Nursing

Outline Include all of the following in each write-up. Demographics: Age, gender, race/ethnicity, educational level. Setting: Place where patient encounter took place. Reason for and Type of Visit: Intake, follow-up; psychotherapy or medication management. Diagnosis: Current diagnosis/diagnoses and the DSM-5 criteria that matches the symptoms or history of symptoms. Rating Scales: Any diagnostic rating scales that would be appropriate for this patient. History of Present Illness: What has recently happened and what is currently going on with patient? Use the eight HPI elements per CPT coding (timing, severity, and so on). Psychiatric History: When patient first started treatment, previous medications, previous inpatient/outpatient treatment, previous diagnoses and age when diagnosed, previous self-harm, and suicidal/homicidal ideations. Substance Abuse History: Any current or past history of substance use (drugs/alcohol/marijuana/nicotine); if patient has a history of substance use, include how long the patient has been sober. Family Psychiatric History: Any family psychiatric history. Medical/Surgical History: Any medical problems or previous surgeries. Medications: For each medication, include name of the medication (both brand name and generic), medication class, patient’s current dose, how the medication works (include the CYP450 system if applicable), patient education for this medication, drug/drug interactions, and lab tests that would need to be ordered for monitoring; include all medications. Mental Status Exam: Please include a mental status exam. Points Discussed in Visit: What did you and your preceptor discuss in the visit? Please list any major talking points between you and your preceptor. Therapy Recommendations: List any current therapy the patient is undergoing. Also, please state what type of therapy would work best for this patient with the given diagnosis. Include a reference supporting your therapy recommendation. Clinical Impression: How you thought the visit went, how receptive to the recommendations the patient appeared, and any mannerisms of the patient that you observed. Diagnosis Code: The ICD 10 diagnosis code(s) for this visit; include all appropriate specifiers. Include the billing/CPT code for the visit. Treatment Recommendations: Follow-up recommendations: time before next visit, therapy recommendations, and so on.

Answer the following questions to this case study Using the case study, assume the case manager role and apply the role to the circumstances of this client. Refer back to part 1 of this week’s assignments for guidance.   What would you as the case manager do with and for Emma and her family? Mrs. Emma W. is an 84 year old widow who retired at age 65 from a part-time job in the housekeeping department of a local hospital to care for her granddaughter and great-grandchild. She has a history of obesity and hypertension. She lives alone in a low income housing project. Her only daughter lives out of state and has no contact with Emma or her daughter Emilee and the grandchild. Emma’s only income is $740 per month from her husband’s Social Security, and Medicare is her only health insurance. Her monthly living expenses (rent, utilities, phone, etc.) amount to $500. Her health is poor and she reluctantly went to a physician who diagnosed her with uncontrolled hypertension, osteoporosis and chronic renal disease and prescribed her medications. The total cost for her medications will exceed $350 per month. A Registered Dietician gives her detailed diet instructions. The cost of the foods far exceeds her usual food budget. She cannot afford her medications or food and her health further deteriorates. Mrs. W is hospitalized with increasing fatigue, shortness of breath, uncontrolled hypertension, 2-3+ generalized edema, elevated BUN and creatinine, low HH. The HCP informs her that she needs dialysis, at least 3 days/week. Emma refuses, stating “I won’t be tied to a machine like my sister for the rest of my life.” She wants to go home, but her granddaughter, Emilee, is concerned that she cannot care for her in her home and hold down her waitress job—not to mention care for her own daughter and manage her own home. Emma has no advance directives and no POA. Mrs. W. is aware of her lack of financial resources and deteriorating health status, but doesn’t know what to do to help improve the situation. 1. What interventions would have helped to prevent this woman’s deterioration in health status? 2. As a health care professional who is aware of this woman’s circumstances, what steps could you take to help her now? 3. You discuss possible nursing home admission with Mrs.W. (Remember that Medicare does not pay for custodial care.) If she will not agree to be admitted, what steps do you think you will need to take to overcome her problems? 4.  Demonstrate the interdisciplinary members that may need to be involved in the client’s care. 5.  Demonstrate the responsibilities of each interdisciplinary member. 6.  Provide a schedule of how the team will effectively collaborate the client’s care. 7. You also discuss Medicaid with Mrs. W. Describe what measures you would need to take to help her access the system. What limitations might you encounter?

