Why you are pursuing your MSN

Statement (under 1,000 words) that will give the admissions committee a better understanding of: 1. Why you are pursuing your MSN? To have better job opportunities in the future. Recent hospital closure (Hahnemann Hospital) after working there for 12 years 2. Your plans upon completion of the degree? Start a home care business serving maternity patients Become a clinical instructor for nursing students 3. How your current work experience will enhance your experience in this program? Thirteen years of nursing knowledge /During my time working as a labor and delivery nurse

Analyse the effects of using ultrasound technology to administer medication to treat disease

Description

Analyse the effects of using ultrasound technology to administer medication to treat disease. For instance, certain cancer treatments can cause serious damage to normal tissues; the use of ultrasound can help administer treatment around healthy tissues. Dissertation needs to be 15000 words, around 12-14 peer reviewed journals, under 10 years old, a list of journals to be used needs to be included in proposal.

Appraise major components of patient safety and health care quality

Case Study 24 This assignment will assess competency 5. Appraise major components of patient safety and health care quality. Part 1: Answer discussion question 6 in Case 24. • What mechanisms can be put in place to prevent this from occurring in the future? Part 2: Evaluate this case in accordance with the Joint Commission’s guidance for Sentinel Events for hospitals. • How does this case meet/or not meet the criteria? Explain your answer.

Financial and Legislative Priorities in Home Health

 Financial and Legislative Priorities in Home Health

 

Paper details:

Goals After completing this module, you will be able to do the following: 1. Demonstrate an understanding of how agency practices, payor mix, and financial intelligence influence agency performance. 2. Explore legislative priorities important to the home care industry. 3. Discuss how home health care nurses can engage the legislative process and remain at the forefront of home health professional nursing practice. Overview This module will examine how finances and reimbursement impact home health care operations. To conclude our exploration of the home health care industry, legislative imperatives influencing the industry will be examined. The Affordable Care Act has challenged the healthcare industry to provide care that is cost-effective yet demonstrate quality patient outcomes. The home care industry has faced reforms that require it to examine its practices to remain viable. The home health care nurse, as administrator, must be actively involved in the day-to-day operations to ensure the future success of his/her agency. Today’s home health care nurse must take an active role in the legislative process to understand how health policy will shape the future of home care services. The opportunity to shape health care policy can be achieved through involvement in a legislative action network. As an example, the National Association of Home Care and Hospice (NAHC) provides education and information on legislative priorities that affect the home care and hospice industries. Learning Materials • Chapter 13 – Clark, M. (2015). Population and community health nursing (6th ed.). Upper Saddle River, NJ: Pearson. • Case Management Society of America’s Standards of Practice for Case Management (2016). • CMS Announces Payment Changes for Medicare Home Health Agencies for 2015 • NAHC Legislative Action Center Discussion Question: Choose one of the following prompts: Changes to reimbursement and payment structures over the last few years have proven to be challenging to home health agencies. Discuss why home health agencies must examine their practices and payor mix to remain viable in today’s environment. OR As the Administrator of a Medicare certified home health agency you are responsible for analyzing and controlling cost variances to maintain agency viability. Identify three metrics you would use to analyze agency financial performance on a daily basis. Discuss why you have selected these metrics.

Medical Malpractice

 Medical Malpractice

 

Paper details:

