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Document Format: Margins are 1 in. (2.54 cm) on all sides.

All text in the document should be double-spaced.

The font is 12-point Times New Roman. Other choices are 11-point Arial and 11-point Calibri.

The title page is page 1. Nursing homework help

There is no running head for learner assignments. (See Academic Writer: Publication Manual §§ 2.1–2.24 for paper requirements.)

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Abstract

An abstract is useful in professional papers, but not always in learner assignments. In fact, unless you are instructed by your faculty or in the course syllabus, do not expect to use abstracts very often at Capella. If you are submitting for publication, remember to check with the journal or professional organization about their criteria for an abstract. The abstract tells your reader about the article, is brief, and stands alone, so no citations are included. The format for an abstract is a single paragraph (not indented on the first line) that follows the title page and is less than 250 words in length. A structured abstract will have a single paragraph without indentation but having labels (e.g., Objective, Method, Results, and Conclusions) on the same line as the text and bold. For published works, the publishing organization will give you guidance on these. However, for student papers, no abstract is needed unless the faculty request one or the assignment requires it. Remember, no citations.

Keywords: include keywords in the abstract—they should be labeled like this, with the words all in lowercase and separated by commas. Only the first line is indented, like a regular paragraph. No period at the end.

 

 

APA Style Seventh Edition Paper Template: A Resource for Academic Writing

American Psychological Association (APA) style is one of the most popular methods used to cite sources in the social sciences, but it is not the only one. When writing papers in the programs offered at Capella University, you will likely use APA style. This document serves as an APA style resource for the seventh edition guidelines, containing valuable information that you can use when writing academic papers. For more information on APA style, refer to the Publication Manual of the American Psychological Association, also referred to as the APA manual (American Psychological Association, 2020b).

The first section of this paper shows how an introduction effectively introduces the reader to the topic of the paper. In APA style, an introduction never gets a heading. For example, this section did not begin with a heading titled “Introduction,” unlike the following section, which is titled “Writing an Effective Introduction.” The following section will explain in greater detail a model that can be used to effectively write an introduction in an academic paper. The remaining sections of the paper will continue to address APA style and effective writing concepts, including section headings, organizing information, the conclusion, and the reference list.

Writing an Effective Introduction

An effective introduction often consists of four main components, including (a) the position statement, thesis, or hypothesis, which describes the author’s main position; (b) the purpose, which outlines the objective of the paper; (c) the background, which is general information needed to understand the content of the paper; and (d) the approach, which is the process or methodology the author uses to achieve the purpose of the paper. This information will help readers understand what will be discussed in the paper. It can also serve as a tool to grab the reader’s attention. Authors may choose to briefly reference sources that will be identified later in the paper as in this example (American Psychological Association, 2020a; American Psychological Association, 2020b). The Writing Center has developed the acronym POETS to help describe the proper writing style for submissions. POETS is the acronym for purpose, organization, evidence, tone, and sentence structure (Capella Writing Center, n.d.). There will be more on this later.

In an introduction, the writer will often present something of interest to capture the reader’s attention and introduce the issue. Adding an obvious statement of purpose helps the reader know what to expect, while helping the writer to focus and stay on task. For example, this paper will address several components necessary to effectively write an academic paper, including how to write an introduction, how to write effective paragraphs, and how to effectively use APA style.

Level 1 Section Heading Is Centered, Bold, and Title Case

Using section headings can be an effective method of organizing an academic paper. Section headings are not required according to APA style; however, they can significantly improve the quality of a paper by helping both the reader and the author, as will soon be discussed.

Level 2 Section Heading Is Aligned Left, Bold, and Title Case

The heading style recommended by APA consists of five levels (APA, 2020b, pp. 47–48). This document contains multiple levels to demonstrate how headings are structured according to APA style. Immediately before the previous paragraph, a Level 1 section heading was used. That section heading describes how a Level 1 heading should be written, which is centered, bold, and using uppercase and lowercase letters (also referred to as title case). For another example, see the section heading “Writing an Effective Introduction” on page 3 of this document. The heading is centered and bold and uses uppercase and lowercase letters. If used properly, section headings can significantly contribute to the quality of a paper by helping the reader, who wants to understand the information in the document, and the author, who desires to effectively describe it.

Section Heading Purposes

Section Headings Help the Reader.  Section headings serve multiple purposes, including helping the reader understand what is being addressed in each section, maintain an interest in the paper, and choose what they want to read. For example, if the reader of this document wants to learn more about writing an effective introduction, the previous section heading clearly states that is where information can be found. When subtopics are needed to explain concepts in greater detail, different levels of headings are used according to APA style.

Section Headings Help the Author.  Section headings not only help the reader; they also help the author organize the document during the writing process. Section headings can be used to arrange topics in a logical order, and they can help an author manage the length of the paper. In addition to an effective introduction and the use of section headings, each paragraph of an academic paper can be written in a manner that helps the reader stay engaged.

Section Headings Can Demonstrate Fine Detail  Short papers and assignments may not require or need a Level 5 heading, but these will be indented, bold, italic, and title case and end with a period. Note the text starts on the line at the end of the heading following the period.

How to Write Effective Paragraphs

Capella University’s Writing Center (n.d.) has adopted a new set of writing standards to assist learners in their goals to improve their scholarly writing. It is based on five skills known by the mnemonic POETS. In other words, a well-developed Capella paper will demonstrate the following standards. The paper will have a clear purpose statement, be logically organized, utilize current and appropriate evidence that is properly cited, maintain a scholarly tone, and demonstrate proper grammar and writing mechanics in the sentence structure (Capella Writing Center, n.d.). Academic writing is sometimes considered dry and boring. A learning experience may need that formula to encourage learning in different ways as the learner moves from passive learner to active scholar. This growth, according to Gilmore et al. (2019), requires the writer to not only think but also to write differently.

Bias-Free Language

In the seventh edition of the APA manual, another focus is on eliminating bias in language in order to provide a more inclusive tone in scholarly writing. While long considered a grammar issue, it is acceptable in APA to utilize they as a singular pronoun (APA, 2020b). In fact, there is an entire chapter of the manual dedicated to ways to reduce bias in scholarly writing. It is important to use an appropriate level of specificity in descriptions and use sensitivity with the use of labels. Other sections include guidelines on age, disability, gender, race and ethnicity, sexual orientation, socioeconomic status, and participation in research. Be aware of intersectionality, a term used to describe a person based on their identified multiple identities, interconnectivity, social context, power relations, complexity, social justice, and inequalities that can result in oppression (Cole, 2019; Hopkins, 2017).

Considering Direct Quotations

Another important point to consider is the use of direct quotations in papers. While plagiarism is considered an academic integrity issue, many learners are concerned with issues such as self-plagiarism and unintentional plagiarism, and there are others who may go as far as purchasing papers for submission (Colella & Alahmadi, 2019). As a learner travels along their chosen academic pathway, their writing skills and mechanics are expected to improve. It is imperative that the learner transition from finding information and quoting the author word for word to using the information to support an idea, paraphrase, and then synthesize and express the findings in one’s own words. Having said that, there are situations in which quotations may be appropriate, so it is important to cite them properly. According to the seventh edition of the APA manual, “When quoting directly, always provide the author, year, and page number of the quotation in the in-text citation in either parenthetical or narrative format” (APA, 2020b, p. 270). If there are not page numbers, identify the location in another manner (such as a paragraph number).

Notice that the above quote contains fewer than 40 words. There is a different style for quotes containing 40 words or more. These longer quotes use a block quotation format:

Do not use quotation marks to enclose a block quotation. Start a block quotation on a new line and indent the whole block 0.5 in. from the left margin. If there are additional paragraphs within the quotation, indent the first line of each subsequent paragraph an additional 0.5 in. Double-space the entire block quotation; do not add extra space before or after it. Either (a) cite the source in parentheses after the quotation’s final punctuation or (b) cite the author and year in the narrative before the quotation and place only the page number in parentheses after the quotation’s final punctuation. Do not add a period after the closing parenthesis in either case. (APA, 2020b, p. 272)

Conclusion

A summary and conclusion section, which can also be the discussion section of an APA style paper, is the final opportunity for the author to make a lasting impression on the reader. The author can begin by restating opinions or positions and summarizing the most important points that have been presented in the paper. For example, this paper was written to demonstrate to readers how to effectively use APA style when writing academic papers. Various components of an APA style paper that were discussed or displayed in the form of examples include a title page, introduction section, levels of section headings and their use, the POETS format, bias-free language, in-text citations, a conclusion, and the reference list.

 

 

References

American Psychological Association. (2020a). Ethical principles of psychologists and code of conduct (2002, amended effective June 1, 2010, and January 1, 2017). https://doi.org.apa.org/ethics/code/index.aspx

American Psychological Association. (2020b). Publication manual of the American Psychological Association (7th ed.).

