HEALTH INSURANCE PLAN

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HEALTH INSURANCE PLAN

Currently, in the United States, an individual is not required to purchase a health insurance plan. However, according to Section 1501 of the PPACA, beginning in 2014, “Individuals will be required to maintain minimum essential coverage beginning in 2014. Failure to maintain coverage will result in a penalty of $95 in 2014, $350 in 2015, $750 in 2016 and indexed thereafter.”Currently, employers are not required to provide health insurance coverage to their employees.

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However, in 2014, the employers’ responsibility in health insurance coverage will change, according to the PPACA. This is the latest update in a long line of US health care reform efforts.Using South University Online Library or the Internet, search on the topic of latest health care reforms. On the basis of your research and your understanding of the topic, answer the following questions:Track the progress of health care reform efforts in the US history starting with the early 1900s detailing the role of Presidents’ attempting to pass health care reform.Give your views on the AALL’s efforts to pass National Health Reform.What are the issues of culture, politics, and special interests in the United States that have made health care reform difficult to achieve?Of these three issues, which issue do you find to be the most difficult to overcome? Why?What is path dependency? What has this been an issue in health reform? How can the power of inertia be overcome?What are the advantages and disadvantages of PPACA that was passed in 2010? HEALTH INSURANCE PLAN

  

NURSES’ RESPONSIBILITIES

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NURSES’ RESPONSIBILITIES

Nurses work together in many environments. Understanding the roles and responsibilities of each type of graduate nurse will foster cooperative relationships.

Directions:

  1. Select and describe a specialty that has evolved in a different direction from that of advanced practice nursing (e.g., informatics, administration, health policy, and/or forensic nursing).
  2. What key differences do you see in this evolution as compared with developed APN specialties?
  3. Describe the future vision and goals each role and relate to emerging healthcare trends and needs. NURSES’ RESPONSIBILITIES

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Assignment Requirements:

  • Your paper must be presented in a single Word document. The paper must be between 2 to 3 pages in length, not including the title and reference list pages. The paper must use proper APA Publication Manual, 6th Editionformatting, including title page, running head, and reference list with properly formatted citations in the body of the paper. 
  • Utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

  • follow the conventions of Standard American English (correct grammar, punctuation, etc.);
  • be well ordered, logical, and unified, as well as original and insightful; and
  • display superior content, organization, style, and mechanics. NURSES’ RESPONSIBILITIES

REPORT ON HOSPITAL COSTS

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REPORT ON HOSPITAL COSTS

As an example guideline, review the study components in the left-side column of the table below. Read the study by Messina et al., and build the data in the right-side column with the key components in that study.

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Research Question: Coyne: Do size and ownership type make a difference in the efficiency and cost results of hospitals in Washington state? (Highlight p.164, second column, starting 15 lines from bottom to seven lines from bottom.) Messina: REPORT ON HOSPITAL COSTS
How did the research question emerge from the review of literature in the article? Coyne: Built on an earlier study by Coyne on performance differences between multi-facility systems and independent hospitals using two cost measures. Cited studies that used a range of variables to measure differences in hospital performance, and noted that prior findings have been inconclusive in regard to hospital size, although economies of scale were found. Messina:  
Independent VariablesType: Coyne: Hospital size and hospital ownership structure. Categorical Messina:  
Dependent VariablesType: Coyne: Efficiency measures – continuous variables.Cost measures – continuous variables. Messina: 
Design Elements1. Quantitative vs. Qualitative2. Sample Size3. Method of sample selection4. Experimental vs. control group?5. Reliable and valid data instruments? Coyne: Quantitative 96Picked all hospitals in state, except investor owned hospitals. No Used data that are commonly used to measure hospital efficiency and performance with high degrees of accuracy (reliable), and data that are historically used and make sense to other hospital users (valid). Messina: 
Describe analysis.What statistics were used? Coyne: Two-way Analysis of Variance (ANOVA)  Messina: 
Did the researchers’ conclusions make sense, did they answer the research question, and did they appear to flow from the review of the literature?Did they explore control of extraneous variables? Coyne: They concluded that size and ownership type make a difference in reported levels of efficiency. Not for profits seem to achieve higher performance levels, and medium and large not for profits operate more efficiently than industry average. The same results were found for cost levels, in that size and ownership type do make a difference, with medium sized hospitals reporting lower costs than large or small hospitals. Yes, when they called for national studies that controlled for case mix, scope of services, and payer mix, all of which could have affected the results in this study in an unmeasured way. Messina: REPORT ON HOSPITAL COSTS

 

REPORT ON HOSPITAL SAFETY CONDITIONS

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REPORT ON HOSPITAL SAFETY CONDITIONS

Preparation

Refer to the Capella library and the Internet for supplemental resources to help you complete this assessment, a Safety Score Improvement Plan.

