Jun 6, 2024 | Health Medical
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hello, I need someone to answer my study question there is an attached pdf for chapter you will find 4 qs pick any 2 of them and answer them please thank you for help in advance
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Jun 6, 2024 | Health Medical
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1 full pages (cover or reference page not included)APA norms It will be verified by Turnitin Find a study published in a nursing journal in 2010 or earlier that is described a s a pilot study. 1. Do you think the study really is a pilot study, or do you think this label was used inappropriately? 2. Search forward for a larger subsequent study to evaluate your response.
Jun 6, 2024 | Health Medical
Description
After reading Chapter 14 and reviewing the lecture powerpoint (located in lectures tab), please answer the following questions. Each question must have at least 3 paragraphs and you must use at 3 least references (APA) included in your post.1. What signs might alert you to a potential professional boundary violation or crossing?2. Contrast the terms terminal sedation , rational suicide, and physician-assisted suicide.This board is due on Sunday at 11:59pm.
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Chapter 14
Ethical Issues in
Professional
Nursing Practice
Relationships and
Professional Ethics
• Nurse–physician relationships
• Nurse–patient–family relationships
– Unavoidable trust
– Boundaries
– Dignity
– Patient advocacy
• Nurse–nurse relationships
The National Council of State Boards
of Nursing’s Professional Boundaries
in Nursing Video
https://www.ncsbn.org/464.htm
Moral Rights and Autonomy (1 of 2)
• Moral rights are defined as rights to perform
certain activities
– Because they conform to accepted standards or
ideas of a community
– Because they will not harm, coerce, restrain, or
infringe on the interests of others
– Because there are good rational arguments in
support of the value of such activities
Moral Rights and Autonomy (2 of 2)
• Two types of moral rights
– Welfare rights
– Liberty rights
• Informed consent
• Patient Self-Determination Act
• Advance directives
– Living will
– Durable power of attorney
Social Justice
• Sicilian priest first used term in 1840; in 1848,
popularized by Antonio Rosmini-Serbati
• Center for Economic and Social Justice
definition
• John Rawls’ concept of veil of ignorance
• Robert Nozick’s concepts of entitlement
system
Allocation and Rationing of
Healthcare Resources
• Does every person have a right to health care?
• How should resources be distributed so
everyone receives a fair and equitable share of
health care?
• Should healthcare rationing ever be considered
as an option in the face of scarce healthcare
resources? If so, how?
Organ Transplant Ethical Issues
• Moral acceptability of transplanting an
organ from one person to another
• Procurement of organs
• Allocation of organs
– Justice
– Medical utility
Balanced Caring and Fairness
Approach for Nurses (1 of 2)
• Encourage patients and families to express
their feelings and attitudes about ethical issues
involving end-of-life, organ donation, and
organ transplantation
• Support, listen, and maintain confidentiality
with patients and families
• Assist in monitoring patients for organ needs
Balanced Caring and Fairness
Approach for Nurses (2 of 2)
• Be continually mindful of inequalities and
injustices in the healthcare system and how the
nurse might help balance the care
• Assist in the care of patients undergoing surgery
for organ transplant and donation patients and
their families
• Provide educational programs for particular
target populations at a broader community level
Definitions of Death
• Uniform Determination of Death Act definition of
death: “An individual who has sustained either (1)
irreversible cessation of circulatory and respiratory
functions or (2) irreversible cessation of all functions
of the entire brain, including the brain stem is dead.
A determination of death must be made in
accordance with accepted medical standards.”
• Traditional, whole-brain, higher brain, personhood.
Euthanasia
• Types of euthanasia:
– Active euthanasia
– Passive euthanasia
– Voluntary euthanasia
– Nonvoluntary euthanasia
• Blending of types may occur
• “Is there a moral difference between actively
killing and letting die?”
Rational Suicide
• Self-slaying
• Categorized as voluntary active euthanasia
• Person has made a reasoned choice of rational
suicide, which seems to make sense to others at
the time
– Realistic assessment of life circumstances
– Free from severe emotional distress
– Has motivation that would seem understandable to
most uninvolved people within the community
Palliative Care
• Approach that improves the quality of life of
patients associated with life-threatening illness,
through prevention and relief of suffering
• Do-not-resuscitate order:
– There is no medical benefit that can come from
cardiopulmonary resuscitation (CPR)
– The person has a very poor quality of life before CPR
– The person’s life after CPR is anticipated to be very
poor
Rule of Double Effect
• Use of high doses of pain medication to lessen
the chronic and intractable pain of terminally
ill patients even if doing so hastens death
• Critical aspects of the rule:
– The act must be good or at lease morally neutral
– The agent must intend the good effect not the evil
– The evil effect must not be the means to the good
effect
– There must be a proportionally grave reason to risk
the evil effect
Deciding for Others
• A surrogate, or proxy, is either chosen by
the patient, is court appointed, or has other
authority to make decisions
• Three types of surrogate decision makers:
– Standard of substituted judgment
– Pure autonomy standard
– Best interest standard
Withholding and Withdrawing
Treatment: 3 Cases
• Case 1: Karen Ann Quinlan
• Case 2: Nancy Cruzan
• Case 3: Terri Schiavo
Terminal Sedation
• “When a suffering patient is sedated to
unconsciousness…the patient then dies of
dehydration, starvation, or some other
intervening complication, as all other lifesustaining interventions are withheld”
• Has been used in situations when patients
need relief of pain to the point of
unconsciousness
Physician-Assisted Suicide
• Act of providing a lethal dose of medication for
the patient to self-administer
• Oregon Nurses Association special guidelines
related to the Death with Dignity Act
– Maintaining support, comfort, and confidentiality
– Discussing end-of-life options with patient and family
– Being present for patient’s self-administration of
medication and death
– Nurses may not administer the medication
– Nurses may not refuse care to the patient or breach
confidentiality
End-of-Life Decisions and Moral
Conflicts with the Nurse
• Communicating truthfully with patients about death due to
fear of destroying all hope
• Managing pain symptoms because of fear of hastening
death
• Feeling forced to collaborate relative to medical treatments
that in the nurses’ opinion are futile or too burdensome
• Feeling insecure and not adequately informed about
reasons for treatment
• Trying to maintain their own moral integrity
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Jun 6, 2024 | Health Medical
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Start by reading and following these instructions:
1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.
2. Read the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.
3. Consider the discussion and any insights you gained from it.
4. Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.
Assignment:
This week you will create a two-part Power Point to discuss the following:
Part one:
Peplau was the first nursing theorist to identify the nurse–patient relationship as being central to all nursing care. Peplau valued knowledge, believing that the nurse must possess extensive knowledge about the potential problems that emerge during a nurse–patient interaction. Peplau’s theoretical work on the nurse–patient relationship continues to be essential to nursing practice.
Describe the phases of the Nurse-Patient relationship as defined by Peplau. Align your presentation regarding the use of Peplau’s theory with a current practice example.
Part two:
Provide a discussion of Orem’s Self-Care Deficit Theory. Identify and explain the three related parts? Identify a current nursing practice example where Orem’s theory would be relevant. Use at least one evidenced-based research article to support your practice example. The PowerPoint should include at least 3 outside references and the textbook. It should include title and reference slides and be 14-20 slides.
Jun 6, 2024 | Health Medical
Description
IMPORTANT NOTE REGARDING WORD LIMIT REQUIREMENTS:
Please note that each and every assignment has its own word limit.
What is meant by the term “determinants of health”? Select a health issue and articulate at least three determinants or factors that contribute to that health issue. Of those contributing factors, which do you think would be the most difficult to change or improve, and which do you think would be the least difficult to change or improve? Why?
PLEASE add the links/sites below to the reference list the use and make sure everything is in proper APA format.
Read “Determinants of Health,” located on the Healthy People 2020 website.
URL:
https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health
Explore the Social Determinants of Health page of the World Health Organization (WHO) website to learn more about social determinants of health.
URL:
http://www.who.int/social_determinants/thecommission/finalreport/en/
MUST be between 200 – 300 words and have at least two citations with the page numbers and two references in APA format.(The List of References should not be older than 2014 and should not be included in the word count.)
Be sure to support your postings and responses with specific references to the Learning Resources.
It is important that you cover all the topics identified in the assignment. Covering the topic does not mean mentioning the topic BUT presenting an explanation from the context of ethics and the readings for this class
To get maximum points you need to follow the requirements listed for this assignments 1) look at the word/page limits 2) review and follow APA rules 3) create subheadings to identify the key sections you are presenting and 4) Free from typographical and sentence construction errors.
REMEMBER IN APA FORMAT JOURNAL TITLES AND VOLUME NUMBERS ARE ITALICIZED.
Jun 6, 2024 | Health Medical
Description
hello, I need someone to do my work the attached have the questions which you must provide them to the work please provide me work document which have the ideas to study them to the presentation it should be 10 mins long thank you for your help
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“Tell me about the personal experience that inspired you to want to be a
Health Care professional?”
You will be asked to respond to the referenced question and others that may
occur during a job interview. The questions beyond the first will not be
distributed prior to class.
The presentations will be made during classes on November 12, 14, and 19.
You will make a short five to ten minute presentation answering the question:
“
Tell me about the personal experience that inspired you to want to be a
Health Care professional?”
>>
As promised, here is the main topic focus. I have also added some typical
questions I might ask if your initial discussion is short.
“What event(s) or person(s) you have encountered in your life up to
now, have had the most influence on why you find yourself pursuing a
career in Health Care?”
Some typical follow-up questions:
•
•
•
•
•
•
•
What activities do you enjoy outside work hours?
Where would your dream trip take you?
What type of volunteer activities provide you with the most satisfaction?
If you could have a cup of coffee with anyone in the world, living or dead,
who would it be and why?
How have you approached a conflict between two close friends?
To what role do you aspire in the Health Care industry?
Why are you here today?
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Jun 6, 2024 | Health Medical
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Provide a critique Kristen Swanson’s Theory of Caring, making sure to identify benefits, consequences and feasibility of application in clinical practice as a family nurse practitioner. Provide evidence using 2 (two) scholarly articles in order to support your critique, 250 words
Jun 6, 2024 | Health Medical
Description
Respond to the following in a minimum of 175 words: Suppose you were planning to conduct a statewide study of the work plans and intentions of nonemployed registered nurses in your state. WOuld you ask open-ended or closed-ended questions? Would you adopt an interview or questionnaire approach? If a questionnaire, how would you distribute it?
Jun 6, 2024 | Health Medical
Description
please submit three different middle childhood or an adolescence interviews. each one should be according to the notes below 1- if you make an interview with child in middle childhood the reference should be from chapter 11,12,13 of this book 2- if you make an interview with an adolescence child, the reference should be from chapter 14,15,16 3- the interview should be minimum 3 pages.
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I.
Biographical Data:
1. first name (can be fictional name), sex, and age of person interviewed
2. share some information about the interviewee’s family situation:
parents and other adults in the home, ages and sex of siblings,
socioeconomic status.
3. your relationship to the person who interviewed
II.
Interview Questions: These questions may be asked in any order be sensitive to the age, feelings, and cognitive understanding of the
person you are interviewing. You may need to reword or explain
more simply for younger children. You may need to ask your interviewee to add
details or additional information in order to get a complete answer,
but be careful not to suggest answers.
1. How do you feel about yourself physically? What changes have you noticed?
What do you notice about yourself in comparison to your friends or classmates?
2. What do you see as the greatest problem facing the world? Why do you think
this is such a big problem? What can be done to develop a solution to this
problem?
3. What is the greatest fear/concern facing you personally right now? Do you
think other people your age have this same fear? What are you doing to resolve
this fear/concern?
4. How do you choose your friends? What kinds of activities do you enjoy
doing with them? What do you do if you have a disagreement with a close
friend?
5. What are your career aspirations? (What do you want to be when you grow
up?) Why are you interested in this career?
6. Answer the question “Who am I?” in 2-3 sentences. Tell me something
about how you see yourself; who you are.
7. Develop one question of your own to ask your interviewee.
III. Based on the answers given, in what ways is the child/adolescent you
interviewed typical or “on the norm” for his/her age or stage in life? In what ways
is the interviewee NOT typical? Support your analysis with materials from the
text and from lecture.
IV. Personal opinions, perspectives,and comments:
CHED
From Birth to Adolescence
From Neonate
to Graduate
!!
SÁTP
10
Hang
MILESTONES
Real Life,
Real Development
IGIRNIA
100
TESTPREP
Are you prepared?
Did You Know…
ISBN 978-0-07-803551-7
MHID 0-07-803551-1
90000
EAN
780078″035517″
www.mhhe.com
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Jun 6, 2024 | Health Medical
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In a Word document, Write 600-800 words in an essay style answer to respond to the following question:
Public health informatics is emerging as a new and distinct specialty area in the global scenario within the broader discipline of health informatics. The potential role of PHI is the use of information science and technology for promoting population health rather than of individuals. Discusses the scope, the limitations, and future perspective of this discipline in context to Saudi Arabia.
Support your writings by at least 3 references (APA style)
You must use the attached cover page on your submission.
Proper formatting, correct referencing and cover page will carry a mark
Important note:
No copy
No p
Jun 6, 2024 | Health Medical
Description
Musculoskeletal Discussion
This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered. For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned.
To support your work with evidence bases references. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. In addition you must respond to your professor if applicable. Complete your participation for this assignment by the end of the week.
For this assignment, you will complete a Aquifer case study based on the course objectives and weekly content. Aquifer cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the Aquifer case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.
The Aquifer assignments are highly interactive and a dynamic way to enhance your learning. Material from the Aquifer cases may be present in the quizzes, the midterm exam, and the final exam.
Learn how to access and navigate Aquifer.
This week, complete the Aquifer case titled “Family Medicine 10: 45-year-old man with low back pain”
Apply information from the Aquifer Case Study to answer the following discussion questions:
Discuss the Mr. Payne’s history that would be pertinent to his genitourinary problem. Include chief complaint, HPI, Social, Family and Past medical history that would be important to know.
Describe the physical exam and diagnostic tools to be used for Mr. Payne. Are there any additional you would have liked to be included that were not?
Please list 3 differential diagnoses for Mr. Payne and explain why you chose them. What was your final diagnosis and how did you make the determination?
What plan of care will Mr. Payne be given at this visit, include drug therapy and treatments; what is the patient education and follow-up?
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You are working with Dr. Lee today. She hands you a triage note from the nurse regarding your
next patient, Mr. Payne:
Forty-five-year-old white male truck driver complaining of two weeks of sharp, stabbing back
pain after lifting a 10-lb. box. The pain was better after a couple of days but then got worse after
playing softball with his daughter. This morning his pain is so bad that he had trouble getting out
of bed.
Dr. Lee provides you some background information about low back pain.
Dr. Lee continues: “There are many causes for LBP. For presenting symptoms that have a broad
differential diagnosis, I find it helpful to think of systems of etiologies in which diseases or conditions can
be categorized.”
You and Dr. Lee take a few minutes to review Mr. Payne’s chart:
Vital signs:
•
•
•
•
•
•
Temperature: 98.6° Fahrenheit
Heart rate: 80 beats/minute
Respiratory rate: 12 breaths/minute
Blood pressure: 130/82 mmHg
Weight: 170 pounds
Body Mass Index: 24 kg/m2
Past Medical History: Diabetes, well controlled. Hypertension, fair control. Hyperlipidemia,
fair control.
Past Surgical History: None
Social History: Works as a truck driver, which involves lifting 20-35 lbs 4 hours of the day,
married with 2 daughters,
Habits: Smoked one pack per day for 20 years. Quit smoking two years ago, drinks one to two
beers occasionally on the weekends, no history of IV drug use.
Medication:
•
•
•
•
•
Metformin 1000mg PO twice daily
Glyburide 10mg PO twice daily
Amlodipine 2.5 mg PO daily
Lisinopril 40 mg PO daily
Simvastatin 40 mg PO daily
Allergies: No known drug allergies.
After introducing yourself to Mr. Payne, you sit down across from him and begin your history,
focusing on the key elements.
“Can you tell me about your back pain?”
“As I told the nurse, the pain started two weeks ago after I lifted a box at work. Right away, I got
this sharp pain on the left side of my back. The box wasn’t even that heavy.
“I talked to the nurse at work; she said to ice it and to take ibuprofen. It got better after three
days. But, I was playing softball with my daughter last weekend, and the pain came back. This
time it was worse than before and became constant. This week, the pain is so bad I can hardly get
out of bed. I get a sharp pain in my back which goes down my left leg to my ankle.”
“On a scale of 0 to 10, with 0 being no pain
and 10 being the worst pain, how severe is the
pain?”
“It’s probably a 7.”
“Have you found anything that improves the
pain?”
“Ibuprofen and Naproxen worked at first, but they are not helping much anymore.”
“What dose of ibuprofen and naproxen were
you taking, how often, and for how many
days?”
“I was taking ibuprofen 400 mg every six hours for three days and then I tried naproxen 250 mg
once daily for five days.”
“What about positions that make things
better or worse?”
“The pain is worse with any movement of my back or sitting for a long time. It is better when I
lie down.”
“Have you had back pain before?”
“Yes, I have back pain from time to time. But I’m usually better after 2 to 3 days. This is the
worst pain I have ever had.”
You complete your history with a review of systems and discover:
Mr. Payne is a 45-year-old male truck driver with a two-week history of low back pain that
radiates down his left leg to the ankle. The pain is worse with sitting and improves with the
supine position. He denies history of trauma, fever/chills, night pain, urinary symptoms, and
bowel or bladder incontinence.
The ideal summary statement concisely highlights the most pertinent features without omitting
any significant points. The summary statement above includes:
1. Epidemiology and risk factors: 45-year-old male; occupation: truck driver
2. Key clinical findings about the present illness using qualifying adjectives and transformative
language:
•
•
•
•
•
•
•
•
•
•
pain present for two weeks
pain radiates down left leg
pain worse with sitting and improves with supine position
no history of trauma
no fever/chills
no night pain
no urinary symptoms
no bowel or bladder incontinence
Dr. Lee tells you, “On physical exam, you can discover problems with the bony structures
and muscles of the spine through inspection of posture, contour, and symmetry, palpation
of the bony prominences, and range of motion testing.
A solid understanding of the neurological exam of the lower extremity will help you
determine if the pain is due to nerve impingement or from muscle and bone.”
You and Dr. Lee return to examine Mr. Payne together.
Perform the back exam systematically in sequential order with the patient:
1. Standing
2. Sitting
3. Supine
4. Dr. Lee walks through the steps for completing a neurologic exam in a patient with back
pain.
5. Back Exam – Standing:
6. Mr. Payne has normal curvature, tenderness on palpation on the left lumbar paraspinous
muscle with increase tone. Full range of motion, but has pain with movement. His gait is
normal. He can walk on his heels and toes. He can do deep knee bends.
7. Back Exam – Seated:
8. Mr. Payne reports no pain when checked for CVA tenderness. He has no pain in his right
leg with the modified version of SLR. While he does not exhibit a true tripod sign, he
does complain of pain when his left leg is raised. Mr. Payne’s reflexes are 2+ and equal at
the knees and 1+ at both ankles. The motor exam reveals 5/5 strength throughout the
lower extremities. His sensory exam is normal.
9. Pulmonary Exam: His lungs are clear.
10. Cardiovascular Exam: His cardiac exam demonstrates a regular rhythm, no murmur or
gallop.
Physical Exam for Back Pain – Seated
Position
Overview of the Neurologic Exam
Deep Tendon Reflexes
Grading Reflexes:
0 No evidence of contraction
1+ Decreased, but still present (hyporeflexic)
2+ Normal
3+ Increased (hyper-reflexic)
4+ Clonus: Repetitive shortening of the muscle after a single stimulation
Decreased patella reflex implies nerve impingement at the L3-L4 level. Decreased Achilles
reflex implies nerve impingement of S1 levels. Hyper-reflexia is a sign of upper-motor neuron
syndrome associated with spinal cord compression.
Muscle Strength
Rating Scale:
0/5 No movement
1/5 Barest flicker of movement of the muscle, though not enough to move the structure to which
it’s attached.
2/5 Voluntary movement, which is not sufficient to overcome the force of gravity. For example,
the patient would be able to slide their hand across a table but not lift it from the surface.
3/5 Voluntary movement capable of overcoming gravity, but not any applied resistance. For
example, the patient could raise their hand off a table, but not if any additional resistance were
applied.
4/5 Voluntary movement capable of overcoming “some” resistance
5/5 Normal strength
i. Hip Flexion (L 2, 3, 4): Ask the patient to lift his thigh while you push down on his thigh
ii. Hip Abduction (L 4, 5, S1): Ask the patient to push his legs apart while you push them
together
iii. Hip Adduction (L 2, 3, 4): Ask the patient to push his legs together while you push them apart
iv. Knee Extension (L 2, 3, 4):
Ask the patient to extend their knee while you push it down.
v. Knee Flexion (L 5, S1, S2):
Ask the patient to flex his knee while you push against it.
vi. Ankle Dorsiflexion (L 4, 5): Ask the patient to point his foot up while you push it down.
vii. Ankle Plantar Flexion (S 1, S 2): Ask the patient to point his foot down while you push it up.
Decreased strength implies nerve impingement of the associated nerve in parenthesis.
Sensation
Test for sharp and light touch along dermatomal distribution, great toe (L5), lateral malleolus,
and posteriolateral foot (S1)
Nerve Root Impingement Syndromes
Nerve
Root
L3
L4
L5
S1
Reflex
Pin-Prick Sensation
Patellar tendon
reflex
Patellar tendon
reflex
Medial
hamstring
Achilles tendon
reflex
Lateral thigh and medial
femoral condyle
Medial leg and medial
ankle
Lateral leg and dorsum of
foot
Posterior calf, Sole of foot,
and lateral ankle
Motor
Examination
Extend
quadriceps
Functional Test
Squat down and rise
Dorsiflex ankle
Walk on heels
Dorsiflex great
toe
Walk on heels
Stand on toes
Walk on toes
(plantarflex ankle)
Check for costovertebral angle (CVA) tenderness, a sign suggesting pyelonephritis.
Modified version of the straight leg raise (SLR) test
While continuing to talk to the patient, raise each leg by extending the knee from 90 degrees to
straight. If the pain is due to structural disease, the patient will instinctively exhibit the “tripod
sign” by leaning backward and supporting himself with his outstretched arms on the exam table.
(The unmodified version of the straight leg raise (SLR) test is done in the next section of the
exam with the patient supine.)
Neurological exam
Check reflexes, muscle strength, and sensation of the lower extremities. Focus on the L4, L5, and
S1 nerve roots because most neuropathic back pain is due to impingement of these. Therefore,
check the patellar reflex (L2-4) and Achilles reflex (S1). Check muscle strength for hip flexion,
abduction, and adduction; knee extension and flexion; as well as ankle dorsiflexion and plantar
flexion. Also, test for sharp and light touch along the dermatomal distribution of the great toe
(L5), lateral malleolus and posterolateral foot (S1).
Dr. Lee continues, “The final part of the exam is done in the supine position.”
Exam – Supine
Mr. Payne’s abdominal exam is negative. His straight leg raising is positive at 75 degrees on
the left and negative on the right. His FABER test is negative and sacroiliac joint is
nontender. His motor exam reveals no weakness of the muscles of the lower extremities
Disc herniation, Lumbar strain
Based on physical exam, you believe that Mr. Payne has back pain with radiculopathy, likely at
the L5/S1 level. Given his risk factor as a truck driver and pain radiating down his leg, Mr.
Payne’s pain is likely due to disc herniation. However, lumbar strain is still a possibility.
Dr. Lee reminds you that disc herniation, a condition which is self-limited and usually resolves
in two to four weeks, remains a working diagnosis for Mr. Payne. She says, “Let’s take a few
minutes, though, to discuss some conditions we still don’t want to miss.”
While Dr. Lee takes the time to return to the exam room and review mechanical low back pain
with Mr. Payne, she asks you to to consider what other testing should be done at this time. Is an
MRI indicated?
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Jun 6, 2024 | Health Medical
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National Center for Healthcare Leadership (NCHL). (2010). Health leadership competency model summary. Retrieved from www.nchl.org/Documents/NavLink/Competency_Model-su…
This assessment has three distinct parts.
Part 1: Critical Leadership Competencies for Health Care Organizations. In Part 1, based on the information from your resources, provide an overview of the leadership competencies required to lead health care organizations into the future.
Part 2: Personal Leadership Gap Analysis. In Part 2, compare the competencies most needed by your organization (from your work in Assessment 1) to the skills you already possess (using the results from your STAR analysis).
Part 3: Individual Leadership Development Plan (ILDP). In Part 3, use the information from your resources, to put together a cohesive individual leadership development plan (ILDP).
PREPARATION
Before you create and submit your assessment, complete the following:
Read Health Leadership Competency Model Summary, linked in the Resources under the Required Resources heading.
Consider the needs of your health care organization Organizational Scorecard. Consider how you add value to the organization by contributing to the achievement of the internal benchmarks within your department and specific to your position of employment.
Conduct a candid self-assessment of your health care leadership competencies, using the Star Format Competency Table linked in the Resources under the Required Resources heading. Once you have a clear picture of your strengths and weaknesses, you will construct an individual leadership development plan to focus upon development of critical success competencies that can help you take your organization into the future. To complete the STAR Format Competency Table, follow these directions:
In the left-hand column, rate your overall performance of this competency in the “ILDP =” field, using a 1 (novice) to 9 (expert) scale.
In the middle columns, provide a specific behavioral example of how you have practiced each competency in a previous work, volunteer or other capacity. You will provide one sentence on the “Situation,” the “Task” you were charged to perform, the “Action” you took, and the “Result” (S–T–A– R).
In the far right-hand column, rate the outcome or result of the specific example by using a 1 (least desirable) to 5 (optimal outcome) scale.
Search for professional, scholarly journal articles on the leadership skills and competencies needed in health care organizations today and into the future. You will need a minimum of five resources to use as support for your assessment.
DIRECTIONS
Read the requirements for each part carefully.
Part 1: Critical Leadership Competencies for Health Care Organizations
Based on the resources you located, identify the top five leadership competencies needed within health care administration in order to ensure the success of health care organizations today and in the future.
Explain why each competency is critical to organizational success.
Part 2: Personal Leadership Gap Analysis
Following completion of the STAR assessment, consider your strengths versus those areas which require additional development. Provide a gap analysis that compares industry needs (as identified in Part 1), the needs of your organization (from your organization’s strategic direction), and the results of your STAR assessment.
In a brief narrative, explain any discrepancies between industry needs and organizational needs. Explain how your areas of strength can offer you additional opportunities for career advancement.
Part 3: Individual Leadership Development Plan (ILDP)
Using the information and resources from Assessment 1 and Parts 1 and 2 from this assessment, construct a cohesive individual leadership development plan in which you complete the following:
Identify at least three specific areas of weakness you need to focus on in order to meet industry and organizational needs.
