In addition to the core EHR administrative and clinical functions, system applications are often acquired to support additional departments within the hospital or other healthcare organizations Health Information Technology. One application is a supporting Financial System with components to assist the billing and coding department in capturing and processing patient claims as part of the Revenue Cycle Management process.

It is recommended that you work on this assignment as you complete your Unit 3 activities, and view lectures and interviews. Your responses should be thorough, well-conceived college-level responses that are grammatically correct. When you answer these questions, justify your responses with facts and details from the readings, and with your conclusions. Please write your answers in complete sentences.

1. Identify three steps in the revenue cycle management process and apply its relationship to the billing and coding process
2. Discuss the responsible party and their role (ex: pre-registration, front desk, clinical, etc.) in executing each of the three steps.
3. Assess the impact of each of the three steps on the revenue cycle management process when not completed accurately. Recommend one method for revising inaccuracies in each step.

Description

• Explain your diagnosis for the patient, including your rationale for the diagnosis.
• Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
• Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.
• Please use the following case for this assignment:

DC is a 46-year-old female who presents with a 24-hour history of RUQ pain. She states the pain started about 1 hour after a large dinner she had with her family. She has had nausea and on instance of vomiting before presentation.

PMH: Vitals:

HTN Temp: 98.8^oF

Type II DM Wt: 202 lbs

Gout Ht: 5’8”

DVT – Caused by oral BCPs BP: 136/82

HR: 82 bpm

Current Medications: Notable Labs:

Lisinopril 10 mg daily WBC: 13,000/mm³

HCTZ 25 mg daily Total bilirubin: 0.8 mg/dL

Allopurinol 100 mg daily Direct bilirubin: 0.6 mg/dL

Multivitamin daily Alk Phos: 100 U/L

AST: 45 U/L

ALT: 30 U/L

Allergies:

• Latex
• Codeine
• Amoxicillin

PE:

• Eyes: EOMI
• HENT: Normal
• GI:bNondistended, minimal tenderness
• Skin:bWarm and dry
• Neuro: Alert and Oriented
• Psych:bAppropriate mood

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references

Background:

The 2019–2020 coronavirus pandemic is an ongoing disease that has devastated many countries all over the world. The outbreak was identified in Wuhan, China in December 2019. The World Health Organization declared the outbreak to be a Public Health Emergency of International Concern on January 30, 2020, and recognized it as a pandemic on March 11, 2020. As of April 27, 2020, more than 3 million cases of COVID-19 have been reported in 185 countries and territories, resulting in more than 208,000 deaths. More than 878,000 people have recovered.

Assignment: (See the Rubric for assignment grading)

Based on your knowledge of the pandemic and its effects on the United States (US), please provide a 3 page, double spaced APA format  written report of the following areas:

• ?  What is the role of politics during the pandemic, and its influence on healthcare, education, equity and economy.
• ?  If citizens are not well in a country, various industries may be negatively impacted because the citizens cannot work to produce goods. This is my definition of the country’s health. What is the role of the “country’s health” on the following industries: food & agriculture, automotive, and entertainment. How has the country’s health influenced these industries?
• ?  If you were currently employed as a public health professional in the US, what would be your recommendation to improve the current health crisis and get Americans back to work safely.

Read Chapter 14 in Alligood (2022).  Orem states there is a need for a nursing language that is enabling for thinking nursing and articulating with other disciplines and for communicating nursing to others in nursing practice situations.

Describe what you think it means to “think nursing?” 

Give an example of nursing language and describe how it is effective for nursing communication. 

What barriers have you experienced in communicating nursing to others?  

Read Chapter 15 in Alligood (2022).    King discusses the goal setting process.

Share a clinical experience where goal setting was or would have been helpful. 

What consequences did you experience because of missed goals? 

What level of insistence can a nurse use for pursuit of a goal? 

Reference in APA format and use NARRATIVE FORM. PLEASE USE RUBIC

Reference

Alligood, M.R. (2022). Nursing theorists and their work (10th ed.).  Elsevier.

NUR – 600Discussion Forum Rubric

Data Analysis and Quality Improvement Initiative Proposal

Prepare an 8-page data analysis and quality improvement initiative proposal based on a health issue of interest. Include internal and external benchmark data, evidence-based recommendations to improve health care quality and safety, and communication strategies to gain buy-in from all interprofessional team members responsible for implementing the initiative.

