Nursing

Discussion: Health literacy
Discussion: Health literacy
Discussion: Health literacy
Week 8 discussion This week’s content discussed in part barriers to health care. Health literacy is a common barrier to health care. Please review the following utube videos on health literacy and answer the following questions: IOM health literacy video. (2002). Retrieved from https://www.youtube.com/watch?v=39A9oU-gOOA Health Literacy: A Prescription to End Confusion – Patients Health Literacy What are your initial thoughts after viewing these videos? What are some strategies you can incorporate in every day practice to assist with health literacy? Submission Details: Post your response to the Discussion Area by the due date assigned. Respond to at least two posts by the end of the week.
Health literacy is the ability to obtain, read, understand, and use information in order to make appropriate decisions and follow instructions for treatment. There are multiple definitions of health literacy, in part, because health literacy involves both the context (or setting) in which health literacy demands are made (e.g., health care, media, internet or fitness facility) and the skills that people bring to that situation.
Since health is a primary contributing factor to , it is a continued and increasing concern for health professionals. The 2003 National Assessment of Adult Literacy (NAAL) conducted by the US Department of Education found that 36% of participants scored as either “basic” or “below basic” in terms of their health literacy and concluded that approximately 80 million Americans have limited health literacy. These individuals have difficulty with common health tasks including reading the label of a prescribed drug. Several factors may influence health literacy. However, the following factors have been shown to strongly increase this risk: age (especially patients 65 years and older), limited proficiency or English as a second language, less education, and lower socioeconomic status. Patients with low health literacy understand less about their medical conditions and treatments and overall report worse health status.
Various interventions, such as simplifying information and illustrations, avoiding , using “” methods, and encouraging patients’ questions, have improved health behaviors in persons with low health literacy. The proportion of adults aged 18 and over in the U.S., in the year 2010, who reported that their health care providers always explained things so they could understand them was about 60.6%. This number increased 1% from 2007 to 2010. The initiative of the has included health literacy as a pressing new topic, with objectives for improving it in the decade to come.
Society as a whole is responsible for improving health literacy. Most importantly, improving health literacy is the responsibility of healthcare and public health professionals and systems.

Novice Researchers Discussion
Novice Researchers Discussion
Permalink:
I need a response to these two people’s posts post on this topic. There is a tendency for novice researchers to develop their own instrument if they cannot readily find one. How might you respond to a peer or manager who asks you to help develop a new too
a tendency for novice researchers to develop their own instrument if they cannot readily find one
Developing any part of a research study has it challenges. For a novice researcher, they may find it to be a little extra difficult due to their lack of experience. However, this should not stop a novice researcher from engaging in research studies. If a novice researcher is asked to develop a new tool to collect patient data, the novice researcher must first perform a literature review and establish a framework (Brannan, Dumsha & Yens, 2013). Once these are done, then creating the method for the study including the tool to collect data is next. The researcher should keep the design of the study simple and standardized but detailed enough that other researchers would be able to duplicate the study exactly (Brannan et al, 2013).
Because anxiety is a feeling that can only be self-reported, collecting data in a narrative or qualitative format would be ideal. According to Rose and Devine (2014), anxiety measuring instruments can be generic or specific depending on the anxiety. Since the peer or manager is specifically wanting data about anxiety prior to the procedure, a the more specific questionnaire tool should be used.
2nd person to respond to (Reji)
It is very challenging to find the best research method that will fit a given research agenda especially for novice researchers. Research problems can be overwhelming and if the novice is not familiar with the terms or concepts of the research the novice researcher will not be able to make an informed decision. To help the novice researcher, make an informed decision and help them find the best-fit research method is important for the novice researcher to appropriately implement his or her study within the accepted parameters (Polit & Beck, 2017).
First step would be to find peer-reviewed literature about the study in question, for this case anxiety prior to cardiac catheterization. Second would be to select a framework design for the data collection by creating a question needed for the study. Third, knowing the limitations and assumptions can eliminate or decrease bias (Ellis & Yair, 2010). After selecting the correct tool for the study, it is important to also know about how the procedure is done to understand what the patient’s go through when having a cardiac catheterization. Knowing how the procedure is done is very helpful because it helps to understand why the patients get anxious. A useful tool that can be developed to gather this data would be a questionnaire for the patients to be asked prior to the procedure. Interviewing individuals that are going to have the procedure or have had the procedure can help to analyze the reason why they experience anxiety.

Relapse Prevention Plan
Relapse Prevention Plan
Permalink:
Assume you are working at an agency with both inpatient and outpatient services. Mary is a client of yours in inpatient so you will be working with her one-on-one at least once a week in inpatient treatment then she will transfer levels (from level III to Level II.I) at which point you will also be her counselor in intensive outpatient. Using your knowledge of clinical interventions, (review Chapter 8), how could you integrate specific counseling interventions (CBT, MI, SF) that target triggers into both inpatient and outpatient treatment. Her diagnoses include Alcohol Use Disorder, Opiate Use Disorder, and Generalized Anxiety Disorder (GAD). Use headings: Inpatient Interventions, Outpatient Interventions.
