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Marketing and the Health Care System

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Marketing and the Health Care System

Select a health care provided with which you are familiar and write a four to six (4-6) page paper in which you:  Determine the direct impact of marketing for the health care provider you selected.  Outline a strategy for the health care provider you selected to determine the utilization of its products or services.  Outline a marketing strategy for the health care provider you selected.  Recommend at least three (3) separate ways the health care provider you selected could shape the buying decisions of its customers.  Provide at least three (3) qualified sources, e.g., peer-reviewed journals, professional organization Website, or health care provider Websites.  Your assignment must follow these formatting requirements:  This course requires use of new Strayer Writing Standards (SWS). The format is different than other Strayer University courses. Please take a moment to review the SWS documentation for details.  Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow SWS or school-specific format. Check with your professor for any additional instructions.  Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

 

SAMPLE ANSWER

Healthcare and Marketing

Introduction

Marketing has become an essential aspect of healthcare facilities in the recent past. Although the concept is crucial, it is still challenging for facilities, especially when trying to understand the impact of their strategies to the targeted market. It is viewed that marketing is not only about reviewing the purchasing behavior of customers. It involves understanding their behavior in their daily habits. In that regard, the application of educational techniques has become an important aspect of healthcare marketing.  The pharmaceutical industry is viewed to entail customers who make informed decisions when choosing healthcare products. This aspect makes the facilities in the sector to employ effective tactics to enhance their sustainability (Yaaminidevi, 2014). The paper tries to evaluate the direct impact of marketing strategies for Handa Pharmaceuticals, California. In addition, it provides a strategy for utilization of its products and ways to improve customer buying decisions.

Direct Impact of Marketing

Handa Pharmaceuticals needs to develop different marketing strategies for its products. Since the targeted market for the firm’s products is considered to be educated, the firm needs to engage in branding services for its drugs. This act can lead to an increase in product sales. Moreover, there may be an improved customer loyalty to the firm’s products. This perspective shows that the firm’s marketing strategies may try to provide a positive impact. From another perspective, it can be viewed that the firm can employ integrated marketing communication. This move may lead to improved advertisement used by the facility. As a result, more people may become aware of the firm’s brand. Therefore, more people will come to the facility for its products due to an increased awareness (Yaaminidevi, 2014).

Marketing and the Health Care System

The facility may also engage in corporate social responsibility. This aspect involves engagement in actions focusing on the well-being of the community and general society. Some of the efforts involved in this act may include the reduction of its product’s price when a client has been diagnosed. Marketing may provide important information to the customers, thereby saving time that would be used to explain to them at the facility.  In addition, the practice will provide customers with vital information on reliable products that may improve their health. Due to the existence of competition in the pharmaceutical industry, marketing will have a significant impact on the customers because there will be an increased awareness of its products (Sana & Panda, 2015).

Strategy for Utilization of Products

Understanding of how the customers utilize the organization’s products is essential for the management. This aspect will enable the facility to develop a suitable strategy to meet the customers’ needs.  A suitable strategy for evaluating customer utilization of the firm’s products is the analysis of customer satisfaction. Customer satisfaction is opined to be  the perceived value and response towards a product or service. Customer satisfaction in the healthcare industry is focused on the level at which the expectations of a client are fulfilled by the product or service. Therefore, improving customer satisfaction can be opined to be an essential aspect in gaining customer loyalty and improving their desire to buy a firm’s products (Williams et al., 2018).

Research Paper Help

Analysis of customer satisfaction may be obtained by studying the records of the firm’s marketing department. The records are opined to provide information on different channels of advertising used, the number of customers that bought the product, and the frequency of purchases done by the market. This feature will enable the management to get a clue of whether the customers were satisfied with the product or not. Another technique to understand customer satisfaction may be the engagement of a marketing research to understand the purchasing trends of the customers. The research may also be used to interview the customers to gain their opinion on how the products meet their needs. Online interaction with the customers on the facility’s website may also be utilized to understand customer satisfaction of the firm’s products (Williams et al., 2018).

Marketing and the Health Care System

Suitable Marketing Strategy

Different marketing strategies may be essential for the organization. However, social media marketing is the most appropriate technique for the marketing of its products. This strategy involves the use of social media sites such as Twitter and Facebook for marketing. It is considered to be one of the latest tactics for promoting healthcare products and services. The technique is suitable because there is advancement in the use of personal computers and smartphones by the targeted market. This feature tries to depict that social media marketing may enable the facility to reach a wider audience (Yaaminidevi, 2014).

It is opined that the targeted market tries to make informed decisions due to its educational level. This aspect shows that the market needs a platform where an interaction between the market and the facility can be enhanced. Through the development of social media pages and groups, the organization can be able to clarify various issues associated with its products.  It can be opined that the connection developed by this type of promotion is suitable in making most of the people in the targeted market to be aware of the organization’s services (Yaaminidevi, 2014).

Ways to Shape Buying Decisions

Since the potential customers for the company’s products are observed to be educated, they need tactical ways to sway their decisions. The following ways are recommended for the firm:-

Use of a reliable communication technique:  Without a suitable communication technique, the marketing process may not be successful. The targeted customers are observed to be formal workers in various sectors. Therefore, it is postulated that most of them will be busy during the week days. In that regard, marketing of the products will require short posts that are straight to the point. This aspect will help save time for the consumers (Yaaminidevi, 2014).

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Development of a suitable brand image:  A suitable branding of the firm’s products will act as a sign of confidence for their usage. With a good brand, customers will have positive perceptions of the product’s quality. In addition, the brand will be held in the consumer’s memory and affect his or her overall impression. Since a brand is difficult to be imitated, it will be helpful in maintaining customers who can relate with it. Therefore, the goal of branding for the product will be to develop a consistent perception of the product, hence swaying the consumers’ purchasing patterns (Sana & Panda, 2015).

Use of Pricing Techniques:  The prices of healthcare products are a significant factor in determining purchasing habits. Customers tend to buy products that they perceive are affordable. Therefore, it is essential to develop a pricing technique that may say the customer’s decision regarding the medical products. A suitable way is by reducing the prices to be lower than its competitors’. This feature will improve on customer loyalty, thereby maintaining the firm’s sustainability in the industry (Sana & Panda, 2015).

Marketing and the Health Care System

Conclusion

Marketing is revealed to be an essential issue in the healthcare industry. The pare tries to reveal that a firm can improve on its sales through suitable marketing techniques In the case of the firm, the paper reveals that social media marketing is suitable because of the increase in the usage of smartphones and personal computers. Apart from the marketing strategy, ways such as branding, suitable communication, and pricing techniques are viewed to sway the purchasing patterns of the customers.

 

References

Sana, S. S., & Panda, S. (2015). Optimal sales team’s initiatives and pricing of pharmaceutical

products. International Journal of Systems Science: Operations & Logistics, 2(3), 168-176.

Williams, P. V., Kavati, A., Pilon, D., Xiao, Y., Zhdanava, M., Balp, M. M., … & Hernandez-

Trujillo, V. (2018). Treatment patterns, healthcare resource utilization, and spending among Medicaid-enrolled children with chronic Idiopathic/Spontaneous Urticaria in the United States. Dermatology and Therapy, 8(1), 69-83.

Yaaminidevi, S. (2014). A study on the behavior change communication in the social marketing

of condoms. International Review on Public and Nonprofit Marketing, 11(2), 181-193.

 

 

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Implementation Plan for a New Economic Opportunity

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Implementation Plan for a New Economic Opportunity

OVERVIEW

Create a detailed implementation plan for an economic initiative.

As a master’s-level health care practitioner you may be expected to create budget and implementation plans to ensure that economic opportunities for the organization are rolled out successfully and can be sustained over multiple years. Additionally, it is important to be able to envision how an economic initiative could be used for different contexts and purposes to keep the investment a viable and positive asset to your organization or care setting.

 

Note: Complete the assessments in this course in the order in which they are presented.

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

  • Competency 1: Competency 1: Analyze the effects of financial and economic factors (such as cost-benefit, supply and demand, return on investment, and risks) in a health care system on patient care, services offered, and organizational structures and operation.
    • Create a budget for relevant expected costs and earnings or benefits over the first five years of a proposed economic initiative.
    • Analyze how a proposed initiative, once implemented, may impact aspects of a care setting and ways in which negative impacts could be mitigated.
  • Competency 2: Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and services offered.
    • Propose a plan to roll out an economic initiative that will enable a care setting to successfully implement it in an ethical and culturally equitable way that will ensure the initiative achieves quality or service improvements.
  • Competency 3: Justify the qualitative and quantitative information used to guide economic decision making to stakeholders and colleagues.
    • Justify the relevance and value of the quantitative and qualitative economic, financial, and scholarly evidence used to support recommendations throughout a plan.
  • Competency 4: Develop ethical and culturally equitable economic strategies to address dynamic environmental forces and ensure the future security of an organization’s resources and its ability to provide quality care.
    • Explain strategies that have been integrated into a proposed economic initiative that will ensure it can remain a viable asset to a care setting in the face of dynamic environmental forces.
  • Competency 5: Apply various communication methods in order to clearly, effectively, and efficiently relate information to stakeholders and colleagues related to economic data, findings, and strategies.
    • Communicate a business and implementation plan in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling.
    • Effectively support a plan and recommendations with relevant economic data and scholarly sources, correctly formatting citations and references using current APA style.

Assessment Instructions:

In this assessment, you will plan for all pertinent details involved in implementing a new initiative.

Scenario

The senior management members have sent you their thanks and notes on your feasibility study for your proposed economic initiative. They have determined that your proposal has the potential to benefit the organization in both the short and long term. The last step in this process is to complete a thorough implementation plan for your proposed initiative. This plan will need to include a budget of relevant expected material, staffing, and capital costs over the first five years of the initiative (see the Resources for some examples and guides about budget planning), as well as projected earnings from the initiative for the care setting. You must also include a plan and timeline for rolling the initiative out, an analysis of how it may impact other aspects of the care setting, an explanation how it can remain viable in the face of environmental changes, and sufficient relevant supporting evidence.