Instructions

Use your current role as Director of Nursing. Choose a quality improvement initiative of professional interest to you. Your current organization is probably working on quality improvement initiatives that can be evaluated, so consider starting there.

To develop your proposal, you will:

· Gather internal and external benchmark data about your quality improvement initiative proposal.

· Analyze the data you have collected.

· Make evidence-based recommendations about how to improve health care quality and safety relating to your chosen issue.

Remember, your initiative’s success depends on the interprofessional team’s commitment to the QI initiative. Think carefully about these stakeholders and how you plan to include them in the process, as they will help you develop and implement ideas and sustain outcomes. Also, remember how important external stakeholders, such as patients and other health care delivery organizations, are to the process. As you are preparing this assessment, consider carefully the communication strategies you will employ to include the perspectives of all internal and external stakeholders in your proposal.

The following numbered points correspond to the grading criteria in the scoring guide. The bullets below each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your proposal addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels related to each grading criterion.

1. Analyze data to identify a health care issue or area of concern.

. Identify the type of data you are analyzing from your institution or from the Vila Health activity.

. Explain why data matters. What does data show related to outcomes?

. Analyze the dashboard metrics. What else could the organization measure to enhance knowledge?

. Present dashboard metrics related to the selected issue that are critical to evaluating outcomes.

. Assess the institutional ability to sustain processes or outcomes.

. Evaluate data quality and its implications for outcomes.&

· Determine whether any adverse event or near-miss data needs to be factored in to outcomes and recommendations.

. Examine the nursing process for variations or performance failures that could lead to an adverse event or near miss.

. Identify trends, measures, and information needed to critically analyze specific outcomes.

. Specify desired outcomes related to prevention of adverse events and near misses.

. Analyze which metrics indicate future quality improvement opportunities.

· Develop a QI initiative proposal based on a selected health issue and supporting data analysis.

. Determine benchmarks aligned to existing QI initiatives set by local, state, or federal health care policies or laws.

. Identify any internal existing QI initiatives in your practice setting or organization related to the selected issue. Explain why they are insufficient.

. Evaluate external national or international QI initiatives on the selected health issue with existing quality indicators from other facilities, government agencies, and nongovernmental bodies on quality improvement.

. Define target areas for improvement and the processes to be modified to improve outcomes.

. Propose evidence-based strategies to improve quality.

. Analyze challenges that meeting prescribed benchmarks can pose for a health care organization and the interprofessional team.

· Communicate QI initiative proposal based on interdisciplinary team input to improve patient safety and quality outcomes and work-life quality.

. Define interprofessional roles and responsibilities relating to data and the QI initiative.

. Explain how to ensure all relevant interprofessional roles are fully engaged in this effort.

. Identify how outcomes will be measured and data used to inform interprofessional team performance related to specific tasks.

. Reflect on the impact of the proposed initiative on work-life quality of the interprofessional team.

. Describe how the initiative enhances work-life quality due to improved strategies supporting efficiency.

· Determine communication strategies to promote quality improvement of interprofessional care.

. Identify interprofessional communication strategies that will help to promote and ensure the success of the QI initiative.

. Identify communication models, such as SBAR and CUS, to include in your proposal.

. SBAR stands for Situation, Background, Assessment, Recommendation.

. CUS stands for “I am Concerned about my resident’s condition; I am Uncomfortable with my resident’s condition; I believe the Safety of the resident is at risk.”

· Communicate QI initiative proposal in a professional, effective manner, writing clearly and logically, with correct use of grammar, punctuation, and spelling.

· Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.

NRNP/PRAC 6665 & 6675 Comprehensive Focused SOAP Psychiatric Evaluation Template

Week 5: Mood and Anxiety Disorders in Children and Adolescents

School and going out with my friends used to be fun, but not anymore. Mom keeps telling me just to go out and have fun, but I don’t see the point of trying. All my friends are better than I am. I keep having these headaches and just feel worthless. I used to get As and Bs in school, but not anymore. I can’t concentrate at school. I would rather be at home sleeping.

