synthesize the evidence using the MEAL plan format.
Evaluate the quality of the evidence, including strengths and weaknesses.

Note: The assessments in this course must be completed in the order presented; subsequent assessments should be built on both your earlier work and your instructor’s feedback on earlier assessments. If you choose to submit assessments prematurely, without considering and integrating your instructor’s feedback, your assessment may be returned ungraded, resulting in your loss of an assessment attempt.

INSTRUCTIONS

In Assessment 5, you defined and substantiated a practice gap or problem at your practice site that has the appropriate scope for a DNP project. In Assessment 6, it is time to collect evidence to substantiate a possible intervention. Being able to find recent peer-reviewed, relevant literature to support your findings, or to support a need for interventions, is a vital part of gaining stakeholder support.

PREPARATION: EVIDENCE TABLE

For this part of the assessment, use the Evidence Table Template [DOCX] to list articles that will help you substantiate an intervention for your chosen practice gap or problem.

Search the library databases for a minimum of five peer-reviewed articles that substantiate an intervention for your chosen practice gap or problem. Complete the evidence table fully for these articles, providing all the required information.

Identify five keywords that relate to a specific practice gap in the PICOT question.
Conduct a literature search using the keywords and select at least five relevant, recent research articles (published within the past five years) that provide information or insight about the intervention.
Create an evidence table and complete each column for each research article.
Add the evidence table as an appendix to this assessment.
PART 1: INTRODUCTION AND REVISED PICOT QUESTION

Begin your synthesis with a brief introduction (1–2 paragraphs) that addresses the following:

An overview of your gap in practice.
An explanation of the intervention you have chosen to research.
End the paragraph by stating your PICOT question, which you have revised using the feedback you received in Assessment 4.
Make sure your PICOT question is in the correct format, all components are well aligned, and it has an appropriate scope for a DNP project.
PART 2: CRITICAL REVIEW OF LITERATURE

For the second part of the assessment, provide a critical review of each of the articles you included in the evidence table.

For each article, write a one-paragraph critique that addresses the following:

Provide a one-sentence overview of the main point of the article.
Be sure each article is correctly formatted in APA format. The author’s last name and date should be used to identify each article, rather than the article title.
Provide the research questions and discuss the research methodology used.
If the research question is not specified, provide the aim of the study instead.
Analyze the theoretical basis and/or conceptual framework used in the study, if described in the study.
Critically appraise the study using one of the following:
SORT.
Johns Hopkins.
What is GRADE?
Report on the study findings and propose a possible application this article could have to your own project topic.
Length: 3–4 pages.
PART 3: SYNTHESIS OF LITERATURE

You have done a great job of collecting a lot of information to substantiate your chosen intervention. Now it is time to summarize the information, reach conclusions, and link the resources that you found. In other words, a synthesis is akin to combining the parts to make a whole. This is accomplished by asking yourself, what is the main point(s) that the selected research articles have in common? Thus, following the MEAL plan, you will write a topic sentence for this section that makes a main point, which is supported and explained by all of the articles you selected. If you devote one paragraph to an entire article, you are creating an annotated bibliography, which is helpful for your personal use to keep track of your articles, but it is not a synthesis of the literature. This skill will be important for you to master before you create your project charter, which must be written professionally, yet succinctly.

For the third part of the assessment, provide a brief synthesis (1–2 paragraphs) of the information you have collected from the five articles you chose.

In your synthesis of the literature:

Following the MEAL Plan, synthesize the intervention using all five articles to clearly identify the intervention.
The paragraph should be in your own words and should not include quotes.
PART 4: EVALUATE QUALITY OF LITERATURE

An important aspect of conducting research is the ability to evaluate the strengths and weaknesses of the sources you intend to use to support your ideas.

In this section, address the following:

Consider the strengths and weaknesses of the evidence you have collected thus far.
Discuss the collective quality of the evidence.
Identify other areas you need to investigate to be able to apply this intervention.
Are there alternative interventions that could also work?
Do you have any unanswered questions?
Are there any areas where further research is needed to find an appropriate solution for this gap in practice?
Length: 1 page, maximum.
ADDITIONAL REQUIREMENTS
Length: 4–6 pages, not including title page or evidence table.
Organization: Use level headings, except for the introduction.
Appendix: Include evidence table as an appendix.
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.
Identify at least five recent research articles that provide information or insight about a specific intervention that addresses the practice gap.
Summarize recent research articles by completing an evidence table.
Provide a critical review of all chosen articles, including methodology, research questions, theoretical basis, and findings.
Synthesize the evidence using the MEAL plan format.
Evaluate the quality of the evidence, including strengths and weaknesses.
Produce text with minimal grammar, usage, spelling, and mechanical errors.
Apply APA formatting to in-text citations and references.

Unformatted Attachment Preview

Evidence Table
Search the Capella library databases for a minimum of five research articles that you will use to support your practice gap
(Assessment 5) or your intervention (Assessment 6). Each article must be relevant and published within the past five years.
Complete the evidence table fully for these articles, providing all the required information. Include this table as an appendix to your
assessment.
Citation
Conceptual
Framework
Design/
Method
Sample/
Setting
Major Variables
Studied and their
Definitions
Measurement
Data
Analysis
Findings
Appraisal: Worth
to Practice
EXAMPLE
Harne-Britner et al.
(2011)
Change theory in
combination with
aspects of behavioral,
social science, and
organizational
theories by Bandura,
Skinner, and Lewin
Quantitative
research
Quasi-experimental
study
Random assignment
of 3 nursing units
into 2 experimental
groups and 1 control
group
Aims of the study
were to determine (1)
the effectiveness of
educational and
behavioral
interventions on
improving HH
adherence; (2)
whether
improvements in HH
adherence were
sustained 6 months
post intervention; and
(3) the relationships
between HH
adherence and HAI
rates on study units.
RNs and patient care
assistants (PCAs)
from 3 medicalsurgical units within
an urban health care
system in
Pennsylvania, USA
A total of 1203
observations (633
RNs and 570 PCAs)
were completed
The control group
received education in
the form of a selfstudy module with a
pre- and posttest.
The experimental
groups received the
same education plus
behavioral
interventions. The
Positive
Reinforcement
Experimental group’s
behavioral
interventions
included individual
and unit rewards for
improved HH
adherence and unitbased recognition by
peers on a sticker
chart. The Risk of
Nonadherence
Experimental group
received additional
educational sessions
about
microorganisms that
are transmitted via
hands
18 data collection
periods per nursing
unit
Data were collected
each month during 3
time frames (5 AM–7
AM, 7:30 AM–9:30
AM, and 3:30 PM–
5:30 PM) reflecting
high work volume to
ensure a
representative sample
SPSS Statistics,
Version 17.0
Chi-square analysis
was used to
determine whether
the 3 nursing units
had similar HH
adherence rates
before any
intervention. The
Fisher exact test was
employed to
determine whether
the change in
adherence rates on
each unit was
statistically
significant.
Education paired
with positive
reinforcement
behavioral
interventions
improved HH
adherence after the
first month (χ2 =
4.27; P = .039); but
the improvement was
not sustained over 6
months. There were
no differences in
infection rates
between the
treatment and control
groups.
Strengths:
-Randomized control
group
-Large sample size
Weaknesses:
-Length of study
Ranking:
Level II
Valid yes
Reliable yes
Applicable yes
Overall rank: High
Reported these data
to the RN and PCA
staff at monthly staffand unit based quality
meetings
1
Citation
Conceptual
Framework
Design/
Method
Sample/
Setting
Major Variables
Studied and their
Definitions
Measurement
Data
Analysis
Findings
Appraisal: Worth
to Practice
OBSERVATION
=Watching one
person having direct
contact with a
patient or handling
patient equipment.
CLEANED HANDS =
Washed at a sink
and/or used alcohol
gel from a dispenser
(e.g., wall mounted,
pocket-sized, or a
bottle that is not wall
mounted) before or
after having direct
contact with a
patient or handling
patient equipment.
AWARE OF
MONITORING: You
told the person you’re
going to observe
them or they verbally
acknowledge that you
are monitoring them
2
Citation
Conceptual
Framework
Design/
Method
Sample/
Setting
Major Variables
Studied and their
Definitions
Measurement
Data
Analysis
Findings
Appraisal: Worth
to Practice
3
SORT: Evidence Table of Key Clinical Recommendations
We would like each article to include an Evidence Table (also called “SORT” or “Strength of
Recommendations Table”). This table will help readers understand the main points of your article,
and the strength of evidence that supports its recommendations. The table should contain the
key clinical recommendations and strength of recommendation ratings for your article as shown
in the sample below:
Clinical recommendation
Evidence rating
Comments
Obtain an ECG in patients
presenting with chest
pain.1,2
C
Based on expert opinion and
consensus guideline in the
absence of clinical trials.
Patients with two normal highly
sensitive troponin tests an hour
apart can safely be sent
home.10
B
Based on consistent results
from cohort studies showing
reduced ER length of stay
and no change in mortality.
Patients with chest pain should
immediately receive oxygen
and if not allergic an aspirin
tablet.17,18
A
Based on consistent
evidence from RCTs
showing reduced mortality.
The SORT table is intended to highlight the most important three to seven recommendations from your
article for clinicians. Each recommendation must be accompanied by a SORT rating of A, B, or C as
defined below (for a full description of the SORT system, see https://www.aafp.org/afpsort). Your
recommendations should emphasize interventions and approaches that improve patient-oriented
outcomes (e.g. morbidity, mortality, quality of life) over disease-oriented evidence (e.g. biomarkers,
surrogate endpoints).
•
•
You should have three to seven recommendations. Try to identify a range of
recommendations, for example, one each about screening, prevention, diagnosis, and two
about treatment.
Each statement should be in the form of a recommendation and should not just present a
fact or piece of medical trivia. For example, “Use the Wells score to determine the risk of
•
•
•
DVT in patients with leg pain” is a recommendation, while “Of patients presenting with leg
pain, 16% have a DVT” is not.
An “A” recommendation should be based on consistent evidence of improved patientoriented outcomes from well-designed studies. Use clear, directive language as this is a
recommendation that should be applied to most patients, such as “Patients age 50 to 74
years should receive screening for colorectal cancer.”
A “B” recommendation is based on lower quality evidence of improved patient-oriented
outcomes or inconsistent evidence. These statements should use language such as
“Consider…” or “…is a practice option” or “…may be effective.”
A “C” recommendation is often something that is standard of care, but for which there have
been no clinical trials or trials have only reported disease-oriented outcomes. In this case,
the recommendation statement should reflect the strength of recommendation, and the
“Comment” column should clarify that this is a recommendation “based on expert opinion in
the absence of clinical trials” or “based on evidence from clinical trials with blood pressure
reduction as the outcome.”
If you are not comfortable assigning the strength of recommendation (below), our medical editors will
do that for you.
To rate the strength of evidence supporting key clinical recommendations, please use the following
guidelines:
Strength of
recommendation
Definition
A
Recommendation based on consistent and good quality patient-oriented
evidence*
B
Recommendation based on inconsistent or limited quality patientoriented evidence*
C
Recommendation based on consensus, usual practice, expert opinion,
disease-oriented evidence,** and case series for studies of diagnosis,
treatment, prevention, or screening
* Patient-oriented evidence measures outcomes that matter to patients: morbidity, mortality, symptom
improvement, cost reduction, quality of life.
** Disease-oriented evidence measures intermediate, physiologic, or surrogate endpoints that may or
may not reflect improvements in patient outcomes (i.e., blood pressure, blood chemistry, physiological
function, and pathological findings).
Use the table below to determine whether a study measuring patient-oriented outcomes is of good or
limited quality, and whether the results are consistent or inconsistent between studies:
Type of Study
Study
quality
Level 1
Good
quality
patientoriented
evidence
Level
2 Limited
quality
patientoriented
evidence
Diagnosis
Treatment/Prevention/Screening
Prognosis
Validated clinical
decision rule
Systematic review/meta-analysis of
randomized controlled trials (RCTs) with
consistent findings
Systematic
review/metaanalysis of
good quality
cohort studies
Systematic
review/metaanalysis of highquality studies
High quality individual RCT +
Prospective
cohort study
with good
follow-up
High quality
diagnostic cohort
study *
All or none study ++
Unvalidated
clinical decision
rule
Systematic review/meta-analysis of lower
quality clinical trials or of studies with
inconsistent findings
Systematic
review/metaanalysis of
lower quality
cohort studies
or with
inconsistent
results
Systematic
review/metaanalysis of lower
quality studies or
studies with
inconsistent
findings
Lower quality clinical trial +
Retrospective
cohort study
or prospective
cohort study
with poor
follow-up
Lower quality
diagnostic cohort
study or
diagnostic casecontrol study *
Level 3
Other
evidence
Cohort study
Case-control
study
Case-control study
Case series
Consensus guidelines, extrapolations from bench research, usual practice, opinion,
disease-oriented evidence (intermediate or physiologic outcomes only), and case
series for studies of diagnosis, treatment, prevention, or screening.
* High quality diagnostic cohort study: cohort design, adequate size, adequate spectrum of patients,
blinding, and a consistent, well-defined reference standard.
+ High quality RCT: allocation concealed, blinding if possible, intention-to-treat analysis, adequate
statistical power, adequate follow-up (> 80%).
++ An all-or-none study is one where the treatment causes a dramatic change in outcomes, such as
antibiotics for meningitis or surgery for appendicitis, which precludes study in a controlled trial.
Assessing Consistency of Evidence Across Studies
Consistent
Most studies found similar or at least coherent conclusions (coherence means that
differences are explainable).
or
If high quality and up-to-date systematic reviews or meta-analyses exist; they support
the recommendation.
Inconsistent
Considerable variation among study findings and lack of coherence.
or
If high quality and up-to-date systematic reviews or meta-analyses exist, they do not
find consistent evidence in favor of the recommendation.
Please use the following algorithm for determining the strength of a recommendation based on a
body of evidence (applies to clinical recommendations regarding diagnosis, treatment, prevention, or
screening). Although this provides a general guideline, authors and editors should adjust the strength
of recommendation based on the benefits, harms, and costs of the intervention being recommended.
Again, if you are unsure how to apply these ratings, the medical editors will do this
for you. At a minimum, you should create a summary table with recommendations and references for
each recommendation.
For more information on how to apply these ratings, please see the explanatory article published
in the February 1, 2004, issue of American Family Physician.
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
4
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.
6
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,
4
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
5
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
6
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.
7
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) tr

Discussion Post Health Care In US

Jun 14, 2024 | Health Medical

Description

Although medical technology brings numerous benefits, what have been some of the main challenges posed by the growing use of medical technology in the United States?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.

school age child

Jun 14, 2024 | Health Medical

Description

Each student will create a focused SOAP note or PowerPoint presentation. SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan. The comprehensive psychiatric SOAP note is to be written using the attached template below. Only the information asked in the video will be used for grading.

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). Click hereLinks to an external site. for more information

O =

Objective data: Medications; Allergies; Past medical history; Family psychiatric history; Past surgical history; Psychiatric history, Social history; Labs and screening tools; Vital signs; 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

for this soap note we will use and encounter date september 7, 2023.pt name is genesis. female 11 years old Hispanic.

mom brings her to the office. she says her daughter, lately in school is getting calls from the teacher saying pt is not concentrating in school, talking a lot, and not paying attention. difficulties listening even at home. when asked about sleep and eating habits. lately, she woke up every four hours. no unknown allergies. pt overall WNL. She was hospitalized for COVID 5 months ago. she stayed in the hospital for a week. pt lives at home with her mom dad and older brother. her relationship with her brother is good.pt has no pas medical history or pys history,. same for the mom and dad. WDL. NO PAST MEDICAL HISTORY. diagnosis ADHD.

secondary diagnosis is an anxiety disorder. start pt on medication. pharmacological medication is 10mg aderal. add education about medication and make sure to add APA references at the end. also, add cbt COGNITIVE BEHAVIORAL THERAPY for non pharmacological treatment

Wellness Question

Jun 14, 2024 | Health Medical

Description

Watch the video Link provided below . Title Yoga for Anxiety & Stress Relief with Koya Webb.How do you feel engaging in these Stress Relief Moves ? Is this something you can incoporate in your day schedule to help reduce stress ?

Discussion Question

Jun 14, 2024 | Health Medical

Description

For this discussion, think about your personal experiences and the ways in which technology has been used in healthcare.What technologies have you been exposed to in the health care environment?Was your experience positive or negative?Define nursing informatics.The National Quality Strategy (NQS), which is led by the Agency for Healthcare Research and Quality, has set priorities to improve care.One of the strategies involves health information technology. Review and discuss this strategy.Please be sure to validate your opinions and ideas with citations and references in APA format.

374 solve 2

Jun 14, 2024 | Health Medical

Description

Psychiatric Nursing-SFD-GR01

Jun 14, 2024 | Health Medical

Description

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.

week 5 smart goal

Jun 14, 2024 | Health Medical

Description

Write three short- and two long-term goals (or vice versa) professional nursing SMART goals. Each goal must be written in the SMART format and include a month and year deadline. In addition, each SMART goal must include three action steps that need to be accomplished to meet the goal. SMART goals must be related only to your professional nursing career development and growth.SMART Goals TemplateReview the rubric for more information on how your assignment will be graded.Important: After you receive feedback from your instructor on this portfolio item, integrate the suggestions and revise it for your final portfolio submission.

Public Health Journal: HIV/AIDS Prevention Strategies

Jun 14, 2024 | Health Medical

Description

After reviewing the Stages of Prevention, write your journal assignment, addressing the following:What are the primary, secondary, and tertiary strategies for HIV/AIDS?Is enough being done from a public health perspective to impact HIV/AIDS?Would a population-based health approach or a high-risk approach be more appropriate to address HIV/AIDS?Be sure to support your response with relevant resources, which should be cited according to APA style.

Nursing Leadership

Jun 14, 2024 | Health Medical

Description

How does empowering and decision-making as a nurse leader relate to client safety outcomes?When would you use empowering strategies?Why is empowerment so challenging to implement as nurses? Roughly 300 words needed

Health Information Systems – Blackboard discussion

Jun 14, 2024 | Health Medical

Description

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.

In developing your initial response, be sure to draw from, explore, and cite credible reference materials. In responding to your classmates’ posts, you are encouraged to examine their opinions, offering supporting and/or opposing views.

You are required to reply to at least two of your peers’ 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.

Material related to the module:

Chapter 5 in Understanding health information systems for the health professions
Alomari, N., Alshehry, B., Alenazi, A., Selaihem, A., AlQumaizi, K., Almishary, M., Elshinnawey, M., Alsuwayt, S., & AlHadlaq, R. (2021). Model of care knowledge among Riyadh First Health Cluster staff at the Ministry of Health, Saudi Arabia. Journal of Family Medicine & Primary Care, 10(8), 3094–3104. https://doi.org/10.4103/jfmpc.jfmpc_405_21
Leeuw, J. A. D., Woltjer, H., Kool, R. B., De Leeuw, J. A., & Kool, T. B. (2020). Identification of factors influencing the adoption of health information technology by nurses who are digitally lagging: In-depth interview study. Journal of Medical Internet Research, 22(8), N.PAG. https://doi.org/10.2196/15630

Deadline and note:
Wednesday 27/9/2023 @9pm GMT for the initial post
Friday 29/9/2023 for the replies (the sooner the better)
Please make sure the replies are something to add and doesn’t contain too much praise
Something like “Thank you for your post. I can add that…”

Benchmark – Risk Management Program Analysis – Part One

Jun 14, 2024 | Health Medical

Description

The purpose of this assignment is to analyze a healthcare risk management program.

The concepts in this assignment will be expanded on in the Topic 2 assignment and the Topic 3 benchmark assignment.

Conduct research on approaches to risk management processes, policies, and concerns in your current or anticipated professional arena to find an example of a risk management plan. Look for a plan with sufficient content to be able to complete this assignment successfully. In a 1,000‐1,250-word paper, provide an analysis of the risk management plan that includes the following:

Description of the health care organization to which the plan applies and the role risk management plays in that setting.
Summary of the type of risk management plan you selected (new employee, specific audience, community‐focused, etc.) and your rationale for selecting that example.
Description of the standard administrative steps and processes in a typical health care organization’s risk management program compared to the administrative steps and processes you identify in your selected example plan. (Note: For standard risk management policies and procedures, look up the Medicare Improvement for Patients and Provider Act (MIPPA)-approved accrediting body that regulates the risk management standards in your chosen health care sector, and consider federal, state, and local statutes as well.)
Evaluation of your selected risk management plan’s compliance with the standards of its corresponding MIPPA-approved accrediting body relevant to privacy, health care worker safety, and patient safety.
Analysis of the key agencies and organizations that regulate the administration of safe health care in your current or future area of concentration and an evaluation of the roles each one plays in the risk management oversight process.
Proposed recommendations or changes you would implement in your risk management program example to enhance, improve, or secure the compliance standards.
Proposed recommendation or changes you would implement to build and support a culture of compassion and concern for patients and health care employee safety. Base your response on the Christian worldview principle that work within the public arena should be performed with compassion, justice, and concern for the common good.

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.

Public Health Question

Jun 14, 2024 | Health Medical

Description

Innovation in Healthcare and Financial Statements (100 points)

Financial statement management is an essential process for healthcare organizations. The challenge for operational leaders is interpretation of financial statement performance.

Select a hospital that publicly displays their financial performance on their website. In a 10-12 slide PowerPoint Presentation address the following requirements:

Describe the Profit Loss Statement:
Review top revenue items
Review cost comparison compared to previous year
Provide your interpretation of the statement – how well is the organization.
Balance Sheet Review:
Review Assets
Review Liabilities
Describe the financial health of the balance sheet
Review Financial Ratios Calculations
Current Ratio
Debt-to-equity Ratio
Working Capital Ratio
Make a recommendation to lease or finance the capital item. Please support your decision with financial data.

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.

Attention & Substance Related Disorders

Jun 14, 2024 | Health Medical

Description

Answer the questions below based on the following case study.

An 8-year-old boy is repeatedly in trouble at school. He has been threatened with suspension after he was verbally and physically aggressive to his teacher. The school has suggested that he has a problem with his concentration and advised his parents to seek help. The school also referred him to the school child psychologist. He keeps wriggling in his seat. His mother says his concentration is fine when he is playing on his computer. What worries her is that he does not seem to think before he does things and will run out across the road without looking.

Summarize the clinical case.
What is the DSM 5-TR diagnosis based on the information provided in the case?
Which pharmacological treatment would you prescribe according to the clinical guidelines? Include the rationale for this treatment.
Which non-pharmacological treatment would you prescribe according to the clinical guidelines? Include the rationale for this treatment excluding a psychotherapeutic modality.
Include an assessment of the treatment’s appropriateness, cost, effectiveness, safety, and potential for patient adherence to the chosen medication. Use a local pharmacy to research the cost of the medication and provide the most cost-effective choice for the patient. Use great detail when answering questions 3-5.

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.
You should respond to at least two of your 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.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET

Grading Rubric

Your assignment will be graded according to the grading rubric.

Discussion Rubric
Criteria Ratings Points
Identification of Main Issues, Problems, and Concepts Distinguished – 4 points
Post is substantively accurate. Identifies and demonstrates a sophisticated understanding of the issues, problems, and concepts surrounding the assignment. Provides exceptional and thought-provoking analysis that directly addresses details and/or examples of the main topic. Excellent – 3 points
Post is mostly related to the topic. Demonstrates understanding of most of the issues, problems, and concepts surrounding the assignment. It provides some supporting details and/or examples. Analyses not as clear as they could be. Fair – 1-2 points
Demonstrates limited understanding of most of the issues, problems, and concepts surrounding the assignment. No details and/or examples are given. Poor – 0 points
Post is off-topic, incorrect and/or irrelevant to the issues, problems, and concepts surrounding the assignment. Analyses are not well organized or clear. 4 points
APA Formatting Guidelines Distinguished – 2 points
The reference page contains at least the required current scholarly academic reference and text reference. Follows APA guidelines of components: double space, 12 pt. font, abstract, level headings, hanging indent, and in-text citations. Excellent – 1 point
The reference page contains one current scholarly academic resource and text reference. Follows most APA guidelines of components: double space, 12 pt. font, abstract, level headings, hanging indent, and in-text citations. Fair – 0.5 points
The reference page contains one current or outdated scholarly academic resource. Many errors of APA guidelines: double space, 12 pt. font, abstract, level headings, hanging indent, and in-text citations. Poor – 0 points
The reference page contains no current scholarly academic resources, only internet web pages, or no reference page. Lack of APA guidelines for references provided or in-text citations. 2 points
Writing Mechanics Distinguished – 2 points
Rules of grammar, usage, and punctuation are followed; spelling is correct. Excellent – 1 point
Few grammatical errors, but sentences could be clearer and more precise. Fair – 0.5 points
The paper contains a few grammatical, punctuation, and spelling errors. Poor – 0 points
The paper contains numerous grammatical, punctuation, and spelling errors. 2 points
Response to Posts of Peers Distinguished – 2 points
Constructively responded to two other posts and either extended, expanded, or provided a rebuttal to each. Fair – 1 point
Constructively responded to one other post and either extended, expanded, or provided a rebuttal. Poor – 0 points
Provided no response to a peer’s post.

2 points
Total Points 10

Dentistry Question

Jun 14, 2024 | Health Medical

Description

Choose one of the following:

Create a short slide presentation (Power point, Prezi, etc.) on infection control for digital radiography. Include pictures. You may also include audio or imbedded videos. Please cite any outside sources appropriately.

-please choose option one: this assignment is for infection control for dental school and all the examples used has to be related to dental Radiology.

required number of slides are 4-5 not including the reference page.

Strategic Business Unit (SBU) Strategy

Jun 14, 2024 | Health Medical

Description

A strategic business unit (SBU) is an independently managed, specialized division or a line of business that focuses on particular product offering and market segment. A corporation, such as a health system, may have several SBUs that each provide distinct services. SBUs typically have separate business plans even though they may be part of a larger business entity. However, each SBU should align with and contribute value to the corporate strategy.Please see attached. thank you!SBU: Cancer ACO is mine

Unformatted Attachment Preview

Strategic Business Unit (SBU) Strategy
A strategic business unit (SBU) is an independently managed, specialized division or a line of
business that focuses on particular product offering and market segment. A corporation, such as a
health system, may have several SBUs that each provide distinct services. SBUs typically have
separate business plans even though they may be part of a larger business entity. However, each
SBU should align with and contribute value to the corporate strategy.
VII.
Strategic Business Unit (SBU) Strategy
a. Description of SBU
i. Strategic innovation of SBU
ii. Corporate organizational structure (e.g., functional, divisional,
decentralized/centralize, geographic division, matrix, and virtual)
iii. Description of value to patient
iv. Unique selling proposition (Text: 36-42)
b. Explain role of corporate in execution of SBU strategy
Briefly describe how BCHUS will support the SBU (e.g., services, employees,
budgets, etc.)
c. SBU Competitive Advantage (differentiation and sustainability)
Strategic Business Unit Strategy
PHC 6148 Strategic Planning and Health Care Marketing
Zachary Pruitt, PhD, MHA, FACHE
Presentation Objectives
• Explain the course’s pivot from corporate-level strategy to SBUlevel strategy
• Analyze population health strategies
• Explain how SBUs can position corporation strategically
• Explain role of corporate in execution of SBU strategy
• SBU Competitive Advantage
2
Strategic Business Unit Defined
• Usually, an independently managed entity or unit of a large
company
• Often with their own visions, missions, objectives, and strategic
plans.
• Goals can be different corporation.
3
Levels of Strategy
Part One
Part Two
4
Strategy, Business, & Marketing Plans
Strategic
Plan
Business
Plan
Marketing
Plan
Performance
Monitoring
Operational
Plan
Budget
Funding
Request
Population Health: A Strategy
Changing the
Financial Model
Many options.
https://getlucidity.com/strategy-resources/revenuemodel-framework-guide/
Revenue Models
• Fee-for-service and prospective payments
• Capitation
• Bundled payments
• Pay-for-performance
Revenue Cycle
FFS begins with a Procedure:
CMS 1500 Form
Current Procedural Terminology (CPT)
http://www.medicalkidunya.com/wp-content/uploads/2016/06/cpt-coing.jpg
Diagnosis Related Groups
Direct Costs
FFS vs Value-based Care
Transition to Value-based Care
Capitation
Capitated payments are pre-arranged payments for healthcare providers to deliver services on
a per member per month (PMPM) basis. Capitation payments control use of health care
resources by putting the physician at financial risk for services provided to patients.
https://www.cbinsights.com/research/medicare-advantage-growth/
Risk Adjustment
http://www.pyapc.com/wp-content/uploads/2015/11/ICD-10-article-chart-new-2.jpg
ACO Operating Model
Medicare ACOs
Bundled or Episode-based Payment Initiatives
https://nahueducationfoundation.org/toolkit/Infographics.cfm
Geisinger’s ProvenCare
• Bundled or episode-based payment
• Coronary Artery Bypass Graft Surgery (CABG)
• 40 discrete care process steps for patients for CABGs
Delbanco, S. (2014). The payment reform landscape: Bundled payment. Health Affairs Blog [Internet].
UnitedHealthcare Care
Bundles Program
Partners HealthCare
• 8 other community hospitals
• Partners Community Physicians Organization represents more
than 6,000 physicians
• Neighborhood Health Plan (NHP)
http://www.partners.org/
Division of Population Health Management
• Created to solve 2
problems:
• Translating system-level risk
into physician-level
incentives
• Harmonizing heterogeneous
incentives and metrics
across payers and contracts
Founded by Boston’s
Massachusetts General
Hospital and Brigham &
Women’s (AMCs)
Powers, B. W., Navathe, A. S., Chaguturu, S. K., Ferris, T. G., & Torchiana, D. F. (2016, May). Aligning
incentives for value: The internal performance framework at Partners HealthCare. In Healthcare. Elsevier.
Partners: 1. Translating Incentives
System-level
Organizationlevel
PhysicianLevel
Powers, B. W., Navathe, A. S., Chaguturu, S. K., Ferris, T. G., & Torchiana, D. F. (2016, May). Aligning
incentives for value: The internal performance framework at Partners HealthCare. In Healthcare. Elsevier.
Partners: 2. Harmonizing Incentives
Powers, B. W., Navathe, A. S., Chaguturu, S. K., Ferris, T. G., & Torchiana, D. F. (2016, May). Aligning
incentives for value: The internal performance framework at Partners HealthCare. In Healthcare. Elsevier.
PHM Incentive Plan
Implementing PHM
Strategies
Slowing Cost Growth
Improving Select Quality
Measures
40% Total
40% Total
40% Total
Patient-centered Medical Home
Target of total medical expense 40%
(10%-20%)
Shared Risk (MDs 13%, Hospitals
10%)
Integrated care management
program (10-20%)
MD Only Risk (7%) – e.g.,
Diabetes Screenings
Specialty Programs (10%)
Hospital Only Risk Choice
Measures (10%)
Discharge Transition Measures
(10%)
Case Study
• Accountable Care in the Safety Net: A Case Study of
the Cambridge Health Alliance
Cambridge Health Alliance ACO
Transformation Model
• Changing the Financial Model
• Building Patient-Centered Medical Home Capability
• Transforming the Workforce and Culture
• Implementing Complex Care Management
• Creating an Effective Referral Process
• Establishing Preferred Tertiary and Community Partnerships
Reducing Waste
Slide from Emily Allinder Scott
Description of Strategic Business Unit
Description of Strategic Business Unit
• Strategic innovation of SBU
• Corporate/SBU organizational structure
• Describe value chain in patient care
• Unique selling proposition (Text: 36-42)
33
Strategic Innovation of SBU
• Describe the Strategic Business Unit
• What service will the SBU provide?
• How will the SBU generate revenue?
• Will there be partnerships?
• Generally, how will the SBU work?
• Describe innovation
• How the SBU is different than existing services in the corporate
portfolio?
• How will SBU strategically position corporation?
34
Organizational
Structure
Strategy determines
structure;
Structure determines
strategy
Corporate Org Structure
Charns, M. P. (1996). Organization design of integrated delivery systems. Hospital & Health Services Administration, 42(3), 411-432.
Organizational Structure
• Divide the work into manageable activities (division of
work)
• Assign responsibilities (span of control)
• Determine lines of command
Division of Work
• Who does what?
Image credits © Gaurav Akrani
Functional Organizational Structure
Departmentalization by
common skills and work
tasks
http://samples.jbpub.com/9780763759643/59643_ch02_5289.pdf
Geographic Divisions
https://www.edrawsoft.com/divisional-organizational-chart.html
Centralized vs. Decentralized
https://courses.lumenlearning.com/boundless-management/chapter/defining-organization/
Matrix Organizational Design
More complex combination of
functional and service line
(divisional)
Hospital Example of Matrix Design
Service Lines
Fine, P. S., & Kuhlenbeck, K. (2021). Implementing a New Service Line Model to Support Growth and Serve Patients. Frontiers of Health Services
Management, 37(3), 4-13.
Service Line Organizational Structure
Departmentalization by common
product, program, or geographical
location (also called divisional)
Health System Corporate Org Structure
Strategic Business Units
https://blog.avada.io/resources/strategic-business-unit.html
Your SBU Structure
• What is the span of control of the SBU executive in
charge?
• Is there a partnership involved with your business plan?
• If so, how does this impact the organizational structure?
• How does information flow?
• How are decisions made?
Org Chart Activity
Your Group Developed a Media Product
Disney wants to buy you. What do you do?
Where does
your
company
belong?
What is the
Org
Structure?
https://bgr.com/wp-content/uploads/2019/04/companies-disney-owns.jpg?quality=98&strip=all
My Example
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
53
Value-based Competition
Porter, M. E., & Teisberg, E. O. (2006). Redefining health care: creating value-based competition on results. Harvard Business Press.54
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
55
Porter’s Value Chain
fourweekmba.com
Porter’s Healthcare Value Chain
Porter, M. E., & Millar, V. E. (1985). How information gives you competitive advantage.
57
Unique Selling
Proposition
See Text pages 36-42
Value to Customer (Patient)
Role of Corporate in
Execution of SBU Strategy
Describe Relationship between Corporate & SBU
• How can Corporate help SBU succeed?
• What resources will corporate provide?
• Financing?
• Contracting/Outsourcing?
• Capabilities?
• Central services?
• Expertise?
• Decision making?
Levels of Strategy
Part One
Part Two
61
Competitive Advantage
Competitive Advantage
• Goal of strategic positioning and market differentiation
• Explicit rationale
• Why, based on corporate strategy, does your business model
make sense?
• Succinct justification
• How does your business model meet the mandate of the CEO?
63
Competitive Advantage must be …
• Strategically important
• Sustainable
• Strong research and development capabilities or personnel
• Access to intellectual property or specialized knowledge
• Superior product or customer support
• Access to capital markets
64
External Sources of Competitive Advantage
• Customer demands
• Policy changes
• Price changes
• Technological innovations
• Emergence of new markets
• New strategic allies, acquisitions, mergers
• Fewer competitors
• Change in payer mix
65
Internal Sources of Competitive Advantage
• Examine core competencies, capabilities, resources,
processes, policies, procedures
• Examine S.W.O.T. analysis
66
S.W.O.T. Analysis
http://commons.wikimedia.org/wiki/File:SWOT_en.svg
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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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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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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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.
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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.
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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 made my money in health insurance. I remember the days
when hospitals, physician practices, ancillary providers, AND insurers were all part
of the same integrated delivery network. Smartly, I stayed out of that integration
business. I resisted it because I knew that some large health systems were just losing
money on the insurance side just to make money on the provider side, or vice versa.
It was a zero-sum game.
A population health strategy for Bay City 143
As a former politician, I also know the importance of having a good name. It’s an asset
you can count on. And BCUHS has a strong brand, which is exactly what we should
leverage in this new health policy environment.
My suggestion—and I’d be interested in hearing what the others think—is to create a
separate insurance company that competes in the ACA’s Health Insurance Exchange.
I know that there are only four current insurance companies competing in the online
marketplace in the Bay Ci

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See attached

241 @Khadoojahmousa

Jun 14, 2024 | Health Medical

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Jun 14, 2024 | Health Medical

Description

Your Tasks
Task 1- Food Log

You will keep a 3-day food log, where you will record the meals and snacks that you ate throughout each day. You can choose to track this using Cronometer or the provided Word document.

Actions

This week’s focus: carbohydrates, sugar, fiber, and calories.* You may record 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 calories-
What was your averageLinks to an external site. calorie count?
Did your calorie count surprise you? Why or why not?
What contributed the most to your calories?
In regard to carbohydrates (general)-
What was your averageLinks to an external site. carbohydrate intake during the 3 days? Was your carbohydrate intake within the daily rangeLinks to an external site. (recall that the average minimum is 130 g/day)? Were you surprised by your averages?
What type of carbohydrate did you eat the most of? Fast-releasing (simple), starches, or fiber?
Reflect on the carbohydrates consumed this week. Did some keep you more satiated than others? Which ones?
In regard to fiber-
What was your averageLinks to an external site. fiber intake during the 3 days?
Are you getting the recommended amount of daily fiber (38 g /day for men; 25 g/day for women)? If yes, what are some foods that you eat that provide the most fiber. If not, what are foods that you can incorporate to help increase your fiber needs?
In regard to added sugars-
Were you surprised by your added sugar values?
Which foods contributed the most to these values?
Looking forward-
What are two foods that you can incorporate and/or swap in order to a) reduce calories; b) increase fiber; or c) reduce added sugar? Be creative!
Example- “I eat a lot of ice cream. One food swap that I can do is eating a half cup of fruit instead of a bowl of ice cream as an after-dinner treat in order to cut back on added sugar”.

Challenge!

Implement these changes during next week’s food log! I will ask you about it next week in Assignment 3.

Submission and Grading

This assignment is due on Saturday, September 23rd 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.

Need Assistance?

Don’t forget to revisit the following pages in the Orientation module to help you get started:

Everything You Need to Know About- DIETARY ANALYSIS ASSIGNMENTS
Video Guides for DAAs
Cronometer Guides
Student Example Using Cronometer.pdfActions
Student Example Using Log Template.pdfActions
Everything You Need to Know About- DIETARY ANALYSIS ASSIGNMENTS
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 bothFinally, 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.
Submission
For Student’s Using the Word Document:
The only thing that you need to submit is the completed Word document. The Task 2 questions are also included within the document.
For Student’s Using Cronometer (or other tracking app):
You will need to either download or take a screenshot of the report from Cronometer. You can then either:
Upload the downloaded report or the screenshot to the assignment page, and then answer the Task 2 questions in the text box.
Paste the screenshot into a Word or pages document, and answer the Task 2 questions on the same document. Then, upload the document to the assignment page on Canvas.
You can also work solely in the submission text box. You should be able to embed your screenshot within the box.

Unformatted Attachment Preview

Food Log- Week 1 of Tracking
Task 1
This week, please log the meal (B [breakfast], L [lunch], D [dinner], S [snack]), food/drink,
serving size, # of servings, carbohydrates, sugar, fiber, and calories (kcals).
You can fill in protein and fat; however, it is not a requirement for this week.
DAY 1
MEAL
FOOD/DRINK
SERVING
SIZE
# OF
SERVINGS
KCALS
CARB
SUGAR
FIBER
FAT
PROTEIN
FOOD/DRINK
SERVING
SIZE
# OF
SERVINGS
KCALS
CARB
SUGAR
FIBER
FAT
PROTEIN
TOTAL
DAY 2
MEAL
TOTAL
DAY 3
MEAL
FOOD/DRINK
SERVING
SIZE
# OF
SERVINGS
KCALS
CARB
TOTAL
[Analysis Questions on Next Page]
SUGAR
FIBER
FAT
PROTEIN
Task 2- Analysis
Please answer the following questions in complete sentences:
1. In regard to caloriesa. What was your average calorie count?
i. Answer
b. Did your calorie count surprise you? Why or why not?
c. What contributed the most to your calories?
2. In regard to carbohydrates (general)a. What was your average carbohydrate intake during the 3 days? Is your carbohydrate intake
within the daily range (recall that the average minimum is 130 g/day)? Were you surprised by
your averages?
b. What did you eat the most of: fast-releasing (simple) carbohydrates, starches, or fiber?
c. Reflect on the carbohydrates consumed this week. Did some keep you more satiated (than
others? Which ones?
3. In regard to fibera. What was your average fiber intake during the 3 days?
b. Are you getting the recommended amount of daily fiber (38 g /day for men; 25 g/day for
women)? If yes, what are some foods that you eat that provide the most fiber. If not, what are
foods that you can incorporate to help increase your fiber needs?
4. In regard to added sugarsa. Were you surprised by your added sugar values?
b. Which foods contributed the most to these values?
5. Looking forwarda. What are two foods that you can incorporate and/or swap in order to a) reduce calories; b)
increase fiber; or c) reduce added sugar? Be creative!
i. Example- “I eat a lot of ice cream. One food swap that I can do is eating a half cup of
fruit instead of a bowl of ice cream as an after-dinner treat in order to cut back on added
sugar”.

Purchase answer to see full
attachment

Writing project for advanced pharmacology

Jun 14, 2024 | Health Medical

Description

Individual variations in drug response in Doc. Formate following the rubric and you can use another references. With checking for plagiarism.

Unformatted Attachment Preview

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)
Pharmacology
for Nurses
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Sixth Edition
Pharmacology
for Nurses
A Pathophysiologic Approach
Michael Patrick Adams
Adjunct Professor of Anatomy and Physiology
Hillsborough Community College
Formerly Dean of Health Professions
Pasco-Hernando State College
Leland Norman Holland, Jr.
Professor
Hillsborough Community College
Polk State College
Carol Quam Urban
Associate Dean for Practice and Strategic Initiatives
Associate Professor
College of Health and Human Services
George Mason University
A01_ADAM8334_06_SE_FM.indd 3
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Executive Portfolio Manager: Pamela Fuller
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Paul DeLuca
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Director, Digital Studio: Amy Peltier
Digital Producer: Jeff Henn
Full-Service Vendor: Pearson CSC
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Manufacturing Buyer: Maura Zaldivar-Garcia, LSC
Communications, Inc.
Cover Designer: Pearson CSC
Text Printer/Bindery: LSC Communications, Inc.
Cover Printer: Phoenix Color
Credits and acknowledgments for content borrowed from other sources and reproduced, with permission, in this
textbook appear on appropriate page within text except for the following:
Unit 1 opener, dimdimich/Fotolia
Unit 2 opener, Lighthunter/Shutterstock
Unit 3 opener, nerthuz/Fotolia
Unit 4 opener, nerthuz/Fotolia
Unit 5 opener, Sebastian Kaulitzki/Fotolia
Unit 6 opener, nerthuz/Fotolia
Unit 7 opener, nerthuz/Fotolia
Unit 8 opener, nerthuz/Fotolia
Unit 9 opener, dimdimich/Fotolia
Cover, Pearson Education
Drug icon used throughout, tassel78/123RF.
Copyright © 2020, 2017, 2014, 2011, and 2008 by Pearson Education, Inc., or its affiliates. 221 River Street,
Hoboken, NJ 07030. All Rights Reserved. Printed in the United States of America. This publication is protected by
copyright, and permission should be obtained from the publisher prior to any prohibited reproduction, storage
in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise. For information regarding permissions, request forms and the appropriate contacts within the
Pearson Education Global Rights & Permissions Department, please visit www.pearsoned.com/permissions/
Unless otherwise indicated herein, any third-party trademarks that may appear in this work are the property of
their respective owners and any references to third-party trademarks, logos or other trade dress are for demonstrative or descriptive purposes only. Such references are not intended to imply any sponsorship, endorsement,
authorization, or promotion of Pearson’s products by the owners of such marks, or any relationship between the
owner and Pearson Education, Inc. or its affiliates, authors, licensees, or distributors.
Notice: Care has been taken to confirm the accuracy of information presented in this book. The authors, editors,
and the publisher, however, cannot accept any responsibility for errors or omissions or for consequences from
application of the information in this book and make no warranty, express or implied, with respect to its contents.
The authors and publisher have exerted every effort to ensure that drug selections and dosages set forth in this
text are in accord with current recommendations and practice at the time of publication. However, in view of
ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package inserts of all drugs for any change in indications
of dosage and for added warnings and precautions. This is particularly important when the recommended agent
is a new or infrequently employed drug.
Library of Congress Cataloging-in-Publication Data
Names: Adams, Michael, 1951- , author. | Holland, Leland Norman, 1957- ,
author. | Urban, Carol Q. (Carol Quam), author.
Title: Pharmacology for nurses : a pathophysiologic approach / Michael
Patrick Adams, Leland Norman Holland, Jr., Carol Quam Urban.
Description: Sixth edition. | Hoboken, N.J. : Pearson, [2020] | Includes
bibliographical references and index.
Identifiers: LCCN 2019000512| ISBN 9780135218334 | ISBN 0135218330
Subjects: | MESH: Drug Therapy | Pharmacological Phenomena | Pharmacology |
Nurses Instruction
Classification: LCC RM301 | NLM WB 330 | DDC 615/.1–dc23 LC record available at https://
lccn.loc.gov/2019000512
ISBN-10:0-13-521833-0
1 20
ISBN-13:978-0-13-521833-4
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About the Authors
MICHAEL PATRICK ADAMS, PHD, is an accomplished ed-
ucator, author, and national speaker. The National Institute
for Staff and Organizational Development in Austin, Texas,
named Dr. Adams a Master Teacher. He has published two
other textbooks with Pearson Publishing: Core Concepts in
Pharmacology and Pharmacology: Connections to Nursing Practice.
Dr. Adams obtained his master’s degree in pharmacology from Michigan State University and his doctorate in
education from the University of South Florida. Dr. Adams
LELAND NORMAN HOLLAND, JR., PHD (NORM), over
25 years ago, started out like many scientists, planning for
a career in basic science research. He was quickly drawn to
the field of teaching in higher medical education, where he
has spent most of his career. Among the areas where he has
been particularly effective are preparatory programs in
nursing, medicine, dentistry, pharmacy, and allied health.
Dr. Holland is both a professor and supporter in nursing
education nationwide. He brings to the profession a depth
of knowledge in biology, chemistry, and medically related
CAROL QUAM URBAN, PHD, RN, Associate Professor, is
the Associate Dean for Practice and Strategic Initiatives in
the College of Health and Human Services at George Mason
University in Fairfax, Virginia. Teaching in the School of
Nursing for over 25 years, and most recently in the position
of Director of the School, she considers pharmacology to be
a course that truly integrates nursing knowledge, skills, and
was on the faculty of Lansing Community College and
St. Petersburg College, and served as Dean of Health Professions at Pasco-Hernando State College for 15 years. He
is currently Adjunct Professor of Biological Sciences at
Hillsborough Community College.
I dedicate this book to nursing educators, who contribute every
day to making the world a better and more caring place.
—MPA
subjects, such as microbiology, biological chemistry, and
pharmacology. Dr. Holland’s doctoral degree is in medical
pharmacology. He is very much dedicated to the success of
students and their preparation for careers in health care.
He continues to motivate students in the lifelong pursuit
of learning.
To the greatest family in the world: Karen, Alexandria, Caleb,
and Joshua.
—LNHII
interdisciplinary teamwork. She has co-authored the
Pearson textbook Pharmacology: Connections to Nursing
Practice with Dr. Adams.
To my daughter, Joy, an extraordinary pediatric hematology-oncology
nurse, and in memory of my son, Keith, and husband, Michael.
—CQU
v
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Thank You
Our heartfelt thanks go out to our colleagues from
schools of nursing across the country who have given
their time generously to help create this exciting new edition. These individuals helped us plan and shape our
book and resources by reviewing chapters, art, design,
and more. Pharmacology for Nurses: A Pathophysiologic
Beatrice Adams, PharmD
Critical Care Clinical Pharmacist
Tampa General Hospital
Department of Pharmacy
Tampa, Florida
Shannon Allen, CRNA, MSNA
Professor
New Mexico Junior College
Hobbs, New Mexico
Candyce Antley, RN, MN
Instructor
Midlands Technical College
Columbia, South Carolina
Culeta Armstrong, MSN, RN
Clinical Assistant Professor
University of Memphis
Memphis, Tennessee
Wanda Barlow, MSN, RN,
FNP-BC
Instructor
Winston-Salem State University
Winston-Salem, North Carolina
Sophia Beydoun, RN, BSN, MSN,
AA-AND
Professor
Henry Ford Community College
Dearborn, Michigan
Approach, sixth edition, has reaped the benefit of your collective knowledge and experience as nurses and teachers,
and we have improved the materials due to your efforts,
suggestions, objections, endorsements, and inspiration.
Among those who gave their time generously are the
following:
Marcus W. Campbell, PharmD,
BC-ADM
Assistant Professor Pharmacy Practice
Director, Center for Drug Information
& Research
LECOM School of Pharmacy
Bradenton, Florida
Rachel Choudhury, MSN, MS, RN, CNE
Associate Dean and Program Director,
ABSN
Musco School of Nursing and Health
Professions
Brandman University
Irvine, California
Darlene Clark, MS, RN
Senior Lecturer in Nursing
Pennsylvania State University
University Park, Pennsylvania
Janice DiFalco, RN, MSN, CNS,
CMSRN, FAACVPR
Professor
San Jacinto College
Pasadena, Texas
Deepali Dixit, PharmD, BCPS
Clinical Assistant Professor
Rutgers University
Piscataway, New Jersey
Staci Boruff, PhD, RN
Assistant Academic Dean of Health
Programs
Professor of Nursing
Walters State Community College
Morristown, Tennessee
Rachael Durie, PharmD, BCPS
Cardiology Clinical Pharmacist
Assistant Professor of Clinical
Pharmacy
Rutgers University
Neptune, New Jersey
Bridget Bradley, PharmD, BCPP
Assistant Professor
Pacific University
Hillsboro, Oregon
Deborah Dye, RN, MSN
Assistant Professor/Nursing
Department Chair
Ivy Tech Community College
Lafayette, Indiana
Mary M. Bridgeman, PharmD,
BCPS, CGP
Clinical Assistant Professor
Rutgers University
Piscataway, New Jersey
Reamer L. Bushardt, PharmD,
P.A.-C
Professor
Wake Forest Baptist Health
Winston-Salem, North Carolina
Adina C. Hirsch, PharmD, BCNSP
Assistant Professor of Pharmacy
Practice
Philadelphia College of Osteopathic
Medicine
Philadelphia, Pennsylvania
Linda Howe, PhD, RN, CNS, CNE
Associate Professor
University of Central Florida
Orlando, Florida
Anne L. Hume, PharmD, FCCP,
BCPS
Professor of Pharmacy
University of Rhode Island
Kingston, Rhode Island
Ragan Johnson, DNP, APRN-BC
Assistant Professor
University of Tennessee
Memphis, Tennessee
Vinh Kieu, PharmD
Assistant Professor
George Mason University
Fairfax, Virginia
Dorothy Lee, PhD, RN, ANP-BC
Associate Professor of Nursing
Saginaw Valley State University
University Center, Michigan
Toby Ann Nishikawa, MSN, RN
Assistant Professor
Weber State University
Ogden, Utah
Dr. Diana Rangaves, PharmD, RPh
Director, Pharmacy Technology
Program
Santa Rosa Junior College
Santa Rosa, California
Jacqueline Frock, RN, MSN
Professor of Nursing
Oklahoma City Community College
Oklahoma City, Oklahoma
Timothy Reilly, PharmD, BCPS,
CGP, FASCP
Clinical Assistant Professor
Rutgers University
Piscataway, New Jersey
Jasmine D. Gonzalvo, PharmD,
BCPS, BC-ADM, CDE
Clinical Associate Professor
Purdue University
West Lafayette, Indiana
Janet Czermak Russell, MS, MA,
APN-BC
Associate Professor
Essex County College
Newark, New Jersey
vi
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Pooja Shah, PharmD
Clinical Assistant Professor
Rutgers University
Piscataway, New Jersey
Dustin Spencer, DNP, NP-C, ENP-BC
Assistant Professor of Nursing
Saginaw Valley State University
University Center, Michigan
Suzanne Tang, MSN, APRN, FNP-BC
Instructor
Rio Hondo College
Whittier, California
Samantha Smeltzer, RN
Professor of Nursing
Mount Aloysius College
Cresson, Pennsylvania
Dr. Jacqueline Stewart, DNP, CEN,
CCRN
Associate Professor of Nursing
Wilkes University
Wilkes-Barre, Pennsylvania
Ryan Wargo, PharmD, BCACP
Assistant Professor of Pharmacy
Practice
Director of Admissions
LECOM School of Pharmacy
Bradenton, Florida
Rose Marie Smith, RN, MS, CNE
Division Dean of Nursing, Liberal
Arts, Social and Behavioral
Sciences
Redlands Community College
El Reno, Oklahoma
Rebecca E. Sutter, DNP, APRN,
FNP-BC
Associate Professor
George Mason University
Fairfax, Virginia
Timothy Voytilla, MSN, ARNP
Nursing Program Director
Keiser University
Tampa, Florida
vii
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Preface
When students are asked which subject in their nursing
program is the most challenging, pharmacology always
appears near the top of the list. The study of pharmacology
demands that students apply knowledge from a wide variety of the natural and applied sciences. Successfully predicting drug action requires a thorough knowledge of
anatomy, physiology, chemistry, and pathology as well as
the social sciences of psychology and sociology. Lack of
adequate pharmacology knowledge can result in immediate and direct harm to the patient; thus, the stakes in learning the subject are high.
Pharmacology cannot be made easy, but it can be
made understandable when the proper connections are
made to knowledge learned in these other disciplines. The
vast majority of drugs in clinical practice are prescribed for
specific diseases, yet many pharmacology textbooks fail to
recognize the complex interrelationships between pharmacology and pathophysiology. When drugs are learned in
isolation from their associated diseases or conditions, students have difficulty connecting pharmacotherapy to therapeutic goals and patient wellness. The pathophysiology
focus of this textbook gives the student a clearer picture of
the importance of pharmacology to disease and, ultimately, to patient care. The approach and rationale of this
textbook focus on a holistic perspective to patient care
which clearly shows the benefits and limitations of pharmacotherapy in curing or preventing illness. In addition to
its pathophysiology focus, medication safety and interdisciplinary teamwork are consistently emphasized throughout the text. Although difficult and challenging, the study
of pharmacology is truly a fascinating, lifelong journey.
New to This Edition
The sixth edition of Pharmacology for Nurses: A Pathophysiologic Approach has been thoroughly updated to reflect
current pharmacotherapeutics and advances in understanding disease.
• NEW! Applying Research to Nursing Practice feature
illustrates how current medical research is used to improve patient teaching. Books, journals, or websites
may be cited, and the complete source information
provided in the References section at the end of
the chapter.
• NEW! Key terms are listed at the beginning of each
chapter along with corresponding page numbers that
indicate where their definitions may be found within
the chapter.
• UPDATED! Check Your Understanding questions
appear throughout the drug chapters to reinforce
student knowledge.
• EXPANDED! Includes more than 40 new drugs, drug
classes, indications, and therapies that have been approved since the last edition.
• UPDATED! Black Box Warnings issued by the FDA are
included for all appropriate drug prototypes.
• UPDATED! Pharmacotherapy Illustrated diagrams
help students visualize the connection between pharmacology and the patient.
• UPDATED! Nursing Practice Application charts have
been revised to contain current applications to clinical
practice with key lifespan, safety, collaboration, and diversity considerations noted.
Organization and Structure—A Body
System and Disease Approach
Pharmacology for Nurses: A Pathophysiologic Approach is organized according to body systems (units) and diseases
(chapters). Each chapter provides the complete information
on the drug classifications used to treat the diseases. Specially designed numbered headings describe key concepts
and cue students to each drug classification discussion.
The pathophysiologic approach clearly places the
drugs in context with how they are used therapeutically.
The student is able to locate easily all relevant anatomy,
physiology, pathology, and pharmacology in the same
chapter in which the drugs are discussed. This approach
provides the student with a clear view of the connection
among pharmacology, pathophysiology, and the nursing
care learned in other clinical courses.
The vast number of drugs available in clinical practice
is staggering. To facilitate learning, this text uses drug prototypes in which the most representative drugs in each
classification are introduced in detail. Students are less intimidated when they can focus their learning on one representative drug in each class.
viii
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Preface
Chapter 15 Drugs for Seizures
ix
179
This text uses several strategies to
Prototype Drug
Valproic Acid (Depakene, others)
connect pharmacology to nursing practice.
Therapeutic Class: Antiseizure drug
Pharmacologic Class: Valproate
Throughout the text the student will find
PHARMACOKINETICS (PO CAPSULES)
Actions and Uses
15 Drugs for Seizures
175
Valproic acid has become a preferred drug for treating manyChapter Onset
Peak
Duration
interesting features, such as Complementypes of epilepsy. This medication has several trade names and
2–4 days
1–4 h
6–24 h
formulations, which can cause confusion when studying it.
tary and Alternative Therapies, Treating
• Valproic acid (Depakene) is the standard form of the drug
Adverse Effects
the Diverse Patient, Community-Oriented
given PO.
Prototype Drug
Phenobarbital
(Luminal)
Side effects include sedation, drowsiness, GI upset, and pro• Valproate sodium (Depacon) is the sodium salt of valproic
longed bleeding time. Other effects include visual disturbances,
Practice, and Lifespan
Considerations,
Therapeutic
Class: Antiseizure drug; sedative
Pharmacologic
agonist
acid given PO or IV. Class: Barbiturate; GABAA receptor
muscle
weakness, tremor, psychomotor agitation, bone
• Divalproex sodium (Depakote ER) is a sustained release
marrow suppression, weight gain, abdominal cramps, rash,
that clearly place the drugs in context with
combination of valproic acid and its sodium salt in a
alopecia,
pruritus,
photosensitivity, erythema multiforme, and
Actions and Uses
With overdose, phenobarbital may cause
severe
respiratory
1:1 mixture. It is given PO and is available in an enterictheir clinical applications.
Re- used for the managefatal hepatotoxicity.
Black Box Warning: May result in fatal
Phenobarbital is a Applying
long-acting barbiturate
depression, CNS depression, coma, and
death.
coated form.
hepatic failure, especially in children under the age of 2 years.
mentPractice
of a variety offeatures
seizures. It isillusalso used to produce sedasearch to Nursing
All three formulations
of
the
drug
form
the
chemiNonspecific
symptoms
often precede hepatotoxicity: weakness,
Contraindications: Administration of phenobarbital is inadvistion. Phenobarbital should not be used for pain reliefcalbecause
valproate itafter absorption or on entering the brain. The
facial edema, anorexia, and vomiting. Liver function tests should
able
in
cases
of
hypersensitivity
to
barbiturates,
severe
uncontrate how currentmay
medical
research
is
used
pharmacokinetics of each form varies, and doses are not
be performed prior to treatment and at specific intervals durincrease a patient’s sensitivity to pain.
trolled pain, preexisting CNS depression,
porphyrias,
severe
ing the
first 6 months
of treatment. Valproic acid can produce
Phenobarbital acts
biochemically
by enhancing interchangeable.
the action of In this text, the name valproic acid is used
to improve patient
teaching.
Patient
Safety
170 Unit
3 The Nervous System
to describe all forms ofrespiratory
the drug, unless
specifically
stated
disease with dyspnea or obstruction,
glaucoma
life-threateningand
pancreatitis
and teratogenic effects, including
the GABA neurotransmitter, which is responsible for suppressing
otherwise.
spina
bifida.
illustrates potential
pitfalls that can lead
or prostatic hypertrophy.
abnormal neuronal discharges that can cause epilepsy. Valproic acid is administered as monotherapy or in combiContraindications:
Hypersensitivity may occur. This
needed
safety precautions.
In collaboration
poisoning—and
changes
in perfusion—such
aswith
those
nation
other AEDsimplementing
to treat absence seizures
and complex
to medication errors.
PharmFacts
contain
medication should not be administered to patients with liver
Interactions
partial seizures.
ER isthe
alsopatient,
approved for
the healthcare
prevenwith
the
provider, pharmacist, and
caused by hypotension, stroke, shock, and cardiac
dys-Depakote
disease, bleeding dysfunction, pancreatitis, and congenital
Administration
statistics and facts
that are Alerts
relevant
to the
tion of migraine headaches
and mania
associated
with bipolar
Drug–Drug:
Phenobarbital
interacts
with
many other drugs.
nurse
are instrumental
in achieving
rhythmias—may
be causes.
metabolicpositive
disorders. therapeutic
Off-label indications
include
behavioral
distur• Parenteral
phenobarbital is a soft-tissue
irritant.disorder.
IntramusItoutcomes.
should
notsevere
be
taken
with
alcohol
or other of
CNS
depressants
Through
a
combination
pharmacotherapy,
chapter. Check Your
Understanding
feabances,
such as agitation due to dementia, Alzheimer’s disease,
Pregnancy
planning
is
a
major
concern
for
women
cular (IM) injections may produce a local inflammatory
reacbecause
these substances
potentiate
barbiturateeffective
action,
Interactions
patient–family
support,
and education,
seizure
or explosive temper in patients
with ADHD; persistent
hiccups;
with students
epilepsy.
Because
several
AEDs
effectivetures encourage
to apply
what
Drug–Drug: depression
Valproic acid interacts
with many drugs. For
tion. IV administration
is rarely
useddecrease
because the
extravasation
the
riskachieved
of life-threatening
respiratory
or
and status epilepticus increasing
refractory
IV
diazepam.
controltocan
be
in a majority
of patients.
example, aspirin, cimetidine, chlorpromazine, erythromycin, and
ness of may
hormonal
contraceptives,
produce
tissue
necrosis. additional barrier methcardiac arrest. Phenobarbital increases
the metabolism of many
they have already
read
in the
chapter.
felbamate may increase valproic acid toxicity. Concomitant warAdministration Alerts
ods of birth control should be used to avoid unintended
drugs, (GI)
reducing
their effectiveness.
• Controlled substance: Schedule IV.
farin, aspirin, or alcohol use can cause severe bleeding. Alcohol,
• Valproic acid is a other
gastrointestinal
irritant. Advise
Students learn
better
supplied
pregnancy.
Prior when
to pregnancy
and considering thepatients
serious
15.2
Types
of
Seizures
benzodiazepines, and other CNS depressants potentiate CNS
not
to
chew
extended-release
tablets
because
• Pregnancy category D.
Lab
Tests:
Barbiturates
may
affect
bromsulphalein
tests and
of seizures,
patients should
consult with theirmouth
healthdepressant action. Use of clonazepam concurrently with valsoreness will occur.
with accurate, nature
attractive
graphics
and rich
The differing
presentation of seizures
relates to their signs
increase
serum
phosphatase.
proic acid may induce absence seizures. Valproic acid increases
• Do
not mix
care provider to determine the most appropriate
plan
ofvalproic acid syrup with carbonated beverages
and
symptoms.
Symptoms
may range
from sudden,
violent
serum phenobarbital
and phenytoin
levels. Lamotrigine, pheit will trigger
immediate
release of
the drug, which
media resources.
Pharmacology
for Nurses:
A
action
for seizure control.
When pregnancy
occurs,because
caution
PHARMACOKINETICS
Herbal/Food:
Kava,
chamomile
potentiate
nytoin, andmay
rifampin
lower valproic
acid levels.
shaking
and
total valerian,
loss of and
consciousness
to muscle
twitchcauses severe mouth
and throat
irritation.
is necessary
because
many
are pregnancy
D.
Pathophysiologic
AOnset
pproach
contains
a genersedation.
• Open capsules and
sprinkle
on
soft
foods
if
the
patient
Peak AEDs
Duration category
ing or slight tremor of a limb. Staring
space, altered
Lab Tests: into
Unknown.
AEDs such as lamotrigine, gabapentin, and zonisamide
cannot swallow them.
20–60 minwith an
4–12uhnequaled
PO; 30 min IV 10–16 h PO; 4–10 h IV
vision, and
are
other treatment
behaviors
ous number ofmay
figures,
Treatment
ofdifficulty
Overdose:speaking
There is no
specific
fora person
Herbal/Food:
Unknown.
• Pregnancy
category
D.
be
considered
because
they
appear
to
have
a
lower
risk
PO; 5 min IV
may exhibit.
Determining
cause of recurrent
seizures
overdose.
Drug removal
may bethe
accomplished
by gastric lavage
of teratogenicity. Some AEDs
may cause folate deficiency,
art program. Pharmacotherapy
Illustrated
is use
essential
for proper
diagnosis
andmay
selection
of the
or
of
activated
charcoal.
Hemodialysis
be
effective
in most
condition correlated with fetal neural tube defects. Vitafeatures appearamin
throughout
effective removal
treatment
options. from the body. Treatment is
Adverse Effects the text, breakfacilitating
of
phenobarbital
supplements may be necessary. Eclampsia is a severe
Methods
of classifying
epilepsy
have
changed
Phenobarbital
is ainto
Schedule
IV drugunthat may cause depensupportive
and consists
mainly of endotracheal
intubation
and over
such as lamotrigine
(Lamictal)
and zonisamide (Zonegran),
ing down complex
topics
easily
hypertensive
disorder
that
continues
to worsen
preg- Seizures
15.8 as
Treating
time. For example,
terms grand
and
petithypotenmalfor
epilepsy
aremal
being
investigated
their roles in treating absence seidence. Common side effects include drowsiness, vitamin defimechanical
ventilation.the
Treatment
of bradycardia
and
nancy
progresses.
It
is
characterized
by
seizures,
coma,
and
with
Succinimides
derstood formats.
Animations
of
drug
zures.
Lamotrigine
has
also
been
have,
forbethe
most part, been replaced by more descriptive found to be effective in
ciencies (vitamin D; folate 3B9 4; and B12), and laryngospasms.
sion
may
necessary.
perinatal
mortality. Eclampsia is likely to occurSuccinimides
from around
patients with partial seizures, usually in combination with
are medications
that suppress
by are
and detailed
labels.seizures
Epilepsies
typically identified using
mechanisms show
the
student
step-by-step
other antiseizure medications.
the 20th week of gestation until at least 1 weekdelaying
after delivery
calcium influx into neurons. By raising the seithe
International
Classification
of
Epileptic Seizures nomenzure eclampsia
threshold, succinimides keep neurons from firing too
of
the
baby.
Approximately
25%
of
women
with
how drugs act.
clature.
These
are are
termed
partial (focal), generalized, and
quickly, thus suppressing
abnormal
foci. They
generally
experience seizures within 72 hours postpartum.
For years,
only effective against absence
Thesyndromes
succinimides (Table 15.1). Types of partial
specialseizures.
epileptic
one of the approaches used to prevent or treat
eclamptic
are listed
in Table 15.5.(focal) seizures or generalized seizures may be recognized
Ethosuximide
Check Your Understanding 15.1
seizures was magnesium sulfate. The mechanism
for this (Zarontin) is the most commonly prebased
on symptoms
observed
during a seizure episode.
scribed drug inA
this class.
It remains
a preferred choice
for
If an antiseizure drug must be discontinued, how will this be accomComplementary
and Alternative
Therapies
substance’s
antiseizure
activity is not
well understood.
Some
symptoms
are
subtle
and
reflect
thewhy
specific
nature
of
absence seizures, although valproic acid is also effective for
plished, and
is this method
necessary?
See Appendix A for the
prototype
feature
forFOR
magnesium
presented
in
THE KETOGENIC
DIET
EPILEPSY sulfate is these
types of seizures. Some
of the newer
antiseizure
drugs,
answer.
neuronal
misfiring;
others
are more
complex.
Chapter 43.
The Seizures
ketogenic can
diet have
is most
often used when
seizures
cannot
be
has a ketogenic ratio of 3 or 4 g of fat to 1 g of protein and carbohya significant
impact
on the
quality
controlled
through
or whenif there
unacceptdrate
de LimaConcepts
et al., 2017). Because
of the high ratio of fat
of
life. They
maypharmacotherapy
cause serious injury
they are
occur
while
15.3(Azevedo
General
of Antiseizure
adverse
effects toathe
medications.
Before antiseizure
drugs
in the diet, complications such as hyperlipidemia and hepatotoxicaable
person
is driving
vehicle
or performing
a dangerous
Pharmacotherapy
were developed,
diet was
primary
treatment
epilepsy.
ity
may occur, and patients on this diet need to be monitored long
M15_ADAM8334_06_SE_C15.indd
179
08/12/2018 14:27
activity.
Almost this
all states
willa not
grant,
or will for
take
away,
studies
have and
examined
the possibility
that theperiod
ketogenic
diet
term
detectofthese
effects
(Azevedo de Lima
et al.,patient
2017;
The to
choice
AEDadverse
is highly
individualize
for each
aRecent
driver’s
license
require
a seizure-free
before
could provide
benefit for
patientsWithout
with Alzheimer’s,
Parkinson’s,
and
Arslan
et al., 2016,).
and depends
on the type of seizures, the patient’s previgranting
a driver’s
license.
successful
pharmacoother neurodegenerative
diseaseslimit
(Rajagopal,
Sangam,inSingh,
&
suggests EEG
that the
dietand
produces
a high pathologies.
success rate
ous Research
medical history,
data,
associated
therapy,
epilepsy can severely
participation
school,
Joginapally, 2016;
Veyrat-Durebex
et al.,
2018).
exact mechacompared
to standardistreatment,
withpatient
better control
of seizures.
Once a medication
selected, the
is placed
on a low
employment,
and
social activities
and
can The
definitely
affect
nism behind theChronic
effectiveness
of the dietmay
is unknown
and appears
to
Improvement
noted rapidly
and the diet
appearsuntil
to be seizure
equally
initial dose.may
Thebe
amount
is gradually
increased
self-esteem.
depression
accompany
poorly
include both direct
effect from
ketone body
increases, and metabolic
effective
seizureortype.
The
mostside
frequently
reported
adverse
control for
is every
achieved,
until
drug
effects
prevent
addicontrolled
seizures.
Important
considerations
in nurschanges
occur, identifying
increasing GABA
and inhibitory
effects
vomiting,
fatigue,
constipation,
diarrhea,
andobtained
hunger.
tional include
increases
in dose.
Serum
drug levels
may be
ing
carethat
include
patients
at risk neurotransmitfor seizures,
ters (Rho, 2017).the pattern and type of seizure activity, and
Cost
and the
of following
the diet
long term may the
alsomost
limit
to assist
thedifficulty
healthcare
provider
in determining
documenting
The ketogenic diet is a stringently calculated diet that is high
in fat and low in carbohydrates and protein. It limits water intake to
avoid ketone dilution and carefully controls caloric intake. Each meal
its use (Wijnen et al., 2017). Those interested in trying the diet must
consult with their healthcare provider to optimize the therapy. The
long-term effects are not yet fully known.
Treating the Diverse Patient: Sports-Related Concussions
There is increased awareness and concern about sports-related
concussions at all ages. Concussions are a form of traumatic
brain injury (TBI) and can range from mild to severe, with immediate and long-term consequences, including dementia and
chronic traumatic encephalopathy (Thomas et al., 2018). Ban,
Botros, Madden, and Batjer (2016) found a relatively low inciM15_ADAM8334_06_SE_C15.indd
175
dence of sports-related
TBI, but an estimated 13% of pediatric
and 14% of adult injuries were considered moderate to severe.
While headaches, dizziness, and visual disturbances were
common after a mild injury, seizures were more common with
severe sports-related concussions, and symptoms may persist
and become chronic (Choe et al., 2016; Merritt, Rabinowitz, &
Arnett, 2015).
M15_ADAM8334_06_SE_C15.indd 170
A01_ADAM8334_06_SE_FM.indd 9
Early detection and intervention is a key strategy in the appropriate treatment of a concussion, but not all patients, particularly
children, seek treatment. Bryan, Rowhani-Rahbar, Comstock, &
Rivara (2016) found that as many as 52% of high school sports
and recreation-related concussions were not report

responseeee.

Jun 14, 2024 | Health Medical

Description

Please respond to discussion below using current APA edition and 2 scholarly references. Must be 150 words.

Clinical experience is one of the academic requirements and qualifications for becoming a professional advanced nurse practitioner. ANP must attend clinical rotations and engage in clinical practice and patient assessment in the clinical facilities. This week’s clinical experience was challenging and insightful at the same time. I managed to interact with and handle different patient cases. I actively participated in patient assessments and coming up with accurate diagnosis and treatment plans for different patient cases. This week was a success since I was able to apply the knowledge I have learned and acquired in my course in handling patient assessments. I gained experience in different clinical practices and handling different clinical cases, which enriched my expertise and competency. However, I encountered challenges handling patients from different cultural and ethnic backgrounds. I learned that patients have other preferences when it comes to medical care, and I was able to understand them and respect their decisions.

Patient Assessment

Rose, a 28-year-old female patient, presented to the clinic with severe abdominal. The patient stated that she had never had such an occurrence and reported that it was the first time she had such an experience. She has never been admitted to the hospital before and has not been on medication in the last six months. The patient, however, has various symptoms, including high blood pressure, high body temperature and fever, nausea, and vomiting (Cesur et al., 2023).

Jun 14, 2024 | Health Medical

Description

Information needs to be based on the lecture slides and videos.No tracing! When asked to draw structures, tracing will be considered a violation of the academic honesty policy outlined in the syllabus.Drawings must be legible and understandable to receive credit.Assignments must up uploaded as a single pdf document,

Unformatted Attachment Preview

Week 4 Assignment: Muscles of the Head, Neck, and Trunk
Please do not post to Chegg, Course Hero, Quizlet, etc. To the Chegg/Course Hero/Quizlet
Experts: If this assignment is posted, do not post an answer, as this is a graded assignment and
violates academic integrity. Please respect academic integrity.
1. Give an example and draw the muscle fiber directions for the following muscle types:
a. Parallel
b. Convergent
c. Unipennate
d. Bipennate
e. Multipennate
f. Circular
2. Identify one synergistic muscle of the following structures. If there are multiple actions for
any of the following muscles, specify the synergistic action for the muscle:
a. Digastric M
b. Sternocleidomastoid M
c. Splenius capitis M
d. Trapezius M
e. Latissimus dorsi M
f. Spinalis M
g. Semispinalis M
h. Serratus posterior superior M
i. Psoas major M
j. Lateral pterygoid M
3. Identify one antagonistic muscle of the following structures. If there are multiple actions for
any of the following muscles, specify the antagonistic action for the muscle:
a. Levator scapulae M
b. External intercostal M
c. Quadratus lumborum M
d. Pectoralis major M
e. Serratus anterior M
f. Deltoid M
g. Genioglossus M
h. Scalene M
4. Identify all the muscles innervated by each of the following nerves:
a. Cervical spinal N
b. Hypoglossal N
c. Glossopharyngeal N
d. Facial N
e. Oculomotor N
f. Intercostal N
5. Draw the suboccipital triangle from the posterior perspective and label the muscles, origins,
and insertions.
6. Draw the anterior neck from the anterior perspective and label the muscles, origins, and
insertions.
7. Draw the erector spinae group from the posterior perspective and label the muscles, origins,
and insertions.
8. Draw the transversospinalis group from the posterior perspective and label the muscles,
origins, and insertions.

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NRS-493-0500 Professional Capstone and Practicum. Topic 3 Professional Capstone and Practicum Reflective Journal – Topic 3

Jun 14, 2024 | Health Medical

Description

Professional Capstone and Practicum Reflective Journal – Topic 3

Assessment Description

Topic Focus: Health care delivery and clinical systems

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 health care delivery and clinical systems (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- Post a draft of your PICOT question. This should be the same question you are using in your research paper. Give and receive feedback to refine your PICOT question.

My answer to this one:

A structure for creating a clinical research question is called a PICOT question. PICOT is an acronym for Population of Focus, Intervention, Comparison, Outcome, and Time (McClinton, 2022). It aids in identifying the patient or population that the researcher intends to examine, the intervention or treatment under consideration, comparing one intervention to another, the intended or anticipated outcome, and the timeline for achieving the desired result (Schiavenato & Chu, 2021).

Geriatric patient falls is a reoccurring problem in the hospital setting that was exposed during my clinical hours with my preceptor. This issue reduces the standard of care and has a detrimental impact on patient outcomes. Falls also have significant financial implications, leading to higher patient treatment costs. Nurses play a major role in fall prevention (Zhao, 2018). They need to familiarize themselves with falls and potential risks. It is imperative to incorporate a fall prevention program into routine clinical practice to reduce the risk of falls and improve patient outcomes. Nurses can get valuable information about falls through PICOT questions (McClinton, 2022). The PICOT question I am using in my research paper is the following:

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)?

2-Explain the difference between qualitative and quantitative data

My answer to this one:

Evaluating evidence is essential to developing evidence in nursing research because it generates data that can be used to support decisions. Qualitative and quantitative data are the two primary approaches for evaluating the evidence (Siedlecki, 2020).

Qualitative research is a type of data that explores and offers more in-depth insights into topics in the real world. When conducting qualitative research, participants’ experiences, perceptions, and behavior are gathered rather than numerical data points. Instead of focusing on how many or how much, qualitative research addresses the hows and whys (Squires & Dorsen, 2018). Qualitative data evaluation involves exploring and analyzing the obtained data, comparing and contrasting ideas, and understanding emerging patterns. The methods used to evaluate this data are not numerical (Aspers & Corte, 2019). The capacity to thoroughly analyze study issues is one of the benefits of qualitative evaluation methods, which are also advantageous because predetermined questions do not constrain interviews. Qualitative evaluation is also flexible, allowing for changes in methodology and direction (Squires & Dorsen, 2018).

Analyzing statistical data serves as the foundation for quantitative methods. Data is gathered in numerical formats to facilitate analysis. The outcomes of this analysis are numerical because it is quantitative (Aspers & Corte, 2019). A particular process is followed while evaluating quantitative data. The first is how variables and data scale measurement are related. For instance, data scales can identify correlations between data and possible cause-and-effect relationships between the given data. Through descriptive statistics, quantitative data can be used to understand the sample better (Siedlecki, 2020). Since it can only be used to look for concrete and statistical relationships, this method’s fundamental disadvantage is that it primarily emphasizes numbers. As a result, researchers may need to pay more attention to broader relationships and themes. Quantitative research can be deceptive due to the assumption that statistical evaluation methods are more reliable than observational ones. However, this research has the advantage of being testable and verifiable, which makes it simpler for future researchers to validate the data (Siedlecki, 2020).

Preparing a case study

Jun 14, 2024 | Health Medical

Description

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. Select your own disease/diagnosis to create the case study based on. Please let me know it first and confirm.

Section

Information to Include

Introduction (patient and problem)

Explain who the patient is (Age, gender, etc.)
Explain what the problem is (What was he/she 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 (Has she/he been diagnosed with other diseases?)
Detail any and all previous treatments (Has she/he had any prior surgeries or is he/she 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 his/her 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.

Nursing Question

Jun 14, 2024 | Health Medical

Description

I had to speak to a patient/resident at a rehab facility. Write down the a couple statements then analyze the interactions using non-verbal and verbal communications. Need to cite 2 articles, and use APA format.I have the interaction with resident written, and a couple paragraphs about the interaction. Need help fluffy it up and with the journal articles. I have uploaded some docs that you can reference. I also uploaded what I have written so far. I am having trouble uploading the rubic. I can scan it to you if you are willing to help.Thank you

Unformatted Attachment Preview

Nonverbal Communication Techniques
Physical Appearance and Dress
Body Movement and Posture
Touch
Facial Expressions
Body coverings, type of dress (formal, casual, or
unkept), jewelry are all examples that can give
insight or promote communication
How a patient positions their body, frequent
shifting, direct eye contact can all provide context to
a patient’s readiness to communicate.
This is a powerful communication tool, cultural
considerations need to be taken into consideration.
Can provoke a positive or negative response from
the patient.
Reveals a patient’s emotional state.
Eye Behavior
A patient’s view can be viewed by others, can signal
that patient is open to communicate.
Vocal Cues or Paralanguage
Includes pitch, the patient’s tone and loudness of
the speech.
Morgan, K. I. & Townsend, M. C. (2020). Essentials of psychiatric mental health nursing. (8th ed.). F. A.
Davis
Therapeutic and Non-Therapeutic Communication Techniques
From Essentials of Psychiatric Mental Health Nursing
Therapeutic Communication Techniques
Technique
Using silence
Accepting
Giving recognition
Offering self
Giving broad
openings
Offering general
leads
Placing the event in
time or sequence
Making observations
Encouraging
description of
perceptions
Encouraging
comparison
Example
Patient: I ate badly and now I’m here so I must be a bad person
Nurse: (silence)
Patient: Actually, I’m just making bad decisions
Yes, I understand what you’re saying
I see that you ate your breakfast
I’ll stay with you for awhile
Is there anything you want to discuss?
Go on
What happened first?
You appear sad today
What was it that increased your agitation today?
Was this pain similar to…?
Restating
Patient: My mind keeps wandering
Nurse: You have trouble concentrating
Reflecting
Patient: She makes me so upset!
Nurse: So you’re angry at your boss?
Focusing
Tell me more about the pain
Exploring
Tell more about those feelings
Seeking clarification
and validation
Do I understand correctly when you said…?
Presenting reality
I see daylight out the window so it must be 10 AM
Verbalizing the
implied
Attempting to
translate words to
feelings
Formulating a plan of
action
It seems overwhelming to share the details of this experience
It sounds like you are feeling hopeless. Is that right?
What could you do differently if you are faced with this situation in
the future?
Non-Therapeutic Communication: Approaches that hinder communication
Technique
Example
Advising
I think you should…
Why don’t you…
Agreeing
Of course, you’re right
That’s good
Defending,
disagreeing, or
challenging
Changing the topic or
introducing unrelated
topics
I don’t believe that
Why are you so anxious?
Patient: The doctor says I have a tumor
Nurse: Let me make your bed now.
Denying
Patient: I am worthless
Nurse: You are very worthy. Everybody is somebody special
Interpreting
What you really mean is…
Making stereotypical
comments
Hang in there
You’re lucky it wasn’t worse
Passing judgment
You shouldn’t have said that
It’s wrong of you to feel that way
Probing
What did your mother say on the phone?
Reassuring
Don’t even worry about…
Everything will be alright
Rejecting
I don’t want to hear about
You shouldn’t feel like that
Requesting an
explanation
Why do you feel that way?
Why would you do that?
Testing
You rated your pain this morning. What did you say to me then?
Morgan, K.I. & Townsend, M.C. (2020). Essentials of psychiatric mental health nursing. (8th ed.). F.A.
Davis.
1
APA Title Page
2
Paper Title
Describe setting and refer to appendix. Refer to prompts 1 and 2
Analyze Patient’s Communication
Refer to prompts 3 and 4
Analyze Student Communication
Refer to prompts 5 and 6
Alternative Therapeutic Communication
Refer to prompt 7
3
References
Morgan, K.I. & Townsend, M.C. (2020). Essentials of psychiatric mental health nursing. (8th
ed.). F.A. Davis.
4
Appendix
Communication Interaction:
Statement #1:
Student:
Student’s nonverbal communication behavior:
Your feelings (not thoughts):
Statement #2:
Resident/Client:
Resident/Client’s nonverbal communication behavior:
Your feelings (not thoughts):
Statement #3:
Student:
Student’s nonverbal communication behavior:
Your feelings (not thoughts):
Statement #4:
Resident/Client:
Resident/Client’s nonverbal communication behavior:
Your feelings (not thoughts):

Purchase answer to see full
attachment

Analyze financial models of reimbursement and their effects on patients and health care providers.

Jun 14, 2024 | Health Medical

Description

Analyze financial models of reimbursement and their effects on patients and health care providers.

Assessment Directions

Course Outcome covered in this assessment:

MN507-2: Analyze financial models of reimbursement and their effects on patients and health care providers.

For this assessment, you will distinguish between Managed Care Organizations (MCO) and Accountable Care Organizations (ACO). Your paper will include the following:

Provide a brief history of both the MCO and ACO.
Define the populations MCO and ACO are intended to serve.
Analyze your role in your specialized area of nursing practice when interfacing with an MCO and ACO clients/patients.

The word count for your paper, excluding the title and the references page, will be 800 words.

Assessment Requirements

Before finalizing your work, you should:

be sure to read the assessment description carefully (as displayed above);
consult the Assessment Rubric to make sure you have included everything necessary; and
utilize spelling and grammar check to minimize errors.

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 7th edition APA formatting and citation style.

Nursing Question

Jun 14, 2024 | Health Medical

Description

write a 3-5 pages essay. 5 References or more. References within last 5 years. In APA Format 7th edition.

Small Group Discussion

Jun 14, 2024 | Health Medical

Description

Research online and find a recent medical error that made the news. 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

NRS-493-0500 Professional Capstone and Practicum. Topic 3 Benchmark – Capstone Change Project Objectives and PICOT

Jun 14, 2024 | Health Medical

Description

Benchmark – Capstone Change Project Objectives

Assessment Description (Remember my topic will be: Falls prevention in hospital setting)

Part A of the assignment (I don’t need references for part A of this assignment)

Review your problem or issue and the cultural assessment. Consider how the findings connect to your topic and intervention for your capstone change project. Write a list of three to five objectives for your proposed intervention. Below each objective, provide a one or two sentence rationale.

After writing your objectives, provide a rationale for how your proposed project and objectives advocate for autonomy and social justice for individuals and diverse populations.

Part B of the assignment (I do need references for part B of this assignment)

Review your problem or issue and the study materials to formulate a PICOT (Patient, Intervention, Comparison, Outcome and Time) question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process. Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Step 1: Create PICOT question; A PICOT question is presented and provides a clear framework for the capstone project change proposal. Your PICOT question should clearly outline all of these elements: patient, intervention, comparison, outcome and time.

Step 2: PICOT Problem: Identify the PICOT problem, what clinical problems or issues may arise from clinical care? The PICOT problem as it relates to evidence-based solution, nursing intervention, patient care, health care agency, and nursing practice is thoroughly described.

Step 3: Describe nursing intervention: A nursing intervention used to address the problem. Compare the nursing intervention to a patient population not currently receiving the nursing intervention, and timeframe needed to implement the change process.

Step 4: Summarize Clinical Problem and Patient Outcome: The clinical problem and how it can result in a positive patient outcome.

Prepare this assignment according to the guidelines found in the APA Style Guide
plagiarism report (less than 10%)

Resources provided by my instructor for this week’s assignments (other resources are under attachments)

https://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementTestingChanges.aspx

https://journals.lww.com/jncqjournal/Abstract/2020/04000/Development_and_Implementation_of_a_Model_for.2.aspx

https://scholarlycommons.baptisthealth.net/cgi/viewcontent.cgi?article=1113&context=nhsrj

https://www.currentnursing.com/nursing_theory/

Unformatted Attachment Preview

AACN Advanced Critical Care
Volume 31, Number 1, pp. 92-97
© 2020 AACN
Clinical
Inquiry
Bradi B. Granger, PhD, RN
Department Editor
Life After PICOT: Taking the Next Step
in a Clinical Inquiry Project
Bradi B. Granger, PhD, RN
T
he art of clinical inquiry begins in the patient care arena with 2 questions:
Why do we practice this way? Could we do it better? Learning to question is a critical thinking skill that can be applied to each aspect of patient care,
from asking why we do a certain practice or procedure, to how, when (the timing of care), and even where (the setting in which care is provided). Often a new
clinical question must be reshaped to be answered—transformed into a format
that is specific and able to be objectively and subjectively measured.
A common approach used to define a clinical question and make it measurable is to identify the Patient Population, Intervention, Comparator, Outcome,
and Time Frame for Evaluation (PICOT). This approach clarifies the clinical
question and establishes a point of departure for a study to answer the question. However, the next step in designing the study is not always clear from
the PICOT question alone. For example, given the question, “In patients with
cardiovascular disease, is technology-based patient education better than standard patient education for improving guideline-directed medication use after
discharge?” how would you design the study? Is it research or quality improvement? What are the next steps?
Using an evidence-based practice model (eg, the Iowa model1) can provide
a map to the next steps: determining the quantity and quality of existing evidence, leading logically to the next decision point in study design. An evidencebased–practice map is a useful step-by-step guide for navigating evidence. In
this example, however, the evidence for educational strategies in cardiovascular disease is voluminous and inconclusive, suggesting more work is needed.
In this case, as with many PICOT questions, the outcome of interest is a
high-priority Centers for Medicare and Medicaid Services and Agency for
Healthcare Research and Quality metric, measured by the hospital version of
the Consumer Assessment of Healthcare Providers Survey score on item 16:
“Did you receive information regarding your medications in a way that you
could understand?”2 Because the question is important to your patients, your
research team, and the organization, and because there are no conclusive
answers in the literature, what are the logical next steps? How would you
narrow the patient population to create a measurable cohort? How will the
groups be defined for the comparison? Many options are possible: 2 cohorts
compared sequentially, using first a standard educational approach, followed
Bradi B. Granger is Professor, Duke University School of Nursing, and Director, Duke Heart Center
Nursing Research Program, 307 Trent Drive, Durham, NC 27710 (bradi.granger@duke.edu).
The author declares no conflicts of interest.
DOI: https://doi.org/10.4037/aacnacc2020986
92
VO L U M E 3 1 • N U MB E R 1 • S PRING 2020
CLINICAL INQUIRY
Table: Criteria for Systematic Consideration of SMART Objectivesa
Objective
Definition
Speciﬁc
Objective clearly states, so anyone reading it can understand, what will be done and who
will do it.
Measurable
Objective includes how the action will be measured. Measuring your objectives helps you
determine if you are making progress. It keeps you on track and on schedule.
Achievable
Objective is realistic, given the realities faced in the community. Setting reasonable objectives helps set the project up for success.
Relevant
A relevant objective makes sense, that is, it ﬁts the purpose of the grant, it ﬁts the culture
and structure of the community, and it addresses the vision of the project.
Time frame
Every objective has a speciﬁc timeline for completion.
Abbreviation: SMART, specific, measurable, achievable, relevant, time frame.
a
Definition adapted from Doran.3
by a comparable time using a technology-based
approach; 2 cohorts compared in parallel, with
1 side of a clinic or patient-care unit using standard education practices and the other side using
technology; a single convenience sample, with
patients alternating assignment to a standard
approach versus technology; or a single group
with individuals randomly assigned to receive
technology-based or standard education. Alternatively, the groups and the delivery of the
intervention could be defined by advanced
practice nurse–based patient groups, registered nurse staffing patterns, clinical settings,
or calendar months, rather than patients. The
possibilities for defining each component of a
PICOT are almost endless. Which is best?
The answer lies in the details of feasibility
that are often specific to your own clinical
setting. Unless you have the luxury of conducting or participating in a large, randomized clinical trial, the best design of a local
clinical inquiry project is a matter of optimizing control and minimizing bias. This is done
using careful consideration and selection of
operational definitions for each component
of the PICOT. Although PICOT questions
are a useful first step in the clinical inquiry
process, answering them requires further
insight into the clinical context, the availability
of preexisting baseline data, time constraints,
and many other logistical questions before
one can determine the best design for the project. The purpose of this column is to describe
next steps after PICOT by highlighting critical thinking skills necessary for designing a
clinical inquiry project that not only is measurable and can answer the question at hand
but is also feasible for your research team to
answer in a reasonable time.
Making Your PICOT SMART
If PICOT is the question, SMART is how
to get there. SMART is an acronym and mnemonic device for specific, measurable, attainable, relevant, and time-bound objectives.3
SMART objectives help define the specific
steps to reach a desired goal—in this case, the
answer to the PICOT or study question. The
Table outlines the details of what might be
considered in a health care approach for using
SMART objectives with each PICOT component. Each component of the clinical inquiry
question is broken down to further examine
and operationally define the nuances and
incremental steps needed to determine who,
what, where, when, how, and why.
A systematic approach for considering each
component of PICOT is useful in real-world
study design because it provides a tool that
lends structure to the critical thinking process. However, such a tool should be used as
simply that, a tool, and should never be used
so rigidly that one’s thinking is limited to a
set of finite checkboxes. Rather, the approach
provided here might be thought of as a means
of getting the creative juices flowing and a
process to ensure that major areas of consideration are not omitted or overlooked in the
design process.
SMART Considerations for “P”
Using our example of technology-based
versus standard patient education for guidelinedirected medication therapy (GDMT) in cardiovascular disease, the population, by
definition, refers to patients with cardiovascular disease. This broad definition requires
additional narrowing to be measurable and
feasible for the study. In a large, randomized
93
CLINICAL INQUIRY
Tier 1: Feasibility
• Number of patients eligible for the intervention
on your unit
• Cycle length: time to see a change or effect
intervention
• Limitations of cost or time
• Constraints of stafﬁng, patient participation, or
other aspects of time
Tier 2: State of the Science
• State of the science (what currently is published)
• Designs that close the gap in published literature
(observational vs experimental designs)
Tier 3: External Input and Key Advisory Personnel
• Patient experts or caregivers
• Community advisory boards
• Key stakeholders affected by the design of the
groups
Figure 1: Decision tree for “C”: comparator group
design in research and quality improvement.
clinical trial, results from a single study may
be generalizable to the larger population,
but for most studies, the design will be limited to a local setting, so the generalizability
of findings will be more limited. It is important to note that large trials rarely achieve
much granularity in the data with regard to
patient preferences for education, such as
local educational venues, regional resources,
family-support demographics, health literacy,
first-language preferences, and other important
regional differences, which are best assessed
and captured in local study designs. Smaller,
single-site studies are useful to inform current
practice in a local setting and must then be
conducted again in other patient groups and
settings to be applied more broadly.
A systematic approach for considering the
population might begin with identifying specific objectives for defining the population for
your PICOT using the SMART acronym. Figure 1 gives an example of how SMART may
apply in our current example of patient education. By considering specific, measurable,
attainable, relevant, and timely criteria for the
population where you work, your operational
definition for the study will include important details such as patient preferences, literacy levels, age range, and how the patients of
interest characterize the problem themselves
94
W W W .AACN ACCON LIN E .ORG
in your own clinical setting. Using SMART to
define “P” may not definitively solve or answer
problems for the population proper, but it
will get you to the next step of a successfully
designed unit- or hospital-based project.
SMART Considerations for “I”
The “I” in PICOT, for intervention, is
typically less abstruse in an initial PICOT as
compared with the population, comparator,
outcome, and timing. Because the research
team arrived at the clinical question themselves, the intervention and the outcome of
interest are generally clear, even if the ways
in which the intervention will be applied
(eg, with regard to timing or sequencing) or
the outcome that will be measured remain a
bit blurry. The team typically recognizes the
“thing” in which they are interested and that
they wish to test or improve.
Take the example of patient education for
GDMT. The question is: Can we do it better?
The educational intervention needs simply to
be specified in a way that is measurable and
feasible. Whether the approach being tested
is novel versus usual care, new content, a new
visual display, or a different level of health
literacy, the intervention itself must be simply
and clearly defined, and measurable.
SMART Considerations for “C”
Defining the comparator (“C,” in PICOT)
group(s) is perhaps the most challenging, but
also the most fun, creative, and exciting aspect
of life after PICOT. The ways in which groups
are defined and compared will also define, in
large measure, the nature of the study and the
challenges yet to come in the weeks, months,
and sometimes years after project approval
and initiation.
First, basic considerations from the literature
review must be assessed. For example, what is
the current state of the science in terms of study
design? In your literature review, were most
studies descriptive or observational, or were
they randomized, controlled studies? The
answer to this baseline question defines the
state of the science and should serve as a
launch pad for subsequent studies of the same
intervention. If randomized assignment of
individuals to the same or similar intervention
has already been carried out and published,
a new study describing group differences or
patient characteristics likely will be difficult
to publish, because it represents a less rigorous
VO L U M E 3 1 • N U MB E R 1 • S PRING 2020
approach and is unlikely to move the science
forward or improve on existing evidence.
Alternatively, if several descriptive or observational studies have been published but few
or no randomized studies can be found in the
literature, then the next logical step is to build
on the evidence by designing a more controlled
or rigorous test of the intervention, which may
include randomization.
A second consideration for where to begin
when designing the comparison group is in
the limitations section of published studies
of the same or a similar intervention. Do previous authors indicate specific limitations to
their studies that might inform the way you
choose to group participants and compare
groups? Can you identify ways to limit bias
in your own study that are based on group
design or grouping strategy?
After taking these preliminary considerations
into account, your team is ready to identify
groups and define a comparison strategy. Many
options are available for designing how the
groups and the comparison will be defined.
The decision tree in Figure 1 depicts a process for evaluating which grouping strategy
is best for you. Three tiers of decision-making
are important to arrive at the best possible
grouping strategy. In tier 1, feasibility issues
are listed for consideration, including the
number of patients eligible for the intervention on your unit; the cycle length, or the
length of time, it would logically take to see
a change or effect from the intervention; and
last, limitations of cost or time. Consideration
of time refers to time constraints of staffing,
patient participation, or other aspects of time
that are associated with the research team
actually delivering, documenting, and entering data for the intervention, as well as the
time required on the part of patients to participate in the study. These feasibility issues
are critical to the success of the study and
must be carefully considered in the design
phase. Any additional feasibility constraints
that arise in the planning and design phase
should be added and accounted for prior to
beginning the project.
Tier 2 describes issues related to the state of
the science and ensures your study will build
on or add to existing science in a meaningful
way. Although replication studies are a good
learning experience for the novice research
team and can make valuable contributions to
existing science, if many replication studies
CLINICAL INQUIRY
already exist, then another is not likely of
added value and will be difficult to justify
to an editor for eventual publication.
Tier 3 addresses other important considerations to take into account when designing
groups, such as input from patient experts or
caregivers, community advisory boards, or
other key stakeholders who may be affected
by the design of the groups and/or the approach
taken for group comparison. Patient or caregiver input into study design can often inform
the way groups are configured or compared,
leading to a more effective study design and
potentially more relevant, realistic, and adoptable results. Patient input into the design strategy is now required for some federal grant
funding. In addition, the perspective of patients
is considered critically important for the eventual
uptake or adoption of results that are relevant to patients. As might be true for our current example of GDMT, patient experts could
contribute valuable input about the relative
utility of a given intervention approach and
whether they would be able to effectively carry
out the expectation of a given group assignment.
SMART Considerations for “O”
The outcome (the “O” in PICOT) measure
and operational definition of that measure
typically include a primary and at least 1 or
2 prespecified secondary outcomes of interest
to the team. The outcome of interest may seem
simple at first, but how it is defined and measured requires more thought and work than
initially meets the eye. For example, what are
we improving and how will we know if that
gets better? If we consider the outcome for our
project on educational interventions for GDMT
in cardiovascular disease, would we be most
interested in improving patient knowledge,
optimizing the content delivered in the 60minute time allocation required by the Centers for Medicare and Medicaid Services, or
ensuring that all classes of medications for a
given cardiovascular indication were actually prescribed according to the guideline?
Or is the team primarily concerned that a
patient goal for taking medication was established and documented, that the skills for
self-managing prescribed medications were
demonstrated, or that a designated caregiver
was present for the education and could also
demonstrate the management of prescribed
medications using a teach-back approach?
Will understanding be measured using a
95
CLINICAL INQUIRY
Population
Who?
• Adults
W W W .AACN ACCON LIN E .ORG
Intervention
What and where?
Comparison
How and when?
• Content
Outcome
Why?
• Group design
Time Frame
For how long?
• Process?
S • CVD? All?
S • Type
S • Prospective
S • Cognitive?
Specify!
• Volume?
M • Turnover?
• Inclusion?
• Health lit
• Mode
M • Learning
style
• Before and
after
M • Repeated
measures
• Conﬁdence
M • Knowledge
• Adherence
• 1 week
• 3 or 6
M months?
• 12 months
• Inpatients
• No. needed
• No. eligible
A • No. consented
• Priority?
• Media
• Time to do?
A • Who will
deliver it?
• Health lit
R • For staff
R • Mode
T N/A
T • Frequency?
• For patient
• Learning style
• Reinforce?
• Teach-back
• Retrospective
• Baseline?
• Behavioral?
• Feasible
A • Accessible
A
• Learner
limitation?
• Educ level
A • Attainable
• What does
lit say?
• None?
R
• Organization
priority
• Staff interest
R • Maybe not
• Documented
R
• Concomitant
T • Sequential
• Cross-over
• Hot topic?
T • Journal
interest?
• Achievable
• Relevant?
• Not needed
T • Too short?
• Too long?
Figure 2: Inquiry algorithm for making a PICOT SMART. CVD indicates cardiovascular disease; educ, education; lit, literature; N/A, not applicable; PICOT, Patient Population, Intervention, Comparator, Outcome, and
Time Frame for Evaluation; SMART, speciﬁc, measurable, attainable, relevant, and time-frame objectives.
validated knowledge scale, a return demonstration, a health-literacy assessment, or a picturebased medication-selection game? Any of
these would be valid outcomes for measuring improving guideline-directed medication
use after discharge.
The fact is, the outcome of almost every
PICOT question can be defined and measured
in a number of ways, and the onus is on the
team to think carefully and systematically
about outcome selection and definition.
SMART considerations for outcome are
shown in Figure 2.
SMART Considerations for “T”
Timing in a PICOT question refers to the
timing of the intervention comparison and
the time frame for the overall duration of the
project. To some extent, the definition of timing depends on the decisions made regarding
groups and comparison approaches. However, an important consideration is the existing literature. If studies have been done and
evaluated for 3 months, does the gap in evidence lie in the months beyond that, when
perhaps the intervention has not been applied,
or has been applied but not evaluated for
96
long enough to determine a sustained effect?
Often in science, early studies test an intervention or novel approach for a very short
time to ascertain early efficacy but do not to
continue the intervention long enough to
assess important sustainability factors, such
as dropout rates and regression to the mean.
A SMART, systematic approach for next
steps in defining “T” in PICOT is shown in
the last column of Figure 2. These key questions about time frames for measurement and
timing of the interval and final evaluations
should be taken into account to answer the
questions about “when” and “for how long.”
A checklist can also be created and used by
the team to ensure that each of the obvious
areas for the implications of timing have been
considered and integrated into the study protocol and the evaluation plan.
Research or Quality
Improvement?
Now that the PICOT is parsed, and specific, measurable, attainable, relevant, and
time-based operational definitions have been
identified for each component of the clinical
question, the study design itself is complete.
VO L U M E 3 1 • N U MB E R 1 • S PRING 2020
One remaining question may be whether the
study represents research or improvement
science (ie, quality improvement). The details
for distinguishing research from quality
improvement can be accessed at the Health
and Human Services website4 or by using the
previously published checklist in this column.5
Conclusion
In summary, the PICOT approach is invaluable in clarifying the basic topic and direction
for clinical inquiry; however, the next steps
after PICOT may be even more important for
the ultimate success of your project. To ensure
that operational definitions are thoughtfully
constructed for each component of PICOT
and options for study design are carefully
CLINICAL INQUIRY
weighed, your team may find SMART objectives a useful addition to PICOT in your clinical inquiry toolkit.
REFERENCES
1. Titler MG, Kleiber C, Steelman VJ, et al. The Iowa model
of evidence-based practice to promote quality care. Crit
Care Nurs Clin North Am. 2001;13(4):497-509.
2. Wolosin R, Ayala L, Fulton BR. Nursing care, inpatient
satisfaction, and value-based purchasing: vital connections. J Nurs Adm. 2012;42(6):321-325.
3. Doran GT. There’s a S.M.A.R.T. way to write management’s
goals and objectives. Manag Rev. 1981;70(11):35-36.
4. Office for Human Research Protections. Quality improvement
activities FAQs. https://www.hhs.gov/ohrp/regulations
-and-policy/guidance/faq/quality-improvement
-activities/index.html. Accessed November 9, 2019.
5. Engel J, McGugan L, Ellis M. Creating clinical research
protocols in advanced practice: part III, building blocks
of study design. AACN Adv Crit Care. 2017;28(1):
74-83.
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Critical-Care Nurses and its content may not be copied or emailed to multiple sites or posted
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Editorial
The Underappreciated and Misunderstood
PICOT Question: A Critical Step in the EBP
Process
Regardless of what model of evidence-based decision-making and practice is selected, Step #1 in the EBP process is to
ask the burning clinical question in PICOT format.
As an early and critical step in the EBP process, it is remarkable to discover how often PICOT questions are incorrectly written. Whether it is the fact that the value of
the PICOT question is underappreciated, the purpose of the
PICOT question is misunderstood, or the approach to formulating and using a PICOT question is taught incorrectly,
the outcome is the same: People are writing incorrect
PICOT questions, which leads to a problematic EBP process
(Table 1).
The purpose of a PICOT question is simple: It is the
mechanism to identify the terms to be used to search for
the best evidence to answer a burning clinical question. In
other words, the PICOT question is the search strategy. The
search strategy leads to an unbiased and effective search.
The unbiased and effective search leads to the evidence.
The evidence answers the question and underpins the evidence-based recommendation, decision, or practice. Instead
of uncovering hundreds of studies, most of which do not
answer the clinical question because of a poorly designed
PICOT question, use of a correctly formed PICOT question
when conducting a search allows for a small number of
relevant studies to be discovered to answer the question.
The fact that this first step in the EBP process is often
undervalued, misunderstood, and miscommunicated is not
a benign problem. It is, instead, a major error that leads to
a number of critical problems that carry through the rest of
the EBP process and can lead to very biased recommendations and those not based on best evidence, the exact opposite of the intent of EBP.
The best way to conduct a great search for evidence is
to write an excellent PICOT question and take that question to a skilled librarian. Many of the dangers caused
by an incorrectly formed PICOT question can be averted
with the expertise of a librarian, and they are surely the
evidence-based practitioners’ most important “searching”
partner. However, not every curious clinician has access to
a librarian. Therefore, PICOT skills have to be developed,
refined, honed, and mastered to avoid faulty results.
The following are some basic tips for writing well-designed PICOT questions.
PICOT questions should not be wordy. Instead of a “P”
of “hospitalized geriatric patients with dementia,” a “P”
422
that would lead to a better search is “geriatric patients with
dementia” OR “geriatric dementia patients” because you
want to search for and find all the literature about the “P”
(population) of interest. Your intent may be to implement
the evidence found on this population when they are in the
hospital, but that is your project not your question. PICOT
questions should not include unnecessary words. Instead,
PICOT questions should include only the key term(s) you
are interested in. Instead of an “I” of “applying a sterile
dressing,” an “I” of “sterile dressing” will lead to a better
search. Extra words such as “provide,” “implement,” “use,”
“deliver,” or “apply” add more words for the search engine
to look for that are not important. Only include the key
words that matter.
PICOT questions should not be used to find evidence to
support the solutions that clinicians have already decided is
the right answer. Instead, PICOT questions should be used
to find out what is the best practice. Instead of an “I” of
“providing distraction activities,” an “I” that would lead to
a better search is “interventions” OR “strategies” because
the best practice is often something that you (and your
committee or task force or council) did not know about
or consider. For instance, what if the best intervention for
addressing agitation in dementia patients is music therapy?
You would never discover the right answer if you only
searched for something that you had already decided on.
This critical error leads people to search for evidence to
support their idea, and it may not be—and often is not—
the best idea. This mistake can be made inadvertently or
with true intention. In the first scenario, you do not realize
that you are making the mistake. In the second scenario,
you intentionally look for evidence to support your idea
and intentionally do not look for anything else. Either way,
this problem needs to be avoided.
PICOT questions are always written in the past tense. You
are searching for things that have already occurred. Research
questions, on the other hand, are written in the present tense.
PICOT questions never include a directional term such
as “increased” or “improved.” Once a directional term is
included, the search is biased; if you only look for studies
where a particular intervention “increased” an outcome of
interest, you will miss all the articles where the intervention “decreased” that outcome. This is a dangerous mistake.
PICOT questions cannot be changed once you have
started searching. More PICOT questions can be written
Worldviews on Evidence-Based Nursing, 2019; 16:6, 422–423.
© 2019 Sigma Theta Tau International
Editorial
Table 1. An Example of a Poorly Written PICOT
Question and the Corrected Version
This is an example of a PICOT question that is wrong in
all facets. A dissection of the question will help
identify the poorly written components.
In hospitalized geriatric patients more than 65 years of
age with dementia (P), how does providing distraction
activities (I) compared with providing traditional
hospital care (C) decrease agitation (O)?
P: hospitalized geriatric patients more than 65 years of
age with dementia
I: providing distraction activities
C: providing traditional hospital care
O: decrease agitation
1. The terms in this PICO question are too wordy.
The words placed into the search database are
the exact words the computer is going to scan in
the literature, so the more words, the less you will
find.
2. By including the word “providing” in the I and C
search, you would miss any study where the title
included words such as “implementing” or
“utilizing” because the computer would be looking
specifically for “providing.”
3. This PICOT is not written in past tense; as such, it
is a research question.
4. PICOT questions should not include any directional
words. They will cause a biased search.
The correctly written PICOT question to yield the most
efficient search would be:
In geriatric patients with dementia (P), how do distraction activities (I) compared with traditional care (C)
affect agitation (O)?
Your PICOT question does not always match the change
project or initiative you originally imagined or planned.
That is because a well-written PICOT question leads you
to the best practice to answer your inquiry, not the answer
you were thinking about or for which you had hoped.
It is critical to invest time in writing a great PICOT question, as it is the gateway to an efficient, effective search and,
ultimately, to making robust, evidence-based recommendations with confidence to assure the best decision-making
possible and to improve care and outcomes.
Lynn Gallagher Ford, PhD, RN, NE-BC, DPFNAP, FAAN,
Senior Director, Helene Fuld Health Trust National
Institute for EBP in Nursing & Healthcare, College of
Nursing, The Ohio State University, Columbus, OH, USA;
Director, Clinical Core, Helene Fuld Health Trust National
Institute for EBP in Nursing & Healthcare, College of
Nursing, The Ohio State University, Columbus, OH, USA
Bernadette Mazurek Melnyk, PhD, APRN-CNP, FAANP,
FNAP, FAAN,
Vice President for Health Promotion, University Chief
Wellness Officer, Dean and Professor, College of
Nursing, The Ohio State University, Columbus, OH, USA;
Professor of Pediatrics & Psychiatry, College of
Medicine, The Ohio State University, Columbus, OH, USA;
Executive Director, Helene Fuld Health Trust National
Institute for EBP in Nursing & Healthcare, The Ohio State
University, Columbus, OH, USA;
Editor, Worldviews on Evidence-Based Nursing, The Ohio
State University, Columbus, OH, USA
for the same inquiry, but you cannot change a question
that you have already used. That question is already part
of your EBP adventure and needs to be included in your
story.
Worldviews on Evidence-Based Nursing, 2019; 16:6, 422–423.
© 2019 Sigma Theta Tau International
423
Copyright of Worldviews on Evidence-Based Nursing is the property of Wiley-Blackwell and
its content may not be copied or emailed to multiple sites or posted to a listserv without the
copyright holder’s express written permission. However, users may print, download, or email
articles for individual use.
———- [ EVIDENCE IN PRACTICE ] ———STEVEN J. KAMPER, P h D 12
Types of Research Questions:
Descriptive, Predictive, or Causal
J Orthop Sports Phys Ther 2020;50(8):468-469. doi:10.2519/jospt.2020.0703
previous Evidence in Practice art icle explained why a specific
and answerable research question is important for clinicians
and researchers . 3 As a reader, if you cannot specify the question
and summarize it simply in your own words, you might as well
not read the study. The type of research question has critical implications
for the study methods. Good-quality, clinically useful research begins
A
with the research question and requires
that the study design match the type of
question.
Descriptive questions can be answered
with cross-sectional or longitudinal de
signs, but predictive and causal questions
usually need longitudinal designs.
Q uestion Types
Research questions fall into 1 of 3 m utu
ally exclusive types: descriptive, predic
tive, or causal. Imagine you are seeking
information about whiplash injuries. You
might find studies that address the fol
lowing questions.
1. Descriptive questions: W hat is the
num ber of whiplash injuries per head
of population? W hat proportion of
people who attend the emergency
departm ent with a whiplash injury
completely recover within 3 months?
W hat impact do whiplash symptoms
have on individuals?
2. Predictive question: How well does a set
of simple clinical measures predict the
likelihood of recovery within 3 months?
3. Causal questions: Are people who re
ceive education and reassurance more
likely to recover in 3 m onths than
people who receive a neck brace and
advice to rest? Do posttraumatic stress
symptoms immediately after whiplash
injury cause slower recovery?
There is a critical distinction between
question type and study design (T A B L E ).
D escriptive Questions
Descriptive questions seek to describe the
“landscape,” to provide an overview of the

PHAR A101 Introduction to Pharmacy

Jun 14, 2024 | Health Medical

Description

I will provide the website for the HW and Quizzes. They are multiple questions online. Week 1-Week 5.The quizzes are on medical terminology and the HW also

372 @manour320

Jun 14, 2024 | Health Medical

Description

Seeattached

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Nursing Question

Jun 14, 2024 | Health Medical

Description

In thinking about collaboration between nursing and other interdisciplinary professionals and the role of the nurse in professional nursing associations as it relates to health care policy:

Identify a legislative/policy of interest related to a workforce/patient care issue (Choose a different topic from the one discussed in previous modules).
Include bill identifying information (e.g. title of bill, identifying number, type of legislation [state or federal], etc.).
Where is this legislation in the approval process?
Why do you feel this legislation is important? Align your explanation with your personal beliefs and values.
Which regulatory agency would be interested and involved in the passing of this policy?
Discuss one aspect (socio-cultural, ethical, economic, political, or legal implications) that you feel would be impacted by the recommended legislation.
Analyze and discuss how the outcomes of this specific legislation could impact practice/patient care/future of healthcare.
Discuss specific ways, nurses as leaders, could advocate for this change.
Incorporate pertinent information gathered from reviewing and referencing the National Academy of Science (2010 & 2021) reports.
Compare/contrast nursing practice standards/regulatory bodies (related to advocating strategies for health care policies) with the practice standards/regulatory bodies of one member of the interdisciplinary team.

Support this information with at least three scholarly references from peer reviewed professional journals and respected websites in addition to the assigned readings.

Your paper will be scored using the Written Assignment Rubric which requires APA format. This assignment length requirement is no more than 5 pages not counting the title page and the reference page. This activity is tied to:

Course Objective 3: Explain the professional responsibility of the registered nurse in terms of advocacy and political engagement. :: The registered nurse must be educated regarding changes and implications of health policies. This is accomplished by being active in and belonging to professional nursing organizations. These organizations offer nurses the opportunities to advance their knowledge, network with other nursing experts to collaborate on pertinent and relevant issues surrounding healthcare, and to provide a collective voice for promoting nursing and setting the standards for quality patient care. The process of networking allows people with similar interests and goals to share ideas and information and offer support and direction. Building networks is also essential for advancement of the profession and building relationships with members of the interdisciplinary health care team. As professionals,nurses have the ability and potential power to influence through established networks and coalitions (Blais & Hayes, 2016)
Course Objective 5: Analyze the future of health care services and the registered nurse’s responsibilities as influenced by the current U.S. health care delivery system.::: The Institutes of Medicine (IOM) and the Robert J. Wood Foundation (RJWF) released a landmark report titled The Future of Nursing: Leading Change, Advancing Health. The vast knowledge, expertise, and influence of the nursing profession was realized, as this document delineated new and expanded roles for nursing. The nursing profession was invited to become active members in the opportunities for collaboration and effecting change for health care in the U.S.The IOM committee posed 4 key recommendations (National Academy of Science, 2010):
Nurses should practice to the full extent of their education and training.
Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.
Effective workforce planning and policy making require better data collection and an improved information infrastructure.
References:

Blais, K. K., & Hayes, J. S. (2016). Professional nursing practice: Concepts and perspectives (7th ed). Pearson Education, Inc.

National Academy of Science. (2010). The future of nursing: Leading change, advancing health.

National Academy of Science. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity.

Nursing Question

Jun 14, 2024 | Health Medical

Description

Instructions
Resources
Attempt 1 available
Attempt 2
Attempt 3

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.

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

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Physical activity and energy balance

Jun 14, 2024 | Health Medical

Description

Part 2 – Evaluation of Physical Activity and Energy Balance-2.docxNow that you have collected your data (part 1), you will begin to analyze your results. Please use the instructions above to complete your paper. The video below will help you understand my expectations for this project. You can also refer to the rubric below to see how your paper will be graded.What you will turn in when you are finished:Your evaluationCalculation sheetSupporting documents (part 1 of your project – specifically the 3 food lists, nutrients report, and physical activity worksheet)You have unlimited submissions for this project but I will only grade your assignment once. I will start grading after the due date and will only grade your most recent submission. Make sure the last thing you submit is your final draft. YOU WILL NOT BE ABLE TO REWRITE FOR A BETTER GRADE. Make sure you do a good job the first time.

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Nutrition Report 
View daily averages for a selected period of time.
Daily Averages for
Last 7 days
Include Today
Filter Days
Completed Days
Include Supplements
Sep 17, 2023 to Sep 23, 2023
Energy Summary
Consumed
Burned
Remaining
Macronutrient Targets
Energy
Protein
Net Carbs
Fat
779.2 (-1364.5 net) kcal / 4160 kcal
19%
35.0 g / 260.0 g
13%
61.5 g / 468.0 g
13%
43.0 g / 138.7 g
31%
Nutrient Targets
Nutrition Scores
Get more with
Cronometer Gold
42%
All Targets
Upgrade to view full set
of nutrition scores
representing well
researched health
concepts
UPGRADE
Highlighted Nutrients
39%
58%
35%
31%
44%
28%
35%
Fiber
Iron
Calcium
Vit.A
Vit.C
Vit.B12
Folate
41%
Potassium
General
Energy
– kcal
0%
Alcohol
-g
N/T
Ca!eine
– mg
N/T
Water
-g
0%
Carbs
-g
0%
Fiber
-g
0%
Starch
-g
N/T
Sugars
-g
N/T
Added Sugars
-g
N/T
Net Carbs
-g
0%
-g
0%
Monounsaturated
-g
N/T
Polyunsaturated
-g
N/T
Omega-3
-g
0%
Omega-6
-g
0%
Carbohydrates
Lipids
Fat
Saturated
-g
n/a
Trans-Fats
-g
n/a
Cholesterol
– mg
N/T
-g
0%
Cystine
-g
0%
Histidine
-g
0%
Isoleucine
-g
0%
Leucine
-g
0%
Lysine
-g
0%
Methionine
-g
0%
Phenylalanine
-g
0%
Threonine
-g
0%
Tryptophan
-g
0%
Tyrosine
-g
0%
Valine
-g
0%
B1 (Thiamine)
– mg
0%
B2 (Riboflavin)
– mg
0%
B3 (Niacin)
– mg
0%
B5 (Pantothenic Acid)
– mg
0%
B6 (Pyridoxine)
– mg
0%
B12 (Cobalamin)
– µg
0%
Folate
– µg
0%
Vitamin A
– µg
0%
Vitamin C
– mg
0%
Protein
Protein
Vitamins
Vitamin D
– IU
0%
Vitamin E
– mg
0%
Vitamin K
– µg
0%
Calcium
– mg
0%
Copper
– mg
0%
Iron
– mg
0%
Magnesium
– mg
0%
Manganese
– mg
0%
Phosphorus
– mg
0%
Potassium
– mg
0%
Selenium
– µg
0%
Sodium
– mg
0%
Zinc
– mg
0%
Minerals
N/T = No Target
Recommendation from Dietary Guidelines
Protein (% kcals). 10-35
Carbohydrate (% kcals) 45-65
Carbohydrate (g) 130
Fiber (g). 28
Added Sugar (% kcals)
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Nursing Question

Jun 14, 2024 | Health Medical

Description

1) In collaboration with the approved course preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Students should consider the clinical environment in which they are currently employed or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a leadership or quality improvement initiative, or an unmet educational need specific to a patient population or community. The student may also choose to work with an interprofessional collaborative team.

Students should select a topic that aligns to their area of interest as well as the clinical practice setting in which practice hours are completed.

Write a 500-750 word description of your proposed capstone project topic. Include the following:

The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal.
The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed.
A description (providing a high level of detail) regarding the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
Effect of the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
Significance of the topic and its implications for nursing practice.
A proposed solution to the identified project topic with an explanation of how it will affect nursing practice.

You are required to cite to a minimum of eight 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. Plan your time accordingly to complete this assignment.

–

2)In collaboration with the approved course preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Write a 150-250 word summary explaining which category your topic and intervention are under (community or leadership).

–

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: Interprofessional Collaboration

While APA style is not required for the body of this assignment, solid academic writing is expected.

create an epi graph instructions below

Jun 14, 2024 | Health Medical

Description

Complete the CDC E-learning activities “Create an Epi Curve” and “Using an Epi Curve to determine mode of spread” at https://www.cdc.gov/training/quicklearns/ 2. Create an epi-graph based on the data in exercise 1 of “Create an Epi Curve.” This can be made in MS Excel or another graphing utility. 3. Submit it with your answers to the exercises in the module (questions start on slide 8) in a MS RTF file or PDF.

Health Questions

Jun 14, 2024 | Health Medical

Description

How does the social determinants of health framework contribute to our understanding of the factors that influence population health outcomes? Provide examples of specific social determinants and their impact on health.

Looking for help with a case study

Jun 14, 2024 | Health Medical

Description

Prompt

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.
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.

Interview with a Nurse Practitioner

Jun 14, 2024 | Health Medical

Description

Hi,Please follow the directions EXACTLY what they say. Nurse Practitioner Interview Learning objective: To explore the role of the APN in depth as she /he functions in the context of the institution in which he/she is employed. Compare and contrast the observed /evaluated advanced practice-nursing roles to that cited in professional guidelines, theory, and research. In other words, does actual application of practice really follow theory and literature? Methods: Develop an Interview Guide with 10-15 questions which reflect the topics reviewed in the course readings and webinar.Some of these topics would be what are professional and societal expectations, health policy, reimbursement, professional role history, demographics, and/or the contextual health care system and agency issues that affect the NP role. Cite the reference(s) for each question in the Interview Guide.Schedule an interview with one (1) NP to learn about their roles within the health care system using the developed interview guide. You will likely learn more if you interview an NP that you do not know. This is strongly recommended.Maintain the ethics of confidentiality during the interview and destroy all data once the paper is completed. Do not tape record. Do not report the name of the NP or the location of the agency.Each interview question should be fully addressed and clearly developed.

5 file ct 500

Jun 14, 2024 | Health Medical

Description

Module 05: Critical Thinking Assignment

Access to Healthcare (100 points)

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.

Utilize headings to organize the content in your work.

Public Health Question

Jun 14, 2024 | Health Medical

Description

I have a written philosophy but my professor has told me to make some changes to make it a better paper. please help. The philosophy I have chosen is cognitive-based philosophy.

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Cognitive-Based Health Promotion Philosophy
Health Education Workshop
In my journey to understand health promotion, I organized a health education workshop
at my mosque. Growing up I noticed traditional, greasy foods are prevalent in my predominantly
Indian community, contributing to obesity, diabetes, and heart attacks among the elderly. This
workshop was all about educating our community about healthy eating. Also, it encouraged
people to switch from unhealthy to more nutritious diets. Throughout the workshop, I talked
about nutrition and the benefits of replacing oily foods with fresh, nutrient-rich ones. Using
evidence-based insights and practical advice, I equipped participants with the knowledge they
needed to make informed food choices. Many community members need more nutrition
knowledge, so this workshop was a great way to bridge that gap.
My philosophy is to enhance understanding and empower individuals to make informed
health decisions. Aside from facilitating access to health care, I promote active participation in
community health initiatives. As a society, we need to emphasize health education, create
supportive environments, and work to reduce health disparities. Everyone should have the
opportunity to achieve optimal health.
Mental Health Journey
As part of another significant chapter of my life, I faced extreme stress, which led to
anxiety, mood swings, and difficulty concentrating. My mental health and overall well-being
were deeply affected by these challenges. My mental wellbeing was improved through selfimprovement books and resources. This information led me to significant resources that guided
me through the complexity of stress management and the significance of mental health. As a
result of reading these materials, I was able to gain a greater sense of self-awareness that had
previously remained closed to me. On my journey to personal growth, I set and pursued goals
while practicing dedicated self-care.
My life changed significantly after this encounter. Stress levels dropped, and my
emotional resilience became a reliable source of support when things got tough. My philosophy
of health promotion, emphasizing personal empowerment and growth through health, aligns
seamlessly with these experiences. I underwent profound and enduring behavioral and cognitive
changes, enhancing my ability to handle life’s challenges with strength and resilience. Educating
those around me within my community about resources that could be easily accessible has
become important to me throughout my journey leading me into my career in health promotion.
During this point in my life, I realized how many other people were going through mental health
challenges without knowledge or support to overcome the battle.
Impact of Mother’s Type 2 Diabetes Diagnosis
The diagnosis of Type 2 Diabetes in my mother profoundly impacted my perception of
health and health promotion. After seeing her struggle with this condition, I realized how
important it is to understand chronic illnesses and make lifestyle changes. Seeing her struggle to
keep up with her medications made me realize that I had to step forward to ensure that she was
taking care of herself. I was there to support her as she went through this drastic change in her
life after being diagnosed with this illness. To better understand diabetes and its treatment
options, I turned to health information portals online. My research helped me understand the
condition and lifestyle changes my mom needed to make. After learning that type 2 diabetes was
genetic, I also decided that I needed to take preventative measures. This experience reinforced
the importance of considering all aspects of health, aligning perfectly with my holistic
philosophy.
The condition of my mom’s well-being propelled me to discover more and gave me
responsibility. As a result, I realized that our well-being should be our top priority, and that we
should take preventive measures to safeguard and upgrade it. This includes eating healthy foods,
exercising, effectively dealing with stress, and focusing on our psychological and emotional
well-being. In addition, my efforts to understand diabetes have clarified the crucial role of early
identification and avoidance in lessening chronic illnesses. I recognized that awareness and
education are critical components of health promotion. Therefore, I actively raise awareness
about diabetes and its risk factors among my peers and the community.
Additionally, I advocated for a balanced and nutritious diet. I understand that food
choices are fundamental to managing and preventing diabetes. I encourage people to embrace a
diet rich in whole grains, vegetables, lean proteins, and healthy fats. Small, sustainable changes
to one’s diet can significantly improve one’s health. Exercise became another cornerstone of my
health philosophy. Regular physical activity helps manage weight and enhances insulin
sensitivity. Exercise should be incorporated into daily routines and found as an enjoyable activity
to encourage long-term adherence to an active lifestyle.
Mental health and stress control are also priorities for me. It is important to practice
mindfulness exercises such as yoga and deep relaxation to deal with life’s unpredictable daily
stresses. For overall well-being, it is vital that the body and brain are in good health. As a result
of my mom’s Type 2 diabetes diagnosis, I got into the health promotion and health field. As a
result, I educated myself, took control of my health, and promoted healthy living in my
community. By raising awareness, making smart decisions, and taking a holistic approach to
wellness, we can all work toward a better, healthier future.
The Three experiences
Through these three experiences, knowledge can transform health. Health education
workshops, self-help resources, and online health information portals are more than just tools;
they represent my commitment to empowering individuals through education, personal growth,
and holistic understanding. Information is key to boosting individual confidence and bringing
about positive changes in healthcare. To me, wellness means achieving mental, physical, and
emotional harmony in all aspects of your life. Through cognitive transformation, we can help
everyone around us improve their well-being and health.
In conclusion, my circumstances emphasizing the value of information, education, and
confidence have influenced my transition to a cognitive-based philosophy. I’ve learned to value
the transforming potential of data in advancing health promotion because of organizing a Health
Education Workshop, overcoming obstacles related to my psychological well-being, and dealing
with my mother’s Type 2 Diabetes condition. These encounters have shaped my career choice
and strengthened my dedication to advancing holistic health and enabling others to make wise
decisions regarding their well-being.

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Description

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://s…

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

Discussion

Jun 14, 2024 | Health Medical

Description

Instructions:Read the article “Understanding situation awareness and its importance in patient safety” (attached below)Respond to two of the following prompts Identify and discuss the five most salient points of the article in your opinion. How do these relate to Medical Assistants? Be specific and detailed.Identify and describe a minimum of ten factors in ambulatory care that would promote situational awareness for new medical assistants. Explain your rationale for the order of ranking each one. Compare and contrast the three levels of cognitive processing described in the article and how these relate to medical assistants. Provide an example that is not already included in the article. You may use examples from previous MA coursework.Expectation: Your original post would be approximately the level of a two-page paper.

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CPD
CONTINUING
PROFESSIONAL
DEVELOPMENT
Understanding situation awareness
and its importance in patient safety
NS840 Gluyas H, Harris S-J (2016) Understanding situation awareness and its importance in patient safety.
Nursing Standard. 30, 34, 50-58. Date of submission: October 29 2015; date of acceptance: December 10 2015.
Aims and intended learning outcomes
Abstract
Situation awareness describes an individual’s perception, comprehension
and subsequent projection of what is going on in the environment around
them. The concept of situation awareness sits within the group of
non-technical skills that include teamwork, communication and managing
hierarchical lines of communication. The importance of non-technical
skills has been recognised in safety-critical industries such as aviation,
the military, nuclear, and oil and gas. However, health care has been slow
to embrace the role of non-technical skills such as situation awareness in
improving outcomes and minimising the risk of error. This article explores
the concept of situation awareness and the cognitive processes involved
in maintaining it. In addition, factors that lead to a loss of situation
awareness and strategies to improve situation awareness are discussed.
Authors
Heather Gluyas Associate professor, Murdoch University, Mandurah,
Australia.
Sarah-Jane Harris Co-ordinator of nursing practice and policy,
St John of God Murdoch Hospital, Perth, Australia.
Correspondence to: h.gluyas@murdoch.edu.au
Keywords
cognitive factors, communication, errors, human factors, patient safety,
situation awareness
Review
All articles are subject to external double-blind peer review and checked
for plagiarism using automated software.
Revalidation
Prepare for revalidation: read this CPD article, answer the questionnaire
and write a reflective account. www.rcni.com/revalidation
Online
For related articles visit the archive and search using the keywords above.
To write a CPD article: please email gwen.clarke@rcni.com
Guidelines on writing for publication are available at:
journals.rcni.com/r/author-guidelines.
This article aims to inform nurses about the
importance of situation awareness and the need
to maintain it to minimise the likelihood of
errors. Situation awareness will be referred to
as SA throughout the article for ease of reading.
After reading this article and completing the
time out activities you should be able to:
Discuss the cognitive processes involved in
maintaining SA.
Identify the factors that can lead to
a loss of SA.
Describe strategies to mitigate the loss of SA.
Identify opportunities to incorporate
knowledge of SA and associated strategies
into professional practice.
Introduction
SA describes an individuals’s perception,
comprehension and subsequent projection
of what is going on in the environment
around them (Endsley 1995). In other words,
it describes people noticing what is going
on around them, working out what the
information they are noticing means, and using
that information to plan required actions or
decisions (Flin et al 2008).
Although this article describes the
significance of SA in health care, it is important
to recognise that SA is part of people’s cognitive
functioning in all contexts. For example, when
driving on a busy road people are not only
undertaking the technical and complicated
task of driving, but also will be scanning the
environment. They will be looking at the
traffic in front of them and for brake lights
or indicators so they can anticipate changing
traffic speeds or the need for evasive action.
They will be watching for other hazards, such
as small children on the pavement who might
run onto the road or people crossing the road
recklessly, which may require corrective action
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to prevent an accident. Thus SA – processing
what is happening, what it means and what
needs to be done as a result – is an important
cognitive state that helps people make decisions
and undertake tasks in relation to all aspects
of their life (Gluyas and Morrison 2013).
Complete time out activity 1
The concept of SA sits within the group of
non-technical skills that include teamwork,
communication and managing the
hierarchical lines of communication that tend
to exist in health care. Hierarchical lines of
communication lead to what is termed as an
authority gradient and arise from a perceived
professional hierarchy that results in junior
staff feeling powerless to question or challenge
senior staff (Gluyas and Morrison 2013).
Non-technical skills are studied in the broader
discipline of human factors, which examines
the relationship between humans’ thinking
and cognitive processing and the environment
(White 2012).
The importance of non-technical skills has
been recognised in safety critical industries
such as aviation, military, nuclear, and oil
and gas. Investigations into major disasters
in such industries identified that rather than
deficient technical skills, it was non-technical
skills, such as a loss of SA, that were implicated
in many incidents (Endsley and Jones 2012).
Examples of catastrophic incidents, where a
loss of SA was a contributing factor, include
the Chernobyl and Three Mile Island nuclear
disasters in 1986 and 1979 respectively, the
Piper Alpha oil rig accident in 1988 and the
Tenerife aviation collision in 1977 (Flin et al
2008, Wachter 2012).
Health care has been slow to embrace the role
of non-technical skills such as SA in improving
outcomes and minimising the risk of error
(Bromiley 2014). Healthcare literature was
beginning to promote discussion about SA and
error from the late 1990s (Gopher and Donchin
2011). However, in 2005, the high-profile case
of Elaine Bromiley identified the crucial role of
SA in clinical care errors. The case involved the
death of a young wife and mother following
failed intubation for routine surgery (White
2012). Elaine’s husband was an airline pilot
and, during the ensuing investigation, noted
that the role of human factors and SA were
not recognised immediately in healthcare
investigations. In 2007, he established the
Clinical Human Factors Group and in so doing
helped to shift the focus on human factors and
SA in health care from the realms of academia
to the clinical area (Reid and Bromiley 2012,
Bromiley 2014).
SA is imperative for improving patient
outcomes in many aspects of clinical care
(Stubbings et al 2012). Even a simple task such
as the allocation of nurses’ meal breaks requires
a degree of SA to ensure that patient care is
not compromised. For example, the following
factors need to be considered:
The nurses going off for a break in
comparison to those remaining on the
ward (the ‘what?’).
Whether the skill mix and numbers of
those remaining on the ward are appropriate
(the ‘so what?’).
Whether this decision would be prudent
in the case of a medical emergency (the
‘what now?’).
To use another example: a nurse walks into a
patient’s room to answer a call bell and notices
that the patient’s drainage bag is full of blood.
This is the ‘what?’ stage of SA. Interpreting the
meaning of this observation may then lead the
nurse to conclude that if the drainage bag is full
of blood, the patient is possibly haemorrhaging.
This is the ‘so what?’ stage of SA. Through
this analysis, the nurse may decide that the
patient is at risk of hypovolaemic shock and,
therefore, requires urgent attention. The nurse
subsequently seeks immediate medical review.
This is the ‘what now?’ stage of SA.
Decision making is required in everyday
clinical practice, not only in specialised
environments or during crises. The aim of SA
is to prevent critical situations from developing
(Stubbings et al 2012). Therefore, it is imperative
that the factors that improve SA are included
in the training and education of healthcare
professionals if patient safety is to be improved.
Training and education programmes
to improve SA involve identifying and
understanding the role of cognitive processing
in SA. This understanding forms the basis
for being able to examine different situations
to identify the factors that will likely have a
negative effect on achieving SA. Individuals
can use this knowledge to improve SA in
similar situations.
Cognitive processing in situation
awareness
SA is not a static state but rather an ongoing
process that is normally used in relation
to dynamic situations that require tasks,
decisions and actions to be undertaken or
completed. It involves three levels or stages of
1 Consider the
following scenario from
an SA perspective:
you are preparing a meal
and your three-year-old
child comes into the
kitchen and starts
to climb onto a stool
‘to help’. You notice
that the pot handle is
facing outwards from
the top of the stove,
there is a sharp knife
on the cutting board
and there is a hot cup
of coffee on the kitchen
worktop. Answer the
following questions:
What information
will you be processing
about the situation
(perception)?
What does this
information mean
(comprehension)?
What actions are
required (projection)?
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CPD patient safety
cognitive performance (Figure 1) (Endsley and
Jones 2012):
Level 1: perception of elements in the
environment.
Level 2: comprehension of the current
situation.
Level 3: projection of future status.
Each of these levels will be discussed separately,
however it is first important to recognise the
effect of time on SA. The perception by the
individual of the amount of time available
until a decision needs to be taken will have
an effect on SA. For example, perceived
time pressures may lead to reactive decision
making (Stubbings et al 2012). If the individual
estimates that a decision is required quickly,
cues may be missed in the perception stage and
not considered in the comprehension stage,
thus leading to a flawed projection stage. In
addition, a rapidly changing situation requires
rapid changes in perception, comprehension
and projection, and can result in outdated or
inaccurate SA (Carayon 2011).
Level 1: perception
The sensory systems of vision, hearing, smell,
taste and touch provide individuals with the
information to perceive what is happening in
the environment around them. For example,
nurses may use any or all of these five senses
when undertaking a physical assessment of a
patient. They may look for and feel skin turgor,
listen to respiratory patterns or a cardiac
rhythm, smell alcohol on a patient’s breath or
smoke on clothing, and hear the sounds of,
FIGURE 1
Three levels of cognitive performance involved in situation awareness
Perception of elements in the environment
Noticing what is going on in the proximate environment
Comprehension of the current situation
Processing the information to make sense of what is happening
Projection of future status
Deciding what tasks, decisions and actions need to happen
(Endsley and Jones 2012)
and see the visual display lights on, a patient
monitor. These sensory inputs are processed
selectively because, in any given situation,
there is a significant amount of information,
which is impossible for an individual to
process. Selective processing of the incoming
information relies on past experiences that are
stored in the memory. These memories provide
nurses with cues to help recognise what it is
important to notice and what can be ignored.
The memories can be stored in either working
or long-term memory stores. However, it is the
working memory (also known as short-term
memory) that has a greater role in the
perception stage of SA (Endsley 1995).
Working memory has a limited storage
capacity – it can store approximately seven
pieces of information (Flin et al 2008), and is
susceptible to losing information unless the
information is consciously and consistently
repeated. For example, if a nurse is walking to
the office to chart physiological recordings and
is interrupted by someone asking a question, it
is likely that the physiological measurements
will be lost in the working memory and will
be replaced with the information contained in
the question. This is important in the context
of SA since retaining important information
to support accurate SA can be compromised
by interruptions and distractions (Endsley and
Jones 2012).
Long-term memory is the main memory
store and holds the information from past
experiences and events. Information is retrieved
from the long-term memory store to assist in
cognitive processing at several different levels
of SA. At the perception level, information
from the long-term memory is transferred
to the short-term memory and is used to
help recognise and prioritise which sensory
information needs to be noted. Information
retrieval from long-term memory to assist
SA perception is increasingly likely if the
information has been used recently, is familiar
or is of particular interest to the individual (Flin
et al 2008).
Failure in the perception stage of SA can
occur because sensory information is not
available or difficult to notice, individuals
do not observe elements in the environment
around them, or the information that
is gathered from the environment is
misinterpreted (Endsley 1995). Accurate
perception of factors present in a given situation
or the environment is vital to guide information
processing in relation to the significance of
these factors and subsequent decision making.
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Level 2: comprehension
The comprehension stage of SA involves
processing the information that is gathered
in the perception level to work out what is
happening and what is significant in the
situation. For example, a nurse carrying out
care for a patient in a multi-bedded room is
engrossed in the task and is not perceiving
the busy ward noises, such as people talking,
trolleys being pushed past and patient call bells
ringing. However, on hearing a loud crash
and someone calling out for help, the nurse
turns, sees a patient lying on the floor and
comprehends that the loud noise and call for
help is probably related to the patient who has
fallen. The nurse will be using information
stored in the long-term memory that provides
understanding of what a loud noise, call for
help and patient on floor probably mean.
The retrieval of stored information
from long-term memory is called pattern
matching. Pattern matching uses information
gathered and stored in the long-term memory
from previous experience to interpret the
information that is gathered in the perception
stage and to inform the comprehension stage.
The stored information is known as mental
models or schema, which are groups of
cues that can mean certain things in certain
circumstances. When pattern matching, not all
the cues need to be present for the individual
to extrapolate the information to the situation
they are trying to understand (Endsley 2015).
People with less experience have fewer
mental models on which to draw from their
long-term memory to make sense of a situation
(Endsley 2015). This is obvious when observing
a nurse who has extensive experience and
advanced skills undertake the complicated
care of an acutely unwell patient. The nurse
is able to detect minute or subtle changes in
a patient’s condition and use multiple pieces
of information such as physiological signs
and symptoms, data from technological
equipment and observation of the patient’s
behaviour quickly. A novice nurse may require
the information to be overt or may spend
additional time focusing on the situation and
processing the information in the working
memory (Carayon 2011).
Failure in accurate comprehension of
the situation can occur for several reasons,
including (Flin et al 2008):
The incorrect mental model being retrieved
from the long-term memory.
The correct mental model being used, but its
elements being applied incorrectly.
The absence of a mental model in the
long-term memory that pattern matches for
the perceived situation.
A simple memory failure.
Failure to comprehend the situation accurately
can lead to delayed care or the provision
of inappropriate care and adverse patient
outcomes (Flin et al 2008).
Level 3: projection
Projection involves using the understanding
of what is going on in the situation to project
what might happen in the future and thus
what actions or decisions are required (Endsley
2000). For example, an experienced surgical
nurse may be assessing a post-operative patient
and note tachycardia, hypotension, a significant
amount of fresh blood in the drainage bag and
restlessness. Pattern matching to a mental model
gained from the nurse’s experience in caring
for many post-operative patients provides
the cues in the comprehension stage that the
possible meaning of such signs is post-operative
haemorrhage. In the projection stage, the
possibilities include patient collapse from
massive haemorrhage. Therefore, the nurse
responds by seeking review, assessing the need
to increase fluid input and further physiological
assessment of the patient.
The projection stage provides the opportunity
to anticipate and predict what might happen
and gives time to prepare and decide the best
course of action. Projection can also heighten
perception since people scan and look for
possible cues indicating that the understanding
of the situation gained in the comprehension
and projection stages is stable or changing
(Endsley 2015).
The description of the three levels or stages
of SA may appear to be linear and a slow,
laborious process. In practice, however, the
process can be almost instantaneous and
appear to be automatic, especially in skilled
individuals (Endsley 2015). The process is
also dynamic and can move to and from the
different levels (Endsley 2015). In addition,
while the individual is occupied by other
tasks or if the situation is rapidly changing,
the monitoring of the situation can result in a
fluctuating SA status (Gartenberg et al 2014).
Factors influencing situation awareness
Effective SA is influenced by several factors,
both internal and external to the individual.
These factors can be related to the context of
the situation, individual factors, task factors
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CPD patient safety
and particular cognitive processing factors
that lead to sub-optimal SA. The factors can
be thought of as ‘red flags’ identifying possible
negative effects on SA (Box 1).
Context factors include workload, busy
shifts, rapidly changing environments and
inappropriately designed or maintained
equipment (Endsley 1995). These factors can
increase stress on the individual’s working
memory capacity and result in ineffective
scanning of the environment (Endsley and
Jones 2012). For example, it is easy to imagine
the challenges involved in maintaining SA if
equipment used for monitoring a patient’s vital
signs does not have built-in safety features
such as audible alarms. To enable accurate
information gathering (perception), data
displays need to be visible and easily read from
all angles, and alarms must be audible and
distinguishable from other equipment alarms.
However, a determination of whether displayed
vital signs are normal or abnormal may require
BOX 1
Factors influencing situation awareness
Context
Workload.
Equipment.
Distractions.
Interruptions.
Inadequate teamwork, for example sub-optimal
communication, co-ordination and co-operation.
Time constraints.
Individual
Fatigue.
Level of knowledge.
Experience.
Language barriers.
Individual cognitive limitations and
tendencies, for example mind wandering
and attentional tunnelling.
Individual life events, for example anxiety
and illness.
Task
Complexity, for example multiple steps.
Novel or new task.
Routine task leading to automaticity.
Cognitive limitations and tendencies
Attentional tunnelling.
Limitation of working memory capacity.
Information overload.
Cognitive sensitivity to certain types of noise,
light and colour.
Confirmation bias.
Attribution bias.
(Reason 2004, Boakes 2009, Endsley 2012, Gluyas and
Morrison 2013)
further interpretation (comprehension) and
reliance on working memory to analyse the
information. During a busy shift, or when
clinicians are multi-tasking and attention is
diverted elsewhere, critical changes in the
patient’s vital signs may be missed. Therefore,
when the patient’s vital signs diverge from
acceptable parameters, safety features such as
audible alarms and flashing lights can assist in
maintaining SA (Drews and Doig 2014).
Distractions and interruptions are particularly
intrusive on the maintenance of SA (Thomas
et al 2015). Individuals rely on working
memory to process information at all three
levels of SA. However, the working memory
has limited storage capacity and therefore has
minimal ability to retain information. Thus,
interruptions and distractions lead to rapid
decay of information in the working memory.
That information is replaced with the sensory
information that has captured attention
from the distraction or interruption (Thomas
et al 2015). Of particular importance is the
distraction of the mind, mind wandering or,
as it is commonly called, day dreaming. This
is when individuals are distracted by their
inner thoughts, to the detriment of the task or
actions being undertaken. Mind wandering
occurs when an individual is undertaking tasks
automatically, for example when the tasks are
familiar and do not require conscious attention.
However, automaticity that allows the mind to
wander is also detrimental to noticing cues in the
surrounding environment and therefore can lead
to a loss of accurate SA (Endsley 2015).
Ineffective teamwork is another context factor
that can result in inadequate SA. If individuals
in a team are not working towards a common
goal because each has a different perception,
comprehension and projection of the situation,
ineffective communication, co-operation
and co-ordination in the team are likely to
result (St Pierre et al 2010). The case discussed
previously of the death of Elaine Bromiley
provides an example of ineffective teamwork
and sub-optimal team SA. In this case, the
anaesthetists were cognitively fixated (attentional
tunnelling) on establishing the patient’s airway
and did not notice the passage of time and the
patient’s decreasing oxygen saturation levels. The
nurses were focused on trying to raise the issue
of patient deterioration and the need to consider
a tracheostomy, but were inhibited by the
authority gradient. There was no clear leadership
for effective communication, co-operation
and co-ordination among team members.
These factors combined and led to a situation
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of inadequate SA of the severity of the clinical
situation and ultimately the death of the patient
(Walker 2008, Gluyas 2015).
Individual factors such as anxiety, illness,
fatigue and negative life events can also affect
working memory capacity. Studies have shown
that fatigue is responsible for a multitude of
errors in health care, for example omissions
and needlestick injuries (Rogers 2008, 2011,
Hewitt 2010, Mahlmeister 2010). Referring to
the previous example of the drainage bag full of
blood, a nurse who is fatigued at the end of a busy
12-hour shift may have a diminished working
memory and find it difficult to process additional
information. The nurse’s environmental
scanning may be impaired as a result of the
amount of pre-existing information being
processed and consequently the blood in the
drainage bag may not be noticed. Conversely, a
graduate nurse may see the blood in the drainage
bag but not comprehend its significance through
lack of experience and knowledge and therefore
may be unable to respond appropriately.
The experience and skill of the individual
has a direct effect on the mental models
that are available for pattern matching in
the comprehension stage, and the ability to
predict what might happen in the future in the
projection stage. Given the synergy of these
factors within a complex, dynamic environment
such as health care, it is easy to understand how
challenging yet vital it is to preserve SA.
Task factors that can affect SA may be related
to the complexity of the task. If a situation
requires the individual to undertake a new
or novel task, depending on the difficulty
associated with the task and/or the experience of
the individual, the cognitive load requirements
may result in the individual focusing on the task
to the exclusion of other tasks that need to be
completed. Conversely, a task that is routine and
can be undertaken with a level of automaticity
may result in slips or lapses, where steps in the
task are done in the incorrect order or left out
completely (Gluyas and Morrison 2013).
From a cognitive perspective, accurate SA
relies on the individual being able cognitively
to juggle many different pieces of information
at the same time, which can result in (Simons
2010, Endsley 2012):
Problems with cognitive processing,
including attentional tunnelling where the
individual focuses on one particular aspect
of the situation and ignores other aspects of
the situation.
Limitations of working memory capacity in
terms of storage.
Information overload in terms of cognitive
processing ability.
Sensitivity to certain types of noise, light
and colour, which can lead to erroneous
perception, comprehension and projection of
the cues in the environment.
Complete time out activity 2
Humans have cognitive biases, which help
individuals manage the load of sensory
information to be processed. However, in a
negative sense, cognitive biases can lead to
incorrect SA. Examples of such biases include
confirmation bias where an individual ignores
information that might challenge the SA mental
model and only focuses on information that
confirms the mental model. Fundamental
attribution bias is where the individual relies
on a mental model that is seen as typical of all
similar circumstances; however, this can lead
to incorrect comprehension, projection and SA
(Mannion and Thompson 2014).
Complete time out activity 3
Strategies to mitigate loss
of situation awareness
The first step in improving SA is to raise
the individual’s awareness of the effect of
personal factors on SA. A tool that has been
adopted by the NHS is the Foresight training
programme (Norris 2012). This is based
on the ‘three bucket’ model (Reason 2004),
which encourages individuals to step back and
examine the three aspects of self, context and
task, which potentially could have a negative
effect on SA and increase the likelihood of
errors. Using this model helps individuals
to identify red flags within themselves,
the context and the task that might have a
detrimental effect on their SA.
Using this model, the first aspect the
individual considers is events that may be
happening in their life, such as fatigue, stress
and illness. The second consideration is the
context in which the individual is working,
where factors such as workload, light, noise,
teamwork and the possibility of interruptions
and distractions are contemplated. The third
aspect is the task being undertaken, for example
in terms of difficulty, complexity and criticality,
as well as the resources (equipment and human)
available. Moreover, the skill, knowledge,
understanding and support required to
complete the task are important aspects in
evaluating the stresses that will affect cognitive
processing. It must be remembered that stress
2 Watch The Monkey
Business Illusion at:
tinyurl.com/27h9ufx.
Follow the instructions
provided at the start of
the clip.
3 Review the list
of factors influencing
SA provided in Box 1.
Make a list of scenarios,
preferably clinical
situations, where
these factors may have
influenced negatively
your perception,
comprehension and
projection of the
situations.
NURSING
STANDARD
april No
20 other
:: voluses
30 no
34 :: permission.
2016 55
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without
Copyright © 2017 RCN Publishing Company Ltd
CPD patient safety
decreases scanning of the environment and the
cognitive capacity to hold information in the
working memory (Endsley 2012).
As people evaluate each of the aspects of
self, context and task, they mentally add them
to one of the three buckets representing each
aspect. The fuller the buckets or the more red
flags identified, the higher the likelihood that
there will be inadequate SA and errors as a
result of compromised cognitive load (Reason
2004, Boakes 2009, Gluyas and Morrison
2013). This strategy is particularly valuable
since it can be used by anyone in any situation
and requires no external tools. Raising
conscious awareness of the effect of stressors
and cognitive overload on the potential loss
of SA and increased risk of errors, prompts
individuals to use strategies to maintain SA
(Gluyas and Morrison 2013).
Having identified previously that working
memory has limited capacity to retain
information, it is important that individuals
adopt strategies to minimise interruptions and
distractions where possible. To some degree,
interruptions can be controlled. Individuals,
when undertaking critical or error-prone tasks
such as the administration of medication, can
verbalise to those around them the need for
uninterrupted or protected time. However,
there will always be times when the individual
is interrupted. Flin et al (2008) suggested that
when people resume the task or duties they
were undertaking before the interruption, they
should take the time to establish consciously
where they were in the task sequence. This will
reduce the likelihood of slips and lapses.
Checklists and checking protocols are useful
for overcoming distractions and interruptions
(Thomassen et al 2011). These strategies
provide a formal means of breaking tasks down
into steps or a sequence of steps. People can then
cue cognitively where they are in the sequence
of steps required to complete a task correctly
(Colligan and Bass 2012). However, checklists
and checking protocols require mindful
checking. If checking is done automatically
TABLE 1
Strategies to improve situation awareness
Situation awareness strategy
Description
Application
Self, context, task stressor evaluation,
also known as the ‘three bucket’ model
or Foresight training.
The individual assesses possible stressors within
the categories of self, context and task that
might negatively affect cognitive functioning.
Individual.
Re-evaluating task sequence after
interruptions or distractions.
The individual evaluates consciously where
they were in the task sequence or action before
resuming the task or action.
Individual.
Checklists and checking protocols.
Individuals check formally each stage against a
list of sequenced steps in a task or procedure.
Individual and team.
Updating current mental model.
The individual reviews consciously and questions
the current mental model to ensure that what
should be happening is and, if not, why not?
Individual.
Self-monitoring for mind wandering.
The individual monitors for cues or situations
where mind wandering is likely to occur.
Individual.
‘Sterile cockpit rule’.
Alerting others with visible warnings that
certain high error or critical procedures are
non-interruptible.
Team and organisational.
Checking in with other team members.
The individual verbalises their current mental
model of the situation and their intended actions
to other team members.
Individual.
Huddles.
The team gathers for a quick review of actions,
outcomes and decisions, and plans future
actions accordingly.
Team.
Simulation.
Individuals and the team practise developing
and maintaining situation awareness in realistic
simulated clinical environments.
Individual, team, organisational.
(Reason 2004, Flin et al 2008, Boakes 2009, Gluyas and Morrison 2013)
56 april
20 :: volfrom
30 no
34 :: 2016
STANDARD
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Nursing Question

Jun 14, 2024 | Health Medical

Description

Discuss the access, cost, and quality of quality environments, as well as recent quality initiatives (See Chapter 24 and Table 24.1). Student is to reflect on the relationship between quality measures and evaluation and role development. In addition, describe this relationship and note how the role of the APN might change without effective quality measures.Length: 1500 words, double-spaced, excluding title, citing’s and reference pages (required)Format: APA 7th Edition (Purdue Owl)At least 8 references

Quantitive Article Research

Jun 14, 2024 | Health Medical

Description

All information will be in the photos belowhttps://usflearn.instructure.com/courses/1817688/files/156114270?verifier=Gq1Td234C7mPkWgxKM1vHWW24NNhU0mWQrdUr3Dn&wrap=1 https://usflearn.instructure.com/courses/1817688/files/155292244?verifier=FOIaLMNXVSwL9zgcmG5n7RV4zVRzCvkcZQq9MLZW&wrap=1

Nursing Question

Jun 14, 2024 | Health Medical

Description

There are significant differences in the quality and span of life between individuals and some populations experience a

disproportionate amount of disease burden. This assignment will identify a health disparity and discuss social determinants of health,
epidemiology, cultural considerations, and health care literacy.
Assignment Criteria:
For this assignment, develop a scholarly paper that includes the following criteria:
1. Identify and define health disparity related to the masters prepared nurse’s area of practice or chosen specialty.
a. Some examples include asthma, cancer, cardiovascular disease, stroke, diabetes, obesity, low birth weight, infant
mortality, HIV/AIDS, TB, Depression, Schizophrenia, Substance Use Disorders, suicide, homicide.
2. Discuss three social determinants of health.
3. Describe how the three social determinants of health could influence the identified health disparity.
4. Identify the epidemiology associated with the chosen health disparity.
a. Specify the incidence at the state level
b. Specify the incidence at the national level
5. Describe the cultural considerations related to the chosen health disparity.
6. Describe the health care literacy challenges of the population impacted by chosen health disparity.
7. The scholarly paper should be in narrative format, 4 to 5 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.
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 three 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).

The Integrative Literature Review

Jun 14, 2024 | Health Medical

Description

PLEASE SEE ATTACHED FILE. BASED LITERATURE REVIEW ON THAT TOPIC ATTACHED. ALSO MAKE SURE PLEGARISM IS NO MORE THAN 20%. Thank you!

Much effort should be devoted to this section as it is a key component of your work. This should be a synthesis of the literature, not a catalog of studies or simply an analysis of the research you discover.

Perform a literature review using a minimum of seven (7) peer-reviewed articles and books, as well as non-research literature such as evidence-based guidelines, toolkits, standardized procedures, etc.
Review of areas in relationship to medicine, nursing, public health, etc.
The review should be critical and synthesize rather than just being a catalog of studies.
Summarize the key findings of the research and its relevancy to your project that point out the scientific status of the phenomenon under question. Such a statement includes:
What we know and how well we know it.
What we do not know.
Describe any gaps in knowledge that you found and the effects this may have on advanced practice nursing as it relates to your project topic.

Your integrative literature review should be 5–6 pages in length, not including the cover or reference pages. You must reference a minimum of 7 scholarly articles published within the past 5–7 years.

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: 80

Rubric
Criteria Ratings Pts

This criterion is linked to a Learning OutcomeCritical Analysis

44 to >36.08 pts

Meets Expectations

Presents a thorough and insightful analysis of significant findings related to the change project topic. Ideas are synthesized and professionally sound and creative. Insightful and comprehensive conclusions and solutions are present. Knowledge gaps are identified and the implications on nursing are expertly explored.

36.08 to >33.0 pts

Approaches Expectations

Presents an accurate analysis of significant findings related to the change project topic. Ideas are sound and creative, but are not well synthesized. Conclusions and solutions may be general or unconnected. Knowledge gaps are identified but the implications on nursing may be general or lacking insight.

33 to >25.96 pts

Falls Below Expectations

Provides insufficient analysis of significant findings related to the change project topic. Ideas are not professionally sound and creative. Ideas are in a list format rather than synthesized. Few if any knowledge gaps are identified and the implications on nursing may be erroneous or missing.

25.96 to >0 pts

Does Not Meet Expectations

The literature is listed, but it is neither analyzed nor synthesized.

44 pts

This criterion is linked to a Learning OutcomeContent

20 to >16.4 pts

Meets Expectations

A minimum of 7 peer-reviewed articles, books, or limited non-research literature (tool kits or standardized procedures) are present. Literature is supported by scientific evidence that is credible and timely. Subtopics are used to support the main topic. All in-text citations are present and correctly formatted.

16.4 to >15.0 pts

Approaches Expectations

There are between 5–6 peer-reviewed articles, books, or limited non-research literature (tool kits or standardized procedures) are present. Literature is supported by scientific evidence that is credible and timely. Only a few subtopics are used to support the main topic and/or subtopics are inappropriate. Most in-text citations are present, but might be improperly formatted.

15 to >11.8 pts

Falls Below Expectations

There are between 2–4 peer-reviewed articles, books, or limited non-research literature (tool kits or standardized procedures) are present. Some of the literature is not supported by scientific evidence that is credible and timely. Subtopics are not used to support the main topic. In-text citations are missing or several are improperly formatted.

11.8 to >0 pts

Does Not Meet Expectations

Most literature included is not supported by scientific evidence that is credible and timely, or there are between 0–1 sources identified. Subtopics are not used to support the main topic. In-text citations are incorrect or missing.

20 pts

This criterion is linked to a Learning OutcomeOrganization

8 to >6.56 pts

Meets Expectations

Content is well written throughout. Information is well organized and clearly communicated.

6.56 to >6.0 pts

Approaches Expectations

Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.

6 to >4.72 pts

Falls Below Expectations

Content is disorganized in many places and it lacks clarity.

4.72 to >0 pts

Does Not Meet Expectations

Content lacks clarity and information is disorganized, or may be a list or a catalog of ideas.

8 pts

This criterion is linked to a Learning OutcomeAPA Format/Mechanics

8 to >6.56 pts

Meets Expectations

Follows all the requirements related to format, length, source citations, and layout. Assignment is free of spelling and grammatical errors.

6.56 to >6.0 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.

6 to >4.72 pts

Falls Below Expectations

Follows most of the requirements related to format, length, source citations, and layout. Assignment contains some spelling and grammatical errors.

4.72 to >0 pts

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.

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attachment

Cover Letter

Jun 14, 2024 | Health Medical

Description

Please see attached. thank you! Only the part due 9/28 is what I need help with. thank you!

