What Is The Definition Of Risk Management?

Record Most Commonly Occur? 3. What Is The Definition Of Risk Management? 4. What Are The PartsHS410 Unit 6: Quality Management – Discussion Discussion
This is a graded Discussion. Please refer to the Discussion Board Grading Rubric in Course Home / Grading Rubrics.
Respond to all of the following questions and be sure to respond to two of your other classmates’ postings:
1. What are the steps in the quality improvement model and how is benchmarking involved?
2. What are the stages in which data quality errors found in a health record most commonly occur?
3. What is the definition of risk management?
4. What are the parts of an effective risk management program?
5. What is utilization review and why is it important in healthcare?
6. What is the process of utilization review?
Please paper should be 400-500 words and in an essay format, strictly on topic, original with real scholar references to support your answers. NO PLAGIARISM PLEASE! This is the Chapter reading for this assignment:
Read Chapter 7 in Today’s Health Information Management.INTRODUCTION
Quality health care “means doing the right thing at the right time, in the right way, for the right person, and getting the best possible results.”1 The term quality, by definition, can mean excellence, status, or grade; thus, it can be measured and quantified. The patient, and perhaps the patient’s family, may interpret quality health care differently from the way that health care providers interpret it. Therefore, it is important to determine—if possible—what is “right” and what is “wrong” with regard to quality health care. The study and analysis of health care are important to maintain a level of quality that is satisfactory to all parties involved. As a result of the current focus on patient safety, and in an attempt to reduce deaths and complications, providing the best quality health care while maintaining cost controls has become a challenge to all involved. Current quality initiatives are multifaceted and include government-directed, private sector supported, and consumer-driven projects.
This chapter explores the historical development of health care quality including a review of the important pioneers and the tools they developed. Their work has been studied, refined, and widely used in a variety of applications related to performance-improvement activities. Risk management is discussed, with emphasis on the importance of coordination with quality activities. The evolution of utilization management is also reviewed, with a focus on its relationship to quality management.
In addition, this chapter explores current trends in data collection and storage and their application to improvements in quality care and patient safety. Current events have been identified that influence and provide direction to legislative support and funding. This chapter also provides multiple tips and tools for both personal and institutional use.DATA QUALITY
Data quality refers to the high grade, superiority, or excellence of data. Data quality is intertwined with the concept of quality patient care; it refers to data that can demonstrate and represent in an objective sense the delivery of quality patient care. When the data collected are reflective of the care provided, one can reach conclusions about the quality of care the patient received.Historical Development
The concept of studying the quality of patient care has been a part of the health care field for almost 100 years. Individual surgeons, such as A. E. Codman, pioneered the practice of monitoring surgical outcomes in patients and documenting physician errors concerning specific patients. These physicians began the practice of conducting morbidity and mortality conferences as a means to improve patient care. Building on the prior work of individual surgeons, the American College of Surgeons (ACS) created the Hospital Standardization Program in 1918. This program served as the genesis for the accreditation movement of the 20th century, which included the concept of quality patient care and the formation of the Joint Commission on Accreditation of Hospitals (JCAH) in 1951. The ACS transferred the Hospital Standardization Program to the JCAH in 1953.
Efforts to improve the quality of patient care have varied during the 20th century, beginning with the establishment of formalized mechanisms to measure patient care against established criteria. A timeline illustrating these efforts is shown in Figure 7-1. These mechanisms focused on an organization’s reaction to individual events and the mistakes of individual health care providers. A variety of quality efforts followed, including ones developed in other industries that were adapted to the health care environment. The concepts of total quality management, defined as the organization-wide approach to quality improvement, and continuous quality improvement, defined as the systematic, team-based approach to process and performance improvement, introduced the team-based approach to quality health care. These newer efforts moved the focus from individual events and health care providers to an organization’s systems and their potential for improvement.Figure 7-1 | Quality management timeline
Accompanying the change in focus were new terms such as quality management, quality assurance, process improvement, and performance improvement. Quality management generally means that every aspect of health care quality may be subject to managerial oversight. Quality assurance refers to those actions taken to establish, protect, promote, and improve the quality of health care. Process improvement refers to the improvement of processes involved in the delivery of health care. Performance improvement refers to the improvement of performance as it relates to patient care. Regardless of the names applied and their respective approaches, most health care organizations in the 21st century are bound by the requirements of various accrediting and regulatory bodies to engage in some function that focuses on the quality of patient care.2
