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   $25 for anyone who is good in reshearch paper can do this due by 12/16/2020 @5pm on eastern time. Exmple is provided.  

• Identify 3 short-term goals and 3 long-term goals related to your professional aspirations. You may also include a 5-year plan. These goals should be reasonable within the time frames presented.
• Describe how you plan to meet your professional goals:
  • What steps will you take?
  • What milestones will you set? (How will you know you are making progress?)
  • How will you use your strengths to meet your goals?
  • What challenges do you foresee, and how will you overcome them to succeed in meeting your goals?
• Explain how this nursing program and specific courses or assignments within it impacted your goals (goals met and goals still to achieve).
  • Identify specific achievements during your program (e.g., a goal GPA, an attendance goal, certificates, improved writing skills)
  • Self-evaluate your success at meeting the program outcomes and essentials.
• Identify memorable assignments or courses, epiphanies, or moments when your course work directly impacted your professional work.
• Describe your current nursing philosophy and reflect on how it supports your goals and aspirations.
• Be sure to include an introduction (introduce yourself briefly) and a conclusion to your presentation.
• 3 PAGES AT LEAST 2 REFERENCES 

compose a 750-1,000 word essay on a current issue relevant to your program of study (health care administration, health informatics, or public health). Clearly explain the context or background of the issue; the impact the topic or issue has on health, health care, or the professional field; and a proposal for how the issue could be successfully resolved. Support your opinions with evidence found in your researThe final essay should demonstrate the qualities of sound academic writing and incorporate three to five relevant, scholarly sources from the GCU Library.

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

Video Transcript:

KARI (on phone): This is Kari the nurse from the Emergency Department. I’m calling to give you a transfer report on Ms. Janet Lieberman. Janet is a 36-year-old woman who came because she felt weak and dizzy. She has a history of Crohn’s disease with intermittent gastritis and six months ago she had surgery and an ileostomy. Traces of serosanguineous effluent were present in her ostomy bag upon arrival. Her Blood type is A-. She is typed and cross-matched for two units of packed RBCs, so please administer as soon as they are available. She started on Infliximab IV six months ago and the last dose was given seven weeks ago. Her vital signs were temperature 98.8, pulse 114, respiration 22, blood pressure 100/60, and oxygen saturation 95%. Her hemoglobin is seven milligrams per deciliter and her hematocrit is 21%. She has an IV of 0.9% sodium chloride 1000- milliliters infusing at 150-milliliters per hour, and has 700-milliliters remaining in the bag. We started an IV while she was in ED. Her skin has been pale, warm, and dry to the touch. She voided 500-milliliters at 1500 in the ED. A hemoccult of her stool was sent to the lab. Esther: Were the coagulation tests within normal range? KARI: Yes, her pro time is 12.2, her PT is 21 seconds, and her INR is 0.7. Esther: Okay, thanks for the report. KARI: You’re welcome. I’ll bring her up to your unit in a few minutes. Esther: Thanks. KARI: Hi Esther, this is Janet Lieberman. Esther: Hi Ms. Lieberman, my name’s Esther. I’ll be taking care of you this evening. KARI: I gave you a transfer report a couple minutes ago. Ms. Lieberman needs the two units of packed RBCs as soon as possible. Esther: Okay. Ms. Lieberman, I need to take a quick look at your ostomy bag. MS. LIEBERMAN: Sure, okay. Esther: Thank you. Do you have any family here? MS. LIEBERMAN: No, I came alone to the emergency room today, but I have a sister who’s on her way to the hospital. KARI: Do you have any questions before I leave? Esther: No, thanks for the report. I can take it from here. KARI: I am going back to the Emergency Department now. Esther’s going to be taking care of you. I hope you feel better soon. MS. LIEBERMAN: Thanks so much for taking such good care of me. Esther: Ms. Lieberman, I need to ask you some questions. MS. LIEBERMAN: Okay, what else do you need to know? Esther: I need to review your abdominal status. Are you having abdominal pain? MS. LIEBERMAN: Oh yes, it’s very sore and crampy. Esther: On a scale of 0 to 10, with 0 being no pain, and 10 being unbearable, how do you rate your pain now? MS. LIEBERMAN: I would say a 6. Esther: When did the pain begin? MS. LIEBERMAN: Uh, after I got up this morning. Esther: Can I ask you where the pain is? MS. LIEBERMAN: Yes, it’s here in the top of my stomach. Esther: Okay, Have you noticed anything that brings on the pain or makes it worse? MS. LIEBERMAN: I’m pretty sure stress makes it worse. Esther: Okay. MS. LIEBERMAN: When I get stressed I don’t eat healthy foods and then I get headaches and take Ibuprofen. Esther: Okay, when you’re feeling a little bit better I’d like to review some ways to manage your stress. For now, I need to take a listen to your bowel sounds. MS. LIEBERMAN: Sure, Okay

A 52-year-old woman complains that she has been missing days of work almost every week. She states she is neglecting her family, and she is sleeping during the day but cannot sleep at night. She denies other health problems, medication, or environmental allergies.

• What are some clinical assessment tools or techniques that you could use to help diagnose this patient’s condition?
• In addition to your initial post, you must respond to at least two of your classmates’ posts in this thread. Your responses should include elements such as follow-up questions, further exploration of topics from the initial post, or requests for further clarification or explanation on some points made by the classmates.

Part 1: Dashboard
Using Microsoft Excel or PowerPoint, create a quality dashboard based on the Community General Hospital Case Study. Your dashboard must include 6–8 measures. Use mock data to represent the measures you have chosen.

Part 2: Written Summary
To accompany your dashboard, write a 2- to 3-page paper in which you do the following:

• Identify the 6–8 quality measures you have chosen for your dashboard.
• Explain why these measures are important to the organization.
• Analyze how the Triple Aim/Quadruple Aim is represented in your chosen measures. 
• Explain how you displayed the measures. Justify your choice of display.
• Provide a strategy for communicating the dashboard throughout the organization.
• Explain how the dashboard could be used as a leadership tool to improve patient outcomes.

 Medicare or Medicaid – which has greater impact in your state? (FLORIDA STATE )APA STYLE 

• 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?
  • 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?
  • 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?
  • 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.

Assignment:

Complete a Power Point to address the following questions and 2 case studies.

1. Title Slide (1 slide)
2. Explain the steps involved in CPT coding (2-4 slides)
3. What are modifiers and when are they used, provide example (2 slides)
4. What are add-ons and when are they used, provide example (2 slides)
5. Explain each type of patient (3-5 slides)
6. 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).
   1. Slide 1: Summary the case: What do you need to know about the case to start the coding process?
   2. 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?
   3. 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)

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)