I NEED A RESPONSE TO THIS ASSIGNMENT

2 REFERENCES 

ZERO PLAGIARISM

Hypersomnolence Disorder

According to American Psychiatric Association (2013), hypersomnolence Disorder is characterized by the self-reported excessive sleepiness lasting for 3 months as evidenced by a prolonged sleep episode of more than 9 hours per day or day time sleep episode occurring at least 3 times a week.

1. The hypersomnolence is accompanied by significant distress or impairment in cognitive, social, occupational, or other important areas of functioning.
2. The hypersomnolence is not better explained by and does not occur exclusively during another sleep disorder such as sleep apnea or narcolepsy
3. The hypersomnolence is not attributable to the physiological effects of a substance e.g. drug abuse or medication.
4. Coexisting mental and medical disorders do not adequately explain the chief complaint of hypersomnolence.

Psychotherapy

In patients with hypersomnolence disorders, the goal of treatment is to curtail daytime sleepiness. Nonpharmacologic measures may help reduce tiredness in some patients (Khan, & Trotti, 2015). The use of cognitive-behavioral therapy can be very helpful in the treatment of hypersomnolence disorders. CBT can be conducted in group or individual sessions and its modality consists of CBT modules that include behavioral, cognitive and educational components. The behavioral part begins with specific techniques aimed at changing sleep-disordered behaviors such as scheduled naps, sleep hygiene, and regularizing sleep schedules at night. The cognitive component is aimed at modifying beliefs, motivations, and emotions that might play an essential role in maintaining hypersomnolence that intensifies symptoms. The educational features include education about hypersomnia, coping skills training, the mechanism of drug action, drug interaction, and perceived limitations of living with chronic hypersomnia (Agudelo et al., 2014).

Psychopharmacology

Modafinil is a non-stimulant medication, wakeful promoting agent, approved by FDA as the first-line intervention to treat hypersomnolence. It acts by blocking norepinephrine and dopamine reuptake transporters. Its plasma concentration normally reaches peak values within 2-4 hours after intake. Modafinil is safe and well-tolerated. Some of the side effects of the medication include headache, nausea, loss of appetite, and nervousness (Sonka & Susta, 2012). Modafinil is a long-acting non-stimulant medication and can provide all-day benefits following morning administration. However, stimuli with a short duration of action such as methylphenidate can be used in combination to achieve alertness quickly on an as-needed basis (Gabbard, 2014).

Referring patients to their primary care physician

Hypersomnolence causes many significant impacts on the quality of life and psychosocial well-being of an individual. Excessive sleepiness can be problematic because it affects the person’s abilities at work, school. It can cause safety issues while driving and also affects other everyday activities. The PMHNP can play an essential role by referring these and patients who present with excessive daytime sleepiness and whose quality of life has been significantly impacted by the condition to their primary physician.  Referring to these patients on time is essential for an early diagnosis and intervention and also to be able to determine any underlying medical disorder that can be causing the excessive sleepiness. Also, an early referral is needed because when hypersomnolence is left untreated, it can lead to social isolation and interfere with daily patient functioning (Khan, & Trotti, 2015).

References

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications

Khan, Z., & Trotti, L. M. (2015). Central Disorders of Hypersomnolence: Focus on the Narcolepsies and Idiopathic Hypersomnia. Chest, 148(1), 262–273. https://doi.org/10.1378/chest.14-1304

Marín Agudelo, H. A., Jiménez Correa, U., Carlos Sierra, J., Pandi-Perumal, S. R., & Schenck, C. H. (2014). Cognitive-behavioral treatment for narcolepsy: can it complement pharmacotherapy? Sleep Science, 7(1), 30–42. https://doi-org.ezp.waldenulibrary.org/10.1016/j.slsci.2014.07.02

Sonka, K., & Susta, M. (2012). Diagnosis and management o

  

Topic for capstone 

.Implementing Opiod Risk assessment tool from a multidisciplinary pain management approach

The purpose of the doctoral capstone project was to: (a) provide education to nursing staff on implementing a structured risk assessment tool in order to identify risk for imminent aggression, manage risk for imminent aggressive behaviors 

Write a 6-8 page double-spaced paper with an additional template in which you analyze potential ethical considerations that may arise from your doctoral project. Determine strategies to address these ethical considerations.

Introduction

Ethical researchers act in honest ways. Ethics are conduct norms or standards that distinguish between right and wrong and acceptable and unacceptable behaviors. Ethical considerations matter because they guard against the fabrication or falsification of data. They promote the pursuit of knowledge and truth, research’s primary goal. Ethical behavior is also crucial for collaborative work because it encourages an environment of trust, accountability, and mutual respect among team members. Likewise, researchers must adhere to ethical standards for the public to support and believe in the research. Although most quality improvement and evidence based practice projects pose minimal risk to human subjects, an IRB screening process for your capstone project is required to ensure the project is meeting the appropriate ethical standards.

The Nuremberg Code (1947) protects human rights and is the leading code for conducting ethical research. It focuses on:

• Voluntary informed consent.
• Freedom to withdraw from research.
• Protection from physical and mental harm.
• Protection from suffering and death.

It also emphasizes the risk-benefit balance of conducting research. The Declaration of Helsinki (1964) underscored the importance of protecting subjects in research and strongly proclaimed that individuals’ well-being takes precedence over scientific and social interests.

Good research is well planned, appropriately designed, and ethically approved. Developing and following a research protocol helps to ensure this. Research needs to seek to answer specific questions rather than just collect data. Researchers must obtain approval from the Institutional Review Board or Ethics Committee. Researchers also need to pay special attention to vulnerable subjects to avoid breech of ethical codes. Although most quality improvement and evidence based practice projects pose minimal risk to human subjects, an IRB screening process for your capstone project is required to ensure the project is meeting the appropriate ethical standards.