Consider the hospital-acquired conditions that are not reimbursed for under Medicare/Medicaid. Among these conditions are specific safety issues such as infections, falls, medication errors, and other safety concerns that could have been prevented or alleviated with the use of evidence-based guidelines. Hospital Safety Score, an independent nonprofit organization, uses national performance measures to determine the safety score for hospitals in the United States. The Hospital Safety Score Web site and other online resources provide hospital safety scores to the public. REPORT ON HOSPITAL SAFETY CONDITIONS

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Read the scenario below:

Scenario

As the manager of a unit, you have been advised by the patient safety office of an alarming increase in the hospital safety score for your unit. This is a very serious public relations matter because patient safety data is public information. It is also a financial crisis because the organization stands to lose a significant amount of reimbursement money from Medicare and Medicaid unless the source of the problem can be identified and corrected. You are required to submit a safety score improvement plan to the organization’s leadership and the patient safety office.

Select a specific patient safety goal that has been identified by an organization, or one that is widely regarded in the nursing profession as relevant to quality patient care delivery, such as patient falls, infection rates, catheter-induced urinary infections, IV infections, et cetera.

Deliverable: Safety Score Improvement Plan

Develop a 3–4-page safety score improvement plan.

  • Identify the health care setting and nursing unit of your choice in the title of the mitigation plan. For example, “Safety Score Improvement Plan for XYZ Rehabilitation Center.”
  • You may choose to use information on a patient safety issue for the organization in which you currently work, or search for information from a setting you are familiar with, perhaps from your clinical work.
    • Demonstrate systems theory and systems thinking as you develop your recommendations. REPORT ON HOSPITAL SAFETY CONDITIONS

Organize your report with these headings:

Study of Factors
  • Identify a patient safety issue.
  • Describe the influence of nursing leadership in driving the needed changes.
  • Apply systems thinking to explain how current policies and procedures may affect a safety issue.
Recommendations
  • Recommend an evidence-based strategy to improve the safety issue.
  • Explain a strategy to collect information about the safety concern.
    • How would you determine the sources of the problem?
  • Explain a plan to implement a recommendation and monitor outcomes.
    • What quality indicators will you use?
    • How will you monitor outcomes?
    • Will policies or procedures need to be changed?
    • Will nursing staff need training?
    • What tools will you need to do this?

Additional Requirements

  •  

Preparation

Refer to the Capella library and the Internet for supplemental resources to help you complete this assessment, a Safety Score Improvement Plan.

Consider the hospital-acquired conditions that are not reimbursed for under Medicare/Medicaid. Among these conditions are specific safety issues such as infections, falls, medication errors, and other safety concerns that could have been prevented or alleviated with the use of evidence-based guidelines. Hospital Safety Score, an independent nonprofit organization, uses national performance measures to determine the safety score for hospitals in the United States. The Hospital Safety Score Web site and other online resources provide hospital safety scores to the public. REPORT ON HOSPITAL SAFETY CONDITIONS

Read the scenario below:

Scenario

As the manager of a unit, you have been advised by the patient safety office of an alarming increase in the hospital safety score for your unit. This is a very serious public relations matter because patient safety data is public information. It is also a financial crisis because the organization stands to lose a significant amount of reimbursement money from Medicare and Medicaid unless the source of the problem can be identified and corrected. You are required to submit a safety score improvement plan to the organization’s leadership and the patient safety office.

Select a specific patient safety goal that has been identified by an organization, or one that is widely regarded in the nursing profession as relevant to quality patient care delivery, such as patient falls, infection rates, catheter-induced urinary infections, IV infections, et cetera.

Deliverable: Safety Score Improvement Plan

Develop a 3–4-page safety score improvement plan.

  • Identify the health care setting and nursing unit of your choice in the title of the mitigation plan. For example, “Safety Score Improvement Plan for XYZ Rehabilitation Center.”
  • You may choose to use information on a patient safety issue for the organization in which you currently work, or search for information from a setting you are familiar with, perhaps from your clinical work.
    • Demonstrate systems theory and systems thinking as you develop your recommendations.

