NURS 499 Safety Assignment (Signature Assignment)

NURS 499 Safety Assignment (Signature Assignment)

This assignment addresses the following CLOs

CLO # 2  –  Design an individually developed team project that has a focus designed to improve patient/community health outcomes. NURS 499 Safety Assignment (Signature Assignment)

 

CLO # 4  –  Analyze readings in collaboration with class peers online, focusing on specific course content.

 

CLO # 6  –  Determine nurse sensitive or other appropriate outcomes for selected project. NURS 499 Safety Assignment (Signature Assignment)

This assignment addresses the following PLOs

 

PLO # 2  –  Participate in patient safety and quality initiatives within the context of an interprofessional team.

 

Other PLOs may be addressed as well

 

The Safety Assignment requires that students design an individually developed team project that has a  focus on SAFEY and is researched and designed to improve patient/community health outcomes.   The entire project or elements of it may involve safety for patients and/or communities.  It can be the stepping stone for your Capstone Project Proposal.

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  1. Identify and describe one significant safety concern in the clinical site in which you are carrying out the Capstone Project (or another clinical site).    Include the complexities of the setting and/or the concern such as:  pertinent history; political, social, financial and/or other constraints/limitations; resources available or needed; limitations of human factors.

 

If the focus of your capstone project is not directly related to a significant safety issue you can complete this assignment by identifying one significant safety concern for another clinical site that you have identified such as a place of employment.  If you do not use your capstone project site you should email your NURS 499 instructor with your alternate site for this assignment. NURS 499 Safety Assignment (Signature Assignment)

 

  1. Describe the nurse sensitive or other outcomes that are appropriate for the safety concern you have identified. If you have designed your capstone project specifically related to the safety concern described in # 1 above you can use those outcomes.
  2. Describe one intervention related to the safety concern. This can be part of your capstone project or something the agency has initiated.
  3. Explain how this intervention will be evaluated and any evaluation data that is available at the time of this assignment.
  4. Describe how the intervention can be related to one of the professional organizations that are concerned with safety (ANA, WHO, Joint Commission, Medicare, Patient Safety Movement, AHRQ).

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The assignment is a 4 to 5 page paper that is submitted to SafeAssign by the due date.  The paper will be graded  according to the rubric.  This paper is also to be posted in the student’s ePortfolio.

Safety Assignment:The Safety Assignment requires that students design an individually developed team project that has a focus on SAFTEY and is researched and designed to improve patient/community health outcomes.The entire project or elements of it may involve safety for patients and/or communities.

It can be the stepping stone for your Capstone Project Proposal.

You can find valuable information on Nurse Sensitive Indicators by viewing the video link below by Dr. Marge Reilly https://youtu.be/aJ6nyCFdVzE

You may also find this Safety Assignment Rubric overview by Dr. Lavin to be useful https://youtu.be/Flxm7LJDBp8

Other Resources:

Articles on Nurse Sensitive Indicators in the Community

Davies_2007_Insights implementing nursing sensitive indicators.pdf

NursingEcARTICLE_NursingSensitiveIndicatorsinAmbulatoryCare.pdf

You may also find the following links about Nurse Sensitive Indicators useful.

  1. American Sentinel University (2011, November 2). What Are Nursing Sensitive Quality Indicators Anyway? Retrieved from http://www.americansentinel.edu/blog/2011/11/02/what-are-nursing-sensitive-quality-indicators-anyway/
  2. Montalvo, I., (2007, September 30) “The National Database of Nursing Quality IndicatorsTM (NDNQI®)” OJIN: The Online Journal of Issues in Nursing. 12( 3), Manuscript 2. DOI: 10.3912/OJIN.Vol12No03Man02. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NursingQualityIndicators.html
  3. Jones, T.L. (2016, May). Outcome Measurement in Nursing: Imperatives, Ideals, History, and Challenges. OJIN: Online Journal of Issues in Nursing, Vol. 21, No. 2, Manuscript 1. DOI: 10.3912/OJIN.Vol21No02Man01. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-21-2016/No2-May-2016/Outcome-Measurement-in-Nursing.html
  4. NDNQI Nursing-Sensitive Indicators https://nursingandndnqi.weebly.com/ndnqi-indicators.html (need to open in new window)
  5. 2018 National Patient Safety Goals https://www.jointcommission.org/assets/1/6/2018_HAP_NPSG_goals_final.pdf AND https://www.jointcommission.org/standards_information/npsgs.aspx
  6. 2014 PSSTS Joint Commission Overview: Mark R. Chassin, MD, FACP, MPP, MPH, President and CEO: Patient Safety Movement https://youtu.be/6sNc4XMQLVQ
nurs_499_safety_signature_assignment_guidelines.docx
NURS 499 Safety Assignment (Signature Assignment).

