Instructions

Concept Synthesis Paper on Personal Nursing Philosophy

You are required to submit a scholarly paper in which you will identify, describe, research, and apply the concepts that underlie your personal philosophy for professional nursing practice.

This will help you identify your own values and beliefs about the established metaparadigms and metatheories of the discipline. It will also help you identify and articulate concepts relevant to your specific practice. This paper is intended to be an exercise in clarification and organization of your professional foundation. You are also required to provide a list of assumptions from personal nursing practice that illustrate the concepts and framework of your theory.

Your paper should follow a format that includes:

• Nursing Autobiography: A brief (1 page) discussion of your background in nursing.
• The Four Metaparadigms: Identification, discussion, and documentation from the literature of your perspective on the basic four metaparadigms/concepts of patient, nurse, health, and environment.
• Two Practice-Specific Concepts: Identification, discussion, and documentation from the literature of your perspective on at least two other concepts specific to your own practice.
• List of Propositions: A numbered list of at least five propositions or assumption statements that clearly connect the concepts described.

Each week, you will complete various segments of your Concept Synthesis Paper and submit it to the Submissions Area for facilitator feedback when necessary. Your paper should integrate these discrete elements and reflect your personal nursing philosophy.

Your Concept Synthesis Paper on your Personal Nursing Philosophy is due in Week 3. However, it is recommended that you begin working on your paper from Week 1 onwards and complete the various components related to the paper week wise as you progress through the course. The suggested tasks for each week are:

Week 1: Nursing Biography and The Four Metaparadigms of Nursing
Week 2: Two Practice-specific Concepts, and List of Propositions/Assumptions
Week 3: Due: Concept Synthesis Paper on Personal Nursing Philosophy

Consider the following questions as you complete your various tasks related to this assignment.

1.

How do I define and employ the four basic metaparadigms of nursing theory in my professional practice?

2.

What are the major concepts I employ that are unique to my professional practice?

3.

What philosophies and theories from the literature of nursing and other disciplines/domains are consistent with these concepts?

4.

How are the concepts of transcultural nursing, the health promotion model, skill acquisition, role theory, and change theory specifically integrated into  my philosophy and practice?

5.

What research supports these theories and concepts?

6.

How do I integrate role and change theory into my professional practice and how may these theories be applied to the organization in which I practice?

The paper is to be thoroughly researched and well documented, with relevant material from the nursing theorists presented incorporated into the paper. Use the current edition of the APA Manual throughout the paper. Sources should focus on references from nursing theory but may also include conceptual and theoretical material from other professional domains. The paper, excluding references or appendices, is to be limited to 6-10 pages. Writing should be succinct and well organized, as it is impossible for the facilitator to evaluate form and content separately.

Your philosophy/framework is to be given a title that is appropriate to its content and emphasis.

Question 1. In coding, the letter A represents a sequela, and the letter D stands for subsequent visit. True or false

Question 2.  Each unique I-10 diagnosis code may be reported more than once for an encounter. true or false

Question 3.  For bilateral sites, the final character of the codes in the I-10 always indicates laterality true or false

Question 4. Multiple codes are often required for late effects, complication codes, and obstetric codes. true or false

Question 5.  Assign codes as directed in the index, only after verifying the code in the tabular. true or false

Question 6.  A late effect is the residual effect after the acute phase of an illness or injury has passed. true or false 

Question 7. It is important to follow any cross-reference instructions in the index of the I-10, such as see also. true or false

Question 8. If there are separate codes for both the acute and chronic forms of a condition, the code for the chronic condition is sequenced first as long as both codes are listed at the same indentation level of the index. true or false 

Question 9. Systemic lupus erythematosus with associated endocarditis (M32.11) is an example of dual coding. true or false 

Question 10. The official Coding and Reporting Guidelines are updated every year by the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA), which could affect the steps to accurate coding. true or false

Question 11. Using the ICD-10-CM (Encoder Pro), complete the following statement. 

 The correct reporting for acute cholecystitis with cholelithiasis with obstruction is:

K80.19

K80.12

K80.10

K80.01 

Question 12. A combination code is a single code used to classify all of the following EXCEPT:

two diagnoses 

diagnosis with an associated secondary process (manifestation)

a diagnosis with an associated complication.

more than two diagnoses.

SECOND PART

Unit IV PowerPoint Presentation

Weight: 10% of course grade

Grading Rubric

Due: Tuesday, 12/04/2018 11:59 PM (CST)

Instructions

Create a minimum of a 10-slide presentation that explains the steps to accurate coding. For each step, include detailed instructions about the coder’s role. Within your presentation, include the need specificity in diagnosis coding with multiple codes as well as how to report acute and chronic conditions, combination codes, residual effects, and late effects. Additionally, include the alphabetical index and tabular.

