Read the instructions on the word document and answer the assignment. 

Health Care Delivery Models and Nursing Practice

Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.

Include the following:

1. Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility.
2. Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.
3. Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.
4. Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.

You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.  

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. 

 1. Eleven-month-old Bianca is being assessed in the chest clinic today by the respiratory nurse. Bianca requires continuous portable oxygen via nasal prongs at 0.5 L/min. Her mother has tried to wean Bianca from oxygen during the night, but Bianca’s O2 saturation often will drop to 92% and her respiratory rate will increase. Bianca was born at 30 weeks gestation and was ventilated for the first 2 weeks of life. She has been on continuous oxygen since birth. There is a student nurse observing today. Outside the exam room, she states to the respiratory nurse that Bianca must have asthma.

-How would the respiratory nurse respond?

-What things would you be concerned about as Bianca gets older?

2. APA Style

3. 3 paragraphs of 3 sentences each

4. 2 references not older than 2015

Read the following case study and submit a 1500 – 2000 word paper that addresses the case study and the questions at the end of the case study. 

Mr. B. is an 83 year old male referred to home health services following a hospital admission for congestive heart failure. His payor source is Medicare (traditional). He lives alone and indicates he does not have sufficient financial resources to afford private-pay in home supportive care. His daughter, who lives in the neighboring county about 30 miles away, has offered her father to move in with her – he has refused and she is not “forcing the issue”. Mr. B. is also not open to discussing moving to an assisted living environment.

This is his third hospital admission for the same problem over the last 12 months and his second admission to a home health agency. He was discharged from the previous home health agency 6 weeks ago. Physician orders are for the home health agency to provide skilled nursing for assessment of his cardiac condition and to teach him about his care and medication regime. Physical therapy has been ordered to establish a home exercise program. Home health aide services have been ordered 3 times a week to assist Mr. B. with his personal care needs.

By the end of the third week of service, it is clear to the RN Case Manager that Mr. B. is not making progress to the established goals. She reports during case conference that he is not a good candidate for teaching because of intermittent confusion and forgetfulness. According to the nurse, no matter what she has tried to teach him and regardless of the aids she has used, Mr. B. continues to take is medication incorrectly. She states, “I know he needs services, but I am not sure that he is in the right environment. I am concerned about Mr. B. – I am not sure why his daughter won’t just step up and put her foot down.”

The physical therapist reports at case conference that the “client lacks motivation”. The home exercise program has been established with Mr. B.; however, he does not complete the exercises between therapy visits.

An improvement in his personal hygiene has been noted with the Home Health Aide (HHA) services. The HHA has also been successful in decluttering his living space. The HHA reports that she is concerned that he is not eating regular meals.

This situation offers an ethical challenge to the professional caregivers and to the agency for which they work. 

Discuss how you would handle this ethical dilemma. Address the following questions as a part of your response:

1. What are your concerns about this case?
2. How does the RN Case Manager meet her ethical responsibilities to the patient and to the organization?
3. What is the best plan of action to ensure the client’s safety and well-being?
4. What are realistic outcomes and goals for this client?
5. Who will provide the ongoing care needs required by this client?

Assignment: Structural Versus Strategic Family Therapies

Although structural therapy and strategic therapy are both used in family therapy, these therapeutic approaches have many differences in theory and application. As you assess families and develop treatment plans, you must consider these differences and their potential impact on clients. For this Assignment, as you compare structural and strategic family therapy, consider which therapeutic approach you might use with your own client families.

Learning Objectives

Students will:

• Compare structural family therapy to strategic family therapy
• Create structural family maps
• Justify recommendations for family therapy

To prepare:

• Review this week’s Learning Resources and reflect on the insights they provide on structural and strategic family therapies.
• Refer to TherapistAid (2020) in this week’s Learning Resources for guidance on creating a structural family map.