Explain the action steps you need to take to increase your competency in those areas. Be sure your action steps are specific, include a timeline, and align with the overall goal of meeting industry and organizational needs.
Create specific performance indicators and measures for each action step to clearly illustrate how you will know that you are making progress on your plan.
If it helps you organize your thoughts, you may use a table format for your ILDP. Just be sure you provide enough detail in each section, relative to the expectations laid out in the scoring guide. You are not required to use a table format; if you prefer, you may simply write this section as a narrative.
ADDITIONAL REQUIREMENTS
Structure: Include a title page, table of contents, and reference page.
Length: 8–12 pages.
References: Cite at least five current scholarly or professional resources.
Format: Use APA style for references and citations.
Font: Times New Roman font, 12 point, double-spaced for narrative portions only.
Jun 6, 2024 | Health Medical
Description
Hello all, what i need is and answer for this prompt from one of my classmates, the answer should be base on what he wrote it has to give any appreciation and at least one question for him and 5 to 6 lines. Thank you Randi Silverhardt RE: Discussion PromptCOLLAPSEHello Dr. Rosie and classmates, Oprah Winfrey’s speech at the Golden Globe Awards accepting the Cecil B. DeMille Award for lifetime achievement was a moving, passionate, and powerful speech that gave the talk show host an opportunity to speak out against racial inequalities over the decades and injustices, mistreatment of women, as well as the current attacks against the media. I, like many who have had the privilege of hearing or reading this speech was moved by the strength of her not only as a woman but as a person, as well as her words. In a few minutes she was able to deliver a powerful and meaningful message that will not soon be forgotten. I believe her audience was all people, but she directed special attention to those who have suffered due to inequality, injustice, sexism as well as racism. She also was able to make a firm point about the president’s attacks on the media and still able to do so in a tactful way, addressing him specifically without using any names and sending him a direct message. The purpose of the speech was to draw attention to these issues and give a voice to those whose suffering has been in silence. She sends the message to these individuals that they are not alone, and the battle is not over. The mood is inspiring and uplifting. It is structured with a powerful introduction to grab the listener’s attention as well as a strong ending enforcing her message and leaving a deep feeling within the audience for them to walk away with. She begins with the story of her own humble beginnings and suffering, sharing her anger, joy, sadness and triumph, and then widens the topic reflecting on history, specifically the suffering of black women. Then she introduces us to Recy Taylor, a woman many of us including myself are unfamiliar with, and her ties to Rosa Parks who was assigned as the investigator of her case, another fact many do not know. She concludes her speech with a powerful call to action by every listener in the room. I believe that it was important that her speech did not single anyone one out, nor place blame on anyone. Instead she used her voice and position to empower people. Ultimately I believe her speech brought people of all genders and colors together and urged them to make a difference as a whole, and to become leaders paving the road to change.
Jun 6, 2024 | Health Medical
Description
PICOT: In
patients with diabetes mellitus 2, what is the effect of diet control as
compared to medication in the management of the disease given six months. Choose eight
peer-reviewed articles from nursing journals. The articles should be current within the last 5 years
and closely relate to the PICOT statement developed earlier in this
course. The articles may include quantitative research, descriptive
analyses, longitudinal studies, or meta-analysis articles. Submit a summary of your articles on the discussion board.
Discuss one strength and one weakness to each of these six articles on
why the article may or may not provide sufficient evidence for your topic.
Jun 6, 2024 | Health Medical
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Place name on top left or right corner of paperNo single word responsesAt least 50+ words in each response to questionsGive questions some thought and answer honestly and sincerely Give examples to explain what you meanWatch the video about Beers Criteria and answer these questions: 1. Write what you thought about the “Beers criteria” video you watched?2. Why is the “Beers criteria” important?https://www.youtube.com/watch?v=USCwt-ISCTY
Jun 6, 2024 | Health Medical
Description
Based on your research and understanding, create a 3 to 4-page report in a Microsoft Word document that includes the following:
•A brief description of your chosen infectious disease along with your reasons for choosing the disease.
•Information on the work conducted by government departments to mitigate the impact of your chosen infectious disease.
•Investigations, research studies, and other surveillance data analyses regarding your chosen infectious disease.
•Instances of the emergence and re-emergence of your chosen disease.
•A brief summary of the government’s findings and investigations about your chosen disease.
•Past, current, and ongoing research pertaining to your chosen disease.
Support your writing with relevant facts or figures and indicate your current knowledge of the infectious disease.
Jun 6, 2024 | Health Medical
Description
Informed Consent FormBy the due date assigned, submit the Informed Consent Letter to the Submissions Area (please note that this is only an example and no data may be collected). Informed Consent Letter Procedure section is clear, described in detail, specific, and all
inclusive. Written in lay language (as documented by reading level
score). Includes risks and benefits relevant to study. Address assent
(if applicable).Informed Consent Letter ExampleIRB Application
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At least two pages. APA format with APA text citation and references. The assignment need involve an interview which I already did and answered the questions that are needed from the interview. However, to complete two pages you will need more details in aswering each question. They are 5 questions which will be in the body paragraphs, there should be introduction and conclusion. documents attached are the Rubric, assignment instruction with interview question briefly aswered, and an example of how the assignment should be done.
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Running head: MEDICATION ERROR ASSIGNMENT
Medication Error Assignment
MEDICATION ERROR ASSIGNMENT
2
Being a nurse means having somebody’s life in your hands. We are tasked with gathering
pertinent information about our patients, monitoring their health status, correctly operating the
medical equipment they require, administering their medications appropriately, promoting their
comfort, and advocating for their needs, among other things. People trust nurses to take care of
them. There are protocols we, as nurses and future nurses, are expected to follow in order to
safely care for our patients. Medication errors are at the forefront of the minds of the people who
create these safety protocols. Mistakes with medication have been named the number one cause
of death in hospitals, and nurses are responsible for making 26-32% of those mistakes (Parry,
Bariball & While, 2015). This is a scary statistic for both patients and nurses.
This example of a medication error comes from a woman who has been a nurse for over
40 years and is nearing retirement now. At the time of the error, she was working in the PACU.
Her patient began experiencing a decrease in blood pressure. It continued to drop to dangerously
low numbers, so norepinephrine was ordered intravenously via an infusion pump. This was
before IV pumps had medication libraries with pre-programmed safe concentrations of the
medications to reduce programming error. This nurse found herself in a very high stress situation
with lots of chaos all around her. She did her drug calculations and programmed the IV pump
herself to administer the norepinephrine. Due to the chaos, she did not have a second nurse verify
her calculations and pump programming right away. As it turns out, she had accidentally
programmed the pump to give too much norepinephrine (C. Emerick, personal communication,
February 28, 2019).
`
Norepinephrine is a drug that stimulates alpha-adrenergic receptors in blood vessels to
create vasoconstriction, which increases blood pressure. It is a high alert medication that requires
another medical professional to check the original order, calculations, and pump programming.
MEDICATION ERROR ASSIGNMENT
3
An overdose of norepinephrine can cause severe vasoconstriction in the periphery, which can
result in ischemia and tissue death. This medication can also cause cardiac arrhythmias that can
eventually lead to death if not corrected in time (Vallerand, Sanoski & Deglin, 2017).
Fortunately, about 20 minutes after the infusion was started, a second nurse checked the
infusion rate and recognized the error. The patient was not showing any adverse signs of an
overdose, yet; the nurses just realized that the infusion rate had not been double-checked. The
mistake was corrected, and the patient showed no signs of harm, and later fully recovered. The
nurse, however, did not recover so easily. She beat herself up about it for weeks afterward. She
felt so terrible and guilty for not following protocols and doing something that could have ended
much worse than it did. She also felt thankful that the error was caught and there was no harm
done to the patient (C. Emerick, personal communication, February 28, 2019) .
Following the error, the nurse had to fill out an occurrence report and notify her
supervisor, the patient, the surgeon, and the anesthesiologist because he was the provider that
ordered the medication. She also had to engage in a “safety huddle” with her supervisor and the
hospital’s risk manager one week after the error occurred. During this meeting they discussed
safety protocols, why they are in place, how to follow them, and what could have been done
differently in this particular situation to prevent the mistake. The nurse says she still thinks about
the error to this day and was very excited when her hospital got the new pre-programmed
infusion pumps. She reports being much more cautious when administering medications now,
despite the new technology (C. Emerick, personal communication, February 28, 2019).
This type of situation seems to be one that happens all too often. Health care
professionals find themselves in stressful, high-intensity situations and safety protocols go out
the window. The biggest part of this situation that needed fixed was the absence of a second
MEDICATION ERROR ASSIGNMENT
4
check by another nurse. Of course, the nurse who made the mistake should have been more
cautious while programming the pump, but anyone can make a mistake, and a second check
could have easily prevented it from happening. There needs to be an emphasis on how to stay
calm in chaotic environments when nurses and future nurses are being educated on how to
handle emergencies. During this education, it should also be reinforced how important the safety
protocols in place are and how they can truly save lives. I believe it is important to talk about
real-life examples of medication errors during education because it puts into perspective how
serious of a problem it really is. As far as other things that could have been done to prevent this
error, I think it has already been implemented: the pre-programmed infusion pumps. These
pumps have a medication library with pre-programmed safe ranges for the concentrations of
medications. It will not allow an infusion setting outside of these safe ranges to be run. This
technology is now preventing mistakes like the one this nurse made, but it is not a replacement
for the six rights and three checks of medication administration.
Nothing will ever be able to completely eradicate medication errors in the clinical setting,
but many things can be done to reduce the rate at which they are occurring. I believe this process
starts with each nurse making the conscious decision to slow down, take their time, and do things
“by the book” when it comes to administering medications. A third of all medication errors being
made at the hands of nurses is just unacceptable. We should hold ourselves and our co-workers
to a higher standard and always have our patients’ safety at the top of our priority list. Nurses are
constantly busy and often feel pressed for time, but would the extra 30 seconds it takes to go
over the six rights again or get a second nurse to check your work really put you that far behind?
MEDICATION ERROR ASSIGNMENT
5
Reference List
Parry, A., Barriball, L., While, A. (2015). Factors Contributing to Registered Nurse Medication
Administration Error: A Narrative Review. International Journal of Nursing Studies, 52,
403-420. https://doi.org/10.1016/j.ijnurstu.2014.07.003
Vallerand, A. H., Sanoski, C. A., Deglin, J. H. (2017). Davis’s Drug Guide for Nurses.
Philadelphia, PA: F. A. Davis Company.
Medication Error Assignment
A medication error assignment is due on the date indicated on the weekly course schedule.
To complete this assignment, you must find a nurse in the hospital who is willing to share with
you a medication mistake he/she has made. You should interview the nurse and type his/her
responses to the questions below. The paper should be at least 2 pages in length (doublespaced), and include accurate information, thoughtful analysis, and meaningful personal
reflection. It should have an introduction, a body, and a conclusion. Factual, or borrowed,
information should be cited in-text, and in an attached reference page. Please present your
work in APA format.
1. What was the mistake? More dosage than needed, What medication was
involved? (Solu-Medrol) How does this medication work in the body*? What is
the worst-case scenario if an error occurs with this medication*? (0-4 points)
*some of this information will likely need to be cited.
2. What was the outcome of this medication error? Was the patient harmed in any
way?(pt was not harmed) What did the nurse have to do following the
medication error? (Called the doctor, did the incident report, )(0-4 points)
3. How did the nurse feel at the time of the incident?(did not know how did she do
that “stupid”) How do they feel now?(“All good”) (0-3 points)
4. How could this mistake have been prevented?What policies or protocols could
be implemented in the hospital to keep this mistake from happening again*? Be
specific and creative! (0-4 points) *some information in this section may need
cited.
5. Additional grading criteria: The paper should demonstrate excellent critical
thinking and analysis. It also should include thoughtful personal reflection and
plausible solutions and prevention ideas. It must be well-written using APA
style formatting, appropriate medical terminology, and excellent sentence
structure, punctuation, and grammar. The paper must have an introduction
(should introduce the reader to the topic of med errors), a body (should answer
the above questions), and a conclusion (should summarize and provide analysis
and outlook for reader). It must include in-text citations, as well as an APA style
reference page. (0-10 points)
Medication Error Paper Gradesheet
(Paper meets the following course objectives: Demonstrates beginning level expository writing skills with
appropriate writing style using the most current APA guidelines; describes key elements that foster safe
medication administration; integrates the professional roles of integrity and accountability into
medication administration; identifies inter-professional interactions for safe administration of
medications)
APA formatting (5 points)
o
Missing/incorrect title page, running head, and/or page numbers
o
Missing/incorrect in-text citations
o
Missing/incorrect reference page
o
NO DEDUCTIONS
Grammar/Writing (5 points)
o
Spelling/word choice errors
o
Punctuation errors
o
Errors with introduction and/or conclusion
o
Sentence structure errors, incomplete sentences, or paragraph format errors
o
Poor use of medical terminology
o
Presents information in conversational writing style, rather than professional writing style
o
NO DEDUCTIONS
Content (15 points)
o
Does not fully answer/develop required questions; does not use appropriate sources of
information to answer questions
o
Does not present plausible, relevant, and/or creative prevention interventions/ideas
o
Lacks evidence of critical thinking or analysis
o
Includes incorrect medication information
o
NO DEDUCTIONS
Grade:________________________/25
Comments:
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Peer Review Worksheet PEER REVIEW ASSIGNMENT-Part I Using the guidelines below, provide feedback to your assigned peers (10 points): The goal for your responses should be to provide the writer with clear, specific possibilities for revision.Focus your attention on the content and structure of the paper, not the grammar.Your job is not to edit your groupmates’ work for grammar mistakes.If you notice a lot of problems with grammar/punctuation, definitely mention this, but don’t make this the focus of your review. Please provide thorough feedback for each question to receive credit for this assignment. Guidelines for peer review: What is the purpose statement of the paper? If there is not a purpose statement, can you identify the purpose of the paper? What is the purpose?What is the author’s position on this nursing topic?How does the introduction, background, and explanation of the nursing topic help define the purpose of the paper? (Hint: Explain if the author is introducing a problem, supporting current practice, or proposing a new practice. Discuss if the introduction caught your attention and why. Explain how the background helped you understand the evolution of the issue and how the key terms/points of the issue defined the purpose). Don’t be afraid to state that you do not understand the issue, ask questions to improve your understanding, or suggest ways to clarify this section of the paper. What is your understanding of this author’s paper at this point? (Ex: The author believes that patient-to-nurse ratios should be based on acuity of the patient load. The background information related to this topic shows that patient outcomes have suffered when nurses care for too many very ill patients. Key terms for this issue are: patient acuity, patient-to-nurse ratio, patient satisfaction, nurse satisfaction, improved patient outcomes. He will present literature to support his position and will use a case study to further illustrate his position.) Pay attention to organization.Make note of any sentence that seems out of place, and any transition from one idea to another that seems abrupt or confusing.Hint: Indicate if the paper “flows” and whether ideas build on each other. Pay attention to clarity.Discuss whether ideas are expressed clearly. Don’t be afraid to ask questions if needed to help the author better explain a concept. See the suggestions below, if needed. Ask questions: In many cases, the best feedback you can offer comes in the form of questions.Here are some examples (you don’t have to use any of these—I only offer them as a handful of sample questions).Show where the writer could provide more information: An effective approach would be to ask for more information and to explain why you think the information would be helpful: Why do you wait until the 4th page to begin talking about ___________ ? What does _____________ mean in the context of _____________? Why is ______________ important? Think about the journalistic questions: Who? What? When? Where? How? I would like to know more about . . . because . . .
Jun 6, 2024 | Health Medical
Description
Helloi need u to do my assignment please use my professor format for part a and bfor c and d create your own format but make sure to use EXCEL for the whole assignment, keep on your mind only excel will be accepted. if u have any question please let me know
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Finkler
Chapter 16, problem 1
Invested:
1. A physician referral service, 2. An ambulance company, 3. Joint venture in the ambulatory area
Hospital put up $15 M of its own money
Hospital borrowed $15 M
Pre-interest income: $6 M
d)
Interest rate: 10%
Next Year
ROI for next year: 15%
Information
Next Year
Next Year with own money
Current Year for Next Year with own money only with loan only
& loan
Investment = Own money
Borrowed money
Assets
Income before interest
ROI before interest exp
Interest rate
Interest expenses
Income after interest
ROI (before interest exp)
a)
ROI (after interest exp)
ROA (before interest exp)
b)
ROA (after interest exp)
City Hospital last year appointed Max Smith as Director of Nonhospital Investments. In his first year, Smith did an excellent
Job of Investing hospital endowment funds. He opened a physician referral service, bought an ambulance company, and
arranged several joint ventures in the ambulatory area. These Initiatives were all quite profitable.
In total, the hospital put up $15 million of its own money and borrowed S15 million of additional money for the
Investments. The preinterest income from all the ventures was $6 million. The interest rate was 10 percent, and the loan
was outstanding for one full year.
City Hospital is now faced with specifying the basis for Smith’s evaluation for the next year. They want to be sure to give
him incentives to continue his good performance. Smith has no control over whether money invested comes from existing
hospital funds or is borrowed by the hospital from a bank.
a) Calculate the ROI.
b) Calculate the ROA
Calculate the Ri, assuming the hospital demands a 15 percent return on all assets invested, before consideration of
Interest cost
d) Suppose that next year projects will be available that will earn a profit of $2.7 million on an investment of $15 million
Which of the above methods will be the most appropriate for next year’s evaluation of Max Smith? The hospital would like
to undertake projects with a 15 percent or better preinterest return
ignore the effect Income taxes in this problem. Solve this problem using either a calculator or a spreadsheet computer
program
Step-by-step solution:
Step 1 of 4
Return on investment
Return on investments (ROI) is a profitability ratio which is used to determine the profitability of the investment. It
also facilitates the comparison of efficiency
or profits among different investments. It is calculated by given formula:
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Write the first draft of your Personal Leadership Portrait (u09a1) based on the following scenario:
You have been offered the opportunity to apply for a leadership position in your organization. As a part of preparing for your interview, you complete a Personal Leadership Portrait. You will use the information from the leadership self-assessment you completed in Unit 8 for this final paper. This Personal Leadership Portrait will bring together all the aspects of leadership that you have examined and discussed over the last nine weeks as you analyze your own leadership qualities, to create a portrait of the effective health care professional and leader you aspire to be.
Your paper should address the following:
1. Analyze your leadership strengths and weaknesses.
Identify at least one leadership theory or style that you believe best aligns with your own thoughts of what leadership means.
Use that theory or style in your analysis and identify strengths and weaknesses. Cite your sources.
Consider potential biases or underlying assumptions in your analysis.
2. Explain how one’s specific leadership characteristics enable oneself to guide, educate and influence others in managing change in interprofessional collaborative relationships.
Consider examples of past successes.
Consider strategies or best practices that could be applied to improve outcomes.
Describe at least two additional leadership characteristics you would like to develop to enhance your effectiveness in this area.
3. Explain how your leadership characteristics will serve to help you build and maintain collaborative relationships across, and within, disciplines.
Consider examples of past successes.
Consider strategies or best practices that could be applied to improve outcomes.
4. Explain how you can best apply the principles of ethical leadership, given your leadership style.
Identify the main principles of ethical leadership within your field of practice (nursing, health administration, or public health). Cite your sources.
Consider examples of past successes.
Consider strategies or best practices that could be applied to improve outcomes.
Where do you have room to grow in this area?
How can you prepare yourself to do so?
5. Explain why diversity and inclusion are important to employee relations and the provision of safe, high-quality health care.
Provide an example you have experienced or read about. Cite your sources.
6. Explain how your leadership characteristics prepare you to develop and lead a diverse team of employees and serve a diverse community within an ethical framework.
In what ways can you address issues of diversity and inclusion, both within an organization and in serving the public?
7. Explain how the academic and research skills you develop as a practitioner-scholar can serve you in your role as an effective health care leader.
What is your understanding of the practitioner-scholar model? How would you apply it in your work?
How might those skills contribute to your effectiveness and credibility as a leader?
How will the knowledge and information you have gained from this course, and from your own research, guide your continued leadership development?
PAPER FORMAT AND REFERENCES
Include a properly formatted cover page abstract, and reference page (See the APA Style Tutorial paper for examples)
Length of paper: 5–7 typed, double-spaced pages, not including the cover page, abstract, and reference page.
References: Cite at least 4–5 different sources. These can come from peer-reviewed journals or other scholarly resources, the assigned unit readings, and other reputable resources. Cite your sources appropriately. Use correct APA formatting for all in-text citations and references.
An APA Style Paper Tutorial [DOCX] and the associated APA Style Paper Template [DOCX] are provided in Resources to help you in writing and formatting your paper. Use APA formatted headers and headings. Format your work per these documents.
GRADING CRITERIA
The assignment requirements outlined above correspond to the grading criteria in the Personal Leadership Portrait Scoring Guide, so be sure to address each point. You may also want to review the performance level descriptions for each criterion to see how your work will be assessed.
Example assignment: You may use the Personal Leadership Portrait Example, linked in the resources, to give you an idea of what a proficient or higher rating on the scoring guide would look like.
U08A1 SUBMISSION REQUIREMENTS
Submit the first draft of your Personal Leadership Portrait paper to SafeAssign.
Access SafeAssign in the courseroom’s left navigation menu. When you submit your paper to SafeAssign, you will receive an originality report with feedback on the use of references and citations. You may use this feedback to make adjustments before you submit your draft to your instructor for their feedback. You will also use this information to make revisions in preparation for the final paper submission in Unit 9.
When you are satisfied with your paper draft, submit it to this assignment by the end of Unit 8, Sunday, 11:59 PM CST. Doing so will generate a new SafeAssign report that both you and your instructor can see. Your instructor will provide feedback to you on the use of citations, referencing, and paraphrasing. The information generated from SafeAssign and the instructor feedback will be used to help guide you in improving the use of paraphrased, synthesized, and quoted materials as you grow in your scholarly writing ability.
Note: There is no minimum percentage requirement for your SafeAssign originality report, and the report information will not be utilized in the grading criteria for this assignment. It is helpful to check with your specific instructor regarding originality scores and suggested ranges.
Once you submit your paper in this assignment, your instructor will automatically receive the report. Your instructor will enter a score noting the completion of the submission (100%) but this is not reflective of the revisions that may be needed.
Note that a high SafeAssign match percentage may indicate that you have issues with proper citations/references and/or plagiarism. Please note that headings, common phrases and references may match, which is to be expected, and your instructor will take this into account. You must pay attention to the SafeAssign match percentage for the further development of your paper.
Your instructor will enter their feedback comments regarding the originality report that you can access and review on your “My Grades” page. The “My Grades” page is in the left navigation menu. If your instructor has any additional concerns regarding the originality report, he or she may contact you privately to assist you.
You will use this feedback to make revisions to your paper, and you will submit the final version of your paper in Unit 9.
Remember, in graduate work, the use of directly quoted material should be limited as it is your understanding, interpretation, and application of the research and literature combined with your experience that is important.
You are encouraged to submit your paper draft to Smarthinking for feedback on the writing component; however, this is not required.
Jun 6, 2024 | Health Medical
Description
Think about a challenging ethical issue you have encountered and explain the inherent dilemma of the issue, consider ethical principles, and offer possible courses of action and defend the action you would take.Write three paragraphs discussing:Issue and Inherent DilemmaEthical PrinciplesCourses of Action and Selected Action TakenYour initial post must be a minimum of 150 – 300 words. Make sure your post shows evidence that you have completed and understood the readings for this week by using the theories/concepts that were covered and by adding quotes and examples from the text that help you answer the question. You must post by 11:59 PM EST on Thursday and comment on the posts of at least two of your classmates by 11:59 PM EST on Sunday. Peer posts should be 100 -150 words and substantive.
Jun 6, 2024 | Health Medical
Description
According to Lake (2018), a successful brand strategy assists with prospering in competitive markets. In addition, the brand of an organization is derived from who you are, who you want to be, and who people perceive you to be. As a health care leader, it is important to know that the brand represented by your organization is effective.
Lake, L. (2018). Learn Why Branding is Important in Marketing. Retrieved from https://www.thebalance.com/why-is-branding-important-when-it-comes-to-your-marketing-2294845
Case Assignment
For this assignment, you will complete an external Brand Audit of a health care organization. Review the list of the 10 Biggest Health Care Companies in the Fortune 500 at the following source:
Lorenzetti, L. (2015). 10 Biggest Health Care Companies in the Fortune 500. Retrieved from http://fortune.com/2015/06/20/fortune-500-biggest-healthcare-companies/
Select a health care organization from the list in the above source and conduct a Brand Audit by completing the following in a 3- to 4-page paper:
Provide a description of the organization (location, size, type, average annual revenue, etc.)
Identify all brand elements (logos, symbols, characters, slogans, trademarks, etc.)
Distinguish the inherent attributes of the services provided (pricing, communications, distribution policies, other relevant marketing activities)
Select a competitive brand (organization).
Identify the differences between the organization that you are conducting the brand audit on and the competitive organization.
Classify the any marketing attributes that either organization does better.
Provide recommendations (supported with scholarly references) for brand positioning and marketing strategies that will leverage and extend the brand effectiveness of the organization.
Assignment Expectations
Conduct additional research to gather sufficient information to support your audit.
Limit your response to a maximum of 4 pages (not including title and reference pages).
Support your analysis with peer-reviewed/scholarly articles, with at least 4 references
Jun 6, 2024 | Health Medical
Description
4-5 paragraphing answering question below include questions in written literature. See uploaded documents and example; read and review all four journal articles/ literature provided. formulate a nursing evidence based PICOT (population/patient/problem, Intervention, Comparison, Outcome.
PICOT Question
What is the PICOT question being answered?
Background
Provide some background information about why this is important. Statistical findings.
Review of Literature
Outline the method for finding the evidence.
What key terms were identified in the literature research?
What criteria were used to determine the inclusion in the review?
Who Critiqued the articles?
Synthesis of Research Finding
Make some comparisons across the evidence.
What levels of evidence of present?
What kinds of samples and designs were used by the researchers?
What were the overall findings in relationship to the PICOT question?
Decision to Change Practice
What is the decision for practice based on the research in light of the PICOT question?
Is the sufficient evidence?
If not describe the implication for future studies.
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Evaluating the Effectiveness of a Fall Risk Screening Tool Implemented in an
Electronic Medical Record System
Yokota, Shinichiroh RN; Tomotaki, Ai MS, RN; Mohri, Ohmi RN; Endo, Miyoko
MS, CNA, RN; Ohe, Kazuhiko PhD, MD
Author Information
Departments of Healthcare Information Management (Messrs Yokota and Mohri) and Nursing (Ms Endo), The
University of Tokyo Hospital, Tokyo, Japan; National College of Nursing Japan, Tokyo, Japan (Ms Tomotaki); and
Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Dr
Ohe).
