Evaluating and Sustaining Improvement

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 The downfall of many quality improvement initiatives is the inability to sustain improvements. Last week, you considered the use of evidence-based practice models as a method for sustaining practice changes to improve quality. This week’s Discussion builds on those concepts of sustainability. You evaluate measurement mechanisms and explore strategies that leadership and improvement teams can use to sustain improvement efforts.
 

To prepare:

  • Review      the evaluation tools presented in the Learning Resources and how the tools      can be used to promote sustainability.
  • Select      a measurement mechanism that can be used to evaluate your quality      improvement initiative. You may wish to conduct additional research on the      use of measurement mechanisms to sustain outcomes of improvement      initiatives.
  • Consider      the influence of leadership and improvement teams in sustaining      improvement efforts. Ask yourself: What specific strategies can leaders      and my improvement team use to sustain our improvement initiative?

By tomorrow Wednesday February 7, 2018 by 12 noon, post a minimum of 550 words essay in APA format with at least 2 references from the list below. Include the levels one headings as numbered below:

post a cohesive scholarly response that addresses the following:

1) Evaluate the influence of leadership and improvement teams in sustaining improvement efforts. 

2) Present a succinct analysis of three or more strategies leaders and teams can use in your response.

Required Readings

Richardson, A., & Storr, J. (2010). Patient safety: A literative review on the impact of nursing empowerment, leadership and collaboration [corrected] [published erratum appears in INT NURS REV 2010 Mar;57(1):158]. International Nursing Review, 57(1), 12–21. doi:10.1111/j.1466-7657.2009.00757.x 

This article analyzes how nurses can improve patient safety. It identifies certain knowledge gaps that inhibit nurses’ ability to improve patient safety that must be addressed before they can effectively make contributions.

Bigelow, L., Wolkowski, C., Baskin, L., & Gorko, M. (2010). Lean Six Sigma: Sustaining the gains in a hospital laboratory. Clinical Leadership & Management Review, 24(3), 1–14.

In this article, a health care organization uses Lean Six Sigma to improve performance, but it does not initially achieve the desired results. It then utilizes an Operational Performance Improvement office from within the organization to receive better training in Lean Six Sigma and it is finally able to improve performance.

Murphree, P., Vath, R. R., & Daigle, L. (2011). Sustaining Lean Six Sigma projects in health care. Physician Executive, 37(1), 44–48. 

The authors of this article consider ways to keep Lean Six Sigma projects operating instead of closing them. They distinguish between closing and controlling, the latter being the last phase in Lean Six Sigma. According to the authors, many organizations close Lean Six Sigma projects when they should be controlling them.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: Organizational change. Baltimore: Author.

Note: The approximate length of this media piece is 10 minutes.

This video examines factors that enhance and impede organizational change. Dr. Wooden and Dr. Freshman discuss change models that can be used to manage the change process and to assist individuals through the transition period 

Epidemiology And Population Health

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Reflect on your nursing practice for a moment. If you could wipe out one illness, what would it be? How would that impact not just an individual patient, but your entire patient population? What would be the long-term benefits of eliminating that one illness?

The eradication of smallpox by 1979 provides an excellent example of this scenario. This eradication came about as a result of global collaborative efforts involving many countries and organizations, as well as the application of epidemiologic methods. In spite of high initial financial costs, it is estimated that millions of dollars continue to be saved around the world each year as a result of the eradication of this disease.

The eradication of smallpox illustrates the rich history of epidemiology and demonstrates the cost/benefits and implications of improving health at the population level. The application of epidemiologic methods and principles to other critical population health issues continues to play an essential role in improving health and health outcomes.

For this Discussion, you will identify a current population health problem, and you will examine how, and if, the problem is being addressed through the application of epidemiologic principles. You will also discuss the cost-effectiveness of dealing with the problem at the population level.

