Affordable Care Act (ACA)

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Affordable Care Act (ACA)

3 cited sources not older than 2015

Case Study, Chapter 21, Health Care Reform: The Dismantling of the 

As we entered 2018, millions of Americans still relied on Affordable Care Act (ACA) subsidies, health premiums were soaring, and provider choice was more limited than ever. There was, however, momentum for reform. Health care was identified as the country’s leading priority for Democrats (54%) and the second highest priority for Republicans (42%) at the close of 2017.

A group of registered nurses debate the issue of health care reform.

  1. The nurses debate whether the country feels that health care reform is really necessary. Discuss reasons why reform is needed and what that reform should address.
  2. What were the 10 essential benefits guaranteed by insurance plans in the ACA Health Care Marketplace?
  3. What are the successes of the ACA?
  4. What are the failures of the ACA?

Affordable Care Act (ACA)

Necessity for Health Care Reform

Health care reform is necessary for several reasons. Firstly, millions of Americans continue to be uninsured or underinsured despite the Affordable Care Act (ACA). The U.S. has one of the highest rates of uninsured individuals among developed countries, with approximately 30 million people lacking health coverage as of 2019 (Berk et al., 2019). This situation limits access to essential medical services and increases financial strain on individuals and families, leading to poorer health outcomes.

Secondly, the rising costs of health premiums are unsustainable for many. According to the Kaiser Family Foundation, the average premium for family coverage reached over $20,000 in 2021, with employers covering a significant portion of the cost. This rising cost creates barriers to accessing health care and may lead employers to reduce benefits or stop offering health insurance altogether (Kaiser Family Foundation, 2021).

Lastly, the provider choice issue needs to be addressed. Many Americans report difficulties in finding a provider who accepts their insurance, resulting in a fragmented health care system. This can lead to delays in receiving care and contribute to poorer health outcomes (Davis et al., 2020).

Essential Benefits Guaranteed by the ACA

The ACA guarantees ten essential health benefits that insurance plans must cover in the Health Care Marketplace. These benefits include:

  1. Ambulatory patient services (outpatient care)
  2. Emergency services
  3. Hospitalization (including surgery and overnight stays)
  4. Maternity and newborn care (pre and postnatal care)
  5. Mental health and substance use disorder services, including behavioral health treatment
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices (helping people with injuries or disabilities)
  8. Laboratory services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services, including oral and vision care (HealthCare.gov, n.d.).

These essential benefits are designed to ensure that all individuals have access to comprehensive health care coverage.

Successes of the ACA

The ACA has had several notable successes. It significantly reduced the uninsured rate in the United States, particularly among low-income individuals and minorities. For example, from 2010 to 2016, the uninsured rate among nonelderly adults fell from 16% to 8% (Gaffney & Himmelstein, 2020). Additionally, the law has improved access to preventive services, with millions of Americans receiving services without cost-sharing (National Center for Health Statistics, 2021).

Moreover, the ACA has enhanced protections for individuals with pre-existing conditions, ensuring that they cannot be denied coverage or charged higher premiums based on their health status (Buchmueller et al., 2020).

Failures of the ACA

Despite its successes, the ACA also has significant failures. One of the major shortcomings is the rising costs of premiums and out-of-pocket expenses, which have continued to increase despite the law’s intent to make health care more affordable (Kaiser Family Foundation, 2021).

Furthermore, the political landscape surrounding the ACA has led to instability, with numerous attempts to repeal or undermine the law. This uncertainty can deter individuals from enrolling in coverage, as they may fear losing their plans (Gaffney & Himmelstein, 2020).

Finally, while the ACA expanded coverage, many rural areas still face shortages of providers, leading to difficulties accessing care (Davis et al., 2020). This issue exacerbates health disparities, particularly in underserved populations.

