Lab Analysis Nursing Assignment

Lab Analysis Nursing Assignment

Lab Analysis Nursing Assignment

please use the attachment for the question

RNNUR235CaseStudyAdultIILabandDiagAnalysisAPAPaper.doc

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Nursing 235: Adult Health II

Laboratory Analysis Case Scenario

Patient Initials: KH Age: 60

Height: 65 in

Weight: 67.13 kg

HPI

KH presented to the ED with c/o bug bite on L thigh that occurred about 10 days ago that has turned into an abscess “as big as a personal sized watermelon.” Patient also reported urinary burning, frequency, and urgency. The ED, WBC 37,000, glucose 317, bicarbonate 13, anion gap 25, large amount of acetone, HgbA1C 10.3. Patient was admitted to the hospital for evaluation and management of DKA, DVT, abscess, and UTI. Lab Analysis Nursing Assignment

Past Medical/Surgical History:

· Type 2 Diabetes Mellitus

· Previous tobacco use (1/2 pack per day)

· MVA 7/13/20: pain in pelvis and knees since accident

Significant Clinical Events:

8/23/20

· Wound culture: staph aureus, methicillin sensitive

· Blood culture: no growth after 5 days (determined on 8/28/10) Lab Analysis Nursing Assignment

· Urine analysis indicates infection and DKA

· Insulin drip for DKA

· IV antibiotics for UTI, multiple abscesses

· IV antifungals for multiple abscesses & topical antifungal for yeast infection

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8/24/20

· Deep muscle abscess extends to femur (visualized via CT)

· I&D done in OR discovered diffuse myositis & muscle necrosis

· S/p insulin drip for DKA treatment

· Wound nurse consult

· Infectious disease consult

8/26/20

· I&D done in OR on L thigh, R groin abscess

· Patient experience bleeding post-op

· SCD and TED hose prescribed for DVT

8/28/20

· d/c Coumadin due to post procedure bleeding, switched to Lovenox

8/29/20

· bleeding from wound, changed lovenox to heparin

· anemia due to blood loss s/p I&D, received 2 units packed RBC

· Constipation for 1 wk, senna, colace, lactulose

8/30/20

· blood glucose 340-360 mg/dL all day

· patient complains of recent onset visual disturbances (since hospitalization on 8/23/10)

· notify MD, increase levemir to 32 units daily

· MD d/c IV antibiotic and heparin, change to PO antibiotics and coumadin

Test/Result Admit 

8/23/20

Sun 

8/29/20

Mon 

8/30/20

Hemoglobin (g/dL) 13.8 7.4L 9.1L
Hematocrit (%) 42.2 21.1L 25.8L
RBC (M/uL) 4.35 2.28L 2.82L
WBC (K/Ul) 37.2H 11.4H 14.2H
MCV (FL) 97.1H 92.5 91.7
MCH (PG) 31.7 32.3 32.3
MCHC (g/dL) 32.7 35 35.2
RDW (%) 15.1H 15.8H 15.5H
PLT (K/uL) 461H 408 428H
MPV (FL) 7.5 6.6 6.3
PT (Sec.) n/a 9.7 10.0
INR n/a 0.93 0.96
PTT (Sec.) n/a 29.4 @ 0600 

30.3 @ 1400

24.6 @ 0600 

48.1 @ 1400

guaiac negative
BUN (mg/dL) 15 7L 6L
Creatinine–mg/dl 0.96 0.29L 0.36L
GFR AF 54 n/a >60
BNP 277H
AGAP 25.0H 8.0 9.0
Chlroide (mmol/L) 92L 102 98
CO2 (mmol/L) 13L 24 25
Potassium (mmol/L) 4.8 4.1 4.0
Sodium (mmol/L) 130L 134L 132L
Glucose (U/L) 397H 266H 368H
HgbA1C 

 

10.3H
Urinalysis 

Color

Yellow

yellow
Appearance 

Clear

Hazy
Spec. Gravity 

1.002-1.030

1.025
PH 

4.5-8.0

5.5
Protein 

Negative

200mg/dL
GLU 

Normal

1000mg/dL
Ketones 

Negative

>150
Blood 

Negative

300
Urobilinogen 

Normal

2mg/dL
Leuk Ester 

Negative

500

Dx. Tests Date and Client Results

Gram Stain 

 

8/23/10 & 8/25/10 wound culture: gram positive cocci staph like
Cultures/ 

Sensitivities

 

8/23/10 blood culture: no growth after 5 days (8/28/10) 

8/23/10 wound culture of groin abscess: staph aureus, sensitive to methicillin, clindamycin, erythromycin, oxacillin, naficillin, amoxicillin, clavulanic acid, ampicillin, sulbactam, SXT, most parenteral and oral cephalosporins

8/23/10 urine culture: >100,000 CFU/mL staph aureus sensitive methicillin, nitrofurantoin, oxacillin, SXT

8/25/10 culture abscess L bottom: staph aureus (see above wound culture for sensitivities)

Therapeutic 

Drug Levels

PT (9-11.5 sec) and INR (2.0-3.0) evaluate therapeutic drug levels of coumadin, PTT (60-70 sec) evaluate therapeutic levels of heparin.

Dx. Tests Date and Client Results

CXR 

 

8/23/10 CXR: cardiac mediastinal silhouettes normal, lungs are clear. No pleural effusion or indication of CHF.
CT/US/ 

Nuc Med/ Spec Proc

 

8/26/10 CT abdomen & pelvis without contrast: inflammatory mass-like density with subcutaneous of R groin containing central air bubbles presumably secondary to recent drainage/intervention. No well-organized fluid collection in region. Body wall and intra-abdominal edema. Few non-specific bubbles of air within lower anterior abdominal wall. Abscess in proximal L thigh and L buttock not imaged. Lab Analysis Nursing Assignment 

8/26/10 CT pelvis with IV contrast: superficial L medial buttock abscess 5-6cm diameter extending inferiorly and connected to large deep muscle abscess, extends to femur measures 8x10cm

 

Cardiac monitoring 

 

Measure and compare with report: 

PR interval:

QRS:

QT interval:

P-P interval regular:

R-R interval regular:

Medications
Cefazolin (Ancef) 

2g/D5W 110mL IVPB q 8hrs infuse over 30 min

 

Clindamycin (Cleocin) 

900mg IVPB infuse over 30 min

Fluconazole (Diflucan) 

100mg PO Q 24hrs

Heparin 

100 units/mL standard infusion

 

 

Warfarin (Coumadin) 

 

 

Nystatin 

Topical

Insulin Aspart 

0-14 units SQ 4 times daily ac/hs

Insulin Detemir (Levemir) 

32 units SQ daily

Polyethylene glycol (Golytely) 

400mL PO one time

Acetaminophen (Tylenol) 

650mg PO q 4 hrs prn

 

 

Oxycodone (Oxycontin) 

5 mg PO Q 4 hrs prn

Morphine (Duramorph) 

4mg IV Q 3hrs prn

Hydromorphone (Dilaudid) 

1mg IV Q 3hrs prn

Calcium Carbonate (Tums) chewable 

500mg PO 3x daily prn

Promethazine (Phenergan) 

6.25mg IV q 4hrs prn

Sennosides/ docusate sodium 

8.6mg/50mg 1 tablet PO BID prn

 

 

Trazadone (Desyrel) 

25mg PO hs prn

 

 

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  • attachment 

    RNNUR235LabandDiagAnalysisRubricFall2020.doc

    Lab Analysis: Grading Rubric

    TOTAL 50 Points

    Content  

     

     

     

     

     

    Points
    Analysis of data All of these criteria apply: 

    · Explanation unclear

    · Interpretation inaccurate

    · Some labs not addressed = 0 points

    2 of these criteria apply: 

    · Explanation partially clear

    · Interpretation partially inaccurate

    · Some labs not addressed = 7.5 points

    Explanation clear as to how altered lab values fit or don’t fit with patient’s current clinical status; all labs addressed; interpretation accurate = 

    15 points

     

    Diagnostic Statement All of these criteria apply: 

    · PCs/NANDAs are not based on lab results.

    · Diagnostic statements are not in correct format = 0 point

    1 of these criteria apply: 

    · PCs/NANDAs are not based on lab results.

    · Diagnostic statements are not in correct format = 5 points

    ·

    Identification of PCs/ NANDAs 

    based on lab results. Diagnostic statements are in correct format. = 10 points

    Desired Outcome All of these criteria apply: 

    · Desired outcomes are not measurable and achievable.

    · Outcomes are not relevant to PCs/ NANDAs = 0 point

    1 of these criteria apply: 

    · Desired outcomes are not measurable and achievable.