How do coping strategies help clients prevent relapse? Present at least two examples of coping strategies and explain how they may benefit the client, their family, and the community in which they live and work.
Read the “Jed Assessment Case Study” and imagine that Jed is your client. Complete the relapse prevention plan worksheet by developing a relapse prevention plan for Jed. Use third person (i.e., Jed will or the client will) and assume that the two of you have formulated the plan together.
APA style is not required but solid academic writing is expected.
Assume you are working at an agency with both inpatient and outpatient services. Mary is a client of yours in inpatient so you will be working with her one-on-one at least once a week in inpatient treatment then she will transfer levels (from level III to Level II.I) at which point you will also be her counselor in intensive outpatient. Using your knowledge of clinical interventions, (review Chapter 8), how could you integrate specific counseling interventions (CBT, MI, SF) that target triggers into both inpatient and outpatient treatment. Her diagnoses include Alcohol Use Disorder, Opiate Use Disorder, and Generalized Anxiety Disorder (GAD). Use headings: Inpatient Interventions, Outpatient Interventions.
How do coping strategies help clients prevent relapse? Present at least two examples of coping strategies and explain how they may benefit the client, their family, and the community in which they live and work.
Read the “Jed Assessment Case Study” and imagine that Jed is your client. Complete the relapse prevention plan worksheet by developing a relapse prevention plan for Jed. Use third person (i.e., Jed will or the client will) and assume that the two of you have formulated the plan together.

Assignment: active workplace listening
Assignment: active workplace listening
Permalink:
Explain the importance of active listening in the workplace: Write a 700- to 1,050 word essay in which you do the following:
Explain the importance of active listening in the workplace.
Explain how supportive and defensive climates can improve relations in the workplace.
Provide examples of the above.
Format your essay according to APA guidelines.
Click the Assignment Files tab to submit your assignment
HCS 131 WEEK 3 HR Memo
HCS 131 WEEK 3 HR Memo
Write a 350- to 700-word memo to your HR department in which you request development of training classes on interpersonal relationships.
Describe the importance and characteristics of interpersonal relationships in the workplace.
Describe how you believe this training would improve the workplace.
Click the Assignment Files tab to submit your assignment.
HCS 131 WEEK 3 Conflict Presentation
HCS 131 WEEK 3 Conflict Presentation
You have been asked to create an informal training for your coworkers regarding dealing with conflict.
Prepare a 7- to 10-slide Microsoft® PowerPoint® presentation in which you do the following:
Describe different types of conflict.
Identify strategies for conflict management.
Include detailed speaker notes.
Click the Assignment Files tab to submit your assignment.
HCS 131 WEEK 5 Employee Relations Memo
HCS 131 WEEK 5 Employee Relations Memo
Your team from Week Four is doing well, but the team dynamic has caused some minor conflicts between two of its members.
Write a 350- to 700-word memo to your employees explaining the importance of positive employee relations.
Click the Assignment Files tab to submit your assignment.
HCS 131 WEEK 5 Course Presentation
Imagine that leadership in your health care company required you to take this course for professional development. They now want you to present to them what you have learned.
Create a 10- to 15-slide presentation outlining what you learned from the course. Include the following:
Important concepts from each week
Best practices for workplace communication
Examples of how you can apply best practices
Include at least two outside sources.
Include detailed speaker notes.
Format your presentation according to APA guidelines.
Click the Assignment Files tab to submit your assignment.
HCS 131 WEEK 4 Consumer Relations Bulletin
HCS 131 WEEK 4 Consumer Relations Bulletin
Create a motivational bulletin of 350 to 700 words that could be posted throughout your workplace, directed to employees, emphasizing effective consumer relations. Include the following:
The importance of effective consumer relations
Strategies for effective consumer relations
Note: Be creative.
Click the Assignment Files tab to submit your assignment.
HCS 131 WEEK 4 Signature Assignment: Teamwork Speech
HCS 131 WEEK 4 Signature Assignment: Teamwork Speech
Leadership has decided to create a new team, making you the manager.
Write a short speech, of 350 to 700 words, to give to your new team at your first team meeting.
Include the following:
Explain the importance of teamwork in the workplace.
Identify strategies for effective team communication
Identify strategies for effective team collaboration.
Include at least two references.
Format your paper consistent with APA guidelines.
Click the Assignment Files tab to submit your assignment.
HCS 131 WEEK 3 HR Memo
HCS 131 WEEK 3 HR Memo
Write a 350- to 700-word memo to your HR department in which you request development of training classes on interpersonal relationships.
Describe the importance and characteristics of interpersonal relationships in the workplace.
Describe how you believe this training would improve the workplace.