Directions

In your 6–10-page plan, you have been asked to be sure to address the following. Note: The bullet points below correspond to grading criteria in the scoring guide. Be sure your work is, at minimum, addressing each of the bullets below. You may also want to read the scoring guide and the Guiding Questions: Implementation Plan for a New Economic Opportunity document, linked in the Resources, to better understand the performance levels that relate to each grading criterion:

  • Create a budget for relevant expected costs and earnings or benefits over the first five years of a proposed economic initiative.
  • Propose a plan to roll out your economic initiative that will enable your care setting to successfully implement it in an ethical and culturally equitable way that will ensure achievement of quality or service improvements.
  • Analyze how your proposed initiative, once implemented, may impact other aspects of your care setting and ways in which negative impacts could be mitigated.
  • Explain strategies you have integrated into your proposed economic initiative that will ensure it can remain a viable asset to your care setting in the face of dynamic environmental forces.
  • Justify the relevance and value of the quantitative and qualitative economic, financial, and scholarly evidence you used to support your recommendations throughout your plan.
  • Communicate your business and implementation plan in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling.
  • Effectively support your plan and recommendations with relevant economic data and scholarly sources, correctly formatting citations and references using current APA style.

Example Assessment: You may use the assessment example, linked in the Assessment Example section of the Resources, to give you an idea of what a Proficient or higher rating on the scoring guide would look like.

Additional Requirements

Your assessment should meet the following requirements:

  • Length: 6–10 double-spaced, typed pages (not including title page and reference list). Your paper should be succinct yet substantive.
    • Be sure to include a separate title page and reference list.
    • Your completed budget plan should be included as an appendix within your final submission.
  • APA format: Resources and citations are formatted according to current APA style.
  • Resources: Cite 3–5 authoritative and scholarly resources. Be sure to include specific economic data and support as part of your cited resources.

Questions to Consider:

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

  • Do you think that cost shifting is a fair practice, or that it should it be legally banned?
  • Why would a change in a hospital’s variable costs change the hospital’s profit-maximizing price?
  • How do ethics and economic decision making come together when addressing health care issues?
  • What is the highest-impact facet of health care economics that relates to your current or desired leadership role? What action steps and resources might you use to assure objective and ethical economic decision making in that role?

 

SAMPLE ANSWER

Implementation Plan for a New Economic Opportunity

Introduction

Mayo clinic aims to develop an Express Care Model to provide urgent care to patients. The Express Care Model will help to provide immediate healthcare services in populated regions. With the shortage of healthcare practitioners, long queues often develop due to many patients seeking healthcare services. The economic initiative is to develop a center that would help the community get quality healthcare services, reduce overcrowding, offer quick and effective care, and reduce wait times among patients who require urgent care (American College of Emergency Physicians [ACEP], n.d.). The center will be able to offer quick, efficient, and effective care and cater for all patients in order to reduce health disparities in the region. The project is deemed profitable and feasible after conducting the environmental and economic analysis of the project. Therefore, the implementation plan will outline the project by focusing on the budget plan, the timeline of the project, and the impact of the project on Mayo clinic.

Proposed Budget Plan for Express Care Model at Mayo Clinic

The economic initiative needs to be economic viable in order to be implemented and be sustainable. The economic opportunity includes the development of a startup budget to help plan the revenues that Mayo clinic will get after five years. The budget will allow the hospital make critical decisions regarding the size of the facility, the number of employees, the number of equipment needed, and the targeted customers who will be served. The operational budget will be calculated in five years, considering the influx of patients, management cost, and employees’ salaries.

Implementation Plan for a New Economic Opportunity

Costs will be regulated by maintaining adequate number of employee and management in-care delivery. Other expenses will include overhead costs that are not linked to the delivery of care, but affect the total cost of running the clinic. Other significant expenses include the essential utilities, insurance, supplies, equipment replacement and repairs, and building maintenance. Tracking the maintenance records and logs will allow Mayo clinic to reduce sudden repairs and plan in case equipment need repair. The utilities will be reviewed by the management team every year to ensure the clinic is running efficiently and excessive spending is controlled. Additionally, managing the insurance, internet and phone cost throughout the five years will be critical. Running costs will also be reduced by conducting regular monitoring of daily operations. To cut running costs, donated supplies will be accepted and office supplies will be reused if possible. Overall, the aim would be to ensure that facility has adequate equipment and facilities, and the environment is conducive for proper delivery of health care services.

Implementation Plan for a New Economic Opportunity

It is estimated that the facility will cater to about 70 patients every day, with about $135 for each visit. Therefore, the profit to be generated in the first year is estimated to be approximately $1,275,046. However, it is estimated that company revenue will increase gradually by about 5 percent every year. The project estimates will be broken down into operational cost, insurance, utilities, and employee salaries.

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The significant employees that will be part of the project include receptionist or patient representative, a supporting Physician Assistant (PA) and full-time physicians. Their salaries will be based on the guidelines provided by the U.S. Department of Labor (2019), which require receptionist or patient representative to earn about $25,000, a medical assistant who will earn about $30,000, Physician Assistant (PA) and a full-time physician who will be paid about $230,000. According to Qin, Prybutok, Prybutok, and Wang (2015), the growth of salaries is estimated to be 2% annually, and the Mayo clinic project aims to honor and follow the guidelines by improving employee’s salary every year. Besides, it is estimated that the facility will require additional employees due to the increase influx of patients and to ensure that the nurse-patient ration is at the recommended rate (Economic Policy Institute, 2018). The operating expenses are considered to be about 12% of the annual revenue based on the analysis of Mayo clinic’s recent trends in its financial statement.

Implementation Plan for a New Economic Opportunity

The expected total capital costs are projected to be $380,000. Half of this budget will be funded by the organization and the rest will be funded by a bank loan. The loan will need to be set at $190,000 to correctly fund this operation. This is also under the assumption that the loan tenure is five years with an interest rate of 7% per year. The loan payment is expected to be $45,520 per year. As laid out in the budget plan, the express care clinic is expected to earn a positive in surplus in the first five years of operation. The cash surplus, as per detailed cost plan, shows that the surplus will decrease during the fourth and fifth year due to increased staffing needs and new hires. The cash surplus is estimated to be about $$8,301,030 after five years.

Rolling out of Economic Initiative

One of the initial steps to rolling out this economic initiative is to develop a timeline for the public. It is estimated that it will take about 2-3 months for the senior management team to approve the budget and changes along with the bank loan to be processed. Construction on the site will be a complete remodel. This is estimated to take about two months, from December 2019 to January 2020. After a detailed discussion with the project team, it was determined that the grand opening for the Mayo Clinic care facility would be February 2020.

With the active participation from the stakeholders during the designing and developmental stages, the facility will be able to ensure proper safety requirements and positive patient experiences at the health care center. The board at Mayo Clinic and the senior management including doctors, nurses, and supporting staff are just a few of the relevant participants who are part of the internal stakeholders. To successfully implement this economic initiative, it is essential to collaborate with the stakeholders to ensure proper implementation. During the implementation, stakeholder’s feedback and concerns will be listened to and taken into consideration for changes. Meetings will be held monthly to discuss the progress of the project with the stakeholders.

Implementation Plan for a New Economic Opportunity

Mayo Clinic continues to strive to improve patient outcomes and experiences. The healthcare institution will focus its efforts and attention on six key areas that would ensure quality healthcare. These areas include efficiency, safety, equity, effectiveness, patient-centered care, and time management (Agency for Healthcare Research and Quality, 2015). As the development of the care facility continues to be implemented, the internal stakeholders will continually assess the project for these six key factors to ensure the mission of Mayo Clinic is upheld. This will help the organization sustain and achieve the long and short-term goals.

The critical external stakeholders will be patients and the public. Patients’ feedback on effective delivery of care and if the services are patient-centered is essential to determine the project success. If care is optimal, patients are more likely to return and refer new patients to the clinic. Encouraging compassionate, ethical and culturally sensitive care along with effective communication will help patients feel satisfied with the services provided in the clinic (Agency for Healthcare Research and Quality, 2015). To further support the providers and staff at the facility, the clinic will initiate training to ensure diversity in terms of gender, age, color, religion, and culture. The physicians will be taught how to treat patients without bias (Cigna, n.d.). Mayo clinic ensures diversity in the workplace and also encourages its employees to continue with their education and training in order to serve patients better. In order to show that the care center appreciates cultural diversity, the nurses will implement different ethical and culturally sensitive approaches in healthcare delivery.

Implementation Plan for a New Economic Opportunity

Revenues from the emergency department will be critical in providing additional revenue for the Mayo clinic. The local ER departments would be able to get more patients requiring emergency treatment. Many more patients would be referred to the facility. Providing treatment to the locals would also help develop trust between the clinic and the community. The Mayo Clinic will be able to handle both minor and critical injuries among patients. This means that the clinic will be able to offer more assistance to patients to guarantee positive outcomes. Such aspects will set the hospital apart from other healthcare institution that provides emergency care or similar services to patients.  Mayo Clinic will ensure that patients are provided with adequate and quality care in every visit. Improving patients’ outcomes leads to patient satisfaction and loyalty, and patients would refer or revisit the clinic when they require healthcare services.

Strategic Ways to Deal with Environmental Forces

Various environmental factors can influence the operation of the new Mayo Clinic facility. The most common issue is the increasing number of facilities offering emergency services around the city. This would lead to increased competition. This might affect the projection of revenue in the health care facility along with making it more challenging to recruit staff. This can also make the clinic and the new facility the best option for patients since it would be more equipped to handle more immediate healthcare services. Most emergency departments are often staffed with emergency care providers who are more familiar with testing requirements, medications and timely care (Chang et al., 2015). This would provide express care patients a higher level of care (Chang et al., 2015). Mayo express care clinic will build trust with the community which will not only help the residents seek the care they need, but also help with the competition with other urgent care providers. This will help in maintaining revenue.

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Mayo clinic needs to source finances with the help of the organization’s leadership and to involve stakeholders before the initiation of the project.  Having equipment and facilities that improve patient health would be necessary for ensuring the project is successful. The model of care at the facility can pose an issue when many patients come to receive care at the facility while the resources might not be enough. Nearly 71% of emergency physicians reported seeing patients daily that had been referred to the emergency department from urgent care facilities that were not equipped to care for them. This can pose a challenge for the management when it is trying to save on the costs of operation and at the same time build trust with the community.