Assignment: Abnormal Findings in Patients

Assignment: Abnormal Findings in Patients

Assignment: Abnormal Findings in Patients

In this assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

In this assignment, you will analyze a SOAP note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.

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GENITALIA ASSESSMENT

Subjective:

· CC: “I have bumps on my bottom that I want to have checked out.”

· HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner over the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed. Assignment: Abnormal Findings in Patients

· PMH: Asthma

· Medications: Symbicort 160/4.5mcg

· Allergies: NKDA

· FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD

· Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective:

· VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs

· Heart: RRR, no murmurs

· Lungs: CTA, chest wall symmetrical

· Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact with a healed episiotomy scar present. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia

· Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, neg McBurney

· Diagnostics: HSV specimen obtained

Assessment:

· Chancre

· PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

To prepare:

With regard to the SOAP note case study provided:

· Review this week’s Learning Resources, and consider the insights they provide about the case study.

· Consider what history would be necessary to collect from the patient in the case study.

· Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

· Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

To complete:

Refer to Chapter 5 of the Sullivan text. Analyze the SOAP note case study. Using evidence based resources, answer the following questions and support your answers using current evidence from the literature.

· Analyze the subjective portion of the note. List additional information that should be included in the documentation. Assignment: Abnormal Findings in Patients

· Analyze the objective portion of the note. List additional information that should be included in the documentation.

· Is the assessment supported by the subjective and objective information? Why or Why not?

· Would diagnostics be appropriate for this case and how would the results be used to make a diagnosis?

· Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least 3 different references from current evidence based literature.

In this assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

In this assignment, you will analyze a SOAP note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.

GENITALIA ASSESSMENT

Subjective:

· CC: “I have bumps on my bottom that I want to have checked out.”

· HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner over the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.

· PMH: Asthma

· Medications: Symbicort 160/4.5mcg

· Allergies: NKDA

· FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD

· Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective:

· VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs

· Heart: RRR, no murmurs

· Lungs: CTA, chest wall symmetrical

· Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact with a healed episiotomy scar present. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia

· Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, neg McBurney

· Diagnostics: HSV specimen obtained

Assessment:

· Chancre

· PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

To prepare:

With regard to the SOAP note case study provided:

· Review this week’s Learning Resources, and consider the insights they provide about the case study.

· Consider what history would be necessary to collect from the patient in the case study.

· Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

· Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

To complete:

Refer to Chapter 5 of the Sullivan text. Analyze the SOAP note case study. Using evidence based resources, answer the following questions and support your answers using current evidence from the literature.

· Analyze the subjective portion of the note. List additional information that should be included in the documentation.

· Analyze the objective portion of the note. List additional information that should be included in the documentation.

· Is the assessment supported by the subjective and objective information? Why or Why not?

· Would diagnostics be appropriate for this case and how would the results be used to make a diagnosis?

· Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least 3 different references from current evidence based literature. Assignment: Abnormal Findings in Patients

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

Assignment: Abnormal Findings in Patients

Assignment: Abnormal Findings in Patients

N522PE Neurological & Musculoskeletal Assessment Assignment 3

N522PE Neurological & Musculoskeletal Assessment Assignment 3

N522PE Neurological & Musculoskeletal Assessment Assignment 3

Assignment 3

Assignment Instructions:

For this 4-5 page assignment, you will conduct a focused health history and physical assessment based upon your Practice Experience work in Shadow Health. Particularly, you will complete a focused assessment on Brian, an adult who is complaining of chest pain. Please submit your summary documentation in MS Word. Use the submission parameters and rubric below to guide you in completion of this written assignment. N522PE Neurological & Musculoskeletal Assessment Assignment 3