Click the Assignment Files tab to submit your assignment.
HCS 131 WEEK 3 Conflict Presentation
HCS 131 WEEK 3 Conflict Presentation
You have been asked to create an informal training for your coworkers regarding dealing with conflict.
Prepare a 7- to 10-slide Microsoft® PowerPoint® presentation in which you do the following:
Describe different types of conflict.
Identify strategies for conflict management.
Include detailed speaker notes.
Click the Assignment Files tab to submit your assignment.

Patient’s Spiritual Needs Discussion
Patient’s Spiritual Needs Discussion
Permalink:
In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.
Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.
In 200-250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale.
In 400-450 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James’s care?
In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?
Remember to support your responses with the topic study materials.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. You are required to submit this assignment to LopesWrite.
Week 5- Patient’s Spiritual Needs: Case Analysis Assignment Rubric:
1. Decisions that need to be made by the physician and the father are analyzed from both perspectives with a deep understanding of the complexity of the principle of autonomy. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 20%
2. Decisions that need to be made by the physician and the father are analyzed with deep understanding of the complexity of the Christian perspective, as well as with the principles of beneficence and nonmaleficence. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 20%
3. How a spiritual needs assessment would help the physician assist the father determine appropriate interventions for his son, his family, or others involved in the care of his son is clearly analyzed with a deep understanding of the connection between a spiritual needs assessment and providing appropriate interventions. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 30%
4. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 7%
5. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 8%
6. Writer is clearly in command of standard, written, academic English. 5%
7. All format elements are correct. 5%
8. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. 5%
Week 5- Patient’s Spiritual Needs: Case Analysis Assignment
There are three different parts to this paper:
· Part one deals with Mike’s decision-making capabilities.
· Part two deals with how to think issues related to sickness and health.
· Part three deals with a spiritual assessment.
Read “Doing a Culturally Sensitive Spiritual Assessment: Recognizing Spiritual Themes and Using the HOPE Questions,” by Anandarajah, from AMA Journal of Ethics(2005).
Read “End of Life and Sanctity of Life,” by Reichman, from American Medical Association Journal of Ethics, formerly Virtual Mentor (2005).
Case Study: Healing and Autonomy – Week 5- Patient’s Spiritual Needs: Case Analysis Assignment
Mike and Joanne are the parents of James and Samuel, identical twins born 8 years ago. James is currently suffering from acute glomerulonephritis, kidney failure. James was originally brought into the hospital for complications associated with a strep throat infection. The spread of the A streptococcus infection led to the subsequent kidney failure. James’s condition was acute enough to warrant immediate treatment. Usually cases of acute glomerulonephritis caused by strep infection tend to improve on their own or with an antibiotic. However, James also had elevated blood pressure and enough fluid buildup that required temporary dialysis to relieve.
The attending physician suggested immediate dialysis. After some time of discussion with Joanne, Mike informs the physician that they are going to forego the dialysis and place their faith in God. Mike and Joanne had been moved by a sermon their pastor had given a week ago, and also had witnessed a close friend regain mobility when she was prayed over at a healing service after a serious stroke. They thought it more prudent to take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Yet, Mike and Joanne agreed to return to the hospital after the faith healing services later in the week, and in hopes that James would be healed by then.
Two days later the family returned and was forced to place James on dialysis, as his condition had deteriorated. Mike felt perplexed and tormented by his decision to not treat James earlier. Had he not enough faith? Was God punishing him or James? To make matters worse, James’s kidneys had deteriorated such that his dialysis was now not a temporary matter and was in need of a kidney transplant. Crushed and desperate, Mike and Joanne immediately offered to donate one of their own kidneys to James, but they were not compatible donors. Over the next few weeks, amidst daily rounds of dialysis, some of their close friends and church members also offered to donate a kidney to James. However, none of them were tissue matches.
James’s nephrologist called to schedule a private appointment with Mike and Joanne. James was stable, given the regular dialysis, but would require a kidney transplant within the year. Given the desperate situation, the nephrologist informed Mike and Joanne of a donor that was an ideal tissue match, but as of yet had not been considered—James’s brother Samuel.
Mike vacillates and struggles to decide whether he should have his other son Samuel lose a kidney or perhaps wait for God to do a miracle this time around. Perhaps this is where the real testing of his faith will come in? Mike reasons, “This time around it is a matter of life and death. What could require greater faith than that?”
Topic 5: Optional Study Materials
Advance Directives
“Advance Directives,” by Hanson and Doukas, from The Penn Center Guide to Bioethics (2009).
Palliative Care
“Palliative Care,” by Weigand, from The Penn Center Guide to Bioethics (2009).
© 2019. Grand Canyon University. All Rights Reserved.
© 2019. Grand Canyon University. All Rights Reserved.
Applying the Four Principles: Case Study
Part 1: Chart (60 points)
Based on the “Healing and Autonomy” case study, fill out all the relevant boxes below. Provide the information by means of bullet points or a well-structured paragraph in the box. Gather as much data as possible.