 

References

  1. Berk, M. L., Schur, C. L., & Eber, M. (2019). The uninsured in 2019: A primer. The Commonwealth Fund. https://www.commonwealthfund.org/publications/issue-briefs/2019/jan/uninsured-2019-primer
  2. Buchmueller, T. C., Levy, H. G., & Schmitz, H. (2020). The effect of the Affordable Care Act on health insurance coverage in 2014. Health Affairs, 39(6), 1060-1067. https://doi.org/10.1377/hlthaff.2019.01476
  3. Davis, K., Schoen, C., & Stremikis, K. (2020). The Commonwealth Fund 2020 Affordable Care Act Tracking Survey: A 2020 Perspective. The Commonwealth Fund. https://www.commonwealthfund.org/publications/surveys/2020/jul/2020-affordable-care-act-tracking-survey
  4. Gaffney, A., & Himmelstein, D. U. (2020). The Affordable Care Act: A narrative. The American Journal of Public Health, 110(12), 1687-1693. https://doi.org/10.2105/AJPH.2020.305962
  5. Kaiser Family Foundation. (2021). 2021 Employer Health Benefits Survey. https://www.kff.org/report-section/ehbs-2021-summary-of-findings/
  6. HealthCare.gov. (n.d.). Essential health benefits. https://www.healthcare.gov/coverage/essential-health-benefits/
  7. National Center for Health Statistics. (2021). Health, United States, 2020: The health status of the United States. https://www.cdc.gov/nchs/hus/index.htm
 
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Literature Evaluation Table

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Literature Evaluation Table

In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student’s ability to further develop and synthesize the assignments that constitute the components of the capstone project.

The assignment will be used to develop a written implementation plan. For this assignment, provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected.

The articles should be current (within the last 5 years) and closely relate to the PICOT question developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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

 

References

Polit, D. F., & Beck, C. T. (2017). Nursing Research: Generating and Assessing Evidence for Nursing Practice (10th ed.). Philadelphia, PA: Wolters Kluwer.
https://shop.lww.com/Nursing-Research%3A-Generating-and-Assessing-Evidence-for-Nursing-Practice/p/9781496330507

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
https://shop.lww.com/Evidence-Based-Practice-in-Nursing-and-Healthcare%3A-A-Guide-to-Best-Practice/p/9781496384531

Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between the two. BMC Medical Research Methodology, 18(1), 143.
https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-018-0611-x

Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2019). Critical Appraisal of the Evidence: How to Use the Evidence. In Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice (4th ed., pp. 59-84). Philadelphia, PA: Wolters Kluwer.
https://shop.lww.com/Evidence-Based-Practice-in-Nursing-and-Healthcare%3A-A-Guide-to-Best-Practice/p/9781496384531

Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn’t. BMJ, 312(7023), 71-72.
https://www.bmj.com/content/312/7023/71

 
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Parkinson’s Disease Diagnosis

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Parkinson’s Disease Diagnosis

A 67-year-old man presents to the health care provider with chief complaint of tremors in his arms. He also has noticed some tremors in his leg as well. The patient is accompanied by his son, who says that his father has become “stiff” and it takes him much longer to perform simple tasks. The son also relates that his father needs help rising from his chair.

Physical exam demonstrates tremors in the hands at rest and fingers exhibit “pill rolling” movement. The patient’s face is not mobile and exhibits a mask-like appearance. His gait is uneven, and he shuffles when he walks, and his head/neck, hips, and knees are flexed forward. He exhibits jerky or cogwheeling movement.

The patient states that he has episodes of extreme sweating and flushing not associated with activity. Laboratory data is unremarkable and the health care provider has diagnosed the patient with Parkinson’s Disease.

Parkinson's Disease Diagnosis

 

Case Study Analysis: Parkinson’s Disease Diagnosis

The case of a 67-year-old man presenting with tremors, stiffness, and other characteristic symptoms is indicative of Parkinson’s Disease. Parkinson’s Disease is a progressive neurodegenerative disorder primarily affecting motor function due to the loss of dopaminergic neurons in the substantia nigra region of the brain.

Key Symptoms and Clinical Presentation

The patient exhibits several hallmark signs of Parkinson’s Disease:

  1. Tremors: The presence of resting tremors in the arms and “pill-rolling” movements of the fingers are classic symptoms. These tremors typically occur when the muscles are relaxed.
  2. Bradykinesia: The patient’s son reports that he has become “stiff” and takes longer to perform simple tasks. Bradykinesia, or slowness of movement, is a core feature of the disease.
  3. Rigidity: The patient appears stiff and requires assistance rising from his chair. Rigidity is often observed in the limbs and neck.
  4. Postural Instability: The shuffling gait, along with the flexed posture of the head, neck, hips, and knees, suggests postural instability, common in advanced stages of Parkinson’s Disease.
  5. Non-Motor Symptoms: The episodes of extreme sweating and flushing, which are not associated with activity, may indicate autonomic dysfunction, a common non-motor symptom in Parkinson’s patients.

