Capstone Project

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In collaboration with your approved course mentor, you will identify a specific evidence-based practice proposal topic for the capstone project. Consider the clinical environment in which you are currently working or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting. Examples of the integration of community health, leadership, and an EBP can be found on the “Educational and Community-Based Programs” page of the Healthy People 2020 website.

Write a 500-750 word description of your proposed capstone project topic. Make sure to include the following:

The problem, issue, suggestion, initiative, or educational need that will be the focus of the project

The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed.

A description providing a high level of detail regarding the problem, issue, suggestion, initiative, or educational need.

Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes.

Significance of the problem, issue, suggestion, initiative, or educational need and its implications to nursing.

A proposed solution to the identified project topic

You are required to retrieve and assess a minimum of 8 peer-reviewed articles. Plan your time accordingly to complete this assignment.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Nursing Test

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1) Cultural competence and diversity are often considered to have the same meaning in healthcare facilities. What is the difference between these two terms and their applicability in terms of healthcare professionals in various healthcare settings?

Although cultural competence and diversity are often considered to have the same meaning in healthcare facilities they are different. Diversity is in fact a component of cultural competency. This includes ethnic and racial backgrounds, age, physical and cognitive abilities, family status, religion, sexual orientation, etc… cultural competency wouldnt exist without diversity . It is important for healthcare professionals to be culturally competent for the sake of the patient’s comfort in receiving services. Lack of cultural competence can lead to noncompliance, missed appointments, and patients seeking care from non-professionals. In the cultural compliance training video an older Hispanic women spoke on how her physician said they’d schedule her a new appointment and she basically said that she wouldn’t show up because it would be the same thing that happened to her at her current appointment; a miscommunication and nothing being resolved. Health professionals who are diverse tend to have a better work ethic and connection with their patients because they’re most likely to be understand certain cultural distinctions, treatment seeking behaviors, etc… (cultural compentency for the health professional)

2) Explain the unique circumstances under which the ancestors of most Black/African American people arrived in the Americas. Why is it important for health service professionals to understand this history?

The first Africans in the New World arrived with Spanish and Portuguese explorers and settlers. By 1600 an estimated 275,000 Africans, both free and slave, were in Central and South America and the Caribbean area. Africans first arrived in the area that became the United States in 1619, when a handful of captives were sold by the captain of a Dutch man-of-war to settlers at Jamestown. Others were brought in increasing numbers to fill the desire for labor in a country where land was plentiful and labor scarce. By the end of the 17th century, approximately 1,300,000 Africans had landed in the New World. From 1701 to 1810 the number reached 6,000,000, with another 1,800,000 arriving after 1810. Some Africans were brought directly to the English colonies in North America. Others landed as slaves in the West Indies and were later resold and shipped to the mainland. (African American History: Scholastic , n.d.) However many “black” colored individuals rather identify themselves with their family-related nationality rather than where they were born or raised. Some rather the term black when being identified and some rather be identified as African American. This is very complex. I know, myself, I do not like to identified as Black I prefer to identify myself and Haitian/Bahamian because I consider the Black culture as people who only speak English and are just Americans with darker colored skin, who eat American meals and have American traditions. I speak English and Creole, I eat Haitian meals and follow Haitian traditions. I was born in America but my parents and older sisters were born in Bahamas and had the Haitian culture bestowed in them so I identify as that. It is important for health service professionals to understand the history of how most Black/African Americans were brought to the Americas so they’d be able to establish a positive relationship with their patients. The best way to approach patients on the matter would be to just humbly ask the person how they identify themselves. (cultural compentency for the health professional)

3) Is Hispanic a racial or ethnic category? Explain. How might this impact the status of the African/Black group, for example, in terms of whether it is the largest or second largest minority group?

Many people confuse racial and ethnic categories when it comes to the Hispanic group. But that is because many people do not know the difference between one’s race and one’s ethnicity. Unlike with ethnicity, one can only belong to one race. See, race is your biologically engineered features. It can include skin color, skin tone, eye and hair color, as well as a tendency toward developing certain diseases. It is not something that can be changed or disguised. People can however change or impersonate ethnicities through choice and principles. Ethnicity is about tradition, learned behavior and customs. It is about learning where you come from, and celebrating the traditions and ideas that are part of that region.(difference between ethnicity and race, n.d.). Thus, Hispanic would fall more into the ethnic category because the Hispanic group has no permanent physical characteristics, language or cultural norms. So a person of Hispanic decent can be Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race. Since Hispanic is not a racial group but an ethnic group, the Hispanic group comprise the largest minority group and the African/Black group comes in second as the second largest minority group. (cultural competency for the health professional)

4) List the racial categories based on the OMB classification in the United States. Explain the geographic origins of the people designated for each of the categories. Why is it important for health professionals to understand cultural differences among and between groups?

