Reflective Analysis: Risk Management and the Role of Managed Care

The purpose of this assignment is to analyze the role of managed care organizations within health care and risk management programs.

Reflect on and evaluate the role that the managed care organization (MCO) plays in today’s health care environment by developing a 250‐500-word response that addresses the following:

  1. What is a health care organization’s administrative role in executing risk management policies and ensuring compliance with managed care organization (MCO) standards?
  2. What value do the regulatory statutes of a typical MCO provide to a health care organization? Consider how strategies pertaining to policies such as conflict resolution and risk management affect patients as well as employees and employers.
  3. What MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?

In addition to your textbook, you are required to support your analysis with a minimum of two peer‐reviewed references.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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

CORNEAL AND RETINAL DISORDERS (NO PLAGIARISM) APA7th ed.

 My subject is Corneal and Retinal disorders. Research paper and PowerPoint presentation

Assignment Objective

This project or assignment will assist the student to examine evidence and challenge assumptions to improve the quality care for patients, families and communities. This assignment should evaluate, analyzes, and reflect on the professional nurse values in practice. In addition, identify legal and ethical standards in practice The Student will identify your patients’ learning need, then create and implement a teaching plan to correct the area(s) of weakness.

Assignment Directions Instructions for completion: Based on information gathered through a thorough assessment, identify a learning need in an assigned topic. Student will complete an APA paper and an oral presentation based on the criteria below.

Assignment criteria:

  • Introduction
  • List learning objectives & learning activities
  • Describe the disease pathophysiology
  • Complication, signs, and symptoms of disease process
  • Treatment for disease process
  • Identify nursing care activities and interventions
  • Identify prevention, health promotion, and research related to the assigned topic
  • Identified learning need for disease process
  • Identify cultural/diversity issues to consider
  • Evaluate, analyzes, and reflect on the professional nurse values in practice
  •  Identify legal and ethical standards in practice
  • Handouts, brochures, printed materials to be given to client
  • Conclusion
  • References

6616: Assessment 3

  • Prepare a job description, 4–6 interview questions, and a 2–3-page narrative overview.
    Note: Complete the assessments in this course in the order in which they are presented.
    Communities and organizations are in need of care coordination experts who can lead interprofessional team efforts across a region and for multiple populations. Organizations and communities need to be able to define and assess the best fit for these highly important roles. An expert who is capable of this type of role should have comprehensive knowledge related to the scope and standard of practice for care coordination and how they are applied in practical ways to achieve best practice outcomes for care coordination. Having a toolkit as a guide can help organizations to understand and achieve the selection of the best candidate for this type of critical position.
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  • Toggle DrawerQuestions to Consider
  • Toggle DrawerResources
  • Assessment InstructionsNote: Complete the assessments in this course in the order in which they are presented.
    Preparation
    For this assessment, you will create a toolkit that includes a brief job description, interview questions, and a narrative overview in the form of a scholarly document.
    Review the Resources for this assessment and conduct your own library research to develop and support your ideas.
    Note: Remember that you can submit all, or a portion of, your draft care plan to Smarthinking for feedback, before you submit the final version for this assessment. However, be mindful of the turnaround time of 24–48 hours for receiving feedback, if you plan on using this free service.
    Requirements
    Prepare a job description, 4–6 interview questions, and a 2–3- page narrative overview.
    Toolkit Format
    Use APA format. Create headings based on the scoring guide criteria. Your faculty may provide a template.
    Supporting Evidence
    Cite 5–7 sources of credible, scholarly, or professional evidence to support your claims and solutions.
    Directions
    Your community is in need of a new care coordination role to assist with care in an organization or on larger scope in the region. For this assessment, you, as a care coordination leader, design the role of a care coordinator by creating a job description and describing the attributes that you are looking for in a candidate to fill this position.
    Following these instructions will help ensure you meet the scoring guide criteria:

    • Describe the care coordinator role need specific to your chosen community or region. This description should include the attributes you deem essential to the role, related to standards of practice.
    • Provide 4–6 interview questions that demonstrate the qualities of an effective, ethical, and culturally aware nurse leader. Think about the standards of practice for care coordination and transition management, leading the interprofessional team in collaborative change, and the candidate’s ability to be a visionary for change in the organization or community.
    • Analyze the ideal candidate’s knowledge related to legal and ethical considerations, stakeholder and interprofessional teams, cultural competence, and data use to improve care coordination in a 2–3-page narrative. In other words, explain what knowledge and skills a care coordinator should demonstrate for this role. such as knowledge of legal and ethical considerations as well as stakeholder and interprofessional team collaboration, being culturally competent, and knowing how to assess and use data to enhance care.
    • The result will be a toolkit to assist the interview team in understanding how to choose the best candidate.
      Scoring Guide Criteria
      Your assessment should meet the following scoring guide criteria:
    1. Create a job description and interview questions for a care coordination leadership position.
    2. Analyze the candidate’s knowledge related to ethical guidelines and practices to improve care coordination.
    3. Analyze the candidate’s knowledge of laws and policies within care coordination.
    4. Analyzes the candidate’s knowledge related to stakeholder and interprofessional teams to implement care coordination.
    5. Analyze the candidate’s knowledge related to data outcomes use to enhance care.
    6. Communicate effectively in an appropriate form and style, consistent with applicable professional and scholarly standards.
    7. Additional Requirements
      Your assessment should also meet the following requirements:
    • Written communication: Written communication is free of errors that detract from the overall message.
    • APA formatting: Your paper should demonstrate current APA style and formatting.
    • Number of resources: Include 5–7 resources, appropriately cited throughout your paper and in your reference list.
    • Length: 2–3 pages, typed and double-spaced, not including the title page and reference list.
    • Font and font size: Times New Roman, 12 point.

NRS 493 -0503 Professional capstone

Document your clinical practice hours using the Lopes Activity Tracker (LAT) in your student portal. Once you have opened the app, click on the link for your class to record your hours. Clinical practice hours should be documented and submitted within 48 hours of the clinical experience. After the hours have been submitted, the preceptor will verify the hours, which are then reviewed by the faculty.

Download the electronic summary of your practicum experience from the Lopes Activity Tracker. Save the file and submit it through the assignment dropbox for faculty approval.

This report is to be submitted in every topic.

Assessment of Community-Level Barriers

For the second written assignment of the course, you will continue in the design of your proposed model program by demonstrating your understanding of your selected population’s challenges, which negatively impact this group’s health and well-being. Based on this week’s research, conduct an assessment of the barriers, limitations, and other distinguishing features, as they exist within your community.

  • Prepare a recap of the model program for your community that you originally shared in the week 2 written assignment.  As stated in the Week Two directions, changes to the potential program can be made as you research and develop the focus of the program.
  • Analyze and discuss at least three critical barriers that impact the health and well-being of your chosen group; one must be a micro-level (individual) barrier that is financial, one must be a macro-level (community/state) barrier that relates to access and funding for care, and  the third barrier may be one of your choosing.
  • Discuss at least one proposed solution for each barrier. Your solution for the micro barrier must include an analysis of various potential funding options (both independent and integrated). Your solution for the macro barrier must include an analysis of financing resources for health care.
  • Research and analyze the regulatory, legal, ethical, and accreditation requirements and issues for the service(s) offered in your proposed program.  Discuss how each will impact the management of the program.

Your assignment should be a minimum of three pages in length (excluding title and reference pages) and should include a minimum of three scholarly sources cited according to APA guidelines as outlined in the Ashford Writing Center. Please note: All assignments in this course are progressive; therefore you should use the same population selected in your Week Two assignment. The Week Two assignment’s contents do not need to be re-submitted with this assignment.

Community Teaching Plan: Teaching Experience Paper and nursing (Due 24 hours)

 

1) Minimum 1 Poster Presentation and minimum 8 full pages- Not words

              Part 1: Minimum 1 Poster Presentation in PPT and 5 pages

              Part 2: 3 pages

              

Submit 1 document per part

2)¨******APA norms

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

         Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 7 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question.

