Prescribing For Older Adults And Pregnant Women

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After assessing and diagnosing a patient, PMHNPs must take into consideration special characteristics of the patient before determining an appropriate course of treatment. For pharmacological treatments that are not FDA-approved for a particular use or population, off-label use may be considered when the potential benefits could outweigh the risks.

In this Discussion, you will investigate a specific disorder and determine potential appropriate treatments for when it occurs in an older adult or pregnant woman.

To Prepare:
  • Choose one of the two following specific populations: either pregnant women or older adults. Then, select a specific disorder from the DSM-5 to use.
  • Use the Walden Library to research evidence-based treatments for your selected disorder in your selected population (either older adults or pregnant women). You will need to recommend one FDA-approved drug, one non-FDA-approved “off-label” drug, and one nonpharmacological intervention for treating the disorder in that population.
By Day 3 of Week 9
  • Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your chosen disorder in older adults or pregnant women.
  • Explain the risk assessment you would use to inform your treatment decision  making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
  • Explain whether clinical practice guidelines exist for this disorder, and if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
  • Support your reasoning with at least three current, credible scholarly resources, one each on the FDA-approved drug, the off-label, and a nonpharmacological intervention for the disorder.

Substance Abuse In Florida

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One of the issues affecting my patient population is the integration of substance abuse management and mental healthcare. Successful integration between substance abuse and mental care has proved to achieve better outcomes. Integration addresses financial barriers and makes patients more satisfied. It also helps increase the quality of care and boost the quality of life on a long-term basis (Crowe et al., 2018). The challenge in integrating mental health and substance abuse where I work has led to poor health outcomes. The challenge has created financial difficulties, making it challenging to address substance abuse effectively. Despite efforts, the organization puts more effort into mental health with a lack of correlation between integration measures.

Information technology plays a significant role in the implementation of evidence-based practice in substance abuse management. Access to the internet makes it easy for health service providers to access information and use it for decision-making. Technological advances have also made it possible to mine large data sets and analyze health needs to determine treatment and management interventions (Mesko et al., 2018). Cloud services facilitate easy access to accurate data from remote areas, facilitating collaborative decision-making and integrated care. It is also easy to access clinical evidence for the assessment and implementation of health care strategies. Lastly, technology enhances the active participation of patients in decision-making (Lattie et al., 2020). Despite the physical distance, patients are connected with healthcare providers throughout.

References

Crowe, A., Mullen, P. R., & Littlewood, K. (2018). Self‐stigma, mental health literacy, and health outcomes in integrated care. Journal of Counseling & Development, 96(3), 267-277.

Lattie, E. G., Nicholas, J., Knapp, A. A., Skerl, J. J., Kaiser, S. M., & Mohr, D. C. (2020). Opportunities for and tensions surrounding the use of technology-enabled mental health services in community mental health care. Administration and Policy in Mental Health and Mental Health Services Research, 47(1), 138-149.

Meskó, B., Hetényi, G., & Győrffy, Z. (2018). Will artificial intelligence solve the human resource crisis in healthcare?. BMC health services research, 18(1), 1-4.

I NEED A COMMENT FOR THIS DISCUSSION BOARD WITH AT LEAST 2 PARAGRAPHS AND USE 3 SOURCES NO LATER THAN 5 YEARS

Define negotiation as it applies to patient education

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Assignment 1

Write a short (50-100-word) paragraph response for each question. This assignment is to be submitted as a Microsoft Word document.

1. Define negotiation as it applies to patient education.

2. Explain how the change in the patient’s status through the years has affected patient education.

3. List the pros and cons of negotiation.

4. Describe the general conditions that would be included in a patient contract.

5. Discuss old age and the baby boomer.

6. List several generational, religious, and cultural differences between the 30-year-old health care professional and the elderly patient.

7. Explain some of the barriers to patient education of the elderly and discuss their special needs.

8. List ways to best approach patient education of the elderly.

9. Discuss some cultural and religious beliefs about death that you have encountered.

10. Explain why it is important to discuss death and dying with the elderly patient and what the impact is on all involved.