    · Outcomes are not relevant to PCs/ NANDAs = 2.5 points

    ·

    Desired outcomes are measurable and achievable and are relevant to the PCs/ NANDAs = 5 points
    Interventions All of these criteria apply: 

    · No specific intervention identified

    · Interventions not relevant to NANDAs or PCs

    · Rrationale do not support selected interventions. = 0 points

    2 of these criteria apply: 

    · Nursing/collaborative interventions are not consistent with NANDAs and PCs;

    · Are not relevant to address/correct altered lab values

    · Rationale do not support the selected interventions. = 7.5 points. Lab Analysis Nursing Assignment

    ·

    Nursing/collaborative interventions are consistent with 

    NANDAs and PCs; relevant to address/

    correct altered lab values. Rationale support selection of interventions. = 15 points

    Evaluation Inaccurate or no identification of effects of nursing interventions on patient’s status = 

    0 points

    Partial identification of effects of nursing interventions on patient’s status = 2.5 points Identification of effects of nursing interventions on patient’s status = 

    5 points

    Format Many spelling or grammar errors; or, no citing of references = deduct 

    4 points

    Some spelling or grammar errors; or, incorrect citing of references; or, references page not in APA format = deduct 2 point Free of spelling and grammar errors; correct citation of references; reference page contains references in APA format = 0 point 

     

     

    TOTAL POINTS
  • attachment 

    RNNUR235LaboratoryandDiagAnalysisGuidelineFall2020.doc

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    LABORATORY ANALYSIS ASSIGNMENT GUIDELINES

    PURPOSE OF ASSIGNMENT

    Integration of health alterations (medical and nursing diagnoses), presenting signs and symptoms, treatments, medications, and their effects on diagnostic laboratory results for a specific client.

    DATA COLLECTION

    The case scenario used for this Laboratory Analysis Assignment is similar to clients that you would have been assigned to in clinical.

    FORMAT

    · Introduction

    · Description of health alterations

    · Define medical diagnoses

    · Explain the pathophysiology for each diagnosis

    · Discuss how diagnoses are interrelated

    · Signs and Symptoms

    · Provide rationale for the client’s S&S in relation to the pathophysiology of his/her health alterations

    · Complete Laboratory Analysis Table

    · Analyze lab data for abnormal, pertinent normal, and therapeutic results, in relation to health alterations, client’s presenting S&S, and treatments (including medications). Explain how the lab results are a reflection of the pathologic process, client responsive or unresponsive to treatment, sign of a side effect or complication of treatment, and what S&S the client might exhibit from the lab results. Lab Analysis Nursing Assignment

    · Identify client problem—nursing diagnosis (NANDA) and/or collaborative problem based on the lab data.

    · Identify NOC and write desired outcome for the client problem. Must be achievable and measurable.

    · List NIC and nursing/collaborative interventions that address/correct the altered lab results. Include rationale for the interventions, with citations for the reference used (use APA format).

    · Evaluate the expected effects of the interventions on the client’s status. Include evaluation of the effectiveness of the interventions, degree that desired outcomes have been achieved, and if the client problem was resolved. Lab Analysis Nursing Assignment

    · Use a separate Diagnostic Analysis table for each client problem. Related laboratory data can be included on the same table. For example:

    · Health alteration: Glomerulonephritis

    · Nursing diagnosis: Excess fluid volume related to inflammation of the glomeruli, decreasing filtration, as evidenced by weight gain, edema, I>O, hypertension, decreased total protein/ablumin, increased BUN/Cr, proteinuria.

    · Lab Data: BUN, Creatinine, albumin, total protein, urinalysis

    · Conclusion

    · References (Use APA format)

Anxiety Case Study Discussion Paper

Anxiety Case Study Discussion Paper

Ivy, age 23, is a white woman who graduated from college last year. She began working as an accountant one month after graduating. Approximately two months ago, she moved into a two-bedroom apartment with another woman who works at the same accounting firm. She states that her roommate recommended that she sees a doctor to find out if she has anemia or “some sort of fatigue syndrome.” She states that she has felt “restless” and “on edge” for most of the past nine months. She becomes easily fatigued and irritable and has difficulty concentrating and falling asleep. She states that sometimes her mind “just goes blank,” and she is worried that her work performance is no longer excellent. Anxiety Case Study Discussion Paper

She reports that all her life she had good grades in school and was very successful in everything she attempted. Although she has been “a worrier from the day I was born,” now she worries more than she ever has and feels nervous “all the time.” Ivy reports that she has a good relationship with her boyfriend, but they do not get to see each other very often because he is attending graduate school 100 miles away. She reports having a satisfying sexual relationship with him. She denies having any problems with relationships with her parents, roommate, or peers. She denies having any financial worries unless she is fired from her job for poor work performance. She reports that she has always been healthy and has taken good care of herself. The only medication she takes is birth control pills, which she has taken for the past four years without any adverse effects.

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Diagnosis: Generalized Anxiety Disorder

1. List specific treatment goals for Ivy.

2. What drug therapy would you prescribe? Why?

3. What are the parameters for monitoring the success of the therapy?

4. Describe specific patient monitoring based on the prescribed therapy.

5. List one or two adverse reactions for the selected agent that would cause you to change therapy.

6. What would be the choice for second-line therapy?

7. What dietary and lifestyle changes should be recommended for this patient?

8. Describe one or two drug–drug or drug–food interactions for the selected agent. Anxiety Case Study Discussion Paper

Statistics 2 Nursing Assignment

Statistics 2 Nursing Assignment

Surveys are often used to gather public health information or data. The first step in analyzing the survey data is to conduct descriptive statistics. Descriptive statistics help provide basic information about the sample group, such as the average age and average income. This information can then be analyzed to effectively measure and describe a population’s health status, behavior, and associated risk factors in relation to these variables. Statistics 2 Nursing Assignment

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The purpose of this assignment is to use Excel to apply descriptive statistics in order to describe the sample who completed a health behavior survey. Use the “Health Behavior Data Set” and the “Descriptive Statistics in Excel Worksheet” to complete this assignment. Refer to the instructional videos in the topic resources as a guide.

For this assignment:

  1. Use the “Data Analysis ToolPak” add-in and Pivot Tables to complete this assignment. Refer to the “Data Analysis ToolPak” resource in the topic resources. Click on the link and select either Windows or Mac for instructions. The Microsoft Excel add-in will enable you to conduct descriptive statistics in Excel.
  2. Read the “Health Behavior Case History and Survey” document to familiarize yourself with the survey and its purpose.
  3. Open the “Health Behavior Data Set” in the Excel. Analyze the survey data and answer the questions in the “Descriptive Statistics in Excel Worksheet.” Submit the “Descriptive Statistics in Excel Worksheet” to the dropbox. Statistics 2 Nursing Assignment

APA style is not required, but solid academic writing is expected.

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 not required to submit this assignment to LopesWrite.

PUB-550-RS2-HealthBehaviorDataset.xlsx
PUB-550-RS2-HealthBehaviorCaseHistorySurvey.docx
PUB-550-RS2-DescriptiveStatisticsExcelWorksheet.docx

Quality Improvement Proposal Assignment

Quality Improvement Proposal Assignment

Quality Improvement Proposal Assignment

Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply the “The Road to Evidence-Based Practice” process, illustrated in Chapter 4 of your textbook, to create your proposal. Quality Improvement Proposal Assignment

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Include the following:

  1. Provide an overview of the problem and the setting in which the problem or issue occurs.
  2. Explain why a quality improvement initiative is needed in this area and the expected outcome.
  3. Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed. Quality Improvement Proposal Assignment
  4. Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
  5. Explain how the quality improvement initiative will be evaluated to determine whether there was an improvement.
  6. Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. Quality Improvement Proposal Assignment

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Quality Improvement Proposal Assignment

https://lc.gcumedia.com/hlt362v/applied-statistics-for-health-care/v1.1/#/chapter/4

 

