Medicare or Medicaid – which has greater impact in your state? (FLORIDA STATE )APA STYLE
6008 Assessment 2
- Develop a 4–7-page business case for the initiative you proposed in Assessment 1. Examine feasibility and cost-benefit considerations over a 5-year period, analyze ways to mitigate risks, and complete a cost-benefit analysis.
Note: Each assessment in this course builds upon the work you have completed in previous assessments. Therefore, you must complete the assessments in the order in which they are presented.
SHOW LESSAs a master’s-level health care practitioner, you are expected to consider a number of factors when analyzing the feasibility of a new initiative. For example, you must consider the various types of risk (such as patient safety, physical plant, financial, or reputation), as well as the present and future value of the service line or economic opportunity in which you are investing. You must also balance your ethical and moral responsibility to provide quality care to patients and populations with your responsibility to protect your organization’s assets and economic viability in the near and long terms.
Competency Map
CHECK YOUR PROGRESSUse this online tool to track your performance and progress through your course. - Toggle DrawerResources
- Assessment InstructionsDevelop a business case for the economic initiative you proposed in Assessment 1. Examine the feasibility and cost-benefit considerations of implementing your proposed initiative over the next five years. Analyze ways to mitigate risks and complete a cost-benefit analysis.
Note: Remember that you can submit all, or a portion of, your draft business case to Smarthinking for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
Requirements
The requirements for your business case, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format and length and for supporting evidence.- Analyze the potential economic opportunities and risks associated with your proposed initiative.
- How do the potential opportunities benefit your organization or care setting?
- How could potential risks pose a threat to the financial security of your organization or care setting?
- How do the potential economic opportunities compare to the potential economic risks?
- Propose ethical and culturally sensitive solutions that address the risks associated with your initiative to the future economic security of your organization or care setting.
- Which risks are potentially the most significant for your organization or care setting?
- How could you modify your proposed initiative to mitigate those risks?
- How have other organizations and experts in the field dealt with similar risks?
- How do ethics and equality factor into your proposed solutions?
- Are your solutions unfairly burdening or disadvantaging any specific groups?
- How will this proposal affect community health care delivery outcomes?
- What makes this a great opportunity for economic growth?
- What potential issues should be considered?
- Which risks are potentially the most significant for your organization or care setting?
- Analyze the economic costs and benefits of your proposed initiative over a five-year period.
- Use the Cost-Benefit Analysis Template [XLSX] for your calculations. Add the worksheet to your business case as an appendix.
- Does your analysis warn against specific aspects of your proposed initiative?
- How would you recommend that your findings be incorporated into decisions about the feasibility of your proposed initiative?
- Propose ethical and culturally equitable ways of keeping costs under control, while maximizing the benefits of your initiative.
- What costs are you most likely to be able to control or reduce?
- How would you go about ensuring this?
- How could controlling or reducing these costs affect the benefits of your proposed initiative?
- What strategies could you employ to maintain or maximize these benefits, while controlling or reducing costs?
- How do you plan to ensure that any cost controls or benefit reductions are ethical and equitable?
- What costs are you most likely to be able to control or reduce?
- Justify the relevance and significance of the quantitative and qualitative economic, financial, and scholarly evidence you used to support your business case.
- This criterion applies to any evidence you cited throughout your business case. Your evidence should be persuasive and relevant to your findings, proposals, and recommendations. Consider one or more of the following questions when citing support evidence:
- How is the evidence relevant to your organization or care setting?
- How is the evidence relevant to your proposed economic initiative?
- How does the evidence illustrate a solution that has been successful in the past?
- How does the evidence illustrate that an initiative or solution is likely to be a net benefit to the organization or care setting?
- This criterion applies to any evidence you cited throughout your business case. Your evidence should be persuasive and relevant to your findings, proposals, and recommendations. Consider one or more of the following questions when citing support evidence:
- Write concisely and directly, using active voice.
- Proofread your document before you submit it to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your business case.
- Apply current APA formatting to in-text citations and references.
- Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:
- Assessment 2 Example [PDF].