In this written assignment, you will examine each of the three types of nursing theory-grand, middle range and micro-range.  Step 1 Using a minimum of two scholarly sources, write a two-page (minimum) paper that responds to the following topics:  Define and/or describe grand, middle range, and micro-range nursing theory.  For each type of theory, give one theorist and his or her theory as an example.  Explain why each theory fits the type you assigned it.  Which theory are you most likely to use in your practice? Explain your reason.  Cite the sources used in the format

Using a variety of instruments (Windshield Survey, Community Assessment Tool, Screening interviews, etc.) while in your community, you will assess the community location. This will lead to a list of identified, prioritized health needs and your recommendations for intervention. Instructions You will complete a windshield survey of your community. The objective of a windshield survey is to assess a community in a short, simple way, compiling data to help form an analysis of that community. Simply put, a windshield survey is the equivalent of a community head-to-toe assessment. There are 6 elements that should be included in your windshield survey (See attachment). You will drive through your community and document your findings on a powerpoint presentation. Take pictures of your community to enhance your powerpoint presentation. A. Familiarize yourself with the instruments for a Windshield Survey (Website Resource 15C, p. 425) and The Community Assessment Tool applied to Phenomenological Communities (Website Resource 15A, p. 425). You may also wish to review Chapter 13, Box 13-1 (p. 343) for examples of assessments that may be appropriate for your community population, since the Community Assessment Tool includes some screening data and information from clients. B. Plan how you will obtain the information for the assessments. 1. Conduct a Windshield Survey assessment. 2. Drive around your community and take pictures. 3. Create a PowerPoint presentation  10 slides addressing each area of the windshield study. Your paper should be formatted per APA and references should be current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) Application of Nursing Process to a Community Read and watch the lecture resources & materials below early in the week to help you respond to the discussion questions and to complete your assignment(s). Read Mauer, F.A. & Smith, C. M. (2013):  Chapter 15-17 and 22 Online Materials & Resources Data at the Centers for Disease Control & Prevention website: http://www.cdc.gov/DataStatistics/  (Links to an external site.)  (Links to an external site.) Play Solve the Outbreak on the Centers for Disease Control & Prevention website at http://www.cdc.gov/mobile/applications/sto/sto-web.html  (Links to an external site.) View National Center for Environmental Health | Centers for Disease Control & Prevention at https://www.youtube.com/watch?v=6Z_gYsRLkwQ   (Links to an external site.)