Correspondence: Shinichiroh Yokota, RN, Department of Healthcare Information Management, The University of
Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan (yokotas@hcc.h.u-tokyo.ac.jp).
Parts of this study were supported by JSPS KAKENHI grant no. 16K20977. The authors thank Dr Kosuke Kashiwabara
(University of Tokyo), for his advice about the analysis, and members of the Medical Safety Management Center
(University of Tokyo Hospital), for their cooperation.
The authors declare no conflicts of interest.
Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is
provided in the HTML and PDF versions of this article on the journal’s Web site (www.jncqjournal.com).
Accepted for publication: November 4, 2017
Published ahead of print: December 21, 2017
Abstract
We investigated the effect of using a fall risk screening tool in an electronic medical record system by using data for
25 039 patients in 24 general wards of a single institution. The probability of the occurrence of falls decreased after
the tool was implemented, but using the tool did not reduce the actual occurrence of falls. This indicates that we
must improve not only the assessment of the risk of falls but also the interventions to prevent falls.
FALLS can cause serious injuries, including fractures and brain contusions,1 and are the most common cause of
hospital admission, directly resulting in 14 million admissions in the United States.2 In addition, falls are associated
with a high cost per patient or per fall.3 It is therefore important that medical institutions take adequate fall
prevention measures.
One step in such fall prevention measures is the use of a fall risk screening tool, many of which have been
developed.4-7 In 2002 in Japan, the Japanese Nursing Association recommended the development of fall risk
screening tools for individual institutions. There was an existing tool in our institution, but in 2014, we improved
this conventional tool by developing a fall risk screening formula for inpatients based on the nursing assessment
records of about 10 000 inpatients stored in the electronic medical record (EMR) system of our institution. The
sensitivity of the tool was 72.1%, the specificity was 69.6%, and the area under the receiver operator curve was 0.777
(95% confidence interval [CI], 0.743-0.812).8 We implemented this improved tool in our EMR system and started
using it in March 2014.8 By using the information entered by nurses (eg, history of fall, risks regarding disease, and
risks regarding activities of daily living) and patient information stored in the EMR (eg, age and gender), the system
predicts whether the fall risk for an individual is high or low.
Several studies have evaluated the performance of existing fall risk screening tools in clinical settings,9-11 and one
study reported the sensitivity and specificity of a tool implemented in an EMR system.12 The primary objective of
introducing and using such fall risk screening tools is to reduce the occurrence of falls; however, there are few
reports on the effectiveness of using these tools on the actual occurrence of falls. One such study used simple
tabulation and a comparison of the occurrence of falls after introducing a screening tool.13 The aim of the present
study was to evaluate whether implementing and using the fall risk screening tool in our EMR system contributed to
a reduction in the occurrence of falls.
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METHODS
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Study design
We adopted a retrospective controlled before-after study design. The Japanese Ministry of Health, Labour and
Welfare guidelines state that the target of analysis in information systems related to medical safety must be evaluated
on the basis of the frequency of incidents and accidents.14 Therefore, we retrospectively evaluated the effectiveness
of our fall risk screening tool by analyzing whether it reduced the occurrence of falls. To define fall, we used the
following definition from the World Health Organization: “A fall is an event which results in a person coming to rest
inadvertently on the ground or floor or other lower level.”15 We excluded cases in which medical staff judged that a
patient had fallen from a piece of furniture such as a chair or bed, as well as cases with duplicate records. The
research ethics committee of the authors’ institution approved this study.
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Data
This study used data from a single institution. We investigated the period before the screening tool was implemented
(pre-period) and the period after implementation (post-period). The pre-period was defined as from April 2013 to
February 2014, and the post-period was defined as from April 2014 to February 2015. These dates were chosen to
avoid any effect due to seasonal factors. We targeted patients who were admitted to and discharged from 24 general
wards during both the pre- and post-periods. The number of beds and the focus of each ward are provided as
Supplemental Digital Content (Table, available at: http://links.lww.com/JNCQ/A410). All wards were acute care
wards and had similar characteristics. One nurse is deployed per every 7 patients, and the nursing practice model is a
mixture of team nursing and primary nursing in these wards. We excluded pediatric, maternity, intensive care unit,
emergency, and psychiatric wards from analysis.
We had to take the risk factors of inpatients into consideration when analyzing the data to reduce the possibility that
a reduction in the occurrence of falls was due to an increase in the hospitalization of patients with mild conditions.
Previous studies have confirmed that “falls have diverse causes,”16 and “many complex patient characteristics,
circumstances, and activities may contribute to inpatient falls.”17 Risk factors adopted in 2 of the most commonly
used tools include The Morse Fall Scale 4-history of falls, secondary diagnosis, ambulatory aid, intravenous therapy,
gait, and mental status-and St Thomas’s Risk Assessment Tool in Falling Elderly Inpatients 5-history of falls,
agitation, visual impairment, frequent toileting, and transfer and mobility scores of 3 or 4. Ideally, we would have
adopted the aforementioned factors as control variables to adjust for patient factors in our analyses; however, we
could not get sufficient data retroactively, so we used another data source in the EMR for control variables.
The data source we used is called the Intensity of Nursing Care Needs (INCN).18 INCN data are used in Japan to
record patients’ daily nursing care, medical treatment, and activities of daily living. Because INCN is an important
tool in the medical fee system in Japan, many institutions use INCN data, including ours. The patients whose scores
are over the cutoff points are considered serious cases, and the amount of reimbursement the medical institution
receives from patients and insurers changes according to the proportion of serious cases. INCN data present patients’
conditions fairly accurately because nurses record INCN data every day, and the data are validated by multiple
nurses. To maintain the quality of INCN data, strict evaluation standards and guidelines are decided at the national
level. In our institution, there is an education program for staff based on these standards and guidelines.
The Cronbach [alpha] coefficient for INCN data in this study, which is an index of internal consistency reliability,
was 0.86. Because the score was high, the operation was deemed valid. Therefore, we judged INCN data to be
adequate for use as control variables to adjust for patient factors in this study. Because the items and rules of INCN
are revised every other year, we selected the following 12 items that did not change during the target term for use in
this study: wound care required, concurrent use of more than 3 intravenous drip infusions, use of an
electrocardiogram, use of a syringe driver, blood transfusion or products required, able to change posture, able to sit
up in bed, able to maintain a sitting position, able to move from a bed or chair, able to maintain oral hygiene, able to
take meals, and able to change clothes.
We created the data set for analysis in the following steps. First, we gathered INCN data of the target patients and
matched it with the data for age and sex. Next, we applied a label to each daily INCN record, stating whether it was
before or after the tool was implemented by using nursing record data. Even after the tool was implemented in
clinical settings, the decisions to use the tool or not and when to use the tool were at the discretion of the nurse in
charge of the patient. Therefore, the post-period contains records in which nurses used the tool (with the tool) and
those in which nurses did not use the tool (without the tool). We excluded INCN records that could not be matched
with nursing record data. Finally, we added a label to each daily INCN record to state whether there was a fall on the
following day or not by using fall report data.
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Statistical analysis
We analyzed differences in the probability of falling
between patient records (1) in the pre- and post-periods,
and (2) in the post-period with and without the tool. The
probability of falling was defined as the probability of a
patient falling in a single day. We adopted a logistic
regression model in which the response variable was the
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logit of the probability of falling. We performed
multilevel analysis 19 of repeated measures in
consideration of the structure of the data, which were
hierarchical and were measured repeatedly. The range of
data, explanatory variables, and random effect in analyses
1 and 2 are shown in Table 1. For analysis, we used R
3.2.4 (R Foundation for Statistical Computing, Vienna,
Austria).
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RESULTS
We created a data set consisting of data for 573 216
patient-days. Logistic regression analysis required 10-fold
the number of events as the number of explanatory
variables 20; our analysis was able to fulfill this condition.
Descriptive statistic values of patients and the occurrence
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of falls are shown in Table 2. The results of analysis 1
provided an odds ratio for the post-period of 0.83 (95%
CI, 0.72-0.95). The results of analysis 2 provided an odds
ratio for the post-period with the tool of 1.12 (95% CI,
0.91-1.37).
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DISCUSSION
On the basis of the results of analysis 1, the probability of the occurrence of falls was significantly reduced during the
post-period. As a previous study 21 states, implementation of a fall risk screening tool may have caused behavioral
changes in nurses in relation to patient care regarding falls, and these behavioral changes reduced the probability of
the occurrence of falls. The results of analysis 2 showed the probability of the occurrence of falls increased during
the post-period with the tool, but this was not statistically significant. This may suggest that using a fall risk
screening tool alone does not reduce the occurrence of falls. According to the Cameron et al 22 systematic review,
only multifactorial interventions in hospitals reduce the rate of falls.23In Japan, fall risk assessment is advocated, but
as our study showed, using a fall risk screening tool alone does not reduce the occurrence of falls; therefore, we have
to promote a care system that includes fall prevention interventions. However, this tool can help identify patients at
risk of falls so that appropriate measures to prevent future falls can be implemented.
There are 2 future challenges. First, nurses in our institution did not record information about interventions with
high-risk patients in a standardized format. Future studies should focus on the effects of interventions with high-risk
patients, and the methods of providing and recording data for nursing intervention should be standardized. Second,
there may be an effect of the level of experience of the nurse in charge. For example, the possibility of falling might
be lower under the care of nurses with more nursing experience or a higher clinical position. We should investigate
the effects of such nurse career attributes 24,25 for a more precise analysis.
This study had the following limitations. We used INCN data as control variables to adjust for patient attributes
instead of using patient risk factors. However, this was not enough to adjust for actual patient risk factors.
Performing a randomized control trial is ideal but difficult because the probability of the occurrence of falls was very
low (1.52 cases/1000 patient-days) in this study period, as shown in Table 2. We were thus unable to avoid potential
underreporting 26 while depending on staff’s voluntary reporting as a data source. It is unclear whether
implementation of this tool affected the number of fall reports.
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CONCLUSION
We investigated the effect of implementing a fall risk screening tool in an EMR system by using data stored in the
EMR. We found the probability of the occurrence of falls decreased after implementation, but using the tool did not
reduce the actual occurrence of falls. This indicated that we have to not only improve the system for assessing the
risk of falls but also intervene to prevent falls.
CIN: Computers, Informatics, Nursing
Issue: Volume 35(1), January 2017, p 18-28
Copyright: Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
Publication Type: [FEATURES]
DOI: 10.1097/CIN.0000000000000290
ISSN: 1538-2931
Accession: 00024665-201701000-00005
Keywords: Clinical decision support, Electronic health records, Informatics, Meaning use, Nursing informatics competencies,
Satisfaction, Usability, Workflow
Hide Cover
[FEATURES]« Previous Article Table of Contents Next Article »
Statewide Study to Assess Nurses’ Experiences With Meaningful Use-Based
Electronic Health Records
McBride, Susan PhD, RN-BC, CPHIMS, FAAN; Tietze, Mari PhD, RN-BC,
FHIMSS; Hanley, Mary Anne PhD, RN; Thomas, Laura PhD, RN, CNE
Author Information
Author Affiliations: Texas Tech University Health Science Center, School of Nursing, Lubbock (Dr McBride), Texas
Woman’s University, College of Nursing, Dallas (Dr Tietze); Sul Ross State University Rio Grand College, Alpine (Dr.
Hanley); and Texas Tech Health University Sciences Center, School of Nursing, Lubbock (Dr Thomas), Texas.
The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial
companies pertaining to this article.
Corresponding author: Mari Tietze, PhD, RN-BC, FHIMSS, Texas Woman’s University, Houston J. and Florence A.
Doswell College of Nursing, T. Boone Pickens Institute of Health Sciences-Dallas Center, 5500 Southwestern Medical
Ave, Dallas, TX 75235 (mtietze@twu.edu).
Abstract
Nursing professionals are at the frontline of the health information technology revolution. The Texas Nurses
Association and Texas Organization of Nurse Executives partnered to evaluate the changing health technology
environment in Texas, in particular the nurses’ satisfaction with the use of clinical information systems. A
descriptive exploratory study using the Clinical Information System Implementation Evaluation Scale and a newly
developed Demographic Survey and the Meaningful Use Maturity-Sensitive Index, with a narrative component, was
conducted in 2014 and 2015. Nurses across Texas received an electronic invitation to participate in the survey,
resulting in 1177 respondents. Exploratory factor analysis revealed that variables of the Meaningful Use MaturitySensitive Index and Clinical Information System Implementation Evaluation Scale show strong interrater reliability,
with Cronbach’s [alpha] scores of .889 and .881, respectively, and thereby inform the survey analysis, indicating and
explaining variations in regional and institutional trends with respect to satisfaction. For example, the maturity of a
clinical information system within an organization and age of the nurse significantly influence the probability of
nurse satisfaction (P < .05). Qualitative analysis of nurses' narratives further explained the nurses' experiences.
Recommendations for future research and educational were identified.
The healthcare industry is undergoing a major transformation to establish an interoperable health information
technology (HIT) infrastructure to connect the nation with electronic health records (EHRs) and health information
exchanges (HIEs). This informatics revolution is affecting all aspects of the nursing profession.1-3 With the passage
of the Health Information Technology for Economic and Clinical Health Act in 2009,3 the Texas Nurses Association
(TNA) Board of Directors formed an advisory committee to evaluate the changing health technology environment
and make recommendations to the TNA Board regarding steps needed to prepare Texas nurses for the rapid uptake of
technology in healthcare settings required by this legislation. The TNA Board joined with the Texas Organization of
Nurse Executives (TONE) to create a statewide partnership with nursing leaders to address the impact of HIT on
nursing in the state of Texas. The TNA and TONE Boards formulated the TNA-TONE HIT Task Force. In 2014, this
task force became an official joint committee of both Boards, with recognition of the importance of HIT to nursing
practice and the importance of both organizations partnering to address nursing impact.
The TNA-TONE HIT committee was charged with examining how Texas nurses were affected by newly
implemented EHRs across the state and to establish baseline measures of nurses' satisfaction to inform evidencebased improvement strategies. To accomplish this goal, a statewide study was initiated to evaluate the perceptions of
nurses about their clinical information systems (CISs), defined as EHRs. The full intent of the study was to evaluate
the nurses' perspectives related to satisfaction with the usability of the institutions' CIS used in patient care delivery
across Texas. This information was intended to inform statewide efforts in Texas to improve the use of HIT for
nurses and other associated stakeholders. The purpose of this article is to summarize the development of a statewide
Texas HIT study, describe the methods used, report the results of the study, and outline the next steps for a statewide
improvement effort to address Texas nurses' satisfaction with their EHRs.
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BACKGROUND AND SIGNIFICANCE OF THE STUDY
The quality of healthcare and patient safety in the United States has become a national concern in recent years,
motivated by the release of several Institute of Medicine (IOM) reports. The first IOM report noted that medical
errors were a national public health problem.4 The same report suggested that substantive improvements in
information technology were necessary to support clinical and administrative decision making about healthcare
systems. A common theme in all of the IOM reports is that broad safety and quality improvement efforts require the
development of innovative, electronic health information systems.4-6
Healthcare organizations in Texas are in the process of adopting and integrating information systems to meet the
requirements of the Office of the National Coordinator (ONC).7 The goal is to move toward universal adoption of
CISs, achieve meaningful use (MU) of EHRs, and establish interoperability through HIEs. With 73.2% of office-based
physicians using a certified EHR system, HIEs could provide a significant improvement in communication between
providers and hospitals. However, literature regarding the evaluation of the benefits that accrue from the adoption of
EHRs for nursing appears limited. For example, in a search of the major electronic databases, the past 5 years yielded
44 articles using electronic health record as a key term and the word nursing in the title. None of the articles
systematically addressed satisfaction.8-10 Within Texas, there has been little effort to systematically evaluate the
experience of nurses who use information technology.
The role of information technology is complex and dependent on the systems and processes in which it is embedded.
Furthermore, health information systems implementation is confounded by human factors and barriers that impede
user acceptance and use of the systems.11-13 If end users believe that the technology is easy to use and is beneficial
in supplying the information they need for decision-making purposes, adoption has a higher likelihood of success. If
end users perceive there is no relative benefit of the new system compared with what had been available to them in
the past, it is reasonable to assume that adoption will be resisted.10,13
Two theoretical models for the successful implementation of information systems were appraised. The DeLone and
McLean Model of Information Systems Success used in a number of information system evaluation studies identified
three dimensions important to systems success: system quality, information quality, and service quality.14 These
dimensions may be measured by user satisfaction, intention to use, and measurable net benefits of the system. The
second model, Rogers' innovation diffusion theory, identified constructs about technology that influence adoption as
well as aspects of the adopters and the adoption process.15 In addition, the innovation diffusion theory considers
organizational factors that influence technology adoption.15,16
Attributes of technological innovation that affect adoption of CISs, also known as EHRs include perceived relative
advantages, compatibility, complexity, trial-ability, benefits realization, adaptability, risk, task performance
improvement, and knowledge. Characteristics of individual adopters that influence the adoption of innovation
include tolerance of ambiguity, intellectual ability, motivation, values, learning style, and organizational or social
position.15 Given the relative newness of the use of CISs, several instruments were considered. The Clinical
Information System Implementation Evaluation Scale (CISIES), developed by Gugerty et al,17 was one that assesses
user satisfaction across organizations and reflects attributes of technological innovation. The instrument is sensitive
to the adopter's characteristics across organizations in both formative and summative evaluations of CIS
implementation. More details about the CISIES will follow.
Assessing end-user perceptions of specific aspects of system functionality, usability, and usefulness is essential to
identify approaches that can be used to make strategic improvements in CIS adoption, implementation, and
optimization of the system. The objective of the TNA/TONE HIT study was to inform a strategy that improves Texas
nurses' satisfaction with their EHRs. To accomplish this goal, baseline measures of satisfaction were needed.
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STUDY METHODS
The statewide multiorganization study was a descriptive and exploratory study to identify key issues with the
current deployment of EHRs in the practice setting and to identify characteristics associated with satisfaction to
inform improvements. To address this aim, several research questions directed the design of the study:
1. What is the relationship between health setting characteristics and the nurses' satisfaction with their EHRs?
2. What is the relationship between the nurses' characteristics and the nurses' satisfaction with their EHRs?
3. What is the relationship between CIS characteristics and the nurses' satisfaction with their EHRs?
4. What are the themes and subthemes that emerge from the narrative comments (qualitative data) by nurses about
using their EHRs that may inform improvement strategies?
The study design was supported by multiple partners, including TNA, TONE, and the Texas Tech University Health
Sciences Center School of Nursing (TTUHSC SON). The TTUHSC provided research oversight and the internal
review board approval for the study. A research subgroup consisted of TNA-TONE HIT committee members
working with two principal investigators to develop the study design, methods, data collection, and analysis
processes.
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Sampling and Survey Response
In this statewide study, nursing staff members, who are end users of a CIS, employed by Texas healthcare
organizations, represent the study population, including RNs, APRNs, LVNs, and support staff such as nursing
assistants. The target population was derived from a representative sampling of nurses employed in private, public,
and federal acute care facilities and their associated ambulatory/episodic care and long-term care units, referred to
collectively as the healthcare organization (HCO).
To determine sample size, an a priori power analysis was conducted to ensure 0.8 power and a Cronbach's [alpha] of
.05. A small effect size revealed the need for 1092 respondents.18 This sample size was deemed to provide adequate
representation of descriptive statistics and statistical modeling using logistic regression to examine factors associated
with predicting satisfaction.
The TNA/TONE online survey was deployed through an e-
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mail sent to staff nurses from the chief nurse officer of the
HCO inviting voluntary and anonymous participation
using a stratified sampling method. The survey was
launched statewide on September 23, 2014. The initial
sampling strategy yielded approximately 250 survey
responses. An improved secondary sampling strategy
utilized a snowball approach with distribution of the
invitation to participate, the survey link, and
communication of purpose through e-mails sent by TNA
and TONE leadership to the membership of both
organizations. This secondary strategy resulted in 1177
total survey responses. Final data analysis to inform the
recommended strategies was reflective of comprehensive
responses from 987 participants. Figure 1 demonstrates the
volume increase from the initial launch in September 2014
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and the revised sampling strategy that resulted in the total
responses concluding in February 2015.
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STUDY DESIGN AND INSTRUMENTATION
Two instruments were used to meet the study objectives. The first of the instruments was the Demographic Survey
and EHR Meaningful Use Maturity-Sensitive Index (MUMSI) designed by McBride and Tietze with a group of
content experts.19 The second instrument was the CISIES designed by Gugerty et al.17
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Demographic Survey
The TNA/TONE research subgroup members designed the Demographic Survey consisting of two sections. The first
section was composed of questions descriptive of key characteristics of each participant such as practice setting, shift,
and experience with computers. These characteristics were used to control for differences in respondents and their
respective organizations. The second section of the Demographic Survey addressed the maturity of the organization's
EHR with respect to federal guidelines for MU 20 and nursing use. Methods to adjust for the maturity of the EHR are
important to fully understand the nurses' experiences, particularly given rapid deployment of EHRs to meet federal
certification guidelines across the state. The Demographic Survey was used to explore the relationships between
CISIES responses, the participant and institutional demographic characteristics such as practice setting, shift,
experience with computers, and type of institution, while controlling for the maturity of the EHR in the institution.
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Meaningful Use Maturity-Sensitive Index
The maturity of an EHR was defined as the level of sophistication of the nurse's knowledge and use of EHR in daily
practice. The research subgroup explored various mechanisms to evaluate the maturity of the EHR in an institution.
The subgroup decided to utilize the ONC's Stage 1 MU measures as the model for capturing different levels of
functional status about the maturity of the EHR. This also reflected the status of MU maturity within the state of
Texas at the time the study was initiated. Content validity of the MUMSI was established with a two-round Delphi
method with quantitative instrument design strategies defined by Lynn.21
The MUMSI was deployed within the demographic
information in the online survey. Figure 2 reflects a
sample from the 24-item instrument and the manner in
which the questions were presented to the participants.
The participants were asked to indicate if the MU
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functionality was present and used, present and not used,
not present, or they did not know if the functionality was
present.
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Clinical Information System Implementation Evaluation Scale
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The CISIES is a 37-item survey designed to measure the participants' satisfaction with their CIS. The CISIES 17 uses
response choices ranging from strongly agree to strongly disagree on a six-point Likert scale. The survey has been
tested for reliability and validity and has a Cronbach's [alpha] ranging from .94 to .96.17 In addition to achieving
many of the study goals, the research subgroup determined that the CISIES provided the most robust data to inform
academic and practice settings with plans needed to address HIT use by nurses.
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Combined Instrumentation of Clinical Information System Implementation Evaluation Scale and
Meaningful Use Maturity-Sensitive Index
Both the CISIES 17 and the MUMSI 19 yielded strong
interrater reliability, with Cronbach's [alpha] scores of .881
and .889, respectively.22 Nunnally et al 23 indicated that .7
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to .8 was an acceptable [alpha] level. Additionally, the
CISIES and MUMSI were examined using an exploratory
factor analysis. The subscales identified within both the
CISIES and the MUMSI can be used to detect further details
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that might inform improvement plans long-term. The
initial examination was performed to assure the research
subgroup that there was no immediate overlap in the
variables explaining the CISIES and the MUMSI. Figure
3 reflects the performance of these two surveys when
combined and analyzed using an exploratory factor analysis
methodology. Note that the rectangles in Figure 3, although
too difficult to interpret, represent each of the items on the
two instruments (for further details of the factor analysis,
contact the corresponding author). The research team
draws the reader's attention to the patterns distinguished
noting the cluster identified as MUMSI, CISIES, and clinical
decision support (CDS).
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Qualitative Narrative Content Analysis
An open-ended question related to nurses' experiences with the use of technology and EHRs in the clinical setting
was included with the survey to gain in-depth textual information from the nurses beyond the constraints of the
instruments utilized. The question was stated as "We are interested in your feedback and anything we might not
have covered, please provide any additional information you care to provide." Of the 1177 surveys completed, 344
respondents provided free text or narrative responses. NVIVO 19 (QSR International, Doncaster, Victoria, Australia)
was used to conduct a word frequency analysis. This analysis detected key terms that could be easily dropped back
into the quantitative data. This result did not fully inform the improvement strategy, so further analysis of the
qualitative data was needed. These narratives were analyzed and coded for themes by the research subgroup.
The confidentiality of participants was maintained through use of an electronic survey administration system
designed and deployed by TTUHSC SON Information Technology Department, which included a Secure Sockets
Layer, a protocol that works through a cryptographic system that secures a connection between a client and a server.
An off-the-shelf software was used to design the online survey including the demographic section, 24-item MUMSI,
and 37-item CISIES questionnaires. No attempt was made to
Jun 6, 2024 | Health Medical
Description
1 full pages (cover or reference page not included)
APA norms
It will be verified by Turnitin
1. How can you guarantee validity and feasibility in your research study with a mix method?
It should not be a summary of validity, feasibility or mix method. Please answer the question only.
Jun 6, 2024 | Health Medical
Description
In the scenario assignments, you are asked to reflect on responses to the presented scenario. This 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 existing knowledge and beliefs. To complete each scenario assignment:
Complete the entire scenario.
Compose your 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 feel is the most ethical and why?
Support your conclusions with evidence and specific examples from the textbook, as well as other sources as needed.
Your reflection must be 1-2 pages in length and follow APA formatting and citation guidelines as appropriate.Scenario is locked down, but attached you can find 3 other students work on it, just go over them and write a new one similar to them.
Unformatted Attachment Preview
Running head: DEATH WITH DIGNITY SCENARIO AND REFLECTION
Death With Dignity Scenario and Reflection
Caroline Cruz
NURS 434
West Coast University
1
DEATH WITH DIGNITY SCENARIO AND REFLECTION
2
The response that I believe is the most ethical is that Dr. Mahal’s assessment of the law is
reasonable. The death with Dignity Act is carefully constructed, and protects both doctor and
patient. In order for PAS to be legal, the patient must be sane and properly informed about
potential alternatives. This is an ethical template that other states considering such a law might
be encourage to adopt. The reason that I believe that this is the most ethical is because these
patients have already been diagnosed with terminally ill prognosis where they only have six or
fewer months to live (Pence, 2017). With the law Death with Dignity Act there are certain
requirements that they must meet in order for them to be approved to die with dignity. According
to Division 9 the requirements that they must meet are that they must be older than 18 years of
age, an attending physician must have primary responsibility of care and treatment of the patient,
the authority from Oregon Health Authority, the patient must be capable to communicate and
make decisions on their own, have a consulting physician confirm the diagnosis and prognosis of
the patients illness, and lastly go to counseling to determine if the patient is capable and not
suffering from psychiatric or psychological disorders (Division, n.d.). If patients are given the
option to relieve their suffering and pain that they have endured from a severely terminally ill
prognosis knowing they only have a certain amount of time left, we are giving them the
opportunity to relieve all the pain that they went through. As health care professionals it is our
duty to care for patients and ensure that they are comfortable and pain free when they do have a
diagnosis/ prognosis that completely affects them on their everyday life. They endure so much
pain and suffering that they are not enjoying the remaining time that they have. If they are given
the opportunity of a death with dignity they are being able to die in peace from pain.