In order to measure patient care for quality purposes, one must first possess data. The data crucial to supporting any quality initiative are the data found in the patient health record. These data must be reliable with respect to quality. Data errors can be made during many stages, such as when data are entered into the record (the documentation process), when data are retrieved from the record (the abstracting process), when data are manipulated (the coding process), when data are processed (the indexing and registry processes), and when data are used (the interpreting process). At each stage, the data must be both consistent and accurate. Furthermore, good quality data are the result of coordinated efforts to ensure integrity at each stage. A recent focus on the legibility of handwritten data, the appropriate use of abbreviations, and their relationship to medication errors has increased pressure from accrediting agencies to improve the quality of data as a means to improve patient safety.
Quality health care management is the result of the dedication of a variety of professionals working in all levels of employment and in all aspects of health care. These professionals are supported by governmental offices at the federal, state, and local levels that define what data they require to be reported to them. When data definitions are not specified by the agency or organization requiring a report, the responsibility to define the data falls to the team or group that is responsible for collecting and disseminating the data. Fundamental to the collection and dissemination of data is the application of the appropriate collection format and reporting tools. However, before data collection can begin, there must be consensus on the perimeters of the data to be collected. The team or group should also select an assessment model, such as quality circles, PDSA, or FOCUS PDCA. Quality circles are small groups of workers who perform similar work that meet regularly to analyze and solve work-related problems and to recommend solutions to management. These groups are also known as Kaizen teams, a Japanese term meaning to generate or implement employee ideas.3 PDSA (Plan, Do, Study, Act), also known as PDCA (Plan-Do-Check-Act),4 is illustrated in Figure 7-2. FOCUS PDCA5 involves finding a process to improve, organizing a team that knows the process, clarifying the current knowledge of the process, understanding the causes of special variation, and selecting the process improvement. Figure 7-3 illustrates the FOCUS PDCA approach.
Essentially, these assess ment models provide groups with guidance about how to organize the process. These models were developed largely as a result of the manufacturing industry quality movement of the 1950s and 1960s led by W. Edwards Deming, J. M. Juran, and Philip Crosby. In the 1960s, these models were applied to the health care sector by Avedis Donabedian, who separated the quality of health care measures into three distinct categories: structure, process, and outcomes.6 In the 1970s, when the Joint Commission on Accreditation of Healthcare Organizations, now known as the Joint Commission, and the Health Care Financing Administration (HCFA), now known as Centers for Medicare and Medicaid Services (CMS), began to mandate quality initiatives, health care looked to the successes of the manufacturing industry for direction and ideas.Figure 7-2 | Plan, do, study (or check), and act assessment modelFigure 7-3 | FOCUS assessment model
The quest for quality, and the tools necessary to achieve it, eventually led to the development of the Malcolm Baldrige National Quality Award. The U.S. Congress created this award in 1987,7 which led to the creation of a new public-private partnership. Principal support for the award comes from the Foundation for the Malcolm Baldrige National Quality Award. The U.S. president announces the award annually. The award initially recognized the manufacturing and service sectors, including both large and small businesses, but it was expanded in 1999 to include the education and health care sectors; several health care organizations have applied for and received this award since then. In 2006, the program expanded even further to consider nonprofit and governmental organizations in the application process. The seven categories in which participants are judged for the Malcolm Baldrige Award are listed in Table 7-1. The focus of the evaluation centers on total quality management with an emphasis on sustaining results.Table 7-1 | Health Care Criteria in the Malcolm Baldrige Award
Leadership
Strategic planning
Customer and market focus
Measurement, analysis, and knowledge management
Workforce focus
Operations focus
Business results
Source: Malcolm Baldrige National Quality Award, http://www.quality.nist.gov Courtesy of The National Institute of Standards and Technology (NIST).
Early pioneers who applied the Malcolm Baldrige concepts found it difficult at times to achieve effective implementation and/or sustain improvement. In an effort to achieve the greatest possible savings from the improvement projects, the Juran Institute, working with Motorola, developed a methodology called Six Sigma.8 Six Sigma is defined as the measurement of quality to a level of near-perfection or without defects. General Electric (GE) and Allied Signal (now Honeywell) also contributed to the development and popularity of the methodology. Part of its success is attributed to the organization of training and leadership. High-level executives are trained and appointed as “champions” to drive the program, and employees receive training and support to become certified internal experts. The amount of training one receives results in different belt levels: black belts are technical personnel who are trained to apply the statistically-based methodology. Master black belts coach black belts and coordinate projects. The project team members are referred to as green belts and also receive basic process-improvement training.
The Six Sigma Improvement Methodology is similar to that of PDCA and FOCUS PDSA, but it uses five steps, known as (D)MAIC: Define, Measure, Analyze, Improve, and Control. Many components of the health care industry have applied the Six Sigma improvement methodology toward the elimination of errors rather than the correction of defects (as it has been applied in the industry). The approach is similar and both ultimately strive for perfection. In light of the fact that one error can be of catastrophic consequence if it involves a sentinel event or even death, the concept of near perfection in the Six Sigma standards is important for all applications of health care delivery.