Develop a 20-minute presentation for nursing colleagues highlighting the fundamental principles of care coordination. Create a detailed narrative script for your presentation, approximately 4-5 pages in length, and record a video of your presentation. Nurses have a powerful role in the coordination and continuum of care. All nurses must be cognizant of the care coordination process and how safety, ethics, policy, physiological, and cultural needs affect care and patient outcomes. As a nurse, care coordination is something that should always be considered. Nurses must be aware of factors that impact care coordination and of a continuum of care that utilizes community resources effectively and is part of an ethical framework that represents the professionalism of nurses. Understanding policy elements helps nurses coordinate care effectively. This assessment provides an opportunity for you to educate your peers on the care coordination process. The assessment also requires you to address change management issues. You are encouraged to complete the Managing Change activity. 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 2: Collaborate with patients and family to achieve desired outcomes. Outline effective strategies for collaborating with patients and their families to achieve desired health outcomes. Competency 3: Create a satisfying patient experience. Identify the aspects of change management that directly affect elements of the patient experience essential to the provision of high-quality, patient-centered care. Competency 4: Defend decisions based on the code of ethics for nursing. Explain the rationale for coordinated care plans based on ethical decision making. Competency 5: Explain how health care policies affect patient-centered care. Identify the potential impact of specific health care policy provisions on outcomes and patient experiences. Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care. Raise awareness of the nurse’s vital role in the coordination and continuum of care in a video-recorded presentation. Script and reference list are not submitted. Preparation Your nurse manager has been observing your effectiveness as a care coordinator and recognizes the importance of educating other staff nurses in care coordination. Consequently, she has asked you to develop a presentation for your colleagues on care coordination basics. By providing them with basic information about the care coordination process, you will assist them in taking on an expanded role in helping to manage the care coordination process and improve patient outcomes in your community care center. To prepare for this assessment, identify key factors nurses must consider to effectively participate in the care coordination process. You may also wish to: Review the assessment instructions and scoring guide to ensure you understand the work you will be asked to complete. Allow plenty of time to rehearse your presentation. Note: Remember that you can submit all, or a portion of, your draft presentation 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. Recording Equipment Setup and Testing Check that your recording equipment and software are working properly and that you know how to record and upload your presentation. You may use Kaltura (recommended) or similar software for your audio recording. A reference page is required. However, no PowerPoint presentation is required for this assessment. If using Kaltura, refer to the Using Kaltura tutorial for directions on recording and uploading your video in the courseroom. Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact [email protected] to request accommodations. Instructions Complete the following: Develop a video presentation for nursing colleagues highlighting the fundamental principles of care coordination. Include community resources, ethical issues, and policy issues that affect the coordination of care. To prepare, develop a detailed narrative script. The script will be submitted along with the video. Note: You are not required to deliver your presentation. Presentation Format and Length Create a detailed narrative script for your video presentation, approximately 4–5 pages in length. Include a reference list at the end of the script. Supporting Evidence Cite 3–5 credible sources from peer-reviewed journals or professional industry publications to support your video. Include your source citations on a references page appended to your narrative script. Explore the resources about effective presentations as you prepare your assessment. Grading Requirements The requirements outlined below correspond to the grading criteria in the Care Coordination Presentation to Colleagues 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. Outline effective strategies for collaborating with patients and their families to achieve desired health outcomes. Provide, for example, drug-specific educational interventions, cultural competence strategies. Include evidence that you have to support your selected strategies. Identify the aspects of change management that directly affect elements of the patient experience essential to the provision of high-quality, patient-centered care. Explain the rationale for coordinated care plans based on ethical decision making. Consider the reasonable implications and consequences of an ethical approach to care and any underlying assumptions that may influence decision making. Identify the potential impact of specific health care policy provisions on outcomes and patient experiences. What are the logical implications and consequences of relevant policy provisions? What evidence do you have to support your conclusions? Raise awareness of the nurse’s vital role in the coordination and continuum of care in a video-recorded presentation. Fine tune the presentation to your audience. Stay focused on key issues of import with respect to the effects of resources, ethics, and policy on the provision of high-quality, patient-centered care. Adhere to presentation best practices.

Attend a online local City or Council meeting then answer the following Questions. Find the local governmental meeting online. (School district website, village hall website, etc.)  Reflect on your experience by answering the required questions.  ***Please chose a meeting in LA county or anywhere in Southern California.  What meeting did you attend for 2 hours?     Insert URL of meeting that you attended here:     Self-Reflection Questions to Answer in at least 19 lines or more What meeting did you go to? When did you go to the meeting? Where was the meeting held? (In what location? In what town?) Why would a nurse need to attend a city council meeting? (At least 4 lines) What happened at the meeting? Be specific about what was discussed and who was discussing it. (At least 4 lines) 6-What did you learn about your community from your attendance at this meeting? (At least 4 lines) What vulnerable population issues or social determinants of health issues were discussed? (At least 4 lines) If not discussed what vulnerable population would you want this meeting to address and why? (provide citations/references to support your points) What did you learn about yourself from your attendance at this meeting? (At least 4 lines) What impact did your attendance at this meeting have on your interests regarding politics or organizations? (At least 4 lines)

Select Health Policy Analysis Paper on a local, state, or federal policy that you have explored along with recommendations based upon the analysis.  • Analyze and evaluate the Health Policy  • Identify application of health policy into clinical practice.  ? Your paper must have an Introduction and a Conclusion  ? Maximum of 6 pages (not including Title and Reference page).  ? APA format  ? At least 5 references within 5 years.