The racial categories based on the OMB classification in the United States are as follows:

· Native Americans or Alaskan Native: A person having origins in any of the original peoples of North America and who maintains cultural identification through tribal affiliations or community recognition.

· Asian/Pacific Islander: A person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian subcontinent, or the Pacific Islands.

· African American/Black: A person having origins in any of the black racial groups of Africa.

· White: A person having origins in any of the original peoples of Europe, North Africa, or the Middle East. (cultural competency for the health professional)

In the healthcare setting it is very important for health professionals to understand cultural differences among and between groups. In health care settings, cultural alertness, compassion, and competence conducts are essential because even such concepts as health, illness, suffering, and care mean different things to different people. Being knowledgeable of cultural customs enables health care providers to provide better service and help avoid misconstructions among staff, residents/patients, and families. Health care providers trained in cultural competency:

  • Demonstrate greater understanding of the central role of culture in healthcare

-Recognize common barriers to cultural understanding among providers, staff, and residents/patients

-Identify characteristics of cultural competence in health care settings

-Interpret and respond effectively to diverse older adults’ verbal and nonverbal communication cues

  • Assess and respond to differences in values, beliefs, and health behaviors among diverse populations and older adults

-Demonstrate commitment to culturally and linguistically appropriate services

-Work more effectively with diverse health care staff.

-Act as leaders, mentors, and role models for other health care providers (Dawn Lehman, Paula Fenza, & and Linda Hollinger-Smith)

  1. A physical therapy office in “Little Haiti” in Miami, Florida is closed due to lack of funds. All patients’ appointments are routed to a nearby hospital’s physical therapy department in which the predominant population served is Cuban. List and describe a minimum some steps you believe the department has to take to meet the needs of the patients from a culturally competent prospective.

Nursing Test

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Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP project. Why? Has your mentor used either theory, and to what result?

The first change theory is Lewin’s Change Theory. This theory is very widely used in nursing. This theory has three stages the unfreezing stage, moving stage, and refreezing stage. The theory has driving and resistant forces and for the theory to be successful the driving forces have to overcome the resistant forces. The other change theory is Rogers’ Change Theory. This theory has 5 stages and they are awareness, interest, evaluation, implementation and adoption.(Oguejiofo,2017) It is successful when nurses who ignored the proposed change earlier adopt it because of what they hear from nurses who adopted it initially. Both of these theory’s are widely used in nursing and both require nurses that want the change or who are willing to make the change. My mentor has used the Lewin’s change theory recently. The hospital already has hourly rounding but she just introduced new paperwork that has to be signed every hour. The unfreezing period she just explained how the new way will be better and she showed the nurses how it will be easier because the techs can also sign the sheet. The moving stage she let the nurses tell her how they feel about the whole situation and letting them express what they think will work. The final stage is refreezing and during this stage she went around for the first week making sure the nurses get this in their daily habit. I believe this theory makes more sense to my EBP because there are a lot of nurses that will be the driving force to make this happen and less people being the resistant force. So, it will be more likely to succeed.

References:

Oguejiofo,N. September 26, 2017. Change Theories in Nursing.

The Politics of Medicare and Medicaid

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Please answer to this discussion post with a minimum of 200 words, APA Style, and no plagiarism. 

________________________________________________________

Hi Class:

I think that Medicaid has had a greater impact compared to Medicare. Medicaid is a government program aimed at supporting low income households by ensuring they can access quality healthcare at low prices. It is funded by both the state and federal levels of government (“1. Introduction: The Medicaid Story,” 2010). It supports these households by covering medical costs associated with medical as well as long term healthcare for individuals that qualify. Medicaid has been identified as the country’s largest public health insurance program. It provides affordable health insurance to people in rural America and to communities that are considered poor.