—Madison, age 16

Mood and anxiety disorders can be particularly challenging to address in childhood and adolescence for many reasons. Children may not be able to fully express or understand their feelings and behaviors. Parents may misattribute or not recognize signs and symptoms. The symptoms of disorders also vary when present in children as opposed to adults. The PMHNP needs to know how to diagnose these conditions and must understand the importance of integrating medication management strategies with both individual and family therapy to optimize treatment outcomes.

Learning Objectives

Students will:

· Explain signs and symptoms of mood and anxiety disorders in children and adolescents

· Explain the pathophysiology of mood and anxiety disorders in children and adolescents

· Explain diagnosis and treatment methods for mood and anxiety disorders in children and adolescents

· Develop patient education materials for mood and anxiety disorders in children and adolescents

Learning Resources

Required Readings (click to expand/reduce)

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

· Chapter 3, “Common Clinical Concerns”

· Chapter 7, “A Brief Version of DSM-5″

· Chapter 8, “A stepwise approach to Differential Diagnosis”

· Chapter 10, “Selected DSM-5 Assessment Measures”

· Chapter 11, “Rating Scales and Alternative Diagnostic Systems”

Shoemaker, S. J., Wolf, M. S., & Brach, C. (2014). The patient education materials assessment tool (PEMAT) and user’s guide. Agency for Healthcare Research and Quality. https://www.ahrq.gov/sites/default/files/publications/files/pemat_guide.pdf

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

· Chapter 60, “Anxiety Disorders”

· Chapter 61, “Obsessive Compulsive Disorder”

· Chapter 62, “Bipolar Disorder in Childhood”

· Chapter 63, “Depressive Disorders in Childhood and Adolescence” 

Required Media (click to expand/reduce)

Center for Rural Health. (2020, May 18). Disruptive mood dysregulation disorder & childhood bipolar disorder [Video]. YouTube. https://youtu.be/tSfYXkst1vM

Mood Disorders Association of BC. (2014, November 20). Children in depression [Video]. YouTube. https://youtu.be/Qg-BBKB1nJc

Psych Hub Education. (2020, January 7). LGBTQ youth: Learning to listen. [Video]. YouTube. https://www.youtube.com/watch?v=Wn4AVjMMYX4

Medication Review

Review the FDA-approved use of the following medicines related to treating mood and anxiety disorders in children and adolescents.

Assignment: Patient Education for Children and Adolescents

Patient education is an effective tool in supporting compliance and treatment for a diagnosis. It is important to consider effective ways to educate patients and their families about a diagnosis—such as coaching, brochures, or videos—and to recognize that the efficacy of any materials may differ based on the needs and learning preferences of a particular patient. Because patients or their families may be overwhelmed with a new diagnosis, it is important that materials provided by the practitioner clearly outline the information that patients need to know.

Photo Credit: Getty Images

For this Assignment, you will pretend that you are a contributing writer to a health blog. You are tasked with explaining important information about an assigned mental health disorder in language appropriate for child/adolescent patients and/or their caregivers. 

To Prepare

· By Day 1, your Instructor will assign a mood or anxiety disorder diagnosis for you to use for this Assignment.

· Research signs and symptoms for your diagnosis, pharmacological treatments, nonpharmacological treatments, and appropriate community resources and referrals.

The Assignment

In a 300- to 500-word blog post written for a patient and/or caregiver audience, explain signs and symptoms for your diagnosis, pharmacological treatments, nonpharmacological treatments, and appropriate community resources and referrals. Although you are not required to respond to colleagues, collegial discussion is welcome. 

Week 5: Mood and Anxiety Disorders in Children and Adolescents

School and going out with my friends used to be fun, but not anymore. Mom keeps telling me just to go out and have fun, but I don’t see the point of trying. All my friends are better than I am. I keep having these headaches and just feel worthless. I used to get As and Bs in school, but not anymore. I can’t concentrate at school. I would rather be at home sleeping.

—Madison, age 16

Mood and anxiety disorders can be particularly challenging to address in childhood and adolescence for many reasons. Children may not be able to fully express or understand their feelings and behaviors. Parents may misattribute or not recognize signs and symptoms. The symptoms of disorders also vary when present in children as opposed to adults. The PMHNP needs to know how to diagnose these conditions and must understand the importance of integrating medication management strategies with both individual and family therapy to optimize treatment outcomes.