Capella University. (n.d.). Writing Center. https://campus.capella.edu/writing-center/home

Cole, N. L. (2019, October 13). Definition of intersectionality: On the intersecting nature of privileges and oppression. ThoughtCo. https://www.thoughtco.com/intersectionality-definition-3026353

Colella, J., & Alahmadi, H. (2019). Combating plagiarism from a transformation viewpoint. Journal of Transformative Learning, 6(1), 59–67. https://jotl.uco.edu/index.php/jotl/article/view/184

Gilmore, S., Harding, N., Helin, J., & Pullen, A. (2019). Writing differently. Management Learning, 50(1), 3–10. https://doi.org/10.1177/1350507618811027

Hopkins, P. (2017). Social geography I: Intersectionality. Progress in Human Geography, 43(5), 937–947. https://doi.org/10.1177/0309132517743677

 

 

Appendix

Tips for the Reference List

  • Always begin a reference list on a new page. It should be placed before any appendices, figures, or tables and titled References.
  • Set a hanging indent that starts with the second line and is double-spaced. You can look in the Paragraph menu of Microsoft Word for formatting the hanging indent so that you will not have to tab the indent. It gives the text a smoother look that remains consistent, even if you make edits.
  • The reference list is in alphabetical order by the first author’s last name. A reference list only contains sources that are cited in the body of the paper, and all sources cited in the body of the paper must be included in the reference list. If you did not cite it, do not list it.
  • The reference list above contains an example of how to cite a source when two documents are written in the same year by the same author.
    • The lowercase letters are used after the date to differentiate the sources. The “a” reflects the alphabetical order in the reference list—not whether it appeared first in the text.
    • The year is also displayed using this method for the corresponding in-text citations, as in the following sentence: The author of the first citation (American Psychological Association, 2020b) is also the publisher; therefore, the word Author is no longer used in the seventh edition.
  • DOI is the digital object identifier.
    • It can be found on the first page of an article, on the copyright page of a book, in the database record of a work, or by searching Crossref.
    • Even if the book is in print, if there is a DOI, use it.
    • Always use the hyperlink format for a DOI—it will always start with https://doi.org/ and will be followed by a number. If the DOI is not in this format, convert it. Do not alter this format, and do not add a final period.
    • There is a short DOI service at http://shortdoi.org/.
  • URL is the uniform resource locator.
    • If there is no DOI, the URL should be used in the reference.
    • Copy and paste the URL directly into your list.
    • Do not add a period at the end.
    • Do use “Retrieved from” before a URL.
  • The Colella and Alahmadi reference is an example of how to cite a source using a URL. Please note that you will not use the Capella link that is often provided in the courseroom. If the URL contains a database title, such as EBSCO or ProQuest, or the name Capella, do not use that in your citation as it will only work for Capella learners and faculty.
  • For examples and further information on references go to:
    • Academic Writer: Sample References.
    • Academic Writer: Reference List.

 

APA Style: Sample Papers shows the title page for a student paper.

 

 

See Academic Writer: Publication Manual §§ 2.9–2.10 (p. 38 in the APA manual) for more information on abstracts.

 

New in APA seventh style—this heading is a regular Level 1 and should be bold.

 

Another important resource for Capella learners is Academic Writer.

 

See also Academic Writer: Introduction.

 

Level 1 section heading

 

This is the format for a complex list within a sentence. The items begin with lowercase letters and are separated by appropriate punctuation.

 

Related items can also be set off from the text and presented as numbered or bulleted lists. For more information on lists, see Academic Writer: Lists.

 

When you have two sources with the same author and date, use a lowercase a, b, c, after the year and alphabetize the sources in the reference list according to the title. For the same author but no date, use n.d.-a and n.d.-b as the date. See Academic Writer: Alphabetizing the Reference List for more information.

 

Something new in APA seventh style—all headings are double-spaced, bold, and written in title case. See Academic Writer: Heading Levels.

 

In POETS, this is the O for organization. See Writing Center: Organization.

 

This is a Level 3 heading. Notice it is aligned left, bold, italic, and title case. The paragraph begins on a new line. See Academic Writer: Heading Levels.

 

This is a Level 4 heading—it is indented, bold, and title case. The heading ends in a period, and the text begins on the same line as the heading.

 

Level 4 heading

 

Level 5 heading

 

The Writing at Capella multimedia presentation will help you understand the POETS model.

 

Notice the et al. here—this article has four authors. In APA seventh style, any source with three or more authors will use et al. for every citation, eliminating the need to remember when this appropriate. For more information, see Academic Writer: Citing References in Text.

 

See Academic Writer: Intersectionality for the guidelines.

 

Note the two citations—in a single set of parentheses and separated by a semicolon. The citations are listed alphabetically.

 

Notice the quotation marks around the quoted text and the placement of the punctuation after the parenthetical citation. See Academic Writer: Quotation Marks for more on the use of quotation marks.

 

Notice there is no period after this citation in a block quote—it looks odd, but it is APA style. See Academic Writer: Quotation Marks.

 

Remember all headings are bold.

 

This is something new in APA seventh style—you no longer need the location of the publisher for print books. Also note that if the author is the publisher, it is only listed as the author. This guideline is found on page 324 of the APA manual.

 

See Academic Writer: Publication Manual § 2.14 for more on appendices.

Nursing homework help

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NR514-NEED RESPONSES

I need help responding to the attached peers’ post in 150 words each.

Translational research is an approach encompassing discoveries, insights, and ideas produced by basic scientific inquiry, later used to address human ailments. It plays a vital role in research, including basic and clinical, by seeking to shift towards the bedside from the bench (Seyhan, 2019). The different aspects of translational research entail identifying targets, pathways, biomarkers, and drugs and formulating and testing human tissue xenograft and animal models. In this view, the approach has found significance when translating fundamental research outcomes by scientists into feasible applications and products. However, these intentions and acts are often challenging to the extent that translational research was labeled “the valley of death.” Nursing homework help

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           The reputation of being a “valley of death,” when describing translational research originated because of the challenges encountered. Translating discoveries into effective treatments is often unsuccessful, costly, and time-consuming (Cure Search, 2020). In this case, a discovery in basic science must be guided by subsequent years of further work prior to it becoming an approved treatment. A notable instance entails the research on cancer, which has taken years to monitor how particular tumors spread and impact the human body. Worse still, it is approximated that the probability of positive outcomes involving translational research is often one percent. To put it into context, it means that out of 5,000 compounds assessed, only five will proceed with Phase I studies (Cure Search, 2020). Thus, the FDA is likely to approve just one or two drugs in the end.

Despite the recent measures to enhance the drug development process, particularly efficiency and safety, the outcomes have been mixed, coupled with high failure rates. These outcomes have been attributed to the inability to move to the therapeutic development process following scientific discoveries. In most instances, the translations are usually lost because most are irrelevant to human ailments (Seyhan, 2019). Other underlying factors further promoting such failure entail a lack of technical expertise, incentives, and funding to progress further with the practices. Ironically, despite the increment in funding for biomedical research by the National Institute of Health (NIH), there has been no rise in novel treatments and cures. Thus, most research has stagnated in the “valley of death.”

Another point to highlight is that developing and approving drugs is often extensive. Seyhan (2019) noted that the duration for a new drug took almost 13 years on average, meaning it could be even more for some drugs. When coupled with the increased costs and risks of failure, those who manage to enter the human trial face the risk of failure. According to the NIH, about 85 percent of research projects are often rejected before testing (Seyhan, 2019). From a financial perspective, it is a high number, resulting in huge losses. The field lacks enough funding and rarely attracts investors besides big pharmaceutical entities and national governments.

Overall, the assignment impacted my thoughts in a more in-depth manner concerning the subject of discussion. I got the opportunity to learn the challenges of translation research, considering that I had less insight into the manifestation of such outcomes. For example, I never understood why some projects have dragged on for more than a decade, including research on ailments, mainly cancer and HIV/AIDS. However, I learned that the process is an organic and reiterative approach requiring constant feedback involving several disciplines to guarantee success. In this regard, translational research embodies many loosely integrated practices touching on the biotech industry, pharmaceutical, and academic sectors.  

References

Cure Search. (2020, November 3). What is translational research? Explaining the “Valley of Death’.” Cure Search for Children’s Cancer. https://curesearch.org/what-is-translational-research-explaining-the-valley-of-death/

Seyhan, A. A. (2019). Lost in translation: The Valley of death across preclinical and clinical divide – identification of problems and overcoming obstacles. Translational Medicine Communications, 4(1).

.

Louann Robinson 

Why is translational research referred to as “the valley of death?” According to Wolfe et al. (2013), it is a “metaphorical depths to which promising science and technology too often plunge, never to emerge and reach their full potential” (p.138). When considering the academic gymnastics, funding, intellectual property issues, rules, procedures, and technology requirements, sound research and development ideas often fall by the wayside, or shall I say, “the valley of death?” (Wolfe et al., 2013).

Klitsie et al. (2019) explain the phenomenon by stating, “too often these concepts remain in the prototype stage: they are never implemented and fall into what is popularly termed the Valley of Death” (p.28).

Health care professionals and organizations need to be able to reach their diverse patient populations to advance patient outcomes effectively. According to Horvat et al. (2014), cultural competence enables providers to tailor health care needs specific to patients with diverse values, beliefs, and social, cultural, and linguistic needs.

All of this is so important because for researchers to address the needs of our underserved minority patient populations, we must first understand our audience. The best intentions and buckets full of money will not reach patients and change outcomes because the message is misunderstood. A great way to reach a minority population is to work with community leaders; this approach provides context and builds relationships and trust.

