Analysis of a Pertinent Healthcare Issue
Interprofessional Organizational and Systems Leadership","The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.
Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.
In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.
To Prepare:
Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.
Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected.
Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.
The Assignment (3-4 Pages):
Analysis of a Pertinent Healthcare Issue
Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:
Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).
Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.
Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.
Looking Ahead
The paper you develop in Module 1 will be revisited and revised in Module 2. Review the Assignment instructions for Module 2 to prepare for your revised paper.
Where in the World Is Evidence-Based Practice?
March 21, 2010, was not EBP’s date of birth, but it may be the date the approach “grew up” and left home to take on the world.
When the Affordable Care Act was passed, it came with a requirement of empirical evidence. Research on EBP increased significantly. Application of EBP spread to allied health professions, education, healthcare technology, and more. Health organizations began to adopt and promote EBP.
In this Discussion, you will consider this adoption. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.
To Prepare:
Review the Resources and reflect on the definition and goal of EBP.
Choose a professional healthcare organization’s website (e.g., a reimbursing body, an accredited body, or a national initiative).
Explore the website to determine where and to what extent EBP is evident.
By Day 3 of Week 1
Post a description of the healthcare organization website you reviewed. Describe where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or goals of the healthcare organization, or in other locations on the website). Then, explain whether this healthcare organization’s work is grounded in EBP and why or why not. Finally, explain whether the information you discovered on the healthcare organization’s website has changed your perception of the healthcare organization. Be specific and provide examples.
By Day 6 of Week 1
Respond to at least two of your colleagues on two different days by visiting the websites they shared and offering additional examples of EBP or alternative views/interpretations to those shared in your colleagues’ posts.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
Will be adding two discussions that will need at least three references all in APA 7 format each.
The mail discussion will need at least 3 references and also in APA 7 format.
Micheals discussion
Evidence based practice presents with summation of ideas, experiences, coupled with literature centered around dedicated man power and hours of work both in the clinical and or research setting which could span for a number of years based on the mission and or vision of the facility working on a certain intervention to bring about global change in the dynamics of either how healthcare is delivered, managed and or improved. Following from a careful perusing of the medical university of South Carolina, the institution presents with a healthcare setting centered on the need to achieve excellence through innovative implementation of quality assurance, patient centered care based on improved clinical practices based on improvements and incorporation of new data on evidence based practices. According to Crabtree et al., (2016, p172) “The MUSC Center for Evidence-Based Practice (EBP), housed jointly in the Library and the Quality Management department of the MUSC Hospital, aims to promote scientific inquiry, EBP, and quality outcomes at MUSC. Through education, the development of evidence-based clinical decision support tools and outcomes research, the Center for EBP has begun to transform the culture of MUSC into one that incorporates best evidence into clinical practice on both an individual and system level”.
Following from the presentation as rendered by Crabtree et al., (2016, p172) “The EBP Nurse Scholars course provides nurses with a comprehensive overview of EBP, prepares them to frame clinical questions, perform literature searches, analyze and evaluate evidence, and translate that knowledge into something clinically meaningful… Pre- and post-course surveys demonstrated that the course improved nurses’ confidence with EBP methods and skills related to research tools, statistical concepts, and study designs. Data collected included responses from students from two EBP Nurse Scholars courses: Spring 2013 and Spring 2014”. The literature speaks to the mission, vision and philosophy of evidence based practice while also bearing in mind the goal of this organization in making their nurses frontiers in the quest and search for results that correlate with caring for patients with evidence based information at the top of their list.
Based on the careful scrutiny and analysis of the recommended resource list, I would be made to understand that the organizations priority and goals centered on the need to show case, while also embracing the innovations of evidence based practices, and its contribution to the healthcare sector. “A regional, collaborative EBP fellowship program, the EBP Institute, was founded in 2006 by nurse leaders from multiple hospitals and academia in San Diego County, California, to promote implementation of EBP by hospital nurses. The fellowship program utilized institution-matched mentors to assist in executing unit-based EBP projects, and included didactic as well as interactive learning experiences in six daylong educational sessions over a 9-month period.” (Kim et al., 2016, p340)
Following from some of the literature on the resource reading list and some of the organizations mode of operation in terms of their mission, philosophy and vision as set forth by their quest for in depth knowledge on evidence based practices and some of their acquired results individually and collectively, I would say I am convinced evidence based practice is worth the time, attention and resources utilized in sustaining researches, grooming future innovators, while also honing in on how to better incorporate evidence based practices into most if not all aspects of healthcare. An example of evidence based practice at work would be the change that was incorporated to the new ways of following through with CPR which formally was accessing a patients airway, breathing and circulation (ABC), but now following from innovative results backed by evidence based practice, the new order of CPR is circulation, airway and breathing (CAB). According to Melnyk (2018, p29) “It is time for practitioners from all healthcare professions to embrace EBP and quickly move from practices steeped in tradition or based on outdated policies to those supported by sound evidence form well designed studies.”