Changes in misdiagnosis will be a risk because of the high number of patients being cared for on the same day by physicians. This can cause nurse burnout issues and medical errors that may put patients’ lives at risk. The clinic will develop critical interventions to reduce the problems of misdiagnosis. Employing more nurses will be valuable in improving the nurse-to-patient ratio. Nurses and physicians should be enough to ensure they have enough time to care for patients. Specialized training is also critical to ensure nurses do not cause medical errors such as misdiagnosis. Mistakes lead to critical ethical and legal issues that may put the organization at risk. Nurses and physicians will also be advised to take breaks in the cause of treatment, report errors, and work for few hours to ensure instances of misdiagnosis are reduced completely.

Implementation Plan for a New Economic Opportunity

Conclusion

The Mayo Clinic budget outline guarantees that the economic initiative is not only smart but profitable. With the participation of the internal and external stakeholders, this economic initiative with be able to face all challenges and dynamic environmental factors. With the implementation of this project, the facility can bring safe and effective care to the surrounding communities. It is believed that the care model used will not only provide additional revenue for the organization, but will also provide relief for the nearby emergency rooms along with aiding the population. The Mayo Clinic will also provide patients with regular screening and treatment to patient who needs emergency care to help reduce the burden of healthcare provision and overcrowding of patients in ER departments. The initiative would require costs monitoring within the five-year period. The discount rate, capital costs, cost of operation, utility cost, regulatory control costs, overhead costs, would be critical in ensuring the efficiency and control of excessive spending. The main risk of the project includes the lack of healthcare facilities to ensure the provision of quality care. Having enough equipment and facilities to improve patient health would be necessary for ensuring the project is successful. Thus, Mayo Clinic will ensure that patients are provided with adequate and quality care for in visit. Improving patents outcome will leads to patient satisfaction and loyalty.

References

Agency for Healthcare Research and Quality. (2015). The six domains of health care quality. Retrieved from https://ahrq.gov/professionals/quality-patientsafety/talkingquality/create/sixdomains.html

American College of Emergency Physicians [ACEP] (n.d.). Urgent Care. Retrieved from http://newsroom.acep.org/2009-01-04-urgent-care-fact-sheet

Chang, J. E., Brundage, S. C., &Chokshi, D. A. (2015). Convenient ambulatory care — Promise, pitfalls, and policy. The New England Journal of Medicine, 373(4), 382–388. Doi: 10.1056/NEJMhpr1503336

Cigna. (n.d.). Cultural competency in health care: Delivering quality care to an increasingly diverse population. Retrieved from https://cigna.com/assets/docs/about-cigna/thn-whitepapers/cultural-competency-in-health-care-final.pdf

Economic Policy Institute. (2018). Nominal wage tracker. Retrieved from https://epi.org/nominal-wage-tracker/

US Department of Labor (2019). Occupational Employment Statistics. Retrieved from https://www.bls.gov/oes/oes_emp.htm

 

Appendix 1:  5-Year Budget for Proposed Economic Initiative

FY 2020 First year

($)

 FY 2021

Second-year

($)

 FY 2022

Third-year

($)

 FY 2023

Fourth-year

($)

 FY 2024

Fifth-year

($)

 Total

($)
Opening Cast Balance $0.0 $1,275,046 $2,842,072 $4,716,078 $6,594,064 $0.00
             
Funds Received $190,000 – – – – –
Loan $190,000 – – – – –
             
Operating Receipts            
    Patient Service Receipts

(UCC)

 $2,400,566 $2,744,546 $3,088,526 $3,432,506 $3,776,486 $15,442,630
Total Receipts $2,400,566 $2,744,546 $3,088,526 $3,432,506 $3,776,486 $15,442,630
             
Operating Payments            
  Staff Salaries $750,000 $775,000 $790,000 $1,110,000 $1,615,000 $5,040,000
  Basic Utilities $40,000 $42,000 $49,000 $51,000 $53,000 $235,000
  Insurance $15,000 $15,000 $15,000 $20,000 $20,000 $85,000
 Other Operating Costs $275,000 $300,000 $315,000 $328,000 $336,000 $1,554,000
Total Operating Payments $1,080,000 $1,132,000 $1,169,000 $1,509,000 $2,024,000 $6,914,000
             
Operating Surplus/Deficit $1,320,566 $1,612,546 $1,919,526 $1,923,506 $1,752,486 $8,528,630
             
Nonoperating Payments            
     Annual Loan      Payment ($45,520) ($45,520) ($45,520) ($45,520) ($45,520) ($227,600)
Total Non-operating Expenses ($45,520) ($45,520) ($45,520) ($45,520) ($45,520) ($227,600)
             
Investments            
Remodeling, furniture, equipment ($380,000) – – – –  
             
Cash surplus/ Deficit $1,275,046 $1,567,026 $1,874,006 $1,877,986 $1,706,966 $8,301,030
             
Closing Cash balance $1,275,046 $2,842,072 $4,716,078 $6,594,064 $8,301,030 $8,301,030

 

 

 

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The Nurse Staffing Standards and Quality Care Act

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The Nurse Staffing Standards and Quality Care Act

  • Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
  • Review the health policy you identified and reflect on the background and development of this health policy.

Post: Please follow This instruction.

  •       This is a discussion
  •       No tittle pages.
  •       No running heads.
  •       This is a Masters level class
  •       APA Format with intext citation

Required to use the reading resources AT LEAST TWO. Outside resources should be peer review Articles.

Tittle: Evidence Base in Design

Short Introduction with purpose statement

 

Post

ü  Post a description of the health policy you selected and a brief background for the problem or issue being addressed.

ü  Explain whether you believe there is an evidence base to support the proposed policy and explain why.

ü  Be specific and provide examples.

Conclusion/ Summary

Reference list in (APA FORMAT)

 

SAMPLE ANSWER

The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act

The Nurse Staffing Standards for Hospital Patient Safety and Quality Act consider that adequate nurse staffing is important in provision of care, preventing adverse events, and improving patient’s outcomes (Congress.Gov, 2019). The bill develops requirements for nurse-to-patient staffing, provides whistleblower protections, and licensed practices for nurses.

The enactment of the bill will ensure healthcare institutions develop and implement staffing requirements that meet the nurse-to-patient staffing plans and ensure patient safety and quality care (Congress.Gov, 2019). Besides, the enactment of the bill will ensure there are enough direct care registered nurses in the operating room, emergency unit, telemetry units, acute care psychiatric care units, postpartum units, well-baby nursery, and during declared emergency (Schakowsky & Brown, 2017).

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The policy is evidence based since hospitals will be needed to improve their plans for staffing, and get involved in re-evaluation of staffing plans (Milstead & Short, 2019). According to Kouatly, Nassar, Nizam, and Badr (2018), patients are more likely to survive when the health care institution follows the mandated patient-nurse ratio. This means that the link between patient-nurse ratios is critical in provision of quality and holistic care. Besides, considering patient-nurse ratio reduces burnout among nurses, which ensure the provision of quality care. For example, the operating room cannot exceed one nurse for each patient. In the psychiatric ward, the nurse to patient ration should be about one nurse for every six patients and in the emergency and pediatric units, there should be about one nurse for every four patients (Schakowsky & Brown, 2017).  However, nurses have the ethical and legal obligation to refuse an assignment if it places the patient’s life at risk (Olley, Edwards, Avery, and Cooper, 2019). Thus, increasing above the required minimums would ensure patients’ needs and care is achieved. Organizations that do not comply need to face civil monetary penalties as the best corrective action.

 

References

Congress.Gov. (2019). H.R.2392 – Nurse Staffing Standards for Hospital Patient Safety and

Quality Care Act of 2017. Congress. https://www.congress.gov/bill/115th-congress/house-bill/2392

Kouatly, I. A., Nassar, N., Nizam, M., & Badr, L. K. (2018). Evidence on Nurse Staffing Ratios

and Patient Outcomes in a Low‐Income Country: Implications for Future Research and Practice. Worldviews on Evidence‐Based Nursing, 15(5), 353-360.   https://doi.org/10.1111/wvn.12316

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.).

Burlington, MA: Jones & Bartlett Learning.

Olley, R., Edwards, I., Avery, M., & Cooper, H. (2019). Systematic review of the evidence

related to mandated nurse staffing ratios in acute hospitals. Australian Health Review, 43(3), 288-293. https://doi.org/10.1071/AH16252

Schakowsky , J., & Brown, S. (May 9, 2017). Schakowsky and Brown reintroduce the Nurse

Staffing Standards for Hospital Patient Safety and Quality Care Act. schakowsky.house. https://schakowsky.house.gov/press-releases/schakowsky-and-brown-reintroduce-the-nurse-staffing-standards-for-hospital-patient-safety-and-quality-care-act/

 

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Week 6: Short Answers

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Week 6: Short Answers

Please answer the following questions in regards to the attached article.  Note: no title page needed only the answers for the questions.

IMPORTANT:

  • 100 – 150 words required for each question answer, including each question within each question. (example two questions within a question = 200-300 words required total)
  • Question #2: requires 200-word count

 

1- What primary appeal (ethos. Pathos, logos) is the author using? Do you believe use of the appeal is convincing to his intended audience?  Provide an example from the text to support and explain your answer.  Also do you see any rhetorical fallacies the author is using?

2- What is your response (in 200 words) to the author’s position. Agree or disagree? Explain.

 

SAMPLE ANSWER

Week 6: Short Answers

  1. What primary appeal (ethos, Pathos, logos) is the author using? Do you believe use of the appeal is convincing to his intended audience?

The primary appeal that the author uses is the logos. Logos is also called the appeal to logic. It is where an author persuades the audience or readers using concrete reasons, facts or even figures. The author thus, looks at what the audience or readers can take as making sense and uses that to build his or her argument. The author does not make blanket statement but uses evidence rather than emotions. The writer presents the evidence is a way that the audience or the writer will understand well. In the reading, the author makes use of evidence in presenting his argument.

Research Paper Help

I believe that the use of logos in the essay makes it more convincing to the readers although the author could have used credible sources in the essay. The author makes use of the logos appeal to persuade the audience to acknowledge that mass shootings are rare and consequently, it is irrational to live in fear of them. He seeks to encourage the audience that phobia of mass shootings is perpetrated by the media who should instead focus on other things that can cause death such as chocking. However, the appeal is not convincing because the sources cited are not credible. For instance, the author cites “according to a commonly cited chart” instead of providing credible sources that will support the argument.

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The author makes use of a number of rhetorical fallacies in the essay. For instance, the author claims that “You are three times as likely to die of choking on food than be in a mass shooting”. The author does not make sound reasoning in such an argument among many others. He just makes such argument in order to appeal to the audience. All over the paper, the author makes several arguments that are meant to appeal to the reader while they may not be supported by credible facts. The author does not give room to the reader to make their own minds about an argument but rather seems to convince them to accept his own view.