11. Explain how to teach a patient with a life-threatening illness.

 

 

Assignment 2

Write a 500-750-word essay on the influence patient education has in health care using the experiences of a patient. Interview a friend or family member about that person’s experiences with the health care system. You may develop your own list of questions.

Suggested interview questions:

1. Did a patient education representative give you instructions on how to care for yourself after your illness or operation?

2. Did a health care professional, pharmacist, nurse, doctor, or elder counselor advise you on your medication, diet, or exercise?

3. Who assisted you at home after your illness or operation?

4. Do you know of any assistance services, i.e., food, transportation, medication, that would help you stay in your home as you get older?

pediatric medications

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The United States has spent more money on healthcare than any country in the western world. Yet they rank 37 in world health outcomes (Kaiser Family Foundation, 2017). The significant contribution to this alarming situation is the poor implementation of evident-based care. Many practices that are routinely implemented in healthcare do not have a solid body of evidence of them. Some even have data that support the claim that they promote adverse outcomes, including 12-hour shifts for nurses. Double-check of pediatric medications, vital signs every 2 or 4 hours on stable patients, 2 license checks on discharge. This practice is steeped in traditional instead of best evident. Resulting in less than optimum care, poor outcome, and wistful healthcare spending.

No wonder why nurses engage in behaviors that are not supported by evidence yet do not employ evidence-based practices. For instance, nurses used to change IV dressings on hospitalized patients daily. Despite the lack of evidence to support this practice. However, when clinical trials investigated how often IV dressings should be changed. They discovered that daily changes resulted in more phlebitis than less frequent changes. Nurses even interrupt patients’ sleep, which is crucial for restorative healing to monitor blood pressure and pulse rates. Despite the lack of evidence that doing so enhances the detection of possible concerns. Indeed, professionals frequently adhere to outdated rules. And procedures without questioning their contemporary relevance, appropriateness, or evidence.

Over the last few decades, there has been an explosion of scientific knowledge to help health professionals in clinical decision-making. Even though this evidence is readily available, the National Academic of Medicine has set a goal for 90 percent of clinical decisions to be backed by timely, up-to-date information based on the best available research by 2020. (Melnyk, & Fineout-Overholt, 2018).

challenges in the implementation of EBP

A multicomponent strategy must be in place at every level to overcome the many challenges in the implementation of EBP. Top administrators and directors/managers must “live the talk” by investing in education and skill-building programs for their physicians and thereby fostering a culture and infrastructure in which EBP is the standard of performance and care ( Melnyk, 2016b). Misconceptions about how to adopt practice based on the best available evidence must be rectified, and knowledge and expertise in the field must be strengthened for clinicians to promote the use of EBP. It must also be remembered that for many physicians who did not learn this approach to decision making and the essential ability in their school program, switching to EBP is a behavior change. However, deficiencies can be rectified through an intense EBP continuing education program that helps enhance and maintain EBP beliefs, knowledge, and competence.

Workplace Environment Assessment

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It is one of the most cliché of clichés, but it nevertheless rings true: The only constant is change. As a nursing professional. You are no doubt aware that success in the healthcare field requires the ability to adapt to change. As the pace of change in healthcare may be without rival.

As a professional, you will be called upon to share expertise, inform, educate, and advocate. Your efforts in these areas can help lead others through change. In this Assignment. You will propose a change within your organization. And present a comprehensive plan to implement the change you propose.

To Prepare:

  • Review the Resources and identify one change that you believe is called for in your organization/workplace.
    • This may be a change necessary to effectively address one or more of the issues you addressed in the Workplace Environment Assessment you submitted in Module 4. It may also be a change in response to something not addressed in your previous efforts. It may be beneficial to discuss your ideas with your organizational leadership and/or colleagues to help identify and vet these ideas.
  • Reflect on how you might implement this change. And how you might communicate this change to organizational leadership.

The Assignment (5-6-minute narrated PowerPoint presentation):

Change Implementation and Management Plan

Create a narrated PowerPoint presentation of 5 or 6 slides with video that presents a comprehensive plan to implement the change you propose.