Due to the fact that this program is funded by two independent bodies, it varied from state to state. Usually, the federal government sets minimum requirements or eligibility standards, amount to be paid as premium and the scope of services available to an individual ((“1. Introduction: The Medicaid Story,” 2010). For one to be eligible for Medicaid, one has to meet strict requirements which are financially based. The entire program has very strict income eligibility requirements which vary from state to state. Klosko (2017) explains that due to this requirement, some of the benefits users of Medicaid get are determined by the financing agreement between both parties.

General services offered under Medicaid include specified inpatient and outpatient services, family planning, nursing facilities and doctors services.

Medicaid is popular among Americans due to the various benefits its users gain from it. However, one should note that there is no single package benefit because the state imposes specific minimum requirements before one is insured (Klosko, 2017). Benefits range from covering preventive healthcare such as immunizations, acute cases for example, where a patient has been hospitalized as well as behavioral conditions such as counselling and psychiatric hospitalization. Non-health services are also covered which include supportive services which are tailor made for people living with disabilities. Disabled patients are given services which allow them to work comfortably in the community which they live.

1. Introduction: The Medicaid Story. (2010). The Politics of Medicaid. doi:10.7312/olso15060-003

References

Klosko, G. (2017). Medicare and Medicaid. Oxford Scholarship Online. doi:10.1093/acprof:oso/9780199973415.003.0008

Practicum Journal: Voluntary and Involuntary Commitment

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Psychiatric Mental Health Nurse Practitioner (PMHNP) may find themselves working in a wide variety of settings—each having their own unique challenges and inherent legal issues. For instance, what do you do in your state of practice when you are providing a therapy/treatment session and a client reports active suicidal ideation? What do you do if you are covering inpatient psychiatric consults and are called to see a patient in the ICU who overdosed on prescription medication requiring intubation? What do you do if you are a PMHNP on an inpatient unit and a client who admitted themselves on a voluntary basis suddenly states that they have decided to sign themselves out of the hospital so that they can go home to kill themselves? These are just some of the legal questions that PMHNPs must know the answers to specific to their state of licensure/practice.

In this Assignment, you investigate your state’s laws concerning voluntary and involuntary commitment. You also analyze a case to determine if the client is eligible for involuntary commitment.

                                   Scenario for Week 7 Case:

You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed?

To Prepare for this Practicum Assignment:

· Review the Learning Resources concerning voluntary and involuntary

commitment.

· Read the Week 7 Scenario in your Learning Resources.

· Research your state’s laws concerning voluntary and involuntary commitment.

                               The Assignment (3 pages):

· Based on the scenario, would you recommend that the client be voluntarily

committed? Why or why not?

· Based on the laws in your state, would the client be eligible for involuntary

commitment? Explain why or why not.

· Did understanding the state laws confirm or challenge your initial

recommendation regarding involuntarily committing the client? Explain.

· If the client were not eligible for involuntary commitment, explain what actions

you may be able to take to support the parents for or against voluntary

commitment.

· If the client were not eligible for involuntary commitment, explain what initial

actions you may be able to take to begin treating the client.

                                                  Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 4, “Theories of Personality and Psychopathology” (pp. 151–191)

Chapter 31, “Child Psychiatry” (pp. 1181–1205)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Neurodevelopmental Disorders”

o “Specific Learning Disorder”

o “Motor Disorders”

Murphy, T. K., Lewin, A. B., Storch, E. A., Stock, S. (2013). Practice parameter for the assessment and treatment of children and adolescents with tic disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 52(12), 1341–1359.

McGarvey, E. L., Leon-Verdin, M., Wancheck, T. N., & Bonnie, R. J. (2013). Decisions to initiate involuntary commitment: The role of intensive community services and other factors. Psychiatric Services, 64(2), 120–126.

Kaltiala-Heino, R. (2010). Involuntary commitment and detainment in adolescent psychiatric inpatient care. Social Psychiatry and Psychiatric Epidemiology, 45(8),785–793. doi:10.1007/s00127-009-0116-3

Lindsey, M. A., Joe, S., Muroff, J., & Ford, B. E. (2010). Social and clinical factors associated with psychiatric emergency service use and civil commitment among African-American youth. General Hospital Psychiatry, 32(3), 300–309. doi: 10.1016/j.genhosppsych.2010.01.007

Health Advocacy Campaign

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You will develop a 9- to 12-page paper that outlines a health advocacy campaign designed to promote policies to improve the health of a population of your choice. This week, you will establish the framework for your campaign by identifying a population health concern of interest to you. You will then provide an overview of how you would approach advocating for this issue. In Week 9, you will consider legal and regulatory factors that have an impact on the issue and finally, in Week 10, you will identify ethical concerns that you could face as an advocate. Specific details for each aspect of this paper are provided each week. The Final Paper will be due in Week 10. This paper will serve as the Portfolio Application for the course.