Unformatted Attachment Preview

Cover Letter
______________________________________________________________________________
Education:
University of South Florida, Tampa, FL
May 2024
– Master of Health Administration
University of South Florida, Tampa, FL
December 2020
– Bachelor Of Science in Public Health
Work Experience:
United Vein and Vascular Centers, (Tampa, FL) PSC
November 2021 – Current
– Provide patients with support and guidance as needed
– Schedule appointments for new and recurring patients based on provided schedule
guidelines
– Maintain hard copy patient records as well as the files stored in our EMR system
– Audit schedule to ensure patient insurance eligibility
– Greet patients upon arrival, sign them in and obtain insurance information and any other
necessary data.
EVOS, (Tampa, FL) Team Leader
April 2020 – October 2021
– Expedite the training of new employees
– Selling, producing and serving food and beverages to guests in restaurant
– Provide one-on-one service to guests and ensure that their needs are taken care of
– Inputting orders in POS system and demonstrating great customer service
– Shape new goals with team leaders and suggested new techniques to improve business
Chipotle, (Tampa, FL) Crew Member
March 2018 – March 2020
– Coached new employees
– Skilled on the register, customer service and daily store preparations
– Aided in increasing projected store sales
– Adapted company values and learned sanitary and safety procedures
Volunteer Experience:
St. Joseph’s Children’s Hospital, (Tampa, FL)
2017 – Present
– Facilitate patient-volunteer interaction by having a cheerful, friendly and compassionate
demeanor in order to improve patient’s attitude
– Assist nurses and medical staff in order to improve safety, comfort and care of patients
– Travel from room to room with checklists and questions designed to assist residents in
daily life
– Engaged in pediatric intensive care unit, respiratory unit and oncology unit
Metropolitan Ministries, (Tampa, FL)
2015 – 2017
– Assisted in the kitchen and collaborated with the chef in order to execute the breakfast
and lunch menus
– Contributed alongside others to complete tasks as a team
– Trained new volunteers in learning the standard procedure when working in a kitchen
Programs:
– Microsoft Word
–
Microsoft PowerPoint
Excel Spreadsheets
eClinicalWorks
Languages:
– Fluent in English: First Language
– Fluent in Spanish: Native Language
Job Posting
Administrative Coordinator
Job Details
Requisition #:629879
Location: Johns Hopkins All Children’s Hospital, Tampa, FL 33601
Category: Clerical and Administrative Support
Schedule: Day Shift
https://jobs.hopkinsmedicine.org/job/administrative-coordinator-clerical-and-administrativesupport-us-fl-tampa-johns-hopkins-6298799608c/?utm_source=indeed.com&ittk=YEPTHQIU2D

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Wellness Question

Jun 14, 2024 | Health Medical

Description

let me know if you have any questions!

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Chapter
5
Cybersafety? WATCH THIS VIDEO!
Chapter 5 covers personal violence, which includes abuse, neglect, violence.
If you have a history of abuse, domestic violence or sexual assault, this is
potentially a very difficult chapter.
If you’d prefer, focus on Internet Safety AND campus safety (pages one and
two of this handout). STOP there.
Or, contact me so we can discuss an alternative assignment.
This is a short chapter/short assignment. You have to read the chapter in order
to get a true sense of the topics. As you read your book, ask yourself:
★
SAFE? What can you do to be safer? What does it even mean to be
safer?
★
CAMPUS: Do you look up while walking and texting at the same time?
Do you know who is around? Do you know where to find campus
safety info?
★
The INTERNET:: How can you staff safe when surfing the web? Online
dating? Answering an email? Making a password?
★
VIOLENCE: What contributes to violence? Do YOU contribute to
violence? What is violence to you–gang violence, abuse and neglect,
personal violence, guns, harassment, drunk driving?
★
HATE CRIME? Have you ever been a victim of a hate crime?
Perpetrated a hate crime? Why is there so much hate?
1
Making a strong password:
PLEASE WATCH VIDEO!
We can all use a little cybersafety. Shall I try to guess your
password? Find things about you on the internet?
What the heck makes a strong password, anyway?
2
Internet Privacy doesn’t really exist.
Cybersecurity is a must!
WATCH THIS VIDEO!
3
For extra credit, put a link or a hashtag in your discussion post for a local agency which provides services to those dealing with sexual assault,
domestic violence, hate crimes, school safety, dating, fire safety, safe driving. etc. Anything that is a link or hashtag fitting to this chapter.
Don’t point out attention to your link or hashtag. Just put it in your discussion.
What can you
do to be safer?
LOOK UP!
If you learn nothing else in this chapter, learn to LOOK UP! PAY ATTENTION.
KNOW YOUR SURROUNDINGS.
There are no rules when it comes to your safety. Do what you have to in order
to be safe. Simple things you can do immediately:
TAKE YOUR EARBUDS OUT/HEADPHONES OFF WHEN WALKING ALONE.
Walk with confidence.
Use campus escort service.
Don’t leave alone with friendly stranger.
Demand a well lit campus.
Use buddy system.
Don’t stop for cars in distress.
Keep car well maintained and full of gas.
Avoid dark parking lots.
Carry pepper spray.
Take a self defense class.
Keep windows & doors locked.
Stick to well traveled routes.
Carry a cell phone.
Be aware of your surroundings.
Walk/jog with a dog.
Check out the safety precautions on RU’s webpage. There are some mighty
good tips included.
If danger seems imminent, take action: Speak in a strong voice. Maintain eye
contact. Stand up straight, act confident, and remain alert.
Draw attention to yourself and your assailant. Scream, “Fire!” After all, if you
yell HELP, there is a greater chance people will run away or ignore you. No
kidding/
Please read your book about these subjects. It’s not that they aren’t important
“enough” to be in this assignment… it’s that they are SO important that I
couldn’t do them justice here.
REMEMBER: if a friend is a victim…Believe them. Recognize they are a victim.
Encourage reporting the crime. Encourage counseling. Be a friend—don’t take
it on yourself! Learn what to do if someone is harmed. Did I mention that you
should believe them? Thank them–they trusted you enough to share their pain,
their recovery, their story.
Men often do not report intimidation, assault or harassment. Why? Fear no one
will believe them. Societal judgment. Humiliation. Not knowing where to go for
help. Men: you are not weak if you seek help in regards to crime!
Violence and abuse comes in many forms: It doesn’t have to be recurrent. It
doesn’t have to leave marks. It doesn’t mean you were weak and couldn’t
stop it. Please take care of yourself. You’re worth it.
Know where to get help. Lang Health Center is a great place to start.
Domestic Violence Resource: https://www.remediesrenewinglives.org/
Sexual Assault Resource: https://rockfordsexualassaultcounseling.org
PLEASE WATCH THE VIDEO ON THIS PAGE
Poverty, political differences, religious differences all play a part in our
view of the world. Depending on who you are and where you are, you
may or may not agree.
We could argue for days about gun violence, gay rights, privilege,
penalty for crimes, texting and driving, the cycle of violence or even if
video games cause violence and anger. Being an asynchronous online
class doesn’t give us that chance.
This a long video but I believe worth watching.
Help be part of the solution. Challenge your thoughts. Challenge your
bias. Be safe. Be kind. Look up!

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Healthcare Insurance

Jun 14, 2024 | Health Medical

Description

create a handout to educate employees on how health insurance impacts preventative care.

Unformatted Attachment Preview

Benefits and Requirements of Insurance (105 points)
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 five 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.
Live Session
Module 5
HCM563
Healthcare Insurance
Instructor Name
Module 5 Learning Outcomes
1. Evaluate the preventative and cost benefits of health insurance for Saudi nationals,
expatriates, and the country.
2. Compare and contrast healthcare costs with the health insurance benefits received
globally.
3. Demonstrate health access and utilization rates with insured versus uninsured
individuals in Saudi Arabia.
4. Create a demonstrative tool illustrating the positive aspects of health insurance.
HCM563: Healthcare Insurance
Preventative Care
(Source: https://pixabay.com/photos/doctor-doctor-s-office-stethoscope-3464761/)
HCM563: Healthcare Insurance
Chronic Disease Care and
Outcomes
● Increased coverage positively impacts those with chronic disease
● Examples include:
○ Improved rates of diabetes diagnosis
○ Increased cancer screenings
● Having to borrow for medical care
● 11.1% of individuals reported borrowing for medical reasons
HCM563: Healthcare Insurance
Financial Protection and the Role
of Insurance
(Source: https://pixabay.com/photos/money-profit-finance-business-2696228/)
HCM/563 Healthcare Insurance
The Concepts of Risk Pools
(Source: https://pixabay.com/photos/risk-word-letters-boggle-game-1945683/)
HCM563: Healthcare Insurance
Risk Pools
►If your group is large enough, then it spreads those with greater health risks to
those healthier individuals (Sickness funds & Private health insurance
►The greater the risk pool, the more stable healthcare premiums will become
►Risk pools do not necessarily mean the premiums will be lower
►The average health of the pool determines whether premiums will be higher or
lower
►Premiums tend to be recalculated annually to account for the health of the risk
pool
►Mandatory insurance, like that in Saudi Arabia, grows the risk pool, as
individuals are required to have health insurance
HCM563: Healthcare Insurance
Adverse Selection
(Source: https://pixabay.com/photos/doors-choices-choose-open-decision-1767563/)
HCM563: Healthcare Insurance
Access to Care
►Access improves health outcomes
►Health insurance can help individuals gain entry into the medical system
►A barrier to healthcare is the high cost of services
►With health insurance, a small copay is usually due
►Under some plans, preventative care is free
HCM563: Healthcare Insurance
Barriers to Dental Health
►Most insurance policies don’t cover dental health
►A study found that Saudi Arabians usually visit a dentist for emergency
treatment and not for preventative care
►Cost, shortage of dentists, difficulty in getting appointment, no need for
treatment, and fear of dentists were the main perceived barriers to access to
dental care
►The study showed that income was the biggest factor to whether Saudis visited
the dentist
►How could health insurance aid in this problem?
Course Code and Title
Well-Being and Self-Reported
Health
(Source: https://pixabay.com/illustrations/age-youth-contrast-old-young-2808492/)
HCM563: Healthcare Insurance
Emergency Departments and
Health Insurance
►Overcrowding of EDs is a reality across the globe
►Long wait times to see primary care providers result in more individuals seeking
care in EDs
►Overcrowded EDs have negative consequences
►Health insurance opening up the private sector could reduce ED usage
HCM563: Healthcare Insurance
Summary
►Health insurance can improve access and utilization of care
►Health insurance helps to insulate individuals and countries
from growing costs of healthcare.
►Breaking down barriers to healthcare will help individuals
achieve better quality of life.
HCM563: Healthcare Insurance
Module 5 Assignment
Requirements
►Assignment
►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
The impact of preventative care on the individual,
and nation; and
HCM563: Healthcare Insurance
coverage;
organization
Figures, examples and statistics supporting your findings.
Creating a Brochure or Handout
►Office has brochure templates.
►https://templates.office.com/en-us/business-tri-fold-brochure-tm00001002
►There is also a tutorial here: https://design.tutsplus.com/tutorials/how-todesign-a-handout-template-in-adobe-indesign–cms-32162
HCM563: Healthcare Insurance
References
► Ahangar, A., Ahmadi, A. M., Mozayani, A. H., & Dizaji, S. F. (2018). The role of risk-sharing mechanisms in finance
health care and towards universal health coverage in low-and middle-income countries of World Health
Organization regions. Journal of Preventive Medicine and Public Health, 51(1), 59.
► Almutlaqah, M. A., Baseer, M. A., Ingle, N. A., Assery, M. K., & Al Khadhari, M. A. (2018). Factors affecting access to
oral health care among adults in Abha City, Saudi Arabia. Journal of International Society of Preventive & Community
Dentistry, 8(5), 431-438.
► American Academy of Actuaries. (n.d.). Risk pooling: How health insurance in the individual market works. Retrieved
from https://www.actuary.org/content/risk-pooling-how-health-insurance-individual-market-works-0
► Erlangga, D., Suhrcke, M., Ali, S., & Bloor, K. (2019). The impact of public health insurance on health care utilisation,
financial protection and health status in low-and middle-income countries: A systematic review. PloS one, 14(8).
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0219731
► Dawoud, S. O., Ahmad, A. M. K., Alsharqi, O. Z., & Al-Raddadi, R. M. (2016). Utilization of the emergency department
and predicting factors associated with its use at the Saudi Ministry of Health General Hospitals. Global Journal of
Health Science, 8(1), 90.
► Office of Disease Prevention and Health Promotion. (2017). Access to healthcare.
https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services
► Sommers, B. D., Gawande, A. A., & Baicker, K. (2017). Health insurance coverage and health—What the recent
evidence tells us. The New England Journal of Medicine, 2017; 377:586-593. DOI: 10.1056/NEJMsb1706645
HCM563: Healthcare Insurance
This concludes our live session.
Thank you for your attendance!
Questions
Take advantage of this opportunity
to seek further clarification.
Next Live Session
►
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HCM563: Healthcare Insurance

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Nursing Question

Jun 14, 2024 | Health Medical

Description

Please answer the questions below.What must be included in the result and discussion section of the research paper?Select a research result and state whether it includes the necessary elements. Why and why not?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 WITHIN Five years. ABSOLUTELY NO AI, CHAT GPT OR OTHER ILLEGAL WRIRING SOURCES THAT DO NOT ADHERE TO ACADEMIC STANDARDS

Organizational Systems and Quality Leadership (TASK 1, TASK 2, TASK 3)

Jun 14, 2024 | Health Medical

Description

TASK 1 (NURSING-QUALITY INDICATORS), TASK 2 (RCA AND FMEA), TASK 3(HEALTHCARE FINANCING)

Unformatted Attachment Preview

9/23/23, 11:48 PM
WGU Performance Assessment
SAT1 — SAT TASK 1: NURSING-QUALITY INDICATORS
ORGANIZATIONAL SYSTEMS AND QUALITY LEADERSHIP — C489
PRFA — SAT1
TASK OVERVIEW
SUBMISSIONS
EVALUATION REPORT
COMPETENCIES
734.3.1 : Principles of Leadership
The graduate applies principles of leadership to promote high-quality healthcare in a variety of settings
through the application of sound leadership principles.
734.3.2 : Interdisciplinary Collaboration
The graduate applies theoretical principles necessary for effective participation in an interdisciplinary team.
734.3.3 : Quality and Patient Safety
The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes,
contributing to and supporting a culture of safety.
INTRODUCTION
National initiatives driven by the American Nurses Association have determined nursing-quality outcome
indicators that are intended to focus plans and programs to increase quality and safety in patient care. The
following outcomes are commonly used nursing-quality indicators:
• complications such as urinary tract infections, pressure ulcers, hospital-acquired pneumonia, and DVT
• patient falls
• surgical patient complications, including infection, pulmonary failure, and metabolic derangement
• length of patient hospital stay
• restraint prevalence
• incidence of failure to rescue, which could potentially result in increased morbidity or mortality
• patient satisfaction
• nurse satisfaction and staffing
SCENARIO
Mr. J is a 72-year-old retired rabbi with a diagnosis of mild dementia. He was admitted for treatment of a
fractured right hip after falling in his home. He has received pain medication and is drowsy, but he answers
simple questions appropriately.
A week after Mr. J was admitted to the hospital, his daughter, who lives eight hours away, came to visit. She
found him restrained in bed. While Mr. J was slightly sleepy, he recognized his daughter and was able to ask
her to remove the restraints so he could be helped to the bathroom. His daughter went to get a certified
nursing assistant (CNA) to remove the restraints and help her father to the bathroom. When the CNA was in
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WGU Performance Assessment
the process of helping Mr. J sit up in bed, his daughter noticed a red, depressed area over Mr. J’s lower spine,
similar to a severe sunburn. She reported the incident to the CNA who replied, “Oh, that is not anything to
worry about. It will go away as soon as he gets up.” The CNA helped Mr. J to the bathroom and then returned
him to bed where she had him lie on his back so she could reapply the restraints.
The diet order for Mr. J was “regular, kosher, chopped meat.” The day after his daughter arrived, Mr. J was
alone in his room when his meal tray was delivered. The nurse entered the room 30 minutes later and
observed that Mr. J had eaten approximately 75% of the meal. The meal served was labeled, “regular,
chopped meat.” The tray contained the remains of a chopped pork cutlet.
The nurse notified the supervisor, who said, “Just keep it quiet. It will be okay.” The nursing supervisor then
notified the kitchen supervisor of the error. The kitchen supervisor told the staff on duty what had happened.
When the patient’s daughter visited later that night, she was not told of the incident.
The next night, the daughter was present at suppertime when the tray was delivered by a dietary worker. The
worker said to the patient’s daughter, “I’m so sorry about the pork cutlet last night.” The daughter asked what
had happened and was told that there had been “a mix up in the order.” The daughter then asked the nurse
about the incident. The nurse, while confirming the incident, told the daughter, “Half a pork cutlet never
killed anyone.”
The daughter then called the physician, who called the hospital administrator. The physician, who is also
Jewish, told the administrator that he has had several complaints over the past six months from his
hospitalized Jewish patients who felt that their dietary requests were not taken seriously by the hospital
employees.
The hospital is a 65-bed rural hospital in a town of few Jewish residents. The town’s few Jewish members
usually receive care from a Jewish hospital 20 miles away in a larger city.
REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no
more than a 10% match to any one individual source can be directly quoted or closely paraphrased from
sources, even if cited correctly. An originality report is provided when you submit your task that can be used
as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that
will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric
aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
Analyze the scenario (suggested length of 2–3 pages) by doing the following:
A. Discuss how the application of nursing-quality indicators could assist the nurses in this case in identifying
issues that may interfere with patient care.
B. Analyze how hospital data of specific nursing-quality indicators (such as incidence of pressure ulcers and
prevalence of restraints) could advance quality patient care throughout the hospital.
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WGU Performance Assessment
C. Analyze the specific system resources, referrals, or colleagues that you, as the nursing shift supervisor,
could use to resolve an ethical issue in this scenario.
D. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or
summarized.
E. Demonstrate professional communication in the content and presentation of your submission.
File Restrictions
File name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg,
wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
RUBRIC
A:UNDERSTANDING OF NURSING QUALITY INDICATORS
NOT EVIDENT
COMPETENT
A discussion of applying nurs-
APPROACHING
COMPETENCE
ing-quality indicators is not
The discussion does not logically
dresses how the application of
provided.
address how the application of
nursing-quality indicators could
nursing-quality indicators could
assist the nurses in the scenario
assist the nurses in the scenario
with identification of issues that
with identification of issues that
may interfere with patient care.
The discussion logically ad-
may interfere with patient care.
B:ADVANCING QUALITY PATIENT CARE
NOT EVIDENT
COMPETENT
An analysis of potential
APPROACHING
COMPETENCE
advancement(s) to patient care
The analysis does not identify
nursing-quality indicators from
is not provided.
specific nursing-quality indica-
the scenario and logically dis-
tors from the scenario or does
cusses how hospital data on the
not logically discuss how hospi-
identified indicators could ad-
tal data on the identified indica-
vance quality patient care
tors could advance quality pa-
throughout the hospital.
The analysis identifies specific
tient care throughout the
hospital.
C:RESOLUTION OF ETHICAL ISSUES
NOT EVIDENT
APPROACHING
COMPETENCE
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COMPETENT
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WGU Performance Assessment
An analysis of the use of system
The analysis describes one or
The analysis describes specific
resources, referrals, or col-
more system resources, refer-
system resources, referrals, or
league for resolving ethical is-
rals, and/or colleagues that are
colleagues that are appropriate
sues is not provided.
inappropriate for the candidate
for the candidate to use in the
to use in the role of nursing shift
role of the nursing shift supervi-
supervisor to resolve the ethical
sor to resolve the ethical issue
issue from the scenario.
from the scenario.
COMPETENT
The submission does not include
APPROACHING
COMPETENCE
both in-text citations and a ref-
The submission includes in-text
citations for sources that are
erence list for sources that are
citations for sources that are
properly quoted, paraphrased, or
quoted, paraphrased, or
quoted, paraphrased, or summa-
summarized and a reference list
summarized.
rized and a reference list; how-
that accurately identifies the au-
ever, the citations or reference
thor, date, title, and source loca-
list is incomplete or inaccurate.
tion as available.
COMPETENT
Content is unstructured, is dis-
APPROACHING
COMPETENCE
jointed, or contains pervasive
Content is poorly organized, is
tail, is organized, and focuses on
errors in mechanics, usage, or
difficult to follow, or contains er-
the main ideas as prescribed in
grammar. Vocabulary or tone is
rors in mechanics, usage, or
the task or chosen by the candi-
unprofessional or distracts from
grammar that cause confusion.
date. Terminology is pertinent, is
the topic.
Terminology is misused or
used correctly, and effectively
ineffective.
conveys the intended meaning.
D:SOURCES
NOT EVIDENT
The submission includes in-text
E:PROFESSIONAL COMMUNICATION
NOT EVIDENT
Content reflects attention to de-
Mechanics, usage, and grammar
promote accurate interpretation
and understanding.
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SAT1 — SAT TASK 2: RCA AND FMEA
ORGANIZATIONAL SYSTEMS AND QUALITY LEADERSHIP — C489
PRFA — SAT1
TASK OVERVIEW
SUBMISSIONS
EVALUATION REPORT
COMPETENCIES
734.3.1 : Principles of Leadership
The graduate applies principles of leadership to promote high-quality healthcare in a variety of settings
through the application of sound leadership principles.
734.3.2 : Interdisciplinary Collaboration
The graduate applies theoretical principles necessary for effective participation in an interdisciplinary team.
734.3.3 : Quality and Patient Safety
The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes,
contributing to and supporting a culture of safety.
INTRODUCTION
Healthcare organizations accredited by the Joint Commission are required to conduct a root cause analysis
(RCA) in response to any sentinel event, such as the one described in the scenario attached below. Once the
cause is identified and a plan of action established, it is useful to conduct a failure mode and effects analysis
(FMEA) to reduce the likelihood that a process would fail. As a member of the healthcare team in the hospital
described in this scenario, you have been selected as a member of the team investigating the incident.
SCENARIO
It is 3:30 p.m. on a Thursday and Mr. B, a 67-year-old patient, arrives at the six-room emergency department
(ED) of a sixty-bed rural hospital. He has been brought to the hospital by his son and neighbor. At this time,
Mr. B is moaning and complaining of severe pain to his (L) leg and hip area. He states he lost his balance and
fell after tripping over his dog.
Mr. B was admitted to the triage room where his vital signs were B/P 120/80, HR-88 (regular), T-98.6, and R32, and his weight was recorded at 175 pounds. Mr. B. states that he has no known allergies and no previous
falls. He states, “My hip area and leg hurt really bad. I have never had anything like this before.” Patient rates
pain at 10 out of 10 on the numerical verbal pain scale. He appears to be in moderate distress. His (L) leg
appears shortened with swelling (edema in the calf), ecchymosis, and limited range of motion (ROM). Mr. B’s
leg is stabilized and then is further evaluated and discharged from triage to the emergency department (ED)
patient room. He is admitted by Nurse J. Nurse J finds that Mr. B has a history of impaired glucose tolerance
and prostate cancer. At Mr. B’s last visit with his primary care physician, laboratory data revealed elevated
cholesterol and lipids. Mr. B’s current medications are atorvastatin and oxycodone for chronic back pain.
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WGU Performance Assessment
After Mr. B’s assessment is completed, Nurse J informs Dr. T, the ED physician, of admission findings, and Dr.
T proceeds to examine Mr. B.
Staffing on this day consists of two nurses (one RN and one LPN), one secretary, and one emergency
department physician. Respiratory therapy is in-house and available as needed. At the time of Mr. B’s arrival,
the ED staff is caring for two other patients. One patient is a 43-year-old female complaining of a throbbing
headache. The patient rates current pain at 4 out of 10 on numerical verbal pain scale. The patient states that
she has a history of migraines. She received treatment, remains stable, and discharge is pending. The second
patient is an eight-year-old boy being evaluated for possible appendicitis. Laboratory results are pending for
this patient. Both of these patients were examined, evaluated, and cared for by Dr. T and are awaiting further
treatment or orders.
After evaluation of Mr. B, Dr. T writes the order for Nurse J to administer diazepam 5 mg IVP to Mr. B. The
medication diazepam is administered IVP at 4:05 p.m. After five minutes, the diazepam appears to have had
no effect on Mr. B, and Dr. T instructs Nurse J to administer hydromorphone 2 mg IVP. The medication
hydromorphone is administered IVP at 4:15 p.m. After five minutes, Dr. T is still not satisfied with the level of
sedation Mr. B has achieved and instructs Nurse J to administer another 2 mg of hydromorphone IVP and an
additional 5 mg of diazepam IVP. The physician’s goal is for the patient to achieve skeletal muscle relaxation
from the diazepam, which will aid in the manual manipulation, relocation, and alignment of Mr. B’s hip. The
hydromorphone IVP was administered to achieve pain control and sedation. After reviewing the patient’s
medical history, Dr. T notes that the patient’s weight and current regular use of oxycodone appear to be
making it more difficult to sedate Mr. B.
Finally, at 4:25 p.m., the patient appears to be sedated, and the successful reduction of his (L) hip takes place.
The patient appears to have tolerated the procedure and remains sedated. He is not currently on any
supplemental oxygen. The procedure concludes at 4:30 p.m.,and Mr. B is resting without indications of
discomfort and distress. At this time, the ED receives an emergency dispatch call alerting the emergency
department that the emergency rescue unit paramedics are enroute with a 75-year-old patient in acute
respiratory distress. Nurse J places Mr. B on an automatic blood pressure machine programmed to monitor
his B/P every five minutes and a pulse oximeter. At this time, Nurse J leaves Mr. B’s room. The nurse allows
Mr. B’s son to sit with him as he is being monitored via the blood pressure monitor. At 4:35 p.m., Mr. B’s B/P is
110/62 and his O2 saturation is 92%. He remains without supplemental oxygen and his ECG and respirations
are not monitored.
Nurse J and the LPN on duty have received the emergency transport patient. They are also in the process of
discharging the other two patients. Meanwhile, the ED lobby has become congested with new incoming
patients. At this time, Mr. B’s O2 saturation alarm is heard and shows “low O2 saturation” (currently showing
a saturation of 85%). The LPN enters Mr. B’s room briefly, resets the alarm, and repeats the B/P reading.
Nurse J is now fully engaged with the emergency care of the respiratory distress patient, which includes
assessments, evaluation, and the ordering of respiratory treatments, CXR, labs, etc.
At 4:43 p.m., Mr. B’s son comes out of the room and informs the nurse that the “monitor is alarming.” When
Nurse J enters the room, the blood pressure machine shows Mr. B’s B/P reading is 58/30 and the O2
saturation is 79%. The patient is not breathing and no palpable pulse can be detected.
A STAT CODE is called and the son is escorted to the waiting room. The code team arrives and begins
resuscitative efforts. When connected to the cardiac monitor, Mr. B is found to be in ventricular fibrillation.
CPR begins immediately by the RN, and Mr. B is intubated. He is defibrillated and reversal agents, IV fluids,
and vasopressors are administered. After 30 minutes of interventions, the ECG returns to a normal sinus
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WGU Performance Assessment
rhythm with a pulse and a B/P of 110/70. The patient is not breathing on his own and is fully dependent on
the ventilator. The patient’s pupils are fixed and dilated. He has no spontaneous movements and does not
respond to noxious stimuli. Air transport is called, and upon the family’s wishes, the patient is transferred to a
tertiary facility for advanced care.
Seven days later, the receiving hospital informed the rural hospital that EEG’s had determined brain death in
Mr. B. The family had requested life-support be removed, and Mr. B subsequently died.
Additional information: The hospital where Mr. B. was originally seen and treated had a moderate
sedation/analgesia (“conscious sedation”) policy that requires that the patient remains on continuous B/P,
ECG, and pulse oximeter throughout the procedure and until the patient meets specific discharge criteria
(i.e., fully awake, VSS, no N/V, and able to void). All practitioners who perform moderate sedation must first
successfully complete the hospital’s moderate sedation training module. The training module includes drug
selection as well as acceptable dose ranges. Additional (backup) staff was available on the day of the incident.
Nurse J had completed the moderate sedation module. Nurse J had current ACLS certification and was an
experienced critical care nurse. Nurse J’s prior annual clinical evaluations by the manager demonstrated that
the nurse was “meeting requirements.” Nurse J did not have a history of negligent patient care. Sufficient
equipment was available and in working order in the ED on this day.
REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no
more than a 10% match to any one individual source can be directly quoted or closely paraphrased from
sources, even if cited correctly. An originality report is provided when you submit your task that can be used
as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that
will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric
aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
A. Explain the general purpose of conducting a root cause analysis (RCA).
1. Explain each of the six steps used to conduct an RCA, as defined by IHI.
2. Apply the RCA process to the scenario to describe the causative and contributing factors that led to
the sentinel event outcome.
B. Propose a process improvement plan that would decrease the likelihood of a reoccurrence of the scenario
outcome.
1. Discuss how each phase of Lewin’s change theory on the human side of change could be applied to the
proposed improvement plan.
C. Explain the general purpose of the failure mode and effects analysis (FMEA) process.
1. Describe the steps of the FMEA process as defined by IHI.
2. Complete the attached FMEA table by appropriately applying the scales of severity, occurrence, and
detection to the process improvement plan proposed in part B.
Note: You are not expected to carry out the full FMEA.
D. Explain how you would test the interventions from the process improvement plan from part B to improve
care.
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E. Explain how a professional nurse can competently demonstrate leadership in each of the following areas:
• promoting quality care
• improving patient outcomes
• influencing quality improvement activities
1. Discuss how the involvement of the professional nurse in the RCA and FMEA processes demonstrates
leadership qualities.
F. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or
summarized.
G. Demonstrate professional communication in the content and presentation of your submission.
File Restrictions
File name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg,
wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
RUBRIC
A:ROOT CAUSE ANALYSIS
NOT EVIDENT
COMPETENT
An explanation of the general
APPROACHING
COMPETENCE
purpose of conducting an RCA is
The explanation does not accu-
scribes the general purpose for
not provided.
rately describe the general pur-
conducting an RCA.
The explanation accurately de-
pose for conducting an RCA.
A1:RCA STEPS
NOT EVIDENT
COMPETENT
An explanation of 6 RCA steps is
APPROACHING
COMPETENCE
not provided.
The explanation does not accu-
tifies and logically describes each
rately identify or does not logi-
of the 6 steps used to conduct an
cally describe one or more of the
RCA, as defined by IHI.
The explanation accurately iden-
6 steps used to conduct an RCA,
as defined by IHI.
A2:CAUSATIVE AND CONTRIBUTING FACTORS
NOT EVIDENT
APPROACHING
COMPETENCE
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COMPETENT
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An application of the RCA
The application of the RCA
The application of the RCA
process to the scenario is not
process to the scenario does not
process to the scenario accu-
provided.
accurately describe causative or
rately describes the causative
contributing factors that led to
and contributing factors that led
the sentinel event outcome, or
to the sentinel event outcome.
the application does not accurately differentiate between
causative and contributing
factors.
B:IMPROVEMENT PLAN
NOT EVIDENT
COMPETENT
A proposed process improve-
APPROACHING
COMPETENCE
ment plan is not provided.
The proposal does not outline a
process improvement plan and
logical process improvement
logically discusses how the pro-
plan, or the proposal does not
posed plan will decrease the like-
logically discuss how the pro-
lihood of a reoccurrence of the
posed plan will decrease the
scenario outcome.
The proposal outlines a logical
likelihood of a reoccurrence of
the scenario outcome.
B1:CHANGE THEORY
NOT EVIDENT
COMPETENT
A discussion of the application
APPROACHING
COMPETENCE
of Lewin’s change theory is not
The discussion does not logically
how each phase of Lewin’s
provided.
describe how Lewin’s change
change theory could be applied
theory could be applied to the
to the proposed improvement
proposed improvement plan, or
plan.
The discussion logically describes
the discussion does not
describe each phase of the
theory.
C:GENERAL PURPOSE OF FMEA
NOT EVIDENT
COMPETENT
An explanation of the general
APPROACHING
COMPETENCE
purpose of the FMEA process is
The explanation does not accu-
scribes a general purpose of the
not provided.
rately describe a general pur-
FMEA process and logically dis-
pose of the FMEA process, or
cusses why the FMEA process
the explanation does not logi-
would be used.
The explanation accurately de-
cally discuss why the FMEA
process would be used.
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C1:STEPS OF FMEA PROCESS
NOT EVIDENT
COMPETENT
A description of the steps is not
APPROACHING
COMPETENCE
provided.
The description of the steps of
defines each of the steps of the
the FMEA process does not ac-
FMEA process.
The description accurately
curately define each of the
steps.
C2:FMEA TABLE
NOT EVIDENT
COMPETENT
A completed FMEA table is not
APPROACHING
COMPETENCE
provided.
The FMEA table is incomplete,
propriately identifies failure
does not identify appropriate
modes related to the improve-
failure modes related to the im-
ment plan proposed in part B and
provement plan proposed in
demonstrates accurate applica-
prompt B, or does not accu-
tion of the scales of severity, oc-
rately apply the scales of sever-
currence, and detection in evalu-
ity, occurrence, and detection in
ating the identified failure
evaluating the identified failure
modes.
The completed FMEA table ap-
modes.
D:INTERVENTION TESTING
NOT EVIDENT
COMPETENT
An explanation of intervention
APPROACHING
COMPETENCE
testing is not provided.
The explanation does not de-
of the testing procedures or
scribe steps of an appropriate
practices that the candidate
testing procedure or practice
would use that are appropriate
that would be used by the candi-
for testing the interventions
date to test interventions from
from the process improvement
the process improvement plan
plan in part B. The explanation
in part B, or the explanation
logically describes how the inter-
does not logically describe how
vention testing procedures or
the intervention testing proce-
practices would improve care.
The explanation describes steps
dures or practices would improve care.
E:DEMONSTRATE LEADERSHIP
NOT EVIDENT
An explanation of how a profes-
APPROACHING
COMPETENCE
sional nurse demonstrates leadhttps://tasks.wgu.edu/student/009077330/course/10460005/task/1235/overview
COMPETENT
The explanation logically describes how a professional nurse
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ership is not provided.
WGU Performance Assessment
The explanation does not logi-
competently demonstrates lead-
cally describe how a profes-
ership in each of the given areas.
sional nurse competently
demonstrates leadership in one
or more of the given areas.
E1:INVOLVING PROFESSIONAL NURSE IN RCA AND FMEA PROCESSES
NOT EVIDENT
COMPETENT
A discussion of involvement in
APPROACHING
COMPETENCE
the RCA and FMEA processes is
The discussion does not logically
how the involvement of the pro-
not provided.
describe how the involvement of
fessional nurse in both the RCA
the professional nurse
and FMEA processes demon-
in either the RCA process or the
strates leadership qualities.
The discussion logically describes
FMEA process demonstrates
leadership qualities.
F:SOURCES
NOT EVIDENT
COMPETENT
The submission does not include
APPROACHING
COMPETENCE
both in-text citations and a ref-
The submission includes in-text
citations for sources that are
erence list for sources that are
citations for sources that are
properly quoted, paraphrased, or
quoted, paraphrased, or
quoted, paraphrased, or summa-
summarized and a reference list
summarized.
rized and a reference list; how-
that accurately identifies the au-
ever, the citations or reference
thor, date, title, and source loca-
list is incomplete or inaccurate.
tion as available.
COMPETENT
Content is unstructured, is dis-
APPROACHING
COMPETENCE
jointed, or contains pervasive
Content is poorly organized, is
tail, is organized, and focuses on
errors in mechanics, usage, or
difficult to follow, or contains er-
the main ideas as prescribed in
grammar. Vocabulary or tone is
rors in mechanics, usage, or
the task or chosen by the candi-
unprofessional or distracts from
grammar that cause confusion.
date. Terminology is pertinent, is
the topic.
Terminology is misused or
used correctly, and effectively
ineffective.
conveys the intended meaning.
The submission includes in-text
G:PROFESSIONAL COMMUNICATION
NOT EVIDENT
Content reflects attention to de-
Mechanics, usage, and grammar
promote accurate interpretation
and understanding.
WEB LINKS
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IHI FMEA Tool
Working with the IHI knowledge base
Please note: Before you engage with IHI, please be sure to review the Working with IHI knowledge base
article to assist with setting up your IHI account. PLEASE FOLLOW THE INSTRUCTIONS CLOSELY IN THE
DOCUMENT. Any deviation from the registration process may result in issues later including enrollment in
courses. We encourage all students to keep a personal copy of the certificate on their computers, as you will
need it later in your program. Please reach out to your assigned CI for assistance as needed.
SUPPORTING DOCUMENTS
FMEA Table.docx
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WGU Performance Assessment
SAT1 — SAT TASK 3: HEALTHCARE FINANCING
ORGANIZATIONAL SYSTEMS AND QUALITY LEADERSHIP — C489
PRFA — SAT1
TASK OVERVIEW
SUBMISSIONS
EVALUATION REPORT
COMPETENCIES
734.3.4 : Healthcare Utilization and Finance
The graduate analyzes financial implications related to healthcare delivery, reimbursement, access, and
national initiatives.
INTRODUCTION
It is essential that nurses understand the issues related to healthcare financing, including local, state, and
national healthcare policies and initiatives that affect healthcare delivery. As a patient advocate, the
professional nurse is in a position to work with patients and families to access available resources to meet
their healthcare needs.
REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no
more than a 10% match to any one individual source can be directly quoted or closely paraphrased from
sources, even if cited correctly. An originality report is provided when you submit your task that can be used
as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that
will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric
aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
A. Compare the U.S. healthcare system with the healthcare system of England, Japan, Germany, or
Switzerland, by doing the following:
1. Identify one country from the following list whose healthcare system you will compare to the U.S.
healthcare system: England, Japan, Germany, or Switzerland.
2. Compare access between the two healthcare systems for children, people who are unemployed, and
people who are retired.
a. Discuss coverage for medications in the two healthcare systems.
b. Determine the requirements to get a referral to see a specialist in the two healthcare systems.
c. Discuss coverage for preexisting conditions in the two healthcare systems.
3. Explain two financial implications for patients with regard to the healthcare delivery differences
between the two countries (i.e.; how are the patients financially impacted).
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WGU Performance Assessment
B. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or
summarized.
C. Demonstrate professional communication in the content and presentation of your submission.
File Restrictions
File name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg,
wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
RUBRIC
A1:COUNTRY TO COMPARE
NOT EVIDENT
COMPETENT
A country for comparison is not
APPROACHING
COMPETENCE
identified.
The identified country for com-
parison is from the given list.
The identified country for com-
parison is not from the given list.
A2:ACCESS
NOT EVIDENT
COMPETENT
A comparison of healthcare sys-
APPROACHING
COMPETENCE
tem access is not provided.
The comparison does not accu-
scribes access to healthcare sys-
rately describe access to health-
tems in both the U.S. and the
care systems in both the U.S.
country chosen in part A1 for
and the country chosen in A1
children, people who are unem-
for one or more of the given
ployed, and people who are re-
groups of people, or the compar-
tired. The comparison logically
ison does not logically
describes the similarities and dif-
describe both the similarities
ferences between access
and differences between access
to each of the healthcare systems
to each of the healthcare sys-
for all of the given groups of
tems for all of the given groups
people.
The comparison accurately de-
of people.
A2A:COVERAGE OF MEDICATIONS
NOT EVIDENT
APPROACHING
COMPETENCE
https://tasks.wgu.edu/student/009077330/course/10460005/task/

Revenue Cycle

Jun 14, 2024 | Health Medical

Description

Describe the importance of revenue cycle management in the acute care environment and the impact it can have on the healthcare organization. In your description be sure to identify the consequences of improper revenue cycle management as it pertains to the healthcare organization as a whole. 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.

Response- Healthcare Payment System

Jun 14, 2024 | Health Medical

Description

1. Emilia

In 1997, the Social Security Act was amended to implement Prospective Payment Systems to control the costs of hospital resources, while maintaining a level of quality care (Harrington, 2021). Since its implementation, prospective payment systems have evolved to something much greater, implementing several systems for services such as home health, physician and non-physician practitioners, and ambulatory surgical settings.The distinction between prospective payment systems for outpatients, home care, medical and non-medical, and outpatient surgical facilities is that the home care authorities provide specialized care to patients who are considered home-bound. “It is essential for healthcare leaders to differentiate the settings and meet the site specific regulations” (Harrington, 2021, p. 141). This is largely different in comparison to practitioners and surgical settings as providers are subject to their own rules, regulations, and billing scale all bound by the patient’s legal health record, entries, and coding systems for entries.

Hospital Outpatient Prospective Payment System (OPPS)

In 1999, the Balanced Budget Refinement Act added amendments to the original Prospective Payment Systems to include the development of the Hospital Outpatient Prospective Payment System, also known as OPPS (Harrington, 2021). OPPS was implemented with a diagnosis-related group (DRG)-like payment system known as Ambulatory Payment Classifications (APCs). This allows a group of codes in a payment category such as xrays, to be same rate based, creating a payment system that is more budget neutral based (Kassing & Berry, 2020). This payment system is used by Medicare to decide how much money a hospital or community mental health center will get for outpatient care provided to patients with Medicare. Services to be included are designated hospital outpatient items and services excluding clinical diagnostic laboratory services, outpatient therapy services, and screening and diagnostic mammography (Kassing & Berry, 2020). This payment system has become the foundation for other payment systems like HHPPS and payment systems used in ambulatory surgical settings. 1 Corinthians 3:11 says, “For other foundation can no man lay than that is laid, which is Jesus Christ” (King James Bible, 1769/2016). Just like with payment systems, anything we do must be done through Him. We cannot stand on any other foundation besides Jesus Christ, otherwise it will crumble.

Home Health Prospective Payment System (HH PPS)

Originally mandated in 1997, the HH PPS was a payment system implemented to assist payment and provide care for patients who are homebound unlike the OPPS which is for all other patients. These services are DMEs, skilled nursing care, various types of therapy, social work, and home health aide services (Harrington, 2021). These agencies are paid based on claims for episode-of-care time periods which is typically 60 days leaving the responsibility in the hands of the agencies as well as providers for proper documentation. This is all assessed via the OUtcome and Assessment Information Set (OASIS) to assess the level of care needed upon initial care provided as well as a continuous assessment (Harrington, 2021). This allows for proper funding to be provided as well as an increase in quality of care provided.

Physician/Non-Physician Practitioners

Physicians and non-physician practitioners are subject to their own billing scale known as the resource-based relative value scale (RBRVS) (Harrington, 2021). “RBRVS became effective on January 1,1992. To avoid major disruptions to physicians’ reimbursements, the RBRVS was gradually phased in, beginning in 1992 with full implementation by 1996 (Harrington, 2021, p. 152-153). This system was implemented to generate a more unbiased standard of assessments of encounters made by providers in comparison to the fee‐for‐service system it replaced. This allows for a comparison of resources needed to provide appropriate levels of care, taking into account labor, equipment, supplies, and more (Gao, 2018). This shifts the profit and loss system directly tied to providers and the correct entry in a patient’s medical record.

Ambulatory Surgical Centers (ASCs)

Lastly, in 2008, the ambulatory surgical centers (ASCs), centers for outpatient surgical services, established payment rates and indicators under the CPT and HCPCS codes. In order for these codes and payments to properly process an ASC must be properly certified as well as accepting of Medicare payments as payment in full (Harrington, 2021). This is all defined under CMS, separate from all other payment systems discussed previously, as all services not covered in ASCs under Medicare Part B are billed to the beneficiary (Harrington, 2021). This allows for ASCs to get paid each year as well as an expansion on the scope of services provided.

References

Gao, Y. N. (2018). Committee representation and medicare Reimbursements—An examination of the Resource‐Based relative value scale. Health Services Research, 53(6), 4353-4370. https://doi.org/10.1111/1475-6773.12857

Harrington, Michael K. Health care finance and the mechanics of insurance and reimbursement. (2nd ed.). Burlington, MA: Jones & Bartlett, 2021.

Kassing, P., & Berry, C. D. (2020). Hospital outpatient prospective payment system: A maturing prospective payment system. Journal of the American College of Radiology, 17(4), 534-541. https://doi.org/10.1016/j.jacr.2019.11.015

King James bible. (2016). Thomas Nelson. (Original work published 1769).

2. Xena

Inpatient, outpatient, home health, physician and non-physician practitioners, and ambulatory surgical settings all have separate prospective payment systems (PPS). Each environment has distinct qualities and payment systems, which I shall contrast and compare below. These many PPSs have developed to fit the unique requirements and complexity of each healthcare domain, demonstrating the significance of customizing compensation strategies to the services offered, patient populations served, and objectives of cost containment and quality improvement within each secto (Harrington, 2021)r.

The majority of services offered in hospital outpatient departments are covered by outpatient PPS. According on clinical criteria and resource usage, services are divided into Ambulatory Payment Classifications (APCs) under the Outpatient Prospective Payment System. Medicare pays a fixed amount for each service included in an APC, and payment rates are established for each APC (Erickson et al., 2020). This method encourages healthcare professionals to offer effective treatment while retaining quality. Due to the fact that compensation are fixed regardless of how much a certain patient costs, it might provide problems for institutions that serve higher-priced patients.

Medicare payments for home health services are governed by the Home Health PPS. Based on patient evaluations, it divides patients into 60-day care episodes and assigns Home Health Resource Groups (HHRGs). According on patient characteristics and anticipated resource use, payment rates are defined for each HHRG. For each episode, home health agencies are paid consistently, which promotes efficiency. Home Health PPS, as opposed to outpatient PPS, is more individualized to the needs of each patient since it takes into consideration their unique ailments and care needs (Jia et al., 2021).

The Medicare Physician Fee Schedule (MPFS) covers both physician and non-physician practitioner services. Relative Value Units (RVUs), which are based on things like doctor effort, practice costs, and malpractice charges, are assigned to each service under this method (Jia et al., 2021). Then, a conversion factor is used to translate RVUs into payment rates. Payments from the MPFS are made on a fee-for-service basis, with amounts fluctuating depending on how sophisticated the service was (Harrington, 2021). Similar to doctors, non-physician practitioners like nurse practitioners and physician assistants can bill on their own terms within their areas of expertise. The MPFS seeks to guarantee that compensation accurately represents the labor required to provide various medical services.

The ASC Payment System, which employs Ambulatory Payment Classifications (APCs) to categorize surgical operations, is used to pay Ambulatory Surgical Centers (ASCs). Medicare pays a fixed charge for each treatment, and payment rates are established for each APC (Erickson et al., 2020). To participate, ASCs must adhere to certain quality and safety requirements. ASCs are frequently more cost-effective than hospital settings for some operations since they have reduced overhead expenses (Jia et al., 2021). However, this approach might not be able to handle complicated or resource-intensive operations that are more appropriate for inpatient hospital settings.

In conclusion, various outpatient, home health, physician and non-physician practitioner, and ambulatory surgical settings have different future payment schemes. All of them strive to keep expenses in check while preserving or raising the standard of treatment. Physicians and non-physicians are paid based on fee-for-service, taking RVUs into account, whereas outpatient and home health PPSs group services and pay flat prices. Ambulatory surgical settings offer a special pricing structure that emphasizes economically sensible operations. Depending on the precise healthcare services offered and the patient group served, each system has both strengths and limitations.

One passage from the Bible that has to do with financial management is “The wise store up choice food and olive oil, but fools gulp theirs down” (Proverbs 21:20). The verse stresses the significance of caution and prudent money management. It implies that people should save and manage their resources carefully for the future rather than wasting them now. It’s important to manage one’s money with caution and foresight, just as one would store up crucial supplies like food and oil. This biblical insight promotes prudent financial management and stewardship.

References

Erickson, S. M., Outland, B., Joy, S., Rockwern, B., Serchen, J., Mire, R. D., Goldman, J. M., & Medical Practice and Quality Committee of the American College of Physicians (2020). Envisioning a Better U.S. Health Care System for All: Health Care Delivery and Payment System Reforms. Annals of internal medicine, 172(2 Suppl), S33–S49. https://doi.org/10.7326/M19-2407

Harrington, M. K. (2021). Health Care Finance: And the mechanics of Insurance and

Jia, L., Meng, Q., Scott, A., Yuan, B., & Zhang, L. (2021). Payment methods for healthcare providers working in outpatient healthcare settings. The Cochrane database of systematic reviews, 1(1), CD011865. https://doi.org/10.1002/14651858.CD011865.pub2

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.

Infection Control

Jun 14, 2024 | Health Medical

Description

Create a short slide presentation (Power point, Prezi, etc.) on infection control and hand hygiene for digital radiography. Include pictures. You may also include audio or imbedded videos. Please cite any outside sources appropriately.

Case Study #7

Jun 14, 2024 | Health Medical

Description

Read Case 7 in the Pruitt, Smith, & Perez-Ruberte text and answer the Discussion Questions associated with the case.

7 file Ct 1

Jun 14, 2024 | Health Medical

Description

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:

o Situation

o Background

o Assessment

o 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.

Noteeee.

Jun 14, 2024 | Health Medical

Description

SOAP note Topic: Difficulty sleeping and restlessness

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.

Attached below is the template to use for the assignment.

Unformatted Attachment Preview

SOAP Note Template
Encounter date: ________________________
Patient Initials: ______ Gender: M/F/Transgender ____ Age: _____ Race: _____ Ethnicity ____
Reason for Seeking Health Care: ______________________________________________
HPI:_________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Allergies(Drug/Food/Latex/Environmental/Herbal): ___________________________________
Current perception of Health:
Excellent
Good
Fair Poor
Past Medical History
• Major/Chronic Illnesses____________________________________________________
• Trauma/Injury ___________________________________________________________
• Hospitalizations __________________________________________________________
Past Surgical History___________________________________________________________
Medications: __________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Family History: ____________________________________________________________
Social history:
Copyright © MVJ 2018
Lives: Single family House/Condo/ with stairs: ___________ Marital Status:________
Employment Status: ______ Current/Previous occupation type: _________________
Exposure to: ___Smoke____ ETOH ____Recreational Drug Use: __________________
Sexual orientation: _______ Sexual Activity: ____ Contraception Use: ____________
Family Composition: Family/Mother/Father/Alone: _____________________________
Health Maintenance
Screening Tests: Mammogram, PSA, Colonoscopy, Pap Smear, Etc _____
Exposures:
Immunization HX:
Review of Systems:
General:
HEENT:
Neck:
Lungs:
Cardiovascular:
Breast:
GI:
Male/female genital:
GU:
Neuro:
Musculoskeletal:
Copyright © MVJ 2018
Activity & Exercise:
Psychosocial:
Derm:
Nutrition:
Sleep/Rest:
LMP:
STI Hx:
Physical Exam
BP________TPR_____ HR: _____ RR: ____Ht. _____ Wt. ______ BMI (percentile) _____
General:
HEENT:
Neck:
Pulmonary:
Cardiovascular:
Breast:
GI:
Male/female genital:
GU:
Neuro:
Musculoskeletal:
Copyright © MVJ 2018
Derm:
Psychosocial:
Misc.
Significant Data/Contributing
Dx/Labs/Misc.
Plan:
Differential Diagnoses
1.
2.
3.
Principal Diagnoses
1.
2.
Plan
Diagnosis
Diagnostic Testing:
Pharmacological Treatment:
Education:
Referrals:
Copyright © MVJ 2018
Follow-up:
Anticipatory Guidance:
Diagnosis
Diagnostic Testing:
Pharmacological Treatment:
Education:
Referrals:
Follow-up:
Anticipatory Guidance:
Signature (with appropriate credentials): __________________________________________
Cite current evidenced based guideline(s) used to guide care (Mandatory)_______________
Copyright © MVJ 2018
DEA#: 101010101
FSU Clinic
LIC# 10000000
Tel: (000) 555-1234
FAX: (000) 555-12222
Patient Name: (Initials)______________________________
Age ___________
Date: _______________
RX ______________________________________
SIG:
Dispense: ___________
Refill: _________________
No Substitution
Signature: ____________________________________________________________
Copyright © MVJ 2018

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READ THE POWERPOINT AND ANSWER THE Q FROM U OWN WORD

Jun 14, 2024 | Health Medical

Description

READ THE POWERPOINT AND ANSWER THE Q FROM U OWN WORD

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EVIDENCED BASED CARE
EVIDENCE-BASED CARE
 Initially began in Canada
 Evidence-based care
•
The process of providing clinically competent care that
is based on the best scientific evidence available
 Includes all health disciplines
2
IMPLEMENTATION OF EVIDENCE PRACTICE
 Find a source of evidence-based content that is
developed using good research techniques
 The evidence-based content itself must be
efficient for clinicians to use at the bedside
 Integrate the evidence-based content into order
sets, plans of care, and documentation forms
THE ACE STAR MODEL OF KNOWLEDGE
TRANSFORMATION
 Provides a framework for systematically putting
evidence-based practice into operation
 Star points
•
•
•
•
•
Knowledge discovery
Evidence summary
Translation into practice recommendations
Integration into practice
Evaluation
4
IMPORTANCE OF EBC
 There is a lack of agreed-upon standards
or processes that are based on evidence
 EBC is a process approach to collecting,
reviewing, interpreting, critiquing, and
evaluating research
 Leads to a state-of-the-art integration of
knowledge and evidence that can be
evaluated and measured through
outcomes
 Should be viewed as the highest level of
care
5
NURSING AND EBC
 The agency for Healthcare Research and Quality
(AHRQ) launched twelve evidence-based practice
centers
 The initiative partnered with public and private
organizations to improve the quality,
effectiveness, and appropriateness of care
 Nurses work with patients in deciding treatment
options
6
ATTRIBUTES OF EBC
 Need to define the meaning of evidence in
each health care agency
Use the term in daily practice
• Look for best evidence when evaluating new
goals and programs
•
 Fundamental principles in EBC
Evidence alone is never sufficient to make a
clinical decision
• Evidence-based care involves a hierarchy of
evidence to guide decision making
•
7
CHALLENGES FOR NURSES
 Rapidly growing body of scientific literature
•
No unaided human being can read, recall, and act
effectively on the volume of material
 Literature is not in a form that is suitable for
application to practice
•
Needs to be evaluated and transformed in order to be
useful
8
CONDUCTING EVIDENCE REPORTS
IN NURSING
 Select problem
 Review the evidence
 Summarize the evidence
 Report results
 Make recommendations for potential clinical
applications
 Implement agreed-upon practice changes
9
PROMOTING EVIDENCE-BASED
BEST PRACTICES
 The U.S. health care system does not have
uniform definitions of what constitutes efficient,
effective, quality health care
 It is difficult to get all clinical health care
providers to apply EBC processes at the unit
level
 EBC processes must be uniform enough to be
valid, but also adaptable to specific needs of
institutions
 EBC requires involvement of and collaboration
between clinical practitioners and health care
researchers
10
Best Practice: In Class Discussion #2
Name: ______________________________________________________________________________
Throughout your education, evidence based practice principles have been utilized, from your core
nursing classes, to research. It has been written in literature however that “some clients who are ill get
well despite nursing care, not as a result of nursing care.”
Please briefly answer the following questions.
1. Does the quality of nursing care have an impact on client outcomes?
2. Do you feel that quality nursing care can make a difference in client’s lives?
3. Identify 5 criteria based on evidence based practice, experience, and prior learning that you would
use to define “quality nursing care”. These criteria should reflect what you believe that nurses do that
makes a difference.
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________
4. How does best practice impact our current and future practice?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
5. What are some methods of best practice principles that you have utilized?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

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Nursing Question

Jun 14, 2024 | Health Medical

Description

2-page written response detailing your selection of one policymaking framework that best supports your priority—particularly, getting your priority on the agenda.-The topic is adolescents who suffer from chronic illnessesIn your response, explain why the framework best describes how you might proceed in effectively moving your advocacy priority forward in the policymaking process.Support your response with evidence.Please ensure the scholarly journals are within the last 5 years

individual reflection

Jun 14, 2024 | Health Medical

Description

Reflect on the incident described in the case scenario that you signed up for. Use the prompts and questions below to help guide your reflective process

Human Factor and Ergonomics

Jun 14, 2024 | Health Medical

Description

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

Jun 14, 2024 | Health Medical

Description

Select a population of interest to your area of work (e.g., women, children, men, adolescents, elderly, LGBTQ) and select a health event or behavior (e.g., substance abuse, CAD, Mental Health, Suicide, cigarette smoking).Search for health statistics about the frequency of this event. Begin your search at the Centers for Disease Control and Prevention and then expand your search to other government and non-governmental sources. Search nationally and locally.Post the following information about your search:population of interesthealth state of behavior searchedlist of sites searched; and description of data retrieved in the search

Infection Control

Jun 14, 2024 | Health Medical

Description

Choose one of the following:Create a short slide presentation (Power point, Prezi, etc.) on infection control for digital radiography. Include pictures. You may also include audio or imbedded videos. Please cite any outside sources appropriately

Nursing Question

Jun 14, 2024 | Health Medical

Description

Hello,I am taking Health Care Policy class and we have to write a Paper.I am providing a PDF copy of what the paper and Rubric consists of. IMPORTANT Points to Consider: Be sure to REVIEW THE GRADING RUBRIC and criteria for the assignment carefully and to include ALL aspects that are required as part of the assignment grade. It should go without saying that NO two papers should look the same The topic that I have to write on is Medcal MarijuanaPLESE LOOK AT ALL ATTACHMENTS ( CDC ETC) AS THEY WILL HELP WITH WRITING PAPER PLEASE MAKE SURE THAT PAPER IS AS DETAILED AS POSSIBLE AND INCLUDES ALL CORRECT IN-TEXT AND REFERENCES AS MY PROFESSOR IS VERY STRICT….THANK YOU! ****PLEASE NO PLAGIARISM/ SELF-PLAGIARISM IS ACCEPTABLE; ALL WRITINGS ARE RUN THROUGH TURN-IT IN FOR VERIFICATION! ****

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Advanced Practice Policy Analysis Paper
1
Assignment Objectives:
1. Explore and analyze health indicators in the community.
2. Identify a problematic area of interest to advanced nursing practice.
3. Evaluate and analyze three health policy options/alternatives for improvement supported
by evidence (using a selected policy analysis tool)
4. Prioritize and recommend one health policy to address the healthcare issue
Purpose: To investigate & integrate knowledge of advanced nursing practice, scholarly inquiry,
& leadership by examining a policy at the level of clinical practice, health care systems, or
public/social health policy.
Important Points:
•
The student MUST obtain PRIOR APPROVAL of the policy problem/issue by the
course instructor :
NOTE: MY policy problem/ issue is Medical Marijuana….Per my
professor: “ I may need to narrow it a bit meaning its use in a specific
population but there are so many different state laws you would find a lot
of information” (I’m not sure of narrowing it is good ? I leave it up to you
Henryprofessor….thank you)
•
The CDC Policy Analysis is the recommended tool and template for this assignment
which provides a well structured format to follow.
•
Recommended resources to write this paper can be found in attachments along with
assignment description and at the following websites provided here:
Policy Analysis | POLARIS | Policy, Performance, and Evaluation | CDC
Federal Nursing Issues – Advocacy & Getting Involved | ANA (nursingworld.org)
Nurse Practitioners Policy Resources | cdc.gov
Advanced Practice Policy Analysis Paper
2
Assignment Instructions:
•
Students are to submit a paper between 6-8 pages excluding title page and reference
pages.
•
Paper must be organized according to the guidelines provided below (REMEMBER TO
FOLLOW THE GRADING RUBRIC) and need to include all the identified sections
and information as it is outlined in the grading rubric and assignment instructions.
•
Paper must be completed in APA format and contain current scholarly sources dated
from 2017 until current.
•
Resources to assist students in conducting a policy analysis are provided throughout
course readings.
Introduction
This part of the assignment should introduce the topics the student will be discussing in the
paper and provide a bit of context about the approach. This is specific to the student content to be
presented and not general to the assignment itself.
Step 1: Identify the Policy Problem/Issue & Provide Context
The first thing the student needs identify is a healthcare issue that, in your opinion, is a
problem that calls for a policy solution, so the first step is to determine the policy issue of
interest (NOTE: MY policy problem/ issue is Medical Marijuana, as mention
above). Students may choose to look at the following broad areas of focus with the
understanding that the area will need to be further tailored to focus the student assignment. Some
broad areas to begin looking for a select policy issue could include health promotion, cost of
healthcare, mental health problems, use of technology in healthcare, MEDICAL MARIJUANA
POLICY etc. Another place to locate health policy issues include through various nursing
organizations such as the American Nurses Association (two sources are provided here, though
there are many others). Remember that no student is to write about nurse burnout for any of the
Fall, 2023 term assignments.
•
https://www.nursingworld.org/practice-policy/work-environment/health-safety/srhadvocacy/.
•
https://www.nursingprocess.org/current-issues-facing-nurse-practitioners.html
Advanced Practice Policy Analysis Paper
•
3
Once the healthcare issue is clearly identified, move to synthesizing data on the
characteristics of the problem or issue, including the:
➢ Burden (how many people it affects), frequency (how often it occurs), severity
(how serious of a problem is it), and scope (the range of outcomes it affects).
•
In the background and significance section of a policy paper, students will include the
details of the issue or problem. This includes the history of the problem and its relation to
advanced nursing practice, the scope of the problem, then explore relevant literature that
details its history.
•
Sources of data for the statement should describe the problem and present a diagnosis of
the causes of the problem using critical statistics such as mortality rates, live births,
morbidity, and other statistics. The student should understand the problem conceptually
and empirically for successful policy analysis.
•
Then, with the problem stated, the student will select a policy (specific policy) to
evaluate the many alternatives and provide a rationale (see the section below or Step
2).
•
Remember the problem or issue MUST be something that can be addressed through
policy AND be relevant to advanced nursing practice. Questions to consider in the
Step 1 include the following:
First, you want to gather information by:
•
Reviewing literature on the topic/problem
•
Identifying best practices/results (i.e. studies, projects, or initiatives that have addressed
the problem; including best practices in other problem/issue areas)
•
Exploring what other jurisdictions are doing or have done to address the same problem
the student identified.
Answer the following questions to get started. Characterizing the data on the details of the
problem or issue (get the specifics) help you refine your question.
•
What is the problem you have identified?
•
Who is being affected?
•
What is the burden (how many people does it affect)?
•
Frequency (how often does it occur)?
•
Severity (how serious is the problem)?
Advanced Practice Policy Analysis Paper
4
•
Scope (what are the range of outcomes affected)?
•
Write a problem statement. (The statement should be in one sentence and the problem
should be easily identifiable). More information can be found at the CDC website:
https://www.cdc.gov/policy/polaris/policyprocess/problem-identification/index.html
Contextualize the problem: Provide historical context by describing how the problem arose and
outlining any previous efforts to address the problem.
•
Identify the scope of the problem and present its context, then explore relevant literature
that details its history.
•
The background should be supported by evidence from credible scholarly sources.
•
Be sure to collect evidence that addresses alternative and opposing points of view on the
problem or issue and include the option of maintaining the status quo
•
Does the background include all necessary factual information?
Step 2: Provide the Landscape
•
Identify the key stakeholders/ and or key factors of previous efforts to address the policy
issue.
➢ These are the individuals and groups likely to affect or be affected by new policies
taken in response to the policy issue under discussion.
•
Identify key factors such as political, social, economic, practical, legal or quality-ofcare factors.
➢
Who are the individuals/groups affected by this problem?
➢
Who are the individuals/ groups who have attempted to address the problem in the
past?
➢
What are the views/ position of the various stakeholders?
➢
It should also identify and describe the major stakeholders (groups or individuals)
that are or will be affected by the policies, including the reasons.
Step 3: Policy Analyses & Policy Option Analysis (Existing Policy Analysis,
Identify and Describe Policy Options; & Assess Policy Options)
Advanced Practice Policy Analysis Paper
5
Policy analysis involves identifying potential policy options that could address the
problem, then using quantitative and qualitative methods to evaluate those options to determine
the most effective, efficient, and feasible option.
First, establish the evaluation criteria you will use to guide your analysis and the policy
selection. Once you have gathered the information, describe/analyze each policy option
separately. You can also identify the various policy alternatives to help achieve objectives and
evaluate each alternative.
Next, demonstrate the potential impact of the policies based on the evaluation criteria.
Research possible policy options relevant to the problem/issue identified and the potential
strategy issue. Discuss the most important legislative, judicial, and regulatory policies that apply
to the health care problem.
Students are required to use a policy analysis tool that has established evaluation
criteria by which to evaluate each of the 3 policy options.
➢
Students may use either the CDC Table 1 and Table 2 or one of the policy analysis tools
described in the course textbook, Patton et al. (2022) Ch. 4.
➢
CDC Table 1 (which can be found at the website below
https://www.cdc.gov/policy/paeo/process/analysis.html. or in blackboard in Word and
PDF formats under the Assignments Folder) provides the questions and answers to be
used to rate each policy option using the specific criteria of Public Health Impact,
Feasibility (political and Operational), Economic and Budgetary Impacts.
Finally, assess the tradeoffs between the options. Based on the analysis, identify the
“best” alternative to address the current issue & policy situation. Provide supporting evidence of
why each policy could be a solution to the problem by answering the following questions for
each criterion. Note that Table 1 provides the criteria to review each policy option individually,
then Table 2 provides a matrix by which to rank the polies; compare and contrast the selected 3
policy options with one another; however, the ranking in Table 2 of low, medium or high and
less favorable, favorable or more favorable needs to be described and supported by the evidence
and explained and described by the student as a way to prioritize one policy over the other. The
interpretation of the various ranks is not implicitly understood so the student needs to provide
a rationale for why each policy is being ranked as it relates to how each policy meets criteria
in Table 1 and effectively addresses the problem/issue as outlined in the paper. It is not
Advanced Practice Policy Analysis Paper
6
enough to simply fill out the table without a further explanation provided; the student is
expected to provide rationales for low, medium and high for health impact supported by the
literature and presented content; the political feasibility (what criteria did the student use and
where is the supporting evidence for placing this policy alternative in this low, medium or high
context? Additionally, budgetary impact at low to high needs to be explained as it relates to each
policy option).
What can be done about the problem? This involves describing:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Describe the existing policy that addresses the issue and assess the efficacy of the current
policy. Exploring what other jurisdictions are doing or have done to address the same
problem the student identified.
Discuss and explore the strengths, weaknesses and shortcomings of the existing policy.
Clarifies underlying assumptions and effectiveness of the current policy including effects
on the roles of key stakeholders (these stakeholders should be clearly and specifically
identified instead of assuming that the reader knows who the ‘stakeholders’ are and also
the rationale for choice of these individuals as ‘stake holders’ (See Step 3 below)
how the policy will impact morbidity and mortality (health impact),
Expound on the policy used to are about to analyze regarding the health issue. Examine
the enforcement implications.
It should also identify and describe the major stakeholders (groups or individuals) that are
or will be affected by the policies, including the reasons.
Consider the fiscal impact of the policy or issue, its impact on social justice, and the
recommended policy’s potential barriers and unintended consequences. Provide rationale
for selection.
Generally this section should look at research about possible policy options relevant to
the problem or issue you have identified and described. Identify barriers to
implementation of selected alternative.
Describe methods to evaluate policy implementation.
Presents viable strategies with potential outcomes for each strategy
the political and operational factors associated with adoption and implementation
(feasibility)
the prospective costs to implement the policy and how the costs may compare with the
prospective benefits (economic and budgetary impact)
Each assertion is researchable and verifiable support from reputable sources. No bias is
evident in the analysis
Consider the fiscal impact of the policy issue, its impact on social justice, and the
recommended policy issue’s potential barriers and unintended consequences. Assess the
trade-offs between alternatives.
Establish/identify criteria that will be used for selection of “best” policy.
Advanced Practice Policy Analysis Paper
•
•
7
Evaluate each alternative & its potential impact relative to the healthcare & patient
outcomes.
A thorough cost-benefit analysis is provided for each policy option/alternative
Step 4: Prioritize Policy Options & Health Policy Recommendation
Rank the possible policy options based on the above criteria and using the context of the
problem/issue provided in the previous sections and prioritize the best policy option that will the
greatest health impact for the identified problem/issue. The prioritization of the selected policy
option must be well supported with a rationale stemming from the literature and link to
advanced practice nursing. Students should follow with an explanation of this rationale that
supports the selection of the prioritized policy option. Also, the student needs to explore the
barriers to implementation of the selected policy option. Explain the methods to evaluate the
effectiveness of policy implementation and discuss the sustainability of the selected policy.
Define Health in All Policies (see link provided below) as an initiative and determine how the
selected policy would fit with this definition. Further, include the limitations of the policy
analysis and discuss the implications of the prioritized policy option for nursing practice,
research, and education.
WEBSITE: https://www.cdc.gov/policy/hiap/index.html
Questions to be considered in Step 4 include:
•
Based on the analysis, identify the “best” alternative to address the current issue & policy
situation.
•
Provide rationale for selection.
•
Describe possible strategies to implement selected alternative.
•
Identify barriers to implementation of selected alternative.
•
Describe methods to evaluate policy implementation.
•
Limitations to the policy option analyses is provided
•
Implications of the policy to practice, policy formulation and implementation, research
and education discussed
•
Health in All Policies is discussed and linked to prioritized policy option
Conclusion
Advanced Practice Policy Analysis Paper
8
The conclusion summarizes the findings and recommendations of the entire analysis. This
focuses on the student’s paper outlining key points that have been learned and assessed
throughout the paper in a comprehensive and succinct manner.
Criteria
Proficient/Exemplary
Competent
Beginner
Introduction Introduce the
overall concepts that will be
described in the student’s paper;
not generic to the assignment
outline. (10 pts)
Identification and support for
the healthcare issue/problem
Detailed description of a
healthcare problem/issue that is
of interest to the advanced
practice nurse and which can be
used to address a policy issue.
(30 pts)
7-10 pts
Clear and concise introduction
of the concepts to be presented
in the paper
0-3 pts
Vague, unclear or no
introduction of concepts to be
presented in the paper
21-30 pts
Clear and detailed outline of the
healthcare issue/problem to be
addressed using policy
provided. How the
problem/issue will be addressed
using policy is evident and
well-defined as is the link
between the issue and advanced
nursing practice.
4-6 pts
Mostly clear but somewhat
generic introduction of the
concepts to presented in the
paper
10-20 pts
Presents a well-considered
position on the issue.
Somewhat but not completely
comprehensive history of the
problem/policy. Key terms,
stakeholders and policy areas
needing analysis and resolution
are somewhat but not clearly
defined
Background/Significance
This should provide a
comprehensive background and
significance of the scope of the
healthcare problem/issues being
addressed through policy for the
duration of the paper that is well
supported by the literature and
research. (30 pts)
21-30 pts
Detailed and comprehensive
background and significance
for the healthcare problem is
provided. Relevant contextual
supporting data provided that
clearly outlines the scope of the
problem with excellent
supporting evidence and
research.
11-15 pts
Clear and comprehensive
identification of the major
stakeholders that shows a direct
relevance to the selected
healthcare issue that is well
supported by the evidence and
literature.
41-60 pts
Comprehensive and detailed
analysis of each of the 3 policy
options is provided. An
appropriate policy analysis tool
with established criteria is used
to individually evaluate each of
the selected 3 policy options.
All relevant health and/or
public health impact,
feasibility, and economic and
budgetary impacts are
considered for each of the 3
policies. Ambiguities, conflicts,
11-20 pts
Somewhat detailed but not
comprehensive background and
significance for the healthcare
problem provided. Mostly
relevant contextual supporting
data provided that outlines the
scope of the problem with good
supporting evidence and
research.
6-10 pts
Somewhat clear but not
comprehensive identification of
the major stakeholders that
shows a fair relevance to the
selected healthcare issue this is
mostly but not fully supported
by the evidence and literature.
21-40 pts
Somewhat clear but not
comprehensive analysis of each
of the 3 policy options is
provided. An appropriate policy
analysis tool with established
criteria is used to individually
evaluate each of the 3 policy
options. Most of the relevant
health and/or public health
impact, feasibility, and
economic & budgetary impacts
are considered for each of the 3
policies. Ambiguities,
0-10 pts
Missing and/or vague
background and/or significance
for the healthcare problem
provided. Vague or missing
contextual data that fails to
outline the scope of the
problem with insufficient
supporting evidence and
research.
0-5pts
Vague, missing, or unclear
identification of the major
stakeholders that shows a
minimal to no relevance to the
selected healthcare issue that
fails to be supported by the
evidence and literature.
0-20 pts
Poor, missing or unclear
analysis of 3 or less policy
options is provided. An
appropriate policy analysis tool
may or may not be used with or
without established criteria by
which to evaluate each of the
presented policy options. Some
or missing relevant health
and/or public health impact,
feasibility and economic &
budgetary impacts are
considered for 3 or less
Landscape Identify stakeholders
as identified in the assignment
instructions above. (15 pts)
Individual policy Option
Analysis criteria provided. Each
of the 3 policy options is
provided using an appropriate
policy tool as outlined in the
assignment instructions that
provides specific criteria for
each policy analysis)
(60 pts)
0-10 pts
Presents a vague or limited
position on the issue. Vague
and incomplete history of the
problem/policy. Key terms,
stakeholders and policy areas
are incompletely or not
analyzed, and resolution is
vague and not clearly defined.
Advanced Practice Policy Analysis Paper
9
problems, and contradictions
related to each of the 3 policies
are explained. Each of the three
policy analyses is well
supported by the literature and
presented in a comprehensive
and easy to follow format in the
paper.
conflicts, problems and
contradictions related to each of
the 3 policies are mentioned but
not fully explained. Each of the
three policy analysis is mostly
but not fully supported by the
literature and presented in a
good but not clearly easy to
follow format in the paper.
Policy Options Comparison:
Each policy is compared to the
other using a matrix or table
with an approved policy tool that
provides a detailed and well
supported ranking system that is
well supported by the literature
and research. How each policy
addresses the healthcare issue as
outlined in the problem
identification, background and
significance is provided. (60 pts)
41-60 pts
Comprehensive and detailed
comparison of the 3 policy
options to one another is
provided using a well-defined
ranking system that is well
supported by the literature and
research. Clear and detailed
link between the policy options
and the healthcare issue as
outlined in the problem
identification, background and
significance is provided.
21-40 pts
Somewhat clear but not
comprehensive comparison of
the 3 policy options to one
another is provided with a fairly
good but not well-defined
ranking system that is fairly
well supported by the literature
and research. Somewhat clear
and detailed link between the
policy options and the
healthcare issue as outlined in
the problem identification,
background and significance is
provided.
Prioritization and Policy
Recommendation: Best policy
option is prioritized with a good
supporting rationale that is well
supported by the literature and
linked to advanced practice
nursing. Barriers to policy
implementation provided that are
realistic and well supported by
the literature. Possible strategies
for implementing selected policy
option provided along with
sustainability (45 pts)
31-45 pts
Detailed and comprehensive
prioritization of one of the
policy options with good
supporting rationale is provided
with a strong link to advanced
practice nursing. Barriers to
policy option implementation
provided with realistic and well
supported evidence and
sources. Possible strategies for
implementing selected policy
provided along with
consideration for sustainability.
16-30 pts
Somewhat clear but not
comprehensive prioritization of
one of the policy options with
fair supporting rationale is
provided with a somewhat
strong link to advanced practice
nursing. Barriers to policy
implementation is provided
with a somewhat realistic and
supported evidence and
sources. Possible strategies for
implementing policy provided
along with consideration for
sustainability.
Limitations to the policy
option analysis provided with
supporting detail along with a
detailed description of Health
in All Policies and how the
selected policy option fits with
this definition that is well
supported by the literature and
sources. (30 pts)
21-30 pts
Detailed and clear discussion of
the limitations of the policy
option analysis provided with
good supporting detail.
Comprehensive description of
Health in All Policies with a
strong rationale and support for
how the prioritized policy
option meets this definition.
11-20 pts
Mostly detailed but somewhat
unclear discussion of the
limitations of the policy option
analysis provided with
somewhat good supporting
detail. Good but not
comprehensive description of
Health in All Policies with a
good but not strong rationale
and support for how the
prioritized policy meets this
definition.
policies. Ambiguities, conflicts,
problems and contradictions
related to the policy are poorly
or not mentioned nor fully
explained. Each of the 3 policy
analyses is missing or not full
supported by the literature and
the analyses is difficult to
understand and interpret as
formatted in the paper.
0-20 pts
Vague, unclear or missing
comparison of the 3 or less
policy options to one another is
provided with a poor and/or
unsupported ranking system
that is not well supported by the
literature and research. Vague,
unclear or missing link between
the policy options and the
healthcare issue as outlined in
the problem identification,
background and significance is
provided.
0-15 pts
Missing, unclear or vague
prioritization of one of the
policy options with poor to no
supporting rationale provided
with a weak or missing link to
advanced practice nursing.
Barriers to policy
implementation is provided
with limited realistic and
unsupported evidence and
sources. Possible strategies for
implementing policy may or
may not be provided with or
without consideration for
sustainability.
0-10 pts
Missing, vague or unclear
discussion of the limitations of
the policy option analysis
provided with missing or vague
supporting detail. Vague or
missing description of Health in
All Policies with limited or
missing rationale and support
for how the prioritized policy
meets this definition.
Advanced Practice Policy Analysis Paper
Implications of the policy to
nursing practice, research and
education are analyzed with
good supporting evidence and
research. (30 pts)
10
21-30 pts
Strong and comprehensive
description of how prioritized
policy informs nursing practice,
research and education are
analyzed with excellent
supporting evidence and
research.
7-10 pts
Summarizes the key points
made throughout the student
paper in a succinct and
comprehensive manner.
Provides appropriate references
and citations to support
concluding comments.
11-20 pts
Somewhat strong but not
comprehensive description of
how prioritized policy informs
nursing practice, research, and
education are analyzed with
good supporting evidence and
research.
4-6 pts
Somewhat summarizes the key
points made throughout the
student paper in a mostly clear
but somewhat generic manner
that fails to be entirely
comprehensive for the student’s
content. Somewhat but not fully
supported by references and
citations.
0-10 pts
Missing, poor or weak
description of how prioritized
policy informs nursing practice,
research, and education are
analyzed with good supporting
evidence and research.
Written Communication &
Research Skills (15 pts)
11-15 pts
Excellent mechanics, grammar,
and word usage. Language is
clear and appropriate. Writing
style is effective. The content
of the paper follows the grading
rubric and is presented in a
clear and comprehensive
manner. References are used to
support statements and text
throughout the paper.
0-5 pts
Poor mechanics, grammar
and/or word usage. Language is
vague and not exactly clear.
Writing style is ineffective. The
content of the paper fails to
follow the grading rubric and is
presented in a disconnected and
largely unclear and limited
manner. References are not
used to support the statements
and text throughout the paper.
Citations and Formatting (APA)
(21 pts) The paper includes all
required APA formatting
elements including title page,
text, reference page, headers and
organization. Paper is well cited
with a minimum of 12 references
and 5 within the past 5 years.
Paper is well paraphrased and
summarized with minimum
direct quotes and frequent use of
same reference. The references
support statements made
throughout the paper. Page
length is in within no more than
8-9 pages not including title
page and reference page.
15-21 pts
Support and evidence are
referenced using paraphrasing
in the students own voice and
are cited and formatted per
APA 7th edition. Minimum of
12 references (at least 5 in the
past 5 years) are utilized with
fewer than 2-3 errors in APA
formatting and references
throughout the paper.
References are used to support
statements throughout the
paper. Expected page length
6-10 pts
Good mechanics, grammar, and
word usage. Language is
mostly clear and appropriate.
Writing style is somewhat
effective. The content of the
paper follows the grading
rubric and is presented in a
mostly clear but not fully
comprehensive manner.
References are used mostly to
support statements and text
throughout the paper.
8-14 pts
Support and evidence are
referenced using paraphrasing
in the students own voice and
are cited and formatted per
APA 7th edition. Minimum of
10-12 references (at least 5 in
the past 5 years) are utilized
with fewer than 3-4 errors in
APA formatting and references
throughout the paper.
References are used to support
statements throughout the
paper.
Conclusion Summarize the main
points made by the student
throughout the paper, this is
specific to the student’s
presentation of content and not
to the assignment. This should
not introduce new concepts but
rather should succinctly
summarize the major points as
they are outlined in the paper; it
should not repeat the
introduction or the key headings
and not be generic to any
conclusion. (10 pts)
Total: 406 pts
0-3 pts
Vague and unclear summary of
the key points made throughout
the student paper that provides
a generic rather than specific
and comprehensive summary of
the student’s content. Fails or
not well supported by
referenced and citations.
0-7 pts
Support and evidence are
referenced using paraphrasing
in the students own voice and
are cited and formatted per
APA 7th edition. Minimum of
less 10 references (at least 5 in
the past 5 years) are utilized
with more than 4 errors in APA
formatting and references
throughout the paper.
References may or may not be
used to support statements
throughout the paper.
Table 1: Policy Analysis: Key Questions
Framing Questions
What is the policy lever—is it legislative, administrative, regulatory, other?
What level of government or institution will implement?
How does the policy work/operate? (e.g., is it mandatory? Will enforcement be necessary? How is it funded?
Who is responsible for administering the policy?)
What are the objectives of the policy?
What is the legal landscape surrounding the policy (e.g., court rulings, constitutionality)?
What is the historical context (e.g., has the policy been debated previously)?
What are the experiences of other jurisdictions?
What is the value-added of the policy?
What are the expected short, intermediate, and long-term outcomes?
What might be the unintended positive and negative consequences of the policy?
Criteria
Questions
Public Health Impact:
How does the policy address the problem or issue (e.g., increase access, protect
Potential for the
from exposure)?
policy to impact risk
What are the magnitude, reach, and distribution of benefit and burden (including
factors, quality of
impact on risk factor, quality of life, morbidity and mortality)?
life, disparities,
o What population(s) will benefit? How much? When?
morbidity and
o What population(s) will be negatively impacted? How much? When?
mortality
Will the policy impact health disparities / health equity? How?
Are there gaps in the data/evidence-base?
Feasibility* :
Likelihood that the
policy can be
successfully adopted
and implemented
Political
Economic and
budgetary impacts:
Comparison of the
costs to enact,
implement, and
enforce the policy
with the value of the
benefits
Budget
What are the current political forces, including political history, environment, and
policy debate?
Who are the stakeholders, including supporters and opponents? What are their
interests and values?
What are the potential social, educational, and cultural perspectives associated
with the policy option (e.g., lack of knowledge, fear of change, force of habit)?
What are the potential impacts of the policy on other sectors and high priority
issues (e.g., sustainability, economic impact)?
Operational
What are the resource, capacity, and technical needs developing, enacting, and
implementing the policy?
How much time is needed for the policy to be enacted, implemented, and
enforced?
How scalable, flexible, and transferable is the policy?
What are the costs and benefits associated with the policy, from a budgetary
perspective?
o e.g., for 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, costeffectiveness, 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?
Where are there gaps in the data/evidence-base?
*In assessing feasibility, it is important to identify critical barriers that will prevent the policy from being developed
or adopted at the current time. For such policies, it may not be worthwhile to spend much time analyzing other
factors (e.g., budget and economic impact). However, by identifying these critical barriers, you can be more readily
able to identify when they shift and how to act quickly when there is a window of opportunity.
Table 2. Policy Analysis Table
Criteria
Public Health Impact
Low: small reach, effect size, and
Scoring
impact on disparate populations
Definitions
Medium: small reach with large
effect size or large reach with
small effect size
High: large reach, effect siz

Project Closing

Jun 14, 2024 | Health Medical

Description

Project Closing is the final phase of the project implementation in which the system is thoroughly tested for functionality at four (4) levels before handing over or signing off the project: unit testing, system testing, stress testing, and acceptance testing.

Describe what these types of testing are. Why are they undertaken? At which stage(s) they are undertaken? Which of these is more crucial to you as a project manager and which is most critical to the organization and why?

Your APA formatted assignment comprising 2-4, double-spaced, typed in 12-point Times New Roman (or 11- point Calibri) excluding the Cover and Reference pages should be submitted by Tuesday. Use credible evidence to support your findings.Module 6 Readings

Electronic Health Record (EHR) System Testing Plan

What is the difference between Unit Testing and Integration Testing?

Difference between Unit and Integration tests

How to Close a Project

Four Steps You Must Take When Closing Your Project

Project closing (pmi.org)

What is Software Testing

What are Unit Testing, Integration Testing, and Functional Testing?

What is Stress testing in software

4 Tips for Successful Project Closure

5 Steps to Project Closure

MN504 DISCUSSION UNIT 5

Jun 14, 2024 | Health Medical

Description

Describe the difference between qualitative and quantitative data as it relates to clinical practice and your clinical question. Provide references to substantiate the distinction of the two data sources. During the week, reply to 1–2 of your peers’ posts with a substantive post of 250–300 words.

Major depressive disorders presentation

Jun 14, 2024 | Health Medical

Description

Discuss Major depressive disorders regarding risk factors, symptoms and signs and psychological methods of treatment.

Letter to the Legislator

Jun 14, 2024 | Health Medical

Description

This assignment provides you with the opportunity to use a specific political advocacy strategy: communication with a legislator via a letter. Expressing your support or lack of support for proposed legislation (bills) can be a powerful way to speak up about an issue. In this assignment, you will identify a proposed bill and voice your support for, or argument for not, passing that particular bill.Completion of this assignment will demonstrate your achievement of the following course outcomes:describe the impact of health care policies on nursing practice and health care work environments to determine the financial and regulatory influences on patient careevaluate the political advocacy process to identify opportunities for nursing professional involvementdelineate strategies that nurses can use to engage in advocacy for health care policy to support equity, access, affordability, and social justice for consumers and in support of the nursing profession

Population Health

Jun 14, 2024 | Health Medical

Description

Review population-level health data for your community on the following website:

County Health Rankings and RoadmapsLinks to an external site.
(https://www.countyhealthrankings.org/ ) ———zipcode 11706

Identify one health-related risk, problem, or disparity that is a concern and respond to the following:

Describe the problem, its magnitude, and its impact.
What existing policy, protocol, or regulatory guidelines are in place to address the issue?
Assess how the quality of healthcare delivery impacts this issue.
Propose two specific assessment strategies to facilitate further appraisal of the issue and explain how each strategy would contribute to an accurate assessment.
Describe two sources of data or information that would be provide key insights regarding the issue.
Explain how the nursing process (or another problem-solving process) can support accurate assessment of the issue and guide policy interventions to improve health-related outcomes.

Analyze ethical-legal principles and dilemmas related to health care

Jun 14, 2024 | Health Medical

Description

Analyze ethical-legal principles and dilemmas related to health care.

Using the information from the case study (below), discuss the following issues from the perspective of an APN role:

Administrator
Practitioner
Educator

Standards of care — Which standards of care were violated and who was responsible?

In your role as an educator, administrator, or practitioner, what risk management steps should be taken before or after the incident to alleviate the issue?

Case Study: Malpractice Action Brought by Yolanda Pinellas

Yolanda Pinellas is a 21-year-old female student studying to be a music conductor. She was admitted for chemotherapy. The medication Mitomycin was administered by intravenous infusion through an infusion pump.

During the evening shift, the infusion pump began to beep. The RN found that the IV was dislodged, discontinued the infusion, notified the physician, and provided care to the infusion site. The patient testified that a nurse came in and pressed some buttons, and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done. The documentation in the medical record indicates that there was an IV infiltration.

Two weeks after the event, the patient developed necrosis of the hand, required multiple surgical procedures, skin grafting, and reconstruction. She had permanent loss of function and deformity in her third, fourth, and fifth fingers. The patient alleges that she is no longer able to perform as a musical conductor because of this.

While reviewing charts, the risk manager noted that there were short-staffing issues during the 3 months prior to this incident, and many nurses were working double shifts (evenings and nights) then coming back to work the evening shift again. The risk manager also noted a pattern of using float nurses among several units.

Assessment Requirements:

Before finalizing your work, you should:

be sure to read the assessment description carefully (as displayed above);
consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary;
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.

hemophilia A

Jun 14, 2024 | Health Medical

Description

Hello I need an essay paper about hemophilia A writing general information, etiology, types, treatment, and dental management it should not be less than 2000 words and 5 references using Harvard style

Fishbone Diagram

Jun 14, 2024 | Health Medical

Description

The purpose of this assignment is to use a Fishbone Diagram to complete a root cause analysis. Identify a problem in your practice environment and utilize the topic Resource “Fishbone Analysis Diagram Template” to work through the problem to the root cause. Refer to “Problem-Solving Your Fishbone Into a Wishbone,” located in the topic Resources to complete this assignment.While APA style is not required for Part 1, 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.Prepare Part 2 of the template 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.

In 2010, the Affordable Care Act opens up the 45-year-old Medicare program

Jun 14, 2024 | Health Medical

Description

MSW 610 WEEK 3 Assigment skills

Jun 14, 2024 | Health Medical

Description

Due Sunday by 11:59pm
Points 60
Submitting a text entry box or a file upload
Unit 3Attending Skills Assignment
Unit 3: Introduction (1 of 4)
Unit 3: Reading and Activities (2 of 4)
Current Assignment: Unit 3: Attending Skills Assignment (3 of 4)
Unit 3: Discussion Transtheoretical Model Stages of Change (4 of 4)
Instructions

Visit this website:

Read Bodenheimer, D. (n.d.) But what should I say next? 5 tips for social workersLinks to an external site.. The New Social Worker.
Then, select two topics from the following list on the website and write a 2-page reflection paper:
Szczygiel, P. (2018). The profound act of sitting with difficult emotions and the value of process in social work practiceLinks to an external site.. The New Social Worker
Calabrese, A. J. (2017). Being present: Social worker’s giftLinks to an external site.. The New Social Worker.
Smith, P. (2017). Active listening in social work: The value and rewardsLinks to an external site.. The New Social Worker.

Be sure to provide the answers to all the following for each of your selected topics:

Share two things that stood out in your selection that can be applied to your experience as an MSW student.
Cite and explain the connection of the topic with one core value from the NASW code of ethics.
Describe how you intend to incorporate what was learned from the reading of the topic selected into social work practice.
REQUIREMENTS

This paper should include the following requirements:

At least 2 pages in length
Use proper APA 7th edition formatting
Include both a title and references page using proper APA formatting
12 pt. font, double-spaced
Use proper in text citations with APA formatting
All references should be within the last five years

Please review the grading rubric for other specific details about this assignment.

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 3 Mini Paper Rubric

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeCompetency 1Professional practice – reflective practice

20 pts

Mastered

Clearly described three things from the readings that can be applied to experience as an MSW student. Provided examples from the reading and linked to practice.

18 pts

Excels

Described two things from the readings that can be applied to experience as an MSW student. Provided examples from the reading and linked to practice.

16 pts

Competent

Adequately described two things from the readings that can be applied to experience as an MSW student. Provided examples from the reading and linked to practice.

14 pts

Needs Improvement

Attempted to describe two things from the readings that can be applied to experience as an MSW student. Provided examples from the reading and linked to practice.

0 pts

Not Present

No discussion from the reading

20 pts

This criterion is linked to a Learning OutcomeCompetency 1Ethical Practice

15 pts

Mastered

Clearly explained the connection of the topic with one core value from the NASW code of ethics and cited the code.

13.5 pts

Excels

Explained the connection of the topic with one core value from the NASW code of ethics and cited the code.

12 pts

Competent

Adequately explained the connection of the topic with one core value from the NASW code of ethics and cited the code.

10.5 pts

Needs Improvement

Attempted to explain the connection of the topic with one core value from the NASW code of ethics

0 pts

Not Present

No link to ethics

15 pts

This criterion is linked to a Learning OutcomeCompetency 6Engagement

15 pts

Mastered

Clearly incorporate what was learned from the reading of the topic selected into social work practice. Provided at least 3 examples from the articles of topics applicable to practice

13.5 pts

Excels

Clearly incorporate what was learned from the reading of the topic selected into social work practice. Provided at least 2 examples from the articles of topics applicable to practice

12 pts

Competent

Incorporated what was learned from the reading of the topic selected into social work practice. Provided at least 1 example from the articles of topics applicable to practice

10.5 pts

Needs Improvement

Attempted to incorporate what was learned from the reading of the topic selected into social work practice. Did not provide details or citation.

0 pts

Not Present

No application to practice.

15 pts

This criterion is linked to a Learning OutcomeWriting

5 pts

Mastered

The paper exhibits a superior command of written English language conventions. The paper has no errors in mechanics, grammar, or spelling.

4.5 pts

Excels

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.

4 pts

Competent

The paper exhibits command of written English language conventions. The paper has minor errors in mechanics, grammar, or spelling that impact the flow of communication.

3.5 pts

Needs Improvement

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.

0 pts

Not Present

The paper does not demonstrate command of written English language conventions. The paper has multiple errors in mechanics, grammar, or spelling that cause the reader difficulty discerning the meaning.

5 pts

This criterion is linked to a Learning OutcomeAPA Formatting

5 pts

Mastered

The required APA elements are all included with correct formatting, including in-text citations and references.

4.5 pts

Excels

The required APA elements are all included with minor formatting errors, including in-text citations and references.

4 pts

Competent

The required APA elements are all included with multiple formatting errors, including in-text citations and references.

3.5 pts

Needs Improvement

The required APA elements are not all included. AND/OR there are major formatting errors, including in-text citations and references.

0 pts

Not Present

There is little to no evidence of APA formatting. AND/OR there are no in-text citations AND/OR references.

5 pts

Total Points: 60

372 @HR_1440

Jun 14, 2024 | Health Medical

Description

See a

Just reference

Jun 14, 2024 | Health Medical

Description

this is can you just give me a referancs https://pubmed.ncbi.nlm.nih.gov/35062086/

Public Health Question

Jun 14, 2024 | Health Medical

Description

Week 6 – Case Study Assignment

Course Outcomes for Assignment:

Effectively gather financial and market information to guide strategic decision making and improve patient outcomes.
Act on financial and market information to guide strategic decision making and improve patient outcomes.

Instructions: Due Tuesday of Week 6 by 11:59 pm EST.

Read Case 20 (pages 127-132) from Gapenski’s Cases in Healthcare Finance – “Coral Bay Hospital.”

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:

What are the NPV, IRR, MIRR, and payback of the proposed ambulatory surgery center? Do the measures indicate acceptance or rejection of the proposed ambulatory surgery center?
One board member wants to make sure that a complete risk analysis, including sensitivity and scenario analyses, is performed before the proposal is sent to the board.
Perform a sensitivity analysis.
What management information is provided by the sensitivity analysis?
Perform a scenario analysis.
What management information is provided by the scenario analysis?
Why is the expected NPV obtained in the scenario analysis different from the base case NPV?
A board member is interested in the utilization breakeven of the Center.
What are the breakeven values of the three input variables that are highly uncertain?
What management information is provided by the breakeven analysis?

For some 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

Due DateSep 26, 2023 11:59 PM

Topic 7 DQ 1

Jun 14, 2024 | Health Medical

Description

Assessment DescriptionCompare three different methods of disseminating evidence related to health care improvement.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

Nutrition Question

Jun 14, 2024 | Health Medical

Description

I’m working on a nutrition question and need the explanation and answer to help me learn.I will upload a document with all the instructions:Here is a brief oneASSIGNMENT DETAILS:For this assignment your job is to analyze information that has been collected from a client and develop a nutrition and lifestyle action plan with that client. This work will allow us to practice the Intervention component of the Nutrition Care Process. Note: We are skipping the Diagnosis step of the Nutrition Care Process for the purposes of this assignment.

Unformatted Attachment Preview

Revised 06/2023
NSC 301: Nutrition Assessment Assignment PART B (100 points)
ASSIGNMENT DETAILS:
For this assignment your job is to analyze information that has been collected from a client and develop a nutrition and
lifestyle action plan with that client. This work will allow us to practice the Intervention component of the Nutrition Care
Process. Note: We are skipping the Diagnosis step of the Nutrition Care Process for the purposes of this assignment.
You will make the action plan based off of client information and dietary reports that were in the class Nutrition
Assessment Assignment Part A by your classmate.
The client-specific information you will use to develop an action plan includes:
1. Nutrition and Diet Assessment Questions and Answers (Part A)
2. Diet and Wellness Plus Nutrient Analysis and Reports
▪ Energy Balance
▪ MyPlate Analysis
▪ 3-day Average report on their dietary intake analysis
▪ Intake vs Goals
▪ DRI Report
▪ Macronutrient Ranges
▪ Daily Food Log (3 days)
▪ Social Needs Screening Tool
**Your files will go through the TurnItIn plagiarism software. If you upload diet/files that are found to be copies of
another student’s diet you will not earn diet analysis points and you will be written up for plagiarism.
Nutrition Care Process: Intervention Snapshot:
Food and/or
Nutrient
Delivery
Customized
Nutriti
on
Educati
on
Nutritio
n
Counsel
ing
A formal process to
instructor train a client
A supportive process,
characterized by a
in a skill or to impart
collaborative counselorclient
relationship, to establish
food,
to, or coordination of
nutrition care with other
Interventions designed to
nutrition and physical
activity
health care providers,
improve the nutritional
Coordination
of Nutrition
Care
Population
Based
Nutrition
Action
Consultation with, referral
approach for food/
knowledge to help
clients
voluntarily manage or
nutrient provision.
modify food, nutrition,
priorities, goals, and
action
institutions, or agencies
well-being of a
and physical activity
that can assist in treating
population.
maintain or improve
plans that acknowledge
and
foster responsibility for
selfcare to treat an existing
health
condition and promote
health
choices and behavior to
or managing
nutrition-related problems
Revised 06/2023
ASSIGNMENT INSTRUCTIONS:
Assignment Phase 1:
1) Please share your original Nutrition Assessment Assignment documents, including the client information questions
and answers and all required reports, with your peers in the dedicated discussion forum for the Nutrition
Assessment Assignment Part B. (20 points)
2) Once you’ve downloaded your peer’s Nutrition Assessment Assignment Part A documents, be sure to save them
because you will have to submit them with your Nutrition Assessment Assignment Part B.
__________________________________________________________________________________________________
Assignment Phase 2:
3) Please write down 3-5 follow up questions you have for the nutrition professional who completed Part A of the
nutrition assessment, regarding the client. Based on the client information that you were provided, what additional
information do you want to know about the client in order to develop the best Nutrition and Lifestyle Action plan?
(Be sure to use complete sentences when crafting your questions. Make sure the questions are relevant to
understanding the client’s nutrition and health status). (5 points)
a.
b.
c.
d.
e.
4) What goals, if any, did the client report in the “Other Questions” section of the Nutrition Assessment Part A? If no
client goals were included, please indicate that no client goals were provided in the table below. (5 points)
Revised 06/2023
5) Based on the dietary and client information you have, what are 3 SMART goals that you would consider suggesting
to your client to improve their nutrition and health status? (Make sure that the goals are specific, measurable,
achievable, relevant, and time-bound) (30 points)
1.
2.
3.
6) For each SMART goal that you identified for the client (in #5), please describe why you selected that goal based off
of the information you were provided. You should provide 3-5 sentences to explain your reasoning for each goal.
Goals should be linked back to the nutrition recommendations provided in the textbook for the life stage of the
client. (30 points)
1.
2.
3.
7) For each SMART goal that you identified for the client (in #5), please provide a list of potential barriers that the
client might experience to implementing each goal. Remember, barriers can exist at different individual,
community, environmental, social or institutional levels. Please, be specific when describing the potential barriers.
(10 points)
SMART Goal
Potential Barrier(s) to Successfully Meeting Goal
1.
2.
3.

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Developing an Education Attainment Policy

Jun 14, 2024 | Health Medical

Description

This assessment addresses the following course objective(s):

Develop institutional, local, state, and/or federal policy initiatives.
Instructions

Healthcare administrators are responsible for analyzing the efficacy of internal policies, and determining when new policy development is needed. For this assignment, you will conduct research on education and degree attainment as it relates to healthcare organization policy. Use the following information to complete this assignment:

Assignment type: Podcast (audio) and written outline

Your role: Healthcare administrator, policy development specialist.

Your audience: Other healthcare administrators, clinical medical professionals, health policy advocates.

Required Podcast content: Explain how administrators can develop an education attainment policy within their organization. For example: requiring a BSN for all non-entry level RN employment. Include information that speaks to your research on the topic, influencing factors (internal and external), barriers and risks, benefits, goals and objectives, etc.

Required Outline content: Create an outline that summarizes key points of your podcast. This does not need to be a word-for-word script.

APA: A minimum of three references should be included to support your content.

Outline: Word document
Assignment Resource(s)

Listen to these podcasts about health policy to familiarize yourself with the tone and atmosphere you will want to create.

https://www.thehealthcarepolicypodcast.com/

Unformatted Attachment Preview

Developing an Education Attainment Policy (1)
Developing an Education Attainment Policy (1)
Criteria
This criterion is
linked to a
Learning
OutcomeContent
& Concepts
This criterion is
linked to a
Learning
OutcomeAnalysis
This criterion is
linked to a
Learning
OutcomeDelivery
Ratings
25 pts
Level 5
Audio file and written outline are
submitted.
40 pts
Level 5
Policy
development is
explained in
excellent detail;
research is
evident;
30 pts
Level 5
Tone,
inflection, and
pace of
delivery is
excellent.
36 pts
Level 4
Policy
development is
explained in
detail; research
is evident;
27 pts
Level 4
Tone,
inflection, and
pace of delivery
is appropriate.
20 pts
Level 3
Audio file is submitted; written outline is
not submitted.
32 pts
Level 3
Policy
development is
explained;
research is
evident;
24 pts
Level 3
Tone,
inflection,
and/or pace of
delivery can be
improved.
0 pts
Level 0
Audio file is not submit
outline is submitted.
28 pts
Level 2
Policy
development is
explained;
minimal research
is evident;
21 pts
Level 2
Tone, inflection,
and pace of
delivery all require
improvement.
24 pts
Level 1
Policy
development is
minimally
explained;
research is not
evident;
18 pts
Level 1
Tone, inflection,
and pace of
delivery are barely
suitable for a
professional
audience.
0
L
T
an
de
su
pr
au
Developing an Education Attainment Policy (1)
Criteria
This criterion is
linked to a
Learning
OutcomeAPA
PRICE-I
Total Points: 100
Ratings
5 pts
Level
The required
APA elements
are all included
with correct
formatting,
including in-text
citations and
references.
4.5 pts
Level 4
The required
APA elements
are all included
with minor
formatting
errors, including
in-text citations
and references.
4 pts
Level 3
The required
APA elements
are all included
with multiple
formatting
errors, including
in-text citations
and references.
3.5 pts
Level 2
The required
APA elements
are not all
included and/or
there are major
formatting
errors, including
in-text citations
and references.
3 pts
Level 1
Several APA
elements are missing.
The errors in
formatting
demonstrate a
limited
understanding of
APA guidelines, intext-citations, and
references.

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Professional Identity Reflection

Jun 14, 2024 | Health Medical

Description

Professional identity is defined as including both personal and professional development. It involves the internalization of core values and perspectives recognized as integral to the art and science of nursing. These core values become self-evident as the nurse learns, gains experience, reflects and grows in the profession. Internalization of ethical codes of conduct is imperative. The nurse embraces these fundamental values in every aspect of practice while working to improve patient outcomes and promote the ideals of the nursing profession. Integral to this outcome is the nurse’s commitment to advocacy for improved healthcare access and service delivery for vulnerable populations and to the growth and sustainability of the nursing profession.Student Outcome: Student will be able to:Articulate a unique role as a member of the health care team, committed to evidence-based practice, caring, advocacy, and safe quality care, to provide optimal health care for diverse patients and their families.Reflection in 500-1000 words on what it means to you to have a professional identity as a nursing student. Rubrics

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Social Work Question

Jun 14, 2024 | Health Medical

Description

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:

Systems Theory – Ludwig von Bertalanffy
Ecological Systems Theory – Urie Bronfenbrenner
Life Model Theory – Gitterman and Germain

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 3 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.

0 pts

Not Competent

Did not complete

20 pts

Total Points: 50

Evaluate the use of protected health information in the cloud through a health information exchange

Jun 14, 2024 | Health Medical

Description

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:

Six 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.

261 @HR_1440

Jun 14, 2024 | Health Medical

Description

See attached

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

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Part F: Evaluation

Jun 14, 2024 | Health Medical

Description

Assessment Description

The purpose of this section is to understand the importance of evaluation in an EBR project. In a 500-750-word paper, include the following as they relate to evidence-based research:

Analyze a minimum of three different methods of project evaluation.
Determine which project evaluation method would be most appropriate for your project and explain why.
Create an evaluation plan for your project.
Develop an adjustment plan that identifies points when a change in direction may be needed. Determine what actions may be needed to ensure a successful implementation.

This assignment requires a minimum of two scholarly articles.

Once you receive your graded assignment, use the instructor feedback to make any necessary revisions to this section as you prepare for your final Benchmark – Evidence-Based Practice Project Proposal – Final Paper assignment due in Topic 8. Refer to “Evidence-Based Practice Project Proposal Format,” located in Class Resources, for more information.

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 not required to submit this assignment to LopesWrite.

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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
Change Model and Implementation Plan
Antwanetta Boswell
Grand Canyon University
HCA-650
Professor Tucker
09/20/2023
2
The Trans Theoretical Model of Behavioural Change (TTM) can be a useful change model
for implementing an evidence-based hand hygiene improvement initiative in a hospital context.
The TTM, created by Prochaska and DiClemente, outlines the many phases of change that people
go through while acquiring new behaviors. Its five steps are pre-contemplation, Contemplation,
Preparation, Action, and Maintenance.
Stage 1: Precontemplation Healthcare professionals may not be aware of the need for
better hand hygiene or may not think it is important. Educating the public about the dangers of
healthcare-associated infections (HAIs) and the advantages of good hand hygiene is the first step
in resolving the issue. Give statistics on current HAI rates to highlight the issue (Sands & Aunger,
2020).
Stage 2: Contemplation Workers in the healthcare industry start to understand the value
of hand cleanliness during the contemplation stage, but they may still be hesitant (Chavali et al.,
2014). Give them evidence-based knowledge on efficient hand hygiene practices to inspire them
to take action and give them chances to express their concerns and ask questions.
Stage 3: Preparation Staff members are ready to act during the planning phase but need
help and resources. Ensure a sufficient supply of soap, PPE, and hand sanitizers. Provide thorough
training programs and promote employee participation in deciding on hand hygiene policies.
Stage 4: Action Healthcare professionals are now actively working to improve their hand
hygiene habits. New protocol implementation, compliance monitoring, and ongoing feedback are
crucial. Celebrate your minor victories and thank your team for their efforts in reinforcing good
behavior.
3
Stage 5: Maintenance Sustaining improved hand hygiene practices is crucial. Continue
monitoring compliance, conduct regular audits, and provide ongoing education and support.
Address any challenges that arise to prevent relapse into old habits.
Conceptual Model of the Project (Appendix) In the conceptual model, the project starts
with the awareness phase, whereby the focus is placed on elucidating the issue of HealthcareAssociated Infections (HAIs) and emphasizing the significance of hand hygiene. The subsequent
phases of the Transtheoretical Model (TTM) are as follows: Precontemplation, Contemplation,
Preparation, Action, and Maintenance. Each level encompasses distinct techniques and activities
customized to meet healthcare personnel’s individual requirements.
The model further illustrates feedback loops, highlighting the repetitive nature of the
transformation process. The implementation plan is adjusted based on feedback obtained through
audits and compliance monitoring, enhancing its long-term efficacy.
In summary, the Transtheoretical Model of Behavioural Change offers a systematic
framework for implementing an evidence-based hand hygiene improvement initiative within a
hospital environment (Rahimi et al., 2019). Healthcare organizations may enhance the probability
of long-term behavior change among personnel, thereby decreasing healthcare-associated
infections by methodically addressing each step. The conceptual model depicted in the appendix
demonstrates this framework’s practical use.
Part E: Implementation Plan
Implementation Plan: Reducing Healthcare-Associated Infections (HAIs) through
Improved Hand Hygiene Compliance
Description of Methods:
Resources Needed:
4
1. Human Resources:
•
Infection Control Team: Responsible for project oversight, education, and
monitoring.
•
Training Staff: To conduct hand hygiene training sessions for healthcare workers.
•
Data Analysts: To analyze compliance data and identify trends.
•
Implementation Team: Comprising key stakeholders and champions to drive
change.
2. Fiscal Resources:
•
Budget for Educational Materials: Development and printing of hand hygiene
educational materials.
•
Funding for Hand Hygiene Products: Purchase hand sanitizers, soap, and PPE.
•
Personnel Costs: Salaries and benefits for project staff.
•
Data Analysis Software: To track compliance data efficiently.
3. Clinical Tools and Process Changes:
•
Educational Materials: Handouts, posters, and videos explaining proper hand
hygiene.
•
Hand Hygiene Products: Adequate supply of sanitizers, soap, and PPE.
•
Compliance Monitoring Tools: Electronic monitoring systems or manual
checklists.
•
Communication Tools: Intranet, emails, and meetings for information
dissemination.
Strategic Analysis:
5
Costs for Personnel: The Infection Control Team, training personnel, and data analysts
will include wages and benefits in the personnel expenses. To enable efficient project management
and compliance monitoring, these expenses are required.
Consumable Supplies: Money will be set aside to purchase PPE, soap, and hand
sanitizers. These tools are necessary for healthcare professionals to maintain good hand hygiene.
Equipment: To simplify compliance tracking and analysis, the project may call for
procuring electronic monitoring devices or data analysis software if not already offered by the
institute.
Computer-Related Costs: The research portion of the assignment may require a librarian
consultation and database access. It is essential to have access to pertinent healthcare databases if
you want to keep current on hand hygiene best practices.
Other Costs: Travel expenses may be incurred for team meetings, training sessions, or
conferences related to hand hygiene. Additionally, costs for developing and printing educational
materials will be essential.
Barriers:
1. Resistance to Change: Some healthcare staff may resist adopting new hand hygiene
protocols due to entrenched habits. This barrier can be addressed through comprehensive
education and support programs to foster buy-in.
2. Resource Constraints: Limited hand sanitizers, soap, and PPE availability may hinder
compliance efforts. Resource assessments and budget allocation prioritization will be
conducted to manage this barrier.
6
3. Compliance Monitoring Challenges: Implementing electronic monitoring systems may
face resistance from staff concerned about privacy. Proper communication and assurance
of data security will be vital.
Timeline:
The project will be implemented over a 12-month, allowing for flexibility in starting at any
time. The timeline is as follows:
1
•
•
•
2
3
4
5
6
7
8
9
10 11 12 13 14 15 16 17
Months 1-2: Precontemplation Stage
•
Assess current hand hygiene practices.
•
Develop awareness campaigns.
•
Form the Infection Control Team.
Months 3-4: Contemplation Stage
•
Launch educational campaigns.
•
Engage healthcare staff in discussions.
•
Begin data collection on current compliance rates.
Months 5-6: Preparation Stage
•
Allocate budget for educational materials and supplies.
7
•
•
•
Conduct comprehensive training for staff.
•
Set up compliance monitoring systems.
Months 7-8: Action Stage
•
Implement new hand hygiene protocols.
•
Monitor compliance and provide feedback.
•
Address any challenges or resistance.
Months 9-12: Maintenance Stage
•
Continue compliance monitoring.
•
Evaluate the effectiveness of the intervention.
•
Develop sustainability plans.
•
Share outcomes with the healthcare community.
Budget Plan
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 projectrelated expenses.
Personnel Costs: $300,000
•
Infection Control Team Salaries and Benefits: $150,000
•
Infection Control Manager: $75,000
•
Infection Control Nurse: $50,000
•
Data Analyst: $25,000
•
Training Staff: $100,000
•
Implementation Team (Stipends): $50,000
8
Consumable Supplies: $100,000
•
Hand Sanitizers: $40,000
•
Soap Dispensers and Soap: $30,000
•
Personal Protective Equipment (PPE): $30,000
Equipment: $20,000
•
Purchase of Electronic Compliance Monitoring System: $20,000
Computer-Related Costs: $15,000
•
Librarian Consultation: $5,000
•
Database Access: $5,000
•
Data Analysis Software: $5,000
O

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Leadership Styles During a Crisis (100 points)

Crisis situations require effective leadership to direct a unified quality healthcare response.

Using the Saudi Digital Library, locate and read three scholarly research articles on the role of leadership in managing quality and safety initiatives during crisis situations in Saudi Arabia.

Based on your readings, prepare a PowerPoint presentation describing your leadership style and how you would use your leadership to effectively manage quality and safety during a healthcare crisis. Explain the crisis situation, the environment, the resources available, the challenges, and proposed solutions to the crisis situation that you are writing about.

Your PowerPoint should meet the following requirements:

Seven to eight slides, not including your title and reference slides.

Each slide must provide detailed speakers notes, with a minimum of 100 words per slide. Notes must draw from and cite relevant reference materials.

Formatted per APA 7th edition and Saudi Arabia Electronic University formatting guidelines.

Utilize headings to organize the content of your work.

Professional design and transitions

Social Work Question

Jun 14, 2024 | Health Medical

Description

Instructions

Read the Case Study- Charlie: p. 392 in:

Dziegielewski, S. (2014). DSM-5 In ActionLinks to an external site.. (3rd ed.). Wiley and Sons.

You will then complete a Mental Status Examination for this Case Study and submit a 1-2 page word document that conducts an assessment of Charlie using the format below.

Complete the Mental Status Examination for this Case study
Identify the Risk and Protective Factors: Biological, Psychological and Social by answering the following questions.
Biomedical Assessment:
Medical Conditions: Does the client report physical conditions? In what ways does it affect the client’s social and occupational functioning and activities of daily living?
Psychological Assessment:
Cognitive Functioning: Does the client have the ability to think and reason about what is happening to them? Is the client able to participate and make decisions regarding their best interest? Lethality: Would the client harm themselves or anyone else because of perception of the problem experienced?
Social/Environmental Assessment:
Social/Societal: Is the client open to outside help?
What support system or helping networks are available?
Does the client have support from neighbors, friends or community organizations (church, membership) What support does the client have from family?
Occupational Assessment:
Does the client have a disability that impairs or prohibit their ability to work?
Is the client a member of a cultural or religious group
Provide the Clinical Diagnosis using the DSM 5 TR using Diagnostic Criteria along with the DSM 5TR Code and title of the diagnosis. Provide a brief justification on why this diagnosis was selected.

Adapted from Dziegielewski (2014).

Provide the Clinical Diagnosis using the DSM 5 TR

Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.

Estimated time to complete: 4 hours

Assignment Resources
Complete the Mental Status Examination Brief Mental Status examinationLinks to an external site.(pdf)
Rubric

MSW620 Unit 3 MSE Rubric

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups

MSE

10 pts

Mastered

All components of the MSE are clearly complete and accurate for the presented case study

9 pts

Excels

All components of the MSE are clearly complete and accurate but not clearly linked to case study

8 pts

Competent

All components of the MSE are somewhat complete and somewhat connected to case study

7 pts

Needs Improvement

Minimal information on the MSE

0 pts

Not Present

No MSE provided

10 pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups

Biomedical

8 pts

Mastered

Medical Conditions are clearly assessed by providing detail for all of the questions with clear connection to case study

7.2 pts

Excels

Medical Conditions are clearly assessed by providing detail for all of the questions with some connection to case study

6.4 pts

Competent

Medical Conditions are partially assessed by providing detail for some of the questions with some connection to case study

5.6 pts

Needs Improvement

Medical Conditions are minimally assessed

0 pts

Not Present

The medical conditions are not assessed

8 pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups

Psychological

8 pts

Mastered

Psychological Conditions are clearly assessed by providing detail for all of the questions with clear connection to case study

7.2 pts

Excels

Psychological Conditions are clearly assessed by providing detail for all of the questions with some connection to case study

6.4 pts

Competent

Psychological Conditions are partially assessed by providing detail for some of the questions with some connection to case study

5.6 pts

Needs Improvement

Psychological Conditions are minimally assessed

0 pts

Not Present

The Psychological conditions are not assessed

8 pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups

Social/Emotional

8 pts

Mastered

Social/ Emotional Conditions are clearly assessed by providing detail for all of the questions with clear connection to case study

7.2 pts

Excels

Social/ Emotional Conditions are clearly assessed by providing detail for all of the questions with some connection to case study

6.4 pts

Competent

Social/ Emotional Conditions are partially assessed by providing detail for some of the questions with some connection to case study

5.6 pts

Needs Improvement

Social/ Emotional Conditions are minimally assessed by

0 pts

Not Present

The Social/ Emotional conditions are not assessed

8 pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
Occupational Assessment

8 pts

Mastered

Occupational Assessment is clearly assessed by providing detail for all of the questions with clear connection to case study

7.2 pts

Excels

Occupational Assessment is clearly assessed by providing detail for all of the questions with some connection to case study

6.4 pts

Competent

Occupational Assessment is partially assessed by providing detail for some of the questions with some connection to case study

5.6 pts

Needs Improvement

Occupational Assessment is are minimally assessed

0 pts

Not Present

The Social/ Emotional conditions are not assessed

8 pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
Diagnosis

8 pts

Mastered

Diagnosis is correct and justified with diagnostic criteria

7.2 pts

Excels

Diagnosis is correct with limited justification

6.4 pts

Competent

Diagnosis is correct with no justification

5.6 pts

Needs Improvement

Diagnosis is incorrect but justified

0 pts

Not Present

Diagnosis is not provided

8 pts

Total Points: 50

dis my problem It is difficult to provide virtual health services by dealing with virtual clinics

Jun 14, 2024 | Health Medical

Description

Program identification

Task 1: Analyzing Educational Needs

Choose a specific subject area or field of study. Describe the process of analyzing educational needs for this subject area. Include factors such as changing societal demands, learner demographics, and emerging trends that can influence program

Task 2: Establishing Program Goals

Based on the subject area you chose in Task 1, create two program goals that address specific learning outcomes or educational needs. Ensure that these goals are clear, concise, and reflect the overarching purpose of the educational program.

Task 3: Considering Influencing Factors

Identify and discuss three key factors that could influence the identification of an effective program. These factors could include considerations related to student diversity, community involvement, technology integration, and alignment with educational standards.

Needs assessment

Task 1: Identifying Stakeholders

List and briefly describe the key stakeholders involved in a needs assessment for your curriculum design. Explain the roles and perspectives of each stakeholder, such as students, teachers, parents, administrators, and community members.

Task 2: Data Collection Methods

Research and describe three different methods commonly used to collect data during a needs assessment. Choose methods that can provide insights into various aspects of the learning environment. For each method, explain its benefits, potential drawbacks, and when it might be most appropriate to use.

Topic 6 DQ 2

Jun 14, 2024 | Health Medical

Description

Assessment DescriptionEvaluation is an important part of the implementation process. At what point should evaluation begin? At what point should the readjustment process begin? How would you go about determining this? Are these processes the same for every project? Why or why not?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

261 layal

Jun 14, 2024 | Health Medical

Description

See attached

241 Layla

Jun 14, 2024 | Health Medical

Description

See attached

Unformatted Attachment Preview

NSG7000 WEEK 5 PROJECT POWER POINT

Jun 14, 2024 | Health Medical

Description

Below is a reminder of the key tasks involved in the Organizational Analysis assignment:

Identify an organization (or unit within an organization) that you believe excels in high-quality relationships and enabling conditions for team performance. This organization can be from any industry.
Develop a scorecard for evaluating the organization or unit. At a minimum, you should include information on the mission and philosophy of the organization or unit, strategic projects, and analysis and implementation of findings. Building & Implementing a Balanced Scorecard.
Make your case based on available first-hand or second-hand data about how the organization scores in terms of relational capability and enabling conditions for team performance. You will need to submit your scorecard as well as the evidence you utilized to your instructor.
Based on your analysis, prepare a 8- to 10-page paper and a 20- to 30-slide presentation based on this paper.

The presentation should: (rough draft due this week)

Include a cover slide with your information.
Cover all salient points from the paper.
Describe the programs or processes that make the chosen organization or unit successful in team building and high-quality relationships.
Include an analysis of the programs or processes.
Include a summary explaining how lessons learned could be applied to another organization.

Unformatted Attachment Preview

1
Organizational Analysis: High-Quality Relations and Teamwork at Mayo Clinic
Sabina Thomas, MSN, ARNP, FNP-C
South University
NSG 7000
Dr. Mary
9/11/2023
2
Organizational Analysis: High-Quality Relations and Teamwork at Mayo Clinic
Developing and maintaining high-quality relationships and team performance is essential
for a high-performing organization. Regardless of the industry, high-quality relationships and
teams help in driving the organization’s mission and vision. In the healthcare industry,
collaboration and team performance promote care quality and safety outcomes. Organizations
that are great in promoting high-quality relationships and team performance also have better
performance outcomes due to the power of teamwork and collaboration. Learning from these
organizations and translating evidence to practice in other organizations is an effective way of
improving organizational performance. This paper discusses Mayo Clinic and its effectiveness in
creating and maintaining high-quality relationships in healthcare, the processes and programs
that sustain these relationships and team performance, attributes, and means of translating these
findings to other organizations.
Description: Mayo Clinic
Mayo Clinic is a large medical group practice with locations in Florida, Arizona, and
Minnesota in the US and internationally in London and Abu Dhabi. The organization has many
facilities ranging from small primary care clinics and mobile clinics to large regional medical
centers. Mayo Clinic has been ranked the top hospital in the country many times and has
consistently made the list of top-ranking hospitals. The organization’s mission is “to inspire hope
and contribute to health and well-being by providing the best care to every patient through
integrated clinical practice, education and research” (Mayo Clinic, n.d.). Mayo’s commitment to
high quality care and performance are partly driven by the high-quality relationships maintained
among stakeholders and high-performance teams providing care in the organization.
3
The success of Mayo in building and maintaining relationships can be associated with the
organization’s philosophy as a non-profit organization with work conducted in peer-reviewed
and team-based approaches. The CEO, Gianrico Farrugia, M.D., upholds the attribute of a
servant leader (Farrugia & Lee, 2020). This attribute is associated with democratic leadership
style which encourages team-based approach and philosophy. The philosophy of the organization
is based on team-based care. As a non-profit organization, Mayo has built its services based on
centralizing patients’ needs rather than accruing a profit. The organization has focused on
integrated care across all locations to provide care continuity and high-quality services (Markel,
2018). The focus of care provision through team collaboration and care integration is a crucial
determinant of high quality-relationships and teamwork in the health system. The
multidisciplinary practice and collaboration across facilities drives team-based work and care
approaches.
The healthcare organization, from its inception, has remained focused on highly
coordinated patient care and hence fostered teamwork and high-quality relationships. The
healthcare organization was started by the collaborative efforts of two brothers, Charles, and
Will Mayo, two surgeons who took after their father and established the clinic in Rochester in
early 20th century (Markel, 2018). From its inception and throughout the more than 100 years of
service, the organization has been focused on providing coordinated care to patients who mostly
needed but could not afford or access health care (Markel, 2018). The organization has gone
ahead to maintain close working relationships among physicians across its facilities and close
coordination of care across all branches.
4
Processes and Programs behind Mayo’s Success
The success of any healthcare organization can be attributed to its leadership. The leaders
at Mayo Clinic are visionaries in that they support futuristic developments and innovation. All
leaders in the organization are physicians or other clinicians and this has ensured that people who
are genuinely interested in medicine and medical innovation are leaders. The use of servant
leadership style and collaborative approaches enhances innovation (Nauman et al., 2022). This
style and leadership attributes have promoted team building and developing amiable employee
relationships. The leaders promote team building and relationships by creating an enabling
environment for staff to interact positively and collaboratively.
Several processes and programs are behind Mayo’s success and among those is physician
leadership. The healthcare organization is led by physicians on all levels through governance
committees. The advantage of physician leadership is that in collaboration with administrative
staff, physicians are able to prioritize patients’ needs (Farrugia & Lee, 2020). Broad participation
is promoted by rotating physicians on assignment and leadership roles in the organization in a
shared governance philosophy (Mayo Clinic, n.d.). Power in the organization is shared and this
allows for communication, collaboration, and focus on the core aspects of patient care. This
model of leadership requires high level of quality relationships and teamwork and hence is partly
to thank for the success of the organization.
Secondly, the organization has processes that mandate care coordination for all patients
hence driving collaboration and high-quality care. Patients are assigned a care coordinating
physician when they present to any of the facilities. The role of these physicians is to ensure all
services are integrated, a care plan is in place, and patients receive appropriate communication
(Farrugia & Lee, 2020). This process allows for care coordination within and outside the
5
organization. One of the programs created to this end is a diabetes care coordination initiative
which the health system has created to reach out to patients with diabetes remotely and ensure
ongoing care and health improvement (Manzaneque et al., 2019). The care coordination
processes and programs are geared towards maintaining care continuity. This has helped in
creating strong relationships with patients and partners in care provision.
In addition to care coordination, the health system provides full multispecialty integration
with shared electronic medical records (EMR). The processes and model of care determine the
success of a healthcare organization. In Mayo Clinic, the organization uses a collegial
multispecialty integration model and has shared health information and data resources across
different facilities (Comfere et al., 2020). This means that when a patient is receiving care in any
of the clinics or hospitals, the care access and services are integrated. This coordination and
integration promote communication, a healthy relationship among providers and patients, and
high-quality care in all branches. The care coordination model and integration allow for
efficiency and accessibility of care for all in line with the organization’s philosophy of doing
what is best for the patients.
Mayo Clinic’s peer-review programs also promote success through accountability and
continuous quality promotion. Staff across all sites are responsible and accountable to each other
and review each other’s work in a collaborative environment. The organization has clinical
practice committees at each site and their role is to collaborate in evaluating care quality and
providing expert protocols to promote care quality (Didehban et al., 2020). The EMR is open to
all authorized providers and requests physicians to provide comments and collaborate remotely.
Internal and external methods of reporting quality and safety in the organization maintain
continuous quality improvement. The peer review program promotes accountability and
6
continuous quality, accounting for the success of the organization in not only managing quality
but also promoting peer collaboration.
The compensation model for Mayo Clinic is another pillar for its success as the
organization has succeeded in promoting focus on patient care quality rather than volumes. All
physicians and permanent employees at Mayo are salaried, eliminating incentives to increase
volume of care (Hayes et al., 2020). This model is beneficial but has also faced criticism.
Healthcare in the US has largely been driven by independent or collaborative physician practices
that seek to turn a profit through reimbursement for care provided or out-of-pocket payments (ee,
2022). This model of care often pushes physicians to strive to provide care to a large number of
patients with the aim being to maximize their profits. In Mayo, however, salaried physicians do
not work to turn a profit. Instead, one must have a certain mentality for serving patients rather
than financial benefits to work at the organization. Providers employed at Mayo focus on the
patients’ needs and care quality and hence provide optimal care rather than striving to make a
profit.
Attributes Making the Success
The identified processes and programs are supported by specific attributes and
characteristics of the staff and care provision at Mayo Clinic, starting with a culture of
teamwork. Since its first days, Mayo has based its care provision in teamwork and collaboration.
This has become a tradition which the organization upholds through hiring processes and
onboarding new staff through enculturation (Hayes et al., 2020). In this culture, professionals are
free to ask for assistance, collaborate with others, and use technologies to support their care
processes. The team-based care has ensured the building of trust among providers, fostering
positive relationships in the staff, and enhancing care outcomes.
7
In addition to the culture of teamwork and trust, Mayo Clinic upholds the principles of
patient-centered care, an attribute that promotes focus on the quality of services and hence has
supported the success of the organization. The follow-up and care coordination programs such as
the stated diabetes initiative are based in this philosophy. In patient-centered care, the focus of
the care team is in meeting all complex needs of the patient with the patient being a member of
the care team (Didehban et al., 2020). The mission and vision of the organization specifies that
care provision is patient-centered, and this translates to focus on patient issues and how to meet
their needs. A culture of patient-centered care has enabled Mayo to succeed in providing high
quality care to its patients.
Moreover, the health system has focused on continuous innovation, an attribute that is
instrumental in promoting continuous quality and success. Innovation is important for every
organization to adapt to changing organizational and industry environment and address any
emerging issues. Mayo Clinic is known for its innovation, especially in the application of
systems engineering to pursue continuous quality improvement projects (Comfere et al., 2020).
The organization’s leadership focus on continuous innovation allows for ongoing measurement
and review of current processes and relations. Focus on continuous innovation is a desirable
attribute because it builds a culture of self-improvement and adoption of the most effective
methods and technologies to improve the organization’s functioning.
Mayo Clinic also supports high quality relationships and teamwork through consensusdriven decision-making. Most of the strategic and key decisions of the organization are reached
through a consensus-driven committee process. On the one hand, committee processes in the
organization take longer than traditional top-down management to reach decisions and hence
management may be slow to make strategic decisions. On the other hand, the attribute engenders
8
teamwork, acceptance of decisions from different stakeholders, and collaboration across
specialties in making important decisions with the patients being in the forefront of such
decisions (Didehban et al., 2020). The consensus-driven decision-making process is based on the
attributes of good teamwork and promotion of shared responsibility and decision-making as
opposed to highly hierarchical systems. The shared clinical and managerial decision-making
creates a culture of collaboration and teamwork.
The other attribute that drives the processes and programs responsible for Mayo’s success
is the people recruited at Mayo. The organization has a deep focus on scholarly care through
research and education conducted in the different clinics and centers. The work environment is
enabling through the provision of adequate resources for providers and other staff in the hospital.
When hiring people, Mayo Clinic looks for physicians that are oriented towards collaboration
and teamwork. Due to the salaried model of compensation, a clinician has no motivation to hang
on to a patient for financial value and neither does the physician lose income by helping another
clinician. The attributes and culture cultivated at Mayo is self-selecting in that it attracts
clinicians with a certain attitude and attributes focused on collaboration and care quality. In the
long-term, physicians who are motivated by the economic reasons cannot survive in Mayo. Only
those who are truly interested in offering high-quality and collaborative patient-first care remain
in this environment and hence the staff at Mayo have shared values of patient-centered
collaborative care.
Translating Mayo Processes and Programs to Other Organizations
The processes and programs at Mayo can be translated to other healthcare organizations
and the first step would be to redefine how decisions are made. Most healthcare organizations in
the US have a top-down decision-making process whereby the CEO at the top and specific
9
directors have a lot of power in strategic decision-making. While this may be great for efficiency
and also productive when the right leaders are in place, it does not encourage teamwork and
relationship-building. The healthcare organization can use the example of Mayo to build teams
for shared strategic decision-making. At the very least, a consultative process should be put in
place for different opinion leaders such as physicians, nurses, and other clinicians to contribute to
key development and strategic decisions.
The second component that can be borrowed from Mayo Clinic is the recruitment and
enculturation of staff in the health organization. The culture of Mayo Clinic is unique due to the
compensation model which only attracts physicians focused on care quality and collaboration.
This uniqueness defines the type and attitudes of staff that are attracted to and retained in the
organization. Hospitals should have unique cultures that help them stand out from the rest with
clear focus on their mission and philosophy (Comfere et al., 2020). A clear focus on care
accessibility, quality, and patients’ needs should be defined in the hospital mission and vision
and the recruitment process designed to ensure only staff that fit the culture are recruited into the
organization. Mayo stands out for its unique approaches and other organizations should emulate
too.
Care integration, coordination, and collaboration should also be adopted in the hospital.
The healthcare industry in the US has been faulted as complex and fractured, frustrating not only
patients but also clinicians and administrative staff. Mayo stands out because the organization
provides integrated multi-specialty care by assigning teams and a specific clinician to each
patient to follow-through the patient journey. Quality improvement programs at other hospitals
should focus on how to provide high quality care in a collaborative and integrated environment.
The first step is freely shared EMR and interoperable EHR systems. Additionally, a care
10
coordination system that ensures patient tracking and ongoing communication needs to be put in
place. This could include integration of telehealth for patient communication and communication
among healthcare staff as well (McLendon et al., 2019). Large healthcare organizations should
focus on integration so as to provide care to all patient needs in a collaborative team-based
environment. These changes can be achieved through innovative quality-improvement projects
and are useful in promoting better relationships and teamwork.
Conclusion
Mayo Clinic is a leading healthcare organization and its programs and processes have
maintained high-quality relationships and teamwork. The organization thrives due to physician
leadership, shared decision-making, a compensation model focusing on care quality,
multispecialty integration in collaborative care environment, and peer-review programs. These
have been maintained through a culture of teamwork and trust, continuous innovation, patientcentered care, and consensus-driven decision-making among other attributes. Other healthcare
organizations can learn from Mayo and implement processes and programs for improvement.
Shared decision-making can be adopted by changing the leadership structure and a unique
culture of quality can be built through recruitment and organizational culture maintained. Above
all, integration and collaboration should be supported by using current technologies and
innovation. Mayo Clinic is a great example of effective patient-centered organization whose
processes are based on healthy relationships and teamwork.
11
References
Comfere, N. I., Matulis III, J. C., & O’Horo, J. C. (2020). Quality improvement and healthcare:
The Mayo Clinic quality Academy experience. Journal of Clinical Tuberculosis and
Other Mycobacterial Diseases, 20. https://doi.org/10.1016/j.jctube.2020.100170
Didehban, R., Caine, N. A., Glenn, S. W., & Hasse, C. H. (2020, September). Role of the
administrative partner and the physician-administrator partnership. Mayo Clinic
Proceedings 95(9), S38-S40. https://doi.org/10.1016/j.mayocp.2020.06.043
Farrugia, G., & Lee, T. H. (2020). Cure, Connect, transform: Three Mayo clinic strategy
components for servant leaders. NEJM Catalyst Innovations in Care Delivery, 1(4).
https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0416
Hayes, S. N., Noseworthy, J. H., & Farrugia, G. (2020, January). A structured compensation plan
results in equitable physician compensation: A single-center analysis. Mayo Clinic
Proceedings 95(1), 35-43. https://doi.org/10.1016/j.mayocp.2019.09.022.
Lee, R. H. (2022). Economics healthcare managers. Peter C. Olden, Ph. D., Chair.
Manzaneque, N. N., Pérez-Arechaederra, D., & Montalbán, J. M. C. (2019). Side effects and
practices to improve management of type 2 diabetes mellitus from the viewpoint of
patient experience and health care management. A narrative review. Endocrinología,
Diabetes y Nutrición (English ed.), 66(10), 596-610.
https://doi.org/10.1016/j.endien.2019.11.005
Markel, H. (2018, Jun. 29). The brilliant brothers behind the Mayo Clinic. PBS News Hour.
https://www.pbs.org/newshour/health/the-brilliant-brothers-behind-the-mayo-clinic
Mayo Clinic. (n.d.). About Mayo Clinic Health System.
https://www.mayoclinichealthsystem.org/about-us
12
McLendon, S. F., Wood, F. G., & Stanley, N. (2019). Enhancing diabetes care through care
coordination, telemedicine, and education: Evaluation of a rural pilot program. Public
Health Nursing, 36(3), 310-320. https://doi.org/10.1111/phn.12601
Nauman, S., Bhatti, S. H., Imam, H., & Khan, M. S. (2022). How servant leadership drives
project team performance through collaborative culture and knowledge sharing. Project
Management Journal, 53(1), 17-32. https://doi.org/10.1177/87569728211037777
13
Appendix: Balanced Scorecard for Mayo Clinic
Objectives
Goals
Indicators
Initiatives
Financial
Perspective
Increase
revenue and
reduce costs
Increase
revenue by
10%
Financial
statements
Negotiate with
suppliers
Customer
Perspective
Have high
patient
satisfaction
levels
Increase
proportion of
patients who
report being
satisfied by
20%
Patient
satisfaction
HCAHPS
Survey
Staff training on
patient care and
interaction
Internal
Processes
Reduce the
rates of errors,
adverse events,
and near-misses
Reduce the
rates of
reported errors
by 25% in one
year
Organizational
safety and
quality
dashboard
Safety
improvement
projects
including
medications
reconciliation
and new
barcode
medication
administration
technologies
Learning and
Growth
Maintain
research and
development
processes
Increase
research
funding and
annual grants
by 20% in 2
years
Financial
statements and
research
publications
Publish current
research and
support
innovators in
the organization

Purchase answer to see full
attachment

discussion response 1

Jun 14, 2024 | Health Medical

Description

please respond to the following discussion post as a peer making a comment . ”

Hello, everyone

My project is about implementing an educational program on transplant liver patients aged 18 to 40 in South Texas.

A balanced scorecard is a valuable tool for evaluating the implementation of an evidence-based project as it provides a holistic view of the project’s performance and its alignment with organizational goals and objectives. In implementing a multidisciplinary post-transplant education team for liver transplant recipients in South Texas, a balanced scorecard can be used to assess various aspects of the project’s success.

The financial perspective evaluates the economic impact of the implementation. It includes assessing budget adherence, intervention cost-effectiveness, and return on investment. It helps determine whether the resources allocated to the project are being utilized efficiently.

Customer (patient) perspective, satisfaction, and well-being of liver transplant recipients are critical. Surveys and patient feedback can be used to measure their satisfaction with the new post-transplant education team and their quality of life.

The internal process perspective assesses the efficiency and effectiveness of the processes involved in implementing the multidisciplinary team. Key performance indicators (KPIs) related to patient education, team member coordination, and patient communication can be monitored to ensure smooth workflow.

Finally, the success of an evidence-based project often depends on the learning and growth of healthcare professionals involved. This perspective focuses on staff development, training, and knowledge acquisition. It measures whether the team is continuously improving and adapting to the changing needs of patients.

A balanced scorecard comprehensively assesses the project’s overall performance by evaluating the project from these perspectives. It allows healthcare administrators and project managers to identify areas that require improvement, make data-driven decisions, and ensure that the implementation aligns with the organization’s strategic goals (Alvarez et al., 2019). Moreover, it helps maintain a focus on both short-term and long-term outcomes, ensuring that the project meets immediate objectives and contributes to the organization’s sustainable success.

Alvarez, L., Soler, A., Guiñón, L., & Mira, A. (2019). A balanced scorecard for assessing a strategic plan in a clinical laboratory. Biochemia Medica, 29(2). https://doi.org/10.11613/BM.2019.020601

MSW 620 WEEK 3 Assigment case study

Jun 14, 2024 | Health Medical

Description

Instructions

Read the Case Study- Charlie: p. 392 in:

Dziegielewski, S. (2014). DSM-5 In ActionLinks to an external site.. (3rd ed.). Wiley and Sons.

You will then complete a Mental Status Examination for this Case Study and submit a 1-2 page word document that conducts an assessment of Charlie using the format below.

Adapted from Dziegielewski (2014).

Provide the Clinical Diagnosis using the DSM 5 TR

Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.

Estimated time to complete: 4 hours

Assignment Resources
Complete the Mental Status Examination Brief Mental Status examinationLinks to an external site.(pdf)
Rubric

MSW620 Unit 3 MSE Rubric

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups

MSE

10 pts

Mastered

All components of the MSE are clearly complete and accurate for the presented case study

9 pts

Excels

All components of the MSE are clearly complete and accurate but not clearly linked to case study

8 pts

Competent

All components of the MSE are somewhat complete and somewhat connected to case study

7 pts

Needs Improvement

Minimal information on the MSE

0 pts

Not Present

No MSE provided

10 pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups

Biomedical

8 pts

Mastered

Medical Conditions are clearly assessed by providing detail for all of the questions with clear connection to case study

7.2 pts

Excels

Medical Conditions are clearly assessed by providing detail for all of the questions with some connection to case study

6.4 pts

Competent

Medical Conditions are partially assessed by providing detail for some of the questions with some connection to case study

5.6 pts

Needs Improvement

Medical Conditions are minimally assessed

0 pts

Not Present

The medical conditions are not assessed

8 pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups

Psychological

8 pts

Mastered

Psychological Conditions are clearly assessed by providing detail for all of the questions with clear connection to case study

7.2 pts

Excels

Psychological Conditions are clearly assessed by providing detail for all of the questions with some connection to case study

6.4 pts

Competent

Psychological Conditions are partially assessed by providing detail for some of the questions with some connection to case study

5.6 pts

Needs Improvement

Psychological Conditions are minimally assessed

0 pts

Not Present

The Psychological conditions are not assessed

8 pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups

Social/Emotional

8 pts

Mastered

Social/ Emotional Conditions are clearly assessed by providing detail for all of the questions with clear connection to case study

7.2 pts

Excels

Social/ Emotional Conditions are clearly assessed by providing detail for all of the questions with some connection to case study

6.4 pts

Competent

Social/ Emotional Conditions are partially assessed by providing detail for some of the questions with some connection to case study

5.6 pts

Needs Improvement

Social/ Emotional Conditions are minimally assessed by

0 pts

Not Present

The Social/ Emotional conditions are not assessed

8 pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
Occupational Assessment

8 pts

Mastered

Occupational Assessment is clearly assessed by providing detail for all of the questions with clear connection to case study

7.2 pts

Excels

Occupational Assessment is clearly assessed by providing detail for all of the questions with some connection to case study

6.4 pts

Competent

Occupational Assessment is partially assessed by providing detail for some of the questions with some connection to case study

5.6 pts

Needs Improvement

Occupational Assessment is are minimally assessed

0 pts

Not Present

The Social/ Emotional conditions are not assessed

8 pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups
Diagnosis

8 pts

Mastered

Diagnosis is correct and justified with diagnostic criteria

7.2 pts

Excels

Diagnosis is correct with limited justification

6.4 pts

Competent

Diagnosis is correct with no justification

5.6 pts

Needs Improvement

Diagnosis is incorrect but justified

0 pts

Not Present

Diagnosis is not provided

8 pts

Total Points: 50

Intermiediate EPI DAG

Jun 14, 2024 | Health Medical

Description

Topic 6 DQ 1

Jun 14, 2024 | Health Medical

Description

Discuss the role of a balanced scorecard in evaluating the implementation of an evidenced-based project.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

discussion – 5-2 anayltical tools

Jun 14, 2024 | Health Medical

Description

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?

To complete this assignment, review the Discussion Rubric and use the Hospital Statistics Basics Formulas resource.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.

Mean:

Median:

Measures of Central Tendency

( ) = h h

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:

Standard Deviation:

Average Daily Census:

Average Daily Newborn Census:

̅2 2 = Σ(X − )

−1

= √∑( X − x̄) (N−1)

Calculating Census

h h h

Average Daily Census for a Patient Care Unit:

Bed Occupancy Ratio:

h h h

Occupancy Rates

h ( × h )

× 100

Newborn Bassinet Occupancy Ratio:

× h

× 100

Bed Turnover Rate:

Direct: Indirect:

Average Length of Stay:

Average Newborn Length of Stay:

Gross (Hospital) Death Rate:

h ( h ) h

× h

Length of Stay

h ( h ) h ( h )

h
h ( h )

Death Rates

h ( )
h ( & h ) h

Net Death Rate/Institutional Death Rate:

× 100

h ( ) h < 48 h h ( h ) h < 48 h h × 100 Postoperative Death Rate: h ( h 10 ) h h × 100 Anesthesia Death Rate: Maternal Death Rate: h h ×100 h h h ( h ) h Newborn Mortality Rate: h h ( h ) h × 100 × 100 Neonatal Mortality Rate: Infant Mortality Rate: Vital Statistics—Newborn h × 1,000 h h h ( ) × 1,000 h h Fetal Death Rate: ⁄ h h + h h × 100 Cancer Mortality Rate: Gross Autopsy Rate: Net Autopsy Rate: h × 100 Autopsy Rates h × 100 h h h h − ′ ′ Adjusted Hospital Autopsy Rate: × 100 Infection Rate: Morbidity and Miscellaneous h ( h ) h h h h h × 100 Newborn Autopsy Rate: Fetal Autopsy Rate: × 100 h h Postoperative Infection Rate: h × 100 h h × 100 h × 100 Cesarean Section Rate: − h ( − ) × 100 h HIM Department Statistics = − × 100 Consultation Rate: Completed Work: Labor Productivity: = Case-Mix Index: h h − h h 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%

Social Work Question

Jun 14, 2024 | Health Medical

Description

Instructions

Beginning Week 3, you will create a theory chart each week to become familiar with different theories as they apply to social work practice and understanding clients.

Chapter 3 presents many strategies for applying theoretical knowledge to practice, including reflective practice and the use of supervision and consultation. For this assignment, think about how you can apply what you are learning in this class to prepare to work with clients.

What strategies will you use from the reading?
Why is consultation and supervision important for professional social work and understanding theory?
Write a 3-4 paragraph reflection discussing specific ways you can think about and apply theory to practice.

You may cite your textbook as a reference, and one additional article. Reflection must include in-text citations and References in APA format.

Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.

Estimated time to complete: 2 hours

Rubric

MSW600 Paper Assignment Rubric 50 pts

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeCompetency 1use reflection and self-regulation to manage personal values and maintain professionalism in practice situations

use supervision and consultation to guide professional judgment and behavior

25 pts

Identifies a creative, focused, and manageable topic that addresses potentially significant aspects of the topic.

22.5 pts

Identifies a creative, focused and manageable topic that addresses important and notable aspects of the topic.

20 pts

Identifies a focused and manageable/ doable topic that appropriately addresses relevant aspects of the topic.

17.5 pts

Identifies a topic that while manageable/ doable, is too narrowly focused and leaves out relevant aspects of the topic.

15 pts

Identifies a topic that is far too general and wide-ranging as to be manageable and doable.

0 pts

Does not clearly identify a topics that is relative to the assignment.

25 pts

This criterion is linked to a Learning OutcomeWriting

15 pts

The paper exhibits a superior command of written English language conventions. The paper has no errors in mechanics, grammar, or spelling.

13.5 pts

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.

12 pts

The paper exhibits command of written English language conventions. The paper has minor errors in mechanics, grammar, or spelling that impact the flow of communication.

10.5 pts

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.

9 pts

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.

0 pts

15 pts

This criterion is linked to a Learning OutcomeAPA

10 pts

The required APA elements are all included with correct formatting, including in-text citations and references.

9 pts

The required APA elements are all included with minor formatting errors, including in-text citations and references.

8 pts

The required APA elements are all included with multiple formatting errors, including in-text citations and references.

7 pts

The required APA elements are not all included. AND/OR there are major formatting errors, including in-text citations and references.

6 pts

Several APA elements are missing. The errors in formatting demonstrate limited understanding of APA guidelines, in-text-citations, and references.

0 pts

There is little to no evidence of APA formatting. AND/OR there are no in-text citations AND/OR references.

10 pts

Total Points: 50

MSW 610 WEEK 2 suicide risk and Screening

Jun 14, 2024 | Health Medical

Description

Instructions

Watch this video and answer the following questions in a 2-page reflection paper, using this video and this week’s readings and videos:

Explain the difference between a suicide risk screening tool vs. suicide risk assessment.
Provide an example of each.
Identify and list the 5 questions of the ASQ screening tool.
Describe the three identifiers of suicide ideation or risk.
Explain the most common myth surrounding suicide that parents fear.
Share your position of this myth.
Reflect on the video and explain what the provider could have done differently in assessing for suicidality, including specific examples.
REQUIREMENTS

This paper should address the following requirements:

At least 2 pages in length
Include a title page and references page with proper APA formatting (not included in page total).
Include properly formatted in text citations to support your thoughts and ideas.
Include references that are no older than five years.

Review the grading rubric for other specific requirements.

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 2 Paper

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups

10 pts

Mastered

Suicide tool and Risk Assessment are clearly explained with examples of each.

9 pts

Excels

Suicide tool and Risk Assessment is clearly explained with limited comparison and contrast and no examples are provided

8 pts

Competent

Suicide tool and Risk Assessment is partially explained with limited comparison and contrast and no examples are provided

7 pts

Needs Improvement

Suicide tool and Risk Assessment is partially explained with no comparison and contrast and no examples are provided

0 pts

Not Present

Suicide tool and risk assessment are not explained; no examples are provided; no comparison/contrasts are included

10 pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups

10 pts

Mastered

All 5 questions on the ASQ tool are identified with reference included

9 pts

Excels

All 5 questions on the ASQ tool are identified with no reference included

8 pts

Competent

Less than 5 questions on the ASQ tool are identified with reference included

7 pts

Needs Improvement

Less than 5 questions on the ASQ tool are identified with no reference included

0 pts

Not Present

None of the questions on the ASQ were identified

10 pts

This criterion is linked to a Learning OutcomeCompetency 7Assess Individuals, Families, Groups

10 pts

Mastered

The identifiers of suicide ideation are clearly explained and examples are provided

9 pts

Excels

The identifiers of suicide ideation are clearly explained and limited examples are provided

8 pts

Competent

The identifiers of suicide ideation are somewhat explained and limited examples are provided

7 pts

Needs Improvement

The identifiers of suicide ideation are minimally explained

0 pts

Not Present

Does not discuss identifiers of suicide ideation

10 pts

This criterion is linked to a Learning OutcomeCompetency 3Advance Human Rights and Social, Economic, and Environmental Justice

10 pts

Mastered

A common myth around suicide is clearly stated with a concise personal reflection on your position

9 pts

Excels

A common myth around suicide is clearly stated with minimal personal reflection on your position

8 pts

Competent

A common myth around suicide is clearly stated with little to no reflection

7 pts

Needs Improvement

A common myth around suicide is minimally stated

0 pts

Not Present

No common myth provided

10 pts

This criterion is linked to a Learning OutcomeCompetency 9Evaluate Practice with Individuals, Families, Groups

10 pts

Mastered

Provides a detailed reflection on the video and clearly explains what the provider could have done differently in assessing for suicidality with specific examples.

9 pts

Excels

Provides a detailed reflection on the video and somewhat explains what the provider could have done differently in assessing for suicidality with specific examples.

8 pts

Competent

Provides a detailed reflection on the video and somewhat explains what the provider could have done differently in assessing for suicidality with vague or limited examples.

7 pts

Needs Improvement

Provides a minimal reflection with no examples

0 pts

Not Present

Did not reflect on the video

10 pts

Total Points: 50

261 @iocean_30

Jun 14, 2024 | Health Medical

Description

See attached

IHP 430 Milestone Two Initiative Proposal

Jun 14, 2024 | Health Medical

Description

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.

No AI or Chatbot! I will be sure to check this.

I will provide the milestone 1 work once you are selected to work on the question.

You will build upon the work completed in Milestone One on workflow improvement for any health information management (HIM) function. I have also added the Milestone two rubric and guidelines, as well as the milestone one paper to build from and reference to the questions, The topic is Workflow Improvement for any health information management (HIM) function.

Requirements: 2 to 5 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.

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 be sure to use scholarly sources published within the last 5 years

Nutrition Question

Jun 14, 2024 | Health Medical

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Health & Medical Question Answer Question #3 Only 200 Words

Jun 14, 2024 | Health Medical

Description

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.

No AI or Chatbot! I will be sure to check this.

Question 1 – summary and details of the MHA program and its benefits to the student’s current position and future goal within the organization

Question 2- explanation of expected gains of the MHA program benefits for the student’s career growth

Question 3- Is the only one I need help with. What are examples of structural, behavioral and intersectional attributes of an organization?

Requirements: Answer Question 3 Only in 200 Words 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.

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

ct 500

Jun 14, 2024 | Health Medical

Description

500

Critical Thinking: Comparative Analysis: Risk

Compare Risk in Different Health Care Systems

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.

discussion reply

Jun 14, 2024 | Health Medical

Description

Your initial post should be at least 500 words, formatted, and cited in current APA style with support from at least 2 academic sources.

Unformatted Attachment Preview

Week 6 discussion
A 74-year-old African American woman, Ms. Richardson, was brought to the hospital
emergency room by the police. She is unkempt, dirty, and foul-smelling. She does not
look at the interviewer and is apparently confused and unresponsive to most of his
questions. She knows her name and address, but not the day of the month. She is unable
to describe the events that led to her admission.
The police reported that they were called by neighbors because Ms. Richardson 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
Ms. Richardson 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 Ms. Richardson 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 interviewer was convinced that was the drug, but other observers thought she might
have said yes to anything that sounded remotely like it, such as “Elavil.” When asked
about the gun, she denied, with some annoyance, that it was real and said it was a toy
gun that had been brought to the house by her brother, who had died 8 years ago. She
was still feeling weak and sick, complained of pain in her shoulder, and apparently had
trouble swallowing. She did manage to smile as the team left her bedside.
QUESTIONS:
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.

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Health & Medical Question

Jun 14, 2024 | Health Medical

Description

Would you consider regina a tragic character at the end of the play little foxes

discussion of Nursing Pathophysiology cardiac and immunity system

Jun 14, 2024 | Health Medical

Description

1. White blood cells (WBC) could be considered an umbrella that includes various types of cells:

a. Which type of WBC is considered “the first line of defense?”

b. Which type of WBC will be elevated in a viral infection?

c. Which type of WBC will be elevated in a child with history of dust mites-induced asthma and eczema?

d. Which of type of WBC will be elevated in a patient with parasitic infection?

2. What is the difference between active and passive immunity?

3. Re: antigen/antibodies

a. What is the meaning of having elevated IgM?

b. The term “conferred immunity” means that which immunoglobulin is present now in the circulation?

c. Case to think: A young adult patient that is not infected with hepatitis-B virus (HBV) but has never been vaccinated against is at high risk to contract the disease. What should be done in this case? (would you vaccinated or administer immunoglobulins?)

4. Explain why individuals infected with chicken pox during childhood are at risk for suffering Shingles later in life?

5. Debate: if vaccinations against viruses cannot prevent suffering from a given disease expected to be covered by the vaccination, what is the reason for the vaccination?

6. Why is immunosuppressive therapy relevant in organ transplantation?

ct 1

Jun 14, 2024 | Health Medical

Description

520

Leadership Styles During a Crisis (100 points)

Crisis situations require effective leadership to direct a unified quality healthcare response.

Using the Saudi Digital Library, locate and read three scholarly research articles on the role of leadership in managing quality and safety initiatives during crisis situations in Saudi Arabia.

Your PowerPoint should meet the following requirements:

Seven to eight slides, not including your title and reference slides.

Each slide must provide detailed speakers notes, with a minimum of 100 words per slide. Notes must draw from and cite relevant reference materials.

Formatted per APA 7th edition and Saudi Arabia Electronic University formatting guidelines.

Utilize headings to organize the content of your work.

Professional design and transitions

reply 3

Jun 14, 2024 | Health Medical

Description

Unformatted Attachment Preview

1
reply for dr
You mention the different types of insurance in the KSA and the services they offer. My follow-up
question is as follows: What are the deficiencies in available coverage that need to be addressed into
order to meet the Vision 2030 goals?
Again, good job.
-Dr. Robert
reply 2
2 days ago
SHATHA BAZHAIR
healthcare contracts
COLLAPSE
An efficient contract management system in Saudi Arabia’s healthcare industry can
lead to numerous benefits, such as better patient care, reduced operational expenses,
and maintained service access (AlNemer, 2018). Insurance policies generally oblige
insurers to cover the insured’s healthcare expenses for a premium paid by the employer.
In Saudi Arabia, the policy’s conditions govern the rights of the parties involved in the
insurance contract, and the policyholder is responsible for paying the premium.
In Saudi Arabia, employers are required to provide insurance coverage for their
employees and dependents, including foreign workers, who must be covered by the
2
Saudi social insurance system. Individuals who are not covered by an employersponsored plan, such as residents and citizens, can purchase individual health insurance
policies from a licensed provider (O’Brien, 2003). These policies typically pay for
hospitalization costs and may also include coverage for specialist and follow-up medical
appointments, as well as prescription drugs. Pre-existing conditions are normally
covered under individual health plans, and the waiting period varies depending on the
policy.
Health plans in Saudi Arabia consist of three parties: Policyholders, insurance
companies, third-party administrators, and service providers. All contracts are set
within specific regulations outlined by each plan and overseen by the Council of
Cooperative Health Insurance (“Implementing Regulations of the Cooperative Health
Insurance Law,” 2014).
A well-managed healthcare system can also benefit the government, as healthcare
spending has increased in recent years. The cooperative health insurance program can
lessen the financial burden on the government money, allowing more resources to be
allocated to other critical industries such as education (Al-Hanawi et al., 2017). Overall,
the program aims to promote long-term public development.
Employers in Saudi Arabia are advised to insure their employees with a licensed
provider, as it adds value in retaining employees and improving their health and
productivity. Employee health insurance is similar to individual health insurance and
typically covers hospitalization costs. Some employer-sponsored health plans may also
include coverage for specialist and follow-up medical appointments. Pre-existing
conditions are usually covered under employee health plans, with the waiting period
varying depending on the policy.
3
In summary, it is critical to have an efficient healthcare insurance system. This includes
streamlining the process of creating, routing, reviewing, and approving contracts,
ensuring compliance, and reducing risks. An effective healthcare insurance system can
also play a vital role in improving patient outcomes, reducing operational costs, and
contributing to long-term public development.
References
AlNemer, H. A. (2018b). Perception of the Benefits and Features of Health Insurance
Policies Offered by the Employers: Empirical Findings from Saudi Arabia.
International Journal of Business and Management, 13(6), 214.
https://doi.org/10.5539/ijbm.v13n6p214
Al-Hanawi, M. K., Alsharqi, O., Almazrou, S., & Vaidya, K. (2017). Healthcare finance
in the Kingdom of Saudi Arabia: A Qualitative Study of Householders’ attitudes.
Applied Health Economics and Health Policy, 16(1), 55–64.
https://doi.org/10.1007/s40258-017-0353-7
Implementing Regulations of the Cooperative Health Insurance Law. (2014). In CCHI.
Council of Cooperative Health Insurance. Retrieved September 18, 2023, from
https://chi.gov.sa/en/AboutCCHI/Rules/document/Implementing%20Regulations%20of
%20the%20Cooperative%20Health%20Insurance%20Law.pdf
O’Brien, E. (2003). Employers’ Benefits from Workers’ Health Insurance. Milbank
Quarterly, 81(1), 5–43. https://doi.org/10.1111/1468-0009.00037
4
reply 3
3 days agoUser’s profile pictureEBTEHAL BAAWADH
Benefits of Healthcare Contracts.
COLLAPSE
In Saudi Arabia, contracting for healthcare involves multiple parties,
including the employer, employee, and residents. There are several
benefits associated with these contracts that positively impact each party
involved.
For employers, contracting for healthcare in Saudi Arabia can provide
various advantages. Firstly, it allows them to offer comprehensive health
coverage to their employees, which is an essential factor in attracting and
retaining high-quality services. By providing healthcare benefits,
employers can demonstrate their commitment to the wellbeing of their
staff, thus fostering a positive work environment (Al-Hanawi, et al., 2020).
Moreover, contracting for healthcare can help employers manage costs
effectively. Through negotiations with healthcare providers, employers can
secure favorable rates and packages, leading to potential cost savings.
Additionally, these contracts often include preventive measures and
5
wellness programs, which can increase productivity among employees (AlHanawi, et al., 2020).
Employees, on the other hand, benefit greatly from healthcare contracts. Such
contracts ensure that individuals have access to necessary medical services
without facing excessive out-of-pocket expenses. It provides a sense of
security and peace of mind, knowing that their healthcare needs are
covered by their employers (Alkhamis, 2017). Furthermore, healthcare
contracts often encompass a wide range of services, including routine
check-ups, emergency care, medication coverage, specialist consultations,
and hospitalization. This comprehensive coverage allows employees to
receive timely medical attention, promoting better overall health and
addressing potential health issues before they worsen (Alkhamis, 2017).
Regarding resident requirements, healthcare contracts play a crucial role in
ensuring access to quality healthcare for all residents in Saudi Arabia.
Residents who are not employed or sponsored by an employer can obtain
private health insurance directly or avail themselves of governmentsponsored health insurance programs, such as the Cooperative Health
Insurance Council (CHIC). These programs aim to provide affordable
healthcare options for residents, ensuring equitable access to necessary
medical services (CHIC, n.d.).
6
It is essential to note that specific requirements may vary depending on the
contractual agreements, such as the extent of coverage, eligibility criteria,
and copayment obligations. Nevertheless, contracting for healthcare in
Saudi Arabia generally benefits employers, employees, and residents by
ensuring easy access to quality healthcare services, promoting well-being,
and complying with legal obligations.
References:
Al-Hanawi, M. K., Almubark, S., Qattan, A. M. N., Cenkier, A., & Kosycarz, E.
(2020). Barriers to the implementation of public-private partnerships in
the healthcare sector in the Kingdom of Saudi Arabia. PLOS ONE, 15(6),
e0233802. https://doi.org/10.1371/journal.pone.0233802
Alkhamis, A. (2017). Critical analysis and review of the literature on healthcare
privatization and its association with access to medical care in Saudi
Arabia. Journal of Infection and Public Health, 10(3), 258–268.
https://doi.org/10.1016/j.jiph.2017.02.014
7
Cooperative Health Insurance Council (CHIC). (n.d.). Implementing Regulations
of the Cooperative Health Insurance Law. Retrieved September 19, 2023,
from
https://chi.gov.sa/en/AboutCCHI/Rules/document/Cooperative%20Health
%20Insurance%20Policy%20Approved.pdf

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Jun 14, 2024 | Health Medical

Description

In addition to the five rights of delegation, name two additional factors the RN should consider before delegating to an AP or LPN. Name three tasks an RN can delegate to an LPN. Name three tasks an RN can delegate to an AP.

