Case study.

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

· Synthroid 100 mcg daily

· Nifedipine 30 mg daily

· Prednisone 10 mg daily

Assignment

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.  

Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

To Prepare

· Review the case study assigned above.

· Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.

· Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.

· Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

Write a 1-page paper that addresses the following:

· Explain your diagnosis for the patient, including your rationale for the diagnosis.

· Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

· Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

Resource for reference——- Need 3+ references.

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

• Chapter 62, “Drugs for Peptic Ulcer Disease” (pp.      703–714)
• Chapter 63, “Laxatives” (pp. 715–722)
• Chapter 64, “Other Gastrointestinal Drugs” (pp.      723–735)
• Chapter      78, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 867–886)

Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., . . . Sanya, A. J. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67(1), 328–357. Retrieved from https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.29367

This article details the diagnosis and management of nonalcoholic fatty liver disease. Review this article to gain an understanding of the underlying pathophysiology as well as the suggested pharmacotherapeutics that might be recommended to treat this disorder.

 

dentify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply “The Road to Evidence-Based Practice” process, illustrated in Chapter 4 of your textbook, to create your proposal.

Include the following:

1. Provide an overview of the problem and the setting in which the problem or issue occurs.
2. Explain why a quality improvement initiative is needed in this area and the expected outcome.
3. Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.
4. Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
5. Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.
6. Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting 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.

Health Promotion in Minority Populations

Select an ethnic minority group that is represented in the United States (American Indian/Alaskan Native, Asian American, Black/African American, Hispanic/Latino, Native Hawaiian, or Pacific Islander). Using health information available from Healthy People, the CDC, and other relevant government websites, analyze the health status for this group.

In a paper of 1,000-1,250 words, compare and contrast the health status of your selected minority group to the national average. Include the following:

1. Describe the ethnic minority group selected. Describe the current health status of this group. How do race and ethnicity influence health for this group?
2. What are the health disparities that exist for this group? What are the nutritional challenges for this group?
3. Discuss the barriers to health for this group resulting from culture, socioeconomics, education, and sociopolitical factors.
4. What health promotion activities are often practiced by this group?  
5. Describe at least one approach using the three levels of health promotion prevention (primary, secondary, and tertiary) that is likely to be the most effective in a care plan given the unique needs of the minority group you have selected. Provide an explanation of why it might be the most effective choice.
6. What cultural beliefs or practices must be considered when creating a care plan? What cultural theory or model would be best to support culturally competent health promotion for this population? Why?

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.

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. Please refer to the directions in the Student Success Center.

6-1 Case Study: Risk Factors

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Instructions

Mr. R is a 48-year-old Hispanic man who has worked the past 10 years as a warehouse worker. He is 5’6″, weighs 175 pounds, and has a waist circumference of 38″. At his last visit at your office, his blood pressure was 140/60 mm Hg. Prior to the visit, he had fasting blood work done, and his primary care provider plans to review the results with him today. The pertinent diagnostic results are as follows: a fasting plasma glucose level of 137 mg/dL, an HDL level of 27 mg/dL, LDL level of 247 mg/dL, a serum triglyceride level of 210 mg/dL. Use the following prompts as guidelines while performing and writing your case study:

1. Identify what this individual is most at risk for based on the information presented in this case above.
2. Explain the significance of this individual’s weight and waist diameter. Explain how this individual is at increased risk for insulin resistance.
3. Explain briefly the differences between hypoinsulinemia, hyperinsulinemia, hyperglycemia, and hypoglycemia as each relate to an individual with type 1 diabetes mellitus and type 2 diabetes mellitus.

  

Pathology: Introduction and Identification

Begin each case study by introducing the scenario/specific themes so that any reader would know what this case study is about. From there, start answering prompts above.

Pathology: Explanation and Plan of Care

Follow the rubric. You need to develop a plan of care for the patient. What education or care would you provide? Provide more than 1 example

Make a table for plan for Pt care

Plan for the Patient Care

  

Assessment

Nursing Diagnosis

Patients Outcome

Interventions

Rationale 

Evaluation of the outcome

Response to Questions

 Explore issues ideas and concerns as it relates to this patient. Integrate your own thought processes into your responses.

(Adequately address prompts above in the case study, and explore issues, ideas, or concerns)

Patient-Care Technologies

Follow the rubric. Explain the role of patient care technologies in caring for this patient. What might assist this patient? Provide different Examples(i.e might be a patient portal,  tele-medicine, etc.)

Incorporation of Resources

Multiple resources best to support claims

Articulation of Response (APA/Mechanics)

For additional details, please refer to the Case Study Guidelines & Rubric

 

Review the performance dashboard for a health care organization, as well as relevant local, state, and federal laws and policies. Then, write a report for senior leaders in the organization that communicates your analysis and evaluation of the current state of organizational performance, including a recommended metric to target for improvement.

