Archive for category: My Nursing Writer

Discuss the role of stakeholders in quality and risk management including the relationships between employers and third party payers with health care organizations.

Discuss the role of stakeholders in quality and risk management including the relationships between employers and third party payers with health

care organizations. What roles do each play in quality and risk management, if any? What is the impact on the patient’s and care they receive? Respond to at least two of your classmates’ postings.

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ANALYZE THE LEGAL, FINANCIAL, AND ETHICAL CONSIDERATIONS OF A CASE INVOLVING PATIENT TRANSFER.The Centers for Medicare and Medicaid Services (CMS) have identified pressure ulcers, or bedsores, as one of the hospital-acquired conditions

The Centers for Medicare and Medicaid Services (CMS) have identified pressure ulcers, or bedsores, as one of the hospital-acquired conditions, or “never events,” that they will not reimburse at the normal rate under Medicare. Pressure ulcers develop over time. One challenge facing health care administrators and providers is getting proper reimbursement for their services in cases of patient transfer if the patient’s conditions were acquired elsewhere.

For this Application you will analyze the legal, financial, and ethical considerations of a case involving patient transfer, based on the following scenario:

A Medicare patient is admitted from a skilled nursing facility for dehydration. There is a close clinical relationship between the facilities, with admissions and services at both facilities referred to each other. A day or two after admission, a pressure ulcer is assessed. There is concern at the hospital about whether they will be paid for this condition.

The hospital staff claims that the pressure sore was caused by the local skilled nursing facility. The skilled nursing facility did not document any skin issues prior to discharge and believes the hospital is blaming it for the hospital’s poor skin care.

As an administrator in this hospital, you would naturally want to get reimbursed for the care now required to treat this patient’s pressure ulcer, to prevent this kind of issue from happening in the future, and also to maintain good organizational ties with this skilled nursing facility.

To prepare for this Application Assignment, complete the following:

Review textbooks in previous courses, such as the excerpts listed in this week’s Optional Resources, or do online research to remind yourself of Medicare payment policies regarding “never events.” Reflect on the ethical implications of Medicare’s “never events” policy. What challenges would you expect to occur regarding who ends up paying for never-event conditions and the impact on quality of care?

Do online research to learn more about pressure ulcers. What causes them and what kind of care is required to treat them?

Review the consequences of false claims, as described in this week’s Learning Resources.

Think through various ways in which an administrator could institute policies to help prevent or mitigate situations such as the one described above.

The Application Assignment:

With these thoughts in mind, write a 3- to 4-page paper in which you address the following questions:

* What are the factors (e.g., timely and appropriate clinical services) that determine whether patients at risk for pressure ulcers receive proper skin care?

* What does administration need to do to ensure that the hospital is not submitting claims for services for which payment is not available under applicable rules?

* Take into account the role of individuals who may want to become a whistleblower, or qui tam relator, under the False Claims Act.

* Legally, how did CMS go about deciding that it would reduce reimbursement for hospital-acquired pressure ulcers and other conditions? Does this policy make sense to you? Why?

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Formulating a specific, applicable research problem statement is an important step in beginning a research process. The problem statement defines the focus of the research study, dictates what methods and tools will be used, and sets the stage for all subsequent elements of the research process.

Formulating a specific, applicable research problem statement is an important step in beginning a research process. The problem statement defines the focus of the research study, dictates what methods and tools will be used, and sets the stage for all subsequent elements of the research process. Because of this, it is necessary to put a great deal of thought into the problem statement to ensure that the rest of the research process will be well planned and appropriate to the problem at hand.

This week’s Discussion asks you to identify evidence-based practice problems that can be addressed using quantitative research methods. Based on the practice problem you select, formulate a quantitative research problem statement. In this Discussion, you are also given the opportunity to evaluate your colleagues’ problem statements. Please refer to this week’s Learning Resources for appropriate and scholarly examples of research problem statements and how they inform the rest of the research process.

