Healthcare

Advanced Health Assessment and Diagnostic ReasoningAssignment 1Case Study Assignment: Assessing Neurological SymptomsImagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

Healthcare Policy and Law In the most general sense, this domain is concerned with an individual’s access to care (e.g., What poli- cies and laws impact an individual’s ability to access needed care?), the quality of the care the person receives (e.g., Is it appropriate, cost-effective, and non- negligent?), and how the person’s care will be financed (e.g., Is the person insured?). However, “access,” “qual- ity,” and “financing” are themselves rather large sub- domains, with their own sets of complex policy and legal issues; in fact, it is common for students to take semester-long policy and/or law courses focused on just one of these subdomains.Public Health Policy and Law The second large topical domain is that of public health policy and law. A central focus here is on why and how the government regulates private individuals and cor- porations in the name of protecting the health, safety, and welfare of the general public. Imagine, for example, that the federal government is considering a blanket policy decision to vaccinate individuals across the coun- try against the deadly smallpox disease, believing that the decision is in the best interests of national security. Would this decision be desirable from a national policy perspective? Would it be legal? If the program’s desir- ability and legality are not immediately clear, how would you go about analyzing and assessing them? These are the kinds of questions with which public health policy and law practitioners and scholars grapple.Bioethics Finally, there is the bioethics domain to health policy and law. Strictly speaking, the term bioethics is used to describe ethical issues raised in the context of med- ical practice or biomedical research. More compre- hensively, bioethics can be thought of as the point at which public policy, law, individual morals, societal values, and medicine intersect. The bioethics domain houses some of the most explosive questions in health policy, including the morality and legality of abortion, conflicting values around the meaning of death and the rights of individuals nearing the end of life, and the policy and legal consequences of mapping the human genetic code.Social, Political, and Economic Historical Context Dividing the substance of health policy and law into broad topical categories is only one way to conceptual- ize them. A second way to consider health policy and

Discussion QuestionBefore beginning work on this discussion forum, please review the link Doing Discussion Questions Right, the expanded grading rubric for the forum, and any specific instructions for this topic.By the due date assigned, respond to the assigned discussion questions and submit your responses to the appropriate topic in this Discussion Area. Respond to the assigned questions using the lessons and vocabulary found in the reading.The Health Insurance Experiment (HIE) is perhaps the greatest experiment in the history of healthcare finance as it explores the interface of people and insurance and the methods for reducing waste in the consumption of healthcare through moral hazard.Tasks:Describe the results of the experiment and analyze how it affects healthcare today.Your initial posting should be addressed at 300–500 words as noted in the attached PDF. Submit your document to this Discussion Area, by the due date assigned. Be sure to cite your sources using APA format.Respond to your peers throughout the unit. Justify your answers with examples, research, and reasoning. Follow-up posts need to be submitted by the end of the unit.

Describe the healthy meal that you have created from the fast food restaurant using the nutritional value of menu items.Name the restaurant and then write a nutritional analysis of the meal you have created. (Explain all of the nutrients found in the meal, like carbs, protein, fat, and some essential vitamins and minerals.)Discuss your reaction to the analysis. Make sure to explain why you feel the way you do about this meal. For example, if your meal is composed primarily of fat, discuss that point; if your meal supplies a lot of sugar per serving, discuss that as well. Please also remember to link excess or limited amounts of nutrients with diseases or the potential for disease. (Too much fat may put you at risk for heart disease, not enough calcium may not support bone health, etc.) Please make sure this section is as detailed as possible.How will this information affect your future food choices? Make sure to explain why you will or will not eat this meal again, and support your answer with the information found in the above sections.In a Word document, please answer and discuss the following questions.Describe the unhealthy meal that you have created from the fast food restaurant using the nutritional value of menu items.Name the restaurant, and then write a nutritional analysis of the meal you have created. (Explain all of the nutrients found in the meal, like carbs, protein, fat, and some essential vitamins and minerals.)Discuss your reaction to the analysis. Make sure to explain why you feel the way you do about this meal. For example, if your meal is composed primarily of fat, discuss that point; if your meal supplies a lot of sugar per serving, discuss that as well. Please also remember to link excess or limited amounts of nutrients with diseases or the potential for disease. (Too much fat may put you at risk for heart disease, not enough calcium may not support bone health, etc.) Please make sure this section is as detailed as possible.How will this information affect your future food choices? Make sure to explain why you will or will not eat this meal again, and support your answer with the information found in the above sections.