Organize your report with these headings:

Study of Factors
  • Identify a patient safety issue.
  • Describe the influence of nursing leadership in driving the needed changes.
  • Apply systems thinking to explain how current policies and procedures may affect a safety issue.
Recommendations
  • Recommend an evidence-based strategy to improve the safety issue.
  • Explain a strategy to collect information about the safety concern.
    • How would you determine the sources of the problem?
  • Explain a plan to implement a recommendation and monitor outcomes.
    • What quality indicators will you use?
    • How will you monitor outcomes?
    • Will policies or procedures need to be changed?
    • Will nursing staff need training?
    • What tools will you need to do this?

Additional Requirements

  • Written communication: Written communication should be free of errors that detract from the overall message.
  • APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.
  • Length: The plan should be 3–4 pages.
  • Font and font size: Times New Roman, 12 point, double-spaced.
  • Number of resources: Use a minimum of three peer-reviewed resources
  • Written communication: Written communication should be free of errors that detract from the overall message.
  • APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.
  • Length: The plan should be 3–4 pages.
  • Font and font size: Times New Roman, 12 point, double-spaced.
  • Number of resources: Use a minimum of three peer-reviewed resources REPORT ON HOSPITAL SAFETY CONDITIONS

NURSING THEORIES

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NURSING THEORIES


This week’s Learning Resources present information about various types of theories. For this Discussion, you will examine some of these theories and evaluate how theory is utilized in research as well as how it informs your nursing practice. NURSING THEORIES

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To prepare:

  • Review the Learning Resources focusing on the different types of theories that are relevant for nursing practice.
  • Locate a scholarly article in the professional nursing literature that discusses a middle range or practice theory. Determine if the theory is descriptive, explanatory, predictive, or prescriptive in nature.
  • With this in mind, consider how nursing theory is utilized in research. For instance, how might this theory be useful for identifying a research problem?
  • Then, reflect on your nursing practice. As indicated in Chapter 2 of Theoretical Basis for Nursing, theories differ in scope—from the more abstract metatheory and grand theories to the more concrete middle range and practice theories. Brainstorm examples of how theory is applied in your nursing practice. Identify one to share in this Discussion.NURSING THEORIES

By tomorrow 6/6/17, post 550 words essay in APA format with 3 references from the list below, that include the level one heading as numbered below:

post a cohesive response that addresses the following:

1)      Summarize your selected article, identifying the middle range or practice theory utilized, and explaining whether the theory was descriptive, explanatory, predictive, or prescriptive. (Include the APA citation for the article.) (SEE ATTACHED PDF)

2)      Describe the value of theory for nursing research. Be specific.

3)      Share an example of how theory is applied in your nursing practice.

Required Readings

McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th ed.). Philadelphia, PA: Wolters Kluwer Health.

Chapter 2, “Overview of Theory in Nursing”

 Chapter 2 presents the evolution of nursing theory and examines the different types of theories that serve as a foundation for nursing practice.

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

Chapter 5, “Research Problem and Purpose”

 Chapter 5 explores a process for identifying, selecting, and refining research topics and articulating the purpose of the research.

Algase, D. (2009). The centrality of theoretical thinking and the value of empirical evidence. Research & Theory for Nursing Practice, 23(4), 251–252. doi:10.1891/1541-6577.23.4.251

 Note: You will access this article from the Walden Library databases.

 This article explores the concept that humans are natural theorists along with the importance of using empirical evidence to support theories.

Gould, D, Moralejo, D., Drey, N., & Chudleigh, J. (2010). Interventions to improve hand hygiene compliance in patient care. Cochrane Database of Systematic Reviews, (9).

 Note: You will access this article from the Walden Library databases.

This systematic review examined recent hand hygiene intervention studies seeking to improve hand hygiene compliance.

Kolcaba, K., Tilton, C., & Drouin, C. (2006). Comfort theory: A unifying framework to enhance the practice environment. Journal of Nursing Administration, 36(11), 538–544.

Note: You will access this article from the Walden Library databases.

 The use of Comfort Theory by a not-for-profit New England hospital to provide a coherent and consistent pattern for enhancing care and promoting professional practice when applying for Magnet Recognition Status is described in this article. NURSING THEORIES

McCurry, M. K., Revell, S. M. H., & Roy, S. C. (2010). Knowledge for the good of the   individual and society: Linking philosophy, disciplinary goals, theory, and practice. Nursing Philosophy, 11(1), 42–52. doi:10.1111/j.1466-769X.2009.00423.x

 Note: You will access this article from the Walden Library databases.

 This article explores many facets of the social concept nursing, and how nursing contributes to the good of society. The philosophical underpinnings, perspective, goals, and application to practice of the social mandate are examined.

O’Connell, K. (2009). Theories used in nursing research on smoking cessation. Annual Review of Nursing Research, 2733–2762. doi:10.1891/0739-6686.27.33

 Note: You will access this article from the Walden Library databases.