To prepare:

Determine a nursing practice problem that is of interest to you and that is appropriate for a quantitative research study. Note: You will continue to use this problem in the Discussions over the next several weeks.
Using the Walden Library and other credible sources, locate and read two or three articles that address your practice problem. (you must cite the articles read in this assignment)
With your practice problem in mind, review the Learning Resources and media presentations focusing on the strategies presented for generating a research problem statement.
Ask yourself: What is the importance of my practice problem to nursing, research, and theory? How might addressing this problem bring about positive social change? How will investigating this problem support evidence-based practice?
By Tomorrow 09/06/17, write a minimum of 550 words in APA format with a minimum of 3 references from the list below which include the level one headings as numbered below:

Post

1) A proposed research problem statement ( it has to be related to nursing for example: could be on diabetes, heart failure or more …)

2) Including sufficient information to make your focus clear and explaining how addressing this problem may bring about positive social change.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Research methods for evidence-based practice: Selecting a research topic and developing a hypothesis. Baltimore, MD: Author.

Note: The approximate length of this media piece is 13 minutes.

In this week’s video, Dr. Leiyu Shi discusses the characteristics of a good research hypothesis and details the steps in developing a hypothesis that can be tested through research.

Laureate Education. (2011). Important events in clinical research history. Retrieved from http://mym.cdn.laureate-media.com/2dett4d/Walden/CLRA/6100/01/mm/timeline/index.html

This timeline identifies and describes key historical events related to the development of clinical research throughout the ages.

Required Readings

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

•Chapter 5, “Research Problem and Purpose”

Chapter 5 outlines how to identify and develop a research problem statement, purpose, and research questions. The chapter also provides examples of both quantitative and qualitative research topics, problems, and purpose.

•Chapter 6, “Objectives, Questions, Variables, and Hypothesis”

This chapter explains the different types of hypotheses and assesses how research variables can be used to formulate research objectives in both quantitative and qualitative studies.

•Chapter 10, “Quantitative Methodology: Noninterventional Designs and Methods”

Chapter 10 describes the principles of research design and those foundational concepts that influence the selection of an appropriate quantitative design: causality, bias, manipulation, control, and validity.

•Chapter 11, “Quantitative Methodology: Interventional Designs and Methods”

This chapter builds on the material presented in Chapter 10 and discusses how to select the most appropriate quantitative research design for addressing a particular research problem.

Select one of the following articles to use for this week’s Assignment:

Fouquier, K.F. (2011). The concept of motherhood among three generations of African American women. Journal of Nursing Scholarship, 43(2), 145–153. (See attached files)

Grey, M., Whittemore, R., Jaser, S., Ambrosino, J., Lindemann, E., Liberti, L., Northrup, V., & Dziura, J. (2009). Effects of coping skills training in school-age children with Type 1 diabetes. Research in Nursing & Health, 32, 405–418. (See attached files)

Methey, N.A., Davis-Jackson, J., & Stewart, B.J. (2010). Effectiveness of an aspiration risk-reduction protocol. Nursing Research, 59, 18–25. (See attached files)

Newhouse, R.P., Morlock. L., Pronovost, P., & Breckenridge-Sproat, S. (2011). Rural hospital nursing: Results of a national survey of nurse executives. Journal of Nursing Administration, 41(3), 129–137. (See attached files)

Handouts

Laureate Education. (2011). Litmus test for a doctoral-level research problem. Baltimore, MD: Author.

Optional Resources

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Demonstrate and apply knowledge of factors to consider when planning to work with a chosen community.