Submission Parameters:

For this written assignment, please use the following guidelines and criteria. Also, please refer to the rubric for point allocation and assignment expectations. The expected length of the paper is approximately 4-5 pages, which does not include the cover page and reference page(s). N522PE Neurological & Musculoskeletal Assessment Assignment 3

  1. Introduction (including purpose statement)
  2. Focus of the assessment
    1. Describe the focus of this particular assessment on the patient complaining of chest pain
  3. Subjective Component
    1. Describe the ROS, PMH, and other relevant data in this section.
  4. Objective Component
    1. Describe the physical examination findings including techniques of examination
  5. Documented evidence to support clinical reasoning
    1. Describe the list of differential diagnoses
  6. Plan of care
    1. Describe the plan of care individualized to findings, life-span stage of development with culturally specific considerations for each focused area of assessment.
  7. Conclusion
  8. References (use primary and/or reliable electronic sources)

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In regards to APA format, please use the following as a guide:

  • Include a cover page and running head (this is not part of the 4-5 pages limit)
  • Include transitions in your paper (i.e. headings or subheadings)
  • Use in-text references throughout the paper
  • Use double space, 12 point Times New Roman font
  • Apply appropriate spelling, grammar, and organization
  • Include a reference list (this is not part of the 4-5 pages limit)
  • Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. NCSBN, AANP)

Rubric – N522PE Neurological & Musculoskeletal Assessment Assignment 3

Competency

20

18

16

0

Points Earned

Focus of the Assessment is identified with Special Considerations including Documented Focused Health History Documentation clearly shows student has completed a focused assessment with identified special considerations including a well-documented focused health history. Documentation supports the student has completed the focused assessment with minimal identification of special concerns. The focused health history is documented. Documentation supports the student has completed the focused assessment without identification of special concerns. The focused health history is documented and lacks depth and specificity of weekly topic. Documentation supports the student attempted to complete the focused assessment without identification of special concerns. The focused health history is briefly documented and lacks depth and specificity of weekly topic. /20

20

18

16

0

 

Documented Physical Examination Findings including Techniques of Examination N522PE Neurological & Musculoskeletal Assessment Assignment 3 Documentation clearly shows student has completed the physical examination and accurately describes the techniques of examination for the week. Documentation supports the student has completed the physical examination and describes the techniques of examination for the week. Documentation supports student completed some of the physical examination for the focused assessment of the week. Documentation is accurate but lacks depth. No evidence that the student is applying read concepts of advanced focused physical assessment. Documentation lacks depth and may lack coherence for understandability of tasks completed in this week. /20

20

18

16

0

 
Documented Evidence to Support Clinical Reasoning with External Course Resources Discourse clearly shows the student has studied the topic and has given thought to the focused assessed topic and documentation for the week. Discourse supports the student has studied the topic and has given thought to the focused assessment topic and documentation for the week. Discourse supports student studied some of the topic for the focused assessment topic this week. Discourse is accurate but lacks depth. No evidence that that student has read or studied the topic.
Discourse lacks depth. May be presented in a rambling manner.
Content is inaccurate &/or is unclear.
/20

20

18

16

0

 
Individualized Plan of Care Based Upon Clinical Findings Accurately presents an individualized plan of care based upon clinical findings. Presents an individualized plan of care based upon clinical findings. Some minor omissions are noted. Presents a plan of care that is not individualized based upon the clinical findings. A plan of care is not presented or the plan of care presented lacks demonstration of competency or is irrelevant to the clinical findings. /20

5

4

3

0

 
Developmentally and Culturally Specific Accurately documents a developmentally and culturally specific assessment and plan of care for the selected patient. Documents a developmentally and culturally specific assessment and plan of care. Presents a developmentally and culturally specific assessment or plan of care and one or both are not based upon the selected patient. A developmentally and culturally specific assessment and plan of care are not presented or based upon the selected patient’s findings. /5