Federal Efforts Whereas the quest for quality led to the development of the Baldrige Award and Six Sigma, efforts at the federal level resulted in the formation of the Agency for Health Care Policy and Research (AHCPR) in 1989. Later changed to the Agency for Healthcare Research and Quality (AHRQ) as part of the Healthcare Research and Quality Act of 1999, this body is a scientific research agency located within the Public Health Service (PHS) of the U.S. Department of Health and Human Services. AHRQ focuses on quality of care research and acts as a “science partner” between the public and private sectors to improve the quality and safety of patient care.
Over time, the agency has changed its focus from developing and supporting clinical practice guidelines to developing evidence-based guidelines. AHRQ’s mission is to develop scientific evidence that enables health care decision-makers to reach more informed health care choices. The agency assumes the responsibility to conduct, support, and disseminate scientific research designed to improve the outcomes, quality, and safety of health care. The agency is also committed to supporting efforts to reduce health care costs, broaden access to services, and improve the efficiency and effectiveness of the ways health care services are organized, delivered, and financed.
AHRQ has achieved numerous accomplishments since its inception. These accomplishments range in focus from the Medical Expenditure Panel Survey (MEPS), the Healthcare Cost and Utilization Project (HCUP), and the Consumer Assessment of Healthcare Plans Survey (CAHPS), to the grant component of AHRQ’s Translation of Research into Practice (TRIP) activity and the Quality/Safety of Patient Care program. The latter program encompasses both the Patient Safety Health Care Information program and the Health Care Information Technology program. Each of the programs listed here provides valuable information to the agency. For example, the Medical Expenditure Panel Survey (MEPS) serves as the only national source for annual data on how Americans use and pay for medical care. The survey collects detailed information from families on access, use, expense, insurance coverage, and quality. This information provides public and private sector decision-makers with important data to analyze changes in behavior and the market.
The Healthcare Cost and Utilization Project (HCUP) also provides information regarding the cost and use of health care resources but focuses on how health care is used by the consumer. HCUP is a family of databases containing routinely collected information that is translated into a uniform format to facilitate comparison. The Consumer Assessment of Health Plans (CAHP) uses surveys to collect data from beneficiaries about their health care plans. The grant component, Translation of Research into Practice (TRIP), provides the financial support to initiate or improve programs where identified. Patient safety research is also an important element of these activities and includes a significant effort directed toward promoting information technology, particularly in small and rural communities where health information technology has been limited due to cost and availability. Other research efforts for patient safety are focused on reducing medical errors and improving pharmaceutical outcomes through the Centers of Excellence for Research and Therapeutics (CERT) program.
E-HIM
AHRQ has provided grants to increase the use of health information technology, including electronic health records.
As a result of the growing concern for the increased use of health information technology (HIT) to improve the quality of health care and control costs, AHRQ awarded $139 million in contracts and grants in 2004 to promote the use of health information technology. The goals of the AHRQ projects are listed in Table 7-2. Grants were awarded to providers, hospitals, and health care systems, including rural health care settings, critical access hospitals, hospitals and programs for children, as well as university hospitals in urban areas. The locations were spread throughout the country from coast to coast, border to border, and included Alaska and Hawaii. Many grant recipients sought to develop HIT infrastructure and data-sharing capacity among clinical provider organizations. Other grant recipients sought to improve existing systems that were considered outdated or to install technology where it had not previously existed, such as pharmacy dispensing systems, barcoding, patient scheduling, and decision-support systems.
Some grants went toward the construction of a fully integrated electronic health record (EHR), such as one effort by the Tulare District Hospital Rural Health Consortium. Some universities received grants to employ technology for disease-specific projects, such as the Trial of Decision Support to Improve Diabetes Outcomes at Case Western Reserve University; others sought to develop cancer care management programs, such as the Technology Exchange for Cancer Health Network (TECH-Net) established by the University of Tennessee; and others worked to automate tracking of adverse events, such as the Automated Adverse Drug Events Detection and Intervention System established by Duke University. Still other grants focused on promoting statewide and regional networks for health information exchange, sometimes referred to as regional health information organizations (RHIOs). The goal of these projects is to develop a health information exchange that connects the systems of various local health care providers so they can better coordinate care and enable clinicians to obtain patient information at the point of care.9 More information concerning the work of RHIOs is found in Chapter 10, “Database Management.”Table 7-2 | Goals of the AHRQ Projects
Improve patient safety by reducing medical errors
Increase health information sharing between providers, labs, pharmacies, and patients
Help patients transition between health care settings
Reduce duplicative and unnecessary testing
Increase our knowledge and understanding of the clinical, safety, quality, financial, and organizational values and benefits of HIT
© 2014 Cengage Learning, All Rights Reserved.