Practicum immersion experiences are required in a community health setting. Community health and leadership practice immersion can occur in the same site and in conjunction with the evidence-based project in the NRS-490V course. Definitions of community-based settings should encourage community integration and involvement; expand accessibility of services and supports; promote personal preference, strengths, dignity; and empower people to participate in the economic mainstream. Examples of the integration of community health, leadership, and an EBP can be found at Healthy People 2020.
The goals of the practice immersion experience is to apply the learning from your research, community health, and leadership courses:
After studying this course, you should be able to:
Demonstrate and apply knowledge of factors to consider when planning to work with a chosen community.
Demonstrate and apply knowledge of approaches that will facilitate engagement of the community.
Demonstrate and apply knowledge and skills required to work constructively with communities.
Demonstrate and apply knowledge related to engagement of organizational leadership and change agents.
Demonstrate and apply knowledge related to disseminating project findings/data with organizational leadership and change agents.
Demonstrate and apply knowledge related to completing an evidence-based project to impact population health outcomes.
Demonstrate and apply Healthy People 2010/2020 principles related to completing an evidence-based project to impact population health outcomes.
According to Healthy People.gov, educational and community-based programs and strategies are designed to reach people outside of traditional health care settings. These settings may include:
Schools
Worksites
Health care facilities
Communities
Each setting provides opportunities to reach people using existing social structures. This maximizes impact and reduces the time and resources necessary for program development.
In a composition of no more than 750 words, describe the nature of your proposed project topic. Include the following in your discussion:
The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed.
A description providing a high level of detail regarding the problem, issue, suggestion, initiative, or educational need.
Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes.
Significance of the problem, issue, suggestion, initiative, or educational need and its implications to nursing.
Preview and utilize the “Project Topic Checklist” resource located in the topic materials to assist in developing your proposed Capstone Project topic. This resource will assist you in organizing your work and will provide additional information regarding the assignment. Note: You are required to retrieve and assess a minimum of 15 peer-reviewed articles. Plan your time to complete this assignment accordingly.
Attach the completed “Project Topic Checklist” to your assignment submission.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

I was looking at healthy people 20/20 and due to the population and the community I am involved in, I am interested in mental health/behavorial health issues. I see alot of ares in mental health that could have better improvement. For example, since my work have LTC psych patients and most of them are young and are often left alone, bored, not being helped effectively. They need something to intrique there interest or activate a mental process. This allows a focus outside of themselves. Something that will spark their imagination.
My community based teaching would be for a facility or a small community that specializes in mental health.
there needs to be outcomes and interventions

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Reflect on your nursing practice for a moment. If you could wipe out one illness, what would it be? How would that impact not just an individual patient, but your entire patient population?

Epidemiology and Population Health
Reflect on your nursing practice for a moment. If you could wipe out one illness, what would it be? How would that impact not just an individual patient, but your entire patient population? What would be the long-term benefits of eliminating that one illness?
The eradication of smallpox by 1979 provides an excellent example of this scenario. This eradication came about as a result of global collaborative efforts involving many countries and organizations, as well as the application of epidemiologic methods. In spite of high initial financial costs, it is estimated that millions of dollars continue to be saved around the world each year as a result of the eradication of this disease.
The eradication of smallpox illustrates the rich history of epidemiology and demonstrates the cost/benefits and implications of improving health at the population level. The application of epidemiologic methods and principles to other critical population health issues continues to play an essential role in improving health and health outcomes.
For this Discussion, you will identify a current population health problem, and you will examine how, and if, the problem is being addressed through the application of epidemiologic principles. You will also discuss the cost-effectiveness of dealing with the problem at the population level.

To prepare:

Review the Learning Resources, focusing on the smallpox epidemic of the 1960s and 1970s and how health organizations applied principles of epidemiology to eradicate this disease. (See attached file)
In light of this example, consider the cost effectiveness of addressing smallpox at the population level.
Using the Learning Resources, research a current population health problem (local or global). Select one on which to focus for this Discussion.
Think about how principles of epidemiology are being applied—or could be applied—to address the problem.
What lessons from the use of epidemiology in the eradication of smallpox might be applicable to this selected problem? What are the financial benefits of addressing this issue at the population level as opposed to the individual level?

By tomorrow Wednesday 02/28/18 by 12pm, write a minimum of 550 words in APA format with a minimum of THREE scholarly references from the list of required readings below. Include the level one headers as numbered below:
Post a cohesive response that addresses the following:

1) Briefly summarize your selected population health problem and describe how principles of epidemiology are being applied—or could be applied—to address the problem.

2) Are there any lessons learned from the use of epidemiology in the eradication of smallpox that can be applied to your selected problem?