To prepare:

  • Review      the Learning Resources, focusing on the smallpox epidemic of the 1960s and      1970s and how health organizations applied principles of epidemiology to      eradicate this disease. (See attached file)
  • In      light of this example, consider the cost effectiveness of addressing      smallpox at the population level.
  • Using      the Learning Resources, research a current population health problem      (local or global). Select one on which to focus for this Discussion.
  • Think      about how principles of epidemiology are being applied—or could be      applied—to address the problem.
  • What      lessons from the use of epidemiology in the eradication of smallpox might      be applicable to this selected problem? What are the financial benefits of      addressing this issue at the population level as opposed to the individual      level?

By tomorrow Wednesday 02/28/18 by 12pm, write a minimum of 550 words in APA format with a minimum of THREE scholarly references from the list of required readings below. Include the level one headers as numbered below:

Post a cohesive response that addresses the following:

1) Briefly summarize your selected population health problem and describe how principles of epidemiology are being applied—or could be applied—to address the problem.

2) Are there any lessons learned from the use of epidemiology in the eradication of smallpox that can be applied to your selected problem?

3) Evaluate the cost effectiveness of addressing this health problem at the population level versus the individual level.

Required Readings

Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.

Chapter 1, “History and Scope of Epidemiology”

Chapter 2, “Practical Applications of Epidemiology” (pages 49–80 only)

Epidemiology is defined and introduced in Chapter 1. This chapter also presents an interesting historical overview that explains the emergence of the field. The assigned section of Chapter 2 addresses several uses of epidemiology.

Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J. L. & Horowitz, M. R. (2016). Population health: Creating a culture of wellness (2nd ed). Burlington, MA: Jones & Bartlett Learning.

Building Cultures of Health and Wellness (xxvii)

In the “Population Health Mandate” section of the course text, the authors provide an introduction to population health, noting that it has three core components: health outcomes, health 

determinants, and policies.

Chapter 2, “The Spectrum of Care”

In Chapter 2, the authors examine the purposes of the population health approach. Two key themes are introduced in this chapter: 1) population health as it relates to the challenges of quality and cost in health care, and 2) population health as an approach to not only reducing the burden of chronic illness but also to promoting wellness and increasing prevention.

Chapter 8, “Behavioral Economics”

In Chapter 8, the authors examine effect of social and cognitive function on an individual’s economic decisions. Reinforced by legislation, behavioral economics can be applied in population health to influence and change health outcomes. Compelling examples of incremental improvements (e.g., corporate wellness programs) are provided throughout the chapter.

Larkin, H. (2010). Managing population health. Hospitals & Health Networks, 84(10), 28–32. 

This article uses examples from a diabetes pilot program to demonstrate the value of population health management. The author discusses how the application of individual patient interventions can positively affect the entire target population, as well as improve the cost effectiveness of management programs.

Center for Global Development. (n.d.). Case 1: Eradicating smallpox. Retrieved March 5, 2012, from http://www.cgdev.org/doc/millions/MS_case_1.pdf

This reading presents the eradication of smallpox in the form of a case study. Many lessons can be learned from the successful global effort to eliminate smallpox.

Centers for Disease Control and Prevention. (2011). Morbidity and mortality weekly report. Retrieved from http://www.cdc.gov/mmwr/

The Morbidity and Mortality Weekly Report (MMWR) is a weekly epidemiological report distributed by the U.S. Centers for Disease Control and Prevention (CDC) to provide, according to the MMWR website, “timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations.” It is one of the most important sources of timely public health data published anywhere.

World Health Organization. (2001). Smallpox. Retrieved from http://www.who.int/topics/smallpox/en/

The World Health Organization provides a succinct overview of the eradication of small pox and its impact on population health.

Note: Explore population health issues presented at the websites below as you prepare for this week’s Discussion and Assignment:

American Public Health Association. (2011). Retrieved from http://www.apha.org/

Centers for Disease Control and Prevention. (2011). Retrieved from http://www.cdc.gov/

Food and Agricultural Organization of the United Nations. (2011). Retrieved from http://www.fao.org/index_en.htm

U.S. Food and Drug Administration. (2011). Retrieved from http://www.fda.gov/

Healthy People 2020. (2011). Global health. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=16

U.S. Food and Drug Administration. (2011). Public health focus. Retrieved from http://www.fda.gov/NewsEvents/PublicHealthFocus/default.htm

Required Media

Laureate Education (Producer). (2012). Epidemiology and population health: Introduction to epidemiology and population health [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 6 minutes.

