Your Discussion post should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

A 15-year-old male reports dull pain in both knees. Sometimes one or both knees click, and the patient describes a catching sensation under the patella. In determining the causes of the knee pain, what additional history do you need? What categories can you use to differentiate knee pain? What are your specific differential diagnoses for knee pain? What physical examination will you perform? What anatomic structures are you assessing as part of the physical examination? What special maneuvers will you perform?

With regard to the case study you were assigned:

· consider the insights they provide about the case study.

· Consider what history would be necessary to collect from the patient in the case study you were assigned.

· Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

· Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. 

 

Week 1: Touchpoint Reflection: Healthcare Systems’ Financial Environments

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Guidelines for Touchpoint Reflections

Touchpoint Reflections: This is a new type posting that occurs in the same type portal as the discussion thread. However, these are treated as “mini”-weekly assignments”. You will be able to see and read the posts of peers but are not required to respond to them. However, if someone responds to your TPR, replying their post is always the collegial thing to do. Your grade is not affected either way.

There are specific formatting and content guidelines. Remember to use the headings as defined to address each section, Experience, Reflection, Implications, in your responses. A downloadable version of the guidelines, which includes further information, is available for access below.  You are encouraged to download these guidelines and rubric to avoid the need for referring back to this page for the link.

• Touchpoint Reflection Guidelines (Weeks 1-3, and 8)
• Touchpoint Reflection Rubric (Weeks 1-3, and 8)

EXPERIENCE

Understanding how your organization is reimbursed for services depends on several components. Assess your organization and identify its care delivery system and payer mix make up. Include percentages represented by each payer group. Identify the key people in your organization from whom you obtained your information. Perhaps it is your unit director, operational directors, financial officers, CNOs. Your direct supervisor might be able to point you in the right direction, Since the information required is often available to the public through public reports you might also access the information through online searches of internal systems or external internet searches.

NR533 Week 1: Touchpoint Reflection Experience Table (Links to an external site.)

Your Name’s Healthcare Organization

Healthcare Delivery System (Type)

Payer Mix

Percentage

Medicare

Medicaid

Managed Care

HMO

PPO

IPA

Self-pay

Uninsured

REFLECTION

Based on this data, discuss the assumptions that could be made about the population demographics for your institution. What influence do these variables have on the types of services offered at your facility?

IMPLICATIONS FOR THE FUTURE

• What might your analysis tell you about the long-term health of your community?
• What future needs might be identified?

Write a 4-5 page evidence-based proposal to support the need for a nurse informaticist in an organization who would focus on improving health care outcomes.

As you begin to prepare this assessment, you are encouraged to complete the Team Perspectives of the Nurse Informaticist activity. Completion of this will help you succeed with the assessment as you explore the nurse informaticist’s role from the different perspectives of the health care team. Completing activities is also a way to demonstrate engagement.

Nurses at the baccalaureate level in all practice areas are involved in nursing informatics through interaction with information management and patient care technologies. Nurses must not only demonstrate knowledge of and skills in health information and patient care technologies, but also how to use these tools at the bedside and organizational levels. Moreover, nurses need to recognize how information gathered from various health information sources can impact decision making at the national and state regulatory levels.

Demonstration of Proficiency

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

• Competency 1: Describe nurses’ and the interdisciplinary team’s role in informatics with a focus on electronic health information and patient care technology to support decision making.     
  • Define nursing informatics and the role of the nurse informaticist.
  • Explain how the nurse collaborates with the interdisciplinary team, including technologists, to improve the quality of patient care.
  • Justify the need for a nurse informaticist in a health care organization.
• Competency 2: Implement evidence-based strategies to effectively manage protected health information.     
  • Explain evidence-based strategies that the nurse and interdisciplinary team can use to effectively manage patients’ protected health information (privacy, security, and confidentiality).
• Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.     
  • Follow APA style and formatting guidelines for citations and references.
  • Create a clear, well-organized, and professional proposal that is generally free from errors in grammar, punctuation, and spelling.

Scenario

For this assessment, assume you are a nurse attending a meeting of your state’s nurses’ association. A nurse informaticist conducted a presentation on her role and its impact on positive patient and organizational outcomes in her workplace. You realize that your organization is undergoing many technological changes. You believe this type of role could provide many benefits to your organization.

You decide to pursue proposing a nurse informaticist role in your organization. You speak to your chief nursing officer (CNO) and human resources (HR) manager. These individuals ask you to prepare a 4–5 page evidence-based proposal to support the new role. In this way, they can make an informed decision as to whether the addition of such a role could justify the return on investment (ROI). They need your proposal before an upcoming fiscal meeting.

Preparation

To successfully prepare for this assessment, you will need to complete these preparatory activities:

• Review assessment resources and activities.
• Conduct independent research on the nursing knowledge and skills necessary to interact with health information and patient care technology.     
  • Focus your research on current resources available through peer-reviewed articles, professional websites, government websites, professional blogs, wiki pages, job boards, et cetera.
  • Consult the BSN Program Library Research Guide for help in identifying scholarly and authoritative sources. 
• Interview peers in your network who are considered information technology experts.     
  • Ask them about how information technology advances are impacting patient care at the bedside, at the organizational level, and beyond.

Proposal Format

The Chief Nursing Officer (CNO) and Human Resources (HR) manager have asked you to include the following headings in your proposal and to be sure to address the bullets underneath each heading:

Nursing Informatics and the Nurse Informaticist

• What is nursing informatics?
• What is the role of the nurse informaticist?