Week 6: Short Answers

  1. What is your response (in 200 words) to the author’s position? Agree or disagree? Explain.

I disagree with the author that people should not be afraid of mass shootings because there are many other reasons to die. Apart from chocking, there are several other accidents that can take place, which is true but should not prevent someone from having a phobia of something because it is rare. Mass shootings are a major issue and the biggest problem is that one can be caught up at any point. Also, although they are rare, mass shootings result in the death of several people at the same time hence it is normal for an individual to have the phobia of mass shootings. Also, it is appropriate for individuals to be aware of the issue so that they can have information on how best they can save themselves from the situation. This is because there are first aid principles that would be applicable in case one has an issue such as choking. The same can be applied in a mass shooting situation and people, who feel like they have the phobia, can have a strategy and gain a better understanding of how to save their lives. Therefore, the individuals are justified to fear mass shootings, contrary to what the author brings up. Secondly, the media can focus on it, even as it focuses on other issues.

 

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Major Regulatory Restrictions on NP Practice

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Major Regulatory Restrictions on NP Practice

Use the provided template to compare and contrast the three major regulatory practice models for NPs: Supervisory, Collaborative, and Independent. Please keep this assignment in the template format provided. This Assignment requires credible and up to date resources for each category. Include in each model at least one state that represents the scope of practice you are discussing. For example, Florida requires a supervisory relationship with a physician along with a practice agreement, formulary, and protocols. In order to apply and receive a DEA license to prescribe controlled substances, you must be approved by the state you are practicing in to prescribe these medications. I have chosen three states , I think they are in the right place.

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SAMPLE ANSWER

Major Regulatory Restrictions on NP Practice

Research Paper Help

 

Topic Supervisory Practice Collaborative Practice Independent Practice
List the name of a State that is representative of each regulatory model. Texas Louisiana Colorado
Evaluate how each model affects the NPs scope of practice? (include, if applicable, the use of protocols, formulary, written agreements, direct versus indirect supervision, referral policy, patient care, review of medical documentation, and payment reimbursement. Supervisory practices in Texas restrict NPs from providing certain primary care services. Using this model, regulatory bodies limit the scope in which NPs can operate in regarding the nature of services offered.

 

 

 

 

 The existing laws in Louisiana require a Collaborative Practice Agreement (CPA) with a physician before providing health services. The agreement indicates collaboration with other healthcare disciplines

 

 

 The independent practice model seeks to ensure that health providers practice effectively. No collaboration agreements or supervision is required (Hain & Fleck, 2014). Through this, the state allows assigned nursing agencies to control the quality of services independently.
How does model of practice serve as a barrier to access to care? The supervisory practice model proves to be challenging for NPs. This is mostly the case, for licensed practice, which limits providers’ delivery despite their qualifications (AANP, 2016). The model limits the providers’ capabilities and chances for providing proper care to patients suffering from acute illnesses. For the independent practice, providers are free to serve in their areas of specialization, with no limitations (Hain & Fleck, 2014).
Compare/contrast the prescriptive privileges of each model and example State The restrictions in Texas limit the operations of NPs, hence reducing the chances of providing services such as drug prescription. Unlike Texas, Louisiana only allows NPs to undertake practices that are described in their licenses, as well as maintaining constant collaboration among the NPs. In Colorado, though, NPs are given freedom to prescribe drugs with minimum supervision, compared to Texas.
Compare/ Contrast how each model impacts payer status for the NP NPs in Texas operate in healthcare centers and assume a role of employees. For Louisiana, NPs are subject to strict policies regarding payer levels, as one is only allowed to undertake licensed activities. NPs use independent models but are compensated based on their qualification levels.
Compare/Contrast how these models may impact NP job satisfaction. Regarding job satisfaction, the supervisory model comes with many restrictions that limit NPs, and does not motivate them (Hain  & Fleck, 2014). The model provides an average satisfaction rate for NPs since it has fewer challenges (AANP, 2016). Job satisfaction for this model is higher since NPs have more freedom that is not provided y the other models.

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Advanced Practice Nursing Role

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Advanced Practice Nursing Role

This is an assignment and does not need to be in essay format, however all questions answered can be mixed within a paragraph or two and flow together. Please see attachment and keep the module sections divided. About one page of length per module section is ok. These questions are for Advanced Practice Nursing (APRN) practicing in Texas– this is important because the laws may differ from state to state.

Minimum of 2 references per section. References need to be provided in APA format.

Module 1.2

Can Advanced Practice Nurses (APRN) practice with any type of population focus or speciality?  Does the Texas BON regulate where APRN’s can practice? Does the Texas BON regulate what type of practice APRN’s can participate in? Does Medicaid or Medicare influence where APRN’s can practice or what type of practice?  Does the Texas Board of Medicine regulate what type of practice APRN’s can participate in?

Compare and contrast the differences between the various APRN credentialing organizations? Does an APRN need to be credentialed?  What purpose does credentialing serve?

Do APRN’s need to be certified? If so, why?  What purpose does APRN certification serve?  What are some types of APRN certification?  Who certifies APRN’s?

 

Module 1.3

Why is there a need for the consensus model?  What is the purpose of the consensus model?  If you move from state to state as a APRN to work, what do you need to ask yourself in order to stay out of trouble?  How did the consensus model come about?

Is Texas compliant with the consensus model? If so why or why not?

What is the proper order in the consensus model?  Please define the purpose of the Certifying organizations? Accrediting organizations? Licensing boards?  What are the four categories of APRNs?

 

Module 1.4

When you prescribe to patients can you prescribe to persons that live outside your state?  For instance, if a person is visiting from Alaska and gets sick and visits your clinic can you prescribe to them?

Can you prescribe to persons that reside in the U.S. Virgin Islands and they are visiting your town and get sick?

Can you prescribe to persons that live in Mexico and they are visiting their daughter that lives in your town?

Can you prescribe Adderall to 11-year-old patients by yourself?

Can you prescribe Morphine to a 50-year patient with chronic pain?

Do you need to keep any records of your prescriptions?

Should you carry insurance when you prescribe?  What type of insurance should you carry?

Should you get a DEA number?  If so what is the process of getting a DEA number?

What is the Texas Prescription Monitoring aware program (PMP)?  When should an APRN utilize this program?

If an APRN is working in Telemedicine and they prescribe medications to a patient that calls in with sinusitis and lives in the same state.  Does prescribing to a patient via telemedicine work differently? and if so how?

Advanced Practice Nursing Role

 

Module 2.1

Beside the Texas Board of Nursing what other agencies or government bodies regulate or create rules for APRN’s?

How can APRN’s influence their state representatives?

What other groups can APRN’s collaborate with to influence potential legislation?

Please include the government address of your state representative and state senator?

Write a letter to your state representative about an APRN issue that matters to you (Example: full practice authority or any other issue that affects APRN’s).  Make sure you address your state representative as Honorable State Representative (their last name).  Mail the letter to their Austin address.

How do APRN’s find out about rule changes or changes in the law?  How do laws become enacted in Texas?

When does the Texas legislature meet? When does the Texas Board of Nursing meet?

 

SAMPLE ANSWER

Advanced Practice Nursing Role

Module 1.2

The Texas Board of Nursing considers that nursing practice is dynamic. The advanced nursing practice evolves through technology development, evidence-based practice, acquisition of knowledge, experience, and the changes in health care delivery (NursingLicensure.org, 2019). The scope of practice shows the type of patients APNs need to perform and forms APNs ability to seek reimbursement for provided services. Therefore, APNs can perform new procedures, practice in new settings, and practice new skills during their practice.

APRNs can practice with any population as they can diagnose and treat the public on various health complications and manage chronic diseases. This means that APRNs can provide specialty care across all people through assessment, diagnosis, and treatment including reproductive and gynecological care (Texas Board of Nursing,2019). Thus, APRNs drive evidence-based care and best practices changes to ensure and improve patient outcomes.

Advanced Practice Nursing Role

The Texas BON regulate where APRN’s can practice. Graduates who complete nursing education in the US or who receive the licensure may be allowed to operate temporarily in Texas (Texas Board of Nursing, 2019). However, individuals graduating from outside the US looking for license in Texas cannot get temporary authorization. Besides, even if they file for NCLEX-PN® they cannot get temporary authorization to practice (NursingLicensure.org, 2019). Medicaid or Medicare does not influence where APRN’s can practice or what type of training. Their role is only to reimburse for services provided. The Texas Board of Medicine also does not regulate what kind of practice APRN’s can participate. The board is only concerned in investigating complaints against medical physicists, surgical assistants, nurse and physicians (Texas Board of Nursing, 2019). There are many APRN credentialing organizations, and APRNs can choose from NCC, PNCB, AACN, and AANPCB, for certification.

APRNs in Texas must have at least a master’s degree to be certified. The certification must be consistent with education (Texas Board of Nursing, 2019). However, there are instances where an individual does not meet Texas standards despite training. The main types of certifications include the American Midwifery Certification Board, the American Academy of Nurse Practitioners, American Nurses Credentialing, and American Association of Critical-Care Nurses (Texas Board of Nursing, 2019). Therefore, the certifications help nurses grow in nursing field, expand their knowledge, and evolve as professionals, which in turn lead to improvement of healthcare delivery.

Module 1.3

The APRN Consensus Model is a model that helps to outline the recommendations regarding APRN licensure, education, certification, accreditation in all states in the United States. The model was developed between 2005 and 2008 by the American Nurses’ Association (National Council of State Boards of Nursing, 2019). The implementation of the model got an endorsement of over 40 nursing organizations in 2008 (National Council of State Boards of Nursing, 2019). The model impacts APRN certification organizations because their certification requirements must reflect the model requirements. APRNs need to stay updated on the requirements of in their profession and population focus to ensure their licensure requirements meet practice in Texas. Thus, the APRN Consensus Model has helped ensure APRNs are trained to ensure public safety, and developing standards, which reaffirm the certification and qualifications of APRNs in medical environments (National Council of State Boards of Nursing, 2019).