Reply to discussion below with at least 150 words, APA format. 2 reference within 5 years.  Across the globe the demand for advanced practice nurses is increasing due to a multitude of factors that include cost, lack of access to care, increased numbers of chronic illness, and health disparities.  According to the Future of Nursing Report nurses should pursue continuous learning and higher levels of education (IOM, 2011).  However, in order to achieve the higher levels of education nurses must have an academic system that allows for a smooth transition to advance their education.  Nurses must also be provided an education that provides them the skills needed to be competent in providing quality care.  According to Leflore and Thomas 2016, the nursing model for an advanced practice nurse education has remained relatively the same for the last 45 years.  Additionally, barriers that still exist for those seeking higher level of education include lack of faculty to educate nurses, competition among clinic locations, and lack of inter-professional education and experience (Leflore & Thomas, 2016).   One way to address the disparity of nurse educators would be to increase salaries, thus encouraging more nurses to choose education for a career path.  In order to encourage greater participation for clinical sites the state could offer an incentivized program which allowed clinical sites relief in the form of tax breaks.  Although many education programs require clinical hours not all students get to experience an array of patients to gain hands on experience.   Thankfully many technology advances have occurred and include simulation-based training.  This wide array of new technology may be sufficient to support the advanced practice nursing clinical hours thus eliminating the barrier of competition for sites and hours required on site.  During my own personal experience, I can attest to the fact that one does not always get a variety of patient cases to experience thus having a combination of live and simulation patients may be beneficial when filling gaps in the patient clinical experience.  Although some advances have been made in education for nurses we have to continue to pursue solutions in order to meet this great need for advanced practice nurses. IOM 2010 Report – The Future of Nursing: Leading Change, Advancing Health. IOM Report Retrieved October 30, 2020 from The Future of Nursing https://www.nap.edu/read/12956/chapter/2 LeFlore, J. L., & Thomas, P. E. (2016). Educational Changes to Support Advanced Practice Nursing Education. The Journal of perinatal & neonatal nursing, 30(3), 187–190. https://doi.org/10.1097/JPN.0000000000000201 less

As a clinical scientist in a small hospital you are in discussions with the clinical multidisciplinary team about the feasibility of introducing a new laboratory test to measure ‘analyte X’ in the biochemistry laboratory. It is hoped the introduction of this test will help reduce the number of patients being referred for unnecessary invasive investigations for disease Y. Critically discuss the considerations for introducing this test. (NB Analyte X = small protein . keep the analyst and disease Unknown and just discuss analytic method . You might want to consider/critically discuss the following in your assignment: • Clinical & analytical requirements for the proposed test. • Possible methods that could be employed to measure X. • Practice considerations for implementing such a test. • Word count 2000-2500 words discuss : principle- cost- time – advantages and disadvantages each procedure- also discuss accuracy and sensitivity – sample preparation – pre and analytic & post analytic considerations. Spectophomtery and Photometry, Turbidity and Nephelometry, different type of ELSIA Atomic Absorption Spectrophotometer and Flame Photometry Immunoassay , Fluorometry and Chemiluminescence. Electrochemistry and Osmometry 2h ·  1. Use original scientific research article papers and do not use commercial websites (such as Google). 2. Include the references used within the text (as numbers in the bracket ( ), in the order it is appearing (Harvard style) and full references (in the reference list) at the end of the assignment (not included in the word count or number of pages).

The COVID-19 response by Healthcare organizations’ in managing the COVID-19 pandemic has been used as a running theme and example throughout the semester. The escalating mitigation and support strategies to maintain public health & patient care delivery has increasingly looked to Health Informatics teams to enact rapid, flexible & key solutions. Consider the experience you have gained with the EHR Go activities, TIGER VLE modules, course readings and lectures to identify two specific/distinct ways an EMR/EHR may be leveraged to support a healthcare organization’s response to support patient care, staff safety and/or public safety during the COVID-19 crisis. Each submission should be a minimum of 250 words (not including citations).  Any citations should be completed in APA format. You will also need to submit a meaningful reply to two classmates’ posts for full credit. I have attached an article below as an example of how one local Health System has utilized their Health Informatics to support COVID-19 management to help with generating ideas. This an example of the early reaction of one organization and is by no means an inclusive set of interventions, but rather, intended to get your ideas flowing. Journal of the American Medical Informatics Association, ocaa037, https://doi.org/10.1093/jamia/ocaa037