QUALITYIMPROVEMENTPROPOSALRUBRIC.xlsx

Rubic_Print_Format

Course Code Class Code Assignment Title Total Points
HLT-362V HLT-362V-OL191 Quality Improvement Proposal 150.0
Criteria Percentage 1: Unsatisfactory (0.00%) 2: Less Than Satisfactory (65.00%) 3: Satisfactory (75.00%) 4: Good (85.00%) 5: Excellent (100.00%) Comments Points Earned
Content 70.0%
Problem or Issue in Practice or Organization 5.0% Overview of the problem and the setting in which the problem or issue occurs is not described. Overview of the problem and the setting in which the problem or issue occurs is partially described. More information is needed to fully understand the problem and the scope of the organization or practice. Overview of the problem and the setting in which the problem or issue occurs is summarized. Some information is needed to fully understand the problem or the scope of the organization or practice. Overview of the problem and the setting in which the problem or issue occurs is described. Some detail is need for clarity. Overview of the problem and the setting in which the problem or issue occurs is described in detail.
Significance of Quality Improvement in Practice or Organization 10.0% Explanation of why the quality improvement initiative is needed is omitted. Quality Improvement Proposal Assignment Explanation of why the quality improvement initiative is needed is partially presented. More information is needed to understand why the quality improvement is relevant to the problem or setting. The expected outcome is unclear. Explanation of why the quality improvement initiative is needed is summarized. Some information is needed to understand why the quality improvement is relevant to the problem or setting. The expected outcome is generally presented. Explanation of why the quality improvement initiative is needed is discussed. It appears that the quality improvement initiative would help address the problem within the described setting. The expected outcome is described. Some information or rationale is needed for support or clarity. Explanation of why the quality improvement initiative is need is clearly discussed. The quality improvement initiative would help address the problem within the described setting presented. The expected outcome is thoroughly described. Overall, the explanation is clear and well supported.
Demonstration of Support From Previous Research 15.0% The use of research to demonstrate support for the quality improvement initiative and its projected outcomes is omitted. Three peer-reviewed sources published within the last 5 years are omitted. The use of research to demonstrate support for the quality improvement initiative and its projected outcomes is incomplete. Overall, the research results do not demonstrate support for the initiative or projected outcomes. Fewer than three peer-reviewed sources published within the last 5 years were used. The use of research to demonstrate support for the quality improvement initiative and its projected outcomes is generally presented. The research results generally demonstrate support for the initiative and projected outcomes. Three peer-reviewed sources published within the last 5 years were used. The use of research to demonstrate support for the quality improvement initiative and its projected outcomes is presented. The research results demonstrate support for the initiative and projected outcomes. The three peer-reviewed sources meet all assignment criteria. The use of research to demonstrate support for the quality improvement initiative and its projected outcomes is clearly presented. The research results strongly demonstrate support for the initiative and projected outcomes. The three peer-reviewed sources meet all assignment criteria and provide critical support for the initiative.
Steps Necessary to Implement Quality Improvement Initiative 15.0% The steps necessary to implement the quality improvement initiative are omitted. The steps necessary to implement the quality improvement initiative are incomplete. It is unclear how the steps presented will lead to implementation. More information is needed. The steps necessary to implement the quality improvement initiative are summarized. Some steps are vague. More evidence or rationale is needed for support. The steps necessary to implement the quality improvement initiative are discussed. Some evidence or rationale is needed for support or clarity. The steps necessary to implement the quality improvement initiative are thoroughly discussed. The implantation steps are well supported with evidence and rationale.
Evaluation of Quality Improvement 15.0% An explanation for how the quality improvement initiative will be measured is omitted. An explanation for how the quality improvement initiative will be measured is partially presented. It is unclear how the evaluation will measure improvement; or it is unclear how the evaluation relates to the quality improvement initiative. A general explanation for how the quality improvement initiative will be measured is summarized. The evaluation is generally appropriate to the quality improvement initiative. An explanation for how the quality improvement initiative will be measured is presented. The evaluation is appropriate to the quality improvement initiative. An explanation for how the quality improvement initiative will be measured is presented in detail. The evaluation is appropriate to the quality improvement initiative. Evaluation proposed is well supported.
Identification of Variables, Hypothesis Test, and Statistical Test 10.0% The variables, hypothesis, and statistical tests needed to prove the quality improvement succeeded are omitted. The variables, hypothesis, and statistical tests needed to prove the quality improvement succeeded are partially presented; one is omitted. The proposed elements are not relevant to proving the quality improvement succeeded. The variables, hypothesis, and statistical tests needed to prove the quality improvement succeeded are summarized. There are inaccuracies. The variables, hypothesis, and statistical tests needed to prove the quality improvement succeeded are presented. Overall, the proposed elements are relevant to proving the quality improvement succeeded. The variables, hypothesis, and statistical tests needed to prove the quality improvement succeeded are presented and accurate. The proposed elements will prove whether the quality improvement succeeded.
Organization and Effectiveness 20.0%
Thesis Development and Purpose 7.0% Paper lacks any discernible overall purpose or organizing claim. Thesis is insufficiently developed or vague. Purpose is not clear. Thesis is apparent and appropriate to purpose. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
Argument Logic and Construction 8.0% Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Quality Improvement Proposal Assignment Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. Writer is clearly in command of standard, written, academic English.
Format 10.0%
Paper Format (use of appropriate style for the major and assignment) 5.0% Template is not used appropriately, or documentation format is rarely followed correctly. Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent. Appropriate template is used. Formatting is correct, although some minor errors may be present. Appropriate template is fully used. There are virtually no errors in formatting style. All format elements are correct.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. Quality Improvement Proposal Assignment

Sleep Case Study Assignment

Sleep Case Study Assignment

Sleep Case Study Assignment

Write at least an one-sentence rationale

Christy Brown is a 32-year-old stay-at-home mom with two children who are 3 and 7 years of age. She brings Macy, the 3-year-old child, to the primary care practitioner because she wakes up almost every night screaming. When Christy goes into Macy’s room, Macy tells her that she was having bad dreams and cannot go back to sleep. Christy states that even when Macy is sleeping, she cannot sleep because of her husband’s loud snoring. These disturbances are causing Christy to be irritable and excessively sleepy in the daytime. Mae White is an ANP who is seeing Christy today. She is a nurse practitioner in the office with Christy’s primary care practitioner. Sleep Case Study Assignment

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1. Mae wants to find out more about Christy’s sleep problems. What assessments should she include when discussing this with Christy?

Rationale:

 

2. Mae learns that since the summer, Macy has been going to bed when her 7-year-old sister goes to bed, and Macy does not take a nap during the day. What should Mae encourage Christy to do to help Macy sleep through the night?

  Rationale:

 

3. Christy asks if there is anything that could be causing her husband to snore so loud. Before Mae can answer, she needs to gather more information. What could indicate that Christy’s husband may have sleep apnea? (Select all that apply.)

 

A. Snoring accompanied by snorting

B. Excessive daytime sleepiness

C. Positive family history of sleep apnea

D. Falling asleep at inopportune times

Assignment 1: Assessing Neurological Symptoms

Assignment 1: Assessing Neurological Symptoms

Case Study Assignment:

Imagine not being able to form new memories. This is the reality of patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.

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

Case study

A 20-year-old male complains of experiencing intermittent headaches. The headaches diffuse all over the head, but the greatest intensity and pressure occurs above the eyes and spreads through the nose, cheekbones, and jaw.

· Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case. Assignment 1: Assessing Neurological Symptoms

With regard to the case study you were assigned:

· 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 you were assigned.

· 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.

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. Assignment 1: Assessing Neurological Symptoms

Assessing And Treating Patients With Sleep/Wake Disorders

Assessing And Treating Patients With Sleep/Wake Disorders

The Assignment: 5 pages

Examine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

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At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. Assessing and Treating Patients with Sleep/Wake Disorders

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Assessing And Treating Patients With Sleep/Wake Disorders

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

BACKGROUND

This week, we examine a 31-year-old male who presents to the office with a chief complaint of insomnia.

SUBJECTIVE

Patient is a 31-year-old male. He states that his insomnia has gotten progressively worse over the past 6 months. Per the patient, he has never been a “great sleeper” but is now having difficulty both falling asleep and staying asleep at night. The problem began approximately 6 months ago after the sudden loss of his fiancé. The patient states this is affecting his ability to perform his job, which is a forklift operator at a local chemical company. The patient states he has used diphenhydramine in the past to sleep but does not like the way it makes him feel the morning after. He states he has fallen asleep on the job due to lack of sleep from the night before. The patient’s medical record from his previous physician states that he has a history of opiate abuse, which began after he broke his ankle in a skiing accident and was prescribed hydrocodone/apap (acetaminophen) for acute pain management. The patient has not received a prescription for an opiate analgesic in 4 years. The patient states recently he has been using alcohol to help him fall asleep, approximately four beers prior to bed.

MENTAL STATUS EXAM

The patient is alert and oriented to person, place, time, event. He makes good eye contact and is dressed appropriately for time of year. He denies auditory/visual hallucinations. Judgement, insight, and reality contact are all intact. Patient denies suicidal/homicidal ideation, and is future oriented.

Decision Point One

 Trazodone: 50–100 mg daily at bedtime

RESULTS OF DECISION POINT ONE

  • Patient returns to clinic in 2 weeks
  • Patient states medication works well but gives him an unpleasant side effect of a prolonged erection of the penis, approximately 15 minutes after waking
  • Patient states this makes it difficult to get ready for work or go downstairs and have coffee with his girlfriend and daughter in the morning
  • Patient denies auditory/visual hallucinations and is future oriented

Decision Point Two

Explain that priapism is a side effect of trazodone that should diminish over time. Continue dose 

RESULTS OF DECISION POINT TWO

  • Patient returns to clinic in 2 weeks
  • Patient states priapism has diminished over time
  • Patient denies auditory/visual hallucinations and is future oriented
  • Patient states trazodone is effective at 50 mg dose but sometimes wakes up following day with next-day drowsiness
  • Patient denies auditory/visual hallucinations and is future oriented

Decision Point Three

Continue dose. Explain to patient he may split the 50 mg tablet in half. The decreased dose should minimize next-day drowsiness. Follow up in 4 weeks 

Guidance to Student
Trazodone is a selective serotonin reuptake inhibitor that has a low side effect profile. It would not be prudent to prescribe sonata as it carries with it the risk of complex sleep behaviors. Hydroxyzine is an antihistamine with strong sedative properties. However, many patients complain of anticholinergic adverse effects the following morning, such as Xerostomia and Xerophthalmia.
The patient is presenting with excessive somnolence. It would be prudent to reduce the dose of trazodone by 50% and reassess in 4 weeks. Assessing And Treating Patients With Sleep/Wake Disorders

Advanced Pharmacology Assignment Paper

Advanced Pharmacology Assignment Paper

As an advanced practice nurse, you will likely encounter patients who will present with symptoms affecting the gastrointestinal (GI) tract. Of special note, is the consideration that most symptoms concerning the GI tract are non-specific and therefore, diagnosing diagnoses of the GI tract require thoughtful and careful investigation. Similarly, hepatobiliary disorders may also mirror many of the signs and symptoms that patients present when suffering from GI disorders.

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How might you tease out the specific signs and symptoms between these potential disorders and body systems? What drug therapy plans will best address these disorders for your patients?

This week, you examine GI and hepatobiliary disorders. You will review a patient case study and consider those factors in recommending and prescribing a drug therapy plan fo your patient.

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

  • Chapter 64, “Drugs for      Peptic Ulcer Disease” (pp. 589–597)
  • Chapter 65, “Laxatives” (pp.      598–604)
  • Chapter 66, “Other      Gastrointestinal Drugs” (pp. 605–616)
  • Chapter 80, “Antiviral Agents I: Drugs for      Non-HIV Viral Infections” (pp. 723–743)

Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., . . . Sanya, A. J. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance fro

ASSIGNMENT:

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom. Advanced Pharmacology Assignment Paper

Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

To Prepare

· Review the case study assigned by your Instructor for this Assignment

· Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.

· Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.

· Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

Write a 1-page paper that addresses the following:

· Explain your diagnosis for the patient, including your rationale for the diagnosis.

· Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

· Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

This week we will be discussing the gastrointestinal and hepatobiliary systems and drugs used to treat those disorders. We will specifically focus on nausea/vomiting,  gastroesophageal reflux disease, peptic ulcer disease,  constipation, diarrhea, irritable bowel syndrome,  inflammatory bowel disease, and  cirrhosis.

CASE STUDY: Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

· Synthroid 100 mcg daily

· Nifedipine 30 mg daily

· Prednisone 10 mg daily. Advanced Pharmacology Assignment Paper

Health History And Physical Assessment Assignment

Health History And Physical Assessment Assignment

Health History and Physical Assessment

Requirements to Follow/grading rubric

To recognize the interrelationships of subjective data (physiological, psychosocial, cultural/spiritual values, and developmental) and objective data (physical examination findings) in planning and implementing nursing care.

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To reflect on the interactive process that takes place between the nurse and an individual while conducting a health assessment and a physical examination. Health History And Physical Assessment Assignment

Rubric

NR304 RUA: Health History and Physical Assessment Guidelines (Sept20)

NR304 RUA: Health History and Physical Assessment Guidelines (Sept20)

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeHealth History: Subjective Data

Required criteria

1. Demographic data

2. Reason for care (why they are in the facility)

3. Present illness (PQRST of current illness)

4. Perception of health

5. Past medical history (including medications, allergies, and vaccinations and immunizations)

6. Family medical history

7. Review of systems

8. Developmental considerations

9. Cultural considerations

10. Psychosocial considerations

11. Presence or absence of collaborative resources (community, family, groups, and healthcare system)

30.0 pts

Highest Level of Performance

Includes 11 requirements for section.

28.0 pts

High Level of Performance

Includes 9-10 requirements for section.

23.0 pts

Satisfactory Performance

Includes 5-8 requirements for section.

15.5 pts

Unsatisfactory Performance

Includes 1-4 requirements for section. Health History And Physical Assessment Assignment

0.0 pts

Not Present

No requirements for this section presented.

30.0 pts

This criterion is linked to a Learning OutcomePhysical Examination: Objective Data

Required criteria

1. From NR302:

o HEENT (head, eyes, ears, nose, and throat)

o Neck (including thyroid and lymph chains)

o Respiratory system

o Cardiovascular system

2. From NR304:

o Neurological system

o Gastrointestinal system

o Musculoskeletal system

o Peripheral vascular system

30.0 pts

Highest Level of Performance

Includes 8 requirements for section.

28.0 pts

High Level of Performance

Includes 7 requirements for section.

23.0 pts

Satisfactory Performance

Includes 4-6 requirements for section.

15.5 pts

Unsatisfactory Performance

Includes 1-3 requirements for section.

0.0 pts

Not Present

No requirements for this section presented.

30.0 pts

This criterion is linked to a Learning OutcomeNeeds Assessment

Required criteria

1. Based on the health history and physical examination findings, determine at least two health education needs for the individual. Remember, you may identify an educational topic that is focused on wellness.

2. Support the identified health teaching needs selected with evidence from two current, peer-reviewed journal articles.

3. Discuss how the interrelationships of physiological, developmental, cultural, and psychosocial considerations will influence, assist, or become barriers to the effectiveness of the proposed health education.

4. Describe how the individual’s strengths (personal, family, and friends) and collaborative resources (clinical, community, and health and wellness resources) effect proposed teaching. Health History And Physical Assessment Assignment

20.0 pts

Highest Level of Performance

Includes 4 requirements for section.

18.0 pts

High Level of Performance

Includes 3 requirements for section.

15.0 pts

Satisfactory Performance

Includes 2 requirements for section.

7.5 pts

Unsatisfactory Performance

Includes 1 requirement for section.

0.0 pts

Not Present

No requirements for this section presented.

20.0 pts

This criterion is linked to a Learning OutcomeReflection

Required criteria

1. Describe the interaction in its entirety: include the environment, your approach to the individual, time of day, and other features relevant to therapeutic communication and to the interview process.

2. How did your interaction compare to what you have learned?

3. What went well?

4. What barriers to communication did you experience?

5. How did you overcome them?

6. What will you do to overcome them in the future?

7. Were there unanticipated challenges to the interview?

8. Was there information you wished you had obtained?

9. How will you alter your approach next time?

10.0 pts

Highest Level of Performance

Includes 9 requirements for section.

9.0 pts

High Level of Performance

Includes 7-8 requirements for section.

8.0 pts

Satisfactory Performance

Includes 5-6 requirements for section.

4.0 pts

Unsatisfactory Performance

Includes 1-4 requirements for section.

0.0 pts

Not Present

No requirements for this section presented.

10.0 pts

This criterion is linked to a Learning OutcomeStyle and Organization

Required criteria

1. Writing reflects synthesis of information from prior learning applied to completion of the assignment.

2. Grammar and mechanics are free of errors.

3. Able to verbalize thoughts and reasoning clearly.

4. Use appropriate resources and ideas to support topic.

5. Adheres to APA recommendations for title page, running head, headings, in-text citations, and reference page.

6. HIPAA protocols followed.

10.0 pts

Highest Level of Performance

Includes 6 requirements for section.

9.0 pts

High Level of Performance

Includes 5 requirements for section.

8.0 pts

Satisfactory Performance

Includes 4 requirements for section.

4.0 pts

Unsatisfactory Performance

Includes 1-3 requirements for section.

0.0 pts

Not Present

No requirements for this section presente

  • attachment 

    physicalAssessmentEssayNR304_Health_History_and_Physical_Assessment_Guidelines_V6_Final.pdf

    NR304 Health Assessment II

    RUA Health History and Physical Assessment Guidelines

    NR304_Health_History_and_Physical_Assessment_Guidelines_V6_Final 1

    Purpose As you learned in NR302, before any nursing plan of care or intervention can be implemented or evaluated, the nurse conducts an assessment, collecting subjective and objective data from an individual. The data collected are used to determine areas of need or problems to be addressed by the nursing care plan. This assignment will focus on collecting both subjective and objective data, synthesizing the data, and identifying health and wellness priorities for the person. The purpose of the assignment is twofold. 1. To recognize the interrelationships of subjective data (physiological, psychosocial, cultural and spiritual

    values, and developmental) and objective data (physical examination findings) in planning and implementing nursing care.

    2. To reflect on the interactive process that takes place between the nurse and an individual while conducting a health assessment and a physical examination. Health History And Physical Assessment Assignment

     

    Course outcomes: This assignment enables the student to meet the following course outcomes. CO 1: Explain expected client behaviors while differentiating between normal findings, variations and

    abnormalities. (PO1) CO 2: Utilize prior knowledge of theories and principles of nursing and related disciplines to integrate

    clinical judgment in professional decision-making and implementation of nursing process while obtaining a physical assessment. (POs 4 and 8)

    CO 3: Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO 1)

    CO 4: Utilize effective communication when performing a health assessment. (PO 3) CO 5: Demonstrate beginning skill in performing a complete physical examination using the techniques of inspection,

    palpation, percussion, and auscultation. (PO 2) CO 6: Identify teaching/learning needs from the health history of an individual. (POs 2 and 5) CO 7: Explore the professional responsibilities involved in conducting a comprehensive health assessment and providing

    appropriate documentation. (POs 6 and 7)

    Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.

    Total points possible: 100 points

    Preparing the assignment Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.

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    1. Complete a health history and physical examination on an individual. Using the following subjective and objective components, as well as your textbook for explicit details about each category, complete a health history and physical examination on an individual. You may choose to complete portions of this assignment as you obtain the health history and perform the physical examination associated with the body systems covered in NR304. The person interviewed must be 18 years of age or older. Please be sure to avoid the use of any identifiers in preparing the assignment and follow HIPAA protocols.

    2. a. Students may seek input from the course instructor on securing an individual for this assignment. b. Avoid the use of client identifiers in the assignment, HIPAA protocols must be utilized. c. During the lab experiences, you will conduct a series of physical exams that include the systems listed in

    Objective Data below. d. Refer to the course textbook for detailed components of each system exam.

    1) Remember, assessment of the integumentary system is an integral part of the physical exam and should be

     

     

    2

    NR304 Health Assessment II RUA Health History and Physical Assessment Guidelines

    NR304_Health_History_and_Physical_Assessment_Guidelines_V6_Final 2

    included throughout each system. e. Keep notes on each part of the health history and physical examination as you complete them so that you can

    refer to the notes as you write the paper, particularly the reflection section. f. Utilize proper medical terminology.