Read the attached article about a case of medical malpractice that resulted in further complications in a 12-year-old boy. The child fell and had a laceration on his knee and was treated by a nurse practitioner. Based on the article answer the following questions: 1. Explain subjective and objective information for this patient. (15 points) 2. Critique the medications prescribed for this child’s condition. Explain what may have been more appropriate to prescribed. (15points) 3. Outline the teaching the nurse practitioner should have given to the parents for this child. (15points) 4. Hypothesize how this malpractice lawsuit could have been avoided. (20points) Standard English: Spelling, grammar, punctuation, paragraph formation, and paper formation used. (5points) References: At least 2-3 current (in the past 5 years), relevant, and sufficient scholarly sources beyond textbooks. (5points) APA/Formatting: Formatted in APA (6th ed.) style to include the references. Keep to one page either one sided or a trifold. May include graphics. (10points) PLEASE ANSWER ALL QUESTIONS HERE IS THE CASE STUDY IF YOU CANT OPEN THE LINK ABOVE: WEEK 7: Legal Case Study Nurse Practitioners Medical Malpractice Case Study with Risk Management Strategies Case Study: Failure to identify and address concerns or questions regarding patient care; failure to complete documentation in a timely manner; failure to act as the patient’s advocate; failure to maintain clinical competencies; failure to follow the standard of care. This case study involves a licensed nurse practitioner working in a walk-in clinic. Indemnity Settlement Payment: Policy limits. (Monetary amounts represent only the payment made on behalf of the insured nurse practitioner) Legal Expenses: In excess of $230,000 Summary The pediatric patient was a 12-year-old male brought into a walk-in clinic by his parents shortly after falling and lacerating his knee. The patient sustained a six centimeter elliptical laceration above his right knee. The patient was examined by the nurse practitioner who documented a normal physical examination, except for evidence of a six centimeter elliptical laceration. The nurse practitioner cleansed the site with Betadine, anesthetized the area and sutured the wound using nylon sutures. The patient was discharged with a prescription for acetaminophen with codeine and a prescription for augmentin, although the healthcare information record stated he was allergic to penicillin. The nurse practitioner did not counsel the parents on dressing or wound care at discharge, but communicated to follow up in 7-10 days for suture removal. The mother filled the antibiotic prescription, but only gave the child one dose after she noticed that a skin rash was resulting. Later, she testified in her deposition that she neither called the walk-in clinic nor the nurse practitioner about a new antibiotic for the child. Two days after the fall, he was admitted to the local hospital with a diagnosis of cellulitis, possibly due to methicillin resistant staphlococcus aureus (MRSA) and was given intravenous antibiotics. Three days after the fall, his right extremity appeared edematous, slightly discolored and he complained of pain with movement. He was taken to surgery with a diagnosis of an abscess of the right thigh. During the operation, the sutures were removed with serosanguinous drainage noted. The tissue surrounding the wound appeared gray and discolored. Four days after the fall, his extremity appeared completely discolored, severely edematous, and he had very limited movement. He was taken back to surgery for a reexploration, further debridement and insertion of a central venous catheter. After the re-exploration, the patient was transferred to a children’s hospital several miles away via helicopter for further treatment and observation. While in the children’s hospital, the patient underwent multiple fasciotomies and surgeries to repair and re-route muscles, tendons and ligaments to his extremity and sacral area due to the advancing necrotizing fasciitis. His condition continued to deteriorate, resulting in a comatose state responding only to painful stimuli. While in this comatose state, he was noted to have recurrent uncontrolled seizures. The patient slowly recovered. Six weeks after the injury occurred, he was discharged from the hospital with home health and wound care services. Following discharge, the child had to re-learn simple activities of daily living, e.g.,walking, running and bathing. Due to the seizures and coma, the child has encountered problems with emotional and intellectual development. The bacterial infection and subsequent treatment impaired movement with his right leg, requiring several skin graphs and physical therapy. Risk Management Comment There was no documentation on wound irrigations or discharge teaching. When the nurse practitioner learned of the patient’s hospital admission, she documented a self-serving addendum to the clinic’s healthcare information record. None of the defense expert reviewers fully supported the nurse practitioner’s care. It was determined that she failed to prescribe the appropriate antibiotic, failed to appropriately suture the wound and failed to irrigate the wound as standard protocol would require. Experts were also critical of the suturing technique that the defendant used. Their testimony noted that the sutures were too tight, creating an anaerobic environment which contributed to the growth of the necrotizing fasciitis.

Overview of the three major environmental health and safety EHS disciplines

Create a PowerPoint presentation of 15 slides (not counting title and reference slides) that provides an overview of the three major environmental, health, and safety (EHS) disciplines. Include each of the following elements: summary of the responsibilities for the discipline, evaluation of types of hazards addressed by the discipline, description of how industrial hygiene practices relate to safety and health programs, description of how industrial hygiene practices relate to environmental programs, evaluation of types of control methods commonly used by the discipline, interactions with the other two disciplines, and major organizations associated with the discipline. Construct your presentation using a serif type font such as Times New Roman. A serif type font is easier to read than a non-serif type font. For ease of reading, do not use a font smaller than 28 points.

