Client Questions

Choose a medical condition from the cardiovascular system and lymphatic system (Lymphoedema) and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? 250 words

What components of the ACA do you think will have a positive effect on improving health care outcomes and decreasing costs? Health care reform in the United States is an important issue, but since the 1930s, presidents who have attempted to reform the system have faced significant political obstacles. Promoting health requires more than a high-performing health care system. First and foremost, health is created where people live, work, and play. Geographic analyses of race and ethnicity, income, and health status repeatedly show that financial, racial, and ethnic disparities persist (Braveman et al.,2010). Individual health and family health are severely compromised in communities where good education, nutritious foods, safe places to exercise, and well-playing jobs are scarce (Halpin, Morales-Suarez-Varela & Martin Moreno,2010). In 2008, Don Berwick, MD, and his colleagues at the Institute for Healthcare Improvement (IHI) first described the Triple Aim of a value-based health care system, improving population health and the patient experience of care, and reducing per capita costs. This framework aligns with the aims of the Affordable Care Act (ACA). Berwick, Nolan, & Whittington, 2008). The Affordable Care Act (ACA) was signed in March 2010, designed to address affordability, accessibility, and financing of health care, with focused efforts on meeting vulnerable populations’ needs. The ACA will require substantial changes in public insurance programs, private health insurance market regulations, and other components of the health care system. The ACA will transform the U. S. health care system by expanding health care access and coverage, reforming payments systems, and increasing the quality and coordination of care (McDonough, 2011). From those components of the ACA, which one will positively affect improving health care outcomes and decreasing costs? The ACA includes a variety of provisions to improve the performance of the health care system and the health status of the population through care coordinated and prevention through  No Copays for Preventive Services: requires most health plans to cover recommended preventive services without copays or cost-sharing. Federal Coordinated Health Care: to integrate care and improve coordination for “dual eligibility” by Medicare and Medicaid.   Prevention and Public Health Investment Fund: to support community and public health initiatives that aim to prevent injury and disease and eliminates access barriers to community health centers and clinical practice. Home Visitation: expands and provides additional funding for evidence-based home visitation programs that foster health promotion and illness prevention. The ACA provisions aim to increase access to care, change the culture of health care from one of cure to one of health promotion and illness prevention, mitigate barriers to practice for primary care providers of all disciplines, etc. From all its components, in my view, the components of Coordination of Care and Prevention is the one that one will have a positive effect on improving health care outcomes and decreasing costs among the nation. Reference Diana J. M.; Deborah B. G.; Freida H. O.; Eileen T. O’G. (2016) Policy & Politics in Nursing and Health Care (7th ed.). St Louis MO, Elsevier Edelman C., Mandle C. L., Kudzma E. C., (2010) Health Promotion Throughout the Life Span (8th ed.). St Louis MO, Elsevier.

RESEARCH PAPER this project will allow you to formulate and hypothetically develop your own research project. The purpose of this project is for the student to complete all the different steps necessary to implement a nursing research project.  This project will be subdivided into 4 different papers that will be submitted throughout the entire semester. . Please see separate file  items for each phase specific instructions  Phase 1-Planning  Phase 2-Design  Phase 3-Implementation  Phase 4-Results  PLEASE I NEED EXCELLENT JOB.