Among its accomplishments of the 21st century, the AHRQ has begun certifying patient safety organizations (PSOs). These organizations were created pursuant to the Patient Safety and Quality Improvement Act of 2005 and are designed to serve as independent entities that collect, analyze, and aggregate information about patient safety. They use this data to identify the underlying causes of lapses in patient safety. PSOs gather data through the voluntary reporting of health care providers and organizations according to the terms of the Patient Safety and Quality Improvement Final Rule (Safety Rule).
A second 21st-century accomplishment of the AHRQ involves the creation of the National Strategy for Quality Improvement in Health Care (National Quality Strategy). Created pursuant to the Patient Protection and Affordable Care Act, the National Quality Strategy aims to improve the overall quality of patient care, reduce costs, and improve patient health. AHRQ developed the National Quality Strategy using evidence-based results of medical research and input from a wide range of stakeholders across the health care system.
A similar effort at the federal level to improve quality patient care was initiated in the U.S. Department of Health and Human Services and resulted in the creation of the Center for Medicare and Medicaid Innovation. Also created pursuant to the Patient Protection and Affordable Care Act, the Center is designed to test innovative care and payment models and encourage adoption of practices that reduce costs, while simultaneously delivering high-quality patient care at lower cost.
E-HIM
The U.S. President connects the use of electronic health records with improvement in quality patient care.
One of the most significant efforts to focus attention on the importance of advancing health information technology as a means to improve the quality of patient care was made by U.S. President George W. Bush. In his State of the Union Address on January 20, 2004, he stated, “By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care.”10 He acted on this statement shortly thereafter, establishing a national coordinator for health information technology within the U.S. Department of Health and Human Services. This coordinator announced that a 10-year plan would be developed to outline the steps necessary to transform the delivery of health care by adopting health information technology in both the public and private sectors. Included in these steps are the EHR and a national health information infrastructure (NHII), topics that are addressed in further detail in Chapter 10, “Database Management,” and Chapter 11, “Information Systems and Technology.”
Private Efforts Concern for improving the quality of health care also moved others to action. The Institute of Medicine, a private nonprofit organization that provides health policy advice under a congressional charter granted to the National Academy of Sciences, conducted an in-depth analysis of the U.S. health care system and issued a report in 2001. This report, Crossing the Quality Chasm: A New Health System for the 21st Century,11 identified a significant number of changes that had affected the delivery of health care services, specifically the shift from care of acute illnesses to care of chronic illnesses. The report recognized that current health care systems are more devoted to dealing with acute, episodic conditions, and are poorly organized to meet the challenges of continuity of care. The report challenged all health care constituencies—health professionals, federal and state policy makers, purchasers of health care, regulators, organization managers and governing boards, and consumers—to commit to a national statement of purpose and adopt a shared vision of six specific aims for improvement.
The report did not include a specific “blueprint” or standard for the future because it encouraged imagination and innovation to drive the effort. Specific recommendations included a set of guiding principles known as the Ten Steps for Redesign, the establishment of the Health Care Quality Innovation Fund to initiate the process of change, and development of care processes for common health conditions—most of them chronic—that afflict great numbers of people. This report served as a driving force behind the funding of grants through AHRQ and the other programs that have already been identified.
The National Committee for Quality Assurance (NCQA) is another organization involved in improving health care quality. Established in 1990, this organization focuses on the managed care industry. It began accrediting these organizations in 1991 in an effort to provide standardized information about them. Its Managed Care Organization (MCO) program is voluntary, and approximately 50 percent of the current HMOs in this country have undergone review by NCQA. Earning the accreditation status is important to many HMOs because some large employers refuse to conduct business with health plans that have not been accredited by NCQA. In addition, more than 30 states recognize the accreditation for regulatory requirements and do not conduct separate reviews.
In 1992, NCQA assumed responsibility for the management of the Health Plan Employer Data and Information Set (HEDIS), a tool used by many health plans to measure the performance of care and service. Purchasers and consumers use the data to compare the performances of managed health care plans. Because more than 60 measures are present in the data set, containing a high degree of specificity, performance comparisons are considered very reliable and comprehensive. The NCQA has designed an audit process that utilizes certified auditors to assure data integrity and validity. HEDIS data are frequently the source of health plan “report cards” that are published in magazines and newspapers. Included in HEDIS is the CAHPS 3.0H survey that measures members’ satisfaction with their care in areas such as claims processing, customer service, and receiving needed care quickly. The data are also used by the plans to help identify opportunities for improvement. A sample of HEDIS measures is shown in Table 7-3.Table 7-3 | Sample HEDIS Measures, Addressing a Broad Range of Important Topics
Asthma medication use
Controlling high blood pressure
Antidepressant medication management
Smoking cessation programs
Beta-blocker treatment after a heart attack
Source: Information compiled from the National Association for Healthcare Quality (NAHQ), http://www.nahq.org.
Courtesy of the National Association for Healthcare Quality.