DRUG DESIGN

1) you have seen that a new drug can cost upwards of $1 billion dollars and take more than a decade to come to market. Yet, there is a need for quick, low-cost drugs for millions of Americans each year. If you were given $490 million in start-up capital, how would you spend it–particularly in the first year? What disease/condition(s) would you target? Where would you look for a lead compound? What technologies would you purchase? In a paragraph or two, describe your initial attempts at drug design. 2) As you have seen, human clinical trials on all drugs are required under the Kefauver-Harris Drug Amendment of 1962. For ethical reasons we generally do not test new drugs on children, pregnant women, and the mentally ill. Instead these patients are given “reasonable” doses with close monitoring at first. In a paragraph or two, describe your thoughts on omitting certain populations from clinical trials. Are we doing the right thing? Should they be tested regardless? 3) Society readily agrees that physical pain is a valid reason to take over-the-counter or prescription drugs. Products which alleviate physical pain, like opioids, have been around for centuries and are widely accepted. Products which alleviate emotional pain, however, are not as widely studied. You do not have to share your personal opinion on happiness drugs, but I would like you to discuss in a few sentences the advantages and disadvantages to a society with no sadness, misery, or sorrow. Is “permanent happiness” is a worthwhile goal for society? Should we be investing in or legalizing drugs that will alleviate emotional pain? What are issues to consider when targeting different types of pain in society?

DIABETES CASE STUDY

History of Present Illness D.T. is 42-year-old Caucasian woman who has had an elevated blood sugar and cholesterol 2 years ago but did not follow up with a clinical diagnostic work-up. She had participated in the state’s annual health screening program and noticed her fasting blood sugar was 160 and her cholesterol was 250. However, she felt “perfectly fine at the time” and did not want to take any more medications. Except for a number of “female infections,” she has felt fine recently. Today, she presents to the clinic complaining that her left foot has been weak and numb for nearly 3 weeks and that the foot is difficult to flex. She denies any other weakness or numbness at this time. She does report that she has been very thirsty lately and gets up more often at night to urinate. She has attributed these symptoms to the extremely warm weather and drinking more water to keep hydrated. She has gained a total of 50 pounds since her last pregnancy 10 years ago, 20 pounds in the last 6 months alone. Past Medical History • Seasonal allergic rhinitis (since her early 20s) • Breast biopsy positive for fibroadenoma at age 30 • Gestational diabetes with second child 10 years ago • Multiple yeast infections during the past 3 years that she has self-treated with OTC antifungal creams and salt bath • Hypertension for 10 years Past Surgical History C-section 14 years ago OB-GYN History • Menarche at age 11 • Last pap smear 3 years ago Family History • Type 2 DM present in older brother and maternal grandfather. Both were diagnosed in their late 40s. Brother takes both pills and shots. • Mother alive and well • Father has COPD • Two other siblings alive and well • All three children are alive and well Social History • Married 29 years with 3 children; husband is a school teacher • Family lives in a four bedroom single family home • Patient works as a seamstress • Smokes 1 pack per day (since age 16) and drinks two alcoholic drinks 4 days per week • Denies illegal drug uses • Never exercises and has tried multiple fad diets for weight loss with little success. She now eats a diet rich in fats and refined sugars. Allergies NKDA Medications • Lisinopril 10 mg daily • Loratadine 10 mg daily Review of Systems General Admits to recent onset of fatigue HEENT Has awakened on several occasions with blurred vision and dizziness or lightheadedness upon standing: Denies vertigo, head trauma, ear pain, difficulty swallowing or speaking Cardiac Denies chest pain, palpitations, and difficulty breathing while lying down Lungs Denies cough, shortness of breath, and wheezing GI Denies nausea, vomiting, abdominal bloating or pain, diarrhea, or food intolerance, but admits occasional episodes of constipation GU Has experienced increased frequency and volumes of urination, but denies pain during urination, blood in the urine, or urinary incontinence EXT Denies leg cramps or swelling in the ankles and feet; has never experienced weakness, tingling or numbness in arms or legs prior to this episode Neuro Has never had a seizure and denies recent headaches Derm Has a rash under her bilateral breast and in groin area Endocrine Denies a history of goiter and has not experienced heat or cold intolerance Vital Signs BP 165/100, T 98 F, P 88 regular, HT 5 feet 4 inches, RR 20 non labored, WT 210 lbs What you need to do: • Develop an evidence-based management plan. • Include any pertinent diagnostics. • Describe the patient education plan. • Include cultural and lifespan considerations. • Provide information on health promotion or health care maintenance needs. • Describe the follow-up and referral for this patient. • Prepare a 3–5-page paper (not including the title page or reference page). Format The paper should be no more than 3–5 pages (not including the title page and reference pages. Assignment Requirements: Before finalizing your work, you should: • be sure to read the Assignment description carefully (as displayed above); • consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and • utilize spelling and grammar check to minimize errors. Your writing Assignment should: • follow the conventions of Standard American English (correct grammar, punctuation, etc.); • be well ordered, logical, and unified, as well as original and insightful; • display superior content, organization, style, and mechanics; and • use APA 6th Edition format as outlined in the APA Progression Ladder. How to Submit: Submit your Assignment to the unit Dropbox before midnight on the last day of the unit. When you are ready to submit your Assignment, select the unit Dropbox then attach your file. Make sure to save a copy of the Assignment you submit. MORE DETAILS When doing the write up of the case study this week, you don’t need to re-write the case study in your assignment. This takes up space. I have the case study information. You can certainly refer to the aspect of the case study you are discussing, but don’t re-write the case study. The format for this assignment is 3-5 pages plus the reference list and title page. As a graduate student and future nurse practitioner, you need to be specific in your discussion. In the week three case study, many students discussed hypertension, the management in general, classes of drugs or diagnostic tests yet never really stated what they would do for the patient. The wrong answer is to send the patient to the emergency department for evaluation and management.