Before you begin, review the complete Assignment.

This week, begin developing your health advocacy campaign by focusing on the following:

To prepare for this final portion of your paper:

Review provisions 7, 8, and 9 of the ANA Code of Ethics in relation to advocacy for population health.

Reflect on the ethical considerations you may need to take into account in your advocacy campaign.

Research the ethical considerations and lobbying laws relevant to the location where your advocacy campaign will occur.

Consider potential ethical dilemmas you might face in your campaign.

To complete: Revise and combine parts one and two of your previous papers and add the following:

Explain any ethical dilemmas that could arise during your advocacy campaign, and how you would resolve them.

Describe the ethics and lobbying laws that are applicable to your advocacy campaign.

Evaluate the special ethical challenges that are unique to the population you are addressing.

Provide a cohesive summary for your paper.

Reminder: You will submit one cogent paper that combines the previous applications (Parts One and Two) plus the new material.

Your paper should be about 10 pages of content, not including the title page and references.

Case Study: Healing and Autonomy

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Write a 1,200-1,500 word analysis of “Case Study: Healing and Autonomy.” In light of the readings, be sure to address the following questions:

Under the Christian narrative and Christian vision, what sorts of issues are most pressing in this case study?

Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James?

According to the Christian narrative and the discussion of the issues of treatment refusal, patient autonomy, and organ donation in the topic readings, how might one analyze this case?

According to the topic readings and lecture, how ought the Christian think about sickness and health? What should Mike as a Christian do? How should he reason about trusting God and treating James?

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.

Benchmark – Evidence-Based Practice Project: Diabetes

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Identify a research or evidence-based article that focuses comprehensively on a specific intervention or new diagnostic tool for the treatment of diabetes in adults or children.

In a paper of 750-1,000 words, summarize the main idea of the research findings for a specific patient population. Research must include clinical findings that are current, thorough, and relevant to diabetes and the nursing practice.

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.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

125.0 Evidence-Based Practice Project—Intervention Presentation on Diabetes

Based on the summary of research findings identified from the Evidence-Based Project—Paper on Diabetes that describes a new diagnostic tool or intervention for the treatment of diabetes in adults or children, complete the following components of this assignment:

Develop a PowerPoint presentation (a title slide, 6-12 slides, and a reference slide; no larger than 2 MB) that includes the following:

A brief summary of the research conducted in the Evidence-Based Project – Paper on Diabetes.

A descriptive and reflective discussion of how the new tool or intervention may be integrated into practice that is supported by sound research.

While APA format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are required to submit this assignment to Turnitin, Only Word documents can be submitted to Turnitin.

Quantitative, Qualitative, Or Mixed Methods Studies

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Application: Critiquing Quantitative, Qualitative, or Mixed Methods Studies

Critiquing the validity and robustness of research featured in journal articles provides a critical foundation for engaging in evidence-based practice. In Weeks 5 and 6, you explored quantitative research designs. In Week 7, you will examine qualitative and mixed methods research designs. For this Assignment, which is due by Day 7 of Week 7, you critique a quantitative and either a qualitative or a mixed methods research study and compare the types of information obtained in each.

To prepare:

Select a health topic of interest to you that is relevant to your current area of practice. The topic may be your Course Portfolio Project or a different topic of your choice.

Using the Walden Library, locate two articles in scholarly journals that deal with your portfolio topic: (does hand washing and appropriate staff dressing among the surgical ward nurses reduce cross infection during patient management?) 1) Select one article that utilizes a quantitative research design and 2) select a second article that utilizes either a qualitative OR a mixed methods design. These need to be single studies not systematic or integrative reviews (including meta-analysis and metasynthesis). You may use research articles from your reference list. If you cannot find these two types of research on your portfolio topic, you may choose another topic.

Locate the following documents in this week’s Learning Resources to access the appropriate templates, which will guide your critique of each article:

Critique Template for a Qualitative Study

Critique Template for a Quantitative Study

Critique Template for a Mixed-Methods Study

Consider the fields in the templates as you review the information in each article.