Learning Objectives

Students will:

· Explain signs and symptoms of mood and anxiety disorders in children and adolescents

· Explain the pathophysiology of mood and anxiety disorders in children and adolescents

· Explain diagnosis and treatment methods for mood and anxiety disorders in children and adolescents

· Develop patient education materials for mood and anxiety disorders in children and adolescents

Learning Resources

Required Readings (click to expand/reduce)

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

· Chapter 3, “Common Clinical Concerns”

· Chapter 7, “A Brief Version of DSM-5″

· Chapter 8, “A stepwise approach to Differential Diagnosis”

· Chapter 10, “Selected DSM-5 Assessment Measures”

· Chapter 11, “Rating Scales and Alternative Diagnostic Systems”

Shoemaker, S. J., Wolf, M. S., & Brach, C. (2014). The patient education materials assessment tool (PEMAT) and user’s guide. Agency for Healthcare Research and Quality. https://www.ahrq.gov/sites/default/files/publications/files/pemat_guide.pdf

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

· Chapter 60, “Anxiety Disorders”

· Chapter 61, “Obsessive Compulsive Disorder”

· Chapter 62, “Bipolar Disorder in Childhood”

· Chapter 63, “Depressive Disorders in Childhood and Adolescence” 

Required Media (click to expand/reduce)

Center for Rural Health. (2020, May 18). Disruptive mood dysregulation disorder & childhood bipolar disorder [Video]. YouTube. https://youtu.be/tSfYXkst1vM

Mood Disorders Association of BC. (2014, November 20). Children in depression [Video]. YouTube. https://youtu.be/Qg-BBKB1nJc

Psych Hub Education. (2020, January 7). LGBTQ youth: Learning to listen. [Video]. YouTube. https://www.youtube.com/watch?v=Wn4AVjMMYX4

Medication Review

Review the FDA-approved use of the following medicines related to treating mood and anxiety disorders in children and adolescents.

Assignment: Patient Education for Children and Adolescents

Patient education is an effective tool in supporting compliance and treatment for a diagnosis. It is important to consider effective ways to educate patients and their families about a diagnosis—such as coaching, brochures, or videos—and to recognize that the efficacy of any materials may differ based on the needs and learning preferences of a particular patient. Because patients or their families may be overwhelmed with a new diagnosis, it is important that materials provided by the practitioner clearly outline the information that patients need to know.

Photo Credit: Getty Images

For this Assignment, you will pretend that you are a contributing writer to a health blog. You are tasked with explaining important information about an assigned mental health disorder in language appropriate for child/adolescent patients and/or their caregivers. 

To Prepare

· By Day 1, your Instructor will assign a mood or anxiety disorder diagnosis for you to use for this Assignment.

· Research signs and symptoms for your diagnosis, pharmacological treatments, nonpharmacological treatments, and appropriate community resources and referrals.

The Assignment

In a 300- to 500-word blog post written for a patient and/or caregiver audience, explain signs and symptoms for your diagnosis, pharmacological treatments, nonpharmacological treatments, and appropriate community resources and referrals. Although you are not required to respond to colleagues, collegial discussion is welcome. 

© 2021 Walden University Page 1 of 3

Response must be at least 510 words written in current APA format with at least two academic references cited. References must be within the last five years. 

1. Discuss the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.
2. Utilizing the five assessment domains, which ones would you utilize on your patients in conducting a comprehensive nutritional assessment.
3. Discuss the functional anatomy and physiology of a psychiatric mental health patient. Which key concepts must a nurse know in order to assess specific functions?

Patient is a 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle. He came in for an annual physical. Patient has no past medical or surgical history, has no known drug allergies, and isn’t currently taking any medication.

He has a family history of diabetes, hypertension, and alcoholism. No recent weight gains of losses, fatigue, fever, or chills. No chest discomfort or palpitations, history of eczema, no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements. Patient’s vital signs are as followed: B/P 158/90; Pulse 88; RR 18; Temp 99.2; Ht 5,7; wt 208; BMI 32.6.

Patient developed and well-nourished. He is anxious – pacing in the room and fidgeting, but in no acute distress.

Choose one diagnosis from the Anxiety Disorders group 

· American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing, Inc. 