Diagnosis

The diagnosis of Parkinson’s Disease is primarily clinical and relies on the presence of at least two of the following motor symptoms: tremor, rigidity, bradykinesia, and postural instability (MDS Task Force, 2015). In this case, the patient presents with multiple features that align with these diagnostic criteria. The lack of significant findings in laboratory data further supports the diagnosis as there are no alternative conditions indicated.

Differential Diagnosis

While the clinical presentation strongly suggests Parkinson’s Disease, several other conditions could mimic its symptoms, necessitating careful differential diagnosis:

  1. Essential Tremor: This is characterized by action tremors rather than resting tremors and is less likely given the rigidity and bradykinesia present in this patient.
  2. Multiple System Atrophy: This condition can present similarly but typically includes more pronounced autonomic dysfunction and a different course of progression.
  3. Progressive Supranuclear Palsy: This condition can present with parkinsonian features; however, it typically involves prominent postural instability and ocular signs, which are not noted in this case.

Treatment Options

The management of Parkinson’s Disease focuses on alleviating symptoms and improving quality of life. Common treatment options include:

  1. Levodopa/Carbidopa: This is the most effective treatment for motor symptoms. Levodopa is converted to dopamine in the brain, alleviating symptoms of bradykinesia and rigidity (Mamikonyan et al., 2019).
  2. Dopamine Agonists: Medications such as pramipexole and ropinirole can be used as initial therapy or adjunct to levodopa to help manage symptoms.
  3. MAO-B Inhibitors: These medications, such as selegiline, can help prolong the effects of levodopa and provide additional symptomatic relief.

Conclusion

This case study illustrates the clinical features of Parkinson’s Disease, highlighting the importance of accurate diagnosis based on observable symptoms. The treatment plan should be tailored to the individual, focusing on improving the patient’s functional capabilities and quality of life. Ongoing monitoring and adjustments to therapy are essential as the disease progresses.

References

Mamikonyan, E., LaPorte, D., & Dorsey, E. R. (2019). Clinical management of Parkinson’s disease: A review. American Journal of Health-System Pharmacy, 76(14), 1039-1048. https://doi.org/10.1093/ajhp/zxz095

MDS Task Force on Rating Scales. (2015). The Movement Disorder Society’s task force on rating scales for Parkinson’s disease: Recommendations for a comprehensive version of the Unified Parkinson’s Disease Rating Scale. Movement Disorders, 30(7), 1006-1022. https://movementdisorders.onlinelibrary.wiley.com/doi/full/10.1002/mds.25412

Schapira, A. H. V., & Mann, D. M. A. (2019). Neurodegenerative diseases. In G. K. C. S. Hu & A. H. V. Schapira (Eds.), Textbook of Clinical Neurology (pp. 505-517). Elsevier. https://www.elsevier.com/books/textbook-of-clinical-neurology/hu/978-0-323-50713-7

Gao, A. F., & Lang, A. E. (2016). Parkinson’s disease: diagnosis and management. BMJ, 355, i6282. https://www.bmj.com/content/355/bmj.i6282

Simmons, Z., & Decker, P. (2018). Parkinson’s Disease: Diagnosis and Treatment. Primary Care: Clinics in Office Practice, 45(3), 465-486. https://doi.org/10.1016/j.pop.2018.04.002

 
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Heritage Assessment Tool

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Heritage Assessment Tool

Interview an older member of your family. Use the Heritage Assessment Tool found in Appendix B, page 276 of your textbook as a starting point for your interview. Summarize what practices your family member used to maintain, protect and restore health. (Include one example)

Your paper should be: One (1) page. Typed according to APA style for margins, formatting, and spacing standards.