 

.Explanation of the main purpose and scope of the cited work

An annotated bibliography is a brief summary and analysis of the journal article reviewed. For more information on annotated bibliographies please visit Purdues OWL: https://owl.english.purdue.edu/owl/resource/614/01/
A total of four annotated bibliographies are to be submitted (not to exceed one page each). The articles must come from nursing scholarly literature and may not be older than 5 years since publication. Please note that the articles must be research based and reflect a quantitative methodology (review our reading assignments). Web pages, magazines, textbooks, and other books are not acceptable.
Each annotation must address the following critical elements:
1.Explanation of the main purpose and scope of the cited work
2.Brief description of the research conducted
3.Value and significance of the work (e.g., studys findings, scope of the research project) as a contribution to the subject under consideration
4.Possible shortcomings or bias in the work
5.Conclusions or observations reached by the author
6.Summary as to why this research lends evidence to support the potential problem identified specific to your role option.
PD: each answer must appear below each numbered item

Human Memory | Nursing School Essays

Write a 5–6-page summary of what you learned from three chosen scholarly sources that relate to the memory issue presented in a movie. Explain how the sources relate to what you learned about how memory functions.
In this assessment, you will be able to explain to others how research findings apply to a particular memory issue.
Suggested Resources
The following optional resources are provided to support you in completing the assessment or to provide a helpful context. For additional resources, refer to the Research Resources and Supplemental Resources in the left navigation menu of your courseroom.
Capella Resources
Click the links provided to view the following resources:

APA Paper Template.
APA Style and Format.

SHOW LESS
Capella Multimedia
Click the links provided below to view the following multimedia pieces:

Human Memory I: Conceptual Approaches  |  Transcript.
Life Without Memory |  Transcript.

Course Library Guide
A Capella University library guide has been created specifically for your use in this course. You are encouraged to refer to the resources in the PSYC-FP3500 – Learning and Cognition Library Guide to help direct your research.
Library Resources
The following e-books or articles from the Capella University Library are linked directly in this course:

Brenneis, C. B. (2000). Evaluating the evidence: Can we find authenticated recovered memory? Psychoanalytic Psychology, 17(1), 61–77.
Lange, E. B., & Verhaeghen, P. (2009). No age differences in complex memory search: Older adults search as efficiently as younger adults. Psychology and Aging, 24(1), 105–115.
Loftus, E. F. (2003). Make-believe memories. American Psychologist, 58(11), 867–873.
Berman, M. G., Jonides, J., & Lewis, R. L. (2009). In search of decay in verbal short-term memory. Journal of Experimental Psychology: Learning, Memory, and Cognition, 35(2), 317–333.
Broekkamp, H., & Van Hout-Wolters, B. H. A. M. (2007). Students’ adaptation of study strategies when preparing for classroom tests. Educational Psychology Review, 19(4), 401–428.
Delaney, P. F., & Verkoeijen, P. P. J. L. (2009). Rehearsal strategies can enlarge or diminish the spacing effect: Pure versus mixed lists and encoding strategy. Journal of Experimental Psychology: Learning, Memory, and Cognition, 35(5), 1148–1161.
Ferla, J., Valcke, M., & Schuyten, G. (2008). Relationships between student cognitions and their effects on study strategies. Learning and Individual Differences, 18(2), 271–278.
Brainerd, C. J., Reyna, V. F., & Ceci, S. J. (2008). Developmental reversals in false memory: A review of data and theory. Psychological Bulletin, 134(3), 343–382.
McCauley, M. R., & Fisher, R. P. (1995). Facilitating children’s eyewitness recall with the revised cognitive interview. Journal of Applied Psychology, 80(4), 510–516.

