Monthly Archives: May 2023

Reply 1

Clinical nurse leaders play an important role in managing quality measures and setting policy thus involves dealing with fiscal responsibility and being answerable for the overall quality of patient care delivery, patient satisfaction and organization outcomes (McBride, 2019). Nonetheless, CNL role is coordinated to collaborate work with other professional teams. Education requirement for nurse leaders based on practice skills. In masters nurses get to improve care, quality and safety of patients, team working is highly encouraged in leadership.

A good leader should have the following trait; integrity, critical thinking, communication skills. Integrity is central in making a nurse leader (McBride, 2019). Integrity help nurses to make sound decisions regarding patients’ treatment plans and safety (Harris, Roussel & Thomas, 2016). Furthermore, effective leadership in nursing practice requires high level of integrity. Due to increased multidisciplinary collaboration, critical thinking skill is very important. Interdisciplinary alliance makes critical thinking an important skill for nurse leaders. Moreover, communication in leadership is key since it helps promote team spirit or teamwork translating to better care outcome.

References

McBride, A. B. (Ed.). (2019). The growth and development of nurse leaders. Springer Publishing Company.

Harris, J. L., Roussel, L. A., & Thomas, T. (2016). Initiating and sustaining the clinical nurse leader role. Jones & Bartlett Learning.

reply 2

According to Dwight Eisenhower as quoted by Mind tool blog (n d) leadership is defined as the art of bringing another person to do something that you want done because he/she wants to do it. Nurses occupy different leadership positions in the healthcare industry and I want to discuss about Nurse Managers. Nurse managers are typically Advanced Practice Nurses who has at least BSN but many hospitals require completion of Master’s degree or current enrollment in a Master’s program, also some nurse managers find it helpful to obtain Masters in Business Administration (MBA). Nurse managers are also called Nurse Administrators (Nurse org, 2020)

Essential responsibilities of a nurse managers include administrative meetings, working with new employees, serving in different committees throughout the hospital, interviewing and hiring of new nurses, acting as a liaison between hospital management and employees, collaborating with medical employees, managing unit budget, handling of disciplinary actions to those who have erred, ensuring that the mission of the hospital is maintained by the employees, set work schedules, oversee patient care, etc.(nurse org, 2020)

Leadership traits are those personal traits needed to be successful as a nurse manager include, advocacy, to speak up for her employees and the patients, should be able to participate in patients care and also in management meetings, he/she should be supportive of her staff and should also be mature in her judgement, strong communication skill is a trait that a nurse manager should possess, he/she should be able to communicate the hospital decision to her employees and also communicate her employee’s concerns to the hospital management (Duquesne, blog, 2017). The leadership style that I feel will make the nurse manager to succeed in his/her job Is the transformational style. Transformational leadership is a leadership style that can inspire positive changes in those who follow. Transformational leaders are generally energetic, enthusiastic, and passionate. Not only are these leaders concerned and involved in the process; they are also focused on ensuring that every nurse under her car becomes the best nurse they can ever be and also be successful in their nursing career. (Cherry, 2020). In order to succeed, a nurse leader should have qualities like listening, flexibility, organized. Be a problem solver, leadership skill, analytical ability, empathetic, confidence, decisiveness, confidence, etc. (nurse org, 2020)

                                                                                    References

Cherry, K. (2020) Transformational leadership. Very well mind. Retrieved from https://www.verywellmind.com/what-is-transformational-leadership-2795313

Duquesne University blog, (2017) Nurse manager: leading the Nurse profession into the future. Retrieved from https://onlinenursing.duq.edu/blog/roles-nurse-manager-leading-nursing-profession-future/#:~:text=Nurse%20managers%20are%20responsible%20for,and%20make%20decisions%20about%20personnel.

Nurse.org (2020) Nurse manager. Retrieved from https://nurse.org/resources/nurse-manager/

Mindtool (n d). What is leadership. Retrieved from https://www.mindtools.com/pages/article/newLDR_41.htm

For this assignment, you will locate two research studies related to the topic and PICOT questions that you developed in Week 2. The articles must be current (within the last five years), and one article must be quantitative, and one article must be qualitative. (The topic I used in week 2 was Juvenile Idiopathic Arthritis.)