5

4

3

0

 
Demonstration of Compliance with Ethical and Legal Standards of Professional Nursing Practice Compliance with the ethical and legal standards of professional nursing practice is explicitly stated in the documentation of the focused physical assessment. Compliance with the ethical and legal standards of professional nursing practice is stated in the documentation. Compliance with the ethical and legal standards of professional nursing practice is briefly implied in the documentation of the focused physical assessment or inaccuracies are evidenced in the written assessment. Compliance with the ethical and legal standards of professional nursing practice is not included in the documentation of the focused physical assessment. /5

10

9

8

0

 
Grammar, Spelling, and Punctuation APA Format APA Format, grammar, punctuation and spelling is accurate with no errors. APA Format, grammar, punctuation and spelling is accurate with less than two types of errors. APA Format, grammar, punctuation and spelling is accurate with five or fewer types of errors. APA Format, grammar, punctuation and spelling is accurate with more than five types of errors. /10
COMMENTS: TOTAL: /100

Discussion 5

This week you have studied neurological and musculoskeletal advanced physical assessment. While a diverse set of advanced physical assessment skills where do you place your greatest level of confidence and what areas need more development. What methods do you use to remember assessment of cranial nerves, mental status, or other important clinical assessments of persons with neurological or musculoskeletal problems? Of these areas of advanced physical assessment what psychomotor skill is most challenging for you to accomplish? Why?

Post a concept to the discussion board that you have had difficulty with and note where you are with resolution of these difficulties.  Please describe the clinical issue completely, citing your sources so that your classmates can reference the information and provide additional “clinical pearls”. In other words, please include primary sources and/or reliable electronic sources to support your arguments. N522PE Neurological & Musculoskeletal Assessment Assignment 3

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Discussion Participation Guidelines & Grading Criteria.

Example Discussion 5 Essay

In the nursing process, the most difficult assessment to remember for me has always been the neurologic exam, not so much as the steps, but in connecting each step with the nerve it was assessing. I still had to focus on remembering the function of each nerve.  To remember the order, I came across this acronym, “On, On, On, They Traveled And Found Voldemort Guarding Very Ancient Horcruxes” (Vasković, 2020).  With this, I was able to keep the nerves in order. The olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, and hypoglossal.  However, to remember whether they are sensory, motor or both, I found this other acronym: “Some Say Money Matters, But My Brother Says Big Brains Matter Most”, to be just as helpful as the previous acronym (Vasković, 2020). 

The autonomic nervous system, cranial nerves, muscle strength, reflexes, mental status, balance, coordination, sensation, and the motor system are included in the neurologic exam.  Although I work in an intensive care unit (ICU), the MMSE is still used with other test in order to differentiate between diagnosis of dementia and altered scores due to physical conditions like sleep apnea, which can cause cognitive and memory problems, physical injuries, and depression (Norris et al., 2016). 

Of all the information on the internet, one that I have been using the most to assist me in is the videos from ICU Advantage. With them, I have been able to continuously practice my weak points, in the hopes to become proficient in the cranial nerves and other physical assessments.  

References

    

Cranial Nerve BASICS – The 12 cranial nerves and how to REMEMBER them! (2020). ICU Advantage. https://www.youtube.com/watch?v=GJBnwZQ60Ss&feature=emb_rel_pause

 

Norris, D., Clark, M. S., & Shipley, S. (2016). The Mental Status Examination. American family physician, 94(8), 635–641.

 

Vasković, J. (2020). 12 cranial nerves. Retrieved October 22, 2020, from https://www.kenhub.com/en/study/overview-of-cranial

325 words

In reply to RT

Re: N522PE

by DC – 
Great insights. Describe the process of assessing the deep tendon reflexes.

11 words

In reply to RT

Re: N522PE

by TC – 
Hi Robert!
I also work in an ICU. We use a CAM and RASS score to assess the patient’s level of consciousness and delirium. I feel as though I do practice neurological assessments, I am not as competent as I should be in the aspects of visual acuity, hearing exams, sensory exams, and deep tendon reflexes. Thanks for sharing your helpful videos!