References
Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving Patient Care Through Nursing Engagement in Evidence-Based Practice. Worldviews on Evidence-Based Nursing, 13(2), 172–175. https://doi-org.ezp.waldenulibrary.org/10.1111/wvn.12126
Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A., & Davidson, J. E. (2016). Predictors of Evidence-Based Practice Implementation, Job Satisfaction, and Group Cohesion Among Regional Fellowship Program Participants. Worldviews on Evidence-Based Nursing, 13(5), 340–348. https://doi-org.ezp.waldenulibrary.org/10.1111/wvn.12171
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Deannas discussion
The healthcare organization website I reviewed is the American Psychiatric Nurse Association (APNA). This organization is the largest membership organization that focuses on different aspects of mental health. For example, they focus on wellness, prevention, and treatment for mental health disorders (APNA, n.d.). As I look for evidence-based practice (EBP) on this website, it is spread out through their vision, structure, collegiality, and continuing education. According to Melnyk and Fineout-Overholt (2018), “EBP enhances healthcare quality, improves patient outcomes, reduces costs, and empowers clinicians”.
The work is grounded in EBP. In the vision statement, they promote EBP advances. In their structure, APNA shares research via online, conference calls, and through chapter meetings. APNA believes this is a way to distribute standards quickly and can reach a wide audience. With collegiality, APNA disperses state of the art information through the website and other modalities that are available to their members only. Lastly, APNA uses continuing education that provides the most current information in mental health research and practices (APNA, n.d.).
The information I discovered change my perception of the organization. I did not know very much about the organization, but after looking into it, I have a better appreciation for what they offer psychiatric nurses and providers who work in this field. I like the idea of conferences that provide continuing education and current information. APNA provides in-person education and online education (APNA, n.d.). It is important to belong to some type of professional organization and one that is specific to your field because they help promote policy and practice. They also provide career growth, networking, and education (Nichols, 2020).
References
American Psychiatric Nurses Association. (n.d.). About the American psychiatric nurses association: An introduction. Retrieved December 1, 2020, from https://www.apna.org/i4a/pages/index.cfm?pageid=3277
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Nichols, J. (2020, September 2020). 10 benefits of joining professional nursing organizations and associations. Retrieved December 1, 2020, from https://nurseslabs.com/10-benefits-joining-professional-nursing-organizations-associations/
Hernandez Family Assessment
Address in a comprehensive client assessment of the Hernandez family the following:
Demographic information
Presenting problem
History or present illness
Past psychiatric history
Medical history
Substance use history
Developmental history
Family psychiatric history
Psychosocial history
History of abuse and/or trauma
Review of systems
Physical assessment
Mental status exam
Differential diagnosis
Case formulation
Treatment plan
Helpful link
http://mym.cdn.laureate-media.com/2dett4d/Walden/SOCW/MSWP/CH/mm/homepage/episodes.html
Legal and Ethical Considerations for Group and Family Therapy
Post an explanation of how legal and ethical considerations for group and family therapy differ from those for individual therapy. Then, explain how these differences might impact your therapeutic approaches for clients in group and family therapy. Support your rationale with evidence-based literature.
Helpful links
Breeskin, J. (2011). Procedures and guidelines for group therapy. The Group Psychologist, 21(1). Retrieved from http://www.apadivisions.org/division-49/publications/newsletter/group-psychologist/2011/04/group-procedures.aspx
Khawaja, I. S., Pollock, K., & Westermeyer, J. J. (2011). The diminishing role of psychiatry in group psychotherapy: A commentary and recommendations for change. Innovations in Clinical Neuroscience, 8(11), 20-23.
Koukourikos, K., & Pasmatzi, E. (2014). Group therapy in psychotic inpatients. Health Science Journal, 8(3), 400-408.
Lego, S. (1998). The application of Peplau's theory to group psychotherapy. Journal of Psychiatric and Mental Health Nursing, 5(3), 193-196. doi:10.1046/j.1365-2850.1998.00129.x
McClanahan, K. K. (2014). Can confidentiality be maintained in group therapy? Retrieved from http://nationalpsychologist.com/2014/07/can-confidentiality-be-maintained-in-group-therapy/102566.html
Quantitative Research Critique and Ethical Considerations
Write a critical appraisal that demonstrates comprehension of two quantitative research studies. Use the ""Research Critique Guidelines – Part II"" document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the study in your responses.