3) Evaluate the cost effectiveness of addressing this health problem at the population level versus the individual level.

Required Readings

Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.
Chapter 1, “History and Scope of Epidemiology”
Chapter 2, “Practical Applications of Epidemiology” (pages 49–80 only)
Epidemiology is defined and introduced in Chapter 1. This chapter also presents an interesting historical overview that explains the emergence of the field. The assigned section of Chapter 2 addresses several uses of epidemiology.

Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J. L. & Horowitz, M. R. (2016). Population health: Creating a culture of wellness (2nd ed). Burlington, MA: Jones & Bartlett Learning.
Building Cultures of Health and Wellness (xxvii)
In the “Population Health Mandate” section of the course text, the authors provide an introduction to population health, noting that it has three core components: health outcomes, health
determinants, and policies.
Chapter 2, “The Spectrum of Care”
In Chapter 2, the authors examine the purposes of the population health approach. Two key themes are introduced in this chapter: 1) population health as it relates to the challenges of quality and cost in health care, and 2) population health as an approach to not only reducing the burden of chronic illness but also to promoting wellness and increasing prevention.
Chapter 8, “Behavioral Economics”
In Chapter 8, the authors examine effect of social and cognitive function on an individual’s economic decisions. Reinforced by legislation, behavioral economics can be applied in population health to influence and change health outcomes. Compelling examples of incremental improvements (e.g., corporate wellness programs) are provided throughout the chapter.

Larkin, H. (2010). Managing population health. Hospitals & Health Networks, 84(10), 28–32.
This article uses examples from a diabetes pilot program to demonstrate the value of population health management. The author discusses how the application of individual patient interventions can positively affect the entire target population, as well as improve the cost effectiveness of management programs.

Center for Global Development. (n.d.). Case 1: Eradicating smallpox. Retrieved March 5, 2012, from http://www.cgdev.org/doc/millions/MS_case_1.pdf
This reading presents the eradication of smallpox in the form of a case study. Many lessons can be learned from the successful global effort to eliminate smallpox.

Centers for Disease Control and Prevention. (2011). Morbidity and mortality weekly report. Retrieved from http://www.cdc.gov/mmwr/
The Morbidity and Mortality Weekly Report (MMWR) is a weekly epidemiological report distributed by the U.S. Centers for Disease Control and Prevention (CDC) to provide, according to the MMWR website, “timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations.” It is one of the most important sources of timely public health data published anywhere.

World Health Organization. (2001). Smallpox. Retrieved from http://www.who.int/topics/smallpox/en/
The World Health Organization provides a succinct overview of the eradication of small pox and its impact on population health.

Note: Explore population health issues presented at the websites below as you prepare for this week’s Discussion and Assignment:

American Public Health Association. (2011). Retrieved from http://www.apha.org/
Centers for Disease Control and Prevention. (2011). Retrieved from http://www.cdc.gov/

Food and Agricultural Organization of the United Nations. (2011). Retrieved from http://www.fao.org/index_en.htm

U.S. Food and Drug Administration. (2011). Retrieved from http://www.fda.gov/

Healthy People 2020. (2011). Global health. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=16

U.S. Food and Drug Administration. (2011). Public health focus. Retrieved from http://www.fda.gov/NewsEvents/PublicHealthFocus/default.htm

Required Media

Laureate Education (Producer). (2012). Epidemiology and population health: Introduction to epidemiology and population health [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 6 minutes.
In this week’s program, “Introduction to Epidemiology and Population Health,” Dr. Hull and Dr. Frerich introduce foundational concepts related to epidemiology, noting that this scientific arena focuses on the study of human populations rather than individuals.

Laureate Education (Producer). (2012). Epidemiology and population health: Epidemiology in nursing practice [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 4 minutes.
In “Epidemiology in Nursing Practice,” Dr. Rebecca Lee, Dr. Donna Shambley-Ebron, and Dr. Missie Willmarth discuss how epidemiology is utilized in nursing practice and, in particular, why it is salient for DNP-prepared nurses.

Optional Resources

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