Advanced Practice Nursing Role

The consensus model has been endorsed and adopted by the state board of nursing in Texas to help in their revision of the policies on the APRN scope of practice and licensure requirements.  The model has a particular order for APRN regulation such as Licensure, Accreditation, Certification, and Education (Milstead & Short, 2019). The uniform model is therefore designed to align the interrelationship aspects within the model as mentioned above.

The certifying organizations, accrediting organizations, and licensing boards are responsible for certifying APRNs based on their patient population focus. They provide tests to examinees looking to become certified nurses in the state of Texas.  The Consensus Model outlines the four types of APRNs, including nurse practitioner (NP), clinical nurse specialist (CNS), certified registered nurse anesthetist (CRNA), and certified nurse-midwife (CNM) (Milstead & Short, 2019).

Module 1.4

APRNs in Texas does not have a prescribing authority of prescribing drugs and offering health care services to persons visiting from a different state in the US such as Alaska. Texas regulates the scope of prescription and primarily prohibited independent prescription (NursingLicensure.org, 2019). The APRNs are required to have the federal DEA registration and must have the prescriptive authority before ordering and prescribing drugs to people visiting from other states.  APRNs still has to get the prescription authority to treat individuals who get sick while visiting the town and are from Mexico or Virgin Island. However, this regulation is always challenging because APRNs should not be deterred from prescribing appropriately for individuals who need emergency treatment while visiting the state since failing to provide care does meet the standard of nursing practice (NursingLicensure.org, 2019). Therefore, APRNs must provide appropriate assessment, treatment, and prescriptions for patients from outside the United States.

APRNs in Texas have limitations when prescribing Adderall to 11-year-old patients by themselves.  The APRNs are limited to prescribing a 90-day supply of Adderall to individuals of the age of 2 years and older. Physician consultation is always needed, and the consultation must be outlined n the patient’s chart (NursingLicensure.org, 2019). Besides, pharmacists are not allowed to fill a schedule of subscription filled by an APRN. Prescription within the hospital can only be done by physician delegation for Schedule II prescriptions.

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APRNs in Texas can prescribe Morphine to a 50-year patient with chronic pain under controlled practice conditions because they must have physician consultation before prescribing the morphine. The Texas Medical Board considers that the patient must first be evaluated before prescribing the morphine including assessment of patient medical history, morphine prescription data (NursingLicensure.org, 2019).  Besides, informed consent must be considered before providing a morphine treatment, and this is tracked through the prescription monitoring program (PMP). The complete medical records for prescriptions must be maintained to help review the patient’s medical data in their future morphine treatment. Besides, the board of nursing requires APNs to help patients with insurance procedures during prescription. Therefore, complying with the Texas Insurance Code §1467.0511 is critical (Texas Board of Nursing, 2019).

The DEA number is essential because all APRNs working in Texas must be registered with the federal Drug Enforcement Administration (DEA). APRNs are covered under the registration, and they get individual DEA registration number. The process of applying the DEA number include application in the DEA website in which you are given a registration ID number based on the state of practice (Texas Board of Nursing, 2019). The ID number is also essential during the renewal of registration.

The Prescription Monitoring Program (PMP) in Texas aims to collect and monitor prescription data for all controlled substances by pharmacies in the state or located in other countries.  The PMP helps APRNs to check and eliminate duplicate controlled substances, get substance history information, and obtain overprescribing of controlled substances (Nursing World, 2019). APRNs with the authority of a physician may treat patients through the use of telemedicine using his or her license. Prescription in telemedicine works differently because there must be an established patient-practitioner relationship and the practitioner must meet the standard of care for the individual.

Module 2.1

Apart from the Texas Board of Nursing, other government bodies and agencies that create rules for nurses include NCSBN, AANA, ACNM, and the Citizen Advocacy Center. These bodies help legislators to make decisions regarding APRNs scope of practice, including the regulatory and regulatory requirements (National Council of State Boards of  Nursing, 2019).  APRNs can influence legislation through policy work involving practice processes and standards and collaborate with patients to ensure quality health care delivery. Influencing policy change also affects resource allocation and provision of care.

Advanced Practice Nursing Role

APRN’s always found out about rule changes or changes in the law through the weekly publication called Texas registry after the Texas Board of Nurses submit all proposed changes (Texas Board of Nursing, 2019). The registry includes notices of rule review, repealed rules, notice of withdrawn, adopted standards, emergency rules, and proposed rules.

Laws are enacted in Texas through the legislations enacted by the Legislature that convenes after every 140 days after every two years (Nursing World, 2019). However, sometimes special sessions can be conducted by the governor in case of emergency issues that may impact the nursing profession more positively. Most legislation can also be amended during the sessions.

 

References

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.).

Burlington, MA: Jones & Bartlett Learning.

American Nurses Association (ANA). (November 14, 2017). ANA Enterprise.

https://www.nursingworld.org/practice-policy/aprn/

National Council of State Boards of Nursing (NCSBN). (20191). APRN consensus

implementation status. NCSBN. https://www.ncsbn.org/5397.htm

National Council of State Boards of Nursing (20192). “Consensus Model for APRN
Regulation: Licensure, Accreditation, Certification & Education,” ncsbn.org, National Council of State Boards of Nursing, https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf

NursingLicensure.org, (20191). Advanced Practice Registered Nurse license requirements in

Texas. Nursing licensure. https://www.nursinglicensure.org/np-state/texas-nurse-practitioner.html

NursingLicensure.org, (20192). Advanced Practice Registered Nurse license requirements in

California. Nursing licensure. https://www.nursinglicensure.org/np-state/california-nurse-practitioner.html

Nursing World. (2019). “FAQ: Consensus Model for APRN Regulation,”
nursecredentialing.org, American Nurses Credentialing Center, https://www.nursingworld.org/certification/aprn-consensus-model/faq-consensus-model-for-aprn-regulation/
Texas Board of Nursing. (2019). National Certification Expectations for Entry-Level
NPS,” aanp.org, American Association of Nurse Practitioners, https://www.aanp.org/education/student-resource-center/starting-your-career/9-education/1060-certification-for-entry-level-nps

 

 

 

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Peer Review – Classical Argument

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Peer Review – Classical Argument

Please answer the questioner attached in regards to the essay that is also attached. Just need the questions answers, no title heading page needed. Thanks!

FYI: please look out for a specific required word count on some of the questions and please comply to it or I would not get the credit for it. Thanks,

 

SAMPLE ANSWER

Peer Edit of 1302 Essay

 

After reading the entire paper, you will follow the checklist below. Do not just check things off the list though; be sure to fill out suggestions at the bottom of each section.

Students who have not filled out the sheet or added elaborate comments to each section will not receive credit for peer-review session.

Formatting:

  1. Does the essay have a title that relates to what the writer is talking about?__yes_____
  2. Is the title properly punctuated-12 point Times New Roman? Is it centered and not underlined? _yes______
  3. Is the essay typed and double-spaced, in Times New Roman? ___yes______
  4. Does the essay include an MLA heading and header? ___yes______
  5. In general, does the paper look uniform and orderly? ___yes_____

Peer Review – Classical Argument

In the space below, suggest one thing to make the format better:

The format is okay and it follows the rules stipulated for MLA writing

Introduction and Narration:

  1. Does the introduction include discussion of both sides of the argument? ___yes____
  2. Does the narration provide discussion of BOTH sides equally? _____yes____
  3. After the intro information, does the author provide a clear thesis? __yes______
  4. Write the thesis statement below:

This is essay is an attempt to show that the question asked is flawed and liberals do not hold the moral high ground, at last in this context

In the space below, suggest one thing to make the introduction better:

The introduction looks good. However, it could be improved by offering more descriptions of the term “moral high ground” as is described by scholars and offer citation.

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Body paragraphs:

  1. Do the body paragraphs support a clear claim? __yes____
  2. Does each body paragraph have a topic sentence that illustrates the focus of the paragraph? ___yes____
  3. Does each body paragraph include at least one quotation? All paragraphs have quotations
  4. Are quotations analyzed—does the writer try to discuss why the quotes are important? ____yes_____
  5. Are quotations parenthetically documented with in-text citation? ___yes_____
  6. Is each paragraph fully developed so that a convincing position is analyzed? Not fully but they have been discussed
  7. Does each body paragraph have more of the writer’s words than quotes? ­­__yes_____
  8. In general, can you understand the purpose of each paragraph as it relates to the argument?__yes___

Peer Review – Classical Argument

In the space below suggest one thing to make the body paragraphs better: __________________________________________________________________________________________the paragraphs would be improved if there is more information about the quotes in relation to what other authors or scholars have written about the topic.

Essay as a whole:

  1. Is the essay free of major grammatical errors and misspelled words? __there are some typos in the essay___
  2. Is the language of the essay clear and easy to read? ___yes____
  3. Are simple, compound, and complex sentences used in the essay? __yes_____
  4. Is the essay free of run-ons and/or fragments? ­­___yes___
  5. Is the essay free of contractions? ­­__yes____
  6. Does the essay use correct punctuation? ____yes__
  7. Is the writer avoiding informal language like: “nowadays” “back then” “till” “for the fact that”? __yes___

 

In the space below, suggest one thing to make the essay better:

The essay could be improved by providing more arguments and citations as well as increasing its length to offer a more valid conclusion. In addition, the essay is not complete and completing it will make it better.

Nursing Paper Help

 

Discuss any unanswered questions that you have and write ONE suggestion to the writer to improve the paper. (For example, does the writer spend TOO much time summarizing or retelling the argument and not ENOUGH time analyzing? If this was the case, suggest a way to improve this issue.)Your response below must be at least 200 words.

 

The essay, although well written and following most of the rules, is not complete. There is no indication that it has concluded and there is missing information in statements such as “cite here” as seen in the essay. In addition, there is a way the writer could summarize some words so that they could be fewer and pave way for more room to discuss the question at hand. For instance, in the second paragraph, the writer says, “It is totally possible for liberals to hold the moral high ground as much as it is possible for conservatives to hold the moral high ground.” This could simply be summarized as “both conservatives and liberals could hold the moral high ground.” The third paragraph seems to leave question marks on the reader. This is because the author writes about the lexicons that have been used by the liberals and even provides the meanings. However, the writer does not bring out the role that the lexicons play in the arguments made or in the essay. The writer could have put more emphasis on the role of those words as this would have made the reader understand why they were used in the first place, and what importance they play.

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Standardized Nursing Terminologies

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Standardized Nursing Terminologies

Please follow these instruction.

Ø  Use required reading resources it is part of the instructions from the professor.