Respond to the Main post bellow, in one or more of the following ways: Ask a probing question, substantiated with additional background information, and evidence. Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives. Offer and support an alternative perspective using readings from  the classroom or from your own review of the literature in the Walden  Library. Validate an idea with your own experience and additional sources. Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings. Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.                                                  Initial post  An intervention program to promote health-related physical fitness in Nurses Nursing  is a very stressful profession and has become more demanding in recent  years. (Kuo, H.-W, 2009, P. 1404) With nursing being increasingly  demanding and strenuous it is important for the nurse to take care of  themselves. Regular exercise can help maintain a healthier lifestyle.  This will always be beneficial not only to the nurse working with the  patients but for the patients as well to have a healthy example of a  current lifestyle.  In  this study 90 nurses were chosen. These nurses came from five different  hospitals. They were separated into two groups experimental and  controlled. Experimental groups are those who are being exposed to a  variable to receive an outcome. (Steadmans Medical Dictionary, 2002)   Controlled group is not being exposed to this variable. In this case  the variable is exercise on the treadmill for three months. Nurses were  exposed to treadmill exercise for three months to see what type of  results they obtained compared to those who were not active. This study  demonstrates that the development and implementation of an intervention  program can promote  health-related physical fitness of nurses. (Kuo, H.-W, 2009, P. 1404) I  do think this is very relevant to our practice because the nurses are  benefiting in a health manner. The extent to which results are  consistent over time and an accurate representation of the total  population under study is referred to as reliability. (Golafshani,  2003)It is important as healthcare workers to live a healthy lifestyle  so that when we educate our patients they are able to see an example. It  also helps nurses be able to release stress in a healthy way and  reduces the risk of many disease. Staying active will help with patient  care when it comes to taking care of our patient at the bedside and will  help us keep our energy for longer periods of time since most of the  day we are on your feet.  Yuan,  S.-C., Chou, M.-C., Hwu, L.-J., Chang, Y.-O., Hsu, W.-H., & Kuo,  H.-W. (2009). an intervention program to promote health-related physical  fitness in nurses. Journal of Clinical Nursing, 18(10), 1,404–1,411. Experimental Group.” Dictionary.com, Steadmans Medical Dictionary, 2002, www.dictionary.com/browse/experimental-group. Golafshani,  N. (2003). Understanding Reliability and Validity in Qualitative  Research. The Qualitative Report, 8(4), 597-606. Retrieved from  https://nsuworks.nova.edu/tqr/vol8/iss4/6

Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement. Due date Thursday 20

Continue to use the scenario to assist you with this assignment. Managed care has had a profound impact on the way that health care is delivered and paid for in the United States. A large portion of Healing Hands Hospital’s revenue comes from managed care reimbursement making managed care a very important part of the business process. Part of the Task Force’s work will include obtaining feedback from the community and a public relations committee has been formed to help educate the community when decisions are made about changes to Healing Hands Hospital. Mr. Johnson, Healing Hands Chief Financial Officer, has asked you to help provide some training to the members of the public relations committee to help them understand managed care and other possible models for reimbursement including value-based reimbursement and Accountable Care Organizations (ACOs), so this can be included in their campaign of community education. Your report to Mr. Johnson should be 3-4 pages, not including title or reference pages, and should include: Identify two types of managed care plans, such as Preferred Provider Organizations (PPO) and how they impact the way that health care is delivered at Healing Hands Hospital. Discuss the future of managed care as a viable reimbursement model for Healing Hands Hospital compared to Accountable Care Organization model and valued based reimbursement. Through legislation such as the Patient Protection and Affordable Care Act and MACRA, there are regulations and requirements set by the Centers for Medicare and Medicaid Services that are designed to improve patient quality of care and ensure highest levels of reimbursement.  How do these laws impact Healing Hands Hospital and its financial plans? More information on these topics can be found in the HCM Learning Center course page. Mr. Johnson, like all healthcare management professionals, believes that the data and information presented must be backed by good research and the reference sources must be listed appropriately in the written report.  Be sure to include at least three references for the information presented in your report using APA formatting. Remember to title this paper “The Role of Managed Care and Other Models for Reimbursement”. Please submit your assignment.

Instruction:  Min: 1500 words, APA Format.  Identify and briefly discuss the body system selected for the topic of this paper ( Cardiovascular System)        Discuss the physiology (structure and function) of the body system including details about the major organ systems (if applicable) Discuss relevant health history questions (subjective data) pertaining to the body system Discuss an overview of the objective data and expected normal physical examination findings for this body system Discuss special physical assessment examination techniques or procedures specific to assessing this body system Discuss how you might adapt your physical assessment skills or techniques to accommodate each of the following specific populations:  i.  Infant/pediatric  ii.  Pregnancy  iii.  Geriatric Identify one major disease or disease process that may significantly impact this body system (Choose any you like) Discuss the expected abnormal physical examination findings that may be associated with this disease or disease process Summarize the key points  – Scholarly Article sources.  – Please no plagiarism

Select one of the following special populations  Care of Families Care of Communities and Target Populations Care of children and Adolescents Care of Men Care of Women Care of Older Population identify and describe: -Key determinants affecting the health of your chosen special population. -At least five health promotion and five illness/injury prevention interventions that might be appropriate for the special population that you selected. -At least 2 restorative health care considerations for your chosen special population and analyze the role of the community health nurse in each. Must be in APA and Must include at least 2 nursing journal articles from 2015-2020