62 words

In reply to RT

Re: N522PE

by DT – 

Thank you, Robert, for your post on acronyms to remember the neurologic exam and the use of ICU advantage. The 12 cranial nerves originate from the brain stem or brain (Bickley & Szilagyi, 2017). Paired nerves relay information from the head and the neck to both sides of the brain (Watson, 2020). The location of the nerves includes the cerebrum, midbrain, pons, pontomedullary, and medulla oblongata. Interestingly, there are five nerves associated with eye function (Watson, 2020). I learned from the ICU advantage video the neuron differences between afferent (sensory) and efferent (motor) (Watson, 2020). The videos have color-coded nerves to identify their location. In addition to the mnemonics you used in your post, they visually used a pictorial representation of the face with the numbers (Watson, 2020). To memorize sensory or motor functions, the author used the pneumonic for the 12 nerves, “some say money matters, but my brother says big brains matter more” (Watson, 2020). I appreciate the use of humor in the work of learning the cranial nerves. N522PE Neurological & Musculoskeletal Assessment Assignment 3

References

Bickley, L. M., & Szilagyi, P. G. (2017). The Nervous System. In R. M. Hoffman (Ed.), Bates’ guide to physical examination and history taking (12th ed., pp. 711–796). Wolters Kluwer.

Watson, E. (2020, February 10). Cranial nerves basics. YouTube. Retrieved October 23, 2020, from https://www.youtube.com/watch?v=GJBnwZQ60Ss

