Client Questions

Provide a minimum of a two to three paragraph response that directly addresses your thoughts on their post. Describe how the results of the measures can be used for quality improvement in one of the following medical settings, physician office (ambulatory care),community health center and hospital Post listed below: JC (Joint Commission)              The mission statement that I have gathered about this organization is that of continuously improving healthcare for the public (The Joint Commission (n.d.). They take into consideration of that of the stakeholders, they evaluate the healthcare organization and inspire them to provide a safe and effectively high quality of care and value to all patients. The joint commission organization can be considered as an accreditation since it is an organization that is not for profit. I would say that the information that is collected and placed on the organizations websites is placed there for the external stakeholders so they can view all the changes that might happen to the organization on a regular basis. When it came to finding the quality improvement measures for this organization they were easy to find on the website just by using the search bar. The list of five improvement measures are data knows best, proper planning prevents poor performance, communicate, invest upfront, and don’t be a dinosaur (The Joint Commission (n.d.). To describe some of the improvement tools a little better than their titles like don’t be a dinosaur means be open to changes as that’s one of the main ways to make changes, data knows best means that data helps organizations make decisions when it comes to changes. Those were just a couple ways in which the joint commission sees fit for quality improvement tools. CMS (Centers for Medicare & Medicaid Services) The mission statement for the CMS is to ensure that the voices and needs of the populations are present as the agency continues to develop, implement, and evaluate programs and policies (Mission-vision-our-work. (2019, June 19). The vision of the CMS organization is for all beneficiaries to receive the highest level of healthcare. The Centers for Medicare and Medicaid services organization can be considered or listed as being a governmental agency as it helps people all over the Unites States whether they have disabilities as a young person or they are getting ready to retire and start drawing social security. The information listed on the CMS website is like that of the joint commission it is on there so the external stakeholders can see all the information right when it changes. The quality measures for CMS are a little different than that of the joint commission organization. The list of quality improvements measures can be listed as clinical processes, patient safety, care coordination, health outcomes, patient engagement and clinical guidelines just to name some of them off. 1 reference and no plagiarism

Purpose This week’s graded topics relate to the following Course Outcome (CO). CO 1: Examine the sources of evidence that contribute to professional nursing practice. (PO 7) CO 2:Apply research principles to the interpretation of the content of published research studies.  (PO 4 & 8) CO 5: Recognize the role of research findings in evidence-based practice. (PO 7 & 8) Discussion Professional nurses rely on research findings to inform practice decisions; they use critical thinking to apply research directly to specific patient care situations. Think about an independent nursing practice problem you care passionately about and would be interested in searching for evidence. The below problems should not be used: *medical/doctor/physician problems such as medications, or medications administration or effects, diagnostics such as EKGs, labs, cardiac catherizations. *staffing, nurse-to-patient ratios, workforce issues are organizational/system /political/administrative/multi-stakeholder problems which nursing cannot solve independently. Describe a significant nursing clinical issue, topic of interest, or practice problem that is important to you. Describe why you chose the problem/topic. Write your clinical question in the PICO(T) format for your nursing practice problem. *To write your clinical question in the PICO(T) format, use the NR439_Guide for writing PICOT Questions and Examples found in your required reading or access the following link: NR439_Guide for writing PICOT Questions and Examples (Links to an external site.) List each of your PICOT elements. Share why you care about this nursing practice problem and why you believe the problem would benefit from finding the best evidence.

The benchmark assesses the following competencies: 1.4 Participate in health care policy development to influence nursing practice and health care. Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population. Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue. Follow this outline when writing the policy brief: Describe the policy health issue. Include the following information: (a) what population is affected, (b) at what level does it occur (local, state, or national), and (c) evidence about the issues supported by resources. Create a problem statement. Provide suggestions for addressing the health issue caused by the current policy. Describe what steps are required to initiate policy change. Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable. Discuss the impact on the health care delivery system. Include three peer-reviewed sources and two other sources to support the policy brief. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.  You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

***Doctorate Level Questions*** No Plagiarism….Paraphrase the content, and provide Citations and References for each source provided….Please provide a substantive response for EACH question. Each question should each have a word count of 150 words or more….Please provide appropriate foundational knowledge, be factual, and enhance the dialogue….Please do not recite the same words just to provide word count….   Question One From the bibliography of your proposed dissertation study, select a peer-reviewed journal article that was done with a quantitative methodology. Cite the article and summarize the study in one paragraph. Then categorize it according to each of the following dimensions: Experimental, quasi-experimental, or non-experimental Descriptive, predictive, or explanatory Retrospective, cross-sectional, or longitudinal Why did you categorize the article as you did? Do articles in your field of interest commonly fall into this category? Why or why not? Question Two What are the primary factors that make it more challenging to conduct experimental studies in the field of education or leadership? Why are these significant? How do these factors affect your own research design for the dissertation study?