Bookstore Resources
The resources listed below are relevant to the topics and assessments in this course and are not required. Unless noted otherwise, these materials are available for purchase from the Capella University Bookstore. When searching the bookstore, be sure to look for the Course ID with the specific –FP (FlexPath) course designation.

Terry, W. S. (2009). Learning and memory: Basic principles, processes, and procedures (4th ed.). Boston, MA: Allyn and Bacon. 

You may find Chapters 7, 8, 9, and 10 particularly relevant to the topics in this assessment.

Assessment Instructions
Write a 4–5-page summary of what you learned from three chosen scholarly sources that relate to the memory issue presented in a movie. Explain how the sources relate to what you learned about how memory functions.
Preparation
To prepare for this assessment, complete the following:

Memory issues are common themes for movies, theater productions, and television shows. Select and view one movie that illustrates an important effect of memory. Some possible choices are Memento (2000), 50 First Dates(2004), Eternal Sunshine of the Spotless Mind (2004), The Notebook (2004), and Total Recall (1990).
Find at least three scholarly or peer-reviewed sources that address the problem in memory and help you better understand the causes and consequences of the memory issue portrayed in the movie. Think about the accuracy with which the character(s) is portrayed as an individual who has the memory condition.
Research the difference between semantic, episodic, and procedural memory.

Directions
For this assessment, complete the following:

Briefly describe the plot of the movie you selected and the main character(s) involved. Explain why you chose the movie in relation to the memory issue of interest, and how the movie illustrates the memory effect of interest (about one paragraph).
Using the three scholarly sources you found that relate to the memory issue presented in the movie, summarize what you learned from the sources and explain how the sources relate to what you learned about how memory functions.
Taking into account what you have learned about memory, describe what was realistic about the movie’s presentation and what inaccuracies you identified. What would you change in the movie to make a more accurate presentation? What type of memory system was dealt with in the movie (semantic, episodic, or procedural)?
Describe and incorporate the relevant scholarship and theories—what is known about the condition and what the problems or unresolved issues are that have yet to be researched—as it relates to the memory condition presented in the movie.

Strive to be as concise as possible and limit the length of your completed assessment to 4–5 pages, in addition to the title page and references page. Support your statements and analyses with references and citations from at least three resources.
Additional Requirements

Include a title page and a reference page.
Use at least three resources.
Follow APA format.
Note: You may use the APA Paper Template linked in the Resources. This resource is not required.
Use 12-point, Times New Roman font.
Double-space your paper.

Human Memory Scoring Guide
CRITERIANON-PERFORMANCEBASICPROFICIENTDISTINGUISHEDSummarize scholarly research articles related to memory.Does not summarize scholarly research articles related to memory.Partially summarizes scholarly research articles related to memory, but the summaries are incomplete.Summarizes scholarly research articles related to memory.Summarizes the key points of scholarly research articles related to memory in a clear and concise manner.Explain how research findings apply to a particular memory issue.Does not identify how research findings apply to a particular memory issue.Identifies ways in which research findings relate to a particular memory issue, but provides little or no explanation.Explains how research findings relate to a particular memory issue.Analyzes how research findings apply to a particular memory issue and supports conclusions with a strong rationale.Describe the problems and unresolved issues within a particular area of research.Does not identify the problems and unresolved issues within a particular area of research.Identifies the problems and unresolved issues within a particular area of research, but provides little or no description.Describes the problems and unresolved issues within a particular area of research.Describes the problems and unresolved issues within a particular area of research and supports conclusions with a strong rationale.Apply theory and research to a particular memory issue.Does not apply knowledge of theory and research to a particular memory issue.Attempts to apply theory and research to a particular memory issue, but the knowledge or application is incomplete or inappropriate to the situation. Applies theory and research to a particular memory issue.Applies theory and research to a particular memory issue and supports conclusions with a strong rationale. Write coherently to support a central idea with correct grammar, usage, and mechanics as expected of a psychology professional.Writing does not support a central idea. Does not use correct grammar, usage, and mechanics as expected of a psychology professional.Writes to support an idea, but the writing is inconsistent and contains numerous errors of grammar, usage, and mechanics.Writes to coherently support a central idea with few errors of grammar, usage, and mechanics.Writes coherently, using evidence to support a central idea with correct grammar, usage, and mechanics, as expected of a psychology professional.Successfully implement APA style.Does not apply proper APA formatting and style.Written communication is adequate but has some APA errors and inconsistencies.Successfully implements APA style with only minor errors in format.Applies scholarly writing skills, and uses proper APA formatting and style in the body of the paper and references list.