Article choice is very important, therefore:

• Articles used for this assignment cannot be used for the other assignments. The selected articles should be original research studies. Review articles, concept analysis, meta-analysis, meta-synthesis, integrative review, and systemic review articles should not be used.
• Mixed-methods studies should not be used.

There are two parts to this assignment.

Part 1: Complete a Rapid Critical Appraisal Checklist

• Select one each: qualitative and quantitative research articles.
• Create a Rapid Critical Appraisal Checklist for the two research articles (one column per article).
• Complete with brief, concise, summarized information.

Part II: Write a summary (one- to two- pages)

• Identify differences between quantitative and qualitative designs and research methods.
• Use current APA Style for your summary paper and to cite your sources.
• Submit the checklist and summary.

  $5 for anyone who good in nursing paper can do this discussion response due by 12/9/2020 @5pm on eastern time. Exmple is provided. 

 Medicare or Medicaid – which has greater impact in Florida? 

Above is the answer of 2 peer.  I need a response for them

PEER 1

Medicare and Medicaid are the greatest insurance programs run by the government. However, they are operated and funded by different parts of the government and primarily serve different groups. Medicare is run by the federal government and mainly provide health coverage to individual aged 65 years and above and those with disability. Medicaid entails collaboration between the state and federal government and provides health coverage to low-income. However, there are those how meet dual eligible criteria. Therefore, as a state and federal-run program Medicaid has greater effects on state governments. State governments co-fund the program and are expected to match federal funding.

From modest beginnings in 1965, Medicaid has grown significantly from $5.3 billion four decades ago, to $449 billion in 2013. In Florida, Medicaid expenditures have grown by 33% between 2012 and 2016. In 2016, the combined state and federal spending on Medicaid increased by 22%. Over these years, the federal government has provided between 55% and 60% of Medicaid funding. During the same time, Medicaid has growth to more than 75% of the Medicare expenditure and its share of national health expenditure has almost doubled. Following the passage of the Affordable Care Act, 2010, states were requested to expand their Medicaid program (Sutter, 2016). According to Ward (2020), the expansion of the Medicaid program has met significant resistant because of its presumed impact on state budgets. Florida is one of the states that have failed to expand its Medicaid plan under the Affordable Care Act. Some stakeholders argue that expanding the illegibility criteria is likely to have significant fiscal implications. Florida is among the states with the highest personal healthcare spending, ranking 5th nationwide. According to Buettgens (2018), the growing Medicaid expenditure are not necessarily driven by increased coverage, but also by changing medical needs, changes in demographics, and other factors affecting consumption of health care services. The debate on the cost implications of expanding Medicaid are likely to persist, but is evident that more Americans have health insurance. 

PEER2 

More often individuals tend not to understand the difference between Medicare in addition to Medicaid. Regardless of them providing assistance to the senior citizens as well as the disabled ones in catering for most of the expenses that are health-related. Medicare is basically a type of health insurance for the people who are disabled, senior or anyone who is known to be suffering from a failure of the kidney which is considered to be permanent. Additionally, it is financed via the contributions of tax security which is contrary to the Medicaid (Hu and Mortensen, 2018).

Florida Medicaid is basically a program that depends on the necessities with benefits which is determined by an individual’s financial in addition to their medical position. It basically provides medical insurance to individuals who are considered to have low incomes in addition to the ones who are disabled. It is a nationwide program which is funded jointly by the federal government in addition to the states. The eligibility of Medicaid, administration in addition to benefits tends to be under the states’ management which are within the guidelines of the federal.

Medicaid basically is known for having an impact which is great within the Florida state in comparison to the Medicare program. It does not provide healthcare which is direct, contrary to that, it pays the nursing homes, hospitals, health plans, physicians in addition to other various caregivers particularly for the services that are covered as well as the ones that have been delivered to the eligible patients. In Florida State it is compulsory for an individual to have a Medicaid so that they can benefit from the healthcare (Munnich and Richards, 2020).

Video Paper Requirements 40 points (select ONE movie and answer all the questions and other information you research to support your answers) The paper must be in APA format.

Personality Disorders

Select one of the following movies and answer the discussion questions that

follow in APA format report.