Begin to draft a paper in which you analyze the two research approaches as indicated below.

Reflect on the overall value of both quantitative and qualitative research. If someone were to say to you, “Qualitative research is not real science,” how would you respond?

To complete this Assignment:

Complete the two critiques using the appropriate templates (see attached files).

Write a 2- to 3-page paper that addresses the following:

Contrast the types of information that you gained from examining the two different research approaches in the articles that you selected.

Describe the general advantages and disadvantages of the two research approaches featured in the articles. Use examples from the articles for support.

Formulate a response to the claim that qualitative research is not real science. Highlight the general insights that both quantitative and qualitative studies can provide to researchers. Support your response with references to the Learning Resources and other credible sources.

As you complete this Assignment, remember to:

Submit your paper to Grammarly and Turnitin through the Walden Writing Center. Based on the Grammarly and Turnitin reports, revise your paper as necessary.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.

Combine all three parts of this assignment into one Word document including both critique templates and the narrative with your references. Submit this combined document.

Required Resources

.

TOTAL OF 6 REFERENCES, MINIMUM OF 3 MUST BE FROM THE LIST PROVIDED BELOW, THE OTHER THREE ARE EXTERNAL.

ALL EXTERNAL REFERENCES MUST BE LESS THAN 5 YEARS OLD AND MUST BE SCHOLARLY.

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 10, “Rigor and Validity in Quantitative Research”

This chapter introduces the concept of validity in research and describes the different types of validity that must be addressed. Key threats to validity are also explored.

Chapter 11, “Specific Types of Quantitative Research”

This chapter focuses on the specific types of quantitative research that can be selected. The focus is on the purpose of the research rather than the research design. These include such approaches as clinical trials, evaluation research, health services and outcomes research, needs assessments, or replication studies.

Cantrell, M. A. (2011). Demystifying the research process: Understanding a descriptive comparative research design. Pediatric Nursing, 37(4), 188–189.
Retrieved from the Walden Library databases. (for review)

The author of this article discusses the primary aspects of a prominent quantitative research design. The article examines the advantages and disadvantages of the design.

Schultz, L. E., Rivers, K. O., & Ratusnik, D. L. (2008). The role of external validity in evidence-based practice for rehabilitation. Rehabilitation Psychology, 53(3), 294–302.
Retrieved from the Walden Library databases.

This article details the results of a study that sought to balance concern for rigor with concern for relevance. The authors of the article derive and determine a rating format for relevance and apply it to cognitive rehabilitation.

Note: For the Discussion this week, you will need to read the method section of one of the following quasi-experimental studies. Refer to the details provided in the Week 6 Discussion area.

Metheny, N. A., Davis-Jackson, J., & Stewart, B. J. (2010). Effectiveness of an aspiration risk-reduction protocol. Nursing Research, 59(1), 18–25.
Retrieved from the Walden Library databases.

Padula, C. A., Hughes, C., & Baumhover, L. (2009). Impact of a nurse-driven mobility protocol on functional decline in hospitalized older adults. Journal of Nursing Care Quality, 24(4), 325–331.
Retrieved from the Walden Library databases.

Yuan, S.-C., Chou, M.-C., Hwu, L.-J., Chang, Y.-O,, Hsu, W.-H., & Kuo, H.-W. (2009). An intervention program to promote health-related physical fitness in nurses. Journal of Clinical Nursing, 18(10), 1,404–1,411.
Retrieved from the Walden Library databases.

Organization Finance

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Throughout this course, you’ve examined the importance of anticipating financial fluctuations that may impact your organization’s ability to provide services. While financial managers have no time machines or crystal balls, they do have expense forecasts. Expense forecasting is one of the preeminent tools that financial managers can use to prepare their organizations for future fiscal turbulence. In this Assignment, you will examine a scenario and generate a corresponding expense forecast in Excel.

Before pursuing an opportunity or making a major purchase, financial decision makers must first ascertain if the expenditures are justified. Determining whether a new process, system, or purchase will yield worthwhile returns is no easy task. However, managers have a variety of tools to help them decide whether the new expenditure is warranted. Analyzing a venture’s benefit/cost ratio, marginal profit and loss statement, and break-even points enable nurse managers to make educated decisions about how they choose to commit their funds.