The major ethical issues in conducting research usually involve:

• Informed consent.
• Beneficence—do no harm.
• Respect for anonymity and confidentiality.
• Respect for privacy.

You are responsible to ensure your project is conducted ethically and responsibly from planning to publication. Be familiar with ethical principles and follow them strictly. Discuss openly with the project team any potential ethical issues. If in doubt, consult the Institutional Review Board (IRB) for expert opinion and direction.

In this assessment, you will apply what you have learned from the CITI training and from your independent research on ethics to your doctoral project. In a 6- to 8-page paper plus a template, you will identify ethical considerations that may arise as part of your doctoral project. You will also identify strategies to address these ethical considerations.

Reference

World Medical Association General Assembly (2004). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. International Journal of Bioethics, 15(1), 124–9.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• Competency 2: Apply strategies to maintain a climate of mutual respect and shared values.
  • Apply historical ethical principles to analyze potential ethical concerns related to your doctoral project.
  • Determine vulnerability or possible concerns for identified project participants.
  • Create strategies to address potential ethical risks related to the doctoral project.
  • Describe the IRB processes to be completed prior to starting the data collection process.
  • Describe possible future changes to your doctoral project that would require IRB approval and the process to follow to obtain this approval.
• Competency 4: Address assessment purpose in a well-organized text, incorporating appropriate evidence and tone in grammatically sound sentences.
  • Create a clear, well-organized, succinct, professional ethics analysis paper that uses appropriate tone and is generally free from errors in grammar, punctuation, and spelling.
  • Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.

Preparation

To successfully prepare for this assessment, you will need to conduct independent research on ethics related to research studies. You will be asked to supply a minimum of five references in your ethics analysis paper over and above those provided under suggested resources.

• Rather than researching the importance of ethical practice (which of course is very important), focus your research efforts on other research studies that have been conducted that are similar to your proposed research. For example:
  • Can you locate other studies that took place in a setting similar to yours?
  • What other studies exist that used participants similar to yours?
  • What studies can you find that address a problem similar to yours?
  • Do other studies exist that used research tools similar to yours, such as surveys, questionnaires, health behavior models, performance improvement plans, et cetera?
  • Examine current resources available through peer-reviewed articles and professional and government websites. These guides can help you identify scholarly and authoritative sources:

Instructions

For this assessment, you will write a 6- to 8-page ethics analysis paper. Include the following headings in your paper and be sure to address the bullets underneath each heading:

Introduction

• In brief, what is your project about?
• Who are the major stakeholders involved?

History of Research Ethics

• What are the major principles in the history of research ethics?
• How do autonomy, beneficence, malfeasance, and distributive justice specifically apply to your project?

Human Subjects/Participants

• What human subjects/participants, if any, will be part of your project?
• What are the exclusion and inclusion criteria for any people who are part of your study?

Recommend a quality or safety initiative that addresses a shortfall in quality and/or safety (UTI) in your current precepted experience environment (or simulation). Include the principles of quality improvement, health care policy, ethical and legal considerations, cost-effectiveness and means to monitor the initiative over time. 

The paper needs to be between 5-8 pages in length in APA format in text citation  with a SWOT analysis and implementation timelines and plan as appendices. Please provide turnitin report. 

Grading Rubric:  

1-Identify the quality or safety concern within the clinical practice and implication of the concern.

2- Recommend an evidence-based quality or safety initiative.

3- Discussion of implementation of the safety initiative: include principles of quality improvement, healthcare policy, and cost-effectiveness.

4- Discussion the SWOT analysis and timeline.

5- How the weaknesses and threats to the initiative will be mitigated  

A healthcare organization allows for mandatory overtime in the case of staffing shortages. You are the supervisor on shift and there is a staffing shortage for one RN for 4 hours into the next shift. There are five RNs currently working. What factors do you take into account in deciding which RN will be required to remain to cover the shift? 

word count 300 APA format references within 5 years.

HA4070D – Regulatory Environment in Health Care

Assignment 06: Appealing Decisions

 

Directions

Complete the questions below based on the problem identified. Your written response should be no less than two to three pages in length.

Problem: Mr. H. was a diabetic and had severe ulcers on his feet. He was a member of an HMO, and his primary care physician had prescribed a treatment regimen that was proving ineffective. In response, the primary care physician offered Mr. H. an amputation below the knee that was his only option. Mr. H. went out of plan to a local wound care center that specialized in diabetic wound treatment where he was advised that vein by-pass surgery would likely take care of his problem. The HMO denied such surgery because Mr. H. referred himself to the specialist without permission. The HMO advised Mr. H.’s family that its utilization review department was reviewing the case, but that it would take at least a month to review. Subsequently, the HMO agreed to approve such surgery, but only if done by Mr. H.’s current medical group, which did not have any physician who had ever performed vein by-pass surgery. Mr. H.’s family asked for him to be transferred to a primary care physician at the medical group that staffs the wound care center. The HMO responded that although they sometimes approve such requests, they would not do so in Mr. H.’s case and that they had already granted enough of his requests. They gave as their reason a provision in the plan documents that prevent referrals outside the plan’s network when the network’s physicians have the capability to perform the required procedure.

This problem is adapted from a real case history developed by the Center for Health Care Rights in California.

• What procedural remedies does the patient likely have under private insurance and under Medicare or Medicaid?

• Are they adequate?

Be sure to include the following based on the criteria below:

Student examines legal issues related to healthcare rationing and medical necessity.

Student identifies remedies the patient would have under private insurance and if they are adequate.

Student identifies remedies the patient would have under Medicare and if they are adequate.

Student identifies remedies the patient would have under Medicaid and if they are adequate.

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