Discussion 4

The topics we’re discussing this week include Medical Billing and issues related to reimbursement, NPI application as advanced nurses, as well as how EHR can be used to facilitate coding and billing. The assigned reading this week is the journal article posted below.

Prepare   examples of various coding and billing issues you have experienced in clinic   settings especially in Peds and women’s health. 

Read the following article:

https://journals.lww.com/jwocnonline/Fulltext/2012/03001/Reimbursement_of_Advanced_Practice_Registered.4.aspx

Prepare a 10-15 slide PowerPoint presentation, with speaker notes, that examines the significance of an organization’s culture and values. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the Topic Materials for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning, and an additional slide for References at the end.

1. Outline the purpose of an organization’s mission, vision, and values.
2. Explain why an organization’s mission, vision, and values are significant to nurse engagement and patient outcomes.
3. Explain what factors lead to conflict in a professional practice. Describe how organizational values and culture can influence the way conflict is addressed.
4. Discuss effective strategies for resolving workplace conflict and encouraging interprofessional collaboration.
5. Discuss how organizational needs and the culture of health care influence organizational outcomes. Describe how these relate to health promotion and disease prevention from a community health perspective.

While APA style format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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.

APA ESSAY- USE ATTACHED FORMAT

****HAVE INTRODUCTION PARAGRAPH AND CONCLUSION PARAGRAPH 

Assignment: 

Answer all of the following questions using headers to separate topics.

1. From your personal experiences with healthcare workflows as a professional (if possible, else as a patient) and from the lessons you have been learning from this course, do you see the adoption of information technology as having been a smooth and graceful experience or a turbulent and sometimes painful one? Dig more deeply into your experiences and point to what you believe were the most critical contributors to the success or the causes of problems with the adoption. Be specific and support your position with references.
2. Based on your reflective analysis in question 1, which do you believe is a larger problem, lack of enough information or information overload? What evidence do you have to support your position?
3. Attack or defend the following assertion: “While it is true that a very small fraction of the population accounts for a significantly large fraction of total costs (e.g. “hot spots”), many of the root causes for these conditions have taken years if not decades to develop and to eliminate these hot spots will require significant life style changes, some with strong cultural reinforcements, long before the symptoms appear.” Support your position with solid evidence. 
4. You have been brought in to help a regional hospital implement a major informatics upgrade that promises to significantly improve efficiency and patient outcomes. Leadership is nervous due to concerns that many of the “older” professionals will resist these changes. What strategy would you employ to maximize the probability of success with this new adoption effort? Explain the underlying rationale and support your position with evidence.

Need responses to my peers done in 12 hours. Please respond to my classmates post as if it were me. 

Requirements:

Min of 150 words per post response— EACH  

1 Scholarly source ( no older than 5 years)—EACH

APA format

POST 1 

Diabetic Ketoacidosis (DKA) is a very serious and common complication of type 1 diabetes, but can also occur in individuals with type 2 diabetes. According to Misra and Oliver (2015) DKA has a mortality rate of 3-5%, and 6% of DKA cases are the initial presentation of diabetes in an individual.

DKA most often occurs due to an illness, such as an infection, “when there is an absolute or relative deficiency of insulin and an increase in the levels of insulin counterregulatory hormones” (McCance et al., 2013, p. 744). The increase of these hormones, along with the deficiency of insulin, cause the body to go into a state in which there is “decreased glucose uptake, increased fat mobilization with release of fatty acids, and accelerated gluconeogenesis and ketogenesis” (McCance et al., p. 744). Additionally, increased ketone concentrations are caused, which then causes a loss of bicarbonate, and leads to the development of a metabolic acidosis.

Hallmark signs of DKA include polyuria, polydipsia, lethargy, nausea, vomiting, altered mental status, Kussmaul respirations, and sweet-smelling (acetone) breath.

In the case of Ms. Blake, the following are all abnormal lab results: Sodium 156; Chloride 115; ABG pH 7.30, PO2 70 and HCO3 20. The ABG values show a metabolic acidosis as well as a low blood oxygen saturation. The sodium may be elevated in this case due to severe dehydration, which can also cause other dangerous electrolyte abnormalities.

For patients with all types of diabetes, it is important to ensure that they understand the many complications that are associated with their diagnosis. For Ms. Blake, it is important to ensure that she understands the severity of her DKA diagnosis, and how it may have been prevented. Education should also be reinforced in regard to the home monitoring of glucose and ketone levels. Additionally, it is important to find out if she has family or friends that are available to check in with her frequently, especially when she if feeling unwell, so that she can be seen by a physician sooner rather than later.

POST 2

Week five case study involves a three-month-old infant diagnosed with pyloric stenosis. The etiology behind pyloric stenosis is unknown at this time but it is thought to have a connection to genetics and environmental factors.  The pathophysiology behind pyloric stenosis involved a thickening of antropyloric portion of the stomach which the lumen has edematous mucosa which cause an obstruction (Hernanz-Schulman, 2018). The hyperplasia and hypertrophy of the muscle literally blocks of the pylorus which inhibits the passage of food to be digested.  The gastric outlet obstruction then causes food to not be able to pass and thus leads to forcefully vomiting.  This typically occurs in infants three to five weeks old (Hernanz-Schulman, 2018).  The classic signs that are hallmark include vomiting, persistent hunger, changes in bowel movements, dehydration, and decreased weight (Hernanz-Schulman, 2018). This case study described that the infant was having frequent episodes of vomiting after eating, swollen belly, fussiness due to being hungry, and decreased weight because the body was not being able absorb any food because it was being blocked from small intestine. 

                Complications from pyloric stenosis include failure to grow, jaundice due to bilirubin buildup, stomach irritation and dehydration (Hernanz-Schulman, 2018).  On assessment a provider may be able to palpate and fill an olive like lump that indicates an enlarge pylorus. They may order follow up ultrasound testing as well. The only treatment for pyloric stenosis is surgical intervention. The surgical intervention known as pyloromyotomy will help open up the pylorus enable food to be able to pass through. Post pyloromyotomy the patient will be able to have gastric emptying which will allow for proper digestion. It would be important to teach the parents on what exactly is happening with the anatomy of the child and why they are presenting with these signs and symptoms. The provider will need to educate them that they will need to immediately see a gastroenterologist or pediatrician for immediate surgery to fix this problem. It is important to let them know these procedures can be done laparoscopic ally and is minimally invasive through the naval.  Once the procedure is completed the provider should let the family know they may still have some vomiting post opt and will be able to eat normally within twenty-four hours. Additionally, it is important to educate them on fluids post opt.  The main thing to stress to these parents is how essential surgical intervention is so the child can eat, grow, and absorb nutrient adequately.

 

The topic is Obesity in teenagers
I would like to have a research paper which contains :
1) Basic Research Paper Layout (around 2 pages basic layout of ideas/thoughts that will be used to complete the research paper. All of the information that is submitted should be relevant to the paper and topic and organized in logical manner
2)Basic research paper introduction
3)Basic research synopsis
4)Basic research abstract
Pls name each of these parts, so I know which one is synopsis, introduction, abstract or layout.
Thank you so much in advance