BHA435 Module 4 Case SLP

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9/25/23, 6:00 PM SLP – BHA435 Healthcare Quality Assessment and Improvement (2023AUG14FT-1)

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Module 4 – SLP

CONTINUOUS QUALITY IMPROVEMENT

Quality assurance and continuous quality improvement is often merged together as
one, however, there are distinct difference between the two terms.

In a 2-page report, complete the following:

Explain in detail and provide a healthcare example of quality assurance in
healthcare.

Explains in detail and provide a healthcare example of continuous quality
improvement in healthcare.

Identify if these concepts work together or independently and explain your
rationale.

SLP Assignment Expectations

Conduct additional research to gather sufficient information to justify/support your
training.

1. Limit your response to a maximum of 2 pages (title and reference pages are not
included in page number count).

2. Support your responses with peer-reviewed articles, with 2 to 3 references. Use
the following link for additional information on how to recognize peer-reviewed
journals:
How to Recognize Peer-Reviewed (Refereed) Journals
http://www.angelo.edu/services/library/handouts/peerrev.php.

3. You may use the following source to assist in formatting your assignment:
Purdue Owl – https://owl.english.purdue.edu/owl/resource/560/01/.

4. For additional information on reliability of sources, review the following source:
https://nccih.nih.gov/health/webresources.

5. This assignment will be graded based on the content in the rubric.

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Womens Health Brochure

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Women’s Health Brochure

Module 01 Content

1.

Top of Form

Competency

Identify multidimensional nursing care strategies for clients with reproductive system disorders.

Scenario

You work in a gynecological office, and your office has been asked to participate in a women’s health fair. The focus of the fair is health promotion. Preventative screening for female reproductive disorders is vital to identify and treat rapidly to produce the best patient outcomes. Preventative screening includes a mammogram and Pap smear and should be performed based on recommended age and associated risk factors. To promote preventative screening, your office will be creating brochures to distribute at the health fair.

Instructions

Design a women’s health brochure by choosing one of the female reproductive disorders covered in this module. In the brochure, include the following:

· Overview of the disease including disease process, signs and symptoms, and risk factors

· Preventative screening

· Diagnostics tests

· Treatment

· Multidimensional nursing care interventions

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Unit 8 Medications for Sleep Disorders —2 Peer Response 600w. due 10-25-23

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Unit 8 Medications for Sleep Disorders —2 Peer Response 600w. due 10-25-23

Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers:

• Compare and contrast your initial posting with those of your peers.

• How are they similar or how are they different?

• What information can you add that would help support the responses of your peers?

• Ask your peers a question for clarification about their post.

• What most interests you about their responses?

Please be sure to validate your opinions and ideas with citations and references in APA format.

Ingrid A.

· There are multiple sleep disorders such as insomnia, sleep apnea, restless leg syndrome, hypersomnia, circadian rhythm disorders, and parasomnia which I think is “sleepwalking” or at least very similar to sleepwalking (Sleep Disorders, 2020).

Screening tools to diagnose sleep disorders can be just as gathering information from the patient, like history and physical. There are other screening tools such as actigraphy which is something like a watch the patient must wear and this tracks the movements the patient makes when sleeping and being awake (How is actigraphy used to evaluate sleep?, 2022)

Adding more we also have polysomnography also known as the “sleep study”, and this particular test records brain waves, oxygen level as well as heart rate (Polysomnography (Sleep Study) 2023). Epic (electronic health record) has something called the stop-bang questionnaire and it basically asks questions about snoring, blood pressure, and the size of the neck. There is also something called the Athens Insomnia Scale and Epworth Sleepiness Scale (Sleep disorders: Clinical tools, 2023).

Z-drugs such as zolpidem, zopiclone, and zaleplon are innovative hypnotics that aid with sleep, reduce sleep latency, and improve quality. These drugs are prescription dispensed only and they work by slowing the activity in the brain (Commissioner, 2023).

Benzodiazepines are medications such as lorazepam, diazepam, temazepam, alprazolam, and clonazepam among others that can have potential side effects such as respiratory depression, drowsiness, impaired judgment, nausea and vomiting, confusion, addiction, and even respiratory distress (Brandt & Leong, 2017).

References:

Brandt, J., & Leong, C. (2017). Benzodiazepines – statpearls – NCBI bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470159/

Commissioner, O. of the. (2023). Taking z-drugs for insomnia? know the risks. U.S. Food and Drug Administration. https://www.fda.gov/consumers/consumer-updates/taking-z-drugs-insomnia-know-risks

How is actigraphy used to evaluate sleep?. Sleep Foundation. (2022, May 10). https://www.sleepfoundation.org/sleep-studies/actigraphy

Mayo Foundation for Medical Education and Research. (2023, February 17). Polysomnography (Sleep Study). Mayo Clinic. https://www.mayoclinic.org/tests-procedures/polysomnography/about/pac-20394877#:~:text=Polysomnography%2C%20known%20as%20a%20sleep,measures%20eye%20and%20leg%20movements.