This assignment has taught me that the most effective way to improve patient care outcomes and compliance is through balancing priorities and effective communication. The patient must understand what I am saying and establish their priority goals; otherwise, what is the point? (see Appendix).

References

Hospital for Special Surgery. (2020, October 23). How to Improve Communications Among Your Healthcare Team. Retrieved May 2, 2022, from https://www.hss.edu/conditions_health-literacy-tips-improve-communication-with-healthcare-team.asp

Horvat,  L., Horey,  D., Romios,  P., & Kis‐Rigo,  J. (2014).  Cultural competence education for     health professionals. Cochrane Database of Systematic Reviews. 2014(5), John Wiley & Sons, LTD.

Klitsie, J. B., Price, R. A., & de Lille, C. S. H. (2019). Overcoming the Valley of Death: A Design Innovation Perspective. Design Management Journal, 14(1), 28–41. https://doi.org/10.1111/dmj.12052

Wolfe, A. K., Bjornstad, D. J., Shumpert, B. L., Wang, S. A., Lenhardt, W. C., & Campa, M. F. (2013). Insiders’ Views of the Valley of Death: Behavioral and Institutional Perspectives. BioScience, 64(2), 138–144. https://doi.org/10.1093/biosci/bit015

                     Appendix

Considerations between patient and provider for improved patient-centered care outcomes (HSS, 2020).

 

 

Carolyn Gaeckle 

Translational research is understood to be the connection between the “bench”, or where research is actually being done, and the patient “bedside”. Translational research is the joining of research and direct patient intervention, or “that harnesses knowledge from basic scientific research into clinical research to create novel treatments and treatment options devices, medical procedures, preventions, and diagnostics essentially forming a bridge between basic research and clinical research” (Seyhan, 2019). Translational research is also sometimes referred to as “the valley of death”, and this may be for a variety of reasons. Between basic science and clinical science lies translational science, where, without proper resources and steps taken, ideas come to die. “To cross the “Valley of Death”, several key requirements must be in place to move these discoveries into new treatments, diagnostics and preventions” (Seyhan, 2019). Some of these requirements include funding and reproducibility. A study could show great promise, but if it lacks reproducibility they are going to have trouble. In addition, if they lack funding, scientists won’t have the monetary resources available to continue their research and disseminate their information. “Even with the fascinating observations and creative science, most of the basic scientific discoveries fail to get into the therapeutic development process and often get lost in translation because they are irrelevant to human disease or lack funding, incentives, and technical expertise to advance any further” (Seyhan, 2019). The process to actually move from just research to real intervention is timely, costly, and involves many different factors. Take for example a new medication that is shown to improve symptoms of a serious mental health disorder. “With an estimated cost of $1–2 billion to develop a new drug, development time lines of 15 to 20 years, and a failure rate of approximately 95%, many pharmaceutical companies have been forced to downsize their operations, especially in early drug discovery” (Gamo et al., 2017).

Gamo, N. J., Birknow, M. R., Sullivan, D., Kondo, M. A., Horiuchi, Y., Sakurai, T., Slusher, B. S., & Sawa, A. (2017). Valley of death: A proposal to build a “translational bridge” for the next generation. Neuroscience research, 115, 1–4. https://doi.org/10.1016/j.neures.2016.11.003

Seyhan, A. A. (2019). Lost in translation: the valley of death across preclinical and clinical divide – identification of problems and overcoming obstacles. Translational Medicine Communications, Vol. 4, (18). https://doi.org/10.1186/s41231-019-0050-7

 

Euridice Nobre 

Translational research is the transformation of basic scientific research into clinical research to develop new treatments, medical procedures, prevention, and diagnostics that improve health (Woolf, 2008). The “valley of death” is the process from basic research to clinical practice or novel therapeutics. This phase of translational research, “Valley of Death,” can be time consuming, costly, and unsuccessful at times (Meslin et al., 2013).

There are “five hills and four translational valleys from discovery to population health” (Meslin et al., 2013), i.e.,T0 basic science research explicates cellular mechanisms, their relationship to disease and identify therapeutic targets and development of treatment procedures; T1 translation to human aims to determine proof of safety, mechanism, and concept; T2 translation to patients is the tryout required for efficacy of the therapeutic agent in patients representing the relevant disease; T3 translation to practice this phase serve to enhance the therapeutic use of a therapeutic agent in clinical practice. Lastly, is the T4 translation to community, which its objective is to identify use and cost effectiveness of the medication, treatment, or prevention in relation to others currently in use (Seyhan, 2019).

In accordance with Meslin et al., (2013), moving from T0 to T4 implicates going through a diverse collection of organizations and institutional players – government, private sector, and lobbyists among them. Furthermore, challenges such as ambiguous regulation, unnecessary bureaucracy, lack of commercial incentives to innovate, and perhaps, few opportunities to revise legislation or to change habits or practices in the light of new knowledge could prevent translational science to works to its potential. Mesling et al. (2013) suggested that scientific innovation involves social and legal controversies and only “giving attention to bridging science policy’s valley of death as we do to biomedical research translational process, prospects can be favorable for the effective translation of science into collective benefit” (p.8).

This assignment impacted my thoughts on this subject as I learned that the existing gap between what is found in the lab and the actual application of evidence-based practice to helping people is associated with poor outcomes such as obesity, healthcare-acquired infections, and injurious falls (Titler, 2018). Some barriers preventing research findings from being translated into clinal practice include lack of facilities to conduct clinical research, an inadequately trained workforce, and funding (Fudge et al., 2016).

 

References

Fudge, N., Sadler, E., Fisher, H. R., Maher, J., Wolfe, C. D. A., & McKevitt, C. (2016). Optimizing translational research opportunities: A systematic review and narrative synthesis of basic and clinician scientists’ perspectives of factors which enable or hinder translational research. Plos One, 11(8). https://web-p-ebscohost-com.library.norwich.edu/ehost/pdfviewer/pdfviewer?vid=1&sid=831a4673-3cda-4c9c-9463-8c51aa81b4e9%40redis

Meslin, E. M., Blasimme, A., & Cambon-Thomsen, A. (2013). Mapping the translational science policy ‘valley of death’. Clinical and Translational Medicine, 2(1), 1-8. https://doi.org/10.1186/2001-1326-2-14

Seyhan, A.A. (2019).  Lost in translation: the valley of death across preclinical and clinical divide – Identification of problems and overcoming obstacles. Transl Med Commun 4, 18. https://doi.org/10.1186/s41231-019-0050-7

Titler, M.G. (2018) Translation research in practice: An introduction. OJIN: The Online Journal of Issues in Nursing, 23(2). 10.3912/OJIN.Vol23No02Man01

Woolf, S. H. (2008). The meaning of translational research and why it matters. JAMA: The Journal of the American Medical Association, 299(2), 211-213. https://doi.org/10.1001/jama.2007.26

 

Nursing homework help

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Nursing homework help

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Poster Title – USU Logo
Your name
 
Significance/Background: Briefly describe the problem you have identified.  Include current statistics, relevant to the problem, peer reviewed articles supporting the problem. Explain if this problem has been occurring  at your clinical setting Nursing homework help
 
PICO-t: Describe problem, population, intervention, comparison, and expected outcomes and time that you would like to measure the results post intervention. Expand on your answer using support from evidence.
 
Aims of the Study – What are you planning to achieve with your study, short term and long term goals.
 
Design/Methods: Your peer reviewed articles support the design and methodology of your project
 
Proposed Interventions
How would you determine the effectiveness of the proposed interventions/treatments with the identified capstone problem?

 
Expected Results/Outcomes
Specify the expected outcomes that will result from the interventions that you will implement to solve the problem. The results or outcomes should be supported with the evidence based information from the peer reviewed articles that you have read

 
Anticipated Conclusions
Include what you have learned in the implementation of this project and will your project benefit your clinical setting/population

 
Potential Implications to Practice
The effect of your capstone project to the nursing profession and practice and humanities
References and contact information
 
Acknowledgement(s)
 

 

 

 

Template below (page 2)

 

 

 

Template for Poster

 

Create your poster using either PowerPoint or Google Slides. Below is an example of how to format your poster. In week 8, you will be required to add your poster to your final oral presentation. You can create this slide, or use the template below:

 

To download the template for your own editing use, you can do the following (you must be logged into your USU email account when accessing this document):

 

Click here to open the Google slide template: Google Slide Poster Template

 

Using Google Slides

If you want to use Google Slides to create your poster, open the template above. Click on File on the top menu bar, then click “Make a Copy”. Rename your copy then click Ok. To submit your poster, download your slide as a PowerPoint, then upload to the assignment submission drop box.

 

To convert to PowerPoint for submission: Click on File, then click “Download As”, then click “Microsoft PowerPoint.” This will open the slide in PowerPoint.

 

 

 

 

 

Module 06 Assignment

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Module 06 Assignment

Module 06 Assignment

Multidimensional Care IV

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Instructions

Submit your completed assignment by following the directions below. You must include 2-3 refences from scholarly sources and a reference list in APA format at the end of this document. Remember that all references should have accompanying in-text citations in the body of your work. Each answer should be appropriately cited, written in full sentences, and double-spaced per APA format.

