This week’s content addressed the processes involved in selecting the most appropriate model to guide a

practice change. Using the assigned readings and your professional experience as a starting point, answer

the following:

1. In outline form, describe the processes to follow to appropriately select a model to guide a change in

practice.

2. Discuss at least 2 specific possible consequences of selecting the wrong model.

 

Choose one of the following topics:

A. Child abuse

B. Elder abuse

C. Intimate Partner Violence

D. Suicide.

Answer all of the following questions in post:

1. Provide data on local, regional, and state violence statistics.
2. What biological, psychological environmental, sociocultural, behavioral, and health system facts are contributing to the violence?
3. What evidence-based intervention might be appropriate for addressing the problem?
4. Who might you collaborate with in resolving the problem?
5. How would you evaluate the effectiveness of your interventions?

Must be in APA and must include at least one nursing journal article 

Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.  

KBY Discussion:

 

Why is developmental assessment essential in the provision of primary care for infants, children, and adolescents, and what are the essential components of this assessment on the basis of this child’s age?

Development assessments are important especially to primary care providers as they guide parents, guardians and caregivers into stages of development of their infant’s children and adolescents. It allows parents and guardians to adjust their expectations at each stage of development and to know their role when providing care during each stage. The assessment is o ensure that they are developing normally at each stage and to identify developmental red flags and recommend appropriate care and guidance if such was to be observed (Burns, et al., 2019). The child in the case study is a newborn and is established as small for gestational age as he fell below the 10th percentile for age (Tinguely, 2021). A complete head to toe assessment is needed to ascertain normality and to rule out any birth defects. Initial assessment include APGAR Score (Appearance, Pulse, Grimace, Activity, and Respiration ) which should be evaluated 1 to 5 minutes of birth. A healthy baby should score between 8 and 10. Evaluate body temperature, evaluate lungs to ensure full expulsion of amniotic fluids and ensure the infant is breathing properly. Assess the umbilical cord. The normal umbilical cord contains two thick-walled arteries and a single thin-walled vein. A single umbilical artery is usually associated with congenital anomalies e.g., cardiac, renal (Burns, et al., 2019).

Which tools will you use to assess specific components of development (such as speech, motor skills, social skills, etc.)? Which tools do you think are the most accurate in assessing the developmental components and why?

Tools I would use to assess specific components for development such as speech, motor skills, social skills, etc are the Ages and Stages Questionaires ASQ:SE-2 and ASQ-3. The ASQ:SE-2 which is a social-emotional screening tool that screens for social emotional development, self regulation, compliance, social communication, adaptive functioning, autonomy, affect and interaction with people. This assessment is conducted at 1month-72 months old. Another tool the ASQ-3 which is a developmental screening tool that assess for developmental communication, gross and fine motor skills , problem solving and social and personal development. This assessment is conducted at 1-5.5years of age (Hay, et al., 2020). Another comprehensive screening tool that assess both developmental and social developmental is the Battelle Developmental Inventory, edition 2 (BDI-2). This tool assesses children from birth-8 years of age and screens for early childhood developmental milestones, measures personal-social, adaptive, motor, communication, and cognitive ability (Burns, et al., 2019).I would choose the  Battelle Developmental Inventory, edition 2 (BDI-2) as it provides a holistic early childhood assessment growth and social skills development from birth to 8 years of age.

Which components would you consider in assessing the basic biological functioning and well-being of your pediatric patients? Why are these components important in providing primary health-care services to children?

Physical, medical and neurodevelopment examination are essential to assess for the biological functioning and wellbeing of pediatrics patients. These include assessing for developmental milestones such as language, motor skills, visual, spatial, attention and social abilities. Assessing for neurological disorders such as ADHD and any form of mental retardation. Medical assessment includes assessing for poor weight gain, any hospitalizations, metabolic disease and exposures to environmental toxins such as lead. Children diagnosed with chronic diseases such as Otis media, hyper or hypothyroidism and chronic renal failure can impact normal development. Knowledge of the child development or acute or chronic diseases are important to providing optimal care to optimize the child well being (Hay, et al., 2020).

References

Burns, C., Dunn, A., Brady, M., Starr, N., Blosser, C. (2019). Burns’ pediatric primary care (7th ed.). Saunders. ISBN:

9780323581967.

Hay, W., Levin, M., Deterding, R. Abzug, M. & Sondheimer, J. (2020). CURRENT diagnosis and treatment: Pediatrics (25th ed.). McGraw-Hill. ISBN: 978-1260457827.