Sleep disorders: Clinical tools. CAMH. (2023). https://www.camh.ca/en/professionals/treating-conditions-and-disorders/sleep-disorders/sleep-disorders—clinical-tools

U.S. National Library of Medicine. (2020, January 3). Sleep disorders. MedlinePlus. https://medlineplus.gov/sleepdisorders.html


Mojgan A

Week 8, Medications for Sleep Disorders

What screening tools can be used to affirm your initial diagnosis that a patient may meet the diagnostic criteria for a sleep disorder?

        There are different tools for assessing sleep disorders. Among various rating scales, the Pittsburgh Sleep Quality Index (PSQI) was specifically designed to evaluate overall sleep quality and is among the recommended questionnaires for examining global sleep patterns and symptoms related to insomnia (Zitser et al., 2022). It is a self-report questioner and will assess the sleep quality over one month. Another useful scale is the Epworth Sleepiness Scale (ESS), which is a questionnaire designed to assess daytime sleepiness. A higher score on the ESS suggests the need for further evaluation for possible sleep disorders (Clinical application of headache impact test (HIT)-6 and Epworth Sleepiness Scale, 2023).

        According to the literature, the gold standard for monitoring sleep and breathing is polysomnography (PSG). PSG observes various physiological factors during sleep, including brain activity, eye movement, heart rate, and muscle activity. It involves the use of special bands around the chest and abdomen, as well as sensors for temperature and airflow in the nose. PSG also utilizes a device to measure airflow and sensors for air pressure in the airway. However, it's important to note that these methods can be invasive and time-consuming to set up and understand (Naik et al., 2023). Home sleep apnea testing (HSAT) is a simplified version of PSG that can be conducted at home and offers several potential benefits compared to traditional PSG, such as increased accessibility, quicker treatment initiation, and cost savings (Johns et al., 2022).

Describe the pharmacological actions of non-z sleep medications?

       Non-benzodiazepine (non-Z) sleep medications, such as zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata), function by enhancing the activity of the neurotransmitter known as gamma-aminobutyric acid (GABA) in the central nervous system. GABA is an inhibitory neurotransmitter that promotes relaxation and facilitates sleep. One key distinction between benzodiazepine medications and non-Z medications is their selectivity in targeting GABA receptors (Stahl, 2021).

       Benzodiazepines act on various GABA receptor subunits (including alpha 1, alpha 2, alpha 3 and alpha 5 receptors) nonselectively. Benzodiazepines acting on alpha2 and alpha3 receptor subtypes have effects that reduce anxiety, promote muscle relaxation, and enhance the effects of alcohol. On the other hand, the alpha5 subtype, found in the hippocampus, may be implicated in cognitive processes. As a result, benzodiazepines are employed for the treatment of sleep disorders, seizure disorders, and anxiety disorders due to their broader spectrum of activity (Stahl, 2021).

        In contrast, non-Z medications selectively target alpha 1 receptors, which are primarily associated with the sleep process. Therefore, non-Z medications are specifically designed to induce and improve sleep without affecting the full spectrum of GABA receptors. Another distinction to note is that benzodiazepines typically have longer half-lives, which means they remain in the body for a more extended period compared to non-Z medications. This difference in half-life can have implications for factors such as prolong sedation and potential for dependence or withdrawal when using these medications. Non- Z medications are usually used for short amount of time and do not cause dependence or withdrawal symptoms (Stahl, 2021).

What problems can occur when benzodiazepines are used to help with sleep?

        Benzodiazepines are potent medications known for their effectiveness, but they come with a range of significant concerns and potential problems. They have sedative properties, leading to drowsiness and increased sleepiness in patients. Additionally, benzodiazepines exhibit a prolonged half-life, resulting in an extended duration of action within the body, which can impact a patient's overall quality of life. These medications have been associated with several adverse effects (Stahl, 2021).

        Benzodiazepines can impair cognitive function, memory, and coordination, potentially leading to accidents and reduced overall performance. A major concern with benzodiazepines is the development of tolerance. Over time, patients may require higher doses to achieve the same therapeutic effect. This can lead to physical and psychological dependence, as patients become addicted to the sedative properties of the medication (Stahl, 2021).

