Based on your clinical practice area and location. What are some of the greatest cultural issues and trends that are frequently encountered? How do we as professional nurses rise to these challenges? Provide examples of cultural recognition and potential health-related issues while implementing evidence-based standards of care
Respond at least 2 times each . The goal is for the discussion forum to function as robust clinical conferences on the patients. Provide a response to 1 of the 3 discussion prompts that your colleagues provided in their video presentations. You may also provide additional information, alternative points of view, research to support treatment, or patient education strategies you might use with the relevant patient.
PNSG 1514
Quality Improvement Assignment
|
Course Learner Outcome Five: Collaborate with other healthcare providers to promote safe and quality patient-centered care. |
· Read the policy below and decide if it reflects best practice for a skilled nursing facility.
· Research current evidence-based practice regarding the attached policy to determine if changes need to occur.
· Describe in detail what you would change in the current policy citing the evidence you gathered.
· Please include and cite at least 1 scholarly resource using APA format.
Pressure Ulcer Prevention and Managing Skin Integrity
I. PURPOSE
A. To maintain the integrity of residents’ skin and overall health.
B. To effectively identify residents who are at risk for skin breakdown.
C. To provide early interventions for residents with skin breakdown and minimize associated risks.
D. To educate staff, residents, and families on measures to prevent skin breakdown.
II. POLICY
Nursing is solely responsible for all aspects of the skin risk assessment and will assess and manage skin integrity for all residents. Risk for pressure ulcer development will be evaluated using the Braden Scale. Skin inspections will be completed on admission for all residents. Any resident with a Braden score < 8 shall have skin inspections done every month. Residents with a Braden score > 8 do not need further skin inspections done.
III.
DEFINITIONS
A. Risk assessment: identification of the potential risk that a resident will contribute to the likelihood for developing skin breakdown.
B. Skin Inspection: a head to toe assessment of residents, intended to detect skin breakdown.
C. Interventions: the steps taken by care providers to increase monitoring of the skin and reduce or alleviate pressure on body parts to minimize or eliminate the risk of skin breakdown.
IV.
PROCEDURE
A. All residents will be assessed one time, on admission to the skilled nursing facility. This will include a head to toe assessment, paying close attention to bony prominences and skin folds.
B. Screening, using the Braden Scale, will be completed by an RN, LPN, or CNA. This must be documented in the medical record.
C. Residents with a Braden score < 8 will have assessments done every month until reaching a score of 8 or higher.
D. All interventions must be documented in the medical record.
V.
INTERVENTIONS
A. Patient Repositioning and Turning; required once per shift.
B. Cleanse and dry skin at routine intervals and at the time of soiling;
recommend tub bath once per week.
C. Proper Nutrition; provide meals high in carbohydrates to promote healing.
D. Implement a specialty bed if indicated.
E. Staff Education; require annual training of nursing staff.
Minnesota State Community & Technical College
© PNSG 1514
8.2023
minimum of two (2) scholarly references are required
The Affordable Care Act (ACA), commonly known as Obamacare, has been a subject of significant political debate in the United States since its enactment in 2010. Legislators often face complex decisions when considering the repeal or replacement of the ACA, as their primary objective is to secure re-election. This discussion explores how cost-benefit analysis has affected efforts to repeal/replace the ACA and how analyses of voters' views can impact legislative leaders' recommendations or positioning on national healthcare policies.
Cost-Benefit Analysis in ACA Repeal/Replace Efforts
1.
Cost Implications for Legislators: Legislators have a vested interest in maintaining fiscal responsibility to appeal to constituents concerned about government spending (Dudley & Park, 2019). A thorough cost-benefit analysis is critical in evaluating potential replacement plans, as they must ensure that any new healthcare legislation is financially sustainable in the long term.
2.
Political Consequences: The cost-benefit analysis also considers the political consequences of supporting or opposing ACA repeal/replace efforts. Legislators who supported the ACA's repeal without a viable alternative risked backlash from constituents who benefited from the ACA's provisions Conversely, those opposing repeal faced pressure from their party and special interest groups advocating for change.
3.
Public Opinion: Cost-benefit analyses should include public opinion data, as supporting an unpopular policy can jeopardize a legislator's chances of re-election. Surveys and polls assessing public sentiment toward the ACA and proposed replacements help lawmakers gauge potential electoral consequences.
Voter Views and National Healthcare Policy Decisions
1.