Your narrated presentation should be 5–6 minutes in length.

Your Change Implementation and Management Plan should include the following:

  • An executive summary of the issues that are currently affecting your organization/workplace (This can include the work you completed in your Workplace Environment Assessment previously submitted, if relevant.)
  • A description of the change being proposed
  • Justifications for the change. Including why addressing it will have a positive impact on your organization/workplace
  • Details about the type and scope of the proposed change
  • Identification of the stakeholders impacted by the change
  • Identification of a change management team (by title/role)
  • A plan for communicating the change you propose
  • A description of risk mitigation plans you would recommend to address the risks anticipated by the change you propose

Culture

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Culturally aware nurses recognize that states of health are revealed differently across cultures and ethnicities. Culture and ethnic background will affect the way each individual responds to health, illness, and death (Stanhope & Lancaster, 2020). These nurses are also aware of their own biases, which may affect the care they provide to others (Stanhope & Lancaster, 2020). Because most nurses work in institutions with individual patients. They are accustomed to delivering culturally competent care on a one-on-one basis.

When a public health nurse deals with a population. He or she must consider how the population culture affects the ways in which the community nurse may interact. This can be with regard to the provision of education. Or mass health care needs such as those required in a foodborne illness. If mass vaccinations are needed for a communicable disease outbreak. Or if education is required to prevent heart disease. In addition to understanding the nuances of the culture of a population, community health nurses must understand the role genetics play in health. Some disorders, such as glaucoma and diabetes, have a genetic link, as do some cancers, such as breast and ovarian.

Please discuss the following questions in your Practicum Discussion:

  • Provide a few examples of community resources that should be put in place to assist your population in resolving their health care needs. What gaps in service do you see that affect your population?
  • Are there any cultural considerations that might inform your approach to caring for this population?
  • Does your population have a genetic predisposition to the health care problem you have identified?
  • Identify at least one evidence-based, culturally competent behavior change that would promote health for your selected population and for the specific health care problem you are addressing?

Quality HealthCare Outcomes

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Quality Health Care Outcomes Paper

 

Top of Form

Bottom of Form

· Quality Health Care Outcomes Assignment

Please upload your assignment here.

· Instructions

 Instructions for Quality Health care Outcomes Paper as PDF

Many provisions of the ACA promote Higher Value Care or value-based reimbursement. An example of these are the Medicare Shared Savings Programs. Within this type of value-based reimbursement, several programs including the  Merit-Based Incentive Payment System (MIPS) ,  the  Hospital Readmissions Reduction Program (HRRP)  and  the Hospital Acquired Condition Reduction Program (HACRP).  Choose one of these value-based programs for your paper.

LINKS

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/HAC-Reduction-Program

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/HRRP/Hospital-Readmission-Reduction-Program

https://qpp.cms.gov/mips/overview

 

Paper Components and Formatting Guidelines

Formatting and Style: Papers should be submitted as one document, 11-point Arial font, with 1-inch margins, double-spaced. Submitted papers should be free of spelling or grammar errors, and the paper should be written in traditional academic APA format.

1. Title Page: Traditional APA format, all pages numbered.  Student Name (with any credentials), Institutional affiliation, Country, Email Address, Date, Course Name

1. The Body of the Paper should be no more than 5 pages double spaced (not including title page). Use the following required Level 1 Headings of (centered, boldface, uppercase and lowercase headings), but feel free to correctly use Level 2 Headings (and Level 3, if necessary).

1. You may include information in a table format or figure if that is helpful to you. If used, reference in the body of the paper but insert after the final reference page.

3. Overview of (either MIPS, HRRP, or HACRP)

1. Provide an overview of the program selected.

3. How (MIPS, HRRP, or HACRP) Intends to Achieve Higher Value

2. Explain broadly how this program was intended to achieve higher value

3. History and Evidence

3. Discuss how the mechanism specifically works.

3. Synthesize the history and evidence that shows — when implemented — the policy has achieved higher value, improves quality outcomes, and decreases costs (e.g., Is it working? Where? Outcomes?)