Nurse Informaticists and Other Health Care Organizations

• What is the experience of other health care organizations with nurse informaticists?
• How do these nurse informaticists interact with the rest of the nursing staff and the interdisciplinary team?

Impact of Full Nurse Engagement in Health Care Technology

• How does fully engaging nurses in health care technology impact:     
  • Patient care?
  • Protected health information (security, privacy, and confidentiality)?
  • Workflow?
  • Costs and return on investment?

Opportunities and Challenges

• What are the opportunities and challenges for nurses and the interdisciplinary team with the addition of a nurse informaticist role?     
  • How can the interdisciplinary team collaborate to improve quality care outcomes through technology?

Summary of Recommendations

• What are 3–4 key takeaways from your proposal about the recommended nurse informaticist role that you want the CNO and the HR manager to remember?

Additional Requirements

• Written communication: Ensure written communication is free of errors that detract from the overall message.
• Submission length: 4–5 double-spaced pages, in addition to a title page and references page.
• Font: Times New Roman, 12 point.
• Citations and References: Cite a minimum of 3 current scholarly and/or authoritative sources to support your ideas. In addition, cite a minimum of 1 current professional blog or website to support your central ideas. Current means no more than five years old.
• APA formatting: Be sure to follow APA formatting and style guidelines for citations and references. For an APA refresher, consult the APA Style and Format page on Campus.

Portfolio Prompt: Save your presentation to your ePortfolio. Submissions to the ePortfolio will be part of your final capstone course.

 

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.

For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.

To Prepare
· Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.

· By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2). Note: Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.

· Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?

· Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.

· If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.

o Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.

o Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

The Assignment: My assignment topic this week is: mammograms 

Assignment (3–4 pages, not including title and reference pages):

Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:
Include the following:

· A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.

o What is its purpose?

o How is it conducted?

o What information does it gather?

· Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

Required readings

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 3, “Examination Techniques and Equipment”

This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process.

Chapter 8, “Growth and Nutrition”

In this chapter, the authors explain examinations for growth, gestational age, and pubertal development. The authors also differentiate growth among the organ systems.

Chapter 5, “Recording Information” (Previously read in Week 1)

This chapter provides rationale and methods for maintaining clear and accurate records. The text also explores the legal aspects of patient records.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Student checklist: Health history guide. In Seidel’s guide to physical examination (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Centers for Disease Control and Prevention. (2018). Childhood overweight and obesity. Retrieved from http://www.cdc.gov/obesity/childhood

This website provides information about overweight and obese children. Additionally, the website provides basic facts about obesity and strategies to counteracting obesity.

Chaudhry, M. A. I., & Nisar, A. (2017). Escalating health care cost due to unnecessary diagnostic testing. Mehran University Research Journal of Engineering and Technology, (3), 569.

This study explores the escalating healthcare cost due the unnecessary use of diagnostic testing. Consider the impact of health insurance coverage in each state and how nursing professionals must be cognizant when ordering diagnostics for different individuals.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Chapter 1, “Clinical Reasoning, Evidence-Based Practice, and Symptom Analysis”

This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.

Gibbs , H., & Chapman-Novakofski, K. (2012). Exploring nutrition literacy: Attention to assessment and the skills clients need. Health, 4(3), 120–124.

This study explores nutrition literacy. The authors examine the level of attention paid to health literacy among nutrition professionals and the skills and knowledge needed to understand nutrition education.

Martin, B. C., Dalton, W. T., Williams, S. L., Slawson, D. L., Dunn, M. S., & Johns-Wommack, R. (2014). Weight status misperception as related to selected health risk behaviors among middle school students. Journal of School Health, 84(2), 116–123. doi:10.1111/josh.12128

Credit Line: Weight status misperception as related to selected health risk behaviors among middle school students by Martin, B. C., Dalton, W. T., Williams, S. L., Slawson, D. L., Dunn, M. S., & Johns-Wommack, R., in Journal of School Health, Vol. 84/Issue 2. Copyright 2014 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.

Noble, H., & Smith, J. (2015) Issues of validity and reliability in qualitative research . Evidence Based Nursing, 18(2), pp. 34–35.

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). History subjective data checklist. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Mosby’s Guide to Physical Examination, 7th Edition by Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2011 by Elsevier. Reprinted by permission of Elsevier via the Copyright Clearance Center.

This History Subjective Data Checklist was published as a companion to Seidel’s Guide to Physical Examination (8th ed.) by Ball, J. W., Dains, J. E., & Flynn, J.A. Copyright Elsevier (2015). From https://evolve.elsevier.com

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

Chapter 2, “The Comprehensive History and Physical Exam” (Previously read in Week 1)

Chapter 5, “Pediatric Preventative Care Visits” (pp. 91 101)

This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles and four boxes approach.

Based on the “Case Study: Healing and Autonomy” and other required topic study materials, you will complete the “Applying the Four Principles: Case Study” document that includes the following:

Part 1: Chart 

This chart will formalize the four principles and four boxes approach and the four-boxes approach by organizing the data from the case study according to the relevant principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice.

Part 2: Evaluation

This part includes questions, to be answered in a total of 500 words, that describe how principalism would be applied according to the Christian worldview.

Remember to support your responses with the topic study materials.

APA style is not required, but solid academic writing is expected.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.