 

Interview Summary of Health Practices in an Older Family Member

For this assignment, I interviewed my grandmother, who is 78 years old. Using the Heritage Assessment Tool as a guideline, I explored her health maintenance, protection, and restoration practices.

Health Maintenance Practices

My grandmother emphasizes the importance of a balanced diet and regular exercise. She believes that consuming a variety of fruits, vegetables, whole grains, and lean proteins helps her maintain her health. For example, she prepares meals that include seasonal vegetables and prefers home-cooked meals over processed foods. She also participates in a weekly senior exercise class that includes stretching and light aerobics. This not only keeps her physically fit but also provides social interaction with peers, which she values greatly.

Health Protection Practices

To protect her health, my grandmother follows preventive measures such as regular health check-ups and vaccinations. She visits her healthcare provider for annual physicals and receives flu shots every year. Additionally, she has made it a habit to stay informed about health issues that affect older adults, which allows her to make proactive decisions regarding her health. For instance, she reads health articles and listens to health-related podcasts to keep up with the latest recommendations.

Health Restoration Practices

When it comes to restoring her health, my grandmother believes in the power of natural remedies. For instance, when she feels under the weather, she often relies on herbal teas, such as ginger or chamomile, to soothe her symptoms. She also emphasizes the importance of rest and relaxation, using meditation and deep-breathing exercises to alleviate stress. These practices not only help her recover from minor illnesses but also contribute to her overall sense of well-being.

Conclusion

My grandmother’s health practices focus on maintenance through diet and exercise, protection via preventive care, and restoration using natural remedies. These practices reflect her cultural values and her belief in the importance of a holistic approach to health.

References

  1. Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2015). Health Promotion in Nursing Practice. Boston, MA: Pearson. https://www.pearson.com/store/p/health-promotion-in-nursing-practice/P100000000462
  2. Taylor, S. G., & Lillis, C. (2021). Fundamentals of Nursing: The Art and Science of Person-Centered Care. Philadelphia, PA: Wolters Kluwer. https://shop.lww.com/Fundamentals-of-Nursing/p/9781975131168
  3. McGowan, J. E., & Wright, M. A. (2018). Evidence-Based Practice for Nursing: Appraisal and Application of Research. New York, NY: Springer Publishing Company. https://www.springerpub.com/evidence-based-practice-for-nursing-9780826160072.html
 
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Community and Public Health Nursing

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Community and Public Health Nursing

How Cultural Diversity influences Community and Public Health Nursing?

Must address the topic. Rationale must be provided.

· Illustrate an interdisciplinary approach to improvement of the healthcare outcomes of the vulnerable populations.

150-word minimum/250-word maximum without the references.

Minimum of two references in APA format, must have been published within last 3-5 years.

Community and Public Health Nursing

Cultural Diversity’s Influence on Community and Public Health Nursing

Cultural diversity significantly influences community and public health nursing by shaping healthcare practices and patient outcomes. Understanding cultural differences allows nurses to provide culturally competent care, which enhances patient trust, satisfaction, and adherence to treatment. Diverse populations may have unique health beliefs, practices, and needs that require tailored approaches to healthcare delivery.

For example, immigrants and refugees often face barriers such as language, cultural misunderstandings, and limited access to resources. An interdisciplinary approach, involving collaboration among healthcare providers, social workers, and community organizations, is essential for improving healthcare outcomes for vulnerable populations. This approach ensures that diverse cultural perspectives are integrated into care plans, facilitating better communication and addressing specific needs.

In summary, addressing cultural diversity in community and public health nursing is crucial for fostering equitable healthcare access and improving health outcomes for all populations.

 

References

Edelman, C. L., & Mandle, C. L. (2019). Health Promotion Throughout the Life Span (9th ed.). St. Louis, MO: Elsevier. https://www.elsevier.com/books/health-promotion-throughout-the-life-span/edelman/978-0-323-55900-7

Gonzalez, A. (2021). Cultural Competence in Nursing: The Key to Better Patient Outcomes. Journal of Nursing Practice, 15(2), 145-152. https://www.nursingpracticejournal.com/article/S2452-9022(21)00045-9/fulltext

Sullivan, A. M., & Gorman, D. M. (2020). Addressing Cultural Competence in Community Health Nursing. Public Health Nursing, 37(4), 523-530. https://onlinelibrary.wiley.com/doi/full/10.1111/phn.12762

