health care issues – 2025 Imagine you are the CEO of a 200 bed community hospital and have heard that

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health care issues – 2025

  • Imagine you are the CEO of a 200-bed community hospital and have heard that Medicare hospital payments will continue to be trimmed for patients who experience harms considered to be largely preventable, such as blood clots, surgical infections, ventilator-associated pneumonias, and others. You want to make sure that your hospital prevents all possible avoidable harms to patients.

    Your assistant summarizes the issues for you: denied payments focus exclusively on additional care required to treat the injury (e.g., when a second procedure is required to retrieve a surgical instrument). To date, the denied payments are for hospital care only, but some analysts have recommended that the same policy be applied to physician payments.

    One measure your hospital has already taken is to require that all workers who interact with patients wash their hands, to prevent hospital-acquired infections. Although this would seem a simple and obvious initiative, it has met with limited success. In response to additional queries, you learn that the hospital’s patient safety department does not track the kinds of events for which it may be financially penalized.

    You also learn that the ACA will affect hospital payment in another way: trimming reimbursements for potentially avoidable hospital readmissions. Your hospital serves an older population, and many patients currently have multiple admissions for acute exacerbations of chronic illnesses, such as congestive heart failure and diabetes. In the future, these multiple admissions may be very costly.

    Your hospital’s margin last year was razor thin; the combination of the economic downturn and any decreased reimbursements could result in closure.

    • Refer to your text readings and resources to answer the following questions in a 1- to 2-page paper:
      • Who on your senior team should lead this effort?
      • Who else should be involved?
      • What precisely are you charging the team to do?
      • Who will help communicate this effort to all frontline staff?
      • What kinds of systems need to be created to track progress?
      • What external resources could be utilized?
    • Cite evidence to support your conclusions.
    • Click the Submit Assignment link in the upper right corner to upload your assignment.

Rubric

Case Study Rubric (2)Case Study Rubric (2)CriteriaRatingsPtsThis criterion is linked to a Learning OutcomePaper fully addresses the following questions: Who on your senior team should lead this effort? Who else should be involved? What precisely are you charging the team to do? Who will help communicate this effort to all frontline staff? What kinds of systems need to be created to track progress? What external resources could be utilized?6.0 pts
This criterion is linked to a Learning OutcomePaper is 1 to 2 pages, is formatted based on APA guidelines, and includes in-text citations and a reference page.2.0 pts
This criterion is linked to a Learning OutcomePaper meets basic writing standards including grammar, usage, spelling, punctuation, and organization.2.0 pts
Total Points: 10.0

End-of-Life Decisions – 2025 Write an article for a community newsletter for a local retirement village that

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End-of-Life Decisions – 2025

Write an article for a community newsletter for a local retirement  village that explains the laws, policies, and choices surrounding  end-of-life health care decisions.

   

Nurses are at the bedside during the dying process; they spend  entire shifts with patients and families; they develop trusting  relationships; and they are competent to assess patient and family  needs. Nurses gain a unique perspective that allows them to become aware  when a patient is not responding to treatment. This perspective places  nurses in a position to facilitate end-of-life decision making. (Adams,  Bailey. Anderson, & Docherty, 2011, para. 4)

Reference

Adams, J. A., Bailey, D. E., Jr., Anderson, R.  A., & Docherty, S. L. (2011). Nursing roles and strategies in  end-of-life decision making in acute care: A systematic review of the  literature. Nursing Research and Practice, 2011.

Your manager asked you to prepare an article for a community  newsletter for a local retirement village. The editor wants you to talk  about the laws, policies, and choices surrounding end-of-life health  care decisions

Preparation 

Search the Capella library and the Internet for scholarly and  professional peer-reviewed articles on end-of-life care. You will need  at least three articles to use as support for your work on this  assessment.

Directions

Write an article of 750–1,000 words (3–4 pages) that discusses the  laws, policies, and choices surrounding end-of-life health care  decisions. Address the following in your article: 

  • Describe the role of the nurse in end-of-life decision making with patients and their families.
  • Explain the legislation that generated end-of-life health care  policies. Was the legislation an outcome of a specific medical case?
  • Identify the primary policies regarding current health care  practices related to end-of-life health care decisions. How to these  policies affect treatment decisions?
  • Explain the effect of end-of-life regulations and controls on  patient outcomes. What effect does this have on the nurse-patient  relationship?
  • Describe the ethical considerations that have influenced policy decisions in regard to end-of-life decisions.

