EVALUATION MANAGEMENT AND ANESTHESIA CODING

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1.   Modifier -P5 indicates that the patient

   A. experienced postoperative anemia.
   B. is not expected to survive without the operation.
   C. received a lower anesthesia dosage.
   D. is advanced in age.


2.   Code 99217 is assigned for

   A. nursing home services.
   B. observation discharge services.
   C. established patient visits.
   D. new patient office visits.


3.   Code range 99218–99220 denotes

   A. emergency room visits.
   B. initial hospital visits.
   C. initial observation care.
   D. follow-up hospital visits.


4.   A physician performs an invasive surgical procedure. Prior to the start of the procedure, the anesthesiologist administers monitored anesthesia. Which modifier should be appended to the anesthesia code?EVALUATION MANAGEMENT AND ANESTHESIA CODING

   A. -G10
   B. -G8
   C. -G1
   D. -G9

5.   When more than one surgery is performed during one anesthesia administration, the coder should

   A. report the anesthesia code with the highest base value unit.
   B. assign modifier -QS to the second surgery code.
   C. assign add-on code 01900 to indicate more than one surgery was performed during a single operative session.
   D. add modifier -QY to the first surgery code.


6.   Modifier -P3 indicates that the patient

   A. received topical anesthesia.
   B. is in a coma.
   C. received local anesthesia.
   D. has severe systemic disease.

7.   ___ modifiers indicate the number of anesthesia cases being directed at one time.

   A. Coordinated time
   B. Conversion
   C. Calculation
   D. Concurrent

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8.   A coder adds modifier -P2 to an anesthesia code. This modifier indicates the patient

   A. is allergic to lidocaine.
   B. received general anesthesia.
   C. is handicapped.
   D. has mild systemic disease.

9.   The risk of morbidity or mortality would be considered as a part of

   A. review of systems.
   B. medical decision-making.
   C. history of present illness.
   D. chief complaint.

10.   A patient who has not been seen by a physician or another physician in the same group within the last three years is a/an _______ patient.

   A. established
   B. new
   C. emergent
   D. existing

11.   The dollar rate of each anesthesia unit is called the _______ factor.EVALUATION MANAGEMENT AND ANESTHESIA CODING

   A. unit conversion
   B. conversion
   C. calculation
   D. base value unit rate

12.   A patient who has been admitted to a hospital is a/an

   A. inpatient.
   B. established patient.
   C. new patient.
   D. ambulatory surgery patient.

13.   A patient undergoes an esophagogastric tamponade with a balloon. How would this procedure be coded?

   A. 43460
   B. 00500
   C. 43460-P1
   D. 00500-P1

14.   Codes in the range of 99224–99226 represent services for

   A. critical care services.
   B. subsequent observations.
   C. consultations.
   D. initial observations.


15.   Which of the following code ranges are add-on codes reported for prolonged physician services?

   A. 99458–99586, 99372
   B. 99212–99252, 99344
   C. 99673–99873, 99001
   D. 99354–99357, 99359


16.   A patient who has been treated by a physician or another physician in the same group within the last three years is a/an _______ patient.

   A. emergent
   B. new
   C. transmitted
   D. established

17.   Modifier -QY indicates that

   A. anesthesia administration was abruptly terminated due to surgical complications.
   B. the surgeon is administering anesthesia.
   C. the physician is supplying topical anesthesia only.
   D. an anesthesiologist is directing the CRNA during anesthesia administration.


18.   _______ circumstance codes are used in situations that increase the difficulty of administering anesthesia.

   A. UNIT administration modification
   B. Extenuating
   C. ASA relativity
   D. Qualifying

19.   Other nursing facility services would be reported with code

   A. 99305.
   B. 99318.
   C. 99525.
   D. 99211.


20.   A patient undergoes a pacemaker insertion. She is not expected to survive if she doesn’t have the operation. What code should be reported?EVALUATION MANAGEMENT AND ANESTHESIA CODING

   A. 00530-P4
   B. 33206-P4
   C. 00530-P1
   D. 33208-P2

Structural Versus Strategic Family Therapies

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Although structural therapy and strategic therapy are both used in family therapy, these therapeutic approaches have many differences in theory and application. As you assess families and develop treatment plans, you must consider these differences and their potential impact on clients.