DEATH WITH DIGNITY SCENARIO AND REFLECTION
3
References
DIVISION 9 – REPORTING REQUIREMENTS OF THE OREGON DEATH WITH
DIGNITY ACT. (n.d.). Retrieved June 18, 2019, from
https://www.oregon.gov/oha/ph/ProviderPartnerResources/EvaluationResearch/
DeathwithDignityAct/Documents/rules.pdf
Pence, G. (2017). Medical ethics: Accounts of ground-breaking cases (8th ed.). New
NY: McGraw-Hill Education
York,
Running head: DEATH WITH DIGNITY SCENARIO AND REFLECTION
Death with Dignity Scenario and Reflection
Mahnoor Abbasi
West Coast University
1
DEATH WITH DIGNITY SCENARIO AND REFLECTION
2
Death with Dignity Scenario and Reflection
It is important to understand that everyone has their right to an opinion, being it ethical
vs. unethical. Most unethical cases though, are termed as illegitimate reasons, so they are
frowned upon by, or as a society.
Out of the four responses that were given in the Death with Dignity scenario and
reflection, the most ethical according to me would be that of Dr. Mahal’s assessment of the law,
which is reasonable. The Death with Dignity Act is carefully constructed, and protects both
doctor and patient. For PAS to be legal, the patient must be sane and properly informed about
potential alternatives. This is an ethical template that other states considering such a law might
be encouraged to adapt.
I believe Dr. Mahal’s views were ethical to me. First, let’s understand the Death with
Dignity law. This law allows a qualified terminally-ill adult to voluntarily request and receive a
prescription medication to speed up the death process (Death with Dignity, 2017). This law as
Dr. Mahal said protects both the doctor, as well as the patient. It is vital to understand that it is
the patient’s legal right, judging by their health condition, to choose if they want to make the
decision of passing PAS (Death with Dignity, 2017). Patient is of sound mind while making this
decision, and has an informed consent to sign, and understand what he or she will be going
through under the Death with Dignity law.
Although I find Dr. Mahal’s views ethical, it is with no doubt that PAS continues to be
debated as either ethical or non-ethical. The ethics of Physician associated suicide is often argued
on the grounds for a dying person who is choosing to escape unbearable suffering at the end of
life. This furthermore causes the physician to be involved in alleviating the suffering and pain,
DEATH WITH DIGNITY SCENARIO AND REFLECTION
and provide aid in the dying process. PAS also comes under unethical views, as some condone
the practice of PAS as a slippery slope that could lead to euthanasia (Starks, 2013).
3
DEATH WITH DIGNITY SCENARIO AND REFLECTION
References
Death with Dignity. (2017). How to Access and Use Death with Dignity Laws. Retrieved from:
https://www.deathwithdignity.org/learn/access/
Starks, Helene. (2013). Physician Aid-in-dying. Retrieved from:
https://depts.washington.edu/bioethx/topics/pad.html
4
Running head: DEATH WITH DIGNITY SCENARIO AND REFLECTION
Oregon’s Death with Dignity Act: Against life
Vivian Toma
West Coast University
1
DEATH WITH DIGNITY SCENARIO AND REFLECTION
2
Oregon’s Death with Dignity Act: Against life
Oregon became the first state to legalize physician-assisted suicide (PAS) when it enacted
the Death with Dignity Act (DWDA) on October 27, 1997. This act allows terminally-ill
Oregonians to end their lives through the voluntary self-administration of lethal medications,
expressly prescribed by a physician for that purpose (Oregon’s Death with Dignity Act, n.d.).
Currently, five additional states and Washington, D.C. have death with dignity statues: California
(End of Life Option Act; 2016), Colorado (End of life Options Act; 2016), District of Columbia
(D.C. Death with Dignity Act; 2016/2017), Hawai’i (Our Care, Our Choice Act; 2018/2019),
Vermont (Patient Choice and Control at the End of Life Act; 2013), and Washington (Washington
Death with Dignity Act; 2008) [Death with Dignity Acts, n.d.]. According to Oregon’s DWDA
annual report from 2018, 249 people received prescriptions for lethal doses compared to 219
people during 2017 (Oregon Death with Dignity Act 2018 Data Summary, 2019).
Though this report shows DWDA’s increasing popularity, I believe that physician-assisted
suicide (PAS) is not a solution. Of the choices at the end of the scenario, PAS is a bad idea from
the start. Regardless of one’s personal beliefs, state-sponsored suicide is not good precedence for
anyone. It sends a message that life is not sacred, and if that door is opened, several undesirable
outcomes may follow. Philosophically, this ethical view of a strong regard for life was embraced
by Immanuel Kant, a non-consequentialist. He believed that ending another person’s life
untimely is unacceptable because it cannot be rationally universalized (categorical imperative),
and it also violates the innate value and dignity of human life (Pence, 2017).
At the beginning of the scenario, Dr. Mahal stated that he believed that the ethics of
“informed” PAS are “sound”, and Oregon’s DWDA conforms to ethical standards and practices.
This was an important distinction according to Dr. Meadows because Oregon DWDA statute
DEATH WITH DIGNITY SCENARIO AND REFLECTION
3
clearly states that a person has to be “capable”, which means that in the opinion of a court or in
the advice of the patient’s attending physician or consulting physician, psychiatrist/psychologist,
a patient has the ability to make and communicate healthcare decisions to healthcare providers
(Oregon’s Death with Dignity Act, n.d.). In Oregon, however, it has been found that fewer
psychiatric consultations are being done to evaluate prospective PAS patients for depression,
which raise the possibility that reversible mental disorders may be playing a factor in PAS
requests (Erdek, 2015). This issue further proves that PAS is a bad policy because it endangers
the weak and vulnerable in the society. The safeguards that profess to lessen the risk have shown
to be insufficient and have often been mitigated or eliminated over time; thus those who deserve
society’s help are instead offered a quick death.
When asked, Dr. Mahal verbalized that pain management’s techniques fail in 5% of cases
of terminally-ill patients, though pain is not the only issue of those who are terminally ill.
According to Erdek (2015), the practice of palliative sedation is an alternative to relieving pain
and anxiety that these patients suffer from. Palliative sedation is the deliberate lowering of a
patient’s level of consciousness via continuous or temporary/intermittent sedation until the
moment of death (Broaeckert, 2011). Its objective is to relieve refractory symptoms; hence,
suffering and is not to lengthen or cut short the patient’s life; the level of consciousness is the
means to that end, whereas in PAS, a person is using himself as a mere means, rather than
respecting himself as an end (Pence, 2017). Dr. Mahal also argued that PAS relieves terminallyill patients of the loss of dignity they may feel during their last moments. In response to his
statement, PAS further encourages attitudes such as loss of dignity and becoming a burden on
others (Doerflinger, 2017). Doerflinger (2017) added that the solution is to care for people in
DEATH WITH DIGNITY SCENARIO AND REFLECTION
4
ways that assure them that they have dignity and it is a privilege, not a burden, to care for them
as long as they live.
Dr. Meadows made a good point that there is no requirement (regardless of time) that
doctors explain the ethical position of those who oppose physician-assisted suicide and that
reminding them of the sanctity of life might serve to jog their memory of what’s morally right
and wrong. Smith (2011) reasoned that in legalizing assisted suicide, some patients would die
instead of ultimately regaining their joy in living. He further added that the legalization of
assisted suicide would cheat at least most people of the time, which is the universe’s most
precious and irreplaceable commodity (Smith, 2011). On top of Smith’s response, I find it
especially disturbing that Oregon’s DWDA allows a patient to participate if he/she is diagnosed
with a terminal illness that will lead to death within six months and that the attending physician
can determine whether this criterion has been met. How is it ever possible to predict death to
happen within a certain timeframe?
In Dr. Meadow’s response to an audience’s question, she stated that physicians are not
required to provide prescriptions to patients if they are not willing to participate in PAS. Though
participation is voluntary, some physicians who participated in PAS feel conflicted. According to
Professor Stevens of Oregon Health and Science University, some physicians who participated in
PAS at Oregon reported that it was a very stressful situation, and the state’s annual 1998 report
observed that the “process of participating in PAS exacted a large emotional toll, as reflected by
such comments as ‘It was an excruciating thing to do…it made me rethink life’s priorities,’ ‘This
was really hard on me, especially being there when he took the pills,’ and ‘This had a tremendous
emotional impact'” (Pies, 2018). I believe that the inner conflict and discomfort experienced by
PAS-participating physicians is directly connected to the Hippocratic Oath, the most important
DEATH WITH DIGNITY SCENARIO AND REFLECTION
foundation of medical ethics, which clearly states, “first, to do no harm.” PAS is fundamentally
incompatible with the physician’s role as a healer, and he/she assumes sole responsibility for the
act of ending the patient’s life.
As a nurse, instead of embracing PAS, I believe that society should respond to suffering
with genuine compassion and care. Patients seeking PAS typically suffer from depression,
anxiety, or other mental illnesses as well as merely from isolation or abandonment. Instead of
helping them end their lives, the government should offer them appropriate medical care and
human presence. For those in physical pain, pain management and other palliative medicine can
better manage their symptoms. To patients for whom death is imminent, hospice care, palliative
sedation, and fellowship can provide comfort in their last days. Anything less falls short of what
human dignity requires. The real issue facing the society that needs to be addressed is making
quality end-of-life care available to all.
5
DEATH WITH DIGNITY SCENARIO AND REFLECTION
6
REFERENCES
Broeckaert, B. (2011). Palliative Sedation, Physician-Assisted Suicide, and Euthanasia: “Same,
Same but Different”? The American Journal of Bioethics, 11(6), 62-64.
doi:10.1080/15265161.2011.577518
Colwell, J. (2018, January 15). Hospitalists weigh ethical, practical impacts of aid-in-dying laws.
Retrieved April 08, 2019, from https://acphospitalist.org/archives/2018/01/impacts-of-aidin-dying-laws.htm
Death with Dignity Acts – States That Allow Assisted Death. (n.d.). Retrieved April 09, 2019,
from https://www.deathwithdignity.org/learn/death-with-dignity-acts/
DEATH WITH DIGNITY SCENARIO AND REFLECTION
7
Doerflinger, R. (2017, January 30). Q&A with the Scholars: Physician-Assisted Suicide and
Euthanasia. Retrieved April 09, 2019, from https://lozierinstitute.org/qa-with-the-scholarsphysician-assisted-suicide-and-euthanasia/
Erdek, M. (2015). Pain Medicine and Palliative Care as an Alternative to Euthanasia in End-ofLife Cancer Care. The Linacre Quarterly, 82(2), 128-134.
doi:10.1179/2050854915y.0000000003
Oregon Revised Statute: Oregon’s Death with Dignity Act. (n.d.). Retrieved April 09, 2019, from
https://www.oregon.gov/oha/ph/ProviderPartnerResources/EvaluationResearch/Deathwith
DignityAct/Pages/ors.aspx
Pence, G. E. (2017). Medical ethics: Accounts of ground-breaking cases. New York, NY:
McGraw Hill Education.
Physician Assisted Suicide – Christian Medical & Dental Associations. (2016, July 21).
Retrieved April 08, 2019, from https://cmda.org/physician-assisted-suicide/
Pies, R. (2018, December 19). How does assisting with suicide affect physicians? Retrieved
April 09, 2019, from http://theconversation.com/how-does-assisting-with-suicide-affectphysicians-87570
Public Health Division, Center for Health Statistics. (2019). Oregon Death with Dignity Act 2018
Data Summary (pp. 1-16, Rep. No. 21). Retrieved April 09, 2019, from
https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONR
ESEARCH/DEATHWITHDIGNITYACT/Documents/year21.pdf.
DEATH WITH DIGNITY SCENARIO AND REFLECTION
Smith, W. (2011, October 13). Wesley Smith: Assisted Suicide Is the Euthanasia of Hope.
Retrieved April 09, 2019, from
https://www.noozhawk.com/article/101311_wesley_smith_assisted_suicide/
8
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Jun 6, 2024 | Health Medical
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1 full pages (cover or reference page not included)
APA norms
It will be verified by Turnitin
3 References not older than 5 years
3 paragraphs for each question
Each question must be identified by a number. For example
1.
Accordingt to Morris (2022) ….
2.
Morris and Holmes (2014) …..
Describe at least 3 nursing care delivery models.2. Describe communication strategies for effective interprofessional teams.
Jun 6, 2024 | Health Medical
Description
Assignment:
Assignment Description: This assignment will be at least 1500 words or more
This week you will reflect upon the effects of the nursing shortage to answer the following questions:
What steps can we take to address the nursing shortage?
Briefly define the series of events that led to the nursing shortage.
Reflect on your future role as a nurse or healthcare employee in the midst of a nursing shortage crisis.
How do you see the role of legislature contributing to safe staffing during a shortage?
Assignment Expectations:
Length:
1500-2000 words (6-8 pages); answers must thoroughly address the questions in a clear, concise manner
Structure:
Include a title page and reference page in APA style
References:
Two scholarly references are required; you should include the appropriate APA style in-text citations and references for all resources utilized to answer the questions
Format:
Save your assignment as a Microsoft Word (.doc or .docx), Open Office (.odt) or rich text format (.rtf) file type
File name:
Name your saved file according to your last name, first initial and the week (for example, “jonesb.week1”)
Submission:
Submit your assignment to the Drop Box
Jun 6, 2024 | Health Medical
Description
Strategies you use to maintain, build up, or improve health over time in an autoetiography. In this context, “bodily eu-appearance” serves to encourage ongoing pursuit of such strategies. Successful strategies, in this context, are generally intended to promote well-being and self- and/or life-affirmation.
Remember: this is not an essay. You may produce either an autoetiography or autopathography journal that logs your personal experiences. Around 6 pages, double space.
* Whether you are doing an autoetiography or autopathography, you will log how the stressful social environment of the 21st century affects your personal experiences. Stress, in and of itself, is not generally considered to be a disease or illness. However, there is general agreement that stress contributes to ill-health and disease. Correspondingly, there is general agreement that people who develop and nurture successful stress reduction strategies are less likely to become ill.
Be sure that your journal provides background about the strategies you are studying.
Be sure that your journal makes clear when and where you perform the strategies you are studying.
Be sure that your journal makes clear (a) the “rules” (i.e., “obligations” and “expectations”) surrounding the performance of the strategies, and (b) what you expect to happen if the strategies are not performed according to the rules.
Jun 6, 2024 | Health Medical
Description
Nutrition Exam. Once you begin the exam you will have 60 minutes to answer 40 Multiple-Choice, True-False, and Matching type questions. Must have knowledge about the subject of Nutrition.
Jun 6, 2024 | Health Medical
Description
The case can be documented or a hypothetical case (fictitious case). The case will be written up according to the SOAP format (below). presentation should simulate presenting a case to a dentist or an oral pathologist. Presentation may be done in Power Point format
SOAP FORMAT
S: (Subjective) Includes the patient’s chief complaint and relevant history.
O: (Objective) Includes the medical history, all data from clinical examination (clinical appearance, consistency, color, size, surface texture, odor, palpation) and radiographic interpretation. Includes noted loss of function or other observations. Also includes any available biopsy or lab reports.
A: (Assessment) List a differential diagnosis starting with most probable diagnosis, and including any other possible conditions.
P: (Plan) List in chronological order. Include patient instructions, referrals, recommended treatment, monitoring intervals, etc.
Overview of NUG
-Painful, erythematous gingivitis
– necrosis of interdental papillae
– caused by spirochete (Borrelia vincentul) and Provotella Intermedia
– associated with stress, drinking, and smoking
– causes bad odor, fever, lymphadenopathy, and metallic taste
– Tx: debridement, Flagyl, chlorhexidine rinse
Jun 6, 2024 | Health Medical
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I need a 1-2 page summary of this article that i copied a link to. Use APA style and make sure you cite properly. https://search-proquest-com.ezproxy.umo.edu/docvie…Also need My Math Lab Homework 4A and Quiz 4A
Jun 6, 2024 | Health Medical
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Response to posts A and B separately in your own words(A) Mr. J.V is a person that believes in keeping fit and also engages in power lifting; therefore based on his lifestyle his intake of protein and carbs as well as a good portion of fiber makes up slightly more than the recommended values. His nutritional status is healthy when compared to the average individual and has large amounts of macronutrients. The most overvalued components of his diet are carbohydrates because this helps him function effectively and ensures that energy is optimized when at the gym. Water is undervalued due to the availability of other liquids available like sodas and energy drinks. Mr. J.V has no medical conditions that limit his nutritional requirement or any preparation of food nor does he have any sensory alterations that would impact his food preparations or nutritional need.(B) To assess the nutritional status of my female friend, I utilized the Mini Nutritional Assessment (MNA) tool, conducted a physical examination, and asked questions related to their diet history. According to the Mini Nutritional Assessment tool, my friend is at risk of malnutrition, scoring 11 out of a possible 14 points (Potter, Perry, Hall, & Stockert, 2017, p. 1065). She reports no recent loss of appetite or weight loss and is usually physically active but does not know if she has lost any weight in the last three months. From the physical assessment, my friend is five foot four inches and weighs 125lbs, and her body mass index (BMI) is 21.5, which is considered a healthy weight (Calculate your BMI, n.d.). My friend is a vegan and states that she values her health and nutrition very much. Her physical signs appear healthy, evidenced by attributes such as shiny hair, smooth skin, reddish-pink mucous membranes, and clean teeth. From her diet history, the only medical condition she reports is being lactose intolerance, which prevents her from all dairy products. My friend has no sensory alterations that would impact her nutritional status. Other diagnostic tests that can be conducted to provide additional information regarding her nutritional health could be laboratory tests for measures of plasma proteins and nitrogen balance.
Jun 6, 2024 | Health Medical
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This assignment requires to choose an immigrant or migrant group to research and create a PowerPoint presentation that provides an overview of the group including narration or speaker notes to elaborate on the slide information and also including the elements below In addition format the presentation according to APA gui
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Week 12 The Immigration Experience Presentation
Submit Assignment
hents
Due Dec 1 by 11:59pm
Points 25
Submitting a file upload
Choose an immigrant or migrant group to research.
its
Create a PowerPoint presentation that provides an overview of the group. The slides should include narration or
speaker notes to elaborate on your slide information.
$
Include the following elements in your presentation:
ces
•
tions
• Briefly describe the history or politics of the group’s immigration experience.
• Outline the group’s strengths and vulnerabilities as a result of the immigrant journey.
Explain what you can do as a clinician to help connect with this population.
Identify resources for language interpretation for this population.
• Take an ethical position regarding questions of deportation, a path to citizenship, and service provision, including
health, education, and employment.
Library
Lesources
Format your presentation according to APA guidelines.
esources
Submit your presentation no later than 11:59 p.m. (Pacific time) on Sunday.
Feedback
Week 12 The Immigration Experience Presentation
Criteria
Ratings
Pts
4.0 pts
3.0 pts
Exceeds
0.0 pts
Met
Clarity of
Message;
Organization,
Spelling, &
Mechanics
Communication is
clear and organized
(i.e specific
introduction,
transitions, and
conclusion). No
spelling and
mechanic errors.
Communication is clear. Keeps
to a clear organizational
pattern, but with some
tangents that do not detract
from the message. Includes
only minor mechanical or APA
formatting errors.
1.0 pts
Not Met
Communication is unclear
with frequent tangents that
detract substantially from the
overall message. Includes
mechanical and APA errors
that detract from
understanding.
No
Submission
No
assignment
turned in
4.0 pts
8.0 pts
Understanding
of Content &
Applicability
to Practice
6.0 pts
10.0 pts
Exceeds
Strong understanding of
assigned materials.
Not Met
Met
Understands assigned materials
with minor errors. Evidence and
0.0 pts
No
Submission
Little evidence of
understanding of
e
E
No
Not Met
No
Submission
samuelmerritt instructure.com/courses/2598187/assignments/23742900
Or Content &
Exceeds
Met
Applicability
Strong understanding of Understands assigned materials
to Practice
assigned materials.
with minor errors. Evidence and
Evidence and guideline guideline based approach with
based approach. Able to minor inconsistencies. Able to
accurately apply didactic apply didactic knowledge into
knowledge into clinical clinical setting with minor errors.
setting.
No
assignment
turned in
10.0 pts
Little evidence of
understanding of
course content or
applicability into
clinical setting.
Approach is not based
on evidence or
guidelines.
5.0 pts
Exceeds
4.0 pts
Met
Presentation
Delivery
(posture,
gesture, eye
contact, and
vocal
expression)
0.0 pts
No
Submission
No
assignment
turned in
Delivery techniques
make the presentation
compelling and
speaker appears
polished and
confident. Language is
compelling and
enhance the
effectiveness of
presentation
Language appropriate
for audience. Meets
the duration
requirements.
Delivery techniques make
the presentation interesting
and speaker appears
comfortable. Language is
thoughtful and generally
supports the effectiveness of
presentation. Language
appropriate for audience.
Slightly over the duration
requirements but able to get
the main message across
within the time frame.
2.0 pts
Not Met
Delivery techniques make the
presentation difficult to
understand and speaker
appears tentative. Language is
mundane and generally does
not support the effectiveness
of presentation. Language is
not appropriate for audience.
Does not meet duration
requirements or does not
establish a clear message
within the time frame.
5.0 pts
0.0 pts
No
Submission
References &
Support
(explanations,
examples
illustrations,
statistics,
analogies,
quotations
from relevant
authorities)
3.0 pts
Exceeds
A variety supporting
materials make
appropriate reference to
information or analysis
that significantly
supports the
presentation or
establishes the
presenter’s credibility/
authority on the topic.
APA style is used when
indicated.
2.0 pts
Met
Supporting materials make
appropriate reference to
information or analysis that
generally supports the
presentation or establishes
the presenter’s credibility /
authority on the topic. APA
style is used when
indicated with minor errors
in formatting
1.0 pts
Not Met
Supporting materials make
appropriate reference to
information or analysis that
doesn’t support or partially
supports the presentation or
establishes the presenter’s
credibility / authority on the
topic. APA style is not used
when indicated or with major
errors in formatting.
No
assignment
turned in
3.0 pts
Visual
Materials
3.0 pts
Exceeds
2.0 pts
Met
1.0 pts
Not Met
0.0 pts
Der
+
erritt instructure.com/courses/2598187/assignments/23742900
2.0 pts
5.0 pts
Exceeds
4.0 pts
Met
Not Met
0.0 pts
No
Submission
Presentation
Delivery
(posture,
gesture, eye
contact, and
vocal
expression)
No
assignment
turned in
Delivery techniques
make the presentation
compelling and
speaker appears
polished and
confident. Language is
compelling and
enhance the
effectiveness of
presentation.
Language appropriate
for audience. Meets
the duration
requirements.
Delivery techniques make
the presentation interesting
and speaker appears
comfortable. Language is
thoughtful and generally
supports the effectiveness of
presentation. Language
appropriate for audience.
Slightly over the duration
requirements but able to get
the main message across
within the time frame.
Delivery techniques make the
presentation difficult to
understand and speaker
appears tentative. Language is
mundane and generally does
not support the effectiveness
of presentation. Language is
not appropriate for audience.
Does not meet duration
requirements or does not
establish a clear message
within the time frame.
5.0 pts
3.0 pts
Exceeds
0.0 pts
No
Submission
References &
Support
(explanations,
examples,
illustrations,
statistics,
analogies,
quotations
from relevant
authorities)
2.0 pts
Met
Supporting materials make
appropriate reference to
information or analysis that
generally supports the
presentation or establishes
the presenter’s credibility /
authority on the topic. APA
style is used when
indicated with minor errors
in formatting.
No
assignment
turned in
A variety supporting
materials make
appropriate reference to
information or analysis
that significantly
supports the
presentation or
establishes the
presenter’s credibility /
authority on the topic.
APA style is used when
indicated.
1.0 pts
Not Met
Supporting materials make
appropriate reference to
information or analysis that
doesn’t support or partially
supports the presentation or
establishes the presenter’s
credibility / authority on the
topic. APA style is not used
when indicated or with major
errors in formatting.
3.0 pts
Visual
Materials
3.0 pts
Exceeds
2.0 pts
Met
0.0 pts
No
Submission
Highly effective use of
visuals that help audience
better understand the
presented materials and
especially the central
message. Visuals are all
explained.
Effective use of visuals
that help audience better
understand the presented
materials and especially
the central message. Some
visuals are explained.
1.0 pts
Not Met
Ineffective use of visuals that
distracts audience from
understanding the presented
materials and especially the
central message. Most
visuals are not explained.
No
assignment
turned in
3.0 pts
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Jun 6, 2024 | Health Medical
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Read the CDC document entitled Public Health Preparedness: Mobilizing State to State. There are nine preparedness goals in the background section. Choose one of the 5 public health emergencies listed below and write a 3000 word paper (plus or minus 10%) that briefly describes the incident and then how and why aspects of the incident were handled well or could have been handled better according to this document. Each of the nine main goals of the CDC document must be addressed in your paper. If a particular one does not apply, state why (with a detailed enough explanation to support your opinion) and move on. I expect that you will be able to discuss or cite relevant topics we cover in the course as evidence that you have read the material and are facile enough to write about the importance of this subject matter even if you are not an expert. Do not include irrelevant extraneous material. The paper should utilize APA format.
Topics:
1. H1N1 outbreak US 2009-2010
2. Flint, Michigan Lead-Water concerns 2015-16
3. Salmonella outbreak 2008-2009
4. Zika Outbreak in Central and South America 2015-16
5. US measles outbreak 1989-1991
6. Ebola outbreak in West Africa, and global response 2013-Present
Jun 6, 2024 | Health Medical
Description
Discussion 5 Legal Implication Competencies and Knowledge What competencies were you able to develop in researching and writing the course comprehensive project? How did you leverage knowledge gained in the intellipath assignments (Units 1– 4) in completing the comprehensive project? How will these competencies and knowledge support your career advancement in management?
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Discussion 5
Legal Implication Competencies and Knowledge
What competencies were you able to develop in researching and writing the course
comprehensive project? How did you leverage knowledge gained in the intellipath assignments
(Units 1– 4) in completing the comprehensive project? How will these competencies and
knowledge support your career advancement in management?