Tinguely, S. (2021). Pediatrics 01: Newborn male infant evaluation and care. Retrieved from https://southu-nur.meduapp.com/document_set_document_relations/30216?section_uid=root

 

This is to be a 4-5 page paper (not including the title and reference page) in APA format (6th ed) answering the following questions.  You do not need an abstract. 3 to 4References

1.  Identify a patient problem you have had in the clinical setting.

• What formal structures were in place to help address the problem?
• How did you or could you use evidence to investigate the problem?
• Did you have time to search for evidence?  If not what were the barriers you faced?
• What databases did you access for evidence and why? (be specific).

2. Find a clinical practice guideline from the National Guideline Clearinghouse archives or any other site that produces guidelines such as the American College of Cardiology CHF guidelines,  that would be suitable for the patient problem you identified.  Critically appraise the guideline using the AGREE II Instrument in your textbook, p 207 box 7.1.

respond 

 

Department of Veterans Affairs (VAMC) is a federal government agency organization that provides healthcare services to its service members. The way the VA charges for service is based on service connection and means test to determine financial eligibility for a copay. A veteran is eligible to seek care within the VA organization if he/she enrolls within the VA, and received in the past twenty-four months. With the passage of the Mission Act 2019, VA is partnered with the community to allow veterans more accessible access to care within their community. For whatever the care the individual is seeking in the community, if it is service-connected, the VA will cover the entire bill. If it is not service-connected, the VA will submit a claim to the individual insurance in an attempt to collect the payment. Again, the way the organization obtains its reimbursement is: based on an individual’s disability acquired during federal service (Service-connected) fees would be determined based on the percentage of coverage. If the care is related to service connection, no copayment is required. Inpatient services no additional charges. If the individuals need to have service that is not related to service connection, the VA will file a claim to the insurance in an attempt to collect payment. Primary care services – individual with service connection- no copay. Non-service-connected for primary care $ 15.00 copay and specialty care (eyes, heart, hearing etc.) $50.00 copay and particular test like MRI/CT scan $50.00 copay.

           If the individuals are not able to pay their bills, the treatment will be provided regardless. The VA is required by law to collect all copay dept for VA health care services 30 days to pay the bill in full, dispute the charge, or request a financial hardship for assistance such as a payment plan or debt relief before the 30 days otherwise, late fees and interest will accrue. As of January 1, 2020, some veterans do not have copay due to their disability rating, income level, or special eligibility. 

Urgent Care Copay rates are in group priority based on military service has eight priority group when the individual enrolled in VA Health care. Priority group 1-5 no copay for the first three visits in each calendar year, and additional visits within the same year will be $30. Group 6 if the condition is related, no copay for the 3 visits, and if not related $ 30 each visit. Group 7-8 $30 copay. 

NR533: Touchpoint Reflections Experience Table

Your Name’s Healthcare Organization: VA Medical Center

Healthcare Delivery System (Type)

 Federal government agency

Payer Mix

Percentage

Medicare

% of service connected

Medicaid

 % service connected

Managed Care

n/a

HMO

 n/a

PPO

 n/a

IPA

 n/a

Self-pay

 welcome

Uninsured

 welcome

Reflection:  

In completing this assignment, I have learned a lot about the organization.  I did not know before to answer patients’ questions about their eligibility for care, details about copay, and what was required for their service or not. Recently with the passage of the Mission Act in June of 2019, everyone was required to complete the modules to learn about the process. The modules completed to fulfill administration requests for their deadlines; however, minimum information retained about the outpatient urgent care services.   Base on this data, the assumptions that could be made about the veterans’ population that the VA health care is not really free. What I have noticed that the individuals are on a fixed income, and they are accruing additional copay, which they cannot afford.  I believe if the frontline staff is empowered with the knowledge of how the institutions can assist the veterans with financial difficulties, this will alleviate some of their burdens. I know each veteran assigns to a social worker. Still, at the time the conversation is taking place, the provider can inform the patient to apply for financial hardship or place a consult with the social worker to address the situation. The variables in coverage do not affect the services provided to the individuals. No one will be turned away for not having the means to pay for care. The organization will do anything to give care to the individuals to fulfill President Lincoln’s promise. “To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s Veterans (VA Mission statement). The other implication I noticed that might happen that VA is funded based on the federal budget; it does not have sufficient funds then, that will affect care.