In this week’s program, “Introduction to Epidemiology and Population Health,” Dr. Hull and Dr. Frerich introduce foundational concepts related to epidemiology, noting that this scientific arena focuses on the study of human populations rather than individuals.

Assignment: Adaptive Response

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As an advanced practice nurse, you will examine patients presenting with a variety of disorders. You must, therefore, understand how the body normally functions so that you can identify when it is reacting to changes. Often, when changes occur in body systems, the body reacts with compensatory mechanisms. These compensatory mechanisms, such as adaptive responses, might be signs and symptoms of alterations or underlying disorders. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis.

Consider the following scenarios:

Scenario 1:

Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.

Scenario 2:

Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished.

Scenario 3:

Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To Prepare

· Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.

· Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations.

· Construct a mind map for the disorder described on the Scenario 1: Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

To Complete

Write a 2- to 3-page paper excluding the title page, reference page and Mind Map that addresses the following:

· For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes.  You are required to discuss all three scenarios within the paper component of this assignment.

· Construct one mind map on the disorder described on Scenario 1. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

Instructor Requirements

As advanced practice nurses, we are scholars, nurse researchers and scientists. As such, please use Peer-Reviewed scholarly articles and websites designed for health professionals (not designed for patients) for your references. Students should be using the original citation in Up to Date and go to that literature as a reference. The following are examples (not all inclusive) of resources/websites deemed inadmissible for scholarly reference:

  1. Up to Date (must use original articles from Up to Date as a resource)
  2. Wikipedia
  3. Cdc.gov- non healthcare professionals section
  4. Webmd.com
  5. Mayoclinic.com

Epidemiology in the News: Randomized Trials

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According to the Centers for Disease Control (CDC), asthma is a leading chronic illness in children ages 5 to 17, a leading cause of school absenteeism, and the third highest cause of hospitalizations in children younger than 15 (2011). The costs associated with treating this chronic illness are high.

A number of randomized control trials have examined the effect of instituting a home management program for treating asthma in combination with pharmaceuticals. These studies found that, by implementing a structured home management program, the morbidity, severity, and frequency of asthmatic episodes were reduced (Agrawl, Singh, Mathew, & Malhi, 2005). Recent research is also exploring how and when to cut back on levels of medication as asthma episodes become controlled, further reducing the cost of this chronic illness; however, controversy remains over the long-term effects of reducing levels of medication due to the disparateness of asthma (Rogers & Reiberman, 2012).

For this Discussion, you are asked to identify an example of an experimental study design in the popular literature and consider the ethical implications of the randomized control trial design.

To prepare:

  • Search the Internet and      credible websites to locate a news piece or article that features a      randomized trial study design. The article should be from a widely      distributed news source, accessible to and written for a lay audience.      Possible sources include, but are not limited to, online magazines, online      newspapers, and health news websites. Be sure to include a link to the      article in your posting. You may not select an article already posted by      one of your colleagues for this Discussion.
  • Critically analyze the      following aspects of the research study:
    • Purpose
    • Study population
    • Length of the trial
    • Data collection methods
    • Outcome measures
    • Results and conclusions
    • Ethical issues associated       with the study
  • Ask yourself: How did this      research study benefit from its randomized design? What was discovered by      randomization that might not otherwise have been demonstrated?

By tomorrow 03/20/2018 , write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”

Post a cohesive scholarly response that addresses the following:

1) Summarize the research study addressing the aspects bulleted above. In your posting, provide a link to the article you selected.

2) Identify and discuss the ethical issues associated with this study.

Required Readings

Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.

Chapter 8, “Experimental Study Designs”

This chapter examines experimental and quasi-experimental study designs.

