Write a 500‐750‐word essay on the influence patient education has in health care using the experiences of a patient. Interview a friend or family member about that person’s experiences with the health care system. You may develop your own list of questions. APA 12 front 

Suggested interview questions:

1. Did a patient education representative give you instructions on how to care for yourself after your illness or operation?
2. Did a health care professional, pharmacist, nurse, doctor, or elder counselor advise you on your medication, diet, or exercise?
3. Who assisted you at home after your illness or operation?
4. Do you know of any assistance services, i.e., food, transportation, medication, that would help you stay in your home as you get older?

How a Bill Becomes a Law

As you have discovered through this course, nurses are influential members of the community and the political system. Therefore, for the purposes of this assignment you will identify a problem or concern in your community, organization, etc. that has the capacity to be legislated. You will conduct research and state a proposal. Through the legislative process, your proposal for the problem or concern may influence an idea for change into a law.

First, refer to the “How a Bill Becomes a Law” media.

http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs440v_how-a-bill-becomes-a-law-v2.1.php/.

Then, view the “Bill to Law Process” to watch the scenario.

After viewing the scenario, refer to the “Legislative Assignment.” You will need to save the document first in order to use it.

Submit the assignment to the instructor. You also reserve the right to submit your completed proposal to the respective government official. However, this is optional. If you select to submit your proposal as a part of the legislative process, refer to “Find Your Representative” or research the contact information on your own.

APA format is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

4-CMS no longer reimburses health care providers for services that are required to treat certain complications of care. The complications of care have been nick-named “never events” because according to CMS, these events should never happen and are “reasonably preventable by following evidence-based guidelines.” Examples of these never-events include, stage III and IV pressure ulcers, PE or DVTs after certain surgeries, injuries resulting from falls while in-patient, retention of foreign object after surgery, surgery on the wrong body part, surgical site infections after certain surgeries, transfusion of the wrong blood type, and UTI resulting from a catheter.

Some of these events are reasonable. There is simply no excuse to operate on the wrong body part and if a physician makes the mistake of leaving a foreign object in someone after surgery, it is reasonable to not pay them for another surgery to remove it. However, some of these events are going to happen even if every precaution has been taken to prevent these events. DVTs and PEs are still possible even when someone is on heparin or lovenox. Regardless of exactly “how” preventable these conditions are, this change by CMS will certainly cause providers in in patient facilities to be more attentive in their care and prevention of these conditions. Because CMS specifically mentions that these events are preventable by evidence-based guidelines, in patient care models are focusing even more on these guidelines and basing their care off of them. For example, most hospitals now have protocols to prevents CAUTIs, such as requirements to perform and document catheter care, and algorithms for early removal of catheters, and prevention of unnecessary insertion of catheters in the first place.

Reference:

O’Rourke, P. T., & Hershey, K. M. (2018, September 14). Never-Event Implications. Retrieved from https://www.the-hospitalist.org/hospitalist/article/124081/never-event-implications

5-The Centers for Medicare & Medicaid Services or CMS is investigating ways that they can help to reduce or eliminate the occurrence of “never events” (ELIMINATING SERIOUS, PREVENTABLE, AND COSTLY MEDICAL ERRORS – NEVER EVENTS, 2006). These events are defined as errors in medical care that are clearly identifiable, preventable, and serious in their consequences for patients. “Never events,” like surgery on the wrong body parts or mismatched blood transfusions can cause serious injury or death to patients. There is not an exact number of “never events” but they are the cause in many deaths and additional health care costs that the CMs is trying to minimize. The rules for reimbursement are changing. The Deficit Reduction Act allows CMS to begin adjusting payments for hospital-acquired infections and reduce the payments when they occur. This has caused for a shift in how hospitals require nurses to care for their patients. At my hospital, they implemented 4eyes on upon admission. This means that two registered nurses must assess every square inch of a patient’s body upon admission to insure that the hospital is not responsible for previously acquired injuries. This helps to prevent unnecessary cost on our part treating wounds that were acquired at home. We still treat them but we are not shown as responsible for their development.

ELIMINATING SERIOUS, PREVENTABLE, AND COSTLY MEDICAL ERRORS – NEVER EVENTS. (2006, May 18). Retrieved April 2, 2019, from CMS.gov: https://www.cms.gov/newsroom/fact-sheets/eliminating-serious-preventable-and-costly-medical-errors-never-events

6-The CMS reimbursement rules for never events required a shift in the patient care delivery model in inpatient facilities as this caused facilities to provide more quality based care to prevent the possibility of not getting paid for services that would be considered acquired through the facility. Many of the patients that come into the hospitals should be coming for their reasons for treatment not acquiring any other conditions due to their stay. Hospitals would be denied any additional payment for case in which one of the selected conditions was not present on admission. This caused many hospitals to panic and they attained means in order for this to be avoided. Due to this, facilities have developed distinct protocols and measures to make sure that this doesn’t occur. These conditions are known as never events, which include:

1. Air embolism
2. Blood incompatibility
3. Catheter-associated urinary tract infection
4. Certain manifestations of poor control of blood sugar levels
5. Deep-vein thrombosis or pulmonary embolism after total knee and hip replacements

2. Falls/trauma
7. Objects left in during surgery
8. Pressure ulcers
9. Surgical-site infections after certain orthopedic and bariatric surgeries
10. Surgical-site infections after coronary artery bypass graft
11. Vascular catheter-associated infection

Reference:

ESBCO Host. (n.d.). Preventing Never Events. Retrieved April 2, 2019, from https://www.ebscohost.com/shared/never-events.pdf.

In clinical settings, patients often present with various respiratory symptoms such as congestion, coughing, and wheezing. While identifying a symptom’s underlying illness can be challenging, it is essential because even basic symptoms such as persistent coughing can be a sign of a more severe disorder. Advanced practice nurses must be able to differentiate between moderate and severe respiratory disorders, as well as properly diagnose and prescribe treatment for their patients. For this reason, you must have an understanding of the pathophysiology of respiratory disorders.

Consider the following three scenarios:

Scenario 1:

Ms. Teel brings in her 7-month-old infant for evaluation. She is afraid that the baby might have respiratory syncytial virus (RSV) because she seems to be coughing a lot, and Ms. Teel heard that RSV is a common condition for infants. A detailed patient history reveals that the infant has been coughing consistently for several months. It’s never seemed all that bad. Ms. Teel thought it was just a normal thing, but then she read about RSV. Closer evaluation indicates that the infant coughs mostly at night; and, in fact, most nights the baby coughs to some extent. Additionally, Ms. Teel confirms that the infant seems to cough more when she cries. Physical examination reveals an apparently healthy age- and weight-appropriate, 7-month-old infant with breath sounds that are clear to auscultation. The infant’s medical history is significant only for eczema that was actually quite bad a few months back. Otherwise, the only remarkable history is an allergic reaction to amoxicillin that she experienced 3 months ago when she had an ear infection.