For this Assignment, as you compare structural and strategic family therapy, consider which therapeutic approach you might use with your own client families.

                                        Learning Objectives

Students will:

· Compare structural family therapy to strategic family therapy

· Create structural family maps (Refer to Gerlach (2015) in this week’s Learning  

   Resources for guidance on creating a structural family map.) or LOOK AT THE 

   ATTACHED ONE.

· Justify recommendations for family therapy

                                                     The Assignment

   In a 2- to 3-page paper, address the following:

· Summarize the key points of both structural family therapy and strategic family 

  therapy Structural Versus Strategic Family Therapies.

· Compare structural family therapy to strategic family therapy, noting the  

  strengths and weaknesses of each.

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· Provide an example of a family in your practicum using a structural family map. 

  Note: Be sure to maintain HIPAA regulations (Refer to Gerlach (2015) in this 

  week’s Learning Resources for guidance on creating a structural family map.) or 

  LOOK AT THE ATTACHED ONE.

· Recommend a specific therapy for the family, and justify your choice using the 

                                                Learning Resources

Required Readings

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.

  • Chapter 5, “Bowen Family Systems Therapy” (pp.      69–88)
  • Chapter 6, “Strategic Family Therapy” (pp.      89–109)
  • Chapter 7, “Structural Family Therapy” (pp. 110–128)

Gerlach, P. K. (2015). Use structural maps to manage your family well: Basic premises and examples. Retrieved from http://sfhelp.org/fam/map.htm

McNeil, S. N., Herschberger, J. K., & Nedela, M. N. (2013). Low-income families with potential adolescent gang involvement: A structural community family therapy integration model. American Journal of Family Therapy, 41(2), 110–120. doi:10.1080/01926187.2011.649110

Méndez, N. A., Qureshi, M. E., Carnerio, R., & Hort, F. (2014). The intersection of Facebook and structural family therapy volume 1. American Journal of Family Therapy, 42(2), 167–174. doi:10.1080/01926187.2013.794046 

Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207–215. doi:10.1111/famp.12025

Ryan, W. J., Conti, R. P., & Simon, G. M. (2013). Presupposition compatibility facilitates treatment fidelity in therapists learning structural family therapy. American Journal of Family Therapy, 41(5), 403–414. doi:10.1080/01926187.2012.727673

Sheehan, A. H., & Friedlander, M. L. (2015). Therapeutic alliance and retention in brief strategic family therapy: A mixed-methods study. Journal of Marital and Family Therapy, 41(4), 415–427. doi:10.1111/jmft.12113

Szapocznik, J., Muir, J. A., Duff, J. H., Schwartz, S. J., & Brown, C. H. (2015). Brief strategic family therapy: Implementing evidence-based models in community settings. Psychotherapy Research, 25(1), 121–133. doi:10.1080/10503307.2013.856044

                                                     Required Media

Psychotherapy.net (Producer). (2010). Bowenian family therapy [Video file]. Mill Valley, CA: Author.

Triangle Productions (Producer). (2001). Brief strategic therapy with couples [Video file]. La Jolla, CA: Author Structural Versus Strategic Family Therapies. 

Utilizing Critical Thinking Skills

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You are an RN working in an Urgent Care. Below is just a brief history  of a client with information limited on purpose to encourage you to  utilize your critical thinking skills.

Subjective information: Miranda is a 26-year-old female who  presents to the office with the complaint of diarrhea for 6 days. She  states she has lost 8 pounds in one week. She is not currently taking  any medications. She has tried over-the-counter remedies for the  treatment of her diarrhea with minimal improvement. She is generally  healthy with only a sinus and bladder infection on occasion.