Flu Epidemic of 1918 Digital History ID 1112Date:1918Document: Camp Devens, Mass. Surgical Ward No. 16 29 September 1918My dear Burt,It is more than likely that you would be interested in the news of this place, for there is a possibility that you will be assigned here for duty, so having a minute between rounds I will try to tell you a little about the situation here as I have seen it in the last week.As you know, I have not seen much pneumonia in the last few years in Detroit, so when I came here I was somewhat behind in the niceties of the Army way of intricate diagnosis. Also to make it good, I have had for the last week an exacerbation of my old “Ear Rot” as Artie Ogle calls it, and could not use a stethoscope at all, but had to get by on my ability to “spot” `em thru my general knowledge of pneumonias…Camp Devens is near Boston, and has about 50,000 men, or did have before this epidemic broke loose. It also has the base hospital for the Division of the Northeast. This epidemic started about four weeks ago, and has developed so rapidly that the camp is demoralized and all ordinary work is held up till is has passed. All assemblages of soldiers taboo. These men start with what appears to be an attack of la grippe or influenza, and when brought to the hospital they very rapidly develop the most viscous type of pneumonia that has ever been seen. Two hours after admission they have the mahogany spots over the cheek bones, and a few hours later you can begin to see the cyanosis extending from their ears and spreading all over the face, until it is hard to distinguish the coloured men from the white. It is only a matter of a few hours then until death comes, and it is simply a struggle for air until they suffocate. It is horrible. One can stand it to see one, two or twenty men die, but to see these poor devils dropping like flies sort of gets on your nerves. We have been averaging about 100 deaths per day, and still keeping it up. There is no doubt in my mind that there is a new mixed infection here, but what I don’t know. My total time is taken up hunting rales, rales dry or moist, sibilant or crepitant or any other of the hundred things that one may find in the chest, they all mean but one thing here–pneumonia–and that means in about all cases death.The normal number of doctors here is about 25 and that has been increased to over 250, all of whom (of course excepting me) have temporary orders– “Return to your proper station on completion of work”–Mine says, “Permanent Duty,” but I have been in the Army just long enough to learn that it doesn’t always mean what it says. So I don’t know what will happen to me at the end of this. We have lost an outrageous number of nurses and doctors, and the little town of Ayer is a sight. It takes special trains to carry away the dead. For several days there were no coffins and the bodies piled up something fierce, we used to go down to the morgue (which is just back of my ward) and look at the boys laid out in long rows. It beats any sight they ever had in France after a battle. An extra long barracks has been vacated for the use of the morgue, and it would make any man sit up and take notice to walk down the long lines of dead soldiers all dressed up and laid out in double rows. We have no relief here; you get up in the morning at 5:30 and work steady till about 9:30 p.m., sleep, then go at it again. Some of the men of course have been here all the time, and they are tired.If this letter seems somewhat disconnected overlook it, for I have been called away from it a dozen times, the last time just now by the Officer of the Day, who came in to tell me that they have not as yet found at any of the autopsies any case beyond the red hepatitis stage. It kills them before it gets that far.I don’t wish you any hard luck Old Man, but do wish you were here for a while at least. Its more comfortable when one has a friend about. The men here are all good fellows, but I get so damned sick o’ pneumonia that when I eat I want to find some fellow who will not “talk shop” but there ain’t none, no how. We eat it, sleep it, and dream it, to say nothing of breathing it 16 hours a day. I would be very grateful indeed it you would drop me a line or two once in a while, and I will promise you that if you ever get into a fix like this, I will do the same for you.Each man here gets a ward with about 150 beds (mine has 168), and has an Asst. Chief to boss him, and you can imagine what the paper work alone is– fierce–and the Government demands all paper work be kept up in good shape. I have only four day nurses and five night nurses (female) a ward-master, and four orderlies. So you can see that we are busy. I write this in piecemeal fashion. It may be a long time before I can get another letter to you, but will try.Good-by old Pal,”God be with you till we meet again”Keep the Bouells open,RoySource: PBS film, Influenza 1918*****After reading this and understanding the present situation,what are your initial feelings about what was being discussed in this article ? What was the author writing about in this article? (1 full page, single spaced)Document 4

