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Week 7 Assignment: Financial Analysis

Week 7 Assignment: Financial Analysis

To make informed decisions and achieve strategic goals, health care leaders must carefully analyze an organization’s financial position. A ratio analysis, for example, may impact decisions for strategic initiatives such as expansions, consolidations, mergers, and acquisitions. For this Assignment, you calculate financial ratios and consider their implications for organizations.

To prepare:

Review the Week 7 Assignment document in this week’s Learning Resources. Examine the financial data for the health care organizations in each scenario.

Note: Your Assignment should show effective application of triangulation of content and resources in your conclusion and recommendations.

The Assignment

Using the scenarios and financial data provided in the Week 7 Assignment document, calculate financial ratios and evaluate their implications on organizational decision making.

 

SAMPLE ANSWER

Week 7 Assignment: Financial Analysis

Scenario 1: ABC Hospital

            In the scenario involving ABC Hospital, option one appears to be the most recommendable one. In the option, ABC would spend $11,995,000 in the development of a new facility focusing on the treatment of cancer. The decision is based on a financial analysis, including a Net Present Value and Future Earnings calculation.

 

  Present Value FE Y1 FE Y2 FE Y3 FE Y4
Year 1 $1,836,547.29 2,000,000      
Year 2 $3,372,905.95   $4,000,000    
Year 3 $3,871,563.31     $5,000,000  
Year 4 $5,688,247.28       $8,000,000
Total PV of FE $14,769,264.00        
Investment $-11,995,000.00        
Net PV $2,774,264.00        

 

The table shows the calculation of the present value for each year. The PV of each year is calculated by using the formula Future Earnings × [1/ (1 + i) ^n], whereby i represents the discount rate (8.9%) and n represents the number of years. The total present value of future earnings exceeds the investment value. Thus, the net present value of the investment shows that the facility would generate enough future earnings to be able to cover the initial cost of the investment, which tends to make it viable.

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Scenario 2: Serenity Health Care

The objective of computing the financial ratios is to advise the board on whether acquiring Hall Healthcare Systems is viable. The acid-test ratio measures the ability of an entity to use its quick assets or near cash to retire the current liabilities that it has immediately. In addition, the current ration measures whether an entity has sufficient resources to settle its short-term obligations.

  2015 2014
Total current assets / Total current liabilities $13,848,196 / $12,934,411 $18,779,217 / $19,708,798
Current Ratio 1.07 0.95
Total current assets – inventory / Total current liabilities $11,180,805 / $12,934,411 $13,189,141 / $19,708,798
Acid Ratio 0.86 0.67

 

Based on the calculations, Hall Healthcare Systems current ratio for the most recent year, 2015, indicates that the firm has adequate resources to cover its short term obligations. However, current ratio for 2014, 0.67, indicates that the facility may not have had enough resources to settle its short term obligations. The acid ratio, on the other hand, was 0.67 and 0.86 for 2014 and 2015 respectively. The ratios, which are less than 1, indicate that Hall Healthcare Systems does not have sufficient near cash or quick assets to cover its short term liabilities immediately. Based on the current ratio, I would advise the CEO to make the acquisition. However, since the acid ratio is less than 1, it is important for Serenity Healthcare to make additional considerations.

Week 7 Assignment: Financial Analysis

Scenario 3: Montgomery Home and Community-Based Services

Break-even volume = Total fixed costs / (Average charge per client – Average variable cost per client)

Total fixed costs = $6,090, Average charge per client = $200, Average variable cost per client = $145. Therefore,

Break –even volume = $6,090 / ($200-$145) = 111 clients

The break-even volume represents the number of clients that would be needed for the new facility to have all its expenses paid for appropriately and to break even. At present, only 15 retired seniors are willing to pay the fee to access the center. Therefore, the investment is not viable, unless the CEO would be willing for 3 years when 120 retired seniors would join the center.

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Payback Period

Year Yearly Cash Flow Cumulative Cash Flow
0 ($317,880) ($317,880)
1 $25,700 ($292,180)
2 $40,000 ($252,180)
3 $78,000 ($174,180)
4 $225,000 $50,820
5 $310,000 $360,820

 

Payback Period = A + (B/C)

=4.14 = 4 + (50,820/360,820)

Therefore, the payback period tends to be more than 4 years, which means that it would take more than for years to cover the costs associated with the initial investment.

 

References

Kampf, R., Majerčák, P., & Švagr, P. (2016). Application of break-even point analysis. NAŠE MORE: znanstveno-stručni časopis za more i pomorstvo63(3 Special Issue), 126-128.

Lane, K., & Rosewall, T. (2015). Firms’ investment decisions and interest rates. Firms’ Investment Decisions and Interest Rates 1 Why Is Wage Growth So Low? 9 Developments in Thermal Coal Markets 19 Potential Growth and Rebalancing in China 29 Banking Fees in Australia 39, 1.

Leyman, P., & Vanhoucke, M. (2016). Payment models and net present value optimization for resource-constrained project scheduling. Computers & Industrial Engineering91, 139-153.

Penman, S. H. (2015). Financial Ratios and Equity Valuation. Wiley Encyclopedia of Management, 1-7.

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Response letter to the author

Response letter to the author

Just need the answers, no title page heading, and please make sure it is the correct word count required as specify in each question.  I will pay for an additional page if need it, just please let me know.

1- In 300 words write a response letter to the author. State whether you agree or disagree with their viewpoint.  Provide at least one example in your response to support your position.

2- In 100-150 words – what is the primary appeal the author uses to get the argument across to the reader? Provide an example and explanation.