Ø  This is a Masters level paper.

Ø  APA format with intext citation

Ø  No running head but there should be number pages.

sources can be more but at least four.

 

To Prepare:

  • Review the concepts of informatics as presented in the Resources, particularly Rutherford, M. (2008) Standardized Nursing Language: What Does It Mean for Nursing Practice?
  • Reflect on the role of a nurse leader as a knowledge worker.
  • Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

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

  • Explain how you would inform this nurse (and others) of the importance of standardized nursing terminologies.
  • Describe the benefits and challenges of implementing standardized nursing terminologies in nursing practice. Be specific and provide examples.
  • Be sure to support your paper with peer-reviewed research on standardized nursing terminologies that you consulted from the Walden Library.

 

The professor emphasis on these two articles to be part of our resources.

Rutherford, M. A. (2008). Standardized nursing language: What does it mean for nursing practice? Online Journal of Issues in Nursing, 13(1), 1–12. doi:10.3912/OJIN.Vol13No01PPT05.

 

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

·         Chapter 25, “The Art of Caring in Technology-Laden Environments” (pp. 525–535)

·         Chapter 26, “Nursing Informatics and the Foundation of Knowledge” (pp. 537–551)

 

SAMPLE ANSWER

Standardized Nursing Terminologies

As tech-driven data delivery and technology are integrated into health care, it is critical for health care practitioners to leverage the systems. Standardized Nursing Terminologies are defined as standardized terms, which are essential in accessing and communicating data and information that can help improve nursing care (Rutherford, 2008). These terminologies increase nurses’ knowledge and skills in delivery of health care, leading to positive patient outcomes. This efficiency also makes it easier for nurses to convey detail care strategies, which are critical components of delivery of quality care (Keenan, Tschannen, & Wesley, 2008). This paper discusses the benefits and challenges of the standardized nursing terminologies in delivery of healthcare.

Benefits of Standardized Nursing Terminologies

Standardized Nursing Terminologies helps to improve population health through improving care. They inform nurses about the benefit of the information system in nursing practice. This helps to achieve the goal of nursing through nursing research, continuity of care, improved outcomes, and documentation of nursing interventions (Rutherford, 2008). Healthcare organizations that decide to employ the use of Standardized Nursing Terminologies may experience a reduction in organization expenditure.  The organization’s productivity increases through ensuring a positive return on financial investment because nurses understand best practices that help provide holistic and quality care. Research has shown that hospitals can save on medication expenditure and improve the efficiency in billing services, upgrading recording services, increasing efficiency in diagnostic processes and reducing billing errors through the implementation of Standardized Nursing Terminologies (Keenan, Tschannen, & Wesley, 2008).

The implementation of Standardized Nursing Terminologies can boost the safety of patients and ensure the provision of quality health care. For example, the terminologies in Electronic Medical System can help to prescribe and order medication for patients as it makes it easier to know when patients ordered medications and which drugs they used or were prescribed by another physician (Rutherford, 2008). Besides, Standardized Nursing Terminologies makes it easier for physicians and nurses to understand the medical issues and problems faced by patients to ensure they are provided with required diagnosis, treatment, medications, and follow up care and services (Rutherford, 2008). As long as health care practitioners get critical information about patients at their figure tips, they would be able to give personalized, efficient, and safe care that patients deserve.

Standardized Nursing Terminologies are primarily designed to help nurses get involved and collaborate with patients in healthcare delivery.  For example, nurses can summarize all clinical information and sent responses to patients in no time through the use of electronic medical records system (Lundberg et al., 2008). Each patient summary has data on the care they received from the hospital, the type of medications prescribed, the medical advice given, and the follow-up services that are required (Rutherford, 2008). The summary is critical in making patients aware of their health conditions and how their families can assist in patient care after discharge. Thus, these terminologies help patients to understand their condition and make more informed decisions on their lifestyle and health.

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Standardized Nursing Terminologies are also critical in reducing misunderstanding among nurses and reducing medical errors in nursing practice. Medical errors are a significant challenge for medical practice due to poor practice and lack of collaboration among health care practitioners and patients (Keenan, Tschannen, & Wesley, 2008).  By improving competencies among nurses, the terminologies help improve nursing care by supporting the process of clinical and epidemiological reasoning (Rutherford, 2008). This can help achieve cross-cultural and unified representativeness among nurses and patients in healthcare delivery. Thus, Standardized Nursing Terminologies are critical in reducing readmissions, shorter lengths of stay, fewer errors, and fewer redundancies in healthcare.

Challenges of Standardized Nursing Terminologies

Although there is a growing literature on the benefits of Standardized Nursing Terminologies, there are potential challenges with the use of the technology such as privacy and security concerns, temporary loss of productivity, changes in workflow, and financial issues (McGonigle & Mastrian, 2017). The significant economic problems in adoption of the terminologies include the increased cost for training to improve nurse’s skills and knowledge in the delivery of healthcare.

The use of the Standardized Nursing Terminologies also leads to the disruption of workflows among nurses and physicians that result in temporary loss in productivity. Loss of organization productivity occurs from learning among end-users such as nurses thereby leading to loss of revenue (McGonigle & Mastrian, 2017). The lack of knowledge of specific terminologies makes it difficult for nurses to provide quality health care. This negatively impacts patients outcome or may increase instance of medical errors during care. Policies makers need to pass legislation that ensures nurses undergo continuous training in nursing to strengthen their understanding of nursing terminologies in the provision of health care.

Conclusion

The paper analyzes the importance of Standardized Nursing Terminologies in healthcare institutions by looking at their benefits and challenges in the health care system. These terminologies are critical in providing precise and efficient care to patients. The terminologies help to develop competencies in nursing practice to help improve nursing care through supporting the process of clinical and epidemiological reasoning. Thus, nurses need to undergo continuous training to enhance their skills and knowledge in nursing that are critical delivery of healthcare and improving patient outcomes.

 

References

Keenan, G. M., Tschannen, D., & Wesley, M. L. (2008). Standardized nursing terminologies can transform practice. Journal of Nursing Administration, 38(3), 103-106. https://emr.ufl.edu/files/2008/13/cv_yai_10.pdf

Lundberg, C., Warren, J., Brokel, J., Bulechek, G., Butcher, H., McCloskey Dochterman, J., …& Spisla, C. (2008). Selecting a standardized terminology for the electronic health record that reveals the impact of nursing on patient care. The online journal of nursing informatics, 12(2). DOI: 10.1097/01.NNA.0000310728.50913.de

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of

knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning

Rutherford, M. (2008). Standardized nursing language: What does it mean for nursing

practice. OJIN: The Online Journal of Issues in Nursing, 13(1), 243-50. DOI:10.3912/OJIN.Vol13No01PPT05

 

 

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PICOT Question and Literature Research-Hypertension

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PICOT Question and Literature Research-Hypertension

 As mentioned below, weeks 1-3 need to be referred back to when completing this assignment. There is a Research Critique Guidelines form that helps with the lay out of the assignment. The previous article citations are sufficient for use due to this being a final draft of previous assignments. I need the assignment by Sunday, September 22, 2019 at 7PM. I am also attaching the previous rubrics with comments from the instructor, so that it is clear where I was docked points and where there needs to be improvement. Thank you so much!!!***

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question 

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

PICOT Question and Literature Research-Hypertension

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

PICOT Question and Literature Research-Hypertension

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

General Requirements

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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

PICOT Question and Literature Research-Hypertension

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

 

SAMPLE ANSWER

PICOT Question and Literature Research

Summary of Clinical Issue:

Hypertension is one of the highest health problems globally because it contributes to increased rates of mortality and morbidity. It is estimated that approximately 56% of coronary artery diseases and 48% of stroke incidences result from hypertension (Chiu et al. 2014). In the US, hypertension affects 29% of the population leading to risks of cardiovascular diseases and stroke.  Factors such as poor dietary practices, sedentary lifestyles, and physical inactivity are the primary contributors to hypertension. According to Osté (2010), physical inactivity augments the risk of hypertension 8-9 times. Lifestyle modifications, including exercise and diet changes are the central management and preventive measures against cardiovascular diseases and hypertension (Apovianet al. 2014).  Besides, lifestyle modifications increase the efficacy of antihypertensive drug and control of blood pressure. Therefore it is critical to maintaining levels of blood pressure through exercises and dietary changes to prevent damage of vital body organs.

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The PICOT question aims to determine whether the DASH and WTW improve blood pressure control among urban African Americans within five months of initiation of the intervention. According to Apovian et al. (2018), enhancing adherence to exercises and the DASH diet is essential to reducing an individual’s blood pressure. However, WTW is an intervention looking to reduce physical inactivity among individuals to help manage cardiovascular diseases and stroke. EBP intervention can be implemented and applied to determine whether they enhance or impede high-quality nursing care. This help to evaluate the outcome of the WTW and DASH on improving the level of patient’s high blood pressure.

PICOT Question:

Does the Dietary Approaches to Stop Hypertension (DASH) (I) in urban African-Americans with hypertension (P) improve blood pressure control (O) within 5 months of initiation of the intervention (T)?

 

Criteria Article 1 Article 2 Article 3
APA-Formatted Article Citation with Permalink Akita, S., Sacks, F. M., Svetkey, L. P., Conlin, P. R., & Kimura, G. (2003). Effects of the Dietary Approaches to Stop Hypertension (DASH) diet on the pressure-natriuresis relationship. Hypertension, 42(1), 8-13.https://www.ncbi.nlm.nih.gov/pubmed/12756219 Chiu, S., Bergeron, N., Williams, P. T., Bray, G. A., Sutherland, B., & Krauss, R. M. (2015). Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: A randomized controlled trial–3. The American journal of clinical nutrition, 103(2), 341-347.

https://www.ncbi.nlm.nih.gov/pubmed/26718414

 Kwon, I., Choi, S., Mittman, B., Bharmal, N., Liu, H., Vickrey, B., Song, S., Araiza, D., McCreath, H., Seeman, T., Oh, S. M., Trejo, L., … Sarkisian, C. (2015). Study protocol of “Worth the Walk”: A randomized controlled trial of a stroke risk reduction walking intervention among racial/ethnic minority older adults with hypertension in senior community centers. BMC Neurology, 15, 91.

https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-015-0346-9
How does the Article Relate to the PICOT Question?  