SOAP Note Analysis

Jun 14, 2024 | Health Medical

Description

Pease complete a SOAP Note analysis based on the following information: SOAP Note Attached, Example of an analysis attached

Rubric SOAP
Case Analysis SOAP GRADING RUBRIC with Cultural interventions
Guidelines:
1-Choose a client from your clinical setting & write up a case analysis (see below for content).
2- SOAP note from your clinical should be included (remove all patient identifiers)
SUBJECTIVE Analysis (10 POINTS) Score received
1- Compare & contrast subjective section with literature
taking into consideration the following criteria;
a-Identified and collected the necessary data including the
patients culture
b-Categorized and organized data using the appropriate format
c-Incorporated all pertinent data/facts
d- Used proper documentation
OBJECTIVE Analysis (10 POINTS) Score received
1- Compare & contrast objective section with literature taking into consideration the following criteria
a. Identified and collected the necessary data
b. Categorized and organized data using the appropriate format
c.Incorporated all pertinent data/facts
d. Used proper documentation
ASSESSMENT Analysis (35 POINTS) Score received
1- Compare & contrast subjective section with literature taking into consideration the following criteria
a-Filtered relevant data from irrelevant data
b.-Interpreted relationships/patterns among data (e.g., noted trends)
c.Integrated information to arrive at diagnosis
d.Identified risk factors
e. Differentials listed & discussed in comparison to actual diagnosis
e. Used proper documentation
PLAN Analysis (35 POINTS) Score received
1- Compare & contrast subjective section with literature taking into consideration the following criteria
a. Recommended an appropriate plan for each problem
b-Included recommendations for non-drug and drug therapy
c-Included recommendations for monitoring
d- Included health education
e- Included follow-up& referrals
f. Incorporate any cultural interventions which were done specifically for this patient
FORMAT ( 10 POINTS) Score received
1- APA
2- References Current
3- Writing clear, concise
4- Summary/Conclusion
TOTAL
** The patient’s culture must be identified and an intervention regarding the culture should be addressed in the plan.

Unformatted Attachment Preview

SOAP Note
Subjective
This patient is an 81-year-old female who presents for a follow up visit regarding recent lab
values. Lab values reflect elevated HgA1C and LDL values. Patient reports no changes in overall
health since last visit. Patient denies chest pain, shortness of breath, dizziness, or other
concerning symptoms. At this patient reports failure to comply with medication regimen,
explains she believed she did not need to take medications anymore. Patient denies smoking,
vaping, or any tobacco products. Patient denies alcohol consumption. Patient has 2 daughters and
3 granddaughters. Patient has no allergies and surgical history of an appendectomy when she was
40 years old.
Objective
Vital Signs:
Blood pressure: 130/78 mm Hg
Heart Rate: 84 bpm
Respiratory Rate: 18 breaths/min
Laboratory Results: HgA1c: 8.2%, LDL: 183mg/dL
HEENT: Pupils are equal, round, reactive and responsive to light and accomodation. No
evidence of icterus or conjunctival pallor. External ears appear symmetrical and without lesions.
The tympanic membranes are intact bilaterally. Nasal passages are patent, with no signs of
congestion or discharge. No tonsillar enlargement or exudates noted.
Appearance: The patient presents well groomed, awake, alert, and oriented with no apparent
distress. No signs of pallor, jaundice, or visible abnormalities.
Neck: No goiter, no masses, no lesions.
Chest: Clear to auscultation.
Heart: Regular rate and rhythm with S1 and S2 heart sounds present. No murmurs, rubs, or
gallops noted on auscultation.
Abdomen: Soft and non-tender on palpation. No masses, organomegaly, or guarding noted.
Extremities: No clubbing, cyanosis, or edema observed in extremities. Peripheral pulses
(femoral, popliteal, dorsalis pedis, and posterior tibial) are bilaterally equal and strong. Sensation
and motor strength are intact in all extremities.
Assessment
The patient is an 81-year-old Cuban female with a history of hyperlipidemia and Type 2 Diabetes
Mellitus. Her current BMI categorizes her as obese, which contributes to her increased risk of
cardiovascular disease. Her vital signs at the time of consultation are within normal range: heart
rate of 84 bpm, blood pressure of 130/78 mm Hg, respiratory rate of 18 breaths/min. Laboratory
values reflected an HgA1c of 8.2% and LDL of 183mg/dL. These values are consistent with the
diagnosis of hyperlipidemia and type 2 diabetes mellitus.
Plan
Discussed with patient lab value results, confirming the diagnosis of hyperlipidemia and type 2
diabetes mellitus. We discussed the complications of unmanaged high cholesterol levels and
glucose values. All complications were discussed with patient such as cardiovascular risk, nerve
damage, blindness, and kidney failure. We discussed importance of diet and physical activity.
Physical activity was recommended to aid in weight management and improve glycemic control.
Patient was instructed to maintain a heart-healthy diet low in saturated fats and refined sugars.
Patient will keep food log and will start coming to the facility for exercise three times a week.
We reviewed and emphasized the importance of medication adherence. Patient is to take
Metformin and Atorvastatin daily. We will see patient for a follow-up appointment in three
months to monitor progress and adjust treatment plan as needed.
1
SOAP Note 2: Cardiology and Respiratory
Zuanlys Delgado, Melissa Fundora, Jorge Gainza, Lisette Metauten, Karina Sanchez
Nicole Weirtheim College of Nursing and Health Sciences
Florida International University
NGR 6002
May 24, 2023
2
Initials of Patient: B.T
Patient Age: 47
Patient Gender: Male
Patient Race/Ethnicity: African American
Initials of provider: M.G
Clinical Setting: Glez and Glez Health Clinic
Subjective
Chief Complaint: Follow-up visit
History of Present Illness
The patient, a 47-year-old African-American male, presents for a follow-up visit after being seen
three weeks ago for an upper respiratory infection. During that visit, an incidental finding of
elevated blood pressure was noted, with a reading of 164/98 mm Hg. The patient vaguely recalls
being informed in the past that his blood pressure was “borderline.” He currently reports feeling
well, without any specific complaints, and his review of systems is negative. The patient denies
smoking cigarettes but admits to consuming a few beers on weekends and having a sedentary
job. A family history assessment reveals that his father experienced a stroke at the age of 69,
while his mother, who is 72 years old, is in good health. There are no known chronic medical
conditions among his siblings. Today, the patient’s blood pressure is measured as 156/96 mm Hg
in the left arm and 152/98 mm Hg in the right arm. His vital signs are within normal limits,
including a pulse of 78 beats/min and a respiratory rate of 14 breaths/min. Physical examination
findings are unremarkable. A clear chief complaint is not explicitly expressed during the
encounter.
Past Medical History
The patient’s past medical history reveals limited significant findings. He recalls being informed
in the past that his blood pressure was “borderline,” indicating a history of possible hypertension.
3
However, there is no documentation of a formal diagnosis or treatment for hypertension.
Additionally, he had an upper respiratory infection three weeks ago, which was managed
appropriately.
Allergies: None
Chronic Medical Conditions: None
Surgical History: None
Past Hospitalizations:None
Psychiatric History: None
Family History
Mother: Age 72, alive, healthy
Father: Deceased, suffered a stroke at age 69
Sibling 1: Age 54, male, healthy
Sibling 2: Age 41, female, healthy
Grandfather: Deceased, hx of HTN and HLD.
Grandmother: Deceased, hx of HTN and DM.
Social History
Cultural Background: African American
Spiritual History/Religious Affiliation and Practices: Practicing Catholic
Complementary/Alternative Care Practices: The patient identifies with his AfricanAmerican heritage and embraces cultural care practices that have been passed down
through generations. For instance, he values traditional herbal remedies and incorporates
them into his health regimen, believing in their holistic healing properties.
Marital Status: Married in a committed relationship for 15 years.
Parental Status: Lives with two children, ages 12 and 8.
4
Work History: The patient has been employed in a sedentary job as an office
administrator for the past 12 years. His work primarily involves administrative tasks,
computer work, and attending to phone calls and emails.
Financial History: The patient has maintained a stable financial status, with no
significant debt and a comfortable income that allows him to meet his financial
obligations and provide for his family’s needs.
Diet history: The patient’s diet history reveals a pattern of suboptimal dietary choices.
Due to convenience and time restrictions, he admits to eating a diet heavy in processed
meals, sugary snacks, and fast food.
Exercise: None.
Stress Management: None
Sleep: The patient claims to occasionally have trouble getting to sleep. He reports
sleeping for about 6-7 hours per night on average. He states that he wants to develop a
more reliable sleep schedule and enhance the quality of his sleep.
Social Support: Siblings, Children, Spouse, and Mother
Sexual History/orientation: The patient identifies as heterosexual and reports being in a
committed relationship with his spouse.
Travel History: None
Review of Symptoms
Constitutional: The patient denies fever, chills, or fatigue.
Head/Face: No reported injuries or specific symptoms related to the head or face.
Eyes: The patient has no vision problems, history of eye conditions, or symptoms such as
discomfort, photophobia, diplopia, spots or floaters, discharge, excessive tearing, or
itching.
5
Ears: The patient does not experience hearing loss, tinnitus, or ear drainage. No history
of chronic ear infections.
Nose: No loss of sense of smell, epistaxis, obstruction, polyps, rhinorrhea, itching,
sneezing, or sinus problems reported.
Mouth/Throat/Neck: No difficulties swallowing. No evidence of gingivitis, mouth
ulcers, or bleeding gums.
Respiratory: No history of respiratory distress, dyspnea, coughing, or hemoptysis
reported.
Cardiac: No reported orthopnea, murmurs, palpitations, arrhythmias, peripheral edema,
or claudication.
G.I.: The patient denies abdominal pain, nausea, or vomiting. Normal bowel movements,
no alarming signs such as melena, hematochezia, hematemesis, hemorrhoids, or jaundice.
GU: No dysuria or blood in the urine. Normal urine stream, clear-yellow in color, with
no hesitancy or dribbling.
Musculoskeletal: No reported achy soreness or severe pain in any specific areas.
Skin/Integument: No reported rashes, bruising, itchiness, or skin lesions.
Psychiatric: No symptoms of irritability or other psychological concerns were reported.
Neuro: No neurological symptoms were reported, except for difficulty falling asleep.
Endocrine: No temperature intolerance or complaints related to hormone therapy.
Hematologic/Lymphatic: No reported swollen lymph nodes or abnormalities.
OBJECTIVE DATA
6
Vital Signs:
Temp: 36.7
BP: 156/96 (L) / 152/98 (R)
Pulse: 78
Resp: 14
Oxygen Saturation: 97%
Ht: 70” / 177.8 cm
Wt: 210 lbs / 95.3 kg
BMI: 30.9
Pain: 0
Physical Examination
Constitutional: Well patient here for 3 week follow up of URI, no complaint
General: Obese, well groomed 47 y.o. African American male. A&O x3, in no acute distress,
normal affect and appropriate
Head/face: Head and scalp normocephalic, normal hair distribution
Eyes: EOM intact, red reflex visualized, PERRLA, no cataracts noted b/l, eyelids without
redness or swelling. Funduscopic examination shows no signs of hypertensive retinopathy
Ears: No tenderness on palpation of tragus, no erythema or effusion. Tympanic membrane
translucent in bilateral ears
Nose: Normal midline septum. No erythema or swelling of turbinates, no discharge
Mouth: Mucous membrane moist, no lesions. Normal dentition, no gingival inflammation
Throat: No Pharyngeal erythema and uvula midline. No ulcers noted. No foul odor from mouth,
no tonsillar enlargement or exudate
Neck: Supple and no lymphadenopathy, no nuchal rigidity and thyroid tissue firm and nontender
Respiratory: No cough, B/L BS clear in all fields, respirations are unlabored, no use of
accessory muscles
Cardiac: RRR, S1S2, no murmurs. Normal pulses in all four extremities. No edema. Cap refill

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Nursing Question

Jun 14, 2024 | Health Medical

Description

Assignment 3.1: Theories of Development
Theories of Development
Objective

Discuss the various theories related to each developmental phase

Assignment Overview

This reaction and response assignment explores the theories of Piaget, Vygotsky, and Erikson.

Deliverables

A one-page (12-point font) report

Step 1 Review the material in this lesson on major developmental theorists.

Be sure to review the theories of Piaget, Vygotsky, and Erikson.

Step 2 Research and read.

Research and read an article about one or more of the major developmental theorists. Using information from your research, apply two theories to the case study.

Step 3 Read this case study.

Vlad is 12 years old and has just changed schools because his parents moved again. He did not do well in his previous five schools. Now he is living next door to his uncle, who likes him a lot and is teaching him about car engines and computers. In his new school, he is becoming a good student. His teachers are surprised but pleased. He is even helping his younger brother with his studies.

Step 4 Using the information you have gathered, write about how two of the major theorists would explain Vlad’s changes in a one-page report.
Include and opinions you may have have about Vlad’s changes.
Discuss what factors may have contributed to Vlad’s improvement in school
Explain how understanding developmental psychology can be beneficial to your future career

Nurs 744 Nursing Informatics

Jun 14, 2024 | Health Medical

Description

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.

No AI or Chatbot! I will be sure to check this.

Please be sure to read, use, and cite the source provided in the link below. Please be sure that additional sources used are scholarly and published within the last 5 years,

Instructions:

Analyze the current healthcare informatics tools used in the COVID-19 pandemic
Examine the pros and cons of the major increase in use of telehealth.
Discuss the top three informatics tools used in pandemic to enhance health outcomes and reduce disease transmission
Gajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth Benefits and Barriers. The journal for nurse practitioners : JNP, 17(2), 218–221. https://doi.org/10.1016/j.nurpra.2020.09.013

Requirements: 2-3 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.

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 be sure to read, use, and cite the source provided in the link below. Please be sure that additional sources used are scholarly and published within the last 5 years,

Nursing Question

Jun 14, 2024 | Health Medical

Description

Please see below the case

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.

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
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.
ASSIGNMENT

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:

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.
BY DAY 7

Submit your Video Case Presentation.

Note: In Week 5: Assignment, Part 2 you will submit two (2) files for the Comprehensive Psychiatric Evaluation, including a Word document and scanned PDF/images of the completed assignment signed by your Preceptor.

Category Item Value
Client Information Site Private Practice
Age Adult (18- 64 years)
Gender Female
Visit Information Student Level of Function Mostly Independent – Level 4
Category of Care Direct Patient Care
Practice Management Type of visit Consultation
Diagnosis 1 Mood Disorder
2 Anxiety Disorder
Student Notes

61 years old female with past psychiatric history of depression and anxiety who presents to the clinic complaining of feeling very sad and depressed. Patient has a right above knee amputation and she has been unable to do adl by herself which is making her feel very depressed. Tx: Discontinue Congentin 0.5 mg Decrease Abilify from 30 mg to 10 mg at bedtime Start Trazodone 150 mg at bedtime

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Week (enter week #): (Enter assignment title)
Student Name
College of Nursing-PMHNP, Walden University
PRAC 6635: Psychopathology and Diagnostic Reasoning
Faculty Name
Assignment Due Date
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template
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:
Physical exam: if applicable
Diagnostic results:
© 2022 Walden University
Page 2 of 3
Assessment
Mental Status Examination:
Differential Diagnoses:
Reflections:
PRECEPTOR VERFICIATION:
I confirm the patient used for this assignment is a patient that was seen and managed by the student at
their Meditrek approved clinical site during this quarter course of learning.
Preceptor signature: ________________________________________________________
Date: ________________________
References
© 2022 Walden University
Page 3 of 3
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar
INSTRUCTIONS ON HOW TO USE EXEMPLAR AND TEMPLATE—READ
CAREFULLY
If you are struggling with the format or remembering what to include, follow the
Comprehensive Psychiatric Evaluation Template AND the Rubric as your guide. It is
also helpful to review the rubric in detail in order not to lose points unnecessarily
because you missed something required. Below highlights by category are taken
directly from the grading rubric for the assignment in Weeks 4–10. After reviewing the
full details of the rubric, you can use it as a guide.
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 criticalthinking 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
© 2021 Walden University
Page 1 of 6
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar
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.)
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.
© 2021 Walden University
Page 2 of 6
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar
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 (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?
© 2021 Walden University
Page 3 of 6
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar
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.
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.
© 2021 Walden University
Page 4 of 6
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar
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.
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
© 2021 Walden University
Page 5 of 6
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar
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.
© 2021 Walden University
Page 6 of 6

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CONCEPT MAP

Jun 14, 2024 | Health Medical

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NIGHTINGALE COLLEGE
DIRECT-FOCUSED CARE: CONCEPT MAPPING ASSIGNMENT WORKSHEET
NURSING PROCESS TEMPLATE:
Assessment (Recognizing Cues)
Which patient information is relevant? What patient data is most
important? Which patient information is of immediate concern?
Consider signs and symptoms, lab work, patient statements, H & P,
and others. Consider subjective and objective data.
Analysis (Analyzing Cues)
Which patient conditions are consistent with the cues? Do the cues
support a particular patient condition? What cues are a cause for
concern? What other information would help to establish the
significance of a cue?
Analysis (Prioritizing Hypotheses)
What explanations are most likely? What is the most serious
explanation? What is the priority order for safe and effective care?
Planning (Generate Solutions)
What are the desirable outcomes? What interventions can achieve
these outcomes? What should be avoided? (SMART Planning- specific,
measurable, attainable, realistic/relevant, time-restricted- Goal
setting)
Implementation (Take actions)
How should the intervention or combination of interventions be
performed, requested, communicated, taught, etc.? What are the
priority interventions? (Mark with asterisk)
Evaluation (Evaluating Outcomes)
What signs point to improving/declining/unchanged status? What
interventions were effective? Are there other interventions that
could be more effective? Did the patient’s care outlook or status
improve?
Patient Information (SBAR, H&P)
Main Concept
(Should be focus of below map)
CONCEPT MAP TEMPLATE:
Recognizing Cues (S&S)
Disease Process/Pathophysiology/Risk Factors
Analyzing Cues/Concerns
Supporting
Prioritizing Hypotheses
1.
2.
Concerning
3.
Generate Solutions/Outcomes/Interventions
SMART Planning
Taking Action – (How To)
1.
1.
2.
3.
4.
5.
2.
3.
4.
5.
Evaluating Outcomes
1.
2.
3.
4.
5.
Page 2 of 2
NIGHTINGALE COLLEGE
DIRECT-FOCUSED CARE: CONCEPT MAPPING ASSIGNMENT WORKSHEET
NURSING PROCESS TEMPLATE:
Assessment (Recognizing Cues)
Which patient information is relevant? What patient data is most
important? Which patient information is of immediate concern?
Consider signs and symptoms, lab work, patient statements, H & P,
and others. Consider subjective and objective data.
Analysis (Analyzing Cues)
Which patient conditions are consistent with the cues? Do the cues
support a particular patient condition? What cues are a cause for
concern? What other information would help to establish the
significance of a cue?
Analysis (Prioritizing Hypotheses)
What explanations are most likely? What is the most serious
explanation? What is the priority order for safe and effective care?
Planning (Generate Solutions)
What are the desirable outcomes? What interventions can achieve
these outcomes? What should be avoided? (SMART Planning- specific,
measurable, attainable, realistic/relevant, time-restricted- Goal
setting)
Implementation (Take actions)
How should the intervention or combination of interventions be
performed, requested, communicated, taught, etc.? What are the
priority interventions? (Mark with asterisk)
Evaluation (Evaluating Outcomes)
What signs point to improving/declining/unchanged status? What
interventions were effective? Are there other interventions that
could be more effective? Did the patient’s care outlook or status
improve?
Patient Information (SBAR, H&P)
Main Concept
(Should be focus of below map)
CONCEPT MAP TEMPLATE:
Recognizing Cues (S&S)
Disease Process/Pathophysiology/Risk Factors
Analyzing Cues/Concerns
Supporting
Prioritizing Hypotheses
1.
2.
Concerning
3.
Generate Solutions/Outcomes/Interventions
SMART Planning
Taking Action – (How To)
1.
1.
2.
3.
4.
5.
2.
3.
4.
5.
Evaluating Outcomes
1.
2.
3.
4.
5.
Page 2 of 2

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NURS FPX6218 Leading the Future of Healthcare

Jun 14, 2024 | Health Medical

Description

Propose a change to one aspect of your local or regional health care system or program that would improve outcomes. Then, conduct a comparative analysis of other, non-U.S. health care systems, focusing on the proposed change. Summarize the proposed change and your comparative analysis in a 4-5 page report.

Social Work Question

Jun 14, 2024 | Health Medical

Description

Refine your research question to include the following:Clear conceptualization and operationalization (in other words, measurable variables)A clear proposition within your research question (how are your variables related to each other)Limited only to the variables in the “Assignment Data” excel file, develop a concrete research question which includes a clear proposition (variable relations)Provide the key characteristics for persons with pid’s 5, 11, and 19For example: the characteristics for person 1 (pid 1) is:18 year old, less than HS education, likes baseball, earns 6,000 per year, and has 1 child.My research question: How was anxiety managed before vs after those who take anti-anxiety medication?(might not make sense but would love to do a paper on patients that take medication such as alprazolam, klonopin, etc)

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2
How to Conceptualize
Research:
Getting Started and Advancing
Ongoing Projects
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Learning objectives
By the end of this chapter you will have the tools to:
••
••
••
Identify and conceptualize a research topic
Formulate a research problem
Anticipate potential ‘Who cares?’ questions
Chapter summary
Conceptualization, the art and practice of discovery, is the first and some may argue the most difficult part
of research. This chapter will provide researchers with strategies for conceptualizing qualitative projects,
including how to use the literature effectively and how to formulate a research question.
INTRODUCTION
We tend to gloss over ‘conceptualization’. Conceptualization is the process of not only
selecting a topic, but formulating a defensible and researchable research problem; it is more
than simply generating a list of interesting topics such as academic achievement gaps or
homelessness. If you jump from a topic to data collection, you will likely end up with random bits of information that are of little use to the researcher or your intended audience.
Such projects not only tend to lack analytical focus, but will be plagued by the challenges
associated with the dreaded ‘Who cares?’. Good conceptualization involves moving from a
general topic to a clear research problem.
This chapter outlines concrete tools for conceptualization. We present them as steps, but
fully acknowledge that in reality research happens in a non-linear fashion. We also note
that some approaches are more exploratory, particularly at the beginning stages of a project. However, whether you start off with a perfectly good research question or not, you will
eventually need to complete every step.
1.
2.
Step One: What is the topic? The first step of any project is to determine what you want to study.
Step Two: What is my problem? Why should anyone care about my problem? You must then
establish the problem your project hopes to solve, including filling in a gap or extending the
literature in a new and exciting direction.
STEP ONE OF CONCEPTUALIZATION: WHAT IS MY TOPIC?
the common problem among students is the feeling that one has nothing to say … you find the huge variety
of things that could be said almost as overwhelming as the huge diversity of things that have been said.
(Abbott, 2004: 85)
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By design, researchers are deeply curious about the social world. If you are lucky, you may
start a project with a topic that is inspired by your discipline, subfield, or event such as the
Occupy Wall Street movement. You may even have some general questions in mind such
as identifying the aspects of the Occupy Wall Street movement that were more or less
successful, or whether it constituted a social movement in the first place. In such cases,
you need the tools presented in this chapter to prevent you from relying on a particular
lens simply out of habit. So if your tried and true method is to view such a movement
through the eyes of the participants or as a Marxist, considering an alternative approach
may help you forge an exciting and less travelled intellectual pathway (Abbott, 2004: 86).
Many budding researchers, however, are interested in many topics that may or may
not be related, such as female body builders and cults, or a broad area, such as children’s
afterschool activities. Yet decisions (and sacrifices) have to be made in the interest of
developing a coherent research design. Initially, pinning down a topic is useful for guiding researchers toward the literature and some preliminary sources of data. As we discuss
below, some initial ‘digging’ can provide you with much needed background and inspiration. This part of conceptualization is an important first, but definitely not last, step
toward developing an informative and interesting research project. This ground work not
only saves time and cuts down on mistakes, it will undoubtedly come in handy time and
time again, whether writing your literature review or defending your project at a proposal
defence or to a journal reviewer.
In Table 2.1 we present a toolkit for generating ideas. You should not get too bogged
down about which tool is better or whether you are executing any one of the options
‘perfectly’; instead, see these exercises as brainstorming tools. You may also find some tools
more or less useful than others depending on your approach.
We present five key sources for inspiration that are divided two groups:
a)
b)
Data and theory driven
Researcher driven
Data and theory driven
Data driven conceptualization includes both secondary and primary sources. We discuss
secondary sources first since they will likely be the most accessible option, particularly for
more novice researchers. Secondary sources are generally one step removed from the original event or people and include published academic and professional articles, commonly
referred to as ‘the literature’. Primary sources include materials that are produced by, for,
or about the people, group, organization or event under study by persons who have direct
and intimate knowledge or experiences. We also discuss the possibility of conducting some
preliminary data collection.
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Table 2.1 What is my topic? Sources of inspiration
a) Data and
theory
driven
Type
Example
1) Secondary sources
Journal articles
Academic or professional books
Research reports
2) Primary sources
Online materials (e.g., blogs)
Websites
Government documents or public records
Archival materials
Brochures, reports, posters
Diaries, letters
Media (online, newspapers, magazines and TV)
Pictures or videos
Furniture, statues, clothing
Music, poetry, art
Maps
Transcripts
Academic and professional articles and reports that
are used as primary sources of data
b) Researcher
driven
3) Primary: Preliminary raw data
that you collect or produce
Pilot project
4) Mapping exercises
Mind map
Concept map
Literature map
5) Abbott’s (2004) ‘Lists’
Aristotle’s four causes
Secondary sources: The literature
The literature will be your first and arguably best friend in the development of a research
project. The literature includes three main sources: a) academic journal articles; b) academic
or professional books; and c) research reports. You will obviously need to use these sources
to construct a literature review. However, in this section, we discuss how you can use the
literature as a source of inspiration.
Academic journal articles
The first and most common source is published journal articles. These articles are peer
reviewed and can be accessed through a variety of sources, including JSTOR and Scholars
Portal. The term ‘peer reviewed’ means that the articles have been reviewed usually by
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two or three experts, and have likely been screened by the editor of the journal. While
journals vary in terms of the degree to which articles are scrutinized, and in many cases
rejected, the process provides a measure of quality control. If you are unsure where to
start, ask experts in your field (e.g., your supervisor) or a librarian at your institution for
the most appropriate sources. The journals supported by your discipline’s professional
association(s) are another great starting place. In sociology for example, the American
Sociological Association, Canadian Sociological Association and the European Sociological
Association all host a variety of high quality academic journals.
There are three main types of academic journal articles:
••
••
••
Research articles: Research articles use primary (e.g., interviews conducted by the author) or
secondary (e.g., archival materials) sources of data to advance a particular original idea, argument or theory.
Theoretical articles: Rather than relying on primary or secondary data (though the author may
refer to such data) theoretical articles attempt to advance or critique a particular theoretical
concept or framework, or make an original theoretical contribution to the literature.
State of the field or review articles: This type of article reviews a large body of research
and theoretical articles. Review articles articulate key arguments, sources of data, theories and
debates on a particular topic. They are a wonderful source, particularly for researchers who are
newer to a particular area. Most disciplines also have journals that are specifically devoted to
publishing review articles. Annual Review of Sociology, Annual Review of Economics and Annual
Review of Political Science are a few examples.
Quick tip: How to search for academic journal articles
Searching for articles on your topic is part art, part science. To ‘strike gold’, you will need
to experiment with different terms and combinations. Some of these terms will be obvious (e.g., layperson terms), and others will be added once you become familiar with terms
that are used in the literature. Below we present an example of searches from a project
on school shootings. Start with the most obvious search terms (e.g., school shootings),
then separate key terms on separate rows of the search engines (e.g., ‘school’ on row one
and ‘shooting’ on row two). Use quotation marks to keep key works together (e.g., ‘school
violence’); if not some search engines will simultaneously search for these terms separately
(e.g., you may end up with thousands of articles containing the word ‘school’ and thousands
of articles containing the word ‘violence’ that have nothing to do with school shootings). In
some cases you will be able to search on a key event, person or organization that is related
to your topic (e.g., ‘Sandy Hook’ or ‘Columbine’, two famous school shootings). Once you are
familiar with the literature, you may come across alternative terms related to your topic. In
the case of school shootings some authors have referred to them as ‘rampage shootings’ or
‘organizational deviance’. You may also add in other terms that according to the literature
are related to school shootings (e.g., bullying), but recognize that these searches will likely
yield many articles that have nothing to do with your core topic.
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Example: Search terms
Key
Combination
Key events, people or
organizations
‘‘School shootings’
‘School’ AND ‘shootings’
‘Sandy Hook’
‘School shooters’
‘School’ AND ‘shooters’
‘Columbine’
‘School violence’
‘School’ AND ‘violence’
Academic or professional books
The literature also includes academic or professional books on your topic. Sources include,
but are not limited to, academic presses.
There are four main types of books:
••
••
••
••
Academic or scholarly books: Scholarly books include original research and ‘state of the field’
chapters that marshal a variety of data to frame a particular issue or make an original contribution. Most of these books are published by academic presses (e.g., NYU Press) or foundations
that support scholarly work (e.g., Russell Sage Foundation).
Popular original works: Popular original works target a wider audience, but may still be
authored by experts. More novice researchers should tread a bit more carefully, since they
will likely have fewer tools to evaluate the relative quality of the argument and any data
that the author used. However, there are many wonderful examples of popular books that
are both high quality and accessible. Venkatesh’s (2008) Gang Leader for a Day is a perfect example. His book is popular in its own right, and is featured in the wildly successful
Freakonomics (Levitt and Dubner, 2009). Yet, at the same time the book is grounded in years
of rich field research.
Original or reprinted edited collections: Edited collections can provide a different kind of
breadth by marshalling chapters from a variety of authors and perspectives on a particular
topic. Edited collections can include a series of original contributions such as previously unpublished data, concepts, frameworks or theories. They can also include reprinted material either
in its entirety (e.g., one chapter that has been reprinted from a previously published book or
article) or a summary of an original contribution.
Encyclopaedias: Unlike a traditional encyclopaedia, scholarly encyclopaedias are typically
produced for a particular discipline or sub-field (e.g., Health), or around a particular theme
(e.g., Social Welfare). These sources will not provide you with a comprehensive examination
of any one topic, but will provide you with a summary of hundreds of key terms, concepts,
theories or methods, depending on the focus of the encyclopaedia. Such sources may help
you formulate a handful of working definitions that you can use when discussing your key
terms or concepts. Most also include cross-references and suggestions for further reading.
The SAGE Encyclopedia of Qualitative Research Methods (Given, 2008), The Encyclopedia
of Social Networks (Barnett, 2011) and The Encyclopedia of Housing (Carswell, 2012) are
just a few examples.
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Quick tip: So many books, so little time …
Despite the potential benefits, if you are on a tight timeline (e.g., a proposal deadline) you may
need to initially limit the number of books you read since one book may take as much time as
reading five or six articles on your topic. We are certainly not trying to discourage you from
reading books on your topic, particularly classic, well-cited or award winning books! We are
just noting that if you have a tight timeline, decisions will have to be made. To help you make
such decisions, there are several sources to help you generate a list of ‘must read’ books:
••
••
••
Book reviews: Read book reviews published in academic journals. There are also academic
journals specifically devoted to book reviews. Contemporary Sociology is just one example.
You should never take any one review as the ‘final word’ unless of course the reviewer is
someone you trust. However, a good book review will provide you with a basic summary of
the book and constructive criticism that is grounded within the larger literature.
Well-cited books: Read the handful of books that seem to be continuously cited by
known experts on your topic, including books that are controversial or that have
received a lot of media attention. Reviewing the books (and journal articles for that
matter) that are cited in the academic literature is a good place to start.
Recognized books: Read books on your topic that have been recognized in some
special way (e.g., an award by your discipline’s professional association). You should
also consider books on your topic that have been featured at recent conferences (e.g.,
author meets critic).
Professional reports
Professional reports include published research, theory, review and working papers. Most
government agencies, think tanks, professional associations, advocacy groups or armslength research consortiums produce professional reports that are widely available to the
public online. Examples of such government bodies or organizations include UNESCO,
WHO, the US Census Bureau, and the Ontario Ministry of Education. All of these agencies
post online research articles, executive summaries or press releases that are chock full of
original and secondary data, policy recommendations, and literature reviews.
Now what? How to use the literature to conceptualize
Key takeaways
••
••
••
••
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First identify key theories, terminologies, concepts, methods, data and interpretations presented in
the literature.
Second identify what is not known, missing or problematic in the literature.
Unless you are already very well versed in the literature, your initial review will require a lot of time.
An ongoing ‘small-c’ critical examination of the literature is essential.
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The literature, when used properly, can be a powerful conceptualization tool and can. help
you identify theories, terminologies or concepts, methods, or data (Maxwell, 2005: 55).
In Table 2.2 we present key questions to get you thinking about what is known in the
literature (column one). Once you have identified the key questions, theories and concepts
that dominate the literature on your topic, you can start to identify what is not known,
problematic or missing (column two) in a manner that will not only aid in conceptualization, but is critical for developing an informed literature review. In short, these are
questions you will need to answer at some point along your journey. Addressing these
questions early on has additional benefits, most notably when you are ready to start your
literature review. As Maxwell (2013: 40) cautions, a literature review is a ‘dangerously misleading term’. Literature reviews that simply summarize or provide an overview of the
existing literature tend to be descriptive or merely parrot what others have already said
(e.g., repeating the limitations of a particular theory or method). This approach also tends to
be only superficially connected to your project and research questions. By asking and answering the questions in Table 2.2, you will be in good shape to start to develop an original
conceptual framework.
Steps
1.
2.
3.
4.
Search the literature on your topic (see sources above).
First identify key theories, terminologies, concepts, methods, data and interpretations presented
in the literature. Second identify what is not known, missing or problematic in the literature (see
Table 2.2).
Verify that your rendering of the literature is correct. Speak to your supervisor and committee
members. Return to your library search engines (e.g., JSTOR) and plug in key terms that relate
to what you have identified as unknown, missing or problematic just to be sure that you have not
missed an important article or stream of the literature.
Discussed in detail below, start to narrow in on the one or two ‘holes’ that you have identified to
construct your research problem and research questions.
Table 2.2 How to use the literature to conceptualize
What is known?
What is not known, problematic or missing?
What questions have been asked
about my topic?
•• What questions have not been asked on my topic?
•• Is there a time, geography, or location dimension to these
questions and if so, what would happen if I altered it?
•• What would happen if I turned dominant questions around?
(e.g., rather than ask why there are so many high school
drop-outs, ask why there are not more)
•• What if I turned positive questions into negative questions (or
negative into positive)? (e.g., so rather than asking how drop-outs
and graduates are different, ask how they are not different)
(Continued)
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Table 2.2 (Continued)
What is known?
What is not known, problematic or missing?
What major theories have been
used to examine my topic?
•• Do these theories adequately capture the phenomenon under
study?
•• Are there other possible theories that should be considered?
What major concepts have been
used to examine my topic?
•• Do these concepts adequately capture the phenomenon under
study?
•• Are there other possible concepts that should be considered?
How have concepts been
defined?
•• Are there other possible definitions?
•• Are there problems with current definitions?
How have they been measured?
•• Are there other possible ways concepts could have been measured?
•• Are there problems with how concepts have been measured?
What kinds of data have been
used to examine my topic?
•• Are there other possible sources of data?
•• Are there problems with the data that have been used?
What concepts, ideas or
relationships tend to be in the
foreground and background?
•• Should a particular concept be given more or less weight?
•• What would happen if I switched the foreground and background?
What are the dominant
interpretations or findings?
•• Do the dominant interpretations make sense?
•• Is there a reasonable connection between the data and
interpretations?
What relationships have been
examined?
•• Are there other relationships that could be examined?
•• Are the relationships currently under study still the most
important, or should we consider new ones?
What has been the context?
•• Is the context of my study the same?
•• Is the context of my study different?
•• Has the context changed?
What are the major debates on
my topic?
•• Have these debates limited the scholarship on my topic in a
particular manner?
•• Does one side appear to have more credibility?
•• Do the debates focus on the data, theories, interpretations or
some combination of the three?
How have others justified their
study or its contributions?
•• Can I use their rationales (with or without some tweaking) to
justify my study and its contributions?
What do others have to say?
•• Do their findings confirm or disconfirm research from my
discipline?
•• What can I learn or take away from their concepts, data, or
interpretations?
What frameworks, theories or
data am I most comfortable
using to study my topic?
•• What alterative frameworks, theories or data are available on my
topic?
•• How would critics of my approach, or scholars using alternative
frameworks, theories or data examine my topic?
Some researchers may warn you about the dangers of ‘ideological hegemony’ generated
from examining the existing literature too closely (Becker, 1986). And it is true, if you
stick only to ‘what is known’ you may limit your ability to see your topic in a new light.
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Importantly, if you cannot demonstrate how your study addresses an unanswered problem
in the literature, then your study will be of little value to your target audience.
However, we argue that a comprehensive understanding and an ongoing ‘small-c’ critical examination of the existing literature will allow you to more confidently represent
‘what is not known, problematic or missing’ in a manner that will increase your chances of
‘inspect[ing] competing ways of talking about the same subject matter’ (Becker, 1986: 149).
Equally important is that using the literature in the spirit of conceptualization does not
marry a researcher to a particular approach since it is more of a question of what or how
you use the literature, rather than whether you should read the literature in the first place.
Primary: Using raw data
Key takeaways
••
••
••
Examine raw data produced by, for or about the group, organization or event of interest.
Consider how these data or presentation of the literature may be used as data in their own right.
Consider conducting a small pilot project, even at very early stages of the project.
The use of primary sources of data is not limited to the ‘data collection’ phase of a project.
There are two main sources of primary data that are worth considering for conceptualization
purposes. The first source is raw data produced by, for or about the group, organization or event
of interest. Data include online materials, including websites, textbooks, archival materials such
as diaries or pictures, online videos, media reports and magazines. Beyond reviewing primary
data for conceptualization purposes, you can also consider how these data may capture important dimensions of your topic and be used as data in their own right. Meyer et al. (2010), for
example, mapped the growing presence of human rights issues in social science textbooks.
Similarly, Wrigley (1989) conducted a content analysis of over 1,000 articles from popular
literature targeted at parents to understand changing attitudes about children’s development.
You may also want to consider using academic and professional reports as a primary source
of data. Mizruchi and Fein (1999), for example, reviewed key journal articles to examine the
social construction of knowledge. Similarly, Colquitt and Zapata-Phelan (2007) examined
five decades of articles published in a highly influential journal, The Academy of Management
Journal, to develop a taxonomy of the theoretical contributions to the field.
The second source of primary data is raw data that you collect or produce, sometimes referred
to as a ‘pilot project’. Some preliminary fieldwork, interviews or analysis of the materials is an
excellent way to get your feet wet and to work out the direction and focus of your project. Pilot
projects are not only incredibly important to work out key data collection instruments (e.g., an
interview schedule) but can fundamentally shape the scope and direction of a project. You will
need to consider this option with your institution’s research ethics board in mind.
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Researcher driven
Key takeaway
••
Use brainstorming exercises at the early stages of conceptualization to articulate what is known about
a topic, and to identify relationships, processes, concepts or missing information.
Researcher driven sources includes a variety of brainstorming exercises that you develop to generate ideas. Below we present two such ideas, but there are certainly other strategies available.
Early mapping: Mind, concept and literature techniques
‘Mapping’ is routinely used in qualitative research, particularly at the beginning stages
of data analysis. Mapping is a ‘graphical tool for organizing and representing knowledge’
(Wheeldon, 2010: 90). Such visual aids can serve as a powerful tool at many stages of a project by allowing (or forcing) researchers to classify and organize information in manageable
chunks. Faced with mountains of data, including interview transcripts, field notes, documents or pictures and videos, researchers use this technique to sketch-out relationships,
sense-making or organizational processes, and the linkage between data and concept or
theoretical ideas. Importantly, mapping allows researchers to embed these understandings
within a broader contextual framework. Mapping can also encourage researchers to take a
‘reflexive approach to how we are classifying’ (Hart, 1998: 143). Ideally, mapping requires
researchers to think about their classification schemes, and the underlying logic that guides
their decision-making.
For our purposes in this chapter, we articulate the benefits of what we refer to as ‘early
mapping’ techniques for conceptualization. In particular, early mapping can also be used
to develop a research project by allowing researchers to articulate what is known about
the topic, and theorize possible or preliminary relationships, processes or concepts (Daley,
2004; Novak and Gowan, 1984; Novak and Cañas, 2006). Below, we present three kinds of
mapping techniques: Mind and Concept Mapping and Literature Mapping (Table 2.3).
Mind and concept mapping
Though similar, researchers make a distinction between ‘mind’ and ‘concept’ mapping
techniques. Mind maps are usually organized around one central idea, concept or theme,
and tend to be more informal and flexible (Buzan and Buzan, 2000). Concept mapping by
contrast is more structured, and often includes multiple ideas, concepts or themes as well as
people, groups or organizations. Concept maps are developed with a good understanding
of the context in which they will be used.
We caution against getting too bogged down about which method is better or whether
you are doing either one ‘perfectly’ at the conceptualization stage. There are entire books
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written about doing both, and that detail various ways to get the job done (e.g., Kane and
Trochim, 2007). We see it as an exercise in getting the pieces of the puzzle down on paper,
developing a good grasp on the key dimensions related to your project, and thinking about
possible puzzles that still need to be answered (Table 2.3). You will likely need to rework
your mind or concept maps several times as your ideas develop.
Mind maps
Mind maps are perfect for researchers who are newer to a topic. Mind maps allow researchers
to get a handle on the central characteristics, themes or concepts.
Mind maps have the following characteristics:
••
••
••
••
••
Visual representation of key themes, concepts, ideas, organizations, people, units or theories.
Built around one central idea or theme, as a flow chart or a as ‘tree’ diagram (Miles and
Huberman, 1994).
The use of simple lines to articulate connections.
The potential to use different shapes to symbolize different components (e.g., using squares
for organizations; circles for people) or different emphases (e.g., using squares for components
directly related to the core; circles for components on the periphery).
Flexible and less structured.
Concept maps
Concept maps are suitable for researchers who have a reasonable grasp of the literature or
topic under study. Concept maps are more structured and multifaceted, and based on an
understanding of the context that they will be used in (Novak and Cañas, 2006). Concept
mapping includes structuring statements, words, and people, groups or organizations based
on either what is known or theorized about the topic of interest. Concepts maps also include
words, symbols and shapes to explain the nature or strength of relationships between two
or more units. Rather than flowing from one concept or idea, concept maps represent multiple start points which may or may not be related to every other unit.
Concept maps have the following characteristics (Figure 2.1):
••
••
••
••
••
••
A multi-hierarchical representation of information. Hierarchies may be based on relative importance, a process, or moving from the general to the specific.
‘Information’ may include not only key ideas, concepts, characteristics and people, groups or
organizations, but also examples.
The use of boxes, circles or other shapes to differentiate various kinds of information (e.g.,
circles to represent theories and boxes to represent concepts).
The use of cross-links which include simple lines, directional arrows or circles to articulate a
relationship between the various characteristics, outcomes and concepts/ideas or units.
The use of linking words (e.g., more, less), shapes (e.g., squares for countries, circles for economic policies) or symbols (e.g., %, +) to explain or elaborate on a particular relationship.
The structure of the concept map and the nature of the relationships are context dependent.
02_Aurini_et_al_Ch_02.indd 19
3/16/2016 6:22:20 PM
02_Aurini_et_al_Ch_02.indd 20
3/16/2016 6:22:20 PM
Objects
(Things)
Words
begins
with
with
Symbols
Infants
begin
with
Labeled
are
connected
using
Creativity
aids
in
used to
form
needed
to see
Experts
Cognitive
Structure
Effective
Learning
Effective
Teaching
Different
Map Segments
between
Interrelationships
show
Crosslinks
may be
constructed in
Units
of Meaning
are
necessary
for
Propositions
is
needed to
answer
Organized
Knowledge
especially
with
Hierarchically
Structured
are
Linking
Words
is
comprised of
includes
Social
e.g.
Personal
Context
Dependent
are
“Focus
Question(s)”
SOURCE: ‘A Summary of the Literature Pertaining to the Use of Concept Mapping Techniques and Technologies for Education and Performance Support.’ 2003. http://www.
ihmc.us/users/acanas/Publications/ConceptMapLitReview/IHMC%20Literature%20Review%20on%20Concept%20Mapping.pdf
Figure 2.1 A concept map of concept maps
Events
(Happenings)
in
Perceived
Regularities
or Patterns
are
Concepts
add to
Associated
Feelings or Affect
help to
answer
represent
Concept Maps
how to conceptualize research
21
Table 2.3 General steps to mind mapping and concept mapping
Steps
Example
1
You are interested in ‘school readiness’, a term used to
describe children’s literacy, numeracy and socio-emotional
development just before they start school. The research
that you have reviewed documents the antecedents of
school readiness, and its consequences to children’s
academic achievement.
Start with a central theme
Write down all of the characteristics,
people, organizations and so forth
associated with the central theme
You start to develop a list that you rework into several
categories or chunks of information:
Antecedents of school readiness:
Family socioeconomic status – parent education; parent
occupation
Parent involvement/contact
Parenting philosophy
Social, family or other support/networks
Neighbourhood cond

Nursing Question

Jun 14, 2024 | Health Medical

Description

The rubric and details are attached in the file

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Decision-Making Process Paper
Instructions
In this assignment, you will be writing a 6 pages paper identifying, comparing and
contrasting at least 3 different decision-making approaches of care from a multidisciplinary
perspective using a pertinent and significant topic in nursing (Topic for Decision Making
Paper: Travel nurses as an important tool to relief hospitals staff during times of strikes.). I’m
currently a travel nurse working on a neuro/stroke unit in Missouri due to the staff
shortage and strike that the hospital is encountering at this time.
The 3 decision making models I chose were the following
Intuitive Decision-Making Approach/Model
Analytical Decision-Making Model/Approach
The Creative Decision-Making Model
You are required to use APA 7th edition format and the page count does not include title
page or reference page. Reflect on your own decision-making practices and the
implications this will have regarding differing approaches taken of nursing leaders and
staff nurses/clinical practitioners in decision making within to issues in practice. To
complete this assignment, do the following:
Select and describe an issue in nursing that impacts nurses at all levels from bedside to
advanced practice(Topic for Decision Making Paper: Travel nurses as an important tool to
relief hospitals staff during times of strikes.)
1. .Make sure to provide an adequate background and its significance to all levels of
nursing using a strong review of the literature. Additionally, this should include a
thorough literature review that provides a good understanding of what the cause of
this problem is; what is suggested to address this problem. Essentially, this review
must support your choices of the decision-making models and this needs to include
how all levels of nursing practice (the bedside nurse to the APN are impacted by the
problem).
2. Identify how you would expect a nurse leader/manager, a bedside/staff nurse and
an Advanced practice nurse (CNO or NP) to address your selected issue using at
least 3different decision-making approaches which are clearly supported by the
literature review. This must first include a detailed analysis/overview of the
selected decision making models and how they are used in practice. Then a detailed
analysis of how these decision-making approaches/models would address the
3.
4.
5.
6.
problem/along with a detailed analysis of how each of the three selected models
would be applied to address the selected issue/problem making sure to incorporate
this at all levels of practice. One of the decision-making models may be more
applicable to the bedside nurse; whereas the other more applicable to the APN;
however, all levels of nursing practice need to be addressed with at least one of the
chosen 3 decision-making models. However, this does not mean that each decisionmaking model will apply to all levels of practice only that in this discussion needs to
include how each level of nursing practice would utilize the decision-making model
to address the problem. For instance, one decision making model may apply to the
bedside nurse; the second decision making model may be more applicable at the
level of APN (CNO, NP, etc) and the other decision-making model may be best
applied to the nurse manager. This section should be detailed; meaning specific, well
thought out, realistic solutions of how the nurse (at the level identified; this may
include more than one level for the same decision-making model or not) would
address the problem using the decision-making model is provided and well
supported by the literature. of the benefits and limitations of various decisionmaking approaches that are applied appropriately to the level of nursing practice to
address the selected issue/problem. This is informed from course readings,
literature, clinical scenarios and other evidence-based and scholarly sources.
Prioritize the best decision-making approach/model to address the selected
problem that is grounded in best practice. This should provide a well-supported
rationale for this choice that includes a good comparison and contrasting of the 3
chosen decision-making models that clearly illustrates why the choice was made,
that is consistent with the decision making model and how it would address the
chosen topic or problem.
Identify a possible funding source that would addresses your approach to solving
the problem. For instance, if the best approach to solving the nurse-to-patient ratio
problem is through the use of SDM and shared governance, perhaps you may seek a
local funding source to provide you with funding to implement a small EBP or
research project that would be funded by a local nursing organization such as Sigma
Theta Tau or perhaps if it was geared more towards assessing the value of this
model towards NP in practice than seeking a local organization that supports
funding for projects being implemented by practicing NP? If seeking money for
research this would need to be overseen by a nurse with a DNP r a PhD or someone
with the credentials to do so that are part of their scope of practice. Consider
looking at federal, state,or local organizations. (I live in the state of Florida)
For example: There are many grants available through the CDC,HRSA, etc. Again, this
need to be specifically applied with sufficient details
Use at least 10 references other than your main text.Uses APA 7th edition
formatting. At least 5 of these need to be within the past five years.

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Two replies?

Jun 14, 2024 | Health Medical

Description

I need two replies for each one of these discussions.

1- It is problematic and warrants thought to test babies for HIV without notifying the mother and disclosing the results. On the one hand, it’s critical to count and monitor the number of newborns with HIV to spot potential epidemics and precisely track the illness. The suggested methodology would test the children without the mother’s knowledge and keep the test results secret. It is crucial to take these ethical ramifications into account.

The planned study has essential ethical ramifications. It may be argued that testing a newborn without the mother’s knowledge violates her autonomy. The state government is depriving the mother of the chance to decide whether or not the test should be performed on her child by failing to inform her of the test. The state government is also depriving the mother of the chance to decide how to proceed if the baby tests positive for HIV by withholding the test results from her. The suggested protocol could be interpreted as a paternalistic act by the state government, making decisions without the mother’s knowledge or agreement.

It is crucial to consider the practical ramifications of the suggested protocol and the ethical ones. If the baby tests positive for HIV, the mother might not be able to get the necessary medical care for her child if she is unaware that the test is being done and is not notified of the results. In this sense, the suggested routine can potentially harm the baby’s health and well-being. The protocol’s lack of transparency may also make people distrust the state government and deter women from participating in future research projects or seeking care for their infants.

It is challenging to defend the practice of testing neonates for HIV without alerting the mother or disclosing the results, given the ethical and practical ramifications of the suggested approach. It is crucial to ensure that moms are informed about the test and aware of the results to defend their rights and guarantee that the newborn receives the proper medical treatment. Additionally, it’s critical to provide the mother with the information she needs to make an educated choice regarding whether the test should be performed and what to do if the baby tests HIV positive.

In conclusion, it is a dubious practice that warrants thought to test babies for HIV without alerting the mother and disclosing the results. The proposed protocol has considerable ethical ramifications, and the practical ramifications could be detrimental to the infant’s health and well-being. It is crucial to ensure that moms are informed about the test and aware of the results to defend their rights and guarantee that the newborn receives the proper medical treatment.

References

Childress, J.F., & Gaare, R.D. (2011). Principles of biomedical ethics (7th ed.). Oxford University Press.

Faden, R.R., & Beauchamp, T.L. (1986). A history and theory of informed consent. Oxford University Press.

Munthe, C. (2013). Autonomy and paternalism in medical ethics. Oxford University Press.

2-If this study is conducted in my hospital without the mothers knowledge or consent the findings and results will not viable. I say this because, there are protocols in place to protect the participants of a study. In this case “the participants” will be mothers and their baby’s that did not have any knowledge or consent to being in a study. One of the protocols in place is called the “Protection of Human Rights”. As stated in Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice e-book, those human rights include right to self determination, right to privacy and dignity, right to anonymity and confidentiality, and right to protection from discomfort and harm. If the study is conducted the state government official will be violating the basic human rights of the mothers and their baby’s. The human rights that will be violated are the right to self determination, and the right to privacy and dignity. The right to self determination is based on being treated as autonomous. Autonomous is defined as “an autonomous agent is one who is informed about a proposed study and allowed to choose to participate or not; subjects have the right to withdraw from a study without penalty” (p.g 246). As the mothers and their baby’s are not being informed about the study their right to self determination is being violated. The right to privacy and dignity is defined as “the freedom of a person to determine the time, extent, and circumstances under which private information is shared or withheld from others” (p.g 246). The mothers are not being informed about the study being conducted therefor, they are not giving consent for their baby’s information to be shared. The right to privacy and dignity is being violated. If the study were to take place they would also not provide an informed consent. An informed consent is a consent form given to the participants of a study to obtain permission to proceed, and it is related to the principles of respect and the right to self determination. As the participants will not receive an informed consent they will be violating their right to self determination and respect. This study should not take place as it violates many human rights of the participants.

LoBiondo-Wood, G., & Haber, J. (2021). Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice (10th ed.). Elsevier Health Sciences (US). https://bookshelf.vitalsource.com/books/9780323762…

neurologic function

Jun 14, 2024 | Health Medical

Description

Compare and contrast the 3 conditions in one of the charts below:

NEUROLOGIC SYNDROME

Dementia

Depression

Anxiety

Risk Factors

Pathophysiology

Clinical Manifestations

Part 2:

Choose a pain or neurologic syndrome to explore. You can also choose a diagnosis not listed (that coincides with your advanced practice specialty) as long as it relates to the neurological function.

Present a hypothetical case that includes the following:

Vital information about a person who might be predisposed to this condition (I.e., a person who may have risk factors for this condition).
The pathophysiology of the disease, including clinical manifestations.
Which diagnostic tests you’d recommend and a rationale for the one(s) you choose.
How this condition compares to other differentials.
The evidence-based recommendations from the AHRQ GuidelinesLinks to an external site. or guidelines recommended from a professional organization. Based on these recommendations, discuss how to manage the condition best.
A patient safety issue that could be associated with the condition presented in this case.

Part 3:

Answer these reflection questions:

What information would a master’s prepared nurse gather from a patient with this condition?
How could the master’s prepared nurse use this information to design a patient education session for someone with this condition?
What was the most confusing or challenging information presented in this case?

Expectations:

Your paper should be 3–4 pages (excluding cover and reference pages).
Use medical terminology and appropriate graduate level writing.
Your resources must include research articles and reference to non-research evidence-based
AHRQ Guidelines.Links to an external site.
Use APA format to style your paper and to cite your sources. Your source(s) should be integrated into the paragraphs. Use internal citations pointing to evidence in the literature and supporting your ideas. You will need to include a reference page listing those sources. Cite a minimum of three resources.

I need a project about medication error and risk reduction

Jun 14, 2024 | Health Medical

Description

I need it as word form and I will send ruberic you will follow

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attachment

Discussion board 4

Jun 14, 2024 | Health Medical

Description

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.

No AI or Chatbot! I will be sure to check this.

The state/region will be provided to you once you are selected to work on the question 🙂

To Prepare:

Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.

Consider how key regulations may impact nursing practice.

Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion.

Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.

oChapter 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.

Requirements: 1 to 2 Full Pages 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.

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

3735 Health Promotion

Jun 14, 2024 | Health Medical

Description

Please use attached blank form to work with. Develop a teaching plan for “Drug Abuse Control among teenagers”. This teaching plan is to be used as a guide in developing your Health Promotion Teaching Presentation. Reference: Edelman p 232-237 for information about teaching plans.Teaching plans should target teenagers, Recommended Settings, Learning Outcomes Include 2 to 4 outcomes. Outcomes need to be measurable, Domain of Learning: Indicate if Cognitive, Psychomotor, or Affective, Teaching Strategies/Materials: Include 1-2 teaching strategies per learning outcome. Strategies may include lecture, case study, role play, demonstration, or group discussion. Strategies must help the learner meet the outcome. Materials are items that aid your teaching and may include your Preventive Services Quick Reference Guide, posters, handouts, or simulation models. Do not use PowerPoint as a teaching strategy. Evaluation Methods: Describe how you will evaluate if your audience achieved the learning outcomes. Examples might include evaluation through audience comments, observation, surveys, or return demonstration. You must develop at least a 5 question quiz to evaluate learning so be sure to include that a quiz will be a part of your evaluation. You will submit this quiz as part of your presentation assignment.Edelman, C., L., Kudzma, E.C., & Mandle, C. L. (2018). Health promotion throughout the life span, 9th Edition. St Louis, MO: Elsevier.

A second area of group process is clarifying content. Where making group processes explicit points to overall group patterns and making them know, clarifying content enlightens the content of members’ interactions (Toseland, 2017). In an effort for members to communicate more effectively, the worker may help the member express themself more clearly or make sure the group understood what a member was saying. Further, a group worker would redirect the group to topics at hand if the group became unfocused or sidetracked by something that was not beneficial to the group. Sometimes, a group may intentionally avoid certain topics because they are considered taboo or are simply uncomfortable. The worker would point these subjects out as part of clarifying content.

Explain how each process might create positive outcomes when facilitating a group.

In an article I found in the Walden Library, Transformative Learning: The Role of Research in Traditional Clinical Disciplines, the researchers sought to prove that if they pointed out the student’s dependence on classroom approaches and being under focused on discipline specific tasks, the students would produce better results. What the researchers found is that when they pointed out these areas to students, their self-awareness improved and a deeper trust in their own informed intuition resulted (Tims, 2014). Self-awareness and trust in self are quite powerful positive outcomes from using the process of making group processes explicit.

Clarifying content was a large contribution to the parental book series that sought to explain same sex peer relationships among children. The authors used a sociometric analysis and noted that relationships formed differently among boys and girls. During the research for the book, they gathered girls and boys into groups and talked with them about their likes and dislikes of certain friends, favorite friends, etc. During this group research, the authors would bring up that the middle childhood aged children were not bringing up topics like sexuality or why boys tended to forge one large friend group where girls had more of a tendency to have multiple small groups of friends (Benenson & Parnass, 1988). The children began to share the reasons why they were uncomfortable addressing sexuality among same sex peer relationships. They also began talking about the differences in friend groups. This is another powerful positive outcome by the group worker letting the members know it is ok to talk about difficult things.

References

Benenson, J., Apostoleris, N., & Parnass, J. (1998). The organization of children’s same-sex peer relationships. In W. M. Bukowski & A. H. Cillessen (Eds.), Sociometry then and now: Building on six decades of measuring children’s experiences with the peer group. (pp. 5–23). Jossey-Bass.

Tims, M. (2014). Transformative Learning: The Role of Research in Traditional Clinical Disciplines. Integrative Medicine: A Clinician’s Journal, 13(4), 24–28.

Toseland, R. W., & Rivas, R. F. (2017). An introduction to group work practice (8th ed.). Boston, MA: Pearson.

Danielle Anderson
MondaySep 18 at 6:32pm

Main Post

Describe two processes for facilitating groups. For each, define the assessment and action that is intended to take place.

Involving group members is all members should be involved and interested in what is being discussed in the group (Toseland, 2017, pg. 114). An assessment can be identifying and describing thoughts, feelings, and behaviors (Toseland, 2017, pg. 114). An action would be supporting the individual and group members (Toseland, 2017, pg. 114). Another process would be Attending skills, attending skills is nonverbal behaviors, such as eye contact and body position, and verbal behaviors that convey empathy, respect, warmth, trust, genuineness, and honesty (Toseland, 2017, pg. 114). An assessment would be analyzing information (Toseland, 2017, pg. 114). An action would be Giving advice, suggestions, or instructions (Toseland, 2017, pg. 114). An article I found is called A social identity approach to facilitating therapy groups, this article briefly describes how group facilitators are group leaders and they need to provide a valuable framework for efforts to understand and increase their effectiveness ( Robertson, 2023).

Explain how each process might create positive outcomes when facilitating a group.

Positive outcomes for involving group members would be providing members with opportunities for leadership roles during program activities by praising members for their leadership efforts and inviting and encouraging members’ participation and initiative during group interaction (Toseland, 2017, pg 114). A positive outcome for attending skills would be scanning the group; scanning the group helps reduce the tendency of workers to focus on one or two group members (Toseland, 2017, pg 114). By attending the group, the client is supposed to be attending and being there all the time with little absences; they will be able to keep learning, sharing more of their stories, and getting help more.

Reference

Toseland, R. W., & Rivas, R. F. (2017). An introduction to group work practice (8th ed.). Boston, MA: Pearson.

Chapter 4, “Leadership” (pp. 98–136)

Chapter 5, “Leadership and Diversity” (pp. 137–159)

https://eds.p.ebscohost.com/eds/detail/detail?vid=8&sid=043db7ac-333b-437c-a9ad-a458316ca15f%40redis&bdata=JkF1dGhUeXBlPXNoaWImc2l0ZT1lZHMtbGl2ZSZzY29wZT1zaXRl#AN=2024-08542-001&db=pdh

Respond to two colleagues:

Compare differences in cost of living between your colleague’s calculations and yours.

Kacey Ryan
MondaySep 18 at 9:04pm

Discussion 1

Describe the EPI’s estimation of what it costs your family to live in your area.

According to the EPI’s estimation on cost of living for a 1 parent 2 child household in Jackson County, Ohio, the annual total income must not exceed $60,214. This includes monthly housing at $735, monthly food at $517, monthly childcare at $1026, monthly transport at $1,002, monthly healthcare at $874, monthly necessities at $454, monthly taxes at $410, for a monthly total of $5,018 and an annual total of $60,214.

Describe what you or your family would have to give up to live within the EPI’s budget.

My family income is approximately $51,400 annually, which is $8814 under the budget. According to this calculation, I wouldn’t have to give up anything. However, I do not qualify for any sort of assistance. However, I do believe there are cuts that could be made to lower our overall cost of living. I believe eating out would be an appropriate place to start. The allotted budget for groceries is fairly close to what I currently spend. To lessen this cost it would require developing a menu, meal prepping, and really thinking out our groceries that are bought to eliminate waste. I believe this change could save us at least $200 a month. Another area to adjust is our electric use. This could be corrected by keeping items unplugged that aren’t in regular use, turning lights off (especially the LED lights in my teenage son’s room), and turning the television off when not in use. Finally, a third area that could be addressed to improve our ability to meet the budget would be minimizing our “want” buys. We do not live luxuriously by any means, but we could afford to cut some of our extra spending on unnecessary items.

Explain how easy or hard it would be to give those things up.

It would be rather difficult to initially give these items up due to being in the routine of habit. The food cut and budgeting would require a lot of discipline and thought before being able to hit the ideal budget. I believe this would be the most difficult change to implement. Saving on the electric use would more than likely be the easiest change. Simple awareness of this factor could make a big difference. The needless spending would be difficult at first to identify and then cut out, but I do believe once we could learn to delay gratification a couple of times, we would find it rewarding.

Determine if the definition of what constitutes poverty is realistic.

I do believe the poverty line identified on the calculator is realistic. However, as stated earlier this is not an accurate representation in regards to receiving government assistance. As a single mother who receives no government assistance due to my income, it has often been a struggle to balance money for groceries and other necessities. I have found ways to spread household items to last longer such as adding some water to fabric softener, adding oats to meals with ground beef to supplement “more” meat,” and buying clothing and other items on sale. Society has made name brands a must and this has affected my budget with my teenage son. While he does not get everything name brand, I do my best to supply him with his likes. The middle class, I believe, suffer the most when it comes to living pay check to pay check. We make too much for assistance, but not enough to live comfortably. Furthermore, as a single mother, if my children have appointments or get sick I have to miss work which cuts into the already tight budget.

References

Economic Policy Institute. (2016b). Family budget calculator.Links to an external site. Retrieved from http://www.epi.org/resources/budget/Links to an external site.

Gould, E., Cooke, T., & Kimball, W. (2015). What families need to get by: EPI’s 2015 family budget calculator.Links to an external site.Economic Policy Institute. Retrieved from http://www.epi.org/publication/what-families-need-…

Sophia Washington
TuesdaySep 19 at 8:07am

Describe the EPI’s estimation of what it costs your family to live in your area.

EPI family budget calculator measures the income a family needs in order to attain a modest yet adequate standard of living. For Wayne county it is as follows:

HOUSING$827

FOOD$356

CHILD CARE$698

TRANSPORTATION$931

HEALTH CARE$771

OTHER NECESSITIES$428

TAXES$561

MONTHLY TOTAL$4,572

ANNUAL TOTAL$54,866

Describe what you or your family would have to give up to live within the EPI’s budget.

In order for my family to live within the EPI’s budget I would have to give up other necessities,child care, and cut back on food expenses.

Explain how easy or hard it would be to give those things up.

It would be easy to give up on child care expenses because I don’t have any small children. Cutting back on food expenses would be difficult but it would be doable. We would need to plan our meals and shop according to the meals listed.

Determine if the definition of what constitutes poverty is realistic.

In my opinion the poverty line is too high. There are so many families I know personally, including myself that have been excluded from programs because according to the poverty line they make too much money. When you are a single parent of one or multiple kids there is no such thing as you make too much money.

References:

DiNitto, D. M., & Johnson, D. H. (2016). Social welfare: Politics and public policy (8th ed.). Boston, MA: Pearson.

Respond to two colleagues:

Explain which estimate of poverty better aligns with your colleague’s stated ability to escape poverty: the EPI’s budget or DHHS poverty threshold.
Celenia Roque
TuesdaySep 19 at 11:02am

Deepening poverty is inextricably linked with rising levels of homelessness and food insecurity/hunger for many Americans, and children are particularly affected by these conditions. Extreme poverty is the strongest predictor of household homelessness. These families are often forced to choose between housing and other survival necessities. At least 11 percent of American children living in poverty are homeless. These are the two limitations/problems as follows:

Hunger. Families often struggle to hide their food insecurity, and some parents may feel ashamed or embarrassed for not being able to adequately feed their children. Children may also feel stigmatized, isolated, ashamed or embarrassed by lack of food. A sample of neighborhoods that classified low-income children ages 6 to 12 as hungry, at risk of hunger, or not hungry found that hungry children were significantly more likely to receive special education services, to have repeated a grade in school and to have received mental health counseling than at-risk-for-hunger or not-hungry children. Among low-income children, children classified as “starving” showed more anxiety, irritability, aggression and oppositional behavior than their peers. In addition, multiple stressors associated with poverty significantly increase the risk of developing mental and functional problems.
Homelessness. Access to permanent and adequate shelter is a basic human need; however, a prolonged economic downturn (including a foreclosure crisis, soaring unemployment, worsening poverty rates and a shortage of affordable housing) may will increase the rate of homelessness. The United States Conference of Mayors (2009) reported that more than 1.6 million children (1 in 45 children) were homeless in the United States in 2010, and approximately 650,000 were under the age of 6. Families with children make up the majority of the homeless population. Families with children make up one-third of the homeless population, usually consisting of a single mother in her twenties and two young children. States in the South and Southwest where poverty is more prevalent have more homeless children than states in the North and Northeast. Homelessness affects children’s health and well-being, and their brain development, causes stress, and prevents them from preparing for school.

Explain how these problems affect a person’s ability to escape poverty.

Homelessness and hunger go hand in hand. Homeless children are twice as likely to experience hunger as their non-homeless peers. Need has adverse effects on children’s physical, social, emotional, and cognitive development.
Americans’ developing bodies are not well adapted to the effects of living without clean water, food, or healthcare. As a result, many children living in poverty are malnourished and diseased. If left untreated (which is expected due to limited access to health care), they will not survive. Millions of people live with hunger and malnutrition because they simply can’t afford enough food, nutritious food, or what it takes to grow enough quality food themselves agricultural supplies needed. Hunger can be seen as a dimension of extreme poverty.
Homelessness and hunger go hand in hand. Homeless children are twice as likely to experience hunger as their non-homeless peers. Hunger has negative effects on children’s physical, social, emotional and cognitive development.
Homelessness disproportionately affects children and youth, including hunger, poor physical and mental health, and missed educational opportunities. Homeless children experience a lack of stability, with 97% of children moving at least once a year, which can lead to school disruption and negatively impact academic performance.

References:

https://www.apa.org/pi/families/poverty
https://www.apa.org/pi/ses/resources/publications/…

Atemkeng Siri Chumbow YesterdaySep 21 at 4:11am
Describe two limitations and/or problems with the poverty threshold.The poverty threshold is a number determined by the government to measure poverty in the United States. This number is used to decide who should be eligible for certain benefits. The poverty threshold is calculated from a household’s gross annual income and the number of people living in the household. Although this measure is meant to help those in need, there are several limitations and problems that make it difficult for people to escape poverty.The first limitation is its accuracy. The poverty threshold is based on an outdated poverty line, adjusted for inflation on a yearly basis, and does not accurately reflect current economic realities. (DiNitto & Johnson, 2016) note that this number is based on the cost of a basic food diet, but does not take into account the cost of other necessary items, such as housing or transportation. As a result, many households living in poverty might not meet the criteria determined by the poverty threshold, which can leave them without the necessary benefits to escape poverty.Another problem of the poverty threshold is its static nature. This number does not change to reflect the cost of living in different areas and, as a result, the same poverty threshold is used regardless of where a person lives. This leaves many low-income households struggling to make ends meet in areas that are more expensive, such as those in urban areas. Furthermore, the poverty threshold does not adjust itself over time to keep up with inflation, making it more difficult for those already living in poverty to buy basic items, such as food, clothing, and housing.Explain how these problems affect a person’s ability to escape poverty.These two limitations cause significant problems for people trying to escape poverty. Without an accurate poverty threshold that takes into account the cost of various items and allows for adjustments to different living areas, people in poverty are left in a situation where their limited resources are not enough to meet their basic needs. Furthermore, the static nature of the poverty threshold makes it almost impossible to keep up with rising prices. As a result, those already living in poverty cannot buy basic necessities, trapping them in a cycle of poverty.In conclusion, the poverty threshold is an important measure to determine eligibility for government benefits. However, its limitations and static nature can create obstacles for people trying to escape poverty. Therefore, it is important for government officials and social workers to work together to find innovative solutions to address the problems associated with this measure, such as increasing the minimum wage and finding ways for low-income individuals to access university-level education. This will help to create programmes and policies that are more accessible to those living in poverty, providing a pathway out to a more secure and stable future.ReferenceDiNitto, D. M., & Johnson, D. H. (2016). Social welfare: Politics and public policy (8th ed.). Boston, MA: Pearson.

Nursing Question

Jun 14, 2024 | Health Medical

Description

ASSIGNMENT #1:

I Will be uploading 2 files. One of them is a small example named “ASSIGNMENT 1 EXAMPLE NEWBORN CARE MAP” so you can get the main idea and better understand the assignement and the other one is the document that needs to be filled in that is named “Newborn Care Map”.

YOU NEED TO MAKE SURE IT IS ALL ORIGINAL WORK. RESOURCES USED ARE ONY BETWEEN 2018 TO 2023, NOTHING OLDER THAN 2018! PLEASE ADD THE REFERENCES.

ADDITIONAL INSTRUCTIONS:

There are specific aspects of the care map/care plan:

Data collection page
Concept map or care plan page
Pathophysiology and rationale

You will do complete assessments, identify diagnoses, prioritize problems, and then decide on a plan of care (goal and objectives, comprehensive interventions (with rationales, evaluation of expected outcomes, and modifications) for at least three priority diagnoses:

1 Physiologic
1 Psychosocial
1 Health promotion behavior
(Risk for infection & pain will not be acceptable)

NOTE: Integrate at least three references (within past 5 years), to include 1 journal article, 1 textbook, and 1 scholarly and reputable website. No nursing care plan books allowed as the 1 textbook reference but may be used as an additional reference. The student must utilize APA format for pathophysiology citations and references.

THANK YOU!

ASSIGNMENT #2 REVISION

I will attach 2 files. One will be the file you need to use to edit your previous work named “Matrnal Care MaMap”

The second one will be the document with the instructor’s feedback.

You did this assignment yourself not too long ago.

I received a 60% and was asked to do a revision on it.

Please read the instructor’s feedback in order to properly do a revision.

Original work only.

Professional work only please.

References must be only from within the past 5 years.

No references before 2018 can be used. I will attach the document for you to revise as well as a document with the instructor’s feedback.

*******************KEEP IN MIND this patient gave birth at the ambulance. SOME INFO THAT YOU ADDED DID NOT MAKE SENSE SINCE MY PATIENT DELIVERED AT THE AMBULANCE.

Now that you have feedback and examples I expect excellent work,

THANK YOU!

Unformatted Attachment Preview

MATERNAL CARE MAP
PT. INITIALS:
V.A.
AGE: 43
years old
Obstetric History:
Gestational age: 39 + 0
Gravida: 6
Para: 5
Full term: 5
Preterm: 0
Abortions: 1
Living: 5
Obstetrical Risk Factors:
Advanced Maternal Age
Drug use: None
VS: T: 37.1 Degrees Celsius
HR: 71 beats per minute
RR: 16 breaths per minute
B/P: 138/82 mmHg
PAIN ASSESSMENT: 6/10
(patient reporting a lowgrade headache)
LATCH Score: – 8/10
(patient can actively
breastfeed the newborn)
Bonding/Attachment: 10/10
Infant Security: – 10/10
Sitz Bath: -Not indicated at
this time.
Allergies/Medications:
NKDA/NKFA
STUDENT NAME:
LMP: EDC: 09/06/2023
PAST MEDICAL HISTORY:
Medication/Substances in Pregnancy:
None before delivery.
Primary support companion: Mother
Attended Childbirth Classes:
Not attending.
Date of Birth: 08/30/2023
Time of Birth: 11:47am
Type of Birth: Spontaneous Vaginal Delivery
at Ambulance
Labor and Birth History
Length of labor: 7 hours 11 min
Length of ruptured membranes: 1 hour
Medications/Anesthesia used: Epidural anesthesia for pain
management.
Delivery method: Spontaneous vaginal delivery in an ambulance
Dilation/Effacement/Station:
At admission: 3 cm dilated, 60% effaced and -1 station.
At 5 hours in labor: 6 cm dilated, 90% effaced and 0 station.
At delivery: 10 cm dilated, completely effaced and +2 station.
PATIENT INFORMATION
PHYSICAL ASSESSMENT DATA
Respiratory: Bilaterally equal, no wheezing or stridor; Patient denies pain; Rate and tidal volume WNL
Cardiac: Heart sounds clear; capillary refill less than 3 seconds; pulse strong and regular
Gastrointestinal: Bowel sounds active in all 4 quadrants; Patient reports no BM in past 24 hours; No evidence of distension.
Genitourinary: Patient mandatory voiding prior to delivery; Straw-colored urine; full bladder not palpated on postpartum assessment.
Fetal Heart Rate Assessment:
Contractions
FHR
Type of Monitor: Fetal External Monitoring
Type of Monitor: Electronic fetal heart monitoring (EFM)
Frequency: Approximately every 5 minutes
Baseline FHR: 110 bpm
Duration: 10-15 seconds each interval
Variability: 5-25 Beats Per Minute (moderate)
Intensity: 70mmHg
Periodic/episodic changes: No changes noted through labor and
delivery
Resting tone: 10 mm/Hg
Labor Assessment/Interventions: Assessed contractions every 20-30 minutes and monitored maternal vital signs to ensure patient
comfort. Provided hydration and emotional support to encourage the mother through the process. Instructed proper positioning and
mobility techniques for labor progression. Administered epidural anesthesia as needed for pain management. Applied warm compresses
and perineal massage when appropriate for relaxation and comfort measures. Provided education on breastfeeding initiation, skin-toskin contact, newborn resuscitation, immediate postpartum care of both mother and baby, and potential concerns in the first 48 hours.
IV FLUIDS: Lactated
Ringers 125 ml/hr
IV SITE: Right hand
LAB DATA
H/H: 4.5 g/dL / 39.2 %
VDRL/RPR: Negative
Type/Rh: O positive
Rubella: Negative
Blood Glucose: 79 mg/dL
HbsAG: Negative
UA: Clear and pale yellow
HIV: Negative
GBS: Not Tested
SOCIO-CULTURAL FINDINGS:
Culture/ethnicity/language: Hispanic / English and Spanish
Health beliefs: The patient is open to discussing her health beliefs but
does not express any specific preferences during the care process.
Economic/Educational: Middle class; college education.
Spiritual beliefs: No spiritual beliefs requested.
Significant others: Mother present
CARE MAP/CARE PLAN
#1 Nursing Diagnosis
Excessive Postpartum Bleeding
Goal
Rationales
Interventions
Evaluation
1. The patient will remain
hemodynamically stable and achieve
adequate hemostasis with no further
than 500 ml blood loss during the
postpartum period.
1. The patient has advanced
maternal age which can be
associated with an increased risk
for postpartum hemorrhage
(McCance & Huether, 2019)
2. There is a risk of retained
placental fragments that, if not
expelled, can contribute to
excessive bleeding after delivery
(McCance & Huether, 2019)
3. Aging placenta and uterine
atony have been known to
predispose patients to severe
bleeding during the postpartum
period (Gill et al., 2023)
1. Monitor hemoglobin results,
vital signs, and amount of lochial
discharge every two to four hours
for 24 hours following delivery
2. Encourage the patient’s use of
early ambulation activities as soon
as possible and provide assistance
as needed
1. Assess for evidence that the
patient is achieving the desired
outcomes including
documented adequate
hemostasis in the postpartum
time frame and hemodynamic
stability.
#2 Nursing Diagnosis
Risk for Impaired Parent-Child Attachment
Goal
Rationales
1. The patient will be able to
1. The mother has been through
effectively bond with her newborn by the childbirth process before and
the end of the postpartum period.
thus may have established
expectations that differ from her
current experience.
2. Limited preparation due to not
attending childbirth classes
3. Partner alive but not present
which could affect their ability to
connect during bonding times with
their baby (de Waal et al., 2023)
Interventions
Evaluation
1. Encourage holding, cuddling,
and skin-to-skin contact between
mother and child.
2. Ask the father questions about
his experience with the baby for
managed validation to maintain a
successful bond.
1. The patient will show
developmentally appropriate
bonding behavior when
assessed before discharge. 1
week reassessments until goals
are achieved.
#3 Nursing Diagnosis
Antepartum Risk for Ineffective Coping Related to Lack of Childbirth Education
Goal
1. The patient will demonstrate
adequate coping strategies related to
childbirth preparation, knowledge,
and education by the end of her
postpartum stay.
Rationales
Interventions
Evaluation
1. Providing information on labor
and delivery can help reduce stress
levels and improve understanding
(Kuo et al., 2022)
3. Utilizing educational resources
tailored to maternal age can
significantly facilitate learning
outcomes regarding pregnancy
health topics (Kuo et al., 2022).
1. Assess the level of knowledge
regarding physiological processes
and expectations for labor,
delivery, and post-partum care.
2. Discuss available antepartum
services available
3. Provide educational materials
that address recommended
treatments and lifestyle changes
associated with pregnancy
By discharge, the patient will
verbalize understanding of the
antepartum period and will
demonstrate practical coping
strategies with minimal
assistance from healthcare
providers related to pain
management, parental role in
providing child care, and
feeding methods for age
groups.
Pathophysiology & Rationale
Post-partum bleeding refers to a scenario where the mother loses more than 1000 mL with signs of hypovolemia within a day of
delivery (McCance & Huether, 2019). It is caused by the shedding of the lining of the uterus as it gradually contracts back to its prepregnancy size after delivery (McCance & Huether, 2019). The uterus may also be slow to heal or may be affected by an infection,
leading to excessive bleeding (McCance & Huether, 2019). In the case of a 43-year-old mother of 6, there is a significant risk of
excessive post-partum bleeding due to multiple births and her age. Her uterus muscles may have become weaker, impairing
contraction after birth and leading to bleeding (McCance & Huether, 2019). Further, multiple pregnancies increase the risk of
infection (McCance & Huether, 2019). The nurse should be aware of the patient’s risk and engage in activities such as uterine
massage and monitoring post-delivery 9(McCance & Huether, 2019)
References
de Waal, N., Boekhorst, M. G., Nyklíček, I., & Pop, V. J. (2023). Maternal-infant bonding and partner support during pregnancy and
postpartum: Associations with early child social-emotional development. Infant Behavior and Development, 72, 101871.
https://www.sciencedirect.com/science/article/pii/S0163638323000632#:~:text=Fundamental%20to%20health%20practices%
20during,for%20optimal%20maternal%2Dinfant%20bonding.
Gill, P., Patel, A., & Van Hook, J. W. (20123). Uterine atony. Treasure Island (FL): StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK493238/
Kuo, T. C., Au, H. K., Chen, S. R., Chipojola, R., Lee, G. T., Lee, P. H., & Kuo, S. Y. (2022). Effects of an integrated childbirth
education program to reduce fear of childbirth, anxiety, and depression, and improve dispositional mindfulness: A single-blind
randomised controlled trial. Midwifery, 113, 103438.
https://www.sciencedirect.com/science/article/abs/pii/S0266613822001899#:~:text=The%20benefits%20of%20childbirth%20
education,methods%2C%20and%20enhancing%20positive%20childbirth
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: the biologic basis for disease in adults and children (8th ed.). St. Louis,
MO: Mosby/Elsevier.
Ricci, S. S., Kyle, T., & Carman, S. (2021). Maternity and Pediatric nursing. 4th ed.
Philadelphia: Wolters Kluwer Health/Lippincott

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Better World Shopper

Jun 14, 2024 | Health Medical

Description

200 words or more. The instructions are in the file below.

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If we as consumers are concerned about the amount of waste we produce, climate
change or other issues affecting people and the environment, what can we do about it?
A Professor at UC Davis believes that voting with our dollars is a good start, so he
created the Better World Shopper project, which includes a free app for your phone
Links to an external site.
, a website, and a book providing information on various companies. This allows
consumers to have some basic information about the behavior of companies they buy
products and services from.
Read the following webpage and complete the assignment below using the webpage or
by downloading the free app:

Links to an external site.
Complete the following exercise on the website: https://betterworldshopper.org/
Links to an external site.
by clicking on the “Search Companies” button or by using the free app on your phone.
1. In the “Category” box look up the “Banks” category, and list 3 banks or credit
unions and their grades.
2. Look up the “Insurance Companies” category and list 3 companies and their
grades.
3. Look up 3 more companies of your choice in any category, list them and their
grades.
4. If the creator of this project asked for your help with promoting the free app
and getting as many people as possible to start using it, how would you
accomplish that? Explain your approach.
5. Did this exercise change your opinion of any companies you listed above?
Explain your answer.
List each of your responses in a separate paragraph for each answer, and clearly label
your responses with numbers 1,2,3,4,5.

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Nursing Question

Jun 14, 2024 | Health Medical

Description

this has two parts. First part is do a reflection paper about my day with a reference. My day was a shadow day. I went to visit Rosecrance Ware Center- i was involved to join Community Support Team where we go to support community individuals who diagnosed with disorders and help them to get their own daily tasks. It’s needed to start the reflection with something about community support team for mental disorders and get a reference for it the. Talk about my day. I had three patients to help during the day with the staff. We go to pick up clients and finish what they ask for. We go to doctor appointments they have, we go grocery store for them to shop, also, get into conversation where we see if they have improvements on attitudes and thinking.this is first part. Second part is writing PICO(T) question about psychological health.

Decontaminating techniques

Jun 14, 2024 | Health Medical

Description

Different types of decontaminating techniques. Why are they important and how can knowing those techniques can be beneficial to a nurse.

Critical thinking ( Research Poster)

Jun 14, 2024 | Health Medical

Description

Research Poster

Non-communicable diseases (NCDs) not only lead the way with respect to mortality rates at a global level but also account for the majority of deaths in high-income countries. According to Bashir (2021), the most common causes of death in Saudi Arabia are ischemic heart disease, road injuries, stroke, chronic kidney disease, lower respiratory tract infections, Alzheimer’s disease, conflict and terror, cirrhosis, neonatal disorders, and diabetes mellitus.

Select one of the causes of death listed above, then assemble a research poster specific to your selected topic and how it progressed to a goal in Saudi Vision 2030. Approach the topic as if you are gathering sources to present this research at a conference. Be sure your references address:

How is your selected cause of death addressed by Saudi Vision 2030?
What are some of the methods in obtaining research and data for shaping KSA policy regarding your selected cause of death?
Any challenges to collecting evidence-based information.
Health policy laws implementing positive social changes in this area of healthcare.
What is the importance of this information?
Why is your selected cause of death relevant to your audience or field of study?
How is it applicable beyond these contexts?

This Research Poster should meet the following criteria:

Include sections for: Introduction, Literature Review, Methods, Results, and Conclusion. Include a title slide and references slide.
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.
Be formatted according to APA 7th edition and Saudi Electronic University writing guidelines.
You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading.

Integrative literature review

Jun 14, 2024 | Health Medical

Description

This should be a synthesis of the literature, not a catalog of studies or simply an analysis of the research you discover.

Use current APA format to style your paper and to cite your source

Topic: Adolescents and STDs/ Unintended Pregnancy

Case Study – Peer Comment

Jun 14, 2024 | Health Medical

Description

Expectations (Inna)

Length: A minimum of 180 words, not including references
Citations: At least one high-level scholarly reference in APA from within the last 5 years
Relate to another studies

Etiology

The most common bacterial causes of Community-Acquired Pneumonia (CAP) include Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Staphylococcus aureus, Legionella species, Chlamydia pneumoniae, and Moraxella catarrhalis. While viral pathogens are increasingly recognized as a cause of CAP, current guidelines recommend empirical treatment for bacterial infection in all CAP patients. This recommendation is based on the absence of rapid and specific diagnostic tests that can conclusively confirm viral etiology at the time of presentation. Moreover, it’s noted that patients with CAP attributed to viral causes often exhibit concurrent bacterial coinfections (Dlugasch & Story, 2024).

The recommended empirical treatment for Community-Acquired Pneumonia (CAP) in the outpatient setting depends on whether the patient has comorbid conditions or risk factors for drug-resistant pathogens (Dlugasch & Story, 2024).

For Patients Without Comorbid Conditions or Risk Factors:

Monotherapy with one of the following is recommended: amoxicillin, doxycycline, or a macrolide (azithromycin or clarithromycin). However, the use of macrolide monotherapy is now a conditional recommendation due to increasing resistance rates. A macrolide should not be used if the local rate of pneumococcal resistance to macrolides exceeds 25%. In the U.S., the average rate of resistance is about 30% (Arcangelo, 2022).

For Patients With Comorbidities:

Broader-spectrum coverage is recommended due to the likelihood that these patients may have risk factors for antibiotic resistance.

Options include:

Monotherapy with a respiratory fluoroquinolone (levofloxacin, moxifloxacin, or gemifloxacin)

Combination therapy with amoxicillin-clavulanate or a cephalosporin plus a macrolide or doxycycline (Arcangelo, 2022).

The rationale for using broader-spectrum coverage in patients with comorbidities is that they are more likely to have had previous healthcare-system contact or prior antibiotic use, increasing their susceptibility to antibiotic resistance. Providing appropriate initial empirical coverage is crucial in these cases to avoid poor treatment outcomes.

Chlamydia, a treatable and curable infection, is typically managed with antibiotics like azithromycin or doxycycline for uncomplicated cases. Repeated infections can occur if sexual partners are untreated or if unprotected sex continues with an infected individual. Newborns with chlamydial eye infection receive azithromycin treatment. After treatment, a 7-day waiting period or correct condom use is advised before resuming sexual activity. Partner notification is crucial to prevent further transmission within sexual networks, emphasizing the importance of prompt diagnosis and treatment (Dlugasch & Story, 2024).

What are the recommended medications to start this specific patient on?

For a patient like Eric Johnson with diagnoses of pneumonia and chlamydia, treatment with doxycycline is a reasonable approach.

Drug Class: Doxycycline is a tetracycline antibiotic.

Generic & Trade Name: The generic name is Doxycycline, and trade names can include Vibramycin, Doryx, Adoxa, and others.

Initial Starting Dose: A common starting dose for adults is 100 mg orally twice a day for both pneumonia and chlamydia.

For Allergies:

Drug Class: Second-generation Antihistamine

Generic & Trade Names: Loratadine (Claritin) or Cetirizine (Zyrtec)

Initial Starting Dose: For Zyrtec take one 10 mg tablet once daily; do not take more than one 10 mg tablet in 24 hours. For Claritin a common adult dosage is 10 mg by mouth once a day.

For High Fever:

Drug Class: Antipyretic and Analgesic

Generic & Trade Names: Acetaminophen (Tylenol)

Initial Starting Dose: may take up to 1000 mg every 6 hours ( 4 times a day), do not exceed 4 gm a day.

Mechanism of Action:

Doxycycline works by inhibiting the growth and spread of bacteria. It does this by interfering with the protein synthesis process in bacterial cells, ultimately preventing their multiplication (Arcangelo, 2022).

Loratadine (Claritin) and Cetirizine (Zyrtec): These are antihistamines that block the action of histamine. These are second generation antihistamines (Arcangelo, 2022).

Acetaminophen (Tylenol): It reduces fever and relieves pain by affecting certain areas of the brain, but its exact mechanism of action is not fully understood.

Side Effects:

Doxycycline can lead to a range of adverse effects. These include gastrointestinal issues like abdominal discomfort, nausea, and diarrhea. Dental problems such as tooth discoloration and enamel issues are also possible, especially with prolonged use. Rare but severe hepatotoxicity may occur, leading to jaundice and irreversible shock. Renal toxicity can manifest as hyperphosphatemia and increased urination and thirst. Photosensitivity reactions may cause skin rashes, and auditory symptoms like tinnitus and hearing loss can occur. Visual disturbances, lightheadedness, dizziness, and headaches are among the central nervous system effects associated with doxycycline use (Arcangelo, 2022).

Loratadine (Claritin) and Cetirizine (Zyrtec): These second-generation antihistamines are generally well-tolerated, with side effects being mild and infrequent. Possible side effects include drowsiness, headache, and dry mouth (Arcangelo, 2022).

Acetaminophen (Tylenol): When used as directed, it is usually well-tolerated. However, excessive use can lead to liver damage, so it’s essential to follow dosing guidelines carefully.

Medication Interactions: Doxycycline can interact with certain medications, including antacids, iron supplements, and other antibiotics, potentially reducing its effectiveness. It’s important to space the timing of these medications apart to avoid interactions.

Non-Pharmacological Interventions: In addition to medication, non-pharmacological interventions for pneumonia may include rest, staying hydrated, and using a cool mist humidifier to ease breathing. For chlamydia, safe sexual practices, such as using condoms, and notifying sexual partners for testing and treatment are important non-pharmacological measures. Return to ED if his symptoms get worse or he experiences allergic reaction. Avoid alcohol and smoking, as they can worsen respiratory symptoms. When experiencing fever, do not use covers and blankets.

References

Arcangelo, V. P. (2022b). Pharmacotherapeutics for advanced practice: A practical approach. Wolters Kluwer.

Cunha, B. A. (2020). Antibiotics essentials. Physicians’ Press.

Dlugasch, L., & Story, L. (2024). Applied Pathophysiology for the advanced practice nurse. Jones & Bartlett Learning.

Nursing Question

Jun 14, 2024 | Health Medical

Description

The Integrative Literature Review.

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: 80

Due: Sunday, 11:59 p.m. (Pacific time)

Rubric

NURS_691A_DE – NURS 691-A Rubric Week 3: Integrative Literature Review

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeCritical Analysis

44 to >36.08 pts

Meets Expectations

36.08 to >33.0 pts

Approaches Expectations

33 to >25.96 pts

Falls Below Expectations

25.96 to >0 pts

Does Not Meet Expectations

The literature is listed, but it is neither analyzed nor synthesized.

44 pts

This criterion is linked to a Learning OutcomeContent

20 to >16.4 pts

Meets Expectations

16.4 to >15.0 pts

Approaches Expectations

15 to >11.8 pts

Falls Below Expectations

11.8 to >0 pts

Does Not Meet Expectations

20 pts

This criterion is linked to a Learning OutcomeOrganization

8 to >6.56 pts

Meets Expectations

Content is well written throughout. Information is well organized and clearly communicated.

6.56 to >6.0 pts

Approaches Expectations

Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.

6 to >4.72 pts

Falls Below Expectations

Content is disorganized in many places and it lacks clarity.

4.72 to >0 pts

Does Not Meet Expectations

Content lacks clarity and information is disorganized, or may be a list or a catalog of ideas.

8 pts

This criterion is linked to a Learning OutcomeAPA Format/Mechanics

8 to >6.56 pts

Meets Expectations

Follows all the requirements related to format, length, source citations, and layout. Assignment is free of spelling and grammatical errors.

6.56 to >6.0 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.

6 to >4.72 pts

Falls Below Expectations

Follows most of the requirements related to format, length, source citations, and layout. Assignment contains some spelling and grammatical errors.

4.72 to >0 pts

Does Not Meet Expectations

Does not follow format, length, source citations, and layout requirements. Assignment contains many spelling and grammatical errors.

8 pts

SOAP rubric. FOR this assignment the patient is a 68 year old patient with schizophrenia. Uploaded documents are for SOAP paper.

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeS (Subjective)

10 pts

Accomplished

Symptom analysis is well organized, with C/C, OLD CART, pertinent negatives, and pertinent positives. All data needed to support the diagnosis & differential are present. Is complete, concise, and relevant with no extraneous data.

5 pts

Satisfactory

Symptom analysis well organized with C/C, OLD CART, pertinent negatives, and pertinent positives. Some extraneous data is present and/or one minor data point missing.

2.5 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

0 pts

Unsatisfactory

Symptom analysis is inadequate, is not organized. Objective or other data is mixed into the subjective data. Important data is missing.

10 pts

This criterion is linked to a Learning OutcomeO (Objective)

10 pts

Accomplished

Complete, concise, well organized, well written, and includes pertinent positive and pertinent negative physical findings. Organized by body system in list format. No extraneous data.

5 pts

Satisfactory

All relevant exams were done thoroughly but extraneous exams were also done. It is somewhat organized in list format.

2.5 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.

0 pts

Unsatisfactory

Omitted important relevant exams and/or subjective data are included. Lacking organization.

10 pts

This criterion is linked to a Learning OutcomeA (Assessment)

10 pts

Accomplished

Diagnosis and differential dx are correct, include ICD code, and are supported by subjective and objective data.

5 pts

Satisfactory

Diagnosis is correct with ICD codes and is supported by subjective and objective data. Differential diagnosis was inaccurate based on subjective and objective data.

2.5 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.

0 pts

Unsatisfactory

Diagnosis is not correct, is not provided or is not reflective of the subjective and objective data provided.

10 pts

This criterion is linked to a Learning OutcomeP (Plan)

10 pts

Accomplished

Plan is organized, complete and supported with 2 evidence-based references. 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).

5 pts

Satisfactory

Plan is organized, complete and evidence-based according to 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.

2.5 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.

0 pts

Unsatisfactory

No Plan provided or is not organized. Does not address all diagnoses identified and/or does not include all 5 components of plan, including medication teaching.

10 pts

Unformatted Attachment Preview

PMHNP– SOAP Note Rubric
Criteria
S
(Subjective)
O
(Objective)
A
(Assessment)
Ratings
10 points
Accomplished
6 points
Satisfactory
4 points
Needs Improvement
0 points
Unsatisfactory
Symptom analysis is
well organized in a
SOAP format, with
C/C, Past Psychiatric
Hx, Social Hx, and
other pertinent past
and current
diagnostic details.
Symptom analysis is
well organized in a
SOAP format, with
C/C, Past Psychiatric
Hx, Social Hx, and
other pertinent past
and current
diagnostic details.
Symptom analysis is
not well organized or
presented in a varied
format. Required data
is missing.
Symptom analysis is
inadequate and is
not organized.
Objective or other
data is mixed into
the subjective data.
SOAP Note is
complete, concise,
relevant with no
extraneous data.
10 points
Accomplished
Some extraneous
data present with 1
minor data point
missing.
6 points
Satisfactory
Mental Status Exam is
complete, concise,
well-organized, and
well-written. Includes
pertinent psychiatric
information.
Organized by MSE list
format.
Mental Status Exam
is partially
incomplete,
organized, and
satisfactorily written.
Includes pertinent
psychiatric
information with
additional extraneous
information included.
Important data is
missing.
4 points
Needs Improvement
0 points
Unsatisfactory
Mental Status Exam is
incomplete, loosely
organized with
improvements
required. Relevant
psychiatric information
is omitted.
Mental Status Exam
is absent,
disorganized in
presentation,
adheres to no
specific format, or
grossly omits
relevant or pertinent
psychiatric
information.
No extraneous
information is
included.
Somewhat organized
in MSE list format.
10 points
Accomplished
6 points
Satisfactory
4 points
Needs Improvement
0 points
Unsatisfactory
Diagnosis and
Differential Dx are
correct with DSM-5
code(s) and supported
by subjective and
objective data.
Diagnosis and
Differential Dx are
correct with DSM-5
code(s) and mostly
supported by
subjective and
objective data.
Diagnosis and
Differential Dx are
correct with DSM-5
code(s) and mostly
supported by
subjective and
objective data.
Missing at least one
(1) pertinent
differential diagnosis
not listed according
to subjective and
objective data.
Working diagnosis is
correct.
All diagnoses
(working diagnosis
and differential
diagnoses) are
incorrect or is
missing based on
the subjective and
objective data
presented.
Includes: 1 working
Dx and 2 Differential
Dx.
P
(Plan)
There is too much
extraneous data
present or 2-3 minor
data points are
missing.
10 points
Accomplished
6 points
Satisfactory
Missing up to two (2)
pertinent differential
diagnoses based on
subjective and
objective data
presented. Or
differential diagnoses
are adequate with an
incorrect working
diagnosis.
4 points
Needs Improvement
Plan is well-organized,
complete, evidence-
Plan is organized,
complete, evidencebased and patient-
Plan is less organized,
is not based on
evidence. Fails to
Pts
10
pts
0 points
Unsatisfactory
Plan is disorganized,
absent, or is missing
10
pts
10
pts
10
pts
based, and patientcentric. Fully
addresses each
diagnosis and is
individualized to the
specific patient.
*Plan requirements:
prescribed
medications, if any;
explanation of offlabel medication use,
if prescribed; risks
and benefits of
medications
identified; therapy
recommendations;
patient education;
referral/follow-up;
and health
maintenance.
Total
centric. Fully
addresses each
diagnosis and is
individualized to the
specific patient.
Plan is missing 1-2 of
the required items.
address each diagnosis
sufficiently or is not
individualized or
patient-centric
all the required
items.
Plan is missing more
than 2 of the required
items.
40
pts
PMHNP Problem-Focused SOAP Note
(Use this template for this Assignment)
Demographic Data
o
o
Patient age and Patient’s gender identity
MUST BE HIPAA compliant.
Subjective
Chief Complaint (CC):
o
Place the patient’s CC complaint in Quotes
History of Present Illness (HPI):
o Reason for an appointment today.
o The events that led to hospitalization or clinic visits today.
o Include symptoms, relieving factors, and past compliance or noncompliance with medications
o Any adverse effects from past medication use
o Sleep patterns – number of hours of sleep per day, early wakefulness, not
being able to initiate sleep, not able to stay asleep, etc.
o Suicide or homicide thoughts present
o Any self-care or Activity of Daily Living (ADL) such as eating, drinking
liquids, self-care deficits or issues noted?
o Presence/description of psychosis (if psychosis, command or noncommand)
Past Psychiatric History (PSH):
o Past psychiatric diagnoses
o Past hospitalizations
o Past psychiatric medications use
o Any non-compliance issues in the past?
o Any meds that didn’t work for this patient?
Family History of Psychiatric Conditions or Diagnoses:
o Mother/father, siblings, grandparents, or direct relatives
Social History:
o Include nutrition, exercise, substance use (details of use), sexual
history/preference, occupation (type), highest school achievement,
financial problems, legal issues, children, history of personal abuse
(including sexual, emotional, or physical).
Allergies:
o
to medications, foods, chemicals, and other.
Review of Systems (ROS) (Physical Complaints):
o Any physical complaints by body system? (Respiratory, Cardiac, Renal, etc.)
Objective
Mental Status Exam:
o This is not physical exam.
o Mini-Mental Status Exam (MMSE) – Full exam
Assessment (Diagnosis)
Differentials
o
o
o
Two (2) differential diagnoses with ICD-10 codes.
Must include rationale using DSM-5 Criteria (Required)
Why didn’t you pick these as a major diagnosis?
Working Diagnosis
o
o
Final or working diagnosis (1), with ICD-10 code.
Must include rationale using DSM-5 criteria required – Which symptoms/signs
in the DSM-5 the patient matches mostly)
Plan
Treatment Plan (Tx Plan):
o Pharmacologic: Include full information for each medication(s) prescribed
o Refill Provided: Include full information for each medication(s) refilled
Patient Education:
o including specific medication teaching points
o Was risk versus benefit of current treatment plan addressed for meds or
treatment
o Risk versus benefit of non-FDA approved for working diagnosis – Off-label use
of medication education to patient addressed?
Prognosis:
o Make Decision for prognosis: Good, Fair, Poor
o Provide brief statement lending support for or against the decided prognosis.
Therapy Recommendations:
o Type(s) of therapy recommended.
Referral/Follow-up:
o Did you recommend follow-up with Psychiatrist, PCP, or other specialist or
healthcare professionals?
o When is the subsequent follow-up?
o Include rationale for the F/U recommendation or referral.
Reference(s):
o
o
o
Include American Psychological Association (APA) formatted references.
Include a reference from the American Psychiatric Association’s Diagnostic
and Statistical Manual of Mental Health Disorders (DSM-5) or the
accompanying Desk Reference of Diagnostic Criteria from DSM-5.
Minimum 2 references are required.

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Discussion ?

Jun 14, 2024 | Health Medical

Description

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NURS 321
Nursing Research & Evidence-Based Practice
Module 1 Individual Discussion Questions
Chapter 1
Currently, the law states that a woman must see a physician in person before she can use
mifepristone (the abortion pill RU 486) to induce an abortion. The law prohibits using a video
conference with the physician and the medication being administered by a nonphysician.
Legislators are seeking information on which they can base their decisions.
Video about medication abortion: https://www.plannedparenthood.org/learn/abortion/theabortion-pill
1. What is an example of qualitative research that could provide needed information?
2. What is an example of quantitative research that could provide needed information?
3. How can the following help these legislators make a decision? Nursing research, evidencebased practice, and quality improvement.
Chapter 2
The nurse is working in a village in the mountains of eastern Haiti. She notes that a number of
the children and pregnant women are eating cookies made with large portions of dirt (mud
cookies). Watch this video to learn more about this concern.

1. Write a research question related to children and pregnant women eating mud cookies in
Haiti.
2. Create a hypothesis related to children and pregnant women eating mud cookies in Haiti.
3. For the hypothesis written, describe the following. Independent variables, dependent
variables, and type of hypothesis.
Chapter 3
The nurse is providing care for a client with type 2diabetes. He notes that the client is using a
beta blocker for migraines. The nurse goes to the break room to find a medical surgical textbook
and a pharmacology textbook. Upon reviewing the information, the nurse reviews the reference
section for each chapter. (Note: Students exploring this case study should access a medical
surgical textbook and a pharmacology textbook.)
1. What are benefits and concerns of accessing these textbooks as a means of searching for
information related to caring for this client?
2. Identify at least one primary source and one secondary source in the reference section of one
of the chapters you accessed to provide care for this client. Locate those articles in CINAHL
or ProQuest. For each article, conduct a preliminary reading of the abstract and identify
possible benefits and concerns about each article.
3. Conduct an Internet search of the two articles that were accessed in CINAHL/ProQuest.
Discuss how these articles are being used in other resources.
Chapter 4
Mr. Alcindor is visiting the community health fair. He has been undergoing active surveillance
for prostate cancer and seems anxious when asking the nurse questions. As the nurse sets a time
for Mr. Alcindor to come to the community health center and discuss his concerns more, she
realizes that she needs to review current research on this topic.
1. Identify two possible resources that can help provide a theoretical perspective on providing
care for Mr. Alcindor.
2. Review the coping section of a textbook (e.g., medical surgical, fundamentals, mental health)
and identify if a theoretical framework was used to help build that content or chapter. What
were your findings?
3. Identify a resource that discusses the framework of resilience. As you critically appraise the
article, do you think resilience would be a better framework to guide care for Mr. Alcindor?
Support your answer.
Chapter 13
A nurse in Haiti is providing teaching on elephantiasis related to lymphatic filariasis. The clients
are coming to a clinic for blood pressure screening. The nurse wonders about the implications of
researching the perceptions of elephantiasis in the surrounding villages and access to medication.
Note: See https://www.washingtonpost.com/national/health-science/for-haitis-elephantiasispatients-specter-of-voodoo-lingers-hampering-care/2012/09/30/2badf306-b170-11e1-80acdab76d0e77c0_story.html
1. With informed consent for participants, what would be some considerations?
2. Who would be included in vulnerable groups when considering a sample?
3. List ways that participant responses to a survey could be tracked.

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Nursing Question

Jun 14, 2024 | Health Medical

Description

Event Report Instructions

In this assignment, you will be given two different scenarios. You will choose one to write out event/incident reports for. Each scenario has multiple incidents. You are required to turn in TWO incident reports based on ONE scenario. You also need to fill out the incident report questions.

Please remember:

Each incident report may only have 1 problem on it.

When describing the event, only use objective information, and be brief and factual. Explain what happen in short declarative sentences.

You must use the template provided.

Include a title page and page numbers.•

Scenerio

Lynette Donovan, a 15-year-old female African American was a passenger in a motor vehicle collision and is now admitted to the hospital with a fractured right femur. The emergency department health care provider applied a cast to the affected leg with insufficient padding.

Lynnette told the nurses that her right leg felt numb, was swollen and looked discolored.

The nurses recognized that these symptoms indicate impaired circulation in the extremity with the cast.

The nurse was unable to reach Lynette’s health care provider despite several calls.

The nurse has not notified the nursing supervisor of the patient’s situation.

David Ortiz is a 23-year-old nursing student newly assigned to the nursing division and to Miss Donovan. His initial assessment notes that the patient’s right leg is swollen, slightly blue, and slightly malodorous. Lynette seems very anxious and upset.

David remembers that Lynette Donovan is legally a minor. She is hurt and afraid and in an unfamiliar setting. She may not be comfortable speaking with the health care providers who are present, and her expressions of pain may be modified by the circumstances she is in.

Lynette Donovan developed gangrene in the right leg. She requires a right below-the-knee amputation.

David Ortiz is returning from escorting Miss Donovan to the operating room for her procedure. He gets on the elevator, where several visitors and two nursing supervisors are talking about the health care provider who “made Donovan lose her leg.”

Health & Medical Question

Jun 14, 2024 | Health Medical

Description

PLEASE PROVIDE ME WITH ANY PROBLEM IN THE WOMEN’S HEALTH CARE (OBGYN

ACON SOAP Note (one at 5 points)

For this assignment, students will create one SOAP note reflective of the patient care experience in the clinical setting under the supervision of the clinical preceptor in the role of the clinical provider. This assignment will evaluate student clinical reasoning skills, interviewing skills, physical exam skills, selection of diagnostic testing, differential diagnosis, pharmaceutical and non-pharmaceutical treatment, patient education, and follow-up plan.

Students must develop the clinical skills and knowledge required for safe practice and deliver best patient outcomes upon graduation. SOAP notes should be used to document each patient seen in the clinical setting. Clear, concise, and thorough documentation is required for continuity of care, safe practice, appropriate reimbursement, and prudent risk management.

When developing the SOAP note, students should use the assignment criteria below and the ACON SOAP Note Template found in Module Week 2. Students should include complete subjective and objective information to support the assessment and plan. The plan must include diagnostic and treatment measures, patient education, and follow-up.

Keep the following points in mind:

Use the ACON SOAP Note template as a guide
Identify and collect relevant subjective and objective data
Use proper medical terminology and documentation
Use proper ICD-10 coding and Current Procedural Terminology (CPT) E/M coding
Identify any cultural/religious/racial/gender influences on care

Assignment Criteria:

Students will complete a SOAP note and include the following:

Subjective findings
Chief complaint (CC)
History of present illness (HPI)
Use mnemonic: onset, location/radiation, duration, character, aggravating factors, relieving factors, timing, and severity (OLDCARTS)
Past medical/surgical/social/family history
Medications
Allergies, prescription/over the counter (OTC)/herbal medications
Review of systems (ROS)

2. Objective findings

Appropriate physical examination based on subjective findings
Relevant positive and negative diagnostic testing including previous pertinent diagnostic tests related to visit
Screening tools and positive and negative results
3. Assessment
Correct primary diagnosis
Correct differential diagnoses
Correct ICD-10/Current Procedural Terminology (CPT) codes

4. Plan

Identify and order correct diagnostics, prescriptions, referrals, and follow-up plan
Patient education relative to treatment plan.
Correctly written out a prescription for one medication prescribed for the patient.
If a medication not prescribed, write out a prescription for a medication that might be prescribed for a similar patient

5. Include two current evidence-based guidelines and/or peer-reviewed scholarly journals to support patient education and treatment plan. References should be from scholarly peer-reviewed journals (check Ulrich’s Periodical Directory) and be less than five (5) years old.

APA format required (attention to spelling/grammar, a title page, a reference page, and in-text citations). Schuiling & Likis: Chapters 25, 26, 27, 28, and 30Week 5 Content
 Go to Modules on the Course Menu, click, and scroll down to Week 5
content
Journal Article:
The North American Menopause Society. (2022). The 2022 hormone therapy
position statement of the North American Menopause Society.
Menopause, 20(7), 767-794.
Class Lecture/Discussion
In-class activities will be facilitated by the instructor and may include small
groups, shared pairs, individual work, groups discussions, and individual/group
presentations. Prior to class, read the weekly content and be prepared to discuss
the following:
 Gynecologic infections
 Sexually transmitted infections
 Urinary tract infection
 Urinary incontinence
 Menstrual cycle
 Uterine bleeding
 Benign gynecological conditions
 Menopause
 Pelvic pain
 Hyper-androgenic disorders

write a 150 words simple reply for each student’s discussion individually

Jun 14, 2024 | Health Medical

Description

1st:Every person has a right to self determination, privacy, anonymity, fair treatment, and protection from discomfort and harm. Involving a vulnerable population including infants is a violation on many accounts. There should be an advocate such as the mother and father or even the nurse taking care of the infant. The state government official trying to participate in this state-wide study to test newborns without respectfully informing the mother raises ethical concerns. Lobiondo-wood and Haber (2022) stated, “Informed consent is a legal principle that means that potential subjects understand the implications of participating in research and they knowingly agree to participate” (p. 247). This dives into the protection of human rights and the right to self-determination. From table 13.2, the right to self-determination is the right for the potential participant to choose to participate or not. In this case, the infants would not have a choice because they are part of the vulnerable population and simply cannot verbalize or comprehend what the study is about. Individuals have the right to know what testing and procedures are being done on them. The mother or father are the primary guardians, making them the first people to go to for consent. This is also an example of a violation of the right to privacy and dignity. Parents or guardians of children who might test positive for HIV could experience immense distress and embarrassment if they wish to keep this sensitive information confidential. They would be unaware of this information being shared with others in the study. HIV is crucial information due to its life-threatening capabilities. Failure to inform the mothers would deprive her of the opportunity to seek proper treatment. This information is crucial to public health purposes because if left untreated, the cases would go unreported, leaving the rest of the population at risk. 2nd:I refute the practice that includes the testing of all newborns for HIV especially since the mothers won’t be addressed regarding the test being performed on their newborns nor will they be informed with the results therefore the findings of the proposed study will be invalid if the protocol is carried out. Special consideration should be given to protecting the rights of vulnerable groups, in this case of newborn children, LoBiondo-Wood and Haber highlight how, “Research in children requires parental permission and child assent” (LoBiondo-Wood and Haber, 242). The research planning to be done doesn’t have the parents permission as the parents aren’t even aware of the proposed study the state government official is interested in conducting. According to LoBiondo-Wood and Haber, “No investigator may involve a person as a research subject before obtaining the legally effective informed consent of a subject or legally authorized representative” (LoBiondo-Wood and Haber, 238). This would automatically make the proposed study invalid if conducted without the legally effective informed consent forms and violates the ethical principle of respect.LoBiondo-Wood and Haber explain that, “Protection of human rights includes (1) right to self-determination, (2) right to privacy and dignity, (3) right to anonymity and confidentiality, (4) right to fair treatment, and (5) right to protection from discomfort and harm” (LoBiondo-Wood and Haber, 245). Someone who’s informed about a proposed study and given the option to participate or not is an autonomous agent as they have the freedom to choose, but a subject’s right to self determination is violated through covert data collection. We know that the data collected would be covert since the newborns will be tested without their own personal knowledge nor their guardians/parents knowledge. The right to privacy and dignity is also violated as the subject doesn’t know what the data collected will be used for or who it’s going to be shared with, and it’s also violated since the information will be withheld from the newborns parents.

Unnatural Causes, Bad Sugar episode reflection

Jun 14, 2024 | Health Medical

Description

Watch the episode Bad Sugar (31 minutes) https://sdsu.kanopy.com/video/bad-sugar2. Write a 150-175 word reflection about the episode. Please be sure to incorporate some thoughts about the social determinants of health and how that relates to the Pima’s situation.

Critical thinking

Jun 14, 2024 | Health Medical

Description

Population Health ManagementResearch a minimum of four articles on the challenges of providing access to healthcare in the Kingdom for the population by considering patient demographics and geographic considerations. Explain the patient education strategies that are needed to overcome some of these challenges. Explain how this strategy supports the mission, vision, and values of Saudi Vision 2030. Summarize the benefits to Saudi patients, healthcare organizations, and healthcare providers.Requirements:The paper should be six pages in length, not including the title and reference pages.You must include a minimum of five credible sources. Use the Saudi Electronic Digital Library to find your resources.The 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.

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Name
CT_Rubric_105
Description
105 Points
Rubric Detail
Levels of Achievement
Criteria
Exceeds Expectation
Meets Expectation
Some Expectations
Unsatisfactory
Content
33 to 35 points
29 to 32 points
26 to 28 points
0 to 25 points
Demonstrates
substantial and
extensive knowledge of
the materials, with no
errors or major
omissions.
Demonstrates adequate
knowledge of the
materials; may include
some minor errors or
omissions.
Demonstrates fair
knowledge of the materials
and/or includes some
major errors or omissions.
Fails to demonstrate
knowledge of the
materials and/or
includes many major
errors or omissions.
37 to 40 points
29 to 36 points
26 to 28 points
0 to 25 points
Provides strong thought,
insight, and analysis of
concepts and
applications.
Provides adequate
thought, insight, and
analysis of concepts and
applications.
Provides poor though,
insight, and analysis of
concepts and applications.
Provides little or no
thought, insight, and
analysis of concepts and
applications.
15 to 15 points
13 to 14 points
11 to 12 points
0 to 10 points
Sources go above and
beyond required criteria
and are well chosen to
provide effective
substance and
perspectives on the
issue under
examination.
Sources meet required
criteria and are
adequately chosen to
provide substance and
perspectives on the issue
under examination.
Sources meet required
criteria but are poorly
chosen to provide
substance and perspectives
on the issue under
examination.
Source selection and
integration of knowledge
from the course is clearly
deficient.
15 to 15 points
13 to 14 points
11 to 12 points
0 to 10 points
Project is clearly
organized, well written,
and in proper format as
outlined in the
assignment. Strong
sentence and paragraph
structure, contains no
errors in grammar,
spelling, APA style, or
APA citations and
references.
Project is fairly well
organized and written
and is in proper format as
outlined in the
assignment. Reasonably
good sentence and
paragraph structure, may
include a few minor
errors in grammar,
spelling, APA style, or APA
citations and references.
Project is poorly organized
and written and may not
follow proper format as
outlined in the assignment.
Inconsistent to inadequate
sentence and paragraph
development, and/or
includes numerous or
major errors in grammar,
spelling, APA style or APA
citations and references.
Project is not organized
or well written and is not
in proper format as
outlined in the
assignment. Poor quality
work; unacceptable in
terms of grammar,
spelling, APA style, and
APA citations and
references.
Analysis
Sources
Demonstrates
college-level
proficiency in
organization,
grammar and
style.
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Otitis Media – Peer Comment

Jun 14, 2024 | Health Medical

Description

Expectations (Jacqueline)

Length: A minimum of 180 words, not including references or attachments
Citations: At least one high-level scholarly reference in APA from within the last 5 year

Discuss what are the potential treatments for this child’s diagnosis

Inflammation and fluid accumulation behind both eardrums describe bilateral Otitis Media (OM), a frequent form of juvenile otitis media. Several methods exist for treating this problem. First, depending on the age, severity of symptoms, and risk factors of the child, a strategy of monitoring and symptomatic care may be recommended for milder instances (Gaddey et al., 2019). The kid should be monitored without administering antibiotics right away, and pain medication such as acetaminophen or ibuprofen, water, and warm compresses for the ears should be used instead. Second, antibiotics are usually necessary when the case of OM is severe or recurrent or when the child is less than 6 months old. Amoxicillin, amoxicillin/clavulanate, and ceftriaxone are frequently used antibiotics. Thirdly, the insertion of tympanostomy tubes may be explored to relieve symptoms and minimize recurrences in cases of chronic or recurrent OM or in the context of persistent hearing loss (Gaddey et al., 2019). In addition, comfort can be significantly enhanced by the use of over-the-counter pain relievers. Close follow-up sessions with healthcare providers should be made to evaluate the child’s progress and treatment efficacy, and parents should be taught the proper dose and potential adverse effects.

What antibiotic/s should be given for this patient’s diagnosis?

Based on the patient’s history and current symptoms, amoxicillin/clavulanate (Augmentin) would be an effective antibiotic for this child’s Bilateral Otitis Media. This antibiotic mix was chosen because it is more effective than either component used alone against a wider variety of bacteria, including some that have developed resistance to amoxicillin. Including clavulanate enhances amoxicillin’s potency and coverage, making it a favorable choice in cases where previous treatments may have been less effective.

How long should you prescribe the chosen antibiotic?

It is essential to effectively manage Bilateral Otitis Media (OM) in children by determining the best period of antibiotic therapy. When a male child of five years of age presents with ongoing symptoms despite prior antibiotic therapy, a 10-day course of amoxicillin/clavulanate is the safest line of action. This time frame is consistent with recommendations and offers a holistic method of treating OM. Bacterial infections, especially Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, are among the leading causes of OM. Because of their resistance, these bacteria may require a longer course of therapy to eliminate. Shorter regimens of antibiotics of about 5-7 days have been proven to increase treatment failure and recurrence, thus prolonging the child’s suffering and threatening consequences (Principi et al., 2023). In addition, a significant safety buffer is provided by increasing the treatment duration to 10 days. It considers that each kid responds differently to treatment and guarantees that the entire course is taken, even if the child shows immediate improvement, which is crucial in preventing bacterial resistance and the continuation of subclinical infection.

What teaching would you give this child’s parents on the prescription?

Parents need to be given detailed instructions on how to take care of their child’s medication. Parents should be instructed on how to give their kids amoxicillin/clavulanate, how long the medication should be given, and the consequences of stopping treatment prematurely (Marek & Timmons, 2019). Parents must know what to do if their child experiences unwanted side effects like diarrhea, a rash, or an upset stomach. It is crucial to find out whether the kid has any known allergies, especially to antibiotics, and to encourage parents to seek quick medical assistance if any signs of an allergic reaction appear. Maintaining adequate hydration and adhering to preventive measures, such as avoiding secondhand smoke and ensuring up-to-date vaccinations, should be emphasized, as should the importance of attending all follow-up appointments with the healthcare provider to monitor the child’s progress and response to treatment.

Write out a correct prescription for the antibiotic you will prescribe for this patient. (Be sure to include all elements needed for a correct prescription.)

The prescription includes all the necessary details for the patient, such as their name, date of birth, weight, age, diagnosis, the prescribed medication, dosage, route of administration, instructions for use, quantity, and refills.

Diagnosis: Bilateral Otitis Media

Medication: Amoxicillin/Clavulanate (Augmentin)

Dosage: 250 mg/5 mL

Route: Oral

Instructions: Administer 5 mL (1 teaspoon) orally every 12 hours for 10 days.

Quantity: 150 mL suspension

Refills: None

References

Gaddey, H. L., Wright, M. T., & Nelson, T. N. (2019). Otitis media: rapid evidence review. American family physician, 100(6), 350-356.

Marek, C. L., & Timmons, S. R. (2019). Antimicrobials in pediatric dentistry. In Pediatric Dentistry (pp. 128-141). Elsevier.

Principi, N., Autore, G., Argentiero, A., & Esposito, S. (2023). Short-term antibiotic therapy for the most common bacterial respiratory infections in infants and children. Frontiers in Pharmacology, 14, 11741

PHC 241 nutrition

Jun 14, 2024 | Health Medical

Description

Patterns of food consumption in the Kingdom

of Saudi Arabia

The purpose of this assignment is to describe patterns of food consumption in the Kingdom of Saudi Arabia (KSA).

Please read the attached article and write a brief summary of it by answering the following questions:

What are the current patterns of food consumption in the KSA?
What dietary gaps can be identified by analyzing the current food situation in the KSA?
Members of which age group have the healthiest diet, and why?

4.In your opinion, what can be done to encourage better patterns of food consumption among the Saudi population?

Unformatted Attachment Preview

ASSIGNMENT COVER SHEET
Course name:
Fundamental Concepts in Food and Nutrition
Course number:
PHC 241
CRN:
xxxx
Patterns of food consumption in the Kingdom
of Saudi Arabia
The purpose of this assignment is to describe patterns of food
consumption in the Kingdom of Saudi Arabia (KSA).
Please read the attached article and write a brief summary
of it by answering the following questions:
Assignment title or task:
(You can write a question)
1.
2.
3.
4.
What are the current patterns of food consumption in
the KSA?
What dietary gaps can be identified by analyzing the
current food situation in the KSA?
Members of which age group have the healthiest diet,
and why?
In your opinion, what can be done to encourage better
patterns of food consumption among the Saudi
population?
Students ID
xxxx
Student name:
xxxx
Submission date:
xxxx
Instructor name:
Grade:
…. Out of 5
Release Date: 17/09/2023
Due Date: 07/10/2023
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 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/intext
Do proper paraphrasing to avoid plagiarism
doi:10.1017/S1368980016003141
Public Health Nutrition: 20(6), 1075–1081
Diet in Saudi Arabia: ﬁndings from a nationally representative
survey
Maziar Moradi-Lakeh1, Charbel El Bcheraoui1, Ashkan Afshin1, Farah Daoud1,
Mohammad A AlMazroa2, Mohammad Al Saeedi2, Mohammed Basulaiman2,
Ziad A Memish2, Abdullah A Al Rabeeah2 and Ali H Mokdad1,*
1
Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600, Seattle,
WA 98121, USA: 2Ministry of Health of the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
Submitted 30 March 2016: Final revision received 8 September 2016: Accepted 10 October 2016: First published online 15 December 2016
Abstract
Objective: No recent original studies on the pattern of diet are available for Saudi
Arabia at the national level. The present study was performed to describe the
consumption of foods and beverages by Saudi adults.
Design: The Saudi Health Interview Survey (SHIS) was conducted in 2013. Data
were collected through interviews and anthropometric measurements were done.
A diet history questionnaire was used to determine the amount of consumption for
eighteen food or beverage items in a typical week.
Setting: The study was a household survey in all thirteen administrative regions of
Saudi Arabia.
Subjects: Participants were 10 735 individuals aged 15 years or older.
Results: Mean daily consumption was 70·9 (SE 1·3) g for fruits, 111·1 (SE 2·0) g for
vegetables, 11·6 (SE 0·3) g for dark ﬁsh, 13·8 (SE 0·3) g for other ﬁsh, 44·2 (SE 0·7) g
for red meat, 4·8 (SE 0·2) g for processed meat, 10·9 (SE 0·3) g for nuts, 219·4 (SE 5·1) ml
for milk and 115·5 (SE 2·6) ml for sugar-sweetened beverages. Dietary guideline
recommendations were met by only 5·2 % of individuals for fruits, 7·5 % for
vegetables, 31·4 % for nuts and 44·7 % for ﬁsh. The consumption of processed
foods and sugar-sweetened beverages was high in young adults.
Conclusions: Only a small percentage of the Saudi population met the dietary
recommendations. Programmes to improve dietary behaviours are urgently
needed to reduce the current and future burden of disease. The promotion of
healthy diets should target both the general population and speciﬁc high-risk
groups. Regular assessments of dietary status are needed to monitor trends and
inform interventions.
Dietary risks are among the most important risk factors
globally and in the Kingdom of Saudi Arabia (KSA) in
particular(1,2). Like many other regions of the world, the
nutrition transition in the Middle East has contributed to the
rising burden of non-communicable diseases(1,3). In KSA in
2013, poor diet accounted for 10·4 % (95 % CI 8·9, 12·2 %) of
disability-adjusted life years and 22·1 % (95 % CI 18·7,
24·5 %) of deaths(3,4). FAO data show an overall increase in
food supply (1961–2007) in KSA, with an increase in the
supply of sugar, meat, animal fat, offal (organ meats), eggs
and milk, and a levelling trend in the vegetable and fruit
supply(5). A similar trend was reported earlier in 2000(6).
Khan and Al Kanhal reported a rapidly increasing surplus of
energy and protein availability in KSA after 1975, compared
with the recommended daily allowances(7).
Keyword
Diet
Foods
Beverages
Nutrition epidemiology
Saudi Arabia
Previous reports have shown the dietary patterns or
energy/nutrient intakes in speciﬁc population subgroups
or regions of KSA(8). However, nationally representative
diet data from KSA are limited to food availability. Food
availability data (such as FAO data) do not represent
intake, as they do not account for wastage and other uses.
Moreover, they do not provide information on diet by age,
sex and socio-economic status.
In 2012, the KSA Ministry of Health published dietary
guidelines on the amount and composition of recommended foods to promote a healthy diet among the
population(9). However, there are not enough data on the
success of the guidelines’ implementation, the population’s current dietary status and the potential impacts of
the guidelines. Therefore, the aims of the present study
*Corresponding author: Email mokdaa@uw.edu
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© The Authors 2016
1076
were to describe the amount of consumption of different
types of foods and beverages in KSA; to describe dietary
consumption by age, sex, socio-economic status and subnational administrative regions; and to assess the degree to
which Saudis’ diets met the dietary guidelines.
Methods
Performed between April and June 2013, the Saudi Health
Interview Survey (SHIS) was a national multistage survey
of individuals aged 15 years or older. For this survey, KSA
was divided into thirteen regions. Each region was divided
into sub-regions and blocks. All regions were included in
the survey. A probability-proportional-to-size method was
used to randomly select sub-regions and blocks. Households were then randomly selected from each block.
A roster of household members was conducted and an
adult aged 15 years or older was randomly selected to be
surveyed from each selected household. If the randomly
selected adult was not present, our surveyors made an
appointment to return. A total of three visits were
attempted before the household was considered as a nonresponse. More details about the study are available in
previous publications(10–13).
The Saudi Ministry of Health and its institutional review
board (IRB) approved the study protocol. The University
of Washington IRB deemed the study IRB-exempt, since
the Institute for Health Metrics and Evaluation received deidentiﬁed data for the present analysis. All respondents
had the opportunity to consent and agree to participate in
the study.
The survey included forty-two questions on diet (a diet
history questionnaire), as well as questions on socioeconomic status (educational and household monthly
income levels) and other aspects of health. Respondents
were asked to report the number of days that they
consumed eighteen food or beverage items in a typical
week over the last year. The food and beverage items
included in the survey were: fruits; pure (100 %) fruit
juices; vegetables; dark meat ﬁsh; other ﬁsh; shrimp; red
meat; poultry meat; processed meat (meats preserved by
smoking, curing or salting, or by the addition of
preservatives, such as in the case of pastrami, salami,
bologna, other packaged lunch meats or deli meats,
sausages, bratwursts, frankfurters and hot dogs); other
processed foods (such as fast foods, canned foods, packaged entrées or packaged soup); eggs; nuts; milk; yoghurt;
laban (a beverage of yoghurt mixed with salt, which is
also known as ayran or doogh); labneh (strained yoghurt);
cheese; and sugar-sweetened beverages (SSB). For each
type of food/beverage that the respondents reported at
least one day of consumption per typical week, the
respondents were asked: ‘How many servings of [this
food/beverage] do you usually consume/eat/drink on one
of those days?’ The interviewers used speciﬁc pictures that
M Moradi-Lakeh et al.
represented the serving size of each type of food/beverage. Moreover, respondents were asked about the type
of oil or fat most often used for meal preparation, and the
usual type of dairy products (full-fat, low-fat, non-fat) and
bread in the household.
There were insufﬁcient data to calculate total energy
consumption directly. Supplemental File 1 (see online
supplementary material) shows the method for indirect
estimation of energy intake and the energy-adjusted daily
food/beverage consumption estimates. Although not an
ideal method for energy adjustment, it can provide more
comparability with other studies for interested readers. An
energy adjustment is also necessary to compare the status
with the dietary guideline recommendations.
Average numbers of daily servings – and their equivalent weight (grams) for foods, or volume (millilitres) for
beverages – were calculated. In cases where the weight of
a serving size had not been clariﬁed in the survey manuals
(fruits, vegetables, processed meat, processed foods
and eggs), we matched our visual manual as closely as
possible to phrases in the guidelines of the US Department
of Agriculture to assign an average weight(14). For fruits
and vegetables, we used the weighted average weight of
one serving of the most common types of fruits and
vegetables based on the most recent food supply data of
FAO in KSA(15). The 99th percentiles of consumption were
used as cut-off points to identify and exclude implausibly
high levels of intake.
The statistical software package Stata 13.1 for Windows
was used for the analyses and to account for the complex
sampling design.
Results
A total of 12 000 households were contacted and 10 735
participants (5253 men and 5482 women) completed the
SHIS, for a response rate of 89·4 %.
Table 1 demonstrates the average daily consumption
of different food and beverage items. Table 2 shows the
food and beverage consumption of men and women.
Non-adjusted consumption of fruit, red meat, other
processed foods, eggs and SSB was statistically higher in
men than women, while yoghurt and cheese consumption
was higher in women than men. Daily consumption of
fruits and vegetables was reported by 10·8 (SE 0·4) % and
25·9 (SE 0·6) %, respectively, and 27·0 (SE 0·7) % reported
daily drinking of SSB.
Mean consumption of processed meat, other processed
foods and SSB was clearly higher in younger age groups
(Table 3), while laban consumption was higher in older
age groups. Consumption of fruit, shrimp, labneh and
cheese had an increasing pattern with higher education
(Table 4). As demonstrated in Table 5, consumption
of some of the food items (fruit, shrimp, red meat and
labneh) was higher in individuals with higher household
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Diet in Saudi Arabia
1077
Table 1 Average daily food and beverage consumption of Saudi adults, 2013
Food/beverage item
Fruits (g)
Vegetables (g)
Pure (100 %) fruit juices (ml)
Dark meat fish (g)
Other fish (g)
Shrimp (g)
Red meat (g)
Poultry meat (g)
Processed meat (g)
Other processed foods (g)
Eggs (g)
Nuts (g)
Yoghurt (g)
Milk (ml)
Laban (ml)
Labneh (g)
Cheese (g)
SSB (ml)
Weight/volume units
Serving size
Meet the recommendations
Serving size
N
Mean
SE
Mean
SE
%
SE
103 g*
105 g*
125 ml
75 g
75 g
75 g
75 g
75 g
69 g*
399 g*
92 g*
40 g
175 g
250 ml
175 g
175 g
50 g
125 ml
10 187
10 334
10 066
10 096
10 082
9801
10 223
10 336
9667
9664
10 219
9768
10 257
10 326
10 269
9866
10 113
9967
70·9
111·1
31·9
11·6
13·8
2·4
44·2
103·0
4·8
97·5
46·0
10·9
75·4
219·4
116·8
28·9
43·7
115·5
1·3
2·0
0·8
0·3
0·3
0·1
0·7
1·8
0·2
2·7
0·7
0·3
2·0
5·1
2·8
0·8
0·9
2·6
0·675
1·078
0·269
0·137
0·159
0·028
0·521
1·304
0·070
0·244
0·500
0·274
0·431
0·885
0·667
0·165
0·874
0·924
0·013
0·019
0·007
0·003
0·003
0·001
0·009
0·022
0·003
0·007
0·007
0·007
0·012
0·021
0·016
0·004
0·018
0·021
5·2†
7·5†
0·3
0·4
44·7‡
0·7
85·7§
0·5
80·2§
0·6
31·4†
26·2†
0·7
0·7
78·6‡
0·6
SSB, sugar-sweetened beverages.
*Estimated through matching of pictures in the survey manual with the descriptions of the US Department of Agriculture guideline(14).
Reference dietary guidelines: †Dietary Guidelines for Americans(25); ‡American Heart Association(24); §American Institute for Cancer Research(23).
Table 2 Daily food and beverage consumption of Saudi male and female adults, 2013
Male (N 5253)
Weight/volume units
Female (N 5482)
Serving size
Weight/volume units
Serving size
Food/beverage item
Mean
SE
Mean
SE
Mean
SE
Mean
SE
Fruits (g)
Vegetables (g)
Pure (100 %) fruit juices (ml)
Dark meat fish (g)
Other fish (g)
Shrimp (g)
Red meat (g)
Poultry meat (g)
Processed meat (g)
Other processed foods (g)
Eggs (g)
Nuts (g)
Yoghurt (g)
Milk (ml)
Laban (ml)
Labneh (g)
Cheese (g)
SSB (ml)
75·7
105·4
34·0
11·5
14·3
2·5
52·4
106·6
5·0
108·4
49·8
11·2
67·1
217·5
122·2
27·5
40·5
131·4
1·9
2·3
1·2
0·4
0·4
0·1
1·2
2·4
0·3
4·3
1·0
0·4
1·9
6·4
3·9
1·0
1·2
3·5
0·620
0·904
0·241
0·123
0·153
0·026
0·590
1·195
0·064
0·239
0·496
0·269
0·349
0·712
0·580
0·149
0·672
0·972
0·016
0·020
0·010
0·005
0·005
0·002
0·014
0·027
0·004
0·009
0·011
0·011
0·010
0·019
0·017
0·006
0·016
0·028
65·9
117·0
29·7
11·7
13·3
2·3
35·7
99·3
4·7
86·0
42·0
10·7
84·2
221·4
111·2
30·4
47·0
98·8
1·9
3·3
1·1
0·4
0·4
0·1
0·9
2·7
0·3
3·2
0·9
0·4
3·6
8·1
3·9
1·2
1·4
3·8
0·547
1·032
0·214
0·123
0·144
0·023
0·403
1·131
0·068
0·194
0·414
0·243
0·420
0·796
0·568
0·164
0·779
0·699
0·017
0·034
0·010
0·004
0·006
0·002
0·012
0·033
0·004
0·008
0·009
0·009
0·020
0·033
0·023
0·007
0·023
0·030
SSB, sugar-sweetened beverages.
incomes. Consumption of SSB was statistically higher
in individuals with lower household incomes (Table 5).
Fruit/beverage consumption in different administrative
regions can be found in Supplemental File 2 (see online
supplementary material).
Vegetable oils were the most common type of oil/fat
used for preparation of food (84·5 (SE 0·5) %). Olive oil and
butter/margarine were reported by 5·3 (SE 0·3) % and
4·8 (SE 0·3) %, respectively. Most of the respondents reported
use of full-fat dairy products (77·6 (SE 0·6) %), followed by
low-fat (15·0 (SE 0·5) %) and non-fat (1·3 (SE 0·1) %); others
had no preference. The most common type of bread was
white bread (79·1 (SE 0·5) %); brown bread and Saudispeciﬁc traditional breads were reported by 20·1 (SE 0·5) %
and 0·8 (SE 0·1) %, respectively, as the usual kind
of bread.
Discussion
The present study is the ﬁrst to describe dietary patterns
in a nationally representative sample of adults in KSA. It
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5·5
13·5
2·9
0·9
1·1
0·5
5·3
6·1
0·3
4·0
2·4
1·1
19·6
27·7
14·5
3·1
3·0
3·6
SSB, sugar-sweetened beverages.
SE
Mean
60·1
112·5
24·3
5·9
7·7
1·0
36·8
78·0
0·9
29·8
26·8
5·4
108·0
247·1
129·0
21·3
28·7
21·6
4·4
5·0
2·2
1·0
1·3
0·3
3·1
4·5
0·7
4·7
2·1
0·8
5·0
11·2
7·7
2·5
1·5
3·5
SE
Mean
68·8
91·5
20·8
7·2
12·4
1·3
54·2
79·8
1·4
32·1
32·6
5·3
67·0
205·0
113·5
19·8
23·0
30·4
3·7
5·2
2·0
0·6
0·9
0·2
1·9
3·9
0·4
4·1
1·4
0·7
6·0
9·4
6·5
2·2
1·4
3·1
SE
Mean
65·5
109·2
25·3
8·7
12·5
1·5
37·9
83·1
2·7
54·1
37·0
8·8
80·5
187·4
112·6
29·4
33·1
42·5
3·5
3·5
2·1
0·6
0·7
0·2
1·8
2·9
0·3
5·1
1·7
0·6
3·2
7·4
4·2
2·1
1·3
4·3
SE
Mean
77·9
105·8
30·9
8·8
13·9
2·2
49·2
83·2
2·4
69·6
44·2
9·2
64·2
170·1
102·0
31·0
31·1
64·9
3·6
4·5
1·4
0·7
0·8
0·3
1·4
4·1
0·5
4·8
1·5
0·7
5·9
9·5
7·0
1·5
1·5
4·9
SE
Mean
65·1
104·8
26·5
12·8
14·6
2·7
34·8
87·2
5·7
84·4
44·1
10·3
72·7
191·3
99·4
27·6
40·5
84·3
2·4
7·4
2·4
0·7
0·9
0·3
1·8
5·5
0·6
6·5
1·4
0·6
6·4
18·0
7·2
2·6
2·5
8·0
46·2
104·8
24·8
10·4
11·7
1·9
31·2
96·4
5·8
93·5
35·8
10·4
64·9
201·3
87·0
30·2
42·9
127·3
SE
SE
2·9
3·8
2·3
0·8
0·8
0·2
2·4
3·9
0·7
7·8
1·8
0·8
3·4
9·1
5·8
2·0
1·7
6·6
SE
56·5
83·0
26·2
11·0
12·8
1·7
51·4
101·1
6·3
121·6
48·4
12·9
57·8
183·0
97·2
23·1
36·9
172·2
2·7
3·4
1·8
0·7
0·7
0·3
1·8
4·0
0·4
5·3
1·6
0·7
3·1
6·9
4·7
1·7
1·1
6·0
Mean
Mean
Mean
Food/beverage item
Fruits (g)
Vegetables (g)
Pure (100 %) fruit juices (ml)
Dark meat fish (g)
Other fish (g)
Shrimp (g)
Red meat (g)
Poultry meat (g)
Processed meat (g)
Other processed foods (g)
Eggs (g)
Nuts (g)
Yoghurt (g)
Milk (ml)
Laban (ml)
Labneh (g)
Cheese (g)
SSB (ml)
66·0
98·2
32·5
12·1
13·9
3·4
47·9
98·1
4·2
96·2
46·6
10·4
61·8
163·6
104·3
28·4
33·7
119·2
Male (N 1857)
Female (N 1193)
Female (N 2169)
Male (N 1495)
Female (N 1575)
Male (N 712)
Female (N 545)
M Moradi-Lakeh et al.
Male (N 1189)
25–39 years
15–24 years
Table 3 Daily food and beverage consumption of Saudi adults by sex and age group, 2013
40–59 years
60 years or more
1078
showed poor dietary practices in the Kingdom. Saudis’
dietary behaviours met dietary recommendations in only
a small percentage of the population, especially for fruit
and vegetable consumption, dairy products, nuts and
ﬁsh meat. Young adults (15–24 years old) had a concerning pattern of high consumption of SSB, processed
meat and other processed foods, as well as low intake of
fruits and vegetables. Other studies on schoolchildren
show that these unhealthy dietary behaviours start
even sooner(16). This evidence calls for a comprehensive
programme to improve the dietary situation of Saudis. The
programme should include all age ranges, considering the
different needs and different dietary challenges of each
age group.
A cluster of dietary risk factors is the leading risk factor
for non-optimal health, with 11·3 million attributed deaths
and 241·4 million attributed disability-adjusted life years
per annum around the world(1). The Global Burden of
Diseases, Injuries, and Risk Factors (GBD) study showed
that in Saudi Arabia, the average levels of consumption of
fruits, vegetables, nuts, whole grains, PUFA and seafood
n-3 fatty acids were far less than optimum, and the average
levels of consumption of processed meats, red meats, total
fatty acids, SSB and sodium were higher than optimal(3).
In the report of the WHO 2005 STEPwise survey, there
was limited dietary information on the consumption of
fruits, vegetables and oils. During the time between the
STEPwise survey and our current study (2005 to 2013), the
percentage of individuals consuming at least ﬁve daily
servings of fruits or vegetables increased slightly, from 5·5
to 7·3 %(11). However, based on food supply data, fruit and
vegetable availability in KSA (about 475 g/d in 2010)(17) is
more than twice the average consumption in our study
(less than 200 g/d). The difference might be related to
using fruits as pure juices (about 32 ml/d) or sweetened
juices, as well as the higher potential of decay in fruits/
vegetables compared with other food items. Further
details on consumption of fruits and vegetables by Saudi
adults have been reported elsewhere(11). Consumption of
olive oil has increased from 1·7 % in the Saudi STEPwise
survey to 5·3 %(18); since higher intake of olive oil is
associated with reduced risk of all-cause mortality, cardiovascular events and stroke, this can be considered a good
replacement(19).
Although there was higher consumption of meat and
SSB by men, and of vegetables by women, non-energyadjusted consumption is not directly comparable between
men and women. Considering the fact that average energy
consumption is usually higher in men, vegetable intake is
expected to remain higher in women after energy adjustment. Some of the different patterns of food and beverage
consumption between men and women may be explained
by theories about the association of meat consumption
with masculinity and vegetable consumption with femininity, but we do not have enough information for that
assessment(20–22).
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Diet in Saudi Arabia
1079
Table 4 Daily food and beverage consumption of Saudi adults by educational level, 2013
Primary or less (N 3286)
Elementary/high school (N 4780)
College or higher (N 2649)
Food/beverage item
Mean
SE
Mean
SE
Mean
SE
Fruits (g)
Vegetables (g)
Pure (100 %) fruit juices (ml)
Dark meat fish (g)
Other fish (g)
Shrimp (g)
Red meat (g)
Poultry meat (g)
Processed meat (g)
Other processed foods (g)
Eggs (g)
Nuts (g)
Yoghurt (g)
Milk (ml)
Laban (ml)
Labneh (g)
Cheese (g)
SSB (ml)
64·2
99·6
22·0
10·3
12·9
0·9
43·9
99·2
4·8
66·3
36·4
11·7
74·9
219·6
104·5
20·3
33·0
86·5
2·3
4·3
1·4
0·5
0·7
0·1
1·6
3·5
0·5
4·2
1·2
0·8
5·0
9·5
4·3
1·4
1·3
5·1
55·6
96·9
25·6
9·9
12·3
2·1
42·1
93·8
4·2
95·3
43·8
9·6
62·1
177·2
97·6
27·9
37·3
120·9
1·7
3·0
1·2
0·4
0·5
0·1
1·2
2·5
0·3
4·0
1·0
0·3
2·4
6·9
3·8
1·3
1·1
3·9
74·8
108·0
35·8
11·9
13·3
3·6
41·5
82·5
5·1
92·8
44·8
9·7
69·7
168·6
99·8
35·5
38·9
88·5
3·0
3·9
1·6
0·6
0·6
0·3
1·4
3·5
0·4
4·7
1·3
0·4
4·0
8·5
5·1
1·7
1·4
4·3
SSB, sugar-sweetened beverages.
Table 5 Food and beverage consumption of Saudi adults by household monthly income level, 2013
Less than 5000 Riyals (N 3161)
5000–14 999 Riyals (N 4549)
15 000 Riyals or more (N 1131)
Food/beverage item
Mean
SE
Mean
SE
Mean
SE
Fruits (g)
Vegetables (g)
Pure (100 %) fruit juices (ml)
Dark meat fish (g)
Other fish (g)
Shrimp (g)
Red meat (g)
Poultry meat (g)
Processed meat (g)
Other processed foods (g)
Eggs (g)
Nuts (g)
Yoghurt (g)
Milk (ml)
Laban (ml)
Labneh (g)
Cheese (g)
SSB (ml)
51·5
94·1
20·9
9·8
13·3
1·7
37·2
89·3
3·4
91·0
38·9
8·1
66·4
188·5
104·7
22·7
37·5
113·6
2·0
3·7
1·5
0·5
0·7
0·2
1·5
3·3
0·4
5·3
1·2
0·5
3·4
8·7
4·9
1·5
1·8
5·4
65·2
96·2
28·3
10·8
13·8
2·3
42·4
88·6
4·4
86·8
45·2
10·1
64·6
166·5
99·5
31·9
36·2
95·9
1·7
2·2
1·4
0·5
0·5
0·2
1·2
2·1
0·3
3·7
1·0
0·4
2·3
4·9
3·2
1·4
0·9
3·2
79·3
118·3
40·5
10·6
14·0
3·9
50·3
93·3
5·2
82·7
42·2
11·2
61·9
189·4
98·7
36·4
35·9
91·0
4·7
6·6
2·4
0·8
0·9
0·4
2·4
4·3
0·7
6·6
1·8
0·8
4·0
11·1
5·8
2·7
1·8
5·6
SSB, sugar-sweetened beverages.
Compared with the recommendations of dietary
guidelines(9,23–25), consumption of fruits, vegetables, dairy
products and nuts is very low, and less than 45 % of the
KSA population consumes ﬁsh as recommended. On the
other hand, there is considerable unnecessary consumption of processed meat and SSB compared with the
recommendations(23,24). A 2006 study in Lebanon showed
that Lebanese adults consume the same amount of ﬁsh
and red meat as Saudis in our study, but less poultry meat
(36 v. 103 g/d) and eggs (12 v. 46 g/d), and more fruits and
vegetables (367 v. 182 g/d)(26).
The previously published GBD estimates for dietary risk
factors in KSA were close to our estimates for red meat,
processed meat and SSB. Our estimate for nuts was higher
than previous GBD estimates (about 11 v. 4 g/d)(3).
Midhat et al. reported the consumption of different food
items as part of the routine meals in the Qassim region of
KSA. However, they did not report the amount (or serving
sizes) of consumption. That study showed an increasing
probability of routine intake of ﬁsh, vegetables, fresh fruits
and barbecued meats (called a ‘healthy diet’) with
increasing age(27). Our ﬁndings showed that Saudis of
older ages consume more fruit and vegetables, and fewer
processed foods. The healthier diet seen among older
individuals might be related to different factors, such as a
birth cohort effect (due to the nutrition transition in the
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1080
younger birth cohorts), the longer life of individuals with
healthy diets, more frequent contacts between health careproviders and older individuals (compared with younger
people), and better adherence among older individuals
to dietary guidelines because of their perceived risk of
disease and death.
The average consumption of fruit, vegetables and
shrimp in individuals with a college or higher education
was more than in other educational groups. The highest
intake of milk was reported by individuals with primary or
less education. Individuals with the lowest household
income had the highest consumption of SSB, while consumption of fruits, vegetables and pure juices was lower
than in individuals with higher income.
In our study, the highest intake of ﬁsh was in the Jizan,
Aasir, Al Bahah and Makkah regions (all located in the
south-western part of the country and close to the Red
Sea), as well as in Riyadh (capital); the lowest consumption of ﬁsh was reported by residents of Ha’il, Al Jawf and
Al Hudud ash Shamaliyah (all located in the north-western
part of the country).
Although the prevalence of obesity has decreased in
recent years in KSA, the current combination of high
overweight/obesity prevalence(28), sedentary lifestyle(10)
and inappropriate diet threatens the current and future
health of the population.
Our study has some limitations. First, we used a diet
history questionnaire that did not contain details for all
types of foods and beverages. Second, our food and
beverage consumption data are self-reported and subject
to recall and social desirability biases. Third, our study did
not include the amount of all foods and beverages (for
instance, complex carbohydrates), and we were not able
to directly calculate total energy expenditure. On the other
hand, our study is based on a large sample size and used a
standardized methodology for all its measures. It is
nationally representative and has the merit of providing
accurate data due to our near-real-time data quality
monitoring through the whole survey period.
The Saudi Ministry of Health has initiated programmes
and projects, such as the Crown Health Project(29,30) and
the Saudi dietary guidelines(9), to alleviate the burden of
risk factors of non-communicable diseases. The outcomes
of these programmes need to be evaluated, so that the
lessons learned from them can be used in the adjustment
of current programmes and the planning and installation
of new comprehensive programmes.
Conclusion
Our study showed that Saudis’ diets do not follow the
guidelines for healthy diets. Increased efforts to improve
eating habits in KSA are needed. These efforts should promote a balanced diet according to energy intake and composition of diet. Speciﬁcally, increasing the consumption of
M Moradi-Lakeh et al.
fruits, vegetables, dairy products, nuts and ﬁsh should be
targeted. Strategies are required to limit the consumption of
processed foods and SSB, especially in young adults. These
efforts should involve all stakeholders, including education
representatives, agriculture partners, food companies and
food importers. In addition, regular assessments of Saudis’
dietary status are needed to monitor trends and inform
interventions. Finally, political will is needed to enforce food
labelling and manufacturing regulations.
Acknowledgements
Acknowledgements: The authors would like to thank
Kevin O’Rourke at the Institute for Health Metrics and
Evaluation for editing the manuscript. Financial support:
This study was supported by a grant from the Ministry of
Health of the KSA. The Ministry of Health had no role in
the design, analysis or writing of this article. Conﬂict of
interest: The study and the authors have not received any
ﬁnancial support from the food industries. Authorship:
A.H.M. conceived and designed the study. M.B., Z.A.M.,
M.A.S. and M.A.A. performed the survey. C.E.B. and F.D.
participated in questionnaire design and interviewers’
training. M.M.-L., A.A. and A.H.M. analysed the data.
M.M.-L., A.H.M., C.E.B., A.A., F.D., M.B., Z.A.M., M.A.S.,
M.A.A. and A.A.A.R. drafted or commented on the manuscript. A.A.A.R. supervised the study. All co-authors are
responsible for the content of this article and have read and
approved the ﬁnal manuscript. Ethics of human subject
participation: The Saudi Ministry of Health and its IRB
approved the study protocol. The University of Washington
IRB deemed the study IRB-exempt, since the Institute for
Health Metrics and Evaluation received de-identiﬁed data
for the analysis. All respondents had the opportunity to
consent and agree to participate in the study.
Supplementary material
To view supplementary material for this article, please visit
https://doi.org/10.1017/S1368980016003141
References
1. GBD 2013 Risk Factors Collaborators, Forouzanfar MH,
Alexander L et al. (2015) Global, regional, and national
comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of
risks in 188 countries, 1990–2013: a systematic analysis for
the Global Burden of Disease Study 2013. Lancet 386,
2287–2323.
2. Memish ZA, Jaber S, Mokdad AH et al. (2014) Burden of
disease, injuries, and risk factors in the Kingdom of Saudi
Arabia, 1990–2010. Prev Chronic Dis 11, E169.
3. Afshin A, Micha R, Khatibzadeh S et al. (2015) The impact of
dietary habits and metabolic risk factors on cardiovascular
and diabetes mortality in countries of the Middle East and
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Diet in Saudi Arabia
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7.
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9.
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12.
13.
14.
15.
16.
17.
North Africa in 2010: a comparative risk assessment analysis.
BMJ Open 5, e006385.
Institute for Health Metrics and Evaluation (2014) GBD
compare visualization tool. http://ihmeuw.org/3qc9
(accessed July 2016).
Adam A, Osama S & Muhammad KI (2014) Nutrition and
food consumption patterns in the Kingdom of Saudi Arabia.
Pak J Nutr 13, 181–190.
Madani KA, al-Amoudi NS & Kumosani TA (2000) The state
of nutrition in Saudi Arabia. Nutr Health 14, 17–31.
Khan MA & Al Kanhal MA (1998) Dietary energy and
protein requirements for Saudi Arabia: a methodological
approach. East Mediterr Health J 4, 68–75.
Alsuﬁani HM, Kumosani TA, Ford D et al. (2015) Dietary
patterns, nutrient intakes, and nutritional and physical
activity status of Saudi older adults: a narrative review.
J Aging Res Clin Pract 4, 2–11.
General Director of Nutrition, Ministry of Health (2012)
Saudi Dietary Guideline (Healthy Diet Palm). Riyadh:
Ministry of Health Publications.
El Bcheraoui C, Tuffaha M, Daoud F et al. (2016) On your
mark, get set go: levels of physical activity in the Kingdom
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El Bcheraoui C, Basulaiman M, AlMazroa M et al. (2015)
Fruit and vegetable consumption among adults in Saudi
Arabia, 2013. Nutr Diet Suppl 7, 41–49.
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Tobacco consumption in the Kingdom of Saudi Arabia,
2013: ﬁndings from a national survey. BMC Public Health
15, 611.
Moradi-Lakeh M, El Bcheraoui C, Tuffaha M et al. (2015)
Self-rated health among Saudi adults: ﬁndings from a
national survey, 2013. J Community Health 40, 920–926.
US Department of Agriculture, Agricultural Research Service
(2014) National Nutrient Database for Standard Reference,
Release 27. http://ndb.nal.usda.gov/ndb/foods (accessed
July 2016).
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(2011) Food Balance Sheets, Saudi Arabia. http://faostat3.
fao.org/download/FB/FBS/E (accessed October 2015).
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among female adolescents in Hail, Saudi Arabia. Am J Res
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Haddad LJ, Hawkes C, Achadi E et al. (2015) Global
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STEPwise Approach to NCD Surveillance. Country-Speciﬁc
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Appetite 56, 447–450.
21. Vartanian LR (2015) Impression management and food
intake. Current directions in research. Appetite 86, 74–80.
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(ac

discussion board

Jun 14, 2024 | Health Medical

Description

Caring for patients with diabetes can be challenging due to the required lifestyle changes, the self-care recommendations, and the complexity of the anti-diabetes medications. In this discussion board (DB), we would like to hear from you what concerns you may have about this as you enter your clinical practice. It takes time and experience seeing patients to become more comfortable–it will happen.Your concern should be stated/explained in 75-100 words and your response should be 75-100 words.

Bias in Primary Source

Jun 14, 2024 | Health Medical

Description

First, you will locate an additional primary source related to your historical event. Next, you will answer questions about your event and the primary source you identified in a previous module. You will then consider whether there is evidence of bias in these sources.Specifically, you must address the following rubric criteria:Conduct source analysis on two primary sources relevant to your historical event.You will respond to specific questions about each source in the activity template.Analyze the primary sources relevant to your historical event for the presence of bias.What clues are present in your two sources that may indicate bias? Provide evidence of these clues from your sources. If you do not think there is bias, provide evidence to support your claim.Compare how your historical event is represented in your primary sources.Do the two sources tell the same story, or are contrasting perspectives represented? Provide evidence from your sources.Locate an additional primary source relevant to your
historical event. Use it and the primary source you identified in a previous
module to answer the questions below. Replace the bracketed text with your
responses.
Source One
Conduct source analysis on a primary source relevant to your
historical event.
Attempt to write the APA style citation for your first
primary source and include a link to it. You will not be penalized for
incorrect format.
·
[Insert citation.] Respond to the following questions:
· Who authored or created the primary source? ·
What was the author’s position in society at the
time the primary source was created? When was the primary source created? Where was the primary source created, released,
or publicized?
Who was the intended audience for the primary
source?
Why was the primary source created? Whose perspective(s) is presented in the source?
Source Two
Conduct a source analysis on a primary source relevant to
your historical event.
Attempt to write the APA style citation for your second
primary source and include a link to it. You will not be penalized for
incorrect format.
·
[Insert citation.] Respond to the following questions:
· Who authored or created the primary source?
·
What was the author’s or creator’s position in
society at the time the primary source was created?

When was the primary source created?
·
Where was the primary source created, released,
or publicized?
·
Who was the intended audience for the primary
source? ·
Why was the primary source created? Whose perspective(s) is presented in the source? Both Sources
Analyze the primary sources relevant to your historical
event for the presence of bias.
·
Compare how your historical event is represented in your primary
sources.
·

Unformatted Attachment Preview

HIS 100 Module One Activity Template: Project Topic Exploration
You must pick a topic from the Research Topics Lists in the Library Research Guide. While it is a good
idea to choose your topic early, you may change it until the next module. Replace the bracketed text
below with your responses. Support your responses with specific details and examples.
Identify the topic you chose to explore:
• The Philippine Revolution
Explain what you already know about the chosen topic based on your personal history or experiences.
• The Philippine Revolution started in 1896 when the Spanish authorities discovered an
anticolonial secret organization that had been formed to free the Philippines from the
Spanish colonial power. The Spanish government has been controlling the Philippines
since the sixteenth century. However, their regime nearly ended when they could not
defeat the Filipino rebellion. In 1898, the US declared war against Spain for sinking their
warship near Havana, Cuba, and took action to defeat the Spanish fleet stationed in the
Philippines (Salem Press, Inc., 2017).
Describe the beliefs, assumptions, and values you have related to the topic you chose.
• My opinion about the Philippine Revolution is that the Philippines strongly desired
independence and sovereignty. Their passion to break free and struggle for their freedom
from the Spanish colony was triggered by the mistreatment they received from the
Spanish rule. In my assumption, the Philippine Revolution was a response to the injustice
they were subjected to by the Spanish government, which led to the creation of a secret
society dedicated to liberating the Philippines. Patriotism and historical awareness are the
values related to the Philippine Revolution (Salem Press, Inc., 2017). The sacrifice made
by the Philippines rebels shows love for one’s country and dedication.
Explain why this topic is relevant to current events or to modern society.
• The Philippine Revolution is relevant to modern society because it highlights themes such as
leadership and sacrifice, human rights, self-determination, and nationalism. Furthermore, it
provides historical lessons and valuable insight into contemporary movements and struggles
worldwide.
1
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.

