READ CASE STUDY ANSWER QUESTIONS ATTACHED APA STYLE PAPER

Chevron Medical Center is a 300 bed trauma hospital in La Porte, Indiana. Chevron Medical Center is a Joint Commission approved Medicare, Medicaid facility and houses a separate large outpatient surgery center adjacent to the main hospital. (You) Sandy Marshall is the Director of Health Information Management, and manage all of the records for both the main hospital and the outpatient surgery center.

Ten months ago, Chevron Medical Center moved totally away from paper medical records and implemented an electronic health record (EHR) system. The move was completed in three phases over an eighteen month time span. The majority of your 16 employees were ecstatic about the move to an EHR and were fully onboard with the change. One of your employees, Donna Hartford is frustrated over all of the security features associated with the new EHR. Donna is very vocal about wanting some of the security features disabled so she can get faster access to patient records and not have to sign in multiple times a day due to the systems auto shut down if idle for 10 minutes. The current process in place for all hospital employees is to first log on to Chevron Medical Center’s main system with a user name (assigned by the hospital IT department) and password (selected by the employee); second, then log on to the electronic health record using the main user name but a different password along with an access code (again assigned by the hospital IT department).

Donna wants to sign on one time and access anything she wants within the main system and electronic health record for as long as she wants with no additional logons or lock outs. She has assured you and the hospitals risk management department she will sign off completely when she goes on breaks, lunch, and at the end of her shift.

Donna has been extremely negative in regards to the new EHR sign on process and has made it a daily goal of hers to complain to anyone and everyone she comes in contact with. This includes co-workers, physician’s, department heads, other employees within the facility, and etc. Once a week, you have a brief department meeting with your staff just to touch base on how things are going, new items you need to share with them, productivity levels, concerns, and etc. During these meetings, Donna exhibits severe negative behavior emphasizing the need to eliminate the security features within the EHR. She becomes very verbally aggressive when one or more of her co-workers do not agree with her and say they have no issues with the process currently in place. There have been one or two times she has hit her fist on the table and shook her finger at everyone. Donna’s behavior is very disruptive and has all your other employee’s fearful she may become physically violent at any given moment. You have consulted Donna on her behavior in the past and she manages to tone it down for several weeks. But within two to three weeks she is back to her aggressive behavior again. You have had quite a number of complaints from other employee’s throughout the facility and know you must take action to control this situation.

Due to the State and Federal rules and regulations in regards to confidentiality and security of patient health information, you are at a loss as to how to possibly accommodate Donna’s request. You have reviewed:

1. Chevron Medical Center’s internal policy and procedures on confidentiality, security, and access to patient health records. It clearly states due to HIPAA and Joint Commission regulations, all EHR systems must be equipped with confidentiality, security, and access controls for protecting patient health records.

Discussion Prompt #1

Please watch the film, And the Band Played On.  This film may be available on the Internet through free sites such as Youtube and Vimeo (please note: accessing these sites is at your own risk).  You may also view the film for purchase online through sites such as Amazon or HBO.

Movie: And the Band Played On (1993), Roger Spottiswoode (Director). Depicts how the CDC discovered how HIV was being transmitted. The film is both entertaining and educational, and it depicts the principles of epidemiology, human behavior, and society’s view of controversial topics.

• What factors inhibited the early war against acquired immunodeficiency syndrome (AIDS)? Do you believe the AIDS outbreak could have been stopped? Why or why not?  What role does advocacy play in the film? How much publicity does HIV/AIDS receive today?  What’s the story of HIV/AIDS in the 21st century? Explain.

Discussion Prompt #2

• How do occupation and culture influence psychosocial stressors that affect middle-aged adults? How does your occupation influence psychosocial stressors?

1 page each

Please see required reading in the attachment

Also the MAP-IT Framework is in the 5th required reading content in the attachment.

MAP-IT FRAMEWORK AS APPLIED TO PUBLIC HEALTH PROGRAMMING

1. Using all of the information you have gathered so far in regard to your community and public health issue, develop a logic model for your proposed program. Make sure to read the required readings on logic model development.
2. Describe where the development of logic model fits in the MAP-IT framework.
3. Discuss why it is important to have a logic model in program planning.

Length: 3 pages double-spaced, excluding the cover page and the reference list.

Fluid, Electrolyte, and Acid-Base Balance 

1. You are a nurse who frequently cares for post-surgical patients in your hospital unit. Most of the medical-surgical patients have IV fluids infusing during their admission. Due to the frequent use of IV fluids on your floor, understanding fluid balance and electrolyte function is primary to your nursing practice.  a. What conditions might lead to the development of hypovolemia? b. How would the amount of patient fluid loss be determined? c. Describe how hypovolemia and third-space fluid shifts correlate. d. Outline the major difference between hypovolemia and third-space fluid shift. e. Which conditions can result in third-space fluid shift? 

2. You are a nurse in a nonsurgical cardiac unit caring for a 92-year-old patient who has two sons, 15 grandchildren, and 49 great-grandchildren. She lives in assisted living and has a history of congestive heart failure (CHF). She consistently struggles with balancing her fluids and electrolytes and has an affinity for dill pickles and sauerkraut. While hospitalized, she remains on a fluid restriction—much to her chagrin, as she loves ice cream.  a. What within her history would indicate she was at risk for hypervolemia? b. How would dill pickles and sauerkraut impact her fluid volume?c. What body areas offer observational evidence of excessive interstitial extracellular fluid (ECF)? d. Why would your patient be on a strict fluid restriction while hospitalized? e. Outline nursing interventions used while a patient is on fluid restriction.

PLEASE follow the instructions. Answer each question in the order it appears and separately. This is the bibliography to guide you:

 1.Potter, P.A., &Perry, A. G. (2017). Fundamentals of Nursing: Concepts, Process, and Practice (9th ed.). St. Louis: MO:  Mosby. ISBN: 9780323327404.

Instructions for Answer to 2 Question

1- After Each DQ (question), write down references

2- 300 minimum words for every DQ, you can go up to 800 words but answer should be complete.

3- 2-3 Peer Reviewed/ scholarly references for each question

4- References should be within 4 years

5- I am in acute care nurse practitioner program.

6- The response to the DQ is expected to be a minimum of 300 words. A minimum of two peer reviewed/ scholarly  resources are expected. These need to be appropriate for a clinical professional to guide decisions about patient care. If a textbook is used for one of these responses, the other needs to be journal or professional-level website. The references need to be correctly formatted, as do the citations for those references.  “ Question words” don’t count towards 300 minimum count”