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc 

__________________________________________________________________________________

Part 1: 

You must demonstrate empathic writing to develop the points. The titles are points 1, 2, 3, 4, and 5. Its writing should be fluid as an essay addressing the items of each point.

Community:

 

Place: The palace at home

Location: Miami

Population: Elderly

Attention focus: Problem Focused

Problem: Hypertension

Guide for Poster Presentation:

Avoid using text more than for headlines. Use icons, stickers, images……. You should address the following items to educate an older population about hypertension: 

1. 3 Risk factors (For example, hereditary hypertension)

2. 3 Protective factors (For example, exercise)

3. 3 prevention mechanisms (For example, low salt diet)

4. 3 Control mechanisms (For example, medical controls)

5. Education: secondary and primary hypertension

6. Signs and symptoms

Guide for the paper:

Suppose that you have already done the pedagogical process in the institution mentioned above using the poster that you designed, now in the paper reflect your experiences as a nurse educator.

1) Summary of teaching plan

a. The nurse used a Poster Presentation to inform the elderly about the prevention Hypertension:

     – Mention the advantages of the presentation poster and why it was selected

b. Mention the importance of teaching elders about the prevention of Hypertension.

c. Mention the objective of educating the elderly about the prevention of Hypertension.

d. Mention why this population should be the teaching focus of the nurse

2) Epidemiological rationale for topic

Hypertension in the elderly

3) Evaluation of teaching experience

a. Mention how you felt doing this education process for this community.

b. Evaluate your performance as a nurse to address the issue

c. Consider improvement opportunities for future activities

4) Community response to teaching

The population responded positively, were participatory and addressed the issue based on their experiences.

5) Areas of strengths and areas of improvement

You must demonstrate empathic writing to develop the points. The titles are points 1, 2, 3, 4, and 5. Its writing should be fluid as an essay addressing the items of each point.

Part 2 :

 1 page: As you finish this course, your philosophy of nursing has probably changed. 

1. As a final review, polish your philosophy of nursing (See file Personal nursing philosophy) based on your newly acquired knowledge.

2 pages: Write a summary reflection answering the following questions based on the readings and discussions throughout the course:

1. As an art and a science, how has your personal nursing philosophy unfolded?

2. Have there been ideas that have challenged your personal values or assumptions?

3. Have there been ideas that have caused you personal conflict and may lead to deconstructing those dispositions in a critical manner?

4. What actions have you taken that illustrate your personal nursing philosophy?

5. Describe your own definition of the concepts involving the meta-paradigm of nursing.

6. Has your first written philosophy of nursing changed? In what ways?

Nursing Leadership

 In the following situations, choose the most appropriate conflict resolution strategy (avoiding, smoothing, accommodating, competing, compromising, or collaborating). Support your decision with rationale and explain why other methods of conflict management were not used. 

Situation 1 You are a circulating nurse in the operating room. Usually, you are assigned to Room 3 for general surgery, but today, you have been assigned to Room 4, the orthopedic room. You are unfamiliar with the orthopedic doctors’ routines and attempt to brush up on them quickly by reading the doctors’ preference cards before each case today. So far, you have managed to complete two cases without incident. The next case comes in the room, and you realize that everyone is especially tense; this patient is the wife of a local physician, and the doctors are performing a bone biopsy for possible malignancy. You prepare the biopsy area, and the surgeon, who has a reputation for a quick temper, enters the room. You suddenly realize that you have prepped the area with Betadine, and this surgeon prefers another solution. She sees what you have done and yells, “You are a stupid, stupid nurse.” 