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Conducting Additional Research

Jun 14, 2024 | Health Medical

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SLP Assignment Expectations
Conduct additional research to gather sufficient information to justify/support your analysis.
Limit your response to a maximum of 4 pages, not including the title or reference pages.
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…
You may use the following source to assist in formatting your assignment:
Purdue Online Writing Lab. (n.d.). General APA guidelines. Retrieved from https://owl.english.purdue.edu/owl/resource/560/01…
For additional information on reliability of sources, review the following source:
Georgetown University Library. (n.d.). Evaluating internet resources. Retrieved from https://www.library.georgetown.edu/tutorials/resea…

Evaluating Internet Resources | Georgetown University Library
Unlike similar information found in newspapers or television broadcasts, information available on the Internet i…

This assignment will be graded based on the content in the rubric.
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nrs 493 professional capstone and practicum, PICOT question

Jun 14, 2024 | Health Medical

Description

Assessment Trait Requires Lopeswrite

Assessment Description

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Step 4: Summarize Clinical Problem and Patient Outcome: The clinical problem and how it can result in a positive patient outcome.

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.

After writing your objectives, provide a rationale for how your proposed project and objectives advocate for autonomy and social justice for individuals and diverse populations.

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.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

2.5: Advocate for autonomy and social justice for individuals and diverse populations.

RUBRIC CRITERIA

Expand All Rubric Criteria

UTI – Peer Comment

Jun 14, 2024 | Health Medical

Description

Expectations

Length: A minimum of180 words, not including references or attachments
Citations: At least one high-level scholarly reference in APA from within the last 5 years

Case 3

18 yo female presents with fever, dysuria, and frequency for about 2 days. She reports being 12 weeks pregnant. Denies any nausea or vomiting. She reports she is allergic to Penicillin.

Diagnosis: Urinary Tract Infection in Pregnancy

Discuss what are the potential treatments for this patient’s diagnosis.

Pregnant women are frequently prone to having urinary tract infection due to physiologic and immunologic changes that take place during pregnancy. Pregnancy itself is a state of relative immunocompromise due to the growing fetus. Moreover, the decreased bladder capacity causes frequency of urination, thus increasing the risk of UTI. This condition is treated with antibiotic therapy after identifying the causative agent obtained from urine culture result. The need to treat UTI prevents potential consequences that usually requires hospitalization. Initial treatment for UTI in pregnancy consists of second or third generation cephalosphorins as well as broad-spectrum antibiotics as alternatives (Habak & Griggs Jr., 2023). Hydration and antipyretics are also recommended in the management of fever.

What antibiotic/s should be given for this patient’s diagnosis?

Safety is the main consideration in choosing antimicrobials during pregnancy. Prior to initiation of antibiotics, it is important to confirm the causative organism to ensure that the prescribed medication is effective based on sensitivity. Penicillins (Amoxicillin and Ampicillin) and cephalosphorins (Cephalexin, with the exception of Ceftriaxone) are the first-line treatment recommended in pregnancy. While these antimicrobials can move across the placenta, they are not known to harm unborn babies.

How long should you prescribe the chosen antibiotic?

Traditionally, short-course antibiotic therapy was practiced, however was shown to be not long enough to completely eradicate the infection (Ghouri & Hollywood,2020). It is essential to complete a seven-day course of antibiotic therapy for adequate treatment. While there are conflicting evidence as to whether pregnant patients should be treated with shorter courses of antibiotic, it is important that the course length of antibiotics is in line with the recommended seven days therapy unless new evidences emerge.

What teaching would you give this patient on the prescription?

Adherence to prescribed antibiotic should be firmly emphasized not only for the purpose of treating UTI but also for the prevention of antimicrobial resistance. As the provider, I will emphasize the responsible use of antibiotic therapy by educating the pregnant patient about the benefits and risks associated with antimicrobial use. Patient is advised to follow up after 2 weeks of completion of treatment for repeat urinalysis and cultures to determine if there are further management necessary. Moreover, counseling on prevention measures should be incorporated in pre-natal visits so pregnant women will appreciate the controllability of this infection rather than rely on medical solution. Through this, pregnant women will adopt practices that will facilitate good health not only for themselves but also for their unborn child.

5. Write out a correct prescription for the antibiotic you are going to prescribe for this patient. (Be sure to include all elements needed for a correct prescription)

As mentioned, the patient reported allergy from Penicillin so I will prescribe her cephalosphorins which has the same efficacy in treating UTI in pregnancy. With her being symptomatic as evidenced by elevated temperature, I will write her a prescription for:

Name: Jane Doe

DOB: 09/21/1986

Rx: Cephalexin (Keflex) 500mg

Sig: 1 tablet twice daily PO for 7 days

Disp: #14 (fourteen)

Refills: 0

Provider: Charma Dalope Date: 09/21/2023

References:

Ghouri, F., Hollywood, A. (2020). Antibiotic prescribing in primary care for urinary tract infections (UTIs) in pregnancy: an audit study. Medical Sciences. doi: 10.3390/medsci8030040.

Habak, P., Griggs Jr., R. (2023). Urinary tract infection in pregnancy. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK537047/

I need help with some pharmacy related questions

Jun 14, 2024 | Health Medical

Description

Jun 14, 2024 | Health Medical

Description

See attached

Unformatted Attachment Preview

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).

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Principles of Healthcare Leadership

Jun 14, 2024 | Health Medical

Description

It is vital as a leader that you understand the difference between leadership and management. In addition, as a leader you must know and possess a variety of skills to lead an organization. While different skills are needed for different types of organizations, there are some fundamentals skills that every leader should have.

Case Assignment

Chapter 3 of Principles of Healthcare Leadership discusses four necessary leadership skills. For your Module 1 Case assignment, review these four necessary leadership skills and conduct additional research. In a 3- to 4-page paper, complete the following:

Explain the difference between leadership and management. Provide an example for each.
Identify and explain each leadership skill in detail.
Rationalize the importance of a health care leader possessing each of these skills.
Identify the importance of cultural diversity in leadership and discuss two ways (actionable items) a leader could promote diversity in the workplace. Discuss the difference in internal and external diversity and provide an example of each, and how they influence the organization.
In conjunction with the four identified skills, identify and explain 2 or 3 additional skills health care leaders should possess.

Rotenstein, L. S., Reede, J. Y., & Jena, A. B. (2021). Addressing workforce diversity- A quality-improvement framework. The New England Journal of Medicine, 384(12), 1083-1086. https://doi.org/10.1056/NEJMp2032224

References:

Al-Sawai A. (2013). Leadership of healthcare professionals: Where do we stand? Oman Medical Journal, 28(4), 285–287. doi:10.5001/omj.2013.79. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC37252…

Healey, B. J. (2018). Chapter 3: Leadership theory. In Principles of healthcare leadership. [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.

Healey, B. J. (2018). Chapter 4: Creativity and innovation in healthcare. In Principles of healthcare leadership. [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.

Healey, B. J. (2018). Chapter 6: The development of trust in healthcare organizations. In Principles of healthcare leadership. [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.

Ledlow, G. J. R., & Coppola, M. N. (2014). Chapter 2: Determining your own leadership style. In Leadership for health professionals: Theory, skills, and applications (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.

Manion, J. (2011). Chapter 1: Leadership: An elusive concept. In Management to leadership: Strategies for transforming health (3rd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.

Optional Reading

Ledlow, G. J. R., & Coppola, M. N. (2014). Chapter 5: Leadership competence I: Professional competencies, and personal skills and responsibilities. In Leadership for health professionals: Theory, skills, and applications (2nd ed.). [Books24x7 version]. Available in the Trident Online Library via the Skillsoft database link.

Wikins, D. (2018). Six healthcare leadership development trends for 2018. Beckers Hospital Review.Retrieved from https://www.beckershospitalreview.com/hospital-man…

Video

Institute for Healthcare Improvement (2015) What traits do healthcare leaders need today?

What Traits Do Health Care Leaders Need Today?

Chapter 2: Determining Your Own Leadership Style in Leadership for Health Professionals: Theory, Skills, and Applications (2nd ed.) provides an assortment of leadership and personality assessments:

Emotional Intelligence – Institute for Health and Human Potential (n.d.) Emotional Intelligence Quiz – https://www.ihhp.com/free-eq-quiz/
Jungian Assessment – Anon (n.d.) Open Ended Jungian Type Scales 1.2 – https://openpsychometrics.org/tests/OEJTS/
Type A and B Personality Indicators – Anon. (n.d.) A/B Personality Test – https://openpsychometrics.org/tests/AB.php
Ennaegram Test – Anon. (n.d.) Open Enneagram of Personality Scales – https://openpsychometrics.org/tests/OEPS/

Part 1:

Complete the following:

Review the chapter in the text to get a better appreciation for each of the assessments listed above.
Complete each leadership and personality assessment listed. (Note: you will need to copy or remember your results of each assessment.)

Part 2:

In a 3- to 4-page paper, complete the following:

Compare and contrast the results of each assessment. Be sure to provide a detailed interpretation.
Identify what you learned new about yourself through completing the leadership and personality assessments.
Based on your self-assessment results, devise a plan to improve any weaknesses while leveraging your strengths.

In your scholarly paper, you should include an introduction and conclusion paragraph.

discussion 3

Jun 14, 2024 | Health Medical

Description

Unlike many countries, we have an employer based heath insurance system except for those under a government program, as Mediciare, Medicaid, Tricare. Please list two advantages/positives, and then two disadvantages/nagatives comparing employer based insurance to government based insurance. Note: Support your position with four separate paragraphs for each of your points in your Initial Posts. minimum 250-300 words provide references

title of presentation (job analysis , employee engagement and job satisfaction

Jun 14, 2024 | Health Medical

Description

this presentation in leadership and recourse i need this presentation about ((job analysis , employee engagement and job satisfaction ) i need the presentation include out line ,objective learning , summary , reference please if u did not understand any thing ask me before start . there is rubric for presentation

Unformatted Attachment Preview

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: ———————————————————————————————————-

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Read these 5 articles and an create an evidence table using the JHNEBP Evidence Rating Scales

Jun 14, 2024 | Health Medical

Description

You would read 5 articles relating to postpartum depression and exercise and create an evidence table following the rubrics, be sure to arrange the table and references alphabetically in an APA format in a consize manner answering the question specifically.

Unformatted Attachment Preview

1
Evidence
Table:
Use
JHNEBP
Evidence
Rating
Scales
2
Sources
Part 2 – Evidence Table
Each student is responsible for reviewing 5 research articles relevant to their PICOT.
Excellent
Good
Fair
Poor
9-10 points
7-8 points
4-6 points
0-3 points
Score
Table is clear and easily
Table is neat and legible.
Table contains layout or
Source information is not
/10
legible. Comparison of data
Appropriately cited. Literature legibility errors.
organized in table format.
logical. Appropriately cited.
review results listed
Literature review results Literature review results
Well organized literature
highlighting the studies which
listed highlighting the
listed are incomplete
review results highlighting the best exemplify the PICOT
studies which best
and/or do not include the
studies which best exemplify problem. Include most
exemplify the PICOT
studies which best
the PICOT problem. Has a
elements needed to evaluate
problem. Include some
exemplify the PICOT
minimum of 5 peer reviewed the quality and strength of
elements needed to
problem. Include few or no
articles. Include all elements
findings. Correctly rates
evaluate the quality and elements needed to
needed to evaluate the quality strength and quality of at least strength of findings.
evaluate the quality and
and strength of findings.
3 studies according to the
Correctly rates strength
strength of findings.
Correctly rates strength and
JHNEBP Evidence Rating Scales. and quality of at least 2
Incorrectly rates strength
quality of articles according to Follows APA guidelines as
studies according to the
and quality of all studies
the JHNEBP Evidence Rating
appropriate.
JHNEBP Evidence Rating according to the JHNEBP
Scales. Follows APA guidelines
Scales. Inconsistently
Evidence Rating Scales.
as appropriate.
follows APA guidelines.
Does not follow APA
guidelines.
Evidence table includes
Complete and correct
Mostly (2/3) complete
All references are
/10
reference list and is formatted reference list using APA
and correct reference list incomplete and incorrectly
using APA Style. Studies are
formatting. Most of the
using APA formatting.
formatted. Most of the
current, 5 years or earlier, if
studies are current, 5 years or
Most of the studies are
studies are not current, 5
current literature is not
earlier, if current literature is
current, 5 years or
years or earlier, if current
available, no more than 10
not available, no more than 10 earlier, if current
literature is not available,
years. All 5 referenced articles years. All 5 referenced articles literature is not available, no more than 10 years. 1 or
are submitted with the table
are submitted with the table as no more than 10 years. 3 none of the 5 referenced
as a .pdf file.
a .pdf file.
out of 5 referenced
articles is submitted with
articles are submitted
the table as a .pdf file.
Restate PICOT question:
Author(s)
and year
Type of study
(design)
Population
characteristics &
sample size (n)
Independent
variable
Dependent
variable
Results
Evidence Strength &
Quality Rating
(JHNEBP)
Restate PICOT question: Are non-pharmacological interventions more effective in managing chemotherapy side effects than
pharmacological interventions in breast cancer patients during treatment?
Author(s) and Type of study
year
(design)
Population
Independent
characteristics &
variable
sample size (n)
Zachariae, R., A randomized Participants were
Internet
Amidi, A.,
controlled
225 Danish
cognitive
Damholdt, M.
trial
breast cancer
behavioral
F.,
survivors age
therapy for
Clausen, C. D.
from 18 to 75
insomnia
, Dahlgaard, J.,
years old with
(iCBT-I) or no
Lord, H., …
significant
iCBT-I therapy
Ritterband, L.
insomnia were
as control.
M. (2018).
recruited
between 2011 to
2013. The
participants were
randomized into
iCBT-I group
(n=133) or
control group
(n=122).
Heckler, C. E., A randomized Of 96 cancer
Cognitive
Garland, S. N., controlled
survivors with
Behavioral
Peoples, A. R., trial
chronic insomnia
Therapy for
Perlis, M. L.,
were recruited
Insomnia
Shayne, M.,
between 2008 to
(CBT-I) or
Morrow, G. R.
2012. They were
control.
,…
randomly assigned
Roscoe, J. A.
to CBT-I +
(2015)
placebo
Dependen
t variable
Sleep
outcomes
and
Fatigue.
Brief
Fatigue
Inventory
(BFI),
Functional
Assessme
nt of
Chronic
Illness
Results
Evidence Strength & Quality
Rating
(JHNEBP)
Insomnia severity,
This is a Level I, quality A
impaired sleep quality, and
research.
sleep efficiency were
A randomized controlled trial is
significant improved by 9
the highest level of research to
weeks of intervention if
find the causal relationship
compared with the control
between intervention and
(p
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Access to Healthcare

Jun 14, 2024 | Health Medical

Description

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 goalsThe 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.presentation should meet the following structural requirements:Be 9-10 slides in length, not including the title or reference slides.Be formatted according to APA writing guidelines. Provide support for statements with citations from a minimum of 8 scholarly articles. These citations should be listed in the Notes section of the slide in which they appear. 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. Utilize headings to organize the content in work.

Reply a Discussion

Jun 14, 2024 | Health Medical

Jun 14, 2024 | Health Medical

Description

Such effort should be devoted to this section as it is a key component of your work. This should be a synthesis of the literature, not a catalog of studies or simply an analysis of the research you discover.

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.

NURS_691A_DE – NURS 691-A Rubric Week 3: Integrative Literature Review

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeCritical Analysis

44 to >36.08 pts

Meets Expectations

36.08 to >33.0 pts

Approaches Expectations

33 to >25.96 pts

Falls Below Expectations

25.96 to >0 pts

Does Not Meet Expectations

The literature is listed, but it is neither analyzed nor synthesized.

44 pts

This criterion is linked to a Learning OutcomeContent

20 to >16.4 pts

Meets Expectations

16.4 to >15.0 pts

Approaches Expectations

15 to >11.8 pts

Falls Below Expectations

11.8 to >0 pts

Does Not Meet Expectations

20 pts

This criterion is linked to a Learning OutcomeOrganization

8 to >6.56 pts

Meets Expectations

Content is well written throughout. Information is well organized and clearly communicated.

6.56 to >6.0 pts

Approaches Expectations

Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.

6 to >4.72 pts

Falls Below Expectations

Content is disorganized in many places and it lacks clarity.

4.72 to >0 pts

Does Not Meet Expectations

Content lacks clarity and information is disorganized, or may be a list or a catalog of ideas.

8 pts

This criterion is linked to a Learning OutcomeAPA Format/Mechanics

8 to >6.56 pts

Meets Expectations

Follows all the requirements related to format, length, source citations, and layout. Assignment is free of spelling and grammatical errors.

6.56 to >6.0 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.

6 to >4.72 pts

Falls Below Expectations

Follows most of the requirements related to format, length, source citations, and layout. Assignment contains some spelling and grammatical errors.

4.72 to >0 pts

Does Not Meet Expectations

Does not follow format, length, source citations, and layout requirements. Assignment contains many spelling and grammatical errors.

8 pts

Total Points: 80

PreviousNext

NURS 5103: Theoretical Foundations Discussion Board.

Jun 14, 2024 | Health Medical

Description

Unformatted Attachment Preview

Discussion #1
Aug 28 – Oct 2
•
•
Must post first.
“Bias consists of attitudes, behaviors, and actions that are prejudiced in favor of or
against one person or group compared to another” (National Institutes of Health, n.d.,
para 1). “Implicit bias is a form of bias that occurs automatically and unintentionally,
that nevertheless affects judgments, decisions, and behaviors” (National Institutes of
Health, n.d., para. 2).
1. https://rn-journal.com/journal-of-nursing/racism-implicit-bias-and-theory-failure-innursing
2. https://www.medicalnewstoday.com/articles/biases-in-healthcare
For this first discussion, read the articles found at the links above. Then go to the
following website, https://nursology.net/nurse-theories/ and select a nursing theory
that attempts to mitigate the negative effects of bias. After doing so, please answer
the following:
1. What is the title, author, and year that the theory was developed?
2. What is the purpose of the theory?
3. Do you think the author was successful in addressing possible implicit bias? Please
explain.
Reference
National Institutes of Health. (n.d.). Implicit bias. U.S. Department of Health and
Human Sciences. Retrieved August 25, 2023,
from https://diversity.nih.gov/sociocultural-factors/implicit-bias
You must start a thread before you can read and reply to other threads
1
NURS 5103: Theoretical Foundations
Discussion Board
Instructions
You will complete three (3) discussions during the semester in which you will synthesize
the content of assigned readings and course material into a collegial discussion with your
peers. Due dates can be found in the Course Calendar.
1. The discussions are located in D2L under Discussions.
2. You should review the grade criteria before making any posts to the discussion
board.
3. You are expected to incorporate content from current readings into your initial
posts and in your comments to peers.
4. Your course faculty will initiate the discussion, usually by asking a series of
questions related to the topic of study.
5. Your initial response to the discussion topic should answer the questions.
Remember to answer the questions!
6. You are expected to comment on at least two (2) peers’ initial posts. Comments to
peers should stimulate discussion. The best way to stimulate discussion is to ask
questions or provide an alternative viewpoint.
7. You must make your initial post before commenting on any of your peers’ posts.
8. You are expected to respond to comments provided by your peers on your initial
post as well as on your comments to your peers’ initial posts; this will encourage
a “back and forth” discussion with your peers.
9. If more than two students provide comments on your initial discussion post, you
will only be responsible for responding to two of them (but you can respond to all
of them if you would like).
10. Create your discussion post in a Word document, then copy and paste the contents
into the body of the discussion. Do not include any attachments!
11. Do not be concerned about spacing and indentations because sometimes this is not
maintained when copying and pasting into the discussion area.
12. References should be cited as appropriate throughout your discussion using APA
format.
13. References should be listed at the end of your discussion rather than on a separate
page. References should be in APA format.
2
Grade Rubric
Criteria
Possible Points
1. Your initial post reveals development of ideas about the
discussion topic.
a. Answers the discussion questions;
b. Incorporates content from assigned readings into post.
25
2. Your initial post contains substantive content.
a. Evidence of critical thinking;
b. Includes the integration of current literature from
referenced sources.
15
3. Peer to peer discussions are facilitated.
a. Initial post is posted by due date;
b. Responds to comments provided by peers on your initial
post.
15
4. Your comments on peers’ initial posts stimulates and advances
discussion.
a. Asks relevant questions, and/or
b. Provides alternative viewpoints (referenced)
20
5. Peer to peer discussions are facilitated.
a. Comments on at least two (2) peer’s initial posts
b. Acknowledges peer’s response to comments.
15
6. Discussion posts are:
a. Written using standard American English which includes
grammar, spelling, and sentence structure;
b. References are cited using APA format within the post
and listed at the end of the post as in a reference page.*
10
TOTAL
100

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Discussion Responses

Jun 14, 2024 | Health Medical

Description

This is a continuation of the assignment completed a week ago. Please see the attached instructions for responses to the discussions per the instructions below, and let me know if you have additional questions. I attached each post, making it a total of 3, so we need responses to each of them on the attached pages to avoid confusion.Students must respond to at least 3 of their fellow classmate’s articles.Response PostsResponse length: 0.5 page

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Treating inpatient hypertension
Topic of choice: When do we treat inpatient hypertension?
This came from a discussion with my hospitalist preceptor as we discussed inappropriate
paging/abuse of Epic SecureChat, and when it is appropriate for nurses to page about blood
pressure management.
Article: Treatment and Outcomes of Inpatient Hypertension Among Adults With Noncardiac
Admissions, 2021
Citation:
Rastogi, R., Sheehan, M. M., Hu, B., Shaker, V., Kojima, L., & Rothberg, M. B. (2021).
Treatment and Outcomes of Inpatient Hypertension Among Adults With Noncardiac
Admissions. JAMA internal medicine, 181(3), 345–352.
https://doi.org/10.1001/jamainternmed.2020.7501
Additional reading just for fun/interest: How should asymptomatic hypertension be
managed in the hospital? (2018)
Summary:
Rastogi et al. (2021) is a cohort study that sought to add to a lacking body of evidence
surrounding hypertension treatment in the inpatient setting. This article specifically focused
on patients who are admitted for noncardiac reasons. The cohort was made up of 22,834
patients admitted between 3-13 days and chart reviews were performed to make sure they
met criteria: 18+ years of age, not pregnant, admitted to medicine service, no admissions for
cardiovascular diagnosis or cerebrovascular event within 30 days, and no cardiovascular
diagnosis as admission diagnosis. The patients were admitted across 10 hospitals.
Measurements taken into consideration were SBP and DBP, as well as heart rate, and
measurements from the ICU were excluded. They decided to use SBP > 140 mmHg as their
standard definition of hypertension. As a part of the chart review, all prior to admission (PTA)
medications were evaluated along with comorbidities of the patients in the study. Further
exploration of the study design and considerations can be found in the article.
There were three phases of analysis: acute treatment of elevated BP, inpatient events
following high blood pressure or after treatment, and lastly the intensification of medication at
time of discharge. Of the patients included in the study, there were abou t 17,810 of the 22,
834 (78%) had at least one elevated blood pressure reading, and about one third of those
were treated. Patients were primarily treated with oral antihypertensives but IV, PO, IM, and
topical administrations were all taken into consideration. Of the patients treated, there were
more listed risk factors for cardiovascular disease and complications such as older
age/African American, and blood pressure readings tended to be higher.
When determining whether or not blood pressure management was helpful vs harmful
in these patients, researchers defined harmful as “resulting in end-organ damage”. End
organ damage was defined as acute kidney injury (AKI), myocardial injury, stroke, and a
composite of all three of these diagnoses. In order to be included in the study, these
outcomes had to occur after the elevated blood pressure reading. Interestingly enough,
those who were treated for elevated blood pressure were actually more likely than the
control patients to end up with AKI or myocardial injury, and results were similar
between those who received PO vs IV treatments. The study found that there were no
greater outcomes with patients who were treated vs left untreated. SBP readings that were
extremely elevated over 220 mmHg were treated 47% of the time. This lack of treatment is
interesting considering that about 80% of resident physicians believed that hypertension
while admitted was a high priority. About one third of hospitalists believed that asymptomatic
hypertension, above 182/100, was reason enough to transfer the patient into the ICU. In
summary, researchers came to the conclusion that “intensification of therapy without signs of
end-organ damage was associated with worse outcomes”.
Upon discharge from the hospital, it was found that about 8% of the patients with
elevated blood pressure readings actually had medication regimens intensified. When it was
intensified, it was not always found to be helpful in overall management.
We do not know exactly when hypertension in the inpatient setting is caused by pain,
nausea, fever, or stress, nor do we know whether or not elevation of BP in these settings is
adaptive vs harmful.
Potential flaws:
•
•
•
•
•
Patients with diagnosis of atrial fibrillation or heart failure were included, but those
with cardiovascular diagnoses that require specific BP management were not
(ACS/CVA)
Other signs of end organ damage may not be as easily measured as AKI, stroke, or
MI and could be missed
•
Potential practice changes:
•
•
•
Treat hypertension conservatively
•
o
o
o
•
o
o
o
•
•
•
•
Is the reading a one off or a trend?
Is the patient symptomatic? And are there signs of end organ damage?
Education among nursing staff regarding symptoms or changes in patient condition
associated with high blood pressure readings
Hospital Surgical Volume and Emergency
General Surgery Outcomes
Hospital Volume of Emergency General Surgery and its Impact on Inpatient Mortality
for Geriatric Patients: Analysis From 3994 Hospitals
This study assessed associations between inpatient surgical outcomes and hospital
case volume for emergency surgery. This was a population-based
retrospective cohort study that used the CMS limited data set files from 2011 to
2013. The cohort was 414,779 patients from 3994 hospitals. This assessed the 7 most
common emergency surgeries evaluated were partial colectomy, small-bowel
resection, cholecystectomy, appendectomy, lysis of adhesions, operative management
of peptic ulcer disease, and laparotomy.
Patients were included in the data analysis if their procedures were considered
emergency or urgency (and they were excluded if considered elective procedures).
Patients were included if their ICD-9 diagnosis met that of the 7 most common
emergency surgeries listed. Patients under 65 were excluded because of significant
comorbidities present in those less than 65 who are on medicare or medicaid; this
dataset is only CMS patients.
The primary outcome assessed was death occurring between admission and discharge;
secondary outcome was length of stay.
Data was analyzed with covariates: the primary independent variable was hospital
surgical volume, but other known or possible covariates were adjusted for. Variables
considered included age range, time of visit, teaching hospital status, transfer-in
status, and gender. Also season of admission, US state, socioeconomic status via
presence of co-insurance along with medicare, and comorbidity per the Charlston
comorbidity index.
A two-way comparison was conducted to describe correlation of covariates to
patients who received surgery in a high-volume center versus a patient in a lowvolume center. A model defining expected death rates was developed, and the death
rates of each hospital for each type of surgery was compared to this standard.
The process of dividing facilities into “high-volume” and “low volume” centers was not
evident.
In analysis of the data, baseline characteristics of high-volume vs. low-volume centers
was: many more total operations in the dataset were performed at low-volume
hospitals. There were no socio-demographic differences between high and lowvolume hospitals. However, high-volume centers had patients with significantly more
comorbidities.
There was significantly better mortality in high-volume centers for patients who
underwent partial colectomy or small bowel resection.
-Surgical technical complications were generally no different between groups.
However, high surgical volume centers had better rates of pneumonia, sepsis, and
cardiac arrest in small bowel resection patients. High surgical volume centers had
better rates of pneumonia and cardiac arrest for colectomies.
Cholecystectomy, lysis of adhesions, appendectomy, and multiple surgery procedures
had better mortality in high-volume centers (not statistically significant)
Laparotomy & Peptic ulcer disease surgeries had better mortality in low-volume
centers (not statistically significant). Maybe this is because there are more critically ill
patients for these operations at high-volume centers. It is hard to account for the
gestalt of low-volume center surgeons who decide to refer on specific acute surgical
issues. Patients receiving these issues at high-volume centers had significantly more
patients with multi-organ failure; and those having ulcer surgery at high-volume
centers were significantly more likely to have had chronic kidney disease. Per the
authors, other research seems to show that extra time taken to send a peptic ulcer
perforation/bleeding to a higher-volume center causes more death instead of doing
emergency surgeries in the lower volume center.
Overall, there may be more to just the surgical skill at high volume centers that
improves outcomes for colectomies and small bowel resection. It may be the
interdisciplinary care, resources, and other perioperative care that help prevent
postoperative complications like pneumonia, sepsis, and cardiac arrest.
For people in America over 65, having small bowel resections or colectomies done at
low-volume centers does seem to be worse than having them completed at highvolume centers. Also, emergency surgical outcomes may be better in general at highvolume centers; this may be related to perioperative care differences and not so much
the surgical skill and techniques. Systems-based approach for perioperative care may
improve surgical outcomes in lower-volume centers to that of higher volume centers.
One must remember that this is a retrospective study that appears to show some
correlations. No causative claims can be made, but the analysis of many different
covariates helps to describe these phenomena.
Ang, D., Sugimoto, J., Richards, W., Liu, H., Kinslow, K., McKenney, M., Ziglar, M., &
Elkbuli, A. (2023). Hospital Volume of Emergency General Surgery and its Impact on
Inpatient Mortality for Geriatric Patients: Analysis From 3994 Hospitals. The American
Surgeon, 89(4), 996–1002. https://doiorg.akin.css.edu/10.1177/00031348211049251
NSG 8712: Acute Care Adult Gerontology Practicum II
Journal Club Discussion
●
Students will select an evidence-based article pertinent to acute care that is less than three years
old. Students will analyze the article, write a brief summary or record a brief summary to be
posted to Brightspace and discuss potential practice changes.
○ Brief, in this assignment, means 1-2 pages or 5 mins if recorded. Journal Club in a
professional setting typically is just that, a brief summary of an article, the statistical
analysis, potential flaws, and potential practice changes.
Discussion Post Grading Rubric
Critical Thinking
20-16 pts
Outstanding:
-Rich in content
-Full of thought
-Insightful
-Broad
Understanding of
Topic
15-11 pts
Proficient:
-Substantial
Information
-Evident that
thought, insight,
and analysis of
sorts has taken
place
110-6 pts
Basic:
-General
information
-Thought,
insight, analysis
is commonplace
5-0 pts
Below
Expectations:
-Rudimentary
and superficial
-Incomplete
Understanding and
Applications of
Concepts
20-16 pts
Outstanding:
-Content applies
to personal and
professional
practice
-Examples of
health care
delivery systems
15-11 pts
Proficient:
-Content of
posting reflects
full
understanding of
concepts with
some application
10-6 pts
Basic:
-Content of post
reflects basic
understanding of
concept little to
now application
5-0 pts
Below
Expectations:
-Content of post
does not reflect
understanding or
concepts
-Incomplete
Application and
Analysis of
Professional
Resources
20-16 pts
Outstanding:
-Post
incorporates
assigned reading,
lessons, expert
opinion, peer
reviewed
content, and life
experiences
15-11 pts
Proficient:
-Post
incorporates
only assigned
reading or life
experiences
10-6 pts
Basic:
-Post
incorporates
mostly expert
opinion or life
experiences
5-0 pts
Below
Expectations:
-Post does not
incorporate
sources and lacks
professional
resources
-Incomplete
Professionalism
20-16 pts
Outstanding:
-Clear, logical
-Grammar
-Respectful
-Actively
engaged in
responses
15-11 pts
Proficient:
-Clear, logical
-Few
grammatical
errors
– Responds but
not actively
engaged
10-6 pts
Basic:
-Obvious errors
in information
-Responses show
lack of
engagement
-Low
engagement
5-0 pts
Below
Expectations:
-Copious Errors
-Difficult to
understand
-Defensive or
disrespectful in
postings
Timeliness
20-16pts
Outstanding:
Posts
15-11pts
Proficient:
1-2 days late
10-6pts
Basic:
>2 days late
5-0 pts
Below
Expectations:
> 3 days late
-Incomplete

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Green initiatives and supply chain

Jun 14, 2024 | Health Medical

Description

Respond to the following in a minimum of 175 words:How important is green in the overall purchasing decision for health care products and supplies? Defend your answer.Does purchasing green products impact the supply chain budget? In what way?

Discussion

Jun 14, 2024 | Health Medical

Description

Discussion Board Assignment 1 Instructions:1) Visit the Website of CDC’s Morbidity and Mortality Weekly Report, (https://www.cdc.gov/mmwr/Links to an external site.); click onto the Corona Virus-19 link and then: Describe TWO separate, interesting events ( articles) that the CDC has reported on in their report on the COVID-19 issue of the MMWR?- Make sure you include any specific or important details from the report AND include your opinion of the event (what made it interesting to you).2) Submit your post by clicking on Reply and either typing in your information, or attaching a file.3) Respond to at least 2 other student’s posts by reading their thread and clicking on the reply button. Your response needs to have some depth by giving specific examples of why you are saying what you are saying- In other words, don’t simply post ” that was a great idea you had”. Refer to your text or cite other media for your answers. Remember to use at least 1 citation in your reply posts along with your opinions.

Nursing Question

Jun 14, 2024 | Health Medical

Description

As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice. Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of

impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.

To Prepare:

Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.

The Assignment: (1- to 2-page Legislation Grid; 1-page Legislation Testimony/Advocacy Statement)

Be sure to add a title page, an introduction, purpose statement, and a conclusion. This is an APA paper.

Part 1: Legislation Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Grid Template. Be sure to address the following:

Determine the legislative intent of the bill you have reviewed.

Identify the proponents/opponents of the bill.

Identify the target populations addressed by the bill.

Where in the process is the bill currently? Is it in hearings or committees?

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:

Advocate a position for the bill you selected and write testimony in support of your position.

Explain how the social determinants of income, age, education, or gender affect this legislation.

Describe how you would address the opponent to your position. Be specific and provide examples.

At least 2 outside resources and 2-3 course specific resources are used.

Drugs for Degenerative Diseases of the Nervous System project

Jun 14, 2024 | Health Medical

Jun 14, 2024 | Health Medical

Description

Hypothesis testing is a fundamental research tool with substantial implications in healthcare practice, facilitating data-driven decision-making and enhancing patient interactions. In one scenario, researchers may assess the efficacy of a new medication. The null hypothesis suggests no significant difference compared to the standard treatment, while the alternative hypothesis claims superiority. To reject the null hypothesis, a common criterion is a significance level, typically set at 0.05 (Smith & Fox, 2010). This threshold means that if the calculated p-value from the data falls below 0.05, the null hypothesis is rejected, indicating the new medication’s efficacy. This decision significantly impacts healthcare practice, guiding treatment choices and ultimately influencing patient well-being (Smith & Fox, 2010; Ambrose et al., 2022).In another example, researchers might investigate the impact of lifestyle factors on disease risk. The null hypothesis posits no relationship between lifestyle and disease risk, while the alternative hypothesis argues otherwise. To reject the null hypothesis, a significance level like 0.05 is again used (Johnson & Brown, 2018). If the p-value is lower than this threshold, the null hypothesis is discarded, signifying that lifestyle indeed influences disease risk. This finding holds significance in healthcare, enabling practitioners to counsel patients on lifestyle modifications to prevent or manage diseases (Johnson & Brown, 2018; Ambrose et al., 2022).In summary, hypothesis testing empowers healthcare professionals to make evidence-based decisions, leading to improved patient outcomes and fostering more informed patient interactions.

PowerPoint on the pathophysiology of nephrotic syndrome

Jun 14, 2024 | Health Medical

Description

Health & Medical Question

Description

1. 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. Submit this SOAP Note to this week’s discussion for peer review.2. 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. Address the following items: Describe your past experience in mental health or with someone with mental illness. What are the reasons you have chosen to work with this population? Discuss any concerns you have regarding this specific clinical course and population Adult/Geriatric. Identify personal and academic/professional goals for the clinical course and population Adult/Geriatric. Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.

hcm5055…..

Jun 14, 2024 | Health Medical

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This
work is important to me. Solve it correctly, without mistakes, without
plagiarism. 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 Please follow the instructions, do it correctly without any similarities

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Module 05: Discussion
Module 05: Discussion
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.
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

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hcm502…//

Jun 14, 2024 | Health Medical

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Module 05: Discussion Forum
Module 05: Discussion Forum
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).
1. 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.
2. 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.
Discussion Rubric Discussion Rubric – Alternative Formats

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Health & Medical Question

Jun 14, 2024 | Health Medical

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Discussion 1. What is the difference between an “honor-oriented society” and a “justice-oriented society” and how do these value differences get expressed in communication? How do different communication values in these societies influence communication about the gospel?

Discussion 2. What is the difference between masculine and feminine cultures? Chapter 13 in your textbook mentions that “gender differences can and often do result in painful gender disparities.” Discuss one example of this that stands out to you from the chapter.

Assessment. For this assignment, you will need to interview an individual a member of the culture you are studying for this semester (i.e., If you are writing your cultural communication practices paper on the culture of Peru, you would interview someone from Peru). Ideally, you should interview someone from a different civilization (not Western Civilization) and someone who is not a Christian; this will allow you to learn about different perspectives from your own on the concepts covered in this topic. Consult with your instructor early on in the process if you are having difficulties coordinating an interview.

This interview can be in person or over the phone (some people who have emailed have found that their interviewees actually plagiarized the responses so you may use email but be very cautious and check the Similarity Score before submitting). This may be someone you know personally or that you locate through a local cultural center, club, religious organization or even an embassy or consulate. You need to obtain permission from this individual to list their contact information in your paper in the event that your instructor needs to verify your work.

During your interview you should ask the following questions:

What do you identify as the most important or distinct practices of your culture?
How are gender roles addressed in your culture?
How is social power, authority, or social roles in a hierarchy expressed in your culture?
In class, we learned that in “honor-oriented societies,” worth comes from one’s role or group membership and in “justice-oriented societies,” worth comes from what one does or doesn’t do. What is the role of honor/shame in your culture? Are honor/pride and dishonor/shame important concepts in your culture?

After your interview, write a 750-1000-word paper summarizing and reflecting on the responses you received. What did you learn from this exchange? How did your perceptions change? Based on your discussion, how do you think your culture is perceived by others? You should incorporate at least three concepts from Chapters 12, 13, or 14 of your textbook in your response.

You must include at least one citation. You may use the textbook or a scholarly article on honor/justice, power distance, gender roles, or cultural practices.

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.

hcm500.husain

Jun 14, 2024 | Health Medical

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Module 05: 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.

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CLC – Evidence-Based Practice Project: Intervention Presentation

Jun 14, 2024 | Health Medical

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Article Site: https://www.sciencedirect.com/science/article/abs/pii/S000293432030339Create a 3-5 slide PowerPoint presentation (not including the title page and references) on the study’s findings and how they can be used by nurses as an intervention. Include speaker notes for each slide and additional slides for the title page and references.- Answer this question in the 3-5 slide powerpoint :Describe the intervention or treatment tool and the specific patient population used in the article

Jun 14, 2024 | Health Medical

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hcm102.shima

Jun 14, 2024 | Health Medical

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College of Health Sciences
Department of Public Health
ASSIGNMENT COVER SHEET
Course name:
Organizational Behavior
Course number:
HCM102
CRN
11523
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. Mohammed Osman 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:
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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

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Nursing Question

Jun 14, 2024 | Health Medical

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I basically need a study guide to help me study for my up coming pharmacology exam.The picture attached is an example of how I would like it to be like. You don’t have to put any sources or anything like that. Separate each section At the bottom of the pages document it tells you what to do for each medication

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Below is a test blueprint for exam 1.
This blueprint is to assist you in focusing on preparation for Exam #1. It is to serve as
a guide when studying. Please make sure you review the ATI modules, pharmacology
book, quizzes, and other ATI materials. Review the drug classes and make sure you
focus on the medications listed below. You want to focus on indications for use,
unusual side/adverse effects, how they are administered, drug interactions and
teaching points.
1. Intro to Pharm (10 Questions)
Please review:
• Accumulation of medications (what causes this)
• Metabolism of drugs
• Therapeutic effects
• Toxic effects
• Onset of medications
• Peak and troughs (What do these mean)
• Routes of administration and how quickly they work
• Half-life
• Extended release medications (what special considerations are there
about these medications)
• Pregnancy category (Know what each mean)
• Food and Drug Interactions
2. Immune (10 Questions)
Medications to review:
• Zidovudine
• Enfuvirtide
• Raltegravir
• Vincasar
• Tamoxifen
• Methotrexate
• Cisplatin
• Immunizations (review what should be given and when)
3. Pain (13 Questions)
Medications to review:
• ASA
• Allopurinol
• Celecoxib
• Morphine Sulfate
• Naloxone
• Acetaminophen
•
Prednisone
4. GI (12 Questions)
Medications to review:
• PPI
• Ondansetron
• Psyllium
• Sulfasalazine
• Metoclopramide
• Loperamide
• Azathioprine
• Omeprazole
• Cimetidine
• Stool softeners
For each of the medications listed above, you want to review the following.
Assessment:
• Actions prior to administering a medication
• Side/adverse effects
• Identify the need for further teaching
• Orthostatic blood pressures
Intervention:
• The rationale for performing the intervention
• Addressing side effects
Teaching
• Identify teaching needs for medications
• Dietary interactions
There will also be 5 Basic math problems for medication administration.

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hcm102.mohamed

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Remote Collaboration and EBC

Jun 14, 2024 | Health Medical

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As technologies and the health care industry continue to evolve, remote care, diagnosis, and collaboration are becoming increasingly more regular methods by which nurses are expected to work. Learning the ways in which evidence-based models and care can help remote work produce better outcomes will become critical for success. Additionally, understanding how to leverage EBP principles in collaboration will be important in the success of institutions delivering quality, safe, and cost-effective care. It could also lead to better job satisfaction for those engaging in remote collaboration.

Remote care and diagnosis is a continuing and increasingly important method for nurses to help deliver care to patients to promote safety and enhance health outcomes. Understanding best EBPs and building competence in delivering nursing care to remote patients is a key competency for all nurses. Additionally, in some scenarios, while you may be delivering care in person you may be collaborating with a physician or other team members who are remote. Understanding the benefits and challenges of interdisciplinary collaboration is vital to developing effective communication strategies when coordinating care. So, being proficient at communicating and working with remote health care team members is also critical to delivering quality, evidence-base care.

The Vila Health: Remote Collaboration on Evidence-Based Care simulation provide the context for this assessment.

Before beginning this assessment, make sure you have worked through the following media:

Vila Health: Remote Collaboration on Evidence-Based Care.

You may wish to review Selecting a model for evidence-based practice changes. [PDF] and Evidence-Based Practice Models, which help explain the various evidence-based nursing models.

For this assessment, you are a presenter! You will create a 5-10-minute video using Kaltura or similar software. In the video:

Propose your evidence-based care plan that you believe will improve the safety and outcomes of the patient in the Vila Health Remote Collaboration on Evidence-Based Care media scenario. Add your thoughts on what more could be done for the client and what more information may have been needed.
Discuss the ways in which an EBP model and relevant evidence helped you to develop and make decisions about the plan you proposed
Wrap up your video by identifying the benefits of the remote collaboration in the scenario, as well as discuss strategies you found in the literature or best practices that could help mitigate or overcome one or more of the collaboration challenges you observed in the scenario.

Be sure you mention any articles, authors, and other relevant sources of evidence that helped inform your video. Discuss why these sources of evidence are credible and relevant. Important: You are required to submit an APA-formatted reference list of the sources you cited specifically in your video or used to inform your presentation. You are required to submit a narrative of all your video content to this assessment and to SafeAssign.

The following media is an example learner submission in which the speaker successfully addresses all competencies in the assessment.

Exemplar Kaltura Reflection.
Please note that the scenario that the speaker discusses in the exemplar is different from the Vila Health scenario you should be addressing in your video. So, the type of communication expected is being model, but the details related to the scenario in your submission will be different.

Make sure that your video addresses the following grading criteria:

Propose your own evidence-based care plan to improve the safety and outcomes for a patient based on the Vila Health Remote Collaboration on Evidence-Care media scenario.
Explain the ways in which you used an EBP model to help develop your plan of care for the client.
Reflect on which evidence you found in your search that was most relevant and useful when making decisions regarding your care plan.
Identify benefits and strategies to mitigate the challenges of interdisciplinary collaboration to plan care within the context of a remote team.
Communicate in a professional manner that is easily audible and uses proper grammar, including a reference list formatted in current APA style.

Refer to Using Kaltura as needed to record and upload your video.

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. If, for some reason, you are unable to record a video, please contact your faculty member as soon as possible to explore options for completing the assessment.

Your assessment should meet the following requirements:

Length of video: 5-10 minutes.
References: Cite at least three professional or scholarly sources of evidence to support the assertions you make in your video. Include additional properly cited references as necessary to support your statements.
APA reference page: Submit a correctly formatted APA reference page that shows all the sources you used to create and deliver your video. Be sure to format the reference page according to current APA style. Submit a narrative of all of your video content.

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.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
Reflect on which evidence you collected that was most relevant and useful when making decisions regarding the care plan.
Competency 3: Apply an evidence-based practice model to address a practice issue.
Explain the ways in which you used the specific evidence-based practice model to help develop the care plan identifying what interventions would be necessary. This requires a particular evidence-based model, such as the Johns Hopkins, Iowa, Stetler, or other.
Competency 4: Plan care based on the best available evidence.
Propose your evidence-based care plan to improve the safety and outcomes for the Vila Health patient with a discussion of new content for the care plan.
Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
Identify benefits and propose strategies to mitigate the challenges of interdisciplinary collaboration to plan care within the context of a remote team.
Communicate via video with clear sound and light, and include a narrative of video content.
Provide a full reference list that is relevant and evidence-based (published within five years), exhibiting nearly flawless adherence to APA format.

hcm102,abdullah

Jun 14, 2024 | Health Medical

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MATH225N 16555 Week 3 Statistical Reasoning for the Health Sciences-VASSILIADIS

Jun 14, 2024 | Health Medical

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Week 3 Lab
Assignment
REQUIRED RESOURCES

Read/review the following resources for this activity:

OpenStax Textbook: Chapter 2
Lesson
Chamberlain University Library
Internet
Week 3 Lab Template
REQUIRED SOFTWARE
Microsoft Word
Internet access to read articles
SCENARIO/SUMMARY

This week’s lab highlights the use of graphics, distributions, and tables to summarize and interpret data.

INSTRUCTIONS

Part 1:

Your instructor will provide you with a scholarly article. The article will contain at least one graph and/or table. Please reach out to your instructor if you do not receive the article by Monday of Week 3.

Part 2:

Title your paper: “Review of [Name of Article]”
State the Author:
Summarize the article in one paragraph:
Post a screenshot of the article’s frequency table and/or graph.
Example:
Frequency Distribution -OR- Graph

Answer the following questions about your table or graph.
What type of study is used in the article (quantitative or qualitative)?
Explain how you came to that conclusion.
What type of graph or table did you choose for your lab (bar graph, histogram, stem & leaf plot, etc.)?
What characteristics make it this type (you should bring in material that you learned in the course)?
Describe the data displayed in your frequency distribution or graph (consider class size, class width, total frequency, list of frequencies, class consistency, explanatory variables, response variables, shapes of distributions, etc.)
Draw a conclusion about the data from the graph or frequency distribution in the context of the article.
How else might this data have been displayed?
Discuss the pros and cons of 2 other presentation options, such as tables or different graphical displays.
Why do you think those two other presentation options (i.e., tables or different graphs) were not used in this article?
Give the full APA reference of the article you are using for this lab.
Be sure your name is on the Word document, save it, and then submit it under “Assignments” and “Week 3: Lab”.
REQUIREMENTS

The deliverable is a Word document with your answers to the questions posed above based on the article you were assigned.

GRADING

This activity will be graded based on the Week 3 Lab Rubric.

OUTCOMES

CO 1: Given scenarios supported by population data, apply sampling techniques and explain potential pitfalls and bias in data collection.

CO 2: Given datasets with qualitative and quantitative data, differentiate between the types of data and how they can be applied in statistical studies for everyday life.

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Week 3 Lab Assignment
Name:________________________
Instructor Name: _______________
Please use this template to help answer the questions listed in the lab
instructions. The “parts” below refer to the parts 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.
Part 1. Read the assigned article.
Please reach out to your instructor if you did not receive the assigned article
for the term by Monday of Week 3.
Part 2. Analyze the article.
Title: Review of [Type out name of Article]
Author(s): [Type out names of Author(s) of the Article]
Summarize the article in one paragraph:
Post a screenshot of a graph/chart from the article that you will analyze:
1
Analysis
(Answer the following questions thoroughly in complete sentences)
A. What type of study is used in the article (quantitative or qualitative)?
Explain how you came to that conclusion.
B. What type of graph or table did you choose for your lab (bar graph,
histogram, stem & leaf plot, etc.)? What characteristics make it this type
(you should bring in material that you learned in the course)?
C. Describe the data displayed in your frequency distribution or graph
(consider class size, class width, total frequency, list of frequencies, class
consistency, explanatory variables, response variables, shapes of
distributions, etc.)
2
D. Draw a conclusion about the data from the graph or frequency distribution
in context of the article.
E. How else might this data have been displayed (Pick two different graphs
that could have been used to display the same data as your selected
graph/table)?
Discuss pros and cons of 2 other presentation options, such as tables or
different graphical displays.
Explain how these graphs would be structured to display the data in the
article. Why don’t you think those two graphs were not used in this article?
F. Give the full APA reference of the article you are using for this lab.
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”.
3
4
2018 Modern Nurse Survey: Nursing shortage leading to nurse burnout
1 of 12

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RNnetwork Blog
Everything you need to know about travel nursing.
Nurse life • Press room
RNnetwork 2018 Portrait of a Modern Nurse
Survey
 December 12, 2018
 9 Min Read
Liz Cornwall
To better understand the changing landscape and emerging challenges of the
nursing profession, RNnetwork recently conducted a follow-up study of its
groundbreaking 2016 survey, which painted a portrait of a modern nurse and
examined different aspects of the national nursing shortage. In this updated
survey, respondents from around the United States shared perspectives about
subjects including workload, the national nursing shortage, the nursing
profession in general and respect in the workplace. New questions about mental
health and self-care also yielded fresh insights into the day and life of a nurse.
The results revealed many of the concerning statistics from the previous study
were either static or growing worse: nurse burnout, overwork and harassment
continue to affect nurses and impact patient care in 2018. True to the problemsolving nature of their training, however, many participants want greater focus on
possible solutions like temporary staffing or investment in new incentives and
programs.
No sign of relief for heavy workloads
Nurse burnout is continually acknowledged as a particular problem in the
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medical profession, and as the nursing shortage continues, there seems to be no
clear solution in sight. In 2018, 62 percent of nurses felt regularly burned out in
their jobs, and 44 percent of nurses believed that burnout had affected their
work performance.
Perhaps most pressing for the future, nearly half of all respondents (49 percent)
had considered leaving nursing in the past two years, a number that has not
changed since RNnetwork’s 2016 survey. Instead of work situations improving, 40
percent of nurses believe they have less free time now than compared to two
years ago. A similarly-sized group (38 percent) felt their available free time had
not changed in two years.
Additionally, in 2016, 63 percent of nurses felt they spent just the right amount of
time at work, which dropped slightly to 60 percent in 2018, further indicating that
hours and expectations are increasing.
The nationwide nurse shortage continues
unabated
The increasing national nursing shortage compounds all of the issues facing
today’s nurses. The Bureau of Labor Statistics predicted that 1.2 million vacancies
will emerge for registered nurses between 2014 and 2022, and the fallout of that
widening gap is becoming significant. This outlook was confirmed by survey
respondents, 91 percent of whom felt their hospital was understaffed.
This nursing shortage has negatively affected workloads for 88 percent of nurses
in 2018, up significantly from 62 percent in 2016. Additionally, nearly 62 percent
of respondents believed the shortage was negatively impacting the quality of care
nurses could provide, with 46 percent feeling even more overworked than they
did two years ago.
Nurses want administrators and government to continue exploring options to
alleviate the shortage. Nurses expressed support for government subsidies of
schooling (38 percent) and creating new nursing programs (29 percent).
Temporary staffing (travel nursing) is another viable solution to nurse burnout or
workload issues, according to 59 percent of nurses.
Work is impacting nurses’ mental health
More than half of nurses (54 percent) reported their workload had negatively
impacted their mental health. Furthermore, 35 percent reported that the state of
their mental health had negatively impacted their work. Although national
conversations on mental health are increasing awareness, 35 percent of
respondents believed it was still taboo to discuss among nurses.
Nearly a quarter of respondents (24 percent) reported taking medication for
anxiety or depression. Of those, 59 percent attribute their anxiety or depression
to the demands of nursing. Three percent of nurses indicated they have
contemplated suicide, due to the demands of their jobs.
As public understanding of the value of mental health increases and long-held
stigmas begin to fall away, the door is opening for conversations in workplaces.
With such widespread mental health problems reported among nurses, it is also
notable that only 16 percent reported meeting with a mental health professional
over the demands of their work – but 47 percent wish they had better access in
the workplace.
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Bullying and harassment continues to be a
problem
The prevalence of bullying and verbal harassment is a significant issue in the
nursing industry. Nearly 40 percent of nurses reported being bullied or harassed
during the past year.
Nurses face this abuse from many directions, and in all areas of their work: 30
percent of bullying or harassment comes from other nurses, 25 percent from
patients, 23 percent from physicians and 22 percent from administrators.
Although any amount of harassment is unacceptable, the data may indicate that
instances of workplace hostility may be decreasing for nurses. In the 2016 report,
45 percent of nurses reported bullying by other nurses, 38 percent by physicians
and 41 percent by administrators.
The data further indicates that 62 percent of nurses believe that physicians
respect them, which is slightly lower than 2016 levels (65 percent). Unfortunately,
only 29 percent of nurses felt respected by administrators, which was a
significant decrease from 46 percent in 2016.
In addition, 21 percent of nurses are also subjected to sexual harassment in the
workplace. Patients are responsible for 43 percent of sexual harassment, with
physicians committing 29 percent of incidents, 24 percent coming from other
nurses and 4 percent from administrators.
2018 Survey Results
Nurse workload
Free time is in short supply for most nurses. When compared to two years ago, 40
percent indicated they had less free time and 38 percent felt things were about
the same. Fifteen percent saw a slight improvement and only seven percent saw
any large increase in free time.
Overwork is a hallmark of burned out employees, and few have more timeintensive schedules than nurses. In the past two years, most nurses have either
seen their workloads increase (46 percent) or stay about the same (32 percent).
Just 22 percent of nurses felt their workloads had become less burdensome.
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Supporting work-life balance is a key goal for many healthcare facilities, but
nurses’ experience varies. Although 37 percent agree their employers support
work-life balance, 36 percent believe their employers do not. Twenty-seven
percent feel ambivalent about their employers’ efforts.
If there is any statistic that should spur administrators to action, it is that nearly
half of nurses (49 percent) have considered leaving during the past two years. The
top three reasons nurses considered abandoning the profession are overwork
(24 percent), spending too much time entering data in EHR (19 percent) and not
having enough time with patients (15 percent). In addition, 38 percent of nurses
said they work second jobs to pay off debts (31 percent), to support their
preferred lifestyle (17 percent), and because their income has decreased (15
percent).
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Bullying and harassment
Nearly 40 percent of nurses reported bullying and harassment in the workplace.
Respondents indicated that 30 percent of bullying and harassment incidents
came from other nurses, 25 percent from patients, 23 percent from physicians
and 22 percent from administrators. Instances of workplace hostility may be
decreasing for nurses. According to 2016 findings, 45 percent of nurses reported
bullying by other nurses, 38 percent by physicians and 41 percent by
administrators.
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Although the majority of nurses said they do not experience sexual harassment
at work (79 percent), it’s worth noting that 21 percent said they do experience
sexual harassment, with the majority of that harassment coming from patients
(43 percent), physicians (29 percent), and other nurses (24 percent).
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National nursing shortage
Eighty percent of respondents believe there is a nursing shortage in their facility,
and 76 percent report they have personally been impacted by the shortage.
Eighty-eight percent of nurses have seen their workloads increase due to fewer
nurses in the industry.
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Nurse burnout
Nurse burnout is a major problem, with 62 percent feeling burned out on a
regular basis, compared to only 22 percent believing it wasn’t an issue. Burnout
reportedly affected work performance for 43 percent of respondents, while 35
percent believed burnout had no impact on performance.
Nurse burnout is also taking a toll on physical and mental well-being, with nurses
reporting symptoms of chronic fatigue (16 percent), anxiety (13 percent),
insomnia (11 percent), and depression (9 percent) due to burnout.
9/17/23, 8:44 PM
2018 Modern Nurse Survey: Nursing shortage leading to nurse burnout
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The vast majority of nurses also reported going into work sick at some point, with
85 percent of respondents admitting to it. More than half (54 percent) believed
that burnout contributed to their sickness.
Not only does nurse burnout affect their personal health (20 percent), it also
impacts their relationships with their families (19 percent) and job satisfaction (24
percent).
9/17/23, 8:44 PM
2018 Modern Nurse Survey: Nursing shortage leading to nurse burnout
10 of 12

To cope with burnout, nurses are turning to exercise (13 percent), food (12
percent), and caffeine (13 percent) as well as spending more time with family (19
percent) and taking time off (17 percent). Temporary staffing (travel nurses) is
also a viable way to address nurse burnout and workload issues, according to 59
percent of respondents.
Mental health
More than half of nurses (54 percent) believe that their workload negatively
impacts their mental health, with 37 percent undecided. Only nine percent of
nurses think their workload has any positive effect on their mental health.
More than half (52 percent) of nurses don’t believe their mental health affects
their work. However, (35 percent) said their mental health was negatively
impacted by their work versus 13 percent who reported a positive impact.
9/17/23, 8:44 PM
2018 Modern Nurse Survey: Nursing shortage leading to nurse burnout
11 of 12

Attitudes toward discussing mental health are changing, but opinions as to
whether nurses should mention the topic in the workplace are divided. It’s a
taboo subject for 35 percent of nurses, but 39 percent are fine discussing mental
health. Twenty-six percent are undecided.
Nearly a quarter of respondents (24 percent) reported taking medication for
anxiety or depression. Of those, 59 percent attribute their anxiety or depression
to the demands of nursing. Three percent of nurses indicated they have
contemplated suicide, due to the demands of their jobs.
Methodology
RNnetwork polled more than 900 nurses working in the United States for insight
into modern opinions and attitudes about nurse burnout, work-life balance,
mental health and harassment in the workplace. Nurses who received the email
survey represented most fields and specialties, and the majority of respondents
had 10 or more years of active practice.
Tags
nurse shortage
survey
travel nurses
travel nursing
About the author
Liz Cornwall
Liz Cornwall is a public relations specialist and is passionate about the company’s
Putting People First culture. Prior to joining RNnetwork, Liz worked in advertising
9/17/23, 8:44 PM
2018 Modern Nurse Survey: Nursing shortage leading to nurse burnout
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graphics, distributions, and tables

Jun 14, 2024 | Health Medical

Description

REQUIRED SOFTWARE
Microsoft Word
Internet access to read articles
SCENARIO/SUMMARY

This week’s lab highlights the use of graphics, distributions, and tables to summarize and interpret data.

INSTRUCTIONS

Part 1:

Part 2:

The deliverable is a Word document with your answers to the questions posed above based on the article you were assigned.

GRADING

This activity will be graded based on the Week 3 Lab Rubric.

OUTCOMES

CO 1: Given scenarios supported by population data, apply sampling techniques and explain potential pitfalls and bias in data collection.

CO 2: Given datasets with qualitative and quantitative data, differentiate between the types of data and how they can be applied in statistical studies for everyday life.

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2018 Modern Nurse Survey: Nursing shortage leading to nurse burnout
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and marketing and also helped launch a pet magazine in Salt Lake City.
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9/17/23, 8:44 PM
Week 3 Lab Assignment
Name:________________________
_______________
Instructor Name:
Please use this template to help answer the questions listed in the lab
instructions. The “parts” below refer to the parts 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.
Part 1. Read the assigned article.
Please reach out to your instructor if you did not receive the assigned
article for the term by Monday of Week 3.
Part 2. Analyze the article.
Title: Review of [Type out name of Article]
Author(s): [Type out names of Author(s) of the Article]
Summarize the article in one paragraph:
Post a screenshot of a graph/chart from the article that you will
analyze:
Analysis
(Answer the following questions thoroughly in complete sentences)
• What type of study is used in the article (quantitative or qualitative)?
Explain how you came to that conclusion.
• What type of graph or table did you choose for your lab (bar graph,
histogram, stem & leaf plot, etc.)? What characteristics make it this type
(you should bring in material that you learned in the course)?
• Describe the data displayed in your frequency distribution or graph
(consider class size, class width, total frequency, list of frequencies,
class consistency, explanatory variables, response variables, shapes of
distributions, etc.)
• Draw a conclusion about the data from the graph or frequency
distribution in context of the article.
• How else might this data have been displayed (Pick two different graphs
that could have been used to display the same data as your selected
graph/table)?
Discuss pros and cons of 2 other presentation options, such as tables or
different graphical displays.
Explain how these graphs would be structured to display the data in the
article. Why don’t you think those two graphs were not used in this article?
• Give the full APA reference of the article you are using for this lab.
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”.

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Medical Terminology Project PROJECT

Jun 14, 2024 | Health Medical

Description

Medical Terminology Project

Develop a game that will help you study and some of your classmates can play.

Alter already known games or develop an original game of your own.

Creativity does count (not looking for you to spend a lot of money or any for that matter).

You Must Use the Following:

 20 prefixes

 20 suffixes

 10 combining forms/root words

 10 whole terms

This is a total of 60 words and word parts. You may use more but not less.

It also must include the following:

 Rules (so if you were not there someone could play it)

 Answer key (you can build you answer key into the game or make it separate)

Discussion post

Jun 14, 2024 | Health Medical

Description

all information is in the photo down below http://playspent.org/I will need you to do the discussion replies for two students after you finish this one. I’ll extend the time later

Discussion

Jun 14, 2024 | Health Medical

Description

Chapter 7 discusses communicable diseases and how several communicable diseases have been eradicated (i.e. smallpox, polio) due to the widespread usage of vaccinations by the general population (herd immunity). Other diseases and viruses do not have vaccines at this time, such as Ebola, HIV. The various COVID-19 vaccines that have become available were developed a year ago. Additionally, there has been more public debate on whether children should or should not be vaccinated.

Answer the following questions:

Should the government mandate childhood vaccinations?

Should adults also be mandated to obtain vaccines by governement or their employers?

Justify your answer using factual data either for or against (or somewhere in the middle) this mandate.

Consider the following supporting questions in your answer:

Do vaccines improve the overall public health?
What are the risks associated with vaccines and do those risks outweigh the benefits?
If vaccines are not required, will the public health be endangered?
What is more important individual rights or the collective good?
Do parents have the right to refuse vaccination for their children?
Would you vaccinate your child?
Should employers be allowed to require vaccines as a condition of employment in certain settings like healthcare or corrections?

n 2010, the Affordable Care Act opens up the 45-year-old Medicare program

Jun 14, 2024 | Health Medical

Description

In 2010, the Affordable Care Act opens up the 45-year-old Medicare program to the biggest changes since its inception. Discuss the components of the Affordable Care Act that you think will have a positive effect on improving health care outcomes and decreasing costs.The discussion must address the topic.Rationale must be provided400 wordsMinimum of two scholarly references in APA format within the last five years published

Reflection -APA

Jun 14, 2024 | Health Medical

Description

The reflective journal is a tool for cultivating your personal-professional self and should focus on the competencies and knowledge you are learning in your field practicum (about yourself, others, social problems, helping relationships, social change &/or social work practice). Its contents should include the following: Reflections on how you see yourself as a developing social worker. Reflections on your understanding of your personal values and the values and ethics of our profession.Reflections on the parallel processes you are experiencing with supervision and practice.Specifically address Cultural Diversity and Cultural Humility Self-Assessment of Journals I believe self-evaluation and assessment is a valuable tool to support equity in learning. You will be asked to self-assess the quality of your work on these journals. When journals are submitted, you will also be required to submit a self-assessment using the rubric provided in this syllabus. Both a point value and supporting comments are required for each area of the rubric. I will still be providing my own feedback and numeric rating, and where our numeric values differ, I will average the two in calculating the total grade for the assignment. The rubric must be completed before the assignment will be assessed by the instructor. Highlighted areas of the rubric are the ones that the student completes.

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My future goal as an MSW is to work in Private Practice and also do Advocacy work on Policy issues,
which include working on the opioid epidemic that is in NY, having stricter laws for domestic violence,
and changing the bail reform in New York….. In my private practice, I would like to have a focus on
trauma work, PTSD, and Work with Sexual assault victims.
I am currently doing my internship for my MSW at Clifton Springs Hospital CPEP (information in
below).
My class Assignment
The reflective journal is a tool for cultivating your personal-professional self and should focus on the
competencies and knowledge you are learning in your field practicum (about yourself, others, social
problems, helping relationships, social change &/or social work practice). Its contents should include the
following:
1. Reflections on how you see yourself as a developing social worker.
2. Reflections on your understanding of your personal values and the values and ethics of our
profession.
3. Reflections on the parallel processes you are experiencing with supervision and practice.
4. Specifically address Cultural Diversity and Cultural Humility
Self-Assessment of Journals
I believe self-evaluation and assessment is a valuable tool to support equity in learning. You will be asked
to self-assess the quality of your work on these journals. When journals are submitted, you will also be
required to submit a self-assessment using the rubric provided in this syllabus. Both a point value and
supporting comments are required for each area of the rubric. I will still be providing my own feedback
and numeric rating, and where our numeric values differ, I will average the two in calculating the total
grade for the assignment. The rubric must be completed before the assignment will be assessed by the
instructor. Highlighted areas of the rubric are the ones that the student completes.
MSW Field Seminar Reflective Journal Grading Rubric—version 8/19/21
Student Name: _ Journal# ____1____
At least one journal must specifically address Cultural Diversity and Cultural Humility related to your
field placement. Does this journal satisfy that requirement? (circle one) x Yes No
Assignment components
Reflection: (Please check those areas that are
addressed in journal)
___ (1) Reflections on, and reactions to, both the
content and process of our seminar sessions (drawing
implications for your developing personal-professional
self and future social work practice);
Student
Numeric(points) __5___(out of 5)
Comments that support this rating –
_ (2) Reflections on how you are seeing yourself as a
developing social worker;
___ (3) Reflections on your understanding of your
personal values and the values and ethics of our
profession;
___ (4) Reflections on the parallel processes you are
experiencing with supervision and practice;
______________________________________
Instructor
Numeric(points) _____(out of 5)
___ (5) Reflections on how you are integrating content
and readings from all social work courses and their
relationship to field practicum experiences.
Point Values:
Meets Expectations (5-4) Points: Addresses in
detail at least three reflection areas and provides
clear examples
Partially Meets Expectations (3-2) Points:
Addresses at least 2 reflective examples in some
depth, limited examples
Does not Meet Expectations (1-0) Points:
Limited or no reflection provided
Competence and Practice Behaviors: Show
relevance to practice behaviors and competencies and
progress/obstacles in achieving the objectives
Reflections on your development towards achieving
practice behavior competence (e.g. areas of tension and
challenges, as well as ah ha moments and discussion
about how you are developing in your practice
knowledge and skills).
Point Values:
Meets Expectations (2) Points: Provides
relevance and discusses progress and /or obstacles
Partially Meets Expectations (1) Points: Lists
relevance to practices behaviors but does not
describe progress/obstacles
Does not Meet Expectations (0) Points: Does
not address
Comments that support this rating-
Averaged Score___
Student
Numeric(points) __2___(out of 2)
Comments that support this rating
______________________________________
Instructor
Numeric(points) _____(out of 2)
Comments that support this rating-
Averaged Score___
Quality of Writing & Use of Literature to Support
Statements: Journals will be assessed based on the
quality of writing, including organization, clarity,
sentence structure, spelling, grammar etc.
Journals require a minimum of two references from the
professional literature, such as social work journals or
texts using the appropriate APA format.
Point Values:
Meets Expectations (3-2) Points: Effectively
communicates ideas and information in an
organized manner, well written.
Uses at least two references with appropriate APA
format
Partially Meets Expectations (1) Points:
Generally clear presentation with occasional
inconsistencies in format & other mechanics of
writing & /or some citing format error; Uses only
1 reference
Does not Meet Expectations (0) Points:
Inconsistent presentation errors in grammar,
spelling; No references used
Final Score: ___________/10
Student
Numeric(points) __3___(out of 3)
Comments that support this rating
______________________________________
Instructor
Numeric(points) _____(out of 3)
Comments that support this rating-
Averaged Score___
This is the place I am doing my MSW Internship
Psychiatric Emergency Program
(CPEP) at Clifton Springs Hospital
& Clinic
If you are struggling with a mental health crisis, we are ready to help. CPEP offers
emergency and crisis psychiatric services to people living in the Finger Lakes region.
Located within the Rob and Pamela Sands Emergency Department, and newly
designed to meet the growing need of patients seeking emergency psychiatric
treatment, our CPEP unit includes safe, private and comfortable evaluation and
consultation rooms, psychiatric patient rooms, and psychiatric extended
observation rooms.
Patients will be asked to come in to the emergency department to be medically
cleared for treatment, then will meet with a Clinical Evaluator for evaluation. After
an assessment, the Clinical Evaluator will determine whether inpatient or
outpatient treatment is needed. Referrals to follow-up services will be provided at
the same time.
If you do not feel comfortable traveling to Clifton Springs Hospital & Clinic, our
mobile crisis team can meet you within Ontario, Wayne, Seneca and Yates counties.
Our confidential phone counseling is also on standby to do everything they can to
help you.
Comprehensive Psychiatric Emergency
Program (CPEP)
If you are struggling right now, we are ready to help.
People living in Ontario, Seneca, Wayne, and Yates Counties who need emergency
and crisis psychiatric services are the focus of CPEP.
Patients will be asked to come to the emergency department to be medically
cleared for treatment, then will meet with a therapist for evaluation. After an
assessment, the therapist will determine whether inpatient or outpatient treatment
is needed. Referrals to any services will be provided at the same time.
If you do not feel comfortable traveling to Clifton Springs Hospital & Clinic, our
mobile crisis team will meet you where you are. Our confidential phone counseling
is also on standby to do everything they can to help you.
Our crisis phone number – (315) 462-1080 – is staffed by a real person 24 hours a
day, 7 days a week. Call if you need to talk.
https://ontariocountyny.gov/99/Mental-Health
National Association of Social Workers website regarding efficacy policy social justice
https://www.socialworkers.org/Advocacy

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reply 1

Jun 14, 2024 | Health Medical

Description

Comparing public, and private hospital.

According to Al-Haroon (2022), One of the most important issues facing humanity is the provision of healthcare. By encouraging healthcare, employers, consumers, medical facilities, families, communities, insurance firms, and the state as a whole can all prevent or considerably reduce human and financial expenses. This is accomplished by preventative actions, and these costs are decreased through the spread of health knowledge. If healthcare is not successfully promoted, a nation’s economy could suffer greatly. People frequently go to medical facilities for assistance in diagnosing and treating their problems in order to meet this demand. Both governmental and private hospitals are included when the term “healthcare facilities” is used. They have different objectives, despite the fact that they are comparable in that they both offer medical care.

In King Fahad hospital of the university that founded on 1981, consider one of the largest hospitals in Khobar its capacity 440 beds, that include various special area, inpatient and outpatient department, operation rooms, and three intensive care unit. KFUH under imam Abdulrahman university, consider as training, and research center to them. It’s a government hospital, accept eligible patients only, providing a free treatment to their patients. But according to privatization program they going to move toward insurance payments. (Shawan, 2021)

On the other hand, almanaa hospital That established on 1949, Khobar branch had 250 beds including inpatient, and other building that include the outpatients. But almanaa hospital had many other branches in the kingdom. It’s a private institution, that need fee for services, either cash, or covered by insurance company. As a private hospital they accept any patients, and any nationality, and waiting time is less comparing to government hospitals, and prices can change annually. (Sayegh, 2020)

Both hospital is under indirect control of ministry of health, following its regulation, strategies, and requirements toward deliver the best care to its patient. Also, both working hard toward achieving 2030 vision, and both hospitals are under ministry of education, which make them full of student, trainee, education, and training department are effectively working toward increase the productivity, and the quality of care. Both hospitals had JCI, and CBAHI accreditation, which make an international protocol applied in both hospitals, and achieve a standard of care.

The impact of law :

The Saudi MOH has performed the typical tasks of the administrative health coordinator. The MOH has extensive regulatory authority. These include regulating the cost of health products, ensuring the quality of services, and stakeholders. Additionally, each regional health directorate distributes global budgets to each hospital. The absence of thorough authority is a major contrast, though. The Saudi MOH needs more control over two significant public sector health systems, in comparison to many other nations where the healthcare ministry has responsibility over all healthcare system components. The military hospitals and academic teaching hospitals are not under their supervision. Additionally, the MOH only indirectly controls the expanding private sector. (Al-Haroon, 2022)

References

Al-Haroon, H. (2022). Assessment of Organizational Commitment Among Nurses in a Major Public Hospital in Saudi Arabia. Journal of Multidisciplinary Healthcare, https://www.tandfonline.com/doi/full/10.2147/JMDH.S256856.

Sayegh, H. A. (2020). Saudi Arabia’s Almana General Hospitals in early talks for IPO-sources. Retrieved from REUTERS: https://www.nasdaq.com/articles/saudi-arabias-alma…

Shawan, D. A. (2021). The Effectiveness of the Joint Commission International Accreditation in Improving Quality at King Fahd University Hospital, Saudi Arabia: A Mixed Methods Approach. Journal of Healthcare Leadership, https://www.researchgate.net/publication/348965252_The_Effectiveness_of_the_Joint_Commission_International_Accreditation_in_Improving_Quality_at_King_Fahd_University_Hospital_Saudi_Arabia_A_Mixed_Methods_Approach.

reply 2

Jun 14, 2024 | Health Medical

Description

Introduction

Al Adwani General Hospital and King Saud Medical City are Two Pillars among many in KSA Healthcare Landscape. These institutions provide healthcare yet vary widely on aspects such as ownership, reach, services rendered, and patients targeted. Despite these disparities between the hospitals, each entity’s primary objective lies in providing the best quality medical services, and the regulatory framework of Saudi Arabian law is crucial in shaping these services and governance procedures.

Al-Adwani General Hospital

Being a privately owned hospital, Al-Adwani General Hospital is funded through direct payments from patients, health insurance revenue, and capital. Al Adwani General Hospital often provides diverse specialty services and cutting-edge technology (Rahman, 2020). Al-Adwani General Hospital offers specialist departments, including cardiology, orthopedic surgery, and obstetrics.

King Saud Medical City, Riyadh

King Saud Medical City, Riyadh, is a public medical institution in Saudi Arabia. Saudi Arabia’s King Saud Medical City is Government Ownership Funding. King Saud Medical City offers health care services to the public, covering locals and expatriates without distinguishing between people with financial constraints (Al-Hanawi et al., 2017). Fully funded through government budget allocation and often subsidized to keep the cost of medical care low on the public’s wallet, King Saud Medical City is a model of national care. King Saud Medical City, Riyadh, provides a full spectrum of medical care, including emergency care, general medicine, and highly specialized departments.

Similarities and Differences

Al-Adwani General Hospital and King Saud Medical City, Riyadh, endeavor to deliver quality healthcare to the populace. However, there are several differences between the two healthcare facilities. Al-Adwani General Hospital is a fee-based private hospital (Rahman, 2020). On the other hand, King Saud Medical City, located in Riyadh, belongs to KAMC and is funded by the government via the national budget. On one side, whereas Al-Adwani General Hospital is expensive because of being private, King Saud Medical City, Riyadh, provides service to the public, which is quite economical for both middle-class and low-income patients (Al-Hanawi et al., 2017). Al-Adwani General Hospital has an outstanding reputation for providing specific services and newfangled medical technology. Conversely, King Saud Medical City of Riyadh provides comprehensive care for more patients, such as emergency and internal medicine.

Impact of Law on Operation

Legislation is critical in supervising and governance healthcare facilities in the Kingdom of Saudi Arabia. Both private and government-run hospitals must adhere to numerous legislations to safeguard the safety of patients, the provision of quality care, as well as proper conduct (Rahman, 2020). All facilities in Saudi Arabia, whether private or public, require a license from MOH to operate. It means that medical treatment is provided in line with international health protocols. These guidelines establish the standards of care to be followed under these regulations, as well as guidelines on matters such as infection control practices, the confidentiality of patient information, medical record keeping, the rights of patients (and their ability to refuse treatment), and obligations to All private and public hospitals must follow all guidelines to ensure quality and safe care for patients. Also, Al-Adwani General Hospital has more control over setting the prices for its services. However, still needs to be in line with rules covering insurance reimbursement and billing processes. As an example, the King Saud Medical City (KSMC) follows a price control mechanism set by the government to make things available to everyone.

Conclusion

In conclusion, Al-Adwani General Hospital and King Saud Medical City, both public and private healthcare facilities in Saudi Arabia, have different ownership, funding, and service delivery structures. The legislation is essential in regulating and governing these facilities’ functioning, ensuring that moral norms, patient safety, and quality requirements are followed.

References

Al-Hanawi, M. K., Alsharqi, O., Almazrou, S., & Vaidya, K. (2017). Healthcare Finance in the Kingdom of Saudi Arabia: A Qualitative Study of Householders’ Attitudes. Applied Health Economics and Health Policy, 16(1), 55–64. https://doi.org/10.1007/s40258-017-0353-7

Rahman, R. (2020). The Privatization of Health Care System in Saudi Arabia. Health Services Insights, 13(1), 117863292093449. h

Nurs 744 Nursing Informatics

Jun 14, 2024 | Health Medical

Description

Instructions:Analyze the current healthcare informatics tools used in the COVID-19 pandemicExamine the pros and cons of the major increase in use of telehealth.Discuss the top three informatics tools used in pandemic to enhance health outcomes and reduce disease transmissionGajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth Benefits and Barriers. The journal for nurse practitioners : JNP, 17(2), 218–221. https://doi.org/10.1016/j.nurpra.2020.09.013

c t 1

Jun 14, 2024 | Health Medical

Description

Module 04: Critical Thinking Assignment

Critical Thinking: Comparative Analysis: Risk

Compare Risk in Different Health Care Systems

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.

Health & Medical Question

Jun 14, 2024 | Health Medical

Description

I attached the template I’m supposed to use for this assignment, thank you!

Objective

Write a statement of the problem, background, and significance of the project.

Deliverables

Write a 2-3 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 paper identifying the statement of the problem, background, and significance of your capstone project.

Step 2: Consider

What issues do you care most about?
What practices and policies do you want it to influence?
What will it allow you to do next?
Who would you like to benefit from the results?

Step 3: Write

Write a paper that addresses the questions above.
Use the template attached below.

Pharmacyology

Jun 14, 2024 | Health Medical

Description

Pharmacology-Critical Thinking:Chapter 48-Substance AbuseInstructionsInstructionsA 36-year-old patient who was found unconscious and was taken to the emergency department has been on the nursing unit for 24 hours, and laboratory results show that he was intoxicated. The patient has a history of alcohol abuse. What should the nurse be aware of while taking care of him?

Patient Evaluation and Management

Jun 14, 2024 | Health Medical

Description

A 34-y.o. female presents with the complaint of a 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.What additional questions should you ask the patient and why?What should be included in the physical examination at this visit?What are the possible differential diagnoses at this time?What tests should you order and why?How should this patient be managed?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.

Pharmacology

Description

Research Paper:

The requirements for the research paper are as follows:

Must be 4 typed pages and submitted through Turnitin. Must be double-spaced, size 12 Times New Roman font.

Papers must include a works cited page and in-text citations should be used for quotations and information from sources used throughout the paper. If it is not your words, it must be cited.

Must have a minimum of 5 academic sources. (Wikipedia is NOT an academic source)

Papers should explain the background of the issue/why it is a debated topic and both sides of the argument for or against it.

Papers should thoroughly and accurately explain the issue as well as provide convincing arguments for both side of the issue.

*Example: If you choose to discuss whether or not the government should provide health care, you would explain the background of the issue and why it continues to be debated. You would then explain the argument for the government providing health care and the argument against it.*

THE IMPACT OF NURSING INFORMATICS ON PATIENT OUTCOMES AND PATIENT CARE EFFICIENCIES

Jun 14, 2024 | Health Medical

Description

In the Discussion for this module, you considered the interaction of nurse informaticists with other specialists to ensure successful care. How is that success determined?

Patient outcomes and the fulfillment of care goals is one of the major ways that healthcare success is measured. Measuring patient outcomes results in the generation of data that can be used to improve results. Nursing informatics can have a significant part in this process and can help to improve outcomes by improving processes, identifying at-risk patients, and enhancing efficiency.

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 concepts of technology application as presented in the Resources.
Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics as a specialty by leading to increased impact on patient outcomes or patient care efficiencies.

The Assignment: (4-5 pages not including the title and reference page)

In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:

Describe the project you propose.
Identify the stakeholders impacted by this project.
Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.
Identify the technologies required to implement this project and explain why.
Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.
Use APA format and include a title page and reference page.
Use the Safe Assign Drafts to check your match percentage before submitting your work.
BY DAY 7 OF WEEK 4

Submit your completed Project Proposal.

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 WK4Assgn_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_5051_Module02_Week04_Assignment_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeIn a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient care efficiency. Your project proposal should include the following:· Describe the project you propose.· Identify the stakeholders impacted by this project.

25 to >22.0 pts

Excellent

The response accurately and thoroughly describes in detail the project proposed….The response accurately and clearly identifies the stakeholders impacted by the project proposed.

22 to >19.0 pts

Good

The response describes the project proposed….The response identifies the stakeholders impacted by the project proposed.

19 to >17.0 pts

Fair

The response topics are superficially addressed.

17 to >0 pts

Poor

The response is very vague or missing.

25 pts

This criterion is linked to a Learning Outcome· Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving.· Explain how this improvement would occur. Be specific and provide examples. Use sufficient supporting evidence in your response.

25 to >22.0 pts

Excellent

The response accurately and thoroughly explains in detail the patient outcome(s) or patient-care efficiencies that the project proposed is aimed at improving, including an accurate and detailed explanation, with sufficient supporting evidence of how this improvement would occur.

22 to >19.0 pts

Good

The response explains the patient outcome(s) or patient-care efficiencies that the project proposed is aimed at improving, including an explanation, with some supporting evidence of how this improvement would occur.

19 to >17.0 pts

Fair

The response is missing one or two of the required elements, contains little supporting evidence or elements are superficially addressed.

17 to >0 pts

Poor

The response is very vague, lacking examples or supporting evidence, or missing.

25 pts

This criterion is linked to a Learning Outcome· Identify the technologies required to implement this project and explain why.· Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

25 to >22.0 pts

Excellent

The response accurately and clearly identifies the technologies required to implement the project proposed with a detailed explanation why….The response accurately and clearly identifies the project team (by roles) and thoroughly explains in detail how to incorporate the nurse informaticist in the project team.

22 to >19.0 pts

Good

The response identifies the technologies required to implement the project proposed with an explanation why….The response identifies the project team (by roles) and explains how to incorporate the nurse informaticist in the project team.

19 to >17.0 pts

Fair

The response is missing one or two of the required elements, or elements are superficially addressed.

17 to >0 pts

Poor

The response is very vague or missing.

25 pts

This criterion is linked to a Learning OutcomeResources

10 to >8.0 pts

Excellent

Assignment includes: 3 or more peer-reviewed research articles and 2 or more course resources.

8 to >7.0 pts

Good

Assignment includes: 2 peer-reviewed research articles and 2 course resources.

7 to >6.0 pts

Fair

Assignment includes: 1 peer-reviewed research article and 1 course resource.

6 to >0 pts

Poor

Assignment includes: 1 or no resources.

10 pts

5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

4 to >3.0 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

3 to >2.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. 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 (1-2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3-4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains 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 – APA:The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, 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 (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 (≥ 5) APA format errors.

5 pts

Total Points: 100

PreviousNext

Nursing Discussion

Jun 14, 2024 | Health Medical

Description

Discussion Board

Discuss the nurse’s role in the policy development model. Additionally, talk about the policy meeting you have attended or will be attending. What key points could a nurse bring to this meeting and subject?

What is a public policy meeting? A meeting held by public or governmental officials to discuss and deal with public problems or issues, communicate and disseminate information, and engage in problem-solving, policy change strategizing and/or decision making. Open public policy meetings are when the public’s business is conducted in open, noticed meetings, where the public, lobbyists and members of the news media have the right to attend, record, broadcast, and in some cases participate in the meeting. An open meeting agenda is usually posted in advance and meeting materials may be made available.

A post seeking approval for your public policy meeting. Choose a meeting to view or attend. It must be a public policy body at work and related to health care. If it is a recorded meeting, please make sure it has been posted within the last year. Title the post with your name and the name of the policy meeting.

For example: Smith: Affordable Health Care Policy Meeting. In the body of the post include the title or topic focus of the policy meeting the date and time of the meeting the location of the meeting (if online, include the website). Some websites are:

https://www.c-span.org/Links to an external site. search the video library or the live sessions)
http://www.youtube.comLinks to an external site. (perform a search for your topic)
Your local government or healthcare organization website

Police meeting attending

→Garcia: Health Security and Pandemic Preparedness

Johns Hopkins Center for Health Security Director Tom Inglesby and J. Stephen Morrison, senior vice president and director for the CSIS Global Health Policy Center, authored a report on the Center for Disease Control and health security. The authors discussed pandemic preparedness and actionable ways on how the CDC can improve messaging, better collaborate with state and local entities, and work with Congress to prevent public health emergencies.

Location: Washington, District of Columbia, United States

First Aired: Jan 17, 2023 | 11:35am EST | C-SPAN 1

Last Aired: Mar 03, 2023 | 4:18am EST | C-SPAN 3

Health Security and Pandemic Preparedness | C-SPAN.org

Compose at least 2-3 paragraphs all in APA format with proper references.

250 words

NURS-FPX4030 Remote Collaboration and Evidence-Based Care.

Jun 14, 2024 | Health Medical

Description

Introduction

Professional Context

Scenario

The Vila Health: Remote Collaboration on Evidence-Based Care simulation provide the context for this assessment.

Instructions

Before beginning this assessment, make sure you have worked through the following media:

Vila Health: Remote Collaboration on Evidence-Based Care.

You may wish to review Selecting a model for evidence-based practice changes. [PDF] and Evidence-Based Practice Models, which help explain the various evidence-based nursing models.

For this assessment, you are a presenter! You will create a 5-10-minute video using Kaltura or similar software. In the video:

The following media is an example learner submission in which the speaker successfully addresses all competencies in the assessment.

Make sure that your video addresses the following grading criteria:

Refer to Using Kaltura as needed to record and upload your video.

Additional Requirements

Your assessment should meet the following requirements:

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.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Nurs 6645 psychotherapy with multiple modalities

Jun 14, 2024 | Health Medical

Description

nclude subjective and objective data; assessment from most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; current psychotherapeutic plan (include one health promotion activity and one patient education strategy you provided); and patient progress toward treatment goals.Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What was 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 in order of highest to lowest priority and explain why you chose them. What was your primary diagnosis and why? Describe how your primary diagnosis aligns with DSM-5-TR diagnostic criteria and is supported by the patient’s symptoms.Plan: Describe your treatment modality and your plan for psychotherapy. Explain the principles of psychotherapy that underline your chosen treatment plan to support your rationale for the chosen psychotherapy framework. What were your follow-up plan and parameters? What referrals would you make or recommend as a result of this psychotherapy session?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.

Do 3 critical points based off of the given topics from ati for nurs 307 peds

Jun 14, 2024 | Health Medical

Description

Do 3 critical points based off of the given topics from ati for nurs 307 peds example is providedno plagiarism and make sure you use the ati book and write the right references3- critical point box has to be 3 bullet points in each boxWrite the topics and concepts based off of the screenshot that i provided 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.

Purchase answer to see full
attachment

PHI-413V Ethical and Spiritual Decision Making in Health Care

Jun 14, 2024 | Health Medical

Description

Benchmark – Patient’s Spiritual Needs: Case Analysis
View Rubric
Assessment TraitsBenchmark

Requires Lopeswrite

Assessment Description

In addition to the topic Resources, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

In 200-250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale.
In 400-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James’s care?
In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

Remember to support your responses with the topic Resources.

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.

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.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

BS in Health Sciences 1.2; BS Nursing (RN to BSN ) 5.2

Assess for the spiritual needs and provide appropriate interventions for individuals, families, and groups.

Attachments

PHI-413V-RS-T3T5CaseStudyHealingAndAutonomy.docx

SUBMIT ASSIGNMENT

Field Experience Site Information Form

Active

Jun 14, 2024 | Health Medical

Description

What health care issue do you this is pressing?

Unformatted Attachment Preview

Fill in this module 4 and 6 to follow after this to prepare for the last section of the slides
Overview
After analyzing your public health issue in Milestone One and studying socioeconomic factors affecting healthcare in this module, you will write a short paper to identify and analyze
socioeconomic barriers and supports involved in addressing the public health issue. Your paper must include an introduction to your public health issue, a discussion of socioeconomic barriers
to change, a discussion of supports for change, and a conclusion with a call to action for your readers. Assume your readers will include healthcare administrators and managers, as well as
healthcare policy makers and legislators.
Prompt
Fill the following sections:
I. Introduction
A. Introduce your public health issue and briefly explain what needs to change to address the issue.
II. Barriers
A. Identify
potential socioeconomic barriers to change and describe each with specific details.
B. Consider patient demographics (e.g., age, ethnicity, and education), geographic factors (e.g., urban/rural location), and psychographic factors (e.g., eating habits and employment
status).
C. Justify your points by referencing your textbook or other scholarly resources.
III. Supports
A. Identify
possible socioeconomic supports for change and describe each with specific details.
B. Consider patient demographics (e.g., age, ethnicity, and education), geographic factors (e.g., urban/rural location), and psychographic factors (e.g., eating habits and employment
status). Explain
C. Justify your points by referencing your textbook or other scholarly resources.
IV. Conclusion
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barriers to addressing a public health issue
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not describe the changes necessary to
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address issue
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but does not support the description with
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for change to address a public health issue
for change to address a public health issue,
supports for change to address a public
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but does not support the description with
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Aggression and Hostility Types and Theories- Case Studies

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This assignment asks you to answer the questions below for all three of the case studies. You will need to describe;Describe the type/s of aggression displayed in the case study (reactive, instrumental, or assertive, etc…)Apply a theory that best explains the type of aggression demonstrated (instinct, frustration-aggression, social learning, etc..) Your answer should be 2 paragraphs for each case studyYou should answer all of the questions for each case study.Font size should be 12-point, times new roman, double spaced, and have a running head and page number.Support your answers with research and citations from our readings and the lecturesAttached below are the case studies as well as sources. I ask that if you can complete the task while only referring to the provided sources then please do so, if not you are welcome to use other peer-reviewed scholarly sources. Please properly cite all sources.

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Case Study 1
Tammy works for the restaurant, Arnaud’s in the French Quarter. She has noticed lately
that she has not felt like going into work or serving with her normal lively style. A
promotion promised to her was not awarded and she felt like she could do nothing to
change that. Although she perceives her work ethic to be stellar, she is often late for her
shift, sometimes texts on her phone during her shift, and sometimes has a wrinkled
uniform. Her boss has spoken to her about this but she feels like he will lighten up when
he gets to know her better. Tammy feels mistreated and hopeless about her prospect of
getting a promotion. She gets mad and tells her coworkers how bad the situation and
particularly her boss is being. She gets the group of waiters to start calling him a little
tyrant in their lounge and starts hanging pictures up of him in emperor uniforms.
Case Study 2
Jerry has been working out all summer for his big shot at college swimming. He focuses
on his technique in the pool and his times have steadily been going down. Lately, he has
noticed his body feeling strong and more ready for the challenge of each workout. His
coach has asked that he not overtrain this summer but he is feeling ready to start
increasing his mileage in the pool. Mastering each phase of his swim has motivated Jerry
to drive to the pool at 5:00 a.m. and begin workouts before all other swimmers are in the
pool. A coach asks him to start working on his strokes and he snaps back, “shut up I am
doing my best.” His teammates think he is crazy, his significant other encourages his
drive, and his parents are concerned that he might hurt himself.
Case Study 3
Alice is a mother of five children with a heart condition. She often discusses with her
friends that she is worried about dying before her children reach college. When her
children start fighting she jumps in and tells them in a firm manner, we don’t do that to
each other, go to your rooms. they almost always listen and obey. Her friends are
extremely supportive and she has doctor’s visits regularly when she is not shuttling the
children.
See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/257822305
Cognitive-Behavioral Therapy in the Treatment of Anger: A Meta-Analysis
Article in Cognitive Therapy and Research · February 1998
DOI: 10.1023/A:1018763902991
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Some of the authors of this publication are also working on these related projects:
Anger and Cardiovascular Disease View project
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Cogn itive Therapy and Research ‚ Vol. 22 ‚ No. 1‚ 1998 ‚ pp. 63-74
Cogn itive-Behavioral Th erapy in the Treatm ent of
An ger: A Meta-Analysis
Rich ard Beck1 an d Eph rem Fernan dez1 ‚2
Anger has com e to be recognized as a significan t social problem worthy of clin ical
attention an d systematic research. In the last two decades ‚ cognitive-behavioral therapy
(CBT) has emerged as the m ost com m on approach to an ger m anagement. The overall
efficacy of this treatm ent has not been ascertain ed ‚ and therefore‚ it was decided to
con du ct a m eta-an alysis of this literature. Based on 50 studies in corporatin g 1‚640
subjects‚ it was fou nd that CBT produ ced a gran d m ean weighted effect size of .70 ‚
indicatin g that the average CBT recipient was better off than 76% of un treated subjects
in terms of anger reduction . This effect was statistically significant ‚ robust‚ and relatively
hom ogen eou s across studies. These fin dings represent a quan titative integration of 20
years of research into a coherent pictu re of the efficacy of CBT for anger m an agement.
The results also serve as an im petu s for con tinu ed research on the treatm ent of anger.
KEY WORDS: anger; cognitive-behavioral therapy; me ta-analysis.
INTRODUCTION
With viole nt crime rising among adole scents ‚ wide spread familial abuse ‚ continuing racial discord ‚ and recent acts of te rrorism ‚ attention has turne d to ange r
as a major proble m in human re lations (Koop & Lundbe rg ‚ 1992; Novello ‚ Shosky ‚
& Froehlke ‚ 1992) . Yet ange r disorde rs have bee n ne glected in diagnostic classifications and treatme nt programs (Eckhardt & Deffe nbache r‚ 1995; Kassinove &
Sukhodolsky ‚ 1995) . Incre asing re fe re nce s to ange r appe ar in PSYCINFO and othe r
database s‚ and practitione rs are increasingly cognizant of the ramifications of ange r
in their clients (Abikoff & Kle in ‚ 1992; Fernande z & Turk‚ 1993 ‚ 1995; Koop &
Lundbe rg‚ 1992) ‚ but little is known about how best to treat ange r disorde rs.
In a surve y of the lite rature on ange r‚ it was found that the vast majority of
ange r tre atment outcome studie s had utilize d a cognitive -behavioral approach. The
pre sent study there fore e valuate d the e fficacy of cognitive -behavioral the rapy ( CBT)
1
Southern Methodist University‚ Dallas‚ Te xas 75275.
2
Address all correspondence to Ephrem Fe rnandez ‚ Ph.D.‚ Departme nt of Psychology‚ Southern
Methodist University‚ Dallas‚ Texas 75275-0442.
63
0147-5916/98/0200-0063$15.00/0 Ó
1998 Plenum Publishing Corporation
64
Beck and Fern an dez
in the tre atment of ange r. Instead of a narrative re view‚ a meta-analysis was conducte d to quantitative ly inte grate the re sults of individual studie s e mploying CBT
for ange r control.
Cogn itive-Beh avior al Th erap y Applied to Anger
Cognitive -be havioral therapy draws upon the rich traditions of be havior modification and rational-e motive or cognitive the rapy (Me ichenbaum ‚ 1976) ‚ paying attention to social cognition (Dodge ‚ 1993) as well as individual constructions of
reality (Mahone y‚ 1993) . It may combine a varie ty of technique s such as relaxation ‚
cognitive re structuring ‚ proble m-solving ‚ and stress inoculation ‚ but rathe r than being a mere form of technical e cle ctism ‚ it is theore tically unifie d by principle s of
le arning theory and information processing. This approach has elicite d much interest in the treatme nt of affe ctive disorde rs such as anxie ty and depression as re ve aled
in recent meta-analyse s by Dobson (1989) and Van Balkom (1994) . The status of
CBT for ange r‚ however‚ re mains uncle ar.
Yet the last 20 ye ars has see n an accumulation of research on the e fficacy of
cognitive -behavioral the rapy in the tre atment of ange r proble ms. This re search has
focused pre dominantly on Novaco ’s (1975) adaptation of Me iche nbaum ’s stre ss inoculation training (SIT) initially develope d for the tre atment of anxie ty (Me ichenbaum ‚ 1975). Using a coping skills approach ‚ stre ss inoculation inte rve ntions are
typically structure d into three phase s: cognitive pre paration ‚ skill acquisition ‚ and
application training. During this performance -base d intervention ‚ the client is e xposed to cognitive reframing ‚ re laxation training ‚ image ry‚ modeling ‚ and role-playing to e nhance ability to cope with proble m situations.
In SIT for ange r proble ms‚ clie nts initially identify situational “ trigge rs” which
pre cipitate the onset of the ange r re sponse . Afte r ide ntifying environme ntal cue s‚
the y re hearse self-state ments intende d to re frame the situation and facilitate healthy
response s (example s of cognitive self-state ments include : “ Relax‚ don ’t take things
so personally ” or “ I can handle this. It isn ’t important enough to blow up over
this ” ). The se cond phase of tre atment require s the acquisition of re laxation skills.
The cognitive se lf-state ments can the n be couple d with relaxation as clie nts attempt ‚
afte r e xposure to the trigge r‚ to mentally and physically soothe themselve s. Finally ‚
in the rehe arsal phase ‚ clie nts are expose d to ange r-provoking situations during the
session utilizing image ry or role-plays. The y practice the cognitive and relaxation
te chnique s until the mental and physical re sponse s can be achie ve d automatically
and on cue . This basic outline of SIT can also be supple mented with alte rnative
te chnique s such as proble m-solving ‚ conflict manage ment ‚ and social skills training
as in the social cognitive model of Lochman and colle ague s (Lochman & Lenhart ‚
1993) .
The purpose of the present study was to e valuate the overall e ffective ne ss of
such cognitive -be havioral treatme nts for ange r by using the methodology of metaanalysis. This e ntaile d computing various summary statistics of the stre ngth of treatment e ffect‚ as well as infe rential tests of the specific re se arch hypothe sis that CBT
statistically significantly re duce s ange r. Finally ‚ the se re sults were conve rted into
CBT for An ger
65
measure s of practical significance . This is particularly informative in the curre nt
climate of manage d health care where there is a pre mium on time-limite d interve ntions like CBT and growing demands for e mpirical evide nce to support the
choice of tre atments. This quantitative synthe sis of the lite rature will also familiarize
reade rs with the main parame ters of rese arch on this topic and gene rate considerations for furthe r rese arch in this area.
Meta-An alys is
Me ta-analysis is a quantitative procedure for evaluating tre atment effe ctiveness
by the calculation of e ffect size s (Fernande z & Boyle ‚ 1996; Glass ‚ McGaw‚ &
Smith ‚ 1981; Rosenthal ‚ 1991). The e ffect size e xpre sse s the magnitude of difference
betwee n tre ated and untre ate d subje cts. Because e ffect size is e xpre sse d in standard
deviation units ‚ it e nable s comparisons among studie s and the computation of summary statistics such as the grand ave rage effe ct size ‚ an inde x of overall effe ctiveness
for the tre atment. Despite its advantage s over narrative and quasistatistical methods
of re view (Fe rnande z & Turk‚ 1989) ‚ meta-analysis has raised certain concerns which
call for spe cific solutions (Fernande z & Boyle ‚ 1996) . For e xample ‚ it has bee n argue d that effe ct sizes obtaine d from studie s of varying quality may not be directly
comparable ; conse que ntly‚ it is now customary to weight e ffects sizes‚ typically according to obje ctive crite ria such as sample size ( which de te rmine s statistical
powe r). Concern has also be en raised about possible inflation in effe ct sizes due
to sampling only publishe d studie s which are more like ly to re port significant re sults
than are non-publishe d studie s (the file-drawe r proble m); this can be counte racted
to some extent by including unpublishe d studie s and also by conducting te sts of
robustne ss that provide a margin of tolerance for null results (Rosenthal ‚ 1995) .
To date ‚ the only docume nted attempt to meta-analyze studie s of ange r manage ment was done by Tafrate (1995) . Howe ve r‚ this revie w has certain methodological limitations. First‚ stringe nt inclusion criteria restricte d the numbe r of CBT
studie s re viewed to only nine . This small numbe r of studie s is unre pre sentative of
the last 20 years of rese arch on CBT. Tafrate confine d his survey to adult sample s
of mostly colle ge stude nts. No doubt ‚ stude nts have ange r proble ms too‚ but the
ne gle ct of nume rous studie s of CBT for oppositional childre n and adole scents
(populations of primary conce rn) is proble matic. Only three of the studie s revie wed
by Tafrate were base d on clinical sample s‚ thus placing limits on the ecological significance of results. Unpublishe d results were ignore d ‚ and due to the small numbe r
of studie s actually re viewed‚ the conclusions re ache d were probably susceptible to
sampling bias. Finally ‚ Tafrate ne glected tests of homoge neity‚ te sts of significance
or tests of robustne ss‚ or weighing of effe ct size s based on any of the design feature s
of the studie s; as e mphasize d earlie r‚ the se statistics have now become standard
practice in meta-analytic revie ws‚ and they can significantly affe ct the conclusions
reached.
To improve upon Tafrate ’s (1995) initial revie w‚ the pre se nt study e xpande d
inclusion criteria ‚ incorporate d unpublishe d studie s‚ and weighte d all e ffect size s.
As de taile d below‚ the scope of the revie w was broade ned to incorporate dive rse
66
Beck and Fern an dez
sample s re ceiving a combination of cognitive and be havioral technique s. In this way‚
more than five time s the numbe r of CBT studie s re viewed by Tafrate were metaanalyze d here .
METHOD
Inclu sion Criteria
A compute r se arch of PSYCINFO and Dissertation Abstracts International from
1970 to 1995 was conducte d. Using keywords such as an ger control ‚ anger treatm ent‚
and an ger m an agem ent and cross-re fe re nce s among article s‚ a total of 58 re levant
studie s of CBT were identifie d. Eight of these were single -case or small-sample
studie s (n < 4) and hence were e xclude d. The final sample consiste d of 50 nomothetic studie s incorporating a total of 1640 subje cts. All studie s provide d data on at le ast one ange r-relate d depe nde nt variable . In te rms of the inde pende nt variable ‚ only cognitive -behavioral tre atments for ange r were se lected. Studie s using pu rely cognitive or behavioral interventions alone were not include d ‚ nor were treatme nts aimed sole ly at re laxation. Typically ‚ the study include d was one in which some form of cognitive reappraisal or re structuring was com bined with some technique of promoting relaxation. The sample s were pre dominantly clinical such as prison inmate s‚ abusive pare nts ‚ abusive spouse s‚ juve nile de linque nts ‚ adole scents in re side ntial treatme nt‚ childre n with aggre ssive classroom behavior ‚ and mentally handicappe d clie nts ‚ but also include d colle ge stude nts with re porte d ange r proble ms. Thirty-five studie s use d self-reporte d ange r as a de pe nde nt variable . Effe ct sizes for 28 of the 35 studie s were calculate d e xclusive ly from se lf re ports of ange r. The re maining se ven studie s combine d depe nde nt measure s of ange r and aggre ssion into e ffe ct size e stimate s. Fifte e n studie s of school childre n and adole scents in place ment (eithe r re side ntial or de tention facility) re fe rred to ange r but only re porte d be havioral ratings of aggre ssion. Since aggre ssive be havior has be en the focus in CBT inte rve ntions for childre n and adole scents ‚ aggre ssion ratings se rve d as the de pe nde nt variable for the se studie s. For younge r populations ‚ measure s of se lf-re porte d ange r are not always fe asible and behavioral ratings of aggre ssion be come a valid alte rnative ‚ just as se lf-re ports of depre ssion and anxie ty in childre n may be le ss acce ssible than the behaviors corre sponding to the se mood disturbance s. Calcu lation of Effect Sizes Glass ’s d (e ffect size) was calculate d for each study whe re means and standard deviations were available for treatme nt and control groups (Glass e t al.‚ 1981). For studie s utilizing single group ‚ pre- ve rsus postte st de signs ‚ and any othe r studie s not reporting means and standard deviations ‚ e ffect size was e stimate d from t- and F-value s. Whe re multiple depende nt variable s were reporte d ‚ e ffect sizes were av- CBT for An ger 67 erage d across variable s to yield one e ffect size per study‚ thus minimizing nonindepende nce in the data. Adopting proce dures recommende d by Rosenthal (1991) ‚ e ach effe ct size was weighte d by sample size ‚ and ave rage d to yield a grand weighte d mean d base d on 50 studie s. Weighting e ffect size s by sample size is an unbiase d and obje ctive procedure for assigning different weights to studie s that vary in statistical powe r. The grand weighte d mean d was tested for significance (d compare d to zero) using a one -sample t-test‚ and 95% confide nce inte rvals were calculate d. A chi square was also calculate d to te st for heteroge ne ity of variance within the se t of e ffect size s. The heteroge ne ity te st is the basis for a de cision on whe ther or not to search for mode rator variable s; in case of significant heteroge ne ity‚ it would be ne cessary to disaggre gate the e ffect sizes according to the variable s influe ncing e ffect size. Finally‚ to addre ss the file-drawe r proble m a fail-safe N‚ as re commende d by Rosenthal ( 1991) ‚ was calculate d to test for robustne ss. A robust finding indicate s that the probability of a Type I e rror arising from unpublishe d ‚ nonsignificant re sults ‚ is ne gligible . As strongly recomme nde d by Rosenthal (1995) ‚ a Binomial e ffect size display (BESD) was also constructe d to provide a more concrete impre ssion of the relative outcome s in tre atment and control groups. RESULTS A total of 50 effe ct size s was obtaine d for the 50 studie s (Table I). O f the se ‚ 40 utilize d control groups while 10 use d single -group ‚ repe ated-measure s de signs. The sample size and de sign feature s for each study are also tabulate d. As summarize d in Table II‚ the effe ct size s range d from ¯0.32 to 1.57 ‚ SD = 0.43. With only one e xce ption ‚ all effe ct size s were positive in value . The grand mean unwe ighte d d was 0.81. The grand mean weighte d effe ct size was 0.70. This differe d significantly from zero‚ t (49) = 13.28 ‚ p < .0001. The 95% confide nce inte rvals for the mean unweighte d e ffect size range d from 0.69 to 0.93. A ste m and le af plot is shown in Table III to display batche s of e ffect sizes. As can be see n ‚ the effe ct sizes approximate d a normal distribution. Most of the e ffect sizes were betwee n 0.5 and 0.99 ‚ and six e ffect sizes reache d about 1.2 ‚ thus making this the mode . A notable outlie r was the one negative value in the data set. Since any effe ct size is a standard de viation unit (z-score ) ‚ it can be conve rted into a pe rcentile by asce rtaining the area unde r the normal curve that is bounde d betwee n that z-score and the tail e nd of the curve . Thus ‚ the grand weighte d mean effe ct size of 0.70 corresponds to an are a unde r the curve of 0.5 + 0.258 ‚ which in turn means that the average subje ct in the CBT treatme nt condition fared be tter than 76% of those not receiving CBT. To furthe r illustrate the practical importance of these re sults ‚ a binomial e ffect size display was adde d ( Table V I). This first e ntaile d conve rsion of the grand weighte d mean d to r‚ which turne d out to be 0.33; as note d in the table ‚ half the value of r was the n adde d or subtracte d from 0.5 ‚ revealing that subje cts re ceiving CBT e xpe rienced a 67% treatme nt succe ss rate whe re as control subje cts had only a 33% succe ss rate . 68 Beck and Fern an dez Table I. Effect Sizes and Sample Sizes for Individual Studies of CBT on Anger a Study Acton & During ( 1992) Barth ‚ Blythe ‚ Schinke ‚ & Schilling (1983) Benson ‚ Rice ‚ & Miranti ( 1986) Boswell (1984) Cain (1987) Dangle ‚ Deschner ‚ & Rasp ( 1989) Deffe nbache r‚ Story‚ Stark ‚ Hogg ‚ & Brandon (1987) Deffe nbache r‚ Story‚ Brandon ‚ Hogg ‚ & Hazaleus (1988) Deffe nbache r‚ McNamara ‚ Stark ‚ & Sabadell (1990a) Deffe nbache r‚ McNamara ‚ Stark ‚ & Sabadell (1990b) Deffe nbache r & Stark ( 1992) Deffe nbache r‚ Thwaite s‚ Wallace ‚ & Oetting (1994) Deffe nbache r‚ Lynch ‚ Oetting‚ & Kemper ( 1996) Deschne r & McNeil (1986) Faulkne r‚ Stoltenbe rg ‚ Cogen ‚ Nolde r‚ & Shooter (1992) Feindle r‚ Ecton ‚ Kingsle y‚ & Dubey (1986) Feindle r‚ Marriott‚ & Iwata (1984) Gaertner ( 1984) Glick & Goldstein ( 1987) Hinshaw ‚ Henke r‚ & Whalen ( 1984) Jackson ( 1992) Ke nnedy ( 1992) Larson (1991) Lochman (1985) Lochman ‚ Burch ‚ Curry‚ & Lampron (1984) Lochman & Curry ( 1986) Lochman ‚ Lampron ‚ Gemmer ‚ Harris ‚ & Wyckoff (1989) Lochman ‚ Ne lson‚ & Sims ( 1981) Macphe rson ( 1986) Mandel ( 1991) McDougall ‚ Boddis‚ Dawson ‚ & Haye s ( 1990) Moon & Eisler (1983) Moore & Shannon (1993) Napolitano (1992) Novaco ( 1975) Olson (1987) Omizo ‚ He rshberger ‚ & Omizo (1988) Pascucci (1991) Rhoades (1988) Rokach ( 1987) Rose ngren (1987) Saylor ‚ Benson ‚ & Einhaus (1985) Schlichter & Horan (1981) Shivrattan ( 1988) Smith & Beckner (1993) Steele (1991) Sample DV De sign N d Abusive pare nts Abusive pare nts SR SR PP TC 29 20 0.85 1.09 SR ‚ BR SR SR BR SR PP TC TC PP TC 54 30 62 12 32 0.40 -0.32 0.83 0.92 1.04 College students SR TC 30 1.27 College students SR TC 32 0.59 College students SR TC 29 0.45 College students College students SR SR TC TC 36 94 1.43 0.82 School children SR TC 80 1.32 Abusive spouses Abusive spouses SR ‚ BR SR ‚ BR PP PP 47 32 0.32 1.57 Clinical adolesce nts BR TC 21 1.16 Adolescent (school) Inmates Juvenile delinquents School children Clinical adolesce nts Inmates School children School children School children BR SR BR BR SR SR ‚ BR SR BR BR TC TC TC TC TC PP TC TC TC 36 19 111 22 40 37 37 80 76 0.68 1.33 0.72 1.29 0.32 1.29 0.21 0.38 0.28 BR BR PP TC 20 32 0.36 0.24 School children Inmates Adolescent volunteers Juvenile delinquents BR SR SR ‚ BR BR PP TC TC TC 12 21 26 18 0.65 1.28 0.53 0.64 College students Clinical adolesce nts Inmates College and adult Clinical adult School children Clinical adolesce nts Forensic in-patients Inmates Adolescent volunteers Clinical adolesce nts Juvenile delinquents Juvenile delinquents Inmates Juvenile delinquents SR ‚ BR SR SR SR ‚ BR SR BR BR SR SR SR SR SR BR SR BR TC TC TC PP TC TC TC TC TC TC TC TC TC PP TC 20 42 75 17 83 24 28 21 95 13 14 19 28 18 19 1.52 0.22 0.68 1.03 0.76 0.84 0.56 0.91 0.69 1.00 1.13 1.20 0.22 0.55 0.57 MR individuals School children Adult volunteers Clinical adolesce nts College students School children School children CBT for An ger 69 Table I. (continued ) Study Stermac (1986) Whiteman ‚ Fanshel ‚ & Grundy (1987) Wilcox & Dowrick (1992) Wu (1990) Sample DV Design N d Forensic patie nts Abusive parents SR SR TC TC 40 24 1.31 1.52 Clinical adolescents Divorced women SR SR PP TC 10 26 1.20 0.49 a CBT = Cognitive-behavioral therapy; DV = de pendent variable; N = sample size; d = effect size; SR = self-reported anger ‚ BR = behavioral ratings of anger/aggre ssion‚ TC = treatment ve rsus control de sign ‚ PP = pre/postdesign. Table II. Meta-Analytic Summary Statistics for Studies of CBT on Ange ra Total N = 1‚640 subjects Grand weighte d mean d: 0.70 95% confidence intervals for unweighted d: 0.69 to 0.93 d compare d with zero: t (49) = 13.28 ‚ p < .0001 2 Heteroge neity of ds: c (49) = 61.71 ‚ p > .10
Fail-safe N: 790; crite rion = 225
a
CBT = cognitive -behavioral therapy.
Table III. Stem and Le af Display of Effect Sizes from
Studies of CBT on Ange ra
Fre quency
Stem
1.00
12.00
18.00
16.00
3.00
¯0.
0.
0.
1.
1.
Leaf
3
222223333444
555556666677888899
0000112222223334
555
Range = ¯0.32 to 1.57
Mean (unweighted) d = 0.81
Standard deviation = 0.43
Median = 1.75
Mode = 1.2
a
CBT = cognitive behavioral therapy; Each stem which
represents the first digit of an effect size is attache d to
several leave s‚ each denoting the first decimal place of
an effect size .
The fail-safe N of 790 was well above the minimal criterion of 225 ‚ indicating
a robust finding. The te st of he teroge neity reve ale d a c 2 (49) = 61.71 ‚ p > .10. This
indicate s homoge ne ity of e ffect size value s‚ and the refore ‚ no ne ed to se arch for
mode rator variable s.
70
Beck and Fern an dez
Table IV. Binomial Effect Size Display of Treatment
(CBT) Versus No Treatment of Anger a
Condition
Treatment
Control
å
Success
Failure
å
67
33
100
33
67
100
100
100
200
a
CBT = cognitive -behavioral therapy. The numbers are in
pe rcentages. To obtain them ‚ d must first be converted to r
(cf. Rosenthal ‚ 1991) ‚ which is halved and then added to or
subtracted from 0.5 (depe nding on the condition) ‚ before
multiplication by 100.
DISCUSSION
Effectiven ess of Cogn itive-Beh avior Th erap y in th e Treatm ent of An ger
Re se arche rs have incre asingly focuse d the ir atte ntion on CB T as a tre atme nt for ange r disorde rs. O ve r the past 20 ye ars ‚ many individua l studie s have
sugge ste d that CBT is an e ffe ctive ‚ time -limite d tre atme nt of ange r proble ms.
O ur m e ta-analysis of 50 nom othe tic studie s of 1 ‚640 subje cts re ve ale d a
we ighte d me an e ffe ct size of 0.70 ‚ sugge stive of mod e rate tre atme nt gains.
Since this is in standar d de viation units ‚ it can be infe rre d that the ave rage
subje ct in the CBT condition was be tte r off than 76% of control subje cts. More ove r‚ this e ffe ct was signific antly diffe re nt from what would be e xpe cted unde r
chance . The grand e ffe ct size was also robust e nough to be unaffe cted by unpublishe d null re sults ‚ and it was re lative ly homoge ne ous across studie s. Since
the populat ions inve stigate d consiste d large ly of abusive pare nts or spouse s ‚
viole nt and re sistant juve nile offe nde rs ‚ inmate s in de te ntion facilitie s ‚ and aggre ssive school childre n ‚ it is appare nt that CBT has ge ne ral utility in the clinical manage me nt of ange r.
The se findings imply that the appare nt popularity of CBT in the treatme nt of
ange r is justifie d by its e ffectivene ss in achie ving the de sire d treatme nt goals. The
results are congrue nt with othe r meta-analyse s docume nting the effe ctiveness of
CBT in the tre atme nt of othe r affe ctive disturbance s‚ in particular ‚ de pre ssion
(Dobson ‚ 1989) and anxie ty (Van Balkom e t al. ‚ 1994) .
At the same time ‚ it may be note d that the grand weighte d e ffect size of 0.70
in this revie w is smalle r than Tafrate ’s ( 1995) reporte d effe ct size of 1.00 for CBT
studie s (which were labe le d as “ multicompone nt” ); this is probably because the latte r consiste d of only nine publishe d studie s‚ none of which were weighte d according
to statistical power. O n the othe r hand ‚ by sampling unpublishe d results ‚ revie wing
studie s with clinical populations ‚ and weighing effe ct sizes by sample size ‚ the present study may have produce d a slight deflation of effe ct size ‚ but one that is probably more reliable .
CBT for An ger
71
Fu ture Con sid eration s
This study was an attempt to summarize and docume nt the progre ss made
ove r the last two decades of rese arch on CBT for ange r tre atment rese arch. The
clinical implications of the meta-analysis are e ncouraging. Clinicians treating clie nts
with ange r control proble ms can now substantiate the ir choice of CBT in the treatment of ange r‚ and expe ct at least mode rate improve ments in the ir clie nts. Moreove r‚ the pre sent findings may se rve as a benchmark against which to evaluate othe r
psychological and pharmacological treatme nts for ange r. O utcome efficacy aside ‚
future re search might also addre ss the cost-e ffectivene ss of the se treatme nts ‚ an
issue of growing interest in the curre nt era of manage d care.
New variations of CBT might also be explore d. Deffe nbache r and colle ague s
have alre ady take n a step in this dire ction with the developme nt of a package calle d
“ cognitive relaxation. ” O n the othe r hand ‚ Lochman and colle ague s have emphasized training pe ople in e ncoding of social stimuli and proble m-solving within a
social context. With additional studie s in these areas‚ it is forsee able that the most
active ingre die nts of CBT may be ide ntifie d and integrate d to produce an e ven
more e ffective regimen for managing ange r.
Anothe r viable frontie r of re search might be client variable s relate d to treatment outcome . These may center around se lf-e fficacy‚ locus of control ‚ impulsivity
versus refle ctivity‚ and a host of traits predisposing individuals to respond to treatment in se le ct ways. Clarification of these variable s may enable the careful matching
of clie nts to spe cific treatme nt re gime ns.
Finally‚ ecological validity re mains a goal for most tre atment outcome research.
In ange r manage ment ‚ well-controlle d laboratory studie s have re ve aled e ncouraging
tre atment e ffects. But the generalizability of these findings to various clinical and
multicultural populations ofte n nee ds to be establishe d. Ultimate ly‚ the ability to
pre dict and control ange r as it occurs spontane ously in differe nt groups of pe ople
within the ir own naturalistic se ttings is a challe nge worth addre ssing.
REFERENCES
Reference s marke d with an asterisk indicate studies included in the me ta-analysis.
Abikoff‚ H.‚ & Klein ‚ R. G. (1992) . Attention-deficit hype ractivity and conduct disorder: Comorbidity
and implications for tre atment. Journal of Consulting and Clinical Psychology‚ 60 ‚ 881-892.
*Actor ‚ R. G.‚ & During‚ S. M.‚ (1992) . Pre liminary results of aggression manageme nt training for aggressive pare nts. Journal of Interpersonal Violence. 7‚ 410-417.
*Barth ‚ R. P.‚ Blythe ‚ B. J.‚ Schinke ‚ S. P.‚ & Schilling R. F. (1983). Self-control training with maltreating
parents. Child Welfare. 62 ‚ 313-324.
*Benson ‚ B. A.‚ Rice ‚ C. J.‚ & Miranti ‚ S. V. (1986) . Effects of anger manageme nt training with mentally
re tarde d adults in group tre atment. Journal of Counseling and Clinical Psychology‚ 54 ‚ 728-729.
*Boswell ‚ J. W. ( 1984) . Effects of a multimodal counse ling program and of a cognitive -behavioral counseling program on the ange r management skills of pre-adolesce nt boys within an eleme ntary school
setting (Doctoral dissertation‚ Pennsylvania State Unive rsity‚ 1984). Dissertation Abstracts International‚ 45 ‚ 372.
*Cain ‚ J. A. (1987) . Anger control: A comparison of cognitive-behavioral and relaxation training‚ with
post-treatment follow-up (Doctoral dissertation‚ United States International University‚ 1987). Dissertation Abstracts International ‚ 48 ‚ 1804-1805.
72
Beck and Fern an dez
*Dangle ‚ R. F.‚ De schner ‚ J. P.‚ & Rasp ‚ R. R. (1989) . Anger control training for adolesce nts in reside ntial
treatment. Behavior Modification ‚ 13 ‚ 447-458.
Deffe nbache r‚ J. L. (1995) . Ideal treatme nt package for adults with anger disorders. In H. Kassinove
(Ed.) ‚ Anger disorders: Definition ‚ diagnosis ‚ and treatm ent (pp 151-172) . Washington DC: Taylor &
Francis.
*Deffenbacher ‚ J. L.‚ Story‚ D. A.‚ Stark ‚ R. S.‚ Hogg ‚ J. A.‚ & Brandon ‚ A. D. (1987). Cognitive-relaxation and social skills interventions in the treatme nt of anger. Journal of Coun seling Psychology‚
34 ‚ 171-176.
*Deffenbacher ‚ J. L.‚ Story‚ D. A.‚ Brandon ‚ A. D.‚ Hogg ‚ J. A.‚ & Hazaleus ‚ S. L. (1988). Cognitive
and cognitive-relaxation treatments of ange r. Cogn itive Therapy and Research ‚ 12 ‚ 167-184.
*Deffenbacher ‚ J. L.‚ Lynch R. S.‚ Oetting‚ E. R.‚ and Ke mper ‚ C. C. (1996). Anger re duction in early
adolescents. Journal of Coun seling Psychology‚ 43 ‚ 149-157.
*Deffenbacher ‚ J. L.‚ McNamara ‚ K.‚ Stark‚ R. S.‚ & Sabadell ‚ P. M. (1990a) . A comparison of cognitive -behavioral and process-oriented group counseling for ge neral ange r reduction. Journal of Counseling and Developm ent‚ 69 ‚ 167-172.
*Deffenbacher ‚ J. L.‚ McNamara ‚ K.‚ Stark‚ R. S.‚ & Sabadell ‚ P. M. ( 1990b). A combination of cognitive ‚
re laxation ‚ and be havioral coping skills in the reduction of gene ral ange r. Journal of College Student
Developm ent‚ 31 ‚ 351-358.
*Deffenbacher ‚ J. L.‚ & Stark‚ R. S. (1992) . Relaxation and cognitive-relaxation tre atments of general
ange r. Journal of Counselin g Psychology‚ 39 ‚ 158-167.
*Deffenbacher ‚ J. L.‚ Thwaites‚ G. A.‚ Wallace ‚ T. L.‚ & Oe tting‚ E. R. (1994) . Social skills and cognitive -re laxation approaches to general anger. Journal of Coun seling Psychology‚ 41 ‚ 386-396.
*Deschner ‚ J. P.‚ & McNe il‚ J. S. (1986) . Results of anger control training for batte ring couples. Journal
of Fam ily Violence ‚ 1‚ 111-120.
Dobson ‚ K. S. (1989). A me ta-analysis of the efficacy of cognitive therapy for depression. Journal of
Consulting and Clinical Psvchology‚ 57 ‚ 414-419.
Dodge ‚ K. A. (1993) . Social cognitive mechanisms in the developme nt of conduct disorder and depression. Annual Review of Psvchology‚ 44 ‚ 559-584.
Eckhardt ‚ C. l.‚ & Deffenbacher ‚ J. L. (1995) . Diagnosis of anger disorders. In H. Kassinove (Ed.) ‚
Anger disorders: Definition ‚ diagnosis ‚ and treatm ent (pp 27-48) . Washington DC: Taylor & Francis.
*Faulkner ‚ K. ‚ Stoltenberg‚ C. D.‚ Cogen ‚ R.‚ Nolder ‚ M.‚ & Shooter‚ E. ( 1992) . Cognitive-behavioral
group treatment for male spouse abusers. Journal of Fam ily Violence ‚ 7‚ 37-55.
*Fe indler‚ E. L.‚ Ecton ‚ R. B.‚ Kingsley‚ D.‚ & Dubey‚ D.R. (1986) . Group anger control training for
institutionalized psychiatric male adolesce nts. Behavior Therapy‚ 17 ‚

MSW 610 WEEK 3 Discussion post

Jun 14, 2024 | Health Medical

Description

Instructions

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 the transtheoretical Model Stages of Change and its significance in social work practice.
Be sure to include the importance of confidentiality in social work practice.
Refer and cite the NASW Code of Ethics 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?

Jun 14, 2024 | Health Medical

Description

Do 3 critical points based off of the given topics from ati for nurs 420 leadership classexample 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

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Peer Response for discussion post

Jun 14, 2024 | Health Medical

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Need peer response for both attached. Needs to be 3 paragraphs with 3 sentences and a reference. Also attached my post too. Initial discussion question: Discuss the purpose of the literature review and which topics are you going to search for the issue discussed on DQ 3? Discuss also what are the challenges that nurses are facing today when they have to do a literature review?

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A literature review is helpful because it highlights the need to study the chosen topic and its connection
to the medical field by reviewing existing literature and identifying gaps. The review explores relevant
and present studies associated with the study question to provide critical, comprehensive, and
purposeful insight (Luft et al., 2022). Moreover, the review guides the methodology by connecting to the
study question and helps indicate data analysis. Therefore, when conducting research in nursing, a
literature review connects the researcher between the known and what is yet to be discovered by
establishing context, refining the research question, and providing ground on existing knowledge.
Based on the issue discussed in DQ3, I will search for topics related to nurse burnout in the emergency
department. I will search for topics like the influence of institutional support on mindfulness programs,
the efficiency of mindfulness interventions, and the prevalence and awareness of burnout among
emergency department nurses (Green & Kinchen, 2021). Moreover, I will search the impact of burnout
on patient outcomes like medication errors, satisfaction scores, and readmission rates.
Nurses face numerous practical, conceptual, methodological, and ethical challenges when planning
studies and conducting literature reviews. Bias and conflict of interest due to the researcher’s
preconceptions resulted in the choice of inappropriate strategies and search methods (Kluwer, 2017).
Moreover, nurses experience Time constraints as they handle demanding schedules and still have to find
time to conduct comprehensive literature reviews and identify the most relevant and valuable
information among the overwhelming publications.
References
Green, A. A., & Kinchen, E. V. (2021). The effects of mindfulness meditation on stress and burnout in
nurses. Journal of Holistic Nursing, 39(4), 356-368. https://doi.org/ 10.1177/08980101211015818
Kluwer, R. (2017). Planning a nursing study
Luft, J. A., Jeong, S., Idsardi, R., & Gardner, G. (2022). Literature Reviews, Theoretical Frameworks, and
Conceptual Frameworks: An Introduction for New Biology Education Researchers. CBE life sciences
education, 21(3), rm33. https://doi.org/10.1187/cbe.21-05-0134
The purpose of the literature review is to become acquainted with the state of the art in your field and
make sure you’re not simply doing what has previously been done (“What is the purpose of a literature
review?” n.d.). For this, nurses must find peer-reviewed and updated articles. Also, they need to make
sure that the source is reliable. I am going to search for topics related to the statistics of medication
errors made during prolonged shifts, and also about the benefits of reduced work hours. Additionally, I
will research the possible solutions to prevent medication errors.
Nurses lack the resources to do a proper literature review. For instance. It was shown that the majority
of nurses experienced issues with organizational factors, resource-related issues, knowledge and
competency-related issues, and communication issues. If resource-related variables comprise all
monetary, material, and manpower-related problems, ethical constraints are discovered to be a
significant difficulty in organizational considerations (Konwar & Kalita, 2018). Therefore, even if nurses
do some research on their own, the lack of resources and assistance makes the implementation either
challenging or impossible.
Organizations must support nurses who want to do a literature review as this will be beneficial not only
for the patients but also for the organization. Arguing against pointless treatments or pharmaceuticals,
nurses can also have an impact on organizational expenses. Nurses, for instance, can be meticulous in
recording and reporting symptoms and patient progress, which would aid doctors in making therapeutic
decisions(“What Are Some Ways Nurses Can Influence Healthcare Organization Costs,? 2023). In this
way, nurses can reduce the cost of care.
REFERENCES:
What Are Some Ways Nurses Can Influence Healthcare Organization Costs?. (2023). Retrieved 19
September 2023, from https://www.registerednursing.org/articles/what-nurses-can-influencehealthcare-organization-costs/
Konwar, G., & Kalita, J. (2018). Original Research Article The Barriers and Challenges of … – IJHSR.
https://www.ijhsr.org/IJHSR_Vol.8_Issue.6_June2018/33.pdf
questions, F., review?, W., & What’s the difference between revising, a. (2023). What is the purpose of a
literature review?. Retrieved 19 September 2023, from https://www.scribbr.com/frequently-askedquestions/purpose-of-a-literature-review/
The literature review serves several crucial purposes in the context of evaluating a training program for
improving pediatric medication safety. Firstly, it helps to establish a comprehensive understanding of
the current state of knowledge on the topic like identifying key studies and research findings related to
medication errors in pediatric care. Secondly, the literature review allows for the identification of gaps
or limitations in the existing literature, which can help shape the research questions and objectives of
the study (Garrard, 2017).
In conducting the literature review for this issue, topics of interest would include studies and articles
related to medication errors in pediatric care, the causes and contributing factors to such errors, the
impact of medication safety training programs on reducing errors, and any specific interventions or
strategies that have been effective in improving medication safety in pediatric units (Uman, 2011).
Additionally, it would be important to explore the literature on the PICOT study components, such as
the effectiveness of training programs among pediatric nurses, as well as the outcomes related to
medication errors. This comprehensive review will provide a solid foundation for the proposed research
study.
Nurses today face several challenges when conducting literature reviews. Firstly, the sheer volume of
published research can be overwhelming, making it difficult to identify and select the most relevant and
high-quality sources. Secondly, access to relevant databases and journals can be limited, especially in
resource-constrained healthcare settings. Additionally, keeping up with the rapidly evolving healthcare
landscape and staying updated on the latest research findings can be challenging (Uman, 2011).
References
Garrard, J. (2017). Health sciences literature review made easy: The matrix method. Jones & Bartlett
Learning.
Uman, L. S. (2011). Systematic reviews and meta-analyses. Journal of the Canadian Academy of Child
and Adolescent Psychiatry, 20(1), 57-59.

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Nursing note on management of high blood pressure

Jun 14, 2024 | Health Medical

Description

Mr. Mark was see today while in the community. He was alert and oriented, denied skin cut or bruise. Client verbalized he was well behaved while in the community. Vital sign was completed while blood pressure was 148/83, Pulse 89, resp 19, O2 100 and client denied pain and discomfort. Nursing teaching was completed on management of high blood pressure. Follow rubric below

reflection self 5-2 wellness

Jun 14, 2024 | Health Medical

Description

Overview

An essential part of developing critical analysis skills is self-reflection. In this activity, you will have the opportunity to consider how using critical analysis influences your personal experience, your field of study, or your profession. Completing this activity will result in a draft of the first part 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 first describe how critical analysis skills have affected your framework of perception. Next, you will describe how examining your bias has influenced how you perceive the world. Finally, you will explain how critical analysis skills can impact your academic or professional lives.

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:

Describe how critically analyzing your issue or event in wellness has informed your individual framework of perception.
Consider how it has altered the way you perceive the community around you and/or 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.
Consider how studying wellness might inform your understanding of the next big topic of study in your field or profession.
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 Five Activity Rubric
Criteria Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value
Individual Framework of Perception 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 connecting critical analysis of wellness to individual framework of perception or providing more detail about that connection Does not attempt criterion 30
Bias 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 30
Field of Study or Profession Explains how critically analyzing wellness can influence a 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 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 10
Total: 100%
Module Five Activity Rubric
Criteria Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value
Individual Framework of Perception 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 connecting critical analysis of wellness to individual framework of perception or providing more detail about that connection Does not attempt criterion 30
Bias 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 30
Field of Study or Profession Explains how critically analyzing wellness can influence a 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 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 10
Total: 100%

2 responses to students discussion

Jun 14, 2024 | Health Medical

Description

by Ronal Perdomo Lugo

Number of replies: 0

Healthcare professionals play an essential role in ensuring that patients’ rights are respected and protected during their medical care. Some of the elements that are addressed in the link presented are:

High quality in hospital care: One of the fundamental rights of patients is to receive high quality medical care. Healthcare professionals should strive to provide an exceptional standard of care, based on scientific evidence and good clinical practice. This involves informed decision making and patient-centred care to ensure that treatment and care are effective and safe. A clean and safe environment: Safety and cleanliness are crucial to patient well-being. Healthcare professionals must maintain a clean and safe hospital environment to prevent infections and injuries. This includes compliance with hygiene protocols and proper management of medical waste to ensure patient safety. Participation in your care: Patients have the right to actively participate in their health care and make informed decisions. This promotes the need to encourage open communication with patients, providing clear and understandable information about their diagnosis, treatment and available options. This allows patients to be involved in decisions related to their health. Protecting your privacy: Respect for patient privacy is a fundamental right. In all actions carried out, the confidentiality of patients’ medical and personal information must be maintained. This involves secure access to medical records and discreet communication about patients’ health status. Assistance when leaving the hospital: Patients have the right to a safe and coordinated transition when leaving the hospital. Health services and providers must ensure that patients receive clear instructions about post-hospital care, including medications and medical follow-up. This helps prevent later health problems and promotes a successful recovery. Help with billing claims: Medical billing processes can be complicated and confusing. People who can offer advice to clients are trained on this and should be available to help patients with their billing claims, providing detailed information on costs and payment options. This ensures that patients do not face unfair charges and can address any billing issues effectively.

In summary, the team of professionals and workers who make up health care services have the responsibility of ensuring that patients’ rights are respected and protected at all stages of their medical care. This involves providing high-quality care, maintaining a safe and clean environment, encouraging patient participation, protecting privacy, facilitating post-hospital transition, and offering assistance with billing issues. By fulfilling these elements, they can significantly contribute to patients’ positive healthcare experience (Kwame & Petrucka, 2022).

References

Kwame, A., & Petrucka, P. M. (2022). Universal healthcare coverage, patients’ rights, and nurse-patient communication: a critical review of the evidence. BMC Nurs, 54.

by Cristina Rodrigues Goncalves – Wednesday, September 20, 2023, 2:47 PM

Number of replies: 0

The AHA Bill of Rights

The American Hospital Association, in very plain language, describes what patients should expect whenever they visit a healthcare center, expectations that can, in other words, be termed as patient rights. To meet the provisions of the rights, the AHA defines that healthcare professionals ought to be committed to working with patients as well as their family members to meet the patient’s needs (American Hospital Association, 2023). In light of this knowledge, this discussion presents some of the strategies that healthcare professionals can adopt to ensure that they uphold and protect patients’ rights.

The AHA recognizes high-quality hospital care as the first right that all patients should be accorded. In the contemporary world, high-quality hospital care may be defined as a form of care that is free from prejudice/discrimination based on any social, economic, political, ethnic, gender, and/or sexuality reasons (American Hospital Association, 2023). Healthcare professionals are obligated to provide equal attention and treatment to all because everyone deserves it regardless of their identity. Thus, avoiding biases would eradicate any instances of negligence, hence guaranteeing constant and consistent attention to the needs of a patient, which can primarily be defined as high-quality hospital care for that patient.

Additionally, patients are entitled to a clean and safe environment when in hospital. Healthcare professionals, as well as healthcare facility owners, can assure safety and cleanliness by ensuring that their facilities are not overcrowded. Overcrowding in any social amenity automatically translates to unsafe/unclean living standards, which would be hazardous in the case of overcrowding in a hospital due to the risk of disease outbreaks from communicable diseases. Safety may also be assured through ensuring proper lighting to prevent accidents and falls, as well as proper dumping of used tools such as needles and scalpels.

The AHA Bill of Rights also introduces the protection of patient privacy as a right that patients should enjoy (American Hospital Association, 2023). Patient privacy has always been crucial and sensitive, making physician-patient confidentiality a critical factor in the care delivery process. Therefore, healthcare professionals have to ensure that patient information is not disclosed to other parties unless the patient has authorized. This is because some information may lead to outcomes such as stigmatization of a patient if it falls into the wrong hands. Therefore, the protection of patient information, which includes locking up files and electronic data with passwords only known to a few authorized persons, would be an effective strategy for promoting and protecting this patient right.

The AHA also stipulates that patients need to be involved in their care. In line with one of the core principles of biomedical ethics, which is the principle of patient autonomy, healthcare professionals have the duty to include patients in the decision-making process in regard to their care plans (Beauchamp & Childress, 2019). Recent research has established that when patients are involved in their care delivery process through inquiries of what they would like, the level of satisfaction with their care is often higher than when they are not. Additionally, compliance with guidelines, medications, and other procedures is also higher when patients are involved in their care. Therefore, healthcare professionals should effectively engage patients with questions and inquiries regarding their preferences in the quest to meet this right, as suggested by the AHA.

References

American Hospital Association. (2023). The patient care partnership | AHA. https://www.aha.org/other-resources/patient-care-p…

Beauchamp, T., & Childress, J. (2019). Principles of biomedical ethics: marking its fortieth anniversary. The American Journal of Bioethics, 19(11), 9-12. https://www.tandfonline.com/doi/full/10.1080/15265…

reply 1

Jun 14, 2024 | Health Medical

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Discussion 525 doctor Replies
Fahad I value your post and perspective on this. Many people, when considering ethics, think of the rule “do unto others as you would
have done unto you” or some sort of ethical code such as the Hippocratic Oath (Resnik, 2020). How do these professional
standards relate to health informatics?
Dr. C
Reference
Resnik, D.B. (2020, December 23). What is ethics in research & why is it important? National Institute of Environmental Health
Sciences. https://www.niehs.nih.gov/research/resources/bioethics/whatis/index.cfm
Discussion 530 Student Replies
Shahad
Difference between Human Factors and Ergonomics
Separate yet related, ergonomics (ERGO) and human factors (HF) improve human-system interactions. How people think,
decide, and use technology is the focus of HF’s psychological and cognitive research. In contrast, ERGO focuses on physical
aspects of human-system interaction and designing workspaces, tools, and equipment that fit human physical capabilities and
restrictions. These disciplines provide a comprehensive strategy to improve patient care, worker well-being, and system
performance in healthcare settings, prioritizing accuracy, safety, and efficiency (Håkansson & Bjarnason, 2020). This study will
compare HF and ERGO, explain how they operate best together in healthcare, and give an example of how their combined
importance could enhance healthcare systems.
How Human Factors and Ergonomics are different.
Human factors (HF) and ergonomics (ERGO) are independent but interconnected sciences that study the complex interplay
between humans and systems, equipment, and environments. HF studies the cognitive and psychological aspects of human
performance in these interactions (Holden, et al., 2021). It covers perception, attention, memory, and decision-making. HF experts
study how people think and process information, especially while using technology or complicated systems. Their goal is to
optimize interactions by matching human strengths and limits.
On the other hand, while residing under the same umbrella of human-system interaction, ERGO takes a more specialized
approach. ERGO’s focal point is the physical dimension of these interactions. It revolves around the design of tools, equipment,
and workspaces, ensuring that they are harmoniously suited to individuals’ physical attributes, movements, and biomechanics
(Sawyer, et al., 2021). This involves considerations like posture, the mechanics of human activities, and the measurement of
physical dimensions (anthropometry). ERGO specialists aim to craft environments that minimize physical strain and discomfort,
creating spaces where individuals can operate efficiently and comfortably.
While HF and ERGO have their unique domains of expertise, they are inherently complementary. Integrating both disciplines
becomes essential in various contexts, such as healthcare, aviation, or manufacturing. In healthcare, for instance, understanding
the cognitive demands on healthcare professionals while using complex medical equipment (HF) must align with designing
ergonomic interfaces and workstations (ERGO) that reduce physical strain during prolonged procedures (Asan & Choudhury,
2021). This symbiotic relationship ensures that human-system interactions are mentally efficient and physically comfortable,
ultimately enhancing overall performance and safety. It is through this collaborative approach that HF and ERGO combine to
optimize the human-technology-environment interface, benefiting both individuals and the systems they engage with.
Why both Human Factors and Ergonomics complement each other in healthcare
HF and ERGO complement each other seamlessly in healthcare due to the intricate and high-stakes nature of healthcare settings.
Healthcare professionals often operate in complex, dynamic environments where the combined expertise of HF and ERGO is
invaluable. HF provides insights into the cognitive and psychological components of healthcare professionals’ performance,
assisting in the improvement of communication, information processing, and decision-making (Sawyer, et al., 2021. In contrast,
ERGO makes sure that the workstations, tools, and physical interfaces are ergonomically created to reduce physical stress, pain,
and the risk of musculoskeletal injuries. The two fields offer a holistic strategy for boosting patient safety, healthcare workers’
wellbeing, and system effectiveness.
Healthcare example
2
The critical healthcare example highlighting the indispensable synergy between Human Factors (HF) and Ergonomics (ERGO) is
in designing surgical suites and using surgical robots. In the field of minimally invasive surgery, surgical robots have become
increasingly common. These robots offer precise control and enhanced visualization for surgeons, allowing for smaller incisions
and quicker patient recovery times. However, their effective use hinges on seamless HF and ERGO principles integration.
HF experts can analyze the cognitive demands on surgeons when using these complex robotic systems. They consider factors like
hand-eye coordination, mental workload, and the usability of the robot’s interface. By understanding the psychological aspects of
robot-assisted surgery, HF specialists help design user-friendly interfaces that reduce the risk of cognitive overload during critical
procedures (Asan & Choudhury, 2021). On the other hand, ERGO specialists ensure that the physical aspects of the surgical suite
and the robotic system are optimized. This includes the ergonomics of the surgeon’s console, the placement of monitors, and the
adjustability of the robot’s arms. By designing the physical environment to minimize strain on surgeons’ bodies during prolonged
surgeries, ERGO experts contribute to surgeon comfort and prevent musculoskeletal injuries.
The critical nature of surgeries demands not only precision but also the well-being of the surgical team. In this context, the
combined application of HF and ERGO principles ensures that surgeons can perform intricate procedures with confidence,
accuracy, and minimal physical and mental fatigue, ultimately benefiting patient outcomes.
References
Asan, O., & Choudhury, A. (2021). Research trends in artificial intelligence applications in human factors health care: mapping
review. JMIR human factors, 8(2), e28236.
Håkansson, E., & Bjarnason, E. (2020, August). Including human factors and ergonomics in requirements engineering for digital
work environments. In 2020 IEEE First International Workshop on Requirements Engineering for Well-Being, Aging, and Health
(REWBAH) (pp. 57-66). IEEE.
Holden, R. J., Abebe, E., Russ-Jara, A. L., & Chui, M. A. (2021). Human factors and ergonomics methods for pharmacy research
and clinical practice. Research in Social and Administrative Pharmacy, 17(12), 2019-2027.
Sawyer, B. D., Miller, D. B., Canham, M., & Karwowski, W. (2021). Human factors and ergonomics in design of A 3:
automation, autonomy, and artificial intelligence. Handbook of human factors and ergonomics, 1385-1416.
Nasser Reply 530
Discuss how Human Factors and Ergonomics are different.
An alternative term for the idea of ergonomics is “human factors.” Traditionally, the two are occasionally separated based on
the human being’s physical and psychological characteristics. While physical characteristics are more frequently linked to
ergonomics, psychological qualities are more frequently linked to human factors. However, the two names can ultimately be
regarded as synonyms. Whether you prefer the terms “human factors,” “ergonomics,” or “human factors and ergonomics (HF/E),”
a full practice necessitates knowledge from a variety of fields, including industrial design, psychology, medicine, occupational
health, physiology, and engineering ( The Difference between Human Factors and Ergonomics. 2020).
Explain why both Human Factors and Ergonomics complement each other in healthcare.
When designing and implementing new technologies, processes, workflows, occupations, teams, and sociotechnical systems,
human factors and ergonomics (HFE) are frequently neglected. HFE is widely acknowledged as a crucial discipline that can assist
in minimizing risks that cause patient falls, reduce or mitigate prescription errors, and improve the design and implementation of
health IT. The International Ergonomics Association states that “Ergonomics (or human factors)i is the scientific discipline
concerned with the understanding of the interactions among humans and other elements of a system, and the profession that
applies theoretical principles, data, and methods to design in order to optimize human well-being and overall system
performance.” The goal of HFE-based system design is to enhance patient safety as well as overall system performance, including
wellbeing (e.g., clinician and patient satisfaction). According to the HFE perspective, patient safety initiatives should not only
decrease and mitigate medical errors and enhance patient safety, but also enhance human wellbeing by increasing things like job
satisfaction, motivation, and technological acceptance. For instance, from the HFE perspective, patient safety initiatives that add
to clinicians’ already heavy workloads would not be deemed to be effectively designed (Carayon et al., 2014).
Provide a healthcare example of why the application of both is critical
A HFE technique was employed to identify and classify patient safety risks in cardiovascular ORs. Step 1: cardiovascular OR
work system hazards identification A team of researchers from various fields, including clinical medicine, health services
research, human factors engineering, industrial psychology, and organizational sociology, identified patient safety hazards in five
hospitals through observations, contextual inquiries, and pictures of the environment and tools in cardiovascular ORs. Four team
members (health services researcher, cardiac anesthesiologist, nurse, and human factors engineer) observed each surgery, with
3
two present. Over 160 hours, 20 heart procedures and 84 contextual queries were monitored. All four team members analyzed
observation notes, contextual enquiries, and images to identify patient safety issues (Carayon et al., 2014).
Researchers employed deductive and inductive methods to analyze qualitative data and classify work system dangers in
cardiovascular surgeries. The SEIPS model was utilized deductively to identify high-level patient safety concerns, which were
subdivided based on data themes. There were 59 patient safety danger categories identified:
1. Care provider: variations in procedures, inappropriate conduct; 2. Task: increased workload, workflow interruptions; 3.
Tools/Technologies: usability issues, delayed availability; 4. Physical environment: limited space, equipment arrangement; 5.
Organization: lack of patient safety culture, poor communication. 6. Processes: lack of evidence-based methods and inadequate
supply chain management.
The study suggests system redesign to address patient safety hazards, including standardizing care, training providers, utilizing
proactive risk assessment, simulating OR layouts, and implementing recommended communication practices like repeat back
(Carayon et al., 2014).
References
The Difference between Human Factors and Ergonomics. (2020, August 6,). https://www.coeh.berkeley.edu/the-differencebetween-human-factors-and-ergonomics
Carayon, P., Xie, A., & Kianfar, S. (2014). Human factors and ergonomics as a patient safety practice. BMJ Quality & Safety,
23(3), 196-205.

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We can but dare we

Jun 14, 2024 | Health Medical

Description

As healthcare providers, we look more and more to technology to improve patient outcomes, streamline operations, and lower costs. Sometimes, technology can be used in ways that have ethical, moral, and legal considerations too. You will be writing about the use of personal devices and social media and their use in healthcare. We can do it, but dare we?

This is a “think outside the box” assignment in which there is not necessarily only one right answer. Still, you are required to find sources that support your opinions. Be sure to cite and reference them in your paper. Submit the assignment by the due date, as instructed by your faculty member.

SCENARIO

You receive a message from a peer at work that there is a big investigation being conducted at work due to a HIPAA violation and that it involved a celebrity who had been admitted to the hospital. As a case manager for the hospital, you are given a company cell phone for hospital use because you are on call three days per week. You have pictures of this celebrity you took the other day. The word is that legal action is being taken against the hospital due to some photos that were sold to the Gossip Gazette. They ask to search your company cell phone.

Look at the assignment guidelines in the Week 4 module and use the attached template that is already in APA format. .

THIS IS AN INDIVIDUAL ASSIGNMENT. Each of you will write your own paper.

This assignment will be submitted to Turn It In and will be screened for integrity violations. DO NOT use quotes of any kind. Paraphrase and cite all content and you will significantly reduce your similarity score.

I have attached a sample paper template to help you with APA formatting. I HIGHLY suggest that you use it and replace all highlighted text with your own content. FOLLOW THE RUBRIC to increase your points!

Please use the template below and the assignment rubric. If you have any questions or need any information let me know. DO NOT USE AI.

(4 pages excluding title and reference page)

Unformatted Attachment Preview

Purpose
The purpose of this assignment is to investigate informatics in healthcare and to apply professional, ethical, and legal
principles to its appropriate use in healthcare technology.
Course outcomes: This assignment enables the student to meet the following course outcomes:
CO 4: Investigate safeguards and decision‐making support tools embedded in patient care technologies and information
systems to support a safe practice environment for both patients and healthcare workers. (PO 4)
CO 6: Discuss the principles of data integrity, professional ethics, and legal requirements related to data security,
regulatory requirements, confidentiality, and client’s right to privacy. (PO 6)
CO 8: Discuss the value of best evidence as a driving force to institute change in the delivery of nursing care. (PO 8)
Preparing the assignment
Your faculty member will provide a scenario for you to address in your paper. Choose an ending to the scenario, and
construct your paper based on those reflections. Choose one of the following outcomes for the end of the scenario:
1. A HIPAA violation occurs, and client data is exposed to the media.
2. A medication error has harmed a client.
3. A technology downtime that impacts patient care occurs, and an error is made.
4. A ransomware attack has occurred, and the organization must contemplate paying the ransom or lose access
to patient data.
Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.
Include the following sections:
a. Introduction – 20 points/10%
• Presents a clearly designed thesis statement or argument.
• Provides a clear and concise overview of the content.
• Offers a compelling argument to elicit the readers attention and generate interest.
b. HIPAA, Legal, and Regulatory Discussion – 20 points/10%
• Identify client privacy and HIPPAA standards as they relate to the impact of technology on nursing care.
• Review healthcare regulations as they relate to the impact of technology on nursing care.
• Describe legal guidelines on appropriate use of technology.
c. Scenario Ending and Recommendations – 50 points/25%
• Presents the selected or assigned scenario ending as the focus of the assignment.
• Evaluates the actions taken by healthcare providers selected or assigned scenario evolves.
• Recommends actions to mitigate the injury sustained in the selected scenario ending.
• Supports recommendations with evidence from recent scholarly publications.
d. Advantages and Disadvantages – 50 points/25%
• Presents at least two advantages of using the specified technology in healthcare.
• Presents at least two risks of using the specified technology in healthcare.
• Describes professional and ethical principles guiding the appropriate use of technology in healthcare.
• Support advantages and risks with evidence from recent scholarly publications.
e. Conclusion and Reflections – 40 points/20%
• Summarizes the selected or assigned scenarios ending including the recommendations.
• Establishes a clear link between the discussion and the thesis statement or argument.
• Discusses thoughtful insights and implications based on the outcomes.
• Describes how new insights will impact future behavior as a healthcare professional.
f. APA Style and Organization – 20 points/10%
• References are submitted with assignment.
• Uses current APA format and is free of errors.
• Grammar and mechanics are free of errors.
• Paper is 4-5 pages, excluding title and reference pages.
• At least three (3) scholarly, primary sources from the last 5 years, excluding the textbook, are provided.
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.
Grading Rubric Criteria are met when the student’s application of knowledge demonstrates achievement of the outcomes for this assignment.
Assignment Section and
Required Criteria
(Points possible/% of total points available)
Highest Level of
Performance
High Level of
Performance
Introduction
20 points
(20 points/10%)
Required criteria
Meets all requirements for section.
1. Presents a clearly designed thesis statement or
argument.
2. Provides a clear and concise overview of the
content.
3. Offers a compelling argument to elicit the
reader’s attention and generate interest.
HIPAA, Legal, and Regulatory Discussion
20 points
(20 points/10%)
Required criteria
Meets all requirements for section.
1. Identify client privacy and HIPPAA standards as
they relate to the impact of technology on
nursing care.
2. Review healthcare regulations as they relate to
the impact of technology on nursing care.
3. Describe legal guidelines on appropriate use of
technology.
1.
2.
3.
4.
Scenario Ending and Recommendations
(50 points/25%)
Required criteria
Presents the selected or assigned scenario
ending as the focus of the assignment.
Evaluates the actions taken by healthcare
providers selected or assigned scenario
evolves.
Recommends actions to mitigate the injury
sustained in the selected scenario ending.
Supports recommendations with evidence
from recent scholarly publications.
Advantages and Disadvantages
(50 points/25%)
50 points
Meets all
requirements for
section.
50 points
43 points
Includes no fewer
than 3 requirements
for section.
43 points
Satisfactory Level
of Performance
Unsatisfactory
Level of
Performance
Section not present
10 points
5 points
0 points
Includes no fewer
than 2 requirements
for section.
Includes no fewer
than 1 requirement
for section.
No requirements for
this section
presented.
10 points
5 points
0 points
Includes no fewer
than 1 requirement
for section.
No requirements for
this section
presented.
38 points
19 points
0 points
Includes 2
requirements for
section.
Includes 1
requirements for
section.
38 points
19 points
Includes no fewer
than 2
requirements for
section.
No requirements for
this section
presented.
0 points
Required criteria
Meets all
1. Presents at least two advantages of using the requirements for
specified technology in healthcare.
section.
2. Presents at least two risks of using the
specified technology in healthcare.
3. Describes professional and ethical principles
guiding the appropriate use of technology in
healthcare.
4. Support advantages and risks with evidence
from recent scholarly publications.
Conclusion and Reflections
40 points
(40 points/20%)
Required criteria
Meets all
1. Summarizes the selected or assigned scenarios requirements for
ending including the recommendations.
section.
2. Establishes a clear link between the discussion
and the thesis statement or argument.
3. Discusses thoughtful insights and implications
based on the outcomes.
4. Describes how new insights will impact future
behavior as a healthcare professional.
APA Style and Organization
20 points
(20 points/10%)
Required criteria
Includes all
1. References are submitted with assignment.
requirements for
2. Uses current APA format and is free of errors. section.
3. Grammar and mechanics are free of errors.
4. Paper is 4-5 pages, excluding title and
reference pages.
5. At least three (3) scholarly, primary sources
from the last 5 years, excluding the textbook,
are provided.
Includes no fewer
than 3 requirements
for section.
Includes 2
requirements for
section.
Includes 1
requirements for
section.
30 points
15 points
Includes 2
requirements for
section.
Includes 1
requirements for
section.
34 points
Includes no fewer
than 3 requirements
for section.
18 points
16 points
Includes 4
requirements for
section.
Includes 3
requirements for
section.
Total Points Possible = 200 points
8 points
Includes 1-2
requirements for
section.
No requirements for
this section
presented.
0 points
No requirements for
this section
presented.
0 points
No requirements for
this section
presented.
1
We Can, But Dare We?
Jane Smith
Chamberlain University
NR360: Information Systems in Healthcare
Dr. Jennifer Holzer
June 20, 2022
2
We Can, But Dare We?
Follow the guidelines in the rubric when writing this section. This is the introduction
paragraph and should include a catchy introductory sentence to entice the reader to read more.
The introduction section should also include a sentence about the purpose of the paper. Use the
words, “The purpose of this paper is…” The last line of your introduction should provide your
reader with a narrative outline of the paper (Hint- use the Level 1 headings here such as patient
privacy and HIPPA standards, legal guidelines on the appropriate use of technology, healthcare
regulations, advantages and disadvantages, recommendations, and reflections).
HIPAA, Legal, and Regulatory Requirements (Level 1 Heading)
Patient Privacy and HIPAA Standards (Level 2 heading) – optional and is not
required for any section
Add your 1-2 paragraphs about patient privacy and HIPPA standards here.
Legal Guidelines (Level 2 heading) – optional and is not required for any section
Add your 1-2 paragraphs about legal guidelines here.
Healthcare Regulations (Level 2 heading) – optional and is not required for any section
Add your 1-2 paragraphs about healthcare regulations here.
Scenario Ending and Recommendations
Select one of the endings to the scenario to focus the assignment and then talk about the
implications of this ending concerning informatics. Evaluate the actions taken by the healthcare
providers as the situation evolved, and recommend actions that could have been taken to mitigate
3
the situation. Ideally this section should have a minimum of 1-2 paragraphs for each bullet point
under this section on the rubric. This section should include a minimum of 1-2 properly
formatted, scholarly, in text citations with complete corresponding references listed on the
Reference page.
Advantages and Risks
This section should begin with a paragraph with evidence from recent scholarly
publications to address the impact of technology on nursing care. One citation should be used in
this paragraph.
Advantages (Level 2 heading) – optional and is not required for any section
The next paragraph in this section should be a discussion of the advantages of using
technology in healthcare. Ideally you should try to have a minimum of three advantages. Use
support from the literature and include citations.
Risks (Level 2 heading)- optional
The next paragraph is where you will discuss risks associated with using technology in
healthcare. Ideally you should try to have a minimum of three risks. Use support from the
literature and include citations.
Professional and Ethical Principles (Level 2 heading)- optional
This last paragraph in this section should describe professional and ethical principles
guiding the appropriate use of technology in healthcare.
4
Conclusion/Reflection
This needs to be a summary of the key points of the paper AND a reflection of lessons
learned as a result of doing this assignment. Discuss how it will impact your nursing practice in
the future. NOTE: It is acceptable for the reflection to be in first person; however, the rest of the
paper should be in third person.
5
References
References should be on a new page at the end of your paper. You need at least 3 scholarly
sources within the last 5 years. If is was cited in this paper then it needs to be included here.
APA 7th edition does not use “Retrieved from” any longer. References should be in alphabetical
order, double-spaced, and have a hanging indention after the first line of each entry. Below are
some examples of properly cited sources. Double check your formatting on
https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_style_introduction.html
Campanella, P., Lovato, E., Morone, C., Fallacana, L., Mancuso, A., Ricciardi, W., & Specchia,
M. (2015). The impact of electronic health records on healthcare quality: A systematic
review and meta-analysis. European Journal of Public Health, 26 (1), 60-64.
McGonigle, D. & Mastrain, K. (2022). Nursing informatics and the foundation of knowledge, 5th
ed. Jones & Bartlett Learning.
Kass, N., Kahn, J., Buckland, A., Paul, A., & Ethics Working Group. (2019). Ethics guidance for
the public health containment of serious infectious disease outbreaks in low-income
settings: Lessons from Ebola. https://bioethics.jhu.edu/wpcontent/uploads/2019/03/Ethics20Guidance20for20Public20Health20Containment20Less
ons20from20Ebola_April2019.pdf
We Can, But Dare We Template (title)
Follow the guidelines in the rubric when writing this section. This is the introduction paragraph and should include a catchy
introductory sentence to entice the reader to read more. The introduction section should also include a sentence about the purpose
of the paper. Use the words, “The purpose of this paper is…” The last line of your introduction should provide your reader with
a narrative outline of the paper (Hint- use the Level 1 headings here such as patient privacy and HIPPA standards, legal
guidelines on the appropriate use of technology, healthcare regulations, advantages and disadvantages, recommendations, and
reflections).
HIPAA, Legal, and Regulatory Requirements (Level 1 Heading)
Patient Privacy and HIPAA Standards (Level 2 heading) – optional and is not required for any section
Add your 1-2 paragraphs about patient privacy and HIPPA standards here.
Legal Guidelines (Level 2 heading) – optional and is not required for any section
Add your 1-2 paragraphs about legal guidelines here.
Healthcare Regulations (Level 2 heading) – optional and is not required for any section
Add your 1-2 paragraphs about healthcare regulations here.
Scenario Ending and Recommendations
Select one of the endings to the scenario to focus the assignment and then talk about the implications of this ending concerning
informatics. Evaluate the actions taken by the healthcare providers as the situation evolved, and recommend actions that could
have been taken to mitigate the situation. Ideally this section should have a minimum of 1-2 paragraphs for each bullet point
under this section on the rubric. This section should include a minimum of 1-2 properly formatted, scholarly, in text citations with
complete corresponding references listed on the Reference page.
Advantages and Risks
This section should begin with a paragraph with evidence from recent scholarly publications to address the impact of technology
on nursing care. One citation should be used in this paragraph.
Advantages (Level 2 heading) – optional and is not required for any section
The next paragraph in this section should be a discussion of the advantages of using technology in healthcare. Ideally you should
try to have a minimum of three advantages. Use support from the literature and include citations.
Risks (Level 2 heading)- optional
The next paragraph is where you will discuss risks associated with using technology in healthcare. Ideally you should try to have
a minimum of three risks. Use support from the literature and include citations.
Professional and Ethical Principles (Level 2 heading)- optional
This last paragraph in this section should describe professional and ethical principles
guiding the appropriate use of technology in healthcare.
Conclusion/Reflection
This needs to be a summary of the key points of the paper AND a reflection of lessons learned as a result of doing this
assignment. Discuss how it will impact your nursing practice in the future. NOTE: It is acceptable for the reflection to be in first
person; however, the rest of the paper should be in third person.
References
References should be on a new page at the end of your paper. You need at least 3 scholarly sources within the last 5 years. If is
was cited in this paper then it needs to be included here.APA 7th edition does not use “Retrieved from” any longer. References
should be in alphabetical order, double-spaced, and have a hanging indention after the first line of each entry. Below are some
examples of properly cited sources. Double check your formatting on
https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_style_introduction.html
Campanella, P., Lovato, E., Morone, C., Fallacana, L., Mancuso, A., Ricciardi, W., & Specchia, M. (2015). The impact of
electronic health records on healthcare quality: A systematic review and meta-analysis. European Journal of Public Health, 26
(1), 60-64.
McGonigle, D. & Mastrain, K. (2022). Nursing informatics and the foundation of knowledge, 5th
ed. Jones & Bartlett Learning.
Kass, N., Kahn, J., Buckland, A., Paul, A., & Ethics Working Group. (2019). Ethics guidance for
the public health containment of serious infectious disease outbreaks in low-income
settings: Lessons from Ebola. https://bioethics.jhu.edu/wpcontent/uploads/2019/03/Ethics20Guidance20for20Public20Health20Containment20Lessons20from20Ebola_April2019.pdf

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Health & Medical Question

Jun 14, 2024 | Health Medical

Description

For this week’s reflection, please read the short article and watch the video about the effects of social media on ADHD.

https://www.psychologytoday.com/us/blog/keep-it-in-mind/201701/is-social-media-increasing-adhdLinks to an external site.