Medical Indications
Beneficence and Nonmaleficence
Patient Preferences
Autonomy
Medical indications are the clinical data that is required to diagnose a patient and the extent of severity relating the medical problem thus determining the treatment options. Beneficence indicates acting with the best intentions in mind while non-beneficence emphasizes on do not harm. The parents of James were acting in his best interests despite the medical indications that James’s conditions would get worse if not treated. They had no intention of harming him and came back when his condition did not improve. Patient preferences refer to the expressed choice of the patient or the substitute decision maker. Autonomy emphasizes on the right of a person to make his/her own decision (Beever, 2016). James is an underage kid that is 8 years old thus cannot exercise autonomy rights. However, the parents should have consulted James before making their decision despite his age to know whether he was comfortable with their decision. The physician could hardly impact this decision but could have at least talked to the parents.
Quality of Life
Beneficence, Nonmaleficence, Autonomy
Contextual Features
Justice and Fairness
Quality of life refers to the relevant medical features of the life of a patient before and after the treatment. James condition before treatment was worse but after constantly undergoing dialysis his condition improved. However, he needs a kidney transplant to effectively address his condition and his father is thinking his brother should give him the kidney or they should rely on faith. Based on the previous encounter, the parents should first consult James and listen to his views regarding the issue. The last time they depended on their faith, the condition of James got worse, thus they should act with his best interests in mind and allow him to get a kidney transplant from his brother. Contextual features determine the legal, social and familial setting that influences one’s medical decisions (Gillon, 2018). The faith of James’s parents that he can be healed through prayers influenced their medical decisions. They are also considering on depending on their faith instead of allowing James to have a kidney transplant from his brother. Justice and fairness emphasizes on equality. The conflict of interest came up when the ideal tissue match was identified as that of his brother. The parents therefore were willing to allow other people including themselves to donate a kidney for James but are not willing for his brother to do so.
©2019. Grand Canyon University. All Rights Reserved.
Part 2: Evaluation
Answer each of the following questions about how principlism would be applied:
1. In 200-250 words answer the following: According to the Christian worldview, which of the four principles is most pressing in this case? Explain why. (45 points)
According to the Christian worldview, beneficence is the principle that is most pressing. This is because the parents are acting with the best of intentions in mind about their son. They have faith that their son will be healed through intensive prayers. They therefore prefer prayers more compared to treatment because of the faith. We cannot put a blame on them because of the deteriorating health of their son because they acted in good faith and as soon as they noticed his condition was getting worse they brought him back to the hospital.
2. In 200-250 words answer the following: According to the Christian worldview, how might a Christian rank the priority of the four principles? Explain why. (45 points)
A Christian can rank the priority of the four principles in such a manner that beneficence comes first then non-maleficence followed by justice and fairness and lastly autonomy. This is because according to Christians, parents should show love to their children by acting in their best interests which is associated to the principle of autonomy. Parents should also ensure that no matter what, they should not harm their children which relates to the principle of non-maleficence (Carr, 2017). Christians are supposed to practice justice and fairness in all their encounters and experiences. Lastly, Christians should also give one another a chance to indicate they thought regarding a certain decision which is associated with the principle of autonomy.
References:
Beever, J., & Brightman, A. O. (2016). Reflexive principlism as an effective approach for developing ethical reasoning in engineering. Science and engineering ethics, 22(1), 275-291.
Gillon, R. (2018). Principlism, virtuism, and the spirit of oneness. In Healthcare Ethics, Law and Professionalism (pp. 45-59). Routledge.
Carr, M. F., & Winslow, G. R. (2017). From conceptual to concrete. In World Religions for Healthcare Professionals (pp. 31-45). Routledge.

Assignment: shortness of breath
Assignment: shortness of breath
Permalink:
D. D. is a 66 year-old female suffering from shortness of breath. She smoked 2 packs a day until she quit 2 years ago. She has a history of bronchiolitis, hyperinflated lD. D. is a 66 year-old female suffering from shortness of breath. She smoked 2 packs a day until she quit 2 years ago. She has a history of bronchiolitis, hyperinflated lungs, pulmonary edema, and syncope. Her primary care practitioner suspects she also has pulmonary hypertension (PH). After examination, D. D. has a PAP of 35 mm Hg and mild CHF.
For this week’s discussion, answer ALL questions below:
1. What is the prevalence of COPD in the United States? Use the most recent data available and provide a citation for your data.(2 pts)
2. Do COPD sufferers die of respiratory causes or other causes? Why? (2 pts)
2. What are the three different medication classes/types of bronchodilators, and how do they EACH function to alleviate the symptoms of COPD? (4 pts)
3. Is lung transplantation a solution for emphysema patients like D.D.? Why or why not? (2 pts)
Please need done within the next hour, its not paragraph require just questions answered.
ungs, pulmonary edema, and syncope. Her primary care practitioner suspects she also has pulmonary hypertension (PH). After examination, D. D. has a PAP of 35 mm Hg and mild CHF.