- ADDITIONAL REQUIREMENTS
Your assessment should also meet the following requirements: - Format: Format your business case using APA current style. Use the APA Style Paper Template [DOCX]. An APA Style Paper Tutorial [DOCX] is also provided to help you in writing and formatting your business case. Be sure to include:
- A title page and references page. An abstract is not required.
- A running head on all pages.
- Appropriate section headings.
- Length: Your business case should be 4–7 pages in length, not including the title page and references page.
- Supporting evidence: Cite 4–5 authoritative and scholarly resources to support your business case. Be sure that your sources include specific economic data.
- Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, after your work has been evaluated.
Portfolio Prompt: You may choose to save your business case to your ePortfolio.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment scoring guide criteria: - Competency 1: Analyze the effects of financial and economic factors (such as cost-benefit, supply and demand, return on investment, and risks) in a health care system on patient care, services offered, and organizational structures and operation.
- Analyze the potential economic opportunities and risks associated with a proposed initiative.
- Analyze the economic costs and benefits of a proposed initiative over a five-year period.
- Competency 2: Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and services offered.
- Propose ethical and culturally equitable ways of keeping costs under control, while maximizing the benefits of an initiative.
- Competency 3: Justify the qualitative and quantitative information used to guide economic decision making to stakeholders and colleagues.
- Justify the relevance and significance of the quantitative and qualitative economic, financial, and scholarly evidence used to support a business case.
- Competency 4: Develop ethical and culturally equitable economic strategies to address dynamic environmental forces and ensure the future security of an organization’s resources and its ability to provide quality care.
- Propose ethical and culturally sensitive solutions that address the risks associated with an initiative to the future economic security of the organization or care setting.
- Competency 5: Produce clear, coherent, and professional written work, in accordance with Capella writing standards.
- Write concisely and directly using active voice.
- Apply APA formatting to in-text citations and references.
- Analyze the potential economic opportunities and risks associated with your proposed initiative.
Healthcare reimbursement
Assignment:
Complete a Power Point to address the following questions and 2 case studies.
- Title Slide (1 slide)
- Explain the steps involved in CPT coding (2-4 slides)
- What are modifiers and when are they used, provide example (2 slides)
- What are add-ons and when are they used, provide example (2 slides)
- Explain each type of patient (3-5 slides)
- For each case study, complete the 3 steps of CPT coding providing rational for your choice of answer and provide the correct CPT code. (3-4 slides per case study, do not include case study in PowerPoint).
- Slide 1: Summary the case: What do you need to know about the case to start the coding process?
- Slide 2: State the procedure to be completed and where the procedure is taking place (hospital or surgery center). What is the CPT code at this point?
- Slide 3: Is there is a need for a modifier or add on for the case? If so explain why and state the updated code
The following websites provide free code look up: https://www.aapc.com/code/, https://www.findacode.com/search/search.php, https://www.supercoder.com/
These websites do offer a free trial and somethings you can find codes without signing up.
Case study one:
Preoperative diagnosis: Morbid obesity
Procedure: Cancellation of gastric bypass, secondary to skin infection
Complications: As above
Indications: A 30-year-old female with a long history of morbid obesity, recently underwent silastic gastric banding, and due to reflux disease, subsequently required a procedure to loosen the band. Most recently she has experienced significant reflux disease, and presents for removal of her band and open Roux-en -Y gastric bypass.
Description of procedure: The patient was brought to the operating room and placed in the supine position. General endotracheal anesthesia was administered. The patient’s gown was removed for prepping, at which point clinicians noticed there were small, acne like lesions over the anterior surface of her abdomen, her intriginous areas, and on her legs. Several of
the lesions fell on the incision line.
Additionally, there was a large midline abdominal wall defect, which was assumed to represent an abdominal wall hernia, and most likely will require a mesh repair. For these two reasons the case was canceled after general anesthesia was administered. The patient was awakened from anesthesia and taken to the recovery room.
There were no immediate complications evident, with the exception of cancellation of the case after general anesthesia.
