Some believe that MCOs are best at managing a patient’s wellness and supporting preventive and early detection services.

Explain the benefit to a third-party payer of this approach over a program such as major medical that only gets involved when the patient has a major illness (hospitalization).

Be specific. 

Discussion board 

250 word count minimum, 

please use APA format, in text citations, include references

Please include two additional post 50 words minimum.

A nursing conceptual model is used to set a guideline and is based on a concept.  Nursing theory

describes the knowledge used to support nursing practice and is based on evidence.

In Florence Nightingales Environmental Theory, she states that the nurse can utilize the patient’s

environment to help optimize their healing. This can be done by making sure certain environmental factors

are present such as:

– clean water

-fresh air,

-sunlight

-cleanliness of the environment

-and appropriate drainage

This practice is still used today to aid is patients healing. Although we no longer need to worry about

things such as appropriate drainage, we still maintain a cleanly environment, make sure the patient has fresh

clean water to drink if allowed. In the hospital setting we turn on lights and open blinds during the day and

turn off lights and close the blinds at night.  We fill out the “white boards” to help the patient stay oriented to

date and day as well as who their providers are and the goal for the day. In the hospital where I work, we

have what is called “Quiet Time” It is a 2-hour block during the day from 1430-1630 where the hallway lights

are turned down, the staff is expected to be quieter in their work and no over head paging is allowed. This is

used to decrease stimulation and promote healing in the hospital patients. Signs are posted all around the

hospital notifying staff and visitors of quiet time hours.

Opioid use during pregnancy comes with many risks to the mother and fetus. In utero, there is a risk of preeclampsia, premature labor and rupture of membranes, placental insufficiency, abruptio placentae, intrauterine growth retardation, and intrauterine death (Ross, Graham, Money, & Stanwood, 2014). While in utero, opioids can also cross the placenta and lead to abnormal growth and development, birth defects, and opioid uptake (Yazdy, Desai, & Brogly, 2015). Neonatal abstinence syndrome (NAS) is a condition in which opioid exposed infants experience drug withdrawal symptoms shortly after birth (Krans & Patrick, 2016).

NAS is characterized by central nervous system hyperirritability, autonomic nervous system dysfunction, and gastrointestinal disturbances (Stover & Davis, 2015). Observed symptoms may include: irritability, excessive crying, poor sleep, increased muscle tone, tremors, hyperthermia, loose stools, excessive movements, yawning, sweating, sneezing, and nasal stuffiness (Stover & Davis, 2015). Some infants may also experience seizures (Stover & Davis, 2015). Neonates with NAS typically require prolonged hospitalization and pharmacotherapy with morphine or methadone (Yazdy et al., 2015).

In this scenario, it is also going to be important for the mother to get clean. Opioid withdrawal is not recommended during pregnancy, however, medication assisted treatment can be started while pregnant (Krans & Patrick, 2016). Mental health assessments and counseling will also be important for this mother. For women that are undergoing medication assisted treatment with methadone or buprenorphine, the AAP and ACOG both encourage breastfeeding (Stover & Davis, 2015). In these cases, breastfeeding is associated with a decrease in the incidence and severity of NAS (Stover & Davis, 2015).  

The long-term consequences of opioid exposure in utero and NAS have been difficult to determine (Stover & Davis, 2015). This is due to small study sizes and issues differentiating the effects of in utero exposures versus postnatal treatments versus environmental influences (Stover & Davis, 2015). Although, studies have found that in general, children with opioid exposures are more likely to have psychiatric issues, attention deficit disorders, and disruptive behaviors (Stover & Davis, 2015). Other effects may also include smaller brains, a thinner cortex, and reduced cognitive abilities (Stover & Davis, 2015).

References

Krans, E. E., & Patrick, S. W. (2016). Opioid use disorder in pregnancy: Health policy and practice in the midst of an epidemic. Obstetrics and Gynecology, 128(1), 4-10. https://dx.doi.org/10.1097%2FAOG.0000000000001446

Ross, E. J., Graham, D. L., Money, K. M., & Stanwood, G. D. (2014). Developmental consequences of fetal exposure to drugs: What we know and what we still must learn. Official Publication of the American College of Neuropsychopharmacology, 40(1), 61-87. https://dx.doi.org/10.1038%2Fnpp.2014.147

Stover, M. W., & Davis, J. M. (2015). Opioids in pregnancy and neonatal abstinence syndrome. Seminars in Perinatology, 39(7), 561-565. https://dx.doi.org/10.1053%2Fj.semperi.2015.08.013

Yazdy, M. M., Desai, R. J., & Brogly, S. B. (2015). Prescription opioids in pregnancy and birth outcomes: A review of the literature. Journal of Pediatric Genetics, 4(2), 56-70. https://dx.doi.org/10.1055%2Fs-0035-1556740

Please pay keen attention to details. At least 5 references. Proper English, reference and in text citation

Directions:

Choose a specific focus of patient practice (e.g., acute care hospital, clinic, primary care, long-term care, home health). Select a particular disease process (congestive heart failure, fall, diabetes, etc.). Identify and fully describe a technology element that could be involved in providing care to a patient with your selected disease process and the patient practice. Define how this technology will integrate treatment, monitoring or communication from the identified care setting to the home and then to ongoing care through the clinic.

Your case report must include the following:

1. Introduction with a problem statement and your disease process described from the focus of patient practice.

2. Synthesized literature review.

3. Description of the case/situation/conditions. Use a real life patient situation or condition to describe your case, including the problems the patient encounters and the barriers to care.

4. Describe at least one technology that may be used as a solution to the patient situation or condition described in your case.

5. Describe how the technology can be used specifically in the case you have proposed.

6. Summary of the case integrating proposed solutions(s).

The newly elected governor of a small state in which the elderly comprise 26% of the total population—twice the national average—is eager to fulfill his campaign promise. He had run for office on the slogan “long-term care for all.” The elderly in the state had overwhelmingly voted for him. Now in office about 9 months, his advisors tell him that providing long-term care services for all citizens in the state will be next to impossible because of high demand for the services. The governor, however, remains undeterred. The cornerstone of his proposed policy includes three things: (1) Develop a state-sponsored long-term care insurance plan. The insurance premiums will be income based, and will cost at least 15% less than a midlevel private long-term insurance plan being sold in the state. (2) Make it mandatory for all citizens, old and young, to purchase LTC insurance, either from the state or from a private insurance company. (3) Place restrictions on the use of nursing home and assisted living services in favor of community-based services.

1.  Give specific reasons why the governor’s policy may not work, pointing out specific problems that would likely arise.

2.  Will the policy work in a large state, everything else being equal? Give reasons.