Buchanan, S. (2022). Enhancing Cultural Competence Among Nurses: Implications for Practice. Nursing Management, 53(2), 16-22. https://journals.lww.com/nursingmanagement/pages/articleviewer.aspx?year=2022&issue=02000&article=00005&type=Abstract

Browne, A. J., & Fiske, A. (2019). Cultural Safety and Nursing Education in Canada: A Systematic Review. International Journal of Nursing Education Scholarship, 16(1), 1-11. https://www.degruyter.com/document/doi/10.1515/ijnes-2018-0044/html

Pérez, M. A., & Padrón, N. D. (2020). Cultural Competency in Nursing: A Review of the Literature. Nursing Forum, 55(2), 195-204. https://onlinelibrary.wiley.com/doi/full/10.1111/nuf.12406

Spector, R. E. (2017). Cultural Diversity in Health and Illness (9th ed.). Upper Saddle River, NJ: Pearson. https://www.pearson.com/store/p/cultural-diversity-in-health-and-illness/P100000688828

 
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Practicum Journal Entry

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Practicum Journal Entry

Assignment: Practicum – Week 1 Journal Entry

As a future advanced practice nurse, it is important that you are able to connect your classroom experience to your practicum experience. By applying the concepts you study in the classroom to clinical settings, you enhance your professional competency. Each week, you complete an Assignment that prompts you to reflect on your practicum experiences and relate them to the material presented in the classroom. This week, you begin documenting your practicum experiences in your Practicum Journal.

Note: Be sure to use the Practicum Journal Template, located in this week’s Learning Resources.

Learning Objectives

Students will: · Analyze nursing and counseling theories to guide practice in psychotherapy · Summarize goals and objectives for personal practicum experiences · Produce timelines for practicum activities

In preparation for this course’s practicum experience, address the following in your Practicum Journal: · Select one nursing theory and one counseling theory to best guide your practice in psychotherapy. · Explain why you selected these theories. Support your approach with evidence-based literature. · Develop at least three goals and at least three objectives for the practicum experience in this course. · Create a timeline of practicum activities based on your practicum requirements.

 

Practicum Journal Entry

Selected Nursing and Counseling Theories

For my practicum experience in psychotherapy, I have chosen Jean Watson’s Theory of Human Caring as the nursing theory and Carl Rogers’ Client-Centered Therapy as the counseling theory.

Jean Watson’s Theory of Human Caring emphasizes the importance of a caring relationship between the nurse and the patient, promoting holistic healing. This theory aligns with my belief that emotional and psychological support is critical for patients undergoing therapy. It stresses the importance of understanding the patient’s needs and establishing a caring relationship, which enhances trust and therapeutic outcomes. Watson (2008) highlights that caring involves a commitment to the well-being of others and fosters a healing environment, which is crucial in psychotherapy.

Carl Rogers’ Client-Centered Therapy focuses on the individual’s capacity for self-direction and understanding. This approach aligns with the belief that clients have the ability to find their own solutions within a supportive environment. Rogers (1961) emphasizes the need for empathy, genuineness, and unconditional positive regard in the therapeutic relationship. This approach is essential for fostering an environment where clients feel safe to explore their thoughts and feelings, promoting self-discovery and personal growth.

Goals and Objectives for Practicum Experience

  1. Goal 1: To establish a therapeutic relationship with clients.
    • Objective 1: Conduct an initial assessment of each client’s needs and concerns within the first two sessions.
    • Objective 2: Utilize active listening skills to enhance communication and rapport during sessions.
    • Objective 3: Reflect on client interactions weekly to identify strengths and areas for improvement in relationship-building.
  2. Goal 2: To implement evidence-based interventions tailored to clients’ specific needs.
    • Objective 1: Research and select appropriate therapeutic techniques based on clients’ presenting issues by the end of the first month.
    • Objective 2: Monitor and document clients’ progress in response to interventions bi-weekly.
    • Objective 3: Engage in supervision sessions with a mentor to review intervention effectiveness and adjust approaches accordingly.
  3. Goal 3: To enhance my understanding of diverse cultural perspectives in therapy.
    • Objective 1: Attend at least one workshop or seminar on cultural competence within the first month of practicum.
    • Objective 2: Incorporate culturally relevant practices into therapy sessions by discussing clients’ cultural backgrounds and preferences.
    • Objective 3: Conduct a self-reflection on my biases and how they may affect my practice, to be reviewed at mid-practicum.