Video link:

https://www.cbsnews.com/news/study-smartphone-linked-to-adhd-in-teens/Links to an external site.

Rubric

Some Rubric (2)

Criteria Ratings Pts

4 pts

Exceptional

3 pts

Average

2 pts

Fair

1 pts

Poor

0 pts

No Marks

4 pts

This criterion is linked to a Learning OutcomeTimely submissionStudent submits reflection by the due date

2 pts

On time

1 pts

Late

2 pts

This criterion is linked to a Learning OutcomeWord CountSubmissions should be at least 250 words in length

2 pts

250 words or greater

0 pts

Less than 250 words

2 pts

This criterion is linked to a Learning OutcomeSpelling & GrammarStudent’s submission is mostly free of grammatical and spelling mistakes

2 pts

Full Marks

1 pts

Poor

There are numerous grammar and spelling mistakes, but these do not impede the reader from understanding the ideas that are being communicated.

0 pts

Unsatisfactory

Numerous spelling and/or grammatical mistakes significantly reduce the reader’s ability to understand what the writer is trying to communicate

2 pts

Total Points: 10

PREVIOUSNEXT

Malaria on Sub-Saharan Africa Discussion Question

Jun 14, 2024 | Health Medical

Description

For the discussion posting this week, list as many of the multiple factors that are associated with the problem you are researching as you can of Malaria on Sub-Saharan Africa. Find evidence-based articles that answer the following questions:What factors will work as part of the solution and why?What factors will prevent you from implementing the proposed solution and why?Who would you need to bring into the proposed solution in order to effectively implement the solution?What additional resources would you need to include in your proposed solution in order to make it viable and effective? Provide justification for each resource.What other information do you need to gather in order to fully implement your proposed solution?Please be sure to validate your opinions and ideas with citations and references.

weekly refl 5

Jun 14, 2024 | Health Medical

Description

For this week’s reflection, please read the short article and watch the video about the effects of social media on ADHD.

https://www.psychologytoday.com/us/blog/keep-it-in-mind/201701/is-social-media-increasing-adhdLinks to an external site.

Video link:

https://www.cbsnews.com/news/study-smartphone-linked-to-adhd-in-teens/Links to an external site.

Rubric

Some Rubric (2)

Criteria Ratings Pts

4 pts

Exceptional

3 pts

Average

2 pts

Fair

1 pts

Poor

0 pts

No Marks

4 pts

This criterion is linked to a Learning OutcomeTimely submissionStudent submits reflection by the due date

2 pts

On time

1 pts

Late

2 pts

This criterion is linked to a Learning OutcomeWord CountSubmissions should be at least 250 words in length

2 pts

250 words or greater

0 pts

Less than 250 words

2 pts

This criterion is linked to a Learning OutcomeSpelling & GrammarStudent’s submission is mostly free of grammatical and spelling mistakes

2 pts

Full Marks

1 pts

Poor

There are numerous grammar and spelling mistakes, but these do not impede the reader from understanding the ideas that are being communicated.

0 pts

Unsatisfactory

Numerous spelling and/or grammatical mistakes significantly reduce the reader’s ability to understand what the writer is trying to communicate

2 pts

Total Points: 10

PREVIOUSNEXT

Discussion post

Jun 14, 2024 | Health Medical

Description

2 different versions of the discussion question with 2 different resources, 300-350 words, in APA styleThe discussion question is : A state government official interested in determining the number infants infected with human immunodeficiency virus (HIV) has approached your hospital to participate in a state-wide funded study. The protocol will include the testing of all newborns for HIV, but the mothers will not be told that the test is being done, nor will they be told the results. Defend or refute the practice and give supporting reasoning for how you choose to answer. How will the findings of the proposed study be affected if the protocol is carried out? *** HINT: Use the elements of informed consent Box 13.2 & Table 13.2 on Protection of Human Rights to help you with this discussion question *** I updated the pictures down.

Lipids research

Jun 14, 2024 | Health Medical

Description

Activity covers the following Course Outcomes:

Relate the importance of nutrition to the prevention of a variety of health problems: cardiovascular disease, diabetes, cancer and obesity.
Determine the risk for chronic diseases through analysis of various factors.
1: Lipid Research

There are 3 questions to address: A, B and C.

Saturated fats may be found in various dairy products, protein foods, Grains and deserts. Review the following 3 recipes. List at least 3 sources of saturated fat within each recipe. Substitute the saturated fat ingredients with healthier ingredients (3 for each recipe). (18 points)
Recipe Modification
Name of food

Lasagna

Club Sandwich

Classic Breakfast

Picture of food

Ingredients list

1 lbs. ground beef

25.5 oz. jar of your favorite pasta sauce.

12 lasagna noodles

1 teaspoon olive oil

15 oz. container of whole milk ricotta cheese.

16 oz. package of shredded mozzarella cheese

2 teaspoons Italian Seasoning

1 egg

1/2 cup Parmesan cheese

3 pieces sliced bread

Butter, softened.

3 tbsp. mayonnaise

Romaine lettuce & 2 tomato slices

Kosher salt

Freshly ground black pepper

2 pieces bacon, cooked

1 thick slice cheddar

2 slices turkey

2 slices ham

2 pancakes make with milk

2 pork sausages

2 slices bacon

button mushrooms (halved)

1 onion (small, cut into rings)

1 tomato (halved)

2 large eggs

I tbsp vegetable oil

Saturated Fat Ingredients

Alternative Ingredients

Part 1B: Most of us do not get enough Omega-3 fat in our diet. Besides salmon, name 2 other sources of Omega 3. What are the 2 health benefits of including Omega 3 in our diet? (4 points)

Part 1 C: Your relative has been diagnosed with high cholesterol. Suggest 3 dietary and/or lifestyle strategies that can lower their cholesterol level and reduce their risk for heart disease. (3points)

Nursing PowerPoint Presentation Question

Jun 14, 2024 | Health Medical

Description

Overview

You will create a short Power Point presentation teaching your audience how to put into practice the fundamental principles that influence transcultural interaction and communication. You will develop a 4-slide presentation, a title slide, presentation slides with narrative notes and a reference slide. Review the information below prior to starting your PowerPoint presentation.

Scenario:

Everyone entering a healthcare system should obtain evidence-based care that is culturally and linguistically appropriate. The U.S. Department of Health and Human Services’ Office of Minority Health developed the Culturally and Linguistically Appropriate Services Standards (CLAS Standards) to improve quality, advance health equity and help eliminate health care disparities (Andrews et al., 2020).

Utilizing 4 (2 from Communication and Language Assistance and 2 from other area of standards) of the National CLAS Standards, in your own words, build a 4 slide presentation teaching your peers how to address the standards at your work place.

The PowerPoint presentation should be in APA format and include:

Title slide (include your name and section number) and brief introduction of project (1 slide – No narrative notes)
4 total CLAS Standards (2 slides – Narrative notes in APA format with APA formatted citations)
Select 2 of the 4 Communication and Language Assistance Standards
Select 2 of any other standards from:
Governance, Leadership, and Workforce, or
Engagement, Continuous Improvement, and Accountability
References slide (2 references required: 1 course material and 1 peer-reviewed reference) (1 slide – No narrative notes)
Reference Course Material: Andrews, M. M., Boyle, J. S., & Collins, J.W., (2020). Transcultural concepts in nursing care (8th ed.). Wolters Kluwer/LWW.
Chapters 9 and 12

Create a catchy email to get MD/DO who are interested in Clinical Research

Jun 14, 2024 | Health Medical

Description

Provide an email template that is catchy to send to MD/DO who have their own private practice. I will be a partner and do the clinical resarch. I will work in their space and use their data base

I need someone to fell this sheet out.

Jun 14, 2024 | Health Medical

Description

Just fill the blank, make it simple, and add the resource you got the information from, please.

hcm502,solve pp

Jun 14, 2024 | Health Medical

Description

Work TeamsImagine 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.
CT Rubric
By submitting this paper, you agree: (1) that you are submitting your paper to be used and stored as part of the SafeAssign™ services in accordance with the Blackboard Privacy Policy; (2) that your institution may use your paper in accordance with your institution’s policies; and (3) that your use of SafeAssign will be without recourse against Blackboard Inc. and its affiliates.

Identifying your Research Design Measures

Jun 14, 2024 | Health Medical

Description

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?”

Unformatted Attachment Preview

Assignment
Purpose
This assignment will provide the structure for you to identify and define the measures for your
research design. For each variable devote a one to paragraph response providing the information
requested in the outline below. Please use APA format and appropriate narrative format (this
means no bullets).
Course Outcomes
This assignment provides documentation of student ability to meet the following course
outcomes:
•
CO 1: Demonstrate proficiency in the use of selected research methods and tools.
Total Points Possible
This assignment is worth 100 points.
Due Date
Please see the due dates below. The Late Assignment Policy applies to this assignment.
Requirements and Guidelines
1. Review the Course Outcomes for this assignment, which are listed above.
2. Using the topic, you have selected for use this term, describe each of the variables that
you propose for your research study. Identify each as an independent (explanatory or
predictive) variable and dependent (response) variable.
Variable 1 (Independent or Explanatory Variable)
A.Identify the concept found in your research question and provide a nominal (conceptual
definition)
B. Provide the operational definition for the variable. In most cases, the measure will require
the use of a previously developed scale. In these cases, use the following guideline in
describing your instrument:
1. What does it measure?
2. How well does it measure the concept?
▪ Indications of validity and reliability.
3. How is it structured?
▪ Number of items
▪ Subscales
▪ Response structure
4. What is the dimension; how many dimensions does the scale measure?
5. How much time & resources does it take to administer and analyze?
6. From whom does the scale obtain information.
C. In one word, identify the level of measurement for this variable.
For all remaining variables identified in your question, (Independent (Explanatory) or Dependent
(Response)), follow the same outline.
Grading Criteria
Your paper will be graded based on following criteria:
•
•
•
•
•
Content
Organization and Coherence of Ideas
Support
Style and Mechanics
Page Length Requirements
Detailed grading rubric can be found below.
Rubric
Assignment Rubric
Assignment Rubric
Criteria
This criterion is
linked to a
Learning
OutcomeContent
Ratings
25 pts
Highest Level of
performance
Excellent
response to
assignment;
response is well
developed and
communicated;
presents
information that is
factually correct,
reflective, and
substantive;
demonstrates
sophistication of
thought behind
central idea;
shows evidence of
having read,
reflected on, and
applied course
readings and
materials;
incorporates
content from text
and class
discussions.
23 pts
Very Good or
High Level of
Performance
Well rounded
response
appropriate to
assignment, but
may have minor
lapses in
development;
clearly states
response and
begins to
acknowledge the
central idea and
main details;
presents
information that
is factually
correct; shows
evidence of
having read and
reflected on
course readings
and materials;
shows
willingness to
incorporate
content
discussed in text
and class
discussions.
Pts
19 pts
Acceptable
Level of
Performance
Does not
appropriately
respond to
assignment
prompt; may
provide only a
basic summary
of one or more
concepts; does
not include a
clear central
idea; thesis may
be too vague to
be developed
effectively;
shows little
evidence of
understanding
course materials;
shows no or only
slight
willingness to
incorporate
content
discussed in text
and or class
discussions.
18 pts
Failing Level of
Performance
18-0 Points:
Does not
properly
respond to
assignment
prompt; presents
information that
is off-topic,
factually
incorrect, or
irrelevant; lacks
a thesis or
central idea;
25 pt
shows no
evidence of s
having read or
interacted with
course
materials; shows
no willingness
to incorporate
content
discussed in text
and or class
discussions.
Assignment Rubric
Criteria
This criterion is
linked to a
Learning
OutcomeOrganizat
ion & Coherence
of Ideas
Ratings
25 pts
Highest Level
of performance
Logical
structure
appropriate to
paper’s subject,
purpose, and
audience;
substantive
introduction
including clear
thesis
statement; paper
is structured so
that ideas
logically flow
and build
throughout;
fully developed
paragraphs;
effective
transitions
between
paragraphs;
logical
conclusion that
clearly
summarizes
ideas and adds
final thoughts
and/or
reflections.
23 pts
Very Good or
High Level of
Performance
Shows logical
progression of
ideas; includes
introduction and
thesis statement,
but they may be
unclear or not
fully developed;
paragraphs are
complete
thoughts; some
transitions
between
paragraphs;
conclusion is
present but may
not provide a
comprehensive
summary of
ideas.
Pts
19 pts
Acceptable Level
of Performance
Lacking internal
paragraph
coherence;
underdeveloped
introduction and
thesis statement;
organization of
ideas is difficult
to understand;
paragraphs need
further
development; few
transitions
between
paragraphs;
conclusion is too
brief and/or
underdeveloped.
18 pts
Failing Level
of
Performance
18-0 Points:
Lacks
coherence; no
clear
introduction or
thesis
statement;
unclear
organization
throughout;
paragraphs are
disjointed; no
25 pt
transitions
s
between
paragraphs;
conclusion is
weak or
missing.
Assignment Rubric
Criteria
This criterion is
linked to a
Learning
OutcomeSupport
This criterion is
linked to a
Learning
OutcomeStyle &
Mechanics
Ratings
Pts
17 pts
Highest Level of
performance
Uses evidence
appropriately and
effectively;
makes several
references to
course material
(e.g., readings,
lecture, videos,
audio clips,
scripture, etc.);
provides
sufficient
evidence and
explanation to
support main
ideas; documents
sources
appropriately.
15 pts
Very Good or
High Level of
Performance
Offers relevant
reasons and
evidence to
support ideas;
makes adequate
references to
course material;
begins to explain
connections
between
evidence and
main points;
documents most
sources
appropriately.
13 pts
Acceptable Level
of Performance
Uses
generalizations to
support ideas;
makes few or
inadequate
references to
course material;
may use examples,
but they are
obvious or
irrelevant; often
depends on
unsupported
opinion or
personal
experience;
documents few or
no sources
appropriately.
11 pts
Failing Level
of
Performance
Uses irrelevant
details or lacks
supporting
evidence
entirely; makes
little or no
17 pt
reference to
course
s
material.
23 pts
Highest Level of
performance
Style &
Mechanics 23
Points Well
organized; may
contain fewer than
three errors; errors
do not impede
meaning; uses
professional and
scholarly
language
throughout;
exemplifies
collegiate level
writing; adheres to
proper APA style
requirements.
19 pts
Very Good or
High Level of
Performance
Fairly well
organized;
contains fewer
than five errors;
errors do not
impede meaning;
uses professional
and scholarly
language
throughout;
meets most APA
style
requirements.
18 pts
Acceptable
Level of
Performance
Somewhat
disorganized;
contains more
than five errors;
errors may
confound
meaning; lacks
professional or
scholarly
language; may
meet some APA
style
requirements.
15 pts
Failing Level of
Performance
Disorganized;
contains many
errors that
confound
meaning;
language is not
23 pt
at a collegiate
level; does not
s
adhere to APA
style
requirements.
Assignment Rubric
Criteria
This criterion is
linked to a
Learning
OutcomePage
Length
Requirements
Total Points: 100
Ratings
10 pts
Highest Level
of
performance
Adheres to all
word count or
page length
requirements.
8 pts
Very Good or
High Level of
Performance
Exceeds half and
almost meets
minimum word
count or page
length
requirement.
Pts
7 pts
Acceptable Level
of Performance
Completes
approximately
half of required
word count or
page length for
assignment.
5 pts
Failing Level of
Performance
Completes less
than half of 10 pt
required word
s
count or page
length for
assignment.

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Nursing Question

Jun 14, 2024 | Health Medical

Description

follow scoring guide for best possible score. Write a 4-6 page analysis of a current problem or issue in health care, including a proposed solution and possible ethical implications.

Collapse All
Introduction

In your health care career, you will be confronted with many problems that demand a solution. By using research skills, you can learn what others are doing and saying about similar problems. Then, you can analyze the problem and the people and systems it affects. You can also examine potential solutions and their ramifications. This assessment allows you to practice this approach with a real-world problem.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

Describe the health care problem or issue you selected for use in Assessment 2 (from the Assessment Topic Areas media piece) and provide details about it.
Explore your chosen topic. For this, you should use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. This approach was introduced in Assessment 2.
Identify possible causes for the problem or issue.
Use scholarly information to describe and explain the health care problem or issue and identify possible causes for it.
Identify at least three scholarly or academic peer-reviewed journal articles about the topic.
You may find the How Do I Find Peer-Reviewed Articles? library guide helpful in locating appropriate references.
You may use articles you found while working on Assessment 2 or you may search the Capella library for other articles.
You may find the applicable Undergraduate Library Research Guide helpful in your search.
Review the Think Critically About Source Quality to help you complete the following:
Assess the credibility of the information sources.
Assess the relevance of the information sources.
Analyze the health care problem or issue.
Describe the setting or context for the problem or issue.
Describe why the problem or issue is important to you.
Identify groups of people affected by the problem or issue.
Provide examples that support your analysis of the problem or issue.
Discuss potential solutions for the health care problem or issue.
Describe what would be required to implement a solution.
Describe potential consequences of ignoring the problem or issue.
Provide the pros and cons for one of the solutions you are proposing.
Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented.
Describe what would be necessary to implement the proposed solution.
Explain the ethical principles that need to be considered (Beneficence, Nonmaleficence, Autonomy, and Justice) if the potential solution was implemented.
Provide examples from the literature to support the points you are making.

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:

Assessment 4 Example [PDF] Download Assessment 4 Example [PDF].
Additional Requirements

Your assessment should also meet the following requirements:

Length: 4–6 typed, double-spaced pages, not including the title page and reference page.
Font and font size: Times New Roman, 12 point.
APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.
Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
Using outside sources: Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.
References: Integrate information from outside sources to include at least three scholarly or academic peer-reviewed journal articles and three in-text citations within the paper.
APA format: Follow current APA guidelines for in-text citations of outside sources in the body of your paper and also on the reference page.

Organize your paper using the following structure and headings:

Title page. A separate page.
Introduction. A brief one-paragraph statement about the purpose of the paper.
Elements of the problem/issue. Identify the elements of the problem or issue or question.
Analysis. Analyze, define, and frame the problem or issue.
Considering options. Consider solutions, responses, or answers.
Solution. Choose a solution, response, or answer.
Ethical implications. Ethical implications of implementing the solution.
Implementation. Implementation of the potential solution.
Conclusion. One paragraph.
Competencies Measured:

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.
Use scholarly information to describe and explain a health care problem or issue and identify possible causes for it.
Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care.
Analyze a health care problem or issue by describing the context, explaining why it is important and identifying populations affected by it.
Discuss potential solutions for a health care problem or issue and describe what would be required to implement a solution.
Competency 3: Apply ethical principles and academic standards to the study of health care.
Explain the ethical principles (Beneficence, Nonmaleficence, Autonomy, and Justice) if potential solution was implemented
Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.
Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
Write following APA style for in-text citations, quotes, and references.
Scoring Guide

Use the scoring guide to understand how your assessment will be evaluated.

View Scoring Guide

Unformatted Attachment Preview

9/20/23, 3:55 PM
Analyzing a Current Health Care Problem or Issue Scoring Guide
Analyzing a Current Health Care Problem or Issue Scoring Guide
CRITERIA
NON-PERFORMANCE
BASIC
PROFICIENT
DISTINGUISHED
Use scholarly
information to
explain a health care
problem or issue.
Does not identify
scholarly
information that
could explain a
health care problem
or issue.
Identifies scholarly
information that
could explain a
health care problem
or issue.
Uses scholarly
information to explain a
health care problem or
issue.
Uses relevant scholarly
information to explain a
health care problem or
issue, including the
reasons that the chosen
information helps to
explain a health care
problem or issue.
Analyze the problem
or issue.
Does not identify a
problem or issue.
Identifies a problem
or issue.
Analyzes the problem
or issue.
Analyzes the problem or
issue including
definition, who is
involved, and causes of
the problem or issue.
Discuss potential
solutions for the
problem or issue.
Does not describe a
potential solution for
the problem or
issue.
Describes a
potential solution for
the problem or
issue.
Discusses potential
solutions for the
problem or issue.
Discusses potential
solutions for the problem
or issue, including
potential consequences
for ignoring the issue.
Explain the ethical
principles
(Beneficence,
Nonmaleficence,
Autonomy, and
Justice) if potential
solution was
implemented.
Does not mention
ethical principles if
the potential
solution was
implemented.
Mentions ethical
principles if the
potential solution
was implemented.
Explains the ethical
principles
(Beneficence,
Nonmaleficence,
Autonomy, and Justice)
if potential solution was
implemented.
Explains the ethical
principles if potential
solution was
implemented and
enriches the analysis
with examples from the
readings.
Produce text with
minimal
grammatical, usage,
spelling, and
mechanical errors.
Produces text with
significant
grammatical, usage,
spelling, and
mechanical errors,
making text difficult
to follow.
Produces text with
some grammatical,
usage, spelling, and
mechanical errors,
making text difficult
to follow at times.
Produces text with
minimal grammatical,
usage, spelling, and
mechanical errors.
Produces text free of
grammatical, usage,
spelling, and mechanical
errors.
Integrate into text
appropriate use of
scholarly sources,
evidence, and
citation style.
Does not integrate
into text appropriate
use of scholarly
sources, evidence,
and citation style.
Integrates into text
mostly appropriate
use of scholarly
sources, evidence,
and citation style,
but there are lapses
in style use.
Integrates into text
appropriate use of
scholarly sources,
evidence, and citation
style.
Integrates into text
appropriate use of
scholarly sources,
evidence, and citation
style without errors and
uses current reference
sources.
https://a21371-1019925.cluster223.canvas-user-content.com/courses/21371~6688/files/21371~1019925/course files/Scoring Guides/a04_scoring_gui…
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Health & Medical Question

Jun 14, 2024 | Health Medical

Description

Compose a 2000-2500-word paper (excluding cover
page, reference page, etc.) on a current or emerging healthcare issue and discuss the impact this
issue has on the management of healthcare organizations. (the effects of COVID-19) Use five scholarly articles to support
the assertions made in the paper.
The final paper should contain the following components: 1. Gain the audience’s attention by describing the background of the health care issue.
2. State the health care issue/problem and prepare the audience for the rest of the paper. 3. Diversity, Equity, and Inclusion impacts
4. Communication impacts 5. Motivation impacts
6. Leadership impacts
7. Workforce impacts
8. Financial impacts
9. Organization or technology impacts
10. Discussion of future implications
11. Summary statement clear (reinforced central ideasI have attached the outline for the proposed paper as well as an annotated bibliography.

I need someone to write me a discussion

Jun 14, 2024 | Health Medical

Description

First please do ASSESS YOURSELF: Are you at Risk for Violence or Injury? Take the assessment on Page 138. What are your thoughts about your answers? Did you learn anything about yourself? How might you improve your overall safety while decreasing your risk for violence and injury? (it’s uploaded)*****Then, For extra credit, put a link or a hashtag in your discussion post for a local agency which provides services to those dealing with sexual assault, domestic violence, hate crimes, school safety, dating, fire safety, safe driving. etc. Anything that is a link or hashtag fitting to this chapter. Don’t point out attention to your link or hashtag. Just put it in your discussion.****@@Cyber-safety: How safe are you on-line? Do you have strong passwords? How do you keep safe on social media? Where do you find information on malware, phishing, ransomware? How could you be safer online? You MUST include something you learned in your book or one of the videos about being safe on the internet. * Please do not forget to get references. (the chapter is uploaded)

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Nursing Question

Jun 14, 2024 | Health Medical

Description

Discuss the influence of the Consensus Model for APRN: LACE. Why is it important? Support your discussions with at least two current scholarly articles (less than 5 years).

Reference Links: https://www.ncsbn.org/papers/consensus-model-for-a…

https://www.ncsbn.org/nursing-regulation/practice/aprn/campaign-for-consensus/aprn-consensus-model-toolkit.page

Length: A minimum of 250 words per post, not including references
Citations: At least two high-level scholarly reference in APA 7th Edition, per post from within the last 5 years

Nursing Question

Jun 14, 2024 | Health Medical

Description

“Quiz”
View the movie “A Beautiful Mind” or “Canvas” and answer the following questions.
All answers must be typed.
Answers are one point each unless otherwise specified.
Due by noon 10/9 (Monday) submitted to Canvas Drop.
Questions for A Beautiful Mind: (You may rent this movie on your own, borrow a copy from
me to watch on campus and return immediately. This movie is also available on Amazon)
1. What Is Paranoid Schizophrenia (1 point)? What evidence of this disorder is depicted
by John Nash? Provide specific examples of Mr. Nash’s behavior that shows he meets
the DSM-V criteria (DSM criteria is in your text p. 191- speak to each point A-F) (3
points).
2. What is the impact of severe mental illness upon healthy family members in the film?
3. What clues are given in the first half of the film that indicated John Nash is in the early
stages of schizophrenia? (what are his first symptoms)
4. How does this film show the fears of the public or stigma about schizophrenia?
5. Give three nursing diagnosis for Mr. Nash include related to and as evidenced by in
the dx. (3 points)
OR
Questions for Canvas: You may use the following link to watch this

1. What is paranoid Schizophrenia (1 point)? What evidence of this disorder is depicted by
the Mom in this movie? Provide specific examples of her behavior meeting the DSM
criteria in your text p. 191- Speak to each point (A-F). (3 Points)
2. What is the impact of severe mental illness upon health family members in the film?
3. How does this film show stigma about mental illness?
4. Name 2 nursing dx for the child in this film include related to and as evidenced by in the
nursing Dx. (2 points)
5. Name 2 nursing dx for the mom in this film. Include related to and as evidenced by in
the nursing Dx. (2 points)

hcm505,solve

Jun 14, 2024 | Health Medical

Description

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 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.

Rubric Rubric – Alternative Formats

NURS 6521C: Advanced Pharmacology

Jun 14, 2024 | Health Medical

Description

Case:

DC is a 46-year-old female who presents with a 24-hour history of RUQ pain. She states the pain started about 1 hour after a large dinner she had with her family. She has had nausea and on instance of vomiting before presentation.

PMH: Vitals:

HTN Temp: 98.8oF

Type II DM Wt: 202 lbs

Gout Ht: 5’8”

DVT – Caused by oral BCPs BP: 136/82

HR: 82 bpm

Current Medications: Notable Labs:

Lisinopril 10 mg daily WBC: 13,000/mm3

HCTZ 25 mg daily Total bilirubin: 0.8 mg/dL

Allopurinol 100 mg daily Direct bilirubin: 0.6 mg/dL

Multivitamin daily Alk Phos: 100 U/L

AST: 45 U/L

ALT: 30 U/L

Allergies:

Latex
Codeine
Amoxicillin

PE:

Eyes: EOMI
HENT: Normal
GI: Nondistended, minimal tenderness
Skin: warm and dry
Neuro: Alert and Oriented
Psych: Appropriate mood
APA Style; Write a 1-page paper that addresses the following:
Explain your diagnosis for the patient, including your rationale for the diagnosis.
Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

Weekly Clinical Experiences as a Nurse Practitioner student.

Jun 14, 2024 | Health Medical

Description

Describe your clinical experience for this week as a nurse practitioner student in a 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.

Module 5 Discussion Topic

Jun 14, 2024 | Health Medical

Description

Please post initial responses and peer responses to the following discussion questions listed below:Shawn is developing a presentation on Guidelines for first year coding students. What should Shawn include to help the students understand the importance of the Guidelines?Different sections of the CPT manual use different methods of organizing the information they contain. Some have major subdivisions based on anatomical site; others base their divisions on procedures. Discuss the reasons why different methods make sense, given the nature of the information represented in the different sections of the CPT. What are two examples to illustrate your thinking?

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Module 5: Q2
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Katie Corcoran posted Sep 20, 2023 7:07 PM
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2. Different sections of the CPT manual use different methods
of organizing the information they contain. Some have
significant subdivisions based on anatomical sites; others found
their divisions on procedures. Discuss why different ways make
sense, given the nature of the information represented in the
various sections of the CPT. What are two examples to
illustrate your thinking?
Current Procedural Terminology (CPT), also known as CPT-4, is
a coding manual that the AMA created to be able to convert
widely accepted descriptions of medical terms. These can range
from medical, surgical, and diagnostic services. These are then
broken into five-digit codes that the healthcare providers can
use. CPT codes are used because they are a quick and efficient
way for healthcare providers to communicate with third-party
payers such as Medicare, Medicaid, and commercial insurance.
The majority of CPT codes are referred to as Category I codes.
These are codes that the AMA has approved.
Category I CPT codes are unlisted codes widely used to
describe services and procedures that the FDA approves.
Category II CPT codes are the codes that are available for
procedures that are being coded for while using the CPT
guideline. These codes are reported as a part of the Quality
Payment Program.
Category III CPT codes are emerging technology and are
temporary codes. These codes describe the services and
procedures the FDA has not approved.
CPT codes are necessary because they help track the health
and performance data that can then be used to show the
efficiency of the codes.
DB 5 Question 1
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Erin Pickles posted Sep 20, 2023 8:14 PM
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1. Shawn is developing a presentation on Guidelines for firstyear coding students. What should Shawn include to help the
students understand the importance of the Guidelines?
Shawn should keep in mind that coding can be a challenging
task to learn while creating a presentation on recommendations
for first-year coding students. Shawn should strive to teach
students the fundamentals of coding and provide an easy-tounderstand overview of all of the regulations. Shawn needs to
explain what coding is in his presentation without delay. He has
the competence to explain the significance of coding, its
applications, and how it influences healthcare. Given how
important the ICD-10-CM is to coding, if I were Shawn, I would
additionally include a few slides to explain their importance. I
would dissect the ICD-10-CM during this part of the discussion
by describing its various components and how to utilize them.
The ICD-10-CM contains a variety of elements that facilitate
coding, but you must first comprehend them, thus Shawn
should discuss them as well. Students participating in Shawn’s
discussion could possibly learn better by hands-on participation
and/or observation. Due to this, a substantial portion of the
discussion should consist of examples that Shawn guides the
students through with detailed explanations. In addition to
describing to the students how he identified the appropriate
code to illustrate it, he may additionally include criteria. He can
also give some instances to illustrate difficult-to-code scenarios
and the most effective ways to come up with solutions to these
issues. Because it has an impact on so many facets of the
patient’s experience, follow-up visits, and the reimbursement
system, accuracy in medical coding is crucial. The students need
to understand why it is so important for their coding to be
accurate, thus Shawn should include information regarding
crucial factors in his presentation. Last but not least, Shawn
needs to inquire about any coding-related queries the students
may have. Students can share their questions and experiences
with one another and learn through each other’s additional
inquiries.
Module 5 Question 1
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Cami Williams posted Sep 19, 2023 12:09 PM
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1. Shawn is developing a presentation on Guidelines for first
year coding students. What should Shawn include to help
the students understand the importance of the
Guidelines?
o Shawn should talk about the difference between an
algorithm and a program, and why it’s important for
them to know these differences. He can then go on
to list some of the guidelines that are included in the
IEEE’s standard for designing programs, which
defines what counts as a “complete program.” This
list includes things like handling multiple inputs,
checking for errors, and performing other tasks that
programmers need to know how to do when they
write their own programs. In order to effectively
teach students how to follow the Guidelines, Shawn
should include a list of examples of how they are
applied in real life. This will help students
understand what the Guidelines are intended to
accomplish, and why they are important. Within
Shawn’s presentation, he could show a short video
or two further explaining the Guidelines and how
they can be applied. The videos should be clear and
concise, as well as readily available to the students
such as a video on youtube that the students can
view again later at their leisure. Another helpful tool
would be to have a handout of the Guidelines hung
in his office and around the room for students to
view. By being able to view the Guidelines
frequently, the students can become more familiar
with them and become confident in their
knowledge. It can be an easy way to create
productive conversation and application of the
Guidelines.
2. Module 5 Discussion Question 1
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Ravyn Laird posted Sep 20, 2023 4:03 PM
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1. Shawn is developing a presentation on Guidelines for first
year coding students. What should Shawn include to help
the students understand the importance of the Guidelines?
Shawn should explain how coding and patient safety are
related. Students need to understand that coding plays a
crucial role in quality care and zero harm. Providers rely on
information that is coded accurate to make informed
decisions on patient care. It is also important to understand
that coded information stays on the patient’s record
permanently.
Another important aspect of coding that Shawn should
emphasize is the role it plays in reimbursement. Complete
and accurate documentation of every patient encounter
ensures the healthcare organization receives the appropriate
compensation. If coding errors arise the claim will
automatically be denied. It is essential that the students
understand that increased claim denial rates equal decreased
revenue for the healthcare organizations.
When it comes to preparing the presentation Shawn should
use easy to read fonts and no bright colors. Bullet points will
also aid the students in retaining the information making it
clear and concise. His first slide should define what
healthcare coding means and its role. Next Shawn should get
into what ICD-10-CM is and how it influences healthcare.
Shawn could also use videos to help aid his students’
understanding on Guidelines. At the end of the presentation
time should be dedicated for a Q&A that will allow students
to ask questions and learn from each other. It is essential
that the environment remains educational and professional
to ensure optimal effectiveness.
References.
ICD-10-CM official guidelines for coding and reporting. (n.d.a). https://www.cms.gov/files/document/fy-2022-icd-10cm-coding-guidelines-updated-02012022.pdf
Elsevier. (2021). Buck’s Step-By-Step Medical Coding, 2022
Edition. Saunders. pp. 73, 205-7, 217.
Module 5 Question 2
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Jill Heflin posted Sep 20, 2023 6:26 PM
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1. Different sections of the CPT manual use different
methods of organizing the information they contain. Some
have major subdivisions based on anatomical site; others
base their divisions on procedures. Discuss the reasons
why different methods make sense, given the nature of
the information represented in the different sections of
the CPT. What are two examples to illustrate your
thinking?
Current Procedural Terminology (CPT) is a manual of
standardized set of codes and terms that was developed by the
American Medical Association (AMA). This manual was
developed with the intention to describe tests, surgeries,
evaluations and any other medical procedures to streamline
reporting, as well as, improving accuracy and efficiency. Each
CPT code is five characters and may be numeric or
alphanumeric. The CPT manual is divided into three categories:
Category I, II, and III.
Each of these CPT categories have different methods of
organizing the information that they each contain. For example,
Category I is divided into six large sections based on which field
of health care they directly relate to: Evaluation and
Management, Anesthesiology, Surgery, Radiology, Pathology
and laboratory, Medicine. Each section is further divided into
subsections with anatomic, procedural, condition, or descriptor
subheadings. The sections are grouped in numerical order,
except for the Evaluation and Management section. The
Evaluation and Management section appears at the beginning
of the listed procedures and are often the most reported codes
in the CPT manual. The Radiology CPT codes are divided into 4
groups by modality: Diagnostic, Ultrasound, Radiation
Oncology, and Nuclear Medicine. The CPT codes are an
integral part of the medical billing process. With the division of
each section, this allows for the coding of simple versus more
complex procedures.
Module 5, Question 2
Contains unread posts
Carson Lemon posted Sep 19, 2023 12:42 PM
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The Current Procedural Terminology manual, or CPT manual,
offers healthcare professionals a guide in coding every medical,
surgical, and diagnostic service. It is used to report medical
procedures and services for processing claims, conducting
research, evaluating healthcare utilization, and developing
medical guidelines for healthcare documentation. This coding
manual was developed by the American Medical Association or
AMA, and it uses 5-digit codes to describe all medical
procedures and services. The CPT manual uses different
methods of organizing and classifying information based on
different types of information.
There are three main categories the CPT manual uses to
identify the different types of codes. Category I CPT codes
describe distinct medical procedures or services and are
updated annually. In addition, there are 6 main sections within
the Category I codes; these include Evaluation and
Management, Anesthesia, Surgery, Radiology Procedures,
Pathology and Laboratory Procedures, and Medicine Services
and Procedures. This first category covers all widely known and
used medical services and procedures.
Category II CPT codes, or supplemental tracking codes, are
used by healthcare workers to track specific information about
their patients. For example, providers can see whether a patient
uses tobacco or is on hormone replacement therapy. These
codes are updated three times a year and help provide better
quality of care for every patient.
Lastly, Category III CPT codes are temporary codes that
represent new technologies, services, and procedures. These
allow for assessment and evaluation of these new services, to
see if they might eventually move up to be a Category I code.
These codes are released every 6 months, and they can only
remain in the third category for up to 5 years.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865623/
Module 5 Discussion Question 2
Contains unread posts
Emily Landewee posted Sep 19, 2023 7:24 PM
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2. Different sections of the CPT manual use different methods
of organizing the information they contain. Some have major
subdivisions based on anatomical site; others base their
divisions on procedures. Discuss the reasons why different
methods make sense, given the nature of the information
represented in the different sections of the CPT. What are two
examples to illustrate your thinking?
The Current Procedural Terminology (CPT) manual describes
the coding system developed by the American Medical
Association. This system is used by healthcare organizations to
take the descriptions of medical, surgical, and diagnostic
services from healthcare providers and turn them into five-digit
numerical codes. These codes allow efficiency in the
communication between health care providers and third-party
payers.
Ensuring that the reported code is correct is extremely
important. If an incorrect code is reported, the provider can be
reimbursed incorrectly, and risk being penalized by the
government for submitting an inappropriate claim. The CPT
manual is updated annually to stay up with the current coding
processes and provide the most current information available.
This is why it is important for the CPT manual to be broken into
different sections, because all of the topics need to be
explained in a way that makes it easy for the reader to
comprehend. Within these sections, different methods are used
to explain the information. The CPT manual is composed of six
sections. These include Evaluation/Management, Anesthesia,
Surgery, Radiology, Pathology/Laboratory, and Medicine. These
sections are then broken down into subsections, subheadings,
categories, and subcategories. Using these tools allows the
person using the manual to get around it faster and easier.
One example to illustrate the methods of the CPT manual is the
surgery section. This section is broken down into subsections
including Integumentary, Musculoskeletal, Respiratory,
Cardiovascular, and many more. We can see that these
subsections are all systems of the body. This can further be
broken down into a subheading like arteries and veins, a
category like embolectomy/thrombectomy, and a subcategory
such as arterial, with or without catheter. So, this section was
broken down into systems that were further broken down into
anatomy and procedure. This process allows the user of the
manual to use it more efficiently since it is broken down using
precise organization. My second example is the radiology
section. This section is broken down into subsections like
diagnostic ultrasound, bone/joint studies, radiation oncology,
and other imaging fields. This makes sense because unlike
surgery being broken down into subsections by the body
system, radiology is broken down into imaging modality
subsections because these can then be broken down into
subheadings and categories related to each modality. This
organization allows the reader of the manual to find what they
are looking for in an efficient manner.

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Health & Medical Question

Jun 14, 2024 | Health Medical

Description

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

1. Read the scenario below:

It is time to renew the annual health insurance policy for employee coverage in the medical practice where you serve as administrator. The plan for the past three years has been a Blue Cross Indemnity Plan, a plan with great benefits that the employees like. The practice covers 80% of the premium regardless if it is for employee only, employee and spouse, or family.

The practice also offers:

A Prescription plan which covers brand name/first generation medications, dental plan through Delta Dental (nominal cost), and vision plan through VSP (nominal cost)

Currently 60 employees including the doctors are covered. Of these, 30 have family coverage, 20 employee/spouse, and 10 single coverage.

For the past three years, the premium costs to the practice have gone up by 12%, 13.5%, and 15%.

While the doctors want to continue to provide health insurance coverage for their employees, they have clearly stated that they cannot afford another double digit increase this year.

You have meetings lined up with sales reps from Blue Cross, Aetna, United, and Cigna.

2. Write the answer to the following question:

What will be your strategy and approach to provide the most comprehensive coverage possible, while maintaining a single digit increase this year?….Use concepts and types of health plans we discussed in class

Discuss the various types of plans available, and what you might do to restructure the plan, benefits, and out of pockets costs (premium responsibility, co-pays, deductibles, co-insurance ) for the employees? Address health insurance, pharmacy, dental, and vision options

Instructions: Part 2

1. Provide a real-life example of your personal experience with health insurance coverage, either directly or indirectly. Include answers to the following questions:

Which private company/government entity provided the coverage?

What were the positive and negative in working with the plan?

If you had to make a suggestion regarding your experience to the health plan’s CEO, what would it be?

Tie concepts from the class to your responses.

Unformatted Attachment Preview

HAP 410
Topic 5, Understanding Health Insurance
Review Attachment #1, Understanding Health Insurance
What is Insurance Defined?
From Wikipedia, the free encyclopedia
Insurance is the equitable transfer of the risk of a loss, from one entity to another in exchange
for payment. It is a form of risk management primarily used to hedge against the risk of a
contingent, uncertain loss.
An insurer, or insurance carrier, is a company selling the insurance; the insured, or policyholder,
is the person or entity buying the insurance policy. The amount of money to be charged for a
certain amount of insurance coverage is called the premium. Risk management, the practice of
appraising and controlling risk, has evolved as a discrete field of study and practice.
The transaction involves the insured assuming a guaranteed and known relatively small loss in
the form of payment to the insurer in exchange for the insurer’s promise to compensate
(indemnify) the insured in the case of a financial (personal) loss. The insured receives a contract,
called the insurance policy, which details the conditions and circumstances under which the
insured will be financially compensated
…Give some examples……Think about your car insurance!
What is Included in Medical Services?
-Preventive Care
-Office Visits for Sick Care
-Emergency and Urgent Care
Lab work (e.g. blood tests)
-X-rays
-Complex Medical Imaging (e.g., CAT Scans and MRI)
-Inpatient hospital stays
-Surgeries
-Mental Health
-Durable Medical Equipment (e.g., Wheelchairs, hospital beds)
-Prescriptions
1
-Very often…employees offer dental and vision insurance as well
– Long Term Care is not included
How Does Heath Insurance Work?
1.Member purchases insurance from carrier through
employer and pays a monthly premium …Paid monthly in
return for coverage under the policy. Price based on
contracted benefits in the health policy. Most employers pay a
portion of the premium, with the employee paying a portion
based on a designated payroll deduction.
– Co-Payment…. Required payment to the provider or
institution at the time of service, per the policy. Very
common for patient to pay a $10-$25 co-pay in a doctor’s
office.
– Deductible….First dollar out of pocket payment required by
some plans before the insurance company pays. The patient,
not insurance company at risk for payment of services at
the beginning of the plan year. Example, the policy
deductible is $1,000.
– Insurance payment…. Portion of health services paid by
the insurance carrier. Amount paid is in the insurance
policy.
– Co-Insurance…. Balance that remains after the
deductible, has been met, which is the responsibility of the
insured. In this example, the patient is responsible for the
$1,000, plus an additional 20% (insurance pays 80%) up to
an out-of-pocket maximum of $5,000. 2.
– Out of pocket maximum….in this example, once the patient
has reached the put of pocket maximum of $5,000, then
the insurance company pays 100%
Who’s Who in Health Insurance?
–
Carrier (insurance company) …company that writes and administers
the health insurance policy
– Self Insured (a company, usually large) that creates a fund for
collection of premiums/ payment of claims for its employees. The
Third-Party Administrator is the outside company that administers
the plan, processes the claims, etc. for the Self Insured.
– Provider…Medical Professional who provides the healthcare services
to the patient. In the medical office this is usually the doctor, nurse
practitioner, physician assistant.
– Beneficiary…Person eligible to receive benefits under the health
insurance policy. … (patient that the policy covers)
– Insured/Guarantor….policy holder in whose name is covered by the
insurance company. Ultimately responsible for payment of the bills.
Makes it possible for Dependents (spouse/, children/ significant
other) of the insured to be covered.
3.
Underwriting…the process of evaluating the risk through actuarial
procedures, which are highly mathematical, and model driven.
Underwriting has become less important with the passage of the
affordable care Act, as insurance applicants can no longer be rejected
because of pre-existing conditions. In the past this was a primary
function of underwriting and allowed the carrier to reject patients who
would undoubtedly use their insurance to incur significant costs. Today,
the primary method of underwriting is a community-based rating
system that takes into account the probable utilization of the entire
population of a specific area or community.
Types of Coverage
– Governmental
– Commercial Carriers/group insurance/employer based
– Commercial Carriers/individual polices
– Health Plans purchased on the exchanges through the Affordable
care Act
– Uninsured / Self pay
Governmental Insurance
I. Medicare…….started in 1965 under Pres. Lyndon Johnson. A
federal health insurance entitlement program…. complements
Social Security, passed in 1935.
– Beneficiary Eligibility Include………Individuals
65+…….Younger individuals with disabilities…. individuals
with end stage renal disease.
4.
A. Four Parts:
-Medicare, Part A …hospital services, including inpatient
hospitalization, Skilled nursing, home care, hospice care.
Patients have a 90-day hospital stay benefit in a given
benefit period (usually one year), plus a 60-day lifetime
reserve. Patient must enroll at the time just before or
after 65th birthday. Premiums covered under Social
Security.
-Medicare Part B….Physician/nurse practitioner services
services, outpatient hospital services, hospital and
ambulatory surgery, physical and speech therapy,
chemotherapy. Patient must be enrolled in Part A, and then
pays monthly premium out of pocket.
– Medicare Part C……. Started in 1997, also called Medicare
Advantage or Medicare Managed Care. Broader in-network
coverage (more restrictive), lower out of pocket costs vs.
Medicare Part B. Plans to phase this down/maybe out.
– Medicare Part D…..started in 2006. Voluntary drug
benefit program. Patient must enroll in a private insurance
plan approved by Medicare for Part D. Coverage. A
restricted formulary is provided based on the diagnosis and
treatment of a medical condition.
– Medigap, or Medicare Supplemental Insurance is an
insurance plan purchased by the beneficiary to cover out of
pocket costs not covered under Medicare, (i.e. 20% out of
pocket co-insurance required for Medicare Part B services)
5.
B. How Medicare Works….Key Players
– Federal Government….Congress mandates Medicare rules
and regulations
– Medicare Administrative Agencies….operational
responsibility. Under the Dept. of Health and Human
Services is CMS (Center for Medicare Services)
– Non-Governmental Medicare Agencies…Private companies
called intermediaries, who contract with CMS to process
claims. Also called MACs (Medicare Administrative
Contractor). Very often a private insurance company as Blue
Cross or Aetna may serve as intermediaries for Medicare in
different sections of the country, since they have the
infrastructure in place.
– Hospitals provide services under Medicare Part A.
.
Providers provide services under Medicare Part B… Note that a
physician can be a participating or non-participating provider. To be
participating, a physician must apply to Medicare to provide services to
beneficiaries. An NPI (National Provider Identifier) number is assigned
for billing
– Participating provider sees Medicare beneficiaries and
“accepts assignment” which means that they accept
Medicare’s fee schedule. Medicare pays 80% of allowable
reimbursement, with remaining 20% collected from the
patient.
6
– Non-participating…doctor does not accept assignment. Fee
schedule is 95% of fee schedule for participating provider.
Payment of the claim sent to patient, not to doctor.
Beneficial for doctor to be participating.
II.
Medicaid
-Provides benefits to low-income groups with no or limited
health insurance. To qualify a family must be at or below the
federal poverty guideline of 135%:
2018 Federal Poverty Level (FPL) Guideline Tables
48 States and the District of Columbia 2018 Federal Poverty Level (FPL) Guideline
Table
Family Size
100%
135%
5
$29,420
$39,717
6
$33,740
$45,549
7
9 more rows
$38,060
$51,381
Federal government provides general guidelines and funding, but
Medicaid programs are administered by each state.
Fee schedule is usually less than Medicare, maybe 75-80% of
Medicare fee schedule. Usually $3.00 co-pay. The indigent
population, along with low reimbursement makes it unpopular with
most doctors.
– Covers basic preventive services, “bare bones coverage” 7.
CHIPS…Children’s Health Insurance Program
CHIP provides low-cost health coverage to children in families
that earn too much money to qualify for Medicaid. In some
states, CHIP covers pregnant women. Each state offers CHIP
coverage and works closely with its state Medicaid program.
Indian Health Service
The IDS is the principal federal healthcare provider of a
comprehensive delivery system for American Indians and Alaskan
Natives. Its mission grew out of the special government to
government relationship between the federal government and the
federally recognized Indian tribes.
III. Tricare
– Worldwide health services with military facilities that
provides services for the military and their families. Which
includes……active duty……retired service
members,…….active/non active/retired National Guard.
– Tricare provides network (military medical personnel and
facilities) and non-network benefits. Only
specialized/medically necessary services usually provided
out of network
– The VA (Veterans Administration) provides acute care,
ambulatory, and rehabilitation services to veterans.
8
–
There are also military hospitals (Walter Reed. Bethesda
Naval) for active military
Commercial Insurance/Group/Employer Based
I. In the U.S. we have an employer-based health insurance system,
although it is more common for patients to purchase indivual
polices based on the current economic situation. Most
commercial insurance companies are for-profit including most
Blue Cross Plans, except for some non-profit Blue Cross Plans
– Major insurance carriers/companies
-Blue Cross/Blue Shield…50+ plans, all independent across
the United States
– Aetna
-Cigna
-United Healthcare (formerly MAMSI)
-Humana
-Kaiser Permanente
-Molina Healthcare
-Highmark
9
II.
Major Categories of Commercial Insurance
–
Fee for Service/Indemnity…. Health insurance of the
1960’s, now rare because it is so expensive. First dollar
coverage, usually 80% covered, 20% out of pocket coinsurance. Flexibility to choose any doctor or hospital.
Preferred Provider Organizations (PPO)…. (Has some
–
model features of Fee for Service) Insurance companies’
contract with networks of providers and hospitals, from which
the patient can select. Doctor accepts/insurance and patient
pays a lower rate, in exchange for joining the network.
-In Network…. providers are contracted to participate in the carrier; s
network, with co-pays and negotiated rates for medical services. 10
With in-network, the provider submits the claim to the carrier on the
member’s behalf. Provider responsible for prior authorizations
-Out of network. The provider is not contracted with the carrier.
Member is responsible for charges above the carrier’s reasonable and
customary amount. Patient submits claim to the carrier, and is
personally responsible for prior authorizations
–
Exclusive Provider Network (EPO)….. same elements of
a PPO, except the provider network is much larger that the
PPO, sometimes covering multiple states. But because of
this, and unlike the PPO, out of network services are not
covered.
–
10
–
Health Maintenance Organization (HMO)…focuses on
preventive care. Primary care physician is the gatekeeper in
the network established by the insurance carrier, which
means that referrals are required to see a specialist, and
pre-authorizations to be admitted to a hospital. Going out
of network usually prohibited. Per some plans, the primary
care doctor paid on a captitated basis, which means a set
fee, is received per member per month, to manage the care
of the patient with a focus on prevention. Kaiser
Permanente is a nationally known HMO
–
Open panel under an HMO. Under this arrangement a
physician and other providers maintain an independent
practice contract with an HMO (in-network Providers) to
see HMO as well as non-HMO patients.
–
Closed panel under an HMO. The physicians and other
providers are typically employees of the HMO or under
exclusive contact to see only HMO patients
Point of Service Plans (POS) are health plans that are a hybrid
of PPO and HMO. They allow a wide range of options to the
patient in seeking care, but pay for these benefits at different
levels , depending on whether or not the service was delivered by
an in-network provider.
– High Deductible Health Plans/Consumer Directed Plans
Due to high healthcare costs, many companies are shifting costs
to their employees through higher deductibles. To go with the
“stick” of higher deductibles, the ‘carrot” is allowing individuals 11
and companies to put “pre-tax” dollars in accounts to help pay for
the high front end deductibles.
Laws have been passed by Congress, where Health Savings
Accounts (HAS), Health Reimbursement Accounts (HRA) and
Flexible Spending Accounts (FSA) have been created.
In 2011, pre-tax medical savings accounts under high deductible
account allowances are now $1,200 per individual, and $2,400 for
a family. Insurance benefits start after the deductible is met.
–
Health Savings Account (HSA)….HSA is a medical
savings account funded in pre-tax dollars by the employee
(insured) although the employer may make a match. Use for current
and future health expenses. It is portable to other companies as the
HAS is owned by the employee.
–
Health Reimbursement Account (HRA)…. Same concept,
except that the medical savings account is funded entirely
by the employer, who enjoys the full tax advantage. This is
owned by the employer, not employee, and is not portable or
carried over to future years.
–
Flexible Spending Accounts (FSA)… Can apply to any
type of health plan, other than high deductible. Allows
employees to set aside pre-tax dollars to pay for qualified
medical expenses.
–
12
Note that most get health insurance covered by their employer,
or may not be employed /or their employer does not provide
health insurance, it is possible to purchase an individual plan from
a commercial carrier for these who do not qualify for Medicare
and Medicaid.
– Other Insurance “Circumstances”
COBRA (Consolidated Omnibus Budget and Reconciliation act of
1978) …Employee can pay out of pocket to continue employer
sponsored health plan 18 months after leaving the organization. Can be
up to 102% of premium.
Workers Compensation…Companies must pay for worker
compensation insurance. Covers employees who become hurt in a workrelated accident or become ill on the job. Workers Comp Review
Boards in each state make decision on claims. Typical allowed benefits
included 66% of wages, plus direct cost for medical treatment.
Required by law!
Other Terms
– Exclusions…services not covered in the policy (common are
laser eye surgery, cosmetic surgery, fertility treatments.)
13
– Referrals…Process of sending a patient to another
provider for services that the referring source believes is
outside their scope of practice. A full transfer of patient
care to the other provider. Referrals must be approved by
the insurance company. Meant to cut down on unnecessary
services.
– Consults…This is when a patient is referred to another
provider for an advanced opinion. Unlike referral, the intent
is that the patient will return to the provider for
continuation of care
–
Pre-Certification…refers to discovering whether a
treatment (surgery, hospitalization, tests) is covered under
a patient’s contract.
.
– Pre-Authorization…. Process of reviewing certain medical,
surgical, behavioral health services to ensure necessity and
appropriateness of care. Many times, requited for nonemergency inpatient and certain outpatient services.
– Pre-Determination…. means discovering the maximum dollar
amount that the carrier will pay for services (surgery,
consulting services, radiology.)
14
Plans purchased thorough the Health Care
Exchanges/Affordable Care Act
Healthcare Reform
Affordable Care Act
The theoretical driving force…. a model/plan to make healthcare
affordable/accessible/high quality. The ACA was passed in 2010.
Driven by President Barak Obama, with passage by Democratic votes
exclusively in the House of Representatives and Senate and deemed
constitutional by the Supreme Court in 2012.
Driving forces…….
1. Aging and increasing population
2. 30 million uninsured in the US
3. Escalating healthcare premiums for insurance, and costs, as
healthcare consumes 17% of our GNP
4. Desire to provide affordable/accessible/high quality healthcare
The lynchpin of the ACA Act is that the entire population of the U.S.
must be covered. Why? Because many the young and healthy do not
have health insurance… by choice.
“I do not need health insurance, because I never need to go to the
doctor and/or hospital. Money spend on premiums can be spent on fun
stuff instead” ……. Until a catastrophic event happens when insurance is
needed.
Again, the concept of insurance is that many pay premiums into a pool.
Very few will need insurance for a “catastrophic” event. In theory the
more in the national health insurance pool, the greater number of
enrollees to spread the risk, and in theory, the lower the premiums,
and healthcare costs……. 15.
There are different levels of plans, platinum, gold, silver, bronze.
Some private insurance companies offer plans in the exchanges.
Many states 36 total, have elected not to create a health
exchange, thus requiring its citizens to purchase from the
federal exchange.
For individuals with incomes between $14,400 and $43,320,
and for families with incomes between $29,330 and $88,200
the government will offset the costs of the premiums with tax
credits.
To summarize, and simply put, in 2017 the Supreme Court said
that the tax for non-compliance for the individual mandate
requiring the purchase of insurance was unconstitutional. The
whole concept of a large pool of health people supporting the true
sick and chronic patients could not take place, and the model did
not work. Now the ACA covers only a small segment of the
population.
16

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SUPERVISOR

Jun 14, 2024 | Health Medical

Description

ALSO KEEP IN MIND —Your written assignments are intended to test your understanding of important concepts and discover how to sharpen your intellectual skills of analysis, synthesis, evaluation, and application. Completing assignments also provides you with opportunities to more fully describe, explain, and analyze what you are reading, discussing, etc. to deepen your learning.

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Health & Medical Question

Jun 14, 2024 | Health Medical

Description

Concept Mapping Assignment OverviewA DIRECT-FOCUSED CARE WRITTEN ASSIGNMENTThe
purpose of this concept map assignment is to help you strengthen a
weakness and to practice utilizing clinical judgment in preparation for
NCLEX. This will be the concept utilized in this assignment. You may use a concept only once for each course. This
assignment will utilize a template designed to promote critical
thinking and clinical judgment and to see how these relate to the
nursing process. The patient you choose might have multiple
co-morbidities. Build your concept map around the concept you chose;
this might not necessarily be the patient’s priority concern. Your
patient might have co-morbidities related to Perfusion and Gas Exchange
which will most often be a higher priority than ‘Infection’. However, to
increase your knowledge about ‘Infection’, complete you map according
to cues (signs and symptoms) and appropriate interventions related to
‘Infection’.

assesment 4

Jun 14, 2024 | Health Medical

Description

follow scoring guide for best possible score. Develop a solution to a specific ethical dilemma faced by a health care professional by applying ethical principles. Describe the issues and a possible solution in a 3-5 page paper.

Collapse All

Introduction

Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behavior. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions.

Instructions

For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

Access the Ethical Case Studies media piece to review the case studies you will be using for this assessment.
Select the case most closely related to your area of interest and use it to complete the assessment.
Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.
Include the selected case study in your reference list, using proper APA style and format. Refer to the Evidence and APA section of the Writing Center for guidance.
Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
Identify who is involved or affected by the ethical problem or issue.
Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
Apply the three components outlined in the Ethical Decision-Making Model media.
Analyze the factors that contributed to the ethical problem or issue identified in the case study.
Describe the factors that contributed to the problem or issue and explain how they contributed.
Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.
Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
Review the Think Critically About Source Quality resource.
Assess the credibility of the information source.
Assess the relevance of the information source.
Discuss the effectiveness of the communication approaches present in a case study.
Describe how the health care professional in the case study communicated with others.
Assess instances where the professional communicated effectively or ineffectively.
Explain which communication approaches should be used and which ones should be avoided.
Describe the consequences of using effective and non-effective communication approaches.
Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
Discuss the key lessons this case provides for health care professionals.
Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
Describe the proposed solution.
Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
Discuss how likely it is the proposed solution will foster professional collaboration.
Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
Apply the principles of effective composition.
Determine the proper application of the rules of grammar and mechanics.
Write using APA style for in-text citations, quotes, and references.
Determine the proper application of APA formatting requirements and scholarly writing standards.
Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following 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:

Assessment 3 Example [PDF] Download Assessment 3 Example [PDF].
Additional Requirements

Your assessment should also meet the following requirements:

Length: 3–5 typed, double-spaced pages, not including the title page and reference page.
Font and font size: Times New Roman, 12 point.
APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.
Written communication: Use correct spelling, grammar, and punctuation.
References: Integrate information from outside sources to include at least two references (the case study and an academic peer-reviewed journal article) and three in-text citations within the paper.
APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.
Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.
Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
Competency 3: Apply ethical principles and academic standards to the study of health care.
Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.
Discuss the effectiveness of the communication approaches present in a case study.
Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
Write following APA style for in-text citations, quotes, and references.
Scoring Guide

Jun 14, 2024 | Health Medical

Description

Review the interactive media under Required Media: Branching exercise. This is provided in the Learning Resources.
Review the information provided in the case (patient presentation, vital signs, pmh, home meds, results of labs and diagnostics. With this information, critically think about what is happening with the patient.
Use your critical thinking skills and current guidelines to develop orders. Include additional labs/diagnostics, what needs repeated and followed up on. Medications that need to be ordered or changed.

The Assignment:

Using the required admission orders template found under the Learning Resources: Required Reading.
Develop a set of orders as the admitting provider.
Be sure to address each aspect of the order template
Write the orders as you would in the patient’s chart. Be specific. Do not leave room for the nurse to interpret your orders.
Do not assume anything has already been done/order. Use the information given. Example: If the case does not mention fluids were given, the patient did not receive fluids. You may have to start from scratch as if you are working in the ER. And you must provide orders if the patient needs to be admitted.
Make sure the order is complete and applicable to the patient.
Make sure you provide rationales for your labs and diagnostics and anything else you feel the need to explain. This should be done at the end of the order set – not included with the order.
Please do not write per protocol. We do not know what your protocol is and you need to demonstrate what is the appropriate standard of care for this patient.
A minimum of three current (within the last 5 years), evidenced based references are required.
INFORMATION NEEDED:
An 84-year-old female is brought in by family with complaints of increased confusion and lethargy.
Patient usually lives alone and is fully functional.
Son reports that she has been increasingly confused and sleeping a lot at home.
Son denies any fever.
Patient complains of pain “all over” and responds to repeated questions with “I think I’m sick”
She has a DNR status but wants full treatment at this time.

EXAM

BP 105/64, HR 115, RR 24, T 96॰ F, SpO2 92% on room air
Patient is alert and oriented to person, however, thinks the year is 1990
PMH: HTN and Diabetes
Home Med: Metoprolol, Insulin, Lantus 10mg at bedtime, Calcium
NKDA
Initial 12-Lead EKG to assess myocardial function
CBC to assess for leukocytosis (increased WBC) and potential anemia
CMP to assess electrolyte disturbances, liver and renal function. And potential for DKA
Urinalysis to assess for potential UTI
Chest X-ray to assess for infiltrates (pneumonia)

RESULTS OF INDICATED TESTS

Complete Blood Count (CBC)

WBC 3.4 k/UL
Hgb 9.3 g/dL
Hct 28%
Platelets 250 k/UL
Differential
Neutrolphil 90%
Bands 10%
Eosinophil 0%
Basophil 0%
Lymphocyte 2%
Monocyte 3%

Complete Metabolic Panel (CMP)

NA+ 132 mEq/L
K+ 3.7 mEq/L
HCO# 27 mEq/L
Cl- 101 mEq/L
Glucose 1766
BUN 55 mg/dL
Creatinine 2.0 mg/dL
Albumin 3.2g/dL
Alkaline Phosphatase 99 IU/L
ALT 38 IU/L
AST 30 IU/L
Total Bilirubin 2.1 mg/DL

Urinalysis (U/A)

Color: Yellow
Clarity: Dark/Cloudy
Sp gravity 1.042
pH 6.2
Total Protein: Negative
Glucose: Positive
Ketones: Negative
Bilirubin: Negative
RBCS: 10
WBC: 12
Leukocyte Esterase: 3+
Nitrite: Positive

Because the patient has circulatory compromise (hypotension, altered mental status) she is in septic shock.

Septic Shock is a subset of sepsis with circulatory and/or cellular or metabolic dysfunction. Patients will have hypotension, decreased urine output, altered mental status-signs of organ damage

Associated with a higher risk of mortality

Aggressive resuscitation and early initiation of septic protocols are a must

Unformatted Attachment Preview

Admission Orders Template
Primary Diagnosis:
Status/Condition (Critical, Guarded, Stable, etc.):
Code Status:
Allergies:
Admit to Unit:
Activity Level:
Diet:
IV Fluids:
Critical Drips (If ordered, include type and rate. Do not defer to ICU protocol.):
Respiratory: Oxygen (If ordered, include type and rate.), pulmonary toilet needs, ventilator settings:
Medications (include ALL, tx of primary condition, underlying conditions, pain, comfort needs, etc., dose
and route):
Nursing Orders (vital signs, skin care, toileting, ambulation, etc.):
Follow-Up Lab Tests:
Diagnostic testing (CXR, US, 2D Echo, etc.):
Consults:
NOTE: (Do not defer management to a specialist. As an ACNP, you must manage the patient’s acute
needs for at least a
24-hour period]. Include indication for consult. For example: “Cardiology consult for evaluation of newonset atrial
fibrillation,” or “Nutrition consult for TPN recommendations.”
Patient Education and Health Promotion (address age-appropriate patient education. if applicable):
Discharge Planning and Required Follow-Up Care:
References (minimum of three timely references that prove this plan follows current standards of care):

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KIN480 Fitness Assess

Jun 14, 2024 | Health Medical

Description

See attachment for the instructions

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Journal 1Flexibility Program
The purpose of each journal entry is to get practice programming for your client based on their
performance in the previous weeks assessment.
Notice that the template provided already has some of the cells filled out and an example
included. Please do not remove any preexisting information. Although there are many ways to
design and prescribe a program, for purposes of this assignment, please use the attached
document. This can act as a basic guideline for future programming.
Download the provided flexibility template above, prescribe stretches for your volunteer, and
upload the document. In addition to the program, provide a 400 word rationale for why the
exercises, number of reps/duration, and number of sets were chosen for your client. Please
submit this in a Microsoft Word document that follows APA guidelines (title page, running head,
page numbers, double spaced, 12 pt. Times New Roman font, proper in-text citation (where
appropriate), reference page).
Lastly, choose three of the prescribed exercises/stretches from different segments of the body and
film yourself identifying the set up, execution, and demonstrating the movement. The link to
your video(s) should be included in the section provided in the template.

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part 3 project health management

Jun 14, 2024 | Health Medical

Description

Overview

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.

Prompt
Success of the Performance Improvement Plan
If 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 Submit

This 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.

Milestone Three Rubric
Criteria Exemplary (100%) Proficient (80%) Needs Improvement (70%) Not Evident (0%) Value
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 20
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 20
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 Does not describe what organizational processes will help the plan be successful 20
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 20
Scholarly Research Meets “Proficient” criteria by including three or more scholarly research articles that give in-depth details supporting identified interdepartmental issue Includes two scholarly research articles that give in-depth details supporting identified interdepartmental issue Includes some scholarly research but does not give in-depth support to identified interdepartmental issue Does not include scholarly research 10
Articulation of Response Submission is free of errors related to citations, grammar, spelling, and syntax and is presented in a professional and easy-to-read format Submission has no major errors related to citations, grammar, spelling, or syntax Submission has major errors related to citations, grammar, spelling, or syntax that negatively impact readability and articulation of main ideas Submission has critical errors related to citations, grammar, spelling, or syntax that prevent understanding of ideas 10
Total: 100%

Nursing Question

Jun 14, 2024 | Health Medical

Description

Module Pre-Assessments are your opportunity to practice applying module content before final submission of your Competency Assessment. Your final Competency Assessment is written. Therefore, you may choose to write your Pre-Assessment responses here as paragraphs, as a script, or as another type of deliverable. Consider what would be most helpful for you.

For your Module 1 Pre-Assessment, respond to the following prompts. These prompts match those in your final Assessment.

Prompts:

You will select a global health issue that is addressed by policy at the national/federal level for both the United States and one additional country, and compare them using a comparison matrix.

Review the following: Global Health Comparison Matrix

Part 1: Global Health Matrix

Compare the national/federal healthcare policy you selected in both the United States and in one additional country. Address the following in the Global Health Comparison Matrix:
Describe the global health issue you selected.
Describe the policy in each country related to the selected global health issue.
Explain the strengths and weaknesses of each policy.
Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
Analyze how each country’s government addressed cost, quality, and access related to the global health issue selected.
Explain how the health policy you selected might impact the global population. Be specific and provide examples.
Explain how the health policy you selected might impact the role of the nurse as an advocate in each country.
Explain how global health issues impact local health organizations and policies in both countries. Be specific and provide examples.

Once you submit your responses, assess yourself using the rubric provided. Use your Pre-Assessment submission and any feedback you may garner to improve and refine your responses.

Use the following rubric to assess your response to the prompts:

Rubric Criteria

Does Not Meet Expectations

Meets Expectations

Exceeds Expectations

Compare the healthcare policy related to a global health issue you selected in both the United States and in one additional country. Address the following in the Global Health Comparison Matrix:

Describe the global health issue selected.

Learning Objective 1.1: Describe global healthcare issues

Response presents a comparison of the selected healthcare policy related to a global health issue in both the United States and in one additional country that does not adequately describe the issue.

Response presents a comparison of the selected healthcare policy related to a global health issue in both the United States and in one additional country that adequately describes the issue.

Response presents a comparison of the selected healthcare policy related to a global health issue in both the United States and in one additional country that clearly and comprehensively describes the issue.

Describe the policy in each country related to the global health issue selected.

Learning Objective 1.2: Compare healthcare policies in the United States and other countries

Response does not adequately describe the policy in each country related to the global health issue selected.

Response adequately describes the policy in each country related to the global health issue selected.

Response clearly and comprehensively describes the policy in each country related to the global health issue selected.

Explain the strengths and weaknesses of each policy.

Learning Objective 1.3: Compare strengths and weakness of healthcare policies in the United
States and other countries

Response does not adequately explain the strengths and weaknesses of each policy.

Response adequately explains the strengths and weaknesses of each policy.

Response clearly and comprehensively explains the strengths and weaknesses of each policy.

Explain how the social determinants of health may impact the global health issue selected. Be specific and provide examples.

Learning Objective 1.4: Compare how the social determinants of health impact healthcare issues in the United States and in other countries

Response does not adequately explain how the social determinants of health may impact the global health issue
selected.

Response is not adequately specific.

Response does not provide adequate examples.

Response adequately explains how the social determinants of health may impact the global health issue selected.

Response is adequate in its specificity.

Response provides adequate examples.

Response clearly and comprehensively explains how the social determinants of health may impact the global health issue selected.

Response provides complete, thorough, and explicit information that fully supports the accurate and comprehensive details provided.

Response provides clear and comprehensive examples.

Analyze how each country’s government addressed cost, quality, and access related to the global health issue selected.

Learning Objective 1.5: Compare how governments of different countries address cost, quality, and access related to healthcare issues

Response does not adequately analyze how each country’s government addressed cost, quality, and access related to the global health issue selected.

Response adequately analyzes how each country’s government addressed cost, quality, and access related to the global health issue selected.

Response clearly and comprehensively analyzes how each country’s government addressed cost, quality, and access related to the global health issue selected.

Explain how the healthcare policy you selected might impact the global population. Be specific and provide examples.

Learning Objective 1.6: Compare how healthcare policies in different countries impact the health of the
global population

Response does not adequately explain how the selected healthcare policy might impact the global population.

Response is not adequately specific.

Response does not provide adequate examples.

Response adequately explains how the selected healthcare policy might impact the global population.

Response is adequate in its specificity.

Response provides adequate examples.

Response clearly and comprehensively explains how the selected healthcare policy might impact the global population.

Response provides complete, thorough, and explicit information that fully supports the accurate and comprehensive details provided.

Response provides clear and comprehensive examples.

Explain how the healthcare policy you selected might impact the role of the nurse in each country.

Learning Objective 1.7: Explain how healthcare policies in different countries impact the role of the nurse

Response does not adequately explain how the selected healthcare policy might impact the role of the nurse in each country.

Response adequately explains how the selected healthcare policy might impact the role of the nurse in each country.

Response clearly and comprehensively explains how the selected healthcare policy might impact the role of the nurse in each country.

Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.

Learning Objective 1.8: Explain how global health issues impact local healthcare organizations and policies in different countries

Response does not adequately explain how global health issues impact local healthcare organizations and policies in both countries.

Response is not adequately specific.

Response does not provide adequate examples.

Response adequately explains how global health issues impact local healthcare organizations and policies in both countries.

Response is adequate in its specificity.

Response provides adequate examples.

Response clearly and comprehensively explains how global health issues impact local healthcare organizations and policies in both countries.

Response provides complete, thorough, and explicit information that fully supports the accurate and comprehensive details provided.

Response provides clear and comprehensive examples.

Unformatted Attachment Preview

Global Health Comparison
Grid Template
Global Health Comparison Grid Template
Use this document to complete the PA006 Assessment.
Global
Healthcare
Issue
Description
Country
United States
Describe the
policy in each
country related to
the identified
healthcare issue.
© 2019 Walden University, LLC.
1
Explain the
strengths and
weaknesses of
each policy.
Explain how the
social
determinants of
health may impact
the global
healthcare issue
you selected. Be
specific and
provide examples.
Analyze how each
country’s
government
addressed cost,
quality, and
access related to
the global
healthcare issue
selected.
© 2019 Walden University, LLC.
2
Explain how the
healthcare policy
you selected
might impact the
global population.
Be specific and
provide examples.
Explain how the
healthcare policy
you selected
might impact the
role of the nurse in
each country.
Explain how
global health
issues impact
local healthcare
organizations and
policies in both
countries. Be
specific and
provide examples.
© 2019 Walden University, LLC.
3
General
Notes/Comments
© 2019 Walden University, LLC.
4
PA006: Global Health Issues
Module 1 Pre-Assessment Submission
Instructions
Note: Although this formative pre-assessment is not graded, a submission is
required before you can advance to your summative assessment.
Module Pre-Assessments are your opportunity to practice applying module content
before final submission of your Competency Assessment. Your final Competency
Assessment is written. Therefore, you may choose to write your Pre-Assessment
responses here as paragraphs, as a script, or as another type of deliverable. Consider
what would be most helpful for you.
For your Module 1 Pre-Assessment, respond to the following prompts. These prompts
match those in your final Assessment.
Prompts:
You will select a global health issue that is addressed by policy at the national/federal
level for both the United States and one additional country, and compare them using a
comparison matrix.
Review the following: Global Health Comparison Matrix
Part 1: Global Health Matrix
Compare the national/federal healthcare policy you selected in both the United
States and in one additional country. Address the following in the Global Health
Comparison Matrix:
1. Describe the global health issue you selected.
2. Describe the policy in each country related to the selected global health
issue.
3. Explain the strengths and weaknesses of each policy.
4. Explain how the social determinants of health may impact the global
health issue you selected. Be specific and provide examples.
RS
5. Analyze how each country’s government addressed cost, quality, and
access related to the global health issue selected.
6. Explain how the health policy you selected might impact the global
population. Be specific and provide examples.
7. Explain how the health policy you selected might impact the role of the
nurse as an advocate in each country.
8. Explain how global health issues impact local health organizations and
policies in both countries. Be specific and provide examples.
Once you submit your responses, assess yourself using the rubric provided. Use your
Pre-Assessment submission and any feedback you may garner to improve and refine
your responses.
Use the following rubric to assess your response to the prompts:
Rubric Criteria
Does Not Meet
Expectations
Meets
Expectations
Exceeds Expectations
Compare the healthcare Response
Response
Response presents a
policy related to a global presents a
presents a
comparison of the
health issue you selected comparison of the comparison of the selected healthcare
in both the United States selected
selected
policy related to a
and in one additional
healthcare policy healthcare policy global health issue in
country. Address the
related to a global related to a global both the United
following in the Global health issue in
health issue in
States and in one
Health Comparison
both the United
both the United additional country
Matrix:
States and in one States and in one that clearly and
additional country additional country comprehensively
Describe the
that does not
that adequately
describes the issue.
global health issue adequately
describes the
selected.
describe the issue. issue.
Learning Objective 1.1:
Describe global
healthcare issues
Response does
Describe the
not adequately
policy in each
describe the
country related to
Response
adequately
describes the
Response clearly and
comprehensively
describes the policy in
the global health
issue selected.
Learning Objective 1.2:
Compare healthcare
policies in the United
States and other
countries
Explain the
strengths and
weaknesses of
each policy.
Learning Objective 1.3:
Compare strengths and
weakness of healthcare
policies in the United
States and other
countries
policy in each
policy in each
each country related
country related to country related to to the global health
the global health the global health issue selected.
issue selected.
issue selected.
Response does
not adequately
explain the
strengths and
weaknesses of
each policy.
Response
adequately
explains the
strengths and
weaknesses of
each policy.
Response clearly and
comprehensively
explains the strengths
and weaknesses of
each policy.
Response does
Response
Response clearly and
Explain how the
not adequately
adequately
comprehensively
social
explain how the
explains how the explains how the
determinants of
social
social determinants of
health may impact social
determinants of health may impact the
the global health determinants of
issue selected. Be health may impact health may impact global health issue
the global health the global health selected.
specific and
issue selected.
provide examples. issue
Response provides
selected.
Response is
complete, thorough,
Learning Objective 1.4:
Response is not
adequate in its
and explicit
Compare how the social
adequately
specificity.
information that fully
determinants of health
specific.
supports the accurate
impact healthcare issues
Response
and comprehensive
in the United States and Response does
provides adequate details provided.
in other countries
not provide
examples.
adequate
examples.
Response provides
clear and
comprehensive
examples.
Response does
Response
Analyze how each
not adequately
adequately
country’s
analyze how each analyzes how
government
country’s
each country’s
addressed cost,
government
government
quality, and
addressed cost,
access related to addressed cost,
the global health quality, and access quality, and
related to the
access related to
issue selected.
global health issue the global health
Learning Objective 1.5: selected.
issue selected.
Compare how
governments of different
countries address cost,
quality, and access
related to healthcare
issues
Response clearly and
comprehensively
analyzes how each
country’s government
addressed cost,
quality, and access
related to the global
health issue selected.
Response does
Response
Response clearly and
Explain how the
not adequately
adequately
comprehensively
healthcare policy
explain how the
explains how the explains how the
you selected
selected
selected healthcare
might impact the selected
global population. healthcare policy healthcare policy policy might impact
might impact the might impact the the global population.
Be specific and
provide examples. global population. global population.
Response provides
Response is
complete, thorough,
Learning Objective 1.6: Response is not
adequately
adequate in its
and explicit
Compare how
specific.
specificity.
information that fully
healthcare policies in
supports the accurate
different countries
Response does
Response
and comprehensive
impact the health of the not provide
provides adequate details provided.
global population
adequate
examples.
examples.
Response provides
clear and
comprehensive
examples.
Explain how the
healthcare policy
you selected
might impact the
role of the nurse
in each country.
Learning Objective 1.7:
Explain how healthcare
policies in different
countries impact the role
of the nurse
Response does
not adequately
explain how the
selected
healthcare policy
might impact the
role of the nurse
in each country.
Response
adequately
explains how the
selected
healthcare policy
might impact the
role of the nurse
in each country.
Response clearly and
comprehensively
explains how the
selected healthcare
policy might impact
the role of the nurse
in each country.
Response does
Response
Response clearly and
Explain how
not adequately
adequately
comprehensively
global health
explain how global explains how
explains how global
issues impact
health issues
global health
health issues impact
local healthcare
impact local
issues impact
local healthcare
organizations and
healthcare
local healthcare
organizations and
policies in both
organizations and organizations and policies in both
countries. Be
policies in both
policies in both
countries.
specific and
countries.
countries.
provide examples.
Response provides
Learning Objective 1.8: Response is not
adequately
Explain how global
health issues impact local specific.
healthcare organizations
Response does
and policies in different
not provide
countries
adequate
examples.
Submissions
Response is
adequate in its
specificity.
complete, thorough,
and explicit
information that fully
supports the accurate
Response
and comprehensive
provides adequate details provided.
examples.
Response provides
clear and
comprehensive
examples.
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making 4 power point slides

Jun 14, 2024 | Health Medical

Description

about the paper just I need 3 to 4 slides include :Brand name, generic name, indication, dosage, route of administration intravenous or intramuscular 3 to 4 slides. I will post question just for making 3 to 4 slides. because it’s a group work and just I have to make 3 to 4 first slides about the grade.

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Abatacept
Soheila Karimi
Indication
Abatacept is considered to be the prescription made for the treatment of moderate to severe
rheumatoid arthritis (RA). It is specifically for adult patients who have not responded adequately
to other disease-modifying antirheumatic drugs (DMARDs), including methotrexate1. It is usually
employed to reduce the signs and symptoms of RA and indicate the progression of joint damage.
Pharmacokinetics Properties
Absorption
Abatacept is administered using subcutaneous injection, giving several advantages for
managing humanoid arthritis. The method of administration results in a sustained absorption of
the drug into the bloodstream directly2,3. The subcutaneous path also facilitates the gradual release
of Abatacept. This is considered to be important in the context of maintaining chronic autoimmune
diseases like RA.
The subcutaneous injection method is important for drugs that require constant therapeutic
levels across the body. This is because it is sustained in the release that contributes to the efficiency
of the drug in controlling the signs and symptoms of RA. It also allows the convenience of a dosing
regimen for patients3. This requires weekly administration of drugs to their patients. Physiological
barriers such as the skin and subcutaneous tissue do not necessarily affect the absorption process
for abatacept. Subcutaneous injection is usually designed to bypass the barriers without such
limitations. The path ensures that the drug is delivered directly into the subcutaneous tissue, which
can easily enter the circulation system. Figure one below shows the chemical structure of
Abatacept.
Figure 1: Chemical structure of Abatacept
Even though specific bioavailability of data for Abatacept and not always available across
the Internet, subcutaneous injection results in high bioavailability. This implies that a significant
portion of the administered dose reaches the bloodstream, leading to effective therapeutic
outcomes4. The high bioavailability is considered a favorable component because it allows for
lower drug doses, reduces the frequency of administration, and maintains therapeutic efficiency.
The absorption of Abatacept through this cutaneous injection offers a reliable and effective
approach to delivering the drug to the targeted tissue of rheumatoid arthritis. This law down the
release of drugs, which ensures a subcutaneous therapeutic level and makes it a valuable treatment
option for patients with moderate to severe or who have not responded properly to other therapies.
Distribution
The drug’s major target tissue is the synovial membrane across the joint affected by
rheumatoid arthritis. Considering the absorption into the bloodstream, Abatacept is suitably
distributed across the body with a key focus on joints affected by RA5. Unlike other medications,
Abatacept does not bind to plasma proteins, which allows it to be readily available for its intended
therapeutic processes.
Metabolism
Abatacept usually goes through minimal metabolism in the body, unlike many other drugs
that are extensively metabolized. Abatacept therapeutic effects are usually accomplished without
having significant metabolic transformation6,7. However, no known metabolites of their
medication have functional implications, and the elimination of the drug is not reliant on metabolic
processes.
Excretion
Abatacept is primarily excreted with the exact percentages and information about the renal
elimination process not readily available across the Internet. However, renal excretion is a common
root for removing drugs from the body.
Pharmacodynamics
Abatacept is usually classified as a disease modification antirheumatic drug (DMARD), a
T-cell co-simulation modulator. The medication is considered important in controlling T-cell
activation and reducing the inflammatory response, which is observed in patients having RA8. The
drug also interferes with the CD80/CD86-CD28 co-stimulatory signal, which specifically
decreases the T cell activation, which is considered the hallmark of the autoimmune response in
RA. Abatacept outlines a high affinity for CD80 and CD86 receptors, which is known to block the
interaction with CD28. The impact is that it mitigates the autoimmune response and reduces joint
inflammation and drag damage in RA patients.
Side Effects
The main side effect associated with the drug includes upper respiratory tract infections,
headache, and nausea. However, more serious side effects might occur, such as infections,
malignancies, and injection site reactions. Because of the immune response modulation, infections
can easily arise due to the suppressed immune system8,9. In addition, the long-term use of the drug
has been considered to increase the risk of malignancies even though these risks should be
balanced against the benefits of Disease Control. Therefore, it is suitable for individuals to
understand that Abatacept has a relatively narrow therapeutic index that emphasizes the need for
careful and constant monitoring during its use.
Other
In addition to its use in rheumatoid arthritis, the drug is also used to effectively treat other
autoimmune diseases, such as juvenile idiopathic arthritis (JIA). The drug is administered as a
subcutaneous injection once a week9. It effectively improves the signs and symptoms of RA and
slows down joint damage progression in clinical processes. Even though generally well-tailored,
the drug requires close monitoring because of the risk of infections and malignancies associated
with immune modulation. It sounds like an important treatment option for patients with moderate
to severe RA who have not responded positively to other therapies.
References
1. Blair, H. A., & Deeks, E. D. (2017). Abatacept: a review in rheumatoid arthritis. Drugs, 77,
1221-1233.
2. Furie, R., Nicholls, K., Cheng, T. T., Houssiau, F., Burgos‐Vargas, R., Chen, S. L., … &
Merrill, J. T. (2014). Efficacy and safety of abatacept in lupus nephritis: a twelve‐month,
randomized, double‐blind study. Arthritis & rheumatology, 66(2), 379-389.
3. Genovese, M. C., Becker, J. C., Schiff, M., Luggen, M., Sherrer, Y., Kremer, J., … &
Dougados, M. (2005). Abatacept for rheumatoid arthritis refractory to tumor necrosis
factor α inhibition. New England Journal of Medicine, 353(11), 1114-1123.
4. Genovese, M. C., Covarrubias, A., Leon, G., Mysler, E., Keiserman, M., Valente, R., … &
Alten, R. (2011). Subcutaneous abatacept versus intravenous abatacept: a phase IIIb
noninferiority study in patients with an inadequate response to methotrexate. Arthritis &
Rheumatism, 63(10), 2854-2864.
5. Kremer, J. M., Genant, H. K., Moreland, L. W., Russell, A. S., Emery, P., Abud-Mendoza,
C., … & Westhovens, R. (2006). Effects of abatacept in patients with methotrexate-resistant
active rheumatoid arthritis: a randomized trial. Annals of internal medicine, 144(12), 865876.
6. Maxwell, L., & Singh, J. A. (2009). Abatacept for rheumatoid arthritis. Cochrane
Database of Systematic Reviews, (4).
7. Moreland, L., Bate, G., & Kirkpatrick, P. (2006). Abatacept. Nature Reviews Drug
Discovery, 5(3).
8. Salem, J. E., Allenbach, Y., Vozy, A., Brechot, N., Johnson, D. B., Moslehi, J. J., &
Kerneis, M. (2019). Abatacept for severe immune checkpoint inhibitor–associated
myocarditis. New England Journal of Medicine, 380(24), 2377-2379.
9. Yu, C. C., Fornoni, A., Weins, A., Hakroush, S., Maiguel, D., Sageshima, J., … & Mundel,
P. (2013). Abatacept in B7-1–positive proteinuric kidney disease. New England Journal of
Medicine, 369(25), 2416-2423.

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Discussion 5

Jun 14, 2024 | Health Medical

Description

For this week’s discussion, you are asked to research a technological or human induced disaster.

(This not the same as in Weeks 3 and 4 where you might have discussed hostage situations, mass shootings, multiple-vehicle or mass transit accidents with multiple critical injuries, bioterrorism, and disease outbreaks.) Here you want to look at situations such as radiological, nuclear accidents, technological disasters (electromagnetic pulse), and hazardous material spills.

In your post, provide the name of the incident you have chosen, and support your answers with evidence/examples. Please provide a working link and a citation for your source(s).

Select 2 of the items below to discuss:

At what point does a technological or man made event become labeled a disaster?
Name and explain the impact categories associated with your disaster.
How well do you think the United States is prepared for a disaster like the one you selected?
Discuss the factors that can influence the effects a disaster may have on a community or region.
What nursing interventions would be a priority for these victims?
What community resources should be provided to the victims for follow up needs?

Support your answer with evidence from scholarly sources.

prospectus form

Jun 14, 2024 | Health Medical

Description

Complete form all the way down to”nature of study question

Unformatted Attachment Preview

1
ADHA Prospectus Form
Students | Complete your doctoral prospectus within this form. Write your responses in the white spaces using a scholarly tone and include in-text
citations and APA reference entries where appropriate. You can click on underlined terms and headings for descriptions, resource links, and
examples located in the Appendix. For additional prospectus information and resources, refer to the Doctoral Research Coach. Complete the
Research Design Alignment Table within this form using the information from earlier sections and self-assess your research design alignment.
Submit this completed form into MyDR for formal evaluation and feedback when your committee chair indicates that you are ready to do so.
Student’s Name | Shaterri Bush
Student ID | A00987525
Program and Specialization* | DDHA
Submission Date |
*Remember that your study focus must be within the realm of your program and specialization area.
Evaluators Only | Complete this section and provide feedback on responses and rubric scores in the form where noted.
Committee Chairperson Name: Dr. Sallie Marie Willis
Second Committee Member Name: Click or tap here to enter text.
PhD Program Director: PD DHA DQ Dr.Kristin Wiginton
Overall Assessment: Choose score.
Overall Assessment: Choose score.
Overall Assessment: Choose score.
Title
In 12 words or less, what is the working title for this study? Include the topic, variables, relationship, and the most critical keywords.
Perception of Healthcare worker after the COVID pandemic
Supporting Literature
The first step in developing your prospectus is to search the literature related to the general area related to healthcare administration you want to
investigate (see the social problem below). In your review of the recent empirical literature, what keywords did you search and in what
databases?
Leadership, healthcare, growth, retention, recruitment, male, personality tests, assessments, feedback, competitive salaries, flexible schedule, work
life balance, cultural fit
Search Log
2
Database Search Terms
Google
Scholar
Result Notes
s
45,317 Too broad, must use more descriptive terms.
Thoreau
Provide ten summaries of recent, scholarly (peer-reviewed) articles and empirical literature. The summaries should include: a) 3 – 5 summaries
within the last five years that justify a current and relevant problem in your discipline or professional field; b) article(s) that support your
theoretical/conceptual framework; c) article that supports your Nature of the Study section; d) additional articles that support that your problem is
current and relevant to your discipline or professional field for a total of 10 summaries.
Include the complete APA reference entry and (a) an in-text citation; (b) what was studied; (c) what was found; and (d) why this research is
important concerning your study. This evidence justifies your research problem.
HSO Justification Literature
(Minimum of 3 sources within the last five years justifying an HSO operational, administrative, or management problem)
3
HSO Problem Supporting Sources
(Social problem, significance, or variables beyond justified HSO problem)
Framework Literature.
(Minimum of 1 source that aligns with the research variables)
Nature of Study Literature Methods and Analysis
(Minimum of 1 source for the methodology and type of analysis)
Nature of Study Literature Dataset
(Minimum of 1 source for the dataset)
Rubric Standard | Justified > Is evidence presented that this problem is significant to the discipline and professional field?
Problem
What social and healthcare administration problems prompted you to search the literature to find out more? Write in complete sentences using a
scholarly tone.
Based on all of the above justification and supporting information (literature, social problem, healthcare administration problem), in one sentence,
what is your operational/research problem?
4
Now that you have read and summarized some recent literature, what significant gap in the literature aligns with the HSO research problem your
study will address? (What is still not known?)
Rubric Standard | Meaningful > Has a significant problem and gap in the research literature been identified?
Rubric Standard | Original > Does this doctoral study have the potential to make an original contribution?
Purpose
To address your stated research problem, what is the purpose of your study? Will you compare, explore, examine, etc.? Complete the purpose
sentence below and be sure to clarify your dependent and independent variables of interest.
Framework (Conceptual or Theoretical)
What theory(ies) and concept(s) support (frame) your study, and who are the original authors? Provide an in-text citation with your response and
the complete APA reference entry with a summary in the Supporting Literature section.
How do these theories and concepts relate to your research problem, purpose, and the nature of your study?
Rubric Standard | Grounded > Is the problem framed to enable the researcher to either build upon or counter the previously published findings
on the topic?
Research Question(s) and Hypotheses
List the question(s) that you plan to use to address the research problem. Your questions must align with your study purpose and include the
dependent and independent variables and how they will be examined.
5
Nature of the Study
What systematic approach (methodology and research design) do you plan to use to address your research question(s)?
What is the possible secondary data source(s)?
What specific data points from these sources do you plan to use to answer your research question(s)?
What limitations, challenges, and barriers might you need to address while conducting this study (e.g., access to participants, data access, data
storage requirements, separation of roles or other ethical considerations, instrumentation fees, etc.)?
Rubric Standard | Feasible > Can a systematic method of inquiry be used to address the problem, and does the approach have the potential to
address the issue while considering potential risks and burdens placed on research participants?
Significance
How will your study address the significant, discipline-specific issue you identified and contribute to your field, discipline, professional practice,
etc., to positive social change?
6
Rubric Standard | Impact > Does this doctoral study potentially affect positive social change?
Rubric Standard | Objective > Is the topic approached objectively?
7
Partner Site Masking Self-Check
Walden capstones typically mask the identity of the partner organization. The methodological and ethical reasons for this practice and exception
criteria are outlined here (link to posted guidance).
☒ Check here to confirm that you will mask the organization’s identity in the final capstone that you publish in ProQuest.
☒ If you perceive that your partner organization’s identity would be impossible to mask or if there is a strong rationale for naming the organization
in your capstone, please check this box so that your Program Director can review your request for an exception. If granted, the IRB must confirm
that exception during the ethics review process. The IRB will also ensure that your consent form(s) and site agreement(s) permit naming the
organization.
8
Research Design Alignment Table | Using an alignment table can assist with ensuring the alignment of your research design.
Research Design Alignment Table Video Tutorial (YouTube) | Doctoral Research Design Alignment Appointments or Office Hours
Note. At the prospectus stage, not all items in the table below can be identified (e.g., data points, data analysis). Please complete the things that you
have placed in this prospectus form. You will revisit this form to adjust as needed during proposal development and finalize your research design.
Research Problem,
Purpose, and Framework
Provide one sentence for
each. These must align
with all rows.
Problem: The social
problem that prompted this
literature search is the
leadership challenges
causing burnout in nursing
professionals.
The healthcare
administration problem
that prompted this
literature search is the
nursing turnover rates that
result from burnout.
Purpose: This quantitative
study aims to examine the
association between
nursing leadership efficacy
and nursing staff burnout.
Framework: The theory
that grounds this study is
the Job DemandsResources (JD-R) model.
Research Question(s), Method,
& Design
List one or more RQs, as
needed; select method; identify
design. Use a separate form for
additional RQs.
RQ1: Is there a statistically
significant correlation between
nurse leadership efficacy and
burnout among nurses between
2019 and 2022?
Method: Quantitative
Design: Descriptive research
design.
RQ2: Replace text with a
response.
Method: Quantitative
Design: replace text with a
response.
Data Collection Tools & Data
Sources
List the instrument(s) and
people, artifacts, or records that
will provide the data for each
RQ.
Questionnaires, The 2018
National Sample Survey of
Registered Nurses, and the
Walden Library.
Survey.
Data Points
List the variables,
specific interview
questions, scales, etc.,
for each RQ.
Variables: The
dependent variables
include inadequate
staffing, lack of
effective
communication and
collaboration, lack of
good management and
leadership, and
stressful working
environment.
Data Analysis
Briefly describe the
statistical or
qualitative analysis
that will address each
RQ.
Pearson correlation.
Scale: Leader Efficacy
Questionnaire (LEQ)
and Maslach Burnout
Inventory Human
Services Survey (MBIHSS)
Nurse interview.
Pearson correlation.
9
RQ3: Replace text with a
response.
Method: Quantitative
Design: Replace text with a
response.
Questionnaires.
Leader Efficacy
Questionnaire (LEQ).
Pearson correlation.
Note. The information in the first column must align with all rows, and each RQ row must show alignment across the columns.
Once your Research Design Alignment Table is completed, reflect on your design alignment. Ask yourself:
1.
Is there a logical progression from the research problem to the purpose of the study?
2.
Does the identified framework ground the investigation into the stated problem?
3.
Do the problem, purpose, and framework in the left-hand column align with the RQ(s) (all rows)?
4.
Does each RQ address the problem and align with the purpose of the study?
5.
Does the information across each row match/align with the RQ listed for that row?
1.
By row, will the variables listed address the RQ?
2.
By row, will the analysis address the RQ?
3.
By row, can the analysis be completed with the data points that will be collected?
Rubric Standard | Aligned > Do the various aspects of the prospectus align overall?
Appendix
The Doctoral Prospectus
The Doctoral Prospectus is a brief document that provides preliminary information about your doctoral research and is used in two ways:
1.
It serves as the tentative plan for developing the proposal and is evaluated to ensure doctoral-level work (e.g., feasibility, alignment, etc.).
2.
It provides information used to assign the committee University Research Reviewer.
Prospectus approval from the committee chair, second committee member, and a program-level designee is required for you to move forward and
work on your proposal. The plan is subject to change, and parts of your research design may need to be adjusted after you complete your exhaustive
literature review during proposal development.
10
…………………………………………………………………………………………………
Title
Example
The Relationship between Nurse Leader Self Efficacy, Burnout, and Intent to Leave
…………………………………………………………………………………………………
Supporting Literature
The most important step in the research process is searching recent, peer-reviewed literature and reading articles related to the general area you
want to investigate. The site is based on an identified social problem. As you read and learn, you will narrow your focus. This is how you will locate
a discipline-specific research problem.
[Note: Scholarly, empirical articles and how to find them.]
First, you will need to determine your search terms or keywords and the databases you should search. As you conduct your search of the literature,
stay organized by keeping a search log.
Example for this Form
The keywords and databases searched included hospital nurse leader retention, nurse leader intent to leave employment, nursing burnout, nursing
stress, and nursing turnover in MedLine, PubMed, and NIH.
Search Log Example
Database
Search Terms
Results
CINAHL
nurse leader turnover, nurse manager turnover, nurse manager burnout,
1175
nurse manager, limited to peer-reviewed, 2016-present
Notes
Search too broad; Narrow by using multiple terms
11
Search Log Example
Database
Search Terms
Results
Thoreau
nurse leader turnover, nurse manager turnover, nurse manager burnout,
nurse manager, nurse leader self-efficacy, self-efficacy, and burnout; 875
limited to peer-reviewed, 2016-present
Still too broad
Thoreau
Combined the above terms; limited to peer-reviewed, 2016 to present
Much better, several relevant articles found
75
Notes
As you read and evaluate literature, you must also organize your research. A literature review matrix is one way to help you visualize what has and
has not been done in your field. It will help you understand the scholarly works related to your area of interest. The importance of organizing and
recording your review of literature cannot be overstated. You will refer to your notes as you write, so start on the right track from the beginning!
[Suggestion: If you keep your search log in an Excel workbook, use the second tab in the same workbook for your literature review matrix.]
For this prospectus form, include the complete APA reference entry and (a) an in-text citation; (b) what they studied; (c) what they found; and (d)
why this is important concerning your study. This evidence justifies your research problem. These sources explain that this problem is meaningful to
the discipline or professional field. The background literature must include the following:
1.
3-5 credible sources within the last five years that all talk about the same professional practice problem
2.
Reference entries related to the framework
3.
Reference entry related to the Nature of the Study.
4.
Additional reference entries that support and justify the research problem.
[Note: During proposal development, you will conduct an exhaustive review and synthesize your sources rather than summarize.]
Supporting Literature Examples
Justification Literature
William, C. & Looker, H. (2020). The influence of frontline manager job stress on burnout, commitment, and turnover intention: A cross-sectional
study. International Journal of Nursing Studies, 49, 1800-1833. https://doi.org/10.1016/j.ijnurstu.2015.09.006
(a) William and Looker (2020); (b) studied the relationship between nurse manager job strain, burnout, lower organizational commitment, and
higher turnover intention; (c) they found that nurse leaders have a high turnover, job strain, and burnout; (d) this in important concerning my
study because establishes a direct relationship between an operational problem and conditions influencing the problem.
12
Heido, S., Bron, P., Frazer, K., & Wing, C., (2019). A quantitative analysis of factors influencing nurse leaders’ intent to stay or leave employment.
Journal of Nursing Management, 23, 105-106. https://doi.org/10.1111/ 12252
(a) Heidi et al., 2019; (b) studied the prevalence of nurse leaders intending to leave their jobs; (c) they found that up to 40% of nurse leaders will
leave their jobs in the next two years as a result of burnout and work dissatisfaction; (d) this is important concerning my study because it supports
the currency and significance of the operational problem.
Adral, J., Link, A., & Borg, T. (2018). Predictors of occupational stress, health and well-being in nurse managers: A cross-sectional survey study.
International Journal of Nursing Studies, 12, 81-92. https://doi.org/10.1016/ ijnurstu.2017.05
(a) Adral et al. (2018); (b) studied predictors of occupational stress with nurse leaders; (c) they found that nurse leaders are making the difficult
decision to leave their jobs while reporting increasing levels of burnout due to increasing occupational stressors; (d) this is important concerning
my study because it justifies the operational problem and future magnitude of the problem.
Wing, C. & Lasky, H. (2019). The influence and impact of frontline manager job strain on burnout, commitment, and turnover intention: A crosssectional study. International Journal of Nursing Studies, 18, 1500-1533. https://doi.org/10.985/j.ijnurstu.2015.09.006
(a) Wing & Lasky (2019); (b) studied the causes and influences of nurse leader burnout and commitment; (c) they found that job strain and stress
had a direct relationship to nursing leaders’ commitment to employment and intent to leave employment; (d) this is important concerning my
study because it justifies that an operational problem exists with job stress, burnout, and intent to leave employment for nurse leaders.
Supporting Literature
Teal, Y., Zack, S., Gate, X. Andrew, Z., Wang, S., Link, H., Lang, Y., Goatz, L., Lutz, L. & Donalds, Z. (2020).
General self-efficacy modifies the effect of stress on burnout in nurses with different personality types. BMC Health Services Research, 81,
367-385. DOI: 10.1186/s12913-018
(a) Teal et al., (2020); (b) studied self-efficacy as one type of self-influence that moderates burnout in professionals who serve others; (c) they
found that increasing self-efficacy may serve as a protector against burnout or a way to heal from existing burnout; (d) this is important about
understanding the connection between protecting and healing from the burnout that results with intent to leave employment.
Figueroa, C., Harrison, R., Chauhan, A., & Meyer, L. (2019). A rapid review of priorities and challenges for health leadership and workforce
management globally. BMC Health Services Research, 1, 1-11. https://doi.org/10.1186/s12913-019-4080-7
13
(a) Figueroa et al. (2019); (b) studied challenges healthcare leaders are facing with workforce management; (c) they found that healthcare
executives are challenged with sustaining a health services leadership workforce that provides safe, accessible, high-quality, people-centered care
across the health care services continuum; (d) this is important about my study because it supports the social health problem facing healthcare
administrators.
McFitz, G., Jackvilee, D., Vickson, M., & Williams, L. (2019). Surviving workplace adversity: a qualitative study of nurses and midwives and their
strategies to increase personal resilience. Journal of Nursing Management, 24, 123-131. https://doi.org/10.1111/jonm.12293
(a) McFitz et al. (2019); (b) studied how strategies used by nurses and midwives to increase personal residence to workplace stress; (c) they found
that nursing professionals can survive workplace adversity using their internal self-motivation, self-organization, and involvement in support
networks; (d) this is important about my study because it supports the positive impact intrinsic motivation, organization and support network may
have mitigated the negative effects of burnout.
Framework Literature
Bandura, A. (1997). Self-efficacy: The exercise of control. New York, NY: W.H. Freeman and Company.
(a) Bandura (1997); (b) studied the ability of a person to regulate one’s level of motivation and behavior; (c) he found that individuals who could
regulate one’s motivation and behavior were defined by their destiny whereby and not an external environment that might cause them to fail due
to stress; (d) this is important about my study because it establishes a framework that connects the conditions surrounding employment burnout
and to possible intent to leave employment.
Nature of Study Literature
Frankfort-Nachmias, C., Leon-Guerrero, A., & Davis, G. (2020). Social statistics for a diverse society (9th ed.). Thousand Oaks, CA: Sage
Publications.
(a) Frankfort-Nachmias, Leon-Guerrero & Davis (2020); (b) published textbook on quantitative linear regression research design; (c) found how
a Pearson correlation can help to understand the magnitude or impact of one variable on another; (d) this is important about determining a
statistical significance between the dependent and independent variable in the study.
AONL (2019). American Organization of Nursing Leadership. Database for nursing employment, job satisfaction, self-efficacy, and retention.
Retrieved from https://www.aonl.org
14
(a) AONL (2019); (b) the AONL houses secondary data on nurse leaders; (c) will provide access to secondary data collected from nursing
managers using the Maslach Burnout Inventory (MBI-HSS) and Leader Efficacy Questionnaire (LEQ); (d) it is important about my study because
it will provide data points for the dependent and independent variable to be analyzed.
Rubric Standard | Justified > Is evidence presented that this problem is significant to the discipline and professional field?
…………………………………………………………………………………………………
Problem
Social Problem
The situation or issue experienced by a population or within your discipline that prompted you to search the literature to find out more is sometimes
called a social problem. It is the issue that students see “on the ground.” The social problem often prompts students to think about a topic of interest.
Usually, such a topic is one that students identify with, sometimes having personally experienced some aspect of the problem as it exists in the world.
Social Problem Example
The issue that prompted me to search the literature is that hospital executives are challenged with sustaining a health services leadership workforce
that provides safe, accessible, high-quality, people-centered care across the health care services continuum.
Research Problem
A research problem is a focused topic of concern, a condition to be improved upon, or a troubling question that is supported in scholarly literature or
theory that you study to understand in more detail, which can lead to recommendations for resolutions. It is the research problem that drives the rest
of the dissertation: the purpose, the research questions, and the methodology.
Research Problem Example
In one sentence, the specific research problem is that hospitals struggle to retain nurse leaders due to increasing levels of nursing burnout due to
increasing occupational stressors.
Gap
The need to address an identified gap in the research literature must be clear and relevant to the discipline and area of practice. Keep in mind that a
hole in the research is not, in and of itself, a reason to conduct research. The gap relates to the rubric standard: Meaningful.
15
Research Gap Example
Although researchers have investigated this issue, there is very little, or no literature on the role self-efficacy plays in nurse leader burnout,
employment stressors, and intent to leave employment.
Rubric Standard | Meaningful > Has a significant problem and gap in the research literature been identified?
Rubric Standard | Original > Does this doctoral study have the potential to make an original contribution?
…………………………………………………………………………………………………
Purpose
To address your stated research problem, what is the purpose of your study? Will you describe, compare, explore, examine, etc.? Be sure to clarify
your variables/concepts of interest. For example: In quantitative studies, state what needs to be studied by describing two or more factors (variables)
and a conjectured relationship related to the identified gap or problem.
Purpose Example
This quantitative study aims to examine if there is an association between the self-efficacy of nurse leaders and self-reported burnout, occupational
stress, and intent to leave.
…………………………………………………………………………………………………
Framework
The framework includes the theories and concepts relevant to your topic. Align the framework with your study’s problem, purpose, research
questions, and background. This theoretical or conceptual framework is the basis for understanding, designing, and analyzing ways to investigate
your research problem (data collection and analysis). Provide the original scholarly literature (citing original authors) on the theory and concepts,
even if it is more than five years old. Please do not cite secondary sources.
Example Theoretical Framework
16
The theories and concepts that ground this study include Bandura’s (1997) theory of self-efficacy, focusing specifically on one’s perception of how
well one can achieve something that appears beyond their reach.
Next, explain how these theories and concepts relate to your research problem, purpose, and the nature of your study. Your topic/approach should
align with the identified framework so that you will either build upon or counter the previously published findings on the topic.
Example Connection for the Conceptual Framework
The logical connections between the framework presented and my study approach include Bandura’s (1997) theoretical work, which shows that an
individual can influence self-efficacy. Further, subsequent research application of Bandura’s theory offers guidance that increasing self-efficacy may
protect against burnout (Teal et al., 2020).
Rubric Standard | Grounded > Is the problem framed to enable the researcher to either build upon or counter the previously published
findings on the topic?
…………………………………………………………………………………………………
Research Question(s) and Hypotheses
List the overarching question and a series of related questions that are informed by the study purpose that will be used to address the research
problem. A research question informs the research design by providing a foundation for generating null and alternative hypotheses in quantitative
studies.
Research Questions Example
RQ1 – Is there a correlation between higher self-efficacy scores for nurse leaders and lower scores for burnout, occupational stress, and intent to
leave?
H₀1 – There is no statistically significant correlation between higher self-efficacy scores for nurse leaders and lower scores for burnout,
occupational stress, and intent to leave.
Ha1 – There is a statistically significant correlation between higher self-efficacy scores for nurse leaders and lower scores for burnout,
occupational stress, and intent to leave.
17
RQ 2 – Are self-efficacy scores for nurse leaders associated with scores for burnout, occupational stress, and intent to leave after controlling for age,
gender, and race/ethnicity?
H₀1 – There is no statistically significant association between self-efficacy scores for nurse leaders and self-reported scores for burnout,
occupational stress, and intent to leave after controlling for age, gender, and race/ethnicity.
Ha1 – There is a statistically significant association between self-efficacy scores for nurse leaders and self-reported scores for burnout,
occupational stress, and intent to leave after controlling for age, gender, and race/ethnicity.
…………………………………………………………………………………………………
Nature of the Study
Explain the systematic approach (research design) you plan to use to address your research question(s). Examples of study design are as follows:
Quantitative—for experimental, quasi-experimental, or non-experimental methods; treatment-control; repeated measures; causal-comparative;
single-subject; predictive studies; or other quantitative approaches
Research Design Example
To address the research questions in this quantitative study, the approach I plan to use will include a Pearson Correlation that will be used for RQ1 to
understand the correlation between the independent variable and each of the dependent variables (Frankfort-Nachmias, Leon-Guerrero, & Davis,
2020). A multivariate multiple regression analysis will be used to address the second research question in this quantitative study (FrankfortNachmias, Leon-Guerrero, & Davis, 2020).
A reference entry for the work on which this approach is based:
Frankfort-Nachmias, C., Leon-Guerrero, A., & Davis, G. (2020). Social statistics for a diverse society (9th ed.). Thousand Oaks, CA: Sage
Publications.
Then, for your planned research design, present the type of data you need and a list of possible secondary data sources that could be used to address
the proposed research question (s). At this point, you should know the type of data needed to address your research question(s). Identify the data
source and how the data will be accessed. Possible secondary data sources, by program, are available on the Center for Research Quality website.
[Note. This is your tentative plan, so keep in mind that things might need to be modified during the proposal stage—particularly after you have
completed your exhaustive literature review.]
Data Source Example
18
For my planned research design, I will need to request access to the American Organization for Nursing database. The secondary data exist for the
Maslach Burnout Inventory Human Services Survey (MBI-HSS) and Leader Efficacy Questionnaire (LEQ).
Next, provide the specific data points you plan to use to answer your research question(s). Data points are the particular variables or types of
information that you will use in your analysis. For example, items on a survey or types of interview questions (not the actual survey or interview
questions). When using secondary data, you must ensure the data include the dependent and independent variables or data points you need to address
your research question.
Example
The MBI-HSS will provide data points for nursing leader burnout, occupational stress, and intent to leave, and LEQ will offer data on nursing leader
self-efficacy ratings.
Finally, provide information on limitations, challenges, and barriers that may need to be addressed when conducting this study. These may include
access to participants, data, separation of roles (researcher versus employee), instrumentation fees, etc. If you are considering collecting data on a
sensitive topic or from a vulnerable population, early consultation with the Institutional Review Board (IRB; IRB@waldenu.edu) during your
prospectus process is recommended to gain ethics guidance that you can incorporate into your subsequent proposal drafts and research planning.
[Note. Find more information on research ethics and potential “red flag” issues in the IRB Guides and FAQs.]
Example
Limitations include participant responses that may vary from one organization to another and are not captured in the existing dataset. Also, the
statistical analyses include multiple variables from two different scales. Both challenges can be overcome; however, the researcher must take time to
work through the challenges when conducting the study. The researcher has consulted with an instructional specialist from Walden’s Center for
Research Quality (CRQ) and will continue to work with committee mentors and CRQ tutors during the doctoral study process.
Rubric Standard | Feasible > Can a systematic method of inquiry be used to address the problem, and does the approach have the potential to
address the issue while considering potential risks and burdens placed on research participants?
…………………………………………………………………………………………………
Significance
19
Here you explain how your study addresses the significant, discipline-specific issue that you identified and will contribute to your field, discipline,
professional practice, etc., to positive social change. Detail how your findings might support the professional practice or allow practical application
(answer the So what? question).
Example
This study is significant because it will add to the growing knowledge on self-efficacy, burnout, occupational stress, and turnover of nurse leaders.
Depending on the results, healthcare leaders can implement strategies to support the development of self-efficacy in nurse leaders or encourage
healthcare leaders to look at variables or systems to reduce burnout and turnover for nurse leaders. Providing nurse leaders with the skill to develop
higher levels of self-efficacy may reduce turnover while stabilizing the patient care environment and creating social change.
Rubric Standard | Impact > Does this doctoral study potentially affect positive social change?
Rubric Standard | Objective > Is the topic approached objectively?
…………………………………………………………………………………………………
Research Design Alignment Table | Using an alignment table can assist with ensuring the alignment of your research design.
Research Design Alignment Table Video Tutorial (YouTube) | Doctoral Research Design Alignment Appointments or Office Hours
Note. At the prospectus stage, not all items in the table below can be identified (e.g., data points, data analysis). Please complete the things th

Health & Medical Question

Jun 14, 2024 | Health Medical

Description

INSTRUCTIONS

Length: 6-8 pages (not including title page or reference page).

12 Font Arial/Times Roman, Double spaced.

On title page: List your name and title of your paper

Grading

Clear thesis statement

Strong supportive and well thought out arguments (3-5 key points)

Incorporated learnings from course.

Well organized

Turn-it In evaluation

Reference Citation Format : APA

Due Date: October 1. End of day.

Submission: Enter into Bb under Assignment tab via TURNITIN LINK

Bio290 Anatomy and Physiology

Jun 14, 2024 | Health Medical

Description

Cell Structure: Cell theory and internal organelles
LEARNING OBJECTIVES

At the end of this simulation, you will be able to:

Explain cell theory
Describe the main differences between the prokaryotes, eukaryotes, plants and animals
Describe the different intracellular and extracellular components forming eukaryotic cells
Lab techniques
Microscopic analysis
Wk 2 – Summative Assessment: The Cell Structure Lab Report [due Mon]
Wk 2 – Summative Assessment: The Cell Structure Lab Report [due Mon]

Exam Content
Identifying protagonist and antagonistic structures and organelles is critical to maintaining physical balance and health.
The final step for this assessment is to complete the lab report.
When you are satisfied with your report, please complete it, and submit your lab report.Resources
Center for Writing Excellence
Reference and Citation Generator
Grammar Assistance

Week 3 Consumer Informatics/Telehealth Case Study Discussion

Jun 14, 2024 | Health Medical

Description

Week 3
Consumer Informatics/Telehealth Case Study
DISCUSSION
PURPOSE

The purpose of this discussion is for you to investigate telehealth and technology relationships to social justice principles.

CASE STUDY SCENARIO

Watch the following video.

Consumer Informatics/Telehealth Case Study (1:55)

Launch External Tool

INSTRUCTIONS

Review the case scenario above and address the following:

Examine concepts such as equity, respect, self-determinism, health literacy, cyclic disadvantage, and healthcare disparities among marginalized populations or groups and how they affect patient outcomes.
Compare and contrast how each patient in the video may benefit from telehealth services and the ethical considerations from the viewpoint of the nurse.
Propose barriers that must be removed to achieve well-being, sufficiency, and healthcare access for all.

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:

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)
Appraise consumer health information sources for accuracy, timeliness, and appropriateness. (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)

Video [MUSIC] Mr. Kasich is a 77-year old who was recently taken to the emergency room after he fellwhen trying to get out of bed. There, he was found to have a bloodglucose level of 35 milligrams per deciliter and was diagnosed withuncontrolled type 2 diabetes mellitus and hypoglycemia despite many years ofwell-maintained the blood glucose levels. After further assessment, Mr. Kasich was transferred toa medical room in the hospital. His background includes diagnosedwith type two diabetes mellitus, advanced congestive heart failure andlung cancer. Has Medicare parts A and B. Lives with wife in a remote area thatis 40 miles from the closest healthcare provider. Is proficient using his home computer. Mr. Lane is a 42-year old who was admittedfor exacerbation of heart failure. His background includes hasdiabetes mellitus type two. Is a long-haul truck driverwith a large trucking company. Is privately insured. Is single andprimarily lives in his truck. Both Mr. Kasich and Mr. Lane are goinghome with telehealth consisting of a telemonitoring device thattransmits weight, blood pressure, blood glucose levels and pulseoximetry to a remote telehealth nurse. Even though the use of telehealth doesnot often include hands on interaction, the goal of keeping patients outof a hospital is consistent with quality nursing practice. Telehealth applications are designedto enhance the patient experience and improve clinical outcomeswhile providing care for patients in their home environmentrather than an institutional setting. Telehealth supports self-careby empowering patients, which is a central tenetof nursing practice.

HCI 214- W4: Interactive Activity

Jun 14, 2024 | Health Medical

Description

W4: Interactive Activity
W4: Interactive ActivityRead the following:- Human-Centered Design and Innovative Research Methods for Healthcare
Watch the following video(s):
What is Human-centered Design?
Edit
Interactive Activity 3
Purpose
The purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos.

Action Items
from your reading and watching the video, give some examples of human centred designe?

note: make it short

3k-5k Biotechnology and data science dissertation sample

Jun 14, 2024 | Health Medical

Description

3k-5k disseration biotech and data science paper. Needs in depth skillset for organizing literature review with data.

MSW 620 Week 3 discussion post

Jun 14, 2024 | Health Medical

Description

Instructions

Classroom Participation

Initial Response
INSTRUCTIONS:
Choose one:
Explain the similarities and differences between autism spectrum disorder and Attention Deficit Hyperactivity disorder.
Describe how a patient can be diagnosed with both conditions.

Create a case example of a client that displays both symptoms of each diagnosis.
Provide a thorough explanation using the criteria in the DSM 5 TR to support your answer.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Your inititial 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:

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

‏Clinical procedures and differences between conventional dentures and obturators

Jun 14, 2024 | Health Medical

Description

Hello I will need, an overview about the topic that included material, clinical steps, different approaches, .. etc

The nurse leader and the systems development life cycle

Jun 14, 2024 | Health Medical

Description

system development life cycle for implementation template

Epidemiology compare and contrast

Jun 14, 2024 | Health Medical

Description

This week we are comparing and contrasting epidemiological methods of research; case-control and cohort study methods. Select either the case-control or cohort study method and compare its features, the methodology, to a randomized controlled trial using the following questions. Please format, organize, your responses using each question below:What is the fundamental difference between the method you have chosen (either the case-control or cohort method) and the randomized controlled trial?What are the advantages and disadvantages of the study method you chose (case-control or cohort study)?What are the characteristics of a correlational study?Where does the method you chose (case-control or cohort study) fall on the research pyramid? What does where it is on the research pyramid mean?

NUTRITION DISCUSSION

Jun 14, 2024 | Health Medical

Description

In Chapters 12 & 14 we reviewed the importance of establishing healthy eating behaviors in children and adolescences as well as the common nutritional concerns of nutrient deficiencies, dental carries, and weight issues. In this discussion post you will read an article on the marketing of food to children and provide your perceptions of the influence of advertising in childhood obesity.

Discussion #2 Summary:

1) Read the paper “What’s on YouTube? A Case Study on Food and Beverage Advertising in Videos Targeted at Children on Social Media” by LeeAnn Tan, See Hoe Ng, Azahadi Omar, and Tilakavati Karupaiah.

2) Answer the following questions in at least 300 words total for entire post (name, title, and resources do not count – only your answers):

a) What type of marketing content is most commonly used by food corporations on YouTube (hint: persuasive techniques)?

b) Before reading the article what did you know about child-directed online food advertisement on childhood obesity? Where did you obtain this information?

c) What is your overall impression of the research and information presented in the paper? Thoughts, reservations, impressions? If you had an opinion regarding marketing food to children on YouTube, how did this article impact your opinion?

d) Are there any foods/beverages you consume that have been advertised on YouTube (pay attention the next time you are binge watching MrBeast)? Did you consume them before or after seeing them on YouTube?

week 5 discussion

Jun 14, 2024 | Health Medical

Description

Lifelong learning involves a commitment to remain current within a rapidly changing, increasingly complex, and technologically reliant healthcare world.

Why is it important for nurses to commit to lifelong learning in relation to patients, organizations, and self?
How can organizations such as Sigma Theta Tau International (STTI) assist nurses in their lifelong learning journey?

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. please use references in initial post and peer responses.

+ 2 peer responses , I will send you the peer responses after initial post is sent to me!

273 @areej_0z

Jun 14, 2024 | Health Medical

Description

See attached

Unformatted Attachment Preview

Purchase answer to see full
attachment

reflection self 5-2 wellness

Jun 14, 2024 | Health Medical

Description

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.

No AI or Chatbot! I will be sure to check this.

Overview

Directions

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:

Submit your short paper as a 1- to 2-full page Microsoft Word document with double spacing, 12-point Times New Roman font, and one-inch margins excluding the title and reference pages. Sources should be cited according to APA style. Consult the Shapiro Library APA Style Guide for more information on citations.

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.

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

clinical/patient outcomes

Jun 14, 2024 | Health Medical

Description

What are clinical/patient outcomes and why is important to link them to the care provided? Why is it so difficult to attribute clinical outcomes to nursing performance? What are clinical practice guidelines and what factors affecting their adoption? What strategies can be used to support their implementation?use attached chapter

Unformatted Attachment Preview

chapter four
Copyright 2016. Springer Publishing Company.
All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law.
Translation of Evidence to Improve
Clinical Outcomes
Julie Stanik-Hutt
PATIENT OUTCOMES MANAGEMENT AND THE APPLICATION OF evidence to practice are
powerful tools that can improve quality of care (The Joint Commission, 2008). The application of these symbiotic processes is the responsibility of all nurses (Foster, 2001).
Since Florence Nightingale, the assessment of patient outcomes has been inextricably
intertwined with nursing care. In fact, Nightingale’s collection and analysis of data regarding morbidity and mortality rates of soldiers under her care in the Crimea contributed to
changes in care and, ultimately, to improved patient outcomes. Its later publication led to
public and political support for the profession of nursing.
The application of the nursing process involves the identification of desired patient
outcomes. Desired patient outcomes are established to direct the application of selected
care interventions. Nursing interventions, based on the biopsychosocial sciences, are developed and implemented with the intention of attaining the established desired outcome.
Finally, results of nursing interventions are assessed and evaluated by comparing the patient’s actual outcomes to the desired outcomes. By doing so, quality and effectiveness of
the delivered care are assessed, and the need for continued or altered care is determined.
The application of evidence-based care is one tool nurses use to improve patient outcomes. Evidence-based practice (EBP) processes can be used to improve care outcomes
one patient at a time or can be used to create clinical practice guidelines (CPGs), which,
when applied in practice, can improve outcomes for groups or populations of patients.
■
CLINICAL OUTCOMES
In health care, quality is defined as the “degree to which health services for individuals
and populations increase the likelihood of attaining desired health outcomes and are
consistent with current professional knowledge” (Institute of Medicine [IOM], 1990,
p. 21). Safety is also a component of quality. Safe care is unlikely to injure or harm
the patient (IOM, 2001; Newhouse & Poe, 2005). In addition, the IOM asserts that, in
order for care to be considered high quality, it should also be patient centered, timely,
73
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AN: 1193798 ; Kathleen M. White, PhD, RN, NEA-BC, FAAN, Sharon Dudley-Brown, PhD, RN, FNP-BC, FAAN, FAANP, Mary F. Terhaar, PhD, RN, ANEF, FAAN.; Translation of
Evidence Into Nursing and Health Care, Second Edition
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II: APPLICATION OF TRANSLATION
efficient, and equitable (IOM, 2001). These characteristics clearly link patient preferences
and care processes with quality (IOM, 1990). Donabedian, the “father” of health care
quality, suggested that care quality could be improved by establishing standards for care
structures and processes. Patient outcomes are the ultimate measures of quality as they
incorporate the influence of both structures and processes of care (Donabedian, 2005;
Van Driel, De Sutter, Christiaens, & De Maeseneer, 2005).
Clinical or patient outcomes are defined as the end results of care that can be attributed to services provided (treatments, interventions, and care). Donabedian (1985)
referred to outcomes as “changes in the actual or potential health status of individual
patients, groups, or communities” (p. 256). Clinical outcomes demonstrate the value and
effectiveness of care and can be assessed for individuals, populations, and organizations
(Hughes, 2008). Outcomes can be either desirable or undesirable (adverse). Outcomes
are quantified or measured through the use of indicators, sometimes also called “metrics.”
Outcome indicators or metrics gauge how patients are affected by their care. Indicators
must be valid and reliable measures that are related to the outcome.
For example, to measure the adequacy of blood glucose control in a patient with
diabetes, you might measure the patient’s finger-stick blood glucose or glycosylated hemoglobin levels. In this case, the finger-stick blood glucose or glycosylated hemoglobin
is the indicator or metric used to measure the outcome of blood glucose control. Indicators or metrics that are reported are referred to as “performance measures” (Dennison &
Hughes, 2009).
Structures that support care and processes that are used to provide care are also
important to care quality and are additional sources of relevant health care outcomes
(Donabedian, 2005; Hammermeister, Shroyer, Sethi, & Grover, 1995). Structure indicators assess the organization and delivery of nursing care. For example, the nurse-to-patient
ratio and skill mix of staff providing care are structure indicators. Process indicators evaluate the nature and amount of care that nurses provide. For example, documentation of
patient teaching or timely reassessment of a patient’s pain after the administration of an
analgesic is an indicator of care processes.
Some ask, “What is the difference between goals, objectives, indicators, and outcomes?” Should they all be called “outcomes?” Outcomes are used to characterize the
result (effect) of an intervention, treatment, or practitioner/provider (cause). This is essentially a cause-and-effect relationship (Parse, 2006). “Goals and objectives are something
to strive for; indicators are signs of progress toward achievement of something, whereas
outcomes are predictors of end-performance” (Parse, 2006, p. 189).
■
LINKING OUTCOMES TO CARE
Assessing care outcomes is not the goal in and of itself. Instead, it is important to assess outcomes in relation to the care provided (Minnick, 2009). When outcomes data
are linked to interventions, they provide patients, payers, and practitioners (individuals,
e.g., nurses, nurse practitioners [NPs], physicians, physical therapists)/providers (organizations or agencies, e.g., hospitals, home care agencies) with information regarding the
potential effect that a health care intervention or practitioner/provider can have on their
lives. It can help patients to make decisions regarding their health care (Brooks & Barrett,
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4: TRANSLATION OF EVIDENCE TO IMPROVE CLINICAL OUTCOMES
75
1998). The data can also influence a payer’s decision making regarding which services
to cover or which practitioners and providers to include in the network. For example,
outcomes data can be used to compare one treatment for a condition with an alternative
treatment or to compare care provided by different health care practitioners and agencies
(Dennison & Hughes, 2009). Outcomes data are useful to practitioners and providers
because they help them to better understand the effects of the services they provide to
their patients. Outcomes can also be compared with standard levels of performance, the
so-called “benchmarks” or “norms,” to determine whether a service, practitioner, or provider is performing at a level that meets the established norms.
Outcomes can be used by practitioners and providers to evaluate and improve the
care they deliver. The best care comes from practitioners who routinely evaluate care
outcomes and use that data to make adjustments to the care they provide as part of a
continuous quality improvement cycle (Mullins, Baldwin, & Perfetto, 1996). This is often called “outcomes management.” Outcomes management refers to the collection and
analysis, in relation to the processes of care, of information that indicates effectiveness of
care. It provides a “checks and balances” process in the provision of health care. It usually
focuses on aggregated outcomes data on groups of patients with common characteristics—for example, patients with diabetes or asthma or some other health problem. By
measuring and evaluating care outcomes of groups of patients, practitioners can identify
areas of their practice that need improvement. Once problems are identified, practitioners
can seek out evidence-based solutions to implement and evaluate. The effectiveness of
the solution is judged by the new outcomes attained. In this way, outcomes measurement
can be linked to EBP, and both can become “complementary, iterative processes which
contribute to quality improvement” (Deaton, 2001, p. 83).
Minnick (2009) discusses challenges encountered in the design and implementation of evidence-based outcome improvement projects. She emphasizes that the first step
is the identification of the overall outcome that a project is intended to address. A population, intervention, comparison, outcome (PICO) question or other formal purpose statement can be used to start the search for evidence, benchmarks, and other data related to
the desired outcome. A PICO question allows one to explore and link knowledge related
to the topic with the patient population and setting involved and the outcome of interest.
This information, as well as the necessary and available resources to carry out the outcome improvement project, should be verified and reviewed with project stakeholders.
Subsequently, a design for implementing and assessing the effects of the project, specifically the outcomes to be measured, should be identified.
■
NURSING OUTCOMES
In the past, the “5 Ds”—death, disease, disability, discomfort, and dissatisfaction—were
the most commonly monitored outcomes of health care quality (Lohr, 1988). They are
outcomes that are easily measured and understood by the public and policy makers.
Donabedian (2005) described the use of patient outcomes of “recovery, restoration of
function and of survival” (p. 692) as indicators of care quality. However, these outcomes
do not adequately represent quality and are not specific to nursing. The first challenge is
to “describe what nurses do (nursing interventions) in response to what sort of patient
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76
II: APPLICATION OF TRANSLATION
conditions (nursing diagnoses) with what effect (nursing outcomes)” (Marek, 1997, p. 8).
Researchers at the University of Iowa have provided leadership in this area by creating the
Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC)
that link nursing interventions to diagnoses and outcomes. These systems allow the evaluation of care provided by nurses and facilitate communication regarding the same.
In 2003, 15 nursing care outcomes were selected for national reporting on nursing
care performance. They included measures of patient-centered outcomes (death among
surgical inpatients with treatable serious complications, pressure ulcer prevalence, falls
prevalence, falls with injury, restraint prevalence, catheter-related urinary tract infections,
central line catheter–associated blood stream infection, and ventilator-associated pneumonia), nursing-centered intervention processes (smoking cessation counseling for acute
myocardial infarction [AMI], heart failure [HF], and pneumonia), and system-centered
structures and processes (skill mix, nursing care hours per patient day, Practice Environment Scale-Nursing Work Index, and voluntary turnover; Kurtzman & Corrigan, 2007).
Since then, several other patient-centered outcomes (patient satisfaction with pain management, patient education, overall care and nursing care, pediatric peripheral intravenous infiltrations, and psychiatric physical/sexual assault) and system-centered structures
and processes (nursing education and certification, nurse job satisfaction) have been added to the list. In addition to their use in performance reporting, these measures can be
used in research, quality improvement, and health care policy activities. For example,
several of the measures are included in the Robert Wood Johnson Foundation’s Transforming Care at the Bedside initiative.
There are various other outcomes that are of interest to and demonstrate the broader effects of nursing care (Mitchell, 2008). These broader categories of outcomes relevant
to nursing would include physiologic, psychosocial, functional, behavioral, symptoms,
quality of life, knowledge, and satisfaction. Physiologic outcomes would include pulse,
blood pressure, blood sugar and lipid levels, peak expiratory flow rates, weight, skin condition, and many other parameters. Psychosocial outcomes could include the individual’s
mood, attitudes, and abilities to interact with others. An individual’s mobility, physical
independence, and ability to participate in desired activities of daily living are functional
outcomes. For example, the ability of a patient with asthma to engage in physical activities such as walking, exercising, or doing housework is a functional outcome. Behavioral
outcomes could include adequacy of coping with health care needs or a patient’s ability
to follow (adhere to) recommended care. Symptoms, such as pain, dyspnea, fatigue, and
others command attention, independent of the diseases that cause them. Because symptoms interfere with a patient’s physiologic, psychosocial, and functional status and quality of life, nurses are especially interested in their control. Quality of life, another natural
outcome of interest for nurses, is a patient’s general perception of the physical and mental
well-being that can be affected by many factors including disease and injury, stress and
emotions, symptom control and functional status, as well as others. Knowledge level, the
individual’s understanding of health-related information, is another outcome of interest.
For example, a patient’s understanding of the causes of asthma and factors that can trigger
and prevent exacerbations would be important to nurses because teaching patients and
supporting their self-care management is a role of nursing. Although patient satisfaction is
a quality indicator for all health care and health care providers, patients’ satisfaction with
their nursing care would be relevant to nurses.
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4: TRANSLATION OF EVIDENCE TO IMPROVE CLINICAL OUTCOMES
77
Outcomes of interest to nurses in advanced practice roles include these broad areas as well and would also include outcomes specific to their advanced practice roles.
Oermann and Floyd (2002) categorize outcomes of advanced practice registered nurses
(APRNs) into clinical, functional, cost, and satisfaction outcomes. For example, certified registered nurse anesthetists (CRNAs) might be interested in complications of oral
intubation or extubation failures, epidural catheter insertion site infections, or patient
satisfaction with postoperative pain relief. Certified nurse-midwives (CNMs) might monitor perineal laceration rates or newborn Apgar scores, and certified nurse practitioners
(CNPs) would be interested in missed diagnoses or prescribing patterns. Data regarding
outcomes and impact derived from APRN practice support policy initiatives related to
APRN education, workforce planning, recognition, regulation, and reimbursement.
Identifying the outcomes that can be clearly attributed only to nursing is a challenge. Attribution requires a high level of confidence that the outcome is a direct result
of the care provided (Dennison & Hughes, 2009). When many care practitioners interact with patients and contribute to the care, it is sometimes difficult to attribute the
outcome in the patient to only one practitioner or treatment. For example, a diabetic
patient is consistently having high fasting blood glucose levels. The NP discusses the
problem and alternative medication adjustments with the patient and then orders a new
daily and sliding scale insulin dose. The RN teaches the patient the correct technique
for finger-stick glucose monitoring. The registered dietitian (RD) reviews the recommended diet and helps the patient practice making better food selections. When the
patient’s mean fasting blood glucose levels fall to within the desired parameters, who
will get the credit? To whom are these results attributed? Is it the NP, the RN, the RD,
or the team?
Nurses affect patient safety outcomes by identifying and mitigating risks, monitoring patient status and communicating with others regarding changes in the patient’s
condition, and surveillance activities that lead to systems improvement to enhance safety.
On the micro level, nurses’ effect on safety variables such as medication errors or patient
falls might be possible. However, it is again difficult to quantify nursing’s effect on safety
outcomes because of the multidisciplinary nature and complexity of our current health
care systems.
Finally, patients’ utilization of health care services, both increased and decreased,
can reflect the influence of nursing care. An increased utilization might derive from nurses
teaching and coaching patients regarding when, where, and how to seek care. Conversely,
if nursing care increases an individual’s ability for self-care management, the need for
unintended office and emergency department visits—decreased utilization—could be the
outcome. Examples of utilization of service outcomes would be intended and unintended
office visits, use of the emergency room, hospital admissions, and length of stay.
Theoretical frameworks can be used to identify and explore the factors that influence nursing’s effect on patient outcomes. Joseph (2007) proposed a theoretical
approach to the examination of the effect of nursing on patient and organizational
outcomes. She proposed that six constructs influence outcomes, including the environment of the health facility, qualities of the nursing unit, the individual nurse, and the
patient, as well as nursing care. She suggested that nursing care is affected by qualities
of the nursing unit where care is given, by the nurse providing the care, and by patient
qualities associated with their needs. Joseph also proposed that the larger environment
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78
II: APPLICATION OF TRANSLATION
of the health facility also affects care by providing the context of care through its mission, organizational structure, and characteristics, as well as its leadership milieu. This
framework is useful in identifying variables that may influence patient as well as organizational outcomes.
■
TRANSLATION OF EVIDENCE TO IMPROVE OUTCOMES
Research findings support the effect of research-based nursing on patient outcomes
(Heater, Becker, & Olson, 1988). A meta-analysis was used to determine the contribution that research-based nursing practice makes to patient outcomes compared with
routine, procedural nursing care. Eighty-four studies (63 published, 21 unpublished) of
independent nursing interventions from 1977 to 1984 were evaluated, and effect sizes
were calculated. Outcomes were grouped into four content areas: behavioral, knowledge, physiological, and psychosocial. Results indicated that individuals who received
research-based nursing care had better outcomes than 72% of subjects who received
routine, procedural nursing care.
Unfortunately, health care practitioners frequently fail to integrate available evidence
into day-to-day patient care (McGlynn et al., 2003). It is reported that the average time
gap from discovery of knowledge to its application in practice is 17 years (IOM, 2001).
Historically, care processes have been based on ritual, personal, and local institutional
preferences (Ackerman, 1999; Kingston, Krumberger, & Peruzzi, 2000). For more than
25 years, attempts have been made to increase the linkage of empiric research results to
practice and to narrow the “bench-to-bedside” gap to improve patient care. But very little
progress has been made in synthesizing and applying the results of research to improve
patient care. To bridge the bench-to-bedside gap, evidence needs to be incorporated into
care protocols that are easily implemented in practice.
Probably one of the earliest examples of the creation of an evidence-based approach
to care was the development in the 1970s of consistent expectations for the performance
of cardiopulmonary resuscitation (CPR). These standards were used to train and test the
competency of health care providers to perform external cardiac massage and rescue
breathing for patients suffering from cardiopulmonary arrest. These standards were based
on limited research data regarding CPR as well as expert opinion, but it standardized the
process of CPR across the country and across disciplines.
Soon thereafter, many institutions developed standing orders (or order sets) to provide consistent care to specific patient populations. These documents were developed for
use in one or perhaps two nursing units within an individual hospital. They simplified
care by establishing one set of orders for the care of a highly selected group of patients—
for example, only those admitted with specific diagnoses, usually surgical procedures.
They were based on preferences and personal expertise of a single physician or small
group of physicians. They sometimes underwent institutional vetting processes.
Critical pathways began to emerge in the 1980s and 1990s as payers and institutions responded to the demands for managed care. Managed care initiatives set expectations for the provision of timely, streamlined, evidence-based care to optimize patient
outcomes (Rotter et al., 2009). Care pathways were usually created by a multidisciplinary
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4: TRANSLATION OF EVIDENCE TO IMPROVE CLINICAL OUTCOMES
79
team to establish a unified but detailed care plan for a set of specific patients, with clearly
described patient outcomes and timelines that could be used to implement patient care
and monitor progress. Variance from the path triggered analysis and intervention. Over
time, these care pathways were more likely to reflect input from all care practitioners
involved with the patient population and were approved through consensus processes.
These multidisciplinary teams included physicians in private practice. The pathways were
used locally for all or most of the patients fitting the population and described the care
they would receive and when they would receive care. They were also used in contracting
with payers to provide specific services for their insured.
■
CLINICAL PRACTICE GUIDELINES
In 1994, the federal government became involved in the movement to translate research
to practice. At that time, the Agency for Health Care Policy and Research (AHCPR), now
the Agency for Healthcare Research and Quality (AHRQ), began to develop care recommendations for common problems (acute pain, cancer pain, pressure ulcers, etc.) and
published them as CPGs. These documents were developed by teams comprising experts
from multiple health care professions who completed exhaustive searches of the research
literature related to the identified problem. The resulting body of research literature was
subsequently reviewed, rated for quality, and synthesized into recommendations related
to risk identification, problem assessment, prevention, and treatment. Larger groups of
experts were asked to review and provide comments on the CPGs before revision and dissemination of the final versions. The Centers for Disease Control and Prevention (CDC)
also got involved in establishing CPGs. For example, in 2003, they established guidelines
for the prevention of health care–associated pneumonia (Tablan et al., 2004).
Today, demands from patients and families, insurers, business leaders, consumer
groups (AARP, American Lung Association, American Cancer Society, etc.), and professional organizations (American Association of Critical-Care Nurses, American College
of Chest Physicians, etc.) are promoting the increased integration of available research
knowledge, practitioner expertise, and patient preferences to improve patient health care.
This is called evidence-based practice. By using EBP to create CPGs, the best available research evidence is translated into a clinically useful form that can be employed by practitioners in day-to-day practice to improve patient outcomes.
CPGs are official recommendations made by recognized authorities regarding the
screening, diagnosis, treatment, and management of specific conditions. They are “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances” (Lohr & Field, 1992, p. 27).
Evidence-based CPGs may help bridge the gap between research and practice. In these
CPGs, research provides the evidence that an intervention is efficacious (produces better
outcomes). The CPG facilitates transfer of this intervention to everyday practice, and
subsequently allows the evaluation of its effect on outcomes in broader patient populations (effectiveness). In this way, EBP leads to the development of practice-based
evidence (Green, 2006). It allows the accumulation of evaluation data on both efficacy
and effectiveness of the intervention.
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80
■
II: APPLICATION OF TRANSLATION
FACTORS THAT AFFECT ADOPTION OF CPG S
Various factors affect the adoption of CPGs. Qualities of CPGs, including ease of use,
complexity, clear scientific basis, strong link between evidence and recommendations,
and other factors influence their use (Davis & Taylor-Vaisey, 1997; Sox, 1994).
The existence of conflicting CPGs with differing recommendations regarding the
same intervention or population, such as have recently been reported for several types of
cancer screening, probably undermine their use. Characteristics of the health care professional also influence the use of CPGs. For example, personal involvement in CPG
development, awareness of as well as agreement and familiarity with CPGs may influence
their use (Cabana et al., 1999; Davis & Taylor-Vaisey, 1997; Haynes, 1993). Vetting by
and support from professional nursing organizations is important to the successful implementation of nursing care guidelines (Davies, Edwards, Ploeg, & Virani, 2008; Ploeg,
Davies, Edwards, Gifford, & Miller, 2007). Health care providers who perceive CPGs
as “cookbook medicine or as a threat to practitioner autonomy are not likely to follow a
CPG” (Sox, 1994). Patient-related factors, such as the ability to predict effect on the patient or the presence of multiple comorbid conditions and even patient satisfaction with
the CPG, have been reported to influence the practitioner’s use of CPGs (Francke, Smit,
de Veer, & Mistiaen, 2008; Sox, 1994). Characteristics of the practice setting, such as
availability of time and personnel, work pressures, and even costs to the practice related
to the implementation of a CPG influence its use (Francke et al., 2008).
An emerging issue that will affect provider use of CPGs, or at least the explanations
of their application with patients, is consumers’ understanding of and attitudes toward
CPGs (Carman et al., 2010; Francke et al., 2008). Recent evidence reveals that patients
do not understand that EBP and CPGs are meant to improve their health and the quality
of health care delivered without increasing patient costs (Carman et al., 2010). Instead,
they believe that care, at least provided by their own physician, is optimal and that use of
a CPG will restrict their access to desired care. Some also believe CPGs are used only to
protect physicians from malpractice claims. These patient attitudes and beliefs could have
a significant effect on their acceptance of CPG recommendations.
Qualitative and quantitative methods and one meta-review have examined the perceptions of administrators, nurses, and a variety of other health care providers regarding
the factors that support and hinder guideline implementation in practice. (Davies et al.,
2008; Dogherty, Harrison, Graham, Vandyk, & Keeping-Burke, 2013; Francke et al.,
2008; Ploeg et al., 2007). One new model specifically focuses on successful implementation of guidelines in nursing (Matther-Maich, Ploeg, Dobbins, & Jack, 2013).
Two recent publications sum up current knowledge regarding the impact of major factors on CPG implementation. Francke et al. (2008) completed a systematic metareview of evidence regarding factors that impact guideline implementation and strategies used to support implementation. They summarized their findings by characterizing
evidence that impacts the implementation of guidelines into one of four categories: the
guideline itself, the professionals involved, the patients involved, and the practice environment. They found that guidelines that were “easy to understand” and grounded in
evidence are more likely to be successfully implemented. There was inadequate data to
determine the relative impact of individual implementation strategies, though most projects used two or more strategies, and those that were integrated into care processes by the
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4: TRANSLATION OF EVIDENCE TO IMPROVE CLINICAL OUTCOMES
81
individual health care provider were the most successful. Lack of knowledge about and
agreement with the guideline among health care providers were identified as major impediments to implementation. Patients who did not understand the value in following a
guideline or provider concerns regarding the presence of multiple comorbid conditions in
a patient hindered guideline implementation. Finally, negative staff or leadership attitudes
and lack of time and resources were environmental factors impeding the implementation
of guidelines.
Dogherty et al. (2013) completed a recent thematic analysis of critical incident
technique data from nurse leaders involved in guideline implementation. Their analysis
emphasized factors to support successful implementation. They found that focus on a
high-priority problem and use of evidence that is not only relevant to the practice but
easy to access and apply is critical. They also cited the importance of a strong cohesive
team (multidisciplinary engagement of stakeholders who share responsibility), “strategic
choreography” (planning, providing resources, anticipating and navigating through challenges, etc.), and enlisting a skilled leader to facilitate the implementation (p. 133).
The federal government and some private payers are devising payment initiatives
related to the use of CPGs. Although the evidence to support these plans is at best controversial, Medicare has implemented incentive programs to reward providers, hospitals,
nursing homes, and home health agencies that demonstrate application of EBP as well as
patient outcomes monitoring (Tanenbaum, 2009). These programs reflect their desire to
improve patient care and control costs through the use of patient outcomes monitoring
combined with the application of research to practice. The Medicare Physician Quality
Reporting Initiative (PQRI), also known as “pay for performance” (P4P), began in 2007. It
allows providers (including NPs), who report satisfactory patient outcomes data related to
covered professional services, to qualify to earn additional payments. Concerns have been
expressed regarding the potential unexpected consequence of P4P, in that the need to
meet patient outcomes’ benchmarks could cause provider avoidance of patients with comorbid or difficult-to-treat problems (“cherry picking”), which might dilute the providers’ ability to show improved patient outcomes (Dennison & Hughes, 2009). Penalties for
poor patient outcomes have also been adopted by Medicare. Since 2009, hospitals have
not been reimbursed for services provided to treat nosocomial infections and other preventable conditions (e.g., catheter-related urinary tract infections, catheter-related blood
stream infections, decubitus ulcers, air emboli). Although this may have reduced hospital
reimbursement rates, it has also driven agencies to examine their patient outcomes and
to search out and apply evidence-based solutions, often in the form of CPGs, to prevent
these adverse patient outcomes.
CPG use has migrated into the h

Nursing Question

Jun 14, 2024 | Health Medical

Description

please can I have discussion 1 post in 12 hours.

Unformatted Attachment Preview

Case Study: End of Life Decisions
George is a successful attorney in his mid-fifties. He is also a legal scholar, holding a teaching
post at the local university law school in Oregon. George is also actively involved in his teenage
son’s basketball league, coaching regularly for their team. Recently, George has experienced
muscle weakness and unresponsive muscle coordination. He was forced to seek medical
attention after he fell and injured his hip. After an examination at the local hospital following his
fall, the attending physician suspected that George may be showing early symptoms for
amyotrophic lateral sclerosis (ALS), a degenerative disease affecting the nerve cells in the brain
and spinal cord. The week following the initial examination, further testing revealed a positive
diagnosis of ALS.
ALS is progressive and gradually causes motor neuron deterioration and muscle atrophy to the
point of complete muscle control loss. There is currently no cure for ALS, and the median life
expectancy is between 3 and 4 years, though it is not uncommon for some to live 10 or more
years. The progressive muscle atrophy and deterioration of motor neurons leads to the loss of the
ability to speak, move, eat, and breathe. However, sight, touch, hearing, taste, and smell are not
affected. Patients will be wheelchair bound and eventually need permanent ventilator support to
assist with breathing.
George and his family are devastated by the diagnosis. George knows that treatment options only
attempt to slow down the degeneration, but the symptoms will eventually come. He will
eventually be wheelchair bound and be unable to move, eat, speak, or even breathe on his own.
In contemplating his future life with ALS, George begins to dread the prospect of losing his
mobility and even speech. He imagines his life in complete dependence upon others for basic
everyday functions and perceives the possibility of eventually degenerating to the point at which
he is a prisoner in his own body. Would he be willing to undergo such torture, such loss of his
own dignity and power? George thus begins inquiring about the possibility of voluntary
euthanasia.
© 2020. Grand Canyon University. All Rights Reserved.
Discussion 1
How often do you engage with or witness death in your work? How has this experience or the lack
of it shaped your view of death? Has it gotten easier or harder for you to accept the fact of death?
As you explain, include your clinical specialty.
Respond to three classmates.
Discussion 2
Reflect on the analysis of the sin of suicide and, thus, euthanasia from the topic readings. Do you
agree? Why or why not? Refer to the lecture and topic readings in your response.
Respond to three classmates.
CASE Study on death and dying
The practice of health care providers at all levels brings you into contact with people from a
variety of faiths. This calls for knowledge and understanding of a diversity of faith expressions; for
the purpose of this course, the focus will be on the Christian worldview.
Based on “Case Study: End of Life Decisions,” the Christian worldview, and the worldview
questions presented in the required topic Resources you will complete an ethical analysis of
George’s situation and his decision from the perspective of the Christian worldview.
Provide a 1,500-2,000-word ethical analysis while answering the following questions:
1.
2.
3.
4.
5.
6.
How would George interpret his suffering in light of the Christian narrative, with an emphasis on
the fallenness of the world?
How would George interpret his suffering in light of the Christian narrative, with an emphasis on
the hope of resurrection?
As George contemplates life with amyotrophic lateral sclerosis (ALS), how would the Christian
worldview inform his view about the value of his life as a person?
What sorts of values and considerations would the Christian worldview focus on in deliberating
about whether or not George should opt for euthanasia?
Given the above, what options would be morally justified in the Christian worldview for George
and why?
Based on your worldview, what decision would you make if you were in George’s situation?
Remember to support your responses with the topic Resources.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the
Student Success Center. An abstract is required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to
become familiar with the expectations for successful completion.

Purchase answer to see full
attachment

MSW 628 WEEK Discussion post

Jun 14, 2024 | Health Medical

Description

Classroom Participation

Initial Response
INSTRUCTIONS:

Identify a policy that impacts mental health. You may use the following website that lists a variety of current mental health policies, or you may identify your own.

MHA (2023). Mental health policyLinks to an external site.. Mental Health America. [website].

For this discussion:

Provide information on the policy, what it addresses and who it impacts.
Then provide a reflection if you believe this policy is effective, why or why not?
What is missing from this policy to make a more effective impact for those with mental health challenges?

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:

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

CASE STUDY ANALYSIS

Jun 14, 2024 | Health Medical

Description

An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.

Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.

An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

This is the prompt for the week 4 Case Study:

A 65-year-old patient is 8 days post op after a total knee replacement. Patient suddenly complains of shortness of breath, pleuritic chest pain, and palpitations. On arrival to the emergency department, an EKG revealed new onset atrial fibrillation and right ventricular strain pattern – T wave inversions in the right precordial leads (V1-4) ± the inferior leads (II, III, aVF)

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Announcements” section of the classroom for your assignment from your Instructor.

The Assignment

In your Case Study Analysis related to the scenario provided, explain the following

The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient.

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.

NURS_6501_Module2_Case Study_Assignment_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeDevelop a 1- to 2-page case study analysis, examing the patient symptoms presented in the case study. Be sure to address the following:Explain both the cardiovascular and cardiopulmonary pathophysiologic processes of why the patient presents these symptoms.

30 to >27.0 pts

Excellent

The response accurately and thoroughly describes the patient symptoms. … The response includes accurate, clear, and detailed reasons, with explanation for both the cardiovascular and cardiopulmonary pathophysiologic processes supported by evidence and/or research, as appropriate, to support the explanation.

27 to >24.0 pts

Good

The response describes the patient symptoms. … The response includes accurate reasons, with explanation for both the cardiovascular and cardiopulmonary pathophysiologic processes supported by evidence and/or research, as appropriate, to support the explanation.

24 to >22.0 pts

Fair

The response describes the patient symptoms in a manner that is vague or inaccurate. … The response includes reasons for the cardiovascular and/or cardiopulmonary pathophysiologic processes, with explanations that are vague or based on inappropriate evidence/research.

22 to >0 pts

Poor

The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing. … The response does not include reasons for either the cardiovascular or cardiopulmonary pathophysiologic processes, or the explanations are vague or based on inappropriate or no evidence/research.

30 pts

This criterion is linked to a Learning OutcomeExplain how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.

30 to >27.0 pts

Excellent

The response includes an accurate, complete, detailed, and specific explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.

27 to >24.0 pts

Good

The response includes an accurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.

24 to >22.0 pts

Fair

The response includes a vague or inaccurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.

22 to >0 pts

Poor

The response includes a vague or inaccurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.

30 pts

This criterion is linked to a Learning OutcomeExplain any racial/ethnic variables that may impact physiological functioning.

25 to >22.0 pts

Excellent

The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning supported by evidence and/or research, as appropriate, to support the explanation.

22 to >19.0 pts

Good

The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning supported by evidence and/or research, as appropriate, to support the explanation.

19 to >17.0 pts

Fair

The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, and/or explanations based on inappropriate evidence/research.

17 to >0 pts

Poor

The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, or the explanations are based on inappropriate or no evidence/research.

25 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 are provided that delineate 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 that delineate 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, yet 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 are vague or off topic.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. ... No purpose statement, introduction, or conclusion were 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 (1 or 2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains 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 paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, 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 (1 or 2) APA format errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) APA format errors.

2 to >0 pts

Poor

Contains many (≥ 5) APA format errors.

5 pts

Total Points: 100

Required Reading

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems; Summary Review
Chapter 33: Alterations of Cardiovascular Function (stop at Dysrhythmias); Summary Review
Chapter 35: Structure and Function of the Pulmonary System; Summary Review
Chapter 36: Alterations of Pulmonary Function (stop at Disorders of the chest wall and pleura); (obstructive pulmonary diseases) (stop at Pulmonary artery hypertension); Summary Review

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Jun 14, 2024 | Health Medical

Description

Students you are responsible for reading the article and providing a critique on your personal thoughts and opinions based on the article itself. You will need to utilize APA format and provide the citation at the top of the assignment. You do not need to include name, title page, etc. just start with the citation and go from there. Assignment is to be submitted on a word document and as said in accordance to the APA guidelines. Paper should consist of: Minimumum 500 words.Double spaced.NO PLAGIARIZING!Citation at the top.Well organized and grammatically correct.Describe the main ideas and what the author wants to express and your personal critique of the article.Analyze each important and interesting point and develop an explanation of the article.Interpret the author’s intention.Summarize and evaluate the value of an article, stating whether you agree or disagree with the author, with supporting evidence.

