Comment1

My EBP project is on type 2 diabetes management through lifestyle changes. I have chosen my place of employment as a research facility being that huge percentage of the population is diabetic. Potential barriers that may prevent my EBP change proposal is the lack of knowledge and unpreparedness of the rest of the team. The company in which I work for has a total of 13 facilities. Each facility has at least one RN and various providers. In order for my EBP change proposal to be successful, the company will have to invest money in training the RNs. Budget is something that has to be meticulously analyzed before approving any type of training. However, the company believes in providing quality patient care and managing our patient’s diabetes will not only reflect in their blood glucose, but also their overall health. According to the article Budget Management Tips for New Managers, it is cost effective to invest time to learn right initially (McCarthy, 2018). At this time, the company is investing time and money to train all medical assistants into working universally throughout the 13 facilities. Being that diabetes is on the rise, and I have conducted evidence-based practice research, I have a good feeling that the company may want to invest time and money into training not only RNs in providing education to patients living with diabetes, but also mental health providers to support these patients.

comment2

Maintaining safe staffing is key.  Keeping staff engaged in the hourly rounding process and not accepting anything less as practice on our CLC is paramount to keeping the residents safe and continue to keep falls at a minimum.  Maintaining an alarm free environment, no matter what the staffing ratios are, will be important. If management is serious about the alarm free environment, then they will need to actively enforce the rounding and not allow it to slide. Lastly, to maintain staff compliance, on-going education needs to be reinforced regarding proper rounding and alarm/restraint statistics on alarm free environments.

Primary Task Response: Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

Accurate coding and billing are essential to a health care facility and to a physician’s financial survival. Coding is a complex task that ties to charges and revenue generation. Failure to capture all charges associated with a patient encounter can result in significant revenue loss. Medical necessity also plays a vital role in the contract with the facility or physician in terms of receiving payment from the third party payer (e.g., an insurance company).

Part 1

For this Discussion Board, you will define medical necessity, and you will describe the criteria to determine it.

Part 2

Once the patient has an established diagnosis and the services and procedures have been ordered, you will code out this information and place it on the claim for payment.

It is important for health care professionals to understand this process to receive accurate reimbursement.

For this part of the discussion, you will be identifying the coding systems that are utilized to support the diagnosis, services, and procedures.

List and discuss the coding system that is utilized to code out the patient’s conditions or diagnosis. Provide an example of a diagnosis with the appropriate code as an example, and respond to the following questions:

• What is the coding system replacing the diagnostic system?
• Will it be implemented this year? Explain your answer.

Next, identify what coding system is utilized to capture the services and procedures that the patient has received (both levels). List an example of a service or procedure with the appropriate code as an example, and respond to the following questions:

• Why is it important to assign the correct codes to the diagnoses, services, and procedures that a patient has received?
• What are the repercussions of submitting incorrect coding and billing errors to the third party payers?

• Develop an educational poster (one page in Word document or PowerPoint slide) on the prevention of mental health or substance use disorder utilizing the IOM (now named the HDM) Model of Prevention Framework category of Universal Prevention.
• Address the following in 1-2 pages on a separate document in APA format:
  • How your PSA poster targets the vulnerable population
  • The burden of the disorder on the health of the population using epidemiological data.
  • Any cultural or stigma considerations.

These are two discussion questions DQ1 and DQ2 

posts must be at least 150 words and have at least one reference cited for each question. In-text citation, please 

Tutor MUST have a good command of the English language Sources need to be journal/scholarly articles.  

Use only articles that are published between 2015-2018 (except for your theory articles which will be older as you must cite primary sources). 

No textbook or direct quotes 

Please separate the two DQ with their reference page 

DQ 1 

How do servant leaders, as compared with leaders who follow the transformational model of leadership, manage organization dynamics and lead change to ensure the continued success of the stakeholders to be served? 

Is servant leadership or transformational leadership the best approach to these tasks?  

DQ 2 

Considering the various virtues or dimensions of character for a servant leader (e.g., virtue, credibility, trust), how might the application of servant leadership be appraised in a health care setting? 

Is servant leadership, versus transformational leadership, plausible in the health care setting that often depends on a hierarchy of command for the safety of patients?

In this assignment I need a peer response for the main discussion, that show below.

The peer’s responses

Discussion Grading Criteria: Agreeing and disagreeing do not mean just voicing one’s opinion. The focus of the discussions should remain on the ideas posed in the readings. Agreeing and disagreeing mean making scholarly arguments from the literature that may support your own ideas. Faculty expects you to support your ideas from the readings or similar scholarly writing about the topic in nursing literature. Always cite your source(s) and reference in APA format.

Remember the post and responses should include scholarly writing about the topic in nursing literature.

Note por the professor:

Hello class,

Please refer to your APA format in your postings. The journal name and volume is italicized font. Ex.

…The American Nursing Journal,7(9),,,,

Please update your APA to reflect doi 

Amely Perez Cicili

Advanced Family Practicum III

The application of national health reform with millions of people receiving health insurance service is increasing the current challenges facing primary care. A major issue focuses on how to rise capacity while improving superiority and cost efficacy. Policy makers and researchers are suggesting innovative approaches to guarantee the system is ready as more people are gaining access (Barnes & Novosel, 2018). While some strategies seek to increase the number of primary care providers (PCPs), others seek to encourage efficient use of existing providers. As providers, Nurse Practitioners have faced some challenges in their scope of practice. Three of these challenges are the autonomy in practice, the teamwork with physicians, and limited prescriptive authority.

State and organizational policies generate misunderstanding around NP roles. In some states, regulations require NPs to collaborate or be supervised by physicians, whereas in other states, these regulatory requirements have been removed by policy makers. Similarly, some organizations restrict NP practice or fail to provide necessary support so NPs can maximally contribute their advanced skills to teams. On the other hand, teamwork between NPs and physicians in primary care has received care due to their overlapping scopes of practice and the fact that lack of agreement exists between them about their respective roles. On the contrary, when patient care suffers, fragmented teamwork and poor collaboration and communication between team members are often found to be contributing factors (Poghosyan, Shang, Liu, et al.,2015).

Limited right for prescription and referral challenged the development of APN scope of practice. Some people believe that only a physician should be allowed to diagnose, refer, or treat any medical condition. Independent prescribing by a NP does not require collaboration with a physician and is a key element of scope of practice for NPs, as well as being part of the APRN Consensus Model, which seeks to achieve uniformity of state regulation of APRN practice. However, regardless of the existence of the consensus model, there are extensive disparities among the states with respect to prescriptive authority. In some states, prescriptive authority is granted at the time of APRN licensure; in others, the APRN must apply separately for these privileges. (Gardner, Chang, & Duffield, 2012).

References:

Barnes, H., Novosel, L. M. (2018). A scoping review of nurse practitioner workforce data: Part Two of a four-part series on critical topics identified by the 2015 Research Agenda Roundtable. Journal of the American Association of Nurse Practitioners. Advance online publication. doi:10.1097/JXX.0000000000000069.

Gardner, A., Chang, C., & Duffield, A. D. (2012). Delineating the practice profile of advanced practice nursing: a cross-sectional survey using the modified strong model of advanced practice. J Adv Nurs, 69 (9), pp. 1931-1942. Google Scholar

Poghosyan, L., Shang, J., Liu, J., Liu, N., et al. (2015). Nurse practitioners as primary care providers: creating favorable practice environments in New York State and Massachusetts. Health Care Manag Rev;40(1):46–55. doi: 10.1097/HMR.0000000000000010. [PubMed] [CrossRef] [Google Scholar]