For this week’s discussion, answer ALL questions below:
1. What is the prevalence of COPD in the United States? Use the most recent data available and provide a citation for your data.(2 pts)
2. Do COPD sufferers die of respiratory causes or other causes? Why? (2 pts)
2. What are the three different medication classes/types of bronchodilators, and how do they EACH function to alleviate the symptoms of COPD? (4 pts)
3. Is lung transplantation a solution for emphysema patients like D.D.? Why or why not? (2 pts)
Please need done within the next hour, its not paragraph require just questions answered.

Assignment: Human Service Provider
Assignment: Human Service Provider
Permalink:
Based on the interview videos you have viewed, summarize what you believe the 3 most prominent characteristics of a human service professional should be. How do these characteristics compare to those desirable for Christians, as described in Scripture? Which of these characteristics do you see in yourself and what will you work on to obtain essential characteristics you may not have acquired yet? Include at least 2 Scripture references as well as references from the introduction videos and your readings in your thread.
I wan’t able to find these videos on iTunes so disregard “as well as refernces from the introduction videos and your readings” thanks.
What is Human Services?
The field of Human Services is broadly defined, uniquely approaching the objective of meeting human needs through an interdisciplinary knowledge base, focusing on prevention as well as remediation of problems, and maintaining a commitment to improving the overall quality of life of service populations. The Human Services profession is one which promotes improved service delivery systems by addressing not only the quality of direct services, but also by seeking to improve accessibility, accountability, and coordination among professionals and agencies in service delivery.
Community Support Skill Standards
Creating Pathways to Careers in Human Services Framing Competencies for Direct Service Workers
What are they?
The Community Skill Standards define the competencies used by direct service workers in a wide variety of service contexts in community settings across the nation. Designed to be relevant to diverse direct service roles (residential, vocational, therapeutic, etc.), the standards are based upon a nationally validated job analysis involving a wide variety of human service workers, consumers, providers and educators.
What will they do?
The Community Support Skill Standards provide comprehensive descriptions of worker roles and responsibilities in twelve critical areas of competence such as Participant Empowerment, Community Networking and Advocacy.
Enhanced with illustrative scenarios and performan

Demographic variables measurement
Demographic variables measurement
Permalink:
1.Question
What demographic variables were measured at the nominal level of measurement in the Oh et al.(2014)study?
Answer:The demographic variabless measured at the nominal level include non-smoker,non-drinker,history of fracture,regular exercise and are considered nominal because can be describe by precentages, and mode.
2.Question
What statistic were calculated to describe body mass index(MBI) in this study?Were these appropiate?
Answer:Mean and standard deviation were the statistic used to calculated BMI.Because BMI is an interval-ratio variable,mean and stadard deviation are appropiate.
3.Question
Were the distributions of scores for BMI similar for the intervention and control groups?
Answer:The distribution of scores for BMI was similar for intervention and control groups because the mean and standard deviation were very similar.
4.Question
Was there a significant difference in BMI between the intervention and control groups?
Answer:There was not a significant difference in BMI between the intervention group and the control group.
5.Question
Bssed on the sample size of N=41,what frequency and percentage of the sample smoked?What frequency and percentage of the sample were non-drinkers(alcohol)?Show your calculations and round to the nearest whole percent.
Answer:
Frequency of participants who smoked=0+0=0
Percentage of participants who smoked=0%
Frequency of participants who were non-drinkers=20+20=40
6.Question
What measurement method was used to measure the bone mineral density(BMD) for the study participants?Discuss the quality of this measurement method and document your response.
Answer:The bone mineral density (BMD) was measurement by ratio/interval level.The mean and standard deviation equal central location and dispersion gives us the shape of the graph.
7.Question
What statics was calculated to determine differences between the intervention and control groups for the lumbar and femur neck BMDs?Were the groups significantly different for BMDs?
Answer:The statistic used to to determined the difference between the intervention and control groups for the lumbar and femur neck BMDs was the mean.The value between lumbar and femur neck does not show us a significant difference.
8.Question
The researchers stated that there were no significant differences in the baseline characteristics of the intervention and control groups(see Table 2).Are these groups heterogeneous or homogeneous at the beginning of the study?Why is this important in testing the effectiveness of the therapeutic lifestyle modification(TLM)program?
Answer: These groups are homogeneous,homogeneous scores are similar,and heterogeneous scores are diferent having a wide variation.This was a key factor because if the groups were heterogeneous the the data results would have been broader and more detailed.I feel as if if we compared the groups with similarities in the beggining, then this allows the results to be more profound when all is concluded.
9.Question
Oh ET AL.(2014,P.296)stared that adherence rate to the TLM program was 99.6%.Discuss the importance of intervention adherence,and document your response.