 Girl Interrupted (1999 Drama; Angelina Jolie, Winona Ryder,

Whoopie Goldberg)

 Fatal Attraction (1987 Thriller/Drama; Glenn Close, Michael

Douglas)

 Natural Born Killers (1994 Thriller/Drama; Woody Harrelson,

Juliette Lewis)

 American Psycho (1999 Drama/Suspense; Christian Bale)

Must answer the following questions in your APA formatted paper.

• Identify the character and the psychological disorder they display.
• Did the movie accurately portray the symptoms of the disorder? Was this an accurate clinical picture? Explain in detail and provide examples from the movie.
• Discuss any inaccuracies and misconceptions perpetrated of the disorder in the Movie. If the disorder was misrepresented explain how this could be misleading to a typical movie-goer?
• How is a personality disorder different from an Axis 1 disorder?

Dissociative Disorders

 Primal Fear (1996 Drama/Suspense; Richard Gere, Edward Norton)

 Me, Myself and Irene (2000 Comedy; Jim Carey, Renee Zellweger)

 Identity (2003 Thriller; John Cusack, Ray Liotta, Amanda Peete)

 Fight Club (1999 Action/Drama; Brad Pitt, Edward Norton)

 Secret window (2004 Thriller; Johnny Depp, John Turturro)

• Identify the character and the psychological disorder they display.
• Did the movie accurately portray the symptoms of the disorder? Was this an accurate clinical picture? Explain in detail and provide examples from the movie.
• Discuss any inaccuracies and misconceptions perpetrated of the disorder in the movie. If the disorder was misrepresented explain how this could be misleading to a typical movie-goer. Many reputable theorists believe DID does not exist. What do you think? Support your thoughts.

 I NEED A RESPONSE FOR THIS ASSIGNMENT

3 REFERENCES

Children and adolescents have the unique advantage and challenge of rapid growth and development within relatively short duration of time.  For this reason, developmental assessments are essential to identify and measuring growth, ensuring milestones are reached at appropriate times (Milbrath, et al., 2020).  Early identification leads to early interventions for children or adolescents who are not appropriately meeting milestones of development.  When performing a general assessment, whether for mental health issues or annual visit, it is important to also rule out any possible developmental symptoms that could be presenting as other acute symptoms.  It is important to ensure that the child or adolescent is developing appropriately or intervene promptly to address potential delays.

One assessment tool that can be used for very young children, even toddlers, is the Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS).  The child plays with toys throughout the evaluation while the provider assesses their level of development (Milbrath, et al., 2020).  This is an effective test for determining the child’s language and cognitive development (Milbrath, et al., 2020).  An advantage of this assessment scale is that it can be used for very young children, as there are no specific questions but rather observation.  This tool is used in children since it involves toys and activity that is rated by the evaluator rather than specific questions that are answered by the client.  

Another tool that could be useful for a wider age range of children is the Early Development of Emotional Competence (EDEC), which is a tool that assesses the correlation between the child’s language skills and emotional abilities, particularly expression or behavior (Na, Wilkinson, & Liang, 2018).  This developmental tool may be more helpful in the mental health context, as it assesses the client’s language development as well as emotional response.  Rather than diagnosing, this tool can be useful in assessing the family dynamics, as parents or caregivers are active participants in this evaluation (Na, Wilkinson, & Liang, 2018).  While parents participate, the assessment tool is focused on the emotional regulation of the child or adolescent client.  This tool is used in children as it evaluates language development in relation to emotions, which would not be applicable for adult clients.

As with all populations of clients, evidence based treatments are most effective in treating a variety of symptoms, and can be taught to a large group to implement for practice (Leathers & Strand, 2018).  One method of treatment that would be more appropriate for children or adolescents over adults would be game or activity based treatment modalities.  This allows for the children to interact in a way that does not require verbal articulation.  While activity or other experiential therapies can be utilized for adults, they are more likely to be utilized and effective with a younger population.  Another treatment modality that would be more appropriate for child or adolescent clients is a technology application that can be used on a computer or tablet (Davidson, et al., 2019).  This is another way to engage children to actively participate in an application on a screen, which comes easily to children and adolescents.  While adults would be capable of utilizing an application on a computer, phone, or tablet, it would be more effective for younger clients. 