        Abruptly discontinuing benzodiazepines can result in unpleasant withdrawal symptoms, which can be challenging for patients. One study by Ritvo et al. (2023) revealed that over 40% of the respondents reported experiencing 17 or more symptoms persisting for at least one year after discontinuing their use of benzodiazepines. Common side effects associated with benzodiazepines include dizziness, drowsiness, and coordination problems, which can be especially problematic for individuals who need to remain alert and functional. It's essential to be mindful of potential drug interactions, as benzodiazepines can interact with other medications, potentially affecting their effectiveness or causing unexpected side effects (Stahl, 2021)

        Given these concerns, it is advisable to use benzodiazepines cautiously and only for short durations. When discontinuing their use, a slow tapering approach is often recommended to minimize the risk of withdrawal symptoms. This ensures that the benefits of these medications are balanced against the potential risks and adverse effects they may cause.

References

Clinical application of headache impact test (HIT)-6 and Epworth Sleepiness Scale (ESS) for sleep apnea headache. (2023). 
Sleep Science and Practice, 7, 1-9. 
https://doi.org/10.1186/s41606-023-00084-2Links to an external site.

Johns, J. D., Armin, M., Alexandra, W., Jeffrey, K. H., Mikula, S. K., & Hoa, M. (2022). Reliability of home sleep apnea testing for diagnosing obstructive sleep apnea in patients with spontaneous cerebrospinal fluid leaks. 
Cureus, 14(10)

https://doi.org/10.7759/cureus.29854

Naik, G. R., Breen, P. P., Jayarathna, T., Tong, B. K., Eckert, D. J., & Gargiulo, G. D. (2023). Morphic sensors for respiratory parameters estimation: Validation against overnight polysomnography.
 Biosensors, 13(7), 703. 
https://doi.org/10.3390/bios13070703Links to an external site.

Ritvo, A. D., Foster, D. E., Huff, C., Reid Finlayson, ,A.J., Silvernail, B., & Martin, P. R. (2023). Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey.
 PLoS One, 18(6) https://doi.org/10.1371/journal.pone.0285584

Stahl, S. M. (2021). 
Stahl’s essential psychopharmacology: Neuroscientific basis and practical application (5th ed.).

Zitser, J., Allen, I. E., Falgàs, N., Le, M. M., Neylan, T. C., Kramer, J. H., & Walsh, C. M. (2022). Pittsburgh Sleep Quality Index (PSQI) responses are modulated by total sleep time and wake after sleep onset in healthy older adults.
 PLoS one, 17 (6) https://doi.org/10.1371/journal.pone.0270095

 Reply

SOAP note

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SOAP note Lumbar pain

Psychopharmacology

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What challenges do you expect with the PMHNP role?

What is the role of the Nurse Practitioner in the use of psychotropic medications? What is so important the knowledge of these class of medications? 

If you copy and paste references from the course into your assignment, be sure to confirm APA formatting before submitting.

see below

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see below

political

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The Electoral College Argument, Politics and Social Media

Discussion

Required Resources

Read/review the following resources for this activity:

· Textbook: Chapters 5, 6 and 10

· Lesson: Read this Week's Lesson which is located in the Modules tab

· Initial Post: minimum of 2 scholarly sources (must include your textbook for one of the sources). Follow-Up Post: minimum of 1 scholarly source for your Follow-Up Post.

· Your Initial Post and your Follow-Up Post must be based on the same Option that you chose in order to receive credit for both posts. 

Initial Post Instructions

For the initial post, respond to one of the following options, and label the beginning of your post indicating either Option 1 or Option 2:

·
Option 1: List the ways in which contemporary presidential campaigns have used social media as a campaign tool. Do you consider social media as a successful tool? Explain your answer. Do you see social media as an unsuccessful tool? Explain your answer and provide examples.

Be sure to make connections between your ideas and conclusions and the research, concepts, terms, and theory we are discussing this week.

Writing Requirements

· Minimum of 2 posts (1 initial & 1 follow-up)

· Minimum of 2 sources cited (assigned readings/online lessons and an outside source) for your Initial Post, and 1 scholarly source for your Follow-Up Post.

· APA format for in-text citations and list of references

EBOOK: The Struggle for Democracy, 2018 Elections and Updates Edition

https://bookshelf.vitalsource.com/reader/books/9780135246849/pageid/227 or

email:
[email protected]

pwd: Bryanthierry@09

evaluate your intervention. preventing homelessnees in veteran population

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Develop a 4-6 page plan that will allow you to evaluate your intervention.

You will also be required to submit your completed practicum hours using CORE ELMS. You must submit a minimum of 20 confirmed hours with each assessment deliverable to receive a grade for the entire assessment.

