Research the delivery, finance, management, and sustainability methods of the U.S. health care system. Evaluate the effectiveness of one or more of these areas on quality patient care and health outcomes. Propose a potential health care reform solution to improve effectiveness in the area you evaluated and predict the expected effect. Describe the effect of health care reform on the U.S. health care system and its respective stakeholders. Support your post with a peer-reviewed journal article.

In today’s fast-paced and global community, most organizations are faced with constant change. Research contemporary organizations that are currently responding to a significant change within the industry, (preferably an organization in healthcare)such as disruptive technology; state, government, or industry regulations; environmental constraints; judicial or legislative rulings; etc.

Choose one organization from your research that has recently responded to major change, or is currently responding to change. Write a paper (1,250-1,500 words) discussing how well the organization is responding to the change dynamics. Include the following:

1. Describe the organization and the change to which it is responding.

2. Discuss the degree to which the change has been disruptive and how the organization has responded to the dynamics created by this change.

3. Evaluate the strategies the organization used in its change plan and determine the level of success the organization experienced with the strategies.

4. Determine the effect the change had on stakeholders, and to what degree stakeholders have resisted. Assess how well stakeholder resistance was addressed.

5. Evaluate the overall implications the change had on interdepartmental collaboration.

6. In your opinion, how well did the leaders of the organization respond and prepare for the change? What worked and what did not work with the strategies they implemented?

7. What modifications would you suggest the leaders of the organization make in order to better address the change dynamics? What additional strategies would you recommend to assist the organization through this change?

APA format with References

Case Study 

Diabetic Ketoacidosis

Patient Profile.

N.B., a 34 year-old Native American man, was admitted to the emergency department after he was found unconscious by his wife in their home.

Subjective Data

· Was diagnosed with type 1 diabetes mellitus 12 months ago

· Was taking 50 units of insulin daily; 5 units of lispro insulin with breakfast, 5 units with lunch and 10 units with supper plus 30 units of glargine insulin at bedtime

· Has a history of flu for 1 week with vomiting and anorexia

· Stopped taking insulin 2 days ago when he was unable to eat

Objective Data

Physical Examination

· Breathing is deep and rapid

· Acetone smell on breath

· Skin flushed and dry

Diagnostic Studies

· Blood glucose level of 730 mg/dL (40.5 mmol/L)

· Blood pH of 7.26

Discussion Questions

1. Briefly explain the pathophysiology of the development of diabetic ketoacidosis (DKA) in this patient

2. What clinical manifestations of DKA does this patient exhibit?

3. What factors precipitated this patient’s DKA?

4. Priority Decision: What is the priority nursing intervention for N.B.?

5. What distinguishes this case history from one of hyperosmolar hyperglycemic syndrome (HHS) or hypoglycemia?

6. Priority Decision: What is the priority teaching that should be done with this patient and his family?

7. What role should N.B.’s wife have in the management of his diabetes?

8. Priority Decision: Based on the assessment data presented, what are the priority nursing diagnoses? Are there any collaborative problems?

4 postsRe: Topic 3 DQ 1

A vulnerable population is a group of people who need special considerations in regard to their health and overall welfare (Falkner, 2018).Vulnerable populations are individuals who are not able to advocate for themselves due to physical, cognitive or mental disability, emotionally unstable people, children and incarcerated individuals.These populations usually have several social determinants of health(SDOH) that contribute to their vulnerability.These SDOH can include poverty, socioeconomic status, race and ethnicity, sexual orientation and no insurance or the underinsured.

 In the United States there are many vulnerable populations.One group that gets a significant amount of media coverage is the lesbian/gay/bisexual/transgender/questioning (LGBTQ) population.The inequality and hardship this group often encounters within the medical community and the higher instance of medical conditions such as Hepatitis B, HIV and AIDS is what makes this population considered vulnerable (Falkner, 2018).In the US, it is estimated that 10 million adults identify as LGBTQ (American Nurses Association [ANA], 2018).Many individuals within the population have reported prejudice from medical providers, leading to reluctance to seek care or delay in treatment due to the bias experienced.The stigma in society, discrimination and failure to recognize the unique civil and human rights deters individual self-determination and access to care which causes negative health outcomes and overall increase in morbidity and mortality (ANA, 2018).All nurses, not just CHN need to understand their own preconceptions and bias when caring for this vulnerable population.Ethically, nurses have a responsibility to provide safe, competent care to all individuals regardless of age, sex, sexual preference, race, ethnicity or socioeconomic status.

9. The

nurse is teaching the mother of a child with cystic fibrosis how to do postural

drainage. The nurse should tell the mother to:

Mark one answer:

    Use

the heel of her hand during percussion

    Change

the child’s position every 20 minutes

    Do

percussion after the child eats and at bedtime

    Use

cupped hands during percussion