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2023 Bargaining and Unions 1 What impact do collective bargaining and unions in healthcare have on you as a healthcare
by adminNursing 2023 Bargaining and Unions
Bargaining and Unions 1 What impact do collective bargaining and unions in healthcare have on you as a healthcare 2023 Assignment
Bargaining and Unions
1. What impact do collective bargaining and unions in healthcare have on you as a healthcare professional? What is the impact for the patient?
Management Theory
2. Compare and contrast the different theories of management in healthcare. Is there one theory that is better suited than another? Why?
Note: Follow instructions please
If you are citing a source you must reference the source in APA format.
If you are using quoted material, you must reference the source with a page or paragraph number (See in-text citation per APA Citation Style).
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2023 Developmental Assessment and the School Aged Child The needs of the pediatric patient differ depending on age as do the
by adminNursing 2023 Developmental Assessment and the school aged
Developmental Assessment and the School Aged Child The needs of the pediatric patient differ depending on age as do the 2023 Assignment
Developmental Assessment and the School-Aged Child
The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:
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 required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
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2023 Please submit your field experience log for Week 2 in one Word document to this assignment Access the Guidelines
by adminNursing 2023 Field Experience Log
Please submit your field experience log for Week 2 in one Word document to this assignment Access the Guidelines 2023 Assignment
Please submit your field experience log for Week 2 in one Word document to this assignment. Access the Guidelines for the Field Experience Requirement page for full instructions. As seen below :
Guidelines for the Field Experience Requirement
You must “attend” at least 4 policy events, at least approximately 1 hour in length. Attendance of at least one of these events must be in-person.
Up to 3 of the 4 events may be online and they must have a health policy focus. Online health policy events/ webinars will be posted from which you may choose. In addition, you may identify your own online policy events, but please check with your instructor to make sure the events you choose are eligible for field hours.
In-person events must be health-related. For example, an example of in-person event would be attendance at a local board of health meeting, a local school-board meeting, a legislative hearing or meeting, a meeting by an executive branch agency that falls under your governor, a meeting by advocacy organization or special interest group, or a meetings of a political party, political group, or candidate.
General Guidelines
Field Log Guidelines
As a way of demonstrating completion of this course requirement, you must submit, in writing, field logs that detail certain aspects of the event. The template for field experience logs is below.
Template for Field Experience Logs
HP609 Field Experience Log Example One
Field Experience Log #1
Title of Event / Sponsors: Rutland County Maternal-Child Health Coalition Tobacco Cessation in Pregnancy Meeting / Vermont Department of Health and the Rutland County Maternal-Child Health Coalition
Preparation Steps Taken: Prior meeting minutes provided by Bethany Yon, Nutritionist at the Vermont Department of Health were reviewed. Pregnancy Risk Assessment Monitoring System (PRAMS) Data from the CDC at https://www.cdc.gov/prams/tobaccoandprams.htm was also reviewed.
Place / Date / Time / Length: Rutland Area Visiting Nurses and Hospice (RAVNAH) in Rutland, Vermont / May 19, 2017 / 9:30 / 2 hours
Topic Under Discussion: Pilot project for smoking cessation program for pregnant women. Names of Participants and Their Titles: Joanne Calvi (District Director / Nursing Supervisor Vermont Department of Health), Jill Hamilton (Registered Dietician / WIC Supervisor, Vermont Department of Health), Bethany Yon (Nutritionist, Vermont Department of Health), Kathleen Romano ( RN supervisor at Rutland Women’s Health Care), Sarah Cosgrove (Respiratory Therapist, Asthma Educator, Community Health Team at Rutland Regional Medical Center), Marjanna Barber-Dubois (QI Facilitator, Community Health Improvement at Rutland Regional Medical Center), Rhonda Williams (Chronic Disease Prevention Chief, Vermont Department of Health), Allison Kurti (University of Vermont Behavioral Health), Marissa Wells (University of Vermont Behavioral Health)
Brief Description of the Testimony / Meeting / Event: Rutland Regional Medical Center’s Women’s Health Clinic is partnering with the Vermont Department of Health to focus on decreasing the rate of smoking in pregnancy. Collaboratively, they are working with area partners to complete a pilot project for an incentive based smoking cessation program, modeled off an University of Vermont based incentive program. This meeting was a review of progress to date, the plans for initial roll out of the pilot project, and the plan for provider education.