Please Include there:

  1. Compromised Airway
  2. Medication Administration
  • Nutritional Requirements
  1. Prevention of Infection

Scenario

You are working the night shift on a medical-surgical unit. Your assignment includes a 19-year-old woman admitted early this morning. She has sustained burns over 30% of her body surface area, with partial-thickness burns on her legs and back. Module 06 Assignment

 

Questions

Discuss the following using instructions and case study outlined on page 1:

  1. The staff are following the Parkland Formula for fluid resuscitation. The client arrived at 0200 and was admitted at 0400. She weighs 110 pounds. Calculate her fluid requirement, using the 4 ml Parkland formula. Explain the time intervals and amounts for each.
  1. Calculate Parkland formula amounts and rates:
Total fluid replacement for 1st 24 hours:  
1st half of fluid replacement (1st 8 hours): Total volume:
Rate per hour:
2nd half of fluid replacement (next 16 hours): Total volume:
Rate per hour:
  1. Why is this time interval important for rescue of the burn victim?

 

  1. The client was sleeping when the fire started and managed to make her way out of the house through thick smoke. You are concerned about possible smoke inhalation. What assessment finding would corroborate this concern?

 

  1. The client is in severe pain. What are the drugs of choice for pain relief? How and when should they be given? Are there any risks associated with these medications?

 

  1. As the client progresses through the stages of burn injury, the focus will begin to shift to nutrition and replenishment. What nutritional requirements are necessary for the client’s burns to heal? What is the goal of nutrition therapy in post-burn care?

 

 

  1. Infection prevention and wound care are necessary to allow for healing of the injured tissue.
  1. What measures are taken with the client suffering from burn injuries to prevent infection?

 

  1. What dressings may be used to prevent infection? Be sure to list and describe at least 3 types of dressings.

 

 

 

 

References

 

 

 

 

Rubric:

The rubric for the assignment can be viewed within Blackboard once you click the assignment.

 

 

Therapy for Clients With Personality Disorders

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Therapy for Clients With Personality Disorders

Assignment: Therapy for Clients With Personality Disorders

Individuals with personality disorders often find it difficult to overcome the enduring patterns of thought and behavior that they have thus far experienced and functioned with in daily life. Even when patients are aware that personality-related issues are causing significant distress and functional impairment and are open to counseling, treatment can be challenging for both the patient and the therapist. For this Assignment, you examine specific personality disorders and consider therapeutic approaches you might use with clients. Therapy for Clients With Personality Disorders

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To prepare:

  • Review this week’s Learning Resources and reflect on the insights they provide about treating clients with personality disorders.
  • Select one of the personality disorders from the DSM-5(e.g., paranoid, antisocial, narcissistic). Then, select a therapy modality (individual, family, or group) that you might use to treat a client with the disorder you selected.

 

The Assignment:

Succinctly, in 1–2 pages, address the following:

  • Briefly describe the personality disorder you selected, including the DSM-5diagnostic criteria.
  • Explain a therapeutic approach and a modality you might use to treat a client presenting with this disorder. Explain why you selected the approach and modality, justifying their appropriateness.
  • Next, briefly explain what a therapeutic relationship is in psychiatry. Explain how you would share your diagnosis of this disorder with the client in order to avoid damaging the therapeutic relationship. Compare the differences in how you would share your diagnosis with an individual, a family, and in a group session.

Support your response with specific examples from this week’s Learning Resources and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources. Therapy for Clients With Personality Disorders

 

 

Also attach and submit PDFs of the sources you used.

 

 

 

 

 

 

 

 

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

 

 

Paris, J. (2015). Psychotherapies. In A concise guide to personality disorders (pp. 119–135). American Psychological Association.

 

Wheeler, K. (Ed.). (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.

Chapter 18, “Dialectical Behavior Therapy for Complex Trauma”

 

 

REQUIRED MEDIA

 

Symptom Media. (2020). Antisocial personality disorder ASPD online CNE CEU courses for nurses [Video]. YouTube. https://www.youtube.com/watch?v=ewBFri65Quw

 

Symptom Media. (2020). Histrionic disorder NP mental health continuing education [Video].

 

Symptom Media. (2020). Narcissistic personality disorder online LPN CE credit CEU unit classes [Video]. YouTube. https://www.youtube.com/watch?v=knfVjj3P9es

 

 

 

 

A Comparative Analysis

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A Comparative Analysis

Assessment 1 Instructions: Evolution of the Hospital Industry: A Comparative Analysis

Top of Form

Bottom of Form

  • PRINT
  • Write a 3 page paper about the similarities and differences in hospital care from the 1800s, 1960s, and today, plus your analysis conclusions. Include a research table in the appendix of your paper. A Comparative Analysis

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Izabella is a health care historian. She has been hired by the Philadelphia Medical Society to research and develop a storyboard of hospital care quality from the first hospital to today’s hospitals. The storyboard will cover the evolution of the hospital environment, staff education, level of care, and how hospital services were paid for.

Izabella’s storyboard begins with the fact that hospitals had humble beginnings in the United States. The first hospital in America was founded in Philadelphia in 1751! Its mission was “to care for the sick-poor and insane who were wandering the streets” of Philadelphia (Penn Medicine, n.d., para. 1). Having a historical perspective on health care changes and trends is critical to understanding how to improve health care today and in the future. What kind of medical care might a patient have received in the first 18th-century hospital?

As a health care administrator, you will often do research on a topic to provide background information for decision making, committee work, or creating policies. It is often best practice to use a comparison table to lay out and visualize your research notations.

Reference

Penn Medicine. (n.d.). History of Pennsylvania Hospital. http://www.uphs.upenn.edu/paharc/features/creation.html

Scenario

Imagine you are a patient with a serious illness in a hospital in the 1800s, in the 1960s, and today. Think about the room configurations, the skills of the nurses and other staff, the level and type of care, and how you would pay for the care, both now and in the previous centuries.

Instructions

Write a 3 page paper about the similarities and differences in hospital care from the different time periods (1800s, 1960s, and today), as well as the conclusions you drew from your analysis. Include a research table in the appendix of your paper.

Complete the following:

  1. The textbook is suggested as the most efficient resource for this assessment, or use at least two other resources from those provided for this assessment. You may also use resources you find on your own from the History of Health Care Researchtab in the Health Care Administration Undergraduate Library Research Guide to research how the hospital industry has evolved in terms of hospital environment, medical staff education, level of care in hospitals, and payment systems.
    • You will need to reference a total of three scholarly sources in your paper.
    • Be sure to cite these references within the body of your paper correctly using APA-style citations.
  2. Complete the Comparative Analysis Table: Hospital Care Evolution, located in the appendix of the Comparative Analysis Template [DOCX].
    • Provide two descriptive changes for each time period under each of the headings.
    • Add bullet points to each cell in the table to document the descriptive changes that you have found for each topic.
    • Document the source where you found the information for each cell in the table, using APA-style citations.
  3. Refer to the Comparative Analysis Assessment Exemplar [PDF]for an example of how to translate the information from the table into a written paper.
    • Note that the assessment exemplar is written about the evolution of physicians’ practices and not hospital care, which is the topic for this assessment.
    • Do not copy the exemplar text into your paper. You should submit original written work about the evolution of hospitals in your paper.
  4. Write an introduction to the paper using the Comparative Analysis Template [DOCX].
    • Include a brief explanation of the purpose of the paper and main ideas.
    • Reference significant trends that you noticed as appropriate.
    • Refer to the Writing Supportpage on Campus for resources to help you as you write and revise your paper.
  5. Write the body of the paper.
    • Write the Hospital Care Evolutionsection in the assessment template, using the information from the Comparative Analysis Table you completed.
      • Describe your findings about each topic in the different time periods under each subtopic heading.
      • Explain the trends in hospital environment, medical staff education, level of care in hospitals, and the payment systems in a short paragraph (3–4 sentences) for each topic, using the subheadings provided in the assessment template.
      • Cite all references used within the body of your paper using APA-style citations.
    • Write the Comparative Analysissection (1–2 paragraphs) in the assessment template.
      • Write a brief summary of your comparisons and analysis about the significance of the key changes from the different time periods.
      • Draw conclusions about how the hospital industry has evolved from the 1800s to the 1960s to today and about the significance of the key milestones from the different time periods.
      • Give specific examples of the impact on the quality of patient care during these time frames.
  1. Write a conclusion paragraph where you summarize the main ideas included in the paper.
    • Explain why it is important to study the history of hospital care for your profession.

Additional Requirements

  • Your paper should be 3 pages, in addition to the title page, appendix, and reference page.
  • Double space your paper, and use Times New Roman, 12-point font, as indicated in the assessment template.
  • Use a minimum of three resources; you may include the textbook.
  • Complete all parts of the assessment template, using the headings provided in the template.
  • Support all points with credible evidence, in the form of APA citations.Refer to Evidence and APA in the Capella Writing Center for help with using APA style.
  • Include a references page in APA format with appropriate citations.
  • Complete the Comparative Analysis Table: Hospital Care Evolutiontable in the appendix of the assessment template.

