No Plegarism please, assignment will be checked with Turnitin. 

Will need minimum of 5 full pages, title, and reference page APA Style, double spaced, times new roman, font 12, and and (3 references within 5 years 2014-2018) with intext citations). 

 

Health information technology (health IT) makes it possible for health care providers to better manage patient care through secure use and sharing of health information. Health IT includes the use of electronic health records (EHRs) instead of paper medical records to maintain people’s health information.

Share the EHR platform that your practice uses (Cerner) and discuss the challenges and barriers to electronic charting. Why have we moved from paper charting to EHR’s?  What is meant by meaningful use regulations and why is this important to know when documenting in the EHR?

Please support your work with at least three evidence based practice resources that are less than 5 years old (2014-2018).

Written Paper (Microsoft Word doc): minimum 1500 words using 6th edition APA formatting

Please review the grading rubric under Course Resources in the Grading Rubric section.

  

Addressing Chronic Disease

According to the Population Health course text, “Roughly 40 million Americans are still uninsured and 112 million Americans (almost half of the U.S. population, 45%) suffer from at least one chronic condition” in the United States, an estimated 125 million persons have at least one chronic condition, and half of these persons have multiple chronic conditions” (Fabius, and Pracilio, Nash, Clark, 2015, p. 4 ).

This week’s Learning Resources examine numerous health problems that result in a need for ongoing care. As you have explored this week, many costs are associated with chronic disease—both in terms of lives lost and socioeconomic burden. What can be done to help reduce chronic disease at the population level?

For this Discussion, you will take an in-depth look at chronic disease, and you will evaluate ways to address this issue through the application of chronic disease models and frameworks. In addition, you will consider the impact of the challenges of managing chronic disease on quality of care delivery.

To prepare:

• Review      the application of chronic disease models as a method for managing chronic      diseases at the population level.
• Consider      characteristics of chronic disease models and how to apply them as      presented in the Learning Resources.
• Consult      Figure 13–7 (p. 267) in Population Health: Creating a Culture of      Wellness and consider examples of determinants and outcomes of      population health with chronic diseases in a specific subpopulation. Then,      select one chronic disease on which to focus for this Discussion.
• Ask      yourself, “What are the challenges of managing this chronic disease? How      do these challenges limit the ability to deliver effective quality care?”      Conduct additional research using the Walden Library and credible websites      as necessary.

By tomorrow 05/01/2018 3 pm, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”

Post a cohesive scholarly response that addresses the following:

1) Identify your selected chronic disease (refer to attached article).

2) Describe the application of a chronic disease model to address this disease at the population level (refer to attached article). Include your rationale for selecting this particular model.

3) Discuss one or more current challenges related to the management of the chronic disease and explain how these challenges limit the ability to deliver effective quality care.

Required Readings

Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J. L. & Horowitz, M. R. (2016). Population health: Creating a culture of wellness (2nd ed). Burlington, MA: Jones & Bartlett Learning.

Chapter 10, “Transitions of Care”

Chapter 10 provides a framework for understanding the challenges faced by the U.S. health care system, including the shift from acute care to chronic care and the costs associated with that shift. Emerging models of chronic care delivery are presented.

Chapter 11, “Healthcare Quality and Safety Across the Care Continuum”

Chapter 11 examines the implications for quality and safety, and the imperative to focus on these issues at the population level under the mandate of the Affordable Care Act. The Examples of population-based quality and safety initiatives are presented.

Chapter 14, “Population Health in Action: Successful Models”

Chapter 14 focuses on improvements within population health, including chronic care. The Chronic Care Model, a conceptual framework, is discussed as a method for distributing care improvement to numerous practice settings. The key characteristics of a successful chronic care model that provide access to board populations are discussed.

Easley, C., Petersen, R., & Holmes, M. (2010). The health and economic burden of chronic diseases in North Carolina. North Carolina Medical Journal, 71(1), 92–95.

This short reading presents an analysis of the economic effects of selected chronic diseases resulting in increased hospitalization, with a focus on behaviors that may be changed to prevent these diseases.

Kim, T. W., Saitz, R., Cheng, D. M., Winter, M. R., Witas, J., & Samet, J. H. (2011). Initiation and engagement in chronic disease management care for substance dependence. Drug & Alcohol Dependence, 115(1–2), 80–86.