    3. Include the following sections, used as section headers within the paper. a. Health History: Subjective Data (30 points/30% [1-2 paragraphs in length])

    1) Demographic data 2) Reason for care 3) Present illness (PQRST of current illness) 4) Perception of health 5) Past medical history (including medications, allergies, and vaccinations and immunizations) 6) Family medical history 7) Review of systems 8) Developmental considerations 9) Cultural considerations 10) Psychosocial considerations 11) Presence or absence of collaborative resources (community, family, groups, and healthcare system)

    b. Physical Examination: Objective Data (30 points/30% [1 paragraph]) 1) From NR302

    a) HEENT (head, eyes, ears, nose, and throat) b) Neck (including thyroid and lymph chains) c) Respiratory system d) Cardiovascular system

    2) From NR304 a) Neurological system b) Gastrointestinal system c) Musculoskeletal system d) Peripheral vascular system

    c. Needs Assessment (20 points/20% [2 paragraphs]) 1) Based on the health history and physical examination findings, determine at least two health education

    needs for the individual. Remember, you may identify an educational topic that is focused on wellness. 2) Support the identified health teaching needs selected with evidence from two current, peer-reviewed

    journal articles. 3) Discuss how the interrelationships of physiological, developmental, cultural, and psychosocial considerations

    will influence, assist, or become barriers to the effectiveness of the proposed health education. 4) Describe how the individual’s strengths (personal, family, and friends) and collaborative resources (clinical,

    community, and health and wellness resources) effect proposed teaching. d. Reflection (10 points/10% [1 paragraph])

    Reflection is used to intentionally examine our thought processes, actions, and behaviors in order to evaluate outcomes. Provide a written reflection that describes your experience with conducting this complete health history and physical assessment. 1) Reflect on your interaction with the interviewee holistically.

    a) Describe the interaction in its entirety: include the environment, your approach to the individual, time of day, and other features relevant to therapeutic communication and to the interview process.

    2) How did your interaction compare to what you have learned? 3) What barriers to communication did you experience?

    a) How did you overcome them? b) What will you do to overcome them in the future?

    4) What went well with this assignment? 5) Were there unanticipated challenges during this assignment? 6) Was there information you wished you had available but did not? Health History And Physical Assessment Assignment

    3

    NR304 Health Assessment II RUA Health History and Physical Assessment Guidelines

    NR304_Health_History_and_Physical_Assessment_Guidelines_V6_Final 3

    7) How will you alter your approach next time? e. Writing Style and Format (10 points/10%)

    1) Writing reflects synthesis of information from prior learning applied to completion of the assignment. 2) Grammar and mechanics are free of errors. 3) Able to verbalize thoughts and reasoning clearly. 4) Use appropriate resources and ideas to support topic. 5) Adheres to APA recommendations for title page, running head, headings, in-text citations, and reference

    page. 6) HIPAA protocols followed.

    For writing assistance (APA, formatting, or grammar), visit the APA Citation and Writing Assistance page in the online library. Please note that your instructor may provide you with additional assessments in any form to determine that you fully understand the concepts learned in the review material.

     

     

    NR304 Health Assessment II RUA Health History and Physical Assessment Guidelines

    NR304_Health_History_and_Physical_Assessment_Guidelines_V6_Final 4

    Grading Rubric Criteria are met when the student’s application of knowledge demonstrates achievement of the outcomes for this assignment. Assignment Section and

    Required Criteria (Points possible/% of total points available)

    Highest Level of Performance

    High Level of Performance

    Satisfactory Level of

    Performance

    Unsatisfactory Level of

    Performance

    Section not present in

    paper

    Health History: Subjective Data (30 points/30%) 30 points 28 points 23 points 15.5 points 0 points

    Required criteria 1. Demographic data 2. Reason for care (why they are in the facility) 3. Present illness (PQRST of current illness) 4. Perception of health 5. Past medical history (including medications, allergies, and

    vaccinations and immunizations) 6. Family medical history 7. Review of systems 8. Developmental considerations 9. Cultural considerations 10. Psychosocial considerations 11. Presence or absence of collaborative resources (community,

    family, groups, and healthcare system) Health History And Physical Assessment Assignment

    Includes 11 requirements for section.

    Includes 9-10 requirements for section.

    Includes 5-8 requirements for section.

    Includes 1-4 requirements for section.

    No requirements for this section presented.

    Physical Examination: Objective Data (30 points/30%) 30 points 28 points 23 points 15.5 points 0 points

    Required criteria 1. From NR302

    o HEENT (head, eyes, ears, nose, and throat) o Neck (including thyroid and lymph chains) o Respiratory system o Cardiovascular system

    2. From NR304 o Neurological system o Gastrointestinal system o Musculoskeletal system o Peripheral vascular system

    Includes 8 requirements for section.

    Includes 7 requirements for section.

    Includes 4-6 requirements for section.

    Includes 1-3 requirements for section.

    No requirements for this section presented.

    Needs Assessment (20 points/20%) 20 points 18 points 15 points 7.5 points 0 points

    Required criteria 1. Based on the health history and physical examination findings,

    determine at least two health education needs for the individual.

    Includes 4 requirements for section.

    Includes 3 requirements for section.

    Includes 2 requirements for section.

    Includes 1 requirement for section.

    No requirements for this section presented.

     

     

    NR304 Health Assessment II RUA Health History and Physical Assessment Guidelines

    NR304_Health_History_and_Physical_Assessment_Guidelines_V6_Final 5

    Remember, you may identify an educational topic that is focused on wellness.

    2. Support the identified health teaching needs selected with evidence from two current, peer-reviewed journal articles.

    3. Discuss how the interrelationships of physiological, developmental, cultural, and psychosocial considerations will influence, assist, or become barriers to the effectiveness of the proposed health education.

    4. Describe how the individual’s strengths (personal, family, and friends) and collaborative resources (clinical, community, and health and wellness resources) effect proposed teaching.

    Reflection (10 points/10%) 10 points 9 points

    8 points 4 points 0 points

    Required criteria 1. Describe the interaction in its entirety: include the environment,

    your approach to the individual, time of day, and other features relevant to therapeutic communication and to the interview process.

    2. How did your interaction compare to what you have learned? 3. What went well? 4. What barriers to communication did you experience? 5. How did you overcome them? 6. What will you do to overcome them in the future? 7. Were there unanticipated challenges to the interview? 8. Was there information you wished you had obtained? 9. How will you alter your approach next time?

    Includes 9 requirements for section.

    Includes 7-8 requirements for section.

    Includes 5-6 requirements for section.

    Includes 1-4 requirements for section.

    No requirements for this section presented.

    Style and Organization (10 points/10%) 10 points 9 points 8 points 4 points 0 points

    Required criteria 1. Writing reflects synthesis of information from prior learning

    applied to completion of the assignment. 2. Grammar and mechanics are free of errors. 3. Able to verbalize thoughts and reasoning clearly. 4. Use appropriate resources and ideas to support topic. 5. Adheres to APA recommendations for title page, running head,

    headings, in-text citations, and reference page. 6. HIPAA protocols followed.

    Includes 6 requirements for section.

    Includes 5 requirements for section.

    Includes 4 requirements for section.

    Includes 1-3 requirements for section.

    No requirements for this section presented.

    Total Points Possible = 100 points

     

     

    NR304 Health Assessment II RUA Health History and Physical Assessment Guidelines

    NR304_Health_History_and_Physical_Assessment_Guidelines_V6_Final 6

     

     

    • Purpose
    • Course outcomes: This assignment enables the student to meet the following course outcomes.
    • Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.
    • Total points possible: 100 points
    • Preparing the assignment
    • Grading Rubric Criteria are met when the student’s application of knowledge demonstrates achievement of the outcomes for this assignment. Health History And Physical Assessment Assignment

Advanced Health IT System in Health Informatics

Advanced Health IT System in Health Informatics

Advanced Health IT System in Health Informatics

1. 100 words —Describe encompassing and advanced health IT system work as it relates to health informatics.

2. 200 words In what ways might having a more encompassing and advanced health IT system work against healthcare providers in the case of a downtime event?

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3. 200 words Is becoming “dependent” or relying on technology a danger in the healthcare setting? Provide example for both cases.

4. 200 words —Should nurses continue to be trained in the “old-fashioned” hard-copy methods of documentation in the event of computer downtime?

5. 200 words —Summarize a research article that speaks of the benefits and risk associated with advanced health IT system work in the healthcare setting.

6. 200 words —Are there security risk associated with advanced health IT system work as it relates to health informatics. Provide examples and case of how patient information can be compromised.

Use APA 7th edition format and at least 3 sources to support your statements including the textbook. Each question should have subheadings. Advanced Health IT System in Health Informatics

  •  

    HealthInformaticsAnInterprofessionalApproach2ndEdition.pdf

    Health Informatics

    An Interprofessional Approach

    SECOND EDITION

    Ramona Nelson, PhD, RN-BC, ANEF, FAAN Professor Emerita, Slippery Rock University, Slippery Rock, Pennsylvania President, Ramona Nelson Consulting, Allison Park, Pennsylvania

    Nancy Staggers, PhD, RN, FAAN President, Summit Health Informatics; Adjunct Professor, College of Nursing and Department of

    Biomedical Informatics, University of Utah, Salt Lake City, Utah

    2

     

     

    Table of Contents

    Cover image Title page Copyright Dedication About the Authors Contributors Reviewers and Ancillary Writers Acknowledgments Preface

    Uses of the book Vendors, applications, foundations and institutions Organization of the book Teaching and learning package

    Unit 1: Foundational Information in Health Informatics 1: An Introduction to Health Informatics

    Abstract Introduction Definition of health informatics Topics and areas of study in informatics Conclusion and future directions Discussion Questions Case Study Case Study Questions

    2: Theoretical Foundations of Health Informatics Abstract Introduction Understanding theories and models Additional informatics-related models Conclusion and future directions Discussion questions Case study Discussion Questions