3. Fit between (MIPS, HRRP, or HACRP) and Evidence-based Nursing

4. Give an example of how evidence-based practice in nursing could fit into the program you selected. For instance, what evidence-based nursing action/ intervention(s) help to reduce infections (or improve quality measure x), which is an intended outcome of (selected program).” Be specific.

3. Recommendations and the Role of Nursing

5. Make 3 recommendations on how this payment mechanism could be improved or work better in your opinion. Consider nurses and nursing and the role they could play in these recommendations.

3. References: References should be included in APA format with a minimum of 3 primary references (peer-reviewed journal articles) published within the past 5 years. All references MUST appear in the body of the paper if they are in the reference list – follow APA guidelines carefully.

3. Figure or Table, if you choose to add one; labeled correctly and referenced in the body of the table correctly.

 

Grading Rubric for Assignment 2: Quality Health Care Assignment

Criteria Details
Overview of Selected Program (MIPS, HRRP, or HACRP)  0 to 15 points

Provides overview of selected program and how it fits into higher value in health care
How program intends to achieve higher value 0 to 25 points

Provides summary of program and detailed explanation of how it is intended to work
History and Evidence  0 to 15 points

Provides evidence that the mechanism works (or doesn’t), studies, models, etc.
Program and Evidence-Based Nursing  0 to 15 points

Describe specific evidence-based nursing efforts that could support this mechanism in achieving outcomes
Recommendations & Role of Nursing 0 to 15 points

3 (Policy) recommendations outlined with clear statements of the role of nursing to support these recommendations.
Formatting and Style  0 to 10 points

Correct formatting, grammar, spelling, punctuation, sentence structure, effective flow of ideas,

tone, correct in-text APA citations.
References (and Figure/ Table, if used) 0 to 5 points

At least 3 primary, current, scholarly sources, correct Reference list APA formatting.

Table or Figure included after Reference list (if you choose to add one), labeled correctly and

referenced in the body of the table correctly.

 

Total Points: 100

Rubric Detail

 

A rubric lists grading criteria that instructors use to evaluate student work. Your instructor linked a rubric to this item and made it available to you. Select Grid View or List View to change the rubric’s layout.

Content

Top of Form

Name: Assignment 2: Quality Health Care Assignment

 

· Grid View

· List View

  Details
Overview Points Range:0 (0.00%) – 15 (15.00%)

Provides overview of value-based reimbursement (higher value care) in healthcare
Explain Specific Program (MIPS or HACRP) Points Range:0 (0.00%) – 25 (25.00%)

Provides summary of program and detailed explanation of how it is intended to work.
Does it Work? Points Range:0 (0.00%) – 15 (15.00%)

Provides evidence that the mechanism works (or doesn’t), studies, models, etc.
Nursing Efforts Points Range:0 (0.00%) – 15 (15.00%)

Describe specific evidence based nursing efforts that could support this mechanism in achieving outcomes
Recommendations Points Range:0 (0.00%) – 15 (15.00%)

Policy recommendations outlined
Style Points Range:0 (0.00%) – 10 (10.00%)

Correct grammar and spelling, accurate sentence structure, effective flow of ideas, correct APA formatting.
References Points Range:0 (0.00%) – 5 (5.00%)

Primary sources, current, scholarly resources, minimum of three references

Name:Assignment 2: Quality Health Care Assignment

Bottom of Form

 

LINKS

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/HAC-Reduction-Program

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/HRRP/Hospital-Readmission-Reduction-Program

https://qpp.cms.gov/mips/overview

 

Exit

Eating Healthy and Maintaining a Healthy Weight Case Study

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 Eating Healthy and Maintaining a Healthy Weight Case Study

Nurse’s Touch: Wellness and Self-Care: Eating Healthy and Maintaining a Healthy Weight Case Study 

Ebook attached below: Nutritional Foundations and Clinical Applications: A Nursing Approach 7th Edition

 

a. Review “How Being Overweight or Obese Affects your Health” case study and answer these questions.