Respond to the post bellow offering additional/alternative ideas regarding opportunities and risks related to the observations shared.                                                         Main Post                         iPhone technology, secure texting, and telehealth             The hospital that I currently work for piloted the use  of iPhones in addition to our work station on wheels (WoW). We can use  this iPhone technology for charting simple nursing interventions,  receive STAT orders and discharge orders, and communicate with our  colleagues through texting. Our WoWs enable us to do “secure texting” to  a physician, some physicians prefer the secure texting technology some  don’t, but surely there are times that the answering service may fail to  page them in a timely manner and the secure texting technology becomes  very useful. As nurses, we can see through our WoWs as soon as the  physician reads the text message, that way we know they are aware. This  technology saves us some precious time we spend on the phone waiting on  hold just to page a physician for orders, condition and/or results. Our  hospital also offers telehealth services especially for those who are  likely to be readmitted due to chronic diseases. We mostly see a  telehealth order for a patient with cardiac issues. Risks and benefits             The biggest threat that I believe healthcare  technology is at risk for is privacy. According to Chaet, Clearfield,  Sabin and Skimming (2017), privacy and confidentiality are just “as  important in the context of telehealth and telemedicine as in hospital  and office settings” (p. 1138). I surmise, organizations providing this  type of technology in healthcare have an incredible security system in  place. The secure texting technology, we are instructed not to use full  names, instead, we use room numbers of the patients.             The biggest benefit of the use of telehealth and  mobile devices for healthcare is accessibility. Use of the iPhone  technology in our hospital is quick and easy to navigate, we can get in  touch with virtually anybody logged in for that shift in the whole  hospital. From a distance, telehealth helps those patients who are  unable to manage their chronic illnesses very well.                                                                                     Trends in healthcare technology             The most promising healthcare technology to me is  virtual visits, mobile health, telehealth, and telemedicine technology.  One can get in touch with a healthcare provider as long as one has a  smartphone and internet access. It could provide access to so many more  patients in need of healthcare that resides in rural areas or have no  means to transport themselves to the physician’s office. It could save  time and money for patients as we all know healthcare can get expensive  very easily and very fast. According to Abuhaimidd, Meetoo and Rylance  (2018), technology in healthcare with the use of mobile devices can  “truly offer the potential to promote healthcare management and health  behaviour change outside formal clinical settings” (p. 1176). This does  not take away the significance of having a physical visit with a  physician, those visits are intended for more complicated health issues,  but I believe this technology has potential to truly help those with  chronic illnesses to be able to manage their health on their own, make  them accountable for their own wellbeing, patients can share data,  interact with clinicians over a mobile device instead of having to go to  the doctor’s office.                                                                                                   Telehealth rules             According to Mastrian and McGonigle (2017), nurses who  participate in telehealth must be “licensed to practice in all of the  states in which they provide telehealth services by directly interacting  with patients” (p. 381). This can be challenging as states have  different rules and regulations regarding licensure, continuing  education requirements are different as well as fees and renewal  process.                                           References Abuhaimid, H. A., Meetoo, D., & Rylance, R. (2018). Health  care in a technological world. British Journal of Nursing, 27(20).  1172-1177. Barreto, E. A., Cohen, A. B., Donelan, K., Estrada, J. J.,  Michael, C., Schwamm, L. H., … Wozniak, J. (2019). Patient and clinician  experiences with telehealth for patient follow-up care. American  Journal of Managed Care, 25(1), 40-44. Chaet, D., Clearfield, R., Sabin, J. E., & Skimming, K.  (2017). Ethical practice in telehealth and telemedicine. Journal of  General Internal Medicine, 32(10), 1136-1140. Mastrian, K. G., & McGonigle, D. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

People of Irish Heritage  People of Italian Heritage  People of Puerto Rican Heritage. 1.  Discuss the organization and the family role in every one of the heritages mentioned about and how they affect (positively or negatively) the delivery of health care. 2.  Identify sociocultural variables within the Irish, Italian and Puerto Rican heritage and mention some examples. References must be no older than 5 years.   A minimum of 700 words is required.