 

SAMPLE ANSWER

Trump has gone off a narcissistic cliff. Does anything matter anymore?

In the recent past, one does not need to be professional in mental health to recognize that something is off with the 45th and current president of the United States of America, Donald Trump. I agree that Trump has gone off a narcissistic cliff. There has been no president in history that has been established to have shown an excessive interest in or admiration of oneself and their physical appearance. Trump, on the other hand, has prompted several discussions regarding his mental stability and connection with reality based on the excessive need for admiration, being arrogant and disregarding others. Also, he has exhibited an outright inability to effectively handle criticism making him expose his sense of entitlement.

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The issue of white nationalism in America is a serious one and requires to be addressed by the president, who is instead choosing to be egocentric and make everything to be about his life instead of handling the issue. In a world where so many items need to be addressed, trump should not be spending so much time being concerned about personal grievances on social media as well as mainstream media. An example of the things that Trump has devoted time to is to tweet about conspiracy theories and in the process, he ignores serious issues such as the three mass shootings that took place in one week. It is for these issues that other people find him mentally unstable. An example is John Kelly who referred to him as “off the rails” and “unhinged” referring to his state of imbalance. We have reached a point where no one knows what to expect from Trump anymore. He seems to change based on his moods from one minute to another as influenced by either headline on the news or even Tweeter. Nothing matters anymore.

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The Primary Appeal used in the Article

The primary appeal that is used by the author is pathos, which seeks to bring about the emotional appeal and persuade an audience to feel what the author wants. The author of this text wants the audience to feel how mentally unstable the president has become and is consequently providing examples to show how he is becoming Narcissistic. The author writes that “With America facing a rising tide of white nationalism and a world on fire, we have a leader who is dangerously unfit, makes everything about him.” In doing so, he attempts to make the audience understand how inefficient the president is and especially the fact that he has become egocentric and not showing active efforts towards handling the issues that the country is facing. The title of the article also prompts one to acknowledge the fact that nothing matters to the president anymore.

 

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Chronic and Acute Asthma

Chronic and Acute Asthma

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

 

1. Describe the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Be sure to explain the changes in the arterial blood gas patterns during an exacerbation.

2. Explain how the factor you selected might impact the pathophysiology of both disorders. Describe how you would diagnose and prescribe treatment for a patient based on the factor you selected.

3. Construct two mind maps—one for chronic asthma and one for acute asthma exacerbation. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.

Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references.

 

SAMPLE ANSWER

Asthma

Asthma is referred to as a chronic inflammatory disorder that causes constriction and obstruction of the bronchial mucosal. Asthma attack can also lead to inflammation of the smooth muscles due to the hyper- responsiveness of the airway resistance or narrowed (Wenzel et al. 2016). Both acute and chronic asthma are often similar in their pathophysiology. This paper analyzes the pathophysiological mechanisms of chronic asthma and acute asthma and explains the changes in the arterial blood gas patterns during an exacerbation (Wenzel et al. 2016). The paper also explains how age factor impact the pathophysiology of both disorders.

Chronic Asthma Exacerbation

The pathophysiology of chronic asthma is characterized by bronchoconstriction stimuli and mucus secretion. The bronchoconstriction is caused by peptide neurotransmitters, the bronchial neural function, and induced by smooth muscle contractions (Evans et al. 2012). In the early stages, the toxic neuropeptides, and eosinophils are released leading to the inflammatory response and bronchial hyper-responsiveness (Evans et al. 2012). Oxygenation is also involved in chronic asthma because of the bronchial airway restriction. Hyperventilation often affects the arterial blood gas leading to hypoxemia and respiratory alkalosis in patents.

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Acute Asthma Exacerbation

The pathophysiologymechanism of acute asthma results when bronchial airways are affected leading to resistance in the airway.  Many cells often lead to hypersensitivity of the airway in acute Asthma such as basophils, eosinophil, neutrophils, mast cells, B lymphocytes, T helper 2 lymphocytes, and dendritic (Lemanske & Busse, 2010). These cells react differently causing inflammatory that may lead to increase in secretions, edema, and bronchospasm. The arterial blood gas in chronic asthma also results due to short inspirations and long expirations due to lack of oxygenation. Patients often trap air due to short and long inspirations that cause respiratory acidosis due to respiratory disadvantage increase in carbon dioxide and a decrease intidal volume (Lemanske & Busse, 2010).

Impact of Age Factor

Asthma as a chronic pulmonary infection affects both adults and children. However, researchers have shown that it is more affected by children below the age of 17 years old (Hasegawa et al. 2015).  Therefore, asthma affects people of all ages, from infants to older adults.  Although treatment may be challenging due to detailed assessment, the inability to distinguish the signs and symptoms of asthma and manage treatments may occur (Ponikowski et al. 216). When assessing patients with respiratory issues, nurses and physicians must conduct analysis of the vaccination, history and physical records to help understand the patient condition and present re-infection of other diseases.

Asthma may be acute or chronic in both children and adults leading to inflammation and increase level of mucus affecting the flow of air. Exacerbation is caused by inflammation and sensitivity. However, it is sometimes due to asymptotic attacks (Ponikowski et al. 216). During exacerbation, patients may experience the use of accessory muscles, increased heart rate, prolonged expiration, expiratory wheezing, nonproductive cough, dyspnea, inability to breathe, and tightness of the chest (Ponikowski et al. 216). Thus, many factors can lead to exacerbation, in all ages including not get enough inhalers, not using medication properly, second-hand smoking in children, allergy season, and flowering season.