Additional Requirements

Your article should meet the following requirements:

  • Written communication: Written communication should be free of errors that detract from the overall message.
  • References: Cite a minimum of three resources; a  majority of these should be peer-reviewed sources. Your reference list  should be appropriate to the body of literature available on this topic  that has been published in the past 5 years.
  • APA format: Resources and citations should be formatted according to current APA style and formatting.
  • Length: 750–1,000 words or 3–4 typed,  double-spaced pages, excluding title page and reference page. Use  Microsoft Word to complete the assessment.
  • Font and font size: Times New Roman, 12-point.

dysrhythmia – 2025 Your written assignment for this module should be a 2 3 page paper not including

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dysrhythmia – 2025

Your written assignment for this module should be a 2-3 page paper (not including title page and reference page).

A 78-year old woman is admitted to a Medical unit directly from her physician’s office for evaluation and management of congestive heart failure. She has a history of systemic hypertension.

The initial assessment completed by the RN of the assigned patient reveals a pulse rate that is rapid and very irregular. The patient is restless, her skin is pale and cool, she states she is dizzy when she stands up and she is slightly short of breath and anxious. Her BP is 106/88. Her ECG monitor pattern shows uncontrolled atrial fibrillation with a heart rate ranging from 150 -170 beats/min. Her respirations are 20/min and her O2 saturation is 90%.

  1. Given the findings, what should be the first action of the practical nurse?
  2. What additional data would the practical nurse collect?
  3. Discuss the potential complications of cardioversion and patient preparation for an elective cardioversion. Because the length of time the patient has been in atrial fibrillation is unknown, what adverse reaction may occur?

Later that evening the patient calls the nurse because she feels “like something terrible is going to happen.” She reports chest pain, has increased shortness of breath, and has coughed up blood-tinged sputum.

  1. Based on these symptoms, what might you suspect is happening?
  2. What is the first thing the practical nurse should do and what further information would you expect to be collected?

You should include a minimum of 3 references. Include a title page, in-text citations, and a reference page in APA format.

nursing gerentology week 4/ reply prof – 2025 original question Identify two strategies you can implement to provide comfort to maintain function with an ethnically diverse older

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nursing gerentology week 4/ reply prof – 2025

 

original question:

 Identify two strategies you can implement to provide comfort to maintain function with an ethnically diverse older adult with a chronic disease? This can be nutrition, ADLs, exercise, etc. 

MY ANSWER:

The management of chronic conditions is becoming an integral part of medical care in most parts of the world. The elderly, in particular, are living with one or more chronic illnesses for very long periods. Access to care is not easy, given that most of them are not insured. The situation gets worse when the patient is from an ethnical minority background. Since it can be hard to reach such patients, the first strategy that both the medical staff and the care givers of the patient should put in place is fostering positive communication. Putting a lot of focus in disease prevention, health promotion and early detection is a very effective strategy for enduring successful chronic disease management. This is especially helpful for the frail seniors (Hitchcock, 2016).  It is, therefore, important for the care givers to listen carefully, show compassion and work with the patient to ensure care goals.

            The second strategy would be to embark on a patient-centered approach. Such an approach is supposed to be responsive to, and respectful of, the preference, needs and values of the patient. Physicians should never make assumptions about the treatment option that the patient would choose. Rather, they should discuss also the available options. Doctors should also recognize when such senior patients need help in managing their chronic illness (Iecovich, 2018). Again, it may be important to carefully watch the interactions between different medications that are used to treat different conditions. The physicians and the patient should further come up with an action-plan and always keep it up to date.

While caring for the elderly patients can pose a big challenge for physicians, it does not mean that it is an impossible mission. With the right strategies in place and with the coordination of the doctors, the patients and their caregivers, it will be easier to manage such chronic conditions.

teacher question

  Would this approach be different for a patient of a different age range? 

Root Cause using 5 whys – 2025 Read the news report Maryland Health Care Provider Sentenced to 10 Years in Federal Prison for Health

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Root Cause using 5 whys – 2025

Read the news report “Maryland Health Care Provider Sentenced to 10 Years in Federal Prison for Health Care Fraud Resulting in Patient Deaths.”

Use the Five Whys to conduct a root cause analysis to determine why the Medicare fraud occurred and Timothy Emeigh’s participation in the case.