You must use at least your textbook as an outside source. Although not a required outside source, you may find the Centers for Disease Control and Prevention website helpful, which can be accessed by clicking the link below:

Centers for Disease Control and Prevention. (n.d.). CDC 24/7: Saving lives, protecting people. Retrieved from http://www.cdc.gov/

All sources used must be cited and referenced according to APA standards.

Resources

Overview

Create a 15-minute oral presentation (3 pages) that examines the moral and ethical issues related to triaging patients in an emergency room.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

· Competency 1: Explain the effect of health care policies, legislation, and legal issues on health care delivery and patient outcomes. 

. Explain the health care policies that can affect emergency care.

. Recommend evidence-based decision-making strategies nurses can use during triage.

· Competency 3: Apply professional nursing ethical standards and principles to the decision-making process. 

. Describe the moral and ethical challenges nurses can face when following hospital policies and protocols.

. Explain how health care disparities impact treatment decisions.

· Competency 4: Communicate in a manner that is consistent with expectations of nursing professionals. 

. Write content clearly and logically, with correct use of grammar, punctuation, and mechanics.

. Correctly format citations and references using APA style.

Context

Working in an emergency room gives rise to ethical dilemmas. Due to time restraints and the patient’s cognitive impairment and lack of medical history, complications can and do occur. The nurse has very little time to get detailed patient information. He or she must make a quick assessment and take action based on hospital protocol. The organized chaos of the emergency room presents unique ethical challenge, which is why nurses are required to have knowledge of ethical concepts and principles.

Questions to consider

To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community.

· How does a triage nurse decide which patient gets seen first?

· How does health disparity affect the triage nurse’s decision making?

· What ethical and moral issues does the triage nurse take into account when making a decision?

· What are triage-level designations?

Resources

· Tingle, J., & Cribb, A. (Eds.). (2014).  Nursing law and ethics  (4th ed.). Somerset, NJ: John Wiley & Sons.

· Cranmer, P., & Nhemachena, J. (2013).  Ethics for nurses: Theory and practice . Maidenhead, UK: Open University Press.

· Aacharya, R. P., Gastmans, C., & Denier, Y. (2011). Emergency department triage: An ethical analysis. B MC Emergency Medicine, 11(1), 16–29.

· Guidet, B., Hejblum, G., & Joynt, G. (2013). Triage: What can we do to improve our practice? Intensive Care Medicine, 39(11), 2044–2046. 

· Kangasniemi, M., & Haho, A. (2012). Human love – The inner essence of nursing ethics according to Estrid Rodhe. A study using the approach of history of ideas. Scandinavian Journal of Caring Sciences, 26(4), 803–810. 

· Gastmans, C. (2013). Dignity-enhancing nursing care: A foundational ethical framework. Nursing Ethics, 20(2), 142–149. 

· Domagala, S. E., & Vets, J. (2015). Emergency nursing triage: Keeping it safe. Journal of Emergency Nursing, 41(4), 313–316.

Internet Resources

Access the following resources by clicking the links provided. Please note that URLs change frequently. Permissions for the following links have been either granted or deemed appropriate for educational use at the time of course publication.

· American Nurses Association. (2015). Ethics and Human Rights. Retrieved from https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/

· American Nurses Association. (2016). Position statement: The nurse’s role in ethics and human rights: Protecting and promoting individual worth, dignity, and human rights in practice settings. Retrieved from https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/the-nurses-role-in-ethics-and-human-rights/

· Vigil, J. M., Alcock, J., Coulombe, P., McPherson, L., Parshall, M., Murata, A., & Brislen, H. (2015). Ethnic disparities in emergency severity index scores among U.S. veteran’s affairs emergency department patients. PLoS One, 10(5). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/26024515

Assessment instructions

Your supervisor has asked you to do a 15-minute oral presentation at a staff meeting about a recent issue that occurred at another hospital in town. Following an industrial accident, two patients arrived at the emergency room of that hospital at the same time, presenting with very similar inhalation injuries. The hospital received a great deal of negative press due to how the patients were triaged in the ER. Your supervisor would like you to use the specifics of this case to review triage procedures and best practices at your facility. Here are the details:

· One is a 32-year-old firefighter, Frank Jeffers, who is presenting with respiratory difficulties that he obtained while evacuating victims of an industrial accident. He is a married homeowner and father of two young boys. He has lived in the community all his life. He has full and comprehensive health insurance through his employer.