 This article identifies theories, theoretical frameworks, and conceptual models that can be applied to a specific topic. In addition, the article discusses ways nurses can devise new theories through their expert knowledge of clinical issues.

Optional Resources

Brilowski, G., & Wendler, M. (2005). An evolutionary concept analysis of caring. Journal of Advanced Nursing, 50(6), 641–650.

 Note: You will access this article from the Walden Library databases.

Connor, M.J. (2004). The practical discourse in philosophy and nursing: An exploration of linkages and shifts in the evolution of praxis. Nursing Philosophy, 5(1), 54–66. doi:10.1111/j.1466-769X.2004.00152.x

Note: You will access this article from the Walden Library databases.

Falk-Rafael, A. (2005). Advancing nursing theory through theory-guided practice: The emergence of a critical caring perspective. Advances in Nursing Science, 28(1), 38–49.

 Note: You will access this article from the Walden Library databases.

Knight, C. M., Moule, P., & Desbottes, Z. (2000). The grid that bridges the gap. Nurse Education Today, 20(2), 116–122. doi:10.1054/nedt.1999.0374

 Note: You will access this article from the Walden Library databases.Bottom of Form NURSING THEORIES

REPORT ON PATHOPHYSIOLOGY DISORDERS AND MALADAPTIVE RESPONSES

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REPORT ON PATHOPHYSIOLOGY DISORDERS AND MALADAPTIVE RESPONSES

Maladaptive responses to disorders are compensatory mechanisms that ultimately have adverse health effects for patients. For instance, a patient’s allergic reaction to peanuts might lead to anaphylactic shock, or a patient struggling with depression might develop a substance abuse problem. To properly diagnose and treat patients, advanced practice nurses must understand both the pathophysiology of disorders and potential maladaptive responses that some disorders cause.REPORT ON PATHOPHYSIOLOGY DISORDERS AND MALADAPTIVE RESPONSES

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Consider immune disorders such as HIV, psoriasis, inflammatory bowel disease, and systemic lupus E. What are resulting maladaptive responses for patients with these disorders?

To Prepare

  • Review Chapter 6 and Chapter 8 in the Huether and McCance text. Reflect on the concept of maladaptive responses to disorders.
  • Select two of the following immune disorders: HIV, psoriasis, inflammatory bowel disease, or systemic lupus E (SLE).
  • Identify the pathophysiology of each disorder you selected. Consider the compensatory mechanisms that the disorders trigger. Then compare the resulting maladaptive and physiological responses of the two disorders.
  • Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factor might impact your selected immune disorders.
By Day 3

Post a brief description of the pathophysiology of your selected immune disorders. Explain how the maladaptive and physiological responses of the two disorders differ. Finally, explain how the factor you selected might impact the pathophysiology of each disorder. REPORT ON PATHOPHYSIOLOGY DISORDERS AND MALADAPTIVE RESPONSES

SYNTHESIS OF NURSING THEORY

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SYNTHESIS OF NURSING THEORY

  1. Choose a contemporary school of nursing, hospital, nursing home, or other facility in the healthcare arena and research the nursing theory used there. 
  2. Describe the changing role of the nurse today and how they are influenced by the organizational nursing theory. SYNTHESIS OF NURSING THEORY

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(Suggestion: You are encouraged to make an appointment and meet with the CNO, director, nurse manager or other nursing leader of your chosen facility and interview them.)

Your presentation should include (60 pts.):

  • How the nursing theory enhances professional nursing practice in the roles of advocate, provider, teacher, manager, researcher, and leader. (20 pts.)
  • How using nursing theory and theory from other disciplines as a basis for the nursing process helps promote health and healing. (10 pts.) 
  • How we can use nursing theory to challenge professional and organizational assumptions, explore alternatives, and guide nursing actions. (30 pts.)

This assignment is a PowerPoint presentation only. (40 pts.)  The presentation should include no more than 20 slides.  If you use graphics be sure they are small in size, so your presentation can be loaded quickly.

When you have completed this assignments, you will be able to differentiate the concepts of person, environment, health, and nursing, as they relate to select nursing theories by:
(Competency 1)

  • identifying and defining the nursing metaparadigms. (10 pts.)
  • analyzing the philosophical bases of the concepts as they relate to specific theorists. (10 pts.)
  • differentiating the concepts as they relate to selected nursing theories. (10 pts.)
  • constructing a personal nursing philosophy by integrating the metaparadigms and the his/her individual values. (10 pts.) SYNTHESIS OF NURSING THEORY

 

PROS AND CONS OF METHODOLOGIES

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PROS AND CONS OF METHODOLOGIES

Continue to use the area of improvement selected in the Week Three QI Plan Part l assignment to complete the following section of the QI plan.