The article proves whether the

(DASH) the diet hasa significant blood pressure (BP)-lowering action

  

The article analyzes whether the DASH Dietary Approaches to Stop Hypertension is a critical dietary modification for reducing cardiovascular disease and blood pressure (BP) risk.

 The article reflects how physical activity through the Worth the Walk” (WTW) can help prevent stroke by reducing blood pressure.
Quantitative, Qualitative(How do you know?) The article is quantitative because it is based on the collection and analysis of numerical data. The article is quantitative because it is based on the collection and analysis of numerical data. The article is quantitative because it is based on the collection and analysis of numerical data.
Purpose Statement The effect of the DASH diet on the pressure-natriuresis relationship to find out the mechanisms of its BP-lowering action. The effects of substituting full-fat for low-fat dairy foods in the DASH diet, with a corresponding increase in fat and a reduction in sugar intake, on blood pressure and plasma lipids and lipoproteins The relationship between the Worth the Walk” (WTW) intervention and biological markers of health including blood pressure, non-HDL cholesterol, and body-mass index,
Research Question Does Dietary Approaches to Stop Hypertension (DASH) diet, rich in fruits, vegetables, and low-fat dairy foods, have substantial blood pressure (BP)-lowering action? Does substituting full-fat for low-fat dairy foods in the DASH diet, with a corresponding increase in fat and a reduction in sugar intake affects blood pressure and plasma lipids and lipoproteins Does the WTW increase physical activity and improve self-efficacy for being physically active and reducing the risk of stroke.
Outcome The study outcome is to find out whether the DASH diet can lower high blood pressure among patients with hypertension. The DASH significantly reduces blood pressure,high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol in the body. The WTW intervention will increase physical activity and reduce the risk of stroke
Setting

(Where did the study take place?)

 The study was carried out in a hospital setting that is not mentioned n the study.

 

 The study was carried out at a clinical research center in Berkeley, California. The study was carried out at four ethnic-specific clusters at senior centers in Los Angeles.
Sample The study sample 412 participants were expected, but a sample size of n=375 was used in the study. The study sample involvesthirty-six participants who finished all the experimental diets and took part in the study. The study sample involves a total of 240 participants (60 participants from each of the four targeted ethnic groups).
Method The study employed a parallel-group design. The study employed a 3-period randomized crossover trial design. The study employed a single-blind randomized wait-list controlled trial design.
Key Findings of the Study The study showed that the DASH diet reduced BP effectively in groups with high sodium sensitivity.Besides, the DASH diet did not imply blood pressure at low intakes of sodium. The HF-DASH diet significantly reduced lipoprotein (VLDL) and triglycerides concentrations and significantly increased LDL compared with the DASH diet.

The DASH dietsignificantly reduced BP, LDL cholesterol, and HDL cholesterol.

 The results showed that the physical activity was improved through the WTW intervention and this, in turn, reduces the risks of stroke. Therefore, WTW intervention reduces hypertension and stroke.
Recommendations of the Researcher It is recommended that the DASH diet is a critical non-pharmacological measure for controlling BP. It is recommended that the modified HF-DASH diet can be used as an effective alternative to the DASH diet. It is recommended that the Worth the Walk should function as the primary stroke prevention model stroke patients.

 

Criteria Article 4 Article 5 Article 6
APA-Formatted Article Citation with Permalink  

Apovian, C. M., Murphy, M. C., Cullum-Dugan, D., Lin, P. H., Gilbert, K. M., Coffman, G., … & Moore, T. J. (2010). Validation of a web-based dietary questionnaire designed for the DASH (dietary approaches to stop hypertension) diet: the DASH online questionnaire. Public health nutrition, 13(5), 615-622.

https://www.ncbi.nlm.nih.gov/pubmed/19912673

  

Osté, M. C., Gomes‐Neto, A. W., Corpeleijn, E., Gans, R. O., de Borst, M. H., van den Berg, E., … & Bakker, S. J. (2018). Dietary Approach to Stop Hypertension (DASH) diet and the risk of renal function decline and all‐cause mortality in renal transplant recipients. American journal of transplantation, 18(10), 2523-2533.

https://www.ncbi.nlm.nih.gov/pubmed/29464830

 Staffiliano, A. B., Tangney, C, C., Fogg, L. (2018). Favorable Outcomes Using an eHealth Approach to Promote Physical Activity and Nutrition Among Young African American Women. The Journal of Cardiovascular Nursing. 33, 62–71.

https://www.ncbi.nlm.nih.gov/pubmed/28481823

 
How Does the Article Relate to the PICOT Question?  

The article looks at the DASH diet its correlation to lowering blood pressure and reduces the risk of heart disease, stroke, and osteoporosis.

The article addresses the Dietary Approach to Stop Hypertension (DASH) diet.

 

 The article analyzes improving healthy nutrition behaviors by including a DASH diet can reduce the risk of hypertension.
Quantitative, Qualitative(How do you know?) The study is qualitative research because itmarked by use of online questionnaires, to collect verbal information,perceptions,and understandings of the topic. The study is qualitative research because itmarked by use of online questionnaires, to collect verbal information, perceptions, and understandings of the topic. The study is qualitative research because itmarked by use of Web-based questions that are accessible via the Internet and mobile devices, to collect verbal information, perceptions, and understandings of the topic.
Purpose Statement Assess the validity of a new, short, online dietary questionnaire created to capture DASH food intake. Dietary Approach to Stop Hypertension (DASH) diet and the risk of renal function decline and all‐cause mortality in renal transplant recipients. Favorable Outcomes Using an eHealth Approach to encourage Physical Activity and Nutrition Among Young African American Women
Research Question Does the validity of a new, short, online dietary questionnaire capture DASH food intake. Does the DASH diet lead to a lower risk of renal function? Does eHealth approach promote physical activity and nutrition among young African American women?
Outcome The DASH OLQ is a critical assessment tool for measuring DASH diet adherence.

The Dietary Approach to Stop Hypertension (DASH) diet reduces the risk of renal transplant among patients.

 To improve healthy nutrition behaviors to decrease health risk behaviors, and decrease the risk of hypertension based on the DASH diet.
Setting

(Where did the study take place?)

The study was carried out atBoston University Medical Center, Boston, Massachusetts. The study was carried out in a large single‐center prospective cohort of RTR at the University Medical Center Groningen. The study was carried out at the University Medical Center
Sample The study sample includes faculty and staff aged 20–70 years at Boston University Medical Center The study sample includes the 817 invited patients;however, 632 participants were eligible for analyses. The study sample of 142 participants was expected, but a sample size of 124 was used in the study.
Method The study employed a cross-sectional validation of the DASH OLQ method. The study employed the observational prospective cohort study, and data were collected through a validated 177‐item food frequency questionnaire. A randomized, pre-post design Web-based design was used in the study.
Key Findings of the Study The DASH OLQ is a critical assessment tool for measuring DASH diet adherence.The DASH diet lowers blood pressure, cholesterol and the risk of stroke, osteoporosis, and heart disease.

 

 The study showed that adherence to a DASH‐style diet is linked with a lower risk of renal function. The DASH participants showed that eHealth approach could be used for changing health behaviors patients with hypertension.
Recommendations of the Researcher It is recommended that the DASH OLQ is important in assessing the DASH diet adherence in clinical practice. It is recommended that a randomized clinical trial should be carried out to show whether adherence to the DASH diet risk of renal function. It is recommended that the eHealth approach is a critical program that can be used for changing health behaviors for other populations at risk.

 

The Link between the PICOT Question and Research Articles

DASH and WTW can help improve blood pressure control among urban African Americans within five months of initiation of the intervention. Hypertension is one of the highest health problems globally because it contributes to increased rates of mortality and morbidity. Physical inactivity and lifestyle modifications including exercise and diet changes are the main management and preventive measures against cardiovascular diseases and hypertension. Individuals can take control of the levels of their blood pressure through taking medication and adhering to lifestyle changes such as exercise, nutrition and weight management, and low sodium intake.

PICOT Question and Literature Research-Hypertension

Healthcare practitioners can provide non-pharmacological treatment and offer holistic care to patients with high blood pressure. The APNs can promote reductions of blood pressures by helping patients take their medications, increase patient’s physical activity, reduce patient’s sodium intake, and improve patient’s follow up visits. Thus, the WTW and DASH tools are successful in helping patients manage their lifestyle and manage their blood pressures and adhere to their treatment plan with the assistance of APNs.

Kwon, et al. (2015) carried out a randomized controlled trial to assess the effects of a culturally designed walking intervention (Worth the Walk) that is community-based to decrease the risk of stroke by increasing the rate of physical exercise among Latino, African American, Korean and Chinese seniors suffering from hypertension. The study demonstrated considerable improvements in knowledge about stroke and body exercise in the intervention group as compared to the control group (Kwon, et al. 2015). The findings of the study suggest that nursing education should highly consider training the nurses about physical exercise and implement the worth a walk intervention to improve patient outcome. Therefore, nurses should consider the intervention as the primary prevention strategy for stroke among seniors in various minority ethnic or racial groups in the United States.

PICOT Question and Literature Research-Hypertension

Chiu, et al. (2015) conducted a study on the effects of substitution of full-fat with low-fat dairy food products in the DASH diet with a corresponding increase in fat and a decrease in the intake of sugar on plasma lipids, lipoproteins and blood pressure. The participants of the study finished the three dietary periods. The HF-DASH and DASH diets profoundly reduced blood pressure compared to the control diet. There was a reduction in the concentration of medium and large very-low-density lipoprotein particles and triglycerides (Chiu, et al.,2015). The HF-DASH diet also increased the peak particle diameter of LDL and decreased the HDL cholesterol, LDL cholesterol, apolipoprotein A-I, large LDL particles Intermediate density lipoprotein and the width of LDL peak compared with the control diet. The researchers did not mention any limitations of the study.