Note: For those Assignments in this course that require you to perform calculations you must:
Use the Excel spreadsheet template for the Week 3 assignment
Show all your calculations and formulas in the spreadsheet.
Answer any questions included with the problems (as text in the Excel spreadsheet).
A title and reference page are NOT needed in this assignment. Put your name and assignment at the top of the Excel spreadsheet.

For those not comfortable with the use of Microsoft Excel, this week’s Optional Resources suggest several tutorials.

To prepare:

Review the information in the Week 9 and 10 Learning Resources dealing with expense forecasting, profit and loss, break-even analysis, and benefit and cost ratio analysis. Focus on how they are calculated and how they can be used in decision making.
View the following tutorial videos, provided in this week’s Learning Resources.
Week 10 Application Assignment Tutorial: Benefit Cost Ratio
Week 10 Application Assignment Tutorial: Breakeven Analysis
Week 10 Application Assignment Tutorial: Expense Forecasting
Week 10 Application Assignment Tutorial: Profit and Loss Scenario
Use the Week 10 Application Assignment Template, provided in this week’s Learning Resources, to complete this assignment. Carefully examine the information in each of the scenarios and provide the necessary calculations. Using this information will help you answer the questions. Note: All the scenarios will be submitted as one document. Each scenario will be on a different tab in the spreadsheet.

Expense Forecasting

In this Application Assignment you calculate scenarios focusing on benefit/cost ratio analysis, marginal profit and loss statements, and break-even analysis. For these scenarios, you will utilize the provided figures to perform calculations and then make recommendations about the viability of the investment opportunities

Expense Forecasting Scenario

Your department has performed 20,000 procedures during the first six months (January–June) of 20X1. Spending during that period of time was $210,000 for fixed expense items and $1,200,000 for variable expense items. Of those amounts, $50,000 of fixed expense money was spent on preparing for a Joint Commission survey. Volume is anticipated to be 10% higher in the second half of the year. On November 1st, two new procedure technicians will begin work. The salary and fringe benefit costs for each are $96,000/year. Based on the information provided, prepare an expense forecast for 20X1.

Annualization for Fixed: (Adjusted Total for Year to Date Expense/6) * 12 =Total Annualized Amounts

Annualization for Variable (Adjusted Total for Year to Date Expense/ 20,000) * 40,000 =Total Annualized Amounts.

Financial Analysis Cycle

Marginal Profit and Loss Statement Scenario
You are examining a proposal for a new business opportunity – a new procedure for which demand is expected to be 1,400 units the first year, growing by 600 units a year thereafter. The price charged per procedure is $1,000. The collection rate is anticipated to be 80%. Each procedure consumes $300 of supplies. Salary cost is estimated to cost $540,000 each year, fringe benefits are 25% of salaries, rent for the facility is $55,000/yr and operating cost are $120,000/yr.

Questions:

Develop a marginal profit and loss statement for this business opportunity.
Based on that analysis, should this opportunity be pursued?

Break-Even Analysis Scenario
You can charge $1,075 for a new service. Demand is anticipated to be 8,000 units a year. Your business is able to handle up to 16,500 units annually, so capacity should not be a problem. The average collection rate is 80%. The new service has annual fixed costs of $4,700,000. Variable cost per unit of service is $420.

Question: Use break-even analysis to determine if this new service is financially viable. If the business is not financially viable, what steps could you take to make a case to proceed with implementation? Explain your decision.

Benefit/Cost Ratio Analysis Scenario
You are considering the acquisition of a new piece of equipment with a useful life of five years. This new technology will make your clinical operation more efficient and allow for a reduction of 10 FTEs. The equipment purchase price is $4,500,000 plus 10% installation fee. The purchase price includes service for the first year, an item that has an annual cost of $10,000. There is a potential for additional volume of 150,000 units in the first year, growing by 30,000 each year thereafter. The price charged per unit is $15.00 with a 50% collection rate. The staff being eliminated are paid $12.50 per hour. The fringe benefits rate is 20%. The hurdle rate is 7.5%.

Questions: After reviewing Dr. Ward’s Video and the calculations below, please answer the following questions:

What is meant by benefit/cost ratio, average payback period and ROI and why are the all important to understand when purchasing new equipment?
Based on this information, would you pursue this opportunity?
Explain your decision in 250-500 words in the text box below.