Johnson, T. S. (2010). A brief review of pharmacotherapeutic treatment options in smoking cessation: Bupropion versus varenicline. Journal of the American Academy of Nurse Practitioners, 22(10), 557–563.

The authors of this article explored treatment options for smoking cessation by examining the research literature, including looking at the results of randomized control trials. This article provides an example of how such a literature review can influence practice demonstrate the use and benefits of randomized control trial study designs.

Milligan, K., Niccols, A., Sword, W., Thabane, L., Henderson, J., Smith, A., & Liu, J. (2010). Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: A meta-analysis. Substance Abuse Treatment, Prevention & Policy, 5, 21–34.

This article examines programs that integrate substance abuse treatment and pregnancy, parenting, or child services. The authors conclude that there is a need for funding of high-quality randomized control trial and improved reporting practices. This article also demonstrates the application of analytic research designs to explore a population health problem.

Talaat, M., Afifi, S., Dueger, E., El-Ashry, N., Marfin, A., Kandeel, A., Mohareb, E., & El-Sayed, N. (2011). Effects of hand hygiene campaigns on incidence of laboratory-confirmed influenza and absenteeism in schoolchildren, Cairo, Egypt. Emerging Infectious Diseases, 17(4), 619–625.

This research study used a randomized control trial to examine the association between hand washing and reducing influenza. As you review this article, notice how they structured the research study and how they measured the association between hand washing and absenteeism.

Physicians’ Health Study (2010). Retrieved from http://phs.bwh.harvard.edu

This large-scale, randomized clinical trial that began in 1982 was designed to test the effectiveness of aspirin and beta carotene in preventing heart attacks (myocardial infarctions, or MIs) in male physicians aged 40–84. The first phase of the trial, which included more than 22,000 study subjects, demonstrated that low-dose aspirin does, in fact, reduce the risk of a first MI by 44%. This article provides a good example of the types of large-scale studies conducted using epidemiologic principles that lead to improved population health.

Required Media

Laureate Education (Producer). (2012). Epidemiology and population health: Experimental studies [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 5 minutes.

In this program, the presenters discuss experimental studies, including the effect of randomization and blinding on study results.

Optional Resources

Groopman, J. (2006, December 18) Medical dispatch—The right to a trial: Should dying patients have access to experimental drugs? New Yorker, 82(42), 40–47.

Dorak, M. T. (2006). Epidemiologic study designs [PowerPoint presentation]. Retrieved from http://www.dorak.info/epi/design.ppt

Ibrahim, M., Alexander, L., Shy, C., & Farr, S. (2000). Randomized trials. ERIC Notebook, 10, 1–4. Retrieved from http://cphp.sph.unc.edu/trainingpackages/ERIC/eric_notebook_10.pdf

Policy Initiatives Impacting Informatics And Health Care

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Though electronic health records (EHRs) may provide an abundance of information at faster speeds than paper-based records ever could, the cost and challenges related to implementation have prevented many organizations from adopting EHRs. The Health Information Technology for Economic and Clinical Health (HITECH) Act aims to increase the adoption rate by providing financial incentives for health care organizations that demonstrate “meaningful use” of EHRs. In order to receive these funds, settings must meet a specific set of requirements identified by the HITECH legislation.

The adoption of an EHR can often be a frenzied process because of the incentives provided by the HITECH Act. In addition, the saturation of the technology market provides settings with an overwhelming amount of options from which to choose.

In this Discussion, you debate the effectiveness of the HITECH Act and Meaningful Use mandates.

To prepare:

· Consider the ways HITECH and Meaningful Use mandates have impacted a health care setting with which you are familiar.

· Conduct research in the Walden Library and through credible nursing organizations to assess how the nursing informatics community is addressing these mandates.

· Create a list that documents the pros and cons that mandates such as these have on health care settings. Reflect upon your list, and determine whether you believe these mandates are beneficial or harmful to health care organizations and nursing practice.