    3: Evidence-Based Practice, Practice-Based Evidence, and Health Informatics Abstract Introduction Evidence-based practice Evidence-based practice models Stevens star model of knowledge transformation Informatics and evidence-based practice Relationship of EBP and PBE Practice-based evidence Informatics and practice-based evidence Conclusion and future directions Discussion questions EBP case study Discussion Questions PBE Case study Pressure Ulcer Case Study Negative Association With Likelihood of Developing a Pressure Ulcer (Less Likely) Positive Association With Likelihood of Developing a Pressure Ulcer (More Likely) Discussion Questions. Advanced Health IT System in Health Informatics

    4: Models, Theories, and Research for Program Evaluation Abstract Introduction Purposes of evaluation Theories and frameworks Methods, tools, and techniques Conclusion and future directions Discussion questions Case study Discussion Questions

    3

     

     

    5: Technical Infrastructure to Support Healthcare Abstract Introduction Electronic health record component model System integration and interoperability Networking systems Other infrastructure models Current challenges Conclusion and future directions Discussion questions Case study Discussion Questions

    Unit 2: Information Systems and Applications for the Delivery of Healthcare

    6: Electronic Health Records and Applications for Managing Patient Care Abstract Introduction Electronic health record components, functions, and attributes Sociotechnical perspectives Electronic health record applications used in the clinical setting Electronic health record benefits Stakeholder perspectives Key issues Conclusion and future directions Discussion questions Case study Discussion Questions

    7: Administrative Applications Supporting Healthcare Delivery Abstract Introduction Major Types of Applications Conclusion and Future Directions Discussion questions Case Study Michael H. Kennedy, Kim Crickmore, and Lynne Miles Discussion Questions

    8: Telehealth and Applications for Delivering Care at a Distance Abstract Introduction Telehealth technologies Telehealth clinical practice considerations for healthcare professionals Telehealth operational and organizational success factors and barriers Telehealth challenges: licensure and regulatory issues for healthcare professionals Telehealth and direct patient health services Conclusion and future directions Discussion questions Case Study Discussion Questions

    9: Home Health and Related Community-Based Systems Abstract Introduction Evolution and milestones Practice models Standardized datasets Supporting home health with electronic health records and health information technology Standardized terminologies Omaha system Conclusion and future directions Discussion questions Case Study Discussion Questions

    10: Clinical Decision Support Systems in Healthcare Abstract Introduction Clinical decision support types and examples Clinical decision support impact Clinical decision support best practices Recent progress toward disseminating clinical decision support on a national level Research challenges Conclusion and future directions Discussion questions Case study Discussion Questions

    4

     

     

    11: Public Health Informatics Abstract Introduction Public health: A population perspective The value of informatics for the domain of public health Conclusions and future public health informatics strategies Discussion questions Case study Discussion Questions

    Unit 3: Participatory Healthcare Informatics 12: The Engaged ePatient

    Abstract Historical background and drivers of the epatient evolution Convergence of epatients, clinicians, patient-centered models of care, and informatics Health 3.0 emerges Conclusion and future directions Discussion questions Case study Discussion Questions

    13: Social Media Tools for Practice and Education Abstract What is social media? Social media tools Social media statistics Benefits of social media Challenges of social media Social media in education Policy Conclusion and future directions Discussion questions Case study Social Media in Education and Healthcare Discussion Questions

    14: Personal Health Records Abstract Definitions of the personal health record The development of the electronic personal health record Principles of an ideal personal health record Examples of existing personal health records Current evidence of benefits of personal health records Current use of personal health records Barriers to personal health record adoption The future of personal health records Discussion questions Case study Discussion Questions. Advanced Health IT System in Health Informatics

    15: mHealth: The Intersection of Mobile Technology and Health Abstract Introduction Driving forces of mobile health Mobile health benefits and challenges Future directions of mobile health and conclusions Discussion questions Case study Discussion Questions

    Unit 4: Managing the Life Cycle of a Health Information System 16: Strategic Planning and Selecting an Information System

    Abstract Introduction Strategic vision and alignment Systems life cycle Conclusion and future directions Discussion questions Case study Key Considerations for System Selection

    17: Project Management Principles for Health Informatics Abstract Introduction The need for project management in healthcare organizations Project, program, and portfolio management Roles and responsibilities: project, program, and portfolio managers Project management tools Project and portfolio management software selection

    5

     

     

    Conclusions and future directions Discussion questions Case study Discussion Questions

    18: Contract Negotiations and Software Licensing Abstract Introduction Overview of licensing agreements Major steps or stages in the performance of a license agreement Specific components of the licensing agreement Conclusions and future directions Discussion questions Case study Discussion Questions

    19: Implementing and Upgrading an Information System Abstract Introduction Reasons to implement or upgrade a healthcare information system New implementation versus an upgrade Implementation and the systems life cycle Preparing for go-live Go-live Post-live maintenance Conclusion and future directions Discussion questions Case study Discussion Questions Case Study Follow-Up Discussion Questions

    20: Downtime and Disaster Recovery for Health Information Systems Abstract Introduction Downtime risk assessment Downtime And Response Planning Downtime policies and procedures Information technology impact and planning Disaster planning Conclusion and future directions Discussion Questions Case Study Discussion Questions

    Unit 5: User Experience, Standards, Safety, and Analytics in Health Informatics

    21: Improving the User Experience for Health Information Technology Abstract Introduction to improving the user experience Definitions of terms and their relationships The goals of usability User-centered design Human-computer interaction frameworks for health informatics Selecting methods to improve the user experience Formal user testing Selecting a type of usability test Conclusion and future directions Discussion questions Case study Discussion Questions

    22: Informatics-Related Standards and Standards-Setting Organizations Abstract Introduction Standardized healthcare terminologies relevant to patient care Healthcare data standardization Data exchange efforts Application of standardized terminologies Conclusion and future directions Discussion questions Case study Discussion Questions

    23: Data Science and Analytics in Healthcare Abstract Introduction Data science in healthcare Characteristics of big data

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    Data science for clinical and translational research Benefits of data science Approaches to analyses Knowledge discovery and data mining Conclusions and future directions Discussion questions Case study

    24: Patient Safety and Quality Initiatives in Health Informatics Abstract Introduction Definitions National initiatives driving adoption and use of health it National efforts related to quality data standards Evaluating quality and patient safety Success factors and lessons learned Conclusion and future directions Discussion questions Case study Discussion Questions

    Unit 6: Governance Structures, Legal, and Regulatory Issues in Health Informatics

    25: Legal Issues, Federal Regulations, and Accreditation Abstract Introduction Legal system Fraud and abuse and billing issues related to electronic health record use Accreditation The intersection of new technology and regulation Conclusion and future directions Discussion questions Case study Discussion Questions

    26: Privacy and Security Abstract Introduction Definitions and concepts Legal and historical context Principles, laws, and regulations guiding practice The importance of information security Current security vulnerabilities Current security challenges Managing security risks with security controls Resources Conclusions and future directions Discussion questions Case study Discussion Questions

    27: The Health Information Technology for Education and Clinical Health Act, Meaningful Use, and Medicare Access and CHIP Reauthorization Act of 2015

    Abstract Introduction Federal initiatives to drive health information technology Conclusion and future directions Discussion questions Case study Discussion Questions

    28: Health Policy and Health Informatics Abstract Introduction Developing and implementing health information technology policy Driving forces for creating health information technology policy Leadership competencies for developing and implementing health information technology policies Leading policy activities through organizational work and leadership Discipline-specific policies: nursing Conclusion and future directions Discussion Questions Case Study Discussion Questions

    29: Health Information Technology Governance Abstract Introduction Health information technology governance: need and core components Key insights

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    Recommendations Conclusion and future directions Discussion Questions Case study Discussion Questions

    Unit 7: Education and Health Informatics 30: Informatics in the Curriculum for Healthcare Professionals

    Abstract Introduction and background Teaching and learning in an evolving healthcare and technology environment Framework for informatics curriculum It takes a village: roles and competencies Conclusion and future directions Discussion questions Case study Discussion Questions

    31: Distance Education: Applications, Techniques, and Issues Abstract Introduction Historical development Terminology Course delivery systems: course management systems Instructional design for distance education and learning Student (learner) support services Issues Conclusion and future directions Discussion Questions Case Study Discussion Questions

    32: Informatics Tools for Educating Healthcare Professionals Abstract Introduction Comprehensive education information system Computerized teaching tools Impact on the teaching and learning process Impact on the faculty role Conclusion and future directions Discussion Questions Case study Discussion Questions

    33: Simulation in Healthcare Education Abstract Introduction The simulation process Application of simulation Conclusion and future directions Discussion questions Case study Discussion Questions

    Unit 8: International Health Informatics Efforts 34: International Efforts, Issues, and Innovations

    Abstract Introduction Key initiatives in world regions International organizations with ehealth involvement International standards efforts Global challenges to ehealth Conclusion and future directions Discussion questions Case study Discussion Questions

    Unit 9: Historical Implications and Future Directions in Health Informatics

    35: The Evolution of Health Informatics Abstract Introduction The roots of informatics within the computer and information sciences Establishing the specialty of health informatics Recognition of the specialty Naming the specialty—naming the discipline Conclusion and future directions Discussion questions

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    Case study Discussion Questions

    36: Future Directions and Future Research in Health Informatics Abstract Introduction Futures research (futurology) The future of health informatics Clinical informatics Improving the user experience for health information technology Analytics (big data) and data visualization Predictive analytics Data visualization Conclusion and future directions Discussion questions Case study Discussion Questions

    Glossary Index

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    Copyright

    3251 Riverport Lane St. Louis, Missouri 63043 HEALTH INFORMATICS: AN INTERPROFESSIONAL APPROACH, SECOND EDITION ISBN: 978-0-323-40231-6 Copyright © 2018 by Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means,

    electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.