Case Study Mental Health – nursing assignment tutor

1-Please read the following case study and answer questions 2-PLEASE INCLUDE INTRODUCTION, CONCLUSION AND REFERENCES LESS THAN 5 YEARS OLD SUBJECTIVE Stefanie is a 32-year-old female from Puerto Rico who presents to your office today with complaints of difficulty sleeping. You learn that Stefanie can go for a few days with minimal sleep (about 3 hours/night), but does not seem to be fatigued the next day. Stefanie explains that after 3 days with minimal sleep, she crashes and has a good nights sleep. She states that sleep will be alright for a few days, even a few weeks, and then she will have a similar issue with sleep. You learn throughout the assessment process that Stefanie has had this problem for years.
She noticed that it began in college and thought it was just because of the workload and academic demands. However, she found that it persisted after college. She also notices that she has periods where she will engage in increased amounts of goal-directed activity. She states that things will just pile up at work and she gets this burst of energy to make everything right. She states that these bursts will last most of the day. She states that these periods show up probably every 2 to 3 weeks.
Stefanie also confesses to problems with being down in the dumps. She states that when she has her episodes in which she endeavors to make everything right, she feels fantastic and on top of the world. However, when these periods of energy end, she reports that she feels depressed but then states: well, maybe not depressed, but I definitely feel sad and empty. She also endorses feelings of fatigue and a decreased ability to concentrate when she is feeling sad. She finally tells you: I have lived with this for so long, I have to admit that it is finally a relief to tell someone how I feel! OBJECTIVE Stefanie is dressed appropriately to the weather. She has no gait abnormalities. Physical assessment is unremarkable.
Gross neurological assessment is within normal limits. MENTAL STATUS EXAM Stefanie is alert and oriented 4 spheres. Her speech is clear, coherent, goal directed, and spontaneous. Self-reported mood is sad. Affect does appear consistent with dysphoria. Eye contact is normal. Speech is clear, coherent, and goal directed. She denies visual or auditory hallucinations. No overt evidence of paranoid or delusional thought processes noted. She denies suicidal or homicidal ideation and is future oriented.
BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PSYCHIATRIC/MENTAL HEALTH NURSE PRACTITIONER (PMHNP) GIVE TO STEFANIE? Answer Chosen: is Cyclothymic disorder In your write-up of this case, be certain to link specific symptoms presented in the case to DSM5 criteria to support your diagnosis. Please answer the following questions: Decision #1: Differential Diagnosis Which Decision did you select?
Answer Chosen: is Cyclothymic disorder Why did you select this Decision? Support your response with evidence and references to the Learning Resources. Answer Chosen: is Cyclothymic disorder. Explain why you did not choose Bipolar I, current phase, depressed, explain why you did not choose Bipolar II, current phase, hypomanic. In your write-up of this case, be certain to link specific symptoms presented in the case to DSM5 criteria to support your diagnosis. o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different? Decision #2: Treatment Plan for Psychotherapy o Why did you select this Decision? Support your response with evidence and references to the Learning Resources. Selected answer is to begin abilify 10 mg orally, explain why you did not select to begin depakote 250 mg daily, explain why you did not select to arrange to see Stephanie every month for a routine check up. o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different? RESULTS OF DECISION POINT TWO Client returns to clinic after four weeks Stefanie reports that her mood is a little more stable, she reported that she has not been sad since taking that medication Decision #3: Treatment Plan for Psychopharmacology o Why did you select this Decision? Support your response with evidence and references to the Learning Resources. The selected answer is maintain current dose of abilify, explain why you did not select to increase abilify to 15 mg, explain why you did not select to discontinue abiliy o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Also include how ethical considerations might impact your treatment plan and communication with clients and their family. Guidance to Student In order to meet the criteria for a major depressive episode, the client needs to have five or more symptoms (refer to DSM5 major depressive episode criteria).
She only demonstrates criteria # 1: depressed mood most of the day, nearly every day, as indicated by either subjective reports (e.g., feels sad, empty, or hopeless) or observation made by others (e.g., appears tearful); criteria # 6: fatigue or loss of energy nearly every day; and criteria # 8: diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others). Thus, Stefanie does not meet the criteria for a major depressive episode as she only has three out of the needed five criteria for the diagnosis of a major depressive episode. In order to meet criteria for a hypomanic episode, the client needs to have a period of abnormally and persistently elevated, expansive, or irritable mood, and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day. Stefanies symptoms last 3 days.
Additionally, during the period of mood disturbance, the person must have three or more of the qualifying symptoms. Stefanie only has an increase in goal-directed activity and distractibility. Thus, Stefanie does not meet criteria for a hypomanic episode as she only has a decreased need for sleep and an increase in goal-directed activity. Since Stefanie has symptoms of both hypomania and depression (but does not meet the criteria for a major depressive or hypomanic episode), and since these behaviors do not occur in the context of a drug/substance or medical condition, Stefanie meets the diagnostic criteria for cyclothymic disorder.
Some providers will treat cyclothymic disorder with pharmacologic agents used to treat bipolar disorder because individuals with cyclothymic disorder have a higher risk of progression to bipolar disorder. However, there is no consensus in the literature as to the optimal treatment, or if prophylactic psychopharmacologic treatment is beneficial in consideration of the side effects associated with antipsychotics and mood stabilizers. Stefanies symptoms are most consistent with orthostatic hypotension, which is not uncommon when initiating Abilify. At this point, it sounds as if the side effects have subsided. There is nothing to tell us that we should increase the dose. Similarly, there is nothing in the case to tell us that we should discontinue the Abilify. Instead, routine monitoring should occur.