Description and Analysis of the Health Policy Issue and Its Implications for Health Care:
Many behaviors and lifestyle choices that individuals choose to take part in significantly impact their health. One such health determinant, the behavior choice to smoke, is the leading cause of preventable disease and death in the United States (Shi & Singh, 2015). Smoking is one of the 3 health behaviors that contributes to four chronic diseases, leading to 50% of deaths in Vermont (Vermont Department of Health, 2017). For women who smoke during pregnancy, there are many additional health concerns related to the impact of smoking on the pregnancy and fetus as well. Some examples of these health concerns are an increased risk for miscarriage, certain birth defects, premature births, low birth weights, and SIDS (Centers for Disease Control and Prevention, 2016).
With the continued high rate of smoking in pregnancy in Vermont, the Maternal Child Health Division of the Vermont Department of Health is focused on addressing this public health concern. Rutland Regional Medical Center was selected as a site for the smoking cessation pilot project for two reasons. First, the Rutland Women’s Health clinic has been working to create smoking cessation programs for pregnant women. Second, the smoking rate during pregnancy is the highest in the state at 29.3%, and has the third lowest smoking cessation rate during pregnancy of 11.2% (Personal Communication, Sarah Cosgrove, May 19, 2017). The grant funded pilot project is looking to provide a financial incentive to women that take part in the smoking cessation program, which includes individual and group counseling, along with urinalysis to confirm compliance with smoking cessation.
Smoking during pregnancy has many implications on health and health care. As noted above, smoking leads to many preventable health conditions. This leads to significant health care costs to treat these medical issues. Between 2000 and 2012, it has been estimated that $133 billion has been spent in health care costs associated to treating tobacco-related illnesses (American Cancer Society, 2016). Melvin, Adams, Ayadi, and Rivera (2004) reported that in 1996, $366 million was spent on neonatal healthcare costs associated to maternal smoking during pregnancy.
The public health program being implemented in this community looks to provide a multidisciplinary team of providers with the education and training they need to educate, support and empower women to make the needed behavior modifications to successfully quit smoking. In addition, they will be utilizing an incentive based program targeted to this specific, high-risk patient population. Shi & Singh (2015) identified such methods as being avenues to motivate behavioral changes in health promotion and disease prevention.
From the public health perspective, it is not the treating of the disease caused by smoking that needs the attention. It is addressing the cause of these conditions, the behavior of smoking, that needs to be the focus to achieve improvements (Harvard University School of Public Health, 2014). Shifting the focus from one of disease treatment to health promotion through primary prevention interventions is key to improving population and public health. Such primary prevention strategies include therapeutic community efforts, such as the program described above, to assists people with smoking cessation to prevent the health conditions that can result from smoking. Hopefully in the future, there will be an increase focus and implementation of such primary prevention programs to improve the health of populations and decrease the costs of healthcare across the United States.
References
American Cancer Society. (2016). Tobacco: The true cost of smoking. Retrieved from https://www.cancer.org/research/infographics-gallery/tobacco-related-healthcare-costs.html
Centers for Disease Control and Prevention. (2016). Tobacco use and pregnancy. Retrieved from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/tobaccousepregnancy/inde x.htm
Harvard University School of Public Health. (2014). United States health policy. Retrieved from https://courses.edx.org/dashboard
Melvin, C. L., Adams, E. K., Ayadi, M. F., & Rivera, C. C. (2004). State estimates of neonatal-healthcare costs associated with maternal smoking: United States 1996. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5339a2.htm
Shi, L., & Singh, D. A. (2015). Delivering health care in America: A systems approach (6th ed.).
Burlington, MA: Jones & Bartlett Learning
Vermont Department of Health. (2017). 3-4-50: Prevent Chronic Disease. Retrieved from http://www.healthvermont.gov/3-4-50
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2023 A minimum of 2 paragraphs Discussion Advanced registered nurse practitioners ARNPs have
by adminNursing 2023 Discussion replay each, similarities less 5%, APA 6th, 2 references,
A minimum of 2 paragraphs Discussion Advanced registered nurse practitioners ARNPs have 2023 Assignment
A minimum of 2 paragraphs
Discussion
Advanced registered nurse practitioners (ARNPs) have to consider a broad range of factors when prescribing medicines. For instance, professionals in this area have to consider federal and state laws that regulate their practices. The focus on controlled substances is particularly important because registered nurses have a responsibility to prevent fraud and diversion (Klein, 2016). ARNPs have the authority to prescribe Schedule II, Schedule III, and Schedule IV drugs if they pass certification (Florida Board of Nursing, 2016). It is imperative to prevent tampering to prevent abuse and negative health effects when prescribing such substances. Similarly, nurses have to identify behavioral red flags and demonstrate outstanding communication skills when dealing with scammers (Klein, 2016).