Case study two:
Clinical diagnosis: Obstructive sleep apnea
Operation: Aborted uvulopalatopharyncoplasty
Postoperative diagnosis: Same
Description of procedure: After obtaining informed consent, the patient was taken to the operating room and placed in a supine position. The patient was properly identified, and the anesthesia service performed bilateral superior laryngeal nerve blocks and applied topical anesthesia to the oropharynx. Attempts were made to orally intubate the patient, using a fiberoptic scope.
The patient exhibited significant coughing and gagging with the procedure. It was extremely difficult to visualize the larynx. After multiple unsuccessful attempts, the procedure was aborted. We decided to take the patient to the recovery room and discuss further treatments of his obstructive sleep apnea, including tracheostomy. The patient was taken to the recovery room in stable condition. There were no complications associated with the procedure.
Summary of findings: Aborted uvulopalatopharyncoplasty, secondary to difficulty with fiberoptic oral intubation
Assignment Expectations:
- Length:
- 16 – 22 slides
- Structure:
- Use the tips at http://www.garrreynolds.com/preso-tips/design/ to create the slideshow. Because good PowerPoints have very few words, submit a script that describes the content of each slide – about 50 words per slide (placed in the Notes Pages).
- Title and reference slides are required
- References:
- Need to be in APA format on a reference slide, and cited in the slides.
- Format:
- Save your assignment as a Microsoft PowerPoint (.ppt or .pptx)
Concepts and theories in nursing
Nightingale Case Study
Assignment Description:
Write a 1000-1500-word APA paper addressing each of the following points. Be sure to completely answer all the questions for each bullet point. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least three (3) outside sources and the textbook using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.
Case Study: Mrs. Adams, a 68-year-old widow who was referred to case management upon discharge from the hospital based on her physician’s recommendation that she is not able to care for herself independently. Her diagnosis is diabetes, hypertension, and breast cancer. She is 5 days’ post-op from a right sided mastectomy. Mrs. Adams apartment is located in a low-income area of the city where crime is prevalent. Upon assessment by the Community Health Nurse, Mrs. Adams apartment was in disorder with minimal airflow or light. Her clothes appeared unchanged and she had no food in the apartment. The small apartment also housed 3 cats and a small dog who Mrs. Adams considers family since the death of her husband 1 year ago. Mrs. Adams complains of pain and draining from her surgical site and a broken air conditioner.
- Using Nightingale’s Environmental Theory, what actions would the nurse take upon the first assessment? What are the five essential components?
- What would be an appropriate plan of care be for Mrs. Adams? How would you prioritize the care plan?
- Apply Nightingale’s Environmental Theory to an area of your nursing practice? What patient-population would benefit from this approach? Support this practice change with at least one evidenced-based article.
Assignment Expectations:
Length: 1000 – 1500 words
Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three (3) outside scholarly sources and the textbook are required for this assignment.
Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.
Format: Save your assignment as a Microsoft Word document (.doc or .docx)
Public Health Discussion
Healthcare for undocumented immigrant.
Use four articles provided.
Therapeutic Communication
Therapeutic communication is the foundation of mental health nursing. It is how mental health nurses build therapeutic rapport. Watch the video below and answer each question that follows it.
https://youtu.be/W1RY_72O_LQ
1.) What forms of verbal and nonverbal communication did the nurse use incorrectly?
2.) What would you do differently?
3.) How does therapeutic communication affect patient care?
APA format, use scholarly article and follow the attached rubric.
Physiology and Pharmacology (Due 24 hours)
1) Minimum 8 full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)
Part 1: Minimum 3 pages
Part 2: minimum 3 pages
Part 3: minimum 2 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 4 references per part not older than 5 years
5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next
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: Physiology
The purpose of the case study is to have you expand upon the pathophysiological disease process by searching for evidence-based practice treatment and advanced practice nursing role implications related to the disease.
Topic: Hypertension
1. Discuss how the patient’s lifestyle and environment impacts the disease process.
2. Identify evidence-based pharmacologic and non-pharmacologic interventions appropriate for the selected disease process.