Objective information: She does not have a temperature, BP  is 102/60, Pulse is 98, and her bowel sounds are present in all   quadrants and are hyperactive. Her abdomen is soft and mildly tender. Utilizing Critical Thinking Skills

In a 2-3 page paper, answer the following questions. Include, at  minimum, two peer reviewed sources (in-text citation), and provide a  Reference page (not included in the page count) using APA Editorial  format.

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  1. What is the pathogenesis of diarrhea?
  2. Describe the different mechanisms of diarrhea (osmotic, secretory and motility).
  3. With the limited information provided, what  additional  information would you like to obtain from her history and physical  to  help direct your care plan? Describe why obtaining this information  would be helpful in leading you to a nursing diagnosis.
  4. What infectious or inflammatory conditions could she be suffering from? Utilizing Critical Thinking Skills

Pharmacokinetics and Pharmacodynamics

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As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics.

Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body. When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharamcodynamic processes.

These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease. In this Discussion, you reflect on a case from your past clinical experiences and consider how a particular patient’s pharmacokinetic and pharmacodynamic processes altered his or her response to a drug.

To prepare:

· Review this week’s media presentation with Dr. Terry Buttaro, as well as Chapter 2 of the Arcangelo and Peterson text, and the Scott article in the Learning Resources. Consider the principles of pharmacokinetics and pharmacodynamics.

· Reflect on your experiences, observations, and/or clinical practices from the last five years. Select a case from the last five years that involves a patient whose individual differences in pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug. When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.

· Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.

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· Think about a personalized plan of care based on these influencing factors and patient history in your case study.

With these thoughts in mind:

Post a description of the case you selected. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient from the case you selected. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case.

– This work should have Introduction and conclusion

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

– Use at least 2 references from class Learning Resources

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com Pharmacokinetics and Pharmacodynamics

LEARNING RESOURCES

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

  • Chapter 2, “Pharmacokinetic      Basis of Therapeutics and Pharmacodynamic Principles” (pp. 17-31)
         This chapter examines concepts related to pharmacokinetics and      pharmacodynamics. It also explores patient factors that health care      providers consider when prescribing drug therapy to patients.
  • Chapter 3, “Impact of Drug      Interactions and Adverse Events on Therapeutics” (pp. 33-51)
         This chapter explains drug-drug, drug-food, drug-herb, and drug-disease      interactions. It also reviews patient factors that influence drug      interactions and then covers adverse drug reactions.
  • Chapter 4, “Principles of      Pharmacotherapy in Pediatrics” (pp. 53-63)
         This chapter explores concepts relating to drug selection, administration,      and interaction for pediatric patients. It also compares age-related      pharmacokinetic differences in children and adults.
  • Chapter 6, “Principles of Pharmacotherapy in      Elderly Patients” (pp. 73-89)
         This chapter describes issues and factors that affect drug therapy for      elderly patients. It then explores concepts relating to drug selection,      administration, and management for elderly patients.

**Scott, S. A. (2011). Personalizing medicine with clinical pharmacogenetics. Genetics in Medicine, 13(12), 987–995. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3290900/

This article examines pharmacogenetic testing in relation to personalized drug therapy plans and explores evidence-based guidelines and recommendations on pharmacogenetic testing.

**Drugs.com. (2012). Retrieved August 22, 2012, from http://www.drugs.com/ 

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

**Haymarket Media, Inc. (2012). Retrieved from http://www.empr.com/

**Institute for Safe Medication Practices. (2012). Retrieved from http://www.ismp.org/

**WebMD. (2012). Medscape. Retrieved from http://www.medscape.com/ Pharmacokinetics and Pharmacodynamics

Qualitative and Mixed Methods Research Designs

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

To prepare:

· Select a health topic of interest to you that is relevant to your current area of practice. The topic may be your Course Portfolio Project or a different topic of your choice Qualitative and Mixed Methods Research Designs.