Constituent Preferences: The views of constituents play a pivotal role in shaping legislative leaders' positions on national healthcare policies. Legislators closely monitor their constituents' opinions on issues like Medicare and Medicaid, as these programs significantly impact healthcare access (Hood, 2017).
2.
Party Alignment: Legislative leaders often align their positions with their party's platform to maintain party support and increase re-election prospects (Hood, 2017). Party leaders may use voter opinion data to shape their policy recommendations and positions on issues like Medicare and Medicaid.
3.
Interest Groups: Voter views are influenced not only by constituents but also by interest groups advocating for specific healthcare policies. Legislative leaders must balance the preferences of these influential groups with those of their constituents when making policy recommendations
Conclusion
Legislators, driven by the imperative of re-election, are significantly influenced by cost-benefit analyses when considering ACA repeal/replace efforts. These analyses guide decisions related to the financial sustainability and political implications of such efforts. Additionally, analyses of voter views are crucial in shaping national healthcare policy decisions, including those affecting Medicare and Medicaid. These views impact legislative leaders' positions, aligning them with party platforms and accommodating the preferences of both constituents and interest groups. Balancing these factors is essential for legislators seeking to secure re-election while making decisions that affect the nation's healthcare system.
References:
Dudley, S. E., & Park, H. S. (2019). Health policy analysis: An interdisciplinary approach. Jones & Bartlett Learning.
Hood, M. V. (2017). The influence of public opinion on legislative policy. In The Oxford Handbook of American Public Opinion and the Media (pp. 353-367). Oxford University Press.
Assessment 2
Community Resources
INSRUCTIONS-Research a selected local, national, or global nonprofit organization or government agency to determine how it contributes to public health and safety improvements, promotes equal opportunity, and improves the quality of life within the community. Submit your findings in a 3-5 page report.
INSTRODUCTION – Many organizations work to better local and global communities' quality of life and promote health and safety in times of crisis. As public health and safety advocates, nurses must be cognizant of how such organizations help certain populations. As change agents, nurses must be aware of factors that impact the organization and the services that it offers. Familiarity with these organizations enables the nurse to offer assistance as a volunteer and source of referral.
PREPARATION– You are interested in expanding your role as a nurse and are considering working in an area where you can help to promote equal opportunity and improve the quality of life within the local or global community. You are aware of several nonprofit organizations and government agencies whose work contributes to this effort in some way. You have particular interest in one of these organizations but would like to know more about its contributions to public health and safety improvements. You would like to report the results of your research in a scholarly paper that you could submit for publication.
Research a selected local, national, or global nonprofit organization or government agency from the list provided. Determine how the organization or agency contributes to public health and safety improvements, promotes equal opportunity, and improves the quality of life within the community. Submit your findings in a 3-5 page report.
As you begin to prepare this assessment, it would be an excellent choice to complete the Nonprofit Organizations and Community Health activity. Complete this activity to gain insight into promoting equal opportunity and
improving the quality of life in a community. The information gained from completing this activity will help you succeed with the assessment.
Choose the organization or agency you are most interested in researching:
·
United Way
.
·
United Nations Children's Fund (UNICEF)
.
·
Federal Emergency Management Agency (FEMA)
.
·
Centers for Disease Control and Prevention (CDC)
.
·
National Center for Transgender Equality
.
·
National Resource Center on LGBT Aging
.
·
Advocacy & Services for LGBT Elders
.
·
National Alliance to End Homelessness
.
·
Urban Triage
.
·
The Arc: For People With Intellectual and Developmental Disabilities
.
·
Alliance for Retired Americans
.
·
Blue Campaign: What Is Human Trafficking?
·
Covenant House
.
Note: As you revise your writing, check out the resources listed on the Writing Center's
Writing Support
page.
Instructions
Research a selected local, national, or global nonprofit organization or government agency from the list provided. Determine how the organization or agency contributes to public health and safety improvements, promotes equal opportunity, and improves the quality of life within the community. Submit your findings in a 3-5 page report.
As you begin to prepare this assessment, it would be an excellent choice to complete the Nonprofit Organizations and Community Health activity. Complete this activity to gain insight into promoting equal opportunity and improving the quality of life in a community. The information gained from completing this activity will help you succeed with the assessment. After completing this activity, choose an organization or agency from the list that you are most interested in researching.
Document Format and Length
Format your paper using APA style.
· Refer to the
APA Style Paper Tutorial [DOCX]
to help you in writing and formatting your paper. Be sure to include:
· A title page and references page. An abstract is not required.
· Appropriate section headings.
· Your paper should comprise 3-5 pages of content plus title and references pages.