3. Identify evidence-based treatment guidelines for the selected processes.
4. Analyze current evidence-based treatment modalities specific to the aging population
a. Include evidence-based treatment guidelines for the selected processes.
5. A discussion of the pathophysiology of the disease, including signs and symptoms.
6. An explanation of diagnostic testing and rationales for each.
7. A review of different evidence-based treatment modalities for the disorder obtained from guideline.gov or a professional organization.
8. How does the information in this case inform the practice of a master’s prepared nurse?
9. How should the master’s prepared nurse use this information to design a patient education session for someone with this condition?
10 . What was the most important information presented in this case?
11. What was the most confusing or challenging information presented in this case?
12. Discuss a patient safety issue that can be addressed for a patient with the condition presented in this case.
Part 2: Medication Paper Rough Draft – Ubrelvy (See paper outline attached)
The purpose of this assignment is to draft and submit a comprehensive and complete rough draft of your medication paper in APA format.
Your rough draft should include all of the research paper elements of a final draft.
Include the following in your rough draft:
1. Abstract
2. Introduction
3. Development the Headings in the outline (see file attached)
4. Conclusion
Part 3: Financing Health Care
Topic: The promise of guaranteed health care coverage for all.
position: CON/AGAINST
Refute the following opinions (Half a page for each point):
1. A choice for a Health Care System on the resolution would be a shared public taxes where everyone is equal.
2. Need for primary care physicians to be increased because of the uneven ratio of them and patients.
3.Having health care coverage will encourage people to look for medical attention when they need it.
4. The requirement for the people can access to health care free is to fulfill the requirements such as annual check-ups and up-to-date immunizations.
Evidence Base in Design
When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.
PLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW:
1). ZERO (0) PLAGIARISM
2). ATLEAST 5 REFERENCES, NO MORE THAN 5 YEARS
3). PLEASE SEE THE FOLLOWING ATTACHED RUBRIC DETAILS.
Thank you.
In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.
To Prepare:
Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
Review the health policy you identified and reflect on the background and development of this health policy.
Write a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.
Response to a discussion post. Advanced Health Assessment
Reading Assignment
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 1, “The History and Interviewing Process”This chapter explains the process of developing relationships with patients in order to build an effective health history. The authors offer suggestions for adapting the creation of a health history according to age, gender, and disability.
Chapter 5, “Recording Information”This chapter provides rationale and methods for maintaining clear and accurate records. The authors also explore the legal aspects of patient records.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–29)
Shadow Health Support and Orientation Resources
Use the following resources to guide you through your Shadow Health orientation as well as other support resources:
Document: Shadow Health. (2014). Useful tips and tricks (Version 2) (PDF)
Document: Shadow Health Nursing Documentation Tutorial (Word document)
Optional Resource
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw- Hill Medical.
Chapter 2, “History Taking and the Medical Record” (pp. 15–33)
Required Media (click to expand/reduce)
Discussion: Building a Health History
Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.
For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.
To prepare:
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
- By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
- How would your communication and interview techniques for building a health history differ with each patient?
- How might you target your questions for building a health history based on the patient’s social determinants of health?
- What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
- Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
- Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
- Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
Case Study
16-year-old white pregnant female living in an inner-city neighborhood
- How would your communication and interview techniques for building a health history differ with each patient?
The interview process has to be adjusted pending on the age group, gender, financial status, culture, and language barrier of the individual being assessed. One must provide a private area and be close to the patient during the interview to provide comfort. Use of laymen’s terms helps the individual to understand healthcare information clearly. Making eye contact is especially important unless there is a cultural factor involved. Taking notes should be minimal and if using a computer; it should be positioned so the patient can see the screen as well. Introduce one’s self to the patient and others present and use their names to build a friendly trustworthy environment.
reluctant to talk and have a clear need for confidentiality (Stewart, 2019).
When speaking with my adolescent patient I would emphasize that our discussion is confidential with limitations if there is a danger to her or others. We will speak privately unless she wants someone else present. She will be given the opportunity to discuss whatever topics she feels comfortable discussing.