Answer:The adherence rate was almost at 100% during the 2 week time period.If the adherence rate would have ben less then the significance and importance of the results would have declined significantlly.I would not put in question the data results as they 99.6% for adherence and the group showed increase.I believe the TLM program is effective.
10.Question
Was the sample for this study adequately described?
Answer:Yes, the sample was adequate, the group showed that the program worked, the program consisted of a mix of individuals and even though it functioned well, I believe if the study was done with more individuals and done at longer intervals, then it would indicate and show more accurate results.

Discussion: Case Pain on Urination
Discussion: Case Pain on Urination
Discussion: Case Pain on Urination
Module 8: Discussion Ann is a 32-year-old married female who presents to her nurse practitioner reporting lower abdominal pain, cramping, slight fever, and dysuria of 3 days duration. History includes: LMP 2 weeks ago (regular) Reports oral contraceptive use Reports pain in lower abdomen with cramping and pain on urination for 3 days Denies any GI problems, reports regular bowel movements. Denies vaginal discharge Ann is married and in a monogamous relationship. Has one child age 2 Reports no use of condoms/sexual intercourse 2-3 times per week Denies any history of STDs Physical Exam reveals: Temp 100.6, P 80 BP 100/62 Wt. 125 Ht. 5’3’’ HEENT WNL No CVA tenderness Pain in lower quadrants with light palpation.Positive inguinal lymphadenopathy External genitalia without lesions or discharge Pelvic exam reveals minimal cervical mucopus Bimanual exam reveals uterine and adnexal tenderness and cervical motion pain. Uterus anterior, midline, smooth, not enlarged 1. Based on the above case the diagnosis is PID, What is an appropriate CDC-recommended therapeutic regimen for this patient?
Chances are we have all crossed our legs a time or two in hopes of making it to the closest restroom in time. But there’s a big difference between having to go, and always feeling like you have to go. For those who live with bladder spasms, that feeling is a painful reality that can lead to embarrassing wetting accidents and an unwanted shift in lifestyle. However, there are a variety of treatment options available to manage the symptoms. Here’s what you need to know about bladder spasms, from the causes to what you can do to ease the pain.
Chances are we have all crossed our legs a time or two in hopes of making it to the closest restroom in time. But there’s a big difference between having to go, and always feeling like you have to go.
What Do Bladder Sp

Impact of Patient Protection Assignment
Impact of Patient Protection Assignment
Permalink:
The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March of 2010. Identify the impact of this legislation on your nursing practice by choosing two key nursing provisions outlined in the topic material “Nursing and Health Reform.”
Discuss how these two provisions have impacted, or will impact, your current practice of nursing.
Nursing and Health Reform
The Patient Protection and Affordable Care Act (PPACA) was signed into law by President Obama on March 23, 2010. This law will enact sweeping changes to almost every facet of the health care system over the next ten years. The law makes changes that will impact providers, insurers, consumers, Medicare & Medicaid, and payment policies. For the purposes of this document we wanted to provide readers with an overview of those provisions in the new law that will impact the nursing community as well as their facilities. This article is intended to provide an overview of those sections of the law most relevant to WOCN members. The information focuses on three main aspects of the law: nursing workforce provisions, payment reform provisions, and facility specific provisions. Each provision is given a brief summary and policy goal of the language contained in the law. Readers can find the full legislative language for each section here: http://www.gpo.gov/fdsys/pkg/PLAW111publ148/html/PLAW-111publ148.htm Nursing Workforce Provisions Policy makers recognized the need for an increased workforce to care for the millions of consumers who would be added to the ranks of the insured under PPACA. This — in conjunction with an already existing workforce shortage within the nursing community — led to a number of provisions designed to increase the number of nurses in the coming years. Those provisions are as follows: Section 5202 Nursing student loan program—Updates the loan amounts for the Nursing Student Loan program and after 2012 the Secretary (of the Department of Health and Human Services) has discretion to adjust this amount based on cost of attendance increases.