 

 

Mind Maps

Acute Asthma

Chronic Asthma and Acute Asthma

 

Chronic Asthma

Acute and Chronic Asthma

Summary

Asthma clinical presentation may be challenging to understand but identifying its signs and symptoms early is important to prevent acute or chronic asthma. Asthma is primarily linked with recurrent of episodes of dyspnea and wheezing, hyper-responsiveness of the airway to stimuli and physical of allergies. Asthma can be prevented through compliant with medications and treatments since its pathophysiology is similar in adults and children.  If it remains untreated, it can lead to death making prevention of recurrence asthma critical.

 

References

Wenzel, S. E., Jayawardena, S., Graham, N. M., Pirozzi, G., & Teper, A. (2016). Severe asthma

and asthma-chronic obstructive pulmonary disease syndrome–Authors’ reply. The Lancet388(10061), 2742. DOI:https://doi.org/10.1016/S0140-6736(16)31720-2

Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G., Coats, A. J., … & Jessup,

  1. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European journal of heart failure18(8), 891-975.

https://doi.org/10.1002/ejhf.592

Hasegawa, K., Cydulka, R. K., Sullivan, A. F., Langdorf, M. I., Nonas, S. A., Nowak, R. M., …

& Camargo Jr, C. A. (2015). Improved management of acute asthma among pregnant women presenting to the ED. Chest147(2), 406-414. https://search.proquest.com/openview/dced603cde8234803185d32130a4b1ba/1?pq-origsite=gscholar&cbl=40575

Evans, R. L., Nials, A. T., Knowles, R. G., Kidd, E. J., Ford, W. R., & Broadley, K. J. (2012). A

comparison of antiasthma drugs between acute and chronic ovalbumin-challenged guinea-pig models of asthma. Pulmonary pharmacology & therapeutics25(6), 453-464. DOI: 10.1183/09031936.00057710

Lemanske Jr, R. F., & Busse, W. W. (2010). Asthma: clinical expression and molecular

mechanisms. Journal of Allergy and Clinical Immunology125(2), S95-S102. https://www.sciencedirect.com/science/article/pii/S0091674909016133

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Cultural Assessment – Chinese culture

Cultural Assessment – Chinese culture

The student will select a culture other than their own and design a paper using evidence based resources to address challenges

Use headings to help guide your reader through the sections of this paper.

  • An introductory paragraph where you define the topic. Be sure the purpose of the paper clearly stated.
  • Remember- in APA format the word “Introduction” is not a heading for the introductory paragraph.
  • Define the chosen culture. What are the characteristics of the culture- health beliefs, food preferences, and religious guidelines?
  • Significance of the topic – Provide examples of appropriate communication, how would the RN interact if there are language barriers, resources that would be included?
  • Discuss two significant health issues that are prevalent within the chosen culture and what the priorities for health maintenance or promotion that need to be addressed.
  • Summary paragraph will briefly recap the main points you raised.
  • Be sure to cite your references.
  • I am an African, any other culture will be fine
  • I will also require an abstract.

 

SAMPLE ANSWER

Abstract

The Chinese culture is one of the most ancient, diverse and sophisticated cultures of the world. The modern-day culture in China is an integration of the westernized lifestyle and old-world traditions, which co-exist in a balanced formula. The culture is ethically ambiguous with various minority groups including the Han, Manchus, Mongols, and Hezhen. The diversity in their languages, cuisines, celebrations, and artistic practices makes the culture different from the western culture. Health practices are constructed against an environment of regular social interactions and negotiations where allegiance to social identity, norms, and cultural traditions play a significant role. Major health conditions affecting this community include respiratory disorders, cancer and dental diseases.

 

Cultural Assessment

Different cultures vary in their systems of health beliefs and values concerning illness and methods of treatment. Western societies such as America view disease as natural scientific phenomena and therefore advocate for medical treatment that fights microorganisms. Other societies, like the Chinese, believe that illness is a result of supernatural phenomena that can be treated through spiritual intervention or using cultural herbs. Some are therefore reluctant to accept a diagnosis of various diseases such as mental retardation. For most Chinese, going for health counseling involves self-disclosure, and this goes against their values. Moreover, cultural values influence patients’ role in managing their health and the decision-making process concerning treatment.

Characteristics of the Chinese culture

Various cultural influences guide the health behaviors of the Chinese community. Health practices are constructed against an environment of regular social interactions and negotiations where allegiance to social identity, norms, and cultural traditions play a significant role. Therefore, beliefs regarding health express psychological factors that shape the choices made about health-related behavior and practices. Chinese beliefs on illness and health are based on a theory of balance and energy flow.  Diet, for example, plays a crucial role in treating illnesses and, sometimes, various dietary prescriptions are used as self-medication. Pregnant women, for instance, should not eat cold fruits such as bananas, to avoid miscarriage. Some take herbal drinks that protect the pregnancy and remove toxins from the womb and ensure a healthy baby.

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The doctors use various traditional Chinese medicines such as herbs, acupuncture, meditation, Tui Na massage, and food to recover and sustain health. Herbs are used in regulating natural body balance and health restoration. The herbs come in the form of powders, pills, or balms for external use. Acupuncture, on the other hand, involves inserting needles into the skin, subcutaneous tissue, and muscles at particular acupuncture points and manipulating them. Tui Na is used for treating chronic pain musculoskeletal conditions. Also, the Chinese nutrition is considered the first line of defense in health matters. A balanced diet includes the five tastes – sour, spicy, sweet, bitter, and salty. The tastes are necessary for providing strength, cooling and warming the body.