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SPECIAL COMMUNICATION
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ACSM Expert Consensus Statement on Exertional
Heat Illness: Recognition, Management, and
Return to Activity
William O. Roberts, MD, MS, FACSM;1 Lawrence E. Armstrong, PhD, FACSM;2
Michael N. Sawka, PhD, FACSM, FAPS;3 Susan W. Yeargin, PhD, ATC;4
Yuval Heled, PhD, FACSM;5 and Francis G. O’Connor, MD, MPH, FACSM, FAMSSM6
as low as 15°C (1). Based on data from
the National Center for Catastrophic
Sport Injury Research at the University
of North Carolina at Chapel Hill,
deaths in athletes from exertional heat
stroke (EHS) have averaged three per
year since 1995, mainly in high school
football players (2). Despite educational
and preventive efforts to lessen EHS
morbidity and mortality, recent literature
reveals little to no change in the annual
number of EHS deaths among athletes
(3). The prevalence of exertional heat
illness across all sports is not known (4).
The difficulty assessing the data and
trends surrounding the epidemiology of
exertional heat illness is partly explained
by the number of cases that are not
treated and documented in medical care facilities, and the
inconsistent terminology and case definitions (5).
The incidence rate of exertional heat illness increases as ambient temperature and relative humidity rise during the
warmer months of the year (6–10); this rate is predicted to increase as average world temperature and relative humidity continue to escalate with climate change (11). The increased
prevalence of obesity, physical inactivity, low physical fitness,
and lack of heat acclimatization may contribute to the increase
incidence rate. However, other factors such as more frequent
heat waves and suboptimal prevention strategies may be responsible (7,12–14). Many medical management issues related
to the recognition, treatment, and recovery of exertional heat
illnesses remain controversial (15,16).
A systematic review of 62 epidemiological studies reported
the highest incidence of exertional heat illness in American
football, running, cycling, and adventure races (5). Marathon
running and triathlons report the highest number of hospitalizations due to the extended duration of vigorous exercise (5).
Few sports are immune from exertional heat illness and examples of rates (per 100,000 athlete exposures) during training
and competition in National Collegiate Athletic Association
Abstract
Exertional heat stroke (EHS) is a true medical emergency with potential for
organ injury and death. This consensus statement emphasizes that optimal
exertional heat illness management is promoted by a synchronized chain of
survival that promotes rapid recognition and management, as well as communication between care teams. Health care providers should be confident in the
definitions, etiologies, and nuances of exertional heat exhaustion, exertional
heat injury, and EHS. Identifying the athlete with suspected EHS early in the
course, stopping activity (body heat generation), and providing rapid total
body cooling are essential for survival, and like any critical life-threatening situation (cardiac arrest, brain stroke, sepsis), time is tissue. Recovery from EHS is
variable, and outcomes are likely related to the duration of severe hyperthermia. Most exertional heat illnesses can be prevented with the recognition and modification of well-described risk factors ideally addressed through
leadership, policy, and on-site health care.
What Is the Clinical Problem?
Athletes, elite, recreational and tactical, and occupational
laborers, regularly perform stressful physical activities in warm
to hot environments, sometimes wearing heavy equipment
(e.g., football player), protective clothing (e.g., firefighter), or
both (e.g., warfighters). Heat stress impairs exercise performance
and causes physiological strain that may evolve into exertional
heat illness in a wide range of temperature conditions starting
1
Department of Family Medicine and Community Health, University of
Minnesota Medical School, Minneapolis, MN; 2Human Performance
Laboratory, University of Connecticut, Storrs, CT; 3School of Biological
Sciences, Georgia Institute of Technology, Atlanta, GA; 4Department of
Exercise Science, University of South Carolina, Columbia, SC; 5Clinical and
Integrative Physiology Unit, Heller Institute of Medical Research, Sheba
Medical Center, ISRAEL; and 6Consortium for Health and Military Performance,
Uniformed Services University of the Health Sciences, Bethesda, MD.
Address for correspondence: William O. Roberts, MD, MS, FACSM,
University of Minnesota Medical School, Minneapolis, 1414 Maryland Ave E,
St Paul MN, 55115, MN; E-mail: rober037@umn.edu.
1537-890X/2009/470–484
Current Sports Medicine Reports
Copyright © 2021 by the American College of Sports Medicine
470
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Special Communication
Copyright © 2021 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
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sports are: men’s American rules football (15.5), wrestling
(2.9), cross-country (4.8), basketball (4.1), soccer (3.1), and
women’s cross country (3.5), outdoor track & field (5.9), tennis
(4.3), field hockey (0.20), and soccer (3.0) (9). High school rates
also vary by sport (17), some examples include girl’s field
hockey (3.9), lacrosse (0.6), volleyball (0.3), soccer (1.1),
cross-county (2.8); and boy’s baseball (0.57) and soccer (0.51)
(7,18). Boy’s American rules football consistently has the
highest rate of exertional heat illness, with Kerr et al. (7,18)
reporting 11 times the rate (4.42 to 5.2) of all other high
school sports combined. In military and occupational settings,
Army and Marine Corps personnel and laborers in occupations with heat-exposed physical activity consistently have
the highest rates of exertional heat illness (19–21).
This American College of Sports Medicine (ACSM) consensus statement replaces the position statement published in
2007 (22) with emerging practices for recognition, prevention,
and management of exertional heat illness (15,16) and focuses
on exertional heat exhaustion (EHE), exertional heat injury (EHI),
and EHS. Additional conditions, such as exercise-associated
muscle cramps, exertional rhabdomyolysis, exercise collapse
associated with sickle cell trait, and exercise-associated
hyponatremia, are not included in this statement, although
they are important to consider in the initial evaluation of a collapsed athlete. The consensus statement will identify evidencebased strategies to reduce morbidity and mortality of exertional heat illness, including introducing a staged return to
activity (RTA) for athletes recovering from an EHS event.
What Is Serious Exertional Heat Illness?
Serious exertional heat illness includes EHS, EHI, and EHE;
whether these entities occur independently or on a spectrum has
not been determined. Exertional heat illness related to strenuous exercise and elevated body temperatures often presents
with athlete collapse and can range from self-limited EHE to
potentially life-threatening EHS (23–27). Any athlete or laborer
presenting with a clinical picture, suggesting a potentially
life-threating exertional heat illness, should be cooled until a
more thorough evaluation can be completed.
EHE is defined as the inability to sustain the required cardiac
output and blood pressure to continue physical activity because
of high skin blood flow requirements and/or dehydration related
to heat stress. Body temperature is elevated by the metabolic heat
produced during exercise but is usually 40°C rectal temperature. The term “heat stroke” reflects the presence of focal “stroke-like” symptoms associated
with warm environments and hyperthermia, although the
symptoms in most victims are more global (encephalopathy)
than focal (stroke syndrome). CNS changes associated with
EHS vary from mild personality deviations to the continuum
of confusion, delirium, stupor, or unconsciousness. Altered
mental status with loss of orientation to person, place, or time
is common. Severe agitation with florid psychosis can occur,
www.acsm-csmr.org
Table 1.
Signs and symptoms of exertional heat illness that often resolve with
rapid cooling.
Common Signs and
Symptoms of Exertional
Signs and Symptoms
Suggesting EHS
Heat illness
Persistent mental status changes
Dizziness
Personality changes (frontal lobe)
Headache
Inappropriate behavior or
aggressiveness
Nausea
Delirium
Unsteady walk
High rectal temperature, >40°C
(104°F)
Generalized weakness
Loss of ambulatory function
(ataxia)
Muscle cramps
Flaccid muscles or persistent
rigidity
Fatigue
Stool incontinence
Chills
Seizure
Eyes closed
Coma
Missing assigned tasks
(cognitive function)
Recurrent vomiting
Sweaty skin (not dry), warm
or cool to touch
Skin color varies from
pale to flushed
Weak or rapid pulse
Tachycardia
Systolic hypotension
and some victims are verbally and physically aggressive with
potential to injure caregivers. In addition to CNS dysfunction,
EHS is usually associated with body temperature >40°C,
along with signs and symptoms of cardiovascular and other
organ system distress (see Table 1). Organ and tissue damage
occur with prolonged hyperthermia, sometimes due to delayed
recognition and cooling, but the damage may not be clinically
evident until later in the disease process. Clinical management
following EHS may require critical care interventions for organ
and tissue damage induced by hyperthermia and sequelae, including systemic inflammatory response syndrome (SIRS) and
disseminated intravascular coagulopathy (DIC) (24–26).
A presenting core temperature ≥40°C alone is not sufficient
to establish the diagnosis of EHS (15,24,25,27). Core temperature values ≥40°C (exertional hyperthermia) have been documented during high-intensity physical activity in both warm
and hot weather with no apparent adverse effects on performance or health (31–33).
EHI is characterized by evidence of organ (e.g., gastrointestinal, kidney, liver, muscle) damage and dysfunction in the presence of hyperthermia without CNS changes seen in EHS and
requires laboratory testing to establish the diagnosis (24–26).
In an exercise setting, EHI also can be a consequence of delayed
recognition and/or inadequate cooling of EHS. The exact clinical pathway to tissue or organ injury is unknown but may be
a result of dehydration and reduced blood flow during a more
severe EHE episode or a direct thermal injury during an EHS
episode in which CNS dysfunction was minor or missed. EHI
Current Sports Medicine Reports
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471
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Figure 1: The impact of heat stress on physiological strain resulting in either adaptation or exertional heat illness.
may or may not be on a continuum as an intermediate condition between EHE and EHS. EHI typically causes tissue and
organ dysfunction that may persist for several weeks (30), including acute kidney injury, transient diarrhea (gut injury),
and/or transaminitis associated with liver injury. More severe
EHI-associated EHS can result in liver or kidney failure requiring organ transplantation for patient survival.
What Is the Pathophysiology of Exertional Heat Illness?
During exercise in the heat, the primary physiological challenge is an increase in cardiac output to support both high skin
blood flow for heat dissipation and high muscle blood flow for
metabolism at the expense of compensatory reductions in renal
and splanchnic blood flow (27,34). When these compensatory
responses are insufficient, skin, muscle, and even brain blood
flow are compromised affecting tissue metabolism and heat exchange (25,27,34). In addition, as ambient temperature increases, sweating increases, and sweat evaporation become the
primary heat transfer mechanism (35). If the high rates of sweating fluid loss are not replaced, the reduced plasma volume (from
dehydration) further elevates physiological strain, impairing
work capabilities and increasing the risk of exertional heat
illness (25,27,34).
Figure 1 diagrams progression from exercise heat stress to
exertional heat illness. The greater the heat stress the greater the
physiological strain as evidenced by hyperthermia, blood pressure
regulation challenges, reduced tissue perfusion, ischemia, and both
elevated oxidative and nitrosative stress (27,34).
If the physiological strain is not excessive, multiple heat exposures will stimulate adaptations, such as heat acclimation
(35) and acquired thermal (heat) tolerance (36), which help
to improve performance in the heat and protect from exertional
heat illness (27). The adaptive changes will induce molecular
adaptions, including heat shock protein (HSP) expression,
which improve tissue/organ protection or thermal tolerance. If
the physiological strain is excessive, it will induce pathological
events, including increased gut permeability, endotoxemia, exaggerated acute phase response and SIRS, coagulopathy, and
cell death (25,27,37). In addition, reduced cerebral blood flow,
combined with abnormal local metabolism and coagulopathy,
can lead to dysfunction of the CNS. These perturbations induce
changes are associated with EHS and EHI. There is no evidence
that EHI or EHS will induce abnormalities to hypothalamic regions, but thermoregulatory feedback loops may be damaged
(15). Of particular concern is intestinal barrier damage accentuating endotoxin leakage and potentiating liver damage,
endotoxemia, SIRS, and sepsis (25,37). The composition of
an athlete’s gut microbiome may predispose an EHS or EHI
victim to endotoxemia and SIRS (38).
Preliminary research indicates there may be an association
with EHS/EHI and long-term health issues. For example,
EHS/EHI victims were reported to have a 3.9 times higher incidence of major cardiovascular events, a 5.5 times greater incidence of ischemic stroke, and a 15 times greater incidence of
atrial fibrillation during a 14-year follow-up period (39,40).
Similarly, a cohort mortality study of male and female U.S.
Army personnel hospitalized for exertional heat illness with
Figure 2: The exertional heat illness chain of survival promotes better outcomes and increases communication between care teams (43).
472
Volume 20 Number 9 September 2021
Special Communication
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an unknown duration of hyperthermia prior to cooling demonstrated a 40% increased long-term mortality risk when
compared with hospital admissions for appendicitis as reference cases (39). Recent evidence from an animal model suggests that 30-d post-EHS epigenetic memory changes can
suppress the immune system and alter HSP responses (41). In
heat-tolerant athletes believed to be fully recovered from a prior
EHS/EHI episode (ranging from 6 wk to 10 years), after a bout
of exercise-heat stress, the lymphocyte HSP72 level was lower
and in vitro lymphocyte HSP70 induction tended to be lower
in post-EHI patients suggesting potential for reduced acquired
cellular tolerance (42). There were no differences between control and post-EHS groups for core temperature or heart rate
(HR), emphasizing the ability to have similar physiological
strain responses during a modest heat exposure and the need
for more detailed molecular biomarkers (42). These findings
suggest that future research is needed to examine the relationship between residual tissue damage from EHS/EHI and
long-term morbidity and mortality.
How Is Exertional Heat Illness Optimally Managed?
Evaluating and managing an athlete or laborer with exertional heat illness requires an effective “chain of survival” comparable to the American Heart Association’s paradigm for out
of hospital cardiac arrest. The “chain of survival” for exertional
heat illness includes four linked steps: prehospital management;
emergency medical service (EMS); advanced clinical management in a medical treatment facility; and finally, guiding the
RTA (See Fig. 2). The first three links in clinical care are detailed
in this section on optimal management; the final step of
Figure 3: The evaluation and field care of an athlete with suspected exertional heat illness. Initiate immediate cooling measures based on the
best and most practical cooling strategy for the site. If both rectal temperature measurement and cooling strategy are readily available, getting a
rectal temperature is the best first step for clinical management decision making. Body cooling should take priority if a rectal temperature cannot
be measured immediately, but a temperature measurement will be needed eventually determine an end point for active cooling. In some settings
with a heat illness care team on site, a recovered athlete may be released to family rather than transported to an emergency facility. Not all EHS
casualties are unconscious, and it is important to look at the full clinical presentation. Based on field experience, the first three boxes in this cascade
can take too much time and aggressive cooling should be started within minutes of collapse. Time sensitivity is obvious in cardiac arrest and acute
stroke syndrome, but not necessarily engrained in those evaluating and managing heat stroke for the first time.
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473
facilitating a RTA with attention to precipitating risk factors
is discussed in sections V and VI.
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Prehospital Management
Exertional heat illness clinical management depends on early
recognition, immediate cooling, and transport to a medical facility for advanced care (see Fig. 3). The observation that the
best outcomes are achieved with rapid reversal of body hyperthermia through early aggressive cooling is supported by robust
literature (43–45); accordingly, prehospital management is the
most critical element of limiting the morbidity and mortality
of an exertional heat illness event. A recent consensus statement
proposed several key steps in the paradigm of prehospital EHS
victim care, including rapid recognition, rapid assessment, and
rapid cooling (43).
Rapid recognition
An evaluation for EHS is usually triggered by the collapse or
near collapse of an athlete or laborer during or immediately following physical activity with heat stress. The differential diagnosis in a collapsed athlete is extensive, but most often due to
sudden cardiac arrest, exertional heat illness, sports-related
concussion, exercise-associated hyponatremia, hypoglycemia,
hypothermia, or exercise-associated postural hypotension
(exercise-associated collapse). Many of these diagnoses have
overlapping clinical presentations and a systematic approach
incorporating vital signs and a brief cognitive assessment will
expedite recognition and initial management, especially for
providers in a field setting (Table 1). In all weather conditions,
self-limiting postexercise collapse is usually due to sudden discontinuation of skeletal muscle pump activity causing venous
pooling and postural hypotension rather than heat illness or
dehydration, and the associated orthostatic instability usually
resolves in less than 30 min with leg elevation and rest (46,47).
A missed EHS diagnosis or delayed whole-body cooling may
lead to single or multiple organ failure or death (14). The entire
clinical picture, including the history of events leading up to the
collapse, mental status changes, vital signs, including rectal temperature, available point of care on site laboratory results, and
regular reassessment, should be considered to optimally establish
a diagnosis and manage the athlete with exertional collapse (24).
Rapid assessment
An unconscious athlete with spontaneous respirations or a
conscious athlete with CNS changes should be assessed for
EHS with an onsite core (rectal) temperature measurement.
However, whole-body cooling should not be delayed for a
core temperature measurement when EHS is suspected based
on clinical circumstances and working diagnosis. Rectal temperature measurement is the best estimate of core body temperature in the field (48–50). Shell temperature measured in
the aural canal or tympanic measures, oral sublingual, temporal artery or forehead, and axilla sites correlate poorly with
rectal temperature and should not be used for clinical decision
making for heat-related problems (48–52).
Rapid cooling
The best outcomes for EHS and EHI require rapid on-site
whole-body cooling. On-site cooling prevents treatment delays
and cooling interruptions associated with transportation to
medical facilities and emergency department (ED) evaluation
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Volume 20 Number 9 September 2021
protocols for encephalopathy. Body cooling serves two purposes:
1) reducing organ and tissue temperatures and 2) supporting
tissue perfusion by vasoconstricting skin and superficial tissue
vessels moving blood volume from the peripheral to the central circulation. Cooling rates >0.15°C·min−1 are best for survival without medical complications. Insufficient or delayed
cooling can result in the medical complications of EHI or
death (45).
Reducing body temperature by any means possible is essential to decrease the morbidity and mortality associated with
EHS, and conductive heat exchange methods are the most effective in the field. The thermal conductivity of water is 32
times that of air and using circulating cold water to facilitate
convective heat exchange at the skin level is the best means
of rapidly reducing core body temperature (51,53,54). Ice water
tub immersion is very effective for whole body cooling in hot, humid conditions (55,56). At the Falmouth Road Race (11.4 km),
there have been no fatalities and limited hospitalizations in 274
consecutive runners, aged 11 to 70 years, rapidly cooled on-site
with ice water tub immersion (56).
Other whole-body cooling methods like rotating ice watersoaked towels on the trunk, extremities, and head augmented
with ice packs in the neck, axilla, and groin; repeatedly dousing
the body with ice water; or spraying with tap water can effectively cool hyperthermic patients (see Table 2). Evaporative
cooling methods are more effective in airconditioned spaces or
low relative humidity environments and often not effective in
the field as high relative humidity limits evaporative heat transfer.
Placing ice packs over major blood vessels in the groin, axilla,
and neck can be combined with other cooling strategies, but is
not recommended as a lone treatment modality. However, in a
“first aid” situation ice packs over the major vessels may be a lifesaving start to therapy.
Initiating whole-body cooling as soon as possible is essential, and Table 2 lists potential methods for use in the field.
The method used will be site-dependent and a blend of several
elements, including clinical experience of the providers, site
assets and limitations, water and ice access, patient size and
body type, and the incidence rate of EHS at the site (57). Victims
with low body mass and with high surface area to mass ratio
(such as children or thin endurance athletes) may cool more
rapidly than victims with large body mass and relatively low
surface area (football linemen) who can store more heat in the
tissues (58). While cold water immersion is very effective, in
some situations the use of 40-gallon tubs and 20 lbs to 30 lbs
of ice may be impractical, and more portable methods may be
an alternative to rapidly initiate whole-body cooling (59).
The primary goal of prehospital cooling is to lower the body
temperature, prioritizing core temperature reduction to below
39°C within 30 min to 60 min of collapse to protect the critical organs. Athletes with indwelling rectal thermistors can
be monitored continuously without interrupting body
cooling. Repeatedly measuring rectal temperature every
10 min, when an indwelling thermistor is not available, interrupts body cooling and reduces the overall cooling rate. The
recommendation to stop active cooling at ~38°C (101°F) to
prevent hypothermic overshoot is empirical and not based
on data showing adverse outcomes. There are no known disadvantages or adverse outcomes from cooling below 38°C
and most “overcooled” athletes will be in the 35°C to 37°C
(95°F to 97°F) range, which has no adverse physiological effect
Special Communication
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Table 2.
Onsite whole-body cooling strategies for EHS casualties that are effective in the field.
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Body Cooling Strategies
Treatment Notes
Ice water (~2°C) or cold water (~20°C)
immersion with stirring: whole body
Immerse body to neck, circulate or stir the water to increase heat
transfer, add ice during cooling, support head above water level.
Continuous supervision.
Ice water immersion: half body
Immerse the torso and pelvic region
Rotating ice water-soaked towels applied to the limbs,
trunk, and head with ice packs in the groin, axilla, and
neck; whole body
2 people, 6–8 towels, change rapidly, wring towels after soaking in
bucket of ice water
Tarp-assisted water immersion: partial body
6–8 people to hold the sides of the tarp. Ensure as much of the
torso and groin are immersed as possible
Cold water dousing: whole body
Free flowing hose or bucket with cool tap water
Ice water-soaked sheets only or with fanning: whole body
Frequently re-wet sheets with cold water
High powered spray misters: whole body
1–2 people to supervise
Water spray and fans: whole body
1 person to spray
Cold water immersion in portable water-impermeable bag:
whole body with head out.
1–2 people, add ice and water as needed
Cooling blanket — cold air (Bair Hugger)
Available in EMS vehicles
The approximate cooling rates will vary with body mass, body fat, surface area, blood flow, and other factors. The strategy must be practical and achievable at the site. Starting whole body cooling immediately is critical to achieve the best outcomes and should not be delayed by starting IV fluids or transfer to
an emergency medical facility.
(24). Simply continuing uninterrupted cooling until the victim
“wakes up” (eyes open, normal behavior, and conversational) is the more effective cooling strategy in this clinical
scenario. Checking a rectal temperature at the point of waking
up will confirm cooling to the goal level and cooling can be
discontinued. If a victim does not wake up in 30 min to
40 min, clinical reassessment is indicated.
Intravenous fluid replacement requirements vary based
on the duration of physical activity and individual sweating
rates. The need for intravenous (IV) fluid replacement is often
clinically apparent following cooling and the return of peripheral blood volume to the central circulation. Peripheral IV
sites complicate cooling procedures, and initiating IV fluids
can be delayed if the patient is responding well to cooling measures (60–63). Oral fluids are preferred to IV fluid replacement
and should be started when the patient can tolerate oral intake.
Emergency Medical Transport
An EHS victim cooled on-site should be transported, as soon
as possible, to a hospital ED that is equipped to evaluate and
manage the complications of EHS and EHI. In road race settings
that manage many exertional heat illness-related problems, casualties with EHS who are promptly recognized, treated, wake up
easily, and clinically stable are often discharged to home with
family. In other settings not accustomed to exertional heat illness
and EHS field management, ED evaluation is strongly recommended following on-site cooling.
If on-site cooling was not started or completed, a suspected
EHS casualty is best managed at the nearest medical facility
with the capability for cooling and medical management of
exertional heat illness complications. EMS vehicles in areas
with high exertional heat illness incidence rate should be equipped
to begin or continue cooling therapy treatment en route (chilled IV
fluids, ice packs, cooling blankets [Bair Hugger™], fans) and use
the vehicle air conditioning at high settings when EHS is suspected.
www.acsm-csmr.org
Many EMS vehicles now carry refrigerated IV fluid chilled to
4°C (39°F) to augment induction of therapeutic hypothermia
in cardiovascular emergencies.
Advanced Medical Treatment Facility Management
The third phase of clinical management involves advanced
care using an ED and hospital with inpatient critical care capability. When an individual with suspected exertional heat illness is transported to the hospital, the EMS dispatcher should
ideally direct the patient to a facility with known experience
and familiarity with heat casualties and notify the ED medical
team in advance to allow preparation for immediate treatment
upon arrival. The diagnosis of EHI and/or EHS can be challenging, as the patient may present with a temperature 3 d of >32°C (90°F)
Wearing heavy clothes, equipment, or uniforms
Individual factors
Age (infants, older adults)
Overweight, high body mass index
Poor physical fitness
Inappropriate work to rest ratios
Predisposing Factors
Exertional heat illness can occur in both healthy and “highrisk” individuals when performing vigorous activity in warm
or hot conditions. Risk factors for exertional heat illness listed
in Table 6 can be unique to a particular exertional event or a
given individual, and often, more than one risk factor is present in an individual victim. While EHS is not completely understood and is challenging to predict, numerous risk factors
associated with EHS have been identified by epidemiologic
data that include environmental, physiological, drug use, and
compromised health factors (25,26). For athletes, the most
common risk factors are low physical fitness, lack of heat acclimatization, obesity, and heat waves or unexpectedly hot
weather (14,25,89). Risk factors outlined in Table 6 can help
identify individuals who should be more closely monitored by
the sports medicine team and staff stakeholders during participation or have a “buddy” assigned to report any signs or symptoms (24,26). The most physically fit, heat acclimated, and
motivated individuals tend to sustain high rates of metabolic
heat production during intense physical activity and are highly
motivated to continue activity even when experiencing excessive fatigue or symptoms of exertional heat illness (see Fig. 4).
In addition, the presence of a predisposing factor (e.g., recent
viral illness or fever) on a particular day increases the risk of
heat stroke in subsequent days and sets up the “multiple-hit
hypothesis” (25,27), which may account for athletes who have
completed the same exercise-heat stress task many times in the
478
Volume 20 Number 9 September 2021
Inadequate heat acclimatization for current conditions
Heat stress in the previous 1 d to 3 d
Hypohydration
Medications and drugs
Diuretics
Anticholinergics
B-adrenergic blockers
Antihistamines
Antidepressants
Stimulants (amphetamines, cocaine, ecstasy, ephedra)
Health conditions
Viral or bacterial infections
Fever
Diarrhea or vomiting
Skin disorders (rash, large area of burned skin)
Diabetes mellitus
Cystic fibrosis/trait
Cardiovascular disease
Behavioral
Self-imposed motivation to excel
Leadership or organizational structure
Peer or coach pressure to excel
Special Communication
Copyright © 2021 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
Downloaded from http://journals.lww.com/acsm-csmr by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCyw
CX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6

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Jun 14, 2024 | Health Medical

Description

Work Teams

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.

reflection week 3

Jun 14, 2024 | Health Medical

Description

Pt is 16 years old female with accompanied by her mother with a PMH of eczema that presents with complaints of nonproductive cough and shortness of breath. Nonproductive cough x3 weeks. However, progressively worse over last 3 days and awakens her at night. Shortness of breath x3 days with exertion. Reports chest tightness. Denies pain. Has had no treatments for cough or shortness of breath. Congestion and runny nose x3 weeks ago that is now resolved. Exposure to second-hand smoke in her home environment.Physical exam reveals tachypnea, labored breathing, subcostal retractions, and expiratory wheezes throughout. PEFR reveals reduced FEV1 consistent with acute asthma exacerbation

Prescriptions

ProAir HFA (Albuterol Sulfate) Inhalation Aerosol 108, 90 base mcg, Take 2 inhalations every 4-6 hours as needed.

Prednisone (Deltasone) 20 mg tablets Take 2 tablets once daily for 5 days, 10 tablets

PRN: Loratadine (Claritin) 10 mg tablets Take 1 tablet once daily as needed 30 tablets

Follow up:

Visit in 2-5 days to evaluate for improvement. If she needs adjustments they would be discussed and in 4-6 weeks mark another visit will be done to determine if she needs any further workup

Using the case above completed this questions

Address the following questions:
Which resources would you recommend if the client requested complimentary alternative medicine (CAM) as part of her treatment strategy?
How would these resources change the education provided to the client? 
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
communicate with minimal errors in English grammar, spelling, syntax, and punctuation

ct 1

Jun 14, 2024 | Health Medical

Description

How is your selected cause of death addressed by Saudi Vision 2030?

What are some of the methods in obtaining research and data for shaping KSA policy regarding your selected cause of death?

Any challenges to collecting evidence-based information.

Health policy laws implementing positive social changes in this area of healthcare.

What is the importance of this information?

Why is your selected cause of death relevant to your audience or field of study?

How is it applicable beyond these contexts?

Reference

Bashar, S. (2021). Leading cause of death in comparison to COVID-19

in Saudi Arabia. European Review for Medical and Pharmacological Sciences, 25, 2468-2469. https://www.europeanreview.org/wp/wp-content/uploa…

For more information and an example of a Research Poster, click here:

Poster Template 1

Poster Template 2

This Research Poster should meet the following criteria:

Include sections for: Introduction, Literature Review, Methods, Results, and Conclusion. Include a title slide and references slide.

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.

Be formatted according to APA 7th edition and Saudi Electronic University writing guidelines.

274 M بنفسجي

Jun 14, 2024 | Health Medical

Description

see attached file

Unformatted Attachment Preview

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.

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Peer Response for Culture in Nursing

Jun 14, 2024 | Health Medical

Description

Need to do 2 peer response. Should be 1-2 paragraphs each, with a reference. Initial discussion post:A 45-year-old Vietnamese woman is in the emergency room with severe abdominal pain. Her teenage sons are with her, ages 14 and 19. The nurse asks if the sons can help interpret to get the history of the illness.1.How can the nurse ensure culturally competent care?2.Was the nurse correct in asking the sons to interpret?3.What might an institutional policy regarding interpretation and translation recommend?

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As a culturally competent nurse, she must be able to analyze the cultural and professional background
of each patient, getting insight into cultural healthcare beliefs and principles. Also, the nurse needs to
look for and gain information about other cultures and ethnic groups (this information can be in journal
articles, textbooks, seminars, workshops, and the Internet. The collection of the patient data about the
displaying problem as well as being able to perform a culturally specific assessment, respect and accept
cultural differences; and being willing to be open and to learn from others is also a key component.
As a nurse we must be aware that patients from other parts of the world might not be familiar with
certain types of diseases seen in the United States, that’s why we don’t make assumptions, and we must
explain every detail in very clear language, avoiding medical jargon.
Interpreters should be neutral and passive. A family member who serves as an interpreter may become
emotionally distressed at receiving upsetting medical news and the information received could be
incorrectly interpreted, and in some circumstances, the family member acting as an interpreter could
become unable to continue interpreting. Also, in many states is prohibited the use of children under age
15 as interpreters in hospitals, clinics, and doctor’s offices. For this reason, a qualified medical
interpreter who can more impartially relate sensitive information is always recommended, often with
better judgment and bedside manner. While is true that one of the children is 19, it still is not the best
choice in these cases, since a family member is emotionally involved and can be impacted negatively by
any negative diagnosis. Use of a minor (under age 18) as an interpreter is only acceptable in emergency
situations. The use of professionals is fully recommended, and it helps to avoid any misunderstandings
of diagnosis, treatment plans, and so on.
State law requires that hospitals have interpreters, either on-site or by telephone, 24 hours a day.
Health plans must pay for these services and patients should not be charged.
Facilities’ policies and procedures help ensure adherence to HIPAA regulations.
POLICY:
The facility will take reasonable steps to ensure that persons with Limited English Proficiency (LEP) have
meaningful access and an equal opportunity to participate in the facility’s services, activities, programs,
and other benefits.
Language assistance will be provided through the use of competent bilingual staff, staff interpreters,
contracts or formal arrangements with local organizations providing interpretation or translation
services, or technology and telephonic interpretation services.
The facility will conduct a regular review of the language access needs of its patient population, as well
as update and monitor the implementation of this policy and these procedures, as necessary.
PROCEDURES:
1. IDENTIFYING LEP PERSONS AND THEIR LANGUAGE
The institution will promptly identify the language and communication needs of the LEP(Limited English
Proficiency) person.
2. OBTAINING A QUALIFIED INTERPRETER
Identify responsible staff person(s), and phone number(s)) is/are responsible for maintaining an
accurate and current list showing the name, language, phone number, and hours of availability of
bilingual staff and providing the list.
3. PROVIDING WRITTEN TRANSLATIONS
When translation of vital documents is needed, each unit in the facility will submit documents for
translation into frequently encountered languages to the responsible staff person. Facilities will provide
translation of other written materials if needed, and written notice of the availability of translation, free
of charge, for LEP individuals.
4. PROVIDING NOTICE TO LEP PERSONS
The facility will inform LEP persons of the availability of language assistance, free of charge, by providing
written notice in languages LEP persons will understand.
5. MONITORING LANGUAGE NEEDS AND IMPLEMENTATION
On an ongoing basis, the facility will assess changes in demographics, types of services, or other needs
that may require a reevaluation of this policy and its procedures. In addition, the facility will regularly
assess the efficacy of these procedures.
References:
Krystallidou D, Langewitz W, van den Muijsenbergh M. Multilingual healthcare communication:
Stumbling blocks, solutions, recommendations. Patient Educ Couns. 2021;104(3):512–6.
Pandey M, et al. Impacts of English language proficiency on healthcare access, use, and outcomes
among immigrants: a qualitative study. BMC Health Serv Res. 2021;21(1):1–13.
https://www.hhs.gov/civil-rights/for-providers/clearance-medicare-providers/example-policyprocedure-persons-limited-english-proficiency/index.html.
In healthcare settings, it is crucial to provide culturally competent care in order to promote successful
communication and fulfill the particular requirements of patients from various cultural backgrounds.
The nurse should take the following actions to ensure a culturally competent treatment in this case
where a 45-year-old Vietnamese woman with significant stomach pain is in the emergency room and her
adolescent boys are there:
Utilize Professional Interpreters: Asking adolescent boys to translate may sound convenient, but it’s
often not a good idea. Family members, particularly teenagers, might lack the language skills or medical
expertise needed to understand complex medical information. The nurse should instead employ
qualified interpreters who are versed in medical jargon and can guarantee appropriate communication.
According to the Joint Commission, In order to promote patient safety and ensure efficient
communication with patients who have limited English proficiency (LEP), healthcare organizations
should make use of certified medical interpreters (Joint Commission, 2010).
Respect Patient’s Preferences: When it comes to who should be present during medical discussions, it’s
crucial to respect the patient’s wishes. The nurse should educate the patient about the advantages of
hiring qualified interpreters before obtaining their informed permission. In order to assure accuracy, it is
imperative to add expert services to the interpretation if the patient still chooses to have her boys
present.
Cultural Sensitivity: The nurse should be attentive to cultural differences and take into account the
Vietnamese community’s cultural traditions and preferences. Family is very important in Vietnamese
culture while making healthcare decisions. The nurse should support professional interpretation while
acknowledging and respecting this cultural value.
To promote effective communication with patients who speak little or no English, institutional policies
relating to interpretation and translation should be in line with best practices and laws. Such policies
may incorporate the following suggestions:
Use of Professional Interpreters: Specifically declare that all medical interactions with patients who
speak a language other than English or have limited English proficiency (LEP) should be conducted via
professional interpreters (Joint Commission, 2010).
Informed Consent: Obtaining patients’ informed consent regarding their chosen means of
communication and the employment of qualified interpreters is a requirement for healthcare
practitioners.
Cultural Competence Training: Mandating cultural competence training for healthcare personnel will
help them better comprehend and be sensitive to people from different cultural backgrounds (Office of
Minority Health, 2017).
Documentation: To monitor and uphold the standard of care, make sure that all patient interactions
with interpreters are recorded in the patient’s medical record (U.S. Department of Health & Human
Services, 2020).
Compliance With Federal Laws: Ensuring that federal laws are followed, including Title VI of the Civil
Rights Act, which mandates that healthcare facilities receiving federal financing offer language access
services (U.S. Department of Justice, 2021).
Healthcare organizations can provide culturally competent treatment and raise the standard of care for
patients with limited English proficiency while also abiding by legal and regulatory obligations by putting
these policies and guidelines into place.
References
Joint Commission. (2010). Advancing Effective Communication, Cultural Competence, and Patient- and
Family-Centered Care: A Roadmap for Hospitals. Retrieved from https://www.jointcommission.org//media/tjc/documents/resources/patient-safety-topics/2010_hospitals_tfoc.pdf
Office of Minority Health. (2017). National Standards for Culturally and Linguistically Appropriate
Services (CLAS) in Health and Health Care. Retrieved from
https://www.minorityhealth.hhs.gov/assets/pdf/checked/finalreport.pdf
U.S. Department of Health & Human Services. (2020). Language Access Plan Toolkit. Retrieved from
https://www.hhs.gov/civil-rights/for-individuals/section-1557/language-assistance-toolkit/index.html
U.S. Department of Justice. (2021). Title VI of the Civil Rights Act of 1964. Retrieved from
https://www.justice.gov/crt/title-vi-1964

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MULTIPLE REGRESSION MODERATION OR MEDIATION IN SPSS

Jun 14, 2024 | Health Medical

Description

In this Assignment, you will access a secondary dataset and construct a research question that can be answered with a moderation or mediation multiple regression analysis.

During this Module, you ideally have used the Support Forum to ask, answer, and otherwise address any questions you had regarding moderation and mediation. In this Assignment, you apply what you have learned to answer a research question using multiple regression, including testing for possible moderation or mediation. Remember that you must still address all the assumptions for multiple regression.

TO PREPARE
Review the module Learning Resources (including media), especially those related to multiple regression, moderation, and mediation analysis methods.
Import the SPSS dataset provided by your instructor.
Review the BRFSS Dataset documentation to familiarize yourself with the variables in the dataset.
ASSIGNMENT

Using the provided dataset, compose a research question that can be answered through a multiple regression analysis. Based on the research question you created, choose either moderation or mediation in your multiple regression analysis technique.

If you chose mediation:

Fit a multiple regression model, testing whether a mediating variable partly or completely mediates the effect of an initial risk factor variable on an outcome variable. Think about whether the model will meet assumptions (or not).
Fit the model, testing for mediation between two key variables.
Analyze the output, determining whether mediation was significant, and interpret that result.
Reflect on possible implications for social change.

If you chose moderation:

Fit a multiple regression model, testing whether a moderating variable partly or completely moderates the effect of an initial risk factor variable on an outcome variable. Think about whether the model will meet assumptions (or not).
Fit the model, testing for moderation between two key variables.
Analyze the output, determining whether moderation was significant, and interpret that result.
Reflect on possible implications for social change.

For both types of analyses:

In two to three pages, excluding the title page and appendix, write an analysis that includes the following:

A description of the research question, hypotheses, and variables, including the type of variable (independent, dependent, mediating/moderating) and level of measurement (categorical, ordinal, continuous).
A clear description and visual display of the statistical analysis in APA Publication Manual, 7th edition (APA) style, including regression tables (e.g., model summary, ANOVA, coefficients) and figures (e.g., regression line) as appropriate.
An analysis of the output, determination about whether the output was significant, and interpretation of the statistical results.
A reflection on possible implications for social change.

The analysis should be in APA format, including a title page, references, and an appendix, which includes your SPSS data output.

Note: For an APA-compliant write-up of these types of analyses, refer to

Warner, R. M. (2021). Mediation. In Applied statistics II: Multivariable and multivariate techniques (3rd ed., pp. 289–308).

The APA-compliant write-up is found on pages 305–306.

Warner, R. M. (2021). Moderation: Interaction in multiple regression. In Applied statistics II: Multivariable and multivariate techniques (3rd ed., pp. 215–253).

The APA-compliant write-up is found on pages 242–243.
DATA
Centers for Disease Control and Prevention. (2021, July 7). Behavioral risk factor surveillance system: Overview: BRFSS 2020https://www.cdc.gov/brfss/annual_data/2020/pdf/overview-2020-508.pdf
Centers for Disease Control and Prevention. (2021, August 6). LLCP 2020 codebook report. Overall version data weightedwith _LLCPWT. Behavioral Risk Factor Surveillance System
https://www.cdc.gov/brfss/annual_data/2020/pdf/cod…
Ferraro, A. (2020). What statistical test should I useWalden University Blackboard. https://waldenu.instructure.com
Document: Guided Sample Dataset: Statistics AnxietyNote: The Statistics Anxiety dataset is not for use in your Assignment. It is used with the Required Media for the Practice: SPSS (Optional) activity.

Crowson, M. (2019, July 27).Multilevel modeling using SPSSJuly, 2019) [Video]. YouTube. https://youtu.be/RU1ps6jaheI

Hageman, K., Kim, A., Sanchez, T., & Bertolli, J. (2015). Chapter 12 | Survey design and implementationIn G. Guest & E. E. Namey (Eds.), Public health research methods (pp. 341–378) SAGE Publications. https://doi.org/10.4135/9781483398839.n12
Walden Office of Research and Doctoral Services. (n.d.). Quantitative, SPSS, and statistics tutoringhttps://academicguides.waldenu.edu/research-center…
Warner, R. M. (2021). Dummy predictor variables in multiple regression. In Applied statistics II: Multivariable and multivariate techniques (3rd ed., pp. 187–214). SAGE Publications.
Warner, R. M. (2021). Multiple regression with multiple predictors. In Applied statistics II: Multivariable and multivariate techniques (3rd ed., pp. 133–186). SAGE Publications.
Download BRFSS_PHYSICAL1(1)-2.sav (98.4 KB)

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Mediation
Mediation
Program Transcript
[MUSIC PLAYING]
MATTHEW JONES: This week, we’re talking about mediation. And just like with
moderation, there are a number of different theoretical and conceptual viewpoints
on how mediation analysis should be carried out. This week in SPSS, I’m just
going to show you one approach of many. And this is often referred to as the
Baron and Kenny approach to mediation. This week, we’re going to be looking at
the question of whether motivation mediates the relationship between anxiety
and final exam score.
Students entering a statistics class might have a high level of anxiety, but that
anxiety might also increase motivation, which in turn might affect final exam
scores. But we can go to SPSS and test this out with our simulated data set. So
using the Baron and Kenny approach, it’s really a four step approach in
performing a multiple regression analysis. So I have to do a series of simple
regression analyzes first.
And the first regression analysis I do is testing the pathway between our
independent variable, class anxiety, and our dependent variable, final score-final exam score. So it can go ahead and click Analyze, Regression. So very
bivariate regression should be familiar to everybody. So in the Dependent
Variable box, I’m going to put final exam score. And in the Independent Variable
box, I’m going to put classic anxiety at time one.
And I can go ahead and run my regression analysis. The output comes up. I can
see the ANOVA. The overall regression is significant. And indeed, classic anxiety
is a significant predictor. So you can see a positive unstandardized coefficient.
As anxiety increases, so does the final exam score.
Now, I need to test for a relationship between my mediator, motivation, and final
exam score. So we just do the same thing– Analyze, Regression, Linear. And so
we’re just going to move our independent variable of anxiety out and move
motivation score, so it’s measured also from an instrument– move that into the
Independent Variable. Click OK. OK.
And we see this, from the ANOVA, the regression is significant. The coefficient is
significant. As motivation increases, so does the final exam score. OK. Then we
need to test for the relationship between our independent variable of class
anxiety and motivation. So back up to Regression, Linear.
So we’re testing each of these direct paths. So motivation moves into the
Dependent Variable box, class anxiety at time one moves into our Independent
Variable. And indeed, we also see, jumping down to our coefficients, that class
© 2017-2022 Walden University, LLC
1
Mediation
anxiety is a significant predictor of motivation. So the final step is we’re going to
conduct a multiple regression analysis. So back to Regression.
And we’re going to put our dependent variable of interest, the final exam score-we already have class anxiety as our independent variable. So we just need to
move motivation back in there. Now that we see that both of our predictive
variables are still statistically significant, and we can see looking at our
coefficients– I’ll look here at our standardized beta– have actually decreased
from when we were just doing that bivariate regression analysis. So that is one of
the variables, motivation, has some sort of mediating effect on class anxiety.
So far we’ve tested all the direct effects in SPSS, but there’s one last important
step to mediation analysis. And that is testing for the indirect effect. There are
many different ways to test for this indirect effect, but one specific test that I’ll
mention is the Sobel test. You can go to an outside Sobel test calculator on the
web– and we’ve listed one of those under your week three resources. But there
are also many others. There are also SPSS macros that can be used to test this
indirect effect as well.
If you’re interested in this, you might want to speak to your instructor about his or
her preference or other resources that he or she may know about.
[MUSIC PLAYING]
Mediation
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Introduction to Moderation
Introduction to Moderation
Program Transcript
[MUSIC PLAYING]
DR. ANNIE PEZALLA: In the previous week, you refreshed your memory of
some of the more straightforward and useful approaches to multiple regression.
This week, you’re introduced to an expanded approach to multiple regression
that tests for a moderation effect in a model. To illustrate moderation, let’s take
an example, one that is relevant to almost anyone taking a statistics class.
Statistics can scare people, and some people are more likely to shut down and
not ask for help in a statistics class than are others. Now you might wonder, is
there a relationship between gender and fear of asking for help in a statistics
class? You might think that women are more likely than men to report a fear of
asking for help, or maybe you think the opposite.
No matter what you think, the relationship between those two variables– gender
and fear of asking for help– is probably quite different depending on the comfort
one has with math. That is, if you’re studying a group of people who all have a
very low comfort with math, women may, indeed, be more fearful than men to
ask for help in a statistics class. So there may be a strong relationship between
gender and fear of asking for help in such a group.
Yet when math comfortability is high, the relationship between gender and fear of
asking for help may be weak or non-existent. That speculation could be tested
with a moderation model. So how could you frame your research question to
examine the role of math comfortability between those variables?
The research question you’d ask is, does math comfortability moderate the
relationship between gender and fear of asking for help?
Essentially, moderation tells you whether the strength of the relationship between
your predictor variable and your dependent variable changes based on the value
of a third variable. My colleague and friend, Dr. Jones, will walk you through this
test in SPSS.
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Introduction to Moderation
Introduction to Moderation
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Introduction to Mediation
Introduction to Mediation
Program Transcript
DR. ANNIE PEZALLA: This week you’re exposed to a slightly different approach
to multiple regression. Up to this point, we’ve assumed that, in the conception of
our models, the independent variable either directly affects or does not affect our
dependent variable. But life isn’t always that simple. It’s pretty common for there
to be an intervening variable through which the independent variable passes to
effect the dependent variable.
Those intervening variables are called mediators, and they serve the same sort
of function that a mediator might serve between two people who have some sort
of relationship but the nature of their relationship is unclear and requires
someone to essentially go between them to help clarify the ways in which they
relate. Testing for mediation gives you the ability to test for those sorts of
relationships, to examine both the direct and indirect effects between your
variables of interest.
Let’s return to our example with the statistics professor and his anxious students.
Using a simple linear regression model, this professor might test for a
relationship between student anxiety of statistics and end of course knowledge
attainment of statistical methods. You might think that anxiety might be a pretty
good predictor of end of course knowledge, that high anxiety predicts low end of
course knowledge.
But the relationship between those variables is almost always a little more
complicated than that. Anxiety could be a good thing or a bad thing. Indeed,
sometimes anxiety is just a reflection of motivation to learn the course material.
From that perspective, motivation could mediate the relationship between anxiety
and end of course knowledge
Dr. Jones will be testing those relationships for you this week as he answers the
question– does motivation mediate the relationship between anxiety and final
score in a statistics course? Both mediation and moderation are incredibly
powerful and popular statistical tests and research. Think about how you might
use either or both of these tests with a dataset that you’ve chosen to use.
Introduction to Mediation
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Formal Literature Review

Jun 14, 2024 | Health Medical

Description

Literature Review Paper

Literature review paper

One of the main learning exercises in the course is a Literature review paper. The literature review paper’s purpose is to answer a significant clinical question. Most of your discussions and activities in this course are created to build the skills need it to write this paper. To do this paper you need to work each week on assignments, that will help you build your skills for the successful completion of this assignment.

Your paper should be 5-6 pages long (double-spaced, 12 font) not including the references and title page). You should have a reference page of at least eight (8) academic sources, including at least five (5) primary research sources that specifically answer the review question. Use APA format for references and citations. All papers must be submitted to be reviewed for similarity, any paper with a score of 20% or higher in the similarity index, will receive an automatic “0”, and will not be reviewed until the similarity score is below 20%.

Step by step directions and a rubric is posted below. After your paper has been corrected and graded, you have the option to revise your literature review paper in order to improve your writing and correct your mistakes. If there is a significant improvement, the grade will be increased. Revisions are due a week after receiving feedback.

Instructions:

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 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)
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
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
Submit a table of the studies as per the matrix development
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

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The Well-Built Clinical Question
PICO Worksheet
INSTRUCTIONS:
Think about a complex clinical problem that you encountered in your daily practice. Use the following
table to identify the patient/population, intervention, comparison, and outcomes. Once is done, try to
formulate your question.
Question Components
Your Question
P – Patient or Population
Pregnant women between 15 to 36 years with
gestational diabetes often face pregnancy
problems resulting from the effects of gestational
diabetes.
Describe the most important characteristics of the
patient.
(e.g., age, disease/condition, gender)
I – Intervention; Prognostic Factor; Exposure
Low carbohydrate intake forms part of the dietary
changes in gestational diabetes management.
Describe the main intervention.
(e.g., drug or other treatment,
diagnostic/screening test)
C – Comparison (if appropriate)
A standard low-fat diet is a known therapy for
managing diabetes.
Describe the main alternative being considered.
(e.g., placebo, standard therapy, no treatment, the
gold standard)
O – Outcome
Comparing the two interventions will help
determine which is effective in glycemic control.
Describe what you’re trying to accomplish,
measure, improve, and affect.
(e.g., reduced mortality or morbidity, improved
memory, accurate and timely diagnosis)
The well-built clinical question:
In Pregnant women between 15 to 36 years with gestational diabetes, what is the effect of _low
carbohydrate diet on __glycemic control compared with standard low-fat diet _______________?
INSTRUCTIONS: Fill in the blanks with information from your clinical scenario:
THERAPY
In__ Pregnant women between 15 to 36 years with gestational diabetes_____________, what is the effect
of _low carbohydrate diet_______________on __glycemic control_____________ compared with __
standard low-fat diet _______________?
Page 1|5
Lesson 4 – Discussion 3
NUR3165
INSTRUCTIONS: Scenario (check all that apply):
Type of Question
X Therapy
Ideal Type of Study
RCT
Note: Meta-analyses and systematic reviews, when available, often provide the best
answers to clinical questions.
INSTRUCTIONS:
 OR →
MeSH/Subject Headings
Main Concepts
(PICO concepts)
Pregnant women,
gestational diabetes
“Pregnancy in Diabetics,”
“Gestational Diabetes”
Low carbohydrate
diet
“Diet, Carbohydrate-Restricted,”
“Low Carbohydrate Diet”
Standard low-fat
diet
“Diet, Low-Fat,” “Standard
Diet”
Glycemic control
“Blood Glucose,” “Glycemic
Control”
AND
Synonyms
Expectant mothers,
Pregnant females,
Pregnancy with diabetes,
Gestational
hyperglycemia
Low carb diet,
Carbohydrate-restricted
eating plan, Dietary
carbohydrate reduction
Regular low-fat diet,
Conventional low-fat
eating plan, Standard
dietary treatment
Blood sugar
management, Glucose
regulation, Glycemic
outcome, Blood glucose
level control
Search Strategy Development
INSTRUCTIONS: Finding the right words to get what you want. From your PICO, fill in as much as you
can of the table below.
Page 2|5
Lesson 4 – Discussion 3
NUR3165
Primary search term
P
I
Pregnant women, gestational
diabetes
Use of low carbohydrate diet
C
Use of standard low-fat diet
O
Synonym 1
Pregnant females,
carbohydraterestricted diet,
dietary intervention
Conventional lowfat diet
Blood sugar control
Glycemic control
Synonym 2
expectant mothers,
diabetes during
pregnancy
Low carb diet
standard dietary
treatment with
reduction of fat
glucose regulation,
glycemic
management
INSTRUCTIONS: List your inclusion criteria –i.e., gender, age, years of publication
INSTRUCTIONS: Check any limit that may pertain to your search:
_____ Age _15-36 years__________________ Language _English_________ Year of publication between
2018 to 2023
RCT studies.
Type of study/publication you want to include in your search: (From Step 2 of tutorial)
__ Individual Research Studies
__
Check the databases you searched:
[X] Cochrane Library
__ CINAHL with Full Text
__ PubMed Clinical Queries
What information did you find to help answer your question?
A search for randomized controlled trials published in English between 2018 to 2023 in the three
databases shows that several studies have been carried out on the use of different interventions, including
dietary adjustments, lifestyle changes, and the use of medications. However, no study has ever been carried
Page 3|5
Lesson 4 – Discussion 3
NUR3165
out to compare the two interventions in the PICOT questions. A study by Mijatovic et al.(2020) shows that
a low carbohydrate diet positively affects glycemic control in managing gestational diabetes (GDM).
Research, such as the study conducted by Mijatovic et al. (2020), has demonstrated that a diet with reduced
carbohydrate content can significantly improve glycemic control by keeping mean glucose levels below 87
mg/dL. This improvement in blood sugar regulation is crucial in preventing fetal overgrowth, a common
complication of GDM.
Additionally, a low-carbohydrate diet helps reduce the risk of giving birth to small-for-gestationalage (SGA) infants, which can be a concern when traditional diabetic diets are used. Therefore, adopting a
low-carbohydrate diet as part of the management strategy for gestational diabetes can effectively promote
maternal and fetal health. Other studies, such as the one by Rasmussen et al.(2020), indicate that a low-fat
diet help in controlling diabetes.
Page 4|5
Lesson 4 – Discussion 3
NUR3165
References
Mijatovic, J., Louie, J. C. Y., Buso, M. E. C., Atkinson, F. S., Ross, G. P., Markovic, T. P., & BrandMiller, J. C. (2020). Effects of a modestly lower carbohydrate diet in gestational diabetes: a
randomized controlled trial. The American journal of clinical nutrition, 112(2), 284–292.
https://doi.org/10.1093/ajcn/nqaa137
Rasmussen, L., Poulsen, C. W., Kampmann, U., Smedegaard, S. B., Ovesen, P. G., & Fuglsang, J. (2020).
Diet and Healthy Lifestyle in the Management of Gestational Diabetes Mellitus. Nutrients, 12(10),
3050. https://doi.org/10.3390/nu12103050
Page 5|5
Lesson 4 – Discussion 3
NUR3165

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nur501 theoretical basis adv nursing

Jun 14, 2024 | Health Medical

Description

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Part one: USE references 2-3 paragraphs
your specialty area of FNP practice. Select a nursing theory, borrowed theory, or
interdisciplinary theory provided in the lesson plan or one of your own findings. Address the
following:
•
•
•
•
•
•
Origin
Meaning and scope
Logical adequacy
Usefulness and simplicity
Generalizability
Testability
Finally, provide an example how the theory could be used to improve or evaluate the quality of
practice in your specific setting. What rationale can you provide that validates the theory as
applicable to the role of the nurse practitioner.
Part two:
1. you will use the five theories/models listed below:
o Health Belief Model
o Transtheoretical Model of Behavioral Change
o Social Cognitive Theory
o Family Systems Theory
o Family Assessment and Intervention Model
2. Search the library for literature. Locate one article related to each selected theory or
model.
o Use only scholarly sources as defined for the NP program: A US-based peerreviewed journal for clinicians (MD/DO/NP/PA) published in the past five years
or the latest clinical practice guideline (CPG).
3. Prepare an annotated entry for each source. Begin with the full APA citation of the
source, followed by 2-3 paragraphs:
o Summarize the article.
o Describe how the article relates to the chosen theory/model.
o Reflect on how the article could (or could not) be relevant to future Nurse
Practitioner practice.
Criteria for Format and Special Instructions
1. The paper should not include a separate title page. No reference page is necessary as it
will incorporate the references into the body of the bibliography.
2. The template must be used for this assignment: NR501NP Week 5 Assignment Template
• Links to an external site..
• A minimum of 5 (five) scholarly references must be used. Required textbooks for this course
and Chamberlain College of Nursing lesson information may NOT be used as scholarly
references for this assignment. Be aware that information from .com websites may be incorrect
and should be avoided.
• References are current – within a 5-year time frame unless a valid rationale is provided and the
instructor has approved them.
• In-text citations are not required in the annotated bibliography.
• Rules of grammar, spelling, word usage and punctuation are followed and consistent with
formal, scientific writing.
Part Three: Use references 2-3 paragraphs
Which of the culture and caring theories most resonates with you for your practice as an NP? How does
the theory integrate the nursing paradigm? What parts of the theory do you identify with? How does
the theory help to meet CLAS standards to advance health equity?

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MSW 610 WEEK 3 Discussion post

Jun 14, 2024 | Health Medical

Description

Instructions

Classroom Participation

Initial Response
INSTRUCTIONS:
Select a case from the reading and discuss how any of these theories can be applied to the case.
Be sure to cite your textbook and case example.
Discuss how this would help you understand the client(s) and apply to practice.
Which theory from this week’s readings do you think is most beneficial? 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:

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

Nursing Question

Jun 14, 2024 | Health Medical

Description

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.

Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

This week, we will be reviewing Gastrointestinal and Hepatobiliary Disorders. You are to write a 1 page paper addressing the requirements written in your assignment. Please follow the directions given and review the grading rubric to ensure all questions have been addressed.

Case:

PMH: Vitals:

HTN Temp: 98.8oF-

Type II DM Wt: 202 lbs

Gout Ht: 5’8”

DVT – Caused by oral BCPs BP: 136/82

HR: 82 bpm

Current Medications: Notable Labs:

Lisinopril 10 mg daily WBC: 13,000/mm3

HCTZ 25 mg daily Total bilirubin: 0.8 mg/dL

Allopurinol 100 mg daily Direct bilirubin: 0.6 mg/dL

Multivitamin daily Alk Phos: 100 U/L

AST: 45 U/L

ALT: 30 U/L

Allergies:

Latex
Codeine
Amoxicillin

PE:

Eyes: EOMI
HENT: Normal
GI:bNondistended, minimal tenderness
Skin:bWarm and dry
Neuro: Alert and Oriented
Psych:bAppropriate mood

To Prepare:

Review the case study assigned by your Instructor for this Assignment
Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.
Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.
Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

Write a 1-page paper that addresses the following:

Explain your diagnosis for the patient, including your rationale for the diagnosis.
Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

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.

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 64, “Drugs for Peptic Ulcer Disease” (pp. 589–597)
Chapter 65, “Laxatives” (pp. 598–604)
Chapter 66, “Other Gastrointestinal Drugs” (pp. 605–616)
Chapter 80, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 723–743)
Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., . . . Sanya, A. J. (2018) The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases Hepatology, 67(1), 328–357. Retrieved from https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/…This article details the diagnosis and management of nonalcoholic fatty liver disease. Review this article to gain an understanding of the underlying pathophysiology as well as the suggested pharmacotherapeutics that might be recommended to treat this disorder. https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/…

NURS_6521_Week4_Assignment_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeExplain your diagnosis for the patient, including your rationale for the diagnosis.

25 to >22.25 pts

Excellent

The response accurately and clearly explains in detail the diagnosis for the patient, including an accurate and thorough rationale for the diagnosis that supports clinical judgment.

22.25 to >19.75 pts

Good

The response provides a basic explanation of 1-2 diagnoses for the patient, including an accurate rationale for the diagnosis that may support clinical judgment.

19.75 to >17.25 pts

Fair

The response inaccurately or vaguely explains the diagnosis for the patient, including an inaccurate or vague rationale for the diagnosis that may or may not support clinical judgment.

17.25 to >0 pts

Poor

The response inaccurately and vaguely explains the diagnosis for the patient, including an inaccurate and vague rationale for the diagnosis that does not support clinical judgment, or is missing.

25 pts

This criterion is linked to a Learning OutcomeDescribe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

30 to >26.7 pts

Excellent

The response accurately and completely describes in detail an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

26.7 to >23.7 pts

Good

The response describes a basic explanation of the appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

23.7 to >20.7 pts

Fair

The response inaccurately or vaguely describes an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

20.7 to >0 pts

Poor

The response inaccurately and vaguely describes an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

30 pts

This criterion is linked to a Learning OutcomeJustify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

30 to >26.7 pts

Excellent

The response provides an accurate, clear, and detailed justification for the recommended drug therapy plan for this patient. … The response includes specific, accurate, and detailed examples that fully support the justification provided.

26.7 to >23.7 pts

Good

The response provides a basic justification for the recommended drug therapy plan for this patient. … The response includes only 1-2 examples that fully support the justification provided.

23.7 to >20.7 pts

Fair

The response provides an inaccurate or vague justification for the recommended drug therapy plan for this patient. … The response may include examples, which may inaccurately or vaguely support the justification provided.

20.7 to >0 pts

Poor

The response provides an inaccurate and vague justification for the recommended drug therapy plan for this patient, or is missing. … The response does not include examples that support the justification provided, or is missing.

30 pts

5 to >4.45 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

4.45 to >3.95 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

3.95 to >3.45 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

3.45 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.

5 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

5 to >4.45 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors

4.45 to >3.95 pts

Good

Contains a few (1–2) grammar, spelling, and punctuation errors

3.95 to >3.45 pts

Fair

Contains several (3–4) grammar, spelling, and punctuation errors

3.45 to >0 pts

Poor

Contains 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 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 >4.45 pts

Excellent

Uses correct APA format with no errors

4.45 to >3.95 pts

Good

Contains a few (1–2) APA format errors

3.95 to >3.45 pts

Fair

Contains several (3–4) APA format errors

3.45 to >0 pts

Poor

Contains many (≥ 5) APA format errors

5 pts

Total Points: 100

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Asthma and Stepwise
Management
Student’s Name:
Walden University:
Due Date:
Long-term Controls for Asthma
• Asthma is a chronic condition caused by
inflammation of the airways.
• Long-term controls for the condition include antiinflammatories mainly glucocorticoids (Rosenthal &
Burchum, 2017).
• Anti-inflammatories suppresses inflammation,
reduce bronchial hyper-reactivity and mucus
production.
• Glucocorticoids impact on patients include speaking
difficulty, retarded growth in children, bone loss, risk
of cataracts glaucoma.
Quick Relief Controls for Asthma
• Bronchodilators are options used for quick relief and
symptomatic relief (Montano et al., 2020).
• Core bronchodilators used in asthma treatment
include beta-agonists and anticholinergics.
• Their mode of action mainly comprises histamine
suppression, increasing ciliary motility to induce
bronchodilation (Rosenthal & Burchum, 2017).
• Some of the bronchodilators’ adverse impacts
include tachycardia, angina, chest pain among others.
Stepwise Treatment and Management
• The stepwise treatment approach is an asthma
treatment plan whereby the doses are gradually
increased and reduced at interval to achieve stability
(Cazzola et al., 2021).
• The approach to treatment aims to gain control of
asthma among patients mainly through reducing
impairment and reducing risk.
• Stepwise treatment mainly suppresses inflammations
and prevents exacerbation through dosage alterations.
Stepwise Treatment and Management of
Asthma
Steps
Care and Medication
Step one
SABA PRN
Step two
Low-dose ICS
Step three
Low-dose ICS and LABA
Step four
Medium dose ICS and LABA
Step five
High dose ICS and LABA
Step six
High dose ICS, LABA and corticosteroids
The treatment is to be stepped up or down
based on the patient’s assessment across the
various steps.
Stepwise Management in Maintaining
Asthma Control
• The core benefit of the stepwise approach in asthma
treatment is that it enables gaining and maintaining
control of the disease (Papi et al., 2020).
• Stepwise management helps in pharmacological risk
and side effects control in the asthma treatment.
• Reassessment of therapy in every patient’s visit
reinforces the disease and intervention control.
• Stepwise treatment also allows for stepping up or
down of treatment thus controlling the disease.
Conclusion
• Asthma is a chronic respiratory disease caused by
inflammation of the airways.
• Core pharmacological options for the disease include
bronchodilators and anti-inflammatories.
• Bronchodilators and anti-inflammatories have
adverse impacts on patients.
• The stepwise treatment approach offers a means for
reducing impairments and risk in asthma treatment.
References
• Cazzola, M., Matera, M. G., Rogliani, P., Calzetta,
L., & Ora, J. (2021). Step-up and step-down
approaches in the treatment of asthma. Expert
Review of Respiratory Medicine, 15(9), 1159-1168.
• Montaño, L. M., Flores-Soto, E., Sommer, B., SolísChagoyán, H., & Perusquía, M. (2020). Androgens
are effective bronchodilators with anti-inflammatory
properties: A potential alternative for asthma therapy.
Steroids, 153, 108509.
References (Cont.…)
• Papi, A., Blasi, F., Canonica, G. W., Morandi, L.,
Richeldi, L., & Rossi, A. (2020). Treatment strategies
for asthma: reshaping the concept of asthma
management. Allergy, Asthma & Clinical
Immunology, 16, 1-11.
• Rosenthal, L. D., & Burchum, J. (2017). Lehne’s
Pharmacotherapeutics for Advanced Practice
Providers-E-Book. Elsevier Health Sciences.
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Nursing Question

Jun 14, 2024 | Health Medical

Description

Present your approved intervention to the patient, family, or group and record a 10–15 minute video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Collapse All

Introduction

Baccalaureate-prepared nurses have many opportunities to reflect on their contributions to patient care outcomes during clinical experiences. Research suggests that creating and sharing video reflections may enhance learning (Speed, Lucarelli, & Macaulay, 2018).

For this assessment, you’ll present your approved intervention to the patient, family, or group and reflect on various aspects of your capstone practicum experience. Such reflection will give you a chance to discuss elements of the project of which you are most proud and aspects of the experience that will help you grow in your personal practice and nursing career.

REFERENCE

Speed, C. J., Lucarelli, G. A., & Macaulay, J. O. (2018). Student produced videos—An innovative and creative approach to assessment. Sciedu International Journal of Higher Education, 7(4).

Instructions

Complete this assessment in two parts: (a) present your approved intervention to the patient, family, or group and (b) record a video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program.

Part 1

Present your approved intervention to the patient, family, or group. Plan to spend at least 3 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. Be sure you’ve logged all of your practicum hours 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.

Use the Intervention Feedback Form: Assessment 5 [PDF] Download Intervention Feedback Form: Assessment 5 [PDF]as a guide to capturing patient, family, or group feedback about your intervention. You’ll include the feedback as part of your capstone reflection video.

Part 2

Record a 10–15 minute video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. A transcript of your video is not required.

You’re welcome to use any tools and software with which you are comfortable, but make sure you’re able to submit the deliverable to your faculty. Capella offers Kaltura, a program that records audio and video. Refer to Using Kaltura for more information about this courseroom tool.

Note: If you require the use of assistive technology or alternative communication methods to participate in these activities, please contact DisabilityServices@Capella.edu to request accommodations. If you’re unable to record a video, please contact your faculty as soon as possible to explore options for completing the assessment.

Requirements

The assessment requirements, outlined below, correspond to the scoring guide criteria, so 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 supporting evidence.

Assess the contribution of your intervention to patient or family satisfaction and quality of life.
Describe feedback received from the patient, family, or group on your intervention as a solution to the problem.
Explain how your intervention enhances the patient, family, or group experience.
Describe your use of evidence and peer-reviewed literature to plan and implement your capstone project.
Explain how the principles of evidence-based practice informed this aspect of your project.
Assess the degree to which you successfully leveraged health care technology in your capstone project to improve outcomes or communication with the patient, family, or group.
Identify opportunities to improve health care technology use in future practice.
Explain how health policy influenced the planning and implementation of your capstone project, as well as any contributions your project made to policy development.
Note specific observations related to the baccalaureate-prepared nurse’s role in policy implementation and development.
Explain whether capstone project outcomes matched your initial predictions.
Discuss the aspects of the project that met, exceeded, or fell short of your expectations.
Discuss whether your intervention can, or will be, adopted as a best practice.
Describe the generalizability of your intervention outside this particular setting.
Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Assess your personal and professional growth throughout your capstone project and the RN-to-BSN program.
Address your provision of ethical care and demonstration of professional standards.
Identify specific growth areas of which you are most proud or in which you have taken particular satisfaction.
Communicate professionally in a clear, audible, and well-organized video.
Additional Requirements

Cite at least three scholarly or authoritative sources to support your assertions. In addition to your reflection video, submit a separate APA-formatted reference list of your sources.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 2: Make clinical and operational decisions based upon the best available evidence.
Describe one’s use of evidence and peer-reviewed literature to plan and implement a capstone project.
Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
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.
Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
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.
Competency 5: Analyze the impact of health policy on quality and cost of care.
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.
Competency 7: Implement patient-centered care to improve quality of care and the patient experience.
Assess the contribution of an intervention to patient, family, or group satisfaction and quality of life.
Competency 8: Integrate professional standards and values into practice.
Assess one’s personal and professional growth throughout a capstone project and the RN-to-BSN program.
Communicate professionally in a clear and well-organized video.
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.

MULTILEVEL MODELING

Jun 14, 2024 | Health Medical

Description

Part of the development of a scholar-practitioner is learning how to critique scholarly research. A good article critique is not just a summary of the findings–that’s what the abstract does—it is a critical analysis of various elements of a research study, including the research problem, study aims, theoretical foundation, research questions, research design, study population, sampling procedures, data collection procedures, analytical approach, and interpretation of findings. As you examine a peer-reviewed journal article, you should question whether the researchers made logical and appropriate choices, evaluate the writing style, note biases and contradictions, and consider potential strengths and weaknesses of the study.

In this Assignment, you will critically analyze a peer-reviewed journal article that demonstrates multilevel modeling. The article provided by the Instructor should provide a good example of multilevel modeling, but sometimes researchers miss important aspects of this complex and advanced analytic technique in their write-up. Pay close attention to the variables involved and types of statistical tests used. Ask yourself whether the authors have provided enough detail that you could repeat the statistical analysis in a similar manner? Were outliers tested? Were assumptions met? How were the models estimated? How many models were used? How was covariance considered? Be sure to provide evidence (i.e., quotes) from the journal article to support your critiques and opinions.

ASSIGNMENT

In two to three pages, write a critique of the assigned article that includes responses to the following prompts:

Explain why the authors used multilevel modeling in their analysis.
Describe the multiple levels addressed in the study.
Describe how the authors shared their results.
If the authors used a graphic to share their results, analyze the effectiveness of using a graphic to interpret the study.
Explain the impact multilevel modeling has on the interpretation of the results for public health practice.
Soriano, F. I. (2013). Chapter five: Quantitative assessment methods. In Conducting needs assessment: A multidisciplinary approach (2nd ed., pp. 75–108). SAGE Publications. https://doi.org/10.4135/9781506335780.n5
Soriano, F. I. (2013). Chapter six: Quantitative data preparation and statistical analyses. In Conducting needs assessment: A multidisciplinary approach (2nd ed., pp. 109–120). SAGE Publications. https://doi.org/10.4135/9781506335780.n6
Subramanian, S. V. (n.d.). e-Source: Behavioral & social sciences research: Multilevel modeling, Office of Behavioral and Social Sciences Research. https://obssr.od.nih.gov/sites/obssr/files/Multile…
Trochim, W. M. K. (n.d.). Survey researchConjoint.ly. https://conjointly.com/kb/survey-research/
Walden University Writing Center. (n.d.). Common assignments: Critique/analysis,
https://academicguides.waldenu.edu/writingcenter/a…
Warner, R. M. (2021). Moderation: Interaction in multiple regression. In Applied statistics II: Multivariable and multivariate techniques (3rd ed., pp. 215–253). SAGE Publications.
Warner, R. M. (2021). Mediation. In Applied statistics II: Multivariable and multivariate techniques (3rd ed., pp. 289–308). SAGE Publications.
SPSS
Institute for Digital Research & Education. Statistical Consulting. (n.d.). Choosing the correct statistical test in SAS, STATA, SPSS, and the University of California, Los Angeles. https://stats.idre.ucla.edu/other/mult-pkg/whatsta…
Institute for Digital Research & Education. Statistical Consulting. (n.d.). SPSS University of California, Los Angeles. https://stats.idre.ucla.edu/spss/

PUBH_8248_Module3_Assignment1 _Rubric
CriteriaRatingsPtsThis criterion is linked to a Learning OutcomeExplain why the authors used multilevel modeling in their analysis.
20 to >17.0 ptsOutstanding
Fully developed and supported, insightful, credible, and scholarly explanation of why the authors used multilevel modeling in their analysis.
17 to >15.0 ptsVery Good
Thorough, well-organized, and supported explanation of why the authors used multilevel modeling in their analysis.
15 to >13.0 ptsMeets Expectations
Adequate explanation of why the authors used multilevel modeling in their analysis.
13 to >0 ptsDoes Not Meet Expectations
Missing, unoriginal, or does not adequately explain why the authors used multilevel modeling in their analysis.
20 pts
This criterion is linked to a Learning OutcomeDescribe the multiple levels addressed in the study.
20 to >17.0 ptsOutstanding
Fully developed and supported, insightful, credible, and scholarly description of the multiple levels addressed in the study.
17 to >15.0 ptsVery Good
Thorough, well-organized, and supported description of the multiple levels addressed in the study.
15 to >13.0 ptsMeets Expectations
Adequate description of the multiple levels addressed in the study.
13 to >0 ptsDoes Not Meet Expectations
Missing, unoriginal, or does not adequately describe the multiple levels addressed in the study.
20 pts
This criterion is linked to a Learning OutcomeDescribe how the authors shared their results.
20 to >17.0 ptsOutstanding
Fully developed and supported, insightful, credible, and scholarly description of how the authors shared their results.
17 to >15.0 ptsVery Good
Thorough, well-organized, and supported description of how the authors shared their results.
15 to >13.0 ptsMeets Expectations
Adequate description of how the authors shared their results.
13 to >0 ptsDoes Not Meet Expectations
Missing, unoriginal, or does not adequately describe how the authors shared their results.
20 pts
This criterion is linked to a Learning OutcomeIf the authors used a graphic to share their results, analyze the effectiveness of using a graphic to interpret the study.
10 to >8.0 ptsOutstanding
If applicable: fully developed and supported, insightful, credible, and scholarly analysis of the effectiveness of using a graphic to interpret the study.
8 to >7.0 ptsVery Good
If applicable: thorough, well-organized, and supported analysis of the effectiveness of using a graphic to interpret the study.
7 to >6.0 ptsMeets Expectations
If applicable: adequate analysis of the effectiveness of using a graphic to interpret the study.
6 to >0 ptsDoes Not Meet Expectations
If applicable: missing, unoriginal, or does not adequately analyze the effectiveness of using a graphic to interpret the study.
10 pts
This criterion is linked to a Learning OutcomeExplain the impact multilevel modeling has on the interpretation of the results for public health practice.
10 to >8.0 ptsOutstanding
Fully developed and supported, insightful, credible, and scholarly explanation of the impact multilevel modeling has on the interpretation of the results for public health practice.
8 to >7.0 ptsVery Good
Thorough, well-organized, and supported explanation of the impact multilevel modeling has on the interpretation of the results for public health practice.
7 to >6.0 ptsMeets Expectations
Adequate explanation of the impact multilevel modeling has on the interpretation of the results for public health practice.
6 to >0 ptsDoes Not Meet Expectations
Missing, unoriginal, or does not adequately explain the impact multilevel modeling has on the interpretation of the results for public health practice.
10 pts
This criterion is linked to a Learning OutcomeWritten Communication: Extent to which writing is professional, appropriate, clear, properly formatted, grammatically and structurally correct, synthesized, supported, and scholarly AND the correct template is used.
20 to >17.0 ptsOutstanding
Writing is fully developed, exceptionally well organized, synthesized, supported, scholarly, and free of writing errors. Concepts are connected throughout paper with appropriate transitions and multiple appropriate resources and examples AND the correct template is used.
17 to >15.0 ptsVery Good
Writing is generally thorough and grammatically correct, with proper formatting and minimal concerns. Synthesis is demonstrated and ideas are supported without reliance on quoting AND the correct template is used.
15 to >13.0 ptsMeets Expectations
Writing adequately meets expectations for writing and synthesis but with infrequent and minor issues AND the correct template is used.
13 to >0 ptsDoes Not Meet Expectations
Writing does not meet basic expectations (e.g., clarity, tone, organization, grammar, spelling, punctuation, source citation, references, title page, synthesis of source material, insufficient originality, etc.) OR the correct template is not used.
20 pts
Total Points: 100
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742
European Journal of Public Health
……………………………………………………………………………………………………………………………………………….
The European Journal of Public Health, Vol. 31, No. 4, 742–748
ß The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/),
which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
doi:10.1093/eurpub/ckab013 Advance Access published on 24 February 2021
……………………………………………………………………………………………
Neighbourhood characteristics and children’s oral
health: a multilevel population-based cohort study
Agatha W. van Meijeren-van Lunteren
Lea Kragt1,2
1,2
, Joost Oude Groeniger3,4, Eppo B. Wolvius1,2,
1 The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
2 Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre,
Rotterdam, The Netherlands
3 Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
4 Department of Public Administration and Sociology, Erasmus University, Rotterdam, The Netherlands
Correspondence: Agatha W. van Meijeren-van Lunteren, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands, Tel: þ31 10
7037733, Fax: þ31 10 7044645, e-mail: a.vanlunteren@erasmusmc.nl
Background: To understand determinants of oral health inequalities, multilevel modelling is a useful manner to
study contextual factors in relation to individual oral health. Several studies outside Europe have been performed
so far, however, contextual variables used are diverse and results conflicting. Therefore, this study investigated
whether neighbourhood level differences in oral health exist, and whether any of the neighbourhood characteristics used were associated with oral health. Methods: This study is embedded in The Generation R Study, a
prospective cohort study conducted in The Netherlands. In total, 5 960 6-year-old children, representing 158
neighbourhoods in the area of Rotterdam, were included. Data on individual and neighbourhood characteristics
were derived from questionnaires, and via open data resources. Caries was assessed via intraoral photographs,
and defined as decayed, missing and filled teeth (dmft). Results: Differences between neighbourhoods explained
13.3% of the risk of getting severe caries, and 2% of the chance of visiting the dentist yearly. After adjustments
for neighbourhood and individual characteristics, neighbourhood deprivation was significantly associated with
severe dental caries (OR: 1.48, 95% CI: 1.02–2.15), and suggestive of a low odds of visiting the dentist yearly (OR:
0.81, 95% CI: 0.56–1.18). Conclusions: Childhood caries and use of dental services differs between neighbourhoods
and living in a deprived neighbourhood is associated with increased dental caries and decreased yearly use of
dental services. This highlights the importance of neighbourhoods for understanding differences in children’s oral
health, and for targeted policies and interventions to improve the oral health of children living in deprived
neighbourhoods.
……………………………………………………………………………………………
Introduction
espite improvements in recent years, low-socioeconomic house-
Dholds are still affected by poor oral health and its negative con-
sequences over the life-course.1 In The Netherlands, large inequalities
in oral health and dental care use among children exist, despite the fact
that dental care for children is fully covered by basic health insurance.2
Extant studies have mainly focussed on investigating the relationship between individual level determinants and oral health.3,4
However, these individual characteristics could not fully explain
disparities in dental caries and dental care utilization, and the success of individual behaviour interventions to reduce oral health
inequalities is limited so far.5,6 As a result, the interest to research
contextual determinants of oral health, has increased in the last
years.4,5,7 Especially the physical and social environment consist of
important determinants that may contribute to inequalities in oral
health.7,8 For example, it is widely known that an unhealthy diet,
including frequent consumption of sugars, increases the risk of dental caries, and that the food choices individuals make is dependent
on the availability of healthy foods in the area where they live.9 Also,
early preventive care by dentists is important to reduce the risk of
childhood dental caries. However, receiving dental care may be dependent on access to and availability of dental health services in the
area where individuals live.10 Lastly, socioeconomic characteristics
of the neighbourhood (e.g. the level of neighbourhood deprivation)
may also be an important determinants for oral health outcomes.4,8
While there have been several studies that found an association between contextual socioeconomic circumstances and oral health, it is
not always clear whether this reflects features of the area or individual characteristics of the residents within the area.8,11 Therefore, it is
of importance to consider the socioeconomic circumstances of the
individuals itself, as well as those of their neighbourhood, when
studying the relationship between contextual factors and individual
oral health outcomes.
An appropriate manner to study contextual factors in relation to
individual health outcomes is multilevel modelling. Multilevel modelling enables researchers to simultaneously analyse the effects of
both neighbourhood and individual level, and accounts for the dependency of individuals living in the same area.12 Few studies have
used multilevel analyses to investigate the relation between contextual determinants and oral health among children.13–17 Two studies
investigated whether the number of dentists in a neighbourhood was
associated with dental care use and dental caries, but no associations
were observed.15,17 A study in Japan showed that the number of
grocery stores per resident was positively associated with dental caries.17 Antunes et al. observed that in Brazil an increased level of the
human development index (a composite measure summarizing
neighbourhood income, instructional attainment and longevity)
was associated with a lower number of untreated carious lesions13,
although this finding was not observed in another Brazilian study.16
Neighbourhood characteristics and children’s oral health
Lastly, whereas two studies in Brazil and Japan found that a higher
average income per neighbourhood was associated with decreased
dental caries in children14,17, this association was not observed in
another Brazilian study.16
Because results of previous studies examining contextual
determinants of oral health are inconclusive, and studies in
Europe have not yet adopted multilevel analyses, this research combines neighbourhood data with individually collected data from
The Netherlands in a multilevel framework to study: (i) whether
neighbourhood level differences in caries and dental service use
exist, and (ii) whether supermarket availability, snack bar availability, dentist availability, and neighbourhood deprivation level are
associated with dental caries and dental services use.
Methods
This study is embedded in The Generation R Study, a populationbased prospective cohort study from foetal life onwards conducted
in Rotterdam, The Netherlands.18 All pregnant mothers living in
Rotterdam expecting to deliver between April 2002 and January
2006 were invited to participate. Data collection started during pregnancy, was continued prenatally, and is still ongoing at various time
points through several data collection methods.18 For the current
study, all data were collected when the children were 6 years. In this
phase 8,305 (85% of original cohort (n ¼ 9 749) children participated
in the study, of which 5 960 children were eligible for this study
(Figure 1). The study was approved by the Medical Ethical
Committee of Erasmus Medical Centre, Rotterdam, The Netherlands
(MEC 198.782/2001/31) and conducted according to the World
Medical Association Declaration of Helsinki. Written informed
consent was obtained from all participants. Water supplies were not
fluoridated during the study period in Rotterdam.
Neighbourhood characteristics
The following contextual factors on neighbourhood level were
studied: supermarket availability, snack bar availability, dentist
availability, and deprivation level. In The Netherlands, communities
consist of districts, and districts are subdivided into
Figure 1. Flowchart showing the selection of the study population
743
neighbourhoods, which is determined by Statistics Netherlands.
Moreover, the postal company in The Netherlands has subdivided
each community in a set of postal codes, which almost correspond
with the neighbourhood division.
The mean number of supermarkets and snack-bars within 1 km
distance for all inhabitants living per neighbourhood in the
year 2010, were available as open source data by Statistics
Netherlands.19 For a postal code area that corresponded with
more than one neighbourhood, the mean of the neighbourhood
variables of areas with similar postal code was calculated.
Dental clinic availability was retrieved via a registry, managed by
Vektis, that contains all health care providers and their working
locations in The Netherlands per postal code for the year 2010.20
For the analyses, the number of dental clinics per 10 000 inhabitants
was calculated and used.
Neighbourhood deprivation was determined by neighbourhood
status scores (NSSs) of the year 2010 derived from The Netherlands
Institute for Social Research.21 These scores are calculated for all
postal codes in The Netherlands on the basis of four characteristics:
average income, unemployed residents, residents with low education
and households with low income. Analyses were performed using a
categorical scale of the NSS: low NSS (< 1), middle NSS (1–1), high NSS (>1), which is based on the standard deviation of the NSS
in The Netherlands.21
Oral health outcomes
For this study two outcomes were analysed: dental caries and dental
care use.
From October 2008–January 2012, 5 578 children visited the
research centre for hands-on measurements. After tooth brushing,
10 photographs of clean teeth were taken using an intra-oral camera
(Poscam USB intra-oral autofocus camera, Digital Leader PointNix,
640 480 pixels). All photographs were scored by one single calibrated dentist, and 10% of the photographs were scored by a second
dentist using the same method. Intrarater-reliability (Cohen’s
kappa ¼ 0.80) and inter-observer reliability (Cohen’s kappa ¼ 0.76)
were evaluated and both showed good agreement.22 Dental caries
was assessed in the primary dentition using the decayed, missing,
744
European Journal of Public Health
and filled teeth (dmft) index.23 Decayed teeth were assessed as
lesions extended into dentin, enamel caries was not taken into account. Missing teeth were only assessed when teeth were extracted
due to caries, which was individually judged based on the dental
development and caries pattern of the child. Filled teeth were scored
if teeth were restored due to caries. The use of intra oral photographs for scoring dmft in epidemiological studies showed high
sensitivity and specificity (85.5% and 83.6%, respectively) compared
to the clinical visual tactile inspection.22
Dental visits were assessed by means of parental questionnaires, in
which parents answered the question whether their child had visited
the dentist in the past year (yes/no).
Covariates
Socioeconomic status (SES) was retrieved via parental questionnaires and measured using: maternal education level, net household
income, maternal employment status, and marital status.
Educational level was defined as: low (no education, primary education, 4 years general secondary school or lower vocational training), middle (>4 years general secondary school or intermediate
vocational school), and high (bachelor’s degree, higher vocational
school or a university degree finished).24 Monthly net household
income was categorized as ‘ e2400’ and ‘> e 2400’, based on
the average monthly general labour income in The Netherlands in
2010.25 Employment status of the mother was dichotomized as ‘paid
job’ or ‘no paid job’. Marital status of the mother was dichotomized
as married (married or registered partnership) or not. Children’s
ethnic background was defined according to the Dutch classification
of ethnic background and classified as ‘Dutch’ if both parents of the
child were born in The Netherlands and ‘non-Dutch’ if one of the
parents was born in another country than The Netherlands.26 Sugar
intake during childhood was assessed in questionnaires with questions about the frequency of consuming high caloric snacks and
sugar containing beverages. For the analyses, sugar intake was
dichotomized as ‘low’ (2 sugar containing products a day) and
‘high’ (3 sugar containing products a day). Tooth brushing
frequency was assessed by means of questionnaires and dichotomized as ‘1 per day’, or ‘2 per day’.
Data analyses
Multilevel logistic regression models were used to estimate Odds
Ratios (ORs) of having mild (dmft 1–3) or severe caries (dmft > 3)
compared to children with no caries (dmft ¼ 0). Multilevel models
are useful to study clustered data, as in this study where children
(level-1) are clustered within neighbourhoods (level-2). We used
random intercept multilevel models for all analysis. In these models,
the intercept is allowed to vary across neighbourhoods thereby
accounting for the clustering of children within neighbourhoods.
We verified that the relationship between each continuous predictor
and the outcome was linear on the logit scale, and that multicollinearity between predictor variables was absent. We constructed
three models for each dental outcome:
(1) Null model: this is an empty model which enabled to observe the
proportion of the total variance that is due to neighbourhood
differences. The variance partitioning coefficient (VPC) was calculated using a method where the individual level variance is
fixed at 3.29 (p2/3) for dichotomous outcome variables.27 The
percentage neighbourhood variance was calculated by dividing
the random intercept variance (neighbourhood level variance
component) by the sum of the individual and neighbourhood
level variances. The VPC can vary between 0 and 100%, the
higher this percentage the larger the role of neighbourhoods in
the existing difference of caries experience between individuals.
The VPC was calculated per imputed dataset and consequently
averaged to present one summary VPC per model.
(2) Model 1: this model includes one of the four neighbourhood
variables separately
(3) Model 2: this model includes all neighbourhood variables
simultaneously
(4) Model 3: Model 2þthe individual variables that were considered
as confounders
Multiple imputation was performed to account for information
bias associated with missing data in the covariates. Missing values
were multiple imputed by generating 10 independent datasets with
the use of chained equations, and effect estimates for each imputed
dataset were pooled and presented in this study. Imputations were
based on all variables in the models, but the main determinants and
the outcomes were not imputed. Statistical analyses were generated
using R 3.6.1 (R Core Team, Vienna, Austria) (packages: mice and
Lme4). P-values 0.05 indicated statistical significance.
Supplemental analyses
For the association between neighbourhood characteristics and
dental caries, sugar consumption and brushing frequency were
considered as mediators rather than confounding factors. To
observe the influence of these variables on the effect estimates, we
performed sensitivity analyses to additionally adjust our models
(Supplementary tables S1 and S2). The same applies for dental caries
as a potential mediator in the association between neighbourhood
characteristics and dental visits (Supplementary table S3). A nonresponse analysis was conducted to evaluate potential selection bias
by comparing the sample characteristics of children with (included)
and without (excluded) available information on postal code and
oral health outcomes (Supplementary table S4).
Results
Population characteristics
The prevalence of mild and severe caries in our study population
was 19.6 and 13.4%, respectively. In the total study population
92.4% visited the dentist yearly. Children with severe caries lived
in neighbourhoods with an average of 3.5 (6SD 2.1) supermarkets
and 15.1 (6SD 14.0) snack bars which is higher than children without caries (mean 6 SD 2.6 6 2.0; and 10.0 6 12.3, respectively). In
addition, 54.5% of children with severe caries and 41.6% of children
with mild caries lived in deprived neighbourhoods, compared with
30.7% of children without caries (Table 1).
Association between neighbourhood characteristics
and dental caries
Differences between neighbourhoods explained 2.7% and 13.3% of
the variance in mild and severe dental caries of 6-year-old children,
respectively (Table 2, null model). Of the neighbourhood
characteristics added in model 1, the VPC reduced the most for
severe caries when NSS was added to the model (VPC: 5.0%). After
controlling for individual characteristics (model 3), the VPC was
(almost) 0% for both mild and severe caries. A statistically
significant association was observed between neighbourhoods
with middle NSS and low NSS and severe caries compared to
neighbourhoods with high NSS (Table 2, model 2).The associations remained after adjustments for individual characteristics,
although not significantly for middle NSS with severe caries
(Model 3: middle NSS: OR: 1.32, 95% CI: 0.96–1.81; low NSS:
OR: 1.48, 95% CI: 1.02–2.15, Table 2).
Association between neighbourhood characteristics
and dental visit
Differences between neighbourhoods explained 2% of the variance
in yearly dental visits of 6-year-old children (Table 3, null model).
Neighbourhood characteristics and children’s oral health
745
Table 1 Individual and neighbourhood characteristics of the study population
Individual characteristics
Child’s gender
Boys
Girls
Child’s age at dental assessment (mean 6 SD)
Child’s age filling out questionnaire (mean 6 SD)
Maternal educational level
Low
Middle
High
Missings
Net income per month
Low (< e2400) High (> e2400)
Missings
Employment status mother
Paid job
No paid job
Missings
Marital status
Married/registered partnership
Unmarried/no registered partnership
Missings
Ethnic background
Dutch
Non-Dutch
Missings
Sugar intake
Low (2 per day)
High (>2 per day)
Missings
Tooth brushing per day
Once
Twice
Missings
Dental visit in past year
No
Yes
Missings
Neighbourhood characteristics
Mean number of supermarkets within 1 km distance 6 SD
Mean number of snack bars within1 km distance 6 SD
Mean number of dental practices 6 SD
Mean dental practice density per 10.000 inhabitants 6 SD
Level of deprivation (mean NSS 6 SD)
Low NSS (most deprived)
Middle NSS
High NSS (least deprived)
Total population (n ¼ 5960) No caries (n ¼ 3105) Mild caries (n ¼ 909) Severe caries (n ¼ 620)
3 003 (50.4%)
2 957 (49.6%)
6.2 6 0.5
6.1 6 0.5
1 548 (49.4%)
1 557 (50.1%)
6.1 6 0.4
6.0 6 0.4
438 (48.2%)
471 (51.8%)
6.3 6 0.6
6.2 6 0.6
331 (53.4%)
289 (46.6%)
6.3 6 0.6
6.2 6 0.6
745 (14.4%)
1 699 (32.8%)
2 735 (52.8%)
781 (13.1%)
259 (9.5%)
844 (30.9%)
1 627 (59.6%)
375 (12.1%)
132 (18.4%)
271 (37.7%)
315 (43.9%)
191 (21.0%)
139 (32.1%)
180 (41.6%)
114 (26.3%)
187 (30.2%)
1 618 (33.2%)
3 262 (66.8%)
1 080 (18.1%)
722 (27.9%)
1 864 (72.1%)
519 (16.7%)
279 (41.3%)
397 (58.7%)
233 (25.6%)
244 (60.1%)
162 (39.9%)
214 (34.5%)
3 673 (74.9%)
1 231 (25.1%)
1 056 (17.7%)
2 073 (79.9%)
521 (20.1%)
511 (16.5%)
465 (68.3%)
216 (31.7%)
228 (25.1%)
211 (52.9%)
188 (47.1%)
221 (35.6%)
3 478 (67.0%)
1 714 (33.0%)
768 (12.9%)
1 790 (65.9%)
925 (34.1%)
390 (12.6%)
497 (68.6%)
228 (31.4%)
184 (20.2%)
313 (70.8%)
129 (29.2%)
178 (28.7%)
3 257 (55.8%)
2 581 (44.2%)
122 (2.0%)
1 859 (61.0%)
1 188 (39%)
58 (1.9%)
406 (46.2%)
473 (53.8%)
30 (3.3%)
170 (29.0%)
416 (71.0%)
34 (5.5%)
1 637 (32.5%)
3 394 (67.5%)
929 (15.6%)
886 (33.5%)
1 756 (66.5%)
463 (14.9%)
224 (32.4%)
467 (67.6%)
218 (24.0%)
123 (29.0%)
301 (71.0%)
196 (31.6%)
1 056 (20.8%)
4 018 (79.2%)
886 (14.9%)
501 (19.0%)
2 136 (81.0%)
468 (15.1%)
147 (21.4%)
541 (78.6%)
221 (24.3%)
111 (25.8%)
320 (74.2%)
189 (30.5%)
386 (7.6%)
4 716 (92.4%)
858 (14.4%)
210 (7.9%)
2 435 (92.1%)
460 (14.8%)
48 (6.9%)
649 (93.1%)
212 (23.3%)
27 (6.2%)
407 (93.8%)
186 (30.0%)
2.8 6 2.0
10.6 6 12.5
3.2 6 2.4
3.3 6 2.8
0.5 6 1.6
2 090 (35.1%)
2 322 (39.0%)
1 548 (26.0%)
2.6 6 2.0
10.0 6 12.3
3.3 6 2.5
3.43 6 2.9
0.3 6 1.6
954 (30.7%)
1 247 (40.2%)
904 (29.1%)
2.9 6 2.1
11.5 6 12.5
3.1 6 2.4
3.1 6 2.7
0.7 6 1.6
378 (41.6%)
334 (36.7%)
197 (21.7%)
3.5 6 2.1
15.1 6 14.0
2.9 6 2.2
2.9 6 2.4
1.2 6 1.5
338 (54.5%)
212 (34.2%)
70 (11.3%)
Numbers are presented as absolute numbers for categorical variables or as mean (SD) for continuous variables. NSS, neighbourhood status
score. Missing values are presented in italic type as absolute numbers and percentages.
The neighbourhood variance was 0% after including neighbourhood
characteristics (Table 3, model 2). Compared to neighbourhoods
with a high NSS, living in a neighbourhood with a low NSS
decreased the likelihood of visiting the dentist (Table 3, model 2).
This association remained after additional adjustment for individual
characteristics, but was no longer statistically significant (Model 3:
OR: 0.81, 95% CI: 0.56–1.18, Table 3).
Discussion
The results of this study show that neighbourhood level differences
in caries and dental health service use exist, but that these neighbourhood differences disappear after controlling for neighbourhood
level and individual level characteristics. Living in a deprived neighbourhood is positively associated with dental caries and suggestive
of decreased dental visits, even after adjusting for several individual
socioeconomic characteristics.
Several studies have investigated the relationship between neighbourhood deprivation and oral health. In line with our results, three
studies found a relationship between deprived areas and caries13,
while two others did not16,31,32. However, only three studies used
multilevel analyses similar to our study.13,16,28 Moreover, merely one
of these studies controlled for individual socioeconomic indicators,
which makes it difficult to conclude whether the poor oral health
outcomes found in deprived areas reflect the individual SES or the
physical and social environment individuals live in.16,33 In our study
we used NSS as a measure of neighbourhood deprivation which is
based on four sociodemographic characteristics. However, many
other measures exist and using these may lead to different results.
For example, a multilevel-study in the UK using area deprivation
scores based on overcrowding in households, male unemployment,
proportion of low SES, and proportion of persons without a car, did
not find an association between area deprivation and the number of
sound teeth among adults.31 Similarly, in an Italian multilevel study
no association was observed between a city deprivation index and
DMFT in 12-year-old children.32 However, whereas the latter study
used the deprivation level of an entire city, we were able to assess
neighbourhood deprivation levels within a city and villages, which
d
d
c
c
NSS, neighbourhood status score; VPC, variance partitioning coefficient (representing the proportion of variance due to neighbourhood level differences).
a: Having no caries was reference category for all models. All analyses were performed using multilevel logistic binomial regression models, and results are presented as odds ratios (OR) with
corresponding 95% confidence interval (CI).
b: high NSS (least deprived) was reference category.
c: The neighbourhood variance and VPC per model, respectively: Supermarkets: 0.07, 2.0%; Snack bars: 0.07, 2.1%; Dental practice density: 0.07, 2.1%; NSS: 0.02, 0.5%.
d: The neighbourhood variance and VPC per model, respectively: Supermarkets: 0.36, 9.7%; Snack bars: 0.37, 10.1%; Dental practice density: 0.47, 12.4%; NSS: 0.17, 5.0%.
Null model: empty model with random intercept only.
Model 1: random intercept model per neighbourhood characteristic separately.
Model 2: model 1 þ all neighbourhood characteristics (number of supermarkets, number of snack bars within 1 km distance. dental practice density, NSS).
Model 3: model 2 þ individual characteristics (gender, age, maternal educational level, family household income, maternal employment status, maternal marital status, and ethnic background).
1.48 (1.02–2.15)
1.32 (0.96–1.81)
0.01
0.2%
1.10 (0.85–1.44)
1.01 (0.82–1.25)
0.00
0%
3.42 (2.22–5.27)
2.00 (1.36–2.93)
0.13
3.7%
1.73 (1.32–2.26)
1.23 (0.98–1.55)
0.01
0.4%
4.58 (3.09–6.78)
2.25 (1.51–3.35)
NA
NA
0.51
13.3%
NA
NA
0.09
2.7%
1.86 (1.49–2.33)
1.27 (1.01–1.59)
1.05 (0.96–1.14)
0.99 (0.98–1.01)
1.00 (0.97–1.04)
0.98 (0.86–1.12)
1.02 (1.00–1.04)
0.95 (0.90–1.00)
1.02 (0.93–1.12)
1.00 (0.93–1.12)
0.98 (0.95–1.01)
1.21 (1.12–1.31)
1.03 (1.02–1.04)
0.96 (0.90–1.02)
1.08 (1.03–1.13)
1.01 (1.00–1.02)
0.97 (0.93–1.00)
NA
NA
NA
NA
NA
NA
Neighbourhood variables
Number of supermarkets within 1 km distance
Number of snack bars within 1 km distance
Dental practice density per 10.000 inhabitants
NSSb (deprivation score)
Low NSS (most deprived)
Middle NSS
Neighbourhood variance
VPC
Mild caries
Mild caries
Severe caries (dmft >3)
Mild caries (dmft 1-3)
Severe caries
Mild caries
Severe caries
Model 3
Model 2
Model 1
Null model
Table 2 Association between neighbourhood and dental cariesa
1.00 (0.90–1.12)
1.01 (0.99–1.02)
0.99 (0.95–1.03)
European Journal of Public Health
Severe caries
746
gives a better understanding on how small local areas can influence
oral health of children. Studies investigating area characteristics and
dental service use are scarce, one previous study in England observed
an association between neighbourhood deprivation and the use of
dental services in elderly, which is comparable with the nonsignificant trend we observed in children.34
Our results indicate that the proportion of variance in dental
caries and dental visits due to neighbourhood level differences is
mostly accounted for by the included individual and neighbourhood
characteristics. Still, the same models also showed that compared to
non-deprived neighbourhoods, living in a deprived neighbourhood
is associated with severe dental caries and a lower likelihood of
visiting the dentist. In fact, the relevance of neighbourhood deprivation for oral health among children could indicate that contextual
factors do matter, but that the administrative boundaries used in
our study to differentiate between neighbourhoods might not be the
most relevant for explaining variation in oral health. Alternatively,
the relevance of neighbourhood deprivation may also suggest a residual effect of SES on oral health. Although we were able to adjust
for several individual socioeconomic indicators, it is possible that
the association between neighbourhood deprivation and poor oral
health reflects the individual socioeconomic circumstances of the
population living in deprived neighbourhoods.33 In absence of
detailed information at various (lower) aggregate levels, we are
not able to favour one explanation over the other and therefore
we elaborate on the potential mechanism behind deprived neighbourhoods and oral health in the following paragraph.
There are several pathways via which living in a deprived
neighbourhood could affect oral health. First, neighbourhoods can
influence health via their physical characteristics.7, 9 In our study,
univariate models indicated that the number of supermarkets was
associated with both oral health outcomes, but these associations
attenuated after adjustments for other neighbourhood variables
(Tables 1 and 2). Thus, the relationship between number of
supermarkets and oral health is attributable to a higher number
of supermarkets and snack bars in more deprived neighbourhoods,
similarly shown before in other studies.35,36 Second, several theories
exist through which the social environment in neighbourhoods
could affect individual health.7 For example, Diez Roux and Mair
suggest that neighbourhood safety, social connectedness and local
institutions may affect health and corresponding behaviours.7 Other
theories note that individuals living in the same neighbourhoods
adapt their behaviours according to how others in the same
geographical and social area behave.37 Overtime, predominant
behaviours in an area can become a collective habitude, making
the relation between neighbourhoods and health status bi-directional.7,38 This implies that the unfavourable oral health outcomes found
in deprived neighbourhoods could reflect oral health-related behaviours of their inhabitants. However, individual behaviours such as
sugar intake and brushing frequency did not influence our results
(Supplementary tables S1 and S2). Also, dental caries experience was
not related to dental visits (Table 1, and Supplementary table S3).
The results of this study have to be seen in the light of some
limitations. Neighbourhood characteristics in this study were based
on aggregated data, and it is important to acknowledge that this
could have led to imprecise neighbourhood level data, causing
non-differential misclassification. Also, our study relies on the
assumptions of strict area borders, however, inhabitants might reside on the border of two areas and live closer to another neighbourhood. Although this would apply to a small number of children in
our study population it could have led to slightly biased results.
Furthermore, we have a large underestimation of the number of
children not visiting the dentist on a yearly basis when observing
regional statistics. In Rotterdam the percentage of children that did
not visit the dentist in 2010 is 37.5% (range: 28.9%–45.5%), whereas
in our study we only found that 7.6% of the children in our study
population did not visit the dentist in the past year.39 This might be
caused by misreporting of the caregivers, but it could also represent
Neighbourhood characteristics and children’s oral health
747
Table 3 Association between neighbourhood and dental visita
Null model
Neighbourhood variables
Number of supermarkets
within 1 km distance
Number of snack bars
within 1 km distance
Dental practice density per
10.000 inhabitants
NSSb (deprivation score)
Low NSS (most deprived)
Middle NSS
(Range) Neighbourhood
variance
(Range) VPC
Model 1
Model 2
Model 3
NA
0.87 (0.83–0.91)
0.90 (0.80–1.00)
0.90 (0.80–1.01)
NA
0.98 (0.98–0.99)
1.00 (0.98–1.02)
1.00 (0.99–1.02)
NA
1.02 (0.97–1.06)
1.01 (0.97–1.05)
1.00 (0.96–1.04)
NA
NA
NA
0.07
0.49 (0.37–0.65)
0.69 (0.52–0.91)
0.68 (0.48–0.97)
0.76 (0.57–1.03)
0.00
0.81 (0.56–1.18)
0.81 (0.60–1.10)
0.00
2%
c
c
0%
0%
NSS, neighbourhood status score; VPC, variance partitioning coefficient (representing the proportion of variance due to neighbourhood
level differences).
a: Children that did not visited the dentist in the past year were the reference category for all models.
All analyses were performed using multilevel logistic binomial regression models, and results are presented as odds ratios (OR) with
corresponding 95% confidence interval (CI).
b: high NSS (least deprived) was reference category.
c: The neighbourhood variance and VPC per model, respectively: Supermarkets: 0.00, 0%; Snack bars: 0.00, 0%; Dental practice density:
0.07, 2.1%; NSS: 0.00, 0%. Null model: empty model with random intercept only.
Model 1: random intercept model including neighbourhood characteristics.
Model 2: model 1þ all neighbourhood characteristics (number of supermarkets, number of snack bars within 1 km distance. dental practice
density, NSS).
Model 3: model 2 þ individual characteristics (gender, age, maternal educational level, family household income, maternal employment
status, maternal marital status, and ethnic background).
the selection bias due to differential participation in our study. The
non-response analysis showed that the majority of excluded participants had missing postal codes and missing caries data
(Supplementary table S4). However, excluded participants with
a

Ruby Bluez Community Hospital Case Study Journal

Jun 14, 2024 | Health Medical

Description

Background Information for the Ruby Bluez Community Hospital Case Study

Context

Ruby Bluez Community Hospital is a 200-bed healthcare facility located in a suburban area. Established in 1995, the hospital provides various services, including emergency care, outpatient services, and specialized departments such as cardiology and neurology. The hospital is well-known for its community outreach programs and has been awarded for its high-quality patient care.

Time Frame

This case study focuses on the period from March 2020 to September 2020, when the COVID-19 pandemic peaked in the region that Ruby Bluez Hospital Community Hospital served.

Participants

Management Team: Comprises the CEO, COO, and Department Heads
Medical Staff: Includes doctors, nurses, and support staff
Patients: Primarily residents of the local area, with a wide range of healthcare needs
Suppliers: Companies providing medical equipment, PPE, and pharmaceuticals

Problem Overview

At the onset of the pandemic, the hospital faced unprecedented challenges, including:

Increased Patient Inflow: A surge in COVID-19 cases led to overcrowding.
Resource Scarcity: Shortage of PPE, ventilators, and ICU beds.
Staffing Issues: High levels of staff burnout, with some falling sick themselves.
Communication Gaps: Inconsistent communication from the management led to confusion among staff.
Financial Strain: Reduced revenues from elective procedures coupled with increased operating costs.

Key Discussion Questions

How effectively did the hospital management carry out the functions of planning and strategizing during this period?
How well did the management organize resources, considering the sudden increase in demand?
What leadership qualities were demonstrated, or lacked, by the management in navigating these challenges?
How did the management exercise control, in terms of performance metrics, quality of care, and adjustments to their initial plans?

Resources to Help You Respond to the Key Questions

Data and Resources

Internal Reports: Hospital management has provided internal reports covering staff utilization rates, financial statements, and quality-of-care metrics.
Staff Interviews: Key staff members have been interviewed to provide their perspectives on the management’s effectiveness.
Patient Surveys: Anonymous surveys were conducted to gather patient feedback on the quality of care.

Internal Reports

Staff Utilization Rates
Summary: The internal report shows that ICU staff are operating at 95% utilization rates, while administrative staff are at 60%.
Key Finding: High staff utilization rates in critical departments like ICU may lead to staff burnout.
Financial Statements
Summary: The hospital’s revenue has declined by 15% compared to last year due to the cancelation of elective surgeries.
Key Finding: Financial strain may affect resource allocation and future hiring.
Quality-of-Care Metrics
Summary: The rate of hospital-acquired infections has risen by 10% in the last quarter.
Key Finding: Rises in infection rates may indicate issues in sterilization or patient care protocols.

Staff Interviews

ICU Head Nurse
Quote: “We’re short-staffed and overworked, which affects our ability to provide the best care to our patients.”
Facility Manager
Quote: “Our cleaning staff is also working extra shifts, but it’s challenging to keep up with the new sanitization guidelines.”

Patient Surveys

Survey Question: Rate your overall satisfaction with the care provided during your stay.
Average Score: 3.5/5
Survey Question: How well did the staff communicate with you about your treatment?
Average Score: 4/5
Survey Question: Were you satisfied with the cleanliness of the hospital?
Average Score: 2.5/5

Supplemental Material

Photos documenting conditions within the hospital (e.g., overcrowding in the emergency room, stock levels of PPE).
Excerpts from emails and memos circulated by the management during this period.

Supplemental Materials

Photos (in the attachment above)

Emails

Emergency Meeting on COVID-19 Response Plan

Date: March 15, 2020

To: All Department Heads

Dear Department Heads,

Due to the escalating COVID-19 situation, we will be holding an emergency meeting tomorrow at 9 AM in the conference room. The agenda will include developing a comprehensive response plan for the hospital. Your attendance is mandatory.

Best,

[CEO]

New COVID-19 Protocols

Date: March 20, 2020

To: Hospital Staff

Team,

Please find attached the new protocols for handling COVID-19 cases. Kindly review them and implement these measures immediately.

Thank you,

[Medical Director]

PPE Shortage

Date: April 1, 2020

To: All Staff

Dear Staff,

We are critically low on PPE supplies. Until new stock arrives, please adhere strictly to the guidelines on PPE usage. We will provide updates as soon as we have them.

Regards,

[COO]

Staffing Rotations for April

Date: April 5, 2020

To: All Department Heads

Heads,

Attached is the staffing rotation schedule for April. Review it and notify me of any conflicts within 24 hours.

Sincerely,

[HR Manager]

Mental Health Resources

Date: April 20, 2020

To: All Staff

Dear Team,

In these stressful times, mental health is a priority. We’ve arranged some mental health resources for you, details of which are attached.

Take Care,

[Head of Staff Wellness]

Update on Ventilator Availability

Date: May 10, 2020

To: ICU Team

ICU Team,

We have received an additional 10 ventilators. Allocation will be discussed in our team meeting tomorrow at 2 PM.

Best,

[ICU Head]

Financial Strain

Date: June 15, 2020

To: Board of Directors

Esteemed Board Members,

We are facing financial strain due to the ongoing pandemic. An urgent meeting is needed to discuss measures for stabilization.

Respectfully,

[CFO]

Revised Safety Protocols

Date: July 1, 2020

To: All Staff

Team,

To alleviate our current staffing challenges, we have hired temporary medical staff. Details are in the attached document.

Thank you,

[HR Manager]

Community Outreach Programs

Date: September 10, 2020

To: Public Relations Team

PR Team,

Given the changing situation, we need to assess our community outreach programs. Meeting scheduled for next week.

Best,

[Head of Public Relations]

Memos

COVID-19 Preparedness Plan

Date: March 18, 2020

From: CEO

To: All Staff

This memo serves to outline our comprehensive COVID-19 preparedness and response plan. Please refer to the attached document for the full details. Your adherence to these guidelines is essential for the safety of all.

Social Distancing Measures

Date: March 25, 2020

From: COO

To: All Department Heads

Effective immediately, all departments are required to enforce social distancing among staff and patients. Please see the attached document for specific guidelines.

Sanitization Procedures

Date: April 2, 2020

From: Head of Maintenance

To: All Staff

Body:

Due to the COVID-19 outbreak, we have intensified our sanitization procedures. The new schedules and checklists are attached. Please adhere to them.

Staff Health Monitoring

Date: April 15, 2020

From: HR

To: All Staff

To ensure everyone’s safety, we are implementing new health monitoring guidelines for staff. These guidelines are attached and are effective immediately.

Revised Visitor Policies

Date: May 1, 2020

From: Administration

To: Front Desk & Security

In light of the recent pandemic, new visitor policies will be in effect starting today. The full details are in the attached document.

Virtual Team Meetings

Date: May 15, 2020

From: CTO

To: All Staff

Virtual team meetings are a new normal. Please find attached the guidelines for setting up and conducting these meetings.

Elective Procedures

Date: June 5, 2020

From: COO

To: Surgical Teams

All elective procedures are postponed until further notice. Please refer to the attached memo for further instructions.

Financial Transparency

Date: June 20, 2020

From: CFO

To: All Staff

This memo is to update all staff on the current financial status of the hospital. For a detailed breakdown, please see the attached financial report.

Remote Work Policies

Date: July 15, 2020

From: HR

To: Non-Essential Staff

Patient Discharge Procedures

Date: August 20, 2020

From: Head of Patient Services

To: Nursing Staff and Case Managers

Given the complexities of discharging COVID-19 patients, we’ve updated our procedures to ensure a smooth transition from hospital care to home or other healthcare facilities. The new procedures are outlined in the attached document. Training sessions will be held this week to address any questions or concerns you may have.

Sincerely,

[Head of Patient Services]

Student Objective

Your objective is to assess the effectiveness of the management functions (planning, organizing, leading, and controlling) during this challenging period. Your analysis should be backed up by at least two peer-reviewed articles and the course book.

Case Study Grading Rubric

Criteria

Excellent

Good

Needs Improvement

Introduction and Summary of the Case

A clear and concise introduction to the case study, including the issues at hand. (9-10 points)

Adequate introduction but may lack some clarity or completeness. (7-8 points)

Incomplete or unclear introduction to the case study. (0-6 points)

Application of Management Functions

Comprehensive analysis incorporating all the functions of management, with excellent use of course concepts and additional research. (36-40 points)

Good analysis covering most of the functions of management, with moderate use of course concepts and research. (28-35 points)

Limited or poor application of management functions and course concepts. (0-27 points)

Industry Experience and Insights

Effectively integrates personal or observed industry experiences to provide practical insights. (18-20 points)

Some integration of industry experience but lacks depth or clarity. (14-17 points)

Little to no integration of industry experiences. (0-13 points)

Remedies and Countermeasures

Offers innovative and well-justified remedies or countermeasures for identified issues. (18-20 points)

Suggests remedies or countermeasures but lacks thorough justification. (14-17 points)

Limited or ineffective suggestions for remedies or countermeasures. (0-13 points)

Use of Peer-Reviewed Articles and Book

Integrates at least 2 peer-reviewed articles and refers to the course book effectively. (5 points)

Uses at least one peer-reviewed article and makes some reference to the course book. (3-4 points)

Fails to include peer-reviewed articles or refer to the course book adequately. (0-2 points)

Organization, Structure, and Grammar

Paper is well-organized, free of grammatical errors, and follows a logical structure. (5 points)

Minor grammatical errors or organizational issues. (3-4 points)

Significant grammatical errors or poor organization. (0-2 points)

Unformatted Attachment Preview

Background Information for the Ruby Bluez Community Hospital Case Study
Context
Ruby Bluez Community Hospital is a 200-bed healthcare facility located in a suburban area.
Established in 1995, the hospital provides a wide range of services including emergency care,
outpatient services, and specialized departments such as cardiology and neurology. The hospital is
well-known for its community outreach programs and has been awarded for its high-quality
patient care.
Time Frame
This case study focuses on the period from March 2020 to September 2020, when the COVID-19
pandemic was at its peak in the region served by XYZ Community Hospital.
•
•
•
•
Participants
Management Team: Comprises the CEO, COO, and Department Heads
Medical Staff: Includes doctors, nurses, and support staff
Patients: Primarily residents of the local area, with a wide range of healthcare needs
Suppliers: Companies providing medical equipment, PPE, and pharmaceuticals
Problem Overview
At the onset of the pandemic, the hospital faced unprecedented challenges, including:
1. Increased Patient Inflow: A surge in COVID-19 cases led to overcrowding.
2. Resource Scarcity: Shortage of PPE, ventilators, and ICU beds.
3. Staffing Issues: High levels of staff burnout, with some falling sick themselves.
4. Communication Gaps: Inconsistent communication from the management led to confusion
among staff.
5. Financial Strain: Reduced revenues from elective procedures coupled with increased operating
costs.
Key Discussion Questions
1. How effectively did the hospital management carry out the functions of planning and
strategizing during this period?
2. How well did the management organize resources, considering the sudden increase in demand?
3. What leadership qualities were demonstrated, or lacked, by the management in navigating
these challenges?
4. How did the management exercise control, in terms of performance metrics, quality of care, and
adjustments to their initial plans?
Data and Resources
Internal Reports: Hospital management has provided internal reports covering staff utilization
rates, financial statements, and quality-of-care metrics.
• Staff Interviews: Key staff members have been interviewed to provide their perspectives on the
management’s effectiveness.
• Patient Surveys: Anonymous surveys were conducted to gather patient feedback on the quality
of care.
•
Internal Reports
1. Staff Utilization Rates
• Summary: The internal report shows that ICU staff are operating at 95% utilization rates,
while administrative staff are at 60%.
• Key Finding: High staff utilization rates in critical departments like ICU may lead to staff
burnout.
2. Financial Statements
• Summary: The hospital’s revenue has declined by 15% compared to last year due to the
cancelation of elective surgeries.
• Key Finding: Financial strain may affect resource allocation and future hiring.
3. Quality-of-Care Metrics
• Summary: The rate of hospital-acquired infections has risen by 10% in the last quarter.
• Key Finding: Rises in infection rates may indicate issues in sterilization or patient care
protocols.
Staff Interviews
1. ICU Head Nurse
• Quote: “We’re short-staffed and overworked, which affects our ability to provide the
best care to our patients.”
2. Facility Manager
• Quote: “Our cleaning staff is also working extra shifts, but it’s challenging to keep up
with the new sanitization guidelines.”
Patient Surveys
1. Survey Question: Rate your overall satisfaction with the care provided during your stay.
• Average Score: 3.5/5
2. Survey Question: How well did the staff communicate with you about your treatment?
• Average Score: 4/5
3. Survey Question: Were you satisfied with the cleanliness of the hospital?
• Average Score: 2.5/5
Supplemental Material
Photos documenting conditions within the hospital (e.g., overcrowding in the emergency room,
stock levels of PPE).
• Excerpts from emails and memos circulated by the management during this period.
•
Supplemental Materials
Photos
Emails
Emergency Meeting on COVID-19 Response Plan
Date: March 15, 2020
To: All Department Heads
Dear Department Heads,
Due to the escalating COVID-19 situation, we will be holding an emergency meeting tomorrow at 9 AM
in the conference room. The agenda will include developing a comprehensive response plan for the
hospital. Your attendance is mandatory.
Best,
[CEO]
New COVID-19 Protocols
Date: March 20, 2020
To: Hospital Staff
Team,
Please find attached the new protocols for handling COVID-19 cases. Kindly review them and implement
these measures immediately.
Thank you,
[Medical Director]
PPE Shortage
Date: April 1, 2020
To: All Staff
Dear Staff,
We are critically low on PPE supplies. Until new stock arrives, please adhere strictly to the guidelines on
PPE usage. We will provide updates as soon as we have them.
Regards,
[COO]
Staffing Rotations for April
Date: April 5, 2020
To: All Department Heads
Heads,
Attached is the staffing rotation schedule for April. Review it and notify me of any conflicts within 24
hours.
Sincerely,
[HR Manager]
Mental Health Resources
Date: April 20, 2020
To: All Staff
Dear Team,
In these stressful times, mental health is a priority. We’ve arranged some mental health resources for
you, details of which are attached.
Take Care,
[Head of Staff Wellness]
Update on Ventilator Availability
Date: May 10, 2020
To: ICU Team
ICU Team,
We have received an additional 10 ventilators. Allocation will be discussed in our team meeting
tomorrow at 2 PM.
Best,
[ICU Head]
Financial Strain
Date: June 15, 2020
To: Board of Directors
Esteemed Board Members,
We are facing financial strain due to the ongoing pandemic. An urgent meeting is needed to discuss
measures for stabilization.
Respectfully,
[CFO]
Revised Safety Protocols
Date: July 1, 2020
To: All Staff
Team,
To alleviate our current staffing challenges, we have hired temporary medical staff. Details are in the
attached document.
Thank you,
[HR Manager]
Community Outreach Programs
Date: September 10, 2020
To: Public Relations Team
PR Team,
Given the changing situation, we need to assess our community outreach programs. Meeting scheduled
for next week.
Best,
[Head of Public Relations]
Memos
COVID-19 Preparedness Plan
Date: March 18, 2020
From: CEO
To: All Staff
This memo serves to outline our comprehensive COVID-19 preparedness and response plan. Please refer
to the attached document for the full details. Your adherence to these guidelines is essential for the
safety of all.
Social Distancing Measures
Date: March 25, 2020
From: COO
To: All Department Heads
Effective immediately, all departments are required to enforce social distancing among staff and patients.
Please see the attached document for specific guidelines.
Sanitization Procedures
Date: April 2, 2020
From: Head of Maintenance
To: All Staff
Body:
Due to the COVID-19 outbreak, we have intensified our sanitization procedures. The new schedules and
checklists are attached. Please adhere to them.
Staff Health Monitoring
Date: April 15, 2020
From: HR
To: All Staff
To ensure everyone’s safety, we are implementing new health monitoring guidelines for staff. These
guidelines are attached and are effective immediately.
Revised Visitor Policies
Date: May 1, 2020
From: Administration
To: Front Desk & Security
In light of the recent pandemic, new visitor policies will be in effect starting today. The full details are in
the attached document.
Virtual Team Meetings
Date: May 15, 2020
From: CTO
To: All Staff
Virtual team meetings are a new normal. Please find attached the guidelines for setting up and
conducting these meetings.
Elective Procedures
Date: June 5, 2020
From: COO
To: Surgical Teams
All elective procedures are postponed until further notice. Please refer to the attached memo for further
instructions.
Financial Transparency
Date: June 20, 2020
From: CFO
To: All Staff
This memo is to update all staff on the current financial status of the hospital. For a detailed breakdown,
please see the attached financial report.
Remote Work Policies
Date: July 15, 2020
From: HR
To: Non-Essential Staff
Patient Discharge Procedures
Date: August 20, 2020
From: Head of Patient Services
To: Nursing Staff and Case Managers
Given the complexities of discharging COVID-19 patients, we’ve updated our procedures to ensure a
smooth transition from hospital care to home or other healthcare facilities. The new procedures are
outlined in the attached document. Training sessions will be held this week to address any questions or
concerns you may have.
Sincerely,
[Head of Patient Services]
Student Objective
Your objective is to assess the effectiveness of the management functions (planning, organizing, leading,
and controlling) during this challenging period. Your analysis should be backed up by at least two peerreviewed articles and the course book.
Case Study Grading Rubric
Criteria
Introduction and
Summary of the
Case
Excellent
Good
A clear and concise
introduction to the case study, Adequate introduction but
including the issues at hand. may lack some clarity or
(9-10 points)
completeness. (7-8 points)
Needs Improvement
Incomplete or unclear
introduction to the case
study. (0-6 points)
Criteria
Excellent
Good
Needs Improvement
Application of
Management
Functions
Comprehensive analysis
Good analysis covering
incorporating all the functions most of the functions of
Limited or poor
of management, with
management, with
application of
excellent use of course
moderate use of course
management functions
concepts and additional
concepts and research. (28- and course concepts. (0research. (36-40 points)
35 points)
27 points)
Industry
Experience and
Insights
Effectively integrates
personal or observed industry Some integration of
experiences to provide
industry experience but
practical insights. (18-20
lacks depth or clarity. (14points)
17 points)
Little to no integration
of industry experiences.
(0-13 points)
Remedies and
Countermeasures
Offers innovative and welljustified remedies or
countermeasures for
identified issues. (18-20
points)
Suggests remedies or
countermeasures but lacks
thorough justification. (1417 points)
Limited or ineffective
suggestions for
remedies or
countermeasures. (0-13
points)
Use of PeerReviewed Articles
and Book
Integrates at least 2 peerUses at least one peerreviewed articles and refers reviewed article and makes
to the course book effectively. some reference to the
(5 points)
course book. (3-4 points)
Fails to include peerreviewed articles or
refer to the course book
adequately. (0-2 points)
Organization,
Structure, and
Grammar
Paper is well-organized, free
Significant grammatical
of grammatical errors, and
Minor grammatical errors errors or poor
follows a logical structure. (5 or organizational issues. (3- organization. (0-2
points)
4 points)
points)

Purchase answer to see full
attachment

Nursing Question

Jun 14, 2024 | Health Medical

Description

Develop an intervention (your capstone project), as a solution to the patient, family, or population problem you’ve defined. Submit the proposed intervention to the faculty for review and approval. This solution needs to be implemented (shared) with your patient, family, or group. You are not to share your intervention with your patient, family, or group or move on to Assessment 5 before your faculty reviews/approves the solution you submit in Assessment 4. In a separate written deliverable, write a 5–7 page analysis of your intervention.

Please submit both your solution/intervention and the 5–7 page analysis to complete Assessment 4.

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Introduction

In your first three assessments, you applied new knowledge and insight gleaned from the literature, from organizational data, and from direct consultation with the patient, family, or group (and perhaps with subject matter and industry experts) to your assessment of the problem. You’ve examined the problem from the perspectives of leadership, collaboration, communication, change management, policy, quality of care, patient safety, costs to the system and individual, technology, care coordination, and community resources. Now it’s time to turn your attention to proposing an intervention (your capstone project), as a solution to the problem.

Preparation

In this assessment, you’ll develop an intervention as a solution to the health problem you’ve defined. To prepare for the assessment, think about an appropriate intervention, based on your work in the preceding assessments, that will produce tangible, measurable results for the patient, family, or group. In addition, you might consider using a root cause analysis to explore the underlying reasons for a problem and as the basis for developing and implementing an action plan to address the problem. Some appropriate interventions include the following:

Creating an educational brochure.
Producing an educational voice-over PowerPoint presentation or video focusing on your topic.
Creating a teaching plan for your patient, family, or group.
Recommending work process or workflow changes addressing your topic.

Plan to spend at least 3 direct practicum hours working with the same patient, family, or group.

In addition, you may wish to complete the following:

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: (a) develop an intervention as a solution to the problem and (b) submit your proposed intervention, with a written analysis, to your faculty for review and approval.

Part 1

Develop an intervention, as a solution to the problem, based on your assessment and supported by data and scholarly, evidence-based sources.

Incorporate relevant aspects of the following considerations that shaped your understanding of the problem:

Leadership.
Collaboration.
Communication.
Change management.
Policy.
Quality of care.
Patient safety.
Costs to the system and individual.
Technology.
Care coordination.
Community resources.
Part 2

Submit your proposed intervention to your faculty for review and approval.

In a separate written deliverable, write a 5–7 page analysis of your intervention.

Summarize the patient, family, or population problem.
Explain why you selected this problem as the focus of your project.
Explain why the problem is relevant to your professional practice and to the patient, family, or group.

In addition, address the requirements outlined below. These requirements correspond to the scoring guide criteria for this assessment, 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.

Define the role of leadership and change management in addressing the problem.
Explain how leadership and change management strategies influenced the development of your proposed intervention.
Explain how nursing ethics informed the development of your proposed intervention.
Include a copy of the intervention/solution/professional product.
Propose strategies for communicating and collaborating with the patient, family, or group to improve outcomes associated with the problem.
Identify the patient, family, or group.
Discuss the benefits of gathering their input to improve care associated with the problem.
Identify best-practice strategies from the literature for effective communication and collaboration to improve outcomes.
Explain how state board nursing practice standards and/or organizational or governmental policies guided the development of your proposed intervention.
Cite the standards and/or policies that guided your work.
Describe research that has tested the effectiveness of these standards and/or policies in improving outcomes for this problem.
Explain how your proposed intervention will improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
Cite evidence from the literature that supports your conclusions.
Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
Explain how technology, care coordination, and the utilization of community resources can be applied in addressing the problem.
Cite evidence from the literature that supports your conclusions.
Write concisely and directly, using active voice.
Apply APA formatting to in-text citations and references.
Additional Requirements
Format: Format the written analysis of your intervention 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.

Portfolio Prompt: Save your intervention to your ePortfolio. After you complete your program, you may want to consider leveraging your portfolio as part of a job search or other demonstration of your academic and professional competencies.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Lead people and processes to improve patient, systems, and population outcomes.
Define the role of leadership and change management in addressing a patient, family, or population health problem and includes a copy of intervention/solution/professional product.
Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
Explain how a proposed intervention to address a patient, family, or population health problem will improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
Explain how technology, care coordination, and the utilization of community resources can be applied in addressing a patient, family, or population health problem.
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 guided the development of a proposed intervention.
Competency 6: Collaborate interprofessionally to improve patient and population outcomes.
Propose strategies for communicating and collaborating with a patient, family, or group to improve outcomes associated with a patient, family, or population health problem.
Competency 8: Integrate professional standards and values into practice.
Write concisely and directly, using active voice.
Apply APA formatting to in-text citations and references.
Patient, Family, or Population Health Problem Solution Scoring Guide
CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Define the role of leadership and change management in addressing a patient, family, or population health problem and includes a copy of intervention/solution/professional product. Does not describe leadership and change management strategies, and does not include a copy of the intervention/solution/professional product. Attempts to describe leadership and change management strategies, and/or does not include a copy of the intervention/solution/professional product. Defines the role of leadership and change management in addressing a patient, family, or population health problem and includes a copy of the intervention/solution/professional product. Defines the role of leadership and change management in addressing a patient, family, or population health problem. Provides an articulate, cogent explanation of the influence that leadership strategies, change management strategies, and nursing ethics had on the development of an intervention and includes a copy of the intervention/solution/professional product.
Propose strategies for communicating and collaborating with a patient, family, or group to improve outcomes associated with a patient, family, or population health problem. Does not describe communication and collaboration strategies. Attempts to describe communication and collaboration strategies. Proposes strategies for communicating and collaborating with a patient, family, or group to improve outcomes associated with a patient, family, or population health problem. Proposes clear, best-practice strategies, well-supported in the literature, for communicating and collaborating with a patient, family, or group to improve outcomes associated with a patient, family, or population health problem. Presents a strong case for the benefits of obtaining input from a patient, family, or group.
Explain how state board nursing practice standards and/or organizational or governmental policies guided the development of a proposed intervention. Does not describe state board nursing practice standards and/or organizational or governmental policies applicable to the development of a proposed intervention. Attempts to explain how state board nursing practice standards and/or organizational or governmental policies guided the development of a proposed intervention. Explains how state board nursing practice standards and/or organizational or governmental policies guided the development of a proposed intervention. Provides an articulate, cogent explanation of how specific state board nursing practice standards and/or organizational or governmental policies guided the development of a proposed intervention. Describes credible research on the effectiveness of these standards and/or policies in improving outcomes.
Explain how a proposed intervention to address a patient, family, or population health problem will improve the quality of care, enhance patient safety, and reduce costs to the system and individual. Does not explain how a proposed intervention to address a patient, family, or population health problem will improve the quality of care, enhance patient safety, and reduce costs to the system and individual. Provides an explanation, dependent upon unsubstantiated assumptions, of how a proposed intervention to address a patient, family, or population health problem will improve the quality of care, enhance patient safety, and reduce costs to the system and individual. Explains how a proposed intervention to address a patient, family, or population health problem will improve the quality of care, enhance patient safety, and reduce costs to the system and individual. Provides an articulate, cogent explanation of how a proposed intervention to address a patient, family, or population health problem will improve the quality of care, enhance patient safety, and reduce costs to the system and individual. Conclusions are well-supported by credible evidence. Cites specific, relevant, and available sources of benchmark data.
Explain how technology, care coordination, and the utilization of community resources can be applied in addressing a patient, family, or population health problem. Does not describe technology, care coordination, and community resources that can be applied in addressing a patient, family, or population health problem. Attempts to explain how technology, care coordination, and community resources can be applied in addressing a patient, family, or population health problem. Explains how technology, care coordination, and the utilization of community resources can be applied in addressing a patient, family, or population health problem. Provides an articulate, cogent explanation of how technology, care coordination, and the utilization of community resources can be applied in addressing a patient, family, or population health problem. Conclusions are well-supported by specific, credible evidence.
Write concisely and directly, using active voice. Does not write concisely and directly, using active voice. Writes passively, with a tendency toward wordiness. Writes concisely and directly, using active voice. Writes concisely and directly. Conveys precise and unequivocal meaning through clear and consistent use of active voice.
Apply APA formatting to in-text citations and references. Does not apply APA formatting to in-text citations and references. Applies APA formatting to in-text citations and references incorrectly and/or inconsistently, detracting noticeably from good scholarship. Applies APA formatting to in-text citations and references. Exhibits strict and nearly flawless adherence to APA formatting of in-text citations and references.

Nursing note on learning disability

Jun 14, 2024 | Health Medical

Description

Ms. Brooks was seen today while in the community. She was alert and oriented, dressed casual, skin was intact, and denied pain and discomfort. Blood pressure 114/89, pulse 98, O2 98.0%, and Temperature 98.5She was seen with a boy child during visit. She verbalized borderline high blood sugar and watches what she eats. Client is benefiting from government program such as food stamp and low cost housing scheme. Client next medical appointment was scheduled for 9th Oct, 2023. Past medical history of learning disability, depression, and anxiety. Nurse educated client on learning disability and how to handle the situation. Follow the rubric below

mn504 discussion response

Jun 14, 2024 | Health Medical

Description

Hi I need one reply to each comment, must include references, thank you

Lauren:The databases I used for my clinical question were CINAHL and Embase. CINAHL was the database that was primarily used. CINAHL contains nursing and allied health literature (CINAHL database, 2023). It was very helpful in my search because when looking at type 2 diabetes, many of the interventions and education that were being analyzed are done by individuals within the nursing profession. Embase contains medical literature (Embase, 2023). These articles helped to contain statistics on interventions and which were most beneficial.

Some features of CINAHL include subject headings, searchable cited references and subject indexing. Subject headings allow the user to search topics, such as “type 2 diabetes” (CINAHL database, 2023). This would help to generate many different articles on the topic that was searched. This is a beneficial way of receiving background information and current statistics on that topic. The next feature was searchable cited references which allows the user to search the references that were included in that article. This is very beneficial because if the article is relevant, the user can search the references, which may result in more valuable articles (Cited reference searching, n.d.). The last feature was subject indexing. Subject indexing helps to include a multitude of scholarly vocabulary which helps to yield more search results (CINAHL database, 2023). CINAHL is user-friendly and has many features that help to yield appropriate and beneficial articles.

Embase also contains features that are beneficial, such as pharmacological adverse effects screening and a systematic search. Embase allows adverse effects of medications to be searched (Embase, 2023). This is very beneficial because it allows healthcare providers to be aware of what effects the medications they are prescribing could have on the patient. The next feature that Embase has is a systematic search which allows a search to be conducted by using the PICOT question (Embase, 2023). This would help to display relevant articles and separate them from articles that are not pertinent. Both databases have features that are very practical and effective. It is important to have these tools while conducting research, so it can be performed more precisely and effectively which will help to result in the proper articles.

References

CINAHL database (2023). EBSCO. https://www.ebsco.com/products/research-databases/…

Cited reference searching. (n.d.). UQ Library. https://web.library.uq.edu.au/research-tools-techniques/search-

techniques/find-everything-your-topic/cited-reference-searching

Embase (2023). Elsevier. https://beta.elsevier.com/products/embase?trial=tr…

Megan:My Clinical question is as follows: How effective are nonpharmacological interventions compared to the effectiveness of psychotropic medications on agitation within six months? The two databases I found helpful when looking for evidence are the Cochrane Database of Systemic Reviews and CINAHL. The CDSR is just one of three databases located within the Cochrane Library. The search options in this database differ from others because it has tabs labeled Cochrane Reviews, Trials, and Clinical Answers. Although this database is small, the advanced search methods are unique and help you to find evidence quickly. Since the database is small, the results will be manageable even with the advanced search options (Hartzell et al., 2023). In the Trials tab, I could locate several RCTs about my clinical question. Van der Steen et al. (2018) discussed the effect music therapy has on patients with dementia. Although music therapy improves other behavioral issues in dementia, it is said to improve agitation or aggression (van der Steen et al., 2018). This approach is rarely considered when caring for people with dementia and may be a better intervention than medication. The CDSR database has several systematic reviews and trials in the advanced search option.

I also used the CINAHL database. It contains significant scientific knowledge regarding healthcare (Hartzell et al., 2023). EBSCOhost produces this database and has many subject areas. This is a bibliographic database; therefore, there are times that the journal article is not in the database (Hartzell et al., 2023). When searching for evidence in CINAHL, the search results may come from journals, books, dissertations, etc. CINAHL database starts with offering an advanced search option. Although it is simple to use, the page of options looks overwhelming. Search options exist for full text, peer review, publications year, and language. A search feature can also be selected for RCTs, which is excellent for this week’s assignment. Balzotti et al. (2019) discussed the efficacy of gesture-verbal therapy and doll therapy on neuropsychiatric symptoms. Participants were put into doll therapy, gesture-verbal, and control groups. It was found that gesture-verbal therapy improved some neuropsychiatric symptoms, whereas doll therapy made some symptoms worse.

References

Balzotti, A., Filograsso, M., Altamura, C., Fairfield, B., Bellomo, A., Daddato, F., Vacca, R. A., & Altamura, M. (2019). Comparison of the efficacy of gesture-verbal treatment and doll therapy for managing neuropsychiatric symptoms in older patients with dementia. International Journal of Geriatric Psychiatry, 34(9), 1308–1315. https://doi-org.libauth.purdueglobal.edu/10.1002/g…

Hartzell, T., Fineout-Overholt, E., & Kelley, C. (2023). Finding relevant evidence to answer clinical questions. In Bernadette Melnyk & Ellen Fineout-Overholt. (5th ed.), Evidence-Based practice in nursing & healthcare. Wolters Kluwer.

Van der Steen, J., Smaling, H., Van der Wouden, J., Bruinsma, M., Scholten, R., & Vink, A. (2018). Music-based therapeutic interventions for people with dementia. Cochrane Database of Systematic Reviews, (7). https://doi.org/10.1002/14651858.CD003477.

Psychotic & Cognitive Disorders

Jun 14, 2024 | Health Medical

Description

Answer the questions below based on the following case study.

TM is a 79-year-old man who was diagnosed with dementia 6 years previously. He lives with his 72-year-old wife. He was a chain smoker for 45 years. She describes a gradual deterioration in his condition such that in recent months she has found it increasingly difficult to manage him. He has become increasingly hostile and aggressive, though he has not actually assaulted her. He has begun to complain about seeing people wandering around the house, and that frightens him. On two occasions he has left the house and been found wandering along the road. She has noticed that his condition fluctuates – sometimes he is very aggressive and confused, while at other times he is more calm and lucid.

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. Your initial post is worth 8 points.
You should respond to at least two of your 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.
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.

Grading Rubric

Your assignment will be graded according to the grading rubric.

2 points
Total Points 10

Nursing Question

Jun 14, 2024 | Health Medical

Description

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.

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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

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

Social Work Question

Jun 14, 2024 | Health Medical

Description

This assignment is past due. I have been sick and not feeling like doing it. Please complete as soon as possible, since it is already past due. If you need any additional information, let me know please! Thank you in advance for your help.

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GLST 220
GOSPEL COMMUNICATION PROJECT: CULTURAL INTELLIGENCE RESEARCH
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
Use the provided worksheet to complete your cultural intelligence research assignment. You
will:
1. Identify a country to research and the cultural cluster it belongs to. Choose a country that
is ethnolinguistically different than your own culture.
2. Discuss CQ Drive by identifying your motivations for sharing the gospel and the ways
CQ can help you to be effective in communication.
3. Discuss CQ Knowledge by identifying 2 cultural systems, 3 cultural value orientations,
and 2 socio-linguistic characteristics, and sharing how these elements of culture might
affect someone’s understanding of the gospel.
4. Support your writing with adequate research from a variety of sources. Each box that
asks for an outside source should include at least 1 citation, and the works cited box at the
bottom of the template should list all sources used in the assignment (at least 3).
COMPLETING YOUR CULTURAL INTELLIGENCE RESEARCH ASSIGNMENT
You should use the provided worksheet to complete your assignment by typing in the white
boxes on the worksheet.
•
•
•
•
•
Each section of the worksheet provides writing prompts, and instructions for word count
and necessary citations.
You should write in complete sentences except for the columns where 1-word answers
are required.
Your writing should be clean and free of grammatical/spelling errors.
Formatting should be clean and easy to read (ensure your font styles and sizes are
consistent).
Your research citations should be integrated into your writing to support your arguments
and show where you got your information. Long quotes will not be counted towards the
required word counts.
Page 1 of 2
GLST 220
You should review the assignment rubric to understand how this project will be assessed and
how to maximize your score on this project.
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
Page 2 of 2
GLST 220
GOSPEL COMMUNICATION PROJECT: CULTURAL INTELLIGENCE RESEARCH
TEMPLATE
INSTRUCTIONS
Choose a country other than your own from one of the 10 cultural clusters and do research about
their culture. Complete this worksheet by writing your answers in the white boxes. Note that the
white boxes will expand as you type in them. You should write in complete sentences and use
proper English grammar, spelling, and language mechanics. Be sure to fulfill all listed word
count and citation requirements. Citations should be integrated into your writing as supporting
evidence and to show where you got your information. Long quotes from outside sources will
not be counted towards the minimum word count. When asked to cite outside sources, you
should do research through materials other than the course textbooks (reputable websites, books,
and peer reviewed articles from the JFL library, etc.). This research will assist you in preparing
your Grand Narrative presentation to effectively share the gospel with someone from that
culture.
Student
Name
Course Section
Number
Introduction
Country
Identify the Cultural Cluster of the
country you chose (Anglo, Nordic
Europe, Germanic Europe, Latin
Europe, Latin America, Confucian
Asia, Southern Asia, Sub-Saharan
Africa, Arab)
Cultural Description: Describe the country and its culture by discussing its geographical
location, primary religion, current events, significant historical events, economic status,
resources, etc. Then, describe at least 3 cultural artifacts that would be considered “top of the
iceberg” facts (art, music, dress, money, customs, food, etc.). (Write 100-300 words and cite
at least one outside source).
Example showing how to use a citation in a sentence:
India has at least 22 officially recognized languages, though English and Hindi are the
primary trade languages (World Fact Book, 2022).
[Type your cultural description here]
CQ Drive
Page 1 of 4
GLST 220
What is your drive or motivation for wanting to share the gospel with someone from this
culture? How do you think cultural intelligence will help you to be more effective in sharing
the gospel? (Write 100-200 words)
CQ Knowledge
CQ Knowledge: Discuss the categories of CQ knowledge by completing the chart below for
cultural systems, cultural value orientations, and socio-linguistic norms.
Cultural Systems: In the chart below, choose 2 of the cultural systems (Economic,
Family, etc.) and identify which description represents the culture you have chosen.
(Simply write the word that describes the cultural system in the adjacent white box. You will
fill-in answers in 2 boxes. For example, for the economic system, I would write “socialist” if
the culture I was studying has a socialist economic system).
Economic System:
Family System:
Socialist or Capitalist?
Kinship or Nuclear?
Education System:
Legal System:
Formal or Informal?
Formal or Informal?
Religious System:
Artistic System:
Mystical or Rational?
Clear or Fluid?
Discuss the Cultural Systems: For each of the 2 cultural systems that you chose above,
discuss the following questions: What evidence shows this cultural system? How might
this cultural system affect their worldview or understanding of the gospel? What biblical
themes might be relevant to someone with this cultural system? (For each system, write
100-200 words and cite at least 1 outside source)
System 1:
System 2:
Page 2 of 4
GLST 220
Cultural Value Orientations: (Choose at least 3 cultural value orientations and complete
the chart below for the culture you have chosen).
Individualism or
Collectivism?
Low-Power
Distance or HighPower Distance?
Low Uncertainty
Avoidance or
High Uncertainty
Avoidance?
Cooperative or
Competitive?
Short-term or
Long-term?
Direct or Indirect
Context?
Being or Doing?
Universalism or
Particularism?
Neutral or
Affective?
Monochronic or
Polychronic?
Discuss the Cultural Value Orientations: For each of the 3 cultural value orientations
that you chose above, discuss the following questions. What might this value orientation
look like in everyday life in that culture? How might it affect a person’s worldview or
understanding of the gospel? What biblical themes might be applicable to that value
orientation? (For each value orientation, write 100-200 words and cite at least one outside
source).
Value Orientation 1:
Value Orientation 2:
Value Orientation 3:
Discuss at least 2 socio-linguistic characteristics of this culture (1 related to verbal
communication and 1 related to non-verbal communication). How might these
characteristics affect the way you share the gospel? (Write 100-300 words and cite at least
one source).
Page 3 of 4
GLST 220
Works Cited
In the space below, list all the sources you have cited on this worksheet (You should have
at least 3 different sources). Be sure to include the title, author, publisher, date of
publication, and website (if applicable). If you used the same source more than once, you
only need to list it once in this section.
Examples Works Cited Entries
“India.” World Factbook 2022. Central Intelligence Agency, Office of Public Affairs.
(accessed February 28, 2022).
Livermore, David. Cultural Intelligence: Improving Your CQ to Engage Our Multicultural
World. Grand Rapids: Baker Academic, 2009
Page 4 of 4

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Health & Medical Question

Jun 14, 2024 | Health Medical

Description

Clinical decision makingproblem-solving approach that nurses use to define patient problems and select appropriate treatmentConcept mapa visual representation of patient problems and interventions that shows their relationships to one anotherCritical thinkinga continuous process characterized by open-mindedness, continual inquiry, and perseverance, combined with a willingness to look at each unique patient situation and determine which identified assumptions are true and relevant

Healthcare question

Jun 14, 2024 | Health Medical

Description

After reading the case study, answer the prompt below in at least 600 words. Using 2 outside reliable resources. A nurse was working in a Hispanic populated underserved high school helping to design a weight loss program for overweight female teens. She wanted to involve teens, parents, and school personnel in designing and implementing the program to ensure it would be supported by the community. The nurse believed that change is best designed by the community that will benefit from the health promotion program. She had a small grant to hire school personnel to help with data collection and dissemination of the study results. Theories of Human Behavior and Health Meta-Theories 1. Theory of Planned Behavior 2. Health Belief Model 3. Trans-theoretical ModePrompt: Which theories could she use in her grant and in the publications that are consistent with her assumptions and approach?

Ati nursing AENP

Jun 14, 2024 | Health Medical

Description

I need help with a 3500 nursing assignment and a poster. The assignment is about CORONARY HEART DISEASE IN WOMEN and the poster is about Alcohol and Drug use in Derbyshire and the midlands.

The poster should be a one page poster and not be together with the paper.

Please the paper is a RANDOMISED CONTROL TRIAL PAPER and you will critique it using a CASP TOOL.

Details of assignment brief and other important informations including article to be used are in the link below.

I have attached examples of how the poster shoud be. Also the work should be referenced within a 10 year time frame. 2013-2023. (35 references minimum)

https://drive.google.com/drive/folders/1RhluQqXzR7…

In the link, you’ll find the assignment brief for the project and the poster. With voice recording explaining how it should be done.

NURS 420- Population Focused Nursing

Jun 14, 2024 | Health Medical

Description

Ambulatory Nursing Practice in the Community

– Clinical Sites: Wound Care, Infusion Therapy, Cardiac Rehab

Required reading:

Swan, B.A., Conway-Phillips, R., & Griffin, K.F. (2006). Demonstrating the value of the RN in

ambulatory care. Nursing Economics$, 24(6), 315-322.

https://wa.opallibraries.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=23659781&site=ehost-live

Swan, B. A. & Griffin, K. F. (2005). Measuring nursing workload in ambulatory care. Nursins Economic$, 23 (5), 253-260.

https://wa.opallibraries.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=19217373&site=ehost-live

Pirschel, C. (2019). Comfort, close to home: The vital role of oncology nursing in ambulatory care. ONS

Voice, 34(11), 16-20.

https://wa.opallibraries.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=139418619&site=ehost-live

American Academy of Ambulatory Care Nursing Position Statement: The role of the Registered Nurse in Ambulatory Care. (2012). Nursing Economic$, 30(4), 233-239.

https://wa.opallibraries.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=79279201&site=ehost-live

Upon completing this assignment, the student will be able to:

Identify the components of the nurse’s role in the community-based health care organization.
Discuss how the nurse’s role within the collaborative process benefits the patient and family.
Discuss the use of the nursing process in teaching and learning in community-based settings.
Identify learning resources for teaching clients in the community.
Discuss the advocacy role of the nurse in client teaching in community-based practice.

6.Assess the nursing care given in ambulatory nursing in terms of the primary, secondary and tertiary levels of prevention.

Discussion 6: Reporting Diabetes Mellitus

Jun 14, 2024 | Health Medical

Description

Please read the attached instructions and complete the discussion below. Be sure to cite information that is taken from other sources.

Discussion 2

Jun 14, 2024 | Health Medical

Description

Respond to the attached discussion

Unformatted Attachment Preview

9/18/23, 6:54 PM

Assignment Information

HCM 320 Module Four Journal Guidelines and Rubric
The Case for Incentivising Health is based on Australian data, but the challenges of combating chronic disease there are similar to the challenges present in the United States. Read the case
carefully and consider the list of main considerations those working in the preventative health space could think about when developing programs, policies or interventions to change
behaviors listed on page five. Address the following questions:
Which of these cues do you consider to have the most impact in terms of changing healthcare behaviors of the patient?
Which of these cues would you most readily respond to as a patient?
Which cues do you think are most likely to be adopted by providers and insurance companies?
Support your responses with examples from your own experience, the case, or references to the textbook or other scholarly sources.
Use the journal as an opportunity to familiarize yourself with the final project requirements and case study. Journal activities in this course are private between you and your instructor. Only
the instructor can view and comment on your assignments.
What to Submit
Your journal assignment should be 2 to 4 paragraphs in length. Submit assignment as a Word document with double spacing, 12- point Times New Roman font, and one-inch margins.
Module Four Journal Rubric
Criteria
Proficient (100%)
Needs Improvement (75%)
Not Evident (0%)
Value
Impact of Behavioral Cue
Discusses the impact of a behavioral cue in
terms of changing healthcare behaviors
and supports the discussion with examples
or references
Discusses the impact of a behavioral cue in
terms of changing healthcare behaviors,
but does not support the discussion with
examples or references
Does not discuss the impact of a behavioral
cue in terms of changing healthcare
behaviors
40
Patient Response
Describes why a behavioral cue would
produce positive responses from patients
and supports the description with
examples or references
Describes why a behavioral cue would
produce positive responses from patients,
but does not support the description with
examples or references
Does not describe why a behavioral cue
would produce positive responses from
patients
30
Providers and Insurance
Companies
Identifies the behavioral cues that are most
likely to be adopted by providers and
insurance companies and supports the
response with examples or references
Identifies the behavioral cues that are most
likely to be adopted by providers and
insurance companies, but does not support
the response with examples or references
Does not identify the behavioral cues that
are most likely to be adopted by providers
and insurance companies
30
https://learn.snhu.edu/d2l/le/content/1379729/viewContent/26927043/View
1/2
9/18/23, 6:54 PM
Criteria
Assignment Information
Proficient (100%)
Needs Improvement (75%)
Not Evident (0%)
Value
Total:
https://learn.snhu.edu/d2l/le/content/1379729/viewContent/26927043/View
100%
2/2

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Nursing Question

Jun 14, 2024 | Health Medical

Description

In a 5–7 page written assessment, define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective. Plan to spend approximately 2 direct practicum hours meeting with a patient, family, or group of your choice to explore the problem 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.

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Introduction

This assessment lays the foundation for the work that will carry you through your capstone experience and guide the practicum hours needed to complete the work in this course. In addition, it will enable you to do the following:

Develop a problem statement for a patient, family, or population that’s relevant to your practice.
Begin building a body of evidence that will inform your approach to your practicum.
Focus on the influence of leadership, collaboration, communication, change management, and policy on the problem.
Preparation

In this assessment, you’ll assess the patient, family, or population health problem that will be the focus of your capstone project. Plan to spend approximately 2 hours working with a patient, family, or group of your choice to explore the problem from a leadership, collaboration, communication, change management, and policy perspective.During this time, you may also choose to consult with subject matter and industry experts about the problem (for example, directors of quality or patient safety, nurse managers/directors, physicians, and epidemiologists).

To prepare for the assessment, complete the following:

Identify the patient, family, or group you want to work with during your practicum The patient you select can be a friend or a family member. You’ll work with this patient, family, or group throughout your capstone project, focusing on a specific health care problem.
Begin surveying the scholarly and professional literature to establish your evidence and research base, inform your assessment, and meet scholarly expectations for supporting evidence.

In addition, you may wish to complete the following:

Review the assessment instructions and scoring guide to ensure that you understand the work you’ll be asked to complete and how it will be assessed.
Practicum Focus Sheet: Assessment 1 [PDF] Download Practicum Focus Sheet: Assessment 1 [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

Define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective and establish your evidence and research base to plan, implement, and share findings related to your project.

Part 2

Connect with the patient, family, or group you’ll work with during your practicum. During this portion of your practicum, plan to spend at least 2 hours meeting with the patient, family, or group and, if desired, consulting with subject matter and industry experts of your choice. The hours you spend meeting with them should take place outside of regular work hours. Use the Practicum Focus Sheet [PDF] Download Practicum Focus Sheet [PDF]provided for this assessment to guide your work and interpersonal interactions. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Requirements

Define a patient, family, or population health problem that’s relevant to your practice.
Summarize the problem you’ll explore.
Identify the patient, family, or group you intend to work with during your practicum.
Provide context, data, or information that substantiates the presence of the problem and its significance and relevance to the patient, family, or population.
Explain why this problem is relevant to your practice as a baccalaureate-prepared nurse.
Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to the patient, family, or population problem you’ve defined.
Note whether the authors provide supporting evidence from the literature that’s consistent with what you see in your nursing practice.
Explain how you would know if the data are unreliable.
Describe what the literature says about barriers to the implementation of evidence-based practice in addressing the problem you’ve defined.
Describe research that has tested the effectiveness of nursing standards and/or policies in improving patient, family, or population outcomes for this problem.
Describe current literature on the role of nurses in policy making to improve outcomes, prevent illness, and reduce hospital readmissions.
Describe what the literature says about a nursing theory or conceptual framework that might frame and guide your actions during your practicum.
Explain how state board nursing practice standards and/or organizational or governmental policies could affect the patient, family, or population problem you’ve defined.
Describe research that has tested the effectiveness of these standards and/or policies in improving patient, family, or population outcomes for this problem.
Describe current literature on the role of nurses in policy making to improve outcomes, prevent illness, and reduce hospital readmissions.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of this problem.
Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to the patient, family, or population problem you’ve defined.
Discuss research on the effectiveness of leadership strategies.
Define the role that you anticipate leadership must play in addressing the problem.
Describe collaboration and communication strategies that you anticipate will be needed to address the problem.
Describe the change management strategies that you anticipate will be required to address the problem.
Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Organize content so ideas flow logically with smooth transitions.
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

Complete the NURS-FPX4900 Volunteer Experience Form in Capella Academic Portal. Include a description of your relationship to the patient, family, or group in the Volunteer Experience comments field.

Context

Nurses in all professional roles work to effect positive patient outcomes and improve organizational processes. Professional nurses are leaders in problem identification, planning, and strategy implementation—skills that directly affect patient care or organizational effectiveness.

Too often, change agents jump to a conclusion that an intervention will promote the envisioned improvement. Instead, the ideal approach is to determine which interventions are appropriate, based on an assessment and review of credible evidence. Interventions could be patient-facing or involve a change in policy and process. In this assessment, you’ll identify and make the case for your practicum focus area, then explore it in depth from a leadership, collaboration, communication, change management, and policy perspective.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Lead people and processes to improve patient, systems, and population outcomes.
Define a patient, family, or population health problem that’s relevant to personal and professional practice.
Competency 2: Make clinical and operational decisions based upon the best available evidence.
Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to a defined patient, family, or population problem.
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 could affect a defined patient, family, or population problem.
Competency 7: Implement patient-centered care to improve quality of care and the patient experience.
Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to a defined patient, family, or population problem and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Competency 8: Integrate professional standards and values into practice.
Organize content so ideas flow logically with smooth transitions.
Apply APA style and formatting to scholarly writing.

Nursing Question

Jun 14, 2024 | Health Medical

Description

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Introduction

Preparation

To prepare for the assessment:

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

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.

Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in Capella Academic Portal.

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.

2 file dis

Jun 14, 2024 | Health Medical

Description

ECON DISTrade barriersSelect a developed country that has implemented a tariff, and a developing country that manufactures products that are impacted by that same tariff. The current US and China tariff “war” cannot be used since these are the two largest economies in the world. Investigate the economic impact of the trade barrier on the developing country and the developed country. Would you recommend that the developed country eliminate the tariff? Explain your reasoning.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.

EPIDEMEOLOGY DISCUSSION ANSWERS

Jun 14, 2024 | Health Medical

Description

Hi I need one reply to each comment, must include references, thank you

Anne:Population health outcomes depend on several factors, including socioeconomic determinants of health, access to healthcare, and individual behavior. However, discrimination and barriers can also impact health outcomes, especially in some populations. We will discuss how biases and barriers impact population health outcomes in Orange County, Florida, in particular when it comes to measuring obesity, in this essay.

Lack of healthcare access hinders quantifying obesity in Orange County, Florida. According to Islami et al. (2022), uninsured people in the US are less likely to obtain preventative treatment, such as obesity screening. Poor health outcomes may follow from this lack of access to healthcare, which can cause undetected obesity. Additionally, the absence of safe locations to exercise and the availability of healthy food alternatives may be a factor in the high obesity rates in Orange County, Florida.

In many different ways, biases can affect population health outcomes. For instance, people from low-income regions may have less access to healthy food alternatives and secure exercise facilities, which might increase the prevalence of obesity. By restricting access to nutritious food alternatives and secure exercise facilities, prejudice can harm population health outcomes in Orange County, Florida. According to Ohri-Vachaspati et al. (2019), low-income communities featured fewer supermarkets and more fast-food restaurants than high-income neighborhoods, making it challenging for people to get healthy food alternatives.

In conclusion, bias and barriers can influence population health outcomes in Orange County, FL, particularly when evaluating obesity rates. Individuals in Orange County, FL, may suffer from poor health outcomes due to poor access to healthcare, good dietary alternatives, and

bias in obesity assessment. Overcoming these barriers and biases is critical to enhancing neighborhood population health outcomes.

References

Islami, F., Guerra, C. E., Minihan, A., Yabroff, K. R., Fedewa, S. A., Sloan, K., … & Jemal, A. (2022). American Cancer Society’s report on the status of cancer disparities in the United States, 2021. CA: A Cancer Journal for Clinicians, 72(2), 112-143. https://doi.org/10.3322/caac.21703

Ohri-Vachaspati, P., DeWeese, R. S., Acciai, F., DeLia, D., Tulloch, D., Tong, D., Lorts, C., & Yedidia, M. (2019). Healthy food access in low-income high-minority communities: A longitudinal assessment-2009-2017. International Journal of Environmental Research and Public Health, 16(13), 2354. https://doi.org/10.3390/ijerph16132354

Nicole: The year of 2020 really expressed to the world that there are explicit biases. Some were cheering healthcare workers and others were harming healthcare workers. Then the George Floyd incident proved that there is systemic racism in the world. This was an example of explicit bias on a national level. Implicit bias also occurs in the healthcare system and deeply affects patient-clinician communication and clinical decision making. Biases have also occurred in healthcare systems that affect admissions, promotions, bedside instruction as well as classroom instruction of clinicians (Vela et al., 2022). Although, this is not published, it is known that in our area, one hospital caters more toward minorities than the other hospital. I wonder, how could this affect patient outcomes? It does seem to create an implicit bias that is not quite so noticeable but relevant to those that are part of those effected by the bias.

There are many people in the area that are very vocal about the bias felt at some local establishment. The people affected by the biases are vocal on social media, they are vocal in local establishments, they are vocal in the schools.

Population

According to the US Census Bureau, the population of Kankakee County is 106,074. 50% female, 50 % male, 18% over the age of 65, 23% 18 or under but older that 5 years of age. The county is 80.7 % white, 15.2% black or African American, 2.4% of other races, or two or more races (USCB, 2022).

Because the housing market is lower in this area, many people are relocating from the city of Chicago. Therefore, some people who are not local by nature, have been more vocal about the bias.

Barriers

Some barriers in the county of Kankakee include lack of transportation. Recently in the last few years a public transportation bus system was created to eliminate this issue. Although it has, to some extent, the schedule is very far apart, making in not so convenient for those without transportation. There are maybe 3 uber drivers in the area and an ADA bus. However, the ADA bus will only pick up if there is a documented disability. Other barriers, include location of provider offices. Most are in the buildings of the two hospitals. The two hospitals are only a mile a part, but on the same side of town. Thus, making it difficult for some who are not near to that location.

With the barriers of the location of the hospitals, limited public transportation options, and known biases at one of the hospitals, this could lead to many illnesses in Kankakee County. Many illness that could be prevented with care that is accessible and unbiased. Some barriers are being worked on, to be eliminated, but the county has not quite achieved this goal. I do believe, that the county as a whole is moving in the right direction.

References

Charlesworth, T., Maharin, B., (2019). Age and Generation Issues. Research: How Americans’ Biases Are Changing (or not) over time. Harvard Business Review.

USCB. (2022). United States Census Bureau. Quickfacts Kankakee County, Illinois. Retrieved From. https://www.census.gov/quickfacts/fact/table/kankakeecountyillinois/PST045222

Vela, M. B., Erondu, A. I., Smith, N. A., Peek, M. E., Woodruff, J. N., & Chin, M. H. (2022). Eliminating Explicit and Implicit Biases in Health Care: Evidence and Research Needs. Annual review of public health, 43, 477–501. https://doi.org/10.1146/annurev-publhealth-052620-103528

Nutrition

Jun 14, 2024 | Health Medical

Description

Directions: Rely on the powerpoints attached to answer the following questions.

1. List and discuss the three (3) main groups of lipids. What is the role of each type of lipid in the body? What is the recommended daily intake of lipids? List 4 healthy Lipids.