· Using the Walden Library, locate two articles in scholarly journals that deal with your portfolio topic: 1) Select one article that utilizes a quantitative research design and 2) select a second article that utilizes either a qualitative OR a mixed methods design. These need to be single studies not systematic or integrative reviews (including meta-analysis and metasynthesis). You may use research articles from your reference list. If you cannot find these two types of research on your portfolio topic, you may choose another topic.

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

o Critique Template for a Qualitative Study

o Critique Template for a Quantitative Study

o Critique Template for a Mixed-Methods Study

· Consider the fields in the templates as you review the information in each article. Begin to draft a paper in which you analyze the two research approaches as indicated below. Reflect on the overall value of both quantitative and qualitative research. If someone were to say to you, “Qualitative research is not real science,” how would you respond? Qualitative and Mixed Methods Research Designs

To complete this Assignment:

· Complete the two critiques using the appropriate templates.

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

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

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

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

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

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

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Organizational Behavior and Business Influences

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You are a family nurse practitioner (FNP) employed as a contract (1099 independent contractor) in a busy primary care practice for 2 years. The providers in the group include one physician, who is also the owner of the practice, and two other nurse practitioners, who are staff employees (W2 employees).

The owner of the practice recently made comments about the need to produce more revenue. You relate with his concerns and feel that you have several strategies that could be helpful. Your contract is up for renewal in 3 months. You are highly satisfied with your job and want to stay with the group. You see 20 patients per day on average and take call every third weekend Organizational Behavior and Business Influences.

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Discussion Question:

What negotiation strategies should you use to propose a contract renewal? How does your role as a 1099 contractor benefit the practice over the W2 employees? What evidence will you present to the practice to reinforce your value in the practice both in terms of revenue and patient satisfaction? Consider any additional services you may be willing to provide under your contract. Use logical reasoning, and provide evidence based rationales for your decisions.Keep in mind that your negotiation terms and conditions must be within the legal scope of practice for an ANP Organizational Behavior and Business Influences.

ADVANCED PATHOPHYISIOLOGY ACROSS THE LIFESPAN

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Topic 1: Case Study

Case Study Posting Requirements

  1. Make sure all of the topics in the case study have been addressed.
  2. Cite at least three sources—journal articles, textbooks or evidenced-based websites to support the content.
  3. All sources must be within five years.
  4. Do not use .com, Wikipedia, or up-to-date, etc., for your sources.

Case Study 1

Organization and Control of Neural Function

Riku is a 19-year-old college student. One morning, after a long night of studying, Riku woke up and made himself a hot cup of coffee and toast.

Much to his surprise, when he brought the cup to his mouth to drink, the coffee spilt onto the table. Riku went to the bathroom mirror and noticed the left side of his face seemed to droop. He quickly got dressed and ran to the medical clinic on the college campus.

As he ran, his left eye began to feel scratchy and dry, but he could not blink in response. The physician at the clinic listened to Riku’s story and then did a careful cranial nerve examination. She concluded that Riku had Bell palsy, an inflammatory condition of the facial nerve most likely caused by a virus ADVANCED PATHOPHYISIOLOGY ACROSS THE LIFESPAN.

  1. What are an afferent neuron and efferent neuron? What are efferent components of the facial nerve and their actions?
  2. Under certain circumstances, axons in the peripheral nervous system can regenerate after sustaining damage. Why is axonal regeneration in the central nervous system much less likely?
  3. At a healthy myoneural junction, acetylcholine is responsible for stimulating muscle activity. What mechanisms are in place to prevent the continuous stimulation of a muscle fiber after the neurotransmitter is released from the presynaptic membrane?

Case Study 2

Somatosensory Function, Pain, and Headache

Ramandeep is an active 23-year-old. She works as a part-time nurse during the day and is studying for a postgraduate certificate in the evening. Ramandeep started to wear a bite plate at night after she began to experience jaw pain and headaches.