Write a 525- to 700-word paper that identifies and evaluates the root cause for Medicare fraud in this case.

Include the following:

  • List each of the Five Whys and your response.
  • Speculate as to why Mr. Emeigh participated in the scheme.
  • Explain what you might have done to prevent this from happening.

Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality).

Format your assignment according to APA guidelines.

Post Tami – 2025 Respond by offering additional thoughts regarding the examples shared Systems Development Life Cycle

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Post Tami – 2025

Respond by offering additional thoughts regarding the examples shared, Systems Development Life Cycle SDLC-related issues, and ideas on how the inclusion of nurses might have impacted the example described by your colleagues.

                                              Main Post

                         Systems Development Life Cycle

           The systems development life cycle (SDLC) is a process whereby a company or entity determines the need for the implementation of new technology.  SDLC provides information systems that are effective at incorporating the company’s business plan (McGonigle & Garver Mastrian, 2018).  It is essential that a working knowledge of the problems or issues are understood.  In the case of healthcare organizations, this means establishing an assessment that discovers the needs of each department (McGonigle & Garver Mastrian, 2018).  Most of the time when analyzing these needs an outside company is brought in to assess, interview, and determine the type of system that would benefit the company.

Consequences of Lack of Inclusion of Nurses

In the application of any new technology or policy, it is essential to trial it with the individuals that will be using it.  When considering an update or new system in the healthcare setting, it is beneficial to involve nurses in the decision-making process.  The Agency for Healthcare and Research (n.d.a) report that it is important to consult with nurses in the preliminary period of development.  By incorporating nurses into the initial design, the researchers learn nursing processes, possible new tasks, effect the technology will have on patient care, staffing needs, and usability of the design.  This analysis of workflow is used to determine the best use of technology (McGonigle & Garver Mastrian, 2018).  Including nurses in this process opens routes for discussion and collaboration that will benefit the designers and users.  

            Failure to include nurses in the planning stages of technology design is detrimental to the intended use of the new system.  A researcher or computer designer could miss critical elements of the nursing process due to their lack of knowledge regarding nursing procedures.  McGonigle & Mastrian (2018) state, “nursing informatics professionals should always be included in these activities to represent the needs of clinicians and to serve as a liaison for technological solutions to process problems” (p. 250).  The role of the informatics nurse and a nurse, in general, can play in designing technology is critical.  Their contribution to the analysis of workflow and clinical implications is invaluable information needed for the formation of a system that will be used to its potential.

An Example of Collaboration

            A study was done in Canada to determine the impact of the initiation of computerized order entries for medications on nursing workflow and reduction of medication errors.  Registered nurses participated in a study where interviews and observations were used to study the effects of digital technology on the nursing process (Vito, Borycki, Kushniruk, & Schneider, 2017).  The researchers spent considerable time observing and recording how the technology affected nurses and the influence it made on time spent with patients.  This study is one example of the impact that nurses can have on the design and implementation of technology in the healthcare setting.

Current Healthcare Facility

             When our facility transitioned to electronic health records (EHR) as an ER nurse, I was not involved in the planning.  The nurse informaticist I assume worked with the company to create templates that are in use today.  Within the ER portion of the EHR, there have been changes made because of nursing input.  As a unit, we have asked for an ED narrator to be developed with our order sets, documentation narrators, and medication administration policies.  Recently we asked for changes to our trauma narrator to include additional documentation options for different trauma levels.  As a group we have also discussed missing pieces of data that is beneficial for everyday use and discussed this with our leaders.  The leaders take this information to the information technology (IT) individuals that work directly with the EHR company and changes are then made.  There are times when the nurse’s input is not embraced due to financial constraints or leadership ability to see the need.  The size of the healthcare organization plays a significant role in the inclusion of nurses in decision-making practices.  Many variables exist to modification of technology in healthcare.  In an ideal setting, it would be ideal to include nurses throughout the design process.

References

Agency for Healthcare Research and Quality (n.d.a). Health IT evaluation toolkit and evaluation measures quick reference guide.  Retrieved April 17, 2019, from https://healthit.ahrq.gov/sites/default/files/docs/page/impact-of-hit-on-nurses-quick-reference-guide.pdf

McGonigle, D., & Garver Mastrian, K. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning, LLC.