Use the practice problem and two quantitative, peer-reviewed research articles you identified in the Topic 1 assignment to complete this assignment.
In a 1,000–1,250 word essay, summarize two quantitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion
Illness and Disease Management
In a Microsoft Word document of 4-5 pages formatted in APA 7 style, describe the information collected about a person with a chronic illness (see attachment). Please note that the title and reference pages should not be included in the total page count of your paper.
Using the information from the interview you conducted in Week 2: (see attachment)
List the support needs of your participant beginning with the highest priority and then in descending order.
Provide examples of appropriate interventions of the professional caregiver, for example, the nurse.
Discuss how to implement objectives of Healthy People 2020 to increase wellness.
Discuss nursing’s role as an advocate for participant acceptance of diagnosis and treatment.
Discuss the impact of the environment on patient’s health.
Include social determinants that impact care.
Include a conclusion
Support your responses with examples and information from library resources, textbook and lectures.
On a separate references page, cite all sources using APA 7 format.
Mental health
1. As a nurse, how would you establish trust and rapport with an adolescent?
2. List 5 reasons why adolescents are high risk for suicide.
3. What evidence-based screening tools are available to screen for suicide in adolescents?
4. If you could develop a resource for adolescent suicide prevention, what would it be?
5. What are safety concerns you need to consider while caring for a patient with an anxiety/trauma related disorder?
6. What are the priorities when conducting your nursing assessment for a patient who has a mental illness and pregnant?
7. Which classification of medications are considered safe for pregnancy to treat an anxiety disorder?
Health Administration
The requirement that hospitals comply with regulations surrounding the release of patients’ health care records
You are an assistant administrator in a nonprofit hospital that receives Medicare and Medicaid funding. Your boss has asked you to make a presentation to other leadership about one of the above policies. She would like for you to provide an overview of the policy, the implications for your organization for non-compliance, as well as recommendations about what you should be doing to ensure compliance.
Create a 10- to 15-slide PowerPoint presentation that covers all of the expectations of your boss. Be sure to provide speaker’s notes that extrapolate on the information within your slides and cite your sources in your slides and speaker’s notes. You should also include a reference slide with at least 3 references
ACA and Health-Care Outcomes &
All human beings deserve health care coverage, whether they can afford it or not. In today’s U.S. healthcare system, to have good health care, it is not just about having health insurance coverage. It must be affordable and accessible. The Affordable Care Act (ACA), passed in 2010, represents the most extensive reform to the U.S. health care system since the introduction of Medicare and Medicaid in 1965 (Duggan, Goda & Jackson, 2019). The positive effect on improving health care outcomes is ACA’s main components, which is improving access to care by enabling more Americans to gain health insurance coverage and containment of healthcare costs (Mason, Dickson, McLemore, and Perez, 2016). By offering the expansion of Medicaid, changes in private (commercial) insurance coverage, the establishment of health exchanges, employer requirements for providing healthcare coverage, and the introduction of the individual mandate (LaFontaine, Vogenberg & Pizzi, 2019).
ACA includes dozens of provisions to expand health insurance coverage, slow the growth rate in health care costs, and reform the market for private health insurance. After implemented many of these provisions in January of 2014, un-insurance rates among nonelderly adults fell substantially, from 20.1 percent in the fourth quarter of 2013 to 15.1 percent by the fourth quarter of 2014 and 12.6 percent by the fourth quarter of 2015 (Duggan, Goda & Jackson, 2019). Also, ACA seeks to contain Medicare costs and pay for coverage expansion by phasing out extra payments to insurers who offered Medicare Advantage Plans, managed the care of private plans that the older population can choose instead of traditional Fee-for-Service (FFS) Medicare. Medicare pays a lower annual increase and pays less for medical equipment. Furthermore, by reducing outstanding payment, taxing employers who offer high-cost private insurance plans, encouraging the development of Accountable Care Organizations (ACOs) for Medicare recipients, especially those with costly chronic conditions. Penalizing hospital by reducing their reimbursement if they have excessive 30-day readmissions and hospital-acquired infections, implementing aggressive Medicare/Medicaid fraud and abuse prevention measures, establishing an Independent Payment Advisory Board (IPAB), implementing administrative simplification measures, and conducting comparative effectiveness research (Mason, Dickson, McLemore, and Perez, 2016).