2. Briefly discuss high and low-density lipoprotein cholesterol.

3. Discuss the nature of proteins. Discuss amino acids. What are the role of proteins in the body? What is the recommended daily intake of proteins? List 4 healthy proteins.

4. List the fat and water soluble vitamins. What are the roles of each in the body?

5. List five (5) minerals. What is the role of minerals in the body?

6. Discuss the functions of body water. Compare water intake versus output.

7. Figure 3.5 (depending on the book edition) listed the structures of the gastrointestinal tract including each structure’s digestive function. For the following structures, discuss their digestive function and percent of digestion for each structure.

a. Mouth

b. Stomach

c. Liver

d. Small intestine

e. Large intestine

8. Figure 3.10 (depending on the book edition) is the overview of human digestion. Please discuss how carbohydrates, proteins, and fats are digested.

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Part 1
Food Nutrients: Structure,
Function, Digestion, Absorption,
and Assimilation
1
Chapter 2
The Micronutrients and Water
2
Micronutrients
Micronutrients Include Vitamins and Minerals
• Micronutrients do not provide energy
• Only needed in small quantities
• Deficiencies and excesses of the micronutrients
affect health
Copyright © 2019 Wolters Kluwer • All Rights Reserved
3
The Nature of Vitamins
Thirteen Fat- or Water-Soluble Vitamins
• Have no common chemical structure
• Except for vit D, body does not make vitamins
• Foods/supplements supply all vitamins
• Plants contain abundant vitamins
– Manufactured via photosynthesis
• Animals obtain vitamins from plants, seeds, grains,
fruits, and meat from other animals
Copyright © 2019 Wolters Kluwer • All Rights Reserved
4
Classification of Vitamins
Vitamins
• Fat soluble
– Vitamins A, D, E, and K
• Water soluble
– Vitamin C
– B-complex
o Thiamine (B1), riboflavin (B2), pyridoxine (B6),
niacin (nicotinic acid), pantothenic acid,
biotin, folic acid, and cobalamin (B12)
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5
Classification of Vitamins
Fat-Soluble Vitamins
• Vitamins A, D, E, and K
– Dissolve and store in fatty tissues
o Dietary lipids provide a source of fat-soluble
vitamins
– Should not be consumed in excess without
medical supervision
– Remain in body tissues; not excreted
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6
Classification of Vitamins
Fat-Soluble Vitamin Toxicity
• Toxicity symptoms
– Nervous system irritability
– Bone swelling
– Weight loss
– Dry, itchy skin
• Other symptoms
– Nausea, headache, drowsiness, hair loss,
diarrhea, bone calcium loss leading to
osteoporosis
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7
Classification of Vitamins
Water-Soluble Vitamins
• Vitamin C and B-complex vitamins
• Act largely as coenzymes
• Disperse readily in body fluids
– Excess intake voided in urine
– Marginal deficiencies develop in 4 weeks of
inadequate intake
• Available in foods, mostly plants
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8
Classification of Vitamins
Vitamin Storage in the Body
• Fat-soluble vitamins not excreted
• Water-soluble vitamins continually excreted by
kidneys
– Must be consumed regularly to prevent
deficiencies
– Vitamin B12 an exception
• Deficiencies appear after 10 to 40 days of no intake
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9
Vitamin’s Role in the Body
• Essential links and
regulators in metabolic
reactions that release
energy from food
• Regulate metabolism
• Protect cells’ plasma
membrane
FIGURE 2.1 Biologic function of vitamins
Copyright © 2019 Wolters Kluwer • All Rights Reserved
10
Defining Nutrient Needs
Dietary Reference Intakes
• Comprehensive approach to nutritional
recommendations
• “DRI” umbrella term
– Recommended Daily Allowance: RDA
– Estimated Average Requirement: EAR
– Adequate Intake: AI
– Tolerable Upper Intake Level
Copyright © 2019 Wolters Kluwer • All Rights Reserved
11
Defining Nutrient Needs
Dietary Reference Intakes (DRIs)
• Recommended Daily Allowance: RDA
– Meets needs of 97% to 98% of healthy people
• Estimated Average Requirement: EAR
– Meets needs of ½ of all healthy people
• Adequate Intake: AI
– Adequate nutritional goals with no RDAs
• Tolerable Upper Intake Level
– Highest average daily intake likely to pose little
risk of adverse health effects
Copyright © 2019 Wolters Kluwer • All Rights Reserved
12
Defining Nutrient Needs
Dietary Reference Intakes (DRIs)
FIGURE 2.2 Theoretical distribution of number of persons adequately nourished by a given nutrient intake
Copyright © 2019 Wolters Kluwer • All Rights Reserved
13
Defining Nutrient Needs
U.S. Govt. 2015–2020 Dietary Guidelines
• Limit saturated fat to 10% daily kilocalories
• Eat a variety of protein including seafood, lean
meats, poultry, eggs, soy, legumes, nuts, and
seeds
• Eat fat-free or low-fat dairy, including milk, yogurt,
and cheese
• Consume ≤10% of kcal·d−1 (about 200 kcal) from
added sugars
• Limit alcohol intake to 1 drink daily for women and
3 drinks daily for men
• Limit daily sodium intake to ≤2300 milligrams
Copyright © 2019 Wolters Kluwer • All Rights Reserved
14
Defining Nutrient Needs
Antioxidant Role of Vitamins
• Vitamins protect against oxidative stress
– Influencing molecular mechanisms and gene
expression
– Provide enzyme-inducing substances to detoxify
carcinogens
– Interrupt uncontrolled cell growth
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15
Defining Nutrient Needs
Antioxidant Role of Vitamins
• Vitamins A, C, E, and β-carotene
– Serve protective functions
– Appropriate vitamin levels of these vitamins
reduce potential for free radical damage
(oxidative stress)
o Protects against heart disease, diabetes,
osteoporosis, cataracts, premature aging, and
diverse cancers
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16
Defining Nutrient Needs
Vitamins and Disease Protection
• Isothiocyanates: natural detoxifier
• Lutein and zeaxanthin: protect eye health
• Lycopene: decreases the risk for heart disease and
cancer risk
• Vitamin E: neutralizes harmful compounds
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17
Homocysteine and CHD
FIGURE 2.3 A. Proposed mechanism for how the amino acid homocysteine damages the lining of
arteries and sets the stage for cholesterol infiltration into a blood vessel. B. Proposed defense against the
possible harmful effects of elevated homocysteine levels
Copyright © 2019 Wolters Kluwer • All Rights Reserved
18
Minerals
The Nature of Minerals
• Consist of 22 mostly metallic elements
• Minerals essential to life
– 7 major minerals
o Required amounts ≥100 mg·d−1
– 14 minor or trace minerals
o Required amounts ≥100 mg·d−1
• Balanced diet provides adequate intake
– Some geographic locations lack specific minerals
Copyright © 2019 Wolters Kluwer • All Rights Reserved
19
Minerals
Kinds of Minerals
• Major Minerals
• Trace Minerals
– Requirement ≥100
mg·d−1
– Requirement ≤100
mg·d−1
o Calcium
o Iron
o Phosphorous
o Fluorine
o Potassium
o Zinc
o Sulfur
o Copper
o Sodium
o Selenium
o Chlorine
o Iodine
o Magnesium
o Chromium
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20
Minerals
Role in the Body
• Provide structure
– Bone and teeth formation
• Maintains normal heart rhythm, muscle
contractility, neural conductivity, and acid-base
balance
• Regulates metabolism
– Enzymes and hormones modulate cellular
activity
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21
Minerals
Role in Catabolism
and Anabolism
FIGURE 2.4 Minerals that function in
macronutrient catabolism and
anabolism
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22
Minerals
Mineral Bioavailability
• Factors affecting mineral bioavailability
– Type of food
– Mineral-mineral interaction
– Vitamin-mineral interaction
– Fiber-mineral interaction
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23
Minerals
Calcium (Ca++)
• Body’s most abundant mineral
• Ca++ + phosphorus (P) forms bones and teeth
• Ca++ + P = 75% of body’s total minerals
• Six important functions
1. Muscle action
2. Blood clotting
3. Nerve impulse transmission
4. Enzyme activation
5. Calciferol (vit D) synthesis
6. Fluid transport across cell membrane
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24
Minerals
Calcium Balance
• Prevents hypercalcemia (higher than normal
blood Ca++) and hypocalcemia (lower than normal
blood Ca++)
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25
Minerals
Calcium Balance
• Two opposing processes control Ca++ balance
1. C++ buildup by its efficient transport from the
small intestine for storage in bone matrix
2. Inadequate C++ intake or ineffective calcium
absorption by intestinal mucosa
o C++ travels opposite from bone into bodily fluids
called C++ resorption
▪ This process negatively impacts males and
females of all ages
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26
Minerals
FIGURE 2.5 Ca++ (blue dots) buildup by its efficient transport from small intestines for storage in bone
matrix (white box upper left). Opposing process of ineffective Ca++ intestinal absorption, denoted by the
smaller white box, occurs where Ca++ leaches from bones leaving them brittle and likely to fracture
Copyright © 2019 Wolters Kluwer • All Rights Reserved
27
Minerals
Osteopenia and Osteoporosis
• Ca++ imbalance can lead to
1. Osteopenia
o
Bone weakens with increased fracture risk
o
Bone density does not achieve peak bone
density or max concentration of bony tissue at
maturation and is not low enough for medical
classification as osteoporosis
2. Osteoporosis
o
Porous bones, with bone density values greater
than 2.5 SD units below normal for age and sex
with significantly increased fracture risk
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28
Minerals
Variation in Bone
Population
FIGURE 2.6 A. Different factors that
affect bone mass. B. Weight-bearing PA
augments skeletal mass during growth
above the genetic baseline. The degree of
augmentation depends on the amount of
bone mechanical loading
Copyright © 2019 Wolters Kluwer • All Rights Reserved
29
Minerals
Osteoporosis Risk Factors
• Advanced age
• Excess sodium intake
• White or Asian woman
• Cigarette smoking
• Underweightness
• Excessive alcohol use
• Anorexia or bulimia
nervosa
• Abnormal absence of
menstrual periods
• Sedentary lifestyle
• Calcium-deficient diet before
and after menopause
• Postmenopause, including
early or surgically induced
menopause
• Family history of
osteoporosis
• Low testosterone in men
• Possible high caffeine intake
• High protein intake
• Vitamin D deficiency
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30
Minerals
Osteogenic Effects
of PA
• Most effective
during growth
– Childhood
– Adolescence
FIGURE 2.7 Osteogenic effects of PA
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31
Minerals
Beneficial Effects of Weight-Bearing
FIGURE 2.8 Beneficial effects of weight-bearing activities
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32
Minerals
Female Triad
• Tightly bound
continuum that
begins with
disordered
eating
(with energy
drain) leading to
amenorrhea and
then
osteoporosis
FIGURE 2.10 The female athlete triad: low energy
availability, menstrual dysfunction, and impaired bone health
Copyright © 2019 Wolters Kluwer • All Rights Reserved
33
Minerals
Female Triad
FIGURE 2.11 Contributing factors
to exercise-related amenorrhea
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34
Minerals
Does Muscle
Strength Relate to
Bone Density?
• Greater maximum
flexion and
extension
strength
in
postmenopausal
women with and
without
osteoporosis
FIGURE 2.12 Comparison of chest press extension and
flexion strength in age- and weight-matched
postmenopausal women with low and normal BMD
Copyright © 2019 Wolters Kluwer • All Rights Reserved
35
Minerals
Reducing Fracture Risk in Osteoporosis
• Risk factor reduction for fracture
1. Strengthen bones by maintaining or increasing
bone density with PA and adequate daily Ca++
intake
2. Reduce spinal forces by avoiding higher-risk PA
to increase spinal and lower-limb joint
compression
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36
Minerals
Phosphorus
• Combines with Ca++ to form hydroxyapatite and
calcium phosphate
• Serves as essential component of AMP, PCr, and
ATP
• Combines with lipids to form phospholipids—part of
cell membranes
• Phosphate enzymes regulate cellular metabolism
• Participates in buffering energy metabolism acid
end-products
Copyright © 2019 Wolters Kluwer • All Rights Reserved
37
Minerals
Magnesium
• Helps regulate metabolism
• Plays vital role in glucose metabolism
• Participates as cofactor in glucose, fatty acids,
and amino acids breakdown
• Affects lipid and protein synthesis
• Preserves proper neurologic system function
Copyright © 2019 Wolters Kluwer • All Rights Reserved
38
Part 1
Food Nutrients: Structure,
Function, Digestion, Absorption,
and Assimilation
1
Chapter 3
Nutrient Digestion and
Absorption
2
Food Nutrient Digestion and Absorption
The Digestive Process
• Digestion = mechanical and chemical food
breakdown of food for absorption into blood for use,
storage, or chemical change
– Requires 24 to 72 hours
– Under involuntary control
o ANS controls GI: PNS increases gut activity:
SNS inhibits activity
– Proteins and CHO degrade and enter intestinal villi
for absorption
– Bile emulsifies lipids, hydrolyze or degrade them
for absorption
Copyright © 2019 Wolters Kluwer • All Rights Reserved
3
Food Nutrient Digestion and Absorption
Beginning of Digestion
• Digestion begins with smell and taste
• In mouth, texture and temperature combine with
odors to produce perception of flavor
• Flavor, sensed through smell, signifies what we eat
Four Hormones Regulate Digestion
• Gastrin, secretin, cholecystokinin (CCK), and gastric
inhibitory peptide (GIP)
Copyright © 2019 Wolters Kluwer • All Rights Reserved
4
Food Nutrient Digestion and Absorption
Four Hormones Regulate Digestion
1. Gastrin
2. Secretin
3. Cholecystokinin (CCK)
4. Gastric inhibitory peptide (GIP)
Digestive Secretions
Organ
Target Organ
Secretion
Action
Salivary glands
Mouth
Saliva
CHO breakdown
Gastric glands
Stomach
Gastric juice
Mixes with food
Pancreas
Small intestine
Pancreatic juice
Degrades CHO, fats, protein
Liver
Gallbladder
Bile
Stored until needed
Gallbladder
Small intestine
Bile
Emulsifies fat
Intestinal glands
Small intestine
Intestinal juice
Degrade CHO, fats, protein
Copyright © 2019 Wolters Kluwer • All Rights Reserved
5
Food Nutrient Digestion and Absorption
Transporting Nutrients Across Cell Membranes
• Two process maintain nutrient transport
1. Passive transport through plasma membranes
without requiring energy
2. Active transport through plasma membrane, which
requires metabolic energy to “power” nutrient
exchange
Copyright © 2019 Wolters Kluwer • All Rights Reserved
6
Food Nutrient Digestion and Absorption
Passive Transport
• Four Types
1. Simple
diffusion
2. Facilitated
diffusion
3. Osmosis
4. Filtration
FIGURE 3.1 A. Simple diffusion. B.
Facilitated diffusion. C. Osmosis. D.
Filtration
Copyright © 2019 Wolters Kluwer • All Rights Reserved
7
Food Nutrient Digestion and Absorption
Active Transport
• Sodium-potassium
pump
– Moves food
through
semipermeable
membranes
– Requires energy
FIGURE 3.2 The dynamics of the sodium–
potassium pump
Copyright © 2019 Wolters Kluwer • All Rights Reserved
8
Food Nutrient Digestion and Absorption
Active Transport
• Coupled transport
– Movement in one
direction
– Requires a
cotransporter
(symport)
FIGURE 3.3 Coupled transport. A molecule of glucose
and a sodium ion move together in the same direction
through the plasma membrane in a symport protein
Copyright © 2019 Wolters Kluwer • All Rights Reserved
9
Food Nutrient Digestion and Absorption
Bulk Transport
• Energy-requiring processes
– Exocytosis: transfers substances through cell
membranes
– Endocytosis: cell’s plasma membrane surrounds
substance, pinches away and moves into
cytoplasm
o Two forms
1. Pinocytosis
2. Phagocytosis
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10
Gastrointestinal Tract Anatomy
FIGURE 3.4 Structures of the gastrointestinal tract and each structure’s digestive function
Copyright © 2019 Wolters Kluwer • All Rights Reserved
11
Gastrointestinal Tract Anatomy
Sphincters
Control Food
Passage
FIGURE 3.5 Propulsion of nutrients through the GI tract. A.
Peristalsis involves the reflex-controlled alternate contraction and
relaxation of adjacent segments of the GI tract, which causes
one-directional flow of food with some mixing. B. Segmentation
contractions involve the alternate contraction and relaxation of
nonadjacent segments of the intestine. This localized intestinal
rhythmicity propels food forward and then backward, causing food
to mix with digestive juices
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12
Gastrointestinal Tract Anatomy
Stomach and Gastric Gland Structures
FIGURE 3.6 Stomach and gastric gland structure. The parietal cells primarily secrete hydrochloric
acid, neck cells secrete mucus, and chief cells produce pepsinogen
Copyright © 2019 Wolters Kluwer • All Rights Reserved
13
Gastrointestinal Tract Anatomy
Stomach
• Volume averages about 1.5 liters
• Expands to 50 milliliters (1.5 oz) when empty to ~6
liters when distended following a large meal
• Contents mix with chemical substances to produce
chyme
• Following meal, stomach usually takes 1 to 4 hours
to empty depending on nutrient concentration and
volume
• Can retain a high-fat meal for up to 6 hours before
small intestine absorbs it
Copyright © 2019 Wolters Kluwer • All Rights Reserved
14
Gastrointestinal Tract Anatomy
Small Intestine
• Three sections
1. Duodenum
2. Jejunum
3. Ileum
• Ninety percentage of all digestion occurs in the
duodenum and jejunum
• Absorption takes place in villi of intestinal mucosa
Copyright © 2019 Wolters Kluwer • All Rights Reserved
15
Gastrointestinal Tract Anatomy
Small Intestine
• Microscopic
structure of small
intestine showing
villi and microvilli
projections
FIGURE 3.7 During digestion, bile produced
in the liver and stored and secreted by
gallbladder increases lipids’ solubility and
digestibility through emulsification
Copyright © 2019 Wolters Kluwer • All Rights Reserved
16
Gastrointestinal Tract Anatomy
Large Intestine (Colon or
Bowl)
•
Includes cecum,
colon, rectum, anus
•
Includes cecum,
ascending colon,
transverse colon,
descending colon,
sigmoid colon,
rectum, anus
•
Serves as a storage
area for undigested
food residue (feces)
•
Absorbs water and
electrolytes
FIGURE 3.8 The large intestine, a 5-foot-long tube,
includes the cecum, colon, rectum, and anal canal.
As chyme fills the cecum, a local reflex signals the
ileocecal valve to close, preventing material from reentering the ileum and small intestine
Copyright © 2019 Wolters Kluwer • All Rights Reserved
17
Digestion of Food Nutrients
Carbohydrate,
Protein, and
Lipid Digestion
FIGURE 3.9 Overview of
human digestion showing
the major enzymes and
hormones that act on
proteins, lipids, and
carbohydrates during their
convoluted journey from
the mouth through the GI
tract
Copyright © 2019 Wolters Kluwer • All Rights Reserved
18
Carbohydrate Digestion and Absorption
• In the mouth, salivary amylase degrades starch to
simpler disaccharides
• Pancreatic amylase continues CHO hydrolysis
• Three enzymes on the brush border complete final stage
of CHO digestion to monosaccharides
– Maltase
– Sucrase
– Lactase
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19
Lipid Digestion and Absorption
• In the mouth, lingual lipase begins lipid digestion of
short-chain and medium-chain SFA
• Gastric lipase continues TG breakdown in the stomach
• Lipid breakdown occurs in small intestine
• Lipid breakdown occurs by emulsifying action of bile and
hydrolytic action of pancreatic lipase
• Cholecystokinin (CCK) releases from duodenum
• Gastric inhibitory peptide and secretin released in
response to high lipid content
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20
Lipid Digestion and Absorption
Fatty Acid Carbon Chain Length Affects Digestive
and Metabolic Processes
• Medium-chain triacylglycerols (MCT)
– MCT rapidly absorb into the portal vein
– Bound to glycerol and medium-chain free fatty
acids
– Bypasses lymphatic system and enters
bloodstream
– Supplements have clinical application for patients
with tissue-wasting disease or with intestinal
malabsorption difficulties
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21
Lipid Digestion and Absorption
Fatty Acid Carbon Chain Length Affects Digestive
and Metabolic Processes
• Long-chain fatty acids (LCFA)
– LCFA absorbed by intestinal mucosa reform into
TGs to form chylomicrons
o Chylomicrons move through lymphatic system
and empty into venous blood
o Lipoprotein lipase allows chylomicrons to
hydrolyze to FFA and glycerol
Copyright © 2019 Wolters Kluwer • All Rights Reserved
22
Lipid Digestion and Absorption
FIGURE 3.10 Digestion of dietary lipids
Copyright © 2019 Wolters Kluwer • All Rights Reserved
23
Protein Digestion and Absorption
• Pepsin initiates protein digestion in stomach
• Gastrin stimulates secretion of gastric hydrochloric acid
• Acidification of ingested food achieves five objectives
1. Activates pepsin
2. Kills pathogenic organisms
3. Improves absorption of iron and Ca++
4. Inactivates hormones of plant and animal origin
5. Denatures food proteins, making them more
vulnerable to enzyme action
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24
Protein Digestion and Absorption
Amino Acids in Liver
• One of three events occurs when AA reach liver
1. Converts to glucose (glucogenic AA)
2. Converts to fat (ketogenic AA)
3. Releases directly into the bloodstream as
plasma proteins or as free AA
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25
Vitamin Absorption
• Occurs mainly by the passive process of diffusion in
the jejunum and ileum
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26
Vitamin Absorption
• Lipids absorb fat-soluble vitamins
• Once absorbed, chylomicrons and lipoproteins transport
vitamins to the liver and fatty tissues
• Water-soluble vitamins diffuse into the blood except for
vitamin B12
– B12 combines with intrinsic factor from stomach and
absorbs it via endocytosis
• Water-soluble vitamins pass into urine when their
concentration exceeds renal capacity for reabsorption
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27
Mineral Absorption
• Fat-soluble vitamins absorbed with lipids
• Once absorbed, chylomicrons and lipoproteins
transport vitamins to liver and fatty tissues
• Water-soluble vitamins diffuse into blood, except for
vitamin B12
– B12 combines with intrinsic factor from stomach
and absorbs via endocytosis
• Water-soluble vitamins pass into urine when
concentration exceeds renal capacity for reabsorption
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28
Mineral Absorption
• Extrinsic (dietary) and intrinsic (cellular) factors control
mineral absorption
• Mineral availability in the body depends on chemical
form
• Excessive dietary fiber negatively impacts mineral
absorption
– Consuming recommended daily 30 to 40 grams of
fiber eliminates this concern
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29
Mineral Absorption
FIGURE 3.11 Absorption of minerals and their common excretion pathways
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30
Water Absorption
• Major absorption of ingested H2O and that contained in
foods occurs by the passive process of osmosis in the
small intestine
• Intestinal tract absorbs about ~9 liters of H2O daily
– 72% absorbed in proximal small intestine
– 20% absorbed from distal segment of small intestine
– 8% absorbed from large intestine
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31
Water Absorption
FIGURE 3.12 Estimated daily volumes of
water that enter the small and large
intestines of a sedentary adult and the
volumes absorbed by each component of
the intestinal tract
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32
PA Effects on Gastrointestinal Functions
• Alters blood flow dynamics
– Different modes, intensities, and durations of PA
acutely affect GI functions
o Mode
▪ Light-to-moderate intensity running results in
faster fluid GER than cycling
o Intensity
▪ Wide variability in GER at less than max
intensities impacted by PA type, training status,
timing of ingestion
o Duration
▪ No duration effects
Copyright © 2019 Wolters Kluwer • All Rights Reserved
33
Health Status, Emotional State, and GI
Tract Disorders
GI Disorders
• Constipation: delay in
stool movement
• Diarrhea: loose,
watery stools
• Diverticulosis: small
pouches that bulge
through tissue
FIGURE 3.13 Diverticulosis and diverticulitis.
Diverticula are pockets that develop in the colon
wall. These small pouches bulge outward through
weak spots in the colon wall
Copyright © 2019 Wolters Kluwer • All Rights Reserved
34
Health Status, Emotional State, and GI
Tract Disorders
GI Disorders
• Heartburn/reflux: sphincter between esophagus and
stomach involuntarily relaxes so stomach’s contents
flow back into esophagus
– Chronic heartburn develops into Gastroesophageal
Reflux Disease (GERD)
Copyright © 2019 Wolters Kluwer • All Rights Reserved
35
Health Status, Emotional State, and GI
Tract Disorders
GI Disorders
• Irritable Bowel Syndrome (IBS)
– Functional GI tract disorder devoid of structural,
biomechanical, radiologic, or laboratory
abnormalities
– Afflicts up to 20% of adults
– Two IBS forms:
o Diarrhea predominant
o Constipation predominant
Copyright © 2019 Wolters Kluwer • All Rights Reserved
36
Health Status, Emotional State, and GI
Tract Disorders
Irritable Bowel Syndrome (IBS)
•
Eight factors cause IBS
1. Increased GI motor reactivity to stress
2. Foods high in fat, insoluble fiber, caffeine, coffee,
carbonation, alcohol
3. Dysfunction of the CCK release system
4. Impaired bowel gas transit
5. Visceral hypersensitivity
6. Impaired reflex control
7. Autonomic dysfunction
8. Altered immune activation
Copyright © 2019 Wolters Kluwer • All Rights Reserved
37
Health Status, Emotional State, and GI
Tract Disorders
Irritable Bowel Syndrome (IBS)
• Four common IBS symptoms
1. Cramping abdominal pain relieved by defecation
2. Altered stool frequency
3. Altered stool form (mucous, watery, hard, or
loose) and passage (strain, urgency, or sense of
incomplete evacuation)
4. Abdominal distension following meals
Copyright © 2019 Wolters Kluwer • All Rights Reserved
38
Health Status, Emotional State, and GI
Tract Disorders
Irritable Bowel Syndrome (IBS)
• Four lifestyle and dietary modifications to counter
IBS
1. Stress reduction
2. Daily small meals
3. High-fiber diet
4. Avoiding foods with lactose and candy with
sorbitol
Copyright © 2019 Wolters Kluwer • All Rights Reserved
39
Health Status, Emotional State, and GI
Tract Disorders
GI Disorders
• Gas: Flatus (lower tract intestinal gas) composition
depends on nutrient intake and the colon’s bacterial
population
– CHO produce most gas; fats and proteins least
– In large intestine, bacteria degrades undigested
CHO to produce H+, CO2, and methane gas, which
exit through the rectum
Copyright © 2019 Wolters Kluwer • All Rights Reserved
40
Health Status, Emotional State, and GI
Tract Disorders
GI Disorders
• Functional Dyspepsia—chronic pain in upper
abdomen without physical cause
– Vague GI symptoms: stomach gnawing or burning,
epigastric pain, nausea, vomiting, belching,
bloating, indigestion, abdominal discomfort
– Three most common causes for dyspepsia
1. Peptic ulcer disease
2. GERD
3. Gastritis (stomach inflammation)
Copyright © 2019 Wolters Kluwer • All Rights Reserved
41
Physical Activity Effects on
Gastrointestinal Functions
• PA alters blood flow dynamics
– Depends on modes, intensities, and durations that acutely
impact GI functions
• Five factors affect gastric emptying rate (GER)
1. Volume: larger food volume increases GER
2. Kilocalorie: content—higher kilocalorie solutions decrease
GER
3. Osmolality: higher food osmolality decreases GER
4. Temperature: cooler foods increase GER
5. pH: higher acidic foods decrease GER
• GER also impacted by emotional state, caffeine, environmental
conditions, menstrual cycle stage, and fitness status
Copyright © 2019 Wolters Kluwer • All Rights Reserved
42

Purchase answer to see full
attachment

dis re

Jun 14, 2024 | Health Medical

Description

Based on your knowledge of healthcare contracts in Saudi Arabia, discuss the benefits of different parties contracting for healthcare in Saudi Arabia. Discuss the parties to a contract and how they are affected. Be sure to distinguish between employer, employee, and resident requirements.Be sure to support your statements with logic and argument, citing any sources referenced. Post your initial response early, and check back often to continue the discussion.

NR3001 Research process

Jun 14, 2024 | Health Medical

Description

Overview

In this Performance Task Assessment, you will create a reference list of terms and concepts relating to the elements of the research process.

As part of your responsibilities at work, you and your colleagues must be able to review and critique nursing research articles in order to apply them in practice. Nursing research, however, uses a very specific set of terms and concepts that can be challenging to differentiate. In an attempt to clarify and ensure understanding, you are creating a reference list of these terms that will help to keep the terminology straight. In the Assessment Template, you are asked to define each term in your own words, then provide an example of where or how this term is used in practice.

Instructions

To complete this Assessment, do the following:

Be sure to adhere to the indicated assignment length.
Access the NR3001 Assessment Template

Before submitting your Assessment, carefully review the rubric. This is the same rubric the SME will use to evaluate your submission and it provides detailed criteria describing how to achieve or master the Competency. Many students find that understanding the requirements of the Assessment and the rubric criteria help them direct their focus and use their time most productively.

Rubric

All submissions must follow the conventions of scholarly writing. Properly formatted APA citations and references must be provided where appropriate. Submissions that do not meet these expectations will be returned without scoring.

This Assessment requires submission of one (1) document, a completed Assessment Template. Save this file as NR3001_firstinitial_lastname (for example, NR3001_J_Smith).

You may submit a draft of your assignment to the Turnitin Draft Check area to check for authenticity. When you are ready to upload your completed Assessment, use the Assessment tab on the top navigation menu.

Important Note: As a student taking this Competency, you agree that you may be required to submit your Assessment for textual similarity review to Turnitin.com for the detection of plagiarism. All submitted Assessment materials will be included as source documents in the Turnitin.com reference database solely for the purpose of detecting plagiarism of such materials. Use of the Turnitin.com service is subject to the Usage Policy posted on the Turnitin.com site.

Case study

Jun 14, 2024 | Health Medical

Description

COMPLEX CASE STUDY PRESENTATION

In Weeks 4, 7, and 9 of the course, you will participate in clinical discussions called grand rounds. In one of these three weeks, you will be a presenter as well as help facilitate the online discussion; in the others you will be an active discussion participant. When it is your week to present, you will create a Focused SOAP note and a short didactic (teaching) video presenting a real (but de-identified) complex patient case from your practicum experience.

You should have received an assignment from your Instructor letting you know which week of the course you are assigned to present.

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. Also review the Kaltura Media Uploader resource in the left-hand navigation of the classroom for help creating your self-recorded Kaltura video.
Select a child/adolescent or adult patient from your clinical experience that presents with a significant concern. Create a focused SOAP note for this patient using the template in the Resources. All SOAP notes must be signed by your Preceptor. When you submit your SOAP note, you should include the complete SOAP note as a Word document and PDF/images of completed assignment signed by your Preceptor. You must submit your SOAP Note 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.
Then, based on your SOAP note of this patient, develop a video case study presentation. Take time to practice what you will say beforehand, and ensure that you have the appropriate lighting and equipment to record the presentation.
Your presentation should include objectives for your audience, at least 3 possible discussion questions/prompts for your classmates to respond to, and at least 5 scholarly resources to support your diagnostic reasoning and treatment plan.

Video assignment for this week’s presenters:

Record yourself presenting the complex case study for your clinical patient. 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).
State 3–4 objectives for the presentation that are targeted, clear, use appropriate verbs from Bloom’s taxonomy, and address what the audience will know or be able to do after viewing.
Present the full complex case study. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; and plan for treatment and management.
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.
Pose three questions or discussion prompts, based on your presentation, that your colleagues can respond to after viewing your video.
Be succinct in your presentation, and do not exceed 8 minutes. Specifically address the following for the patient, using your SOAP note as a guide.
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 their mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis, and why? Describe how your primary diagnosis aligns with DSM-5-TR diagnostic criteria and is supported by the patient’s symptoms.
Plan: What was your plan for psychotherapy (include one health promotion activity and patient education)? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Discuss an identified social determinate of health impacting this patient’s mental health status and provide your recommendation for a referral to assist this patient in meeting this identified need (students will need to conduct research on this topic both in the literature and for community resources).
Reflection notes: What would you do differently with this patient if you could conduct the session again? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow-up, discuss what your next intervention would be.

A note on grading:

Presenters: Review the Grand Rounds Presenter Rubric attached to this discussion to ensure you meet the scoring criteria.
Participants: Review the Grand Rounds Participant Rubric located on the following Week 4 Assignment 1 page to ensure you meet the scoring criteria. Note the Week 4 Assignment 1 page is for viewing the participant rubric only. Your response should be posted in the forum of this page.
WEEK 4 PRESENTERS:
BY DAY 3

Post your video and your focused SOAP note to the Grand Rounds Discussion forum. You must submit two files for the SOAP note, including a Word document and scanned PDF/images of completed assignment signed by your Preceptor. Then, actively respond to and guide the conversation as your colleagues post responses to your video.

WEEK 4 PARTICIPANTS:
BY MULTIPLE DAYS BETWEEN DAYS 4 AND 7

Respond at least 2 times each to all colleagues who presented this week (should be 2-3 presenters each week). The goal is for the discussion forum to function as robust clinical conferences on the patients. Provide a response to 1 of the 3 discussion prompts that your colleagues provided in their video presentations. You may also provide additional information, alternative points of view, research to support treatment, or patient education strategies you might use with the relevant patient

Academic Poster & Presentation-PICO Question

Jun 14, 2024 | Health Medical

Description

The purpose of this assignment is to provide the student the opportunity demonstrate competency in performing the role of the psychiatric mental health nurse practitioner in a safe environment.

PICO Question “How have the dynamics of fentanyl use correlated with fentanyl-related deaths changed in children (aged zero to eighteen years) compared to adults (aged nineteen and above years) in the last three years?”

Submission Instructions:

To complete this assignment, address the following criteria:

Posters should include the following content:
A Project title. This should be placed towards the top of the poster, including the names of the authors and university affiliation
An Introduction section. This should highlight the problem addressed in a brief literature review with citations and your hypothesis or hypotheses.
The Purpose section: The poster states the objectives of this inquiry relative to the overall evidence-based literature review on this topic.
The Methods/Search Strategy section. An overview of how you studied your primary source(s): Describes the evidence-based solution. How was it developed? Include the theoretical framework (if applicable). Identify databases searched and inclusion/exclusion criteria.
The Results The poster describes the search, the number of studies included, and the level of evidence.
The Synthesis of Evidence The poster briefly describes the synthesis of the evidence that includes major trends and notable gaps.
The Implications for Practice section. The poster includes recommendations for practice, education, or future research based on the review and synthesis of the evidence.
A References section. Make sure your references include at least four references with three primary research articles. Primary articles describe studies in which the authors collected the data themselves. References must be in APA format. If you cannot fit four or more references into your poster, you should provide the references separately as an attached Word document. For assistance with APA formatting, please contact BrainFuse Online link in Canvas or visit the STU library at https://www.stu.edu/library/Links to an external site.

Academic Poster Format

Present your poster in electronic formatLinks to an external site.. Use the linked video as a guide for your assignment.
Students may use PowerPoint Poster template.
Video for creating poster

Grading Rubric

Your assignment will be graded according to the grading rubric.

NUR 670 Poster Presentation Rubric
Criteria Ratings
Points
Project Title Exemplary – 4-5 points
Thoroughly, accurately, and clearly reflect the content of the presentation. Distinguished – 2-3 points
Reflects content very well but not thoroughly. Novice – 0-1 points
Does not reflect content of the presentation. 5 points
Introduction: The abstract states the objectives of this inquiry relative to the overall evidence-based literature review on this topic Exemplary – 4-5 points
Identifies a creative, focused, and manageable topic that addresses potentially significant and previously less explored aspects of the topic, problem, and/or project. Distinguished – 2-3 points
Project and/or research question moderately described. Moderately clear rationale. Purpose was somewhat focused and clear. Novice – 0-1 points
Vaguely described project and/or research question. Weak rationale. Purpose was poorly focused and not sufficiently clear. 5 points
Purpose: States the purpose of the study and why it is important to practice and/or patient care Exemplary – 4-5 points
Background information is engaging and leads to a clear purpose statement. Relevance to advanced practice nursing and the field of psychiatry is articulated well. Distinguished – 2-3 points
Background information is at times unclear or uninteresting. Relevance to advanced practice nursing or psychiatry could be more clearly articulated. Novice – 0-1 points
Background information is illogical or unrelated to the topic. There is no relevance to advanced practice nursing or the field of psychiatry. 5 points
Search Strategy: The poster identifies databases searched, inclusion/exclusion criteria, number of studies included and level of evidence. Exemplary – 7-10 points
Methods are appropriate to address aim/question and connected to the purpose of the research; Identifies method used to support thesis or answer the research question. Distinguished – 3-6 points
Methods are inappropriate to address research aim or question. Methods are unclear or not connected to purpose of research Novice – 0-2 points
Research strategy was not clearly mentioned but implied; or, not appropriate for purpose of the research. 10 points
Synthesis of Evidence: The poster briefly describes the synthesis of the evidence that includes major trends and notable gaps in the research. Exemplary – 14-20 points
Thorough comparison and contrast of findings are provided and relate to the main discussion points in the order of their appearance in the purpose statement. Focus is on research findings rather than research methods. Study limitations that might have led to different findings are discussed. Gaps and controversies that exist in the literature are clearly discussed. Distinguished – 7-13 points
Comparison and contrast of findings are provided but lack thoroughness. Discussion of findings could relate better to the main discussion points in the purpose statement. Study limitations are discussed, but possible connections to differences in findings are not clearly identified. Gaps and controversies in the literature are discussed, but clarity could be enhanced. Novice – 0-6 points
Comparison and contrast of findings are lacking. Discussion of findings does not relate well to the main discussion points in the purpose statement. Study limitations are not mentioned. Gaps (what is unknown and needs to be researched) and controversies that exist in the literature are not discussed. 20 points
Implications for Practice: Does the poster present significance to psychiatry and is it relevant to the advanced practice nurse role? Does it include recommendations for practice, education, or future research based on the review and synthesis of the evidence? Exemplary – 7-10 points
Thorough comparison and contrast of findings are provided and relate to the main discussion points in the order of their appearance in the purpose statement. Focus is on research findings rather than research methods. Distinguished – 3-6 points
Comparison and contrast of findings are provided but lack thoroughness. Discussion of findings could relate better to the main discussion points in the purpose statement. Study limitations are discussed, but possible connections to differences in findings are not clearly identified. Gaps and controversies in the literature are discussed, but clarity could be enhanced. Novice – 0-2 points
Comparison and contrast of findings are lacking. Discussion of findings does not relate well to the main discussion points in the purpose statement. Study limitations are not mentioned. Gaps (what is unknown and needs to be researched) and controversies that exist in the literature are not discussed. 10 points
Writing and Scholarly Voice: Identifies a creative, focused, and manageable
topic that addresses potentially significant and
previously less explored aspects of the topic,
problem, and/or project Exemplary – 4-5 points
Writing is fluid, precise, and clear; lexicon of the field is clearly explained and defined; the tone is professional; vocabulary and syntax are mature; scholarly style and format are accurately used; the candidate’s ‘voice’ is heard and yields a definitive presence, authority, and understanding of the issues being discussed. Distinguished – 2-3 points
Writing is somewhat developed and professional; spelling, punctuation, grammar, in general, meet program and institutional standards; dissertation formatting is adequate; the lexicon of the respective field is understood and used properly. Novice – 0-1 points
More work developing academic writing skills necessary; syntax or vocabulary may not be well developed; a reliance on jargon may be a weakness, writing may be difficult to read or understand; tone may not exhibit an understanding of the academic writing genre; errors of spelling, punctuation or formatting may be present; document may have formatting problems, the candidate may not have a command of the field’s lexicon. 5 points
Oral Presentation: The abstract is concise and coherent. Exemplary – 13-20 points
Narration and/or answering of questions is engaging, thorough, and adds greatly to the presentation. Presentation is well-rehearsed. Voice, eye contact and pacing hold interest and attention of the audience; introduced self and project. Distinguished – 4-12 points
Narration and/or answering of questions is somewhat lacking. Audio-Video presentation does not support the content of the presentation. Some difficulty communicating ideas. Poor voice projections; some eye contact; no introduction; mispronounced a few words; long pauses; appears somewhat confused. Novice – 0-3 points
Narration and/or answering of questions is lacking, Audio-Video presentation was not submitted or the video was not created using the audio or video platform required in the instructions. Great difficulty communicating ideas. Poor voice projection; no eye contact; no introduction; mispronounced words; stopped or had long pauses; read entirely from notes. 20 points
Overall Appearance: The abstract presents significance to psychiatry and is it relevant to the advanced practice nurse role? Exemplary – 7-10 points
Prominently positions title/authors of paper thoroughly but concisely presents main points of introduction, hypotheses/ propositions, research methods, results, and conclusions in a well-organized manner. Overall visually appealing; not cluttered; colors and patterns enhance readability; Uses font sizes/variations which facilitate the organization, presentation, and readability of the research Graphics (e.g., tables, figures, etc.) are engaging and enhance the text content is clearly arranged so that the viewer can understand order without narration. Distinguished – 3-6 points
Visual appeal is adequate; somewhat cluttered; colors and patterns detract from readability Use of font sizes/variations to facilitate the organization, presentation, and readability of the research is somewhat inconsistent/distractions Graphics (e.g., tables, figures, etc.) adequately enhance the text Content arrangement is somewhat confusing and does not adequately assist the viewer in understanding order without narration. Novice – 0-2 points
Not very visually appealing; cluttered; colors and patterns hinder readability Use of font sizes/variations to facilitate the organization, presentation, and readability of the research is inconsistent/distracting Graphics (e.g., tables, figures, etc.) do not enhance the text Content arrangement is somewhat confusing and does not adequately assist the viewer in understanding order without narration. 10 points
APA Formatting: The poster, including all citations, level headings and the references, and follows the 7th Edition APA format. Exemplary – 7-10 points
Follows APA guidelines of components: double space, 12 pt. font, abstract, level headings, hanging indent and in-text citations. The references contain at least the 6-8 required current scholarly academic reference and text reference. Distinguished – 3-6 points
References page contains one current or outdated scholarly academic resource. Many errors of APA 7th guidelines: double space, 12 pt. font, abstract, level headings, hanging indent, and in-text citations. Novice – 0-2 points
References page contains no current scholarly academic resources, only internet webpages or no reference page. Lack of APA guidelines for references provided or in-text citations. 10 points
Total Points
100

Attached are word docs from previous discussions in course based on PICO question. I just cut and pasted it. The comments in yellow are the corrections the professor suggests. Please let me know if you have any questions. I will need to put a pic on poster, according to video. But I guess you will send me poster which is editable and I will be able to add that on my own?double space, 12 pt. font, abstract, level headings, hanging indent and in-text citations. The references contain at least the 6-8 required current scholarly academic reference and text reference.

NUR 670 Poster Presentation Rubric

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeProject Title

5 to >3.0 pts

Exemplary

Thoroughly, accurately, and clearly reflect the content of the presentation.

3 to >1.0 pts

Distinguished

Reflects content very well but not thoroughly.

1 to >0 pts

Novice

Does not reflect content of the presentation.

5 pts

This criterion is linked to a Learning OutcomeIntroduction:The abstract states the objectives of this inquiry relative to the overall evidence-based literature review on this topic

5 to >3.0 pts

Exemplary

Identifies a creative, focused, and manageable topic that addresses potentially significant and previously less explored aspects of the topic, problem, and/or project

3 to >1.0 pts

Distinguished

Project and/or research question moderately described. Moderately clear rationale. Purpose was somewhat focused and clear.

1 to >0 pts

Novice

Vaguely described project and/or research question. Weak rationale. Purpose was poorly focused and not sufficiently clear.

5 pts

This criterion is linked to a Learning OutcomePurpose:States the purpose of the study and why it is important to practice and/or patient care

5 to >3.0 pts

Exemplary

Background information is engaging and leads to a clear purpose statement. Relevance to advanced practice nursing and the field of psychiatry is articulated well.

3 to >1.0 pts

Distinguished

Background information is at times unclear or uninteresting. Relevance to advanced practice nursing or psychiatry could be more clearly articulated.

1 to >0 pts

Novice

Background information is illogical or unrelated to the topic. There is no relevance to advanced practice nursing or the field of psychiatry.

5 pts

This criterion is linked to a Learning OutcomeSearch StrategyThe poster identifies databases searched, inclusion/exclusion criteria, number of studies included and level of evidence.

10 to >6.0 pts

Exemplary

Methods are appropriate to address aim/question and connected to the purpose of the research; Identifies method used to support thesis or answer the research question.

6 to >2.0 pts

Distinguished

Methods are inappropriate to address research aim or question. Methods are unclear or not connected to purpose of research

2 to >0 pts

Novice

Research strategy was not clearly mentioned but implied; or, not appropriate for purpose of the research

10 pts

This criterion is linked to a Learning OutcomeSynthesis of Evidence:The poster briefly describes the synthesis of the evidence that includes major trends and notable gaps in the research.

20 to >13.0 pts

Exemplary

Thorough comparison and contrast of findings are provided and relate to the main discussion points in the order of their appearance in the purpose statement. Focus is on research findings rather than research methods. Study limitations that might have led to different findings are discussed. Gaps and controversies that exist in the literature are clearly discussed.

13 to >6.0 pts

Distinguished

Comparison and contrast of findings are provided but lack thoroughness. Discussion of findings could relate better to the main discussion points in the purpose statement. Study limitations are discussed, but possible connections to differences in findings are not clearly identified. Gaps and controversies in the literature are discussed, but clarity could be enhanced.

6 to >0 pts

Novice

Comparison and contrast of findings are lacking. Discussion of findings does not relate well to the main discussion points in the purpose statement. Study limitations are not mentioned. Gaps (what is unknown and needs to be researched) and controversies that exist in the literature are not discussed.

20 pts

This criterion is linked to a Learning OutcomeImplications for Practice:Does the poster present significance to psychiatry and is it relevant to the advanced practice nurse role? Does it include recommendations for practice, education, or future research based on the review and synthesis of the evidence?

10 to >6.0 pts

Exemplary

Thorough comparison and contrast of findings are provided and relate to the main discussion points in the order of their appearance in the purpose statement.  Focus is on research findings rather than research methods.

6 to >2.0 pts

Distinguished

2 to >0 pts

Novice

10 pts

This criterion is linked to a Learning OutcomeWriting and Scholarly Voice:Identifies a creative, focused, and manageable
topic that addresses potentially significant and
previously less explored aspects of the topic,
problem, and/or project

5 to >3.0 pts

Exemplary

Writing is fluid, precise, and clear; lexicon of the field is clearly explained and defined; the tone is professional; vocabulary and syntax are mature; scholarly style and format are accurately used; the candidate’s ‘voice’ is heard and yields a definitive presence, authority, and understanding of the issues being discussed.

3 to >1.0 pts

Distinguished

Writing is somewhat developed and professional; spelling, punctuation, grammar, in general, meet program and institutional standards; dissertation formatting is adequate; the lexicon of the respective field is understood and used properly.

1 to >0 pts

Novice

More work developing academic writing skills necessary; syntax or vocabulary may not be well developed; a reliance on jargon may be a weakness, writing may be difficult to read or understand; tone may not exhibit an understanding of the academic writing genre; errors of spelling, punctuation or formatting may be present; document may have formatting problems, the candidate may not have a command of the field’s lexicon.

5 pts

This criterion is linked to a Learning OutcomeOral PresentationThe abstract is concise and coherent.

20 to >12.0 pts

Exemplary

Narration and/or answering of questions is engaging, thorough, and adds greatly to the presentation. Presentation is well-rehearsed. Voice, eye contact and pacing hold interest and attention of the audience; introduced self and project.

12 to >3.0 pts

Distinguished

Narration and/or answering of questions is somewhat lacking. Audio-Video presentation does not support the content of the presentation. Some difficulty communicating ideas. Poor voice projections; some eye contact; no introduction; mispronounced a few words; long pauses; appears somewhat confused.

3 to >0 pts

Novice

Narration and/or answering of questions is lacking, Audio-Video presentation was not submitted or the video was not created using the audio or video platform required in the instructions. Great difficulty communicating ideas. Poor voice projection; no eye contact; no introduction; mispronounced words; stopped or had long pauses; read entirely from notes

20 pts

This criterion is linked to a Learning OutcomeOverall AppearanceThe abstract presents significance to psychiatry and is it relevant to the advanced practice nurse role?

10 to >6.0 pts

Exemplary

Prominently positions title/authors of paper thoroughly but concisely presents main points of introduction, hypotheses/ propositions, research methods, results, and conclusions in a well-organized manner. Overall visually appealing; not cluttered; colors and patterns enhance readability; Uses font sizes/variations which facilitate the organization, presentation, and readability of the research Graphics (e.g., tables, figures, etc.) are engaging and enhance the text content is clearly arranged so that the viewer can understand order without narration

6 to >2.0 pts

Distinguished

Visual appeal is adequate; somewhat cluttered; colors and patterns detract from readability Use of font sizes/variations to facilitate the organization, presentation, and readability of the research is somewhat inconsistent/distractions Graphics (e.g., tables, figures, etc.) adequately enhance the text Content arrangement is somewhat confusing and does not adequately assist the viewer in understanding order without narration

2 to >0 pts

Novice

Not very visually appealing; cluttered; colors and patterns hinder readability Use of font sizes/variations to facilitate the organization, presentation, and readability of the research is inconsistent/distracting Graphics (e.g., tables, figures, etc.) do not enhance the text Content arrangement is somewhat confusing and does not adequately assist the viewer in understanding order without narration

10 pts

This criterion is linked to a Learning OutcomeAPA FormattingThe poster, including all citations, level headings and the references, and follows the 7th Edition APA format.

10 to >6.0 pts

Exemplary

Follows APA guidelines of components: double space, 12 pt. font, abstract, level headings, hanging indent and in-text citations. The references contain at least the 6-8 required current scholarly academic reference and text reference.

6 to >2.0 pts

Distinguished

References page contains one current or outdated scholarly academic resource. Many errors of APA 7th guidelines: double space, 12 pt. font, abstract, level headings, hanging indent, and in-text citations

2 to >0 pts

Novice

References page contains no current scholarly academic resources, only internet webpages or no reference page. Lack of APA guidelines for references provided or in-text citations.

10 pts

Total Points: 100

Unformatted Attachment Preview

Creating a Search Strategy (PICO Question)
not graded yet
Rosalind Lopez
St Thomas University
NUR 670: Psychiatric Integration Practicum
Dr Linda Mays
September 14, 2023
The Importance of an Effective Search Strategy
Search strategies are crucial in determining the quality, authenticity, and credibility of the
literature review undertaken. An effective search strategy involves searching for materials from
reliable sources relevant to the study topic. An efficient search strategy, which focuses on
reviewing existing literature, helps retrieve the right articles from a database, which is crucial in
answering the study question (Walden University, 2023). A search strategy helps outline the
parameters and dimensions of the study, such as the population sample to be used, the sampling
methods, the study design, the methodology, and the methods of analysis. It is also helpful in
filtering the research materials to be used by eliminating older materials that are no longer
relevant to the study topic (Walden University, 2023). An efficient and well-executed review can
thoroughly answer research questions and establish a solid platform for advancing knowledge
(Snyder, 2019). My PICO question seeks to address “How have the dynamics of fentanyl use
correlated with fentanyl-related deaths changed in children (aged zero to eighteen years)
compared to adults (aged nineteen and above years) in the last three years?” My search was
limited to research articles not older than three years, as the question addressed Fentanyl use
dynamics in the US among both adults and children within the last three years. This discussion
emphasizes the importance of an effective search strategy when conducting a literature review,
compares the reliability of evidence-based research using an evidence pyramid, and provides
detail on the search strategy used to conduct the literature review for my PICO question.
Reliability of Evidence-Based Research
The evidence pyramid has seven levels, which visualize the different types of research
evidences based on the quality and amount of evidence presented in a study. The various levels
are presented in a pyramid, with the top having the highest quality of evidence for the study
topic. In contrast, the bottom of the pyramid presents the least reliable evidence (Walden
University, 2023). The different types of pieces of evidence, from the top of the pyramid to the
bottom, include systematic reviews, critically appraised topics, article synopses (critically
appraised individual researches), randomized controlled trials, cohort studies, case series/casecontrolled studies, and lastly, background information, also known as expert opinions.
Systematic reviews provide the highest quality of evidence as they target a specific clinical
question and comprehensively review it (Walden University, 2023). Critically appraised topics
and critically appraised individual articles, which are below systematic reviews, also provide
quality literature reviews on specific topics. However, in literature reviews, randomized
controlled trials, cohort studies, and case series are less reliable as they contain unfiltered
information. Therefore, their reliability is limited. Background information, also known as expert
opinions, is at the bottom of the pyramid and is the least reliable since the information may not
be based on research.
Search Strategy
My PICO question revolves around establishing the correlation between fentanyl use and
fentanyl-related deaths in children compared to adults. An in-depth research was necessary to
establish the evidence related to this question. The first phase entailed choosing databases that
provided research-based evidence relevant to the PICO question. I used Google Scholar, Pub
Med, and Jstor, three online libraries, and databases for peer-reviewed articles. Using a
combination of the key terms, a preliminary search was carried out. The PICO question served as
the basis for the development of keywords and phrases. To ensure a thorough search, synonyms
and phrases that were closely similar were also used. I combined Boolean operators with key
words and used inclusion and exclusion criteria to narrow search. Articles that were not peer
reviewed or outside of the United States were excluded. Only articles within the last three years
were included. Each study that met the above criteria were subject to a full review. At first, I
aimed to find systematic reviews, critically appraised topics, and critically appraised individual
articles on the PICO question. However, such materials are limited, and I could barely find any
related to the topic. I managed to find some critically appraised individual articles on the topic.
One such article was by D’Orsogna et al. (2023), which discusses the role of fentanyl in
accelerating deaths in the US across different genders, races, and other demographics. I then
sought randomized controlled trials and cohort studies, which I found numerous. Such studies
include Warren et al.’s (2023) study, which reviews data on opioid misuse among US youths
aged 12 to 21. Another helpful study was by Arredondo (2023), a report in the Los Angeles
Times focusing on fentanyl-related deaths among youths. A study by Friedman et al. (2023) was
found relevant to the study question as it reviews the trends in deaths due to drug overdose
among US youths. Another study by Gaither (2023), shows the trend of pediatric deaths from
fentanyl, with more than a 30-fold increase in fentanyl-related deaths occurring between 2013
and 2021. Despite the many research articles found through research, the search criteria were
narrowed down by eliminating materials with information from the last three years.
References
Arredondo, V. (2023). “No child should be dying”: Fentanyl-related deaths among kids rising, Yale
study says. Los Angeles Times. https://www.latimes.com/world-nation/story/2023-0511/fentanyl-deaths-children-teens-opioids-yale-school-of-medicine-study-jama-juliegaitherLinks to an external site.
D’Orsogna, M.R. (2023). Fentanyl-driven acceleration of racial, gender, and geographical disparities
in drug overdose deaths in the United States. PLOS Glob Public
Health, 3(3). https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.00007
69Links to an external site.
Friedman, J., Godvin, M., Shover, C., Gone, J., Hansen, H., & Schriger, D. (2022). Trends in Drug
overdose deaths among US adolescents, January 2010 to June 2021. JAMA Network, 327(14),
pp. 1398-1400. https://doi.org/10.1001/jama.2022.2847
Gaither, J. (2023). National Trends in Pediatric Deaths From Fentanyl, 1999-2021. JAMA Pediatr.
2023 Jul 1, 177(7), pp.733-735.
https://doi.org/10.1001/jamapediatrics.2023.0793.
Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal
of Business Research, 104, pp.333-339. https://doi.org/10.1016/j.jbusres.2019.07.039.
Walden University. (2023). Evidence-based research: Levels of evidence
pyramid. https://academicguides.waldenu.edu/library/healthevidence/evidencepyramidLinks to
an external site.
Warren, K.L, Adams, J., & Bobashev, G. (2023). Trends in opioid misuse among individuals aged 12
to 21 years in the US. JAMA Netw Open. 6(6).
https://doi.org/10.1001/jamanetworkopen.2023.16276
The Purpose of the PICO Question
You must fine-tune your PICO question, it is not structured correctly. You will not earn the highest score on the
academic poster if this is not revised.
You must use scholarly references only. Please visit Brainfuse for more information.
Rosalind Lopez
St Thomas University
NUR 670: Psychiatric Integration Practicum
Dr Linda Mays
August 31, 2023
The Purpose of the PICO Question
The PICO question refers to a structured scientific approach used for framing and
formulating a research question. It is a mnemonic that assists clinicians in developing a
foreground question in an evidence-based practice. PICO stands for Population/Problem,
Intervention, Comparison, and Outcome (NYU, 2023). The population defines the group or issue
under the study, including demographics and characteristics of individuals. The intervention
component outlines various diagnostic tests and treatments used in addressing the problem being
investigated. The comparison element of the PICO question contrasts the selected intervention to
another approach (NYU, 2023). On the other hand, the outcome states the dependent variable,
including the desired result of the research.
Purpose
The primary aim of the PICO question is to investigate and provide an answer to a serious
clinical issue. According to Ford and Melnyk (2019), PICO is a searching strategy that leads to
unbiased evidence. Ideally, evidence-based research focuses only on relevant studies to uncover
the answer to the clinical question. This implies that the PICO question offers an effective
literature search involving keywords and inclusion criteria. It also enables the research to focus
on a specific clinician issue and outcome (Eriksen & Frandsen, 2018). Notably, the PICO
question entails a narrow scope of investigation, which enhances focus and clarity. Another
purpose of this strategy is that it allows the researcher to identify specific care for the patient
(Eriksen & Frandsen, 2018). This is because the PICO question facilitates evidence appraisal
through comparison with other treatments. In addition, the framework promotes collaboration
among clinicians and patient-centered care since it supports evidence-based practice.
Selected PICO Question
The PICO question chosen for this week focuses on the impact of fentanyl use on children
compared with adults. It states, “How have the dynamics of fentanyl use correlated with fentanyl
related deaths changed in children (aged zero to eighteen years) compared to adults (aged
nineteen and above years) in the last three years?” Deaths related to fentanyl use have increased
among children under 18 years in the recent past. According to Jenco (2023), fentanyl deaths in
children in the United States reached 94 percent in 2021. Significantly, teenagers between 15 and
19 years were disproportionately affected by the problem. As such, fentanyl use is a serious
clinical issue that warrants investigation.
The PICO question helps in identifying individuals and groups affected by fentanyl use. In
this case, the population under interrogation is children between zero and eighteen years. The
intervention in the question involves observing the changes in fentanyl deaths over the last three
years. Research shows a significant rise in opioid and fentanyl deaths among children between
2020 and 2022 due to the Covid-19 pandemic (Jenco, 2023). The PICO question also provides a
comparison between the changes in fentanyl deaths in children and adults. Spencer et al. (2022)
indicate that deaths from drug overdose were 62 per 100,000 population among individuals
within 35-44 years in 2021. This shows the outcome of the research issue under investigation. It
demonstrates that there is a general increase in fentanyl deaths in children and adults. In this
case, the PICO question provides a structured strategy for obtaining evidence regarding fentanyl
use and deaths among children versus adults. The systematic approach ensures clarity in how the
clinical problem is addressed.
References
Eriksen, M. B. & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome
(PICO) as a search strategy tool on literature search quality: a systematic review. Journal of the
Medical Library Association, 106(4), 420–431. https://doi.org/10.5195/jmla.2018.345
Ford, L. G. & Melnyk, B. M. (2019). The underappreciated and misunderstood PICOT question: A
critical step in the EBP process. Worldviews on Evidence-Based Nursing, 16(6), 422-423.
https://doi.org/10.1111/wvn.12408
Jenco, M. (2023). Study: Fentanyl involved in 94% of pediatric opioid deaths in 2021. American
Academy of Pediatrics, https://publications.aap.org/aapnews/news/24370/Study-Fentanylinvolved-in-94-of-pediatric-opioid?autologincheck=redirected
NYU. (2023). Capstone and PICO project toolkit. https://guides.nyu.edu/pico/question
Spencer, M. R., Miniño, A. M., & Warner, M. (2022). Drug overdose deaths in the United States,
2001–2021. NCHS Data brief, 457, 1-8.
https://www.cdc.gov/nchs/products/databriefs/db457.html
Psychiatry Issues in the United States Public Health Domain: Fentanyl-Related Deaths
PICO Question and Emerging Psychiatric Problem
Rosalind Lopez
St Thomas University
NUR 670: Psychiatric Integration Practicum
Dr Linda Mays
August 24, 2023
Real-world current problem in US psychiatric care
Treatment-resistant depression is a major real-world issue currently emerging in the US
psychiatric care system. According to Weissman et al. (2023), treatment-resistant depression is a
form of depression where standard pharmacotherapy and psychotherapy do not work to ease the
patient’s symptoms, requiring them to seek alternative therapies or modify medical dosages. The
issue of treatment-resistant depression is cross-cutting, affecting the psychological and
sociological dynamics of the patients’ lives. As it continues to become a formidable issue in the
United States psychiatric system, it cross-cuts the various areas through which it can be
addressed. As indicated by Schreiber et al. (2023), there is a strong significant association
between the emergence of high opioid use, including fentanyl use, among adolescents and adults
in America and the growing incidence of treatment-resistant depression among the same
population. Thus, the changes in the incidence of fentanyl use, and depression, in turn, may be
interconnected as important facets of nursing and psychiatric care practice in the United States.
Yet, this interconnection and the specific issues remain underexplored, despite their importance
in shaping the trajectory of healthcare in the United States in recent years.
PICO Question
The PICO question, “How have the dynamics of fentanyl use correlated with fentanyl
related deaths changed in children (aged zero to eighteen years) compared to adults (aged
nineteen and above years) in the last three years?, ” is an important area of interest for advanced
practice nursing. P (Population): Children aged zero to eighteen years, I (Intervention):
Dynamics of fentanyl use, C (Comparison): Comparison of children (aged zero to eighteen
years) to adults (aged nineteen and above years), O (Outcome): Pattern of fentanyl-related deaths
in the last three years.
Importance of the selected PICO question
According to Opsahl et al. (2020), patient-based care is the premise of any professional
healthcare practice, including nursing. As such, the focus of the selected PICO question on
specific patient groups is imperative to this. For instance, the focus on the impact of fentanyl
deaths on children is an interesting area of nursing practice. Similarly, fentanyl is a commonly
used and abused opioid among adolescents and adults and a leading cause of depression among
abusers (Nguyen et al., 2020; Oliva et al., 2020). Due to the severity of its impact on dopamine
levels and other chemicals in the brain, fentanyl is believed to exacerbate or contribute to
depression. During active addiction and during withdrawal, depression symptoms can be caused
by fentanyl. Due to this, the focus of the question on children and adults alike introduces a new
dynamic to understanding how mortalities and depression related to fentanyl use can be
mitigated. Moreover, this question influences evidence-based practice in nursing. Advanced
nursing practice emphasizes utilizing the latest medical research in decision-making related to
patient care (Opsahl et al., 2020). As such, addressing this PICO question will inform the
creation of a body of evidence that focuses on the possible protocols and interventions that can
be utilized to reduce mortalities related to fentanyl in adults and children.
Overall, this PICO question is of significant public health impact. According to Nguyen et
al. (2020), fentanyl related deaths are a major concern in the American public health domain.
Research informed by this question will be crucial in forming reference points for health
campaigns, workshops, and educational conferences on preventing fentanyl deaths among all
people across the United States. Further, this question is important in resolving the emerging
public health issue of drug-resistant depression as a public health concern in America since the
pandemic. Fentanyl is a widely used narcotic in the hospital environment. However, with recent
concerns about opiate overdose and toxicity, all healthcare providers should be familiar with the
drug’s adverse effects and how to reverse them (Ramos-Matos et al., 2023). Ultimately, the PICO
question is a reference point for nurses in advanced practice to improve their patient care
outcomes and public health initiatives significantly. Further, this question is imperative in
improving healthcare quality across healthcare centers in the United States.
References
Nguyen, A. P., Glanz, J. M., Narwaney, K. J. & Binswanger, I. A. (2020). Association of opioids
prescribed to family members with opioid overdose among adolescents and young adults. JAMA
Network Open, 3(3), e201018e201018. https://doi.org/10.1001/jamanetworkopen.2020.1018Links to an external site.
Oliva, E. M., Bowe, T., Manhapra, A., Kertesz, S., Hah, J. M., Henderson, P. & Trafton, J. A. (2020).
Associations between stopping prescriptions for opioids, length of opioid treatment, and
overdose or suicide deaths in US veterans: observational
evaluation. BMJ, 368. https://doi.org/10.1136/bmj.m283Links to an external site.
Opsahl, A., Nelson, T., Madeira, J. & Wonder, A. H. (2020). Evidence‐based, ethical decision‐
making: using simulation to teach the application of evidence and ethics in practice. Worldviews
on Evidence‐Based Nursing, 17(6), 412-417. https://doi.org/10.1111/wvn.12465Links to an
external site.
Ramos-Matos, C., Bistas, K. & Lopez-Ojeda, W. (2023). Fentanyl. In: StatPearls [Internet]. Treasure
Island (FL): StatPearls Publishing; 2023 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK459275/
Schreiber, S., Keidan, L. & Pick, C. G. (2023). Treatment-Resistant Depression (TRD): Is the Opioid
System Involved?. International Journal of Molecular Sciences, 24(13),
11142. https://doi.org/10.3390/ijms241311142Links to an external site.
Weissman, C. R., Bermudes, R. A., Voigt, J., Liston, C., Williams, N., Blumberger, D. M., … &
Daskalakis, Z. J. (2023). Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant
Depression: Mismatch of Evidence and Insurance Coverage Policies in the United States. The
Journal of Clinical Psychiatry, 84(3), 46813. https://doi.org/10.4088/JCP.22com14575Links to
an external site.

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attachment

History Case Study

Jun 14, 2024 | Health Medical

Description

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: The American System, Transportation, and Communication
Read the following primary source:

In Defense of the American System, 1832Links to an external site.

Then, address the following:

Describe the idea of Henry Clay’s “American System.”
Based on Clay’s economic vision of America, analyze how the American System would build the American market and economy?
Analyze the role of mechanization and communication in the American System.

Option 2: The Indian Removal Act of 1830
Read the following primary source:

Transcript of President Andrew Jackson’s Message to Congress ‘On Indian Removal’ (1830)Links to an external site.

Then, address the following:

Evaluate the rationale that President Jackson used in the removal of the Native Americans from east of the Mississippi River. Did the removal have the intended impact?
Identify the responsibilities given to the President under the Indian Removal Act of 1830.
Compare Jackson’s actions toward Native Americans in the context of his First Inaugural Address with the path of events during the Trail of Tears.
Determine if the removal of the Native Americans from east of the Mississippi River violate the principles found in the Declaration of Independence?

Option 3: The Abolitionist Movement
Read the following primary source:

Declaration of Sentiments of American Anti-Slavery Society (1833)Links to an external site. (Click on arrows to view all images of the document. Click on plus and minus signs to enlarge or reduce size of images.)

Then, address the following:

Assess if abolitionists were responsible reformers or irresponsible agitators?
Explain how abolitionists upheld the Declaration of Independence as the foundation of antislavery and abolitionist thought.
Assess the effect of the Gag Rule on the Abolitionist Movement.
Analyze how the women’s rights movement would gain momentum from the antislavery movement.
REQUIREMENTS
Length: 2-3 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

Week 3 Responses

Jun 14, 2024 | Health Medical

Description

NURS 676 Week 3 Discussion Responses Vicente Gutierrez Seizures are described as any type of epileptic event, seizure disorder is closely related to epilepsy which is described as recurrent seizures that are brought on by excessive excitability or neurons in the brain (Burchum & Rosenthal, 2021). Seizures are treated by antiseizure drugs, the type of medication a person affected by seizures depends on the specific type of seizure they are diagnosed with. For instance, seizure types are separated into two broad categories, partial and generalized seizures, depending on the type of seizure a patient has is the medication that will be prescribed to treat their symptoms (Burchum & Rosenthal, 2021). Medication’s focus is to suppress discharge of neurons within a seizure focus and to suppress propagation of seizure activity in certain areas of the brain (Burchum & Rosenthal, 2021). Antiseizure medications nearly all act through five basic mechanisms: sodium influx, suppression of calcium influx, promotion of potassium efflux, blockade of receptors of glutamine, and potentiation or increase of gamma-aminobutyric acid (GABA) (Burchum & Rosenthal, 2021). When an antiseizure medication is started the provider and the patient will work together to ensure the medication is being effective as well as educating the patient to increase adherence and compliance. A trial period of the medication is important to establish a therapeutic dosage to subside the symptoms of the seizure while not causing undesired side effects (Burchum & Rosenthal, 2021). One of the main potential drug interactions with antiseizure medication is the use of oral contraceptives in women of childbearing age (Burchum & Rosenthal, 2021). It is important to establish a plan with the patient and provider since antiseizure medications decrease the effectiveness of oral contraceptives (Burchum & Rosenthal, 2021). McKenzie Rosendale For asthma exacerbation, there are two phases: early and late. The early phase happens when IgE antibodies are released into the body. These antibiotics can be triggered by many ways with one being the environment. Once the antibodies are released, it will bind to mast cells and basophils (Sinyor & Perez, 2023). When a allergen enters the body, the mast cells will release cytokines, histamine, prostaglandins, and leukotrienes (Sinyor & Perez, 2023). With this reaction happens, it makes the smooth muscles to contract making it hard to breathe. The late phase in asthma exacerbation happens a few hours after the initial reaction and eosinophils, basophils, neutrophils, and T cells will migrate to the lungs, which causes inflammation and constriction (Sinyor & Perez, 2023). An adrenergic agonist decreases the transmission by binding to presynaptic alpha 2 receptors. It also dilates the bronchial passages to help with the constriction from the asthma exacerbation (Sinyor & Perez, 2023). The most appropriate is adrenergic agonists that are selective for beta 2 receptors (albuterol). Beta 2 agonists are typically administered through inhalation, which minimizes systematic effects (Rosenthal & Burchum, 2021, pg. 104). If too much of a beta 2 agonists are inhaled, the effects may be angina pectoris and/or tachycardia because it activates the beta 1 receptors. The typical treatment for a severe asthma attack is a nebulized short acting beta agonist, which can be an inhaled medication. The dosage for this medication is between 1.25-5 mg every four to eight hours as needed (AAAAI, 2023). The dosage for a child is 0.63-2.5mg/kg every four to six hours (AAAAI, 2023). A nurse practitioner can determine the dosage based on the child’s weight and for an adult, the nurse practitioner would be to start at the lowest dose and slowly increase the dosage over time. NURS 530 Week 3 Discussion Responses Maria Sanchez “Mental illnesses are common and found in different cultures and across the socioeconomic spectrum. When left untreated, the consequences can be devastating” (Rogers, 2022, p. 618). Mental illness has been on the rise and although we are more open about talking about it, we still have work that needs to be done. There continues to be a stigma surrounding mental illnesses. The stigma towards mental illness could be due to differences in values, beliefs, religion, culture, age, and much more. Nurse practitioners have a responsibility to their patients to provide a space that is safe, welcoming, and open regarding mental illness. Nurse practitioners can implement various strategies/techniques in their practice to foster open communication, and reduce stigma surrounding schizophrenia, mood disorders, anxiety disorders, PTSD, and OCD. Nurse practitioners can discuss their patients with the lead psychiatrist and interdisciplinary team. The open discussions between nurse practitioners, psychiatrists, and interdisciplinary team can allow for open communication, dialogue of treatment, feedback of treatment, and discussions about alternative treatments. Open communication allows for clear communication between interdisciplinary team and setting of goals. This can reduce stigma because there is clear communication, discussion, and education that occurs between those involved in the treatment team. If a person is knowledgeable, it will allow for them to be more comfortable, confident, and open to talk about mental illness thus normalizing mental illness. Another method that a nurse practitioner can help reduce stigma on mental health is knowing how to effectively communicate with their patients. Nurse practitioners must be aware of the language that they use and must be careful in making sure that they are not using words, phrases, or making comments that could be judgmental, offensive, or blaming patients for their mental illness. Nurse practitioners need to be aware of their own personal beliefs and not let them get in the way of the care for their patients. Khrystene Nguyen I understand the challenges of providing effective pain relief with opioids in neurological patients. Every patient is different, and their pain management therapy may differ from the next. A good place to start is to examine their prior medical records and the medications they are presently prescribed. Conducting a thorough assessment of the patient’s pain, underlying neurological conditions and any coexisting medical issues are also essential. Creating an individualized treatment plan can also aid in targeting the patient’s specific pain needs when considering the severity of pain and treatment goals. An important aspect when prescribing opioid pain medication is to assess for risk factors for opioid misuse, addiction, and overdose. If opioids are necessary, treatment should be initiated with the lowest effective dose and titrated appropriately and cautiously while monitoring the patient’s response (Rogers, 2022). It is also important to regularly assess the patient’s pain and treatment plan to adapt to changing needs and minimize the risk of opioid-related problems. Another option if the patient requires a revision in pain management is to explore alternative therapies such as rehab, psychological support, or complementary therapies to enhance pain management.

analyzing a current issue impacting the health of the aging population in Saudi Arabia

Jun 14, 2024 | Health Medical

Description

Instructions for submission:

The assignment must be submitted with a correctly filled cover sheet (Name, ID, CRN, Submission date) in Word; Pdf is not accepted.
Your answer should be 1 to 2 pages, a maximum of 1000 words.
Papers not meeting the minimum length requirement will be returned ungraded.
Paper outline: Title page— Introduction—Body—Conclusion
Text size 12-Times New Roman with 1.5-line spacing.
The heading should be Bold
The text color should be Black
Do proper paraphrasing to avoid plagiarism with appropriate references/sources.
Papers containing plagiarized material (whether intended or unintended) will receive a Zero.
References must be in APA format

skills lab

Jun 14, 2024 | Health Medical

Description

Reflect on your experience as a nursing leadership student assisting fundamental students in the skills lab. Describe a specific scenario where you had to demonstrate effective leadership and communication skills. How did you approach guiding and supporting the fundamental students in their skill development? What were some challenges you encountered, and how did you overcome them? Discuss the impact of your leadership on the fundamental students’ learning and confidence. Based on this experience, identify one key aspect of your leadership style that you would like to further develop and explain how you plan to enhance it to become a more effective nursing leader.**Response must be a minimum of 500 words.

Global Health Question

Jun 14, 2024 | Health Medical

Description

Unformatted Attachment Preview

Critical Thinking: Comparative Analysis: Risk (125 points)
Compare Risk in Different Health Care Systems
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.
Here are some friendly reminders:
1. You have a critical thinking assignment this week.
2. You have a Module Quiz this week.
3. You do not have a discussion forum this week.
4. Next Live Session is this Week 4/Module 4.
a. Link: https://eu.bbcollab.com/guest/90391bcfd2a0
4166a3a7c3ba0d5ee4f2
5. Learning Outcomes for Week 4:
• Evaluate examples of health system regulations and the
healthcare system in the Kingdom of Saudi Arabia.
• Evaluate the challenges involved in implementing
regulations.
• Compare types and levels of licensure, certification, and
accreditation requirements for healthcare professionals in the
UK, USA, Germany, and KSA.
• Analyze the KSA health system regulations that meet global
standards with examples.
• Evaluate plans for implementing improvements that reduce
risk in complex healthcare systems in Saudi Arabia.
Critical Thinking: Comparative Analysis: Risk
Compare Risk in Different Health Care Systems
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.(Choose one risk and compare it between the three countries)
Examine medical malpractice environment and process.
What type of regulation oversight occurs in the healthcare space?
Analyze how risk is measured.
Here is an example for the US :
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 7th edition guidelines, as appropriate.
. No plagiarism more than 25%
Choose one risk and talk about it.
1. Learning Outcomes for Week 4:
• Evaluate examples of health system regulations and the
healthcare system in the Kingdom of Saudi Arabia.
• Evaluate the challenges involved in implementing
regulations.
• Compare types and levels of licensure, certification, and
accreditation requirements for healthcare professionals in the
UK, USA, Germany, and KSA.
• Analyze the KSA health system regulations that meet global
standards with examples.
• Evaluate plans for implementing improvements that reduce
risk in complex healthcare systems in Saudi Arabia.
Chapter 3
GLOBAL
HEALTH:
SYSTEMS,
POLICY, AND
ECONOMICS
Chapter 3: Overview
• Introduction
• Micro and Macro Models
• Convergence of Problems and Responses
• Nature of Tradeoffs, Ideology, and Ethics
• Policy-Making Around the World
• Conclusion
Introduction
• World Wide Challenge of health policy
making in the 21st century
• Medicine within social organizations
• Government intervention or non
intervention
• Policy-making challenges
• All nations have problems with cost,
quality, access and health outcomes
Micro and Macro Models
• The political process
• Involves governmental and
nongovernmental organizations (NGO)
and individuals
• Micro and macro frameworks
• Analogous to economics
Micro and Macro Models
• Characteristics of the policy marketplace model
• Assumptions
• Policy actors
• Disparities in power
• Currency used
• Impact of governmental regulation
Micro and Macro Models
• The policy systems model:
Characteristics
• Complexity
• Interrelatedness
• Interdependent
• Cyclical processes
Micro and Macro Model
• Longest’ s model of health policy
development
• Recognition of inputs
• Policy formation
• Policy outputs
• Implementation
• Outcomes
Convergence of Problems
and Responses
• Convergence of variations in health
organizations
• Cost containment
Convergence of Problems
and Responses
• Access to care
• Disadvantaged subpopulations
• Informal payments (bribes)
• Political instability
Convergence of Problems
and Responses
• Impact of new technologies
• Cost and complexity
• Balance between old and new
• Economic and ethical conflict
Convergence of Problems
and Responses
• Quality of care considerations
• Technologic complexity
• Enable the aggregation of data
• New information technology
Convergence of Problems
and Responses
• Measuring health outcomes
• Potential benefit of health IT
• Consensus about existing problems
• US system expensive, wasteful,
unsustainable
Convergence of Problems
and Responses
• Sustainability
• Growing financial stress on public
and private sectors
Convergence of Problems
and Responses
• Achieving sustainability
• Quest for common ground
• Digital backbone
• Incentive realignment
Convergence of Problems
and Responses
• Achieving sustainability
• Quality and safety standardization
• Resource deployment
• Innovation
• Adaptability
Convergence of Problems
and Responses
• Assessment of progress in policymaking
• Technology based sustainability
• Quality and safety standardization
Convergence of Problems and
Responses
• Price Waterhouse Cooper (PWC) study
recommended solutions:
• Quest for common ground
• Digital backbone
• Incentive
• Quality and safety standardization
• Strategic resource deployment
• Climate of innovation
• Adaptable delivery roles and structures
Nature of Tradeoffs,
Ideology, and Ethics
• Tradeoffs
• Source
• Importance
• Economic efficiency and political
equity
• Prioritizing efficiency and equity
Nature of Tradeoffs,
Ideology, and Ethics
• Tradeoffs
• Political obstacles
• Expectations of the populace
• Ethical and ideological
disagreements
• Social experimentation without public
consultation
• Undeveloped “rule of law”
Nature of Tradeoffs,
Ideology, and Ethics
• Tradeoffs
• Components of justice
• Libertarian perspective
Policy-Making Around the World
• Assessment of ability to address
challenges
• Assessment of sustainability of US
system
• No reform will lead to de facto rationing
• Reform faces significant political problems
• Something major will occur in the next
one or two decades
Policy-Making Around the World
• Equating national health service with
rationing
• Situation in developing countries
• Political instability
• Social inequality
• Immature economies
Conclusion
• Not at all clear how leadership will meet the
health system challenges in the next 20 years
• Absence of a true US national health systems
and stable international health systems is
creating de facto rationing
• Advocates argue for cost controls on expenditures
and/or more taxes on upper-income citizens
• Significant backlash against the ACA
• Should not lose sight of past achievements
This Section Reserved
for Instructors
Suggested Discussion or
Research Questions
Discussion or Research Questions
• Describe how health policy making is a political
process.
• Describe the characteristics associated with the
Policy Marketplace Model (Micro model) of health
policy decision making.
• What are the characteristics associated with the
Policy Systems (Macro) model of health policy
making?
Discussion or Research Questions
• What are the stages of the Longest model of health
policy making how do they impact on individual
health policies?
• Describe the major problems faced by all nations as
they attempt to formulate health policy and their
implications on health system development.
• What are the implications associated with an
increased emphasis on the use of outcomes
measurements on the delivery of health care
services?
Discussion or Research Questions
• How does having a truly integrated
national health system impact the
implementation of technical and structural
reforms?
• What are the benefits of having a robust
health information infrastructure
integrated within the healthcare delivery
system?
• What is the primary underlying trade-off in
the development and implementation of a
national healthcare delivery system?
Discussion or Research Questions
• What are the primary political obstacles in using
explicit trade-off analysis in health policy making?
• Describe how the individual and social components
of justice influence the debate on ethical health
policy.
Discussion or Research Questions
• Describe how health policy making is a political process.
• Describe the characteristics associated with the Policy Marketplace Model (Micro model) of health
policy decision making.
• What are the characteristics associated with the Policy Systems (Macro) model of health policy
making?
• What are the stages of the Longest model of health policy making how do they impact on individual
health policies?
• Describe the major problems faced by all nations as they attempt to formulate health policy and their
implications on health system development.
• What are the implications associated with an increased emphasis on the use of outcomes
measurements on the delivery of health care services?
• How does having a truly integrated national health system impact the implementation of technical
and structural reforms?
• What are the benefits of having a robust health information infrastructure integrated within the
healthcare delivery system?
• What is the primary underlying trade-off in the development and implementation of a national
healthcare delivery system?
• What are the primary political obstacles in using explicit trade-off analysis in health policy making?
• Describe how the individual and social components of justice influence the debate on ethical health
policy.
General Question Categories
• Structure and Evaluation Healthcare Services and Systems
• Global Burden of Disease
• Cultural Influences
• Medical Travel and Tourism and Off Shoring
• Health Communication, Marketing, Social Marketing
• Data and Measurement
• Policy, Strategy, and the Regulatory Environment
• Global Health Leadership
• International Best Practices
Suggested Topic Areas To Use When Facilitating Discussions, Projects, or
Case Studies
• Engagement of stakeholders
• Effectively working in and managing teams
• Learning how to get in front of the problem or identify opportunities
• Learning to communicate effectively
• Assessment of solutions that fit the country
• Embracing systems thinking
• Recognize and embrace diversity
• Sustaining the mission of health as well as health care

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Discussion post and peer response

Jun 14, 2024 | Health Medical

Jun 14, 2024 | Health Medical

Description

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 please.please use a word document. times new roman for the font type and 12 font size. double spaced. for the references please use APA formatThe 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.

EVIDENCE BASED PRACTICE

Jun 14, 2024 | Health Medical

Description

Submit a 4-5 page, 7th ed. student APA paper, not including title and references.

Select a PEER reviewed EBP Research paper from a professional advanced practice journal related to your APN track. i.e. FNP, AGACNP, PSYCH article ….that is < 5 years old. Evaluate the paper using the following criteria. Identify your APN track. What method did you use to find the article? (Cochran library, Silver Platter etc.) Journal name and year of article publication. Title and all authors. Identify the topic and question under study (PICOT if given) Subjects - how many and how were they identified? What were the research methods used in the study? Methodology What did the finding show? Interpret the finding. (i.e. p value and sign levels.) What does this mean? What is the significance of the findings for professional practice in your specific APN track ? Submit your paper to your ePortfolio site. Submit a link at the bottom of your paper to the ePortfolio site for your instructor. Submit the paper to the Canvas assignment site. Submit a link to the article at the bottom of the paper Identify which of the MSN essential(s) this assignment meets.

Nursing Question

Jun 14, 2024 | Health Medical

Description

Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.

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:

Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.

The Assignment: (1- to 2-page Legislation Grid; 1-page Legislation Testimony/Advocacy Statement)

Be sure to add a title page, an introduction, purpose statement, and a conclusion. This is an APA paper.

Part 1: Legislation Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Grid Template. Be sure to address the following:

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:

Advocate a position for the bill you selected and write testimony in support of your position.
Explain how the social determinants of income, age, education, or gender affect this legislation.
Describe how you would address the opponent to your position. Be specific and provide examples.
At least 2 outside resources and 2-3 course specific resources are used.
NURS_6050_Module02_Week04_Assignment_Rubric
NURS_6050_Module02_Week04_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeFederal and State LegislationPart 1: Legislation GridBased on the health- related bill you selected, complete the Legislation Grid Template. Be sure to address the following:• Determine the legislative intent of the bill you have reviewed.• Identify the proponents/opponents of the bill.• Identify the target populations addressed by the bill.• Where in the process is the bill currently? Is it in hearings or committees?
35 to >31.0 ptsExcellentThe response clearly and accurately summarizes in detail the legislative intent of the health- related bill. …The response accurately identifies in detail the proponents and opponents of the health-related bill. …The response accurately identifies in detail the populations targeted by the health-related bill. …The response clearly and thoroughly describes in detail the current status of the health- related bill. 31 to >27.0 ptsGoodThe response accurately summarizes the legislative intent of the health-related bill. …The response accurately identifies the proponents and opponents of the health-related bill. …The response accurately identifies the populations targeted by the health-related bill. …The response accurately describes the current status of the health-related bill. 27 to >24.0 ptsFairThe response vaguely or inaccurately summarizes the legislative intent of the health-related bill. …The response vaguely or inaccurately identifies the proponents and opponents of the health-related bill. …The response vaguely or inaccurately identifies the populations targeted by the health-related bill. …The response vaguely or inaccurately describes the current status of the health-related bill. 24 to >0 ptsPoorSummary of the legislative intent of the health-related bill is vague and inaccurate or is missing. …Identification of the proponents and opponents of the health-related bill are vague and inaccurate or is missing. …Identification of the populations targeted by the health-related bill is vague and inaccurate or is missing. …The description of the current status of the health- related bill is vague and inaccurate or is missing.
35 pts

This criterion is linked to a Learning OutcomePart 2: Legislation Testimony/Advocacy Statement• Advocate a position for the bill you selected and write testimony in support of your position.• Explain how the social determinants of income, age, education, or gender affect this legislation.• Describe how you would address the opponent to your position. Be specific and provide examples.
40 to >35.0 ptsExcellentTestimony clearly, accurately, and thoroughly provides statements that fully justifies a position for a health-related bill…. Response provides a detailed, thorough, and logical explanation of the social determinant affecting the topic, and how to address opponents to the position for the health-related bill and includes one or more clear and accurate supporting examples. 35 to >31.0 ptsGoodTestimony clearly and accurately provides statements that somewhat justifies a position for a health-related bill. …Response provides an accurate explanation of the social determinant affecting the topic, and how to address opponents to the position for the health-related bill and may include at least one supporting example. 31 to >27.0 ptsFairTestimony used to justify a position for a health-related bill is vague or inaccurate. …Explanation of how to address the opponents and social determinant for the position for the health-related bill is vague or inaccurate, lacks logic, and/or the supporting examples are vague or inaccurate. 27 to >0 ptsPoorTestimony used to justify a position for a health-related bill is vague and inaccurate, incomplete, or is missing. …Explanation of how to address the opponents and social determinant for the position for the health-related bill is vague and inaccurate or is missing.
40 pts

This criterion is linked to a Learning OutcomeReferences
10 to >8.0 ptsExcellentResponse includes 3 or more course resources and 2 or more outside sources. 8 to >7.0 ptsGoodResponse includes 2-3 course resources and 2 outside sources. 7 to >6.0 ptsFairResponse includes fewer than 2 course resources and/or fewer than 2 outside resources. 6 to >0 ptsPoorResponse includes 2 or fewer resources.
10 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and OrganizationParagraphs 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 is provided which delineates all required criteria.
5 to >4.0 ptsExcellentParagraphs 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 ptsGoodParagraphs 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 ptsFairParagraphs 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 ptsPoorParagraphs 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 paper follows correct APA format for title page, font, spacing, indentations, 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

Total Points: 100

************PLEASE MAKE SURE TO FOLLOW CURRENT APA FORMAT EXACTLY, USE SCHOLORLY SOURCES AND FOLLOW THE RUBRIC VERY CLOSELY******* THANK YOU

372 saeed

Jun 14, 2024 | Health Medical

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read article and answer questions

Jun 14, 2024 | Health Medical

Description

Provide brief responses to the questions below about the discussion readings. You can work in groups but you have to submit the assignment individually.

Wang 2018

1. Provide at least three reasons used by the authors to justify this study (from the Introduction).
2. What is the study design used to address the research question?
3. What is the purpose of the information presented in Table 1? What would you consider to be the main message(s) from that table?
4. Based on the results from this study, what do you consider to be the main risk factors for COPD in China? Why?
5. What are the main conclusions that can be derived from the information presented in Figure 3?
6. What are the main limitations of this study? Are they adequately discussed in the manuscript?

Rasmussen 2016

1.What is the main aim of the study presented in the article? What is the scientific rationale supporting this aim?

2.The authors conducted a nested case-control study. Why do you think they used this study design and not a cohort design?

3.What are the main findings from the study?

4.What is the purpose of Figure 3?

5.How did the authors evaluate the presence of unmeasured confounding?

6.What are the main strengths of the study?

7.What are the main limitations of the study?

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Series
Asthma 1
Risk factors for asthma: is prevention possible?
Richard Beasley, Alex Semprini, Edwin A Mitchell
Asthma is one of the most common diseases in the world, resulting in a substantial burden of disease. Although rates
of deaths due to asthma worldwide have reduced greatly over the past 25 years, no available therapeutic regimens can
cure asthma, and the burden of asthma will continue to be driven by increasing prevalence. The reasons for the
increase in asthma prevalence have not been deﬁned, which limits the opportunities to develop targeted primary
prevention measures. Although associations are reported between a wide range of risk factors and childhood asthma,
substantiation of causality is inherently diﬃcult from observational studies, and few risk factors have been assessed in
primary prevention studies. Furthermore, none of the primary prevention intervention strategies that have undergone
scrutiny in randomised controlled trials has provided suﬃcient evidence to lead to widespread implementation in
clinical practice. A better understanding of the factors that cause asthma is urgently needed, and this knowledge could
be used to develop public health and pharmacological primary prevention measures that are eﬀective in reducing the
prevalence of asthma worldwide. To achieve this it will be necessary to think outside the box, not only in terms of risk
factors for the causation of asthma, but also the types of novel primary prevention strategies that are developed, and
the research methods used to provide the evidence base for their implementation. In the interim, public health eﬀorts
should remain focused on measures with the potential to improve lung and general health, such as: reducing tobacco
smoking and environmental tobacco smoke exposure; reducing indoor and outdoor air pollution and occupational
exposures; reducing childhood obesity and encouraging a diet high in vegetables and fruit; improving feto-maternal
health; encouraging breastfeeding; promoting childhood vaccinations; and reducing social inequalities.
Introduction
Asthma is one of the most common chronic diseases in
the world, resulting in a substantial worldwide burden of
disease.1 The temporal trend of increasing prevalence of
asthma over the past 60 years (ﬁgure 1) is likely to
continue as transitional communities progressively
adopt lifestyles of high-income countries and become
urbanised.2 Over recent decades the public health priority
has been to improve the assessment and management of
asthma,3 resulting in a 42% reduction in age-standardised
asthma death rates worldwide between 1990 and 2013.4
However, as no therapeutic regimen can cure asthma,
such approaches will always have their limitations. As a
result, it is necessary to gain a better understanding of
the factors that cause asthma, and to develop alternative
public health and pharmacological primary preventive
measures that are eﬀective in reducing the prevalence of
asthma worldwide. In this Series paper, we review
current evidence for the risk factors for asthma and its
primary prevention, and propose priorities for research
that will lead to the implementation of eﬀective primary
intervention strategies.
Can asthma be prevented?
It is reasonable to suggest that asthma prevention is
possible,
because
standardised
international
epidemiological studies in both children and adults have
shown that some populations have very low asthma
symptom prevalence rates.5,6 These surveys have identiﬁed
worldwide patterns of asthma symptom prevalence that
are not accounted for by existing knowledge of the
causation of asthma,5,6 but they do provide data on risk
www.thelancet.com Vol 386 September 12, 2015
Lancet 2015; 386: 1075–85
See Editorial page 1014
This is the ﬁrst in a Series of
two papers about Asthma
Medical Research Institute of
New Zealand, Wellington,
New Zealand
(Prof R Beasley DSc,
A Semprini MBBS); and
Department of Paediatrics,
Child and Youth Health,
University of Auckland,
Auckland New Zealand
(Prof E A Mitchell DSc)
Correspondence to:
Prof Richard Beasley, Medical
Research Institute of
New Zealand, Wellington 6242,
New Zealand
Richard.Beasley@mrinz.ac.nz
factors on which primary prevention measures might be
based. However, developing eﬀective and feasible primary
prevention strategies has proven a diﬃcult task because of
the range of potential risk factors, the inherent diﬃculty in
establishing causality from observational association
studies, the resources needed to undertake adequately
powered randomised controlled trials (RCTs) with
extended follow-up beyond infancy, and the scarcity and
often highly complex nature of primary prevention
intervention studies.
The heterogeneity and complex natural history of the
disease confound attempts to assess the importance of
individual risk factors or primary prevention strategies
that use single interventions. Asthma is a syndrome of
various overlapping phenotypes with deﬁned clinical and
Search strategy and selection criteria
We searched PubMed using “Asthma” and “Primary
prevention”. We applied the ﬁlter for “clinical trial” and
reviewed the results to isolate primary prevention trial
reports. We searched Embase and World Health Organization
Clinical Trials Registry with the terms “asthma” and “primary
prevention” and reviewed the results for primary intervention
trials and duplicates from PubMed. We searched the Cochrane
Library database using the terms “Asthma” and “Primary
prevention” and applying “trials” ﬁlter. Further relevant
references were obtained from the reference lists of reviewed
manuscripts, including studies in which asthma was a
secondary outcome variable. Publications in all languages
and until March 17, 2015, were considered.
1075
Series
40
Australia
England and Wales
Scotland
Israel
Japan
New Zealand
Norway
Singapore
Sweden
Taiwan
USA
Netherlands
Italy
Greece
35
30
Prevalence (%)
25
20
15
10
5
0
1955
See Online for appendix
1960
1965
1970
1975
1980
Year
1985
1990
1995
2000
2005
Figure 1: Global trends in asthma symptom prevalence in children by country
Studies were selected in which at least two prevalence datapoints were obtained with the same asthma symptom criteria in the same age group, population and
geographical area. Countries were included if initial data available was from before 1985, to provide long-term international trends in asthma symptom prevalence.
Prevalence datapoints were a minimum of four years apart. The same diagnostic criteria were used in each study, although these were not standardised between
studies. The populations studied included children, ranging from 5 to 18 years. References for the studies included in this ﬁgure are provided in the appendix.
Example phenotypes
Age of onset
Childhood vs adult
Clinical
Episodic vs persistent
Pathophysiological
Partially reversible airﬂow obstruction
Comorbidities
Rhinosinusitis
Genetic
β2 receptor polymorphisms
Environmental risks
Occupational asthma
Inﬂammatory
Eosinophilic vs non-eosinophilic
Immunological
Atopic vs non-atopic
Biomarkers
Fractional exhaled nitric oxide
Endotypes
Aspirin sensitivity
Response to therapy
Steroid resistance
Severity
Amount of treatment needed to achieve control
Mortality risk
History of life threatening attack
Table 1: Examples of asthma phenotypes in relation to speciﬁc
characteristics
In this review we address the risk factors and primary
prevention strategies for childhood asthma, recognising
that most adult asthma ﬁrst develops in childhood, and
that adult onset asthma often has its origins earlier in
life.8 We focus on school-age (5–18 years) rather than
preschool (younger than 5 years) children with asthma
because of the favourable natural history of transient
forms of wheezing during infancy.9 We do not
diﬀerentiate risk factors related to asthma severity,
recognising that measures to reduce risk of developing
asthma will lead to a disproportionately greater reduction
in the prevalence of severe asthma in the population.10
Risk factors are considered from the perspective of how
they might be relevant to the planning of primary
prevention intervention studies, from which public
health or pharmacological intervention strategies could
be developed.
Risk factors
physiological characteristics, underlying inﬂammatory
processes with identiﬁable biomarkers, genetic and
environmental risk factors (and their interactions),
response to therapies, natural history, and comorbidities.7
However, our understanding is insuﬃcient to deﬁne
asthma phenotypes in this multidimensional, unifying
way, with approaches limited to the presence or absence
of individual characteristics, as outlined in table 1. It is
likely that there will be both common and diﬀerent risk
factors across phenotypes, and that the opportunity exists
for both broad and narrowly targeted intervention
measures.
1076
A comprehensive list of risk factors for the development
of asthma in childhood is presented in table 2. Age is an
important consideration in respect of the diﬀerent
phenotypes of childhood wheeze. Children with
persistent and late onset wheeze, but not those with
transient forms of wheezing up to 3 years of age, have
greater risk of having persistent childhood asthma.9
These ﬁndings suggest that for any primary prevention
strategy to target those at risk of persistent childhood
asthma, it would be necessary to identify early clinical,
immunological or genetic biomarkers for the chronic
forms of the disease.11 Sex aﬀects the risk of asthma in an
www.thelancet.com Vol 386 September 12, 2015
Series
Association
Demographics, developmental, lifestyle
Association
(Continued from previous column)
Age
Nonlinear
Diet
Sex
Age dependent
Fruit and vegetables
Family history
Positive
Mediterranean diet
Negative
Genetics
Positive
Breastfeeding
Negative
Low gross national product
Negative
Raw milk
Negative
Agricultural subsistence
Negative
Probiotics
Negative
Urbanisation
Positive
Fast food
Positive
High-income lifestyle
Positive
Fish oils
Negative
High altitude
Negative
Selenium
Negative
Low birthweight or fast infant weight gain
Positive
Vitamin A
Negative
Preterm
Positive
Vitamin D
Negative
Caesarean delivery
Positive
Vitamin E
Negative
Atopic sensitisation
Positive
Magnesium
Negative
Rhinitis
Positive
Trans-fatty acids
Positive
Stress
Positive
Salt
Positive
Day care
Negative
Inhaled exposures
High body-mass index
Positive
Maternal smoking
Sedentary behaviour
Positive
Paternal smoking
Positive
Child smoking
Positive
Infection related
Negative
Positive
Respiratory syncytial virus
Positive
Indoor air pollution
Positive
Rhinovirus
Positive
Outdoor air pollution
Positive
Positive
Occupational exposure
Positive
Pertussis
Medication
House dust mite
Positive
Paracetamol
Positive
Endotoxin
Negative
β agonists
Positive
Farm animals
Negative
Antibiotics
Positive
Cats
Variable
(Table 2 continues in next column)
Moulds
Positive
age-dependent manner, with asthma being more
prevalent in boys until the age of 13 years, after which it
is more prevalent in girls.12 Understanding the complex
biological mechanisms that cause sex-associated
diﬀerences could guide preventive measures.12
Genetic predisposition is an important but poorly
characterised component of asthma risk. Family history
for asthma increases the risk to a child, however it is
clear that inheritance does not follow a straightforward
Mendelian pattern. Many loci across many chromosomes
have been associated with asthma,13 and inconsistency in
replicating linkages, methodological limitations, strong
chronological eﬀect on gene expression, and the
heterogeneity of asthmatic phenotypes have frustrated
eﬀorts to fully deﬁne the disease at the genetic level.14 A
better understanding of genetic and environmental
interactions will provide opportunities for novel targeted
treatments to reduce the risk of developing asthma and
its progression to severe disease.
The association between parental smoking and
childhood asthma risk now extends beyond maternal
smoking during pregnancy and throughout childhood to
a separate and additive association with paternal smoking
during childhood.15 Active smoking in childhood is an
important risk factor for asthma risk in adolescence.16
www.thelancet.com Vol 386 September 12, 2015
Variation exists in the strength and direction of associations, depending on
factors such as atopic versus non-atopic disease, population income, coexistence
of other risk factors, and methodological diﬀerences between studies. Categories
are broadly deﬁned and individual risk factors may overlap.
Table 2: Reported associations between risk factors and childhood asthma
Real potential exists to reduce asthma risk through
reducing tobacco use.
Pre-term birth (
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Quality Healthcare: Measuring NP Performance

Jun 14, 2024 | Health Medical

Description

The National Committee for Quality Assurance (NCQA) was formed to ensure the quality of patient care and measurement of patient outcomes with set standards.

Healthcare Effectiveness Data and Information Set (HEDIS) is a performance measurement tool used by millions of health insurance plans. There are 6 domains of care:

Effectiveness of Care
Access/Availability of Care
Experience of Care
Utilization and Risk Adjusted Utilization
Health Plan Descriptive Information
Measures Collected Using Electronic Clinical Data Systems

You may access the 6 domains of care by clicking this link:

(NCQA, n.d. https://www.ncqa.org/hedis/Links to an external site.)

As an APN, productivity will be an important measurement for the practice to determine reimbursement and salary. Fee-for-service practices will require a set number of patients per day to maintain productivity. A capitated practice will require the APN to have a large panel of patients but also will focus on controlling costs. This can be accomplished through effective primary care that is accessible, convenient for the patients, and has a method of measuring the quality of care.

Write a formal paper in APA format with a title page, introduction, the three required elements below, conclusion, and reference page.

You are now employed as an NP in primary care. Choose one performance measure from one of the six domains of care, i.e. Adult BMI Assessment, Prenatal, and Postpartum care, etc.

Develop three different patient interventions for that one performance measure and how you would specifically implement the intervention and measure the outcomes for that particular performance measure in clinical practice.

How would these primary care interventions result in improved patient outcomes and healthcare cost savings?

How can these interventions result in improved NP patient ratings?

powerpoint poster

Jun 14, 2024 | Health Medical

Description

The purpose of this assignment is to provide the student the opportunity demonstrate competency in performing the role of the psychiatric mental health nurse practitioner in a safe environment.

assignment based on PICO question: In college students aged 18-24, how does poverty level affect tobacco dependence compare to race?

Dimensions for print posters: Print posters tend to be in the range of 3 x 4 feet.
use this video to create poster

Submission Instructions:

To complete this assignment, address the following criteria:

Posters should include the following content:
A Project title. This should be placed towards the top of the poster, including the names of the authors and university affiliation
An Introduction section. This should highlight the problem addressed in a brief literature review with citations and your hypothesis or hypotheses.
The Purpose section: The poster states the objectives of this inquiry relative to the overall evidence-based literature review on this topic.
The Methods/Search Strategy section. An overview of how you studied your primary source(s): Describes the evidence-based solution. How was it developed? Include the theoretical framework (if applicable). Identify databases searched and inclusion/exclusion criteria.
The Results The poster describes the search, the number of studies included, and the level of evidence.
The Synthesis of Evidence The poster briefly describes the synthesis of the evidence that includes major trends and notable gaps.
The Implications for Practice section. The poster includes recommendations for practice, education, or future research based on the review and synthesis of the evidence.(how does this impact the psychiatric mental health nurse practitioner )
A References section. Make sure your references include at least four references with three primary research articles. Primary articles describe studies in which the authors collected the data themselves. No older than 5 years old. References must be in APA format. If you cannot fit four or more references into your poster, you should provide the references separately as an attached word document.

5 files, ct

Jun 14, 2024 | Health Medical

Description

mportant! This is the first of several Critical Thinking assignments that will build the foundation for a research paper due in Module 12.

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:

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
Paper Title
Author
Name of the University
Course Name/Number/Assignment Number
2
Research Topic Selection and Explanation
Identify which topic you selected (be as specific as you can):
▪
Antibiotic use in healthcare – prophylactic pre-surgery, post surgery, children,
adults, MRSA resistance
▪
Artificial Intelligence (AI) – surgical procedures, patient care decision making,
▪
Big data analytics in healthcare – Information management, Electronic health
records
▪
Chronic diseases – Diabetes, COPD, arthritis, obesity, hypertension, Alzheimer’s,
heart disease, osteoporosis, cancer, stroke
▪
Clinical practice guidelines – for any given profession
▪
Communicable diseases – Covid, RSV, Pneumonia, tuberculosis, HIV, STDs
▪
Diabetic foot disease
▪
Ethical decision-making in healthcare
▪
Mental health – Bipolar, Depression, Schizoaffective disorder, Anxiety disorders,
PTSD, Eating disorders, Personality disorders
▪
Non-communicable diseases – heart disease, stroke, cancer, asthma, COPD,
physical injuries
▪
Patient safety culture
▪
Vaccines – Covid, RSV, Pneumonia, Shingles, Influenza, Hepatitis B
3
Discuss why the topic is selected. Who does it impact? Are there ethical or legal
challenges? What are the potential applications of current and future research on this topic? Does
it promote improved quality, lower costs, or more accessible care? 2 pages double spaced is
about 500 words.
10 Related References (Journal Articles)
Basri, R., Issrani, R., Hua Gan, S., Prabhu, N., & Khursheed Alam, M. (2021). Burden of stroke
in the Kingdom of Saudi Arabia: A soaring epidemic. Saudi Pharmaceutical Journal,
29(3), 264–268. https://doi.org/10.1016/j.jsps.2021.02.002

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Medically Compromised Project

Jun 14, 2024 | Health Medical

Description

please write about Drugs in general, but focus on marijuana. Use Part IX from our textbook under Substance Abuse Chapter 29 and Chapter 30. Please make a Research Paper about Dug Abuse specifically Marijuana, and make a very professional PowerPoint presentationDental Management of the Medically Compromised Patient – E-Book (konkur.in)

Nursing Question

Jun 14, 2024 | Health Medical

Description

Review the Anxiety Interactive Case Study patient scenario and analyze the data to determine the health status of the patient.

Select the Patient Subjective Information tab. Within this tab, you will be able to watch a video to gain more insight regarding the patient as well as view important patient details.

For this assignment, you will

Review the Case Study.
Review the Comprehensive Case Study Content Exemplar to understand what is needed within your paper.
Use the Comprehensive Case Study Paper Template to write the assignment in the proper format.
Follow the requirements on the rubric and within the Content Exemplar.
Interactive Comprehensive Case Studies should be 5-pages in length, excluding the title and reference pages.
Interactive case studies should include a minimum of three evidence-based practice guidelines or articles.
All papers should conform to the most recent APA standards.

Your case study write up should include specific reference to relevant guidelines and other clinical information. The national guidelines should also be considered within treatment plans.

When you have completed viewing the patient information, download the Comprehensive Case Study Paper Template (Word) from the assignment page in Moodle. Use this document to complete the assignment and then submit it to the assignment drop box. Additionally, there is an Exemplar document for review to help guide your case study write up.

References

https://www.aafp.org/pubs/afp/issues/2015/0501/p61…

Clinical Practice Review for GAD | Anxiety and Depression Association of America, ADAA

Discussion Question

Jun 14, 2024 | Health Medical

Description

Consider the quality improvement topic you chose last week.Discuss where you would find appropriate evidence-based guidelines to implement a quality improvement initiative related to this topic.Search the Herzing library for a peer reviewed quantitative primary research study that supports the change you would like to consider. Include an appropriate link or PDF of the study.Discuss the connections of the evidence-based guidelines with the peer reviewed research.Please be sure to validate your opinions and ideas with citations and references in APA format.

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Sepsis / Septic Shock: Immediate Versus Early Antibiotic
Administration
Search date
05/07/2022
Author
Kylie Porritt BN, GradDipNursSc(Cardiac), MNSc, PhD
updated by Sandeep Moola PhD
Publication date
15/08/2022
Question
What is the best available evidence regarding the effectiveness and safety of immediate versus early
antibiotics for patients with severe sepsis and/or septic shock?
Clinical Bottom Line
Sepsis is a clinical syndrome characterized by systemic inflammation due to infection and is recognized as
a medical emergency.1,2 Each year across the world, there are approximately 49 million cases of sepsis
and 11 million deaths from sepsis.1 Early recognition and management of sepsis is critical. The
administration of antibiotics is a crucial component of sepsis management, with evidence suggesting
antibiotic therapy is associated with a decrease in mortality.1,2 However, debates exist on the timing of
antibiotic administration and its impacts on patient outcomes.
The administration of immediate antibiotic therapy (zero to one hour) compared to early antibiotic therapy
(one to three hours) for patients with sepsis and septic shock was examined in a systematic review. In
severe sepsis or septic shock, the findings demonstrated no difference in mortality rates between patients
who received immediate antibiotic therapy compared to early antibiotic therapy. The overall quality of the
evidence was assessed as low and therefore caution should be exerted when interpreting the findings.1
(Level 3)
Patients suspected of sepsis who meet one or more high risk criteria are recommended to be
administered a broad-spectrum antimicrobial at the maximum dose recommended within the first hour of
being identified at high risk. People in the below group are at a higher risk of developing sepsis:2 (Level
3)
the very young (under one year) and older people (over 75 years) or people who are very frail
people who have impaired immune systems because of illness or drugs
people who have had surgery, or other invasive procedures, in the past six weeks
people with any breach of skin integrity (for example, cuts, burns, blisters or skin infections)
people who misuse drugs intravenously
people with indwelling lines or catheters.
A multi-national clinical guideline recommended that for adults with possible septic shock or a high
likelihood for sepsis, antimicrobials should be administered immediately, ideally within one hour of
recognition. This was based on very low to low quality evidence.3 (Level 5)
Characteristics Of The Evidence
This evidence summary is based on a structured search of the literature and selected evidence-based
health care databases. The evidence in this summary comes from:
A systematic review of 13 studies (prospective observational and retrospective cohort studies) including
33,863 participants.1
Evidence-based clinical practice guidelines.2,3
Best Practice Recommendations
1. Patients suspected of sepsis and assessed as at high risk of developing sepsis should receive a broad-
spectrum antimicrobial within the first hour of being identified at high risk. (Grade A)
References
1. Rothrock S, Cassidy D, Barneck M, Schinkel M, Guetschow B, Myburgh C, et al. Outcome of immediate versus early antibiotics in
severe sepsis and septic shock: a systematic review and meta-analysis. Ann Emerg Med. 2020; S0196-0644(20): 30337-1.
2. National Institute for Health and Care Excellence. Sepsis: recognition, diagnosis and early management: NICE guidelines 51. 2016.
www.nice.org.uk/guidance/qs51
3. Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, et al. Surviving sepsis campaign: international
guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021; 47(11):1181-1247.
Archived Publications
1. JBI-ES-1480-1 (Published at 6 April 2021)
Author(s) potential or perceived conflicts of interest are collected and managed in line with the International Committee of Medical Journal Editors (ICMJE) standards.
How to cite: Porritt , K, Moola, S. Evidence Summary. Sepsis / Septic Shock: Immediate Versus Early Antibiotic Administration. The JBI EBP Database. 2022; JBIES-1480-2.
For details on the method for development see Munn Z, Lockwood C, Moola S. The development and use of evidence summaries for point of care information systems: A
streamlined rapid review approach. Worldviews Evid Based Nurs. 2015;12(3):131-8.
Note: The information contained in this Evidence Summary must only be used by people who have the appropriate expertise in the field to which the
information relates. The applicability of any information must be established before relying on it. While care has been taken to ensure that this Evidence
Summary summarizes available research and expert consensus, any loss, damage, cost or expense or liability suffered or incurred as a result of reliance on
this information (whether arising in contract, negligence, or otherwise) is, to the extent permitted by law, excluded.
Copyright © 2022 JBI licensed for use by the corporate member during the term of membership.

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wk4 assign

Jun 14, 2024 | Health Medical

Description

Name: Ms. Connie Weidre

Gender: female
Age: 53 years old
T- 99.0 P- 102 R 24 156/86 Ht 5’4 Wt 1lbs73
Background: Lives with her husband in Memphis, TN, has one daughter age 25. She has never
worked. Raised by mother, she never knew her father. Mother with hx of generalized anxiety and
was verbally abusive, abused benzodiazepines; no substance hx for patient. No previous
psychiatric treatment. Has one glass red wine with dinner. Sleeps 12-13 hrs.; appetite decreased.
Has overactive bladder, untreated. Allergic to Zofran; complains of headaches, takes prn
Tylenol, has diarrhea 2-3 times weekly, takes OTC Imodium.
Symptom Media. (Producer). (2016). Training title 40 [Video].
https://go.openathens.net/redirector/waldenu.edu?u…
tch/training-title-40

https://video-alexanderstreet-com.eu1.proxy.openat…

“Fear,” according to the DSM-5-TR, “is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat” (APA, 2022). All anxiety disorders contain some degree of fear or anxiety symptoms (often in combination with avoidant behaviors), although their causes and severity differ. Trauma-related disorders may also, but not necessarily, contain fear and anxiety symptoms, but their primary distinguishing criterion is exposure to a traumatic event. Trauma can occur at any point in life. It might not surprise you to discover that traumatic events are likely to have a greater effect on children than on adults. Early-life traumatic experiences, such as childhood sexual abuse, may influence the physiology of the developing brain. Later in life, there is a chronic hyperarousal of the stress response, making the individual vulnerable to further stress and stress-related disease.

For this Assignment, you practice assessing and diagnosing patients with anxiety disorders, PTSD, and OCD. Review the DSM-5-TR criteria for the disorders within these classifications before you get started, as you will be asked to justify your differential diagnosis with DSM-5-TR criteria.

Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing anxiety, obsessive-compulsive, and trauma- and stressor-related disorders.
Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
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.

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate 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-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.
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.).

Unformatted Attachment Preview

Week (enter week #): (Enter assignment title)
Student Name
College of Nursing-PMHNP, Walden University
NRNP 6635: Psychopathology and Diagnostic Reasoning
Faculty Name
Assignment Due Date
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template
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
© 2021 Walden University
Page 2 of 3
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template
Diagnostic results:
Assessment:
Mental Status Examination:
Differential Diagnoses:
Reflections:
References
© 2021 Walden University
Page 3 of 3
Week (enter week #): (Enter assignment title)
Student Name
College of Nursing-PMHNP, Walden University
NRNP 6635: Psychopathology and Diagnostic Reasoning
Faculty Name
Assignment Due Date
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template
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
© 2021 Walden University
Page 2 of 3
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template
Diagnostic results:
Assessment:
Mental Status Examination:
Differential Diagnoses:
Reflections:
References
© 2021 Walden University
Page 3 of 3
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar
INSTRUCTIONS ON HOW TO USE EXEMPLAR AND TEMPLATE—READ
CAREFULLY
If you are struggling with the format or remembering what to include, follow the
Comprehensive Psychiatric Evaluation Template AND the Rubric as your guide. It is
also helpful to review the rubric in detail in order not to lose points unnecessarily
because you missed something required. Below highlights by category are taken
directly from the grading rubric for the assignment in Weeks 4–10. After reviewing the
full details of the rubric, you can use it as a guide.
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 criticalthinking 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
© 2021 Walden University
Page 1 of 6
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar
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.)
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.
© 2021 Walden University
Page 2 of 6
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar
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 (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?
© 2021 Walden University
Page 3 of 6
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar
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.
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.
© 2021 Walden University
Page 4 of 6
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar
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.
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
© 2021 Walden University
Page 5 of 6
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar
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.
© 2021 Walden University
Page 6 of 6

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Discussion

Jun 14, 2024 | Health Medical

Description

Identify a quality improvement topic you are interested in.What is the role of the APRN in improving patient outcomes related to this topic?Discuss benchmarks for monitoring improvement.Consider causes of decreased patient outcomes related to this topic.Discuss workforce challenges that may impact patient outcomes related to your topic.Please be sure to validate your opinions and ideas with citations and references in APA format.

102 @Sollkj

Jun 14, 2024 | Health Medical

Description

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Unformatted Attachment Preview

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

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HLT-306V-O500 Advanced Patient Care

Jun 14, 2024 | Health Medical

Description

Homework Topic 5
Assessment Description

Write a short (50-100-word) paragraph response for each question posed below. Submit this assignment as a Microsoft Word document.

Define CAM.
Describe the patient who uses CAM the most.
List some common misconceptions about CAM.
Identify methods of including the use of CAM in patient education.
Discuss the safe use of CAM.
List ways in which conventional medicine and CAM can be integrated.
Define ethical theories, ethical principles, and values.
Provide examples of ethical issues in patient education and compliance, and describe ways in which an effective professional/patient relationship and a poor health professional/patient relationship can impact these issues.
Explain what is meant by “ethical patient education practices”.
Explain the purpose of informed consent.
Discuss what factors determine the patient’s ability to give informed consent.
Compose a sample informed consent form. .
Discuss the process of communication to use with the patient and the family when obtaining informed consent.

312 سارة

Jun 14, 2024 | Health Medical

Description

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PHC 312 Group Assignment Paper
College of Health Sciences
ASSIGNMENT COVER SHEET
Course name:
Health Communications
Course code:
PHC312
CRN:
14474
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:
Dr. Ibrahim Alqasmi
Grade:
…. Out of 10
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).

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Nursing Question

Jun 14, 2024 | Health Medical

Description

Public Policy Meeting Assignment

Submit a 3-4 page summary paper on the public policy meeting. Include headings in your paper that address these components:

The purpose of the meeting, key participants, key agenda items, and meeting logistics
Background information and a description about the committee
One specific topic that was discussed at the meeting and an explanation of the committee process
An analysis of the key stakeholder positions related to the topic discussed
Key interactions that occurred at the meeting
Outcomes of the meeting including the specific topic focus
Current APA Style, proper grammar, and references as appropriate

Due Sunday, 11:59 p.m. (Pacific time)

Please see the following instructions and the sample paper attached. (Written Assignment this week – Public Policy Meeting – Part of the requirement is to include an analysis of the key stakeholder positions related to the discussed topic. Check out the course Glossary for a definition of a “stakeholder,” and read Chapter 59 of the Mason et al. text for more information about stakeholders in health policies.)

Please see the link for the Public Policy Meeting that you need to watch to complete the assignment attached

https://www.c-span.org/video/?528874-3/senate-deba…
Rubric

NURS_510_DE – Public Policy Meeting Paper

Criteria Ratings Pts

This criterion is linked to a Learning OutcomePurpose

40.5 to >33.21 pts

Accomplished

The purpose of the meeting, key participants, and key agenda items and meeting logistics are well documented including a description of relevant facts about the committee and background information.

33.21 to >30.38 pts

Emerging

The purpose of the meeting, key participants, key agenda items meeting logistics, and a description of relevant facts about the committee and background information are mostly included and explained, but some components are missing.

30.38 to >0 pts

Unsatisfactory

The purpose of the meeting, key participants, key agenda items and meeting logistics, and a description of relevant facts about the committee and background information may be missing or severely lacking in detail and explanation.

40.5 pts

This criterion is linked to a Learning OutcomeTopic

30 to >24.6 pts

Accomplished

A summary about one specific topic that was discussed at the meeting and an explanation of the committee process is included and clear.

24.6 to >22.5 pts

Emerging

A summary about one specific topic that was discussed at the meeting and an explanation of the committee process is included, but lacks clarity and detail.

22.5 to >0 pts

Unsatisfactory

A summary about one specific topic that was discussed at the meeting and an explanation of the committee process is absent or severely lacking in detail.

30 pts

This criterion is linked to a Learning OutcomeKey Stakeholder Position

30 to >24.6 pts

Accomplished

Illustrates an in-depth analysis of key stakeholder positions related to the topic discussed.

24.6 to >22.5 pts

Emerging

Analysis of key stakeholder positions related to the topic is discussed, but is missing some components and may be unclear.

22.5 to >0 pts

Unsatisfactory

Analysis of key stakeholder positions related to the topic may be absent or severely lacking in detail.

30 pts

This criterion is linked to a Learning OutcomeKey Interactions & Outcomes

34.5 to >28.29 pts

Accomplished

Effectively summarizes key interactions that occurred at the meeting and outcomes of the meeting, including the specific topic focus.

28.29 to >25.88 pts

Emerging

Some key interactions that occurred at the meeting and outcomes of the meeting, including the specific topic focus are included, but missing relevant details and information.

25.88 to >0 pts

Unsatisfactory

Key interactions that occurred at the meeting and outcomes of the meeting, including the specific topic focus may be absent or severely lacking in detail.

34.5 pts

This criterion is linked to a Learning OutcomeOrganization, Writing & APA

15 to >12.3 pts

Accomplished

APA format is followed. Written in a clear, concise, formal, and organized manner. Information from sources is paraphrased appropriately and accurately cited.

12.3 to >11.25 pts

Emerging

APA format is mostly followed. Writing is generally clear and organized but is not concise or formal in language. Multiple errors exist in spelling and grammar with minor interference with readability or comprehension. Most information from sources is paraphrased and cited correctly.

11.25 to >0 pts

Unsatisfactory

APA format may not be followed. Writing is generally unclear and unorganized. Errors in spelling and grammar detract from readability and comprehension. Sources are missing or improperly cited.

15 pts

Total Points: 150

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1
Public Policy Meeting Paper
Student’s Name
West Coast University
NURS 510 Policy Organization and Financing Healthcare
Dr. Johns
Due Date
2
Public Policy Meeting Paper
The public policy meeting that I viewed was a hearing conducted by the Senate Health,
Education, Labor and Pensions Subcommittee on Employment and Workplace Safety. The
purpose of the hearing was to discuss the growing shortage of medical professionals and how the
shortage was worsened by the COVID pandemic. The hearing consisted of a witness panel of
four professionals who are not only stakeholders in the industry but are also experts in their
specific field of work.
Participants and Topics Discussed
The hearing was conducted and lead by Chairman Senator John Hickenlooper. The
members that participated in the hearing were ranking member Senator Mike Braun, Senator Bill
Cassidy, Senator Patty Murray, Senator Tammy Baldwin, Senator Tommy Tuberville, and
Senator Jacky Rosen. The hearing included a special panel of witnesses who gave a presentation
of different topics. The first witness was Dr. Margaret Flinter, PhD, APRN who is the Senior
Vice President and Clinical Director at the Community Health Center Incorporated in Clinton,
CT. The second witness was Dr Reynold Verret, President of Xavier University of Louisiana.
The Third witness was Norma Quinones who is the Nursing Services Manager at Clinica Family
Health in Lafayette, CO. The fourth witness was Rachel Greszler who is an economist and is the
Senior Policy Analyst and Research Fellow at the Heritage Foundation. The topics that were
discussed included identifying talent before college, diversifying the health care workforce,
addressing primary care shortages, health care training, and student debt. All of these topics are
both important factors and potential barriers that affect the health care worker shortage in the
U.S.
Background
The health care worker shortage has been an ongoing problem in the U.S. that has affected
the availability and delivery of quality health care. The recent COVID-19 pandemic has
exacerbated this problem to a critical level, as hospitals and health care systems around the
3
country were overwhelmed with patients during each viral surge that took place. Short staffing,
inadequate caregiver to patient ratios, and health care worker fatigue acted as compounding and
detrimental stressors on an already burdened health care industry.
During his opening speech, Chairman Hickenlooper stated that The Association of
American Medical Colleges estimated that by the year 2034 there will be a shortage of 124,000
Physicians. There will also be a need to hire an additional 200,000 nurses per year to keep up
with those demands. It is also important to note that the coming retirement of nurses from the
baby boomer generation will add to the number of nurses needed. According to data from the
Bureau of Labor Statistics, employment projections of RNs from 2019-2029 suggest that there
will be 175,900 job openings for RNs each year through 2029 (Rosseter, 2020). Job stress from
the pandemic has also further added to the shortage. During his opening remarks, Senator Mike
Braun noted that a study in October 2021 found that 18% of health care workers had quit their
job, and an additional 31% were thinking about leaving.
Subcommittee Description, Logistics, Interactions, and
Outcomes
The hearing was conducted on February 10, 2022, at the Dirksen Senate Office Building
and was recorded and made available on C-Span. The Subcommittee on Employment and
Workplace Safety exists to address employment issues such as worker health and safety,
workforce education and training, wage and hour laws, and workplace flexibility (U.S. Senate
Committee on Health, Education, Labor and Pensions, n.d). The hearing began with opening
remarks by Chairman Hickenlooper and Ranking Member Braun, including statistical data about
the health care worker shortage. The members then presented each of the expert witness on the
panel, sharing their backgrounds and accolades. Next, each witness was given a time allotment to
present their views on addressing the health care worker shortage, which took about 45 minutes
in total. After the witness presentations, there was a time allotment for the committee members
to ask questions of each witness. Responses were supposed to be limited to one minute but all of
4
the witness went over their allotted time and were told anything about it. The questioning took an
additional 45 minutes. After all members were allowed to ask their questions. Chairman
Hickenlooper then gave closing remarks and adjourned the hearing. The hearing was about an
hour and thirty minutes in length. There were no specific outcomes from the meeting as the
intention of this meeting was to allow for a hearing of key witnesses on the topics discussed.
Highlighted Topic and its importance to the Committee
Process
Dr. Margaret Flinter, PhD, APRN, was the first witness that presented to the committee.
Dr. Flinter was by far the most powerful presenter at the hearing. She brought up a solid, credible
idea to the committee that would significantly help address the healthcare worker shortage. She
suggested that nurse practitioners should be the “bedrock, the core, and the foundation of
primary care.” She also stated that in order to do this, we need to make it a standard that all NPs
undergo a 1-year post-graduate residency program in their specialty, which in this case is
primary care. Dr. Flinter is the founder of the Nurse Practitioner Residency Program that is
already in use by the Community Health Center. This Program is specially designed and
structured to ensure intensive clinical training with expert preceptors. Dr. Flinter stated that this
extra training also enhances an NP’s skills to improve practice, health care delivery, and enhance
their ability to provide quality preventative care and health promotion. The residency has proved
to give NPs the tools they need in order to be the lead in the primary care team. This is an
important topic of discussion because one of the purposes of a committee is to identify issues
that are suitable for legislative review and to recommend a course of action to the senate. If the
subcommittee agrees on Dr. Flinter’s view that NPs should be spearheading primary care, then
legislation may come in the future that can actually make that happen.
Key Stakeholders
A Stakeholder is a person or a group that has a concern or interest in an organization.
This typically includes the investors, employees, customers, suppliers/vendors who take part in
5
an organization. In healthcare, stakeholders include patients, providers (including individual
caregivers and institutions), payors, policy makers, and can include suppliers such as
pharmaceutical and medical equipment companies (Lübbeke et al., 2019). In the hearing, each of
the witness are key stakeholders who are affected by the topics that were discussed. For example,
Dr. Flinter’s company and NP training program would greatly benefit from a decision by
senators of the subcommittee to introduce future legislation that would make funding available
for NP post graduate residencies. Also, Dr Reynold Verret, President of Xavier University,
would naturally benefit from his suggestion of funding for ethnically diverse students seeking
careers in healthcare, which was the topic he discussed in his presentation. Other key
stakeholders included members of the subcommittee. For example, chairman Hickenlooper
expressed his views that there is a further need for diversity of health care workers during the
hearing, which was another topic that was covered. He also has an interest in seeing legislation
pass that would address that need, whether it be through funding or possible regulations.
Conclusion
The hearing conducted by the Subcommittee on Employment and Workplace Safety
brought up some important topics that are currently affecting health care in the U.S. today,
including worker shortage, enhancing Nurse Practitioner practice in primary care, the need for
diverse representation of healthcare workers, and the need for better training and funding for
future health care workers. I particularly enjoyed Dr. Flinter’s presentation on nurse practitioners
in primary care and how to better enhance NPs training to make them leaders in primary care. It
was also very refreshing to see senators on both sides of the political spectrum interacting in a
polite and professional manner. The only we can truly get good policies and legislation passed is
through true bipartisanship, and it is going to take good collaboration of both political parties to
solve the health care worker shortage.
6
References
C-Span (2022, February 10) Senate Health, Education, Labor and Pensions Subcommittee on
Employment and Workplace Safety: Hearing on Reducing Health Care Worker Shortage
[Video] C-Span.org https://www.c-span.org/video/?517865-1/hearing-reducing-healthcare-worker- shortage
Lübbeke, A., Carr, A. J., & Hoffmeyer, P. (2019). Registry stakeholders. EFORT open
reviews, 4(6), 330–336. https://doi.org/10.1302/2058-5241.4.180077
Rosseter, Robert. (2020) Fact Sheet: Nursing Shortage. American Association of Colleges of
Nursing. https://www.aacnnursing.org/Portals/42/News/Factsheets/Nursing-ShortageFactsheet.pdf
U.S. Senate Committee on Health, Education, Labor and Pensions. (n.d.) About Subcommittee.
https://www.help.senate.gov/about/subcommittees

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HCI-214: Consumer Health Informatics

Jun 14, 2024 | Health Medical

Description

PurposeThe purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos. Action Itemsfrom your reading and watching the video, give some examples of human centred designe?

261 pre Judy

Jun 14, 2024 | Health Medical

Description

topic is Health risks for health workers on night shift.

➢ Font should be 12 Times New Roman

➢ Heading should be Bold

➢ Line spacing should be 1.5

➢ Avoid Plagiarism

➢ The presentation must be submitted on blackboard with the filled cover page as a Word file and as ppt slides by the leader for each group by email for the instructor.

➢ Use graphics and shapes whenever you can

➢ All assignments must carry the references using APA style. Please see below the weblink about how to cite APA reference style.https://guides.libraries.psu.edu/apaquickguide/intext.Click or tap to follow the link.

➢ How to Create a Poster in PowerPoint

– Each presentation should consist of 15-20 slides minimum and includes these elements in the following order:

▪ Cover sheet.

▪ Outline.

I do have an anatomy lab2 experiments

Jun 14, 2024 | Health Medical

Description

All Experiments are attached below. Please answer each one in its file and send them back, DO NOT MIX THEM BECAUSE EACH ONE HAS A DIFFERENT DROPBOX.Please, if there are any questions, let me know. Do not hesitate yourself by asking me. I hope everything is clear for you in the attached files.

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PRE-LAB QUESTIONS
1. What are the functional requirements of life?
2. Using Table 1, identify the major similarities and differences between prokaryotic and
eukaryotic cells.
3. Where is DNA housed in a prokaryotic cell? Where is it housed in a eukaryotic cell?
4. Compare and contrast the role of secretory vesicles, the lysosome, and the peroxisome.
5. Identify three structures that provide support and protection in a eukaryotic cell.

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clinical week 5

Jun 14, 2024 | Health Medical

Description

Describe your clinical experience for 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 White male , 55 years old came in with complaints of lower back pain.Assessed pt’s back, pt back was asymmetrical on the left side. More tender when touched. Pt stated he fell on hisboat in July bt never wen tot the doctor to get it checked out. Lumbar Xray shows compression fracture of L4-L5 Refer pt to orthopedic surgeon . Pt prescribed Baclofen 10 mg TID X 3 days Ibuprofen 600 q6 hours for pain. Pt educated to not lift anything greater than 5 pounds to avoid any strain on the back
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 post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources.

ST3003 Normal Distribution and Confidence Intervals

Jun 14, 2024 | Health Medical

Description

Overview

Access the following to complete this Assessment:

ST3003 Rubric
ST3003 Assessment Template
Research Article PDF

For this Performance Task, you will compute confidence intervals and hypothesis tests for normal distributions. You will be assessed on the Professional Skills of Written Communication, Interpreting Data & Quantitative Fluency, and Technology. To make certain you are addressing all aspects of the Professional Skills, please review the rubric to determine what is necessary for meeting the requirements. Visit the Professional Skills resources, as needed. Your response to this Performance Task should reflect the criteria provided in the rubric and adhere to the required length.

Instructions

To complete this Assessment, do the following:

Be sure to adhere to the indicated assignment length.

IMPORTANT INFORMATION ON INTERPRETING THE ASSESSMENT RUBRIC (CLICK TO EXPAND)

Rubric

This Assessment requires submission of two (2) files. The first file is completed on the provided template and includes the two parts. Save your file as follows:

ST3003_firstinitial_lastname _project (e.g., ST3003_J_Smith)

The second file should is your excel file where all computations are completed for the assessment. Save this file as

ST3003_firstinitial_lastname_excelwork (e.g., ST3003_J_Smith)

When you are ready to upload your completed Assessment, select Submit Attempt.

Click each of the items below for more information on this Assessment.

PART 1: CONFIDENCE INTERVALS IN RESEARCH

This part will make use of the following article, which explores how prevalent depression, anxiety, and stress are in healthcare workers at COVID 19 isolation sites in Botswana:

Siamisang, K., Kebadiretse, D., Tjirare, L. T., Muyela, C., Gare, K., & Masupe, T. (2022). Prevalence and predictors of depression, anxiety and stress among frontline healthcare workers at COVID-19 isolation sites in Gaborone, Botswana. PLoS ONE, 17(8), e0273052. https://doi.org/10.1371/journal.pone.0273052

Table 3 of the journal article displays the number of healthcare workers who report various levels of depression, anxiety, and stress. These numbers are presented as the number of workers as well as the percent of the total (447). Confidence intervals are given for each percentage value. Choose one level of either depression, anxiety, or stress (e.g., normal depression) to use to address the following questions.

Show how the given percentage was derived based on the sample data.
Write 1–2 sentences explaining how the confidence interval would be interpreted.
Based on this interval, provide one value that could be considered reasonable as the true population proportion and one that would not be considered reasonable as the true population proportion. Fully explain your reasoning.
If a subsequent study was completed that increased the sample size to 1,000 participants, explain one change you would expect to see in the confidence intervals. Explain why you feel this change would occur.

Table 1 of this journal article provides a breakdown of characteristics of the 447 participants in this study. The number of participants is given followed by the percentage in ().

Provide one reason why you believe a confidence interval was not presented for this data.

PART 2: USING THE NORMAL DISTRIBUTION

Open the Body Data file created in ST3001 and use this to address the following questions.

Given that BMI is approximately normally distributed, present the following summary statistics for BMI of smokers and nonsmokers (Hint: Think about ST3001.).

Smokers

Nonsmokers

Mean

Standard deviation

Sample size (n)

Use this table to answer the following questions based on your individual data. For each part, write a 1-sentence explanation as to how Excel was used to assist you in your computations.

Find the percent of smokers expected to have a BMI of greater than 25 (overweight).
Find the percent of nonsmokers expected to have a BMI of less than 18.5 (underweight).
A normal BMI range is between 18.5 and 24.9. Shat percent of smokers are expected to be within this range? What percent of nonsmokers are expected to be within this range?
A researcher is interested in which BMI represents the 90th percentile (90% are at this BMI level or lower). What BMI score represents the 90th percentile cutoff rate?
PART 3: CREATING CONFIDENCE INTERVALS

Using the information from Part 2 above, calculate a 90%, 95%, and 99% confidence interval for both groups and complete the following table:

Group

90% confidence interval

95% confidence interval

99% confidence interval

Smokers

Nonsmokers

As the level of confidence increases, what happens to the width of the confidence interval: Does it increase or decrease? Explain one reason why this would happen.
Using the 95% confidence interval, compare the BMI of smokers vs. nonsmokers. Write a 2- to 3-sentence paragraph explaining whether these intervals overlap or not. What does that indicate about the differences in BMI between the two groups?
Explain in 1–2 sentences one situation in which you as a researcher might choose a 99% confidence interval or a 90% interval. Fully justify your choice.

discussion questions

Jun 14, 2024 | Health Medical

Description

5 discussion questions. Answers must be at least 40 words each. APA format with at least two scholarly resources. I have attached chapter 7 in case you need it.

Sara E. Wilensky and Joel B. Teitelbaum

When I took office, health care costs had risen rapidly for decades, and tens of millions of Americans were uninsured. Regardless of the political difficulties, I concluded comprehensive reform was necessary. The result of that effort, the Affordable Care Act (ACA), has made substantial progress in addressing these challenges. Americans can now count on access to health coverage throughout their lives, and the federal government has an array of tools to bring the rise of health care costs under control. However, the work toward a high-quality, affordable, accessible health care system is not over. (Obama, 2016, p. 526)

Discussion Question 1

Even though the primary legislative bills to repeal and replace the Affordable Care Act (ACA)—the AHCA and BRCA—did not have sufficient support across U.S. Congress to become law, and some of their provisions may not have been allowed under reconciliation rules, it is worth considering the main features of the bills to understand the type of health reform changes many Republicans support (see TABLE 7-1). Overall, these bills reduced taxes, eliminated government mandates, lowered federal government spending, lowered premiums for some people while increasing them for others, phased out the Medicaid expansion under the ACA, and ended Medicaid as an entitlement program. According to the nonpartisan Congressional Budget Office (CBO), the effect of the bills would be to significantly increase the number of uninsured, significantly reduce the deficit, lower costs for young and healthy consumers, and increase costs for older and poorer consumers (Congressional Budget Office, June 26, 2017; Congressional Budget Office, July 23, 2017). Everyone agrees the ACA can be improved. Are there features of these bills that you think have merit? Should states have more flexibility under the ACA? How much of the cost burden should young and healthy individuals bear in order to make health insurance more affordable for elderly and sicker individuals?

Discussion Question 2

Are there alternatives to the individual mandate that accomplish the same goals without engendering so much political turmoil? Could policymakers have designed an incentive system that would be as effective as a mandate? What are the pros and cons of using a mandate versus an incentive? Can you think of incentives to encourage enrollment that have occurred in other parts of the healthcare system?

Discussion Question 3

There was a lengthy debate about whether to include a public option in health reform. A public option is some type of government-run health plan that would be available to compete with private plans. A public option could exist within the health exchange model or outside of it. Instead of a public option, Congress voted to require the Office of Personnel Management, which runs the Federal Employees Health Benefit Program, to contract with at least two multistate plans in every state health insurance exchange.

What are the pros and cons of having a public option? Does the Office of Personnel Management compromise achieve all or some of the goals of having a public option? Why do you believe the Office of Personnel Management compromise was acceptable to legislators but the public option was not?

Discussion Question 4

Republican policymakers that are involved in bipartisan discussions to revise the ACA are focused on providing states with increased flexibility regarding benefit design, premium pricing, and other features. Although states are generally home to social welfare changes, it is difficult to provide universal health care on a state-by-state basis. If state health reform efforts lead the way, the country could have a patchwork of programs and policies that vary from state to state, with the potential to make health coverage even more complex and inefficient than it is currently. On the other hand, it is also important to recognize that a health reform strategy focusing on states has benefits as well. At its best, state-level reform can be accomplished more rapidly and with more innovation than at the federal level. State legislatures may have an easier time convincing a narrower band of constituents important to the state than Congress has in accommodating the varied needs of stakeholders nationwide.

What are the advantages and disadvantages of compromising regarding the state role in the ACA? Is it worth giving up some degree national uniformity and stronger consumer protections in exchange for political stability and allowing state to experiment with health reform design? How well do you think the public will be served in their access to affordable health insurance and access to health care if states have more control? How does your response differ if you are living in California or New York versus Texas or Florida?

Discussion Question 5

A group of friends were talking about the Affordable Care Act (ACA), illustrating the wide-ranging viewpoints about the law. Calvin, whose daughter Mia is struggling to make a living as an artist, is pleased that Mia has health insurance for the first time since graduating from college. Although Mia cannot stay on her parents’ insurance because she just turned 27, she can now afford a good health insurance plan that she found on her state’s health exchange. While Calvin has not noticed much of a change in his own health insurance coverage, which he obtains through his government employer, his friend Katherine is upset about health reform. She does not want the government forcing her to purchase health insurance (although she always chose to be insured in the past), and she recently found out that her old plan was cancelled because it did not meet the law’s requirements. Katherine found several new plan options to choose from, but none had her exact combination of benefits, providers, and price. In addition, Katherine’s uncle, Ethan, is 55 years old and self-employed. He purchases his health insurance on his state’s exchange and because he has preexisting conditions, he is grateful to be able to find a plan. Even so, Ethan’s premiums will increase by 15% this year and his deductible is $5,000, making health care difficult to afford even with insurance. Another friend, Jara, told Katherine she should be willing to pay a little more or change some aspects of her plan to help the millions of people who can now afford insurance for the first time as a result of the ACA. After witnessing her uncle’s experience, however, Katherine is skeptical that the government is going to be able to keep its promises.

What are the competing viewpoints about the ACA exemplified by these friends? Which of these friends’ views will be the most pressing concern going forward in the discussions about the ACA?

Unformatted Attachment Preview

Health Reform in the United States: Recent and Past History
The array of problems facing the healthcare system has led to numerous health reform proposals and
implemented policies. The concept of health reform can have several different meanings. Given the
patchwork health insurance system, health reform often refers to changes that seek to reduce the
number of uninsured. Due to the high and increasing cost of healthcare services, health reform might
also include changes that seek to contain costs and control utilization. The notion of health reform could
also address other shortcomings, such as trying to reduce medical errors, strengthening patient rights,
building the public health infrastructure, and confronting the rising cost of medical malpractice
insurance. The Affordable Care Act (ACA), the federal health reform law passed in 2010, touches on
many of these issues (Patient Protection Affordable Care Act, 2010).
Health reform has been difficult to achieve in the United States. Many reform efforts have been
attempted, with varying degrees of success, on a national level. Numerous authors have addressed the
main factors that deter significant social reform in this country, including health reform (Blake &
Adolino, 2001; Gordon, 2003; Jost, 2004). Factors that are prominently discussed include the country’s
culture, the nature of U.S. political institutions, the power of interest groups, and path dependency (i.e.,
the notion that people are generally opposed to change).
Americans have a complicated and partisan view of the proper role of the federal government in the
healthcare arena. On one hand, 60% of respondents to a 2017 survey felt that the federal government
has a responsibility to ensure healthcare coverage for all Americans (Pew Research Center, 2017). This is
much higher than the 47% who shared that view in 2010, at the height of the health reform debate
(Newport, 2010). Of those who supported federal intervention in the 2017 survey, 33% would like to see
a single-payer system developed (Pew Research Center, 2017).
At the same time, there was a stark difference of opinion based on the respondent’s political views.
While 85% of Democrats and Democrat-leaning independents believed the federal government was
responsible for ensuring healthcare coverage, only 32% of Republicans and Republican-leaning
independents agreed (Pew Research Center, 2017). Even so, over half (57%) of Republicans and
Republican-leaners supported the continuation of Medicaid and Medicare, the country’s largest public
health insurance programs. Furthermore, only 5% of respondents thought the federal government
should not have any role in ensuring healthcare coverage (Pew Research Center, 2017).
Many aspects of the U.S. political system also make it difficult to institute sweeping reform. For
example, although presidents have significant influence on policy agenda setting and proposing budgets,
they have limited power to make changes without the assistance of the U.S. Congress. The federal
government is often politically divided, with different parties holding power in the executive and
legislative branches. This division often results in partisanship and policy inaction due to different policy
priorities and views.
Furthermore, although members of Congress may ride the coattails of a popular president from their
own party, they are not reliant on the president to keep their jobs. The issues and views their
constituents care about most may not align with the president’s priorities. In those cases, members of
Congress have a strong incentive to adhere to the wishes of those who vote for them, instead of simply
following the president’s lead. Barring an overwhelming wave of discontent, as occurred in the 2010
midterm elections when Democrats suffered historic losses in Congress, it is usually difficult to unseat
incumbents. Even when there is a historic level of turnover, reelection rates remain very high. For
example, 97% of House incumbents successfully defended their seats in 2016; even in the Senate, where
turnover is relatively more common, 93% of incumbents won reelection in 2016 (Kondick & Skelley,
2016). As a result, legislators in Congress may have confidence in focusing on their district’s or state’s
needs before those of the entire nation.
Federal legislative rules also support inaction or incremental reform over sweeping changes. In the U.S.
Senate, 60 (of 100) votes are needed to break a filibuster in most cases. Thus, even the political party in
the majority can have difficulty effectuating change. One exception to the filibuster rule is the
“reconciliation” process, which allows bills to pass with only 51 votes. Reconciliation is used as part of
the budgetary process, and bills passed via reconciliation: (a) may not be filibustered (so can pass with
51 votes), (b) can only pertain to federal revenue and spending issues, (c) must comply with spending
and revenue targets set forth in the budget resolution, and (d) must adhere to other budgetary rules
(Tax Policy Center, 2017). The reconciliation process is being increasingly used when one party maintains
a slim majority and that party cannot find 60 votes to pass a bill. In 2010, the Democrats used a
reconciliation bill to pass the ACA after they lost their filibuster-proof majority, and recently, the
Republicans attempted to use a reconciliation bill to pass their ACA repeal and replace bills.
Historical Attempts and Failures at Health Reform
Since the early 1900s, when medical knowledge became advanced enough to make health care and
health insurance desirable commodities, there have been periodic attempts to implement universal
coverage through national health reform. The Socialist Party was the first U.S. political party to support
health insurance in 1904, but the main engine behind early efforts for national reform was the American
Association for Labor Legislation (AALL), a “social progressive” group that hoped to reform capitalism,
not overthrow it (Starr, 1982, p. 243). In 1912, Progressive Party candidate Theodore Roosevelt
supported a social insurance platform modeled on the European social insurance tradition that included
health insurance, workers’ compensation, old-age pensions, and unemployment insurance. After his loss
to Woodrow Wilson, the national health insurance movement was without a strong national leader for
three decades.
The AALL continued to support a form of health insurance after Roosevelt’s defeat and drafted a model
bill in 1915. This bill followed the European model, limiting participation to working class employees and
their dependents. Benefits included medical aid, sick pay, maternity benefits, and a death benefit. These
costs were to be financed by employers, employees, and the state. The AALL believed that health
insurance for the working population would reduce poverty and increase society’s productivity and wellbeing through healthier workers and citizens.
Opposition to AALL’s bill came from several sources (Starr, 1982, pp. 247–249). Although some members
of the American Medical Association (AMA) approved of the bill conceptually, physician support rapidly
evaporated when details emerged about aspects of the plan that would negatively impact their income
and autonomy. The American Federation of Labor (a labor union) opposed compulsory health insurance
because it wanted workers to rely on their own economic strength, not the state, to obtain better wages
and benefits. In addition, the federation was concerned that it would lose power if the government, not
the union, secured benefits for workers. Employers were generally opposed to the bill, contending that
supporting public health was a better way to ensure productivity. In addition, they feared that providing
health insurance to employees might promote malingering instead of reducing lost workdays. After
experiencing the high cost associated with workers’ compensation, employers also were not eager to
take on an additional expensive benefit. Of course, the part of the insurance industry that had already
established a profitable niche in the death benefit business was strongly opposed to a bill that included
a death benefit provision. Employers, healthcare providers, and insurers have, in general, remained
staunch opponents of national health reform over the years, whereas unions have supported national
reform efforts. However, this dynamic has changed recently with more provider groups, employers, and
even some insurers calling for a national solution to the problems of rising healthcare costs and the
uninsured.
The country’s entry into World War I in 1917 also changed the health reform debate. Many physicians
who supported the AALL bill entered the military, shifting their focus away from the domestic health
policy debate. Anti-German sentiment was high, so opponents of the bill gained traction by denouncing
compulsory health insurance as anti-American. One pamphlet read: “What Is Compulsory Social Health
Insurance? It is a dangerous device, invented in Germany, announced by the German Emperor from the
throne the same year he started plotting and preparing to conquer the world” (Starr, 1982, p. 253).
The next time national health insurance might have taken hold was from the mid-1930s through the
early 1940s as the country was coping with the difficulties of the Great Depression. During this time
there was a significant increase in government programs, including the creation of Social Security in
1935, which provided old-age assistance, unemployment compensation, and public assistance. Yet the
fourth prong of the social insurance package, health insurance, remained elusive. President Franklin
Roosevelt heeded his staff’s advice to leave health insurance out of Social Security because of the strong
opposition it would create (Starr, 1982, p. 267). Opposition from the AMA was particularly strong—they
believed that “socialized medicine” would increase bureaucracy, limit physician freedom, and interfere
with the doctor–patient relationship.
Even so, members of Roosevelt’s administration continued to push for national health insurance. The
Interdepartmental Committee to Coordinate Health and Welfare Activities was created in 1935 and took
on the task of studying the nation’s healthcare needs. This job fell to its Technical Committee on Medical
Care. Instead of supporting a federal program, the committee proposed subsidies to the states for
operating health programs. Components of the proposal included expanding maternal and child health
and public health programs under Social Security, expanding hospital construction, increasing aid for
medical care for the indigent, studying a general medical care program, and creating a compensation
program for those who lost wages due to disability.
Although President Roosevelt established a National Health Conference to discuss the recommendation,
he never fully supported the Medical Care Committee’s proposal. With the success of conservatives in
the 1938 election and the administration’s concerns about fighting the powerful physician and state
medical society lobbies, national health reform did not have a place on Roosevelt’s priority list. Senator
Robert Wagner (D-NY) introduced a bill that followed the committee’s recommendations in 1939, and
although it passed in the Senate, it did not garner support from the president or from the House.
World War II provided another opportunity for the opposition to label national health insurance as
socialized medicine. But once the war neared an end, President Roosevelt finally called for an “economic
bill of rights” that included medical care. President Truman picked up where Roosevelt left off, strongly
advocating for national health insurance. President Truman’s proposal included expanding hospitals,
increasing public health and maternal and child health services, providing federal aid for medical
research and education, and, for the first time, a single health insurance program for all (Starr, 1982, p.
281). Heeding lessons from earlier reform failures, Truman emphasized that his plan was not socialized
medicine and that the delivery system for medical and hospital care would not change.
Again, there was strong opposition to the proposal. The AMA vehemently rejected the proposal, and
most other healthcare groups opposed it as well. Although the public initially approved of it, there was
no consensus about how national health insurance should be structured, and more people preferred
modest voluntary plans over a national, compulsory, comprehensive health insurance program (Starr,
1987, p. 282). Additional opposition came from the American Bar Association, the Chamber of
Commerce, and even some federal agencies concerned about losing control over their existing
programs. In the end, only the hospital construction portion of the proposal was enacted.
When Truman won reelection on a national health insurance platform in 1948, it appeared the tide had
turned. However, the AMA continued its strong opposition and its attempts to link national health
insurance to socialism. Congress considered various compromises but never reached a consensus. The
public remained uncertain about what kind of plan to favor. Employers maintained their opposition to
compulsory insurance. In addition, one large group of potential supporters—veterans—was
disinterested in the debate because they had already secured extensive medical coverage through the
Veterans Administration. As the Korean War moved forward, Truman’s focus shifted away from national
health insurance and toward the war effort and other priorities.
National health insurance did not return to the national policy agenda until the 1970s. The landscape
then was quite different from Truman’s era. Medicaid and Medicare had been created, healthcare costs
had begun to rise exponentially, and the economy was deteriorating. In 1969, President Nixon declared
that a “massive crisis” existed in health care and that unless it was fixed immediately, the country’s
medical system would collapse (Starr, 1982, p. 381). The general public seemed to agree, with 75% of
respondents in one survey concurring that the healthcare system was in crisis (Starr, 1982, p. 381).
Democrats still controlled Congress by a significant margin, and Senator Edward Kennedy (D-MA) and
Representative Martha Griffiths (D-MI), the first woman to serve on the powerful House Committee on
Ways and Means, proposed a comprehensive, federally operated health insurance system.
At the same time, a movement supporting health care and patient rights was gaining momentum. These
included rights to informed consent, to refuse treatment, to due process for involuntary commitment,
and to equal access to health care (Starr, 1982, p. 389). The public was both anxious to obtain care and
willing to challenge the authority of healthcare providers.
The Nixon administration’s first attempt at health reform focused on changing the healthcare system’s
financing from one dominated by a fee-for-service system, which created incentives to provide more
and more expensive services, to one that promoted restraint, efficiency, and the health of the patient.
The result was a “health maintenance strategy” intended to stimulate the private industry to create
health maintenance organizations (HMOs) through federal planning grants and loan guarantees, with
the goal of enrolling 90% of the population in an HMO by the end of the 1970s (Starr, 1982, pp. 395–
396). Ironically, group health plans, often labeled socialized medicine, had become the centerpiece of a
Republican reform strategy.
Nixon’s proposal included an employer mandate to provide a minimum package of benefits under a
National Health Insurance Standards Act, a federally administered Family Health Insurance Program for
low-income families that had a less generous benefit package than the one required by the National
Health Insurance Standards Act; reductions in Medicare spending to help defray the costs; a call for an
increase in the supply of physicians; and a change in how medical schools were subsidized. Opponents
were plentiful, and this plan did not come to fruition. Some believed the plan was a gift to private
insurance companies. Advocates for the poor were outraged at the second tier of benefits for lowincome families. The AMA was concerned about HMOs interfering with physician practices and
supported an alternative that provided tax credits for buying private insurance.
After the 1972 election, Nixon proposed a second plan that covered everyone and offered more
comprehensive coverage. Private insurance companies would cover the employed and a governmentrun program would cover the rest of the population, with both groups receiving the same benefit
package. Senator Kennedy and Representative Wilbur Mills (D-AR) supported a similar plan, and it
appeared a compromise was close at hand. However, labor unions and liberal organizations preferred
the original Kennedy plan and resisted compromising with the hope of gaining power in the 1974 postWatergate elections. Fearing the same political shift, insurance companies actually supported a
catastrophic insurance plan proposed by Senator Russell Long (D-LA), believing it was better than any
plan that would come out of a more liberal Congress after the elections. Once again, there was no
majority support for any of the bills, and a national health insurance plan was not enacted.
Although President Jimmy Carter gave lip service to national health reform, he never fully supported a
proposal. It was not until the election of Bill Clinton in 1992 that the next real attempt at national health
insurance was made. The Clinton administration plan, dubbed the Health Security Act, was designed to
create national health insurance without spending new federal funds or shifting coverage from private
to public insurance. It relied on the concept of “managed competition,” which combined elements of
managed care and market competition.
Under the Health Security Act, a National Health Board would have established national and regional
spending limits and regulated premium increases. “Health alliances” would have included a variety of
plans that were competing for the business of employees and unemployed citizens in each geographic
area. All plans were to have a guaranteed scope of benefits and uniform cost sharing. Employers would
have been required to provide coverage for their workers at a defined high level of benefits, and those
with 5,000 employees or fewer would have had to purchase plans through the health alliance. Subsidies
were provided for low-income individuals and small businesses. Funding was to be provided from costcontainment measures that were reinvested. Forced by the Congressional Budget Office (CBO) to
provide an alternative funding strategy should the cost containment not create enough funds, the plan
also included the option of capping insurance premium growth and reducing provider payments.
Like the national health insurance plans before it, the Health Security Act had opponents from many
directions. The health alliances were attacked as big government, employers resisted mandates and
interference with their fringe benefits, some advocates feared that cost containment would lead to care
rationing, the insured were concerned about losing some of their existing benefits or cost-sharing
arrangements, the elderly feared losing Medicare, and academic health centers were concerned about
losing funds based on new graduate medical education provisions. In addition, the usually strong
support from unions was missing because of an earlier disagreement with the president on trade
matters. It is also generally accepted that the Clinton administration made several political mistakes that
made a difficult political chore nearly impossible. The Health Security Act never made it to a vote.
The ACA Becomes Law
In many ways, 2010 was a very unlikely year to pass a national health reform plan. The country had been
growing increasingly ideological, with the popular and electoral votes almost evenly split in both the
2000 and 2004 presidential elections. Even though Barack Obama won the electoral vote in a landslide
over John McCain (365 to 173), only 53% of the population voted for Obama in 2008 (CNN, 2008).
In addition to the ideological divide, and against a backdrop of a faltering economy, partisan differences,
and the recent passage of two massive government spending bills, President Obama pursued a national
health reform plan. Given the history of failed reform efforts, it would have been an accomplishment to
pass health reform in the best of times, and clearly this was not the best of times.
Health care has long been a priority for Democrats, and President Obama was no exception. Perhaps
Obama’s dedication to passing health reform stemmed in part from his personal experience: Obama’s
mother died of ovarian cancer, and he had seen her worry about paying her medical bills as much as
beating the disease (CNN, 2007). Thus, for Obama, signing comprehensive health reform legislation into
law would represent the opportunity to make sure that others would not endure the same experience.
Health reform efforts did not begin smoothly. President Obama initially wanted former U.S. senator Tom
Daschle to run both the U.S. Department of Health and Human Services (USDHHS) and the White House
Office on Health Reform. It was thought that his experience in the Senate and relationships with
legislators were the right combination to take the lead on health reform. When his nomination was
derailed due to personal tax problems, it was not a good omen. As deliberations in Congress lagged,
Democrats were not able to present a bill to President Obama before recessing for the summer. During
the summer of 2009, members of Congress went home to their constituents and held town hall
meetings to discuss health reform. Some of the meetings erupted in vocal opposition to health reform,
and the media focused on these town hall meetings throughout the summer. Obama and the Democrats
were criticized for losing the momentum for reform by letting the debate linger.
At the same time, there were several instances when the health reform effort appeared politically
doomed, and President Obama’s leadership made a clear difference. Obama attempted to reclaim the
upper hand on health reform with a speech to a joint session of Congress in September 2009. He
memorably proclaimed, “I am not the first president to take up health reform, but I intend to be the
last” (The New York Times, 2009). Although public support for health reform had been on the decline for
several months, September 2009 polls showed that 62% still thought it was important to address health
reform at that time, and 53% thought the country as a whole would be better off if health reform
passed (Kaiser Family Foundation, 2009). Less support existed for the Democrats’ specific reform
proposal, however, with 46% in support of the proposed change and 48% opposed to it (Cohen & Baltz,
2009).
In January 2010, an event occurred that some assumed was the death knell of health reform. In the
2008 elections, Democrats had made significant gains in Congress, earning a 59–41 majority in the
Senate and a 257–178 majority in the House. Furthermore, Senator Arlen Specter of Pennsylvania
switched parties, giving Democrats the crucial 60th vote needed for a filibuster-proof majority. Although
the numbers were now in their favor, President Obama, Senate Majority Leader Harry Reid (D-NV), and
House Speaker Nancy Pelosi (D-CA) would have to balance the competing interests of conservative
Democrats who were concerned with having too much government intervention, progressive Democrats
who sought a public insurance option to compete with private companies, Blue Dog Democrats who
were most concerned with fiscal discipline, and pro-life and pro-choice factions who would battle over
whether and how abortion services would be included in any health reform bill.
The Obama administration tried to avoid events that doomed earlier health reform efforts. Although the
failed effort by the Clinton administration probably provided the most relevant lessons, Obama
confronted some of the same obstacles that reformers had faced decades earlier. At times, President
Obama was accused of learning some of the lessons too well, swinging the pendulum too far to the
other side. Obama was not alone in providing leadership on health reform. Reid’s and Pelosi’s
determination to see health reform succeed, and their skill in mobilizing and controlling their caucuses,
were essential to the passage of the ACA. It is likely that health reform would not have passed without
the skillful efforts of all three leaders working together. Even so, it is clear that the health reform effort
would not even have begun without a president who put health reform at the top of the agenda and
stuck with it despite the pitfalls and political opposition.
The legislative process for completing the bill was long, rocky, and ultimately partisan. The House of
Representatives moved more quickly and with less fractious debate than the Senate. Instead of having
multiple House committees work on competing bills, as occurred during the Clinton administration,
House Democratic leaders created a “Tri-Committee” bill jointly sponsored by Charles Rangel (D-NY),
Henry Waxman (D-CA), and George Miller (D-CA), the chairmen of the House Ways and Means, Energy
and Commerce, and Education and Labor (later renamed the Education and Workforce committee)
committees, respectively. On November 7, 2009, the House passed its health reform bill with only two
votes to spare, 220–215 (Affordable Health Care for American Act, H.R. 3962, 2009). Only one
Republican voted for it, and 39 conservative Democrats voted against it. The bill from the then-moreliberal House contained several provisions that were likely to be rejected by the Senate: a public health
insurance option to compete with private plans, a national health insurance exchange instead of statebased exchanges, more generous subsidies for low-income individuals, a broader expansion of
Medicaid, and higher taxes on wealthier Americans.
Finance Committee Chairman Max Baucus (D-MT) led the effort in the Senate. The legislative process he
established was lengthy, and some observers believed he compromised on too many issues in an
attempt to forge a bipartisan bill. For a time Senator Charles Grassley (R-IA) actively participated in the
health reform deliberations, and a few other Republican senators appeared willing to consider a
bipartisan measure. Ultimately, however, a bipartisan agreement could not be reached. In a 2009
Christmas Eve vote, the Baucus health bill passed 60–39, with all Democrats and two Independents
voting for the measure and all Republicans voting against it (Patient Protection and Affordable Care Act,
H.R. 3590, 2009).
Following tumultuous disagreements with versions of the plan, and the loss of a filibuster-proof
majority, the House and Senate leaders agreed to use the budget reconciliation process to amend the
Senate bill. The House then passed the Senate version of the bill along with a companion reconciliation
bill that amended certain aspects of the Senate bill. The reconciliation bill included more generous
subsidies for individuals to purchase insurance than existed in the standalone Senate bill, the closure of
the Medicare Part D doughnut hole, a tax on more generous insurance plans, changes to the penalties
on individuals who would not buy insurance and for employers that would not offer insurance, and an
increase in Medicare and investment taxes for higher earners. The Senate then passed the reconciliation
bill. Once again, the final vote to approve the bills was along party lines. The House approved the Senate
bill by a vote of 219–212, with all Republicans and 34 Democrats voting against it (Khan, 2010).
President Obama signed the bill into law on March 23, 2010 (Patient Protection Affordable Care Act,
2010).
Some observers argue that Obama may have overlearned the lesson about working with Congress, and
that in doing so, he did not provide enough guidance to legislators and allowed the debate over health
reform to linger for too long (Morone, 2010, p. 1097). On the one hand, it is difficult to criticize Obama’s
approach because he was ultimately successful. On the other hand, could the problems stemming from
the 2009 town halls have been avoided? Would public opinion of the health reform effort be higher if
the process had been better managed? Only time will tell whether Obama was successful over the long
term. With the volatility and divisive partisan bickering of today’s Congress, what the future holds is still
unclear.
Overview of the Patient Protection and Affordable Care Act
While President Obama left the details of health reform legislation to Congress, he did lay out what he
believed to be the most important principles that should guide the legislation’s development. Soon after
becoming president in 2009, Obama delineated those principles, saying that any health reform measure
should do the following:
Protect families’ financial health (slowing the growth of out-of-pocket expenses and protecting people
from bankruptcy due to catastrophic illness).
Make health insurance coverage more affordable (reducing administrative costs, wiping out
unnecessary tests and services, and limiting insurers’ ability to charge higher premiums for certain
populations).
Aim for insurance coverage universality.
Provide portability of insurance coverage.
Guarantee choice of health plans and providers (including keeping current ones).
Invest in disease prevention and wellness initiatives.
Improve patient safety and healthcare quality.
Maintain long-term fiscal sustainability (reducing cost growth, improving productivity, and adding new
revenue sources).
The extent to which these principles were brought to life in what eventually became the Affordable Care
Act lives along a spectrum: for example, (1) health insurance was absolutely made more affordable for
millions of people; (2) disease prevention and wellness initiatives seem to be gaining momentum,
though slowly; and (3) universal insurance coverage was absolutely not achieved. Whatever the case
with any particular principle, it is instructive to look to four key reforms that became law under the ACA
as having paved the way for President Obama’s overall vision to come to fruition. These four reforms
essentially reordered long-standing relationships among health system stakeholders (individuals,
providers, insurers, employers, governments, etc.). As a result of this reordering, all of these
stakeholders were legally obligated to alter normative behaviors. These changes include: (1) mandates
(individual and employer); (2) changes to private insurance rules; (3) creation of health insurance
exchanges; and (4) expansion of Medicaid.
The first major mandate change, known as the individual mandate, is a requirement that most
individuals maintain “minimum essential health coverage” (i.e., health insurance) or face financial
penalties that are spelled out in the ACA. This requirement was a critically important beam in the ACA
architecture; because it creates a new, large pool of individuals who will be paying premiums to
insurance companies, it created leverage for policymakers who were eager for private insurers to accept
many of the ACA’s other insurance reforms that may otherwise have been unpalatable. For certain
individuals whose socioeconomic status makes it impossible for them to purchase (or gain through an
employer) the type of minimum coverage mandated by the ACA, and who do not qualify for Medicaid
(even under the ACA expansion), federal subsidies are made available under the law.
The individual mandate is an essential part of health reform for several key reasons:
Adverse selection: Without the mandate, people who are in poor health or otherwise expect to use
more healthcare services would be more likely to purchase health insurance, while healthier people
would be more likely to opt out of insurance coverage. This would lead to an insurance pool that is
relatively sick and thus more expensive, a problem referred to as adverse selection.
Free riders: Without the mandate, some healthy individuals would choose not to purchase health
insurance but then later need health care, and they will likely receive some care even though they are
uninsured. This is especially true if the individuals have the resources to pay for healthcare services.
These individuals are referred to as free riders bec

Question masters in nursing

Jun 14, 2024 | Health Medical

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To what extent are healthcare services in your area [to be more specific in your ZIP CODE] providing telehealth and remote monitoring options and does this benefit the patient population?Please let at least 3 examples where you were able to research thin in your neighborhood.Zip code is Miami fl 331774 apa cutations

Week 3 Discussions

Jun 14, 2024 | Health Medical

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Hello,

This assignment comes in 3 parts. Each discussion needs to be from 250-300 words with 1 reference (scholarly peer reviewed articles within the last 5 years). I will also need 2 peer responses for each discussion.

