Discussion 18618173

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1.  Discuss the cultural beliefs related to delivery of health care from the Haitian and Iranian population.

2.  Discuss any differences and/or similarities in the delivery of health care in both culture.

3.  How religious beliefs influence the delivery of health care in both.  Give at least one example.

apa arial 12 ,500 words min

 
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Discussion 18731371

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This week builds on that foundational awareness with a focus on the application of evidence-based practice models as a strategy to improve patient safety and other quality dimensions. In this Discussion, consider how these strategies can sustain practice changes.

To prepare:

Read: Newhouse, R.P. (2007) Diffusing confusion among evidence-based practice, quality improvement and research. JONA 37,432-535 (see attached pdf)

Read: Mazurek Melynk B., Gallagher-Ford, L., English Long, L., & Fineout-Overholt, E. (2014) The establishment of Evidence-Based practice competencies for practicing registered nurses and advanced practice nurses in real world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-Based Nursing 11(1),5-15. (see attached pdf)

We all agree that research is the highest form of reliable evidence, when implemented in an organization that provides the basis for an evidence based practice. FIND a research study published in a peer reviewed journal related to a clinical practice problem that is of interest to you, and which would ultimately contribute to an evidence based practice.

The discussion assignment:

ANSWER the following discussion questions. Include the research study in your post (attach it to the post and post it in doc sharing). See page 11 #15 in Mazurek Melynk, Gallagher Ford, English Long and Fineout-Overholt. In this assignment, you are being asked to critically appraise a single research study for its relevance to a QI practice problem.

Discussion questions:

1) What was the purpose of the research?

2) Identify the independent and dependent variables in the study.

3) Briefly describe the research design, data collection method(s), and instruments used to measure the variables under study.

4) Briefly summarize study findings, conclusions and recommendations. Do you agree with these?

5) As a DNP prepared nurse, would you recommend a change in nursing practice based on the study? Defend and/or justify your decision based on research evaluation principles. In other words, does the evidence generated by this research article signify a need to change nursing practice? If not, why not; if so, why?

Post by tomorrow Wednesday January 31, 2018 by 10 pm America New/York time

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

  • Chapter 14: “Leadership      for Quality”
  • Chapter 16: “Implementing Quality as the Core      Organizational Strategy”

Baur, C. (2011). Calling the nation to act: Implementing the national action plan to improve health literacy. Nursing Outlook, 59(2), 63–69.

Note: You will access this article from the Walden Library databases.

This article describes the aspects of the National Action Plan to Improve Health Literacy. It starts by covering the background and objectives of the plan and then moves to its vision and goals.

Ferrara, L. R. (2010). Integrating evidence-based practice with educational theory in clinical practice for nurse practitioners: Bridging the theory practice gap. Research & Theory for Nursing Practice, 24(4), 213–216.

Note: You will access this article from the Walden Library databases.

The author of this article discusses using constructivist theory to teach nurse practitioner students to use evidenced-based practice. She focuses on introducing the student’s theoretical knowledge into real-life practice.

Grant, B., Colello, S., Riehle, M., & Dende, D. (2010). An evaluation of the nursing practice environment and successful change management using the new generation Magnet Model. Journal of Nursing Management, 18(3), 326–331. doi:10.1111/j.1365-2834.2010.01076.x

Note: You will access this article from the Walden Library databases.

Health care organizations have implemented the Magnet Model as a way to successfully implement practice change. This article examines the aspects of this process.

Lavoie-Tremblay, M., Bonin, J.-P., Lesage, A., Farand, L., Lavigne, G. L., & Trudel, J. (2011). Implementation of diagnosis-related mental health problems: Impact on health care providers. Health Care Manager, 30(1), 30(1): 4-14 (50 ref). doi:10.1097/HCM.0b013e3182078a95

Note: You will access this article from the Walden Library databases.

The study within this article analyzes two cases related to the implementation of diagnosis-related mental health programs.

Mark, D. D., Latimer, R. W., & Hardy, M. D. (2010). “Stars” aligned for evidence-based practice: a TriService initiative in the Pacific. Nursing Research, 59(1), S48–S57. doi:10.1097/01.NNR.0000313506.22722.53

Note: You will access this article from the Walden Library databases.