The benefits of protection to your bone joints muscles and ligaments

The benefits of protection to your bone joints, muscles and ligaments for the position paper

 

Paper details:

https://edge.apus.edu/portal/site/408622/tool/a3516913-bcd5-45ae-a942-bf793d3a3149/student-submit/807988 https://edge.apus.edu/access/content/attachment/408622/Assignments/763b69d3-2369-45ab-8ed5-16feb853a609/Essay%20Rubric.pdf https://edge.apus.edu/access/content/attachment/408622/Assignments/c124bd60-dc86-4b80-8dbd-84b5bed60bb4/Citation%20Styles%20are%20Different.pdf

Senior Seminar Health Care Management – Collaboration

Introduction You are an analyst at an accountable care organization that has recently been formed due largely to state funding that was allocated to improve population health, and management. You are planning to invite stakeholders to a presentation to explain why there is a need for a combined population health management system. This system will collect de-identified patient data into one central repository that can be used to analyze and even predict population health trends. You are creating a memo inviting each of the stakeholders to participate. In this memo, you will explain key population health ideas so they understand why their contribution is essential and why they should plan to attend the meeting. This requires you to create buy-in across multiple organizations: County hospital, medical school (provides ambulatory care services via physicians, residents, fellows and medical students), a private for-profit healthcare system, and a Medicare Advantage Plan through United Healthcare. In creating this memo, you will need to demonstrate why it is essential for collaboration to occur which may feel counterintuitive to the for-profit entities for example. Plan to explain what the Institute of Healthcare Improvement’s Triple Aim initiative is. You will also need to explain why each entity is actually a stakeholder in Population Health and why everyone should be prepared to consider contributing their information in an attempt to explain Population Health, Population Health Improvement, and Population Health management. Directions Carefully Read: Swarthout, M., & Bishop, M. A. (2017). Population health management: Review of concepts and definitions. American Journal Of Health-System Pharmacy, 74(18), 1405-1411. doi:10.2146/ajhp170025 Initial Post: Based on their observations, in this scenario, and upon a careful review of the available literature, the student is to: Consider him or herself to be the analyst at an accountable care organization. The student is to prepare a formal memo which will go out to the leadership team of each stakeholder. As a reminder, the student must convince the stakeholders to at least attend a meeting for which the analyst will give a separate presentation.