Write a 1,400- to 1,750-word paper in which you complete the following for the area of improvement: PROS AND CONS OF METHODOLOGIES

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  • Improvement Methodologies
    • Analyze each methodology you researched. Explain the pros and cons of each methodology for your chosen area of improvement.
    • Choose one of these methodologies for your organizational QI plan and explain why you chose this methodology over others.
  • Information Technology
    • Analyze each information technology application you researched.
    • Analyze how these applications will be used to help improve the area of improvement you have chosen.
  • Benchmarking
    • Analyze how benchmarks and milestones are involved in managing the use of quality indicators.
    • Analyze three potential benchmarks and milestones from quality indicators that could be used for your plan.
  • Mission, Vision, Strategic, and Operational Plans
    • Analyze how performance and quality measures are aligned to an organization’s mission, vision, and strategic plan in general.
    • Analyze how the measures are aligned with the mission, vision, and strategic plan of an organization. PROS AND CONS OF METHODOLOGIES
  • Barriers
    • Challenges
    • Analyze barriers that can interfere with the implementation or revision of quality measures.
  • Successful Implementation
    • Implementation
    • Analyze strategies to ensure successful implementation of new quality measures.

Cite at least 3 sources according to APA guidelines to support your information.

Click the Assignment Files tab to submit your assignment. PROS AND CONS OF METHODOLOGIES

AN OPINION LEADER

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AN OPINION LEADER

An opinion leader is someone who is well respected, experienced, and patient (Hamric, Hansen, Tracy, & O’Grady, 2014, p. 277). This is a person who leads by example and is seen as leader because of the qualities they possess not by the position they hold. An opinion leader is often sought out by others for their advice and expertise (Hamric et al., 2014, p. 277).  AN OPINION LEADER

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I see many characteristics of an opinion leader in myself. I have always been committed to continuing education and have attended several conferences and continuing education seminars. Due to this many of the nurses that I work with are eager to hear what I have learned in these conferences. My peers trust my clinical judgement and skills and often seek out my advice or my help with difficult skills. I feel I also show characteristics of an opinion leader when educating the certified nurse aids (CNAs). The CNAs I work with respond more effectively when I take my time to educate them why something is important rather than just telling them to do a task. 

An example of a time that I felt I was acting as an opinion leader was after attending an in-service put on by our local pharmacy. At that in-service, I learned that the use of Diphenhydramine in elderly patients drastically increases the risk of falls (J. Krichner, personal communication, January 21, 2015). Prior to this in-service, myself and the other nurses I worked with would routinely ask physicians for orders for Acetaminophen with Diphenhydramine when patients were having difficulties sleeping. After sharing this information with my peers all of the nurse stopped requesting Acetaminophen with Diphenhydramine as a first request to the physicians as a sleep aid. This continuing education allowed myself to make an important change to better care for my patients.  AN OPINION LEADER

References

Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. (2014). Advanced practice nursing: 

            an integrative approach (5th ed.). St. Louis, MO: Elsevier/Saunders. AN OPINION LEADER

RESPONSE TO EMERGENCY SITUATION

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RESPONSE TO EMERGENCY SITUATION

Scenario 1

One of the primary goals of the public health system is to protect the general public. The citizens of the United States enjoy specific freedom and basic rights guaranteed by the Constitution. However, in an emergency situation, it is possible that specific rights such as the right to confidentiality of an individual may be compromised in an effort to protect the public. RESPONSE TO EMERGENCY SITUATION

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Research the South University Online Library or the Internet for an article involving quarantining an individual. Based on your research, answer the following questions regarding the above scenario:

  • What occurred to warrant the quarantine? Was this justified?
  • Does the need to protect the public outweigh an individual’s right to confidentiality? Why or why not?
  • What other basic rights of an individual may be compromised in times of an emergency?

Scenario 2

A successful response to an emergency situation often involves collaboration with other agencies in the community and the government. Imagine you are the director of the local health department. You have just received a call about a suspected outbreak of Ebola hemorrhagic fever in the community. RESPONSE TO EMERGENCY SITUATION

On the basis of your understanding of the topic of “collaboration with agencies and the government” and the above scenario, answer the following questions:

  • How would you put your bioterrorism preparedness plan into action? Which agencies will be involved in your plan and why?
  • Would the agencies involved be different in case there was a natural disaster such as an earthquake? Why or why not?RESPONSE TO EMERGENCY SITUATION