Sometimes the pain radiated to her ear, and she would apply a hot water bottle to it to ease the discomfort. Her husband mentioned to her that he heard her grinding her teeth at night while she was sleeping. She knew then that her headaches might be from temporomandibular joint syndrome, and she went to her dentist to confirm her thoughts.

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In addition to the bite plate, the dentist also recommended she should continue with the application of heat, use NSAIDs when needed, and incorporate regular relaxation exercises throughout her stressful days.

  1. What effect does heat have on nociceptors so that it makes a good nonpharmacologic treatment for pain?
  2. Heat and cold treatment are both hypothesized to have an effect on the release of endogenous opioids. What are these chemicals, and why are they hypothesized to be beneficial in the body?
  3. Using your knowledge of physiology, how do NSAID analgesics function in the management of pain?

Case Study 3

Disorders of Motor Function

John is 63 years old and receives home care by an occupational therapist twice a week. His therapist is currently working with John on maintaining joint flexibility and balance. John demonstrates resting tremor, so his therapist is also working on adaptive techniques, so John can continue to use his hands to write, use the computer, and cook simple meals. John’s wife assists with his mobility and walks slowly beside him, holding his arm. Sometimes she needs to help him open his prescription bottles, so he can take his medicine, a combination of levodopa and carbidopa.

  1. What motor disease does John demonstrate? One of his signs is resting tremor. What is the difference between a resting tremor and an intention tremor?
  2. What is the advantage of combining levodopa with carbidopa? What is the benefit of anticholinergic drugs in the management of Parkinson disease?
  3. Parkinson disease involves the destruction of the substantia nigra and the nigrostriatal pathway. Where are these structures anatomically?
  4. The patient with Parkinson disease typically presents with a masklike facial expression. Why does he or she have a masklike facial expression? How are the eyes, mouth, and laryngopharynx affected by this disease? ADVANCED PATHOPHYISIOLOGY ACROSS THE LIFESPAN

Case Study 4

Disorders of Brain Function

Bonnie is a 70-year-old woman who lives alone. One evening, she felt light-headed and dizzy. When her head began to ache, she decided to take an analgesic and go to bed early. The following morning, upon awakening, she was unable to move the bed sheets with her right arm. At this point she was experiencing tingling sensations in her limbs, and she had difficulty keeping her balance. She dialed 911 for help, and by the time the ambulance arrived, she was confused and unable to articulate her words although she knew what information he was asking of her. In the hospital, she was examined and treated for ischemic stroke.

  1. Stroke, or brain attack, involves brain tissue injury. Describe ischemic penumbra and what factors contribute to the survival of the neurons involved. What happens if the cells of the penumbra are unable to be preserved?
  2. Compare and contrast hypoxia and ischemia. What condition is more dangerous to the brain? Explain your answer.
  3. Knowing what you do about the effects of ischemia on the brain, why would someone with ischemic stroke develop cerebral edema?
  4. What type of aphasia was Bonnie exhibiting when talking to her caregivers? Explain your answer.

Case Study 5

Sleep and Sleep Disorders

Jessica is six years old. Her parents recently saw her pediatrician because they were concerned about the sleeping difficulties Jessica has been having. Often she would scream out loud in her sleep. Her parents would rush to her room and find her sitting upright in bed, panting heavily in a state of panic. Jessica would not respond to her parent’s words of consolation, and the next morning she would have no memory of the incident at all. Her parents were worried about the anxiety their daughter was experiencing and asked the pediatrician what they could do about her nightmares. The pediatrician explained Jessica was likely suffering from sleep terrors and carefully described what that meant.

  1. What are the similarities and differences between nightmares and sleep terrors?
  2. What are the characteristics of motor, sensory, and autonomic function during REM sleep? What is thought to be the importance of this stage of sleep?
  3. Jessica’s pediatrician said that the careful management of sleep hygiene may help to decrease the incidence of her sleep terrors. What is included in an overview of the general features that demonstrate good sleep hygiene?

