MDC Competing Needs in Policy Development Discussion
Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs …

MDC Competing Needs in Policy Development Discussion
Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations. For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care? In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue. To Prepare: Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1. Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined. By Day 3 of Week 3 Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples. Code of Ethics for Nurses With Interpretive Statements (View Only for Members and Non-Members) (nursingworld.org) Ethical Nursing Care Versus Cost Containment: Considerations to Enhance RN Practice (nursingworld.org) Ethical Awareness: What It Is and Why It Matters (nursingworld.org)

Rasmussen College Ethical Issues Related to Managed Care Assignment
Throughout this week, you read about managed care and third-party payers, the basic components of insurance.Up until recen …

Rasmussen College Ethical Issues Related to Managed Care Assignment
Throughout this week, you read about managed care and third-party payers, the basic components of insurance.Up until recent years the only options for the uninsured, if they qualified for it, were Medicare and Medicaid. With the passage of the Affordable Care Act, the landscape of insurance is changing.For this week’s written assignment, read the following article:Hamel, M.B., Blumenthal, D., Abrams, M., & Nuzum, R. (2015) http://www.nejm.org/doi/full/10.1056/NEJMhpr1503614#t=article. The New England Journal of Medicine, 372, 2451-2458. Retrieved from http://www.nejm.orgAfter reading the article, answer the following questions:What are your initial thoughts from the article?How do you think the Affordable Care Act improves health care for Americans?Who do you think will benefit the most from the Affordable Care Act? Why?Why are some states slower to participate than others?If you could create a healthcare plan for the United States, what would it include, who would be covered?

PICO Heart Failure
PICO Heart FailureTo complete this week, after reading chapter two in Melnyk and reviewing the lectures you submit a 2-3 p …