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Jun 6, 2024 | Health Medical
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Responses to classmate colleagues’ initial postings: Read a selection of your classmate’s postings and provide a substantive reply to your colleagues by Day 6, (Saturday), in one or more of the following ways, by: (a) expanding on your classmate colleague’s posting; (b) offering an insight from having read your classmate’s posting; (c) corroborating an idea from your own experience; (d) concurring or disagreeing by explaining why with supporting evidence or concepts from the readings or literature; (d) asking a probing question. You must provide response postings to at least three (3) classmate colleagues’ postings. Responses must contain 200–250 words (not including references) and at least 1 reference. References in the response postings will support response statements and assertions; and serve as an additional resource to fellow classmates. week 11
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Joshua Sayoc
Week 11
COLLAPSE
Common environmental hazards that require public health interventions
There are several environmental hazards that require public health intervention. We have
seen several instances of environmental hazards that necessitated public health
intervention over the past couple of years. One of the most recent instances of public health
intervention that happened earlier this year in several states across the country was due to
measles outbreak that has affected several communities and locals. Washington state’s
response to the measles outbreak was by passing legislation that removed religious or
personal belief vaccine exemptions from school vaccine requirements (La Corte, 2019).
Another common environmental hazard that requires public health intervention are
instances of water contamination that harm animals and humans that are exposed to the
contaminated water. A high profile and recent instance of water contamination unfolded
and is currently under investigation in Flint, Michigan where residents have been exposed
to lead and other contaminates in their water when the city’s water source changed in
2014. The CDC stepped in to assess the damage caused by the contaminated water, test the
water, and step up screening protocols for those affected by lead in their water (Ruckart et
al., 2019).
Preventing disease in wake of disasters
Considering environmental factors is especially important following a disaster, whether it
is man-made or natural. In instances of floods or hurricane’s or any event that brings
excess water it is crucial that health department, responders, and residents address all
pools of standing water. Leaving pools of standing water is a great environmental risk for
all of this in the affected community because of mosquito eggs that survive in standing
water, which leads to an increased number in the mosquito population, and possibly an
increase in disease such as malaria (“Zika Virus,” 2014).
In the aftermath of several disasters it may also be advisable to boil all water prior to
drinking to kill of contaminates that have entered the water supply. Water boil alerts are
issued to ensure that residents of the affected area do not become sick because they ingest
bacteria infected water. These types of advisories can go into effect following events such
as tornados or hurricanes, where debris from the high winds or flood water enters water
wells or sanitized water sources (US EPA, 2013).
La Corte, R. (2019, March). Washington House passes bill limiting vaccine exemptions.
Retrieved March 31, 2019, from The Seattle Times website:
https://www.seattletimes.com/seattle-news/bill-limiting-vaccine-exemptionspasses-washington-state-house/
Ruckart, P. Z., Ettinger, A. S., Hanna-Attisha, M., Jones, N., Davis, S. I., & Breysse, P. N. (2019).
The Flint Water Crisis: A Coordinated Public Health Emergency Response and
Recovery Initiative. Journal of Public Health Management and Practice : JPHMP,
25(Suppl 1 LEAD POISONING PREVENTION), S84–S90.
https://doi.org/10.1097/PHH.0000000000000871
US EPA, O. (2013, May 22). Tornadoes [Collections and Lists]. Retrieved November 6, 2019,
from US EPA website: https://www.epa.gov/natural-disasters/tornadoes
Zika Virus. (2014, November 5). Retrieved November 6, 2019, from CDC website:
https://www.cdc.gov/zika/vector/mosquitoes-and-hurricanes.html
Lorraine Ondrasik
Post 11-Lorraine Ondrasik-Environmental and Occupational Health Issues
COLLAPSE
Lorraine Ondrasik
Environmental Hazards
While common environmental hazards of food and water borne exposures, viral illnesses,
and bacterial possibilities are much more transparent and discussed for causation of
disease in the medical community; other exposures including toxin related chemical
exposures, or vector borne disease due to the effects of climate change possibilities are
rarely discussed amongst medical providers as having an effect on medical disease. I don’t
recall talking to my fellow providers in the office about the sudden increase in pediatric
asthma with relationship to the environment, but I will frequently refer the child to the
allergist for their opinion and testing options for the child only to find that testing even
with the most severe asthmatic rarely produces an etiology that can be treated. They don’t
discuss air quality with families, nor do they discuss use of protective options when the air
is obviously bad, and they never suggest staying inside on a day that is numbered as high
on the pollutant scale.
Vector borne illness such as the ZIKA outbreak of 2015 and other concerns for mosquito
carried diseases such as West Nile virus received attention, but internally only do we bring
warnings to the patients we saw during the heaviest reports of these concerns. Neither did
I see much warning to the public at large.
Lyme tick born illness has been getting a little more attention lately and the latest
recommendation to treat abruptly has helped mitigate more serious consequences of the
tick disease as it is studied in medical text promising to cause devastating neurological
consequences left untreated.
Other environmental health issues have been around for thousands of years. Rather than
claim the wrath of God in a certain Egyptian city, the 10 plagues beginning in 1279
BC onward, that greatly affected the inhabitants, have since been studied by scientists as
the effect of climate changes at that time and have woven into present day science the
theories they have now, and those that occurred than, and boil it down to the change in
increase carbon dioxide. (Ehrenkrantz, 2008). National geographic has put out a convincing
program as to this verification of this theory. In 1870 there was recognition of the elevation
of carbon dioxide in the air and that it caused recognizable climate change issues. Now that
the levels are higher and there is more concern for air quality, higher heat levels for longer
duration and even melting in the artic areas is blamed on the higher carbon dioxide/
diminishing ozone layer/ poor air quality, and this triad is blamed for global warming. It is
also subsequently demonstrating the presence of more illness, more vector born problems
and poor air quality causing specifically more respiratory problems.
A latest compilation of air quality related incidents indicate that the number of people
affected by disasters in 2016 was the highest it has been in the last decade, of which
hydrological, meteorological and climatological disasters comprised 90.9%(Banwell, 2018)
This does not include those biological hazards which are also influenced by climate change.
While the 8733 reported disaster deaths in 2016 was lower than in previous years, these
mortality rates reflect the tip of the iceberg in terms of health impacts of climate change
and disasters. (Banwell, 2018)
While It is important to look at environment health concerns and their epidemiology, it is
equally important to recognize that what ever theories are out there, and during the
controversies, that exist, that prevention is always going to be half the battle.
Prevention Options for Responders and Victims
To aid in prevention options, CDC scientists are tracking these developments closely, and
environmental tracking methods and results can be found on the CDC website,
www.EPHtracking.cdc.gov (Environmental Public Health Tracking). (CDC, 2017) There is
also tracking for the dangerous hazard’s responders face in specific types of environmental
disasters which are teaching aids for prevention for these responders. For recognition of
some of the hazards that responders can be subjected too in the field, there are over 50,000
types. The top 50 are named in the tracking guide. In addition, air quality started to become
noticeably bad in 1950 and in the 1990’s the issue started to be addressed. Safe drinking
water is easier for 90 % of people who drink regulated water systems but 10% of people
drink water from wells and findings can include Arsenic, BP, Nitrate, Tetrachloroethylene,
Radium Uranium and Trichloroethylene. (CDC, 2017) Pesticide exposure for spraying crops
is a chemical applied to foods in the fields where they are growing and that we buy in the
market and we are far from knowing the damage they are causing. Ultraviolet light rays are
affecting the increase of skin cancers and no doubt due to the ineffectual layer of protection
once afforded naturally by the ozone layer and consequently we must wear UV protection
afforded by creams and sprays. (CDC. 2017)
Furthermore, there are teaching guides to help responders learn the consequences of
exposures and how to protect themselves from them. Finally, protection from waste, and
chemicals exposures are important for responders to recognize in protecting themselves.
(WHO, 2018)
First responders also realize that the primary first needs of all victims include food safety
and security, water safety, air quality protection and other chemical pollution exposure
protection. Responders also recognize that the ultimate goad of families is to return to life
in their homes as they know it, so depending upon the disaster, teams are deployed to
communities to inspect damage, and repair as needed. (You-tube, Kansas, 2017)
The safety of responders is also a critical issue and in an article in MMRW 2006, a
surveillance summary after 9/11 shows the damage both to the victims rescued from the
twin towers an in total over 60,000 survivors including those responders who today
continue to suffer both from cancer related diseases, and others, and with sustained
respiratory damage due to prolonged poor air quality exposure. (MMRW, 2006)
In February 27,2003, many responders gathered at the RAND Corporation-National
Institute for Occupational Safety and Health workshop Protecting Emergency Responders
to discuss Safety Management in Major Disaster and Terrorism Response in Arlington, Va.
(Jackson, 2004)From the examples of several large-scale response operations (the
September 11 terrorist attacks, Hurricane Andrew, and the Northridge Earthquake), the
authors who compiled the results of this meeting were led to the conclusion that the
emergency response community should put in place structures and preparedness efforts
that will formalize an integrated, incident-wide approach to safety management at major
disaster response operations.
Any rescue response shows a planned cycle that includes information gathering, analyzing
data received, and taking immediate action. (WHO, 2017) The Occupational Safety Health
Administration (OSHA) got involved to further set high standards to protect responders
and have safety techniques in place and inside the ICS (Incident Command System). There
is an excellent cookbook instructional guide to specific teaching and reaction to specific
types of disaster responses for responders in the book entitled “Occupational Safety and
Health in Public Health Emergencies”, developed by WHO and ILO (International Labor
Office). Soon after that meeting, the International Health Regulations (IHR) were
recognized as a legal instrument that binds 196 countries and help the international
community to prevent and respond to acute public health risks that have the potential to
cross borders and threaten people world-wide. Within that pact, also binding is the
responsibility of these countries to report public health events to WHO and action then
begins as soon as possible both to protect responders and those affected. Then the ICS
(Incident Command System) is given the go ahead to react. (WHO, ILO, 2007)
.
References
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Banwell, N., Rutherford, S., Mackey, B., Street, R., & Chu, C. (2018). Commonalities
between disaster and climate change risks for health: A theoretical
framework. International journal of environmental research and public health, 15(3),
538.
Centers for Disease Control and Prevention (CDC). (2017). Better Information for Better
Health: CDC’s Environmental Public Health Tracking Program [Video file]. Retrieved
from https://www.youtube.com/watch?v=T1Ad79HGeJE
Ehrenkranz, N. J., & Sampson, D. A. (2008). Origin of the old testament plagues:
explications and implications. The Yale Journal of Biology and Medicine, 81(1), 31–42.
Jackson, B. A., Baker, J. C., Ridgely, M. S., Bartis, J. T., & Linn, H. I. (2004). Protecting
Emergency Responders, Volume 3: Safety Management in Disaster and Terrorism
Response. Santa Monica, CA: RAND
Corporation. https://www.rand.org/pubs/monographs/MG170.html
Kansas ESF-8. (2013). ESF-8: Environmental Health [Video file]. Retrieved
from https://www.youtube.com/watch?v=MKm7h6NgIjQ
Office of Disease Prevention and Health Promotion, U.S. Department of Health and
Human Services. (2019, July 12). 2020 Topics & Objectives: Environmental Health.
Retrieved from https://www.healthypeople.gov/2020/topicsobjectives/topic/environmental-health
World Health Organization (WHO). (2018). Occupational safety and health in public
health emergencies: A manual for protecting health workers and responders.
International Labor Office,
Geneva. https://www.who.int/occupational_health/Web_OSH_manual.pdf
Joselyn Carballo
Environmental Health
COLLAPSE
Environmental Hazards
Environmental health hazards can be substances or events that pose a threat to the natural environment or to
human health (Al-Sharqi, 2017). This term encompasses air pollution, natural disasters, and man-made
threats (Al-Sharqi, 2017). Typically, in cases of environmental hazards such as those listed, public health
interventions are required. For example, in the case of an existing biological threat, government agencies will
conduct investigations and reinforce that proper security protocols are followed in laboratories and
organizations containing confidential information and biological agents that could be used maliciously.
Importance of Environmental Health for Disease Prevention in the Wake of Disasters
The field of environmental health is essential to prevent and mitigate the effects of both natural and manmade disasters. According to the Office of Disease Prevention and Health Promotion, environmental health
aims to prevent and control any disease, disability, or injury that could occur as a result of the interactions of
humans with the environment. Within environmental health, there is ongoing surveillance of water quality,
air pollution, toxic substances and hazardous wastes. These surveillance efforts are important in ensuring
that human health is not affected in the case of different kinds of disaster. In the case of an outbreak, public
health officials would be able to respond quickly due to the surveillance efforts of environmental health
organizations and departments. Furthermore, the field of environmental health works to stay up to date with
the resources and planning that states, territories, and countries have in place to respond to climate change,
biological threats, and other types of disasters. Environmental Health also works directly and indirectly in
educating the public on topics such as water contamination, disposal of hazardous waste, climate change, and
many other topics that affect the relationship between humans and their environment.
Hazardous Exposures Associated with Public Health Disaster Response and Recovery Operations
When responding to public health disasters, there are many occupational hazards that public health
personnel need to keep in mind. First responders face various risks, including exposure to hazardous
substances, physical injury, and trauma (Jackson et al., 2004). The importance and limitations of
preparedness planning become evident when first responders are helping to carry out various response
efforts that expose them to risks that may not have been accounted for when planning. However, there are
also cases in which planning can make the difference between life and death for many of those assisting
affected populations. For example, providing updated training at regular intervals helps those that are
required to go into the affected area to treat victims, as well as remain vigilant of potential exposures to
disease, debris, and other risk factors. In the case of natural disasters, workers working to clean up debris can
be exposed to contaminated water, weak infrastructure, confined entryways, and exposure to biological and
chemical substances (Fardhosseini et al., 2015). Unexpected exposures to disease can be extremely
dangerous not only for the workers affected, but to the vulnerable populations they are assisting. Disease
outbreaks can be catastrophic in areas where resources are limited.
References:
Al-Sharqi, Anas H. (2017). Occupational Stress, And Sleep Quality On Fatigue Among Commercial Airline
Pilots- Based On Moderating Effects Of Job Related Factors. Occupational Medicine & Health Affair, 05(02). doi:
10.4172/2329-6879-c1-032
Fardhosseini, Mohammad Sadra, Esmaeili, Behzad, & Wood, Richard (2015). A Strategic Safety-Risk
Management Plan for Recovery After Disaster Operations. ResearchGate. Retrieved from
https://www.researchgate.net/publication/289254873_A_STRATEGIC_SAFETYRISK_MANAGEMENT_PLAN_FOR_RECOVERY_AFTER_DISASTER_OPERATIONS
Jackson, B. A., Baker, J. C., Ridgely, M. S., Bartis, J. T., & Linn, H. I. (2004). Protecting Emergency Responders,
Volume 3: Safety Management in Disaster and Terrorism Response. Santa Monica, CA: RAND Corporation.
https://www.rand.org/pubs/monographs/MG170.html
Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services. (2019,
July 12). 2020 Topics & Objectives: Environmental Health. Retrieved from
https://www.healthypeople.gov/2020/topics-objectives/topic/environmental-health
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Jun 6, 2024 | Health Medical
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This assignment is about the community of people who has G -Tube especially patients with cerebral palsy. The file attached below have the instructions for the assignment.Instructions: Choose the TOP priority problem for this community and identify one or more objectives for this community. Research evidence-based interventions that might assist you in achieving stated objective/s.
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Part 3: Planning for Community Change
Instructions: Choose the TOP priority problem for this community and identify one or more
objectives for this community. Research evidence-based interventions that might assist you in
achieving stated objective/s.
_______________________________________________________________________
Problem: _write identified problem here_____________________________________
Objective/s
Interventions
Evaluation
Create at least one objective for Evidence-based
•
List objective and
this community.
interventions that might help evaluate whether or not it
Must be SMART:
to achieve stated objective/s. was met.
S: Specific
**Provide rationale and
•
Report on successes
M: Measurable
citations for interventions. •
Report on barriers and
A: Achievable
limitations.
R: Realistic
•
Report on suggestions
T: Time oriented (remember,
for future projects.
you have a short time with this
community so keep this in mind
when creating objectives)
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Jun 6, 2024 | Health Medical
Description
please reply to the following two post 100 word each with one reference
#1
Dalia Mesa
The family nurse practitioner can work in a number of settings which include in clinics where they can provide their expertise to the community families. Nurse practitioners can also work in private offices and practice where they can render their expertise primarily and only to families that employ the use of the specific private practice. Subsequently nurse practitioners can also employ the use of hospice centers , nurse managed health centers , school clinics, home health care and community health centers. These are some of the many and central areas that the family nurse practitioner can practice and provide their working expertise.
Moreover the role that the family community nursing access model has and plays in healthcare is immense as it encomapssess and fills many aspects of the healthcare field. Subsequently, “An NP is an essential part of a transdisciplinaryhealth team. The combination of medical skills and nursing care provide a unique role that can fill gaps in many primary care settings, and improve patient outcomes.”(Wessel, n.d.g)
Reference
Wessel L, A (n.d.g)Nurse Practitioners in Community Health Settings Today. PDF
# 2
Discussion 7: Dayana De Leon
Community health nursing is an essential part of healthcare delivery, especially in vulnerable populations. Community nurses play a critical role in disease prevention, health promotion, healthcare follow-up, disability alleviation, and management of primary care. Community health nursing is made possible through the application of the community nursing practice model which combines the skills of social work, public health, and nursing in the improvement of healthcare conditions, alleviation of illnesses, and the rehabilitation of communities (Hartzler, Tuzzio, Hsu & Wagner, 2018). In particular, the elements of practice under the Community Nursing Practice Model can be used to ensure better health outcomes for underserved communities.
In underserved communities, the community health nursing model can be used to address healthcare disparities. Patients living in underserved communities share unequal burdens of mortality and morbidity because of discrimination, socio-economic marginalization, and other related factors. Community health nurses can achieve better health outcomes in underserved communities through several key elements of practice. These include assessment of population needs, identification of community health determinants, equitable implementation of health policies, and evaluation of community health initiatives.
Overall, the community healthcare model provides an avenue for healthcare stakeholders to build partnerships across a wide range of social-economic settings. The model provides a framework for healthcare delivery that builds upon community resources and local expertise. Extant research shows that the model is effective in the delivery of all types of care (Hartzler, Tuzzio, Hsu & Wagner, 2018). The one MSN essential that correlated with the Community Nursing Practice Model is Essential VIII which reads, Clinical Prevention and Population Health for Improving Health (American Association of Colleges of Nursing, 2017). The essential recognizes the need for master’s prepared nurses to design healthcare delivery models that are suited to individuals, families, and targeted communities.
References
American Association of Colleges of Nursing. (2017). The essentials of master’s education in nursing. March 21, 2011.
Hartzler, A., Tuzzio, L., Hsu, C., & Wagner, E. (2018). Roles and Functions of Community Health Workers in Primary Care. The Annals Of Family Medicine, 16(3), 240-245. doi: 10.1370/afm.2208
Jun 6, 2024 | Health Medical
Description
NSG/486: Public Health: Health Promotion And Disease Prevention
Wk 3 Assignment: Public Health Program Planning
Assignment Content
#1
Review the Healthy People 2020 Leading Health Indicators.
Select one leading health indicator and research a state-level health prevention program aimed at achieving it.
Locate your state’s vital statistics and/or census data to compare the outcomes of the selected leading health indicator.
Evaluate the state-level program’s effectiveness in meeting the Healthy People 2020 goals based on your statistical and census data findings.
Determine if there is evidence in your community of alignment to the Healthy People 2020 goals through local programs and funding.
Explain the evidence by providing links, a description, and summary of the program(s).
Format your assignment as one of the following:
-18- to 20-slide presentation
or
-875-word paper
******Please note the State that I live in Texas******
#2
NSG/486: Public Health: Health Promotion And Disease Prevention
Wk 3 Practice Learning Assignment: Morbidity and Mortality
Assignment Content
Develop a graphical representation showing the indicators of morbidity and mortality for the leading health indicator you selected for this week’s Public Health Program Planning assignment.
List a minimum of five indicators and provide a rationale for each.
Cite any gaps in programs to address the indicators.
Format your assignment as one of the following:
-Concept/mind map
-Matrix
-Chart
#3
On a separate page:
Respond to the following in a minimum of 175 words:
-As digital epidemiology becomes more prevalent, what are some of the ethical considerations of using big data in public health surveillance?
1 citation within the paper and cite using APA format
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Many States and Territories use Healthy People as a guide to improving health. Find your State or
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Each State and Territory has a Healthy People Coordinator who serves as a liaison with the Office of
Disease Prevention and Health Promotion (ODPHP). The Coordinator’s job is to ensure their State
or Territory’s plan is in line with Healthy People goals and objectives.
Find the Healthy People Coordinator in your State or Territory.
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Leading Health Indicators
Healthy People 2020 provides a comprehensive set of 10-year, national goals and objectives for
improving the health of all Americans. Healthy People 2020 contains 42 topic areas with more than
1,200 objectives. A smaller set of Healthy People 2020 objectives, called Leading Health Indicators
(LHIs), have been selected to communicate high-priority health issues and actions that can be taken
to address them.
Great strides have been made during the past decade: life expectancy at birth increased; rates of
death from coronary heart disease and stroke decreased. Nonetheless, public health challenges
remain, and significant health disparities persist.
Track Progress Toward LHIs!
Check out our interactive infographic to see the Nation’s progress toward each Leading Health
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The Healthy People 2020 LHIs place renewed emphasis on overcoming these challenges as we
track progress over the course of the decade. The indicators will be used to assess the health of the
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Jun 6, 2024 | Health Medical
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helloi need to do problem 1 and 2 ch13 make sure to use the format that i upload it and please use EXCEL just the excel doc will be expect for my assignment
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Problem 2. If a nursing home buys 500 syringes for $8 each, then uses 500,and then buys 500 more for $9 each,
what is the cost of the syringes used, and what is the value of the ending syringe inventory
Beginning
inventory
(BI)
+
Purchases
(P)
Perpetual Inventory
(BI) + (P) – (S) = ?
No usage
Beginning inventory
1st purchase
2nd purchase
Total
Beginning inventory
1st purchase
2nd purchase
Total
Weighted Average
Beginning inventory
1st purchase
2nd purchase
Total
Average cost
LIFO
Beginning inventory
1st purchase
2nd purchase
Total
Ending
inventory
(EI)
=
Periodic Inventory
(BI) + (P) – ? = (EI)
Purchase
Quantity
Unit
Cost
Total
Cost
–
Specific Identification Purchase
Quantity
Beginning inventory
1st purchase
2nd purchase
Total
0
FIFO
–
Units
sold/used
(S)
Purchase
Quantity
$0
Unit
Cost
Total
Cost
Unit
Cost
Total
Cost
Unit
Cost
Purchase
Quantity
–
0
Usage
Quantity
Total
Cost
$0
#DIV/0!
Unit
Cost
0
Usage
Quantity
$0
Total
Cost
0
Usage
Quantity
$0
Cost of
Usage
$0
Usage
Quantity
$0
Purchase
Quantity
Usage
Quantity
0
Cost of
Usage
$0
Cost of
Usage
$0
Cost of
Usage
$0
Cost of
Usage
$0
Quantity of
Ending
inventory
–
Cost of
Ending
inventory
$0
Quantity of
Ending
inventory
0
Quantity of
Ending
inventory
0
Quantity of
Ending
inventory
0
Quantity of
Ending
inventory
0
Cost of
Ending
inventory
$0
Cost of
Ending
inventory
$0
Cost of
Ending
inventory
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Jun 6, 2024 | Health Medical
Description
Nurse-Patient Communication, Interdisciplinary Communication, and Patient Safety (40 points)
**please use principles from your reading assignment to answer the questions that you will be addressing in your paper. You should have no more than 1 direct quote per page. This would allow you to critically think through the knowledge you have learned and put information into your own words with properly citing information.
This assessment requires you address the following topics:
• Define each of the seven principles of patient- clinician communication
• Explain how you apply three of these to your interactions with your own patients—use specific examples from your own clinical nursing practice.
• Describe the three methods being used to improve interdisciplinary communication
• Choose the one that you think applies best to your own area of practice, or the one that your area of practice currently uses, and clearly describe how you use it.
• Explain the ethical principles that can be applied to issues in patient-clinician communication
• Explain the importance of ethics in communication and how patient safety is influenced by good or bad team communication.
Overview
This assessment requires you address the following topics:
Define the seven principles of patient- clinician communication
Explain how you apply each of these to your interactions with your own patients
Describe the three methods being used to improve interdisciplinary communication
Choose the one that you think applies best to your own area of practice, or the one that your area of practice currently uses, and clearly describe how you use it.
Explain the ethical principles that can be applied to issues in patient-clinician communication
Explain the importance of ethics in communication and how patient safety is influenced by good or bad team communication
Make sure you also include a clear, separate introduction and conclusion as a part of this assignment, as these are worth separate points on the grading rubric.
References
Minimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)
Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.
Style
Unless otherwise specified, all the written assignment must follow APA 6th edition formatting, citations and references.
Number of Pages/Words
Unless otherwise specified all papers should have a minimum of 600 words (approximately 2.5 pages) excluding the title and reference pages
textbook: burkhardt &nathaniel (2013) ch 18,19,20
Jun 6, 2024 | Health Medical
Description
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.
Jun 6, 2024 | Health Medical
Description
Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of:Patient experiencePopulation healthCostsWork life of healthcare providers
Jun 6, 2024 | Health Medical
Description
Consider the following patient scenario:A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart). Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.
Jun 6, 2024 | Health Medical
Description
The submissions for this assignment are posts in the assignment’s discussion for this group.
Jun 6, 2024 | Health Medical
Description
Drugs in society exam which includes Matching, fill in the blanks, multiple choice, and short answer.
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Midterm Exam
Study Guide
Exam Format: Fill in the Blank, Short Answer, Multiple Choice
Terms (definitions)
1. Terms:
a. Legal Instrumental
b. Legal Recreational
c. Illegal Instrumental
d. Illegal Recreational
2. Drug Control:
a. Supply Reduction
b. Harm Reduction
c. Demand Reduction
3. Drug Terms:
a. Legalization
b. Decriminalization
c. Medicalization
Matching / Fill in the Blank / Multiple Choice
1. Drug/Brain Physiology (Neurons, receptors, neurotransmitters)
2. Theoretical models of addiction – moral, disease, social education,
personality
3. Dopamine pathway & Addiction (Physiology of addiction)
4. Definition / Warning signs of addiction
5. Prevention strategies / Types of prevention programs / Levels of prevention
6. Effective prevention vs. Ineffective prevention
7. Treatment options
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Jun 6, 2024 | Health Medical
Description
Descriptive epidemiology is used to evaluate trends in health and disease and to be able to make comparisons among the population and subgroups within countries; and to provide a basis for planning, provision, and evaluation of services.
As a health officer, you have been asked to collect information to characterize and summarize tuberculosis epidemic in your state.
Write a paper in which you do the following:
Discuss the pattern and distribution of the disease in the population of your state as well as subgroups within the state.
What recommendations would you make to your administrator based on your findings?
Describe the basic types of epidemiologic study designs that are used to test hypotheses, identify associations and establish causation.
Be sure you support essay with evidence from the literature.
Length: 2–3 pages, excluding title page and references.
Jun 6, 2024 | Health Medical
Description
Explain how interprofessional collaboration will help reduce errors, provide higher-quality care, and increase safety. Provide an example of a current or emerging trend that will require more, or change the nature of, interprofessional collaboration.