By Day 3

Post a brief scholarly commentary that describes your stance on issues related to HITECH and meaningful use. 

Include in your commentary your personal beliefs on the issue, your experiences in a health care organization, and/or the pros and cons surrounding these initiatives. 

Select at least one of the following to underscore your stance:

· Mandating change. Do the HITECH Act and Meaningful Use mandates help to drive and equalize change across all health care settings, or do they lead to rapid and sloppy implementations?

· The benefits or ramifications that stem from the use of incentives and disincentives.

· The influence of across-the-board mandates on patient safety, ethics, and quality of care. (I select this one)

· The allocation of funds specifically earmarked for HITECH and Meaningful Use. Is it worth it or wasted?

***APA style with reference, 600 characters minimum*** Due date 3/28/2017 6:00pm E.T***

Required Readings

Saba, V. K., & McCormick, K. A. (2015). Essentials of nursing informatics (6th ed.). New York, NY: McGraw-Hill. 

  • Chapter 5, “Open Source and Free Software”

This chapter introduces the role that open source and free software plays in informatics. The disruptive and beneficial effects of such software are also described.

  • Chapter 16, “Nursing Informatics and Healthcare Policy”

Much debate has revolved around the health care policies of the Obama administration. This chapter highlights the impact these policies could have on health care and the nursing informatics discipline in particular.

  • Chapter 18, “Establishing Nursing Informatics in Public      Policy”

Chapter 18 emphasizes the responsibility that nurse informaticists have in voicing their needs and concerns to public health care policy drivers. The chapter also stresses why informatics leaders need equal parts education, advisement, competencies, and support.

  • Chapter 27, “Computerized Provider Order Entry”

In this chapter, the authors explore the intricacies of electronic health record vendor applications. The chapter examines integration of electronic health records (EHRs) in the practice setting, the possible impacts EHRs can have on medical errors, and how nurses can support successful EHR adoption.

  • Chapter 43, “The TIGER Initiative”

This chapter assesses the TIGER initiative and its impact in the clinical setting. The chapter details how TIGER aims to integrate evidence and technology informatics into daily use to make health care safer and more effective.

Bolla, Y. (2011). Meaningful use 101. Nursing Management, 42(8), 18–22. 

Retrieved from the Walden Library databases.

Meaningful use has the potential to impact all facets of the health care setting. This article defines meaningful use in its most basic terms and describes its stages in detail.

Hersh, W., Jacko, J. A., Greenes, R., Tan, J., Janies, D., Embiand, P. J., & Payne, P. R. O. (2011). Health-care hit or miss? Nature (London), 470(7334), 327–329.

This article explains the HITECH Act and its origins and benefits. The article also details how the HITECH Act presents an opportunity to expedite the adoption of EHRs in the United States.

Risk management in the health care setting.

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Throughout this course, you have identified, examined, and provided individual as well as collaborative analysis on multiple facets of risk management in the health care setting.

Addressing the knowledge you have gained, and building on that knowledge to add your evaluation of the role that the managed care organization (MCO) plays in today’s health care environment, develop a 250-500 word reflection to incorporate the following:

  1. What is a health care organization’s administrative role regarding oversight of risk management policies and ensuring compliance with managed care organization (MCOs) standards?
  2. What is your assessment of the value provided to an organization that stems from the regulatory statutes of a typical MCO? Consider the establishment of conflict resolution and risk management strategies within the health care organization from the employer/employee perspective as well as in regards to patient conflict circumstances.
  3. What MCO responsibilities pertain to the Patient Protection and Affordable Care Act (PPACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?

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.

Disorders Of The Reproductive Systems

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Select two disorders of the male and/or female reproductive systems that interest you. Post a description of the two reproductive disorders you selected, including their similarities and differences. Then, select one of the following factors: genetics, ethnicity, age, or behavior. And explain how the factor you selected might impact the diagnosis of treatment for the reproductive disorders. 