Finding Evidence-Based Practice in Healthcare· In this activity, you will choose a PICO(T) question and develop a search strategy to find the best evidence to support the intervention.· What You Need to KnowPeer-reviewed journals contain research studies with evidence to do the following two tasks:1) Support the identified health care challenge and the need to improve it.2) Substantiate potential interventions and show that they are evidence-based and have been successful at closing gaps in practice or addressing health care challenges.It is important, then, to become familiar with performing a search of the literature based on a PICO(T) question. Likewise, it is crucial to master your skills in using databases to conduct your search.· Levels of Evidence Pyramid.As you have learned in the readings, quantitative studies result in some of the best possible evidence that can be used in the EBP process. Qualitative studies and the evidence they produce is also an area of research that is increasing rapidly in terms of its importance, validity, and relevance. This week, you will have the opportunity to reacquaint yourself with some of the most common quantitative and qualitative research methods and designs employed in the field of public health and health care.Quantitative research is a systematic investigation of phenomena by gathering quantifiable, numeric data and performing statistical, mathematical, or computational techniques. These types of studies collect data and information from or about a group of individuals or a sample of a population using surveys or questionnaires and with the help of existing data sources that track performance indicators and metrics and other data. There are four main types of quantitative research designs: descriptive, correlational, quasi-experimental and experimental. The differences between the four types primarily relate to the degree the researcher designs for control of the variables in the experiment.View the following presentation toknowaboutquantitativeresearchdesigns:·KaiserPermanenteSouthernCaliforniaNursingResearch(n.d.).NursingresearchseriesPart10:Quantitativestudydesign:Interventional[SlidePresentation]|TranscriptRetrievedfromhttp://kpnursing.org/_SCAL/research/researchseries/10_quantitativeinterventionalstudydesign/player.htmlQualitative research is significantly different from quantitative research in terms of its philosophical foundations, practical objectives, management of the investigative process, and use and interpretation of acquired data. The qualitative approach to an inquiry can provide a rich, experiential understanding of specific health care topics, greater than is generally possible with quantitative methods. Although assessing the methodological quality of qualitative studies is complex and somewhat subjective, your assessment skills in inductive reasoning, context flexibility, and theoretical analysis will grow in proportion to your use of qualitative research in your own practice and your frequency of reading this type of literature.View the following presentation to know about qualitative research designs:· Kaiser Permanente Southern California Nursing Research. (n.d.). Nursing research series – Part 8: Qualitative research design [Slide Presentation] | Transcript Retrieved from http://kpnursing.org/_SCAL/research/researchseries/08_qualititativerd/player.htmlOne area of potential confusion when reading about research methods and research designs is differentiating the two. Research methods are generally considered to be the broad underlying philosophical and practical approaches (that is, quantitative versus qualitative or intervention versus observation) to answer a research question. A research design, on the other hand, is more like a blueprint about what steps need to be taken to answer the research question or problem. Research designs include study sample collection and recruitment strategies, the timeframe where interventions take place, the nature of instruments used for measuring efficacy or outcomes, and types of precautions used during data collection procedures.Review the following chapter in your Evidence-Based Practice in Nursing and Healthcare textbook, to learn about both quantitative and qualitative study methods and designs:· Write Your Discussion PostFinding the Best Evidence to Answer Different PICO(T) QuestionsNote: Remember to adhere to the requirements for initial discussion postings and responses addressed in the Discussions section of the Course Policies and Expectations presentation.ANSWER THE FOLLOWING PICO(T) questions below USING NO LESS THAN 300 WORDS!!!3. In patients with acute respiratory distress syndrome (P), will the implementation of a pulmonary hygiene protocol (I) compared with standard positioning care (C) improve weaning parameter metrics (O) during the next three months (T)?