Jun 6, 2024 | Health Medical
Description
Discuss the role of public health in response to emerging infections and biological incidents?Guidelines:*Number of words should be 250 to 500. * References should be in APA style
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Chapter 11: Public Health Response to
Emerging Infections and Biological
Incidents
PHC 372: Public Health Outbreak and Disaster Management
1
Upon completion of this week’s assignments, you will be able to:
• Describe phases of a pandemic and associated public health responses.
• Describe types of chemical and biological agents and their public
health dangers.
• Explain the public health strategies used in containing chemical and
biological agents and their public health dangers.
• .وصف مراحل الوباء واالستجابات المرتبطة بالصحة العامة
• .وصف أنواع العوامل الكيميائية والبيولوجية ومخاطرها على الصحة العامة
• شرح استراتيجيات الصحة العامة المستخدمة في احتواء العوامل الكيميائية والبيولوجية وأخطار الصحة
.العامة
PHC 372: Public Health Outbreak and Disaster Management
2
Public Health Role
•
•
•
•
•
•
•
•
•
•
Develop and use multidisciplinary protocols for collaboration
Establish specific criteria for monitoring infections and activating surveillance
systems
Increase lab capacity and education microbiologists about reporting
Develop and activate diagnostic clinical and treatment protocols to improve
rapid reporting
Plan for and respond to pandemic influenza or biological incidents
تطوير واستخدام بروتوكوالت متعددة التخصصات للتعاون
وضع معايير محددة لرصد العدوى وتفعيل أنظمة المراقبة
زيادة القدرات المعملية وعلماء األحياء الدقيقة التعليم حول اإلبالغ
تطوير وتفعيل البروتوكوالت التشخيصية السريرية والعالجية لتحسين سرعة اإلبالغ
خطط لمواجهة األنفلونزا الجائحة أو الحوادث البيولوجية واالستجابة لها
PHC 372: Public Health Outbreak and Disaster Management
3
Public Health Role, cont.
•
•
•
•
•
Utilize and expand access to Health Alert Network (HAN)
Develop contingency plans for mass mortuary services
Train all health organizations required to deliver care
Communicate emergency instructions, prevention, control, and treatment
information
Resolve legal issues related to public health authority in emergencies
(Landesman, 2012, p. 259-260)
( استخدام وتوسيع الوصول إلى شبكة التنبيهات الصحيةHAN)
وضع خطط طوارئ لخدمات مشرحة جماعية
تدريب جميع المنظمات الصحية المطلوبة لتقديم الرعاية
التواصل مع تعليمات الطوارئ والوقاية والسيطرة والعالج
حل القضايا القانونية المتعلقة بسلطة الصحة العامة في حاالت الطوارئ
PHC 372: Public Health Outbreak and Disaster Management
4
Response to Unknown Disease
•
•
•
•
•
•
Public health department is first responder in cases of identifying infectious disease
Issues such as climate change, globalization, and inadvertent transport of vectors increase the
likelihood of health systems facing new or uncommon diseases
CBRNE (chemical, biological, radiological, nuclear, and high-yield explosive) events differ from
other types of disasters and require different preparedness approach
Likelihood of shortage of medical services, equipment, hospital beds
Prolonged demand for medical care as illness spreads
High demand for mortuary/funeral services
إدارة الصحة العامة هي المستجيب األول في حاالت تحديد األمراض المعدية
.تؤدي قضايا مثل تغير المناخ والعولمة والنقل غير المقصود للمتجهات إلى زيادة احتمال تعرض النظم الصحية ألمراض جديدة أو غير شائعة
تختلف أحداثCBRNE (.المواد الكيميائية والبيولوجية واإلشعاعية والنووية وذات اإلنتاجية العالية) عن األنواع األخرى من الكوارث وتتطلب نه ًجا مختلفًا للتأهب
أسرة المستشفيات، المعدات، احتمال نقص الخدمات الطبية
الطلب المطول على الرعاية الطبية مع انتشار المرض
الجنازة/ ارتفاع الطلب على خدمات الجنازة
PHC 372: Public Health Outbreak and Disaster Management
5
Public Health Response to Unknown Disease Outbreaks
• Detection of unusual events
كشف األحداث غير العادية
• Investigation and containment of potential threats
• التحقيق واحتواء التهديدات المحتملة
تنظيم الرعاية
• Organization of care
• Laboratory Capacity
القدرة المخبرية
• Coordination and communication
التنسيق واالتصال
(Landesman, 2012, p. 261)
PHC 372: Public Health Outbreak and Disaster Management
6
Stages of a Pandemic
Interpandemic period
فترة ما بين الفاشيات
Phase
Characteristics
1
No new influenza virus subtypes have been detected in humans. Flu virus subtype that has caused
human infection may be present in animals; if so, risk of human infection is low.
قد يكون نوع الفيروس الفرعي الذي تسبب في العدوى البشرية موجودًا في الحيوانات ؛ إذا كان.لم يتم اكتشاف أي نوع جديد من فيروسات اإلنفلونزا في البشر
. فإن خطر العدوى البشرية منخفض، األمر كذلك
2
No new influenza virus subtypes have been detected in humans. Circulating animal influenza virus
subtype poses substantial risk of human disease.
. ينتقل النوع الفرعي لفيروس األنفلونزا الحيواني الخطر الكبير من األمراض البشرية.لم يتم اكتشاف أي نوع جديد من فيروسات اإلنفلونزا في البشر
Pandemic alert period
فترة التنبيه الجائحة
3
Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of
spread to a close contact.
. أو في معظم الحاالت النادرة من االنتشار إلى اتصال وثيق، ولكن ال ينتشر من إنسان آلخر، العدوى البشرية مع نوع فرعي جديد
4
Small cluster(s) with limited human-to-human transmission, but spread is highly localized, suggesting
that the virus is not well adapted to humans. ولكن، المجموعة (المجموعات) الصغيرة ذات االنتشار المحدود من إنسان إلى إنسان
. مما يشير إلى أن الفيروس غير مهيأ بشكل جيد للبشر، انتشارها مترجم إلى حد كبير
5
Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming
increasingly better adapted to humans, but may not yet be fully transmissible (substantial
pandemic risk). لكنه قد ال يكون قابال، مما يشير إلى أن الفيروس يتكيف بشكل أفضل مع البشر، لكن انتشارها من إنسان آلخر ما زال محليا، كتلة (أو مجمعات) أكبر
.لالنتقال بشكل كامل
.)خطر الوباء
Pandemic period فترة
الجائحة
6
Pandemic; increased and sustained transmission in general population جائحة؛ انتقال متزايد ومستمر في عموم السكان
Postpandemic period
فترة ما بعد
الوباء
PHC 372: Public
Outbreak
Disaster
Return to the interpandemic
periodHealth
(Phase 1).
.)1 المرحلةand
( الوباء
فترة ما بينManagement
العودة إلى
7
Chemical or Biological Warfare
•
•
Threat of chemical or biological warfare (CBW) attack is growing as terrorist
activity increases
Covert releases – no prior warning; biological agent presents as illness in community
•
•
•
Likely to be no immediate impact due to incubation period of disease
Could spread to other geographical areas during incubation period
Public health response – will need to quickly determine that an attack has occurred, identify the
organism, and prevent more casualties through prevention strategies
•
• ( يتنامى خطر الحرب الكيماوية أو البيولوجيةCBW) كلما ازداد النشاط اإلرهابى
• ال يوجد تحذير مسبق يعرض العامل البيولوجي كمرض في المجتمع- اإلصدارات السرية
• من المحتمل أال يكون هناك تأثير مباشر بسبب فترة حضانة المرض
• يمكن أن ينتشر إلى مناطق جغرافية أخرى خالل فترة الحضانة
ومنع وقوع المزيد من الضحايا من خالل استراتيجيات، وتحديد الكائن الحي، ستحتاج إلى تحديد سرعة وقوع الهجوم- استجابة الصحة العامة
الوقاية
PHC 372: Public Health Outbreak and Disaster Management
8
Critical Biological Agents
CDC identifies three major categories of high-priority agents:
• Category A – pose the highest risk because they include organisms or toxins that poses the
highest risk to the public and national security because they can be easily spread from person
to person, result in high death rates, might cause public panic, and require special action for
public health preparedness
• E.g., anthrax, botulism, smallpox, pneumonic plague
• Category B – are moderately easy to spread, result in moderate illness and low death rates,
and require specific enhancements of CDC’s laboratory capacity and enhanced disease
monitoring
• E.g., ricin, typhus fever, encephalitis, salmonella
•
•
تحددCDC :ثالث فئات رئيسية من العوامل ذات األولوية العالية
مما يؤدي إلى ارتفاع، تشكل أعلى درجة من المخاطر ألنها تشمل الكائنات أو السموم التي تشكل أكبر خطر على األمن العام والوطني ألنه يمكن أن ينتشر بسهولة من شخص إلى آخر- الفئة أ
ويتطلب اتخاذ إجراء خاص للتأهب للصحة العامة، ذعرا عا ًما
ً وقد يسبب، معدالت الوفيات
•
الطاعون الرئوي، الجدري، التسمم الغذائي، الجمرة الخبيثة، على سبيل المثال
•
وتتطلب تحسينات محددة للقدرات المختبرية لمراكز السيطرة على األمراض وتعزيز رصد، وينتج عنها مرض معتدل ومعدالت وفيات منخفضة، يسهل انتشارها بشكل معتدل- )الفئة (ب
األمراض
•
الريسين وحمى التيفوئيد والتهاب الدماغ والسالمونيال، على سبيل المثال
PHC 372: Public Health Outbreak and Disaster Management
9
Critical or Biological Agents, cont.
•
Category C – include emerging pathogens that could be engineered for
mass spread in the future because they are easily available, easily produced
and spread, and have the potential for high morbidity and mortality rates
and major health impact
(Landesman, 2012, p. 271-272)
، تشمل مسببات األمراض الناشئة التي يمكن هندستها لالنتشار الشامل في المستقبل ألنها متاحة بسهولة ويسهل إنتاجها وانتشارها- الفئة جيم
ولديها إمكانات عالية لمعدالت المراضة والوفاة والتأثير الصحي الرئيسي
PHC 372: Public Health Outbreak and Disaster Management
10
Biological Incident Response Plan
Biological Incident Annex (BIA) – outlines federal response framework, including actions, roles,
and responsibilities
• Threat detection/assessment using disease surveillance and environmental monitoring
• Procedures to identify and notify at-risk populations
• Investigation and response procedures
• Epidemic control
• Recovery activities
•
( ملحق الحوادث البيولوجيةBIA) – بما في ذلك اإلجراءات واألدوار والمسؤوليات، يحدد إطار االستجابة الفيدرالية
•
تقييم التهديد باستخدام مراقبة األمراض والرصد البيئي/ كشف
•
إجراءات لتحديد وإبالغ السكان المعرضين للخطر
•
إجراءات التحقيق واالستجابة
•
السيطرة على الوباء
•
أنشطة االسترداد
PHC 372: Public Health Outbreak and Disaster Management
11
Federal Response
Response Chronology – HHS
• Notification of threat of biological incident or disease outbreak
• Collaboration with relevant agency partners to assess situation and determine appropriate actions
• Identification affected population and geographic scope
• Initiation of protective measures for everyone affected
• Targeted epidemiological investigation
• Dissemination of safety information and necessary medical precautions
• Intensified syndromic surveillance
• Organization and potential deployment of federal public health and medical response assets
•
•
– كرونولوجيا االستجابةHHS
•
اإلخطار بالتهديد الحادثة البيولوجية أو تفشي المرض
التعاون مع الشركاء المعنيين من الوكاالت لتقييم الوضع وتحديد اإلجراءات المناسبة
•
تحديد السكان المتضررين والنطاق الجغرافي
•
الشروع في اتخاذ تدابير وقائية لجميع المتضررين
•
االستقصاء الوبائي المستهدف
•
نشر معلومات السالمة واالحتياطات الطبية الالزمة
•
المتالزمة المكثفة
المراقبة
ِ
•
تنظيم ونشر أصول الصحة العامة واالستجابة الطبية الفيدرالية
PHC 372: Public Health Outbreak and Disaster Management
12
Controlling the Epidemic
HHS will:
• Assist with epidemic surveillance and coordination
• Assess the need for increased surveillance
• Make recommendations regarding need for:
•
•
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Isolation
Quarantine
Social-distancing
•
•
•
سوفHHS:
المساعدة في مراقبة وتنسيق الوباء
•
تقييم الحاجة لزيادة المراقبة
:تقديم توصيات بشأن الحاجة إلى
•
عزل
•
الحجر الزراعي
•
االجتماعي التباعد
PHC 372: Public Health Outbreak and Disaster Management
13
Regional Planning
Regional agreements should plan for coordination between agencies and government, roles,
chain of command, reimbursement, distribution of scarce resources, information management
strategies, and maintenance, inventory, and supply of response equipment
Preparation can be modeled after pandemic influenza planning
Should plan for three levels of response:
• Incidents with: up to 100 victims, 100-10,000 victims, and more than 10,000 victims
• How to obtain and distribute vaccines and antiobiotics
Planning for surge capacity
•
•
•
•
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واستراتيجيات، وتوزيع الموارد النادرة، والسداد، وسلسلة القيادة، واألدوار، ينبغي لالتفاقات اإلقليمية التخطيط للتنسيق بين الوكاالت والحكومة
وتوريد معدات االستجابة، والمخزون، والصيانة، إدارة المعلومات
•
يمكن إعداد النموذج على غرار التخطيط لألنفلونزا الجائحة
•
:يجب التخطيط لثالثة مستويات من االستجابة
•
ضحية10000 وأكثر من، ضحية10000-100 ، ضحية100 الحوادث مع ما يصل إلى
•
كيفية الحصول على وتوزيع اللقاحات ومضادات الحيوية
•
التخطيط لزيادة القدرة
PHC 372: Public Health Outbreak and Disaster Management
14
Defining Biological Events
“A possible bioterrorism event includes one of the following:
•
•
•
A single, definitively diagnosed or strongly suspected case of an illness caused by a recognized
bioterrorism agent occurring in a patient without a plausible explanation for his or her illness
A cluster of patients presenting with a similar clinical syndrome with either unusual
characteristics (age distribution), or unusually high morbidity or mortality without an obvious
etiology or explanation
An unexplained increase in the incidence of a common syndrome above seasonally expected
levels”
• :يشمل حدث اإلرهاب البيولوجي المحتمل أحد ما يلي
•
تم تشخيصها بشكل نهائي أو مشكوك فيها بشدة بسبب مرض ناجم عن عامل إرهاب بيولوجي معترف به يحدث في مريض دون، حالة مرضية واحدة
تفسير معقول لمرضه
•
أو معدالت مراضة أو وفيات عالية بشكل، )مجموعة من المرضى الذين يعانون من متالزمة سريرية مشابهة إما بخصائص غير عادية (التوزيع العمري
غير عادي دون وجود سبب واضح أو تفسير
• ” ً زيادة غير مبررة في حدوث متالزمة مشتركة فوق المستويات المتوقعة موسميا
PHC 372: Public Health Outbreak and Disaster Management
15
Detecting and Responding to Biological Events
•
•
Accurate diagnosis may be delayed since many biological events have similar symptoms
to flu initially
Full mobilization is necessary
• Suspected samples sent to labs for rapid confirmation of bioterrorism agents
• Deploying active surveillance and epidemiological teams
• Ensuring isolation, other necessary precautions
• Initiating treatment and prevention measures
• Launching pre-established communication protocols between agencies, government, and the
public
•
قد يتأخر التشخيص الدقيق ألن العديد من األحداث البيولوجية لديها أعراض مشابهة لإلنفلونزا في البداية
•
التعبئة الكاملة ضرورية
•
أرسلت عينات مشتبه بها إلى المختبرات للتأكيد السريع لعوامل اإلرهاب البيولوجي
•
نشر فرق المراقبة واألوبئة النشطة
•
االحتياطات األخرى الضرورية، ضمان العزل
•
الشروع في إجراءات العالج والوقاية
•
إطالق بروتوكوالت اتصال سابقة التأسيس بين الوكاالت والحكومة والجمهور
PHC 372: Public Health Outbreak and Disaster Management
16
Active Surveillance and Epidemiological Investigations
•
•
For rapid surveillance, tools and materials must be prepared in advance, including:
•
Questionnaires to determine care and risk exposure
•
Sampling strategy
•
Centralized database
•
Mechanism to call and deploy teams to conduct surveillance
Public health will track cases and perform epidemiological investigations
•
Implement active hospital-based surveillance
•
Enhance passive surveillance
•
Contact tracing
•
Coordination with poison control
•
: بما في ذلك، يجب إعداد األدوات والمواد مسبقًا، للمراقبة السريعة
•
استبيانات لتحديد الرعاية والتعرض للمخاطر
•
استراتيجية أخذ العينات
•
قاعدة بيانات مركزية
•
آلية الستدعاء ونشر فرق إلجراء المراقبة
•
ستتتبع الصحة العامة الحاالت وتجري تحقيقات وبائية
•
تنفيذ المراقبة النشطة المستندة إلى المستشفى
•
تعزيز المراقبة السلبية
•
االتصال تتبع
•
التنسيق مع مكافحة السموم
PHC 372: Public Health Outbreak and Disaster Management
17
Mass Medical and Mortuary Care
•
•
Guidelines needed for:
• Care of exposed patients
• Managing the media and informing the public
• Plan for mass antibiotic prevention or immunization
Hospital preparedness
• Surge capacity – bed shortages, mass-number triage, staff shortages
• Medical protocols – stockpiling of medications and vaccines, procedures for contact with
potentially exposed patients, rapid screening, standard precautions (such as masks)
•
•
:المبادئ التوجيهية الالزمة من أجل
•
رعاية المرضى المعرضين
•
إدارة وسائل اإلعالم وإعالم الجمهور
•
خطة للوقاية من المضادات الحيوية الشامل أو التحصين
•
االستعداد في المستشفى
•
ونقص في الموظفين، وفرز عدد جماعي، نقص في الفراش- قدرة الطفرة
) االحتياطات القياسية (مثل األقنعة، الفحص السريع، إجراءات االتصال مع المرضى المعرضين للخطر، تخزين األدوية واللقاحات- البروتوكوالت الطبية
PHC 372: Public Health Outbreak and Disaster Management
18
Point of Distribution (POD)
•
•
Facilitate distribution of medicine or vaccines
POD activities:
•
Screening
•
Registration
•
Triage
•
Briefings on risk of exposure, symptoms, side effects of antibiotics
•
Specimens collection
•
Dispensing station
•
Counseling
•
Security at entrance, exit, and pharmaceutical supply area
•
Space to fill out forms and conduct interviews
تسهيل توزيع األدوية أو اللقاحات
أنشطةPOD:
تحري
التسجيل
نخب
جلسات إعالمية عن مخاطر التعرض لألعراض واألعراض واآلثار الجانبية للمضادات الحيوية
جمع العينات
محطة االستغناء
تقديم المشورة
األمن عند الدخول والخروج ومنطقة إمدادات األدوية
مساحة لملء النماذج وإجراء المقابالت
PHC 372: Public Health Outbreak and Disaster Management
19
Laboratory Response Network (LRN)
•
•
•
•
Function is to assist in U.S. response to biological and chemical terrorism
Network of approximately 169 biological and 54 chemical laboratories with capacity to respond to acts of
CBW, emerging infectious diseases, and other public health threats
LRN assists by identifying disease, providing direct and reference services, and conducting rapid testing
Three levels:
•
Sentinel – hospital-based labs; might be first to identify suspicious specimen
•
Reference – can perform tests to detect and confirm the presence of a threat agent
•
National – part of the CDC and USAMRIID; handle the most dangerous agents which have the highest risk of lifethreatening disease
•
•
الوظيفة هي المساعدة في االستجابة األمريكية لإلرهاب البيولوجي والكيميائي
مختبرا ً كيميائيا ً لديها القدرة على االستجابة ألفعال54 مختبرا ً بيولوجيا ً و169 شبكة تضم حواليCBW وغيرها من التهديدات الصحية العامة، واألمراض المعدية الناشئة،
•
يساعدLRN عن طريق تحديد المرض وتقديم الخدمات المباشرة والمرجعية وإجراء االختبارات السريعة
•
:ثالثة مستويات
ً مختبرات في المستشفيات ؛ قد يكون- الحارس
•
أوال لتحديد العينة المشبوهة
•
يمكن إجراء اختبارات لكشف وتأكيد وجود عامل تهديد- المرجع
•
National – جزء منCDC وUSAMRIID؛ التعامل مع أخطر العوامل التي لديها أعلى خطر من األمراض التي تهدد الحياة
PHC 372: Public Health Outbreak and Disaster Management
20
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Jun 6, 2024 | Health Medical
Description
This week you will examine your current eating habits. The key to completing this assignment is starting it early in the week. You will be required to log in all your food for 3 consecutive days and then analyze the outcomes. I would highly recommend you use My Fitness Pal (Links to an external site.) to track your food, however you can use a different program or app if you are comfortable with that.
Nutrition Assignment Chart.docx – Fill in all the spaces on the chart in calories not in grams
The grams must be converted to calories in order to fill out this chart.
Nutrition Assignment Example.docx – Here I have completed the nutrition data chart based on 3 days of food consumption taken from My Fitness Pal
Nutrition Assignment Rubric.pdf – This is how you will be graded on the assignment
How to use My FItness Pal.docx
*** You will submit 3 documents – 3 day food log (from My Fitness Pal – you may want to screen shot each day), nutrition chart, and essay ***
WHAT YOU NEED TO DO:
1. 3 day food log you can do thorugh My Fitness Pal (Links to an external site.) 2. Nutrition chart you can do on here Nutrition Assignment Chart.docx – 3. For the essay you need to do 1 page double spaced regarding what you discovered about your diet and talk about How your macronutrient percentages (percentage of carbs, fat, and protein) compare to what is recommend for you and How your total calories compare to what is recommend for you?
Jun 6, 2024 | Health Medical
Description
After reading Chapter 13 and reviewing the lecture powerpoint (located in lectures tab), please answer the following questions. Each question must have at least 3 paragraphs and you must use at 3 least references (APA) included in your post.1. Describe at least 3 nursing care delivery models.2. Describe communication strategies for effective interprofessional teams.3. Describe the behaviors that are important to demonstrate when working within a team to enhance teamwork and collaboration in the context of quality and safety.
Unformatted Attachment Preview
Chapter 13
Teamwork and
Collaboration in
Professional Nursing
Practice
Healthcare Delivery System
• Population shifts
• Cultural diversity
• Patterns of diseases
• Advances in technology
• Economic changes
Models of Care
• Healthcare system models:
– Chain of command
– Complex adaptive systems (CASs)
• Nursing models of patient care:
– Team nursing
– Total patient care
– Case management
Roles of the Professional Nurse
• Caregiver
• Manager
• Advocate
• Collaborator
• Educator
• Researcher
• Leader
Teamwork and Collaboration
• Refers to functioning effectively within
nursing and interprofessional teams,
fostering open communication, mutual
respect, and shared decision making to
achieve quality patient care (QSEN, 2007)
Collaborative Practice Goals
• Improve client satisfaction with care
• Enhance continuity across continuum of care
• Provide research-based, high-quality, costeffective care that is driven by expected outcomes
• Promote mutual respect and communication
between clients and healthcare team members
• Provide opportunities to resolve issues and solve
problems
Levels on the Continuum of
Collaboration
Information exchange
Consultation
Referral
Lowest Level _______________________________________________________Highest Level
Communication
Coordination of care
Co-management
between patient and
each professional
Interprofessional Collaborative
Practice Domains
• Values/ethics for interprofessional practice
• Roles and responsibilities for collaborative
practice
• Interprofessional communication practices
• Interprofessional teamwork and team-based
practice
Interprofessional Team
Communication
• TeamSTEPPS (Team Strategies and Tools to
Enhance Performance and Patient Safety)
• SBAR (Situation, Background, Assessment,
and Recommendation)
• Cross-monitoring
• CUS (Concerned, Uncomfortable, Safety)
• Call out, check back, and 2-challenge rule
Team Performance
• Groupthink
• Excessive authority gradients
• Excessive courtesy
• Performance-shaping behaviors
Barriers to Interprofessional
Communication and Collaboration
• Cultural differences, gender differences,
generational differences, personality differences
• Hierarchy, organizational culture, differences in
schedules and routines, differences in jargon,
professional rivalry, disruptive behavior
• Differing values and expectations, varying
qualifications and status, and complexity of care
requiring rapid decision making
UQ Interprofessional Practice: Harness
the Power of Healthcare Teams Video
https://youtu.be/iLwFrMYttz4
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Jun 6, 2024 | Health Medical
Description
This home work is on nursing care plan. I will upload all the instructions later.
Unformatted Attachment Preview
NURS 411 – Concept Map Project – Word
ences
Mailings
Review
View
Help
Tell me what you want to do
Nursing
10 points
Nursing Interventions with Rationale
Identify 5 interventions for each nursing
diagnosis. Be sure to support your
rationale with references
(text & journal articles).
mundo points
Pharmacology
Identify all pharmacological agents
involved in the care of the client.
10 points
Pathophysiology
Identify the physiology of primary and
secondary diagnosis. Make sure that you
explain the disease process and how the
nursing diagnosis relates,
CONCEPT MAP
20 points
Display all medical diagnoses in a circle at the center of your map.
Display all nursing diagnoses in boxes around the circle.
Be sure to include relevant data to support the relationship
among the primary and secondary diagnoses.
This should include lab data, pharmacology, and assessment data.
Use arrows to show relationships among the diagnosis
Mailings
Review
View Help
Tell me what you want to do
Grading Rubric for Concept Map Project
This assignment has a total point value of 100 and is worth 15 % of your grade.
Submit this grading tool with your Concept Map Project
Criteria
Possible Points
Your Grade
Diagnosis
mmmll points
Nursing and Medical Diagnoses
Identify primary diagnosis and at least
two secondary medical diagnoses.
Identify and prioritize 3 nursing diagnoses
w points
Data to Support Diagnoses
Objective and subjective data that
supports the nursing diagnoses chosen.
(health assessment data)
wo points
Relationship between diagnoses
Identify the relationship among
the
primary and secondary medical diagnoses
Variables
Identify stressors for each of the following variables
Physiological
5 points
Psychological
5 points
Socioeconomic
w points
Cultural
points
Spiritual
me points
Client
5 points
Patient Profile
List all pertinent demographic data
including age and sex
ayout
NURS 411 – Concept Map Project
References
Word
Mailings
Review
View
Help
Tell me what you want to do
School of Professional Studies
Department of Nursing
NURS 410/411
Concept Map Project
This assignment has a total point value of 100 and is worth 15% of your Assignment grade.
Submit project on a poster board.