Advanced practice nurses have to deal with a set of barriers that limit their ability to prescribe medicines. First of all, ARNPs have to consider such factors as state licensure and regulations. The situation has improved over the years, and such organizations as the American Association of Nurse Practitioners (AANP) seek to improve the prescriptive authority of nurse practitioners. Nevertheless, nurse practitioners have to deal with such issues as supervision and delegation. It is also noted that physician professional organizations believe that it is necessary to limit the scope of nursing practice because of such factors as the overall quality and safety of care (Hain & Fleck, 2014). Available research indicates that most of the concerns voiced by the opponents of unrestricted prescriptive authority are unreasonable. It is also suggested that payer policies affect the ability of registered nurses to prescribe medicines because of low reimbursement rates (Hain & Fleck, 2014). The situation is challenging because both public and private payers often prevent nurse practitioners from practicing independently. It may be beneficial to cooperate with policymakers to address the problem and eliminate the barriers that have an adverse effect on advanced practice nurse prescribers.
References
Florida Board of Nursing. (2016). Important legislative update regarding HB 423. Retrieved from https://floridasnursing.gov/new-legislation-impacting-your-profession/
Hain, D., & Fleck, L. M. (2014). Barriers to nurse practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2). DOI: 10.3912/OJIN.Vol19No02Man02
Klein, T. (2016). Legal and professional issues in prescribing. In T. M. Woo, & M. Robinson (Eds.), Pharmacotherapeutics for advanced practice nurse prescribers (4th ed.) (37-50). Philadelphia, PA: F. A. Davis Company.
Advanced Practice Nurses (APRNs) as health professionals, are tasked with the responsibility to care for and safeguard the health and safety of patients. One duty of care owed by APRNs is on ethical and legal prescribing of medication. APRNs are expected to adhere to strict standards of prescribing, which serve the needs of the patient, minimize medical errors as well as maintain high levels of professionalism and accountability (Mitchell & Oliphant, 2016). In 2007, the World health Organization (WHO), outlined 7 guidelines which were meant to serve as a universal regulatory framework for ethical prescribing for all health practitioners, including APRNs. They are as follows: (1)Evaluate and define the patient’s problem; (2) Determine the therapeutic objective of the drug therapy; (3) Select an appropriate medication; (4) Provide patients with information, warnings and instructions; (5) Monitor the patient regularly; (6) Consider drug costs when prescribing and (7) Use appropriate tools, such as prescribing software and electronic drug references, to reduce prescription errors.
While the role of APRNs has been extended to include drug prescription, the independence to do so is not absolute. The primary barrier to APRN prescribing involves state practice and licensure (Hain & Fleck, 2014). Only 22 states so far have given full independence to APRNS to prescribe to patients. In the majority of states, including Florida, APRNs can only prescribe with the supervision or collaboration of a qualified physician. Another major barrier lies in the lack of physician cooperation and goodwill. The American Medical Association for instance, is yet to accept and support APRNs as capable of handling independent practice (Hain & Fleck, 2014). Thirdly, APRNs grapple with a physician-biased insurance system that discriminates against nurse practice. Several payer policies and reimbursement models in various states fail to recognize nurse practitioners as primary care providers, thereby affecting the extent of APRN practice including prescription (Altman et al.,2016).
References
Altman, S. H., Butler, A. S., Shern, L., & National Academies of Sciences, Engineering, and Medicine. (2016). Removing Barriers to Practice and Care. In Assessing Progress on the Institute of Medicine Report the Future of Nursing. National Academies Press (US).
Hain, D., & Fleck, L. (2014). Barriers to nurse practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2).
Mitchell, A., & Oliphant, C. M. (2016). Responsibility for Ethical Prescribing. The Journal for Nurse Practitioners, 12(3), A20.
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