Sleep disorders are conditions that result in changes in an individual’s pattern of sleep (Mayo Clinic, 2020). Not surprisingly, a sleep disorder can affect an individual’s overall health, safety, and quality of life. Psychiatric nurse practitioners can treat sleep disorders with psychopharmacologic treatments; however, many of these drugs can have negative effects on other aspects of a patient’s health and well-being. Additionally, while psychopharmacologic treatments may be able to address issues with sleep, they can also exert potential challenges with waking patterns. Thus, it is important for the psychiatric nurse practitioner to carefully evaluate the best psychopharmacologic treatments for patients that present with sleep/wake disorders.Reference: Mayo Clinic. (2020). Sleep disorders. https://www.mayoclinic.org/diseases-conditions/sleep-disorders/symptoms-causes/syc-20354018To prepare for this Assignment:· Review this week’s Learning Resources, including the Medication Resources indicated for this week.· Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with sleep/wake disorders.The Assignment: 5 pagesExamine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. (https://mym.cdn.laureate media.com/2dett4d/Walden/NURS/6630/DT/week_11/index.html)You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.Introduction to the case (1 page)· Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.Decision #1 (1 page)· Which decision did you select?· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.Decision #2 (1 page)· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.Decision #3 (1 page)· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

1. In patients with acute respiratory distress syndrome (P), will the implementation of a pulmonary hygiene protocol (I) compared with standard positioning care (C) improve weaning parameter metrics (O) during the next three months (T)?

1. Do employees behave differently in a flat versus a hierarchical organizational structure? Explain your answer.2. Do employee personality types differ between hierarchical and flat organizations?3. What is difficult about policy implementation in a flat organization? What is difficult about policy implementation in a hierarchical organization?4. How do you overcome employee apathy toward policy compliance?5. Create a policy framework implementation plan for the fictional Specialty Medical Clinic (the plan should not be longer than two pages). The Specialty Medical Clinic is being acquired by a larger parent organization under HIPAA compliance law. The parent organization is a hierarchical structure with multiple departments and clinics. The medical clinic is a flat organization. Following is an outline of those areas of the plan you need to include:Parent Medical ClinicAcquires Specialty Medical ClinicPublish Your Policies for the New Clinic{Explain your strategy.}Communicate Your Policies to the New Clinic Employees{How are you going to do this?}Involve Human Resources and Executive Management{How do you do this smoothly?}Incorporate Security Awareness and Training for the New Clinic{How can you make this fun and engaging?}Release a Monthly Organization-Wide Newsletter for All{How can you make this newsletter succinct?}Implement Security Reminders on System Logon Screens for All{This is for access to sensitive systems only.}Incorporate Ongoing Security Policy Maintenance for All{Review and obtain feedback from employees and policy-compliance monitoring.}Obtain Employee Questions or Feedback for Policy Board{Review and incorporate into policy edits and changes as needed.}