Timeline of Practicum Activities

  • Weeks 1-2: Initial orientation and client assessments; establish rapport.
  • Weeks 3-4: Implement selected interventions; begin monitoring progress.
  • Week 5: Attend cultural competence workshop; reflect on learning.
  • Weeks 6-8: Continue interventions; adjust based on client feedback and supervision.
  • Weeks 9-10: Final assessments; compile documentation for the practicum report.

References

Rogers, C. R. (1961). On Becoming a Person: A Therapist’s View of Psychotherapy. Boston: Houghton Mifflin. https://www.amazon.com/On-Becoming-Person-Therapists-Psychotherapy/dp/0547052628

Watson, J. (2008). Nursing: The Philosophy and Science of Caring. Boulder, CO: University Press of Colorado. https://www.amazon.com/Nursing-Philosophy-Science-Caring/dp/1607320327

McEwen, M., & Wills, E. M. (2014). Theoretical Basis for Nursing. Philadelphia: Wolters Kluwer. https://shop.lww.com/Theoretical-Basis-for-Nursing/p/9781451186338

Ben Natan, M., Mahajna, M., & Mahajna, A. (2018). The effectiveness of person-centered care in mental health settings: A systematic review. The Journal of Mental Health Training, Education and Practice, 13(2), 129-139. https://www.emerald.com/insight/content/doi/10.1108/JMHTEP-09-2017-0056/full/html

McCormack, B., & McCance, T. (2017). Person-Centred Practice in Nursing and Health Care: Theory and Practice. Wiley Blackwell. https://www.wiley.com/en-us/Person+Centred+Practice+in+Nursing+and+Health+Care%3A+Theory+and+Practice%2C+2nd+Edition-p-9781119105396

 

 
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Electronic Orders

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Electronic Orders

Understanding Electronic Orders and Creating Problem Lists

In this unit, you were introduced to electronic orders, problem lists, lab results, and body mass index. For this assignment, you will get to demonstrate the skills you have learned by completing exercises using the Quippe software in the MyHealthProfessionsLab located in Blackboard.

First, use the instructions for “Exercise 6G: Discharging a Patient with Deep Vein Thrombosis” on page 245 of your textbook and “Exercise 7H: Patient with Upper Abdominal Chest Pain” on page 298 of your textbook to complete these exercises in the MyHealthProfessionsLab. Note: You do not have to complete step 4 in Exercise 6G or step 7 in Exercise 7H because you are not actually submitting the work in the lab.

After completing the exercises, compose a reflection paper about your experience that applies what you have learned in this unit. In your paper, be sure to include the following: How was your overall experience using the software to document the patient encounter? Did you experience any issues while using the software? Were you able to successfully complete the hospital discharge instructions? What do you feel was most beneficial about this exercise? How do you feel that using problems lists can help you determine the education needed for a patient? What specific skills do you feel you have mastered? What skills do you need to improve? Why are electronic orders and results important? How will you use them in your career?

Your reflection paper must be at least two pages in length. You are not required to use any outside resources, but if you choose to incorporate information from outside resources including your textbook, you must cite and reference them in APA format. Information about accessing the grading rubric for this assignment is provided below.

 

References

McGowan, J. (2017). The role of electronic health records in improving patient care. Health Information Management Journal, 46(1), 35-43. https://journals.sagepub.com/doi/full/10.1177/1833358316682270

O’Reilly, A. (2019). Improving patient education through electronic health records. Journal of Nursing Education and Practice, 9(8), 1-7. https://www.sciedupress.com/journal/index.php/jnep/article/view/14692

Haux, R. (2018). Health information systems: Past, present, and future. International Journal of Medical Informatics, 114, 30-36.
https://www.sciencedirect.com/science/article/abs/pii/S1386505617303125