Nurses from a military health care system in Hawaii established ways to use and evaluate evidence-based practices. This article details the process and results of this collaborative effort between the Army, Air Force, and Navy.

Scobbie, L., Dixon, D., & Wyke, S. (2011). Goal setting and action planning in the rehabilitation setting: Development of a theoretically informed practice framework. Clinical Rehabilitation, 25(5), 468–482. doi:10.1177/0269215510389198

Note: You will access this article from the Walden Library databases.

In order to develop a theory-based framework for setting goals, the authors of this article use casual modeling to determine effective patient outcomes. They identify four major components of the framework that can be used to set effective goals.

Optional Resources

Schifalacqua, M. M., Mamula, J., & Mason, A. R. (2011). Return on investment imperative: the cost of care calculator for an evidence-based practice program. Nursing Administration Quarterly, 35(1), 15–20. 

 
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Discussion 18744463

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Read the Case Law and answer the questions.

Instructions:

  1. Read the Case Law – Werth vs. Taylor (See Below)
  2. Then, answer the questions below.
    1. Did this case turn out the way you thought it would? Why or why not?
    2. How could Cindy have assured herself that she would not receive any blood no matter what happened?
    3. Would it have made any difference in the outcome of the case if the anesthesiologist had interviewed Cindy before the procedure and told her that her life could be in danger if she refused blood during both procedures?
    4. What kind of consent is it when there is an emergency situation and the physician/healthcare worker needs to act or the patient may lose their life?
  3. Your paper should be:
    • One (1) page
    • Typed according to APA style for margins, formatting and spacing standards
    • Typed into a Microsoft Word document, save the file, and then upload the file
    • CASE LAW
    • Case Law Werth vs. Taylor 475 N.W.2d 426, 427 (Mich. Ct. App. 1991) Cindy Werth was expecting twins. Because she was a Jehovah’s Witness and had a firm belief in the religion’s teaching “that it is a sin to receive blood transfusions”, Cindy signed a “Refusal to Permit Blood Transfusions” form as part of her hospital preregistration. After delivery, Cindy had complications and was experiencing uterine bleeding. She was advised to undergo a dilatation and curettage and agreed. Again, she discussed her refusal to allow a blood transfusion with her obstetrician/gynecologist (OB/Gyn). After being placed under anesthesia and despite the specialist’s efforts during surgery, Cindy continued to bleed and was experiencing, among other things, premature ventricular activity and a significant decrease in blood pressure. The anesthesiologist (Dr. Michael Taylor) determined that Cindy needed a blood transfusion to sustain her life. Cindy’s OB/Gyn expressed Cindy’s refusal of blood transfusions, but the anesthesiologist proceeded anyway stating that it was medically necessary. The Werth’s filed a malpractice suit, alleging that Dr. Taylor committed battery by performing the transfusion without Cindy’s consent. Dr. Taylor moved for a summary disposition “because Cindy’s refusal was not conscious, competent, contemporaneous and fully informed.” The trial court found that Cindy’s refusals of a transfusion were made when she contemplated “merely routine elective surgery” and not life-threatening circumstances, and that, “it could not be said that she made the decision to refuse a blood transfusion while in a competent state and while fully aware that death would result from such refusal.” The record apparently reflected “the unexpected development of a medical emergency requiring blood transfusion to prevent death or serious compromise of the patient’s wellbeing.” 
 
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Discussion 18756563

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 Options Menu: Forum

Under the content section, read the article by Janet Jacobsen, “Lack of Reported Medication Errors Spurs Hospital to Improve Data Focus, Patient Safety.”

Please answer the following questions based on the information provided in the article;

  1. What is the purpose of what this study is trying to accomplish?
  2. What is the process(es) or activities involved in the response to a?
  3. What is the purpose of measuring and reporting performance?
  4. What is the purpose of reporting quality measurement data?
 
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Discussion 18806197

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Find the uploaded instructions. I need this paper in 3 hours

 
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Discussion 18806199

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Kindly find the attached file. I need the answer in 3 hours.

