1. Identify concepts of health and disease
2. Differentiate between the basis of disease in relation to normal body function
3. Discuss interrelationships between pathophysiology, pharmacology, diagnostic testing, and management on health and disease
4. Explain the physiologic signs and symptoms of disease and their impact on functional health status
5. Delineate the risk factors highly correlated with specific health conditions
6. Identify the impact of specific diseases on the U.S. population and globally
7. Successfully critically consider current scholarly literature on a topic (write a literature review) using proper APA citations, references, and formatting

The Omnibus Budget Reconciliation Act (OBRA), also known as the Nursing Home Reform Act of 1987, has dramatically improved the quality of care in the nursing home over the last twenty years by setting forth federal standards of how care should be provided to residents. 

This Act is interpreted with the U.S. Code of Federal Regulations (42 CFR Part 483). Such improvements include less use of antipsychotic drugs, a reduction in chemical and physical restraint use, and a reduction in inappropriate use of indwelling urinary catheters.

Mandates

The quality of care mandates contained within OBRA, and the regulations, require that a nursing home must provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care. 

In order to participate in Medicare and Medicaid programs, nursing homes must be in compliance with the federal requirements for nursing homes.

The mandates of OBRA are regarded in the nursing home setting to represent minimum accepted standards of care. The failure of a nursing home to comply with the OBRA quality of care mandates in caring for a resident represents a failure to exercise the degree of reasonable care and skill that should be expected.

Penalties

The Indiana State Department of Health is responsible for ensuring that nursing homes follow these mandates through the state survey process. The Department of Health and Human Services (DHHS) and the states may apply penalties against nursing homes for failure to meet the minimum standard of care as defined in the OBRA regulations. 

Such penalties may include fines, appointment of administrative consultants to run the nursing home while deficiencies are remedied, and even closure of a nursing home.

• Residents must be assessed to identify their medical problems and their abilities to perform basic self-care activities. The DHHS established a uniform data set, referred to as the minimum data set (MDS), to document this assessment.
• The nursing home is responsible for the safety of each resident. This includes being responsible for orders written by the resident’s primary physician or other medical provider. If the physician writes an order that does not comply with the federal regulations, the nursing home is responsible for making sure the physician changes such order. The mere presence of a physician’s inappropriately written order does not absolve the nursing home of responsibility in providing safe care.
• Provide services that will enhance each resident’s quality of life to its fullest (42 CFR §483.15).
• Maintain the dignity and respect of each resident (42 CFR §483.15).
• Develop a comprehensive care plan for each resident (42 CFR §483.20).
• Conduct a comprehensive and accurate assessment of each resident’s overall health upon admission and at each required interval (42 CFR §483.20).
• Prevent a decline in activity of daily living (ADL) activities, including the ability to eat, toilet, bathe and walk. Staff must provide for ADL care when necessary (42 CFR §483.25).
• Prevent the development of pressure sores, and if a resident has pressure sores, provide the necessary treatment and services to promote healing, prevent infection, and prevent new sores from developing (42 CFR §483.25).
• Provide appropriate care to those who have urinary incontinence and restore bladder function if possible. This also includes only using urinary catheters when appropriate as outlined in the regulations to prevent adverse consequences related to such use (42 CFR §483.25).
• Prevent accidents, including falls, accidental poisonings and other incidents that could cause injuries (42 CFR §483.25).
• Maintain adequate nutrition to prevent unnecessary weight loss (42 CFR §483.25).
• Provide each resident with sufficient fluid intake to prevent dehydration (42 CFR §483.25).
• Ensure that residents are free from significant medication errors (42 CFR §483.25).
• Have sufficient nursing staff (42 CFR §483.30).
• Ensure that each resident’s rights to choose activities, schedules, and health care are maintained (42 CFR §483.40).
• Provide pharmaceutical (medication) services to appropriately meet the physical and psychological needs of each resident (42 CFR §483.60).
• Maintain accurate, complete, and easily accessible clinical records for each resident (42 CFR §483.75).

Please Answer this question  in APA style 

CASE STUDY: Mrs. J is repeatedly asking for a nurse; other patients are complaining, and you simply cannot be available to Mrs. J for long periods.  Considering the setting and the OBRA guidelines, what would you do to manage the situation?

 Please 20 % less of similarity. 

After reading Chapter 13 and reviewing the lecture powerpoint (located in lectures tab),  please answer the following questions.  Each question must have at least 3 paragraphs and you must use at 3 least references (APA) included in your post.

1.  Describe at least 3  nursing care delivery models.

2.  Describe communication strategies for effective interprofessional teams.

3.  Describe the behaviors that are important to demonstrate when working within a team to enhance teamwork and collaboration in the context of quality and safety.

Answer the following questions and write a paper (3 pages) about the problem of lack of knowledge regarding the differences of effect between first-in-class imported medications and me-too drugs.

· Introduction

· Why we need to fix this problem?

· How to study this problem?

· What is the Significant of the problem?

· What are the consequences of solving this problem?

· Theoretical Background of Me-too drugs

· Conclusion

You will need to find 4 articles located in scholarly journals. Scholarly journal articles are also referred as primary source peer reviewed articles. A scholarly journal article can be found in the South University Online Library. To find more information regarding utilizing the South University Library and accessing scholarly journal articles click on Library Guide. What cannot be used for this assignment are web pages, magazines, newspapers, text books, and other books. Finally, current research for our purposes is an article that was published within the last 5 to 6 years.

Remember this is a course on human development so when looking for articles make sure they are related to the subject matter covered in the course. To help in your search here are some of the major areas we covered in this course (these are meant as a guide, not specific topics to find).

• Major developmental theories across the lifespan
• Nature of geographic, gender, social, cognitive, emotional, and developmental factors during each period of development
• Developmental factors that impact one another.
• Historical and current trends in development
• Current trends which may differentially impact the future development of populations in the United States
• Social, and diversity issues related to developmental psychology

With the major areas above in mind, focus on at least two of the following age groups:

• Childhood
• Adolescence
• Adulthood
• Older Adults

First, give an overview of each article, including:

• Write a 2-paragraph summary for each article.
• Write a 1-2 paragraph analysis and evaluation for each article found.
• Make sure to integrate course material in that analysis

Then, write a summary (1-2 pages) integrating what was leaned from the articles reviewed on the chosen age groups as seen from the life-span perspective. Cover the following in that summary:

• What similarities did you find in the types of research and what was being studied? What differences did you find?
• Based on your course readings, what developmental theories did you find that were applicable?
• Explain how the life-span perspective may provide a way of better understanding the research reviewed.