· The other is Brent Damascus, a 58-year-old man. Brent is presenting with respiratory difficulties with the same intensity as Mr. Jeffers above. He is well known at the hospital emergency room, as he is a frequent visitor with various complaints, including asthma, headaches, and tremors. He is homeless, unemployed, and uninsured. He stays many nights at the YMCA and eats lunch at the soup kitchen. He has lived in the community for over 10 years and has been arrested several times for petty theft.

Preparation

Search the Internet for scholarly and professional peer-reviewed articles on best practices in triage nursing. You will need at least three articles to use as support for your work on this assessment.

Directions

Create a 15-minute presentation (3 pages) that examines the moral and ethical issues that occurred when triaging these two patients and the best practices for managing this in the future.

Divide your draft into a number of talking points that you can summarize neatly. Keep in mind that an oral presentation requires slightly different language than an essay. The aim is to communicate your message so keep sentences simple and focus on the key points you want to deliver. Address the following in your presentation:

· Explain the health care policies and protocols that are in place that direct triage care in an emergency situation.

· Explain how health care disparities impact treatment decisions.

· Identify the health care policies that are in place that direct care for uninsured individuals. Is there a difference in how these individuals are triaged?

· Describe the moral and ethical challenges nurses can face when following hospital policies and protocols. Is there a conflict when a severely injured person is also uninsured?

· Recommend evidence-based strategies that should be applied for managing the care of uninsured and indigent population.

·

Additional Requirements

Your presentation should meet the following requirements:

· Written communication: Written communication should be free of errors that detract from the overall message.

· References: Include a reference section with a minimum of three references; a majority of these should be peer-reviewed sources. All resources should have been published within the last 5 years.

· APA format: Resources and citations should be formatted according to current APA style and formatting.

· Length: 3 typed, double-spaced pages, excluding title page and reference page. Use Microsoft Word to complete the assessment.

· Font and font size: Times New Roman, 12-point.

AMP-450V Module 5 Connected Health and the Digital Age of Medicine

Leadership and Vocation – Data-Driven Decision Making: Incorporating the Evidence

Grand Canyon University

Explore the technology systems offered by Nanthealth, a provider of “telehealth” and health management services via the following link:

Prepare a brief (8-10 slides) PowerPoint presentation in which you do the following:1.Identify at least two technology innovations to connect patients, providers, and insurers across the care continuum.2.Describe how the technologies work to provide patients and providers with data necessary for health care decision making.3.Discuss how the real-time data encourages outcome-focused planning.4.Predict what impact the technology will have on future health care delivery. Provide rationale and examples.

Presentations must include speakers’ notes on each slide, as well as references for the presentation. A minimum of three academic references from credible sources are required for this assignment. The slide count (8-10 slides) does not include the introduction and References slide(s).

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.

Data Analysis

As a nurse engaged in evidence-based practice, it is important to recognize how statistics and other data analysis tools are used to generate and assess evidence. Most nurses need only a foundational understanding of statistical tools and terminology to understand the majority of research studies. As a nurse, you should be able to recognize the most commonly used statistical tests, how and when they are used, and how significance is determined.

In this Discussion, you examine different types of statistics and statistical tests, when and why these particular tests would be selected for use, and, most importantly, what the results indicate. To this end, you will be assigned to a group by Day 1 of this week. Each group will be assigned one of the five chapters listed in this week’s Learning Resources and will develop a study sheet on their chapter that will be shared with the other groups.

To prepare:

• Review the information in your assigned chapter (Chapter 19 p. 473 to 477. Credibility of Quantitative Results  See attached file)
• Write a minimum of 200 to 250 words in APA format that includes the following:

• The key concepts of the chapter: Focus on the basic concepts that are important for nurses to understand as they review research studies. ( In this case, focus only on Credibility of Quantitative Results)
• A description of the statistical methods covered in the chapter, what they measure, and under what circumstances they are used. Identify examples of how the statistical methods have been used in research studies. ( In this case, focus only on Credibility of Quantitative Results
• An explanation of the key statistical tests and how they measure significance (if applicable). ( In this case, focus only on Credibility of Quantitative Results )

Readings

• Polit, D. F., & Beck, C. T. (2012).  Nursing research: Generating and assessing evidence for nursing practice (Laureate Education, Inc., custom ed.).Philadelphia, PA: Lippincott Williams & Wilkins.Chapter 19, “Processes of Quantitative Data Analysis and Interpretation”
  
  The previous chapters have described a number of different statistical tests used to examine data in a quantitative study; this chapter focuses on how to analyze and interpret the results. It describes the steps in the analysis process and how to determine the credibility of the results.