Introduction

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

In the era of health care reform, many of the laws and policies set by government at the local, state, and federal levels have specific performance benchmarks related to care delivery outcomes that organizations must achieve. It is critical for organizational success that the interprofessional care team is able to understand reports and dashboards that display the metrics related to performance and compliance benchmarks.

Maintaining standards and promoting quality in modern health care are crucial, not only for the care of patients, but also for the continuing success and financial viability of health care organizations. In the era of health care reform, health care leaders must understand what quality care entails and how quality in health care connects to the standards set by relevant federal, state, and local laws and policies. An understanding of relevant benchmarks that result from these laws and policies, and how they relate to quality care and regulatory standards, is also vitally important.

Health care is a dynamic, complex, and heavily regulated industry. For this reason, you will be expected to constantly scan the external environment for emerging laws, new regulations, and changing industry standards. You may discover that as new policies are enacted into law, ambiguity in interpretation of various facets of the law may occur. Sometimes, new laws conflict with preexisting laws and regulations, or unexpected implementation issues arise, which may warrant further clarification from lawmakers. Adding partisan politics and social media to the mix can further complicate understanding of the process and buy in from stakeholders.

How many health care laws can you name that affect your practice in your current or future workplace? How do they impact your daily work? How many regulatory agencies oversee the types of services your health care organization provides? Which regulatory agencies apply to your workplace setting? Are you familiar with the process of complying with those agencies in order to maintain certification? You might be overwhelmed as you consider these broad questions.

Demonstration of Proficiency

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

• Competency 1: Analyze the effects of health care policies, laws, and regulations on organizations, interprofessional teams, and personal practice.
  • Analyze challenges that meeting prescribed benchmarks can pose for a heath care organization or an interprofessional team.
• Competency 3: Lead the development and implementation of ethical and culturally sensitive policies that improve health outcomes for individuals, organizations, and populations.
  • Advocate for ethical action in addressing a benchmark underperformance, directed toward an appropriate group of stakeholders.
• Competency 4: Evaluate relevant indicators of performance, such as benchmarks, research, and best practices, for health care policies and law for patients, organizations, and populations.
  • Evaluate dashboard metrics with regard to benchmarks set by local, state, or federal health care policies or laws.
  • Evaluate a benchmark underperformance in a heath care organization or an interprofessional team that has the potential for greatly improving overall quality or performance.
• Competency 6: Apply various methods of communicating with policy makers, stakeholders, colleagues, and patients to ensure that communication in a given situation is professional, clear, efficient, and effective.
  • Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically, with correct use of grammar, punctuation, and spelling.
  • Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style.

Preparation

For this assessment, you may choose one of the following three options for a performance dashboard to use as the basis for your benchmark evaluation.

Option 1: Dashboard and Health Care Benchmark Evaluation Simulation

You may use the data presented in the Dashboard and Health Care Benchmark Evaluation media piece as the basis for your assessment submission.

If you decide to use the simulation dashboard for your evaluation, review the dashboard, as well as  relevant local, state, and federal laws and policies. Consider the metrics within the dashboard that are falling short of the prescribed benchmarks.

Option 2: Actual Dashboard From a Professional Practice Setting

If you choose an actual dashboard from a professional practice setting for your evaluation, be sure to add a brief description of the organization and setting that includes:

• The size of the facility that the dashboard is reporting on.
• The specific type of care delivery.
• The population diversity and ethnicity demographics.
• The socioeconomic level of the population served by the organization.

Note: Ensure that your data is Health Insurance Portability and Accountability Act (HIPAA) compliant. Do not use any easily identifiable organization or patient information.

Option 3: Hypothetical Dashboard Based on a Professional Practice Setting

If you have a sophisticated understanding of dashboards that are relevant to your own practice, you may also construct a hypothetical dashboard for your evaluation, based on that setting. Your hypothetical dashboard must present at least four different metrics, at least two of which must be underperforming the relevant benchmark set forth by a federal, state, or local laws or policies. In addition, be sure to add a brief description of the organization and setting that includes:

• The size of the facility that the dashboard is reporting on.
• The specific type of care delivery.
• The population diversity and ethnicity demographics.
• The socioeconomic level of the population served by the organization.

Note: Ensure that your data is HIPAA compliant. Do not use any easily identifiable organization or patient information.

Instructions

Structure your report in such a way that it would be easy for a colleague or supervisor to locate the information they need. Be sure to cite relevant local, state, or federal health care laws or policies when evaluating metric performance against prescribed benchmarks. Cite an additional 2–4 credible sources to support your analysis and evaluation of the challenges in meeting the benchmarks, the potential for performance improvement, and your advocacy for ethical action.