Cultural Assessment – Chinese culture

Barriers to receiving quality care

Most health care professionals expect that patients will conform to mainstream values and this has created barriers for cultural groups such as Chinese to receive healthcare.  The various barriers include; “face-saving,” use of cultural herbs and lack of trust for healthcare providers.  Face-Saving is a strong concept in the Chinese culture. Patients avoid looking weak or foolish and they, therefore, avoid being vocal with healthcare providers concerning their health issues. Also, Most of them prefer using alternative and complementary medicine such as herbs, acupuncture, and massage. Moreover, some patients do not fully trust nurses and the with hold relevant information concerning their health.  Chinese also believe in karma, and according to them, it is bad luck to talk about death or illness.

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Chinese residents in New York encounter countless socioeconomic problems and are faced with high disease dominance and poor health standards. Respiratory disorders, cancer and dental diseases are prevalent among the Chinese community. Structural factors, such as, affordability, accessibility, and service availability including health insurance, lack of finances, and cultural factors such as health beliefs and proficiency of the English language cause healthcare disparities. Additionally, barriers in the health system may prevent Chinese population from obtaining appropriate health care.

Cultural Assessment – Chinese culture

Summary

Healthcare providers should be aware of the important Chinese cultural beliefs. A poor understanding of cultural differences may lead to adverse clinical outcomes such as the use of harmful remedies, delayed immunization, non-compliance and reduced participation. Due to this, health disparities among members of this group are evident. The firm belief in traditional healing practices prevents the Chinese from seeking further medication. Some of the curing approaches used by this community, such as massage, may be too expensive. Patients, especially those not covered by insurance, suffer from an easily curable disease due to inadequate knowledge on alternative and affordable medical care. The lack of understanding has led to high mortality and morbidity rate. Nurses should combine cultural information with clinical assessment of the patient to provide culturally sensitive care.

 

References

Ch’en, J. (2018). China and the West: society and culture, 1815-1937. Routledge.

Wang, Y. K. (2010). Harmony and war: Confucian culture and Chinese power politics.

Columbia University Press.

 

 

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Rough Draft: Capital Punishment in Criminal Justice

Rough Draft: Capital Punishment in Criminal Justice

Rough Draft Due Week 7 and worth 150 points Instructions: Writing Activity 3 has two sections to complete. You will use the writing templates in Webtext chapter 7 to complete them. Once you complete all templates, you will be able to download your work and submit it to Blackboard. The Webtext will guide you through the process.

 

Section 1 Rough Draft Create your Rough Draft by using the writing templates in Webtext chapter 7.

 

Your rough draft should include an introduction paragraph, 2-5 body paragraphs for all supporting points in your paper, a counter perspective, and a conclusion paragraph. While the rough draft should be complete, it does not have to be perfect. After you submit it, you will get feedback from your instructor to help make revisions before submitting the final version of your paper in week

 

SAMPLE ANSWER

Capital Punishment in Criminal Justice

Capital punishment, also referred to as the death penalty is a justice system where the offenders, when found guilty, are killed. Several justifications have been made for the penalty and against it and the debates have advanced with time. The death penalty dates back to Eighteenth Century B.C. in the Code of King Hammurabi of Babylon, which codified the death penalty for different crimes (Paternoster, 1991). The reasons for the penalty varied among different societies and they included sexual crimes, blasphemy, magic as well as a violation of religious obligations among others (McFeely, 2019). In history, capital punishment involved various ways of killing an individual including crucifixion, stripping the skin off an individual, stoning, burning, dismemberment and crushing among other methods. In the modern world, industrialized countries may use lethal injections among other modern forms. However, in the USA, capital punishment is given through the firing squad (McFeely, 2019). In the USA the punishment has been used for treason, murder, and people involved in the use of spies by governments to obtain political and military information (Vila and Morris, 1997). Although the pro-death crusaders argue that it serves as a deterrent to others who would want to engage in similar crimes, the argument is often tempered by some more critical factors.

The criminal justice system is tasked with the responsibility of reflecting the moral views of society. As a result, inflicting the penalty of death on its citizenry entirely violates religious teachings on the sanctity of life. In various religious beliefs, there is a supreme God that gives and takes life, and therefore, when one ends the lives of others, they seem to be assuming the role of God. Also, Capital punishments infringe on the inviolability, sanctity, and dignity of an individual’s life as only God should be allowed the right to take the lives of people. In addition, the action is morally wrong as it involves committing a crime as compensation for another crime or simply following the example of the criminal by carrying out an equally bad action (Binder et al. 2016). One main characteristic of capital punishment is that it ends up denying the offender the opportunity of rehabilitation, which is supposed to be the main goal of the justice system (Haney, Weill, and Lynch, 2015).

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Secondly, the criminal justice system has been filled with errors previously, and consequently, an innocent individual may be put to death for a mistake that they did not commit (Brown, & McGee, 2018). Also, the capital punishment process is expensive and there are several costs involved including special prison housing and staff costs. The governments spend a significant amount of tax payer’s money to fund such processes. The money would be used to carry out other important activities like educating the poor in society or coming up with programs that would seek to establish corrective behaviors or deter youths from getting into crime (Brown, & McGee, 2018).

The main argument that surrounds the topic is the ability of the capital punishment penalty to effectively serve as a deterrent to crime (Rice, 2017). The idea behind capital punishment is that when criminals are punished by being put to death, potential criminals will be discouraged from crime. However, this does not seem to be the case considering the proportional severity deterrent and economic theories of human nature. They establish that a penalty served for a crime is supposed to allow an individual to calculate the benefits of crime vis-à-vis the crime. If it was to be true that physiological pleasures of crime are weighed against the pain of execution, then there would be no cases of homicide as well as other cases that call for the death penalty. The growing statistics of homicides across different parts of eth United States of America dispute the fact that the death penalty serves as a deterrent to crime in modern times. Therefore this proves that there should be other methods that would be adopted to help people revert from their criminal ways and the death penalty is not effective.