Write a 1,200-1,500-word essay describing the electronic health records incentive programs, also known as meaningful use. It offers financial incentives and was designed to improve quality, safety, and efficiency of care through the use of electronic health records. Describe the three stages of meaningful use and their measures. Explain the challenges and barriers faced by facilities in implementing each stage of meaningful use.  Include three to five references, including your textbook. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Part 2: Objective information: Fetal heart tones are 130, with minimal variability Vaginal exam is 4 cm/90%effaced/ -1 station She is complaining of pain – 8/10 on a numerical scale. An IV has been started with an 18 gauge catheter with 1 liter of Lactated Ringers at 150 ml per hr in left forearm.How can you provide non pharmacological comfort to this patient? What are the pharmacological methods to use? Without prenatal records or history GBS is unknown. What must you provide? Contractions are 5 minutes apart and you receive an order to augment labor – what non pharmacological methods can you employ (or ask the MD to provide?) Pitocin is ordered, please include at what rate you will start Pitocin, and how often you titrate. What equipment is needed to hang and run Pitocin IV? Preterm Labor Management Preterm labor Group B: complete Part 1 Part 1: 25 y/o presents to Labor and Delivery with complaints of uterine cramping and lower back pain. Denies any vaginal bleeding at this time. Has related history of a preterm birth at 32 weeks gestation with her last pregnancy. The baby is 3 years old now and has no developmental issues. Her current gestational age is 30 weeks. She is O+ and all other lab values are normal. No noted STI’s.1. Group Beta Strep is missing from the labs – most often is obtained at 35 – 37 weeks gestation. 2. Without this information it is often determined to treat the patient anyway – presumptively to protect a premature baby from the risk. 3. What other information would you like to ask her? 4. What nursing intervention will you provide? 5. What screening tests are often obtained to help determine her risk for preterm labor. 6. And if it is determined she is in preterm labor what medications may you want to use with a doctors order? 7. Please also give dose, side effects and possible result of the medication. Please answer all questions include intext citation and 3 references

The term “knowledge worker” was first coined by management consultant and author Peter Drucker in his book, The Landmarks of Tomorrow (1959). Drucker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services. Does this sound familiar? Nurses are very much knowledge workers. What has changed since Drucker’s time are the ways that knowledge can be acquired. The volume of data that can now be generated and the tools used to access this data have evolved significantly in recent years and helped healthcare professionals (among many others) to assume the role of knowledge worker in new and powerful ways.  In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker. You will prepare a PowerPoint presentation with an infographic (graphic that visually represents information, data, or knowledge. Infographics are intended to present information quickly and clearly.) to educate others on the role of nurse as knowledge worker. Reference: Drucker, P. (1959). The landmarks of tomorrow. New York, NY: HarperCollins Publishers. To Prepare: Review the concepts of informatics as presented in the Resources.  Reflect on the role of a nurse leader as a knowledge worker. Consider how knowledge may be informed by data that is collected/accessed. The Assignment: Explain the concept of a knowledge worker. Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker. Develop a simple infographic to help explain these concepts. NOTE: For guidance on infographics, including how to create one in PowerPoint, see “How to Make an Infographic in PowerPoint” presented in the Resources. Your PowerPoint should Include the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ responses.  A good example of a scenario that would benefit from access to data is a case where a healthcare centre wants to know the number of patients visiting on a daily basis so as to establish whether the available staff is enough.  Data of this nature can be collected by registering all the patients that come to seek medical services on a daily basis for a period of one month. Upon registering the patient, the data might be stored in the computer and retrieved when needed. The only people that will be allowed to access such information are the staff members (McGonigle, 2017). The specific knowledge that will be derived from the data on a number of the patient visit is information on whether there is a shortage of labour force. In any case, the health facility will, for instance, establish that the number of patients visiting the facility is too high when compared to the available number of nurses; this will be taken to mean that there is a staff shortage. It will also be interpreted to mean that the current staff is being overworked and so the quality of health services being provided is more likely to be compromised (Sweeney, 2017). A nurse leader can use clinical reasoning and judgment in the formation of knowledge from this experience to approximate the overall performance of the health facility being managed. The nurse leader could for example reason that since the health facility is understaffed, it may not be performing well. The nurse leader could judge that the patient feedback is more likely to be negative suggesting poor performance. This is due to the fact that feedback from the patients is one of the tools used to tell whether a health facility is performing well or not (McGonigle, 2017). References McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning. Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1). **Attached is an example of one presentation** (8 to 10 slides)