reply 1 and 2 for 12/10/2021

reply 1nitiatives and health policies are very crucial when it comes to the health sector’s progress. They are the key things, which usually ensure the health services delivery by the APNs. The health initiatives also play a crucial role in implementing the policies, and they provide that essential health practices are practised. The three major initiatives and policies that impact the advanced practice nurse are the Affordable Care Act and Patient protection, the Consensus Model for APRN Regulations, and the Institute of Medicine report.One of the policies that are being used to direct and guide my work as an APN is ACA. Some interventions were made by the policy that affected the APNs practice. Health insurance guidelines and reimbursement are one of the policy aspects that cause APNs to be reimbursed at a lower rate as compared to physicians (Lanford & Quadagno, 2021). Expansion of the nurses’ scope and limiting the scope of APNs is another issue with ACA law. Only very few states do allow APNs to operate independently. The law also expanded health services generally hence increasing workload to the duties of APNs.Secondly, the Institute of Medicine recommendation is another initiative policy. One of the recommendations was for the nurses to advance their studies up to the doctorate level. The policy raised the alarm on whether the APNs entry point is raised (Lanford & Quadagno, 2021). The second recommendation was that the limited and scope barriers should be removed hence gagging APNs in their services delivery. This recommendation will affect my practice positively since it will allow me to conduct several health services, which I am able to do without any boundaries. The Consensus Model has also impacted APRN nature of practice for APRN Regulation. Its recommendation states that APRNs are supposed to be allowed to operate independently. This independent practice regulation is vital in guiding how we should collaborate with our fellow health practitioners to achieve interprofessionalism.2. Medicaid eligibility criteria for three different states.Medicaid is referred to the federal program and joint state; they come together with the Health Insurance Program of children intending to offer health coverage to several American citizens like children, pregnant women, seniors, people with disabilities, and parents. Some policies are regulating participation in Medicaid programs. However, there are some policies that are the same in all states, whereas some of the policies differ as per the state.In this discussion, we will focus on Montana, Wisconsin, and Alaska. We will contrast and compare the Medicaid eligibility and the Medicaid eligibility policy implication for these states’ residents. In both three countries, for one to be eligible for Medicaid coverage, the person must be a legal alien, a citizen and a resident of that particular state, and a permanent resident of the United States of America. In addition, the person must also have the need a healthcare cover or healthcare insurance cover.The person who requires the coverage must also be confirmed that their financial status cannot manage to afford covers such as private insurance or Medicare, which is being offered by the private sector. This means that the individual must be categorized among those people with low income (O’connor, 2017). The individual must also be in categories of pregnant women, blind, and those children below the age of 18, disabled persons, and those in the age of 65 years old and above.Being that some of the regulatory policies for eligibility are common in these states, there are still other differences. For instance, in Wisconsin, the individual’s household income should not be more than $ 17,131 per year. While in Montana, they require that the individual’s household should not have an income of more than $ 12 880. In addition, in Alaska, the maximum income requirement for the individual’s household is $ 21 400. The criteria of the eligibility of these states have several implications. This is to ensure that the services of Medicaid are offered to those who deserve it the most (O’connor, 2017). However, because the insurance policy mostly depends on taxpayers’ contributions, it would be better if it were rendered even to those who believe that they are not able to afford the Medicare cover. This is because there are some individuals whose income is above the maximum, but they are not able to afford expensive health care insurance.ReferencesLanford, D., & Quadagno, J. (2021). Identifying the Undeserving Poor: The Effect of Racial, Ethnic, and Anti-Immigrant Sentiment on State Medicaid Eligibility. The Sociological Quarterly, 1-20.O’connor, S. (2017). Using social media to engage nurses in health policy development. Journal of nursing management, 25(8), 632-639.Reply 2Health initiatives have long served as a guide for nursing care practice. Health care initiatives seek to wisely minimize the burden of disease, injury, and disability, as well as to improve the population’s health and functioning (Medicine & Committee on Enhancing Federal Healthcare Quality Programs, 2003).  A variety of initiatives aimed at enhancing the health of the American population were established and put into motion as a result of the Patient Protection and Affordable Care Act of 2010 (Nash & Fabius, 2019) and date back to the Florence Nightingale era. Health policies, initiatives, and programs are critical in assisting APNs in carrying out their professional obligations.Several significant programs establish a framework for innovation with the goal of making population health efforts the norm rather than the exception. In health care, like in many businesses, clear goals and objectives, as well as rules and standards, give an understanding of expectations and drive efforts to provide safe, high-quality care (Nash & Fabius, 2019). Initiatives to promote healthy living, for example, began in 1990. Since Healthy People 1990, the United States has made substantial progress on important public health issues, as organizations at the local, state, territorial, tribal, and national levels have directed their resources and efforts toward improving the health and well-being of all people. Reductions in major causes of death, such as heart disease and cancer, as well as improvements in preventative behaviors, such as childhood vaccines, and reductions in risk factors, such as smoking, high blood pressure, and high cholesterol, are examples of accomplishments (History of healthy people, n.d.).The Health People 2030 iteration of the Healthy People project builds on knowledge accumulated over the last four decades. According to History of Healthy People (n.d.), one of the most important lessons learned from these projects over the last 40 years is that a widely accessible plan with attainable goals can help individuals, organizations, communities, and other stakeholders enhance population health (History of healthy people, n.d.).  If APNs use this framework to guide patient care and treatment, as well as the data gained from this program over the last 40 years and other similar programs, it is possible to enhance healthcare, as well as overall patient health and quality of life.2. Please locate the Medicaid eligibility criteria for 3 different states. Compare and contrast the eligibility criteria, then discuss the implications of the criteria for people in each state.Medicaid is a federal-state partnership that, in conjunction with the Children’s Health Insurance Program (CHIP), covers about 72.5 million Americans, including children, pregnant women, parents, seniors, and people with disabilities. Medicaid is the United States’ single largest source of health coverage.Federal law compels states to cover certain groups of people in order to participate in Medicaid. Low-income families, pregnant women and children who meet certain criteria, and those receiving Supplemental Security Income (SSI) are all mandatory eligible groups. States have additional coverage options and may elect to cover other categories, such as persons receiving home and community-based services and children in foster care who would not be eligible otherwise (Medicaid, n.d.).The baseline eligibility requirements for Medicaid in Georgia Florida, and California are as follows: applicants must be residents of the respective states or legal aliens, must be in need of health care/insurance assistance, and must demonstrate a financial situation that is deemed or described as low income or very low income (Medicaid States Fact Sheets, 2019).Georgia:In addition to meeting the basic eligibility requirements, one may qualify for Medicaid in Georgia if pregnant, a child or teenager, 65 years of age or older, legally blind, disabled, or in need of nursing home care. Additional situations that may make an individual eligible include: if you are leaving Temporary Assistance for Needy Families (TANF) and need health coverage, a family with children under 19 and have very low or no income, an income higher than the limits and you have medical bills you owe (and you are pregnant, under 18 or over 65, blind, or disabled), or caring for a child who is in foster care or has been adopted. An individual is also encouraged to apply if someone in their family needs health care, even if the individual is not certain they will qualify. Some income and resources, according to the Georgia Medicaid eligibility page, do not count as income and may not be counted against you (Medicaid fact sheets, n.d.).Florida:In addition to meeting the basic eligibility requirements individuals may qualify if they are pregnant, responsible for a child 18 years of age or younger, blind, have a disability or a family member in your household with a disability, or are 65 years of age or older m (Florida Medicaid, n.d.)California:In addition to meeting the basic eligibility requirements, one may qualify for Medicaid in California if pregnant, responsible for a child 21 years of age or younger, blind, have a disability or a family member in your household with a disability, or 65 years of age or older (California Medicaid, n.d.)Income Eligibility per StateThe Federal Poverty Level (FPL) is an income measure published annually by the Department of Health and Human Services (HHS). The federal poverty level is used to determine your eligibility for various programs and benefits.2021 Federal Poverty levels:  100% of FPL: $21,960 for a family of three; $12,880 for an individualGeorgiaFloridaCaliforniaChildren252%215%266%Pregnant225%196%213%Parents35%32%138%Childless Adult0%0%138%Seniors & People w/ Disabilities74%88%100%Eligibility Levels (as a % of FPL)(Medicaid States Fact Sheets, 2019)ReferencesCalifornia Medicaid. (n.d.). Benefits. Retrieved December 6, 2021, from https://www.benefits.gov/benefit/1620Federal poverty level. (n.d.). HealthCare.gov. Retrieved December 6, 2021, from https://www.healthcare.gov/glossary/federal-poverty-level-fpl/Florida Medicaid. (n.d.). Benefits. Retrieved December 6, 2021, from https://www.benefits.gov/benefit/1625History of healthy people. (n.d.). Health. Retrieved December 7, 2021, from https://health.gov/our-work/national-health-initiatives/healthy-people/about-healthy-people/history-healthy-peopleMedicaid. (n.d.). Medicaid. Retrieved December 6, 2021, from https://www.medicaid.gov/medicaid/index.htmlMedicaid fact sheets. (n.d.). Georgia Medicaid. Retrieved December 6, 2021, from https://medicaid.georgia.gov/organization/about-georgia-medicaid/medicaid-fact-sheetsMedicaid states fact sheets. (2019, October 17). Kaiser family foundation. Retrieved December 6, 2021, from https://www.kff.org/interactive/medicaid-state-fact-sheets/Medicine, I. O., & Committee on Enhancing Federal Healthcare Quality Programs. (2003). Leadership by example: Coordinating government roles in improving health care quality (1st ed.). National Academies Press. https://www.nap.edu/read/10537/chapter/4Nash, D., & Fabius, R. (2019). Population health: Creating a culture of