- How might you target your questions for building a health history based on the patient’s social determinants of health?
There are several areas to concentrate on to build a history based on social determinants of health. One should enquire about the individual’s personal status, sexual history, living conditions, occupation, environment, military record, and social needs.
According to the information provided my patient lives in an inner city neighborhood. This may be an indication of poverty and limited resources. One would inquire if housing, clothing, food, and access to medical care are adequate. If they are not, community resource information would be provided and a social worker referral to aide her. Also, one must ascertain if she is in an abusive relationship or being abused at home.
- What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
Assessing an individual’s health risks is very important in determining what potential health problems one may face. “One of the main goals of documenting the social history (SH) of the patient is to identify factors outside of past or current medical conditions that may influence the patient’s overall health or behaviors that create risk factors for specific conditions” (Sullivan, 2018). Asking what their eating habits are, do they exercise, how much alcohol do they consume, do they smoke cigarettes, do they use recreational drugs, what are their sleeping habits, do they take their medications as prescribed, do they practice unsafe sex, and what is their family history of medical problems. Also, inquiring about their family history of mental illness is important. Religion and culture can affect how the individual’s treatment plan will be developed.
One would obtain the young lady’s family health history at this time to determine if she is at risk for familial issues during her pregnancy. This would be a great opportunity to provide prenatal education and stress the importance of continuity of care during pregnancy.
- Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
Adolescent girls are more likely to die during childbirth than women in their twenties or older. If a pregnancy is unplanned, the mother may not be getting the prenatal care she and her baby need or may not even be healthy enough to carry a child to term.
- Teens are often unprepared for the realities involved in parenting an infant. Often, complex relationships and financial burden combined with balancing school and parenting are stressful and can put a newborn at risk.
- Teens who are pregnant or raising a baby have a hard time finishing school. Only 3 percent of teens who have a baby receive their college diploma before the age of 30.
- Many teen parents are single. Being a single parent can have financial and emotional stressors and a stressed parent puts a baby at risk.
- Parents often need resources to help them navigate their child’s well-being and development. Teens may not be aware of this type of assistance. (Heuristic, 2016)
References
Heuristic. (2016). Risks of Teen Pregnancy. Retrieved from: (nationwidechildrens.org)
Stewart, B.S.J.B.J.F.J.D. R. (2019) Seidel’s Guide to Physical Examination. [VitalSource
Bookshelf]. Retrieved from https://bookshelf.vitalsource.com/#/books/9780323481953/
Sullivan, D. D. (2018). Guide to Clinical Documentation. [VitalSource Bookshelf]. Retrieved
from https://bookshelf.vitalsource.com/#/books/9780803694194/
Photo Credit: Getty Images/Caiaimage
follow up discussion
Follow up discussion please one paragraph using same resource 2 citation and reference add information or comment on the following post
A systemic review of literature is a structured and well-guided search for available literature that have been reviewed, free of bias, and can be recommended for practice. (Houser, 2016). According to Houser (2016), conducting a systematic review that results in an evidence-based practice guideline requires the ability to develop research questions methodically, write inclusion criteria, conduct in-depth literature searches, and review the results of many studies critically (p.10). It is therefore important for a nurse to be well knowledgeable about ways to identify and review articles that are evidence-based and can be safely implemented during patient care. Below are some of the importance of systemic review literature stated by Boren and Moxley (2015)
- It prevents personal options and bias that may result in patient harm
- A reviewed literature provides the opportunity for continuous study and improvement.
- A systematic review draws upon the best health services research principles and methods to address specific medical issues.
- Gives researchers the opportunity to examine current practices
- Helps with the development of guidelines for practice and work-related policies
References
Boren, S. A., & Moxley, D. (2015). Systematically Reviewing the Literature: Building the Evidence for Health Care Quality. Missouri Medicine, 112(1), 58–62.
Houser, J. (2016). Nursing research: Reading, using and creating Evidence. [VitalSource Bookshelf]. Retrieved from https://online.vitalsource.com/#/books/9781284138887/