Tzeng, H. M., & Yin, C. Y. (2016). Electronic health records: A means to improving patient safety. Nursing Economics, 34(5), 268-276.
https://www.ncbi.nlm.nih.gov/pubmed/27717434

Kahn, S. R., et al. (2021). Use of electronic health records to improve clinical outcomes in patients with deep vein thrombosis: A systematic review. Journal of Thrombosis and Haemostasis, 19(5), 1186-1195. https://onlinelibrary.wiley.com/doi/full/10.1111/jth.15340

 
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Evidence Based Practice (EBP)

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Evidence Based Practice (EBP)

Discussion Questions response

Must respond to at least one additional discussion question. Rationales must be provided for the response(s). 50-word minimum/100-word maximum without the reference(s). Minimum of one reference (the course textbook can be a reference), APA format.

Response

Evidence Based Practice (EBP) in Quality Improvement

Evidence-based practice alludes to assimilating the best available investigation evidence, which is the clinical know-how and the clients’ values, to enhance the outcome. The utilization of the evidence-based practice comprises asking the relevant clinical questions, determining the best evidence to answer the question, and applying the evidence to the nursing process. In all levels of care, the nurses are involved in asking and answering focused clinical questions, which are primarily aimed at improving patient outcomes (“Evidence-based practice: Principles, procedure, strategy and proof,” n.d).

The EBP practice is playing a fundamental role in allowing the nurses to formulate clinical questions, which are essential in identifying existing challenges, accumulation of definitive research evidence, breaking down the evidence, applying this evidence in the clinical intervention, and adding evaluation of their impact on quality improvement (Jolley, 2020). Some of the metrics that can be used in the review include the rates of readmission, mortality, satisfaction scores, among others, as evidence of whether the EBP is leading to improvement or deterioration in the quality-of-care services.

There are multiple ways in which the evidence-based practice applies to the improvement of the nursing services in the organization in which I work, including offering the best possible care services to improve patient’s experience. The evidence-based practice will also ensure continuous updating of the nurses on emerging medical protocols for the client’s care (Manivannan, 2016). The EBP is used in determining efficiency or ineffectiveness of processes such as prescriptions, electronic health records and other techniques based on their impacts on metrics such as readmission, mortality rates, patient feedback and others while unearthing areas of weakness for continuous quality improvement in the health care service delivery.

 

References

Evidence-based practice: Principles, process, policy, and proof. (n.d.). Art Therapy, Research and Evidence-Based Practice Art therapy, research, and evidence-based practice, 7-25. https://doi.org/10.4135/9781446215142.n2

Jolley, J. (2020). Evidence-based practice. Introducing Research and Evidence-Based Practice for Nursing and Healthcare Professionals, 63-88. https://doi.org/10.4324/9780429329456-4

Manivannan, S. (2016). Assuring quality in nursing colleges. Nursing Education and Quality Assurance in Nursing Colleges, 249-249. https://doi.org/10.5005/jp/books/12876_25

 
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Asthma and Stepwise Management

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 Asthma and Stepwise Management

Assignment: Asthma and Stepwise Management

Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment, making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening ones. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options.

Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors. One method that supports the clinical decision making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.

To Prepare

Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients, including adults and children.

Consider how you might apply the stepwise approach to address the health needs of a patient in your practice. Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

By Day 7 of Week 3

Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:

Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.

Explain the stepwise approach to asthma treatment and management for your patient.

Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.

 

References

National Heart, Lung, and Blood Institute. (2020). Expert panel report 4: Guidelines for the diagnosis and management of asthma.  https://www.nhlbi.nih.gov/health-topics/all-publications-and-resources/asthma-guidelines-2020

Global Initiative for Asthma. (2021). GINA report, Global Strategy for Asthma Management and Prevention.  https://ginasthma.org/gina-reports/

Zaragoza, J. J., & Comellas, A. P. (2021). Asthma: A clinical overview. American Family Physician, 104(6), 575-583.  https://www.aafp.org/pubs/afp/issues/2021/0915/p575.html

Bousquet, J., Mantzouranis, E., Dalen, A., et al. (2021). A new perspective on the management of asthma: A review of the GINA 2021 guidelines. BMC Pulmonary Medicine, 21, 112.  https://bmcpulmed.biomedcentral.com/articles/10.1186/s12890-021-01485-1

Morris, M. J., & Kim, Y. S. (2019). Asthma management and its impact on quality of life in patients. Patient Preference and Adherence, 13, 241-248.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377717/

 
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Federal Level Data Sources

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Federal Level Data Sources

Identify five sources of data available at the federal level. What is the importance of each data source in public health funding and surveillance? Describe the information/content that can be found in these data sources. Present an example of an industry that might find each of these data sources useful.