Case Study 6

Disorders of Thought, Emotion, and Memory

Ella is 88 years old and was living at home until very recently. Her children, who visited her regularly, noticed she was becoming more forgetful. At first, she mislaid objects, and then she began to forget her doctor’s appointments. With time, her personality changed and she became withdrawn. At home she would forget to turn off the stove or leave the kettle on until it boiled dry. After seeking advice from a gerontologist and social worker, Ella’s children placed her in a nursing home with a unit equipped for patients with Alzheimer disease.

  1. What is dementia? Why is Alzheimer disease based on a “diagnosis of exclusion”?
  2. What are the macroscopic and microscopic features of the brain that are typical in Alzheimer disease?
  3. One of Ella’s children brought her a new pair of slippers to wear in the nursing home. A minute after she received them, Ella could not remember the exchange and asked what they were doing on her bed. What part of the brain has largely been affected to produce this behavior, and what is the pathophysiology involved?

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Home ADVANCED PATHOPHYISIOLOGY ACROSS THE LIFESPAN

Health Policy Proposal Analysis

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Nurses engaged in the policy arena often are asked to provide information on a health care topic of interest to policy makers. This is frequently accomplished through developing a policy brief. A policy brief advocates for a particular recommendation (prior to the enactment of a policy). Learning how to write a policy brief in a clear, succinct, scholarly, and professional manner is an essential skill for advanced practice nurses.

For this Assignment, you will assess one of the recommendations from the Institute of Medicine’s “The Future of Nursing: Leading Change, Advancing Health: Report Recommendations. You will then develop a policy brief to advocate for this recommendation (the written policy brief is due in Week 7) Health Policy Proposal Analysis. 

To prepare:

  • Review      the Lavis et al. article on preparing and writing policy briefs provided      in the Learning Resources (See      attached file).
  • Select      one of the recommendations within the IOM The Future of Nursing:      Leading Change, Advancing Health: Report Recommendations to focus      on for this assignment. (For this assignment, I have selected      RECOMMENDATION 1, please see attached file)
  • Research      the history of the problem behind the recommendation and what has been      done to try to solve the problem.

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  • What      does the recommendation say should be done? Are there any groups, nursing      and others, currently supporting work to implement the recommendation      (e.g., Kaiser Family Foundation, professional organizations)? Does the      recommendation suggest specific groups that should be involved in the      implementation? Think critically about how the recommendation should be      implemented – did the IOM get it right? What other strategies are possible      to consider?

By Sunday 04/15/2018 12pm, 

To complete:

  • Develop      a scholarly and professionally written 2- to 3-page single-spaced policy      brief on the recommendation you selected from the IOM report following the format presented in      the Lavis et al. article (follow the exact format, including how the layout      of the paragraphs, and the way the references [at least 10 scholarly      references] are displayed at the end, numbered in-text and number plus      citation at the end, copy the same exact format as the article please).      (See attached file for the article). Include the following:
    1. Short       introduction with statement of the problem.
    2. The       selected recommendation (from the IOM Report)
    3. Background
    4. Current       characteristics
    5. The       impact of the recommendation from the perspective of consumers, nurses, other       health professionals, and additional stakeholders
    6. Current       solutions
    7. Current       status in the health policy arena
    8. Final       conclusions
    9. Resources       used to create the policy brief Health Policy Proposal Analysis

Required Readings

Hyder, A., Syed, S., Puvanachandra, P., Bloom, G., Sundaram, S., Mahmood, S., … Peters, D. (2010). Stakeholder analysis for health research: case studies from low- and middle-income countries. Public Health, 124(3), 159–166.

This study demonstrates how the engagement of stakeholders in research and policy making can assist in the successful implementation of policy proposals. The authors propose that by engaging stakeholders, researchers and policy makers are provided with multiple perspectives on proposed policies, which can lead to greater success with policy adoption and implementation.