Competencies Measured

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

  • Competency 1: Analyze trends in the U.S. health care system from a historical perspective.
    • Compare and contrast the hospital environments of the 1800s, 1960s, and today.
    • Compare and contrast the level of care provided in hospitals of the 1800s, 1960s, and today.
    • Compare and contrast the payment systems in the hospitals of the 1800s, 1960s, and today.
    • Draw conclusions about how the hospital industry has evolved from the 1800s, to the 1960s, to today.
  • Competency 3: Analyze the development of medical education in the United States.
    • Compare and contrast the staff education level in hospitals of the 1800s, 1960s, and today.
  • Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others.
    • Appropriately addresses all components of the assessment prompt, using the assessment description to structure text.
    • Apply APA formatting to in-text citations and references.

 

 

Health Care in History

  • Young, K. M., & Kroth, P. J. (2018). Sultz & Young’s health care USA: Understanding its organization and delivery(9th ed.). Jones & Bartlett Learning. Available in the courseroom via the VitalSource Bookshelf link.
    • Chapter 1, “Overview of Health Care: A Population Perspective,” pages 1–21.
    • Chapter 2, “Benchmark Developments in the U.S. Health Care System,” pages 23–43.
  • The U.S. Health Care Timeline.
    • Review this timeline for the major milestones in health care in the United States.
  • Cai, C., Runte, J., Ostrer, I., Berry, K., Ponce, N., Rodriguez, M., Bertozzi, S., White, J. S., & Kahn, J. G. (2020). Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses.PLoS Medicine, 17(1), 1–18.
    • This article is an analysis of the fiscal feasibility of having a single-payer health care system in the United States.
  • Tuohy, C. H. (2019). Political accommodations in multipayer health care systems: Implications for the United States.American Journal of Public Health, 109(11), 1501–1505.
    • This article provides the chance to learn from other developed countries’ experiences with single-payer universal health care and apply it to the U.S. multi-payer system.
  • Morone, J. A. (2010). Presidents and health reform: From Franklin D. Roosevelt to Barack Obama.Health Affairs, 29(6), 1096–1100.
    • This resource offers a historical timeline of the U.S. health care system reforms from Roosevelt to Obama.
  • (n.d.). Healthcare crisis: Who’s at risk?http://www.pbs.org/healthcarecrisis/index.htm
    • This website offers a variety of topics related to health care.
    • Click on the Healthcare Timelinein the left menu of the website, under The Issues heading.

 

 

Hospital Evolution

  • Young, K. M., & Kroth, P. J. (2018). Sultz & Young’s health care USA: Understanding its organization and delivery(9th ed.). Jones & Bartlett Learning. Available in the courseroom via the VitalSource Bookshelf link
    • Chapter 4, “Hospitals: Origin, Organization, and Performance,” pages 71–107.
  • Schwartz, C. C., Ajjarapu, A. S., Stamy, C. D., & Schwinn, D. A. (2018). Comprehensive history of 3-year and accelerated US medical school programs: A century in review.Medical Education Online, 23(1), 1.
    • This article includes a chronological look at the changes in U.S. medical schools from the years 1800 to 2017.
  • Gruber, J., & Levy, H. (2009). The evolution of medical spending risk.Journal of Economic Perspectives, 23(4), 25–48.
    • This article explains the evolution of private and public health care expenditures from 1960 to 2007.
  • Bai G., Yehia F., & Anderson G. F. (2020). Charity care provision by US nonprofit hospitals.JAMA Internal Medicine, 180(4), 606–607.
    • This article addresses the IRS not-for-profit hospital requirement to provide charity care, or uncompensated care, to medically needy and low income patients.
  • The Joint Commission. (n.d.). History of the Joint Commission.https://www.jointcommission.org/about-us/facts-about-the-joint-commission/history-of-the-joint-commission/
    • This resource shows a historical timeline and milestones of the Joint Commission (JC) and hospital quality initiatives (HQI) from 1910 to 2020.
  • Key Milestones in the History of Medicare and Medicaid Timeline.
    • Changes in health care quality have both influenced Medicare and Medicaid and vice versa.

 

 

Evolution of the Hospital Industry: A Comparative Analysis Scoring Guide

CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Compare and contrast the hospital environments of the 1800s, 1960s, and today. Does not address the hospital environments of the 1800s, 1960s, and today. Describes but does not compare and contrast the hospital environments of the 1800s, 1960s, and today. Compares and contrasts the hospital environments of the 1800s, 1960s, and today. Compares and contrast the hospital environments of the 1800s, 1960s, and today. Gives specific examples of the impact on the quality of patient care during these time frames.
Compare and contrast the staff education level in hospitals of the 1800s, 1960s, and today. Does not address the staff education level in hospitals of the 1800s, 1960s, and today. Describes but does not compare and contrast the staff education level in hospitals of the 1800s, 1960s, and today. Compares and contrasts the staff education level in hospitals of the 1800s, 1960s, and today. Compares and contrasts the staff education level in hospitals of the 1800s, 1960s, and today. Gives specific examples of the impact on the quality of patient care during these time frames.
Compare and contrast the level of care provided in hospitals of the 1800s, 1960s, and today. Does not address the level of care provided in hospitals of the 1800s, 1960s, and today. Describes but does not compare and contrast the level of care provided in hospitals of the 1800s, 1960s, and today. Compares and contrasts the level of care provided in hospitals of the 1800s, 1960s, and today. Compares and contrasts the level of care provided in hospitals of the 1800s, 1960s, and today. Gives specific examples of the impact on the quality of patient care during these time frames.
Compare and contrast the payment systems in the hospitals of the 1800s, 1960s, and today. Does not address the payment systems in the hospitals of the 1800s, 1960s, and today. Describes but does not compare and contrast the payment systems in the hospitals of the 1800s, 1960s, and today. Compares and contrasts the payment systems in the hospitals of the 1800s, 1960s, and today. Compares and contrasts the payment systems in the hospitals of the 1800s, 1960s, and today. Gives specific examples of the impact on the quality of patient care during these time frames.
Draw conclusions about how the hospital industry has evolved from the 1800s, to the 1960s, to today. Does not address how the hospital industry has evolved from the 1800s, to the 1960s, to today. Compares and contrasts but does not draw conclusions about how the hospital industry has evolved from the 1800s, to the 1960s, to today. Draws conclusions about how the hospital industry has evolved from the 1800s, to the 1960s, to today. Draws conclusions about how the hospital industry has evolved from the 1800s, to the 1960s, to today. Supports conclusions with several appropriate and significant references and citations from the professional literature.
Appropriately addresses all components of the assessment prompt, using the assessment description to structure text. Does not address the assessment prompt. Writing lacks a clear purpose or message that inhibits effective communication with the intended audience. Appropriately addresses all components of the assessment prompt, using the assessment description to structure text. Appropriately addresses all components of the assessment prompt and uses the prompt to guide organization. Additionally, shares information relevant to all assessment components at a level that communicates clear meaning.
Apply APA formatting to in-text citations and references. Does not apply APA formatting to in-text citations and references. Applies APA formatting to in-text citations and references incorrectly and/or inconsistently, detracting noticeably from good scholarship. Applies APA formatting to in-text citations and references. Exhibits strict and nearly flawless adherence to APA formatting of in-text citations and references.

 

 

 

 

Health Care Quality Evolution Milestone Events Chart

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Health Care Quality Evolution Milestone Events Chart