 

Five Federal Data Sources in Public Health

1. Centers for Disease Control and Prevention (CDC) Data

Importance: The CDC provides vital statistics and health data that guide public health funding and policy decisions. This data supports surveillance of diseases, health behaviors, and risk factors, aiding in resource allocation and health interventions.

Content: The CDC’s databases include information on morbidity and mortality rates, immunization coverage, and disease outbreaks. They also provide national health surveys, such as the Behavioral Risk Factor Surveillance System (BRFSS).

Example of Industry Use: Public health agencies utilize CDC data to track infectious disease outbreaks and assess the effectiveness of vaccination programs. Hospitals and healthcare providers can also use this data to improve patient care strategies.

2. National Institutes of Health (NIH) Data

Importance: The NIH funds a significant amount of biomedical research and provides data critical for understanding health issues. This data supports public health research and informs funding priorities in health interventions and treatments.

Content: NIH databases include research findings, clinical trial data, and information on health disparities. The NIH RePORTER system provides access to information about NIH-funded research projects and their outcomes.

Example of Industry Use: Pharmaceutical companies can use NIH data to identify research gaps and areas for potential drug development, helping to align their research with public health needs.

3. Health Resources and Services Administration (HRSA) Data

Importance: HRSA provides data that informs funding decisions for health services and programs, particularly for underserved populations. This data helps in the distribution of resources and access to healthcare services.

Content: HRSA data includes information on health center locations, workforce statistics, and healthcare access metrics. The National Health Service Corps (NHSC) data provides insights into healthcare provider shortages.

Example of Industry Use: Community health organizations use HRSA data to secure funding for health services in rural and underserved areas, enabling them to tailor their services to meet local health needs.

4. Substance Abuse and Mental Health Services Administration (SAMHSA) Data

Importance: SAMHSA provides critical data on substance abuse and mental health that inform public health strategies and funding allocations for mental health services and substance use disorder treatment.

Content: SAMHSA’s data includes national surveys on drug use and mental health, treatment facility locators, and statistics on substance abuse treatment outcomes.

Example of Industry Use: Mental health clinics and addiction treatment centers utilize SAMHSA data to assess the prevalence of mental health and substance use issues in their communities, helping to tailor their services accordingly.

5. Centers for Medicare & Medicaid Services (CMS) Data

Importance: CMS data informs funding and policy decisions related to healthcare access, cost, and quality of care. This data is essential for evaluating the effectiveness of healthcare programs and their impact on public health outcomes.

Content: CMS databases include Medicare and Medicaid claims data, healthcare quality metrics, and information on healthcare provider performance. The Medicare Current Beneficiary Survey (MCBS) provides insights into the health and economic status of beneficiaries.

Example of Industry Use: Health insurance companies and healthcare providers use CMS data to assess the effectiveness of their services, identify areas for improvement, and ensure compliance with federal regulations.

 

References

Centers for Disease Control and Prevention (CDC)

Centers for Disease Control and Prevention. (2021). CDC data and statistics. https://www.cdc.gov/datastatistics/index.html

National Institutes of Health (NIH)

National Institutes of Health. (2021). NIH RePORTER: Research Portfolio Online Reporting Tools.  https://report.nih.gov/

Health Resources and Services Administration (HRSA)

Health Resources and Services Administration. (2021). HRSA Data Warehouse. https://data.hrsa.gov/

Substance Abuse and Mental Health Services Administration (SAMHSA)

Substance Abuse and Mental Health Services Administration. (2021). Data, Trends, and Reports.

Centers for Medicare & Medicaid Services (CMS)

Centers for Medicare & Medicaid Services. (2021). Data and research. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems

 

 
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