    This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).

    ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

    Notices Knowledge and best practice in this field are constantly changing. As new research and

    experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.

    Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. Advanced Health IT System in Health Informatics

    With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.

    To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.

    Previous edition copyrighted 2014. International Standard Book Number: 978-0-323-40231-6 Executive Content Strategist: Kellie White Content Development Manager: Lisa Newton Senior Content Development Specialist: Danielle M. Frazier Publishing Services Manager: Jeff Patterson Senior Project Manager: Jodi M. Willard Design Direction: Ryan Cook Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1

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    Dedication

    To my husband, Glenn M. Nelson, who always manages to be there To my daughters, who managed to pick wonderful husbands,

    Dorianne & Michael Hollis and Leslie-Ann & Kristopher Bidelson and

    To my grandchildren, who are today’s joy and tomorrow’s hope, Mackenzie, Hope, Ella, and Molly

    Ramona Nelson To my father, Forest Thorpe, who supported education for women

    during an age when it was deemed superfluous and

    To my husband, Bob Staggers, who has always been a champion of strong women Nancy Staggers

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    About the Authors

    Ramona Nelson holds a baccalaureate degree in nursing from Duquesne University and a master’s degree in both nursing and information science and a PhD in education from the University of Pittsburgh. In addition, she completed a postdoctoral fellowship at the University of Utah. Prior to her current position as president of her own consulting company, Ramona was a Professor of Nursing and Chair of the Department of Nursing at Slippery Rock University. Today Ramona continues her association with Slippery Rock University in the role of Professor Emerita. Her primary areas of interest include informatics education for health professionals, social media and empowered patients, and the application of theoretical concepts in health informatics practice. Advanced Health IT System in Health Informatics

    Her past publications include textbooks, monographs, book chapters, journal articles, World Wide Web publications, abstracts, and newsletters. She has been recognized as a Nursing Informatics Pioneer by the American Medical Informatics Association. In addition, she was named a fellow in the American Academy of Nursing in 2004 and in the National League for Nursing Academy of Nursing Education Fellows.

    Nancy Staggers is a nursing informatics pioneer who is actively involved in informatics user experience research. Her education was at the University of Wyoming and the University of Maryland School of Nursing, culminating in a PhD with a concentration on informatics and research. Her background includes both health informatics practice and academia. She was a health informatics executive in the Department of Defense and elsewhere, leading enterprise acquisitions and installations of inpatient electronic health records. Her academic career includes professorships at both the University of Utah and the University of Maryland. Nancy’s academic work began with developing nursing informatics competencies and later leading teams to revise the American Nurses’ Association document on the scope and practice of nursing informatics in the United States in 2002 and 2008. Her research program focuses health IT support and redesign for complex activities such as electronic medication administration records and handoffs/care transitions. Recently she led a team on the user experience community at the Healthcare Information and Management Systems Society to identify nursing user experience issues and solutions for nurses’ interactions with health IT. She was elected as a fellow in the American Academy of Nursing in 1999 and received the American Medical Informatics Association Virginia K. Saba nursing informatics award in 2013 for her contributions to informatics. She owns her own health informatics company, which focuses on research consultations and international collaborations. She is also adjunct professor of informatics at the Department of Biomedical Informatics and College of Nursing, University of Utah, and she teaches user experience research methods for the Health Informatics program at the University of Alabama Birmingham. Nancy publishes widely on health informatics topics, concentrating on user experience research. Advanced Health IT System in Health Informatics

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    Contributors

    Antonia Arnaert, RN, MPH, MPA, PhD Associate Professor, Ingram School of Nursing, McGill University Montreal, Quebec, Canada

    Nancy C. Brazelton, RN, MS Application Service Director, Information Technology Services, University of Utah Health Care, Salt Lake City, Utah

    Christine A. Caligtan, RN, MSN Health Data and Patient Safety Clinical Specialist, Health Data Integrity, PatientsLikeMe, Cambridge, Massachusetts

    Robin L. Canowitz, AB, JD Senior Attorney, Vorys, Sater, Seymour and Pease, LLP, Columbus, Ohio

    Heather Carter-Templeton, PhD, RN-BC Assistant Professor, Capstone College of Nursing, The University of Alabama, Tuscaloosa,

    Alabama Associate Professor and Reference Librarian, Health Sciences Library, University of Tennessee

    Health Science Center, Memphis, Tennessee Diane Castelli, RN, MS, MSN Adjunct Clinical Nursing Instructor Cape Cod Community

    College West Barnstable, Massachusetts Kathleen G. Charters, PhD, RN, CPHIMS Clinical Information Systems Specialist, Defense

    Health Agency Healthcare Operations Directorate, Clinical Support Division, Integrated System Support, Measurements & Clinical Reporting, Falls Church, Virginia

    Jon C. Christiansen, BS, JD Attorney, TechLaw Ventures, PLLC, Salt Lake City, Utah Helen B. Connors, PhD, RN, DrPS (Hon), FAAN, ANEF Executive Director, Center for

    Health Informatics; Associate Dean, University of Kansas School of Nursing, Kansas City, Kansas Vicky Elfrink Cordi, PhD, RN Clinical Associate Professor Emeritus, The Ohio State

    University, Columbus, Ohio Mollie R. Cummins, PhD, RN, FAAN Associate Dean for Research and the PhD Program;

    Associate Professor, College of Nursing; Adjunct Associate Professor, Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah

    Andrea Day, RN, MS, PMP Informatics Nurse Consultant New Market, Maryland Mical DeBrow, PhD, RN Associate Director, Health Economics and Outcomes Research,

    Boehringer Ingelheim Pharmaceuticals, Houston, Texas Guilherme Del Fiol, MD, PhD Assistant Professor, Department of Biomedical Informatics,

    University of Utah, Salt Lake City, Utah Vikrant G. Deshmukh, PhD, MS, MSc Adjunct Assistant Professor, Population Health

    Sciences, University of Utah School of Medicine; Adjunct Assistant Professor, College of Nursing, University of Utah; Lead Principal Data Warehouse Architect, Enterprise Data Warehouse, University of Utah Health Care, Salt Lake City, Utah

    Patricia C. Dykes, PhD, RN, FAAN, FACMI Senior Nurse Scientist, Program Director, Center for Patient Safety Research and Practice, Program Director, Center for Nursing Excellence, Brigham and Women’s Hospital, Boston, Massachusetts

    William Scott Erdley, DNS, RN, CHSE Simulation Education Specialist, The Behling Simulation Center, Jacobs School of Medicine and

    Biomedical Sciences, University at Buffalo, Buffalo, NY Adjunct Professor, School of Nursing, Niagara University, Niagara University, New York David L. Gibbs, PhD, CPHIMS, CHPS, CISSP Assistant Professor, Department of Health

    Information Management, Texas State University, San Marcos, Texas Bryan Gibson, DPT, PhD Assistant Professor, Department of Biomedical Informatics,

    University of Utah, Salt Lake City, Utah Teresa Gore, PhD, DNP, FNP-BC, NP-C, CHSE-A Associate Professor and Director of Experiential Learning College of Nursing, University of

    South Florida, Tampa, Florida President, International Nursing Association for Clinical Simulation and Learning (INACSL),

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    Morrisville, North Carolina Nicholas R. Hardiker, PhD, RN, FACMI Professor of Nursing and Health Informatics, School of Nursing, Midwifery, Social Work &

    Social Sciences, University of Salford, Salford, England Director, eHealth Programme, International Council of Nurses, Geneva, Switzerland Adjunct Professor, College of Nursing, University of Colorado, Denver, Colorado Angel Hoffman, MSN, RN Principal/Owner, Advanced Partners in Health Care Compliance,

    Pittsburgh, Pennsylvania Susan D. Horn, PhD Adjunct Professor, University of Utah School of Medicine, Health

    System Innovation and Research Program, Salt Lake City, Utah Valerie M. Howard, EdD, MSN, RN Dean and University Professor, School of Nursing and

    Health Sciences, Robert Morris University, Moon Township, Pennsylvania Sarah J. Iribarren, PhD, RN Postdoctoral Research Fellow, School of Nursing, Columbia. Advanced Health IT System in Health Informatics

    University, New York City, New York Jonathan M. Ishee, JD, MPH, MS, LLM Assistant Professor, School of Biomedical

    Informatics, University of Texas Health Science Center; Partner, Vorys, Sater, Seymour and Pease, LLP, Houston, Texas

    David E. Jones, PhD Applied Public Health Informatics Fellow, Utah Department of Health, Salt Lake City, Utah

    Irene Joos, PhD, MSIS, MN, BSN, RN Professor & Former Director, Online Learning, Department of Information Technology; Adjunct Faculty, Department of Nursing, La Roche College, Pittsburgh, Pennsylvania

    Kensaku Kawamoto, MD, PhD, MHS Associate Chief Medical Information Officer, University of Utah Health Care; Assistant Professor, Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah

    Jacob Kean, PhD, MA, BS Research Speech-Language Pathologist, VA Salt Lake City Health Care System; Associate Professor, Population Health Sciences, University of Utah School of Medicine, Salt Lake City, Utah

    Michael H. Kennedy, PhD, MHA, FACHE Associate Professor, Department of Health Services and Information Management, East Carolina University, Greenville, North Carolina

    Tae Youn Kim, PhD, RN Associate Professor, Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, California