Select a client for whom you have provided care to complete your project. The client should
have both primary and secondary diagnoses to qualify for the study. Present the client’s profile
including all pertinent demographic data. Identify and prioritize 3 nursing diagnoses.
Describe the relationship among the primary and secondary diagnoses.
Identify the five stressors: physiological, psychological, socioeconomic, cultural and spiritual.
Construct a map to display all the medical diagnoses in a circle at the center of your map.
Display all nursing diagnoses in boxes around the circle, using arrows to show relationship
among the diagnoses. Be sure to include relevant data to support the relationship among the
primary and secondary diagnoses. This should include assessment data, lab data, and
pharmacological agents. Describe the pathophysiology of each diagnosis.
The map must be clear and concise.
Q
va
W
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Jun 6, 2024 | Health Medical
Description
Answer the following questions;Mention and discuss the Healthy People 2020 wellness goals and objectives for older adults.Define and discuss the aging process and the demographic characteristics of the elderly population in your community.Identify and discuss nursing actions that address the needs of older adults.Mention and discuss health/illness concerns common to the elderly population.A minimum of 3 evidence-based references besides the class textbook no older than 5 years must be used and quoted according to APA guidelines and must be from a gerontology journal. A minimun 800 words
Jun 6, 2024 | Health Medical
Description
For the article, you need to critique a peer reviewed nursing journal that is no older than 3-5 years. Select articles that are related to one of these topics: End of Life Care, Palliative Care, Ethical issues related to End of Life Care.
The article review should be 2-3 pages long (if you go a little over that’s ok; if your review is shorter than 2 pages or longer than three, you may lose points).Please make sure that you use double spacing.Your review is worth 15% of your final grade.
I will be looking for the following things when I grade:
Bibliographic Information:
You can either make this the subtitle of your assignment or you can incorporate this information into the first sentence or two of the review. There is no need for a separate works cited page.
If incorporating into a sentence: include Last name, First name. (Year) “Title of Article” Title of JournalVolume (Number): page spread (e.g. 4-20).
A BRIEF summary of the article:
You should summarize the main points the author discusses.
Make it clear what the author’s central argument is.
This summary is only to give the necessary background for the analysis you will give, not the main thrust of your review.You will be able to include more detailed information in the course of actually critiquing the article.Your summary should not take up more than a half page or so.
A detailed analysis of the article.
The is the most important part of the review and where most of the points will be allocated.
You need to show that you have read the article and that you have thought critically about the content.
When assessing the authors point of view, think about the following:
Is the argument made clearly?
Does the author support their opinions with clear explanations?
Does the authors view align with what you know about this topic?
What is the intended audience for this article?
Does the author give sufficient background information?
IS the article convincing? Why? Or why not?
If you disagree with the author, why, what changes would you propose?
Use these questions as a guideline and not a list of questions that you must answer.
Finally indicate how the results will impact nursing practice- be specific with four or more implications.
Give thought to how you will organize your review; don’t just list ideas as they come to you. The assignment needs to flow logically from one idea to the next.It needs to be presented chronologically in the order in which the information was presented in the article.Don’t jump from topic to topic. Try to stick to one idea per paragraph.
When doing an article review, please keep in mind that there is no right or wrong answer.As long as you can support what you are saying with evidence from the article you are entitled to your opinion.
Unformatted Attachment Preview
RUBRIC Article Review
Essential components
Excellent
Good
Satisfactory
Poor
20
Bibliographic
material
20
Includes: author
(Last name, First
name); publication
year; “Title of
Article”; Name of
Journal; Volume;
Number: page
spread (e.g. 4-20).
18
Includes six of these:
author
(Last name, First
name); publication
year; “Title of Article”;
Name of Journal;
Volume; Number:
page spread (e.g. 420).
16
Includes five of
these: author
(Last name, First
name); publication
year; “Title of
Article”; Name of
Journal; Volume;
Number: page
spread (e.g. 4-20).
0
Includes less than
five of these:
author
(Last name, First
name); publication
year; “Title of
Article”; Name of
Journal; Volume;
Number: page
spread (e.g. 4-20).
20
Article
summary
20
Summarize the
author’s main
points and clearly
describe the
author’s central
argument
18
Summarize the
author’s main points
and somewhat
describes the
author’s central
argument
16
Summarize the
vaguely describes
the author’s
central argument
30
Article analysis
28
Analyze the article
including the intended
audience; your
current understanding
of the author’s central
argument; and
suggestions you
would make to the
author
26
Describes the
article and
somewhat
indicates the
author’s central
argument and its
congruence with
current literature
30
Implications for
nursing
practice
20
Critically analyze
the article
including the
intended audience;
how well the
central argument is
clearly explained;
is it congruent with
current literature;
your agreement
with the argument;
and suggestions
you would make to
the author
30
Explains four or
more implications
of the results for
nursing practice
0
Does not
summarize the
author’s main
points and does not
describe the
author’s central
argument
0
Does not clearly
describes the
article
28
Explains three
implications of the
results for nursing
practice
26
Explains two
implications of the
results for nursing
practice
100
TOTAL
0
Does not connect
results to nursing
practice
CUNY SPS NURS 312 Article Review Instructions
The purpose of this assignment is to stimulate your thinking about the secondary literature that you
read. Taking a critical look at the literature we read can help us to avoid relying on any untrustworthy
sources and can help to examine our own thoughts about what we read.
For the article, you need to critique a peer reviewed nursing journal that is no older than 3-5 years.
Select articles that are related to one of these topics: End of Life Care, Palliative Care, Ethical issues
related to End of Life Care.
The article review should be 2-3 pages long (if you go a little over that’s ok; if your review is shorter than
2 pages or longer than three, you may lose points). Please make sure that you use double spacing. Your
review is worth 15% of your final grade.
I will be looking for the following things when I grade:
1. Bibliographic Information:
a. You can either make this the subtitle of your assignment or you can incorporate this
information into the first sentence or two of the review. There is no need for a separate
works cited page.
b. If incorporating into a sentence: include Last name, First name. (Year) “Title of Article”
Title of Journal Volume (Number): page spread (e.g. 4-20).
2. A BRIEF summary of the article:
a. You should summarize the main points the author discusses.
b. Make it clear what the author’s central argument is.
c. This summary is only to give the necessary background for the analysis you will give, not
the main thrust of your review. You will be able to include more detailed information in
the course of actually critiquing the article. Your summary should not take up more
than a half page or so.
3. A detailed analysis of the article.
a. The is the most important part of the review and where most of the points will be
allocated.
b. You need to show that you have read the article and that you have thought critically
about the content.
c. When assessing the authors point of view, think about the following:
i. Is the argument made clearly?
ii. Does the author support their opinions with clear explanations?
iii. Does the authors view align with what you know about this topic?
iv. What is the intended audience for this article?
v. Does the author give sufficient background information?
vi. IS the article convincing? Why? Or why not?
vii. If you disagree with the author, why, what changes would you propose?
d. Use these questions as a guideline and not a list of questions that you must answer.
4. Finally indicate how the results will impact nursing practice- be specific with four or more
implications.
Give thought to how you will organize your review; don’t just list ideas as they come to you. The
assignment needs to flow logically from one idea to the next. It needs to be presented chronologically in
the order in which the information was presented in the article. Don’t jump from topic to topic. Try to
stick to one idea per paragraph.
When doing an article review, please keep in mind that there is no right or wrong answer. As long as
you can support what you are saying with evidence from the article you are entitled to your opinion.
372
Schedule With Abstracts
This session will highlight current evidence supporting MBE in healthcare, as well as ongoing work by
palliative care programs with trainees and interprofessional teams. Finally, we will demonstrate examples of
art-based teaching strategies with audience participation such that participants may begin to design MBE
programs tailored to their home institution.
Partnerships in Dialysis and Palliative
Care & Hospice: ‘Innovative Models for
End-of-Life Care for End-Stage Renal
Disease Patients’ (TH315)
Keith Lagnese, MD FACP HMDC, University of Pittsburgh School of Medicine, Pittsburgh, PA. Jane Schell,
MD, University of Pittsburgh, Pittsburgh, PA.
Objectives
Describe the end of life outcomes for end stage
renal disease (ESRD) patients and the need for
innovative models of care for this population.
Dialysis organization perspective: Describe an
Innovative Model for concurrent hospice and
dialysis patients.
Hospice organization perspective: Expanding Access for ESRD patient’s within Current Medicare
Hospice Benefit (MHB)
As multiple different studies and surveys continue to
illustrate, palliative and hospice medicine has failed
to have an appropriate impact on the quality of life
for the end-stage renal disease (ESRD) population.
People with Chronic Kidney Disease (CKD) remain
less likely to die at home, spend more time in the hospital and at higher costs in the last 3 months of life.
(Kerr M et al, NDT, 2016).
The tide does to be slowly changing ‘upstream’ as
aggressive dialysis centered care intersects further
with palliative patient-centered approaches for this
fragile patient population. The evolution of movements such as Comprehensive Conservative Care
(CCC) focus on holistic patient-centered care for patients with stage V CKD (Davison et al Kidney Int
2015). Another example would be similar work being
done by The Coalition for Supportive Care of Kidney
Patients. Nearly all CKD patients want to discuss their
prognosis, treatment options and ultimately die
comfortably at home. (Clin J Am Soc Nephrol 5: 2010)
Fortunately this has not gone unnoticed by the ultimate original payer, Medicare, and hence in 2013,
CMMI’s demonstration project for ESRD holds renewed hope with creation of new coordinated programs with new acronyms: CEC (comprehensive
ESRD Care) and ESCO (ESRD seamless care organizations). We will not only look at national U.S. ESCO
outcomes data, but will share a detailed information
about Dialysis Clinic Inc (DCI) experiences with this
truly innovative model. As the largest non-profit
Vol. 57 No. 2 February 2019
dialysis provider in the U.S. we will go beyond the
data and share first hand details of care coordination
strategies and how the field of nephrology has begun
to reset its paradigm for treating CKD. The role of
palliative and hospice care in the ESCO model also
be discussed.
Unfortunately, further downstream in the trajectory of
life for ESRD patients, the dialysis churn for the Medicare population continues to limit access to hospice.
In a very recent large cross-sectional study of 770,000
Medicare beneficiaries, only 20% of these patients
enrolled in hospice and of this subset, nearly half
only enrolled for 3 days or less. Although dying at
home was more likely in the hospice patients, they
did not fare any better in regards to hospitalization,
ICU admits and overall healthcare costs in the last
week of life. (Wachterman et al; JAMA Int Med April
30, 2018).
In order to increase hospice access for dialysis dependent patients, we will explore the history of ‘Open Access’ models as well as share outcomes on ‘Expanded
Access’ program within a large not for profit hospice
in PA. (UPMC Family Hospice). We will show how
close coordination with Palliative nephrologists can
result in significant increase in hospice length of stay
as well as patient satisfaction and decreased hospitalization. Lastly, we will share our thoughts on how the
Medicare hospice benefit ‘Carve-In’ model will likely
increase hospice Los for dialysis patients through
improved care coordination.
No Patient Left Behind: Integrating
Addiction Treatment with Buprenorphine
into Your Outpatient Palliative Care
Practice (TH316)
Julie Childers, MD MS FAAHPM, University of Pittsburgh, Pittsburgh, PA. Robert Horowitz, MD
FAAHPM, University of Rochester Medical Center, Rochester, NY. Kathleen Broglio, DNP ACHPN ANP-BC
CPE FPCN, Dartmouth Hitchcock Medical Center,
Lebanon, NH. William Jangro, DO, Thomas Jefferson
University, Philadelphia, PA.
Objectives
Describe the principles of buprenorphine (Suboxone) prescribing for opioid use disorder.
Identify different strategies that outpatient palliative care practices can use to incorporate buprenorphine treatment of addiction into their
setting.
Discuss how to overcome barriers to implementing buprenorphine prescribing within their palliative care practices.
Patients with serious illness are not exempt from
opioid use disorders raging through our communities.
Outpatient palliative care clinicians are increasingly
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Jun 6, 2024 | Health Medical
Description
In this case study you will review a client who is suffering with major depression and develop a plan of care based on the case study. Review the case study and answer the questions. Place the questions in a Word document to be submitted via the Dropbox.
A title page or a running head are not needed. However, the document should adhere to APA format guidelines including font size, grammar and format. Response is clearly written using Standard English including correct grammar, spelling, punctuation, and complete sentences and paragraphs, and be free of typographical errors.
Your end document should be at least three pages in length (with the supplied questions) and not including the reference page. All questions should be answered, and responses should be on topic and demonstrate understanding of material covered by the case study.
You should make at least one direct reference to the unit’s material to support this plan of care. You should use a journal article retrieved from the library to support your paper as well as at least one reference to this unit’s assigned reading. Please review the rubric for point distribution.
How to Submit
When you are ready to submit your Assignment, click the Dropbox, then attach your Word document file. Make sure to save a copy of the Assignment you submit.
Depression Case Study
Assessment
K.S. is a 45 year old woman complaining of insomnia. Initial impression is a fatigued and tearful woman. She is being seen by the nurse practitioner and you are doing an intake assessment in her office. K.S. checks in and is smelling heavily of alcohol. Breathalyzer reveals an alcohol level of 0.25% or over three times the legal limit. Her primary complaint, “I just need something to help me sleep.”
K.S. reports a recent move from a neighboring state after obtaining a bachelor’s degree in elementary education. She reports an unintentional 20 pound weight loss since starting the job. She has only been here for 3 months after being hired by the local school system. She is unmarried, and has no local friends. She broke up with her long-time fiancé two months ago, since he did not want to follow her to her new job.
K.S. reports, “My boss is not supportive, it’s either sink or swim here…I can’t sleep, I feel nauseated all of the time…I just spent my life’s savings on four years of college and I just don’t think I can be a teacher…I just wasted four years of my life. I don’t think I can stand it anymore.”
How do you respond therapeutically to K.S.? (1 point)
K.S. has no pertinent medical or psychiatric history and is not taking any medications at the time of her admission. K.S. is diagnosed with major depression and feels she is a danger to herself at this time. K.S. is admitted to the inpatient psychiatric unit for major depression. She is assigned to Dr. Akey-Heart.
What symptoms support a diagnosis of major depression? What are you trying to prevent or promote when she is admitted? (1 point)
What three criteria would make K.S. a priority for admission for inpatient psychiatric care? (1 point)
List two nursing diagnoses in the order of priority that apply to K.S. (one should address safety). Include two SMART goals (1 point).
List 3 nursing interventions for each nursing diagnosis to help K.S. meet these goals (1 point).
Dr. Akey-Heart prescribes sertraline 50 mg po daily x5 days then increases to 100 mg po daily.
During initiation of a new selective serotonin reuptake inhibitor (SSRI), it’s important to monitor for serotonin syndrome, what are the symptoms of serotonin syndrome? What is the black box warning for teens and young adults who take this medication? What other adverse effects do medications in this class include? (1 point)
Why is the first week on antidepressants the most dangerous time? (1 point)
What benefits do SSRI’s have over tricyclic antidepressants? What advantages does this medication have over MAO inhibitors? (1 point)
How to Submit
Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.
Jun 6, 2024 | Health Medical
Description
Critical Thought Journal
Students are to maintain a personal journal of clinical activities for each period of time they are in clinical area.CTJ’S will be submitted to the faculty instructor once each week in a manner and at a time specified by the faculty.
List learning goals that you worked on today and what you accomplished.
Identify in specific detail your progress toward accomplishing specific course objectives.List objectives by their number (1-7) and discuss your progress
3.Reflect on your perceptions of growth over time in meeting your learning goals,professional goals,and personal goals.
4.Address problems /frustrations/joys of your clinical experience and your reactions to and thoughts about them.Identify things you might to differently the next time.
Critical Thought Journal should not just be a listing of what you did,but rather a narrative of what you learned from what you did.How are your growing professionally from these experiences.One of two sentences entry is not acceptable
Jun 6, 2024 | Health Medical
Description
Discipline:
Medicine and Health
Type of service:
Research Paper
Spacing:
Double spacing
Paper format:
APA
Number of pages:
5 pages
Number of sources:
5 sources
Paper detalis:
Describe 3 data
analytic tools used in health care. State the pros and cons of each data
analytic tool. Describe one tool that would be best implemented in a
large health care system, with justification. Describe one tool that
would be best implemented in a small health care practice, with
justification. Include an appropriate introduction and conclusion and at
least 5 scholarly sources to support your reasoning. APA format is
required.
Jun 6, 2024 | Health Medical
Description
Look at the United Nation’s Sustainable Development Goals found at: https://www.un.org/sustainabledevelopment/sustainable-development-goals/
In at least 200 words, explain how your community’s goals (from Extra Credit opportunity #2) fit (or do not fit) with the SDGs. Simple Sentences Please.
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1
Running head: COMMUNITY HEALTH
Community Health
Emmanuel Gyasi
Phhe 469
2
Community health
The below areas were identified in Dupage county and its potential areas to consider for
intervention. The community’s health plan is to deliver affordable, accessible, and quality health
services to residents.
The three major priority problems are substance abuse, access to healthcare facilities, and
injury and violence. There is increased use of alcohol and binge drinking among the county
residents, and also the use of illicit drugs. Drug rehabilitation program is the solution to the
problem to enable the patient to confront the substance, avoid the substance, and the acute
consequences that come with drug abuse.
They do not have easy access to health facilities due to the expensive costs. Decisionmakers across health systems should lower the costs, coordinate care, and increase access to
improve the quality of services.
Both intentional and unintentional acts of violence contribute to the injury problem. People
should be educated on safety during traveling in both cars and bicycles: which involves using
helmets and safety belts to avoid the many injuries.
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Jun 6, 2024 | Health Medical
Description
Hello good evening. I need assistance with 2 responses to 2 initial post for my Collaborative Nursing Class
Jun 6, 2024 | Health Medical
Description
apa style 2000-2500 words not including bibliography author title source n date Primary source should be academic texts, peer-reviewed journals and websites for WHO, FAO and other respected international organissation
Jun 6, 2024 | Health Medical
Description
C
90%
95%
99%
z*
1.645
1.960
2.576
Selected z* values from Table C:
For credit show or explain all answers.
1. (Round final answers to one decimal place.) A river passes through a small town. A scientist estimates the depth of the river where is passes through the town from a simple random sample of 20 measurements. She finds the average depth to be 5.2 feet. Suppose it is known the river’s depth through the town is distributed normally with a standard deviation (s ) of 2 feet.
(a) (5 pts.) Estimate the river’s depth through town with 95% confidence (i.e. Construct a 95% confidence interval).
(b) (5 pts.) Interpret the interval in part (a) above (i.e. say in words what it means).
(c) (5 pts.) How many measurements of the river’s depth would the scientist need to take if she wants to estimate its depth within a margin of error of ± .7 feet with 95% confidence?
(d). (5 pt.) If the scientist changed her level of confidence to 92%, what would be the critical value z*?
2. A researcher claims the yearly per person consumption rate of soft drinks is 52 gallons. In a simple random sample of 30 people, the mean of their yearly consumption is 54.3 gallons. The standard deviation (σ) of the population is 5.0 gallons. At the 5% level of significance, is this evidence the yearly soft drink consumption rate is different from 52 gallons per person? Carry out a test of significance to answer this question:
(a) (5 pts.) State your hypotheses using mathematical notation (symbols).
(b) (5 pts.) Calculate the value of the test statistic.
(c) (5 pts.) Determine the p-value.
(d) (5 pts.) State your conclusion in terms of the problem.
3. A study comparing body temperature between males and females was conducted.
Results are listed below:
Gender
n
s
Females
65
98.5
0.73
Males
62
98.1
0.71
Let and represent the mean body temperatures of all female and male responses, respectively.
(5 pts) Does this data give evidence that male and female body temperatures differ?
(5pts) Give a 90% confidence interval for . Interpret the interval.
State hypotheses, calculate the test statistic, approximate the P-value, and state your conclusion in terms of the problem.
Multiple Choice (1 pts. each)
1.Assume that event A occurs with probability 0.4 and event B occurs with
probability 0.5.Assume that A and B are disjoint events. Which of the following must be true?
a. It is possible that neither A nor B will occur.
b. If A occurs, then B does not occur.
c. The probability that A does not occur is 0.6.
d. All of the above
2. The central limit theorem says that when a simple random sample of size n is drawn from any population with mean m and standard deviation s, then when n is sufficiently large
a. the standard deviation of the sample mean is s2/n.
b. the distribution of the population is approximately Normal.
c. the distribution of the sample mean is approximately Normal.
d. the distribution of the sample mean is exactly Normal.
3. The P-value of the test of the null hypothesis is
a. the probability the null hypothesis is true.
b. the probability the null hypothesis is false.
c. the probability, assuming the null hypothesis is true, that the test statistic will take a value at least as extreme as that actually observed.
d. the probability, assuming the null hypothesis is false, that the test statistic will take a value at least as extreme as that actually observed.
4. You plan to construct a confidence interval for the mean µ of a Normal population with (known) standard deviation σ.Which of the following will reduce the size of the margin of error?
a. Use a higher level of confidence.
b. Increase the sample size.
c. Increase σ
d. All of the above.
5. You conduct a statistical test of hypotheses and find that the test is statistically significant at level a =0.05 with a
P-value=0.03.You may conclude that
a. the test would also be significant at level a = 0.10.
b. the test would also be significant at level a = 0.01.
c. both a and b are true.
d. neither a nor b is true.
6. If two variables, x and y, have a very strong linear relationship, then
a. there is evidence that x causes a change in y
b. there is evidence that y causes a change in x
c. there might not be any causal relationship between x and y
d. None of these alternatives is correct.
7. The correlation coefficient is used to determine:
a. A specific value of the y-variable given a specific value of the x-variable
b. A specific value of the x-variable given a specific value of the y-variable
c. The strength of the relationship between the x and y variables
d. None of these
8. If there is a very strong correlation between two variables then the correlation coefficient must be
a. any value larger than 1
b. much smaller than 0, if the correlation is negative
c. much larger than 0, regardless of whether the correlation is negative or positive
d. None of these alternatives is correct.
9. Sale of eggs that are contaminated with salmonella can cause food poisoning among consumers. A large
egg producer takes an SRS of 200 eggs from all the eggs shipped in one day. The laboratory reports that 11 of
these eggs had salmonella contamination. Unknown to the producer, 0.2% (two-tenths of one percent) of all
eggs shipped had salmonella. In this situation
a. 0.2% is a parameter and 11 is a statistic.
b. 11 is a parameter and 0.2% is a statistic.
c. both 0.2% and 11 are statistics.
d. both 0.2 % and 11 are parameters.
10. Which of the following statements are true?
I. The mean of a population is denoted by .
II. The population mean is a statistic.
(a) I only.
(b) II only.
(c) All of the above.
(d) None of the above.
11. A dietician claims that 60% of people in the U.S. are trying to avoid trans fats in their diets. You randomly select 100 people and find that 58 of them are trying to avoid trans fats. Use this information for questions (a) and (b) below.
(a) In a test of significance seeking evidence against the dietician’s claim, the alternative hypothesis is
A) Ha: p ≠ 58
B) Ha: μ ≠ 60
C) Ha: p ≠ 0.58
D) Ha: p ≠ 0.60
(b) Using the appropriate table, if the test statistic was -0.41 the p-value would be:
A) 0.25< p <0.5
B) p<0.25
C) p = 0.3409
D) p = 0.6818
12. SHOW WORK. An SRS of 18 recent birth records at the local hospital was selected. In the sample, the average birth weight was 119.6 ounces and the standard deviation was 6.5 ounces. Assume that in the population of all babies born in this hospital, the birth weights follow a Normal distribution, with mean . The standard error of the mean is
A) 6.50 ounces
B) 1.53 ounces
C) 0.36 ounces
D) 0.02 ounces
13. Do SAT coaching classes work? Do they help students to improve their test scores? Four students were selected randomly from all of the students that completed an SAT coaching class. For each student, we recorded their first SAT score (before the class) and their second SAT score (after the coaching class).
Student
1
2
3
4
First SAT score
920
830
960
910
Second SAT score
1010
800
1000
980
To analyze these data we should use
A) the one-sample t test.
B) the matched pairs t test.
C) the two-sample t test.
D) Any of the above tests are valid. It just needs to be a t since is unknown.
14. In a test of significance, the P-value is
A) the probability the null hypothesis is true.
B) the probability the null hypothesis is false.
C) the probability, assuming the null hypothesis is true, that the test statistic will take a value at least as extreme as that actually observed.
D) the probability, assuming the null hypothesis is false, that the test statistic will take a value at least as extreme as that actually observed.
15. If conditions for inference were met and the true population standard deviation (σ) was known, the test statistic used for inference for a single true mean (μ) of a population is:
A) p
B) χ2
C) t
D) z
16. The variability of a statistic is described by
A) the spread of its sampling distribution.
B) the amount of bias present.
C) the vagueness in the wording of the question used to collect the sample data.
D) the stability of the population it describes.
17. You conduct a statistical test of hypotheses and find that the null hypothesis is statistically significant at level = 0.05. You may conclude that
A) the test would also be significant at level = 0.10.
B) the test would also be significant at level = 0.01.
C) both a and b are true.
D) neither a nor b is true.
18. The average age of residents in a large residential retirement community is 69 years with standard deviation 5.8 years.A simple random sample of 100 residents is to be selected, and the sample mean age of these residents is to be computed. We know the random variable has approximately a Normal distribution because of
a. the law of large numbers.
b. the 68-95-99.7 rule.
c. the central limit theorem.
d. the population we’re sampling from has a Normal distribution.
19. In a statistical test of hypotheses, we say the test is statistically significant at significance level if
a.the p-value of the test is less than or equal to
b.the p-value is greater than
c.the test statistic is less than or equalto
d.the p-value is less than or equal to .05
20. The sampling distribution of a statistic is
a.the probability that we obtain the statistic in repeated random samples.
b.the mechanism that determines whether randomization was effective.
c.the distribution of values taken by a statistic in all possible samples of the same size from the same population.
d.the extent to which the sample results differ systematically from the truth.
Select the word(s) from the following alphabetized list that best completes the sentences below, and write the word(s) in the blank space provided.
Word list: bias, categorical, confounding, correlation, distribution, experimental, explanatory, factor, frequency, p-value, inference, margin of error, probability, quantitative, regression, robust, response, sampling, standard error, simple random sample, treatments, variability, z-score, stratified random sample, observational study.
(1 pt) The______________ of any outcome of a random phenomenon is the proportion of times the outcome would occur in a very long series of repetitions.
(1 pt) The probability, assuming that the null hypothesis is true, that the test statistic would take a value as extreme or more extreme than that actually observed is called the ________________ of the test.
(1 pt) Statistical ______________ provides methods of drawing conclusions about a population from sample data.
(1 pt) A ___________ of size n consists of n individuals from the population chosen is such a way that every set of n individuals has an equal chance to be sample actually selected.