The Impact of The Patient Protection and Affordable Care Act (PPACA) on Nursing Practice Assignment
Section 5203 Health care workforce loan repayment programs—Establishes a loan repayment program for individuals who are willing to practice in a pediatric medical or surgical subspecialty or in a child mental or behavioral health care for at least 2 years in an underserved area. Recipients, which include psychiatric nurses, social workers, and professional/school counselors, are eligible to receive $35,000/year in loan repayments for participation in an accredited pediatric specialty residency or fellowship. HHS is to give priority to applicants who are or will be working in a school setting, have familiarity with evidence-based healthcare, and can demonstrate financial need. Section 5204 Public health workforce recruitment and retention programs—Establishes Public Health Workforce Loan Repayment Program to assure an adequate supply of public health professionals to eliminate workforce shortages in public health agencies. HHS will repay up to 1/3 of loans incurred by a public health or health professions student in exchange for an agreement to accept employment with a public health agency for at least three years. Those serving in priority service areas may qualify for additional loan repayment incentives at department’s discretion. Section 5205 Allied health workforce recruitment and retention programs—Authorizes an Allied Health Loan Forgiveness Program to assure there is an adequate supply of allied health professionals to eliminate workforce shortages at public health agencies, acute care facilities, ambulatory care facilities, and other underserved health facilities. Section 5206 Grants for State and local programs—Authorizes HHS to make grants to accredited educational institutions that support scholarships for mid-career public health and allied health professionals who seek additional training in their respective fields. Section 5207 Funding for National Health Service Corps—Increasing funding for National Health Service Corps (NHSC) and extends authorization of appropriations for the Corps thru 2015. For FY2016 and beyond, a formula for funding is established to tie increased costs in healthcare to the number of individuals residing in health professions shortage areas. Section 5209 Elimination of cap on commissioned corps—Removes cap of 2800 commissioned officers in National Health Services Corps regular corps. Section 5210 Establishing a Ready Reserve Corps—Reconstitutes the Public Health Service Corps into the commissioned Regular Corps and a Ready Reserve Corps for service in time of national emergencies. Section 5301 Training in family medicine, general internal medicine, general pediatrics, and physician assistantship—Establishes a grant program for hospitals, medical schools, academically and affiliated PA training programs to develop and operate accredited training programs for the provision of primary care. Section 5302 Training opportunities for direct care workers—Establishes a 3 year grant program under which an institution of higher education can subsidize training of individuals at that institution who are willing to serve as direct care workers in a long-term or chronic care setting for at least two years after completion of their training. Section 5305 Geriatric education and training; career awards; comprehensive geriatric education—Authorizes HHS to award grants to advanced practice nurses who are pursuing a doctorate or other advanced degree in geriatrics and who, as a condition of accepting a grant, will agree to teach or practice in the field of geriatrics, long-term care, or chronic care management for a minimum of 5 years. Section 5309 Nurse education, practice, and retention grants—Adds 2 new grant programs specifically focused on nurse retention. One will authorize HHS to award grants to accredited nursing schools or health facilities to promote career advancement among nurses. The 2nd will permit HHS to make awards to nursing schools or health facilities that can demonstrate enhanced collaboration and communication among nurses and other health care professionals. Priority directed towards applicants that have not previously received an award. Section 5310 Loan repayment and scholarship program—Expands Nurse Loan Repayment and Scholarship Programs to provide loan repayment for students who serve for at least two years as a faculty member at an accredited nursing school. Section 5311 Nurse faculty loan program—Increases the Nurse Faculty Loan Program amounts from $30,000 to $35,000 in FY 2010 and FY 2011, declares that the amount of these loans will thereafter be adjusted to provide for cost-of-attendance increases for yearly loan rates and the aggregate loan. Creates new authority to permit HHS to enter into an agreement with individuals who hold unencumbered RNs and who have already completed, or are currently enrolled in, a master’s or doctorate training program for nursing. HHS will provide up to $10,000/year to master’s recipients and $20,000/year to those who earn a doctorate so long as these individuals spend at least 4 years out of a 6 year period as a full-time faculty member at an accredited nursing school. Section 5312 Authorization of appropriations for parts B through D of title VIII— Authorizes $338 million in appropriations to carry out nursing workforce development programs in FY 2010. FY 2011-2016 will be funded according to what HHS determines as “such sums as may be necessary” to carry out these programs. Section 5404 Workforce diversity grants—Expands the workforce diversity grant programs by permitting such grants to be used for diploma and associate degree nurses to enter bridge or degree completion programs or for student scholarships and stipend programs for accelerated nursing degree programs, This statute instructs HHS to consider recommendations from the National Advisory Council on Nurse Education and Practice and to consult with nursing associations. Section 5507 Demonstration projects to address health professions workforce needs; extension of family-to-family health information centers—Establishes a demonstration grant program to provide educational and training opportunities for low-income individuals for positions in the healthcare field that pay well and are expected to be in high demand. Program will primarily serve State TANF recipients, but HHS required to award at least 3 demonstration grants to eligible entities that are Indian Tribes, tribal organizations or Tribal colleges and Universities. Section 5509 Graduate nurse education demonstration—Appropriates $50 million/year FY 2012 thru FY 2015 to establish a graduate nurse education demonstration program in Medicare. Hospitals selected will be reimbursed for educational and clinical instruction costs