This article presents a study on treating substance abuse as a chronic disease. The authors discuss challenges to treatment options and propose methods for more appropriately managing treatment for substance dependence as a chronic illness.

Ormond, B. A., Spillman, B. C., Waidmann, T. A., Caswell, K. J., & Tereshchenko, B. (2011). Potential national and state medical care savings from primary disease prevention. American Journal of Public Health, 101(1), 157–164.

In this article, the authors examine whether population-based primary prevention activities lead to reduced disease onset in the short run, and, consequently, to cost savings within the health care system at both the state and national levels.

Tenforde, M., Jain, A., & Hickner, J. (2011). The value of personal health records for chronic disease management: What do we know? Family Medicine, 43(5), 351–354.

This reading examines evidence related to the value of electronic personal health records (PHRs), noting that additional research is needed to evaluate this for chronic disease management.

United Nations. (2011, September 19). Non-communicable diseases deemed development challenge of ‘epidemic proportions’ in political declaration adopted during landmark general assembly summit. Retrieved from http://www.un.org/News/Press/docs/2011/ga11138.doc.htm

The United Nations met in September 2011 to collaborate on global plans to address the control and prevention of chronic diseases. This report from the general assembly notes the high cost of not managing chronic disease worldwide.

Yale School of Public Health. (2012). Chronic disease epidemiology. Retrieved from http://publichealth.yale.edu/cde/index.aspx

Yale School of Public Health sponsors this site. Explore the information presented on addressing chronic disease through epidemiology.

Florida Department of Health. (n.d.). Bureause of epidemiology: Surveillance and investigation guidance. Retrieved March 5, 2012, from http://www.floridahealth.gov/diseases-and-conditions/disease-reporting-and-management/disease-reporting-and-surveillance/surveillance-and-investigation-guidance/index.html

This Florida-based agency monitors chronic disease conditions in Florida’s population using a variety of population-based surveillance systems.

World Health Organization. (2012). Chronic diseases and health promotion: Integrated chronic disease prevention and control. Retrieved from http://www.who.int/chp/about/integrated_cd/en/

The World Health Organization monitors chronic diseases worldwide. This website provides an overview of their programs, monitoring efforts, and activities they engage in to reduce the incidence of chronic disease globally.

 

As a nurse manager, it is imperative to understand how social technologies can impact productivity, peer-to-peer relationships, and patient safety within the workplace. Collaborating with HR to understand policies and the organization’s expectations related to the use of social technologies allows nurse managers to more effectively and appropriately integrate today’s social platforms while mitigating the occurrence of inappropriate behaviors.

For this week’s Discussion, your Instructor will assign you to one of the scenarios below. You will then use that scenario to investigate the social, ethical, and legal ramifications of social technologies.

Scenario One: You have recently been promoted to charge nurse for the day shift in your department. As a result of this promotion, your former peers are now reporting directly to you. You have been working in your setting for five years and consider many of these peers to be your friends. The way that one of your friends posts on social media sites has always bothered you. Many times, her comments are inappropriate, discussing her negative feelings about “ignorant superiors” and “annoying patients.” You also know that she frequently accesses these sites for extended periods of time while patients are waiting to be helped. Now that she reports directly to you, how do you address this? If your workplace does not have a formal policy on social media use, how can you adapt her behaviors to align with the expectations of nursing professionalism?

 Post an explanation of the possible social, ethical, and/or legal ramifications of your assigned scenario. Explain the policy your current or past workplace has on the use of social technologies and how effective you believe the policy is. If your workplace does not have a policy, explain what the accepted practices or expectations are for your setting. Has lack of policy led to any problems? Support your responses by referencing authentic examples from the workplace and this week’s Learning Resources as appropriate. 

 

Alichnie, C. (2012). Social media and nursing. Pennsylvania Nurse, 67(1), 3–10.  Retrieved from the Walden Library databases.

This article discusses the use of social media in nursing. The author determines that social media can be a means to an end if it’s used wisely, professionally, and within legal and ethical boundaries.

  

Need 2 responses done. Answer as if it were me. 

– Min 150 words EACH, 

– Min 1 scholar source (no later than 5 years) EACH, 

– APA format. 

The post: Karen is still not convinced that Theory has any place in APN practice. Provide a specific example of how theory is relevant to APN practice in one of the four specialties (CNM, CNP, CRNA or CNS). Provide evidence to support your arguments.