Week 3: Discussion on Priority Actions to Take When FloatingCaroline CombsNo unread replies.No replies.Participation Requirement: You are required to post a minimum of three (3) times in each discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. on Wednesday. On additional days, respond to your peers’ posts as well as additional faculty posts. Responses to peers must be posted by 11:59 p.m. on Sunday each week a discussion is due.Step 1: Read the following articlesAmerican Nurse Association. The American nurse. On less familiar ground. Strategies aim to reduce random floating, improve the experience. August 31, 2017. (Attached to discussion) (Links to an external site.)Brown T. Nurses are talking about: floating and rapid response duty. Medscape Sunday September 17, 2017. http://blog.diversitynursing.com/blog/nurses-are-talking-about-floating-and-rapid-response-duty (Links to an external site.)Davies K. Advance healthcare networks for nurses. Float assignments. Nursing advisor. http://nurseadvisormagazine.com/nurse-advisor/in-the-breakroom/float-nursing-to-reduce-healthcare-costs/ (Links to an external site.)Nurse.com. Do registered nurses have to float to areas where they have not been trained or feel comfortable working? Is this legal? December 11, 2013. https://www.nurse.com/blog/2013/12/11/do-rns-have-to-float-to-units-where-they-have-not-been-trained-or-feel-comfortable-working-is-this-legal/ (Links to an external site.)O’Connor K, Dugan LJ. Addressing floating and patient safety. RN Nursing February 2017-Vol47Issue2page5758doi:10.1097/01.NURSE.0000511820.9590378.https://journals.lww.com/nursing/Fulltext/2017/02000/Addressing_floating_and_patient_safety.15.aspx#:~:text=%20Addressing%20floating%20and%20patient%20safety%20%201,nurses%20may%20perceive%20floating%20negatively%2C%20it%27s…%20More%20 (Links to an external site.)RN responsibility when floating to new patient care unit or assigned to new population. https://www.rn.ca.gov/pdfs/regulations/npr-b-21.pdf (Links to an external site.)Priority Actions to take when FloatingFloating is defined as “the reassignment of staff from one nursing unit to another based upon the patient census and acuities”. Floating is difficult and has always been a problem for nurses but safe patient care is always the goal. Floating is a reality that often cannot be avoided, particularly in the hospital setting. Floating may cause anxiety, stress, overwhelming, scary, draining, dissatisfaction, disruptive, and feeling of frustration even to a very experienced and skillful nurse to be pulled to work on a unit outside her/ his comfort zone. This might be caused by discomfort from unfamiliarity related to diverse patient population, staff, unit, and the processes to a work on a different department. Working in unfamiliar area makes nurses uneasy by not knowing what to expect. Yes, they know how to take care of the patients but without proper orientation to the unit/ area one will be floating is not easy. Whenever staff members are sent to float to an unfamiliar unit, it is expected that at least they will be able to perform the basic assessment and skills.What Should the Registered Nurse Do When She/He Has to Float?Before accepting patient assignment when floating to a different unit…Make sure you have the necessary knowledge, judgement, skills, and ability to provide the required patient care. The nurse should not accept any patient care assignment he/ she is not competent to deliver the care but instead accept limited assignment of nursing care duties you can utilize your current competence.Remember that the department you are floating will be glad to have you to help them decrease their patient work load. You will be responsible for your own actions and will be the one to face disciplinary action by a State Board of Nursing if you are not competent to perform the assignment delegated to you.Talk to the Charge Nurse of the unit you are floating if you refuse the assignment being given to you and discuss the reason of your refusal. Let him/ her know that you are there to help but they should give you patient assignments that you are competent and comfortable to handle. The Charge Nurse of your permanent unit may be able to help you as well in talking to the unit you are floating If they insist for you to take the assignment. You may seek the help of the Nursing Supervisor. You can write an incident report to cover yourself.According to American Nurses Association (ANA), “Registered Nurses must have the professional right to accept, reject, or object in writing to any assignment that puts patients or themselves at serious risk for harm.” The Joint Commission on floating clearly states that when an employee is asked to float to a different unit, that unit must be similar to his or her own and that the nurse must demonstrate competencies specific to that unit. Furthermore, the assigned employees should be floated to areas of comparable clinical diagnoses and acuities.Initial Discussion Assignment:You are a nurse on a medical-surgical unit that is currently well staffed with each nurse at a 3:1 ratio. There were two call outs in the oncology unit and it is your turn to float. The charge nurse informs you that you are being floated to the oncology unit and that you have been assigned to care for four patients.Your discussion posting must address all of the following issues:Summarize the concepts of floating that were addressed in the attached articles.What steps would you take in this scenario to ensure a safe transition into the unfamiliar unit?Why are these steps important?What are some of the legal ramifications that can occur if you accept an assigned that is out of your scope of practice?On less familiar ground Strategies aim to reduce random floating, improve the experience.pdf