attributed to training advanced practice nurses to provide primary/preventive care, translational care, chronic care management, as well as any other nursing services appropriate for the Medicare eligible population. Those hospitals selected will partner with community based care settings and accredited nursing schools to undertake the demonstration program and will reimburse partners for their share of costs. Section 10501—Permits faculty at public health schools that offer PA education programs to obtain faculty loan repayment under the workforce diversity program. Also makes other improvements to the NHSC program, such as a provision to increase the loan repayment amount, allowing half-time service and permitting teaching to count for as much as 20% of the service commitment to the NHSC. Pilot and Incentive Payment Program Provisions: In addition to policies aimed at increasing the number of nurses, policy makers also sought to more closely integrate nursing into new payment pilot programs that would offer incentives to primary and chronic care managements as well as provide alternatives to the current fee-forservice programs. Payment revisions are as follows: Section 2703 State option to provide health homes for enrollees with chronic conditions— Creates a state option under Medicaid to provide coordinated care through a “health home” for individuals afflicted with chronic conditions. States could receive 90 percent of the funding needed to support Medicaid enrollees who designate a provider or team of medical professionals as their health home through Federal Medical Assistance Percentages (FMAP). Section 3022 Medicare shared savings program—Establishes a shared savings program under which a group of providers and suppliers may form a legally structured Accountable Care Organization (ACO) to manage and coordinate care for Medicare fee for service beneficiaries. Section 3024 Independence at home demonstration program—Creates the Independence at Home demonstration program for chronically ill Medicare beneficiaries in order to test a payment incentive and service delivery system that would utilize physician and nurse practitioner directed, home-based primary care teams with the aim of reducing expenditures and improving health outcomes. Section 3501 Health care delivery system research; Quality improvement technical assistance—Establishes a Center for Quality Improvement and Patient Safety within the Agency for Healthcare Research and Quality (AHRQ). This center will support the identification of best practices for quality improvement in the delivery of health care services by identifying healthcare providers that employ best practices and finding ways to translate these practices rapidly and effectively into practice elsewhere. The Center will establish a Quality Improvement Network Research Program to support research on healthcare delivery system improvement. The Director of AHRQ, under this section, will also be directed to award technical assistance grants to struggling healthcare providers to aid in the implementation and adoption of best practices identified by the Center. Section 3502 Establishing community health teams to support the patient- centered medical home—Authorizes HHS to establish a grant program for states/state designated entities to establish community-based interdisciplinary, interprofessional teams to support primary care practices within a certain area. Health teams must support patient-centered medical homes, defined as a mode of care that includes personal physicians, whole person orientation, coordinated and integrated care and evidence-informed medicine. Section 5208 Nurse-managed health clinics—Authorizes $50 million in grants for the cost of operation of Nurse-Managed Health Clinics (NHMC) that provide comprehensive primary care or wellness services without regard to income or insurance status of patients. NHMCs must provide care to underserved or vulnerable populations and be associated with an academic department of nursing, qualified health center or independent nonprofit health or social services agency. Also establishes a new program to support nurse-managed health centers, authorizes to be appropriated $50 million for FY 2010 and such sums as may be necessary for FY 2011-2014. Section 6301 Patient-Centered Outcomes Research—Establishes non-profit Patient Centered Outcomes Research Institute. Purpose of Institute will be to assist patients, physicians, purchasers and policy-makers in making informed health decisions. Facility Specific Provisions Finally, PPACA makes facility specific changes including provisions directly impacting hospice and palliative care facilities, those provision follow: Sections 6101-6121—Require Medicare Skilled Nursing Facilities (SNFs) and Medicaid nursing facilities to disclose information on their ownership and organizational structure to government authorities. Mandates that such facilities implement compliance and ethics program within 3 years of enactment. Section 6103 directs the Nursing Home Compare Medicare Website to release staffing data for each facility, including resident census data, hours of care provided per resident per day, staffing turnover and tenure. Impact of Patient Protection Assignment Section 6105 directs the Secretary to create a standardized complaint form and requires states to establish a complaint resolution process, as well as providing whistleblower protection. Both provisions are effective within 1 year of enactment. Section 3004 Quality reporting for long-term care hospitals, inpatient rehabilitation hospitals, and hospice programs—Requires quality reporting programs for long?term care hospitals, inpatient rehabilitation facilities, and hospice providers in 2014. HHS must issue regulations by October 1, 2012 that will list the specific quality reporting measures that must be reported. Providers who do not participate in the program would be subject to a reduction in their annual market basket update. Section 10325 Revision To Skilled Nursing Facility Prospective Payment System—Delays implementation of certain skilled nursing facility Version 4 of the Resource Utilization Groups (RUG-IV) published in the Federal Register on August 11, 2009 payment system changes by one year to October 1, 2011. Section 10326 Pilot Testing Pay-for-Performance Programs for Certain Medicare Providers—Directs HHS to conduct a separate pilot program under Medicare to test the implementation of a value-based purchasing program for payments under such title for the following provider groups: Psychiatric hospitals, Long-term care hospitals, Rehabilitation hospitals, PPS-exempt cancer hospitals and Hospice programs. The Impact of The Patient Protection and Affordable Care Act (PPACA) on Nursing Practice Assignment Impact of Patient Protection Assignment