                                                                 ANSWERS TO POST:                                                                          

POST 1:

As an emergency room nurse, working alongside several nurse practitioners, it is very apparent that nursing theory is relevant to everyday practice. Woten and Karakashian (2017) describe the role of an emergency room nurse practitioner as, an advanced practice nurse with specialized training that can provide holistic care to patients. The idea of providing holistic care branches from several nursing theorists that discuss the importance of treating every individual as a whole. For example, an individual may arrive to the emergency department with chest pain, which will immediately warrant an electrocardiogram.  The patient will then be triaged and have vital signs taken. Most patients with chest pain will have blood work and a chest x-ray. Sometimes patients may present with chest pain and all the results are negative, this does not mean that the patients pains are not legitimate or a concern.  As a holistic provider, we are to rule out every life-threatening emergency but also provide continuation of care. Sometimes patients may not have a primary care provider, a support system, or means of seeking further help.  This is where the provider is to seek help from a social worker and assist the patient in having follow-up care. In some cases, the patient may be admitted to the hospital for further testing that cannot be completed in the emergency room.  This plan of care shows a holistic approach to treating a patient. Patients “pain” level should never be ignored, even though results are negative. On several occasions, patients are treated with antacids to rule out gastritis or GERD that can cause chest pain, and anti-inflammatory medication to treat possible costochondritis. The importance of a holistic approach is to avoid missing any possible findings that are not initially seen and so that if there is something that may occur the patient is not treated as if nothing is wrong with them.  Holistic nursing care is one of the most important theories all nurses should follow, it leads to the best possible patient outcomes.

POST 2:

Theory helps to generate knowledge in which nursing should develop in the future. Nursing theory can be used to improve and evaluate the quality of clinical practice by distinguishing the practice that can help patients with better care and enhance professional status for nurses. Nursing theory helps to define a relationship that creates a domain of interest in the healthcare profession. A valuable theory creates expectations about a conduct, health problems, and environment that are reasonable and reliable with daily remarks. For instance, in nursing theory class, we discussed Watson theory of caring which focuses on the caring aspect of nursing practice. I think that it is a very important theory because it reflects on the ability to create a relationship of trust and respect with patients. The theory of Watson implies the ability for a nurse to care for patients holistically to accommodate a better relationship between patients and healthcare providers. A recent study was done that applies Watson’s theory of practice in an assessment for patients with chronic heart failure with acceptance of collaboration between nurses and patient for transpersonal teaching-learning was showed to be efficient on improving CHF self-management. The strategy of nursing management of care for CHF patients activates the main element of Watson’s model for an enhancement for a better result of self-management care for CHF patients (Leong, Lao, & Chio, 2013).  A CNP can use the Watson model to interact with patients. For instance, as a future NP, it is vital that we connect with patients, so we can create a good relationship with patients in order to help them. Based on King’s theory, nursing is outlined as a practice of interactions between nurse and patients to perceive and set goals to reach the goals (Leon-Demare et al., 2015). The function of king’s theory of goal accomplishment to NP clinical encounters supports the nursing foundations motivating advanced practice nursing. King’s theory accentuates on a constructive bond between the presence of connection and patients ‘point of view of belief and gratification as outcomes of the NP patient connection.

 No Plegarism please,  will be checked with Turnitin. 

Will need minimum of 300 words, APA Style, double spaced, times new roman, font 12, and and Include: (3 references within 2015-2018)with intext citations.  

Topic 1K.N. is a 24-year-old woman who presents to the family practice clinic complaining of sudden urgency to urinate, back pain, frequent urination, and pain with urination. Symptoms began approximately 48 hours ago.

She awoke from sleep with urgency and suprapubic discomfort 2 nights ago. Her urine now has a strong odor and a cloudy appearance. She has an allergy to Bactrim.

1. What are some appropriate questions to ask the patient?
2. What are three differential diagnoses for the patient?  ( Urinary Tract Infection,, Overactive Bladder, Cystitis, Noninfectous Urethritis)
3. What physical examination would you perform? (Urine culture
4. What diagnostics would you include?
5. Create an evidenced-based plan of care. Include pharmacological and non-pharmacological treatments.

Urine dipstick results: Color, dark yellow, specific gravity 1.035, ph 5.5, protein (-), Ketones (-), Bilirubin (-), Trace blood, Leukoesterase (+), Nitrites (+), Urobilinogen (-)