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Healthcare Legislation, Regulatory Agencies, and Quality Initiatives Milestone Description
1)     1791 Regulating Healthcare States were given the right to regulate health and formally began licensing physicians (Chaudhry, 2010).
2)     1800 State medical boards State medical boards license, discipline, and regulate physicians and other health care professionals to protect the public (Truex, 2014).
3)     1850 First health insurance policy The Franklin Health Assurance Company of Massachusetts was the first commercial insurance company in the U.S. to provide private health care coverage benefits for injuries not resulting in death (Scofea, 1994).
4)     1862 U.S. Army Medical Department and the United States Sanitary Commission formed  Post-Civil War, new health-related agencies, hospitals, and medical research and care implemented to care for the post-Civil War injured and increase population health awareness (Reilly, 2016). Health Care Quality Evolution Milestone Events Chart
5)     1886 U.S. Army established the Hospital Corps The first U.S. data repository to collect medical data. This was implemented by the Surgeon General’s Office and the Library of the Surgeon General (Weedn, 2020).
6)     1900 Self-pay is the primary source of payment for healthcare services Most Americans continued to pay their own health care expenses, which often meant either uncompensated charity care or no care. Hospitals were voluntary institutions that were privately supported (University of Pennsylvania School of Nursing, n.d.).
7)     1908 Workers’ compensation legislation President Theodore Roosevelt signed legislation to provide workers’ compensation (WC) for certain federal employees in unusually hazardous jobs (U.S. Department of Labor, n.d.).
8)     1915 American Association of Labor Legislation (AALL) The first universal access health insurance legislation. It would provide limited insurance benefits to working class, their dependents, and others who earned less than $1,200 a year. Although supported by the American Medical Association (AMA), it was never passed into law (Derickson, 2002).
9)     1916 The Federal Employees’ Compensation Act (FECA) Replaced the 1908 WC legislation to include civilian employees of the federal government. They were provided medical care, survivors’ benefits, and compensation for lost wages under FECA (U.S. Department of Labor, n.d.).
10)  1920 Introduction of prepaid health plans (direct contracting) Direct contracting between employers, local hospitals, and physicians for medical services was the first predetermined fee that was paid monthly or yearly basis. These prepaid health plans were the precursor of today’s managed care plans and capitation payments (Young & Kroth, 2018).
11)  1921 -1976 Indian Health Services (IHS) The Snyder Act of 1921 and the Indian Health Care Improvement Act (IHCIA) of 1976 created the legislative authority for Congress to provide funding to Native Americans for health care services, which is now known as the Indian Health Services (IHS) (Warne & Frizzell, 2014).
12)  1921 Sheppard-Towner Maternity and Infancy Act Legislation to reduce maternal and infant mortality. The Act was challenged and then said to be unconstitutional by the Supreme Court. Additionally, the Act was opposed by the American Medical Association. The act was not renewed and expired in 1929. (Moehling & Thomasson, 2012).
13)  1927 Workers’ Compensation Act Office of Workers’ Compensation Programs (OWCP) administers FECA as well as the Longshore and Harbor Workers’ Compensation Act of 1927 and the Black Lung Benefits Reform Act of 1977 (Young & Kroth, 2018).
14)  1929 Blue Cross (BC) Insurance Policy Baylor University, Dallas, TX, guaranteed schoolteachers 21 days of hospital care for $6 a year. Other groups of employees in Dallas joined, and in a short time period BC becomes hospital insurance nationwide (Young & Kroth, 2018).
15)  1930 Blue Shield (BS) Plans Blue Shield (BS) was founded to provide insurance to lumber and mining camps of the Pacific Northwest at the turn of the century. Employers paid fees to medical service bureaus, which were composed of groups of physicians. BS becomes physician insurance nationwide (Young & Kroth, 2018).
16)  1938 The Food, Drug, and Cosmetic Act was signed by President Franklin Delano Roosevelt Food, drug, and cosmetic safety implemented. The new law brought cosmetics and medical devices under control, and it required that drugs should be labeled with adequate directions for safe use (Young & Kroth, 2018; FDA, n.d.).
17)  1939 Wagner National Health Act (S.1620) The bill would have allowed the states to implement mandatory and universal health care but did not pass due to WWII (United States national health program: Wagner, bill, S. 1620, 1939).
18)  1946 Hill-Burton Act Provided federal grants for modernizing hospitals during the Great Depression and WWII (1929-1945). In return for federal funds, hospitals were required to provide services free or at reduced rates to patients unable to pay for care (Young & Kroth, 2018).
19)  1947 Taft-Hartley Act Amended the National Labor Relations Act of 1932, restoring a more balanced relationship between labor and management. An indirect result of Taft-Hartley was the creation of third-party administrators (TPAs), which administer health care plans and process claims, thus serving as a system of checks and balances for labor and management (Achermann, 2009).
20)  1948 International Classification of Disease (ICD), World Health Organization (WHO). Classification system used to collect diagnoses for statistical purposes. Originally used for mortality reporting but later and today used for morbidity reporting as well (Young & Kroth, 2018).
21)  1950 Major medical insurance Birth of the major medical insurance for catastrophic and prolonged illness, with deductibles and lifetime maximum benefit amounts (Young & Kroth, 2018).
22)  1951 The Joint Commission (JC): Facility Accreditation The Joint Commission does accreditation for hospitals and other medical facilities to ensure the facilities pass CMS, state and other inspections and ensure that services and facilities are safe and effective care of the highest quality and value (Young & Kroth, 2018).
23)  1956 Dependents’ Medical Care Act The Dependents’ Medical Care Act of 1956 was signed into law and provided health care to dependents of active military personnel (precursor to CHAMPVA 1973 and now TriCare 1988) (Young & Kroth, 2018).
24)  1966 Social Security Amendments of 1965 Medicare-Title XVIII insurance for Americans over the age of sixty-five (65). Medicaid-Title XIX a cost-sharing program between the federal and state governments to provide health care services to low-income Americans (Young & Kroth, 2018).
25)  1966 Current Procedural Terminology (CPT) The Current Procedural Terminology (CPT) codes were developed by the AMA in 1966 as a way to describe and track physician and other professional medical services. The CPT Code book is updated annually, and changes go into effect on January 1 of each new year (Dotson, 2013).
26)  1970 Controlled Substances Act (CSA); Drug Enforcement Agency (DEA): Controlled substances Controlled Substances Act (CSA) was created to improve the manufacturing, importation and exportation, distribution, and dispensing of controlled substances. Manufacturers, distributors, and dispensers of controlled substances must be registered with the Drug Enforcement Administration (DEA) (Gabay, 2013).
27)  1970 Occupational Safety and Health Administration Act OSHA) The Occupational Safety and Health Administration Act (OSHA) was designed to protect all employees against injuries from occupational hazards in the workplace (Young & Kroth, 2018).
28)  1972 Professional Standards Review Organizations (PSROs) Created as part of Title XI of the Social Security Amendments Act of 1972 were Professional Standards Review Organizations (PSROs), which were physician-controlled nonprofit organizations that contracted with CMS to provide for the review of hospital inpatient resource utilization, quality of care, and medical necessity. The PSROs were replaced with Peer Review Organizations (PROs), as a result of the Tax Equity and Fiscal Responsibility Act of 1982, or TEFRA (Young & Kroth, 2018).
29)  1973 Health Maintenance Organization Act The Health Maintenance Organization Assistance Act of 1973 authorized federal grants and loans to private organizations that wished to develop health maintenance organizations (HMOs), which are responsible for providing health care services to subscribers in a given geographic area for a fixed fee (Young & Kroth, 2018).
30)  1974 Employee Retirement Income Security Act of 1974 (ERISA) ERISA is a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans. This law allows employers to be self-insured (Young & Kroth, 2018).
31)  1975 U.S. Nuclear Regulatory Commission (NRC) The NRC is a federal agency that ensures safe use of radioactive materials. They license and regulate the nation’s civilian use of radioactive materials to provide reasonable assurance of adequate safety for people and the environment. In health care this would include all diagnostic medical use, therapeutic medical use, and medical research use (United States Nuclear Regulatory Commission, 2020).
32)  1976 Food and Drug Administration (F.D.A.): Medical Equipment   FDA: Medical Device Amendments passed to ensure safety and effectiveness of medical devices, including diagnostic products (FDA, n.d.).
33)  1977 Health Care Financing Administration (HCFA) The DHHS combine health care financing and quality assurance programs into one agency, HCFA. Medicare and Medicaid programs were transferred to HCFA, which is now CMS (Young & Kroth, 2018).
34)  1980 American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)             The AAAASF was established to standardize and improve the quality of health care in outpatient facilities. AAAASF accredits thousands of facilities worldwide including clinics, surgery centers, and state/federal health agencies, and patients acknowledge that AAAASF sets the “Gold Standard in Accreditation” (American Association for Accreditation of Ambulatory Surgery Facilities, n.d.).
35)  1980 Department of Health and Human Services (DHHS) The Office of Education and the Department of Health, Education and Welfare (HEW) became the Department of Health and Human Services (DHHS) (U.S. Department of Health & Human Services, n.d.).
36)  1981 Omnibus Budget Reconciliation Act (OBRA) The OBRA was federal legislation that expanded the Medicare and Medicaid programs. Government became more involved in nursing homes, including restraint restrictions (Svahn, 1981).
37)  1982 BCBS Association The Blue Cross Association and the National Association of Blue Shield merge to create the BlueCross BlueShield Association (BCBSA) (Young & Kroth, 2018).
38)  1983 Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) TEFRA created Medicare risk programs, which allowed federally qualified HMOs and competitive medical plans that met specified Medicare requirements to provide Medicare-covered services under a risk contract. TEFRA today is known as Medicare Part C or Medicare Advantage. The Act also enacted a prospective payment system (PPS), which is a predetermined payment for inpatient services based on diagnoses codes. The PPS went into effect in 1983 and is called diagnosis-related groups (DRGs), which is the hospital inpatient reimbursement system. Peer-review organizations (PROs), now called quality improvement organizations, or QIOs, were also created (Young & Kroth, 2018).
39)  1983 Inpatient Perspective Payment System (IPPS) Medicare IPPS is how hospitals are paid for inpatient stays. Each admission is coded with ICD-10-CM diagnoses and ICD-10-PCS hospital procedure codes. Based on the reason for the admission and the severity of illness and procedures performed, the inpatient stay is assigned a Diagnostic Related Group (DRG). The hospital is paid a flat fee for the cost-based DRG. Reimbursement is based on the primary diagnoses, comorbidities and complications (severity of Illness) and procedures performed (Young & Kroth, 2018; Centers for Medicare & Medicaid Services, 2021a).