Parents play an important role in assessing child clients, as the parents are able to articulate observable symptoms or concerns that the young client may not be able to identify or label.  Another role that parents play in assessment and treatment is how they may be affected by their children’s diagnoses or symptoms.  It is important to identify parents who require increased support related to treatment, as there are specialized assessment tools to measure this as well (Samadi, Abdollahi-Bograbadi, & McConkey, 2018).  This can be an important part of the assessment and evaluation process for children and parents alike.  Often, the stressors experienced in the home environment affect and exacerbated already existing symptoms among children and parents.

References

Davidson, T.A., Bunnell, B.E., Saunders, B.E., Hanson, R.F., Danielson, C.K., Cook, D., Chu,

B.C., Dorsey, S., Adams, Z.W., Andrews III, A.R., Walker, J.H., Soltis, K.E., Cohen,

J.A., Deblinger, E., & Ruggiero, K.J.  (2019).  Pilot evaluation of a tablet-based

application to improve quality of care in child mental health treatment.  Behavior

Therapy, 50(2), 367-379.  doi:10.1016/j.beth.2018.07.005.

Leathers, S.J., & Strand, T.C.  (2018).  Social work training in the use of evidence-based

treatments for children: What works?  Journal of Social Work Education, 54(S1), S41-

S55.  doi:10.1080/10437797.2018.1434444.

Milbrath, G., Constance, C., Ogendi, A., & Plews-Ogan, J.  (2020).  Comparing two early child

development assessment tools in rural Limpopo, South Africa.  BMC Pediatrics, 20,

197.  doi:10.1186/s12887-020-02101-0.

Na, J.Y., Wilkinson, K., & Liang, J.  (2018).  Early Development of Emotional Competence

(EDEC) assessment tool for children with complex communication needs: Development

and evidence.  American Journal  of Speech-Language Pathology, 27, 24-

36.  doi:10.1044/2017_AJSLP-16-0058.

Samadi, S.A., Abdollahi-Boghrabadi, G., & McConkey, R.  (2018).  Parental satisfaction with

caregiving for children with developmental disabilities: Development of a new

assessment tool.  Children (Basel), 5(12), 166.  doi:10.3390/children5120166.

Discuss why you have decided to complete your at this time, and the concern you have about completing your baccalaureate degree. base on the reading in the materials, what strategies can you implement to be a successful student.

1. Prepare examples of various coding and billing issues that you have experienced in the clinical setting (Peds and women’s health).

2. Provide a brief description about the NPI numbers for nurse practitioners.

Read the following article:

https://journals.lww.co m/jwocnonline/Fulltext/ 2012/03001/Reimburse ment_of_Advanced_Pra ctice_Registered.4.aspx

answer:

During my previous clinicals, I have noticed providers complaining about different coding and billing issues. The most common complaint was not having enough data. If the provider fails to provide enough information, like not linking the diagnosis to the right CPT code then the payer may deny the transaction or create a delay. Another common issue includes having to uncode if the patient is billed for the wrong services. Many other errors like telemedicine coding errors, missing or incorrect information and incorrect procedure codes. Although there are many possible errors, there is also multiple ways to avoid them. It is the providers job to prevent those errors (Grant-Kels, Kim, & Graff, 2016). 

A National Provider Identifier is a unique 10-digit number given to healthcare providers by Medicare and Medicaid services. This NPI number was brough around 1996 under HIPAA. It was then in 2006 when it became mostly used. This allows the provider to identify themselves in transactions or medical correspondence. The provider will carry this unique code throughout their career to any practice that they join (Adams, Norman, & Burroughs, 2020). This is not a confidential number since anyone can look up an NPI number in the registry. Finally, in order to obtain one, the provider must apply under the NPPES website. 

References

Adams, D. L., Norman, H., & Burroughs, V. J. (2020). Addressing medical coding and billing part II: a strategy for achieving compliance. A risk management approach for reducing coding and billing errors. Journal of the National Medical Association, 94(6), 430–447.