Rough Draft: Capital Punishment in Criminal Justice

In conclusion, capital punishment should be abolished from the legal system because it is morally wrong and is very costly in addition to the fact that it gives man the position of God considering everyone has one life. Also, it has been established that it is not an effective tool to act as a deterrent to crime as evidenced by the increase in the levels of crime in the USA as well as in different parts of the world.

 

References

Binder, G., Fissell, B., & Weisberg, R. (2016). Capital punishment of unintentional felony

murder. Notre Dame L. Rev., 92, 1141.

Brown, L. L., & McGee, S. G. (2018). Social Work and Capital Punishment: a Call to

Action. Journal of Human Rights and Social Work3(4), 229-239.

Haney, C., Weill, J., & Lynch, M. (2015). The death penalty. In B. L. Cutler & P. A. Zapf

(Eds.), APA handbooks in psychology. APA handbook of forensic psychology, Vol. Criminal investigation, adjudication, and sentencing outcomes (pp. 451-510). Washington, DC, US: American Psychological Association. http://dx.doi.org/10.1037/14462-017

McFeely, W, S. (2019). Trial and Error: Capital Punishment in U.S. History. Retrieved

From: http://historymatters.gmu.edu/d/5420

Rice, S. K. (2017). Darkness to Light: Procedural Injustice as Crisis for Capital

Punishment Legitimacy. Seattle Journal for Social Justice, 15(3), 13.

Paternoster, R. (1991). Capital punishment in America (p. 20). New York: Lexington Books

Vila, B., & Morris, C. (Eds.). (1997). Capital Punishment in the United States: A documentary

history. Westport, CT: Greenwood Press.

 

 

 

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Organizational Development and Planning

Organizational Development and Planning

Discussion: Organizational Development, Workforce Planning, and Succession Planning

 

Organizational development is focused on improving the efficiency and effectiveness of a workplace. As part of this process, strategic planning professionals often work with leadership teams to develop strategies for short-term and long-term organizational development, including workforce planning and succession planning. This helps ensure that health care organizations recruit, train, and retain employees that are capable of meeting strategic objectives. For this Discussion, examine the following scenarios and suggest strategies for organizational development, workforce planning, and succession planning.

 

Scenario 3: Myrtle Healthcare System is an integrated health care organization providing health care services in Colorado. Recently, an investigative reporter from the local television news station reported that leadership at Myrtle’s flagship hospital, Jackson Hospital, will be getting annual bonuses of $25k in December and a 10% increase in their salaries for the next year. This story comes at a time when frontline staff members have been complaining repeatedly about the deplorable working conditions and lack of pay increase in five years. Unfortunately, leadership has consistently refused to host an employee town hall meeting to discuss their concerns collectively. The employees are now asking for the union to intervene so that this matter may be quickly resolved to restore the employees’ trust in leadership and the public’s trust in the organization’s ability to provide quality patient care.

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To prepare:

  • Review the scenario assigned to you by the Instructor.
  • Consider strategies for short-term and long-term organizational planning, workforce planning, and/or succession planning.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit!

By Day 3

Post: a cohesive response to the following:

Briefly describe the scenario assigned to you by the Instructor. Recommend strategies for short-term and long-term organizational development, workforce planning, and/or succession planning. Defend your recommendations. Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.

Read a selection of your colleagues’ postings. Consider how your colleagues’ postings relate to the information presented in the Learning Resources and to your own posting.

By Day 5

Respond to at least two of your colleagues’ postings and continue the Discussion through Day 7. Expand on this Discussion by providing additional insights or alternative perspectives to colleagues who were assigned different scenarios than you. For example, if you were assigned Scenario 1, respond to colleagues who were assigned Scenario 2 and Scenario 3.

 

SAMPLE ANSWER

Organizational Development and Planning

The current healthcare environment for healthcare facilities entails various issues that demand strategic planning. These issues include increased competition, government policies, poor management of funds, and employee payments among others (Payne et al., 2018). The scenario presents a case of Myrtle Healthcare System which operates in Colorado. A flagship hospital of Myrtle is reported to increase its leadership salaries at a time when its employees are opposing the firm’s working conditions and payment policies.

Strategies for Short-Term Development

The company should engage in developing cash-flow forecasts. This strategy is essential in estimating the facility’s cash collections within short periods. The facility’s leadership also needs to develop a situational analysis.  This strategy will enable the management to understand the problems that face the hospital. Moreover, the management needs to create communication with the employees. This move will eliminate doubt from the employees as it will provide answers for what the firm is planning. In addition, the facility can improve on its employee-leadership relations. This can be enhanced by creating a fair reward system such as promotions basing on merit. This strategy is prone to shift the management’s reputation in the eyes of the employees. As a result, there will be successful operations in the hospital (Maruyama & Braga, 2014).

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Strategies for Long-Term Development

In the long run, Myrtle needs to create a SWOT analysis to review its long-term viability. This act will enable the management to develop decisions basing on the analysis. This strategy will enable the leadership to make suitable payment and employee relations in the long run.  Moreover, the management needs to redesign its personnel objectives. This strategy enhances positive employee operations and relations in the long run. Engagement in employee training on leadership skills is suitable in creating future leaders for the hospital (Maruyama & Braga, 2014).