Situation 2 You are the intensive care unit charge nurse and have just finished an exhausting 8 hours on duty. Working with you today were two nurses who work 12-hour shifts. Each of you were assigned two patients, all with high acuity levels. You are glad that you are going out of town tonight to attend an important seminar because you are certainly tired. You are also pleased that you scheduled yourself an 8-hour shift today and that your replacement is coming through the door. You will just have time to give report and catch your plane. It is customary for 12-hour nurses to continue with their previous patients and for assignments not to be changed when 8- and 12-hour staff are working together. Therefore, you proceed to give report on your patients to the 8-hour nurse coming on duty. One of your patients is acutely ill with fever of unknown origin and is in the isolation room. It is suspected that he has meningitis. Your other patient is a multiple trauma victim. In the middle of your report, the oncoming nurse says that she has just learned that she is pregnant. She says, “I can’t take care of a possible meningitis patient. I’ll have to trade with one of the 12-hour nurses.” You approach the 12-hour nurses, and they respond angrily, “We took care of all kinds of patients when we were pregnant, and we are not changing patients with just 4 hours left in our shift.” When you repeat this message to the oncoming nurse, she says, “Either they trade or I go home!” Your phone call to the nursing office reveals that because of a flu epidemic, there are absolutely no personnel to call in, and all the other units are already short staffed. 

Situation 3 You are the charge nurse on a step-down unit. It is your first day back from a 2-week vacation. The shift begins in 10 minutes, and you sit down to make staffing assignments. The central staffing office has noted that you must float one of your RNs to the oncology unit. When you check the floating roster, you note that Jenny, one of the RNs assigned to work on your unit today, was the last to float. (She floated yesterday.) That leaves you to choose between Mark and Lisa, your other two RNs. According to the float roster, Mark floated 10 days ago, and Lisa floated last 11 days ago. You tell Lisa that it is her turn to float. Lisa states that she floated three times in a row while Mark was on vacation for 2 weeks last month. Mark says that vacations should not count and that he should not float because it is not his turn. Lisa says that Jenny should float, as she floated to oncology yesterday and already knows the patients. Jenny says that she agreed to come in and work today (on her day off) to help the unit, and she would not have agreed to do this if she had known that she would have to float. Mark says that it is the last day of a 6-day stretch, and he does not want to float. Jenny says that it is not her turn to float, and she does not want to float willingly. 

Situation 4 You are a new nurse working on a busy medical/surgical floor. The mode of patient care delivery used on the unit is team nursing. You have grown increasingly frustrated, however, with a licensed vocational nurse/licensed practical nurse on your team who is unwilling to answer call lights. You have directly observed her both ignore call lights and go out of her way to avoid answering the lights. When you confront her, she always provides an excuse such as she was on her way to do something for another patient or that she did not notice the blinking call light. The result is that you often must run from one end of the hall to the other to answer the call lights because patient safety could be at risk. Your frustration level has risen to the point that you no longer wish to work with this person. 

Situation 5 You are a staff nurse on a small telemetry unit. The unit is staffed at a ratio of one nurse for every four patients, and the charge nurse is counted in this staffing because there is a full-time unit secretary and monitor technician to assist at the desk. The charge nurse is responsible for making the daily staffing assignments. Although you recognize that the charge nurse needs to reduce her patient care assignment to have time to perform the charge nurse duties, you have grown increasingly frustrated that she normally assigns herself only one patient, if any, and these patients always have the lowest acuity level on the floor. This has placed a disproportionate burden on the other nurses, who often feel the assignment they are being given may be unsafe. The charge nurse is your immediate supervisor. She has not generally been responsive to concerns expressed by the staff to her about this problem. 

MN552

 

Watch the following videos, then complete the required assignment. Review the document in Course Resources for instructions on accessing the videos.

Lab 1

OSCE Clinical Skills

Back pain 23:59

Upon completion of watching the video write up the scenario into a SOAP format. Is there anything you would do differently on your plan?

Lab 2

OSCE Clinical Skills

Shoulder pain 24:30

Upon completion of watching the video write up the scenario into a SOAP format. Is there anything you would do differently on your plan?  

How to Submit

Submit your SOAP notes to the unit Dropbox before midnight on the last day of the unit.