– This work should have Introduction and conclusion

– This work should have at 4 to 5 current references (Year 2013 and up)

– Use at least 2 references from class Learning Resources

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com

LEARNING RESOURCES

**Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

  • Chapter      32, “Structure and Function of the Reproductive Systems”

This chapter establishes a foundation for examining alterations of reproductive systems by examining the female and male reproductive systems. It covers the development of both reproductive systems and effects of aging on the systems.

  • Chapter      33, “Alterations of the Female Reproductive System

This chapter covers alterations of the female reproductive systems. It also explores the epidemiology, clinical manifestations, evaluation, and treatment of sexually transmitted infections.

  • Chapter      34, “Alterations of the Male Reproductive System”

This chapter covers alterations of the male reproductive systems. It also explores the epidemiology, clinical manifestations, evaluation, and treatment of sexually transmitted infections.

**Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

  • Chapter      22, “Disorders of the Female Reproductive Tract”

This chapter reviews the normal structure and function of the female reproductive tract. It then examines disorders specific to the female reproductive tract such as menstrual disorders and infertility.

  • Chapter      23, “Disorders of the Male Reproductive Tract”

This chapter reviews the normal structure and function of the male reproductive tract. It then explores disorders specific to the male reproductive tract such as male infertility and benign prostatic hyperplasia.

Details: Reflective Analysis: Risk Management And The Role Of Managed Care

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Throughout this course, you have identified, examined, and provided individual as well as collaborative analysis on multiple facets of risk management in the health care setting.

Addressing the knowledge, you have gained, and building on that knowledge to add your evaluation of the role that the managed care organization (MCO) plays in today’s health care environment, develop a 250-500 word reflection to incorporate the following:

1. What is a health care organization’s administrative role regarding oversight of risk management policies and ensuring compliance with managed care organization (MCOs) standards?

2. What is your assessment of the value provided to an organization that stems from the regulatory statutes of a typical MCO? Consider the establishment of conflict resolution and risk management strategies within the health care organization from the employer/employee perspective as well as in regards to patient conflict circumstances.

3. What MCO responsibilities pertain to the Patient Protection and Affordable Care Act (PPACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?

In addition to your textbook, you are required to support your analysis with a minimum of four peer-reviewed references

Book used by school. Risk Management in Health Care Institutions: Limiting Liability and Enhancing Care, 3rd Edition.

Assignment: Antibiotic Stewardship

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Construct a professional paper that outlines the advanced practice role – a nurse practitioner – to advance the CDC’s antibiotic resistance initiative.

Assignment Requirements

  1. Introduction that identifies your advanced practice role and your view of how that role will be able to impact the antibiotic resistance dilemma.  Support your discussion with at least two references from the literature. 
  2. Review the CDC’s goals and identify one of the CDC’s key strategies that you will be able to promote/support in your advanced practice role. Support your discussion with at least two references from the literature. 
  3. Discuss three activities/actions that you will develop to support the promotion of the key strategy that you identified in item 2 above.  Each action/activity needs to be well designed and supported with at least one reference from the literature. For example, if you are a:  
    • nurse practitioner student – what prescribing practices, patient education practices, monitoring programs, etc., will you engage with, and provide justification for your strategies, etc.

Instructions 

  • Prepare and submit a minimum of a 6 page paper pages [excluding title and reference pages].
  • Format consistent with APA style without an abstract page. 
  • Answer all the questions above. 
  • Support your position with examples.
  • Please review the rubric to ensure that your assignment meets criteria.
  • Submit the following documents to the Submit Assignments/Assessments area:
    • Assignment: Antibiotic Stewardship

Drug Treatments For HIV/AIDS

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While HIV/AIDS is still currently incurable, the prognosis for patients with this infectious disease has improved due to advancements in drug treatments. Consider the case of Kristy Aney. Kristy was diagnosed with HIV in 1992 and was told she would survive, at most, 10 more years. Despite unfavorable odds, Kristy is still alive 20 years later. Since her diagnosis, she has witnessed tremendous improvements in HIV/AIDS treatments which have helped patients live longer with fewer side effects. While she acknowledges that these drug treatments have kept her alive, she fears that improvements in drug therapy have led to more people becoming complacent about the disease (Idaho Statesmen, 2012). In fact, the number of people living with HIV/AIDS in the United States is higher than it has ever been (CDC, 2012). This poses the question: Is there a relationship between drug advancements, societal complacency, and infection?