40)  1984 CMS Standardization of Information submitted on Medicare Claims HCFA, now known as CMS, required providers to use the HCFA-1500 (now called the CMS-41500) to submit Medicare claims. The HCFA Common Procedure Coding System (HCPCS) (now called Health Care Procedure Coding System) was created, which included CPT, level II (national), and level III (local) codes. Commercial payers also adopted HCPCS coding and use of the CMS-1500 claim form. The CPT codes change yearly because technology and medical advancements drive the changes (Young & Kroth, 2018).
41)  1986 Consolidated Omnibus Budget Reconciliation Act (COBRA) Provides workers and their families who lose their health benefits the right to continue those benefits for 18 months or 36 months due to the death of a spouse (Young & Kroth, 2018).
42)  1988 Clinical Laboratory Improvement Act (CLIA) Clinical Laboratory Improvement Act (CLIA) legislation established quality standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results regardless of where the test was performed (Centers for Medicare & Medicaid Services, 2021b).
43)  1989 Agency for Healthcare Research and Quality’s (AHRQ) The AHRQ mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable (Young & Kroth, 2018).
44)  1989 Health Plan Employer Data and Information Set (HEDIS) The National Committee for Quality Assurance (NCQA) developed the HEDIS, which created standards to assess managed care systems using data elements that are collected, evaluated, and published to compare the performance of managed health care plans (Young & Kroth, 2018).
45)  1991 Standardized Evaluation and Management Codes (Physician Office Visit CPT Codes) The AMA and CMS implement major revision of CPT, creating a new section called Evaluation and Management (E/M), which describes patient encounters where the physician must document for quality purpose; past, family and social history (PFSH), physical exam (PE), and medical decision making (MDM) (AMA, 1991).
46)  1991 National Committee for Quality Assurance (NCQA) The NCQA ensures the quality of managed care plans by providing standard and objective information about HMOs (Marjoua & Bozic, 2012).
47)  1992 Resource-Based Relative Value Scale (RBRVS) system Cost-based fee schedule for physicians under Omnibus Reconciliation Acts (OBRA) was created. Each CPT code is assigned a relative value unit (RVU) and multiplied with an annual conversion factor to reimburse the physician more cost-effectively based on their work, overhead, and risk of malpractice (McCormack & Burge, 1994).
48)  1993 Clinton proposed the Health Security Act of 1993 Based on six guiding principles of security, simplicity, savings, choice, quality, and personal responsibility (Young & Kroth, 2018).
49)  1996 National Correct Coding Initiative (NCCI) The NCCI was created to promote correct coding initiatives and to eliminate improper medical coding. NCCI edits are developed based on coding conventions defined in the American Medical Association’s Current Procedural Terminology (CPT) manual (Centers for Medicare & Medicaid Services, 2021f).
50)  1996 Health Insurance Portability and Accountability Act of 1996 (HIPAA) The HIPAA established regulations that govern privacy, security, and electronic transactions standards for health care information. It also created portability of health insurance when an employee terms from their job. The primary intent of HIPAA is to provide better access to health insurance, limit fraud and abuse, and reduce administrative costs (Young & Kroth, 2018).
51)  1997 Balanced Budget Act (BBA); Children’s Health Insurance Plan (CHIP); OIG Fraud & Abuse Audits Title XXI, State Children’s Health Insurance Program (SCHIP) established to provide uninsured, low-income children health insurance under state Medicaid programs. The Balanced Budget Act of 1997 (BBA) addresses health care fraud and abuse issues. The DHHS Office of the Inspector General (OIG) provides investigative and audit services in health care fraud cases (Young & Kroth, 2018).
52)  1999 Center for Improvement in Healthcare Quality (CIHQ) The CIHQ is a membership-based organization comprised primarily of acute care and critical access hospitals, for which it provides accreditation services (Center for Improvement in Healthcare Quality, n.d.).
53)  1999 Omnibus Consolidated and Emergency Supplemental Appropriations Act (OCE- SAA) amended the BBA of 1997 to require the development and implementation of a Home Health Prospective Payment System (HHPPS) The OCE-SAA required the development and implementation of a Home Health Prospective Payment System (HHPPS), which reimburses home health agencies at a predetermined rate for health care services provided to patients. The HHPPS was implemented October 1, 2000, and uses the Outcomes and Assessment Information Set (OASIS), a group of data elements that represent core items of a comprehensive assessment for an adult home care patient and form the basis for measuring patient outcomes for purposes of outcome-based quality improvement (McCall et al., 2013).
54)  2000 Outpatient Prospective Payment System (OPPS) Medicare’s OPPS is used to pay hospital outpatient services. Ambulatory Payment Classifications (APCs) are used to calculate reimbursement and is for hospital-based outpatient claims. It is a cost-based system that uses CPT codes and payment classifications to pay for similar services under group flat fee payments (Centers for Medicare & Medicaid Services, 2021e).
55)  2000 Benefits Improvement and Protection Act of 2000 (BIPA) The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) requires implementation of a $400 billion prescription drug benefit, improved Medicare Advantage (formerly called Medicare+Choice) benefits, faster Medicare appeals decisions, and more (Young & Kroth, 2018).
56)  2000 Managed Market Competition; Consumer-driven health plans Markets were consolidating and managed care was accelerating, and consumer were driving the insurance market-driven health plans. Consumers want the best health care at the lowest cost. Consumer-driving plans were, for example, employer-paid with high-deductible insurance plans with medical savings accounts used by employees to cover deductibles and other medical costs when covered amounts are exceeded (Well, 2002).
57)  2001 Administrative Simplification Compliance Act (ASCA) The ASCA establishes the compliance date (October 16, 2003) for modifications to the Electronic Transaction Standards and Code Sets as required by HIPAA. Covered entities must submit Medicare claims electronically unless the Secretary of DHHS grants a waiver (Centers for Medicare & Medicaid Services, 2021c).
58)  2002 announced that quality improvement organizations (QIOs) CMS OIOs perform utilization and quality control review of health care furnished, or to be furnished, to Medicare beneficiaries. QIOs replaced peer review organizations (PROs), which previously performed this function (Young & Kroth, 2018).
59)  2005 National Provider Identifier, NPI The Standard Unique Health Identifier for Health Care Providers (or National Provider Identifier, NPI) is implemented (Centers for Medicare & Medicaid Services, 2021c).
60)  2005 Patient Safety and Quality Improvement Act of 2005 Amends Title IX of the Public Health Service Act to provide for improved patient safety and reduced incidence of events adversely affecting patient safety. It encourages the reporting of health care mistakes to patient safety organizations by making the reports confidential and shielding them from use in civil and criminal proceedings (Centers for Medicare & Medicaid Services, 2021c).
61)  2005 Deficit Reduction Act of 2005 Created the Medicaid Integrity Program (MIP), which is a fraud and abuse detection initiative and program (Young & Kroth, 2018).
62)  2006 Physician Quality Reporting Initiative (PQRI) or System (PQRS) The Tax Relief and Health Care Act of 2006 (TRHCA) authorized implementation of a physician quality reporting system that establishes a financial incentive for eligible professionals who participate in a voluntary quality reporting program (Young & Kroth, 2018).
63)  2009 American Recovery and Reinvestment Act of 2009 The American Recovery and Reinvestment Act (ARRA) authorized an expenditure of $1.5 billion for grants for construction, renovation and equipment, and the acquisition of health information technology systems (Young & Kroth, 2018).
64)  2009 Health Information Technology for Economic and Clinical Health (HITECH) Act The Health Information Technology for Economic and Clinical Health (HITECH) Act provides DHHS with the authority to establish programs to improve health care quality, safety, and efficiency through the promotion of health IT, including electronic health records and private and secure electronic health information exchange (Young & Kroth, 2018).
65)  2010 Patient Protection and Affordable Care Act (2010) The PPACA (2010) provides quality affordable access to health insurance for Americans. The Act provides a broader range of mandated prevention services, where patients are not to be charged copayments or deductibles on those services to incent them to get the preventive services. The Act eliminates lifetime caps on benefits and extends coverage of college students to age 26 (Young & Kroth, 2018).
66)  2014 National Coordinator for Health Information Technology (ONC) The ONC is the office that supports the administration’s healthIT.gov efforts. It is a primary resource to the entire health system to support the adoption of health information technology and the promotion of nationwide, standards-based health information exchange (HealthIT.gov, 2021).
67)  2015 Hospital Quality Reporting (HQR) and Initiative (H.Q.I.) The HQR began in 2003, mandated by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003. Failure to successfully report resulted in a 0.4 percentage point reduction in the annual market basket used in the reimbursement. This increased to a 2.0 percent reduction under the Deficit Reduction Act of 2005. Under the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act of 2010 the reduction is one-quarter of the hospital’s applicable annual payment rate in 2015 and beyond if all Hospital Inpatient Quality Reporting Program requirements are not met (Centers for Medicare & Medicaid Services, 2021d).
68)  2015 Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and Merit-based Incentive Payment System (MIPS) Repeals the Sustainable Growth Rate (PDF) formula, value-based purchasing. Implements MIPS, which combines the former PQRS reporting system with ePrescribe and meaningful use into the one program with four (4) components (Quality Payment Program, n.d.).
69)  2021 American Rescue Plan Act (ARPA) The American Rescue Plan Act of 2021, also called the COVID-19 Stimulus Package or American Rescue Plan. The ARPA expands A.C.A. health insurance subsidies and lowers costs (Centers for Medicare & Medicaid Services, 2021c).
70)  2021 Medicare Care Compare Medicare search engines that allow Medicare recipients to sign up, log in, and find and compare nursing homes, hospitals, physicians, other providers of care. There is also a look up externally for non-Medicare patients, but the data is limited. The compare data compares from the quality measures and cost data submitted through the quality reporting programs. The data provides transparency and was initiated by the consumerism movement in health care (Medicare.gov, 2021).
71)  2030-2000 Healthy People 2000, 2010,  2020, 2030 Healthy People 2030 is the fifth decade of the program. Healthy People 1990 began a ten-year population health initiative. Every ten years since its inception goals have been set, population health data is measured and outcomes are analyzed. The 1990 to 2000 span of time was the baseline of the program. For Healthy People 2000, the second iteration of the initiative, was guided by 3 broad goals: a) increase the span of healthy life, b) reduce health disparities and c) achieve access to preventive services for all. For Healthy People 2010, the focus increased on improving quality of life. The one significant overarching goal was to eliminate health disparities and not just simply reduce them. For Healthy People 2020 there were four goals: a) attain a high-quality of life; b) live longer without preventable disease, disability, injury, or premature death; c) achieve health equity and eliminate disparities; and d) improve all groups in regard to health status. Finally, for Healthy People 2030, the fifth iteration rolled out in August 2021, there is increased emphasis on the lessons learned over the last 4 decades to improve health equity, health literacy, and a new concentration on well-being (Health.gov, n.d.; Kroth, & Young, 2018).