 
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Discussion 18806203

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Kindly find the attached file. I need the answer in 3 hours

 
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Discussion 18840397

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WEEK 1: DISCUSSION- FOUNDATION OF THE ROLE OF THE NURSE PRACTITIONER AS PRESCRIBER LEGAL AND PROFESSIONAL ISSUES IN PRESCRIBING

  • Describe NP practice in your state.
  • Tell the class what your state laws are related to nurse practitioner prescribing.
  • Include how many continuing education hours are required for your state.
  • Describe the importance of knowing the specific laws in your state pertaining to Nurse Practitioners prescribing medications.

( Must be 300 words) Have APA format citation. only about 2 references is enough

 
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Discussion 18858363

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Mr. Russell is a 69-year-old male who presents to your clinic with complaints heart palpitations and light headedness on and off for the past month. He has a history of hypertension and is currently prescribed HCTZ.

Vital Signs: B/P 180/95, Irregular HR 78, Resp. 20, Weight 99 kilograms

Lower extremities with moderate 3+edema noted bilaterally, ABD + BS, Neuro AOX3,

Labs: NA 143mEq/L, CL 99 mmol/L BUN 18mg/dL, Hbg 15.

  • What are your treatment goals for Mr. Russell today?
  • What is your pharmacologic plan; please state your rationale for your plan?
  • What are five key patient education points based on your plan?
  • How would your plan change if your patient is African American?

(must be atleast 300 words)

(atleast 3 references)

(references need to be in APA format)

 
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Discussion 18880931

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Review Figure 10.1 on p. 239 and the Billing Workflow section on pp. 238-239 of Health Information and Technology Management.

Write a 150- to 350-word response to the following:

Discuss at least two components described in the Billing Workflow section in Ch. 10 of Health Information and Technology Management.

  • How do these components affect health care reimbursement?

Billing Workflow

  • 1. Providers of all types verify patient insurance eligibility with the health plan, either prior to or during the admission or visit. Medical offices collect and post copays at the visit.
  • 2. The patient is treated and discharged or checked out.
  • 3. As you learned in Chapter 9, the provider usually needs to bill a third party, the insurance plan, in order to receive payment. The insurance bill is called a claim. The first step in preparing the claim is to assign procedure codes for the services rendered and the supplies used and diagnosis codes representing the disease or medical condition.
  • 4. Using these codes and the patient registration information, a computer program generates a paper or electronic claim to be sent to the insurance plan.Before the claim is sent to the insurance plan, an insurance or claim specialist reviews the claim to make sure there are no errors. Because of the volume of claims, a computer program is used to examine the claim data and identify problems. Once the claim is correct, it is sent to the insurance plan (usually electronically).
  • 5. When the claim is received by the insurance plan, it is adjudicated. If the claim is correct, a payment is sent to the provider; this is called the remittance. A paper or electronic document is generated that explains the amounts that were paid. This is called the remittance advice or explanation of benefits(EOB).
  • 6. When the remittance is received by the provider, the payment amount is recorded in the patient accounts system. Frequently, the amount billed does not equal the amount paid. This may be the result of a contractual agreement that stipulates that the provider will accept a discounted payment and/or that a portion of the charges is the patient’s obligation. An accounting entry called a write-down adjustment is posted to adjust the charge.
  • 7. If the patient has a secondary insurance plan, a claim is next sent to the second plan. In certain cases the first plan will automatically forward the claim to the second plan. This is called a “piggyback” claim or coordination of benefit (COB) claim. For example, when a Medicare patient has a supplemental insurance policy with the fiscal intermediary who processes the Medicare claims, the company will sometimes process the secondary claim automatically. This eliminates the need for the provider to file a second claim. These are also known as crossover claims.
  • 8. Most health plans require the patient to pay a portion of the medical bill. These payments are referred to as the copay, coinsurance, and deductible amounts. The copay amount is usually stated on the patient’s insurance card and collected during the patient visit. The coinsurance amount is usually a percentage of the allowed amount and is not known until the claim has been adjudicated. The EOB tells the provider what amount is the patient’s responsibility.When all the patient’s insurance plans have responded with remittance advice, a bill or statement is sent to the patient for any amounts due that are the patient’s responsibility. The patient statement should clearly show the amounts paid or denied by the insurance plans, any adjustments to the charges required by the plan contract, and the amount due from the patient.
  • 9. When patient payments are received by the medical office or hospital, they are posted to the patient’s account. When the account balance is zero, no further statements will be sent.
 
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