Purpose as a nurse

Answer the following question in at least three (3) paragraphs:What sense of purpose or duty guides you in life as a nurse?What is your mission statement?What are your hopes and concerns for your community, your country, and the world now and long-term?

Reading Assignment

A clockwork orange

Picot Research

Prepare this assignment as a 1,500-1,750 words using the instructor feedback from the previous course assignments and the guidelines below.PICOT QuestionRevise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).Research CritiquesIn the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal assignment.Proposed Evidence-Based Practice ChangeDiscuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

Business Writer

Details:As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals.Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics.Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics, and medical homes.In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform.A minimum of three scholarly references are required for this assignment.While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Disc – WK 8(A)

SEE THE ATTACHED HOMEWORK TITLED Disc- WK 8 (A)

The Invisible patient

After reviewing The Invisible Patients documentary, define/describe in detail an ethical dilemma that was experienced by the NP. Please note, there are several ethical issues, so there should be diversity in the responses.  Explain how you would have handled the situation.How is the NP in the documentary a Disruptive Innovator?Discuss if there is a relationship between your personal beliefs and values and this ethical dilemma/barrier.Describe at least one mechanism to overcome the barrier discussed.Examine the potential cost and benefits to this barrier.Remember there is no right or wrong answer for this ethical question. Suggested reference Look at the Nuremburg Code (US Department of Health & Human Services, 2005; Washington, 2012) as it was the major start of ethics in research and that can carry over to nursing practice.