1. How does additional body weight affect physical status?

2. What are some of the barriers and challenges to losing weight in the U.S.?

3. Discuss cultural considerations when discussing weight and weight loss with clients.

4. What would you suggest to help Mark achieve a healthy weight?

APA format (6th ed.) and is free of errors

Grammar and mechanics are free of errors free of Plagiarism

References: Use your book, the outside source must be within the last 5 yrs, Scholarly Article or Nurse journals within the last 5 yrs

Type out the questions and respond to the question in APA format with citation and very detailed responses

sampling methods

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  1.  sampling methods

  2. Appraise and debate the sampling methods and determine the quality of the sampling procedures in reducing bias. Consider the following questions:
    • Was the sampling method and inclusion/exclusion criteria adequate to reduce sampling bias?
    • Are the sample characteristics representative of the target population?
    • Was the sample size adequate?
    • Was there a decrease in sample size?  If so, did the researchers identify decreases early and attempt to reduce the impact?  Was a decrease, if any, adequately explained by the researchers?

Quantitative And Qualitative Nursing Research

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MS: Number 1 peer post

The two significant nursing research designs are qualitative and quantitative methods. Interviews and focus groups are the considerable methods of collecting data in qualitative research. This is different from quantitative research that employs experiments (Hennink, Hutter & Bailey, 2020). Qualitative research is the description for one that investigates a phenomenon in an in-depth and holistic manner. Most importantly, qualitative research methods tend to compile narratives with a flexible research design (Roni et al., 2020).

On the other hand, quantitative research investigates a phenomenon based on precise measurements. Also, quantitative analysis analyzes with the help of a rigorous and controlled design. Research conducted by Rutberg and Bouikdis (2018) reveals that quantitative research involves numbers based on accuracy. This is different from qualitative research that employs an individual’s perceptions and experiences (Rahman, 2020). In this regard, it can be argued that quantitative analysis involves numeric data from experiments. Here, the study is usually structured, and the researcher is in complete control of the data.

An excellent example of a qualitative research question relevant to nursing states, “How could cachexia be prevented among cancer patients receiving aggressive protocols involving chemotherapy and radiation?” In the future, I would seek to know more about cancer patients. Therefore, I would employ this question to enhance the collection of data based on experience. Based on quantitative research, consider the question, “How many times do you visit the dentist for a teeth checkup despite being healthy in a year?” I would employ this question in the future to determine the exact number of times one should visit a dentist within a year. Regarding the question, one would note that the research is based on accuracy and credible numbers.

 

Number 2 peer post

In research there are many forms of how we can measure and present the research to the public and in turn create evidenced based practice. Two main methods of nursing research are quantitative and qualitative research. Although they both help us measure research, they are drastically different in their purpose and analysis.

Quantitative research is objective, tests theory, and is considered “hard science” (Hitchcock, n.d). Objective data is not influenced by personal thoughts or opinions and is purely factual. While qualitative research on the other hand is subjective, forms theory, and is considered “soft science” (Hitchcock, n.d). In contrast to objective data, subjective data is based on personal feelings and opinions and not on facts. In deciding what tool to use it is important to look at the type of data you are wanting to receive and what you are testing.

employee satisfaction survey

An example of qualitative research would be an employee satisfaction survey. It is purely based on the employees feelings about their own job satisfaction and is not based on facts. Each employee will have their own opinion as to how they ‘feel’ or ‘do not feel’ satisfied at work. Even though there satisfaction may be based on many different factors, none of them are quantifiable. An example of quantitative research from my current job and department would be recording turn over room time between surgeries.

The time would start when the previous patient leaves the room and ends when the next patient enters the room for surgery. The time is recorded in minutes and includes all necessary turnover actions and procedures to prepare for the next patients surgery. This quantitative research would let us know how long turn over times average and it is a purely objective number. Nothing I say or feel about it or any input from anyone else changes these times. The facts and numbers are simply what they are. When doing nursing research it is important to know what type of data your research is applying so it can be properly presented.