You may wish to review the Dashboard Benchmark Evaluation Example [DOC] for additional support in planning and developing your submission for this assessment.

Note: The tasks outlined below correspond to grading criteria in the scoring guide.

In your report, be sure to:

• Evaluate dashboard metrics against the benchmarks set by local, state, or federal health care laws or policies.
  • Which metrics are below the mandated benchmarks in the organization? Evaluate weaknesses within the entire set of benchmarks.
  • What are the local, state, or federal health care laws or policies that set these benchmarks?
• Analyze challenges that meeting prescribed benchmarks can pose for the organization or for an interprofessional team.
  • What are the specific challenges or opportunities that the organization or interprofessional team might have in meeting the benchmarks? For example, consider:
    • The strategic direction of the organization.
    • The organization’s mission.
    • Available resources:
      • Staffing.
      • Operational and capital funding.
      • Physical space.
      • Support services (any ancillary department that supports a specific care unit in the organization, such as a pharmacy, cleaning services, and dietary services).
    • Cultural diversity in the organization.
    • Cultural diversity in the community.
    • Organizational processes and procedures.
  • How might these challenges be contributing to benchmark underperformance?
• Evaluate a benchmark underperformance in the organization or interprofessional team that has the potential for greatly improving overall quality or performance.
  • Which metric is underperforming its benchmark by the greatest degree?
  • Which benchmark underperformance is the most widespread throughout the organization or interprofessional team?
  • Which benchmark affects the greatest number of patients?
  • Which benchmark affects the greatest number of staff?
  • How does this underperformance affect the community the organization serves?
  • Where is the greatest opportunity for improvement in the overall quality or performance of the organization or interpersonal team—and ultimately in patient outcomes?
• Advocate for ethical action in addressing the benchmark underperformance that has the potential for greatly improving overall quality or performance.
  • At which group of stakeholders should your advocacy be directed? Which group could be expected to take the appropriate action to improve the benchmark metric?
  • What are some ethical actions that the stakeholder group could take that support improved benchmark performance?
  • Why should the stakeholder group take action?
• Communicate your findings and recommendations in a professional and effective manner.
  • Ensure that your report is well organized and easy to read.
  • Write clearly and logically, using correct grammar, punctuation, and mechanics.
• Integrate relevant sources to support your arguments, correctly formatting source citations and references using current APA style.
  • Did you cite relevant local, state, or federal health care laws or policies when discussing the mandated benchmarks?
  • Did you cite an additional 2–4 credible sources to support your analysis, evaluation, and advocacy?

Additional Requirements

• Structure: Include a reference page.
• Length: 2–5 pages should be sufficient for presenting a thorough and concise evaluation, not including any pages for presenting your data and your reference page.
• References: Cite 2-4 current scholarly or professional resources.
• Format: Use APA style for references and citations.
  • You may wish to refer to the following APA resources to help with your structure, formatting, and style:
    • APA Style and Format.
    • APA Paper Tutorial.
    • APA Paper Template.
• Font: Times New Roman font, 12 point, double-spaced for narrative portions only.

Grading Rubric:

1)  Evaluate dashboard metrics with regard to benchmarks set by local, state, or federal health care policies or laws. 

Passing Grade:  Evaluates dashboard metrics with regard to benchmarks set by local, state, or federal health care policies or laws, and identifies knowledge gaps, unknowns, missing information, unanswered questions, or areas of uncertainty (where further information could improve the evaluation). 

2)  Analyze challenges that meeting prescribed benchmarks can pose for a heath care organization or an interprofessional team. 

Passing Grade:  Analyzes challenges that meeting prescribed benchmarks can pose for a heath care organization or an interprofessional team, and identifies assumptions on which the analysis is based. 

3)  Evaluate a benchmark underperformance in a heath care organization or an interprofessional team that has the potential for greatly improving overall quality or performance. 

Passing Grade:  Evaluates a benchmark underperformance in a heath care organization or an interprofessional team that has the potential for greatly improving overall quality or performance; defends reasoning for selecting this benchmark over another with similar potential for improvement. 

4)  Advocate for ethical action in addressing a benchmark underperformance, directed toward an appropriate group of stakeholders. 

Passing Grade:  Advocates for ethical action in addressing a benchmark underperformance, directed toward an appropriate group of stakeholders, and recommends criteria for evaluating the effectiveness of the recommended action. 

5)  Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling. 

Passing Grade:  The evaluation and analysis are professional, effective, and insightful; the content is clear, logical, and persuasive; grammar, punctuation, and spelling are without errors. 

6)  Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style. 

Passing Grade:  Integrates relevant sources to support arguments, correctly formatting citations and references using current APA style. Citations are free from all errors.