 

 

 

References

 

Achermann, J. (2009). Small gifts and big trouble: Clarifying the Taft Hartley act. University of San Francisco Law Review, 44(1), 63–94.

American Association for Accreditation of Ambulatory Surgery Facilities. (n.d.). We maintain the highest standards for outpatient accreditation. https://www.aaaasf.org/who-we-are/

Center for Improvement in Healthcare Quality. (n.d.). Welcome to CIHQ. https://www.cihq.org/

Centers for Medicare & Medicaid Services. (2021a). Acute inpatient PPS. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS

Centers for Medicare & Medicaid Services. (2021b). Clinical laboratory improvement amendments (CLIA). https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA

Centers for Medicare & Medicaid Services. (2021c). CY 2002 Physician fee schedule proposed rule with comment period. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched

Centers for Medicare & Medicaid Services. (2021d). Hospital inpatient quality reporting program. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalRHQDAPU

Centers for Medicare & Medicaid Services. (2021e). Hospital outpatient prospective payment system (OPPS). https://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/LimitedDataSets/HospitalOPPS

Centers for Medicare & Medicaid Services. (2021f). National correct coding initiative edits. https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd

Chaudhry, H.J. (2010). The important role of medical licensure in the United States. Academic Medicine, 85(11), 1657. doi:10.1097/ACM.0b013e3181f557ed

Derickson A. (2002). “Health for three-thirds of the nation:” Public health advocacy of universal access to medical care in the United States. American Journal of Public Health, 92(2), 180–190. https://doi.org/10.2105/ajph.92.2.180

Dotson P. (2013). CPT® Codes: What are they, why are they necessary, and how are they developed?. Advances in Wound Care, 2(10), 583–587. https://doi.org/10.1089/wound.2013.0483

Gabay M. (2013). The federal controlled substances act: Schedules and pharmacy registration. Hospital pharmacy, 48(6), 473–474. https://doi.org/10.1310/hpj4806-473

Health.gov. (n.d.). History of healthy people. https://health.gov/our-work/healthy-people/about-healthy-people/history-healthy-people

HealthIT.gov. (2021). https://www.healthit.gov/

Marjoua, Y., & Bozic, K. J. (2012). Brief history of quality movement in US healthcare. Current reviews in Musculoskeletal Medicine, 5(4), 265–273. https://doi.org/10.1007/s12178-012-9137-8

McCall, N., Korb, J., Petersons, A., & Moore, S. (2003). Reforming Medicare payment: Early effects of the 1997 Balanced Budget Act on postacute care. The Milbank Quarterly, 81(2), 277–173. https://doi.org/10.1111/1468-0009.t01-1-00054

McCormack, L. A., & Burge, R. T. (1994). Diffusion of Medicare’s RBRVS and related physician payment policies. Health Care Financing Review, 16(2), 159-173. https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/HealthCareFinancingReview/Downloads/CMS1191353dl.pdf

Medicare.gov. (2021). Find & compare nursing homes, hospitals & other providers near you.  https://www.medicare.gov/care-compare/

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Quality Payment Program. (n.d.). APMs overview. https://qpp.cms.gov/apms/overview

Reilly R. F. (2016). Medical and surgical care during the American Civil War, 1861-1865. Baylor University Medical Center Proceedings, 29(2), 138–142. https://doi.org/10.1080/08998280.2016.11929390

Scofea,L. A. (1994). The development and growth of employer-provider health insurance. Monthly Labor Review, 117(3), 3–10. https://www.bls.gov/opub/mlr/1994/03/art1full.pdf

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The Healthcare Quality Evolution

 

 

The theoretical foundations of qualitative and quantitative methods

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The theoretical foundations of qualitative and quantitative methods are very different, but many researchers believe both methods should be used in the research study to increase validity and reliability. What advantages or disadvantages do you see in using both types of methods in a nursing study? Support your answer with current evidence-based literature.

Ethics assessment 2: Matrix of Ethical Theories

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Write a 2-3 page paper that explains and defends your view on the issue of whether or not patients with no other treatment options have a moral right to unproven drugs.IntroductionMany doctors, nurses, medical technicians, and other health care workers are involved in medical research. The field of medicine is not limited to the direct treatment of patients but also involves the continued expansion of medical research. A large part of such research is clinical research, which puts patients into the role of experimental subjects. This raises a number of challenging questions for health care ethics, many of which follow from the fact that physicians, nurses, and others involved in clinical research have a dual role. As researchers, they are committed to generating new knowledge about diseases, developing new treatments and drug therapies, and, in general, helping to improve the welfare of human beings by eliminating or controlling diseases and increasing longevity. However, researchers involved in clinical research must also be committed to the highest quality care for individual patients taking part in research studies. This assessment explores some of the ethical issues that clinical research raises and some of the safeguards in place to protect the interests of patients involved in research.Demonstration of ProficiencyBy successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:Competency 1: Articulate ethical issues in health care.Explain how the principle of informed consent is relevant to these issues.Explain the costs and benefits of offering unapproved experimental drugs to patients.Competency 2: Apply sound ethical thinking related to a health care issue.Identify relevant ethical theories and moral principles.Articulate arguments using examples for and against offering pre-approved drugs to wider pools of patients.Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.Exhibit proficiency in clear and effective academic writing skills.PreparationWhen a new drug is undergoing clinical trials to be approved for treatment, it must pass through a number of distinct phases of testing. These phases require rigorous study and evidence to demonstrate the safety and efficacy of new treatments. Passing through these phases and achieving approval takes many years for some trials. Before approval, patients not part of a clinical trial have limited or no access to experimental drugs, even though these drugs could be helpful and potentially save their lives. There are various groups pushing for greater patient access to drugs still in the experimental stage. In recent years, the FDA has made it somewhat easier to receive treatment with experimental drugs, but according to advocacy groups there are still too many restrictions (Munson, 2014).This leads to a potential quandary when early stages of research on a drug sometimes suggest that the drug could be effective in treating a certain disease. On one hand, offering easier access to early stage trial drugs could help individuals suffering with a medical condition. However, on the other hand, making early access to experimental drugs easier could limit the pool of patients available to participate in clinical trials that establish whether or not the drug is truly effective and safe. This is an important consideration, as the vast majority of experimental drugs turn out to be completely ineffective or could have very dangerous side effects that will only show up over time and across a wider test population.When completing this assessment, it is important to keep in mind the ethical arguments that are relevant to both views regarding the right to experimental drugs. It may be useful to review the suggested resources and conduct additional independent research while you are planning your assessment submission.InstructionsDo patients with no other treatment options have a moral right to unproven drugs? Write a paper that explains and defends your view on this issue. In addition to reviewing the suggested resources, you are encouraged to locate additional resources in the Capella library, your public library, or authoritative online sites to provide additional support for your viewpoint. Be sure to weave and cite the resources throughout your work. In your paper, address the following points:Identify relevant ethical theories and moral principles.Explain how the principle of informed consent is relevant to the issue.Explain the costs and benefits of making unproven, unapproved experimental drugs widely available to patients. Consider the costs and benefits not only to the individual patients who take these drugs but also potential costs and benefits to other patients.Explain arguments using examples for and against offering pre-approved drugs to wider pools of patients.Support your view using ethical theories or moral principles (or both) that you find most relevant to the issue.Additional RequirementsWritten communication: Written communication is free of errors that detract from the overall message.APA formatting: Resources and citations are formatted according to current APA style and formatting guidelines.Length: 2–3 typed, double-spaced pages.Font and font size: Times New Roman, 12 point.

Week 2 discussion comment.

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Comment using your own words but please provide at least one reference for each comment.Do a half page for discussion #1 and another half page for discussion #2 for a total of one page.Provide the comment for each discussion separate.