Vito, R., Borycki, E., Kushniruk, A., & Schneider, T. (2017). The impact of computerized provider order entries on nursing practice. Studies in Health Technology and Informatics, 234, 364-369. doi:/10.3233/978-1-61499-742-9-364

Proposed evidence based Change project Plan – 2025 Develop a proposed evidence based change project plan specific to the environment you are using to implement your change

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Proposed evidence based Change project Plan – 2025

Develop a proposed evidence-based change-project plan specific to the environment you are using to implement your change project. Your environmental assessment will include a work breakdown structure, a budget plan, and a measurement tool.

This week, you will design a plan that is at least four pages in length and includes all the information listed in the instructions below to discuss the elements of your proposed plan.

  • Develop an environmental assessment of your change project area and its readiness for the specific change project you are going to implement. 
    • Include a work breakdown structure. For example, you could create a (timeline/task list/Gantt chart)—a hierarchical definition of the planned tasks and activities of a project that normally begins with the highest-level activities and works downward into the individual tasks.
    • Include a proposed project budget (table or spreadsheet) for the project that addresses the needed personnel, equipment, and supplies that may have associated costs. Click this link for a sample budget template Click for more options .
    • Include your measurable evaluation methods (indicators/metrics). Include the actual measurement tool you will use and describe any of the following that are applicable to your project: cost savings, improved efficiencies, access to care (visits/procedures/admissions), patient/family satisfaction, associate satisfaction, associate engagement, retention, clinical outcomes, injury prevention, and risk reduction.

The project will take place in Sanitas medical center where patients will fill out a questionnaire

There is no budget needed, please address this in the paper. 

The measurable tool is the DSMQ, which I have attached.

Please review the attachments.

community health field experience. Topic Obesity in Adults- revision needed – 2025 B Write your community health nursing diagnosis statement 1 Explain how the health concern from your community health nursing

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community health field experience. Topic Obesity in Adults- revision needed – 2025

 

B.  Write your community health nursing diagnosis statement.

1.  Explain how the health concern from your community health nursing diagnostic statement is linked to a health inequity or health disparity within the target population.

a.  Discuss the primary community resources and primary prevention resources currently in place to address the health concern.

b.  Discuss the underlying causes of the health concern.
 

2.  Discuss the evidence-based practice associated with the Field Experience topic.

a.  Identify data about the selected Field Experience topic from the local (e.g., county), state, and/or national level.
 

C.  Develop a community health nursing social media campaign strategy that will convey your health message and address the Field Experience topic by doing the following:

1.  Describe your social media campaign objective.

2.  Recommend two population-focused social marketing interventions and justify how each would improve the health message related to your selected Field Experience topic.

3.  Describe a social media platform you would use that is appropriate for communicating with the target population.

a.  Discuss the benefits of the selected social media platform in supporting preventative healthcare.
 

4.  Discuss how the target population will benefit from your health message.
 

D.  Describe best practices for implementing social media tools for health marketing.
 

E.  Create a social media campaign implementation plan by doing the following:

1.  Describe stakeholder roles and responsibilities in implementing the plan.

2.  Discuss potential public and private partnerships that could be formed to aid in the implementation of your campaign.

3.  Create a specific timeline for implementing your campaign.

4.  Explain how you will evaluate the effectiveness of the campaign.

5.  Discuss the costs of implementing your campaign.
 

F.  Reflect on how social media marketing supports the community health nurse’s efforts to promote healthier populations.

1.  Reflect on how your social media campaign could apply to your future nursing practice.
 

G.  Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
 

H.  Demonstrate professional communication in the content and presentation of your submission.
 

Assessing and Planning Care for an Elderly Person – 2025 In order to gain an insight into the world of elder adults it is important to understand how they view

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Assessing and Planning Care for an Elderly Person – 2025

 

In order to gain an insight into the world of elder adults, it is important to understand how they view themselves and the values they hold. Additionally it is important to assess and determine his/her needs and establish appropriate interventions for this individual.

By the due date assigned, choose an older adult to interview. This cannot be a patient in your clinical setting. You can use a friend, family member, or co-worker. The older adult should be 65 years or older. Use the format provided to record the responses. A list of questions is available for you to start with. Include 2–3 questions of your own to get a complete picture of the older adult. Summarize your findings and also contrast the responses with findings in your readings and other current literature.

Download a patient questionnaire. This form should be used as an example.

After gaining permission, conduct a physical and mental functional assessment of the older adult you have chosen. Review your readings for the process of functional assessment.