Lavis, J. N., Permanand, G., Oxman, A. D., Lewin, S., & Fretheim, A. (2009). SUPPORT Tools for evidence-informed health Policymaking (STP) 13: Preparing and using policy briefs to support evidence-informed policymaking. Health Research Policy & Systems, 71–79. doi: 10.1186/1478-4505-7-S1-S13

The purpose of a policy brief is to communicate an issue clearly and definitively to policy makers. The authors of this article propose an outline for policy briefs and also stress the importance of using research when creating a policy brief.

Lowery, B. (2009). Obesity, bariatric nursing, and the policy process: The connecting points for patient advocacy. Bariatric Nursing & Surgical Patient Care, 4(2), 133–138.

This article provides an example of nurse involvement in policy making by examining a bariatric nursing issue. The author stresses that nurses, in their patient-advocacy role, have a responsibility to be involved in the health care policy process.

Moore, K. (2006). How can basic research on children and families be useful for the policy process? Merrill-Palmer Quarterly, 52(2), 365–375.

Institute of Medicine. (2010). The future of nursing: Leading change, advancing health: Report recommendations. Retrieved from http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Recommendations.pdf

Introduced in Week 2, this IOM report highlights four key recommendations in its proposal for the future directions of the nursing profession. These recommendations focus on nursing practice, education and training, partnerships with other healthcare professionals, and workforce planning and policymaking.

National Center for Policy Analysis (2010). Ideas changing the world: Free-market health care policy. Retrieved from http://www.ncpa.org/healthcare/

The NCPA is a nonprofit, nonpartisan organization that promotes private sector solutions to public policy issues (See attached file and choose recommendation 1).

Slack, B. (2011). The policy Process. Retrieved from http://people.hofstra.edu/geotrans/eng/methods/ch9c2en.html 

The author presents a policy-making framework and provides details on the four steps of that process: problem definition, policy objectives and options, policy implementation, and policy evaluation and maintenance.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy: Agenda setting and the policy process. Baltimore: Author. 

Note: The approximate length of this media piece is 17 minutes Health Policy Proposal Analysis.

Dr. Kathleen White and Dr. Joan Stanley share their insights into agenda setting and how issues are moved forward into the policy process.

Optional Resources

Barnes, M., Hanson, C., Novilla, L., Meacham, A., McIntyre, E., & Erickson, B. (2008). Analysis of media agenda setting during and after Hurricane Katrina: Implications for emergency preparedness, disaster response, and disaster policy.

 American Journal of Public Health, 98(4), 604–610.

Jennings, C. (2002). The power of the policy brief. Policy, Politics & Nursing Practice, 3(3), 261–263. doi: 10.1177/152715440200300310

Neumann, P. J., Palmer, J. A., Daniels, N., Quigley, K., Gold, M. R., & Chao, S. (2008). A strategic plan for integrating cost-effectiveness analysis into the US health care system. American Journal of Managed Care, 14(4), 185-188.

Plan, Policy, Procedure Relationship Diagram. (n.d.). Retrieved from http://www.informationsecurityintel.com/docs/Fig.%204.3.pdf Health Policy Proposal Analysis

Building a Health History for Patients with Diverse Backgrounds

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In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.

Case 1

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs.

He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.” Building a Health History for Patients with Diverse Backgrounds

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To prepare:

  • Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
  • Select one of the three case studies. Reflect on the provided patient information.
  • Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.
  • Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
  • Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information? Building a Health History for Patients with Diverse Backgrounds

The Use of Clinical Systems to Improve Outcomes

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New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings The Use of Clinical Systems to Improve Outcomes.

To Prepare:

  • Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
  • Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
  • Identify and select 5 peer-reviewed articles from your research.

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The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

  • Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
  • Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples The Use of Clinical Systems to Improve Outcomes.