    Gerald R. Ledlow, PhD, MHA, FACHE Chair and Professor, Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia

    Kim Leighton, PhD, RN, ANEF Assistant Dean, Research & Simulation Faculty, Development, Institute for Research & Clinical Strategy, DeVry Medical International, Iselin, New Jersey

    Louis Luangkesorn, PhD Research Assistant Professor, Industrial Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania

    Ann M. Lyons, PhD, RN Medical Informaticist, Data Science Service, University of Utah, Salt Lake City, Utah

    Kathleen MacMahon, RN, MS, CNP Telehealth Nurse Practitioner, American Telecare, Minneapolis, Minnesota

    Michele P. Madison, JD Partner, Morris, Manning and Martin, LLP, Atlanta, Georgia Shannon Majoras, JD Associate, Vorys, Sater, Seymour and Pease, LLP, Cleveland, Ohio E. LaVerne Manos, DNP, RN-BC Faculty, School of Nursing, University of Kansas; Program

    Director, Interprofessional Master of Science in Health Informatics and Post-Master’s, Interprofessional Certificate in Informatics Center for Health Informatics, University of Kansas; Director of Nursing Informatics, Center for Health Informatics, University of Kansas, Kansas City, Kansas

    Karen S. Martin, RN, MSN, FAAN Health Care Consultant, Martin Associates, Omaha, Nebraska

    Cynthia M. Mascara, RN, MSN, MBA Principal Clinical Consultant, Strategic Clinical Consulting, Cerner Corporation, Kansas City, Missouri

    Susan A. Matney, PhD, RN-C, FAAN Medical Informaticist, Healthcare Data Dictionary (HDD) Team, 3M Health Information Systems, Salt Lake City, Utah

    Christine D. Meyer, PhD, RN Healthcare IT, Independent Consultant, Bridgeville,

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    Pennsylvania Michele Mills, MBA.PM, PMP, CPHIMS, FHIMSS Director, Information Technology

    Services, University of Utah Health Care, Salt Lake City, Utah Sandra A. Mitchell, PhD, CRNP, FAAN Research Scientist, Outcomes Research Branch,

    National Cancer Institute, Rockville, Maryland Judy Murphy, RN, BSN, FACMI, FHIMSS, FAAN Chief Nursing Officer, Global Healthcare

    & Life Sciences, IBM, Washington, DC Daniel A. Nagel, RN, BScN, MSN, PhD(c) Lecturer, Department of Nursing & Health. Advanced Health IT System in Health Informatics

    Sciences, University of New Brunswick, Saint John, New Brunswick, Canada Scott P. Narus, PhD Medical Informatics Director, Intermountain Healthcare Associates;

    Professor, Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah Ramona Nelson, PhD, RN-BC, ANEF, FAAN Professor Emerita, Slippery Rock University, Slippery Rock, Pennsylvania President, Ramona Nelson Consulting, Allison Park, Pennsylvania Sally Okun, RN, MMHS Vice President, Advocacy, Policy, and Patient Safety,

    PatientsLikeMe, Cambridge, Massachusetts Hyeoun-Ae Park, PhD Professor, College of Nursing, Seoul National University, Seoul, South

    Korea Mitra Rocca, Dipl. Inform. Med. Senior Medical Informatician, Center for Drug Evaluation

    and Research U.S. Food and Drug Administration, Silver Spring, Maryland Kay M. Sackett-Fitzgerald, BSN, RN, MEd, MSN, EdD Fitzgerald Consulting, Jenkintown,

    Pennsylvania Loretta Schlachta-Fairchild, RN, PhD, FACHE, LTC (Ret.) U.S. Army Nurse Corps Health

    Information Sciences Research Program Manager, Joint Program Committee-1 (JPC-1), U.S. Army Medical Research and Materiel Command/Department of Defense Health Agency, Fort Detrick, Maryland

    Rebecca Schnall, PhD, MPH, RN-BC Assistant Professor, School of Nursing, Columbia University, New York, New York

    Kumiko O. Schnock, PhD, RN Research Fellow, Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts

    Charlotte A. Seckman, PhD, RN-BC, CNE Assistant Professor, Course Director, Organizational Systems and Adult Health, School of Nursing University of Maryland, Baltimore, Maryland

    Joyce Sensmeier, MS, RN-BC, CPHIMS, FHIMSS, FAAN Vice President, Informatics, Healthcare Information and Management Systems Society, Chicago, Illinois

    Catherine Janes Staes, BSN, MPH, PhD Assistant Professor, Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, Utah

    Nancy Staggers, PhD, RN, FAAN President, Summit Health Informatics; Adjunct Professor, College of Nursing and Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah

    Teresa Stenner, MA Program Manager, Center for Health Informatics, University of Kansas Medical Center, Kansas City, Kansas

    Kathleen R. Stevens, RN, MS, EdD, ANEF, FAAN Professor and Director, Improvement Science Research Network, School of Nursing, University of Texas Health Science Center, San Antonio, Texas

    Jim Turnbull, DHA, MBA, BA Chief Information Officer, University of Utah Health Care, Salt Lake City, Utah

    Karen B. Utterback, MSN, RN Independent Consultant, Homecare, Mitre, Hattiesburg, Mississippi

    Dianna Vice-Pasch, MSN, RN, CCM, CTCP Associate Degree Nursing Faculty Kentucky Community and Technical College Systems Lexington, Kentucky

    Judith J. Warren, PhD, RN, FAAN, FACMI Professor Emeritus, School of Nursing, University of Kansas Medical Center, Kansas City, Kansas

    Charlene R. Weir, PhD, RN Associate Professor, Department of Biomedical Informatics, University of Utah School of Medicine; Associate Director, IDEAS Center of Innovation, Veterans Affairs Salt Lake City, Salt Lake City, Utah

    Kathy H. Wood, PhD, FHFMA, CHFP Assistant Professor, College of Health, Human Services, and Science, Ashford University, San Diego, California

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    Reviewers and ancillary writers

    Reviewers Joanna V. Bachour, MSN, RN Assistant Professor and Lab Manager, MCPHS University,

    School of Nursing, Worcester, Massachusetts Carol J. Bickford, PhD, RN-BC, CPHIMS, FHIMSS, FAAN Senior Policy Advisor,

    Department of Nursing Practice & Work Environment, American Nurses Association, Silver Spring, Maryland

    Connie B. Bishop, DNP, MBA, RN-BC Clinical Assistant Professor, College of Health and Human Services, School of Nursing, North Carolina A&T State University, Greensboro, North Carolina

    Barbara Blackwell, EdD, RN-BC Director, School of Nursing (RN and LPN School), Holy Name Medical Center School of Nursing, Teaneck, New Jersey

    Mary T. Boylston, RN, MSN, EdD, AHN-BC Professor of Nursing, Nursing Department, Eastern University, St. Davids, Pennsylvania

    Kathleen M. Burke, PhD, RN Assistant Dean in Charge of Nursing, Professor of Nursing, Adler Center for Nursing Excellence, Ramapo College of New Jersey, Mahwah, New Jersey

    Pat Callard, DNP, RN, CNL Associate Professor of Nursing, College of Graduate Nursing, Western University of Health Sciences, Pomona, California

    Karen Chang, PhD, RN Associate Professor, School of Nursing, College of Health and Human Services, Purdue University, West Lafayette, Indiana

    Amanda Dorsey, MSHI, FHIMSS Assistant Professor, UAB MS in Health Informatics Program, University of Alabama at Birmingham, Birmingham, Alabama

    Judith A. Effken, PhD, RN, FACMI, FAAN Professor Emerita, College of Nursing, The University of Arizona, Tucson, Arizona

    Matthew J. Fox, MSN, RN-BC Assistant Professor of Nursing, Ohio University-Zanesville, Zanesville, Ohio

    Robert L. Garrie, MPA, RHIA Associate Professor, Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama

    Lynda R. Hardy, PhD, RN Associate Dean for Research, College of Nursing, University of Tennessee, Knoxville, Knoxville, Tennessee

    Gayle McGinty, MSN, RN Assistant Professor of Nursing, MCPHS University, School of Nursing, Worcester, Massachusetts

    Carol M. Patton, PhD, FNP-BC, CRNP, CNE Informatics Health Certificate, CNE, Associate Clinical Professor, Drexel University, Philadelphia, Pennsylvania

    Alison Pittman, RN, MSN, CPN Clinical Assistant Professor, Texas A&M Health Science Center, College of Nursing, Bryan, Texas

    Teresa L. Scherer, MS, RN Clinical Instructor, School of Nursing, Idaho State University, College of Technology, Pocatello, Idaho

    M. Kathleen Smith, MScEd, RN-BC, FHIMSS Managing Partner, Informatics Consulting and Continuing Education, L.L.C., Weeki Wachee, Florida

    Nadia Sultana, MBA, RN, BC Clinical Assistant Professor, College of Nursing, New York University, New York, New York

    Lindsay Tucker, BA, AAA, CPC Training and Education Manager, Moses Cone Health System, Adjunct Professor, Guilford Technical Community College, Greensboro, North Carolina

    Dorothea M. Winter, PhD, RN Professor of Nursing, Nursing Department, Salisbury University, Salisbury, Maryland

    ANCILLARY WRITER Jane M. Brokel, PhD, RN, FNI Adjunct Faculty, College of Nursing, University of Iowa, Iowa

    City, Iowa; Section Instructor, School of Nursing and Health Sciences, Simmons College, Boston, Massachusetts