 

References

Maruyama, U.G.R., & Braga, M.A.B. (2014). Human resources strategic practices, innovation

performance & knowledge management. Proposal for Brazilian organizations. Independent Journal of Management & Production, 5(3), 710-732.

Payne, R. A., Hovarter, R., Howell, M., Draws, C., & Gieryn, D. (2018). Succession planning in

public health: addressing continuity, costs, and compliance. Nurse Leader16(4), 253-256.

 

 

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Advanced Practice Nursing Role

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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Literature Search

Literature Search

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

The Assignment: (4-5 pages)

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

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

 

SAMPLE ANSWER

Literature Search

The health care sector across the world requires the establishment of targeted clinical systems to help improve patient outcomes.  The development and application of evidence-based practices as best clinical systems approach can lead to delivery of health care. Best outcomes refer to the absence of the sign and symptoms of a disease, which can be achieved through quality improvement.   This paper addresses the application of The Dietary Approaches to Stop Hypertension (DASH), its outcomes and efficiencies, and lessons learned from its application.

Summary One

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 nutrition103(2), 341-347. https://www.ncbi.nlm.nih.gov/pubmed/26718414

The study by Chiu, et al. (2015) examines 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 Dash diet enhances low-density lipoprotein, lowering of high blood pressure and cholesterol that is high-density lipoprotein. The researchers used a sample size of three health persons to conduct a randomised crossover trial based on three periods. The individuals consumed a standard Dash diet, a control diet, a lower carbohydrate modification of DASH diet, and a high-fat diet for three weeks each which was separated by two weeks’ periods for washouts. The researchers then conducted laboratory measurements that included the concentration of lipoprotein particles determined by the mobility of ions, which was established at the end of each experimental diet.

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The study results showed that 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.  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.

Literature Search

The DAS diet significantly lowered blood pressure to the same extent as the HF- DASH diet and also reduced the concentration of VLDL and plasma triglyceride without increasing the cholesterol. The findings of the study can help improve nursing practice in managing hypertension. Nurses should create awareness among patients and the community at large about the DASH and HF-DASH diet to help reduce the mortality rates and the costs of treatments.

Summary Two

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.  Hypertension42(1), 8-13. https://www.ncbi.nlm.nih.gov/pubmed/12756219

Akita et al. (2003) assess the effects of the DASH diet on the pressure-natriuresis relationship to identify its mechanisms of lowering blood pressure. The Dietary Approaches to Stop Hypertension can act as primary mechanism for lowering blood pressure through consumption of a diet with vegetables, fruits, and low-fat dairy foods. The article uses a controlled trial method where DASH sodium trial and randomised feeding trial were used. The participants were not healthy individuals as they had systolic blood pressure (SBP) ranging between 120 and 159 and Diastolic blood pressure ranging between 80 and 95 without blood pressure-lowering medication. Statistical analysis was conducted by comparing the x-intercept and the steepness of the curve of the pressure-natriuresis between DASH diets and the control diet as well as the subgroups and testing them by the use of Student t-test for the non-paired samples.

Literature Search

The results of the study showed that the DASH diet effectively lowered blood pressure groups though a diuretic action with high sensitivity of sodium. This means that the article provides proof on whether the DASH diet lowers blood pressure within the first five months if intervention by testing its effects on pressure-natriuresis. Nurses should consider Dietary Approaches to Stop Hypertension as one of the primary nonpharmacological approaches to stop high blood pressure.

From the study, it is critical to note that the DASH diet should be used as a primary nonpharmacological treatment of blood pressure. DASH diet is a significant intervention in lowering the levels of high blood pressure among urban African Americans.  It also helps nurses understand the mechanism of the DASH diet in lowering BP, which makes it possible for them to speculate on patients and those situations it can be beneficial.

Summary Three

Kim, H., & Andrade, F. C. (2016). The diagnostic status of hypertension on adherence to the

Dietary Approaches to Stop Hypertension (DASH) diet. Preventive medicine reports4, 525-531. https://doi.org/10.1016/j.pmedr.2016.09.009

Kim and Andrade (2016) address the status of hypertension after adhering to the DASH diet. DASH diet is primarily used for patients with hypertension. However, it is unknown if the diagnosis of hypertension can help patients adhere to the DASH diet and nutrient intake.  The authors use linear regression analysis to analyse the relationship between DASH diet and diagnosis of hypertension.  The study used a sample of patients with hypertension and a DASH score of between 0 and 10 to help measure the intake of nutrients.

Literature Search

The study results indicated that the increased consumption of protein, fat, and sodium was linked to the diagnostic status of hypertension. The patients who followed the DASH diet showed reduced effect of stroke and hypertension. However, patients who did not engage in health nutritional behaviour showed no effect after using the DASH diet. Therefore, most patients did not adhere to the DASH guidelines regardless of their health condition.

I have learned that although the DASH diet is critical in reducing hypertension among patients, most do not adhere to the guidelines which continue putting their health at risk.  Nurses need to create awareness on management of hypertension through the use of DASH diet by stressing the importance of diet in managing hypertension and the effect nutrition has when under medication.

Summary Four

Seangpraw, Auttama, Tonchoy, and Panta, (2019) analyses the effect of Dietary Approach to Stop Hypertension (DASH) diet on hypertension among elderly patients. The study employed quasi-experimental research by enrolling the elderly patients with hypertension as selected groups were then assigned to receive the DASH randomly. The sample size was 85, which was obtained after a full 90 days follow up intervention.