Grant-Kels, J. M., Kim, A., & Graff, J. (2016). Billing and up coding: What’s a doctor-patient to do?. International journal of women’s dermatology, 2(4), 149–150. https://doi.org/10.1016/j.ijwd.2016.08.003

 Hello i need a Briefly, Good and Positive Comment for this Post.Thank you.  I need at least two references  

Yvonne Amune 

Week 5 discussion

COLLAPSE

Top of Form

NURS 6660 Week 5 Clinical Supervision Discussion Video Transcript

           Anxiety disorders are psychiatric conditions that share characteristics of excessive fear of real or perceived imminent threat. According to Thibaut (2017), anxiety disorders are the most prevalent psychiatric disorders- accounting for 7.3% of all psychiatric disorders worldwide. Anxiety disorders are distinguished from one another by the triggers that induce the anxiety, fear, or other associated behavior and may include generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, selective mutism, separation anxiety disorder, medication/substance-induced anxiety disorder, and social phobia (American Psychiatric Disorder, 2013; Thibaut, 2017).

           A client I observed is N.B, a 15-year old male Caucasian presented to the clinic by his mother, who was concerned about his anxious behavior. The client’s mother described him as a shy person with little friends. For this reason, N.B spends most of his time playing video-games in his room. The client’s mother also revealed that N.B has always had problems meeting new people. During the interview, N.B looked uncomfortable. He could not keep eye contact and was fidgeting. N.B’s mother also revealed that he has always struggled in the presence of his peers. N.B has severally turned down his peer’s invitations to hang out and often engages in avoidance behaviors. After assessing the client, a diagnosis was made for social anxiety disorder (Social phobia) 300.23 (F40.10) (American Psychiatric Disorder, 2013).

           The DSM-5 diagnostic criteria for social anxiety disorder (Social phobia) involves marked fear or anxiety of one or more social situations where an individual is exposed to scrutiny by others- (in peer settings for children). The social situations always provoke fear or anxiety and must have been lasting for six months or more. In the given case, the client met the diagnostic criteria for social anxiety disorder.

Therapeutic Approach and perceived Effectiveness

           The most appropriate treatment for N.B is cognitive behavioral therapy (CBT). CBT is regarded as the approach with the highest level of evidence in the treatment of social anxiety disorder (Bandelow et al., 2017). CBT’s goal in treating social anxiety disorder is to enable the client to gain self-consciousness by changing maladaptive behaviors and negative thoughts that make oneself uncomfortable in social situations. In their study, Pinjarkar et al. (2015) examined the effectiveness of CBT in treating social anxiety and found a clinically significant improvement in the subject’s self-consciousness and avoidance behavior (63.79%). In another study, David et al. (2014) concluded that cognitive therapy resulted in better outcomes than wait-list in the treatment of social anxiety disorder patients (78% of the subjects did not meet avoidant personality criteria at the end of treatment). The study also showed that cognitive-behavioral therapy was more superior to expressive and art therapy in the treatment of social anxiety disorder (71%) (David et al., 2014).

Thank you for listening to me.

I look forward to hearing from you on alternate therapeutic approaches.

References

Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety             disorders. Dialogues in Clinical Neuroscience, 19(2), 93–107.

David M., C., Anke, E., Ann, H., Freda, M., Melanie, F., Nick, G., Louise, W., & Jennifer,          W. (2014). Cognitive therapy versus exposure and applied relaxation in social   phobia: A Randomized controlled trial. Journal of Consulting and Clinical             Psychology, 74(3), 568–578.

Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety disorders:        an update on the empirical evidence. Dialogues in Clinical Neuroscience, 17(3), 337–      346.

Pinjarkar, R. G., Sudhir, P. M., & Math, S. B. (2015). Brief cognitive behavior therapy in         patients with social anxiety disorder: A preliminary investigation. Indian Journal of       Psychological Medicine, 37(1), 20–25. https://doi.org/10.4103/0253-7176.150808

Thibaut F. (2017). Anxiety disorders: A review of current literature. Dialogues in Clinical           Neuroscience, 19(2), 87–88.

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Based on the required topic study materials, write a reflection about worldview and respond to following:

1. In 250-300 words, explain the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism within health care.
2. In 250-300 words, explain what scientism is and describe two of the main arguments against it.
3. In 750-1,000 words, answer each of the worldview questions according to your own personal perspective and worldview:
   1. What is ultimate reality?
   2. What is the nature of the universe?
   3. What is a human being?
   4. What is knowledge?
   5. What is your basis of ethics?
   6. What is the purpose of your existence?

Remember to support your reflection with the topic study materials.

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.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.