Introduction

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

Once an intervention is planned and implemented it is important to evaluate the degree to which the outcomes of the project were achieved. By evaluating the desired outcomes of an intervention, it is possible to make more informed decisions about opportunities for continuous improvement. It is also possible to identify strategies and approaches that could be useful in improving one’s personal practice in other contexts or care areas.

Preparations

  • Read Guiding Questions: Evaluation Plan Design [DOC]. This document is designed to give you questions to consider and additional guidance to help you successfully complete this assessment.
  • As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.
    • What specific piece or pieces of technology did you propose using in your implementation plan?
    • How did the type of technology you chose impact the development of your implementation plan?
    • How will the incorporation of the technology you propose make your implementation plan more successful?

Instructions

Note: The assessments in this course are sequenced in such a way as to help you build specific skills that you will use throughout your program. Complete the assessments in the order in which they are presented.

Your evaluation plan design will be the forth section of your final project submission. The goal for this is to finalize the outcomes that your plan is seeking to achieve and to create a plan to evaluate the degree to which those outcomes would have been achieved if your intervention plan has been implemented. This will allow you to determine the degree to which the plan was successful in addressing the identified need of your target population and setting.

You will also discuss ways in which your role allows you to lead change and drive quality improvement, and to potentially improve the project in the future. In addition, you will reflect on how the project will leave you better prepared for success in other aspects of your current and future career. Provide enough detail so that the faculty member assessing your implementation plan design and discussion will be able to provide substantive feedback that you will be able to incorporate into the final draft of your project.

At minimum, be sure to address the bullet points below, as they correspond to the grading criteria. You may also want to read the scoring guide and the Guiding Questions: Evaluation Plan Design [DOC] document to better understand how each criterion will be assessed. In addition to the bullet points below, provide a brief introduction that refreshes the reader’s memory about your problem statement, your planned intervention, and how you intended to implement your intervention (this should only be a single paragraph).

Reminder: These instructions are an outline. Your heading for this this section should be Evaluation of Plan and not Part 1: Evaluation of Plan.

Part 1: Evaluation of Plan
  • Define the outcomes that are the goal of an intervention plan.
  • Create an evaluation plan to determine the impact of an intervention for a health promotion, quality improvement, prevention, education, or management need.
Part 2: Discussion

Advocacy

  • Analyze the nurse’s role in leading change and driving improvements in the quality and experience of care.
  • Explain how the intervention plan affects nursing and interprofessional collaboration, and how the health care field gains from the plan.

Future Steps

  • Explain how the current project could be improved upon to create a bigger impact in the target population as well as to take advantage of emerging technology and care models to improve outcomes and safety.

Reflection on Leading Change and Improvement

  • Reflect on how the project has impacted your ability to lead change in personal practice and future leadership positions.
  • Reflect on the ways in which the completed intervention, implementation, and evaluation plans can be transferred into your personal practice to drive quality improvement in other contexts.
Address Generally Throughout
  • Integrate resources from diverse sources that illustrate support for all aspects of an evaluation plan for an intervention, as well as for professional discussion about the plan.
  • Communicate evaluation plan and discussion of the project in a professional way that helps the audience to understand how the outcomes will be evaluated, as well as what was learned through the project process.

dicussion post sociology

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Respond to two (2) of the following prompts:

  1. How is masculinity described by the authors of our text? Using specific examples, discuss why patriarchal masculinity is not the only form of masculinity. (USLO 5.1, 5.3)
  2. How is sexism explained by the authors of our text? Using specific examples, discuss how society propagates misogyny and objectification of women. (USLO 5.3)
  3. Using one of the three theoretical primary sociological perspectives featured in our text (i.e., functionalism, conflict, and symbolic interactionism) discuss the social construction of gender. Present two tangible examples of how this theory best explains how gender is socially constructed. (USLO 5.4)
  4. Where and how do you get your news? Do you watch network television? Read the newspaper? Go online? How about your parents or grandparents? Do you think it matters where you seek out information? Why, or why not? (USLO 5.5)
  5. How have digital media changed social interactions? Do you believe it has deepened or weakened human connections? Defend your answer. (USLO 5.6)
  6. Do you think technology has truly leveled the world in terms of opportunity? What is your community’s situation in terms of digital inclusion – do you feel there are communities in your region that are struggling to achieve digital inclusion and equity? What are some techniques that we may use to achieve digital equity and inclusion in the U.S.? (USLO 5.7)
  7. In what ways has the Internet and digital apps changed your perception of reality? Explain using a symbolic interactionist, functionalist, and conflict theory perspective. (USLO 5.8)