Supporting Evidence
Cite at least three credible sources from peer-reviewed journals or professional industry publications published within the past 5 years that support your research findings.
Graded Requirements
The research requirements, outlined below, correspond to the grading criteria in the assessment scoring guide, so be sure to address each point.
· Explain how the organization's mission and vision enable it to contribute to public health and safety improvements.
· Include examples of ways a local and/or global initiative supports organizational mission and vision and promotes public health and safety.
· Evaluate an organization's ability to promote equal opportunity and improve the quality of life in the community.
· Consider the effects of social, cultural, economic, and physical barriers.
· Assess the impact of funding sources, policy, and legislation on the organization's provision of services.
· Consider the potential implications of funding decisions, policy, and legislation for individuals, families, and aggregates within the community.
· Explain how an organization's work impacts the health and/or safety needs of a local community.
· Consider how nurses might become involved with the organization.
· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
· Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
· Write with a specific purpose and audience in mind.
· Adhere to scholarly and disciplinary writing standards and APA formatting requirements.
Additional Requirements
Before submitting your paper, proofread it to minimize errors that could distract readers and make it difficult for them to focus on your research findings.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Analyze health risks and health care needs among distinct populations.
·
·
· Explain how an organization's work impacts the health and/or safety needs of a local community.
Competency 2: Propose health promotion strategies to improve the health of populations.
·
·
· Explain how an organization's mission and vision enable it to contribute to public health and safety improvements.
Competency 3: valuate health policies, based on their ability to achieve desired outcomes.
·
·
· Assess the impact of funding sources, policy, and legislation on an organization's service delivery.
Competency 4: Integrate principles of social justice in community health interventions.
·
·
· Evaluate an organization's ability to promote equal opportunity and improve the quality of life in a community.
Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health.
·
·
· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
· Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Scoring Guide
Use the scoring guide to understand how your assessment will be evaluated.
|
CRITERIA |
NON-PERFORMANCE |
BASIC |
PROFICIENT |
DISTINGUISHED |
|
Explain how an organization’s mission and vision enable it to contribute to public health and safety improvements. |
Evaluate an organization’s ability to promote equal opportunity and improve the quality of life in a community.
Assess the impact of funding sources, policy, and legislation on an organization’s service delivery.
Explain how an organization’s work impacts the health and/or safety needs of a local community.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Please see attachment for instructions
Healthcare Professional Interview:Interview with a culturally competent Registered Nurse, Nursing Leader, or Advanced Practice Nurse. BSN students must select a nursing professional with a BSN or higher degree in nursing practice. The interview must address the following topics:
This is an all-or-none assignment. Please ensure that all of the concepts listed above are included in your interview. The interview should be at least one page in length and uploaded. Please pay close attention to spelling and grammar.
How will the degree program you are seeking support your career plans at UHealth Tower as an acute care nurse practitioner in 3-5 years?
Please see attached
Unit 3 Discussion – ICD-10 Codes. Due 7-25-23. 1000words. 4 references
1. Why is accurate coding using the ICD-10-CM important?
2. Use your lecture materials to determine what ICD-10 Codes to assign for this patient encounter.
3. In paragraph form, construct a discussion that supports the Codes you identified.
4. In the discussion explore how the ICD-10 Codes that you assigned impact third party payor reimbursement for this visit.
5. Summarize an article that pertains to ICD-10-CM
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Chief Complaint:
Older sister reports – “Our mother died three weeks ago and we lost our father several months ago. I think that my sister was depressed and just wanted to be with them.”
History of Present Illness:
31-year-old female who was brought to the hospital by ambulance. She was found slumped over in her car in front of the funeral home where memorial services for both her father and mother had recently been held. On the seat beside her were two empty bottles of sleeping pills, a Bible opened to Psalm 23, and a note that read
: “I am going to be with mom and dad. It is just too sad being here anymore without them. I love you all and you will be in my prayers.” When she was found by the funeral home director her hair was oily and unkempt and she smelled as if she had not bathed in a long time. She was wearing a dirty orange T-shirt and jeans.
PMH:
Depression when she was a junior in HS which led to psychiatric admissions at 15 and 19 years of age. For these admissions she was treated with antidepressants and psychotherapy. Length of stay for both admissions was approximately 5 weeks. At age 19, following a suicide attempt, she met her first husband in the psych ward of the hospital. Diagnosed with bipolar disorder 6 years ago.