Literature Search

The study demonstrated considerable improvements in hypertension in intervention and control groups. The diastolic blood pressure and systolic blood pressure of the patients in the intervention group reduced. Nurses should consider the intervention as the primary prevention strategy for high blood pressure among seniors in various minority ethnic or racial groups in the United States. The findings of the study suggest that nursing education should highly consider training the nurses about DASH diet intervention to improve patient outcome.

I have learned that high blood pressure is reduced using DASH diet intervention among elderly patients. Nursing practice should emphasise increased use of DASH diet among the minority groups, especially elderly patients with hypertension, to reduce the risks of stroke and high blood pressure. It is the responsibility of the nurses to create awareness on the benefits of DASH diet in minimising the stroke cases, which can, in turn, reduce the treatment costs and reduce the mortality rates.

 

Summary Five

Kawamura, A., Kajiya, K., Kishi, H., Inagaki, J., Mitarai, M., Oda, H., … & Kobayashi, S.

(2016). Effects of the DASH-JUMP dietary intervention in Japanese participants with high-normal blood pressure and stage 1 hypertension: an open-label single-arm trial. Hypertension Research39(11), 777. https://www.nature.com/articles/hr201676

Kawamura et al. (2016) address the impact of the DASH-Japan Ube Modified diet Program (DASH-JUMP) dietary patients with stage 1 hypertension and high-normal blood pressure.  The DASH-JUMP diet emphasises the consumption of vegetables, fruits, whole grains, and low-fat dairy foods to reduce blood pressure and the risks of cardiovascular diseases. It is essential to include a variation in the composition of the macronutrients in the DASH diet while still enhancing the preservation of the benefits of lipid and blood pressure risk factors.

Literature Search

The study used fifty-eight participants who consumed a standard DASH-JUMP four weeks.  After the intervention, it was found that the DASH-JUMP significantly reduced the BMI, fasting serum glucose level and fasting insulin level. The extent of adherence to diet determines the effectiveness of the intervention of the DASH diet. This means that the DASH-JUMP diet was an effective nutritional strategy for reducing high blood pressure among patients.

Most people with the problem of following prescribed diets have difficulty if adhering to DASH-JUMP diet. It is the responsibility of the nurses to create awareness and advice patients to follow prescribed diets to increase the effectiveness of DASH-JUMP intervention. This would help effectively implement the use of the DASH-JUMP diet as a nonpharmacological treatment of blood pressure because it is effective in controlling the level s of high blood pressure within five years of intervention.

 

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.  Hypertension42(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 nutrition103(2), 341-347. https://www.ncbi.nlm.nih.gov/pubmed/26718414

Kawamura, A., Kajiya, K., Kishi, H., Inagaki, J., Mitarai, M., Oda, H., … & Kobayashi, S.

(2016). Effects of the DASH-JUMP dietary intervention in Japanese participants with high-normal blood pressure and stage 1 hypertension: an open-label single-arm trial. Hypertension Research39(11), 777. https://www.nature.com/articles/hr201676

Kim, H., & Andrade, F. C. (2016). The diagnostic status of hypertension on adherence to the

Dietary Approaches to Stop Hypertension (DASH) diet. Preventive medicine reports4, 525-531. https://doi.org/10.1016/j.pmedr.2016.09.009

Seangpraw, K., Auttama, N., Tonchoy, P., & Panta, P. (2019). The effect of the behaviour

modification program Dietary Approaches to Stop Hypertension (DASH) on reducing the risk of hypertension among elderly patients in the rural community of Phayao, Thailand. Journal of multidisciplinary healthcare12, 109. DOI: 10.2147/JMDH.S185569

 

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Reducing Readmission Rate

Reducing Readmission Rate

  • Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs.
  • Select a healthcare program within your practice and consider the design and implementation of this program.
  • Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation.

The Assignment: (2–3 pages)

In a 2- to 3-page paper, create an interview transcript of your responses to the following interview questions:

  • Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
  • Who is your target population?
  • What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
  • What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
  • What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
  • Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?

 

SAMPLE ANSWER

Healthcare Program: Reducing Readmission Rate

The healthcare institution needs changes in its medical practice and policy based on measures aimed to reduce the current rate of readmission to normal rates. Within the health care sector, organizations with increased readmission rates risk having fined on reimbursement, which Medicare receives as a result (Jiang and colleagues, 2016).  Improving the performance of the hospital would be important in reducing the rate of patient readmission. The targeted population involves the patients with cardiovascular diseases such as myocardial Infarction. The increased rate of readmission is because of the outcome of poor health among the patients.

Evidence-based strategies can help in addressing performance issues in healthcare institutions. To achieve the success of the program would focus on improving the communication skills within the health care facility. During patient care, communication between nurses and physicians, and nurses and the patients is imperative to help in the treatment process. Effective communication among the healthcare practitioners and the patient facilitates collaboration to health care delivery leading to the provision of holistic and quality care (Jiang and colleagues, 2016). In addition, collaborative communication often motivates nurses and physicians to provide quality care.   Nurses have to develop a good rapport with their patients by engaging them and collaborating to ensure quick recovery.

As an advocate of the program to with cardiovascular diseases, patient education on adherence and living a healthy lifestyle will be important before discharge. Patients need to understand the care plans after discharging them so that they can be able to take care of themselves in a more effective way. Having the knowledge to care for ourselves after being discharged improves patient’s outcome and improves quality of life (Peter and colleagues, 2015).   After discharging patients, it is important to follow up on patient adherence and self care. Self management and medication adherence is important in improving patient outcome and quality of life. Brooke et al., (2014) consider that patients need to work in a more collaborative way with their physicians and nurses to improve their health outcomes. This can only be achieved if they are educated on the importance of collaborating, adhering to their medications and self care.