The Assignment

In a 2- to 3-page paper, address the following:

• Summarize the key points of both structural family therapy and strategic family therapy.
• Compare structural family therapy to strategic family therapy, noting the strengths and weaknesses of each.
• Provide an example of a family in your practicum using a structural family map. Note: Be sure to maintain HIPAA regulations.
• Recommend a specific therapy for the family, and justify your choice using the Learning Resources.

Assignment 2: Experiential Versus Narrative Family Therapies

This assignment was introduced to you in Week 3.

Although experiential therapy and narrative therapy are both used in family therapy, these therapeutic approaches have many differences in theory and application. As you assess families and develop treatment plans, you must consider these differences and their potential impact on clients. For this Assignment, you compare Experiential and Narrative Family Therapy.

Learning Objectives

Students will:

• Compare experiential family therapy to narrative family therapy
• Justify recommendations for family therapy

To prepare:

Students will:

• Compare experiential family therapy to narrative family therapy
• Justify recommendations for family therapy

To prepare:

• Review this week’s Learning Resources and reflect on the insights they provide on experiential and family therapies.

The Assignment

In a 2- to 3-page paper, address the following: 

• Summarize the key points of both experiential family therapy and narrative family therapy. 
• Compare experiential family therapy to narrative family therapy, noting the strengths and weaknesses of each.
• Provide a description of a family that you think experiential family therapy would be appropriate, explain why, and justify your response using the Learning Resources. 

Note: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided by the Walden Writing Center provides examples of those required elements (available at  http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

Part 2: Family Genogram

Develop a genogram for the client’s family you selected. The genogram should extend back at least three generations (parents, grandparents, and great grandparents).

Research videos and websites about mission and vision statements in health care organizations.

Write a 175- to 265-word response to the following questions:

• What did you find the most interesting? What did you find to be the most positive? Provide details.

Need case studies done pls. two different answer . same question

Patient is a 24-year-old female administrative assistant who comes to the emergency department with a chief complaint of severe right-sided headache. She states that this is the sixth time in the last 2 months she has had this headache. She says the headaches last 2–3 days and have impacted her ability to concentrate at work. She complains of nausea and has vomited three times in the last 3 hours. She states, “the light hurts my eyes.” She rates her pain as a 10/10 at this time. Ibuprofen and acetaminophen ease her symptoms somewhat but do not totally relieve them. No other current complaints.

In your Case Study Analysis related to the scenario provided, explain the following:

• Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
• Any racial/ethnic variables that may impact physiological functioning.
• How these processes interact to affect the patient.

Part 1 – Getting Started

Balancing School and Life – My Quality of Life Self-Care Plan. The purpose of developing this Plan is to set a framework and a plan to maintain wellness and to stay motivated and engaged throughout your Program. Doing this will help you achieve success during your coursework and as a professional nurse.

The goal of the Project is to help you become self-aware and reflective as a means of identifying personal self-care strategies that will increase your energy and help you manage your stress. The Project will give you a chance to learn how this is accomplished as you will be doing similar work with clients during the Program and as a professional nurse to assist them in the same way.

Use the Quality of Life Self-Care Wheel to assess your current state. After you determine your scores, in a 2-3 page paper complete the following:

1. Discuss those areas that are strengths (higher scores) and those areas that need further development (lower scores).

2. Identify two strategies you can use to maintain or maximize each identified strength. 

3. Identify two strategies you can use to strengthen each area needing development. Explain how you will put these strategies into action. Be specific. For example, instead of stating, “I need to exercise,” your action should state “I will begin to walk 20 minutes a day, 3 days a week.” The action should be SMART- Specific, Measurable, Attainable, Realistic, Timeframe 

4. Also attach your completed form

• Minimum length 2-3 pages not including cover or reference. APA formatting

Submit your completed assignment by following the directions linked below. 

Save your assignment as a Microsoft Word document. (Mac users, please remember to append the ‘.docx’ extension to the filename.) 

E9-5,7,8,9 (p.103-104), E10-2,3,5,7,8 (p.113-114) and E12 – 1,2,3,8,9 (p.133-135)