PICO Heart Failure
PICO Heart FailureTo complete this week, after reading chapter two in Melnyk and reviewing the lectures you submit a 2-3 page paper that explores the background of your issue. For this paper #1 you will be defining this issue or disease using the literature. It will end with the PICOT question. The parts of your paper should include:IntroductionDefinitionEpidemiologyClinical PresentationComplicationsDiagnosisConclusion with PICOT QuestionWhat I have provided below is what I have written up to this point, before the professor had asked about the 7 bullet points above. I have references that are 5 years old or older which was not liked. The Danna article is a study protocol. It has not been done. Glogowska is a qualitative study. Did the Gustafsson review measure the indicated outcome variables in your targeted population? The Travis study was conducted in an urban area. The studies must align with your targeted population. All studies must be current- published within the last 5 years.This is a research paper I has used from a previous research course. But it needs to be evidenced based project. I could provide the whole paper????? and each week let you know what is wanted???????Heart disease affects the circulatory system and overall ability of the heart to function in its normal state. It is the number one source of demise and primary cause of disability for Floridians (Florida Department of Health, n.d.). Heart disease consists of coronary artery disease (CAD), heart failure (HF), and additional heart related diseases. It is primarily a disease associated to regimen and can be treated or stopped with teaching of risk factors and lifestyle modifications.Background of the ProblemAccording to the existing Community Health Assessment Summary for Volusia County, Florida concluded in 2013, the six central causes for ambulatory care sensitive conditions (ACSC) causing in hospital inpatient releases for uninsured individuals are associated to chronic diseases that can be managed through early intervention (Community Health Assessment, 2013) . These conditions are diabetes, cardiovascular disease, cancer, obesity, access to health care and tobacco use (Community Health Assessment, 2013). These conditions accounted for 1,046 hospital admissions related to congestive heart failure and 2,655 hospital admissions related to coronary artery disease in Volusia County (Community Health Assessment, 2013).Statement of the ProblemHeart Failure (HF) remains a repeated source of unforeseen hospital admittances and a costly condition (Glogowska et al., 2015). Studies continue to display a discontinuation and crumbling of care once heart failure patients are released from the healthcare facility (Glogowska et al., 2015).A Heart Failure Program can have a pronounced influence on decreasing the amount of repeated admittances through enabling individuals with information and care to assist with management of continuing illness and increase compliance with their treatment plan in outpatient clinics that can be coordinated and managed by the Advanced Practice Nurse (APN) (Danna, Garbee, & Kessler, 2014). It can develop patient-provider interactions; diminish unsuitable use of the emergency department with increased applicable usage of primary and specialty care, and in general enhanced well-being of the peoples (Danna et al., 2014).Significance of the DiseaseCirculatory disease integrates all diseases of the heart and blood vessels. These consist of: atherosclerosis, rheumatic heart disease, heart failure, cerebrovascular, hypertension, and ischemic heart. “Congestive heart failure is the first-listed diagnosis in 875,000 hospitalizations, and the most common diagnosis in hospital patients age 65 years and older” (Emory Healthcare, 2017). As a state, outlining these concerns through execution of guidelines in several facets of care to make certain that Floridians can attain high quality healthcare that will lead to a healthier quality of life.The accumulative costs of supervision of this illness have caused the necessity to cultivate and place a community centered heart failure program that can be managed in an outpatient locale (Gustafsson & Arnold, 2016). Numerous individuals do not understand their disease course or abide by the given care plans (Travis, Hardin, Benton, Austin, & Norris, 2012). It stands for this purpose that there exists a necessity meant for heart failure programs that center on residents health-based care directed by an advance nurse practitioner that can work with a multidisciplinary team in order to deliver proficient services, increase wellbeing results and eventually diminish healthcare expenses (Gustafsson & Arnold, 2016).Decreasing heart failure remittance requirements must be initiated throughout in-patient hospitalizations. This can exist by expending the appropriate multidisciplinary action plans, medication administration, altering risk factors and way of life, as well as patient education focused on evidence based guidelines and procedures (Travis et al., 2012). This shows that heart failure programs in an outpatient locale ensure enhanced patient gratification, symptom management and largely quality of life expectancy (Gustafsson & Arnold, 2016).PICOPICO QuestionHeart failure individuals have the top hospital remittance rates in the United States (Shaw et al., 2014). Teaching is very imperative for these residents, mutually inpatient and outpatient. It is vital to have a number of training modals accessible for patients to study and to be more effective in decreasing remittance rates (Shaw et al., 2014). For individuals who are 65 years old and older with heart failure (P), does an outpatient heart failure program lead by a APN have decreased hospital remittance (I) by increasing patients’ empowerment and gaining control over the disease process (C) thus enhancing patient satisfaction, symptom management and overall quality of life (O)?It is vital that individuals identify initial indications of worsening heart failure (Siabani et al., 2013). Timely follow up by registering individuals in a heart failure program can avert deteriorating results and allow patients to manage their personal health care with the support of an APN and a multidisciplinary team that can address a number of aspects of the disease process (Danna et al., 2014).Prescription compliance, dietary management, ADL’s and weight monitoring are part of the discharge treatment plan. All heart failure patients are to be registered in the heart failure program at discharge. The facets will be observed and measured by tracking readmission rates and trends. Readmissions and heart failure program registration will be monitored by means of medical records and current hospital databases that will record information on admittance, upon discharge, and remittance centered on the heart failure diagnosis.References:Community Health Assessment (2013). Retrieved from November 18, 2017 from http://www.floridahealth.gov/provider-and-partner-…Danna, D., Garbee, D., & Kessler, P. (2014). Effectiveness of advanced practice nurse-led heart failure clinics on all-cause mortality: A systematic review of quantitative evidence protocol. JBI Database of Systematic Reviews and Implementation Reports, 12. http://dx.doi.org/10.11124/jbisrir-2014-1753Emory Healthcare (2017).Heart & Vascular: Conditions & Treatments.Heart Failure Statistics.Retrieved November 18, 2018 from https://www.emoryhealthcare.org/heart-vascular/wellness/heart-failure-statistics.htmlFlorida Department of Health (n.d.).Heart Disease.Retrieved September 18, 2017 from http://www.floridahealth.gov/diseases-and-conditions/heart-disease/index.htmlGlogowska, M., Simmonds, R., McLachlan, S., Cramer, H., Sanders, T., Johnson, R., … Purdy, S. (2015). Managing patients with heart failure: A qualitative study of multidisciplinary teams with specialist heart failure nurses. Annals of Family Medicine, 13, 5. http://dx.doi.org/10.1370/afm.1845.Gustafsson, F., & Arnold, M. (2016). Heart failure clinics and outpatient management: Review of the evidence and call for quality assurance. European Heart Journal, 25, 1596-1604. http://dx.doi.org/10.1016/j.ehj.2004.08.004Shaw, R., McDuffle, J., Hendrix, C., Edie, A., Lindsey-Davis, L., Nagi, A., … Williams, J. (2014). Effects of nurse-managed protocols in the outpatient management of adults with chronic conditions. Annals of Internal Medicine, 113-121. http://dx.doi.org/10.7326/M13-2567Siabani, S., Leeder, S., & Davidson, P. (2013). Barriers and facilitators to self-care in chronic heart failure: A meta-synthesis of qualitative studies. SpringerOpen Journal, , 320. Retrieved from http://springerplus.com/content/2/1/320Travis, L., Hardin, S., Benton, Z., Austin, L., & Norris, L. (2012). A nurse-managed population based heart failure clinic: Sustaining quality of life. Journal of Nursing Education and Practice, 2. http://dx.doi.org/10.5430/jnep.v2n4p1

Fortis College Centerville Assessing and Treating Patients With ADHD Case Study
Assignment: Assessing and Treating Patients With ADHD Not only do children and adults have different presentations for ADH …

Fortis College Centerville Assessing and Treating Patients With ADHD Case Study
Assignment: Assessing and Treating Patients With ADHD Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. Different people may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for patients across the life span. For this Assignment, you consider how you might assess and treat patients presenting with ADHD. To prepare for this Assignment: Review this week’s Learning Resources, including the Medication Resources indicated for this week. Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with ADHD. The Assignment: 5 pages Examine Case Study: A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. Introduction to the case (1 page) Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient. Decision #1 (1 page) Which decision did you select? Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #2 (1 page) Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #3 (1 page) Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Conclusion (1 page) Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

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