To tackle insurance coverage issues, it is essential for healthcare professionals and pharmacy and therapeutics (P&T) or related committees in all practice settings to realize that today’s ACA differs from the original 2010 act. As plan requirements, government funding, and patient affordability change, so too must the plans offered by third-party healthcare payers or purchasers (employers, municipalities, and unions). ACA established new coverage guidelines on plan eligibility and scope that private insurers must follow. The most well-known policy deriving from the changes prevents insurers from denying coverage to individuals based on pre-existing medical conditions. Another part of the rule made it illegal for insurers to charge a greater fee based on a person’s health status or gender. Moreover, coverage expanded for young adults, who can claim dependent status on their parents’ health insurance up to the age of 26, with no restrictions regarding their living situation, financial independence, or health insurance options offered by their employer. Insurers are prohibited from imposing lifetime limits on coverage, and this coverage could not be rescinded. Furthermore, to encourage wellness checks, the act established mandatory minimum coverage standards known as “essential health benefits” and instituted zero dollar co-payments for many preventive health services (LaFontaine, Vogenberg & Pizzi, 2019).
ACA set out guidelines for employers with more than 50 full-time employees and instituted financial penalties for those who were unwilling to comply. A highly controversial aspect of ACA was the individual mandate. In 2010, the act laid the groundwork for supplementing insurance-risk pools with healthier patients by instituting an individual mandate for health insurance. Beginning in 2014 and extending through 2016, patients without insurance coverage were required to pay an annual tax penalty. Now: On December 20, 2017, the Tax Cuts and Jobs Act passed by Congress finalized the individual mandate’s permanent repeal, with the penalty phasing out in 2019. As conversations about the repeal were heating up in 2017, the Congressional Budget Office (CBO) estimated what repealing the mandate would cost: the report concluded that the number of people with health insurance would decrease by four million in 2019 and increase to 13 million by 2027. To provide patient-centered care in today’s healthcare environment, understanding the system within which patients and providers function is more critical than ever (LaFontaine, Vogenberg & Pizzi, 2019)
Discussion
: Response must be at least 350 words written in current APA format with at least two academic references cited. References must be within the last five years. Respond by extending, correcting/refuting, or adding additional nuance.
Angiotensin-converting enzymes (ACEIs) inhibitors are common antihypertensive agents which once administered act within the lungs to inhibit conversion of angiotensin I to form angiotensin II. Angiotensin II is a vasoconstrictor within the human body. To decrease blood pressure, production of angiotensin II which is also an aldosterone release stimulator has to be prevented. This also results in the subsequent increase in serum potassium with a decrease in serum sodium and fluid loss. ARBs work to raise the effects caused by renin-angiotensin-aldosterone system which blocks a patient’s blood pressure (Victor et al., 2018). Calcium-channel blockers inhibit calcium ion movement across cell membranes within the arterial muscle. This causes alteration of the cells leading to blockage of cell contractions. Due to the alteration on the cells, cardiac impulse is relatively slowed as arterial dilation and relaxation is achieved.
Diuretics such as thiazide diuretics are first drug treatment used for high blood pressure. These drug work by widening blood vessels and increasing amount of urine produced which helps get rid of sodium and water released as urine (Schellack & Naicker, 2020). This reduces the fluid going through one’s arteries and veins thus reducing blood pressure. Sympathetic nervous system drugs are used to increase low blood pressure and avert cardiac arrest through blocking breakdown as well as enhancing reuptake of neurotransmitters with stimulation for the release of produced catecholamines. Through this processes, activation of the sympathetic nervous system which modifies its functionality facilitate management of hypertension in patients.
Before patients are prescribed with antihypertensive drugs, healthcare practitioners should ensure patients understand the mechanism of action of the different classes of drugs as they alter the regulatory mechanism. This enhances their knowledge of the possible side effects brought about with their use. When carrying out teaching, patients need to be educated on the essence of adhering to prescribed medication. This is key in enabling them to effectively manage their blood pressure (Prihanti et al.,2020). The health hazards of taking higher doses due to failure to take prior medication should be enhanced. Taking higher doses could lead to very low blood pressure levels which increases the health risks and could result to complications or even death.
Instructions on drug use should be highly sensitized. Creation of effective communication channels and strategies should be sought to encourage patient-provider interactions. This facilitates easier management, monitoring and evaluation of patients even when they are receiving home-care. Through communication, patients can relay health improvement or deterioration and possible effects of drugs. This guides the healthcare provider to assess the patient condition and apply desirable effective interventions based on the progress. The need to communicate with the healthcare provider before administering new medication should also be addressed. Constant consultation helps avoid drugs that could lead to contraindication and adverse reactions owing to drug-drug interactions (Prihanti et al., 2020). There is also the need for patients to report adverse side effects or reaction experienced with antihypertensive drugs. This facilitates early interventions protecting patients from extended complications and promote better management of hypertension among the patients.