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The role of a nurse in the implementation of the program will involve educating patients on the importance of collaboration with the pharmacists, physicians and nurses. The nurses through the leadership of the organization will train patients on the effective communication and the implicating it has in improving the patient’s outcome (Gopee & Galloway, 2017). The follow up services to ensure patients adhere to their medication will be done by nurses and physicians who will be assigned the patients to ensure they are recovering and commit to their medications. All health care practitioners who will be involved in follow up care will undergo training on cultural competence so they can be able to attend to culturally diverse patients.  Cultural competence is important as it help nurses to understand the patient’s background and cultural beliefs before commencing care (Brooke et al., 2014).

The major stakeholders will be caregivers, pharmacists, physicians, and nurses. The stakeholders will be involved to help with the process implementation including assigning financial resources and policy execution. Proper communication and engagement of stakeholders will help them to understand the proposed policy change (Gopee & Galloway, 2017). Thus, the recommended strategies will improve performance of health care institutions to help prevent increased rate of readmission among patients with cardiovascular diseases.

 

References

Brooke, B. S., Stone, D. H., Cronenwett, J. L., Nolan, B., DeMartino, R. R., MacKenzie, T.

A., … & Goodney, P. P. (2014). Early primary care provider follow-up and readmission after high-risk surgery. JAMA surgery149(8), 821-828. doi: 10.1001/jamasurg.2014.157.

Gopee, N., & Galloway, J. (2017). Leadership and management in healthcare. SAGE

Publications Ltd.

Jiang, H. J., Boutwell, A. E., Maxwell, J., Bourgoin, A., Regenstein, M., & Andres, E.

(2016). Understanding patient, provider, and system factors related to Medicaid readmissions. Joint Commission journal on quality and patient safety42(3), 115-121. https://www.ncbi.nlm.nih.gov/pubmed/26892700

Peter, D., Robinson, P., Jordan, M., Lawrence, S., Casey, K., & Salas-Lopez, D. (2015).

Reducing readmissions using teach-back: enhancing patient and family education. Journal of Nursing Administration45(1), 35-42. DOI:

10.1097/NNA.0000000000000155

 

 

 

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The conservative or liberal philosophies

The conservative or liberal philosophies

Please answer the following questions in regards to the essay topic enclosed.  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)

1- Explain your topic and why you believe (or do don’t believe) it is an important matter for the general public.

2-How do you plan to use Hass and Flower’s concept of purpose and context in your argument essay?

3-What was the most dominant appeal used by the debate members discussing your topic? Why do you believe that appeal was used most?

4- Which primary appeal do you think best suits your debate topic? Explain

 

SAMPLE ANSWER

Explain your topic and why you believe (or do don’t believe) it is an important matter for the general public.

The topic of discussion is “Liberals Hold the Moral High Ground.” It is a debate about the two opposing philosophies i.e. the conservative or liberal philosophies and the extent to which their ideas work towards achieving national identity in America. At the same time, each brings up points that are designed to indicate the best outcomes for the country and especially regarding the policy goals. The debate is an important one for the p8blic because of the interest in the side that offers higher moral ground this means that it seeks to establish which of the philosophies aims at bringing out the great good for a large number of people. Also, because of the divided political arena in the country, it is necessary to understand the side of the political divide that offers policies or ideas that reflect the culture of the country.  In doing so, the side will play a role in embracing the virtues of the country that are cherished by a large number of people.

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How do you plan to use Hass and Flower’s concept of purpose and context in your argument essay?

I intend to make use of the content strategies provided to get information from the debaters and use it for my essay. This means that I will have to first of all sum up the content. This will be followed by paraphrasing of the content so that I can ensure that I write it in my own words. I will also try my best to interpret the information that is provided. I will then make use of rhetorical strategies to go beyond simply understanding the text. This will involve analyzing the content so that I can attempt to account for the thoughts, as well as the purpose that the author had when providing the content. Also, I will put in the effort to understand the context that the author of the text is looking at as well as the intended impact of the content on the audience.

What was the most dominant appeal used by the debate members discussing your topic?

The appeal that was mostly used by the speakers is the pathos appeal. This is a type of appeal used in debates or public speaking that seeks to appeal to the emotions of the audience.  The people that sue the pathos appeal seek to offer a convincing argument to the audience and this is achieved by creating an emotional response to a plea or a story. In this case, the audience is being convinced about the moral standings of each part of the debate side. Each side seeks to bring out ideas or pleas so that they can be seen to be better than the opponents.

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Why do you believe that appeal was used most?

I believe that the appeal is used most because they all want to prove that they have a better moral standing as compared to the opponents. In doing so, they aim at bringing out their points to prove that they have been designed with the utmost good of the larger population in mind. The conservatives and the liberals seek to establish the meaning of morality by explaining what morality is to them. The liberals believe that morality is anchored on caring and looking after the disadvantaged people in society as well as ensuring justice, fairness, and generosity. Conservatives believe that morality is brought about by fairness, respect for leadership as well as an individual sense of responsibility and patriotism.

The conservative or liberal philosophies

Which primary appeal do you think best suits your debate topic?

The pathos appeal is the most suitable appeal for thus debate topic. This is because the debate topic requires one to take a side that they strongly believe speaks to the heart of the people. In doing so, there is a need to support the arguments by presenting the points in a way that the audience will acknowledge that the policies embody the most cherished virtues. In doing so, it will be important to not only capture their attention or provide facts as is seen in the logos appeal, it involves convincing them that the ideology of the supported side is the best for the country.

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