To prepare:

  • Review Chapter 49 of the Arcangelo      and Peterson text, as well as the Krummenacher et al. and Scourfield      articles in the Learning Resources.
  • Reflect on whether or not the      prevalence of HIV cases might be attributed to increased complacency due      to more advanced drug treatment options for HIV/AIDS.
  • Consider how health care      professionals can help to change perceptions and make people more aware of      the realities of the disease.
  • Think about strategies to educate HIV      positive patients on medication adherence, as well as safe practices to      reduce the risk of infecting others.

With these thoughts in mind:

Post an explanation of whether or not you think the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options. Then, explain how health care professionals can help to change perceptions and increase awareness of the realities of the disease. Finally, describe strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.

This work should have Introduction and conclusion

– This work should have at 3 to 5current references (Year 2012 and up)

– Use at least 2 references from class Learning Resources

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com

Required Readings

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

  • Chapter 8, “Principles of      Antimicrobial Therapy” (pp. 111-134)
         This chapter covers factors that impact the selection of an antimicrobial      treatment regimen. It also examines the clinical uses, adverse events, and      drug interactions of various antimicrobial agents such as penicillin.
  • Chapter 12, “Fungal Infections      of the Skin” (pp. 163-196)
         This chapter explores the pathophysiology of several fungal infections of      the skin as well as related drug treatments and examines the importance of      patient education when managing these infections.
  • Chapter 14, “Bacterial      Infections of the Skin” (pp. 181-196)
         This chapter begins by examining causes of bacterial infections. It then      explores the importance of selecting an appropriate agent for treating      bacterial infections.
  • Chapter 32, “Urinary Tract      Infection” (pp. 519-526)
         This chapter covers drugs used to treat urinary tract infections and      identifies special considerations when treating geriatric patients,      pediatric patients, and women.
  • Chapter 35, “Sexually      Transmitted Infections” (pp. 512-535)
         This chapter outlines the causes, pathophysiology, and drug treatment of      six sexually transmitted infections, including gonorrhea, syphilis, and      human papilloma virus infection (HPV). It also examines the importance of      selecting the proper agent and monitoring patient response to treatment.
  • Chapter 49, “Human Immunodeficiency Virus” (pp.      843-860)
         This chapter presents the causes, pathophysiology, diagnostic criteria,      and prevention methods for HIV. It also covers various methods of drug      treatment and patient factors to consider when selecting, administering,      and managing drug treatments.

Krummenacher, I., Cavassini, M., Bugnon, O., & Schneider, M. (2011). An interdisciplinary HIV-adherence program combining motivational interviewing and electronic antiretroviral drug monitoring. AIDS Care, 23(5), 550–561.

This article analyzes medication adherence in HIV patients and examines factors that increase adherence as well as factors that contribute to termination or discontinuation of treatment.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

Scourfield, A., Waters, L., & Nelson, M. (2011). Drug combinations for HIV: What’s new? Expert Review of Anti-Infective Therapy, 9(11), 1001–1011.

Note: Retrieved from the Walden Library databases.

This article examines current therapies and strategies for treating HIV patients. It also examines factors that impact selection of therapy, including drug interactions, personalization of therapy, costs, management of comorbidities, and patient response.

Required Media

Laureate Education, Inc. (Executive Producer). (2012). Antimicrobials. Baltimore, MD: Author.

This media presentation outlines principles of antimicrobial therapy 

Note: The approximate length of this media piece is 7 minutes.

Mayer, K. H., & Krakower, D. (2012). Antiretroviral medication and HIV prevention: New steps forward and New Questions. Annals of Internal Medicine, 156(4), 312–314.