Information from Sister:
Older sister reports ‘hard life’. Reports both parents were alcoholics. Parents would go to bars almost every night and leave the 8 children in the care. The children were eventually removed from the home. Some of the children went to the Catholic girls’ home others were placed in “horrible” foster homes where they were subjected to physical and sexual abuse.
Reports numerous siblings, including the patient, have been through several detoxification centers for alcohol abuse.
Patient is in her second marriage with 3 daughters – 2 from the first marriage and 1 from the current marriage.
Reports that after having her third baby the patient went into a ‘terrible depression’. The patient was under the care of a psychiatrist for this depression and was placed on an anti-depressant after about 3 months of being under the psychiatrist’s care. After 3 weeks of being on this anti-depressant the patient is reported as having gotten ‘really weird’; patient was staying up all night pacing around her house and talking to people on the phone, she would go on shopping sprees for 2-3 days at a time and max out all her credit cards. The patient finally crashed and was taken to the hospital by her family and it was during this admission, 6 years ago, that the patient was diagnosed with bipolar disorder. Sister reports the patient has been on Lithium since being diagnosed with bipolar disorder.
Reports their father had been sick for a while so his death was not unexpected. However, their mother went downhill fast and the patient is reported to not cope well with the mother’s illness/death.
Reports the patient hadn’t been eating lately with noted weight loss. Additionally, the sister reports the patient had been smoking and drinking ‘more than usual’ lately.
Family Hx:
Paternal grandmother – depression
Two maternal aunts – bipolar disorder
Mother and father – alcohol abuse
Father died from pancreatic cancer
Mother died from heart failure
3 living brothers, 3 living sisters, one deceased brother who had an AMI at age 34
Social Hx:
Divorced and remarried
Worked as a nurse’s aid and health insurance claims adjuster
Attends church regularly
Smoked 1ppd for 15 years
History of alcohol abuse with several DWI violations
History of IV drug use, not in the last 10 years
ROS:
Information from sister:
Neuro – history of migraine headaches since late teens, takes Imitrex prn
SIGECAPS:
Sister reports: at times the patient is up all night – particularly when bipolar symptoms not well controlled, the patient seemed to be more depressed since the loss of their mother, does not believe the patient felt guilty surviving parents, patient has been not been attentive to her personal hygiene, the patient appeared to be obsessing on parental loss, patient appeared to be losing weight and therefore suspect she was not eating well, patient seemed to not be engaging in typical daily activities; patient had not expressed having suicidal ideations, had not expressed homicidal ideations
Medications:
Lithium 600mg po Q AM and 600mg po Q HS
Sumatriptan 50-200mg po PRN
Allergies:
ASA – swelling of face
Physical Examination:
General – lethargic and slow to respond to questions; BP 110/72, P 66, RR 12, T 97.0, SpO2 on RA 95%, Ht 66 in, Wt 135 lbs, BMI 21.8
Integument – skin pale, warm, dry; good turgor; several cystic lesions on chin; no rashes, ecchymoses or petechiae noted
HEENT – Head is normocephalic and atraumatic, pupils dilated with sluggish reaction to light, TMs gray and shiny bilateral, nares patent without discharge noted, no tonsillar enlargement, moist mucous membranes
Neck – supple without adenopathy, no thyromegaly
Lungs – CTA
Breasts – deferred
Cardiovascular – heart with RRR without murmur/gallop, multiple varicosities noted bilateral lower extremities
Abdomen – soft, non-distended, active bowel sounds, non-tender, no organomegaly
Genitalia/Rectum – deferred
Musculoskeletal – no major limitations of ROM or gross abnormalities noted
Neurologic – oriented to person, DTRs 2+ and equal bilateral, no localizing signs, CN II- XII grossly intact
Diagnostics – Na 139 meq/L, K 3.7 meq/L, Cl 108 meq/L, HCO3 23 meq/L, Bun 10 mg/dL, Cr 0.7 mg/dL, fasting Glu 102 mg/dL, Ca 8.7 mg/dL, PO4 3.2 mg/dL, Protein 4.8 g/dL, Mg 2.0 mg/dL, AST 33 IU/L, ALT 20 IU/L, GGT 82 IU/L, Alb 2.9 g/dL, TSH 4.1, Vit B12 203 pg/mL, Hgb 12.2 g/dL, HCT 36.8 %;
Lithium 0.08meq/L
Urine dipstick – 6.3 pH, SG 1.021, all other parameters negative
Assessment:
You will be evaluating the subjective and objective data sets to determine the diagnoses for this patient encounter.
Plan:
The plan cannot be developed until the diagnoses are assigned.