In 500-750 words, post in your assigned group your response to the prompt. In your initial post, refer at least one article related to your entry from a reputable newspaper (can be online) or other media source that is current within one month and post the link. You must have at least two references in your initial posting, and the media source can be one of the two. An easy way to find current articles on health policy is through Kaiser Health News. Discussion Topic: In your post, you should discuss if and how the ACA has impacted your topic, and the impact of Republican proposals to repeal/replace the ACA on your topic. Group 1: Health Disparities: What are two public policies needed to reduce racial and ethnic disparities in health care? Required Resources:   Munoz, P., Kim, M., Chang, M. (2015). The Color of Wealth. Retrieved from https://www.bostonfed.org/publications/one-time-pubs/color-of-wealth.aspx Healthy People 2020: Social Determinants of Health Hayes, S., Riley, P., Radley, D. (2017). Reducing Racial and Ethnic Disparities in Access to Care. Retrieved from https://www.commonwealthfund.org/publications/issue-briefs/2017/aug/reducing-racial-and-ethnic-disparities-access-care-has Derose, K., Gresenz, C., Ringel, J. (2011). Understanding Disparities in Health Care Access. Retrieved from https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2011.0644 Access and Disparities in Access to Health Care. Content last reviewed June 2018. Agency for Healthcare Research and Quality, Rockville, MD. Retrieved from https://www.ahrq.gov/research/findings/nhqrdr/nhqdr15/access.html

Respond one of your colleagues’ posts by offering a possible resolution to their  questions/concerns with supporting documentation.   at least 2 references in each peer responses               A cost-benefit analysis is an estimate that analyzes the cost and benefit of a policy or project to evaluate its worth (Hwang, 2016). For lawmakers, the value of a political decision is measured by votes gained compared to votes loss. The fear of being voted out of office definitely played a role in derailing the efforts to repeal and replace the Affordable Care Act (ACA). The pushed to repeal and replace ACA begin to heat up after President Trump was sworn into office as a part of his campaign promise. Many Americans are divided on the issue, with the growing majority against the repeal and replace proposal (Milstead & Short, 2019). The divide creates a challenging decision for politicians hoping to get reelected in the battleground states. The problem arises because no political spin can deny that more people are covered since the passing of ACA, and the repeal of ACA would cause millions of Americans to lose coverage (Grogan, 2017).  The decision made by legislative leaders are affected by the views of the voters if it poses a threat to the leaders reelection. While having control of both houses in congress republicans were still leary about voting on issues that impacted Medicaid and Medicare (Mistead and Short, 2019). The issue of healthcare is one that exposes all the tricks and tactics that make up politics. The proceed with caution mood looming over political decisions related to healthcare indicate that politicians care more about being reelected than the issue itself (Mistead and Short, 2019). It is a logical strategy. Elected officials have all made the claim that their purpose is to represent the people. Legislative leaders are so worried about the blow back from a decision affect their reelection that it was even suggested that they should repeal ACA symbolically without actually changing anything (Leonard, 2017).  The cost-benefit analysis was originally a political tactic used to discredit regulatory programs (Sinden, 2019). According to Sinden (2019), the cost of implementing project would be inflated over the value of the benefit to devalue the benefit of the regulation. According to Cole (2012), CBAs are subjective, and the value human lives can easily be manipulated and discounted to promote or denounce regulations. In the case of our legislative leaders, the vote is more valuable than a human life.

Watch the “Diary of Medical Mission Trip” videos dealing with the catastrophic earthquake in Haiti in 2010. Reflect on this natural disaster by answering the following questions: Propose one example of a nursing intervention related to the disaster from each of the following levels: primary prevention, secondary prevention, and tertiary prevention. Provide innovative examples that have not been discussed by previous students. Under which phase of the disaster do the three proposed interventions fall? Explain why you chose that phase. With what people or agencies would you work in facilitating the proposed interventions and why?