Week 3

NUR 500 Part 1-Discussion 1

What is the difference between high-, middle-, and low-range theories? Explain your understanding of a middle-range nursing theory. Identify a research study in which a middle-range theory was applied. Discuss the study results and implications for practice.

NUR 510 Part 2- Discussion 1

Identify three components of the Patient Protection and Affordable Care Act that went into effect in 2014 and discuss their impact or potential impact on the practice of nursing and medicine. Be specific as to what the provision states, who it affects, and the impact that it may have.

Please watch the video before answering the question

NUR 510 Part 3- Discussion 2

Describe a type of health care spending that you consider wasteful or services that you consider have little or no benefit. Explain why you find the spending wasteful, and if eliminated, what impact it may have on the American public.

Please read the instructions below before answering the questions

When you are considering the various spending initiatives, think about the Federal deductions that will begin coming from your paycheck soon, thanks to Congressional spending and Presidential spending:

Biden signs the $2.4 trillion infrastructure bill into law in November 2021: https://www.forbes.com/sites/jonathanponciano/2021/11/15/everything-in-the-12-trillion-infrastructure-bill-biden-just-signed-new-roads-electric-school-buses-and-more/?sh=354d741f161fLinks to an external site.
Biden signs Democrats’ $740 billion spending bill into law in August 2022: https://www.washingtontimes.com/news/2022/aug/16/biden-signs-democrats-740-billion-spending-bill-la/Links to an external site.
Biden signs the $1.7 trillion Omnibus Spending Bill into law in December 2022: https://www.cnn.com/2022/12/29/politics/joe-biden-omnibus/index.htmlLinks to an external site.

Where can we reduce wasteful spending in healthcare?

Same question, thank you

Jun 14, 2024 | Health Medical

Description

More heads are better than one, so I am asking all of you to conduct research and see what other oral health related community events are being offered during this semester. Please complete the following for full credit for this discussion:1. Conduct research for any oral health community events that are being offered during this semester.2. Post the details for this event in the discussion thread. I will review the events and those that meet the community service qualifications for this course will be approved for community service credit upon attendance.

Social Work Question

Jun 14, 2024 | Health Medical

Description

The purpose of the Pro-Con Analysis paper is for you to have the opportunity to present a balanced argument where you discuss both sides of an issue before revealing your own position. Giving pros and cons about an issue allows the reader to formulate their own opinions before hearing your final analysis. A good paper gives fair, equal treatment to both sides of an issue, describes advantages and disadvantages and provides specific research to support the ideas and finally it provides a summary and writers view on the topic.

A minimum of five (5) empirical articles for Pro arguments and five (5) articles for Con arguments should be included in each paper. You are required to incorporate at least two current commentaries (one pro and one con) from nationally recognized newspaper (e.g. NY Times, Washington Post). Please see the Rubric in your syllabus for specific criteria. To earn the maximum points available you must have at least 12 sources (5 pro journal articles, 5 con articles, and 2 newspapers) on your reference page. Of the 10 journal articles some may present both pro and con arguments and can be used as such in your paper.

The Pro/Con Analyses Paper should follow this outline:
1. Overview of the issue.
Present the nature and scope of the issue – definition of the issue; number of people
affected; institutions or organizations involved.
2. Clearly identify the policy option related to the problem that you are analyzing.
3. Discuss the arguments made in support of and in opposition to the policy option chosen.
4. The final part of the paper should include your opinion/recommendations and reasons
for your position.
Did you change your mind as a result of your research? Did you become more entrenched in
your position? Or, have you become ambivalent or confused? (Your
opinion/recommendations should be at least one page.)
Guidelines for the Pro/Con Analyses Papers:
1″ margins, all sides; double spaced; 12-point font
Title page;
Abstract is not necessary and should not be included;
Be sure to spell check and edit your paper before you submit it
Length: 6 page minimum, 8 page maximum excluding the title page and reference list.
The format and references should conform to American Psychological Association (APA) standards.
Students should consult the Publication Manual of the American Psychological Association (current

edition) for style, format, and general reference.

I am doing my pro-con paper on Florida’s abortion law. For part 4, my opinion is that I am pro abortion and pro choice. Maximum 8 page maximum.

Interactive Activity HCI314 Explain how does the evaluation of information systems effect E health

Jun 14, 2024 | Health Medical

Description

Learning Activities
Evaluation of E-Health PDF
Watch the following video(s):
Evaluation of Information Systems Evaluation of Information Systems – Alternative Formats
Interactive Activity 3
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 how does how does the evaluation of information systems effect E health

NoTe:should be a minimum of six lines

Health & Medical Question

Jun 14, 2024 | Health Medical

Description

Just wanted to send to you to update and let me know the cost. If I could receive it back within 3 days. If you need me to resend the papers I will but for now Ill send the comments rec back for corrections.

Unformatted Attachment Preview

9/19/23, 10:16 AM
Feedback for Submit Your Project Here – COM-20041-XH018 Address Complex Challenges 23DA08 – Southern New Hampshire …
COM-20041 Project Rubric
Activity: Submit Your Project Here
Course: COM-20041-XH018 Address Complex Challenges 23DA08
Name: Mary Dieterich-Callaway
Rubric Criteria
Mastered
Not Yet
Not Evident
Describes your
complex challenge
and factors that
contribute to the
complexity of the
issue supported by
examples
Describes your
complex challenge and
factors that contribute
to the complexity of
the issue supported by
examples
Shows progress
toward expectations,
but with errors or
omissions; areas for
improvement may
include explain how
different factors
interact to contribute
to the overall
complexity of the
challenge or providing
specific examples
Does not attempt to
describe a complex
challenge and factors
that contribute to the
complexity of the
issue
Criterion Feedback
9/19/23
The work must be cited to add objectivity to the work.
Please provide a discussion that is fact-based (cite your work) and avoids generalizations or
your opinion.
9/10/23 – Mary, you have done a great job of introducing your topic.
You have a good start in analyzing your complex challenge; however, be sure to specifically
state what the challenge is supported by relevant research (don’t forget to provide in-text
citations). Please refer to the library resources and use your own words to convey the ideas
from sources. As it stands right now you have a good basis for pointing out the issue, however
it is opinion-based vs. fact-based due to the lack of supporting evidence. Additionally, be sure
to clearly state the specific factors that have contributed to the complexity of the issue in
order to meet this rubric criteria.
Although you have introduced the topic, more is needed to understand the complexity of the
issue. Who is most impacted by stressful work environments (i.e. leaders or employees)? Is
workplace stress more impactful based on specific industries or occupations?
Socioeconomic factors were part of your topic, so be sure to address this area. What
are socioeconomic factors and how does this impact stress? How does socioeconomics
influence how stress is managed and addressed? As you situate the topic, you must also
include research to support the topic. Without research, the information becomes opinion
based and does not support the magnitude of the problem. Project Resources: In the Unit
Resources under Your Research Challenge the article titled, “Choosing aTopic”, presents
overarching questions to guide the process of inquiry in research so you are deliberate with
your research question or the complex challenge you may be trying to solve. The website, “Ask
the Right Questions” provides strategies to explore when scoping your research and refining
your question. Review the article found under the Unit Resources: Research Methods and
Research Methodologies titled, “Four Primary Lenses” to examine the four primary lenses
commonly used by a variety of professionals in the field to help individuals in one profession
problem-solve more effectively, or apply new and innovative ways of addressing the problem
in their field.
https://learn.snhu.edu/d2l/lms/dropbox/user/folder_user_view_feedback.d2l?ou=1376789&db=2423136&grpid=0
1/8
9/19/23, 10:16 AM
Feedback for Submit Your Project Here – COM-20041-XH018 Address Complex Challenges 23DA08 – Southern New Hampshire …
Rubric Criteria
Mastered
Not Yet
Not Evident
Evaluates at least
seven primary or
Evaluates at least
seven primary or
Does not evaluate any
primary or secondary
secondary sources
secondary sources for
their relevance,
Shows progress
toward expectations,
but with errors or
omissions; areas for
improvement may
include providing an
credibility
for their relevance,
validity, and
credibility
validity, and credibility
sources for their
relevance, validity, and
evaluation of all three
elements for at least
seven sources
Criterion Feedback
9/19/23
Move this annotated bibliography to the section directly after the complex challenge. This
allows the reader to see the framework of the sources as soon as they read the challenge to
set up the rest of the paper.
9/10/23 – You are off to a good start here as well, however the annotated bibliography is
formatted in a very specific way.
Provide a heading entitled Annotated Bibliography
1. Double-check to ensure all of your sources support your challenge. Do you need to find
additional sources?
2. Make sure your reviews are not too detailed. The summary should be 1-2 paragraphs. You
have lot of extra information outside of the annotated bibliography section where you have
summarized the credibility and provided other explanations of the sources, however each
source should include their own explanation and not wrapped in together with other sources
that you have found.
3. The format for an annotated bibliography is very specific. You state the source prior to any
review/discussion. Please set your sources up to reflect this format. See this source below:
https://owl.purdue.edu/owl/general_writing/common_writing_assignments/annotated_bibliogr
aphies/annotated_bibliography_samples.html
4. Clearly evaluate each of your sources against these five (5) criteria:
Authority: Authority refers to the credibility of the author or creator of the information.
A person with authority is an accepted expert in his/her field.
Accuracy: Accuracy refers to how factual the source is. An accurate source has reliable
references to back up its claims – references that can be verified.
Currency: What is current varies from subject to subject. Medical research relies on a
shorter time period for currency than literary or historical studies.
Relevance: Is the source really relevant to your topic? Does it strengthen your
argument? Some sources may only relate to your topic in a loose way, especially topics
with multiple subcategories.
Objectivity: The point of view and purpose of a source can help you determine how
objective a source is and how much bias plays a role
Please addressed the criteria, for every source in this section, and clearly state why it meets or
does not meet that criteria by asking these questions.
1. Are the authors an authority? Why or why not?
2. Is the information presented factual? Why or why not? How do you know?
3. Is the information current? Why or why not?
4. Is the source really relevant to your topic? Does it strengthen your argument?
5. Is the point of view objective?
https://learn.snhu.edu/d2l/lms/dropbox/user/folder_user_view_feedback.d2l?ou=1376789&db=2423136&grpid=0
2/8
9/19/23, 10:16 AM
Feedback for Submit Your Project Here – COM-20041-XH018 Address Complex Challenges 23DA08 – Southern New Hampshire …
Rubric Criteria
Mastered
Not Yet
Not Evident
Includes research
sources that
Includes research
sources that
Shows progress
Does not include any
research sources
individually and
individually and
collectively are
appropriate to the
discipline subject or
but with errors or
omissions; areas for
in which challenge is
branch of knowledge
in which challenge is
sources relevant to
the subject area
situated
situated
collectively are
appropriate to the
discipline subject or
branch of knowledge
toward expectations,
improvement may
include selecting
Criterion Feedback
9/19/23
The verb tense and tone is confusing.
In this section, you will discuss the methods used to analyze your topic.
As you were searching for sources, why did you determine that these methods were most
appropriate to analyzing your topic? Why were these methods appropriate to evaluating the
challenge?
Keep in mind that this this is not so much about your process, but more about the
research methods that you considered when you selected the sources to support your stance.
Provide just a paragraph or two that includes more context around your issue and a detailed
explanation that discusses the research methods of the supporting sources (qualitative,
quantitative, case studies, primary data, secondary data, etc.). In this explanation, inform on
the types of methods that were used, why they are relevant, credible, and how the sources
have used research to address your challenge.
9/10/23 – You should look specifically at the methods that are used in your research and
discuss how these methods help to examine the topic. For example, if you evaluate a survey or
study then consider the methods used and how it helps to understand the topic and the issue
more effectively. Is the research used more quantitative or qualitative in nature? How does
a qualitative or quantitative analysis help to examine the challenge. When you were selecting
sources for the topic, why did you feel these were the most appropriate to examine the
issue?
Consider adding a paragraph that includes more context around your issue and and a detailed
explanation that discusses the research methods of the supporting sources (qualitative,
quantitative, case studies, etc.). In this explanation, inform on the types of methods that were
used, why they are relevant, credible, and how the sources have used research to address your
challenge. This is not so much about your process, however more about how
the research methods that you considered when you selected the sources to support your
stance.
https://learn.snhu.edu/d2l/lms/dropbox/user/folder_user_view_feedback.d2l?ou=1376789&db=2423136&grpid=0
3/8
9/19/23, 10:16 AM
Feedback for Submit Your Project Here – COM-20041-XH018 Address Complex Challenges 23DA08 – Southern New Hampshire …
Rubric Criteria
Mastered
Not Yet
Not Evident
Proposes course of
Proposes specific
course of action or
Shows progress
toward expectations,
Does not propose any
course of action
actions that represent
a reasonable solution
but with errors or
omissions; areas for
to the complex
challenge supported
improvement may
include supporting the
by applicable
methods, tools,
technologies, or
necessary resources
from at least five of
the most appropriate
recommendation with
at least five sources
action that
represents a
reasonable solution
to the complex
challenge supported
by applicable
methods, tools,
technologies, or
necessary resources
from at least five
sources in the
annotated
bibliography
from the annotated
bibliography
sources in the
annotated
bibliography
Discusses the
research and how
your interpretation
supports your
recommendations
Discusses the research
and how your
interpretation
supports your
recommendations
Shows progress
toward expectations,
but with errors or
omissions; areas for
improvement may
include discussing
how your
recommendations are
relevant, logical, and
directly linked to the
research findings
Does not attempt to
discuss the research
Criterion Feedback
9/19/23 As you incorporate rationale to support your recommendations, you will need to
summarize the research and discuss how it aligns to each of the five (5) courses of action.
Try starting a new paragraph that specifically uses the rubric item as a starter. For instance:
Based on the research found, X [source] supports my recommendation of______…Y [source]
indicated _____, which supports my recommendations of _______
For example, you may discuss a survey instrument that provides evidence for your
recommendations. In this case, you would explain the research and how it supports your
courses of action (i.e. A survey was conducted by Smith (2019) that showed xxxx, which
supports my recommendation of xxxx).
The information within your interpretation connects to your solution. Make sure that you go
further in explaining the specific elements of the research that aligns from the five sources
that support your recommendations.
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4/8
9/19/23, 10:16 AM
Feedback for Submit Your Project Here – COM-20041-XH018 Address Complex Challenges 23DA08 – Southern New Hampshire …
Rubric Criteria
Mastered
Not Yet
Not Evident
Discusses the
Discusses the
significance and
Shows progress
toward expectations,
but with errors or
omissions; areas for
improvement may
include addressing any
Does not attempt to
discuss the
significance and
limitations of the
research in
supporting your
recommendations
limitations of the
research in supporting
your
recommendations
significance and
limitations of the
research
limitations or potential
biases in the research
and assess their
impact on the
conclusions
Criterion Feedback
9/19/23
A component of the significance of the study is to illustrate the contribution that your study
will make to the existing literature on the problem or broad problem areas of education.
This section is about the research that you found and reviewed. Since you cannot review every
piece of research, we are interested in the pros and cons of the research that you used.
Answer these questions to show the significance of the research:
who benefits from the study
how that specific audience will benefit from its findings.
what contribution will your study make to the literature or to the field?
The significance of the study’s purpose is to make clear why your study was needed and the
specific contribution your research made to furthering academic knowledge in your field.
No study is completely flawless or inclusive of all possible aspects. When
discussing limitations in research, explain how they impact your findings because creating
their short list or description isn’t enough.
Answer these questions to show the limitation of the research:
did the research not include an important sector (i.e. age, culture, industry)?
was the research limited (i.e. only 10 participants)?
what did you feel was missing in how the research was conducted overall?
if you had to conduct research, what adjustments would you make to the current
processes to strengthen the results?
Examples include: research design (constraints on your population); insufficient sample size,
time constraints, cultural bias, etc.
Remember that future research of a topic is built upon prior research. By highlighting
limitations, you suggest a possible path for future researchers.
The significance and limitations should reference the research, not the recommendations.
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5/8
9/19/23, 10:16 AM
Feedback for Submit Your Project Here – COM-20041-XH018 Address Complex Challenges 23DA08 – Southern New Hampshire …
Rubric Criteria
Mastered
Defends the course
Defends the course of
action or actions you
of action or actions
you have
recommended over
the alternatives
based on relevant
methods, resources,
tools, and ethical
implications
have recommended
over the alternatives
based on relevant
methods, resources,
tools, and ethical
implications
Not Yet
Not Evident
Does not attempt to
defend the course of
Shows progress
toward expectations,
but with errors or
action or actions
recommended
omissions; areas for
improvement may
include explaining why
the recommended
course of action is
superior to the
alternatives,
highlighting strengths
or how it addresses
the problem
Criterion Feedback
9/19/23
This section is for you to draw conclusions about everything you discovered along the way as it
pertains to the research – not so much about your opinion.
Using the recommendations as your conclusion you will need to defend why your actions and
recommendations are the most suitable versus what you have found. Using in-text
citations, cite your work that justifies your position and avoid generalizations.
Be sure to address the WHY? Explain why these methods are better than other methods used
in research attempting to solve the same/similar issues? What research have you found that
would support this method making this the best choice over the alternatives?
Avoid generalizations and cite your work that justifies your position. Be sure to defend why
your actions and recommendations are the most suitable versus what you have found. This
means including in-text citations to support your position.
9/10/23 – Mary, you have added a lot of information in your conclusion as well and even have
information that does not really apply, for example, you have stated “The purpose of this
annotated bibliography is to present a range of perspectives on workplace
stress and its impact on individuals and organizations.” This is out of place.
This section is for you to draw conclusions about everything you discovered along the way as it
pertains to the research – not so much about your opinion. For instance address the WHY?
Based on what other methods found in research? WHY is this method better than other
methods used in research attempting to solve the same/similar issues? What research have
you found that would support this method making this the best choice over the alternatives?
Also, once you have addressed the interpretation and the significance/limitation rubric items
this area will develop more.
Please review the resources Reading: The Conclusion and Reading: Writing Commons, How to
Write a Compelling Conclusion to help guide you towards writing a strong conclusion that
shows your reflection on your research and what sums up what you’ve learned.
https://learn.snhu.edu/d2l/lms/dropbox/user/folder_user_view_feedback.d2l?ou=1376789&db=2423136&grpid=0
6/8
9/19/23, 10:16 AM
Feedback for Submit Your Project Here – COM-20041-XH018 Address Complex Challenges 23DA08 – Southern New Hampshire …
Rubric Criteria
Mastered
Not Yet
Not Evident
Consistently and
Consistently and
effectively
Shows progress
towards expectations,
Does not provide an
organized response
communicates in an
organized way
but communication is
inconsistent or
effectively
communicates in an
organized way
ineffective in a way
that negatively
impacts
understanding
Criterion Feedback
9/19/23
We will review this once all revisions are made.
9/10/23 – It appears that the information in your brief has been rewritten using a tool that
helps to avoid plagiarism, as the words do not flow resulting in incoherent sentences. Please
make sure to use your words as the brief currently lacks cohesiveness which is presenting a
great deal of unclarity.
Uses citations for
areas requiring
attribution
Uses citations for
areas requiring
attribution, with minor
errors
Uses citations for
ideas requiring
attribution, but with
major omissions
Does not use citations
for ideas requiring
attribution
Criterion Feedback
9/19/23
This research brief calls for two separate lists: the annotated bibliography found in the body of
the brief and the references list at the end of the brief.
The annotated bibliography should be the section that follows the complex challenge section.
That is because this annotated bibliography helps the reader understand as soon as possible
what you used to address your complex challenge and how reliable the information is.
The references page(s) follows at the end of the paper and lists that information that
references all sources used (author(s), date, publication, website link), including those from the
annotated bibliography but does not include a summary of the research.
There should be a minimum of 7 sources here – the same ones that are in the annotated
bibliography.
Use the same citing style that you use for all of your other projects.
1. It is necessary to include in-text citations in the body of the brief; the sources of these
citations should all be visible on the references page.
2. This list will then act as a guide and provide the information necessary for your reviewer
to locate and retrieve any source you cite in the body of the paper.
3. Each source you cite in the paper must appear in your reference list; likewise, each
entry in the reference list must be cited in your text. Remember, you cannot post just a
URL or website address as an in-text citation.
Please go to this link:
https://learn.snhu.edu/d2l/le/content/1157169/viewContent/19873594/View
to address any requirements you may have for in-text citations and reference page to support
your references.
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7/8
9/19/23, 10:16 AM
Rubric Criteria
Feedback for Submit Your Project Here – COM-20041-XH018 Address Complex Challenges 23DA08 – Southern New Hampshire …
Mastered
Not Yet
Not Evident
We expect that many students use additional sources to support their work even though the
sources are not part of the annotated bibliography.
9/10/23 – Since there is additional writing and research to complete, this rubric item will be
reassessed during resubmission of your project. Please review your paper to ensure that you
have cited all directly quoted and/or paraphrased information and that all references
correspond to an appropriate in-text citation (including images and charts). The Citation Help
tile located in BrightSpace can help to determine when and how to cite your sources
appropriately. This resource includes access to the CfA Citation Guide and CfA Citation Maker,
which will help to cite your sources.
Overall Score
Mastered
Not Yet
This submission demonstrates mastery of
This submission needs improvement and does not yet demonstrate
this competency.
mastery of this competency.
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8/8
9/19/23, 10:16 AM
Feedback for Submit Your Project Here – COM-20041-XH018 Address Complex Challenges 23DA08 – Southern New Hampshire …
COM-20041 Project Rubric
Activity: Submit Your Project Here
Course: COM-20041-XH018 Address Complex Challenges 23DA08
Name: Mary Dieterich-Callaway
Rubric Criteria
Mastered
Not Yet
Not Evident
Describes your
complex challenge
and factors that
contribute to the
complexity of the
issue supported by
examples
Describes your
complex challenge and
factors that contribute
to the complexity of
the issue supported by
examples
Shows progress
toward expectations,
but with errors or
omissions; areas for
improvement may
include explain how
different factors
interact to contribute
to the overall
complexity of the
challenge or providing
specific examples
Does not attempt to
describe a complex
challenge and factors
that contribute to the
complexity of the
issue
Criterion Feedback
9/19/23
The work must be cited to add objectivity to the work.
Please provide a discussion that is fact-based (cite your work) and avoids generalizations or
your opinion.
9/10/23 – Mary, you have done a great job of introducing your topic.
You have a good start in analyzing your complex challenge; however, be sure to specifically
state what the challenge is supported by relevant research (don’t forget to provide in-text
citations). Please refer to the library resources and use your own words to convey the ideas
from sources. As it stands right now you have a good basis for pointing out the issue, however
it is opinion-based vs. fact-based due to the lack of supporting evidence. Additionally, be sure
to clearly state the specific factors that have contributed to the complexity of the issue in
order to meet this rubric criteria.
Although you have introduced the topic, more is needed to understand the complexity of the
issue. Who is most impacted by stressful work environments (i.e. leaders or employees)? Is
workplace stress more impactful based on specific industries or occupations?
Socioeconomic factors were part of your topic, so be sure to address this area. What
are socioeconomic factors and how does this impact stress? How does socioeconomics
influence how stress is managed and addressed? As you situate the topic, you must also
include research to support the topic. Without research, the information becomes opinion
based and does not support the magnitude of the problem. Project Resources: In the Unit
Resources under Your Research Challenge the article titled, “Choosing aTopic”, presents
overarching questions to guide the process of inquiry in research so you are deliberate with
your research question or the complex challenge you may be trying to solve. The website, “Ask
the Right Questions” provides strategies to explore when scoping your research and refining
your question. Review the article found under the Unit Resources: Research Methods and
Research Methodologies titled, “Four Primary Lenses” to examine the four primary lenses
commonly used by a variety of professionals in the field to help individuals in one profession
problem-solve more effectively, or apply new and innovative ways of addressing the problem
in their field.
https://learn.snhu.edu/d2l/lms/dropbox/user/folder_user_view_feedback.d2l?ou=1376789&db=2423136&grpid=0
1/8
9/19/23, 10:16 AM
Feedback for Submit Your Project Here – COM-20041-XH018 Address Complex Challenges 23DA08 – Southern New Hampshire …
Rubric Criteria
Mastered
Not Yet
Not Evident
Evaluates at least
seven primary or
Evaluates at least
seven primary or
Does not evaluate any
primary or secondary
secondary sources
secondary sources for
their relevance,
Shows progress
toward expectations,
but with errors or
omissions; areas for
improvement may
include providing an
credibility
for their relevance,
validity, and
credibility
validity, and credibility
sources for their
relevance, validity, and
evaluation of all three
elements for at least
seven sources
Criterion Feedback
9/19/23
Move this annotated bibliography to the section directly after the complex challenge. This
allows the reader to see the framework of the sources as soon as they read the challenge to
set up the rest of the paper.
9/10/23 – You are off to a good start here as well, however the annotated bibliography is
formatted in a very specific way.
Provide a heading entitled Annotated Bibliography
1. Double-check to ensure all of your sources support your challenge. Do you need to find
additional sources?
2. Make sure your reviews are not too detailed. The summary should be 1-2 paragraphs. You
have lot of extra information outside of the annotated bibliography section where you have
summarized the credibility and provided other explanations of the sources, however each
source should include their own explanation and not wrapped in together with other sources
that you have found.
3. The format for an annotated bibliography is very specific. You state the source prior to any
review/discussion. Please set your sources up to reflect this format. See this source below:
https://owl.purdue.edu/owl/general_writing/common_writing_assignments/annotated_bibliogr
aphies/annotated_bibliography_samples.html
4. Clearly evaluate each of your sources against these five (5) criteria:
Authority: Authority refers to the credibility of the author or creator of the information.
A person with authority is an accepted expert in his/her field.
Accuracy: Accuracy refers to how factual the source is. An accurate source has reliable
references to back up its claims – references that can be verified.
Currency: What is current varies from subject to subject. Medical research relies on a
shorter time period for currency than literary or historical studies.
Relevance: Is the source really relevant to your topic? Does it strengthen your
argument? Some sources may only relate to your topic in a loose way, especially topics
with multiple subcategories.
Objectivity: The point of view and purpose of a source can help you determine how
objective a source is and how much bias plays a role
Please addressed the criteria, for every source in this section, and clearly state why it meets or
does not meet that criteria by asking these questions.
1. Are the authors an authority? Why or why not?
2. Is the information presented factual? Why or why not? How do you know?
3. Is the information current? Why or why not?
4. Is the source really relevant to your topic? Does it strengthen your argument?
5. Is the point of view objective?
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2/8
9/19/23, 10:16 AM
Feedback for Submit Your Project Here – COM-20041-XH018 Address Complex Challenges 23DA08 – Southern New Hampshire …
Rubric Criteria
Mastered
Not Yet
Not Evident
Includes research
sources that
Includes research
sources that
Shows progress
Does not include any
research sources
individually and
individually and
collectively are
appropriate to the
discipline subject or
but with errors or
omissions; areas for
in which challenge is
branch of knowledge
in which challenge is
sources relevant to
the subject area
situated
situated
collectively are
appropriate to the
discipline subject or
branch of knowledge
toward expectations,
improvement may
include selecting
Criterion Feedback
9/19/23
The verb tense and tone is confusing.
In this section, you will discuss the methods used to analyze your topic.
As you were searching for sources, why did you determine that these methods were most
appropriate to analyzing your topic? Why were these methods appropriate to evaluating the
challenge?
Keep in mind that this this is not so much about your process, but more about the
research methods that you considered when you selected the sources to support your stance.
Provide just a paragraph or two that includes more context around your issue and a detailed
explanation that discusses the research methods of the supporting sources (qualitative,
quantitative, case studies, primary data, secondary data, etc.). In this explanation, inform on
the types of methods that were used, why they are relevant, credible, and how the sources
have used research to address your challenge.
9/10/23 – You should look specifically at the methods that are used in your research and
discuss how these methods help to examine the topic. For example, if you evaluate a survey or
study then consider the methods used and how it helps to understand the topic and the issue
more effectively. Is the research used more quantitative or qualitative in nature? How does
a qualitative or quantitative analysis help to examine the challenge. When you were selecting
sources for the topic, why did you feel these were the most appropriate to examine the
issue?
Consider adding a paragraph that includes more context around your issue and and a detailed
explanation that discusses the research methods of the supporting sources (qualitative,
quantitative, case studies, etc.). In this explanation, inform on the types of methods that were
used, why they are relevant, credible, and how the sources have used research to address your
challenge. This is not so much about your process, however more about how
the research methods that you considered when you selected the sources to support your
stance.
https://learn.snhu.edu/d2l/lms/dropbox/user/folder_user_view_feedback.d2l?ou=1376789&db=2423136&grpid=0
3/8
9/19/23, 10:16 AM
Feedback for Submit Your Project Here – COM-20041-XH018 Address Complex Challenges 23DA08 – Southern New Hampshire …
Rubric Criteria
Mastered
Not Yet
Not Evident
Proposes course of
Proposes specific
course of action or
Shows progress
toward expectations,
Does not propose any
course of action
actions that represent
a reasonable solution
but with errors or
omissions; areas for
to the complex
challenge supported
improvement may
include supporting the
by applicable
methods, tools,
technologies, or
necessary resources
from at least five of
the most appropriate
recommendation with
at least five sources
action that
represents a
reasonable solution
to the complex
challenge supported
by applicable
methods, tools,
technologies, or
necessary resources
from at least five
sources in the
annotated
bibliography
from the annotated
bibliography
sources in the
annotated
bibliography
Discusses the
research and how
your interpretation
supports your
recommendations
Discusses the research
and how your
interpretation
supports your
recommendations
Shows progress
toward expectations,
but with errors or
omissions; areas for
improvement may
include discussing
how your
recommendations are
relevant, logical, and
directly linked to the
research findings
Does not attempt to
discuss the research
Criterion Feedback
9/19/23 As you incorporate rationale to support your recommendations, you will need to
summarize the research and discuss how it aligns to each of the five (5) courses of action.
Try starting a new paragraph that specifically uses the rubric item as a starter. For instance:
Based on the research found, X [source] supports my recommendation of______…Y [source]
indicated _____, which supports my recommendations of _______
For example, you may discuss a survey instrument that provides evidence for your
recommendations. In this case, you would explain the research and how it supports your
courses of action (i.e. A survey was conducted by Smith (2019) that showed xxxx, which
supports my recommendation of xxxx).

Health & Medical Question

Jun 14, 2024 | Health Medical

Description

Paper details: Resources this week speak about the conviction and courage required to understand and speak to systems and hierarchies of power. Using the hot topic article about pandemics, write an essay on how educational institutions can effectively address systemic racism.

Unformatted Attachment Preview

A Pandemic Amongst a Pandemic: The Black Community Is Exhausted
Advice & News | by Leslie Ekpe
Thursday, July 9, 2020
   
Johnny Silvercloud/Shutterstock
“If you are neutral in situations of injustice, you have chosen the side of the oppressor. If an
elephant has its foot on the tail of a mouse, and you say that you are neutral, the mouse will not
appreciate your neutrality.” – Desmond Tutu
Dear University Officials:
I am a Black doctoral student who is disheartened by the monotonous statements from
universities addressing the systemic racism that has plagued our communities over the past
few weeks. I am sharing my thoughts and perspective with you because I believe that it is
essential you recognize what many of the individuals in the Black community are experiencing
in the midst of the coronavirus pandemic. Black academics are facing traumatizing events, and
a statement is not going to be enough. In the wake of the protests against the murders of
Breonna Taylor, Ahmaud Arbery, George Floyd, Rayshard Brooks, and the multiple lynchings
masked as suicides, the boilerplate statements presented by administrators of universities far
and near is a clear representation of the trends in direct obliviousness in addressing structural
racism. Unfortunately, entirely too often, we see this to be the nature of the academy. The Black
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only a national issue; it is infiltrating our college classrooms.
Being Black in America is overwhelming. It is time to stop ignoring that fact. Black Americans
are dying at a disproportionate rate at the hands of police officers, all the while also dying at
three times the rate of white people due to COVID-19. Some claim that these two issues -police brutality and the coronavirus — are related to each other. In both cases, the severity of
the death toll derives from structural racism and injustice.
Moreover, a thorough reexamining of systemic racism is needed for the remedy. We cannot
erase 400 years of injustice, but we can strive — now and collectively — to ensure that America
is a place where everyone will treat equality with integrity and fairness. The anti-Blackness
propaganda is being practiced in our institutions, and unfortunately, ignorance has created
barriers in the dismantling of these practices. The fight you are witnessing for racial equality is
not new to the Black community in the academy. There is a clear gap in universities upholding
the commitments contained in mission and vision statements versus what is being practiced.
The acts of racism are being normalized across our nation. Thus, many individuals have
systematized bigotry as a natural part of the culture of higher education. So, while you may
believe that the academy has made strides in reconstructing the structural practices and
policies that permeate bias and prejudice, it is clear that societies’ influences will continue to
enact challenges on the discussion of race and racism in the academy. Don’t ignore this.
James Baldwin once stated, ‘I can’t believe what you say, because I see what you do.’ It is time
to do more. I share the following suggestions to help you be more cognizant of Black
academics’ sentiments during this upsetting time.
Language Matters
Pay close attention to the words that you use in statements that address your community. By
stating that individuals in your communities have ‘free speech,’ you are enabling individuals of
other races who are not Black to infiltrate the corrupt system. Your ineffective statements mirror
ethical relativism dressed as what is equitable. And while the academy is encouraged by the
momentum for change, there is a recognized worry that administrators are missing the mark in
addressing the pervasive racism that is taking place within universities with pacifying ‘WE ARE
WITH YOU’ statements.
Can we agree that we operate inside a culture that needs to be questioned, rather than
handled as a brand? As higher education administrators, you have a moral responsibility due to
Black academics. Statements and actions from the universities should assume those
responsibilities, not undermine them. Whether deliberate or not, the rhetoric of ‘inclusivity’ may
be a means for universities to abdicate their duty to do their part in removing segregation and
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patriarchal processes. It is time for mission statements that illuminate the inclusivity that your
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university has yet to offer. It is time for administrators to set out clear outlines and actionable
steps to create change, not just at the administrative and leadership levels, but also in white
colleagues’ behavior and mindset. It is in the university’s best interest that when decisions are
made that directly affect Black academics, we are actively involved. We need our white peers
to note their cultural advantages and bring attention to these problems by ensuring that as such
decisions take place and choices are made, the Black community is actively engaged. Change
starts with dialogue, and we must be able to do the work to have these conversations.
While your dedication to ensuring the campus populations’ well-being is appreciated, also
realize the challenges Black academics are facing when adapting to the ‘new norm’ the COVID19 pandemic has brought. We are fighting an uphill battle of questioning whether the next
hashtag will be our father, mother, sister, brother, or even ourselves. For Black scholars, the
problem of concentrating and focusing on academics is even more complicated when we live
moment to moment with a reasonable fear of unjustifiably being killed daily at the hands of
police. Be wary of this and create action plans that encompass deliberate initiatives that will
ensure safety for the Black community. Too few Black academics have someone to share our
daily encounters of racial tension, feelings of disdain and marginalization, and racial fight
fatigue. The last thing we need is decisions being made on our behalf that are not a direct
representation of what is needed.
Intentionally Listening
The Black community needs administrators to listen with intent. In recent weeks, we have seen
scholars on Twitter address discriminatory practices and conversations that have directly
impacted their educational journeys (#BlackInIvory, #BlackInTheAcademy, #MinorityTax).
These reports should not be brushed under the carpet like the others concealed for the
university’s reputation. Not only have these hashtags been quite disturbing, but the hashtags
have revealed once more the altogether hate and prejudice that continues to have a
disproportionate impact on Black communities causing constant anxiety, anger, and pain.
It is not up to you to tell Black scholars how they should feel. The racialized society is in a
current state of grotesqueness. The deluge of suffering and the flood of deliberate ignorance in
the wake of abuse generates considerable distrust in addressing institutional injustice
problems. These are lived experiences of your Black community, so it’s not the responsibility of
the higher-ups to investigate whether the experiences are credible. It is also not Black peoples’
responsibility to make you feel better about the mild frustration protesting of racism causes to
you.
Think about the decisions that you are making before enacting them. Are they creating
disadvantages for the Black community? Even though you are accountable to your institution
as administrators, remember that your actions will inevitably directly affect your Black
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their expectations are addressed explicitly.
Promote Inclusivity
As administrators tasked with making challenging decisions, I ask that you consider how your
actions are consistent with the university’s mission and vision statements. The university should
be employing and practicing inclusivity throughout campus, not just in the diversity and
inclusion office. We are sick of people running behind quotations from Martin Luther King Jr.
and practicing the total opposite of what he believed. It is up to university leadership to choose
where to go from here: anarchy or community? There is an opportunity — indeed, a duty — to
uplift the discourse on race, class, police brutality, and dignity.
It is time to begin encouraging anti-racist legislation, culturally sensitive curricula, nonviolent
demonstrations, critical dialogue, and constructive debates on these difficult topics. Universities
should strive for communities that are accepting and tolerant of everyone — understanding of
all. My skin tone should not preclude me from earning a place on campus — much like your
facial image or name should not keep you out. We are both going to be better off to address the
elephant in the room, just as you would if your white community were at risk. No matter
whether physical or mental, challenges are part of the road to meaningful progress. Less talk,
more action. If you invest thousands of dollars into inclusive marketing, make sure you keep
the same energy when investing in university practices.
Speak Against Racism and Social Inequality
As university leaders, it is critical to be intentional in addressing the systemic racism occurring
in our nation because it ultimately has a direct impact on your university. It is challenging for the
Black community to maintain professional and scholarly responsibilities after witnessing our
brothers’ and sisters’ lynching due to racial profiling. Your Black community is running on
fumes. We are tired. We are angry. Unfortunately, this space is also very familiar. Cultural
discrimination is intolerable, and at our world-leading institutions, we cannot tolerate faculty,
staff, researchers, and students being abuse victims. We expect institutions to have robust
procedures in place to respond to incidents. At a time, such as this, your silence speaks
volumes. Support the Black community as much as you do when cheering for us on the field
and court. You cannot acknowledge Juneteenth by bringing news of true freedom — freedom
from oppression, violence, and systemic racism — when your university practices reflect the
direct opposite. Even after a century and a half, that goal remains sadly evasive in many ways.
Recommit yourself as a university to be partners on the path to achieving true equality for your
Black community and turning attention toward the mission of anti-racism resolutely. Your efforts
may be lengthy, and the battle may be rough, but be aware that there is no progress without
struggle.
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Morgan Pettway
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3 years ago
“Keep that same energy …” as a former graduate student, I felt that in my soul. Several great points!
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Maxwell
3 years ago
Very well put article outlining the mental toll recent events in this country has put on black Americans. All
and inclusion departments should the taking the steps mentioned here to ensure their black American stu
feel safe and wanted on their respected campus.
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Jarett Fields
3 years ago
Asè!!
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Stuart Rosenberg
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The article only addresses police brutality and the deaths from Covid 19. We should realize what the term
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brutality means…white police officers indiscriminately killing black people for no reason. Even if that is tru
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percentage of these deaths is miniscule compared to the murder of black on black in cities like Chicago. O
course, no mention of this in the article. How convenient to ignore this powerful impact on the entire black
community. As far as Covid 19 is concerned we already know that certain governors in certain states have
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deliberately forced their health commissioners to falsify death certificates to read: death from the Covid 1
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opposed to the real cause of death. There is a big difference in actually dying from the Covid 19 or dying w
course, certain parties ant to ignore these pertinent facts as it does not fir their political agenda. They are
How
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By Dr. Cobretti D. Williams
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Comparing
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You should then write a rejoinder with historical and scholarly evidence. The writer was addressi
made. It is not just the police, the entire criminal justice system in the United States needs a rebo
View More ArticlesSystemic or structural injustice is the name (for neophytes). Years of slavery, segregation, black
Jim Crow laws, and policies that undermine minority populations have created the inner city viole
alluded to. You should take some time to read about American history! Our actions or inactions t
shape tomorrow. Enough is enough!
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Health & Medical Question

Jun 14, 2024 | Health Medical

Description

ONE PAGE MIN.

Please open all these articles and write about them.

Make sure you use ALL the words listed below.

Write an abstract on the following:

– The Normal Immune System II Wikipedia: “Clonal Selection”, “Major Histocompatibility

complex”, “Human Leukocyte Antigen”, “Complement system”

Wikipedia links:

https://en.wikipedia.org/wiki/Clonal_selection

https://en.wikipedia.org/wiki/Major_histocompatibi…

https://en.wikipedia.org/wiki/Human_leukocyte_anti…

https://en.wikipedia.org/wiki/Complement_system

WRITING ABSTRACTS – PSL 460 – DR. ROOT-BERNSTEIN

The purpose of writing an abstract is to condense the material you have read into the most succinct form. To abstract is to pare away the unnecessary elements of an argument or its presentation to discover its essence. Since every narrative contains many levels of discourse and many themes, abstracting requires you to make informed decisions about what elements are most important. These decisions will depend on the questions you are asking and the problems you are trying to solve. You can’t do a good job of abstracting until you have a clear question or problem in mind! Before you start reading, ask yourself what you want to know. Keep your question or problem in mind as you read!

It is often easiest to write out whatever comes to mind in answering your question without regard to length and then to go back and pare away at it to make it suitably short.

If you have done your job well, your abstract should be able to achieve the brevity of a TV Guide description of a movie plot. It should state the basic problem and its resolution: “Man meets married woman, kills her husband, who turns out to be his twin brother adopted out at birth.” A line this succinct should form the first sentence of your abstract. The abstract itself should then consist of a short paragraph or two single spaced that describes the most important elements of the plot line you describe in your first sentence. Try to balance generalizations with one or two specific examples.

Your abstract must include:

1) 2) 3) 4)

the main argument or arguments made by the author(s); the key concept(s) upon which they base their argument(s); the main points or data that support their argument(s).

Definitions of any key technical terms

Health advocacy

Jun 14, 2024 | Health Medical

Description

The essay will require to use a residualist conversion approach to identify an appropriate health advocacy goal.The
first material is shiffman & smith theory of change framework while
the second document contains different types of theory of change. So,
you can choose from anyone you’re comfortable with and apply it to the
chosen problem.Please, also give examples to help illustrate your points effectively. Another
Hint: Please when choosing a health problem, Consider choosing an issue
that affects a particular state or location rather than globally. So
that It will lot easier to apply the theory of change to that chosen
location

Unformatted Attachment Preview

GLOBAL ADVOCACY AND POLITICAL PRIORITY
ASSIGNMENT 1 QUESTION
Within public health, there is a focus on research, epidemiology and program development.
However, very often effective action on the part of governments does not occur without
significant influence from civil society in the form of health advocacy as community
organising.
The Purpose of this assignment is to critically appraise a health issue in terms of its structural
determinants and discuss the application of a theory of change for effective health advocacy.
Your task is to write an academic essay that uses a social problem analysis and theory of
change framework to prepare for health advocacy on a pressing health issue.
This essay requires you to use a residualist conversion (Jamrozik & Nocella, 1998)
approach to identify an appropriate health advocacy goal. This problem framing process
will explicitly incorporate an understanding of the relevant social determinants of health. The
key elements of a theory of change for the identified health advocacy goal will be discussed
for a particular national or sub-national setting.
Your essay should:
1. Include an introduction that briefly outlines the importance of the health issue and
the structural determinants that are relevant. (150 words)
2. Outline the application of a residualist conversion analysis to explain how your
chosen issue is a predictable negative by-product of the pursuit of dominant interests and
values in society. Explain how your issue is commonly converted from a political into a
technical problem. You will propose an alternative framing that recognizes the political and
structural framing of the problem. Explicit application of structural determinants of
health will be included in this process drawing on model by Solar and Irwin (2010). (800
words)
3. Finally you will discuss how a theory of change for health advocacy could be applied
to address the identified problem in a particular setting. Use of relevant reports, statistics,
and potential NGO alliances will be included. (900 words)
4.
Include a conclusion that concisely summarises your key points. (150 words)
KEY RESOURCES/MATERIALS: (1) Jamrozik, A., & Nocella, L. (1998). The Sociology
of Social Problems: Theoretical Perspectives and Methods of Intervention. Cambridge
University Press.
(2) Solar, O., & Irwin, A. (2010). A conceptual framework for action on the social
determinants of health.
Other Useful Resources/Materials:
➢ Gemma Carey, Eleanor Malbon, Brad Crammond, Melanie Pescud, Philip Baker, Can
the sociology of social problems help us to understand and manage ‘lifestyle drift’?,
Health Promotion International, Volume 32, Issue 4, August 2017, Pages 755–761,
https://doi.org/10.1093/heapro/dav116
➢ Levy, Barry S. (ed.), Social Injustice and Public Health, 3rd edn (New York, 2019;
online edn, Oxford Academic, 22 Aug. 2019),
https://doi.org/10.1093/oso/9780190914653.001.0001, accessed 11 Sept. 2023.
➢ (Chapter 9: An A–Z of Tobacco Control Advocacy Strategy). (2007). In Chapman,
Public health advocacy and tobacco control [electronic resource] : making smoking
history (p. 1 online resource (346 p.)). Blackwell Pub.
https://doi.org/10.1002/9780470692479. (Note: Please Read section titled Advocacy:
the neglected sibling of public health)
➢ Kingdon, John W.. Agendas, Alternatives, and Public Policies, Update Edition, with
an Epilogue on Health Care: Pearson New International Edition, Pearson Education
UK, 2013. ProQuest Ebook Central,
https://ebookcentral.proquest.com/lib/acu/detail.action?docID=5138173.
➢ Cockerham, William C.. Social Causes of Health and Disease, Polity Press, 2013.
ProQuest Ebook Central,
https://ebookcentral.proquest.com/lib/acu/detail.action?docID=1604131.
➢ Baum, F., & Fisher, M. (2014). Why behavioural health promotion endures despite its
failure to reduce health inequities. From Health Behaviours to Health Practices, 5768. https://doi.org/10.1002/9781118898345.ch6
➢ Baum. (2015). The new public health / (Fourth edition..). Oxford University Press,
https://ebookcentral.proquest.com/lib/acu/detail.action?docID=4786467. (Note:
Please Read Chapter One and Thirteen)
➢ Shiffman, & Smith, S. (2007). Generation of political priority for global health
initiatives: a framework and case study of maternal mortality. The Lancet, 370(9595),
1370–1379. https://doi.org/10.1016/S0140-6736(07)61579-7
➢ Carlisle. (2000). Health promotion, advocacy and health inequalities: a conceptual
framework. Health Promotion International, 15(4), 369–376.
https://doi.org/10.1093/heapro/15.4.369
➢ Erik Blas. (n.d.). Social determinants approaches to public health: from concept to
practice. https://www.who.int/publications/i/item/9789241564137. (Read Chapter 2:
Scaled up and marginalised.)
➢ Marmot, & Bell, R. (2012). Fair society, healthy lives. Public Health, 126(1), S4–S10.
https://doi.org/10.1016/j.puhe.2012.05.014
➢ Wilkinson, & Marmot, M. G. (Eds.). (2003). Social determinants of health [electronic
resource] : the solid facts / (2nd ed.). World Health Organization Regional Office for
Europe.
➢ Phelan, Link, B. G., & Tehranifar, P. (2010). Social Conditions as Fundamental
Causes of Health Inequalities: Theory, Evidence, and Policy Implications. Journal of
Health and Social Behavior, 51(1_suppl), S28–S40.
https://doi.org/10.1177/0022146510383498
➢ WHO Commission on Social Determinants of Health (Ed.). (2008). Closing the gap in
a generation : health equity through action on the social determinants of health : final
report /. World Health Organization.
➢ Donkin, Goldblatt, P., Allen, J., Nathanson, V., & Marmot, M. (2018). Global action
on the social determinants of health. BMJ Global Health, 3(Suppl 1), e000603–
e000603. https://doi.org/10.1136/bmjgh-2017-000603
➢ Jamrozik. (1998). The sociology of social problems : theoretical perspectives and
methods of intervention (Nocella, Ed.). Cambridge University Press; Cambridge
University Press. (Read Chapter Three Methods of Intervention in Social Problems)
➢ Klugman. (2011). Effective social justice advocacy: a theory-of-change framework
for assessing progress. Reproductive Health Matters, 19(38), 146–162.
https://doi.org/10.1016/S0968-8080(11)38582-5
➢ Cairney. (2016). The Politics of Evidence-Based Policy Making [electronic resource]
/. Palgrave Macmillan UK : (Read Chapter 3 health and advocacy barriers and
solutions)
➢ McClelland, & Smyth, P. (Eds.). (2014). Social policy in Australia : understanding for
action (3rd edition., p. 1 online resource (xvii, 302 pages) :). Oxford University Press.
(Note: Please read: ‘Chapter 3 — A Framework for Understanding and Action’)
➢ Policy Interventions and Citizen Engagement. (2005). In Considine, Making public
policy : institutions, actors, strategies / (pp. 141–164). Polity Press,.
➢ McClelland, & Smyth, P. (Eds.). (2014). Social policy in Australia : understanding for
action (Third edition., p. 1 online resource (xvii, 302 pages) :). Oxford University
Press. (Note: Please read: ‘Chapter 4 — The Institutional Context for Decisions and
Action’, pages 60-77)
Length: 2000 words no +/- 10% (including in-text references but excluding the
end reference list). Referencing style: APA 7, a citation should be provided
upon every mention of an idea, statistic, concept, argument, etc. that has
come from someone other than yourself.
Formatting:
•
•
•
•
•
Microsoft Word document (not PDF)
Essay writing
1.5 line spacing
Normal margins
Font 12/ Times New Roman
PLEASE STRICTLY FOLLOW THE CRITERION 1-5 STATED BELOW WHEN
WRITING YOUR ESSAY.
CRITERION 1- A CLEAR LINK SHOULD BE MADE BETWEEN THE
CHOSEN HEALTH TOPIC, THE CHOSEN AND SOCIAL DETERMINANT
OF HEALTH (SDH).
•
Please excellently provide analysis of a high-level, detailed description of link
between health issue and social determination of health
Underpinned by the scientific literature
– Please, include citations for all key statement
CRITERION 2- AN ANALYSIS OF THE HEALTH ISSUES IS PROVIDED
THAT APPLIES THE RESIDUALIST CONVERSION (JAMROZIK &
NOCELLA, 1998) APPROACH TO ANALYSIS AND CONSIDERS THE
APPROPRIATE GOALS FOR EFFECTIVE ADVOCACY.
–
Please Excellently undertake Health issue analysis in an extremely detailed
manner,
–
Also, excellently show a very clear understanding of concepts related to
residualist conversion.
•
Underpinned by the scientific literature
– Please, include citations for all key statement
CRITERION 3- A THEORY OF CHANGE SHOULD BE ARTICULATED
THAT
INFORMS
THE
HEALTH
ADVOCACY
STRATEGY.
THE ANALYSIS OF THE HEALTH ISSUE SHOULD INCORPORATE A
THEORY OF CHANGE THAT IS SUPPORTED BY APPROPRIATE
SCHOLARLY LITERATURE. THIS ANALYSIS SHOULD ALSO IDENTIFY
THE WAY POWER WILL BE UNDERSTOOD AND STRATEGICALLY
EMPLOYED AND WILL SUPPORT THE KEY ADVOCACY GOAL.
–
Excellently explain in a highly detailed manner, the theory of change implications
of the chosen health issue
Please Show a very clear understanding of concepts related to power and
advocacy strategies.
– Underpinned by the scientific literature
CRITERION 4- SCIENTIFIC WRITING, FORMATTING, GRAMMAR,
PUNCTUATION, AND SPELLING:
•
Very high quality of scientific writing, logical, clear and eloquent; and meets word limit
and formatting requirements. There are no errors with grammar, spelling, punctuation, and
meaning is easily discernible. The essay should read without interruption.
-Avoid padding (‘each and every…’ …’both positive and negative’’)
CRITERION 5- REFERENCES AND REFERENCING:
•
References used should be credible, relevant, and of high quality. Mixed use of published
books, peer-reviewed scientific journal articles, high quality databases, and/or
reports. APA 7 referencing should be accurate in all instances. All statements of fact and
ideas taken from elsewhere should be referenced. Use Wide range of references, at least
up to 45 references and above.
-A Citation per Key Statement.
SUMMARY
The Essay must contain:
• An introduction that briefly outlines the importance of the health issue and the
structural determinants that are relevant
•
•
•
•
•
•
Outline the application of a residualist conversion analysis to explain how your
chosen issue is a predictable negative by-product of the pursuit of dominant interests
and values in society.
Explain how your issue is commonly converted from a political into a technical
problem.
You will propose an alternative framing that recognizes the political and structural
framing of the problem
Explicit application of structural determinants of health will be included in this
process drawing on model by Solar and Irwin (2010).
discuss how a theory of change for health advocacy could be applied to address the
identified problem in a particular setting
A conclusion that concisely summarises your key points.
• High quality presentation, in terms of format, meeting general requirements for
task; coherence of expression; and adherence to conventions of writing (spelling,
grammar, length) and referencing
Tips:
(1) Where appropriate, use sub-headings that align with the criterion.
(2) You can also include graph, image or statistical data if need be.
(3) Gauge the number of words and emphasis to use for each section.
ADVOCACY EVALUATION
PATHWAYS FOR CHANGE:
10 Theories to Inform
Advocacy and Policy
Change Efforts
Sarah
Stachowiak,
ORS Impact
October
2013
This is an update and expansion of the Pathways brief originally published by Organizational Research
Services in 2009. This brief may not be reproduced whole or in part without written permission from
the author or the Center for Evaluation Innovation.
ADVOCACY EVALUATION
PATHWAYS TO CHANGE:
10 Theories to Inform
Advocacy and Policy
Change Efforts
Sarah
Stachowiak
Foreword
T
he first Pathways for Change brief originally was published in 2008 in response to growing interest
from evaluators, funders, and advocates to evaluate advocacy and policy change efforts. Since that
time, the field of advocacy and policy change evaluation has grown, and theories of change continue to
serve as bedrock for evaluative efforts. Given this context, the time is ripe to expand on the original work.
This updated brief maintains most of the content from the original piece and provides information on four
additional theories. It continues to focus on theories most directly applicable to either understanding
how policy change happens or how specific advocacy tactics play out; this brief does not focus on more
comprehensive social science theories. Additionally, at the time of the original brief, the utility and
application of this work were largely theoretical. This update includes an expanded section on how
evaluators, advocates, and funders can apply these theories to advocacy and policy work.
Introduction
A
dvocates of all stripes seek changes in policy as a way to achieve impact at a scale and degree of
sustainability that differs from what can be achieved through direct services or programs alone.
Advocates and funders each come to policy work with a set of beliefs and assumptions about how change
will happen, and these beliefs shape their thinking about what conditions are necessary for success, which
tactics to undertake in which situations, and what changes need to be achieved along the way.
These worldviews are, in actuality, theories of change, whether or not they have been explicitly stated or
documented as such. When articulated as theories of change, these strategy and belief system roadmaps can
clarify expectations internally and externally, and they can facilitate more effective planning and evaluation.
This brief lays out 10 theories grounded in diverse disciplines and worldviews that have relevance to the
world of advocacy and policy change. These theories can help to untangle beliefs and assumptions about
the inner workings of the policy making process and identify causal connections supported by research
1 | PATHWAYS FOR CHANGE: 10 Theories to Inform Advocacy and Policy Change Efforts
www.evaluationinnovation.org
to explain how and why a change may or may not
occur. This piece is not meant to be comprehensive of
Defining Theory of Change
all possible relevant theories and approaches; rather, it
T
introduces and illustrates a handful of theories that may
be useful to advocates, funders, and evaluators. While
the theories included may have broad applicability, the
brief is grounded in the context of US domestic policy.
Knowing about existing theories may sharpen your own
thinking, provide new ways of looking at the policy world,
and give you a leg up on developing your own theory of
change. The final section gives concrete examples of the
way in which advocates, funders, and evaluators can use
this brief in their work.
heory of change can be defined as
the conceptual model for achieving a
collective vision. A theory of change typically
addresses the linkages among the strategies,
outcomes, and goals that support a broader
mission or vision, along with the underlying
assumptions that are related to these
linkages. Theories of change can be expressed
in many forms but ultimately should explain
how you get from “here” to “there.”1
1
Organizational Research Services. (2007). A guide to
measuring advocacy and policy. Prepared for the
Annie E. Casey Foundation. Seattle, WA.
10 Theories of Change Related to Advocacy and Policy Change Efforts
B
rief summaries follow of 10 social science theories of change relevant to advocacy and policy change
efforts.2 These comprise two types of theories:
Global theories are theories that explain how policy change occurs more broadly, and
Tactical theories are theories from various social science disciplines that apply to common advocacy
tactics that are likely part of broader advocacy efforts or campaigns.
Global theories include the following:
1. “Large Leaps” or Punctuated Equilibrium theory
2. “Policy Windows” or Agenda-Setting theory3
3. “Coalition” theory or Advocacy Coalition Framework
4. “Power Politics” or Power Elites theory
5. “Regime” theory
Tactical theories include the following:
1. “Messaging and Frameworks” theory
2. “Media Influence” or Agenda-Setting theory3
3. “Grassroots” or Community Organizing theory
4. “Group Formation” or Self-Categorization theory
5. “Diffusion” theory or Diffusion of Innovations
2
3
Overviews of the theories are based on the seminal works that undergird them. Summarizing complex theories into one page or
less necessarily distills the information significantly. For greater depth or nuance, please see the Bibliography to access the original
sources.
Both Kingdon (“Policy Windows”) and McCombs and Shaw (“Media Influence”) use the term “Agenda-Setting Theory” to quite
different ends. To be true to the original authors, we use the term for both. To differentiate between them, we refer to Kingdon’s
work as “Policy Windows” and McCombs and Shaw’s work as “Media Influence.”
2 | PATHWAYS FOR CHANGE: 10 Theories to Inform Advocacy and Policy Change Efforts
www.evaluationinnovation.org
GLOBAL THEORIES
TACTICAL THEORIES
3 | PATHWAYS FOR CHANGE: 10 Theories to Inform Advocacy and Policy Change Efforts
www.evaluationinnovation.org
Psychology
Communications
Messaging and
Frameworks or
Prospect theory
(Tversky & Kahneman)
Media Influence or
Agenda-Setting theory
(McCombs & Shaw)
Political issues on the public’s agenda will depend on the
extent of coverage a given issue receives by mass news
media.
Individual’s preferences will vary depending on how
options are presented.
Policy change happens through the support and
empowerment of policy makers by a close-knit body of
influential individuals.
Change happens when a new idea for a program or policy
is communicated to a critical mass, who perceives it as
superseding the current policy/program (or lack thereof)
and thus, adopts the idea.
Sociology
Political Science
Regime Theory (Stone)
Policy change is made by working directly with those with
power to make decisions or influence decision making.
Diffusion theory
or Diffusion of
Innovations (Rogers)
Sociology
Power Politics or
Power Elites theory
(Mills, Domhoff)
Policy change happens through coordinated activity
among a range of individuals with the same core policy
beliefs.
Social Psychology Policy change can be achieved when individuals identify
with groups and subsequently act in a way that is
consistent with that social group or category membership.
Political Science
Coalition Theory or
Advocacy Coalition
Framework (Sabatier,
Jenkins-Smith)
Policy can be changed during a window of opportunity
when advocates can successfully connect two or more
components of the policy process (e.g., the way a problem
is defined, the policy solution to the problem, and/or the
political climate of their issue).
Group Formation or
Self-Categorization
theory (Turner, Tajfel)
Political Science
Policy Windows or
Agenda-Setting theory
(Kingdon)
Like seismic evolutionary shifts, significant changes in
policy and institutions can occur when the right conditions
are in place.
Social Psychology Policy change is made through collective action by
members of the community who work on changing
problems affecting their lives.
Political Science
Large Leaps
or Punctuated
Equilibrium theory
(Baumgartner & Jones)
HOW CHANGE HAPPENS
Grassroots or
Community
Organizing theory
(Alinsky, Biklen)
DISCIPLINE
THEORY (Key Authors)
Matrix of Theories
• You have trusted messengers and champions to model or
communicate the innovation
• The focus is on a new idea for a program or policy
• Cohesion among your organization’s members is a prerequisite for
change
• You are looking to build or tighten your base of support
• Your organization’s role in an issue is as a “convener” or “capacitybuilder” rather than as a “driver”
• A distinct group of individuals is directly affected by an issue
• You want to put the issue on the radar of the broader public
• You have strong media-related capacity
• A key focus of the work is on increasing awareness, agreement on
problem definition, or salience of an issue
• The issue needs to be redefined as part of a larger campaign or
effort
• You have access to or can become part of this coalition or regime
• You know or suspect that a coalition of non-politicians is deeply
involved in policy making
• Focus may be on incremental administrative or rule changes
• You have one or more key allies in a position of power on the issue
• You have a strong group of allies with a common goal
• A sympathetic administration is in office
• You have internal capacity to create, identify, and act on policy
windows
• You can address multiple streams simultaneously (e.g., problem
definition, policy solutions, and/or political climate)
• You have strong media-related capacity
• Large-scale policy change is the primary goal
WHEN THIS THEORY MAY BE USEFUL
The description for each theory includes a short summary; important underlying assumptions associated
with the theory; the theory’s application to advocacy; and an example theory of change that visually
illustrates key concepts, strategies, and outcomes.4, 5
Global Theories
C
ompared with Tactical theories, Global theories represent more encompassing worldviews about
how policy change happens. Advocates may be more successful if they operate within one of these
frameworks rather than several simultaneously. While some Global theories share similar assumptions or
components, explicitly acknowledging which theory resonates can help groups make focused strategic
choices about possible tactics and allow them to leverage the assumptions inherent to that point of view
more effectively.
GLOBAL
1 “LARGE LEAPS” Theory of Change
THEORY
Believers of the Large Leaps theory recognize that when
conditions are right, change can happen in sudden, large
bursts that represent a significant departure from the past,
as opposed to small incremental changes over time that
usually do not reflect a radical change from the status quo.
This theory also is referred to as Punctuated Equilibrium
theory, stemming from evolutionary science terminology.
Frank Baumgartner and Brian Jones, major thinkers in this
area, developed the model and have used it in longitudinal
studies of agenda-setting and decision making.
Large Leaps theory posits
that large-scale change can
occur when an issue is defined
differently, when new actors
get involved, or when the issue
becomes more salient and
receives heightened media and
broader public attention.
The theory holds that conditions for large-scale change are ripe when the following occur:
Q an issue is defined differently or new dimensions of the issue gain attention (typically a fundamental
questioning of current approaches);
Q new actors get involved in an issue; or
Q the issue becomes more salient and receives heightened media and broader public attention.
While these conditions set up the environment in which large-scale change can occur, they do not predict or
guarantee it. For example, an issue may achieve increased attention and focus, but the heightened attention
may not result in policy change. However, when all of the right conditions occur simultaneously, change is
exponential, not incremental.
4
5
The strategies shown in the maps are meant to be illustrative, not exhaustive.
Strong advocacy capacity within an organization is key to success—i.e., the ability to choose strategies appropriate to the context
and issue, identify opportunities for progress, develop relationships, make midcourse corrections, and communicate effectively.
Though this key factor is highlighted specifically in only one theory of change, it is a critical component to the successful application of all 10 theories.
4 | PATHWAYS FOR CHANGE: 10 Theories to Inform Advocacy and Policy Change Efforts
www.evaluationinnovation.org
Underlying Assumptions
Q Government institutions typically maintain the status quo and have a monopoly over the way issues
are defined and decisions are made.
Q Though institutions try to maintain their monopoly, the American political system of separation of
powers and overlapping jurisdictions allows many different venues through which to pursue change.
Q People pay attention to only a few issues at a time, and large-scale change is unlikely without more
attention focused on an issue.
Q People typically become mobilized through redefinition of the prevailing policy issue or story, a
narrative that should include both facts and emotional appeals.
Q Media can play an integral role by directing attention to different aspects of the same issue and
shifting attention from one issue to another. However, media attention does not cause policy change
directly—it typically precedes or follows the change.
Q Large-scale change typically involves creating or eliminating institutions (e.g., departments, agencies).
Application to Advocacy
Q Advocacy efforts should focus on questioning policies at fundamental levels, as opposed to making
administrative or rule changes to existing policies.
Q Issue definition and agenda-setting are key to mobilizing new people around an issue.
Q Promising strategies include issue framing, mobilizing supporters, and media advocacy.
Reading the Outcome Maps
T
he outcome maps related to particular advocacy strategies and tactics featured in this brief show the
potential theoretical connection between that strategy through to policy change and ultimate impact.
Solid lines represent outcomes clearly stated in the seminal research. Outcomes connected by dotted lines
are hypothetical and are illustrative of how that tactic ultimately supports the longer-term policy change
and impact desired by advocates.
5 | PATHWAYS FOR CHANGE: 10 Theories to Inform Advocacy and Policy Change Efforts
www.evaluationinnovation.org
“LARGE LEAPS” Theory of Change
OUTCOMES
STRATEGIES
Refine issue/Issue framing
Mobilize new actors
• Public
• Legislators
• New allies/Unexpected allies
Get media attention to focus on
new definition or aspect of policy
STRENGTHENED ALLIANCES
STRENGTHENED BASE OF SUPPORT
Increased number of allies/partners
Increased media attention
SHIFT IN SOCIAL NORMS
STRENGTHENED BASE OF SUPPORT
Increased awareness of issue
Increased visibility of issue
SHIFT IN SOCIAL NORMS
STRENGTHENED BASE OF SUPPORT
• Increased agreement about issue
definition and need for change
Increased political & public will for issue
• Increased salience of and prioritization
of issue
IMPROVED POLICIES
• “Significant” changes in institutions
• “Significant” changes in policy
IMPACT
Changes in social and/or physical conditions
6 | PATHWAYS FOR CHANGE: 10 Theories to Inform Advocacy and Policy Change Efforts
www.evaluationinnovation.org
GLOBAL
2 “POLICY WINDOW” Theory of Change
THEORY
The Policy Windows theory is John Kingdon’s classic theory of agenda-setting attempts to clarify why some
issues get attention in the policy process and others do not. He identified three “streams” related to the
policy system:
1. Problems: The way social conditions become defined as “a problem” to policy makers, including the
problem’s attributes, its status, the degree of social consciousness of the issue, and whether the
problem is perceived as solvable with clear alternatives.
2. Policies: The ideas generated to address problems.
3. Politics: Political factors, including the “national mood” (e.g., appetite for “big government”),
campaigns by interest groups and advocates, and changes in elected officials.
According to this theory, to increase the likelihood that an issue will receive serious attention or be placed
on the policy agenda, at least two of the streams need to converge at critical moments or “policy windows.”
Policy windows are windows of opportunity that arise when there is the possibility for policy change.
Underlying Assumptions
Q Policy streams operate independently.
Q Advocates can couple policy streams when a policy window opens. For example, advocates can
attach their solutions to a problem that has gained prominence on the agenda (even if its rise was
independent of their efforts).
Q Success is most likely when all three components (problems, policies, and politics) come together
during a policy window.
Q Policy windows can be predictable (e.g., elections, budget cycles) and unpredictable (e.g., a dramatic
event or crisis, such as a plane crash or hurricane). Policy windows also can be created.
Q The way a problem is defined makes a difference as to whether and where the problem is placed on
the agenda. Problem definition also has a value or emotional component; values and beliefs guide
decisions about which conditions are perceived as problems.
Q Often there are many competing ideas on how to address problems. To receive serious consideration,
policy options need to be seen as technically feasible and consistent with policy maker and public
values.
Q To effectively recognize and take advantage of open policy windows, advocates must possess
knowledge, time, relationships, and good reputations.
7 | PATHWAYS FOR CHANGE: 10 Theories to Inform Advocacy and Policy Change Efforts
www.evaluationinnovation.org
Application to Advocacy 6
Q Promising strategies include:
•
impacting problem definition (i.e., framing the issue, monitoring indicators that assess the
existence and magnitude of issues, initiating special studies of an issue, promoting constituent
feedback);
•
developing policy options (e.g., through research, publications, and the like), and;
•
influencing the political climate (e.g., coalition building, demonstrations, and media advocacy).
Q Advocates and organizations need adequate capacity to create and/or recognize policy windows and
then respond appropriately.
STRATEGIES
“POLICY WINDOW” Theory of Change
Define the
problem, e.g.,
• Indicator tracking
• Framing
• Research
• Organizing
Develop policy
solutions, e.g.,
• Research/think
tanks
SHIFT IN SOCIAL NORMS
• Increased agreement on
problem definition
OUTCOMES
• Increased agreement on
solutions to problems
Strengthen
organizational
capacity
• Relationships
• Credibility
• Ability to identify
policy window
• Ability to “couple”
streams
CHANGE IN CAPACITY
Increased ability to
create/recognize/respond
to policy window
effectively
Influence the
political climate, e.g.,
• Coalition building
• Demonstrations
STRENGTHENED
BASE OF SUPPORT
Increased political will
IMPROVED POLICIES
Changes in policy
IMPACT
Changes in social and/or physical conditions
6
To study an application of Kingdon’s theory to an advocacy effort, see: Coffman, J. (2007). Evaluation based on theories of the
policy process. The Evaluation Exchange, 13(1 & 2), 2–6. Retrieved July 3, 2013, from http://www.hfrp.org/evaluation/the-evaluationexchange/issue-archive/advocacy-and-policy-change/evaluation-based-on-theories-of-the-policy-process.
8 | PATHWAYS FOR CHANGE: 10 Theories to Inform Advocacy and Policy Change Efforts
www.evaluationinnovation.org
GLOBAL
3 “COALITION” Theory of Change
THEORY
Coalition theory, developed by Paul Sabatier and Hank Jenkins-Smith and commonly known as the Advocacy
Coalition Framework, proposes that individuals have core beliefs about policy areas, including a problem’s
seriousness, its causes, society’s ability to solve the problem, and promising solutions for addressing it.
Advocates who use this theory believe that policy change happens through coordinated activity among
individuals and organizations outside of government with the same core policy beliefs.
Underlying Assumptions
Q Coalitions are held together by agreement over core beliefs about policies. Secondary beliefs
about how policies are executed are less critical to alignment (e.g., administrative rules, budgetary
allocations, statutory revision).
Q Diverse groups can operate effectively and efficiently due to shared core beliefs; in other words, little
time is needed to reach shared understanding.
Q Core beliefs are resistant to change, unless
• major external events, such as changes in socio-economic conditions or public opinion, are skillfully
exploited by proponents of change; or
• new learning about a policy surfaces across coalitions that changes views about it.
Q Policies are unlikely to change unless
• the group supporting the status quo is no longer in power; or
• change is imposed by a hierarchically superior jurisdiction.
Application to Advocacy
Q Coalitions can identify and reach out to diverse groups with similar core policy beliefs (e.g., unlikely
allies).
Q Coalitions typically will explore and pursue multiple avenues for change (e.g., engaging in legal
advocacy and working on changing public opinion), often simultaneously, to find a route that will
bear fruit.
Q Promising strategies include:
• influencing like-minded decision makers to make policy changes;
• changing incumbents in various positions of power;
• affecting public opinion via mass media;
• altering decision maker behavior thr

i need 2 file in this qoustion with different reference

Jun 14, 2024 | Health Medical

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Critical Thinking: Comparative Analysis: Risk

Compare Risk in Different Health Care Systems

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.

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Jun 14, 2024 | Health Medical

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Nurs 6645 psychotherapy with multiple modalities

Jun 14, 2024 | Health Medical

Description

Include subjective and objective data; assessment from most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; current psychotherapeutic plan (include one health promotion activity and one patient education strategy you provided); and patient progress toward treatment goals.Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What was 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 in order of highest to lowest priority and explain why you chose them. What was your primary diagnosis and why? Describe how your primary diagnosis aligns with DSM-5-TR diagnostic criteria and is supported by the patient’s symptoms. Plan: Describe your treatment modality and your plan for psychotherapy. Explain the principles of psychotherapy that underline your chosen treatment plan to support your rationale for the chosen psychotherapy framework. What were your follow-up plan and parameters? What referrals would you make or recommend as a result of this psychotherapy session?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.

Nursing Question

Jun 14, 2024 | Health Medical

Description

Part 1

Complete a nursing theorist video analysis/reflection of one of the nursing theorist videos provided in the course. We highly recommend that you watch as many of these videos as you can throughout the course. This is a great opportunity for you to see and hear directly from the actual theorists that you are reading about in the text. (The video selected is Hildegard Peplau: Interpersonal relations in Nursing)

Please see the close captions for the video attached below. (I was unable to send you the video). Also see attached a sample paper

After watching one of the theorist videos, reflect on what you have learned.

Compose a paper that addresses the following:

Explain why you chose to watch this particular theorist’s video. (The video selected is Hildegard Peplau: Interpersonal relations in Nursing)
Describe the parts of your personal philosophy where you agree or disagree with this theorist.
Is there anything that surprised you in the video? If so, what surprised you?
Would you recommend this video to another student? If so, why would you recommend it?
What value did you receive from watching it?

Directions for Nurse Video Reflections:

You will choose what videos you want to answer questions on, but view as many as you can, they are very interesting!

Compose a paper that addresses the following:

Explain why you chose to watch this particular theorist’s video.
Describe the parts of your personal philosophy where you agree or disagree with this theorist.
Is there anything that surprised you in the video? If so, what surprised you?
Would you recommend this video to another student? If so, why would you recommend it?
What value did you receive from watching it?

Please organize your paper with headings- you can use each question above as the heading over that section/paragraph.

I do not need a Cover page nor Reference page.
PLEASE see the example paper attached here to guide you if you are unsure!

Your paper should be 2–3 pages in length, in APA style, typed in Times New Roman with 12-point font, and double-spaced with 1″ margins. If outside sources are used, they must be cited appropriately.

Due: Sunday, 11:59 p.m. (Pacific time)

Points Possible: 100

Rubric

NURS_500_DE – Video Reflection Rubric

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeCritical Analysis

40 to >32.8 pts

Meets Expectations

Presents an exemplary articulation and insightful analysis of the theorist video. Draws insightful and comprehensive conclusions regarding the value of watching the specific theorist video. Response indicates a comprehensive, high-level understanding of the theorists’ ideas and how they relate to the student’s personal philosophy.

32.8 to >30.0 pts

Approaches Expectations

Presents an accurate analysis of significant concepts within the theorist video. Offers some detail and some examples regarding the value of watching the specific theorist. Makes some attempt to relate the theorist’s ideas to the student’s personal philosophy.

30 to >23.6 pts

Falls Below Expectations

Provides insufficient explanations of significant concepts within the theorist video. Offers little or insignificant detail and no examples for the value of watching the specific theorist. Fails to relate the theorist’s ideas to the student’s personal philosophy.

23.6 to >0 pts

Does Not Meet Expectations

Does not, or incorrectly, responds with insufficient explanations for theorist choice, video value, and relation to personal philosophy.

40 pts

This criterion is linked to a Learning OutcomeContent

40 to >32.8 pts

Meets Expectations

Includes explanation for why the student chose to watch the specific theorist. Describes the value of watching the video. Explains whether or not the student would recommend the video to another student and why.

32.8 to >30.0 pts

Approaches Expectations

Includes explanation for why the student chose to watch the specific theorist. Describes the value of watching the video, but does not explain whether the student would recommend the video to another student and why.

30 to >23.6 pts

Falls Below Expectations

Provides several insufficient or inaccurate explanations of why the student chose the specific theorist video and the value of watching the video, although attempts are made. There is no mention of recommendations.

23.6 to >0 pts

Does Not Meet Expectations

Information is inaccurate or inadequate. Response indicates little or no understanding of the content in the video.

40 pts

This criterion is linked to a Learning OutcomeMechanics

15 to >12.3 pts

Meets Expectations

Answers are well written throughout. Information is well organized and clearly communicated. Assignment is free of spelling and grammatical errors.

12.3 to >11.25 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.

11.25 to >8.85 pts

Falls Below Expectations

Answers are somewhat organized and lacks some clarity. Contains some spelling and grammatical errors.

8.85 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.

15 pts

This criterion is linked to a Learning OutcomeAPA Format

5 to >4.1 pts

Meets Expectations

Follows all the requirements related to format, length, source citations, and layout.

4.1 to >3.75 pts

Approaches Expectations

Follows length requirement and most of the requirements related to format, source citations, and layout.

3.75 to >2.95 pts

Falls Below Expectations

Follows most of the requirements related to format, length, source citations, and layout.

2.95 to >0 pts

Does Not Meet Expectations

Does not follow format, length, source citations, and layout requirements.

5 pts

Total Points: 100

Part 2

For this assignment I need you to pick two nursing theories for future a comparison assignment and explain why you are selecting those 2 theories ( I just need a small paragraph for this part)- choose 2 from the books below. One has to be a Grand range theory and the other a middle range.

Based on the reading assignment (McEwen & Wills, Theoretical Basis for
Nursing, Unit II: Nursing Theories, chapters 6–9), select a grand nursing theory.

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.

See Attached document for reading

Unformatted Attachment Preview

The New World of Healthcare
Data Science: Blending Data,
Environments, and Creating
Disruptive Business Models
Jacob Krive, PhD
Biomedical and Health Information Sciences
University of Illinois at Chicago
The “new” old wave
• Just a short time ago, the “new way” was EMR replacement of paper
• In provider environments, EMRs become legacy “base” environments
where primary data resides, gathered at the point of care
• In Pharma, clinical studies were performed in single isolated
computer applications: no sharing, no (automated) cross-study
analysis, no link to real-time provider data
• Provider, Pharma, and Retail are separate “old” worlds: no data
linkage
• Can we do better and think different in these different times?
Phased drug development
How can we do better?
• Shorten drug development process
• Ensure market success of the drug longer term
• Predict and prevent drug market flops
• Prolong life of a drug in the market
• Detect and prevent harmful side effects
• Pull drugs off the market early to harm fewer patients, when
necessary
• Integrate and blend data confined in the points of care systems with
R&D data confined in the pharma applications
Data integration: Proliferation of the medical
Data
research
clouds
Source
Clinical Data
Transport
Consent
Management
Data Lake
Data DeIdentification
Data
Reservoir
Data
Anonymization
Data
Integration
Data Ocean
HIPAA
(Providers)
GxP
(Life Sciences)
It is not just text data anymore: Image classification
and model recognition architectures
Integration of the healthcare data domains
Provider
EMR
Provider
EMR
data transport
data transport
Data batch
data normalization
mobile
applications
computer
applications
Big Data: Hadoop, HBase, HDFS, Datamart
data processing
Patients
Clinical
Investigators
Data
Scientists
Life Sciences
Applications
Data no longer has to be confined
• Data transport mechanisms: HL7, FHIR, XML, JSON
• Medical data vocabularies: SNOMED, LOINC, CPT, ICD, RxNorm
• Data normalization and data processing
• Data visualization
• Data can move in multiple directions, a true exchange – not just
upload or download or a single translation
• Let’s discuss your assignments
Questions and Discussion
Unit 6 Readings/Resources
Attached Files:
•
New World of Data Science Lecture Krive 2017.pdf New World of Data Science Lecture Krive 2017.pdf Alternative Formats (514.553 KB)
Unit 6
Required
Ebook – Reddy, Chandan K., Aggarwal, Charu C. (Ed.) (2015). Healthcare Data Analytics. United States:
Boca Raton, Florida, CRC Press, Taylor and Francis Group. ISBN: 978-1-482-23211-0. – chapters 11 and
18.
Download the chapters from the links provided:
Chapter 11: Temporal Data Mining for Healthcare Data
http://proxy.cc.uic.edu/login?url=https://www.taylorfrancis.com/books/9781482232127/chapter
s/10.1201%2Fb18588-17
Chapter 18: Data Analytics for Pharmaceutical Discoveries
http://proxy.cc.uic.edu/login?url=https://www.taylorfrancis.com/books/9781482232127/chapter
s/10.1201%2Fb18588-25
Here is the link for access to the entire book, if needed.
http://proxy.cc.uic.edu/login?url=https://www.taylorfrancis.com/books/9781482232127
Krive, J. (2017). The new world of healthcare data science: Blending data, environments, and creating
disruptive business models.

. Retrieved from BHIS 540 Health Data Science
course. link at top of page.
Recommended
Cloud Computing
1. Stokes, D. (2013). Compliant cloud computing-managing risks. Pharmaceutical Engineering 33,(4), 111.
https://docplayer.net/1761713-Compliant-cloud-computing-managing-the-risks.html
2. Smith, R. (2011). Storm clouds? Cloud computing in a regulated environment. Journal of GXP
Compliance, 15(4),71-76.
http://proxy.cc.uic.edu/login?url=https://search.proquest.com/docview/905946024/fulltextPDF/9246E4FE8
60749ABPQ/1?accountid=14552
3. Driscoll, A., Daugelaite, J., Sleator, R. (2013). Big data, Hadoop and cloud computing in
genomics. Journal of Biomedical Informatics, 46, 774-781
http://proxy.cc.uic.edu/login?url=http://www.sciencedirect.com.proxy.cc.uic.edu/science/article/pii/S153204
6413001007?via%3Dihub
4. Lougheed, C., Jain, A., Meil, D., Jarrell, B. (2014). U.S. Patent No. 2014/0032240 A1. Washington, DC:
U.S. Patent and Trademark Office.
https://docs.google.com/viewer?url=patentimages.storage.googleapis.com/pdfs/US20140032240.pdf
5. Archtecting for HIPAA security and compliance on Amazon web services (2017), Retrieved from
https://docs.aws.amazon.com/whitepapers/latest/architecting-hipaa-security-and-compliance-onaws/architecting-hipaa-security-and-compliance-on-aws.html
6. FDA resource on Real World Evidence. (2020). Retrieved from https://www.fda.gov/scienceresearch/science-and-research-special-topics/real-world-evidence
Unit 6
Assignment
1. Attend Unit 6 live lecture online via Blackboard Collaborate.
2. Complete the assigned readings, follow links to online materials, and listen to lecture recording as
necessary.
3. By the deadline, complete and post the following Data Science / System Architecture Challenge
deliverables to the assignment folder in this unit.
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.
1. 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.
2. 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.
3. 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.
4. 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.
5. 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:
a. 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.
b. 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.
Minute Paper
Please complete the minute paper by the deadline.

Purchase answer to see full
attachment

Social Work Question

Jun 14, 2024 | Health Medical

Description

please see attachments

Unformatted Attachment Preview

SOWK 530
LIFE MAP ASSIGNMENT INSTRUCTIONS
A Life Map is a pictorial narrative of your life that provides a visual road map of key events and
experiences that have impacted your development. The goal is to trace significant moments of
your life from birth to present day. Please watch the short video entitled Create a Map of Your
Life to get started. You may be as creative as you like, however the map must be organized,
legible, and a chronological pictorial account of your life from point A (past) to point B
(present). If you are using symbols to depict emotions or positive/negative experiences, please
include a map key or legend to explain. Wording should also be easily readable.
You may need to speak to parents or siblings to start your life map and identify key events from
your earliest years. Then begin by organizing your thoughts and memories into a written
timeline. Use the written timeline to create the map. Your map should be scanned and uploaded
as a PDF. Images may be neatly hand-drawn, computer generated, real images, etc.
The map should cover biological, psychological, social, and spiritual key life events that
highlight your social environment and development. Life events, milestones, and trajectory
changing experiences that are unique to your development should be included to provide an
overview of your life. As an adult, a minimum of 10-15 points on the map are needed. The map
will be graded based up detail, creativity, and legibility. Please google images of life maps, that
look like a map or visual timeline.
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
SOWK 530
LIFE MAP PAPER ASSIGNMENT INSTRUCTIONS
An introspective analysis of one’s own life is important for social workers. The life course
perspective emphasizes how our lives are shaped by relationships, transitions, decisions, etc., all
of which impact our worldview, values, and biases. It is important that we understand ourselves
and the lens through which we operate, so that we may better connect with those we serve.
For this assignment you will develop a 6–8-page paper, not including the title page and
references, based upon your Life Map. Please use the Life Map to create a narrative that
articulates your development from a life course perspective and incorporate various
developmental theories. The paper must include a discussion of life changing events (use
textbook terms such as life events, turning point, and trajectory), at least 2 developmental
theories (major developmental theories include Erikson’s Theory of Psychosocial Development,
Piaget’s Theory of Cognitive Development, Bowlby’s Theory of Attachment, and Kohlberg’s
Theory of Moral Development). Fowler’s theory of spiritual/faith development must also be
included. The textbook and 3 additional peer reviewed sources* should be cited, for a minimum
of 4 scholarly sources.
The paper should begin with an introduction (age, sex, marital status, pets, employment, etc.),
followed by organizational headings to include: Life Changing Events (any specific events or
milestones that changed the trajectory of your life), Application of Developmental Theories
(discuss and apply at least 2 theories), Spiritual Developmental (discuss Fowler’s theory and
the development of your personal faith), and As a Social Worker (discuss how your personal
development impacted or informed your desire for social work). In the introduction, please
discuss why it is important for social workers to be aware of their own development.
If scripture is used in your paper, it should be properly cited and referenced. Please follow the
instructions carefully, use the template provided, and use current APA format. “Upload” your
paper as a Word document; PDFs cannot be graded. Please see APA information below to assist
you:
1. Please review the 7th edition of the APA manual pages 261-262, page 266, Figure 8.2
(p.262), and Table 8.1 (p.266) for citation examples.
2. Please see page 325 for formatting of scripture citations and biblical references.
3. Please refer to page 270 for Principles of Direct Quotations. A citation is NOT
synonymous with a direct quote. Direct quotes are NOT original content and should be
used sparingly. The ability to paraphrase and summarize more effectively demonstrates
critical thinking and comprehension.
The JFL Library is an excellent source and will provide everything you need to complete
research and writing assignments in this course. Click on “Resources” at the top, then “Jerry
Falwell Library” on the left. You may enter search terms directly into the search window. To
refine your search, click “advanced search” >>>> click “scholarly materials/peer reviewed”
>>>> then fill in additional filters like the date range. Below is an example of a peer reviewed
article; notice that there are authors, a year, a journal name, a volume, issue, page range (articles
are typically several pages), and a doi and/or URL. These are clear indicators of a peer reviewed
article.
Page 1 of 2
SOWK 530
Lee, C. D. (2018). Social work with groups’ practice ethics and standards: Student confidence
and competence. Research on Social Work Practice, 28(4), 475–481.
https://doi.org/10.1177/1049731516655456
Please see the Life Map Paper Resources for links to these websites.
•
*This video discusses differences between a general publication, a scholarly article, and a
peer-reviewed article: What is a Scholarly or Peer-Reviewed Journal?
•
This video takes a closer look at searching for scholarly resources within the JFL:
Finding Peer-Reviewed & Scholarly Articles.
Scripture citations must include the translation/version of scripture, as well as the original and
last revision publication date. The reference is for the translation/version, not your personal
bible. Please see examples of correct formatting below:
Citation: According to John 3:16, “For God so loved the world He gave His one and only son,
that whoever believes in him shall not perish but have eternal life” (New International Version,
1978/ 2011).
Citation: Scripture tells us, “For God so loved the world He gave His one and only son, that
whoever believes in him shall not perish but have eternal life” (John 3:16, New International
Version, 1978/ 2011).
Reference
New International Version Bible (2011). New International Version online.
www.biblegateway.com (original work published 1978).
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
Page 2 of 2
SOWK 530
LIFE MAP ASSIGNMENT INSTRUCTIONS
A Life Map is a pictorial narrative of your life that provides a visual road map of key events and
experiences that have impacted your development. The goal is to trace significant moments of
your life from birth to present day. Please watch the short video entitled Create a Map of Your
Life to get started. You may be as creative as you like, however the map must be organized,
legible, and a chronological pictorial account of your life from point A (past) to point B
(present). If you are using symbols to depict emotions or positive/negative experiences, please
include a map key or legend to explain. Wording should also be easily readable.
You may need to speak to parents or siblings to start your life map and identify key events from
your earliest years. Then begin by organizing your thoughts and memories into a written
timeline. Use the written timeline to create the map. Your map should be scanned and uploaded
as a PDF. Images may be neatly hand-drawn, computer generated, real images, etc.
The map should cover biological, psychological, social, and spiritual key life events that
highlight your social environment and development. Life events, milestones, and trajectory
changing experiences that are unique to your development should be included to provide an
overview of your life. As an adult, a minimum of 10-15 points on the map are needed. The map
will be graded based up detail, creativity, and legibility. Please google images of life maps, that
look like a map or visual timeline.
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
SOWK 530
LIFE MAP PAPER ASSIGNMENT INSTRUCTIONS
An introspective analysis of one’s own life is important for social workers. The life course
perspective emphasizes how our lives are shaped by relationships, transitions, decisions, etc., all
of which impact our worldview, values, and biases. It is important that we understand ourselves
and the lens through which we operate, so that we may better connect with those we serve.
For this assignment you will develop a 6–8-page paper, not including the title page and
references, based upon your Life Map. Please use the Life Map to create a narrative that
articulates your development from a life course perspective and incorporate various
developmental theories. The paper must include a discussion of life changing events (use
textbook terms such as life events, turning point, and trajectory), at least 2 developmental
theories (major developmental theories include Erikson’s Theory of Psychosocial Development,
Piaget’s Theory of Cognitive Development, Bowlby’s Theory of Attachment, and Kohlberg’s
Theory of Moral Development). Fowler’s theory of spiritual/faith development must also be
included. The textbook and 3 additional peer reviewed sources* should be cited, for a minimum
of 4 scholarly sources.
The paper should begin with an introduction (age, sex, marital status, pets, employment, etc.),
followed by organizational headings to include: Life Changing Events (any specific events or
milestones that changed the trajectory of your life), Application of Developmental Theories
(discuss and apply at least 2 theories), Spiritual Developmental (discuss Fowler’s theory and
the development of your personal faith), and As a Social Worker (discuss how your personal
development impacted or informed your desire for social work). In the introduction, please
discuss why it is important for social workers to be aware of their own development.
If scripture is used in your paper, it should be properly cited and referenced. Please follow the
instructions carefully, use the template provided, and use current APA format. “Upload” your
paper as a Word document; PDFs cannot be graded. Please see APA information below to assist
you:
1. Please review the 7th edition of the APA manual pages 261-262, page 266, Figure 8.2
(p.262), and Table 8.1 (p.266) for citation examples.
2. Please see page 325 for formatting of scripture citations and biblical references.
3. Please refer to page 270 for Principles of Direct Quotations. A citation is NOT
synonymous with a direct quote. Direct quotes are NOT original content and should be
used sparingly. The ability to paraphrase and summarize more effectively demonstrates
critical thinking and comprehension.
The JFL Library is an excellent source and will provide everything you need to complete
research and writing assignments in this course. Click on “Resources” at the top, then “Jerry
Falwell Library” on the left. You may enter search terms directly into the search window. To
refine your search, click “advanced search” >>>> click “scholarly materials/peer reviewed”
>>>> then fill in additional filters like the date range. Below is an example of a peer reviewed
article; notice that there are authors, a year, a journal name, a volume, issue, page range (articles
are typically several pages), and a doi and/or URL. These are clear indicators of a peer reviewed
article.
Page 1 of 2
SOWK 530
Lee, C. D. (2018). Social work with groups’ practice ethics and standards: Student confidence
and competence. Research on Social Work Practice, 28(4), 475–481.
https://doi.org/10.1177/1049731516655456
Please see the Life Map Paper Resources for links to these websites.
•
*This video discusses differences between a general publication, a scholarly article, and a
peer-reviewed article: What is a Scholarly or Peer-Reviewed Journal?
•
This video takes a closer look at searching for scholarly resources within the JFL:
Finding Peer-Reviewed & Scholarly Articles.
Scripture citations must include the translation/version of scripture, as well as the original and
last revision publication date. The reference is for the translation/version, not your personal
bible. Please see examples of correct formatting below:
Citation: According to John 3:16, “For God so loved the world He gave His one and only son,
that whoever believes in him shall not perish but have eternal life” (New International Version,
1978/ 2011).
Citation: Scripture tells us, “For God so loved the world He gave His one and only son, that
whoever believes in him shall not perish but have eternal life” (John 3:16, New International
Version, 1978/ 2011).
Reference
New International Version Bible (2011). New International Version online.
www.biblegateway.com (original work published 1978).
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
Page 2 of 2
LIFE MAP PAPER
1
Life Map Paper: My Story
John C. Doe
Department of Social Work, Liberty University
Author Note
Student Name
I have no known conflict of interest to disclose.
Correspondence regarding this submission should be addressed to
Enter student name, enter email address
LIFE MAP PAPER
2
Life Map Paper: My story
APA formatting requires double spacing and 1-inch margins. There are specific font
types that are acceptable. Times New Roman 12-point font is traditionally the preferred choice.
The title of your paper goes on the top line. It should be centered, bolded, and in title case. You
will then write an introductory paragraph. You will not use the heading “Introduction”. The
introduction should be basic and background information about you. Include information similar
to a summary or bio, and include things such as age, race, sex, marital status, hobbies, religious
preference, etc. Also discuss why you believe it is important for social workers to understand
their own developmental history. The introductory paragraph contains a thesis sentence. This
sentence gives the reader an idea of what to expect when reading the paper. It is often the last
sentence of the paragraph.
Life Changing Events
In this section, discuss any life changing events that occurred and shaped your life. This
may be a school experience, familial or personal trauma (only share what you are comfortable
discussing), a move across the country, death in the family, birth in the family, accident, etc.
Think of key things that may have shifted the trajectory of your life; the textbook refers to these
as turning points. What is your recollection of how you were impacted? In what ways are you
different because of these events?
Application of Developmental Theories
Critically analyze your development relative to the information in the text. Discuss at
least 2 developmental theories and how you progressed through the stages. What were the
milestones? In what ways have you successfully advanced through some stages? Where do you
think you may have some work to do to successfully navigate through a stage? What challenges
did you encounter? What insights have you gained about yourself, your social environment, and
LIFE MAP PAPER
3
its impact upon you after reviewing developmental theories? At least 2 theories must be
discussed. The text and 2 additional sources should be cited and referenced.
Spiritual Developmental
Use Fowler’s theory as a backdrop to discuss your spiritual development. Where do you
feel that you are currently? What has the process felt like? What difficulties, questions, or
setbacks have you encountered? How would you describe your spiritual worldview? Fowler’s
theory should be cited and provide the foundational context of the discussion.
As a Social Worker
Discuss how your Life Map/life story has informed your desire to pursue a career in
social work. Consider how your personal life story shapes your interaction within society. How
will this impact your work with clients? Discuss how you plan to be true to yourself and still
meet clients where they are when their values may be very different than your own.
LIFE MAP PAPER
4
References (begin on a new page)
Author, A. A., Author, B. B., & Author, C. C. (Year). Title of article. Title of Journal, volume
number(issue number), pages. https://dx.doi.org/xx.xxx/yyyyy
Author, A. A. (year). Title of the textbook (edition.). Publisher.
Lee, C. D. (2018). Social work with groups’ practice ethics and standards: Student confidence
and competence. Research on Social Work Practice, 28(4), 475–481.
https://doi.org/10.1177/1049731516655456

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Social Work Question

Jun 14, 2024 | Health Medical

Description

Please follow the instructions in the document. This assignment is past due so please complete this assignment as soon as possible.

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PSYC 101
ESSAY ASSIGNMENT INSTRUCTIONS
In General Psychology, you will write several essays throughout the term. For each essay you
will answer a question about the Module: Week topic(s), writing in a way that is engaging and
furthers discussion on the topic. Use the guidelines below to write a substantive essay:
1. Each essay must include at least 400 words.
2. While meeting the word count is important, it is possible to write an essay that is long
enough, but not substantive enough to earn full credit. The second criteria of a good essay is
including a clear and substantial answer to the prompt. When preparing your essay, ask
yourself,
• Does my essay answer the question or questions being posed?
• Does it clearly answer all parts of the question, supported by course materials?
3. When answering the essay question, it is important to use concepts, research, and/or theories
from the Module: Week material to support your thoughts. A good essay will:
• Offer a thoughtful response on the topic being discussed, and
• Demonstrate a thorough understanding of the topic by using material from the
resources provided for that Module: Week in your answer. Using anecdotes or
personal experiences are not as substantial or scholarly as using research and/or
theory to advance the discussion.
4. A good essay offers something new and fresh.
• Avoid simply answering the question with a simple response or reiteration of what
the textbook says.
• Present information in a way that advances thought on the topic and shows a clear
understanding of and reflection on the material.
• Demonstrate your knowledge by presenting facts.
• Demonstrate your understanding by providing practical application.
• This does not mean that you write and write and write, but rather that you present a
thought-filled and reflective essay that addresses the question being asked in a way
that demonstrates a true depth of understanding of the Module: Week material.
5. A good essay is written in a scholarly way. Each essay:
• Is free of grammatical and spelling errors,
• Uses current APA format (Student Standards),
• Includes in-text citations and a reference section,
• Includes an APA-formatted title page,
• Demonstrates a solid understanding of course concepts by using scholarly sources
rather than personal experience or anecdotes,
• Paraphrases and synthesizes research effectively rather than simply quoting material.
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
Page 1 of 2
PSYC 101
Please see the Essay Prompts under the Essay Resources.
Please review the Essay Grading Rubric prior to writing your first essay to determine what is
expected.
Page 2 of 2
PSYC 101
ESSAY PROMPTS
Essay: Fearfully and Wonderfully Made Assignment
In the “Biology of Behavior” chapter, the authors of your textbook write: “We are fearfully and
wonderfully made, and the complexity of our brain is amazing evidence of God’s creation. Also,
the complexity of our brain uniquely positions humans to be able to have a relationship with
God.” Using information from the textbook to support your responses, answer the following:
•
•
What information on our nervous system and brain stands out to you as evidence that we
have been uniquely created to be able to have a relationship with God?
How does the information from chapter 2 support the biblical view that we are “fearfully
and wonderfully made” and uniquely created for God himself?
Essay: You be the Developmental Psychologist Assignment
For this assignment, imagine that you are an expert in human development who has been tasked
with the following:
•
•
•
Choose a life stage (i.e., infancy, early childhood, adolescence, older adulthood, etc.) and
domain (physical, cognitive, socioemotional).
Using information from the “Developmental Psychology” chapter, describe the primary
need(s) of individuals in that stage of life.
Suggest at least three activities that would foster healthy developmental outcomes based
on the need(s) you have described.
Essay: What I Say Versus What I Do Assignment
In the “Personality and Social Psychology” chapter, we looked at different studies of social
behaviors (i.e. obedience, conformity, helping, and bystander behavior) that show that people
may behave differently when placed in a situation than they report they would behave when
merely asked what they’d do. Using information from the textbook to support your responses,
answer the following:
•
•
•
What do studies in social psychology show us about the difference between what we
think and say we would do in situations versus our actual behaviors when placed in
them?
How does this matter to research in social psychology and the use of self-report measures
in many studies?
How could this discrepancy between what we think we’d do and what we actually do be
looked at biblically? That is, how would God explain why we don’t always do what we
think we’d do?
Essay: Motivation, Values, and Purpose Assignment
Page 1 of 2
PSYC 101
In the “Motivation and Emotion” chapter, we looked at numerous factors influencing motivation.
Using information from the textbook, answer the following:
•
•
Using the concepts from the “Motivation and Emotion” chapter, describe what motivates
you in your educational pursuits.
Then look at the Venn diagram in chapter one (FIGURE 1.7 Intersecting Areas that
Comprise Purpose) and describe how values and purpose might inform one’s motivational
experience.
Essay: You be the Professor Assignment
One of the most critical skills for students to master is how to study! Using information from the
“Learning, Memory and Intelligence” chapter in your textbook, answer the following:
•
•
Applying what you have learned in the reading, what study strategies would you
recommend to students and why?
What cautions would you give students about multitasking and why?
Essay: That’s Your Perception Assignment
The systems responsible for sensation are remarkably similar from one person to another, yet
perceptions of the same event can vary from person to person. Using information from the
“Sensation and Perception” chapter in your textbook, answer the following:
•
•
•
What factors create differences in perceptions from person to person?
Do these differences in perception indicate differences in reality?
Can we be confident that our perceptions reflect reality?
Page 2 of 2

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HCI-314: Public Health Informatics – Activity 3

Jun 14, 2024 | Health Medical

Description

PurposeThe purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos. Action ItemsExpalin how does how does the evaluation of information systems effect E health?

102 @Llxuix

Jun 14, 2024 | Health Medical

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see attached

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TDABC Week5

Jun 14, 2024 | Health Medical

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Create an overview of the cost measurement process for “Naloxone Training to First responders across the state of Mississippi” and develop the project charter. Attached is a TDABC worksheet template you can use .

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Please fill out the Project Charter below
PROJECT CHARTER
Background
The Subject of Study
Problem Statement
Project Design
Project Setting
Care Cycle
Types of Costs
Project Timeline
Project Team
Role of HBS
Communication
Process Maps
Cost Data
Output/ Publication
Stake Holders
Challenges
Sustainability
15 |

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3 ct r

Jun 14, 2024 | Health Medical

Description

Critical Thinking: Comparative Analysis: Risk

Compare Risk in Different Health Care Systems

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.

261 pre ماريا

Jun 14, 2024 | Health Medical

Description

topic is the role of occupational health in prevention of occupational diseases

➢ Font should be 12 Times New Roman

➢ Heading should be Bold

➢ Line spacing should be 1.5

➢ Avoid Plagiarism

➢ The presentation must be submitted on blackboard with the filled cover page as a Word file and as ppt slides by the leader for each group by email for the instructor.

➢ Use graphics and shapes whenever you can

➢ How to Create a Poster in PowerPoint

– Each presentation should consist of 15-20 slides minimum and includes these elements in the following order:

▪ Cover sheet.

▪ Outline.

3 file ct poster

Jun 14, 2024 | Health Medical

Description

Research Poster (105 points)

‏Non-communicable diseases (NCDs) not only lead the way with respect to mortality rates at a global level but also account for the majority of deaths in high-income countries. According to Bashir (2021), the most common causes of death in Saudi Arabia are ischemic heart disease, road injuries, stroke, chronic kidney disease, lower respiratory tract infections, Alzheimer’s disease, conflict and terror, cirrhosis, neonatal disorders, and diabetes mellitus.

‏Select one of the causes of death listed above, then assemble a research poster specific to your selected topic and how it progressed to a goal in Saudi Vision 2030. Approach the topic as if you are gathering sources to present this research at a conference. Be sure your references address:

* How is your selected cause of death addressed by Saudi Vision 2030?

* What are some of the methods in obtaining research and data for shaping KSA policy regarding your selected cause of death?

* Any challenges to collecting evidence-based information.

* Health policy laws implementing positive social changes in this area of healthcare.

* What is the importance of this information?

* Why is your selected cause of death relevant to your audience or field of study?

* How is it applicable beyond these contexts?

‏Reference

‏Bashar, S. (2021). Leading cause of death in comparison to COVID-19

‏in Saudi Arabia. European Review for Medical and Pharmacological Sciences, 25, 2468-2469. https://www.europeanreview.org/wp/wp-content/uploa…

‏For more information and an example of a Research Poster, click here:

‏Poster Template 1

‏Poster Template 2

‏This Research Poster should meet the following criteria:

* Include sections for: Introduction, Literature Review, Methods, Results, and Conclusion. Include a title slide and references slide.

* 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.

* Be formatted according to APA 7th edition and Saudi Electronic University writing guidelines.

* You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting

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Template Provided By Genigraphics – 800.790.4001 – Replace This Text With Your Title
REPLACE THIS BOX WITH
YOUR ORGANIZATION’S
HIGH RESOLUTION LOGO
REPLACE THIS BOX WITH
YOUR ORGANIZATION’S
HIGH RESOLUTION LOGO
John Smith, MD1; Jane Doe, PhD2; Frederick Jones, MD, PhD1,2
1University of Affiliation, 2Medical Center of Affiliation
Abstract
Methods and Materials
Click here to insert your Abstract text. Type it in or copy and paste from your Word document
or other source.
Click here to insert your Methods and Materials text. Type it in or copy and paste from your
Word document or other source.
5
4.5
4
3.5
This text box will automatically re-size to your text. To turn off that feature, right click inside
this box and go to Format Shape, Text Box, Autofit, and select the “Do Not Autofit” radio
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read up to 3 feet away on a 24×36 poster, and up to 6 feet away on a 48×72 poster.
3
Series 1
2.5
Series 2
2
Series 3
1.5
1
0.5
0
Category 1
Category 2
Category 3
Category 4
Zoom out to 100% (for 24×36) or 200% (for 48×72) to preview what this will look like on your
printed poster.
Zoom out to 100% (for 24×36) or 200% (for 48×72) to preview what this will look like on your
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Introduction
Results
Genigraphics® has provided this template to assist in preparation of a medical or scientific
research poster. The dimensions are set to 24” high by 36” wide but prints can be scaled up or
down in size to any dimension with a 2:3 aspect ratio. For example, if you order a 36” x 54”
poster using this template, we will print the file at 150% of its original size. If you order a 48”
x 72” poster, we will print at 200%. The most critical factor is that your template and poster
dimensions must be proportional:
Click here to insert your Results text. Type it in or copy and paste from your Word document
or other source.
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document or other source.
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This text box will automatically re-size to your text. To turn off that feature, right click inside
this box and go to Format Shape, Text Box, Autofit, and select the “Do Not Autofit” radio
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To change the font style of this text box: Click on the border once to highlight the entire text
box, then select a different font or font size that suits you. This text is Calibri 20pt and is easily
read up to 3 feet away on a 24×36 poster, and up to 6 feet away on a 48×72 poster.
To change the font style of this text box: Click on the border once to highlight the entire text
box, then select a different font or font size that suits you. This text is Calibri 20pt and is easily
read up to 3 feet away on a 24×36 poster, and up to 6 feet away on a 48×72 poster.
Zoom out to 100% (for 24×36) or 200% (for 48×72) to preview what this will look like on your
printed poster.
Zoom out to 100% (for 24×36) or 200% (for 48×72) to preview what this will look like on your
printed poster.
Order your poster from Genigraphics and we will perform a free design review and advise you
if we see anything that may be a concern for printing. We’ll even help tidy things up.
We have more history with PowerPoint® than any other printing company. In fact, we helped
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reproduction available.
Figure 1. Label in 16pt Calibri.
Chart 1. Label in 16pt Calibri.
Discussion
Speaking of Results, yours will look better if you remember to run a spell-check on your
poster! After you’ve added your content click on Review, Spelling, or press F7.
Conclusions
Click here to insert your Conclusions text. Type it in or copy and paste from your Word
document or other source.
Table 1. Label in 16pt Calibri.
Heading
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Item
800
790
4001
Item
356
856
290
Item
228
134
238
Item
954
875
976
Item
324
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301
Item
199
137
186
Figure 2. Label in 16pt Calibri.
Contact
References
Email:
Website:
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1.
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6.
7.
8.
9.
10.
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Discussions Week 3

Jun 14, 2024 | Health Medical

Description

For each discussion include 250-300 words and 1 reference. Each discussion post will need 2 peer responses consisting of 150 words and 1 reference

NUR500

PART 1: Week 3 Discussion Forum

NUR510

Week 3 Discussion 1

Week 3 Discussion 2

Nursing Question

Jun 14, 2024 | Health Medical

Description

Public Policy Meeting Assignment

Submit a 3-4 page summary paper on the public policy meeting. Include headings in your paper that address these components:

Week 3 Public Policy Meeting Paper

Public Policy Meeting Topic Approval Form

Student Name:

Assignment Date: September 7, 2023

Title of Policy Meeting: Cato Institute Discussion on Combating the Fentanyl Crisis

Date of Meeting: August 18, 2023

Time of Meeting: 10:41 PM

Location of Meeting: Washington, District of Columbia, United States

Website if applicable: https://www.c-span.org/video/?529974-1/cato-instit…

Written Assignment ( Please follow instructions as outlined, deductions will be given if they are not included)

Please include this before your paper after your title page

Public Policy Meeting Topic Approval Form

Student Name :

Assignment Date:

Title of Policy Meeting

Date of Meeting

Time of Meeting:

Location of Meeting

Website if applicable

Public Policy Meeting Written Assignment Details

Introduction (Please include an introduction to include the purpose of the assgnment. Deductions will be given if there is no introduction, follow the rubrics instructions to formulate your introduction.

Here is an example:

The purpose of this assignment was to attend a Public Policy Meeting, which was approved by the instructor. The meeting was held on (date) at (time) located at (place). This paper will describe the components of the meeting. Included in this paper will be the purpose of the meeting, key participants and the description of the committee, key agenda items and background information. Additionally, this writer will continue with one specific topic that was discussed at the meeting and an explanation of the committee process. There will be an analysis of the key stakeholders’ position related to this specific topic along with key interactions that occurred at the meeting. The paper will also include outcomes of the meeting including specific topic or areas of focus.

Please include these 10 Bold headers before each section in your paper ( Deductions will be given if they are not included) Do not number them in your paper.

Introduction

Purpose of the Meeting

Key Participants and description of the committee

Key Agenda Items

Background information

One specific topic that was discussed at the meeting and an explanation of the committee process

An analysis of the key stakeholders’ position related to this specific topic

Key interactions that occurred at the meeting

Outcomes of the meeting including specific topic focus

Conclusion

( You must include a conclusion to summarize your paper. Deductions will be given if a conclusion is not included.)

Here is an example

In conclusion, this writer attended a Public Policy Meeting, which was approved by the instructor. The meeting was held on (date) at (time) located at (place). This paper described the purpose of the meeting, key participants and the description of the committee, key agenda items and background information. Additionally, this writer focused on one specific topic that was discussed at the meeting and an explanation of the committee process. An analysis of the key stakeholders’ position related to this specific topic along with key interactions that occurred at the meeting was completed. The outcomes of the meeting were also discussed along with areas of focus.

Submit a 3-4 page summary paper on the public policy meeting. Include headings in your paper that address these components: See Above ( Bold Headers must be included)

Current APA Style, 12 Font, Times Roman double spaced, Title page and separate reference page in a hanging format ( meaning all lines except the first need to be indented) as well as proper grammar.

Post an explanation of how the use of CBT in groups compares to its use in family.

Jun 14, 2024 | Health Medical

Description

COGNITIVE BEHAVIORAL THERAPY: COMPARING GROUP, FAMILY, AND INDIVIDUAL SETTINGS

There are significant differences in the applications of cognitive behavior therapy (CBT) for families and individuals. The same is true for CBT in group settings and CBT in family settings. In your role, it is essential to understand these differences to appropriately apply this therapeutic approach across multiple settings. For this Discussion, as you compare the use of CBT in individual, group, and family settings, consider challenges of using this approach with groups you may lead, as well as strategies for overcoming those challenges.

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 videos in this week’s Learning Resources and consider the insights provided on CBT in various settings.
BY DAY 3

Read a selection of your colleagues’ responses.

BY DAY 6 OF WEEK 1

Respond to at least two of your colleagues by recommending strategies to overcome the challenges your colleagues have identified. Support your recommendation with evidence-based literature and/or your own experiences with clients.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!

LEARNING RESOURCES
Required Readings
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?u…
“Culture and Psychiatric Diagnosis”
Goldenberg, I., Stanton, M., & Goldenberg, H. (2017). Family therapy: An overview (9th ed.) Cengage Learning.
Chapter 12, “Behavioral and Cognitive-Behavioral Models”
Wheeler, K. (Ed.). (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.
Chapter 8, “Cognitive Behavioral Therapy”
Chapter 21, “Psychotherapeutic Approaches with Children and Adolescents”
pp. 793–802 only
Chapter 22, “Psychotherapy with Older Adults”
pp. 840–844 only
Required Media
Beck Institute for Cognitive Behavior Therapy. (2018, June 7). CBT for couplesLinks to an external site. [Video]. YouTube.
MedCircle. (2019, December 13). What a cognitive behavioral therapy (CBT) session looks likeLinks to an external site. [Video]. YouTube.
PsychExamReview. (2019, April 30). Cognitive therapy, CBT, & group approaches (intro psych tutorial #241)Links to an external site. [Video]. YouTube.

OPTIONAL RESOURCES
Beck, A. (1994). Aaron Beck on cognitive therapyLinks to an external site. [Video file]. Mill Valley, CA: Psychotherapy.net.
Eysenck, H. (n.d.). Hans Eysenck on behavior therapyLinks to an external site. [Video file]. Mill Valley, CA: Psychotherapy.net.
Psychotherapy.net. (Producer). (2009). Rational emotive behavior therapy for addictionsLinks to an external site. [Video file]. Psychotherapy.net: Author.
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practiceLinks to an external site. [Video]. https://waldenu.kanopy.com/video/counseling-and-ps…
CBT (starts at 2 hours 27 minutes)

presentation

Jun 14, 2024 | Health Medical

Description

presentation about Occupational stress and impact on employee well-beingØ The PPT should not be more than 15 slides and not less than
10 slides. Use appropriate references as per the APA Style. is must slides including introduction and conclousin no plgarism

312 @Ff665665

Jun 14, 2024 | Health Medical

Description

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nursing project: nursing diagnosis, and concept map

Jun 14, 2024 | Health Medical

Description

i have a project about to write down 3 nursing diagnosis and a concept map

Health & Medical Question

Jun 14, 2024 | Health Medical

Description

you submit this assignment late, 20% will be taken off before grading.

Your Final paper should be 8-10 pages, double-spaced, Times New Roman 12pt font

NOTE that a page is about 250 words.

The final paper for this class includes your:

Cover page your name, a topic, class, professor’s name, and due date of the assignment

Make sure you use APA-style headings for your paper. – a template will be provided to you

Introduction of your career goals and how they will fit into your personal lifestyle.
Career trajectory plan (1 page)

Asset map – a chart or make a timeline of your career plan – you can use canva.com and draw.ioor https://app.diagrams.net/ (which is owned by Google) (1 page)

Professional portfolio – summary of your resume in bullet points, emphasizing what you are good at (1 page)

Your internship site
Brief history of your internship site, program/project (1 page)

Community-based map – including federal, state, & local elected officials https://www.commoncause.org/find-your-representative/ and community leaders https://www.nyc.gov/site/cau/community-boards/community-boards.page& the neighborhood health profile https://www.nyc.gov/site/doh/data/data-publications/profiles.page. You can recreate the chart so it looks neater than the website.

Screenshot the map
total population, ages
write about the health issues and outcomes (pick 3 to write about)
(1/2-1 page)
Top 3 health issues in that community (1-2 pages)
Synopsis of project-based work completed in your internship
Skills that you used and learned (1-2 pages)
Recommendations that you would provide the internship, such as improving the internship and what students need to know – focus on professional skills and communication (1/2-1 page)
Any other interesting additional components (1/2-1 page)

References: At least 1 academic journal, 1 website, and one YouTube video – must be in APA style

Make sure this assignment is in WORD or PDF format.

Note that this paper has other parts that are due later in the semester, such as:

Final presentation (in PowerPoint) – look for your group number and that is the day and time you are presenting.
Career roadmap and specialization essay – which is a summary of your final paper –> Tjis assignment will change into a Memo assignment to provide you with more skills.
Infographic – which is a picture summary of your final paper

Check any grammar and spelling errors, and typos before you submit your PowerPoint.

Public Health Analysis

Jun 14, 2024 | Health Medical

Description

Unformatted Attachment Preview

Public Health Analysis Paper Instructions
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. Voiceover presentation for slides is optional.
1
Public Health Analysis: Hypertension
Public Health Analysis: Hypertension
The world population is increasing vastly. At the same, the world is experiencing an
increasing rate of diseases. Chronic diseases are among those that have created a critical
concern in today’s public health. A report by Kulkarni et al. (2020) documented that in 2020,
almost 30% of American adults had multiple chronic diseases. In the United States, chronic
2
diseases account for about 75% of healthcare spending (Raghupathi & Raghupathi, 2018).
One of the chronic diseases affecting public health is hypertension. It is described as
increased blood pressure. In the United States, for instance, the disease is noted to affect older
adults. It is reported that about 70% of adults aged more than 65 years have hypertension
(Buford, 2017). Worryingly, this number is predicted to continue rising. With its predicted
increasing rate, it shows that hypertension will remain a critical public health concern. As
such, it is important to report that the following is a public health analysis paper that mainly
focuses on the issues surrounding hypertension.
As mentioned above, the rate of individuals with hypertension is increasing rapidly.
While old age is considered the primary risk factor, today, reports of young people with
hypertension are also increasing. Several issues are raised in the direction of this issue. For
instance, numerous reports show that most people are adopting unhealthy lifestyles. In
addition, there is an increased number of obese individuals, which is among the risk factors
for developing hypertension. Another understudied issue affecting the increasing rate of
hypertension is the inadequate number of knowledgeable staff in advanced practice nursing to
provide effective management of hypertension. Relatedly, Benetos et al. (2019) highlight that
this has created insufficient follow-up measures in managing the disease.
The disease is also explored as one of Health People 2020’s objectives. The disease is
included in the heart disease and stroke topics. According to Health People 2020 (n.d.), new
measures are needed to monitor cardiovascular diseases, including hypertension. It is
important to report that the public health analysis of hypertension will majorly assist not only
the health sector but also communities that are burdened by this disease, including the
minorities in the United States.
Literature Review
3
As has been previously discussed, hypertension remains to be one of the significant
risk factors for severe morbidity and mortality across the globe. According to Basile and
Bloch (2021), hypertension treatment is recorded to be among the most common office visit
reasons. This assumption is supported by Van Bussel et al. (2019) in that most of the affected
are the elderly, who majorly rely on general practitioners for treatment. The following is a
literature review focusing on the statistics of hypertension, the causes and risk factors, and the
impact it has to the public health.
Hypertension Statistics in the United States
Causes and Risk Factors
The Impact of Hypertension on Public Health
References
Basile, J., & Bloch, M. J. (2021, August 4). Overview of hypertension in adults.
https://www.uptodate.com/contents/overview-of-hypertension-in-adults
4
Benetos, A., Petrovic, M., & Strandberg, T. (2019). Hypertension management in older and
frail older patients. Circulation Research, 124(7), 1045-1060.
https://doi.org/10.1161/circresaha.118.313236
Buford, T. W. (2017). Hypertension and aging. Ageing Research Reviews, 26, 96-111.
https://doi.org/10.1016/j.arr.2016.01.007
Healthy People 2020. (n.d.). Heart disease and stroke.
https://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
Kulkarni, A., Mehta, A., Yang, E., & Parapid, B. (2020). Older Adults and Hypertension:
Beyond the 2017 Guideline for Prevention, Detection, Evaluation, and Management
of High Blood Pressure in Adults. Journals of the American College of Cardiology.
Raghupathi, W., & Raghupathi, V. (2018). An empirical study of chronic diseases in the
United States: A visual analytics approach to public health. International Journal of
Environmental Research and Public Health, 15(3), 431.
https://doi.org/10.3390/ijerph15030431
Van Bussel, E., Reurich, L., Pols, J., Richard, E., Moll van Charante, E., & Ligthart, S.
(2019). Hypertension management: Experiences, wishes, and concerns among older
people—a qualitative study. BMJ Open, 9(8),
e030742. https://doi.org/10.1136/bmjopen-2019-030742
NSG7005 Week 8 Project Rubric
Course: NSG7005-Clinical Prevention and Population Health CP02
Criteria
No Submission
0 points
Emerging (F through
D Range) (1-27)
27 points
Satisfactory (C
Range) (28-31)
31 points
Proficient (B Range)
(32-35)
35 points
Exemplary (A Range)
(36-40)
40 points
Criterion Score
Develop a 20-25
slide powerpoint
presentation
summarizing
your Public
Health Analysis
Paper
Student did not
submit assignment
Poorly Developed
presentation
missing length or
details
Developing
presentation with
adequate length
but lacking detail
Well-Developed
presentation with
adequate length
and details but
lacking clarity and
organization.
Thoroughly
developed
presentation with
adequate length,
details, clearly
organized.
/ 40
Summarize your
review of the
literature
Student did not
submit assignment
Poorly described
or omitted
summary of
review of
literature
Developing
description of
review of
literature
Detailed
description of
review of the
literature.
Thoroughly
described review
of the literature
with depth and
organization.
/ 40
Describe
strategies or
policies that
have been used
to address the
issue and
address if they
are working or
not.
Student did not
submit assignment
Limited details
without a clear
explanation of
strategies that
have been used or
if they are working
Developing details
and explanations
of strategies that
have been used
and if they are
working
Well-partially
developed details
and some clear
explanation of
strategies that
have been used
and if they are
working.
Thoroughly
provided a
detailed and clear
explanation of the
strategies that
have been used
and if they are
working.
/ 40
Criteria
Discuss what
strategies you
propose to
improve the
situation and
address if
legislative
change is
needed
Criteria
Used correct
spelling,
grammar, and
professional
vocabulary.
Cited all sources
using APA
format. No
errors.
Total
No Submission
0 points
Student did not
submit assignment
No Submission
0 points
Student did not
submit assignment
Emerging (F through
D Range) (1-27)
27 points
Satisfactory (C
Range) (28-31)
31 points
Proficient (B Range)
(32-35)
35 points
Exemplary (A Range)
(36-40)
40 points
Minimally
explained strategy
proposal and
legislation
Explained strategy
proposal and
legislation but
missing details
Detailed
explanation of
strategy proposal
and legislation
Thoroughly
explained strategy
proposal and
legislation
Emerging (F through
D Range) (1-27)
27 points
Satisfactory (C
Range) (28-31)
31 points
Proficient (B Range)
(32-35)
35 points
Exemplary (A Range)
(36-40)
40 points
Incorrect spelling,
grammar, and
professional
vocabulary. Poor
citation of sources
using APA format.
Many errors
Moderated
number of errors
in spelling,
grammar, syntax,
and professional
vocabulary. Cited
some sources;
with moderate
APA format errors.
Minor number of
errors in spelling,
grammar, syntax,
and professional
vocabulary. Cited
some sources;
with minor APA
format errors.
Near perfect use
of correct spelling,
grammar, syntax,
and professional
vocabulary. Cited
all sources using
APA format.
Criterion Score
/ 40
Criterion Score
/ 40
/ 200
Overall Score
No Evidence
0 points
minimum
Emerging (F through D Range)
(1-138)
Satisfactory (C Range)
(139-158)
Proficient (B Range)
(159-178)
Exemplary (A Range)
(179-200)
1 point minimum
139 points minimum
159 points minimum
179 points minimum
Public Health Analysis Paper Instructions
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?
Strictly follow the attached rubric
You should include Speaker’s Notes
Your PowerPoint presentation should be 20-25 slides, in APA 7 format, with details included.
Be creative. Voiceover presentation for slides is optional.

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What is the future of FFS in the wake of changes for the vision 2030 goals ?and plans in healthcare across KSA

Jun 14, 2024 | Health Medical

Description

What is the future of FFS in the wake of changes for the vision 2030 goals ?and plans in healthcare across KSAwhit refrence

Health promotion

Jun 14, 2024 | Health Medical

Description

To develop a health promotion campaign.

Health Care Short answer questions

Jun 14, 2024 | Health Medical

Description

Health Care Short answer questions.Need 800 words, no plagiarism and please be on time.

Week 8: Current Issues/Trends PowerPoint Presentation

Jun 14, 2024 | Health Medical

Description

Choose from one of the following topics:
Nursing during an epidemic, pandemic or natural disaster across the country or around the globe
The effect of the media on nursing image. How can nurses educate the public and help portray the true image of nursing?
The prevalence and impact of substance abuse among nurses (impaired nursing)
Impact of collective bargaining on the nursing profession
Social media influences on health or health care delivery
Impact of workplace harassment and violence on the nursing profession
You may select from ONE of the following technological advances and discuss its impact on patient outcomes:
Telehealth technology
Health applications
Health-related/electronic wearables
You must use the PowerPoint presentation template provided at the top of this assignment.
You are to create bullet points for each slide, not including the title and reference slides. Every slide must have a speaker note with a minimum of 4-5 sentences addressing the bulleted items on the slide.
Include a minimum of 4-5 peer-reviewed research articles as references in the presentation. All research articles need to have been published within 5 years from today’s date. No blog, chat, other university or Wikipedia information allowed in presentation. The PowerPoint presentation must follow current APA styleLinks to an external site..
Your presentation should include the following slides:
Title slide
Why the topic was chosen
How your topic impacts nursing practice
Current relevance of the topic
Clinical Practice Integration
Plan for lobbying: Describe in detail your plan for how you would lobby your legislators or local government for funding and support for your chosen current issue or trend.
Conclusion
Reference slide
High Turnitin scores will be evaluated on an individual basis and may result in points deducted and/or a grade of “zero” for the assignment. Use the Turnitin Plagiarism Check to upload your assignment and verify your plagiarism score before submitting your assignment.

You will need to follow these steps below for saving your PowerPoint so that your speaker notes are visible:

Open your PPT and go to “file” in top left corner.
Click “print” option. Make sure “print all slides” and “print slides with notes” is selected.
Go to “Save As” on the left hand side and be sure you save as a PDF.
Under your save as selection, click “more options”. Select the “Options” button and click the “Publish What” pull-down and then select “Notes Pages.” (If you click slides it will not show the speaker notes)
Click “OK.”
Complete your selection process by checking “Open file after publishing” and selecting the “Optimize for: ‘Standard’ and ‘Minimum Size’” choices.
Click on “Save” next to the “Tools” button at the bottom of the box.
Rubric

NURS_440_OL – Week 8 PowerPoint Presentation

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeIdentification, definition, and description of topic, background & why topic was chosen

40 pts

Meets or Exceeds Expectations

Provides an exemplary and insightful analysis of the identification, definition, description and background of the topic & why it was chosen

30 pts

Mostly Meets Expectations

Provides accurate identification, definition, description and background of the topic & why it was chosen

20 pts

Approaches Expectations

Provides partial identification, definition, description and background of the topic & why it was chosen

10 pts

Below Expectations

Provides limited identification, definition and description and background of the topic & why it was chosen

0 pts

Does Not Meet Expectations

Missing identification, definition and description and background of the topic & why it was chosen

40 pts

This criterion is linked to a Learning OutcomeHow the topic impacts nursing

40 pts

Meets or Exceeds Expectations

Presents an exemplary and insightful analysis of the current issue and trend and how the topic impacts nursing

30 pts

Mostly Meets Expectations

Presents an accurate analysis of the current issue and trend and how the topic impacts nursing

20 pts

Approaches Expectations

Presents a partial analysis of the current issue and trend and how the topic impacts nursing

10 pts

Below Expectations

Provides limited explanations of the current issue and trend and how the topic impacts nursing

0 pts

Does Not Meet Expectations

Lacks understanding for the current issue and trend and how the topic impacts nursing

40 pts

This criterion is linked to a Learning OutcomeCurrent Relevance

40 pts

Meets or Exceeds Expectations

Presents an exemplary and insightful analysis of the current relevance of the issue and trend in nursing

30 pts

Mostly Meets Expectations

Presents an accurate analysis of the current relevance of the issue and trend in nursing

20 pts

Approaches Expectations

Presents a partial analysis of the current relevance of the issue and trend in nursing

10 pts

Below Expectations

Provides limited explanations of the current relevance of the issue and trend in nursing

0 pts

Does Not Meet Expectations

Lacks understanding of the current relevance of the issue and trend in nursing

40 pts

This criterion is linked to a Learning OutcomeClinical Practice Integration

40 pts

Meets or Exceeds Expectations

Presents an exemplary and insightful analysis of how the current issue and trend is integrated into clinical nursing practice

30 pts

Mostly Meets Expectations

Presents an accurate analysis of how the current issue and trend is integrated into clinical nursing practice

20 pts

Approaches Expectations

Presents a partial analysis of how the current issue and trend is integrated into clinical nursing practice

10 pts

Below Expectations

Provides minimal analysis of how the current issue and trend is integrated into clinical nursing practice

0 pts

Does Not Meet Expectations

Lacks understanding of how the current issue and trend is integrated into clinical nursing practice

40 pts

This criterion is linked to a Learning OutcomePlan for lobbying

40 pts

Meets or Exceeds Expectations

Presents an exemplary and insightful analysis of the importance of lobbying legislators or local government for support funding. Offers detailed and specific examples of current legislation regarding the effect on current clinical practice settings

30 pts

Mostly Meets Expectations

Makes accurate connections to the importance of lobbying legislators or local government for support funding. Offers some detailed examples of current legislation regarding the effect on current clinical practice settings

20 pts

Approaches Expectations

Makes partial connections to the importance of lobbying legislators or local government for support funding. Offers few detailed examples regarding effect on current clinical practice settings

10 pts

Below Expectations

Provides insufficient connections to the importance of lobbying legislators or local government for support funding. Offers no details and/or examples regarding effect on current clinical practice settings

0 pts

Does Not Meet Expectations

Information is missing. Response indicates no understanding of the importance to lobby for any support funding

40 pts

This criterion is linked to a Learning OutcomeCreativity and Professionalism

40 pts

Meets or Exceeds Expectations

Includes an exemplary visual presentation (i.e. data, graphs & clip arts) to capture the audience in slides/presentation. Writing contains no spelling, grammatical, and/or mechanical errors. References and citations contain no APA errors. Sources include peer-reviewed, research-based articles, within last 5 years

30 pts

Mostly Meets Expectations

Includes an adequate visual presentation (i.e. data, graphs & clip arts) to capture the audience in slides/presentation. Writing contains 1-3 spelling, grammatical, and/or mechanical errors. References and citations contain 1-3 APA errors. Most sources include peer-reviewed, research-based articles, within last 5 years

20 pts

Approaches Expectations

Include partial (i.e. data, graphs & clip arts) to capture the audience in slides/presentation. Writing contains 4-6 spelling, grammatical, and/or mechanical errors. References and citations contain 4-6 APA errors. Few sources include peer-reviewed, research-based articles. Sources are >5 years old

10 pts

Below Expectations

Include few (i.e. data, graphs & clip arts) to capture the audience in slides/presentation. Writing contains >7 spelling, grammatical, and/or mechanical errors. References and citations contain greater than 6 APA errors. Sources are included, but are not current, not peer-reviewed, and/or are not research-based articles

0 pts

Does Not Meet Expectations

Template was not used. No visuals were included. Writing contains many spelling, grammatical, and/or mechanical errors. No reference or citations were included.

40 pts

Total Points: 240

Additionally, the weblinks below can help you formulate your ideas and may help create the political plan.

Please reach out if you have any questions about this assignment.

https://www.ncsbn.org/index.htmLinks to an external site.

https://www.nursingworld.org/

Links to an external site.

https://www.congress.gov/

Links to an external site.

https://www.congress.gov/help/tips/explore-a-bill

Links to an external site.

https://www.congress.gov/legislative-process

Links to an external site.

https://www.seiu.org/nurses/

Links to an external site.

https://www.nationalnursesunited.org/

Links to an external site.

http://www.nln.org/

Unformatted Attachment Preview

NURS 440 PowerPoint
Template
Student Name
School
Course
Faculty Name/Title
Date
*
You may change the color & background and remember to include colorful, visual illustrations (i.e. data,
graphs, clip arts, embedded video etc…) appropriate to engage your audience!
Why The Topic Was Chosen
1. Explain why you chose your topic, referring to assignment guidelines.
2. Why is this topic meaningful to you?
3. Provides full and complete Identification, definition, and description of topic,
background & why topic was chosen
How The Topic Impacts Nursing Practice
1. Please show how your topic impacts nursing practice and/or patient care
2. How will the topic impact your role as a nurse in the nursing workforce or in the
clinical setting?
Current Relevance
1. Provide a full description of your topic
2. Describe how your chosen topic is relevant/current to nursing practice
Current Relevance (Cont’d)
1. Provide a critical analysis supported by evidence based practice that
is credible and timely (i.e. data, graph, research, statistics).
Clinical Practice Integration
1. How your topic is integrated and used in clinical practice
Plan for Lobbying
1. Describe in detail what and how you would lobby your legislators
or local government for funding to support your topic.
(will you write a letter, social media, etc. include main points you will
present to persuade funding)
2. What current or proposed legislation already exists that pertains to your
topic?
Plan for Lobbying (Cont’d)
1.
Make insightful, clear and accurate connections to importance of
lobbying legislators & government
Conclusion
1. Show insight and comprehensive solutions/conclusions regarding your chosen
topic
References
Remember to:
Include at least 4-5 research articles (Use WCU Online Library)
2. References need to be within the last 5 years
3. Do not include: blogs, chats, other universities, Wikipedia
4. Follow APA style
1.
Directions for Submitting your Powerpoint
1. Open your PPT and go to “file” in top left corner.
2. Click “print” option. Make sure “print all slides” and “print slides with notes”
is selected.
3. Go to “Save As” on the left hand side and be sure you save as a PDF.
4. Under your save as selection, click “more options”. Select the “Options”
button and click the “Publish What” pull-down and then select “Notes
Pages.” (If you click slides it will not show the speaker notes)
5. Click “OK.”
6. Complete your selection process by checking “Open file after publishing” and
selecting the “Optimize for: ‘Standard’ and ‘Minimum Size’” choices.
7. Click on “Save” next to the “Tools” button at the bottom of the box.

Purchase answer to see full
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Revise NRS 434 Adolescence: Contemporary Issues and Resources

Jun 14, 2024 | Health Medical

Description

Hi, the answer has already been completed and just needs to be revised which has been attached. The answer currently does not address the part of the prompt that states “Outline assessment strategies to screen for this issue and external stressors during an assessment for an adolescent patient.” The answer does not mention specific assessment strategies that can be used for the adolescent patient. The following sentence also has incorrect capitalizations “Regarding assessment strategies to screen for Mental Health among Adolescents, the following should be considered.” The answer was also supposed to not exceed “550 Words Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages.” The answer currently is “572 Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages.” The answer also did not answer the following prompt correctly either which states “Describe what additional assessment questions you would need to ask and define the ethical parameters regarding what you can and cannot share with the parent or guardian.” The answer does not provide specific assessment questions to ask. It just states what should be asked to the adolescent patient rather than develop literal specific questions to ask that end with a question mark. Furthermore, the question asks to define ethical parameters which is not included in the answer. The answer just states that there are ethical parameters but never lists which ones. This is evident in the following sentence “There are ethical parameters regarding what I can and cannot share with the parent or guardian, as the adolescent has a right to privacy (Meherali et al., 2021).”

Research the range of contemporary issues teenagers face today. In a 500-550-word paper, choose one issue (besides teen pregnancy) and discuss its effect on adolescent behavior and overall well-being. Include the following in your submission:

Describe the contemporary issue and explain what external stressors are associated with this issue.
Outline assessment strategies to screen for this issue and external stressors during an assessment for an adolescent patient. Describe what additional assessment questions you would need to ask and define the ethical parameters regarding what you can and cannot share with the parent or guardian.
Discuss support options for adolescents encountering external stressors. Include specific support options for the contemporary issue you presented.

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.

500-550 Words Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages

Please be sure to include an introduction with a clear thesis statement in the last sentence of the introduction 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 paragraph

Please be sure use a minimum of three peer-reviewed sources published within the last 5 years

Requirements: Please be sure to revise the answer based on the requested edits

Unformatted Attachment Preview

1
Contemporary issues teenagers face today: Mental Health Issues
Student Name
Institutional Affiliation
Course Code
Instructor
Date
2
Introduction
Mental health issues are a huge contemporary issue that adolescents face today. It is
estimated that 1 in 5 adolescents have a mental health disorder, the most common being anxiety
and depression. Many factors can contribute to mental health issues in adolescents, like the
history of the family with mental issues, bullying, and academic impediments (Al-Zawaadi et al.,
2021). Mental health disorders can significantly impact an adolescent’s life, making it difficult to
function at home, school, and social situations. The paper below focuses on mental health as a
contemporary issue affecting adolescents.
Many external stressors can contribute to mental health issues in adolescents. Family
history is a major factor, as mental health disorders can be passed down from generation to
generation. Bullying is also a major stressor, as it can lead to feelings of isolation, anxiety, and
depression. Social media can also be a source of stress for adolescents, as it can create a sense of
comparison and inadequacy (Gunasekaran et al., 2022). Academic pressure can also be a major
stressor, as adolescents feel the need to meet the expectations of their parents and teachers.
Regarding assessment strategies to screen for Mental Health among Adolescents, the
following should be considered. Family history should be assessed, as mental health disorders
can be passed down from generation to generation. The adolescent should also be asked about
any experiences with bullying, as this can be a major stressor. Social media use should also be
assessed, as it can be a source of stress for many teenagers (Gunasekaran et al., 2022).
Adolescents should also be asked about their academic performance, as this can be a major
source of stress.
3
There are many additional assessment questions that I would need to ask in order to
assess for mental health issues in an adolescent patient. I would need to ask about family history,
as mental health disorders can be passed down from generation to generation. I would also need
to ask about experiences with bullying, as this can be a major stressor. I would also ask about
their academic performance, as this can be a major source of stress, predisposing them to mental
issues. There are ethical parameters regarding what I can and cannot share with the parent or
guardian, as the adolescent has a right to privacy (Meherali et al., 2021). However, if the
adolescent is at risk of harming themselves or others, the parent or guardian should be notified.
Many support options are available for adolescents experiencing external stressors to
mental health. Family counseling can be helpful for families who are struggling with mental
health issues. Therapy can also be helpful for adolescents who are struggling to cope with
external stressors. There are also many support groups available, such as support groups for
families with mental health issues and support groups for adolescents struggling with mental
health issues (Meherali et al., 2021). Medication can also be helpful for adolescents who are
struggling with mental health disorders.
Conclusion
Mental health issue is one of the contemporary issues affecting adolescents today. The
issue manifests due to anxiety and depressive disorders. Academic pressure also plays a role in
the manifestation of the issue. Some stressor factors to the condition are family history, bullying,
and academic strain. Assessment is based on determining the issue within the family tree or
4
whether acts such as bullying and social media pressure lead to the condition’s manifestation.
Treatment can be both pharmacological and psychological.
5
References
Al-Zawaadi, A., Hesso, I., & Kayyali, R. (2021). Mental Health Among School-Going
Adolescents in Greater London: A Cross-Sectional Study. Frontiers in Psychiatry, p. 12.
https://doi.org/10.3389/fpsyt.2021.592624
Gunasekaran, K., Vasudevan, K., & Srimadhi, M. (2022). A mixed method study assesses mental
health status among adolescents in Puducherry, India. Journal of Family Medicine and
Primary Care, 11(6), 3089. https://doi.org/10.4103/jfmpc.jfmpc_2420_21
Meherali, S., Punjani, N., Louie-Poon, S., Abdul Rahim, K., Das, J. K., Salam, R. A., & Lassi, Z.
S. (2021). Mental Health of Children and Adolescents Amidst COVID-19 and Past
Pandemics: A Rapid Systematic Review. International Journal of Environmental
Research and Public Health, 18(7), 3432. https://doi.org/10.3390/ijerph18073432

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Power point

Jun 14, 2024 | Health Medical

Description

Hello,How are you? You have wrote this paper for me a few days ago. I didn’t realize I also need a Power Point presentation on this paper. Can you please help me?PDCA paper Research inquiry: Quality/Safety Research Proposal Address a current problem that your organization is facing utilizing a PDCA methodology and write a research paper to improve safety and quality in your organization. (Outcome 1,2,3,4,5) (8 hours) APA Format, 5 pages in content, excluding Title and References pages; one Reference is your textbook. The references must be published within the last 5 years. Theses are instructions: Present your paper in class. Continuous Improvement Methodology- PDCADiscuss the credibility of the source and the research/researchersBe prepared to answer questions10 Slides including speaker notes (excluding title and reference slides).

Nutrition Lab Report

Jun 14, 2024 | Health Medical

Description

I’m working on a nutrition question and need guidance to help me learn.

Total points for Lab 3: Hematocrit and Hemoglobin write up is 100.

(4 points) Cover sheet – Include your first and last name, names of lab partners, date, lab exercise name and title, NFS 3101.01.

(5 points) Objectives – Restate the objectives using your own words. Remember to use bullet points.

(10 points) Raw Data – Include your data table in your lab report.

(20 points) Calculations – Calculate the value of your unknown using the Formula method (for Hemoglobin lab). Show mean and mean – blank calculations.

(15 points) Discussion – Discuss the results of the lab in detail. I am looking for details here. What results did you get? What do they mean?

(10 points) Assessment – Discuss new things you learned in the lab and the interesting things you found. This should contain at least 3 different items to receive full credit.

(6 points per question) – Answer the questions at the end of Lab 3

I uploaded the lab report also lab example. it is going to be look like that. also I uploaded the picture which has information for your table

Unformatted Attachment Preview

standard curve was .2628 and with the plug in method, we found x to be 10.5, which did not
make much sense, compared to the other group. We hypothesize that we pipetted the solutions
incorrectly on the plate. In general, the method that was the most appropriate is the standard
curve y = mx+b. The one point method is less accurate because the absorbance of .2628 had to
be measured out on the graph and based on that assumption, would be the concentration level.
The (Au/As) x Cs g/dL had a closer result to the y =mx+b but I still stand by relying on the
standard curve equation to solve for x.
The hematocrit was done as a class. 30% hematocrit was the end result, which means that
it is on the lower side of the ranges for adults. It is still in range for a female. However, for a
male, it would be too low. This hematocrit may be low because of a deficiency in iron, folate, or
vitamin B 12. Hemoglobin determination was also taken for the different standards and
concentrations of the blood samples.
Assessment
I learned a lot about blood and its components in lab. I have never studied blood before
and I didn’t really know the differences between whole blood, plasma, and serum. I learned that
whole blood contains all of the blood components and needs an anticoagulant to avoid clotting.
Plasma has clotting factors, and serum does not have any clotting factors. I also learned about
anemia. I knew what anemia was, but I did not know the 3 classifications of anemia and their
MCV and MCHC values. I learned that normocytic and macrocytic have the same MCHC %
(31-35) and microcytic has less than 30% MCHC. Finally, I also learned about the one point
method. I have never used this method before, so it was interesting to see how it turned out.
Questions
1. What is hematocrit? Under what conditions is the hematocrit low? High?
2. Comment on the results of the blood hematocrit. Was the mean within the normal
range? Explain.
3. What is the difference between leukocytes and erythrocytes?
4. What is anemia? How is anemia classified? What are the 3 different types of anemia?
5. Explain the difference between iron deficiency anemia and folic acid/B 12 anemia.
What causes iron deficiency anemia? What causes folic acid anemia? What causes
vitamin B12 anemia? I
Laboratory Three:
Hemoglobin & Hematocrit Determinations
Objective:
➢ To identify blood collection tubes and additives.
➢ To learn the different types of additives, including anticoagulants.
➢ To learn the difference between whole blood, plasma, and serum.
➢ To familiarize the student with the concept of hematological examination and anemia.
Background: Blood Facts
Outside the body, blood will normally dot within 10 to 30 minutes, unless anticoagulants
are used.
• Plain Red-Top Vacutainer Tube: Freshly drawn blood collected in a tube containing
additives will coagulate forming a clot within 10 to 30 minutes of collection.
During the coagulation process, the clotting factors are used up, so that when a red-top
tube is centrifuged, the resulting fluid portion of the blood is called serum.
• Red w/Gray- or Gold-Top Vacutainer Tube: These tubes contain a clot
activator that speeds up the clot formation. They also contain a polymer gel called
a serum separator. These tubes are also known as Serum Separator Tubes
(SSTs).
✓ When these tubes are centrifuged, this polymer gel is forced upward and
wedges between the heavier red cells that remain on the bottom of the tube,
and the lighter serum that remains on the top of the gel.
✓ This is an important feature because some clinical instruments can become
dysfunctional if red cells can aspirate through the system.
✓ These SSTs also allow for the serum to be easily poured off for transfer,
instead of being aspirated or pipetted.
• Purple-Top and Green-Top Tubes: Freshly drawn blood collected in a tube
containing anticoagulants will not clot.
• Purple-Top (Lavender) Vacutainer Tube: This tube contains the anticoagulant
liquid EDTA Ethylene Diamine Tetra Acetate). This tube is also known as a
Hematology Tube.
• Green-Top Vacutainer Tube: This tube contains the anticoagulant Heparin.
Note: When these tubes are centrifuged, the lighter, clear yellow fluid portion, which rises
to the top (supernatant), is called plasma. This layer cannot be poured off.
Whole Blood, Plasma, and Serum:
Whole Blood: This specimen has all the blood components and chemical compounds
evenly distributed. An anticoagulant is usually employed to ensure that a clot does not
develop. It is recommended that blood tests be conducted as soon as possible after
collection (30 min to 2 hours). Whole blood must be stored at refrigerator temperatures
(2-8 °C). Whole blood cannot be frozen (-20 °C) because the RBCs will lyse. Eventually
hemolysis will occur even in the refrigerator.
Plasma: This specimen has the clotting factors. It can be recovered from tubes with or without
anticoagulant additives. If it is taken from plain tubes, it must be separated immediately before
clotting begins. It can be stored in the refrigerator or freezer.
Serum: This specimen does not have the clotting proteins like fibrinogen, or the other
clotting factors because the blood cells could clot. It can be stored in the refrigerator or
freezer.
Hemoglobin & Hematocrit Introduction:
In clinical practice, the hematological examination includes a determination of the complete
count (CBC). This includes the hematocrit, the hemoglobin concentration, the numbers of red
blood cells (RBC), and the type and number of white blood cells (WBC). The RBC are also
known as erythrocytes and the WBC are also known as leukocytes. The CBC also includes
parameters derived from hematocrit, hemoglobin, and RBC measurements (i.e., erythrocyte
indices). The erythrocyte indices include the mean corpuscular hemoglobin concentration
(MCHC).
WBC count (103 / μL): The total number of white blood cells (all types) per microliter of blood.
This includes neutrophils, lymphocytes, and monocytes. A differential count (“diff”) is a means
to evaluate specific types of WBC in the blood smear and their percent distribution. WBC count
is decreased in protein-energy malnutrition (PEM) and in folate or vitamin B12 deficiency; and
increases with infection or trauma.
Hematocrit (Hct: %): The volume of red blood cells packed by centrifugation. Centrifugation
separates the cellular components of blood from the plasma. Hct is reduced in iron, folate, and
vitamin B12 deficiency; and is increased in dehydration.
Hemoglobin (Hgb: g/dL or mmol/L): The concentration of hemoglobin in grams per deciliter of
blood. Hgb is decreased in iron, folate, and vitamin B12 deficiency.
RBC Count (106 / μL): The number of red blood cells per microliter of blood. A decreased RBC
count is seen in folate or vitamin B12 deficiency.
Erythrocyte Indicies:
Mean Corpuscular Volume (MCV: μm3 or fL): represents the average size of RBC in a blood
sample. This size is measured by the volume in cubic microns or femtoliters. MCV is a
calculated value, expressed in cubic micrometers, of the average volume of an erythrocyte. MCV
decreases in iron deficiency (microcytic anemia) and increases in folate or vitamin B12
deficiency (macrocytic anemia) and in chronic alcoholism
Mean Corpuscular Hemoglobin (MCH: pg or fmol): represents the average amount (weight)
of hemoglobin in each RBC, expressed in pictograms or femtomole. MCH is increased in
macrocytic, pernicious anemia. MCH is decreased in microcytic anemia.
Mean Corpuscular Hemoglobin Concentration (MCHC: g Hgb / dL or mmol/L or %):
represents the average concentration of Hgb in the RBC. MCHC is a calculated value of the
amount of hemoglobin present in the RBC compared to its size. A ratio of weight to volume is
expressed as a percentage. MCHC is decreased in iron deficiency anemia. MCHC describes the
color of the RBC.
▪
▪
▪
Normochromic = red color, within normal range of Hgb
Hypochromic = pale red, below normal range
Hyperchromic = deep red, above normal range
Anemia: represents a decrease in the ability of the blood to deliver oxygen to the
tissues. Anemia most often results from malnutrition (for example, iron, and folate or
vitamin B12 deficiency), hemorrhage or hemolysis. Anemias can be classified
according to the mean RBC size (Mean Corpuscular Volume) and the chromaticity, or
color, of the cells as measured by the mean Hgb concentration in RBCs (Mean
Corpuscular Hemoglobin). According to this scheme, three categories of anemias can
be designed:
Normocytic, normochromic anemia
Microcytic, hypochromic anemia
Macrocytic, normochromic anemia
MCV (fL)
85-100
100
MCHC (%)
31-35

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Nursing Question

Jun 14, 2024 | Health Medical

Description

Case Study

Read the following case study:

Sue is an RN who has been practicing for 3 years and typically works in labor and delivery, and she volunteers at a clinic that serves diabetic OB patients. She encounters two patients, one who has developed gestational diabetes and the other who has been diabetic her entire life.

While working on her normal shift in labor and delivery, Sue is in charge of a student nurse who will be graduating in 2 weeks and assigns this nurse to the newly admitted patient with gestational diabetes. The patient started having contractions about 2 hours ago that are now 2–3 minutes apart, lasting approximately 10–15 seconds.

Assignment

Create a concept map showing Benner’s stages from novice to expert and its alignment to the nursing process for an improved nursing care plan.

Write a 525- to 700-word summary explaining the concept map and how the concepts in Benner’s theory relate to the nursing process, including alignment with critical thinking and clinical decision-making for an improved nursing care plan. In addition, address the following:

Define each stage on the continuum and describe the characteristics associated with each stage. Include setting, patient needs, level of understanding, and complexities that may contribute to increased risks.
Explain where you fall on the continuum. Where do Sue and the student nurse fall?
Include an explanation to why you placed each stage in the specific area.
Use this information to develop a personalized nursing theory or model for the above scenario to address the care needed for each patient

Include at least 2 peer reviewed articles scholarly resources from the University Library to support you work. From within the past 5 years.

Cite and format your sources according to APA guidelines.

Public Health Question

Jun 14, 2024 | Health Medical

Description

The Ministry of Health has developed rules, regulations, and standard operating procedures concerning telehealth services. Review these documents and draft a survey you can provide to patients to determine whether the organization is following these requirements.

Address the following requirements in the survey:

Draft at least 10 survey questions.
Draft questions related to medical privacy and telehealth services.
Include questions that will lead to determining whether the facility is following the Standard Operating Procedures.
Include a paragraph with each survey question detailing how you feel this question will help improve patient privacy regarding telehealth services in your country.

Your paper should meet the following structural requirements:

Three to four 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.

Clinical Judgement Plan

Jun 14, 2024 | Health Medical

Description

SEE guided template. Do exactly as is.Use link to complete assignment on google doc as seen in guided template.https://docs.google.com/document/d/1HLhfci5fRgoTo-…

IDS 402 Id

Jun 14, 2024 | Health Medical

Description

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.

Nutrition Question

Jun 14, 2024 | Health Medical

Description

Blog #4: Questions about FiberIin you blog, answer the following questions from a consumer with lay knowledge of nutrition. I keep hearing about fiber, what is it? Are there different types? If so, can you provide me with some dietary examples?I have heard that eating oatmeal everyday can keep me from needing to take a statin to lower my cholesterol level. Is this true? If so, how does it work?I am a busy college student, and I often just have a sandwich for lunch. I know it is important to get fiber. How can I increase my fiber intake at lunch?How much fiber should I be consuming each day? Use at least one scholarly source to answer these questionsNOTE: Blog posts should be between 350 and 500 words to keep readers engaged. Make sure to include at least 1 image/media and citations for your information

Nursing Question

Jun 14, 2024 | Health Medical

Description

Here is the citation for the article that must be discussed in part A.

·Santo, K., Hyun, K., Keizer, L., Thiagalingam, A., Hillis, G., Chalmers, J., Redfern, J., & Chow, C. (2018). The effects of a lifestyle-focused text-messaging intervention on adherence to dietary guideline recommendations in patients with coronary heart disease: An analysis of the TEXT ME study. International Journal of Behavioral Nutrition and Physical Activity, 15(45). https://doi.org/10.1186/s12966-018-0677-1

INSTRUCTIONS

a.Introduction and Key Points (5 Points)

Choose one of the assigned articles located under the main topics in the table above; selects and identifies one of the questions listed in 5a. – 5e. (THE ARTICLE I HAVE PROVIDED)
Defines the topic and question
States why it is a problem
Information presented in logical sequence

b.Article Search (5 Points)

Conduct an article search – a good resource is the school Library. If you start the assignment early, the library has resources/support to help find an appropriate article.
The article must be current (less than 5 years) and from a credible resource (peer-reviewed or a reputable organization).
List the database that you searched and list the terms and methods used
Number of articles located – this is the number of articles that showed up in the results list for the terms you used
Source outside of ATI module used – the article used cannot be the one that is listed in the ATI Nutrition Module

c.Article Findings (25 Points) – this is based on the article you found in 6(b) (ARTICLE YOU FIND)

How it addresses the main topic
Type of research conducted in the article selected (e.g., quantitative, qualitative, etc.)
Findings of research conducted in the article
Why this article was chosen

d.Evidence for Practice (25 Points)

Summary of evidence
How it will improve practice
How this evidence will decrease a gap to practice
Any concerns or weaknesses located in the evidence

e.Sharing of Evidence (20 Points)

Who would you share the information with?
How would you share this information?
What resources would you need to accomplish this sharing of evidence?
Why would it be important to share this evidence with the nursing profession?

f.Conclusion (5 Points)

Summarizes the theme of the paper
Information presented in logical sequence
All key points addressed
Conclusion shows depth of understanding of topic

g.APA Style (10 Points)

APA style used properly for citations
APA style used properly for references
APA style used properly for quotations
All references are cited, and all citations have references

*NOTE: Must adhere to current APA guidelines and formatting.

h.Writing Mechanics (5 Points)

No spelling errors
No grammatical errors, including verb tense and word usage
No writing errors, including sentence structure, and formatting
Must be all original work

PAPER MUST BE 2 PAGES NOT INCLUDING TITLE AND REFERENCE PAGE

lab report