Please submit your Lab directly into the text submission tool located in the Unit Lab Dropbox.

death of the child

  1. Is the death of a child with a chronic illness more tragic than that of an adult? Why or why not? Give examples.
  2. What would you do and/or say to parents who had a child with a chronic illness who is dying?
  3. Find a resource (e.g., book, article, toy, specialty) that can be used to support children through the dying process and provide a summary of how that resource is used. The resource may be intended to help children understand death or for children who are dying.

NR224 RUA Safety Goals Guidelines

NR224 RUA Safety Goals Guidelines
NR224 RUA Safety Goals GuidelinesCriteriaRatingsPtsThis criterion is linked to a Learning OutcomeIntroduction of Brochure (3 points/6%)Required Criteria
1. Includes brochure title

2. Identifies date published

3. Describes individuals or groups

4. Brochure properly cited, included on reference list, and submitted with assignment

3.0 ptsHighest Level of Performance
Includes no less than 4 required criteria.
2.0 ptsSatisfactory Level of Performance
Includes no less than 3 required criterion.
1.0 ptsUnsatisfactory Level of Performance
Includes no less than 2 required criterion.
0.0 ptsSection not present
Section not present or includes 1 or fewer required criteria.3.0 pts
This criterion is linked to a Learning OutcomeSummary of Brochure (10 points/20%)Required Criteria

1. Main topics discussed

2. Includes information to promote communication between patients and healthcare providers

10.0 ptsIncludes no less than 2 required criteria.

8.0 ptsIncludes no less than 1 required criteria

0.0 ptsSection not present
10.0 pts
This criterion is linked to a Learning OutcomeEvaluation of Brochure (20 points/40%)1. Supported with evidence from a recent (5 years)scholarly, nursing journal article

2. What was done well, and what could have been improved in the brochure?

3. Why did this topic interest you?

4. Was the information provided in the brochure beneficial? Could you incorporate it in your patient education?

5. Was the information presented clearly?

6. Did current nursing or healthcare related research support the information presented in the brochure?

7. What population or individuals does this article apply to (i.e., who will benefit the most from this brochure)? Who else can use this information?

8. Will this information increase patient safety? Defend your answer

20.0 ptsHighest Level of Performance
Includes no less than 8 required criteria.
18.0 ptsHighest Level of Performance
Includes no less than 7 required criteria.
16.0 ptsSatisfactory Level of Performance
Includes no less than 6 required criteria.
8.0 ptsUnsatisfactory Level of Performance
Section present yet includes 5 or less required criteria
0.0 ptsSection not present
No requirements for this section presented –OR –section not present.20.0 pts
This criterion is linked to a Learning OutcomeConclusion (5 points/10%)Required criteria 1.Restates main ideas

2. Includes supporting information from body of paper

3. Summarizes the benefits of following the brochure’s advice to a person at risk

5.0 ptsIncludes no less than 3 required criteria.

4.0 ptsIncludes no less than 1 requirement for section.

2.0 ptsPresent, yet includes no required criteria.

0.0 ptsSection not present.
5.0 pts
This criterion is linked to a Learning OutcomeAPA Style and Organization (2 points/4%)Required criteria

1. Adheres to all APA 6th edition formatting guidelines for title page, margins, and in-text citations, and references
2. Section headers useda.Introduction
b.Summary of brochure
c.Evaluation of brochure
d.Conclusion

2.0 ptsIncludes all required criteria

0.0 ptsDoes not include all required criteria
2.0 pts
This criterion is linked to a Learning OutcomeClarity of Writing (10 points/10%)Required criteria
1. Proper use of Standard English
2. Shows original thought
3. No spelling or grammar errors
4. Information presented in a logical progression

10.0 ptsHighest Level of Performance
Includes no less than 4 requirements for section.
9.0 ptsHigh Level of Performance
Includes no less than 3 requirements for section.
8.0 ptsSatisfactory Level of Performance
Includes no less than 2 requirements for section.
4.0 ptsUnsatisfactory Level of Performance
Includes 1 requirement for section.
0.0 ptsSection not present
No requirements for this section presented.10.0 pts
Total Points: 50.0

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