· Scan Pages 189-233 

Overview  

As you will learn throughout the program, the diagnosis of a variety of psychiatric illnesses is not always an easy or straightforward process. Multiple observations and assessment methods are often employed to reach a diagnosis. This approach can include the use of standardized assessment instruments.  This then aids you in defining a treatment plan and choosing specific treatment plans to use in the care of your clients.  

You are tasked with identifying a standardized assessment instrument/tool to measure the disorders listed for each week. You will keep these instruments in the form of a “portfolio” that you can use in your clinical practice to assess clients who present with a variety of symptoms.  

Instructions:  

Instrument/ Tool criteria:  

For each assessment, you are tasked with selecting, you will identify an instrument and:  

1. List what DSM diagnosis the tool/instrument is used for  

2. Identify an assessment/diagnosis instrument 

3. Appraise a scholarly, peer-reviewed article that addresses the use of the instrument to support your choice as an evidence-based instrument for practice.  

4. Evaluate the instrument’s appropriateness for diagnosing the condition it is designed to assess or if the developers of the instrument reported that the instrument is only part of a comprehensive assessment for the disorder.  

5. Describe whether or not the instrument can be used to measure patient response to therapy/treatment or if it is strictly for assessment and diagnosis.  

6. Discuss the psychometrics/scoring of the instrument, including reliability and validity.  

7. Discuss any limitations associated with the use of the instrument. 

8. Include a link to view the assessment if possible.

Use the following template in completing your portfolio assignments. Your information can be in bulleted format or just a couple of sentences for each criterion listed above. However, you must use APA citations.  You are NOT required to write this in a paper format.  Turn in one document for each week’s topics.  (However, create a file on your desktop to compile your portfolio as you move through the term.)  This will ensure you can have easy access to show the full portfolio and once you begin clinicals and practice.  Throughout the program, you will continue to add to the portfolio in each course. 

he purpose of this assignment is to examine how publicly reported data influence internal quality improvement initiatives.

Identify a specific health care organization of your choice. Review its Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores and Hospital Acquired Infections (HAIs) reports.

In a 1,250-1,500-word paper, discuss your findings on the HCAHPS scores and HAIs for the health care organization you selected. Include the following in your paper:

Describe the health care organization you have selected.

Discuss the role of HCAHPS and HAIs in creating quality indicators and how they contribute to the quality improvement process.

Discuss how the HCAHPS and HAIs data of your selected organization compare to national benchmarks.

Discuss the role of consumer satisfaction in quality improvement.

Describe the intent and outcomes of public reporting.

Discuss what actions leadership could take at your selected organization based on the reported HCAHPS and HAIs data.

This assignment requires four to six scholarly resources.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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

You are required to submit this assignment to LopesWrite. A link to the LopesWrite Technical Support Articles is located in Class Resources if you need assistance.

Rubric

A description of the selected health care organization is thorough.

A discussion of the role of HCAHPS and HAIs in creating quality indicators and how they contribute to the quality improvement process is thorough.

A discussion of how the HCAHPS and HAIs data of the selected organization compare to national benchmarks is thorough.

A discussion of the role of consumer satisfaction in quality improvement is thorough.

A description of the intent and outcomes of public reporting is thorough.

A discussion of the actions that leadership could take at the selected organization based on the reported HCAPHS and HAIs data is thorough.

Case 1

J.J is a nurse practitioner who works in a primary care facility. He believes that one of the most important aspects of his work is to foster a therapeutic relationship with his clients. He is using effective communication techniques.

Many of his clients have altered sensory perception such as blindness and deafness. Because of these conditions, He has to be extremely patient with his clients. J.J. also finds that the use of respect and humor help him bond more readily with his clients.

Questions for the case

For better results with his clients, J.J must secure trust with his patients. Discuss strategies that promote trust between patients and health care providers.

Once you received your case number; answer the specific question on the table above. Then, continue to discuss the 3 topics listed below for your case:

1. Moral distress is a frequent situation where health care providers should face. Please define and discuss a personal experience where you have faced Moral distress in your practice.
2. Discuss how health promotion relates to morality.
3. Discuss your insights about your own communication strengths and weaknesses. Identify situations in which it may be difficult for you to establish or terminate a therapeutic relationship.

Your initial post should be at least 550 words, formatted and cited in current APA style with support from at least 3 academic sources.