Describe how the concepts of leadership and management differ from each other. In what areas do they overlap? Explain how the goals of management and leadership may sometimes overlap. As a nurse leader, do you believe you can expand your influence to create change by taking advantage of this overlap? Explain your answer. With reference.

Comment 1

The PPACA was aimed to improve the health care system, offering affordable health insurance to more Americans, expand the Medicaid program to cover all adults that live below the poverty level, and to support innovative medical care delivery methods designed to lower the costs of health care generally (Lampert, 2009). The PPACA mandates that everyone that is legal will have health coverage in the United States or a penalty will have to be paid at the end of the year. With the influx of people now receiving healthcare, they will be seeking medical attention where in the past they would not. The increase in people seeking medical attention will result in a needed increase in nurses to take care of these patients and more training to gain more expertise and skills to be able to manage the emerging needs and diseases.

A key nursing provision is the health care workforce loan repayment program (Section 5203). This section focuses more on children. It has a focus on pediatric medical or surgical and children mental and behavioral health care. The repayment program will offer psychiatric nurses, social workers, and professional/school counselors up $35,000 a year in loan repayments for their participation in an accredited pediatric specialty residency program.  A second key provision is public health workforce recruitment and retention programs (Section 5204).  This provision is aimed at eliminating the shortage of public health agencies. This provision has offered a one third repayment of loans for an exchange of a contract of employment acceptance with a public health agency for three years. This program is offered to eligible public health or health professions.

I know my nursing career will be affected by the provisions that were listed above along with all the other provisions listed in the PPACA. Offering loan repayments will give nurses the incentive to obtain higher degrees. Recruitment and retention would likely decrease the nurse shortage by new nurses coming in and showing loyalty to the season nurses.

Comment 2

The effect of the Patient Protection and Affordable Care Act (PPACA) resonates profoundly in the U.S. healthcare environment and among the public. Two key provisions of the act include: 1) Guaranteed issue prohibits insurers from denying coverage to individuals due to pre-existing conditions; 2) Section 5204 Public health workforce recruitment and retention programs.

           With the first requirement, health care setting experienced a rise in the number of new patients, as expected. Many of these patients were probably afraid or restricted from going to the hospital or seeking medical care due to the lack of healthcare coverage. The impact is that more people are seeking medical care. From my nursing practice, I observe some of these patients have chronic illnesses that have been neglected and thus require more care. Also, more patients come for medical services; emergency rooms fill with more patients. This increases patients’ population. In return, this affects nurse to patient ratios. Nurses have to care for more patients. They have to work extra time due to shortage of staff. The downsides is that nurse morale is low and the risks for medical errors are high.  

                The second nursing provision (Section 5204) retained refers to the established “Public Health Workforce Loan Repayment Program.” This provision gird to assure an adequate supply of public health professionals to eliminate workforce shortages in public health agencies. The positive impact of this provision is that government will repay up to “1/3 of loans incurred by a health professions student in exchange for an agreement to accept employment with a public health agency for at least three years” (CDC). Ultimately, this provision makes it easier to attract young people to the field of nursing. This will have a positive impact on the nursing shortage. It is an attract incentive for many current nurses to pursue their studies and opt for advanced degree in nursing. This is exactly what I am intended to do.

Comment 3

Nice post! Some important aspects of the ACA, include the consumer assistance program, which is a program that helps people enroll in coverage as well as file complaints if a person is denied payment for any type of healthcare service. There are also preventative healthcare services if eligible, paid by insurance. Seniors that are on Medicare who are struggling with prescription costs, can find assistance with discounts and rebates as well. The ACA also offers more options when choosing insurance coverage. There is also a pre-existing condition insurance plan for people who may have a disability or chronic condition, that were previously denied coverage under regular insurance options. In addition, parents are able to cover their children under the age of twenty-six if they are unable to get insurance. The ACA has given people the ability to choose any doctor they wish to see, whether or not they are affiliated with a network or not. Additionally, the Children’s Health Insurance Program (CHIP) will be extended from 2015 through 2019, providing coverage to children in low-income families (KHN, 2018).

For your assigned topic(s), you are to discuss the incidence and prevalence of the disorder, pathophysiology from an advanced practice perspective, physical assessment and examination, evidence-based treatment plan and patient education, as well as follow up and evaluation to assess the efficacy and outcomes of the evidence-based treatment plan for management of an episodic, acute, and chronic case involving the pathology(s) you are sharing. The entry should be posted in the Discussion space; do not post the Discussion as an attachment.

Respiratory

1. Pneumonia
   1. Community — Acquired
   2. Pneumococcal
2. Chronic Obstructive Pulmonary Disease
3. Interstitial Lung Disease
4. Sleep Apnea
5. Cough

Cardiovascular

1. Valvular Disease
2. Dyslipidemia
3. Atherosclerotic Coronary Artery Disease
4. Acute Coronary Syndrome
5. Peripheral Artery Disease
6. Deep Vein Thrombosis
7. Chronic Venous Insufficiency

Use the following Case Scenario, Subjective Data, and Objective Data to answer the Critical Thinking Questions.

Case Scenario

Mrs. J. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is so exhausted she cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5 kg
2. Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%
5. Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin

Critical Thinking Questions

What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications?

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)

Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

The first step of the EBP process is to develop a question from the nursing practice problem of interest.

Select a practice problem of interest to use as the focus of your research.

Start with the patient and identify the clinical problems or issues that arise from clinical care.

Following the PICOT format, write a PICOT statement in your selected practice problem area of interest, which is applicable to your proposed capstone project.

The PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Conduct a literature search to locate research articles focused on your selected practice problem of interest. This literature search should include both quantitative and qualitative peer-reviewed research articles to support your practice problem.

Select six peer-reviewed research articles which will be utilized through the next 5 weeks as reference sources. Be sure that some of the articles use qualitative research and that some use quantitative research. Create a reference list in which the six articles are listed. Beneath each reference include the article’s abstract. The completed assignment should have a title page and a reference list with abstracts. 

Suggestions for locating qualitative and quantitative research articles from credible sources:

1. Use a library database such as CINAHL Complete for your search.
2. Using the advanced search page check the box beside “Research Article” in the “Limit Your Results” section.
3. When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative.

To narrow/broaden your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Diabetes and pediatric and dialysis. To determine what research design was used, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to Turnitin.