(1 pt) A ______________ line is a straight line that describes how a response variable y changes as an explanatory variable x changes.
(1 pt) The ____________ of a variable tells us what values the variable takes and how often it takes these values.
(1 pt) When the standard deviation of a statistic is estimated from data, the result is called the ____________ of the statistic.
(1 pt) The _______________ measures the direction and strength of linear relationship between two quantitative variables.
(1 pt) ________________ variable measures an outcome of study.
(1 pt) ______________ variable may explain or influence changes in ____________ variable.
(1 pt) ______________ observes individuals and measures variables of interest but does not attempt to influence the responses; The purpose is to describes some group or situation.
(1 pt) __________ Analysis (FA) is an exploratory technique applied to a set of observed variables that seeks to find underlying factors (subsets of variables) from which the observed variables were generated.
(1 pt) __________ design is the branch of statistics that deals with the design and analysis of experiments. The methods of __________ design are widely used in the fields of agriculture, medicine, biology, marketing research, and industrial production.
(1 pt) “randomization”: The random allocation of experimental units to experimental __________ . To allocate at random, each unit must have had the same chance of receiving any of the possible __________ .
(1 pt) __________ variable: a variable that varies with a proposed explanatory variable and therefore whose effect it cannot be separated from.
Unformatted Attachment Preview
Homework # 3
Selected z* values from Table C:
C
z*
90% 95% 99%
1.645 1.960 2.576
For credit show or explain all answers.
1. (Round final answers to one decimal place.) A river passes through a small town. A scientist estimates the
depth of the river where is passes through the town from a simple random sample of 20 measurements. She
finds the average depth to be 5.2 feet. Suppose it is known the river’s depth through the town is distributed
normally with a standard deviation ( ) of 2 feet.
(a) (5 pts.) Estimate the river’s depth through town with 95% confidence (i.e. Construct a 95% confidence
interval).
(b) (5 pts.) Interpret the interval in part (a) above (i.e. say in words what it means).
(c) (5 pts.) How many measurements of the river’s depth would the scientist need to take if she wants to
estimate its depth within a margin of error of ± .7 feet with 95% confidence?
(d). (5 pt.) If the scientist changed her level of confidence to 92%, what would be the critical value z*?
2. A researcher claims the yearly per person consumption rate of soft drinks is 52 gallons. In a simple random
sample of 30 people, the mean of their yearly consumption is 54.3 gallons. The standard deviation (σ) of the
population is 5.0 gallons. At the 5% level of significance, is this evidence the yearly soft drink consumption rate
is different from 52 gallons per person? Carry out a test of significance to answer this question:
(a) (5 pts.) State your hypotheses using mathematical notation (symbols).
(b) (5 pts.) Calculate the value of the test statistic.
(c) (5 pts.) Determine the p-value.
(d) (5 pts.) State your conclusion in terms of the problem.
Homework # 3
3. A study comparing body temperature between males and females was conducted.
Results are listed below:
Gender
n
s
̅
Females 65
98.5
0.73
Males
62
98.1
0.71
Let 1 and 2 represent the mean body temperatures of all female and male responses, respectively.
a. (5 pts) Does this data give evidence that male and female body temperatures differ?
State hypotheses, calculate the test statistic, approximate the P-value, and state your conclusion in terms
of the problem.
b. (5pts) Give a 90% confidence interval for 1 − 2 . Interpret the interval.
Homework # 3
Multiple Choice (1 pts. each)
1. Assume that event A occurs with probability 0.4 and event B occurs with
probability 0.5. Assume that A and B are disjoint events. Which of the following must be true?
a. It is possible that neither A nor B will occur.
b. If A occurs, then B does not occur.
c. The probability that A does not occur is 0.6.
d. All of the above
2. The central limit theorem says that when a simple random sample of size n is drawn from any population with mean
and standard deviation , then when n is sufficiently large
a. the standard deviation of the sample mean is 2/n.
b. the distribution of the population is approximately Normal.
c. the distribution of the sample mean is approximately Normal.
d. the distribution of the sample mean is exactly Normal.
3. The P-value of the test of the null hypothesis is
a. the probability the null hypothesis is true.
b. the probability the null hypothesis is false.
c. the probability, assuming the null hypothesis is true, that the test statistic will take a value at least as extreme as that
actually observed.
d. the probability, assuming the null hypothesis is false, that the test statistic will take a value at least as extreme as that
actually observed.
4. You plan to construct a confidence interval for the mean µ of a Normal population with (known) standard
deviation σ. Which of the following will reduce the size of the margin of error?
a. Use a higher level of confidence.
b. Increase the sample size.
c. Increase σ
d. All of the above.
5. You conduct a statistical test of hypotheses and find that the test is statistically significant at level =0.05 with a
P-value=0.03. You may conclude that
a. the test would also be significant at level = 0.10.
b. the test would also be significant at level = 0.01.
c. both a and b are true.
d. neither a nor b is true.
6. If two variables, x and y, have a very strong linear relationship, then
a. there is evidence that x causes a change in y
b. there is evidence that y causes a change in x
c. there might not be any causal relationship between x and y
d. None of these alternatives is correct.
7. The correlation coefficient is used to determine:
a. A specific value of the y-variable given a specific value of the x-variable
b. A specific value of the x-variable given a specific value of the y-variable
c. The strength of the relationship between the x and y variables
d. None of these
8. If there is a very strong correlation between two variables then the correlation coefficient must be
a. any value larger than 1
b. much smaller than 0, if the correlation is negative
c. much larger than 0, regardless of whether the correlation is negative or positive
d. None of these alternatives is correct.
Homework # 3
9. Sale of eggs that are contaminated with salmonella can cause food poisoning among consumers. A large
egg producer takes an SRS of 200 eggs from all the eggs shipped in one day. The laboratory reports that 11 of
these eggs had salmonella contamination. Unknown to the producer, 0.2% (two-tenths of one percent) of all
eggs shipped had salmonella. In this situation
a. 0.2% is a parameter and 11 is a statistic.
b. 11 is a parameter and 0.2% is a statistic.
c. both 0.2% and 11 are statistics.
d. both 0.2 % and 11 are parameters.
10. Which of the following statements are true?
I. The mean of a population is denoted by ̅.
II. The population mean is a statistic.
(a) I only.
(b) II only.
(c) All of the above.
(d) None of the above.
11. A dietician claims that 60% of people in the U.S. are trying to avoid trans fats in their diets. You randomly select
100 people and find that 58 of them are trying to avoid trans fats. Use this information for questions (a) and (b)
below.
(a) In a test of significance seeking evidence against the dietician’s claim, the alternative hypothesis is
A) Ha: p ≠ 58
B) Ha: μ ≠ 60
C) Ha: p ≠ 0.58
D) Ha: p ≠ 0.60
(b) Using the appropriate table, if the test statistic was -0.41 the p-value would be:
A) 0.25< p
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Jun 6, 2024 | Health Medical
Description
Discipline:
– Nursing
Type of service:
Essay
Spacing:
Double spacing
Paper format:
APA
Number of pages:
1 page
Number of sources:
0 source
Paper detalis:
Directions: Visit the United States Census Bureau at https://www.census.gov/quickfacts/FL
(Links to an external site.)
. Select a city or town in the state of Florida. Define the population
demographics (race, median income, per capita income, gender, age,
persons per square mile, educational level and any other pertinent
statistic). Select one race from this demographic and define how you
would tailor an educational program. Be sure to list what morals and
values of the population would impact the program. List at least two
references in APA format. Your entry should be at least three
paragraphs.please use middleburg florida as the city
Jun 6, 2024 | Health Medical
Description
For this assessment, you will implement the preliminary care coordination plan you developed in Assessment 1. Present the plan to the patient in a face-to-face clinical learning session and collaborate with the patient in evaluating session outcomes and addressing possible revisions to the plan.NOTE: You are required to complete this assessment after Assessment 1 is successfully completed.Care coordination is the process of providing a smooth and seamless transition of care as part of the health continuum. Nurses must be aware of community resources, ethical considerations, policy issues, cultural norms, safety, and the physiological needs of patients. Nurses play a key role in providing the necessary knowledge and communication to ensure seamless transitions of care. They draw upon evidence-based practices to promote health and disease prevention to create a safe environment conducive to improving and maintaining the health of individuals, families, or aggregates within a community. When provided with a plan and the resources to achieve and maintain optimal health, patients benefit from a safe environment conducive to healing and a better quality of life.This assessment provides an opportunity for you to apply communication, teaching, and learning best practices to the presentation of a care coordination plan to the patient.You are encouraged to complete the Vila Health: Cultural Competence activity prior to completing this assessment. Completing course activities before submitting your first attempt has been shown to make the difference between basic and proficient assessment.
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 1: Adapt care based on patient-centered and person-focused factors.
Design patient-centered health interventions and timelines for care delivered through direct clinical interaction that is logged in the CORE ELMS system.
Competency 2: Collaborate with patients and family to achieve desired outcomes.
Evaluate learning session outcomes and the attainment of mutually agreed-upon health goals, in collaboration with a patient.
Competency 3: Create a satisfying patient experience.
Evaluate patient satisfaction with the care coordination plan and progress made toward Healthy People 2020 goals and leading health indicators.
Competency 4: Defend decisions based on the code of ethics for nursing.
Make ethical decisions in designing patient-centered health interventions.
Competency 5: Explain how health care policies affect patient-centered care.
Identify relevant health policy implications for the coordination and continuum of care.
PREPARATION
In this assessment, you will implement the preliminary care coordination plan you developed in Assessment 1 and communicate the plan to the patient in a professional, culturally sensitive, and ethical manner.To prepare for the assessment, consider the patient experience and how you will present the plan. Make sure you schedule time accordingly.Note: Remember that you can submit all, or a portion of, your plan to Smarthinking Tutoring for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
INSTRUCTIONS
Note: You are required to complete Assessment 1 before this assessment.For this assessment:
Complete the preliminary care coordination plan you developed in Assessment 1.
Present the plan to the patient in a face-to-face clinical learning session. Communicate in a professional, culturally sensitive, and ethical manner.
Collaborate with the patient in evaluating session outcomes and addressing possible revisions to the plan.
Reminder: The time you spend presenting your final care coordination plan must be logged in the CORE ELMS system. The total time spent in securing individual participation in this activity in Assessment 1 and presenting your plan in this assessment must be at least three hours. The CORE ELMS link is located in the courseroom navigation menu.Please be advised that the Volunteer Experience form requires that you provide the name and contact information for at least one individual with whom you worked as part of your direct clinical activity. Your faculty may reach out to this individual to verify that you have accurately documented and completed your clinical hours.
Document Format and Length
Build on the preliminary plan document you created in Assessment 1. Your final plan should be 5–7 pages in length.
Supporting Evidence
Support your care coordination plan with peer-reviewed articles, course study resources, and Healthy People 2020 resources. Cite at least three credible sources.
Grading Requirements
The requirements, outlined below, correspond to the grading criteria in the Final Care Coordination Plan Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Design patient-centered health interventions and timelines for care delivered through direct clinical interaction that is logged in the CORE ELMS system.
Address three patient health issues.
Design an intervention for each health issue.
Identify three community resources for each health intervention, so the patient may make an informed decision about what resources to use.
Make ethical decisions in designing patient-centered health interventions.
Consider the practical effects of specific decisions.
Include the ethical questions that generate uncertainty about the decisions you have made.
Identify relevant health policy implications for the coordination and continuum of care.
Cite specific health policy provisions.
Evaluate learning session outcomes and the attainment of mutually agreed-upon health goals, in collaboration with the patient.
What aspects of the session would you change?
How might revisions to the plan improve future outcomes?
Evaluate patient satisfaction with the care coordination plan and progress made toward Healthy People 2020 goals and leading health indicators.
What changes would you recommend to improve patient satisfaction and better align the session with Healthy People 2020 goals and leading health indicators?
Additional Requirements
Before submitting your assessment, proofread your final care coordination plan to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your plan.You must submit your hours to the CORE ELMS system before you can complete this assessment and course.Portfolio Prompt: Save your presentation to your ePortfolio. Submissions to the ePortfolio will be part of your final Capstone course.
Jun 6, 2024 | Health Medical
Description
Essay needs to be at least 4-6 pages and a minimum of 3 scholarly resources. It should be in APA format with graduate level writing. Further, it should be plagiarism free.
Jun 6, 2024 | Health Medical
Description
I have worked with you on this paperplease just edit the mistakes on the comments and add ab abstract
Unformatted Attachment Preview
Running head: EMERGENCY MANAGEMENT
Community Emergency Preparedness
October 29, 2019
1
EMERGENCY MANAGEMENT
2
Introduction
Recent studies have shown the significance of communities in early emergency
preparations in preventing significant disasters from impacting more on its existing
environmental surrounding (Canton, 2019). Additionally, Canton (2019) noted that many nations
are facing substantial challenges concerning the occurrence of natural calamities and hazards.
Annually, countries lose billions of dollars in attempting to recover after a disaster. These
disasters have been a burden to many nations such as India, United States, China, Bangladesh,
Japan, and the Philippines. Due to their landscape, such countries are prone to natural calamities
such as landslides, tsunamis, hurricanes, earthquakes, storms, volcanoes, and floods/drought,
among others. Based on the statistical report by Kostigen (2015), over 3000 people were
displaced due to Tropical Cyclone in Port Vila and 24 others died in the process. Nations
continue to face an increasing number of natural calamities substantially. As such, they are
required to come up with the best tactics to adequately prepare themselves to mitigate and
recover the affected assets. Understanding the tactics and techniques necessary to facilitate
emergency management within such nations can help reduce the impacts caused by these natural
hazards and calamities.
Becoming more acquitted with the process of emergency management is vital for
investors to help communities to prepare for disasters adequately. Many individuals, groups, and
nations lack the proper understanding of emergency management in reducing the impact of
natural calamities. Reducing the burden of countries when dealing with all humanitarian aspects
of emergency is one of the global most focused issues in contemporary society. Finding the best
techniques and strategies to fully prepare through all aspects of emergencies, namely
“preparedness, response, mitigation, and recovery” continues to be a significant challenge for
EMERGENCY MANAGEMENT
3
many groups, businesses and countries. The term emergency management (EM) refers to a
concept that helps in managing and organizing the available resources and accountability for
addressing humanitarian issues thereby decreasing the dangerous effects of all-natural calamities,
including disasters (Canton, 2019). Organizations such as World Health Organization (WHO),
the Federal Emergency Management Agency (FEMA), Red Cross and the Department of
Homeland Security (DHS) have over the years come up with the best practices and strategies to
effectively mitigate such disasters through research and development (Schoch-Spana et al.,
2018).
However, different researchers and scholars have demonstrated some controversies
related to emergency management (Chen, Kang & Tjosvold, 2017). The disaster management
techniques today may not effectively help nations to mitigate and recover from all from a
significant disaster safely. In most cases, such techniques and strategies have resulted in more
fatal damages on physical infrastructure, thereby not qualified to act as mitigation process
practices. Ideally, delivering the best methods remains to be the concept that emergency
management and continuations disaster recovery management want to demonstrate when
addressing with community’s disaster management problems. Community emergency
preparedness has been one of the challenging aspects of mitigating and reducing the impact of
the risks involved (National Research Council, 2007). Therefore, the central aim of emergency
management is to develop the best strategy for possible disasters and emergencies that could
damage the normal operations of institutions and nations. Therefore, this ongoing scholarly paper
focuses on discussing emergency management (EM) based on the existing literature to help a
specific audience and population that has inadequate knowledge about EM to manage and
mitigate their natural calamities and hazards effectively.
EMERGENCY MANAGEMENT
4
Analysis
There is evidence of numerous literature materials and resources that define and support
the concept of EM and bring the best possible knowledge on how to mitigate and recover the
existing lost assets effectively. Recovery from natural calamities has been a challenging issue,
particularly for those countries that are still developing, for instance, India and some of the
Southern Asian countries such as Bangladesh (Baten, González & Delgado, 2018). As a result,
they continue to remain weak and lack infrastructure. It is essential to look at the existing
literature that offers valuable information on how such communities can effectively-prepare
themselves before such disasters to mitigate and recover efficiently.
According to Oloruntoba, Sridharan, & Davison, (2018), arguments, analytical
procedures and prior preparations are necessary for successful mitigation and recovery of natural
disasters. The authors have helped to proposed effective framework processes that have been
proven to assist countries facing disasters and calamities to reduce its impact on the overall
people and the assets. Based on their framework of analysis, preparedness is a critical aspect in
all aspects of emergencies, and it focuses on reducing the possibility of damage from a natural
disaster or hazards. With the continuous challenges facing developing countries in acquiring
proper technology to facilitate the early preparation mechanism, becoming more acquitted with
the best methods also makes countries to be at an advantage when addressing such issues.
This literature has aimed to propose a framework of processes and activities after a series
of Tropical Cyclone had a continuous negative impact on countries as such countries become
more aware and gain more understanding of and the contribution to better natural calamity
preparedness and recovery in the future of nations. Oloruntoba et al. (2018) have focused on two
EMERGENCY MANAGEMENT
5
empirical framework models that can predict and forecast calamities within a country. In any
event of any natural disaster, whether human-made or natural, can be addressed with the concept
of preparedness. The research has emphasized more on these frameworks of processes and
practices to be incorporated in the four phases of the disaster life cycle. Hence, it becomes more
effective in improving a country’s resilience to disasters and calamities.
Organizations and communities can implement disaster training and educational
programs that aim at assisting them in early preparation to combat the coming disaster. These
communities face issues with disasters they are unprepared for, thereby taking them by surprise
(Himes-Cornell et al., 2018). As such, educational programs that focus on empowering the
citizens to become more vigorous in preparing for disaster and calamities can reduce the impact
of such disasters.
Research done by the National Research Council (2007) noted the significance of
analyzing the credibility of the phases of the disaster life cycle by incorporating the changing
world of technology. With the advancement of technology in today’s sophisticated and complex
society, nations have the chance to adapt to information systems to adequately prepare for
disasters. Information systems can survey and notify the community of any changes in the
climate to focus on gathering more resources for early mitigation and recovery processes. With
the ability of such systems to detect and analyze the magnitude of earthquakes and the force of
windstorms that can bring a significant loss in the community can be mitigated. Planning is very
vital when it comes to emergency management (National Research Council, 2007). It helps to
reduce the effects of an unavoidable calamity. Before and during a disaster, information systems
can also be useful in enhancing communication, thereby facilitating coordination of activities
and processes towards the overall achievement of successful management of the disaster.
EMERGENCY MANAGEMENT
6
The National Research Council (2007) has focused its many years in research and
development (R&D) to discover the best practices and processes that communities can utilize to
become more resilient to disaster. Although many countries are using the aspects of emergencies
plan processes (mitigation, recovery, response, and preparedness), the NRC seeks to enlighten
peoples’ understanding on the significance or the role of information technology (IT) in
emergency management and emergency preparedness. Information technology (IT) plays a
crucial role in the disaster life cycle by ensuring the necessary resources are well allocated and
distributed among the most affected areas (National Research Council, 2007). Information
technology also has helped improve communication in emergency management and
preparedness; thereby; people can receive quick assistance during a disaster.
For many years, communities have to lack technological advancement that helps in the
communication process during a disaster. As such, it takes longer for them to receive aid from
the relevant organizations. Additionally, there was a lack of coordination and improper
distribution of resources from different regions that were affected. Therefore, through the
advancement of technology, it provides communities with the opportunity to advance their
emergency management and preparedness National Research Council (2007).
Understanding the concept of emergency preparedness and management can be
significant for communities to enlighten their disaster management processes. To support the
National Research Council (2007), scholars such as Van De Walle, Turoff, & Hiltz, (2014) have
helped advance more research on the potential behind information systems in disaster
management. Improvement in the emergency management department entails incorporating such
organizational systems. The ability to successfully recover from a disaster depends on the
EMERGENCY MANAGEMENT
7
community’s aggressiveness in implementing sociotechnical systems that help to gather, process,
store and distribute data to the relevant people.
According to Van De Walle et al., (2014), information systems have helped transform
how communities prepared for disasters and have increased their ability to mitigate and recover
from such successfully. Information systems are composed of critical elements that are necessary
for emergency management and preparedness. Such vital items include technology, structure
(roles), human resources, and task. Before and during disaster and calamity, organizations and
governmental agencies can use these key elements to effectively organize themselves to deliver
effective services in the affected regions (Van De Walle et al., 2014). It fosters good
communication flow through telecommunication systems and software. Additionally, it helps to
effectively and efficiently group teams following regions so as not to concentrate on one
particular region.
By doing so, these groups can be given tasks and responsibilities during a disaster,
therefore, facilitating easy management and coordination of processes for mitigating and
recovery. The possibility of successful recovering from a disaster is guaranteed through the
implementation and establishment of information systems. Furthermore, Van De Walle et al.,
(2014) have proven the potential for this technology in assisting communities to gather
information, process, and store it in response to emergency management (Van De Walle et al.,
2014).
In other words, communities can use this information from the previous disaster to have
an understanding of the amount of resources that were used during that time to gather enough
resources to counteract the coming disaster adequately (Kruger et al., 2018). With the available
resources, tools, and technologies, communities become more resilient, even those that are prone
EMERGENCY MANAGEMENT
8
to strong earthquakes. Having that understanding, the National Research Council (2007) urges
nations to improve their emergency management and preparedness techniques to help adequately
and efficiently in mitigating and recovering successfully.
Knowledge, skills and expertise can be of help in advancing emergency preparedness and
management. Preparation is essential and continues to be a very vital source in the disaster life
cycle. Countries that have prepared and planned effectively through the use of technology have
the potential and possibility of recovering from a significant disaster successful. Most
communities are yet to adopt and implement these systems to address humanitarian issues and
challenges and respond to the disaster. Therefore, applying information technology and methods
can help to enhance a proper response mechanism from organizations that offer aid and
governmental agencies such as FEMA and DHS (Van De Walle et al., 2014).
Conclusion
In conclusion, it is evident that many communities are still facing increasing challenges
in response to the disaster and natural calamities. Traditional process and practices assisted these
communities in mitigating and recovering from the disaster. However, they have not been
successful in reducing the overall impact. Therefore, through the help of existing literature,
communities have a chance of successfully recovering from such a disaster. Understanding of
emergency preparedness and management is crucial for countries that experience frequent
disasters and natural calamities. Ideally, delivering the best methods remains to be the concept
that emergency management and continuations disaster recovery management want to
demonstrate when addressing with communities’ disaster management problems. Community
emergency preparedness has been one of the challenging aspects of mitigating and reducing the
impact of the risks involved. With evidence from different scholars and researchers, countries
EMERGENCY MANAGEMENT
can begin to implement these technology services for effective response and mitigation
processes. Countries continue to substantially struggle with an increasing number of natural
disasters and calamities. As such, they are required to develop the best tactics to prepare
themselves to mitigate and recover the affected assets completely. Therefore, understanding the
tactics and techniques necessary to facilitate emergency management within such nations can
help reduce the impacts caused by these natural hazards and calamities.
9
EMERGENCY MANAGEMENT
10
References
Baten, A., González, P. A., & Delgado, R. C. (2019). Natural Disasters and Management
Systems of Bangladesh from 1972 to 2017: Special Focus on Flood. OmniScience: A
Multi-disciplinary Journal, 8(3), 35-47.
Chen, Y. F., Kang, Y., & Tjosvold, D. (2017). Constructive controversy and guanxi relationships
for disaster recovery. International Journal of Conflict Management, 28(4), 410-436.
Canton, L. G. (2019). Emergency Management: Concepts and strategies for effective programs.
John Wiley & Sons.
Himes-Cornell, A., Ormond, C., Hoelting, K., Ban, N. C., Zachary Koehn, J., Allison, E. H., …
& Okey, T. A. (2018). Factors Affecting Disaster Preparedness, Response, and Recovery
Using the Community Capitals Framework. Coastal management, 46(5), 335-358.
Kostigen, T. (March 19, 2015). The Riskiest Places for Natural Disasters. Retrieved October 27,
from, https://www.mnn.com/earth-matters/wilderness-resources/stories/the-riskiestplaces-in-the-world-for-natural-disasters
Kruger, J., Hinton, C. F., Sinclair, L. B., & Silverman, B. (2018). Enhancing individual and
community disaster preparedness: Individuals with disabilities and others with access and
functional needs. Disability and Health Journal, 11(2), 170-173.
National Research Council. (2007). Improving disaster management: the role of IT in mitigation,
preparedness, response, and recovery. National Academies Press.
Oloruntoba, R., Sridharan, R., & Davison, G. (2018). A proposed framework of key activities
and processes in the preparedness and recovery phases of disaster management.
Disasters, 42(3), 541-570.
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Schoch-Spana, M., Ravi, S., Meyer, D., Biesiadecki, L., & Mwaungulu Jr, G. (2018). Highperforming local health departments relate their experiences at community engagement in
emergency preparedness. Journal of Public Health Management and Practice, 24(4),
360-369.
Van De Walle, B., Turoff, M., & Hiltz, S. R. (2014). Information systems for emergency
management. Routledge.
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Jun 6, 2024 | Health Medical
Description
INTERNSHIP REFLECTION PAPER
talk about – health science major (occupational and physical therapy )
Students will write a 3, double-spaced final reflection paper. Your reflection paper should be a well-crafted and thoughtfully written critical analysis of your internship experience.
The reflection paper should address, but does not need to be limited to, the following:
– Describe your activities at the internship.
– What you learned through your internship and how it was of value to your academic and career goals.
– A description of the most important assignment(s) and why they were significant.
– What surprised you about the internship, if anything.
– Whether the internship has changed your perception of what you want to do.
– The opportunities provided to you to network, collaborate and learn new skills during this internship.
-Were you able to put classroom learning into practice?
– A description of the top three skills you developed during your internship. How do the knowledge/skills you developed relate to your major and overall goals?
– In what way did the internship meet your expectations?
– Do you feel the knowledge/skills you have gained were only attainable outside the classroom?
– Is there any way in which the internship could be improved?
– Would you recommend this internship to another student? Why or Why not?
Jun 6, 2024 | Health Medical
Description
Review and compile the data from your community and family assessments.
Ensure you have included an explanation of the LHI(s) that apply to your family’s community.
Format your genogram and ecomap as a mind map or other visual representation.
Format your family and community assessment data as one of the following:
Table
Chart
Matrix/spreadsheet
Legal-sized infographic
525- to 700-word summary
10- to 15-slide presentation
Select one theory relevant to family/community health and one non-nursing theory that will help the family adjust their behavior.
Summarize the key points of each.
Explain the specific application to family/community health or patient behavior.
Address the strengths and limitations of each.
Explain how the theory integrates the nursing process and is applicable at each level of prevention.
Format your theory assignment as one of the following:
7- to 10-slide presentation
7- to 10-minute oral presentation
350- to 525-word paper
Another format approved by your instructor
Include at least one peer-reviewed and one evidence-based reference and an APA-formatted reference