Besides, Akita, Sacks, Svetkey, Conlin and Kimura, (2003) consider that the extent of adherence to diet determines the effectiveness of the intervention of the DASH diet. Most people with the problem of following prescribed diets have difficulty if adhering to DASH diet. It is the responsibility of the nurses to create awareness and advice patients on how to follow prescribed diets to increase the effectiveness of DASH intervention (Akita, Sacks, Svetkey, Conlin & Kimura, 2003). It is also essential to include a variation in the composition of the macronutrients in the DASH diet while still enhancing the preservation to the benefits of lipid and blood pressure risk factors. Therefore, improving adherence to exercises and the DASH diet is essential to reducing an individual’s blood pressure. This is because of studies with exercise adherence

PICOT Question and Literature Research-Hypertension

Interventions to Address the Health Issue

Individuals can take control of the levels of their blood pressure through taking medication and adhering to lifestyle changes such as exercising, smoking and alcohol cessation, nutrition and weight management, stress management, and low sodium intake.

i.                Nutrition and Weight Management: Obesity and overweight are closely linked to increased levels of blood pressure (Orzech et al. 2014). Therefore, keeping track of how much and what an individual eat is essential. Eating foods with low trans fats, cholesterol, refined sugar, and saturated fats is essential (Staffileno, Tangney, Fogg, 2018). Besides, having vegetable and fruits as part of the diet every day is very critical.  Seeking the help of dietitian can help the patient plan eating habits and lose weight.

  1. Exercising: According to Paganas et al. (2014), regular exercises help to reduce the risks of cardiovascular diseases. It reduces LDL-cholesterol and increase HDL-cholesterol, reduces weight among obese individuals, reduces blood pressure, and reduce endothelial dysfunction. Therefore, exercising regularly helps in the management of hypertension. It is recommended that the exercises should involve a regular and safe exercise program.
  2. PICOT Question and Literature Research-Hypertension
  • Reducing sodium intake: Most patients with hypertension are sensitive to sodium in their food. With the help of a dietitian, individuals can evaluate their choices of food and eat foods low in sodium. Besides, using the DASH diet, patients can choose the sodium levels that meet their health requirements (Chiu et al. 2015). It encourages individuals to reduce their sodium level to help reduce hypertension and instead eat foods rich in nutrients such as magnesium, calcium, and potassium that help lower blood pressure.

Evidence Based Changes and Measuring Tools

  1. The Dietary Approaches to Stop Hypertension (DASH)

DASH is a dietary eating blueprint that focuses on whole grains, low-fat nutritional foods, vegetables and grains as the primary dietary modification for reducing high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) and blood pressure (Chiu et al. 2015).  Adherence to the DASH dietary regime is liked to reduce the risk of hypertension because the consumption of the DASH diet has lower LDL cholesterol compared to the Western diet that has saturated fats (Chiu et al. 2015). Therefore, the DASH diet has a lower content of saturated fats that may help reduce risks of blood pressure and cardiovascular diseases. The level of adherence to the DASH also strongly determines the efficacy of the intervention because poorer adherence does not provide benefits on blood pressure and lipid risk factors.

PICOT Question and Literature Research-Hypertension

  1. “Worth the Walk” (WTW)

The WTW is an intervention looking to reduce physical inactivity among individuals to help manage cardiovascular diseases and stroke (Kwon et al. 2015). The main tools objective is to measure to increase walking levels which are measured in mean steps per day to prevent sedentary lifestyle and inactivity. The tool also aims to determine the correlation between the intervention and its impact on c-reactive protein (CRP), glycosylated hemoglobin (HgA1c), non-HDL cholesterol, body-mass index, and blood pressure (Kwon et al. 2015). Finally, the tool also focuses on the self-efficacy and behaviors that help control risk factors of high blood pressure and stroke. Thus, WTW help to increase an individual’s physical activity, which can serve as the primary high blood pressure prevention among individuals.

PICOT Question and Literature Research-Hypertension

Conclusion

The major insights developed regarding the role of EBP is that APNs have the role and responsibility to provide a wide range of health care services to patients of all ages. Nurses must provide EBP practices to help improve the patient’s outcome based on the best available evidence. The DASH and WTW as an EBP intervention can improve blood pressure control among urban African Americans within five months of initiation of the intervention. The EBP intervention can be implemented and applied to determine whether they enhance or impede high-quality nursing care. This helps to evaluate the outcome of the WTW and DASH on improving the level of patient’s high blood pressure. Thus, EBP intervention on hypertension promotes an attitude of inquiry among nurses that can guide them to provide care more effectively as informed by the available evidence.

 

References

Akita, S., Sacks, F. M., Svetkey, L. P., Conlin, P. R., & Kimura, G. (2003). Effects of the Dietary

Approaches to Stop Hypertension (DASH) diet on the pressure-natriuresis relationship. Hypertension, 42(1), 8-13.https://www.ncbi.nlm.nih.gov/pubmed/12756219

Apovian, C. M., Murphy, M. C., Cullum-Dugan, D., Lin, P. H., Gilbert, K. M., Coffman, G., …

& Moore, T. J. (2010). Validation of a web-based dietary questionnaire designed for the DASH (dietary approaches to stop hypertension) diet: the DASH online questionnaire. Public health nutrition, 13(5), 615-622.

https://www.ncbi.nlm.nih.gov/pubmed/19912673

Chiu, S., Bergeron, N., Williams, P. T., Bray, G. A., Sutherland, B., & Krauss, R. M. (2015).

Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: a randomized controlled trial–3. The American journal of clinical nutrition, 103(2), 341-347. https://doi.org/10.3945/ajcn.115.123281

Hagins, M., Rundle, A., Consedine, N. S., & Khalsa, S. B. S. (2014). A randomized controlled

trial comparing the effects of yoga with an active control on ambulatory blood pressure in individuals with prehypertension and stage 1 hypertension. The Journal of Clinical Hypertension, 16(1), 54-62. https://doi.org/10.1111/jch.12244

Kwon, I., Choi, S., Mittman, B., Bharmal, N., Liu, H., Vickrey, B., Song, S., Araiza, D.,

McCreath, H., Seeman, T., Oh, S. M., Trejo, L., … Sarkisian, C. (2015). Study protocol of “Worth the Walk”: a randomized controlled trial of a stroke risk reduction walking intervention among racial/ethnic minority older adults with hypertension in senior community centers. BMC Neurology, 15, 91. doi:10.1186/s12883-015-0346-9

Migneault, J. P., Dedier, J. J., Wright, J. A., Heeren, T., Campbell, M. K., Morisky, D. E., Rudd,

P., Friedman, R. H. (2012). A culturally adapted telecommunication system to improve physical activity, diet quality, and medication adherence among hypertensive African-Americans: A randomized controlled trial. Annals of Behavioral Medicine, 43(1), 62-73. doi:http://dx.doi.org/10.1007/s12160-011-9319-4

Osté, M. C., Gomes‐Neto, A. W., Corpeleijn, E., Gans, R. O., de Borst, M. H., van den Berg, E.,

… & Bakker, S. J. (2018). Dietary Approach to Stop Hypertension (DASH) diet and the risk of renal function decline and all‐cause mortality in renal transplant recipients. American journal of transplantation, 18(10), 2523-2533.

https://www.ncbi.nlm.nih.gov/pubmed/29464830

 

 

 

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Vargas Family-Discharge Summary

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Vargas Family-Discharge Summary

Read the entire “Vargas Family Case Study” (all eight sections). Consider the progress (or lack thereof) over the past eight sessions. Using the “Discharge Summary Outline” template; include the following in your outline:

1. A brief summary of what was going on with the family

2. A review of the initial treatment goals

3. Theories and interventions used

4. A brief discharge summary for the family treatment

5. Clinical recommendations for sustained improvement or referrals for additional services

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.

This assignment uses a scoring guide. Please review the scoring guide prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center.

 

SAMPLE ANSWER

PCN-521 Module 8:Vargas Case Study Discharge Summary Outline

  1. A brief summary of what was going on with the family at the onset of counseling:

 

  1. At the onset of counseling, the family was divided. The main reason behind the division was the constant disagreement between Bob and Elizabeth concerning Frank’s bad behavior. Frank was impulsive, consistently lost things, did not listen and was consistently picking on his sister, Heidi. While Elizabeth believed that Frank had ADHD, Bob minimized his behavior claiming that it was normal behavior for a boy. Bob and Elizabeth constantly argued with each other and this created tension in their marriage and the family in general.

Nursing Paper Help

  1. A review of the initial treatment goals:

 

  1. The main goal of the first session was to develop a hypothesis that was maintaining the problem.
  2. The second goal was to develop a therapeutic relationship with each family member to improve the therapy session.
  • Theories and interventions used
    1. Week 1:
      1. Rapport building
      2. Family fun day out
    2. Week 2:
      1. Weekly soccer matches
    3. Week 3:
      1. Developing a family tree
    4. Week 4:
      1. Structural family therapy
      2. Family structure chart
  • Mirroring activity
  1. Constructing genogram
  1. Week 5:
    1. Bateson’s cybernetic model
    2. Strategic family therapy
  • Mental research institute model
  1. The Milan Family system model
  2. Haley and Madanes Strategic Approach

Vargas Family-Discharge Summary

  1. Week 6:
    1. Act and talk it out
    2. Soccer for the mind
  • Paint your feelings
  1. Week 7:
    1. Narrative therapy
  2. Week 8:
    1. Solution-focused brief therapy

Vargas Family-Discharge Summary

  1. A brief discharge summary for the family treatment:

 

  1. Reasons for seeking therapy: the family came to therapy to work on their communication problems. Elizabeth and Bob were fighting in front of their children, Frank was attacking his sister while Heidi’s achievements were ignored leaving her exposed to developing attention deficit disorder.
  2. Significant findings: Frank should get an official ADHD diagnosis and if he has the disorder, proper treatment interventions should be administered. The interventions proposed are designed to facilitate a state of wellness for the entire family. The weekly soccer matches appear to be working as the family report progress and improved interaction. Bob has shown the most transformation towards the end of therapy. He understands the amount of work Elizabeth puts in to take care of Frank. Heidi is also closer to Frank and she no longer feels ignored

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  1. Treatment: solution focused brief therapy was used where solutions were identified. Several sessions were held with the entire family where observations were made. Narrative therapy was also used together with solution-focused brief therapy
  2. Termination of therapy condition: the family has improved its communication strategies, Bob is more passionate about Elizabeth’s struggles and Frank and Heidi are interacting positively. The family is holding weekly bonding sessions over soccer matches and everyone is enjoying each other’s company.
  1. Clinical recommendations for sustained improvement or referrals for additional services:
    1. Frank is referred to a pediatrician for further analysis according to the American Psychiatric Association’s Diagnostic and Statistical Manual
    2. The family should continue to have weekly family time
    3. The family should hold therapy sessions with the extended family
    4. Frank should be enrolled in a soccer camp to improve his soccer skills

 

 

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