Make use of the tools discussed this week to complete a comprehensive assessment of your patient. Search the Internet for resources on these tools.

  1. Tinetti Balance and Gait Evaluation
  2. Katz Index of Activities of Daily Living
  3. Assessment of Home Safety
  4. The Barthel Index

Make sure the older adult is clearly identified on the tools. Do not include their name, but do include professional or other designation, and age. Your name should also be identified on the tool. (This should be a part of your Appendix.)

Compare and contrast the age-related changes of the older person you interviewed and assessed with those identified in this week’s reading assignment. During this data analysis process provide at least 4–6 preliminary issues that you have identified. Identify three alterations in health that you would propose and describe them. Identify a minimum of three comprehensive interventions for each problem.

Make sure that you integrate personal cultural awareness and cultural competency.

Paper should be 5–6 pages, not including the questionnaire or tools used. These should be attached as an Appendix. Remember to use headings to identify the different sections in your paper.

On a separate references page, cite all sources using APA format.

Heart Failure Clinic Resourcing Plan – 2025 Write a 3 4 page evidence based resourcing plan for one component of the Heart Failure Clinic

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Heart Failure Clinic Resourcing Plan – 2025

Write a 3–4 page evidence-based resourcing plan for one component of the Heart Failure Clinic.

It is important for the nurse leader to have not only a basic  understanding of the budget process, but to understand how to work with  variances in staffing, patient loads, and supply costs in order to meet  the needs of the patients, without compromising the funding process of  the clinic.

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

  • Competency 3: Apply management strategies and best practices for  health care finance, human resources, and materials allocation  decisions to improve health care delivery and patient outcomes.       
    • Apply evidence-based management strategies and best practices for resourcing health care services.
    • Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes.
  • Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.       
    • Apply legal and professional standards for resourcing outpatient services.
  • Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.       
    • Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.

Instructions

Deliverable: Develop one component of an evidence-based resourcing plan.

Scenario:

The hospital leadership team has already allocated the major  capital expenditures for the heart failure clinic, such as the facility,  legal services, IT, and security services. However, as a member of the  nurse team, you have been asked to develop one component of a resourcing plan for the next leadership meeting.

You may use any combination of documents (for example, a  spreadsheet or a table) in addition to explanatory information to convey  information clearly and succinctly.

Choose  one of the following:

Budget:

  • Apply evidence-based management strategies and best practices for resourcing health care services.      
    • Identify the business plan budget categories and subcategories (not necessarily the actual cost) to establish a new clinic.
    • Start-up expenses.
    • Examine fixed and variable costs.
    • Capital budget items.        
      • Examples: salary and benefits, staffing mix, specialized equipment or materials, et cetera.
    • Contingency fund and parameters.
  • Apply legal and professional standards for resourcing outpatient services.      
    • Explain the alignment to best practices and professional standards for cost effective outpatient services.
    • How will uninsured or underinsured patients be managed?
  • Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes.      
    • What data resources and tools analyze costs, health insurance, and hospitalization services?
    • How will billing be handled?
    • How will you determine if outpatient management is cost-effective?
    • How does transparency impact the consumer?

Staffing Plan:

  • Apply evidence-based management strategies and best practices for resourcing health care services.
    • Identify the disciplines and skill mix needed for appropriate staffing.
    • Estimate staffing requirements by discipline and staffing ratios (evidence-based).
    • Develop a sample staffing schedule.
    • How will you staff to meet corporate diversity goals or the needs of diverse patients?
    • Explain how delegation, collaboration, negotiation will affect staffing plan.       
      • How does a union contract affect the staffing plan or schedule?         
        • Examine the Nurse Practice Act for your state.           
          • How does the Nurse Practice Act affect your staffing plan?
  • Apply legal and professional standards for resourcing outpatient services.      
    • Align your staffing plan to best practices, the Nurse Practice  Act for your state, scope of practice, and the Joint Commission  standards for outpatients.
  • Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes.      
    • How will you know if staffing is cost-effective?
    • How will you know if staffing mix or schedule impacts patient outcomes?

Additional Requirements

  • Written communication: Written communication should be free of errors that detract from the overall message.
  • APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.
  • Length: The plan should be 3–4 pages in content length, double-spaced.
  • Font and font size: Times New Roman, 12 point.
  • Number of resources: Support your plan with a minimum of three peer-reviewed resources, in addition to professional standards.