 

4 Employee share purchase plans: safe bet or risky business? 5 What are the particular challenges…

4 Employee share purchase plans: safe bet or risky business?
5 What are the particular challenges of introducing a broadly based option plan?
1 What are the strengths and weaknesses of agency theory as a means of understanding executives’ motivation and behaviour?
 

Components of Nursing Knowledge – nursing assignment tutor

Components of Nursing Knowledge
Please write using active voice.
1. Organization – Information in logical, interesting sequence, the paper has a clear and well-developed introduction, body and conclusion.
2. Introduction – Interesting, clear & concise introduction to the topic of the paper, telling the reader what will be discussed.
3. Content – Interesting, clear & concise discussion of theassumptions & core concepts of the theory, model or topic fullysupport points with convincing arguments, ideas, and data.
4. Theory & Case Study – The theory is clearly explained, and the case study helps to demonstrate the theories usefulness. Problems with the theory are also discussed, the bibliography is complete and reflects appropriateSources. Used Case no more than seven years old, but if there is an original, please acknowledge it with the current case.
5. Use of APA format references NO older than seven years old – Uses at least seven relevant professional references, not including the textbook, and at least five from academic journals. Please used peer review journal and nursing peer review journals. Use quotation marks and give page(s) number for all quotes in the paper. Uses APA correctly.

 

Personal Statement for Medical School Applications

Personal Statement for Medical School Applications
GPA: 3.84 Hispanic, bilingual – fluent in English and Spanish I live in a border town in South Texas, so I wanted to make the theme of my personal statement on pursuing a career in medicine in order to acquire the necessary skills to provide medical care in medically underserved communities like those in South Texas. Happy to listen to any ideas you think may be great themes.

 

Financial Risk in nursing – nursing assignment tutor

Financial Risk in nursing
The key to success in any business is in reporting risks prior to occurrence. Problems and risks cannot be solved unless they become a reality. However, risk management has made it easier for businesses to made problems a reality even before occurrence. With every business, financial risk is a problem that is given so much weight compared to other business risks (Barr & Dowding 2012). For every business particular those that are not out to make profit and rely on community financial contributions, financial risk is a major problem. Looking at healthcare statistics in financing, a higher percentage of healthcare organizations depend on donors and the community to fund their projects on an annual basis. However, donors and community support are mostly given to healthcare organizations that are out to give back to the society and provide community-centered care.
Many community healthcare organizations tend to rely much on philanthropic donations to provide service to the community. With the increase in funding and donations, business planner in healthcare organizations tend to assume that these donations with automatically be made when its time. Financial planners should not rely on financial donations when preparing the budget because every budget should be prepared without factoring in any donations (Barr & Dowding 2012). It would also be hard for Debbie to balance her calculations for the future and the present when donations are added and thus she might not be able to come up with actual calculations needed for the next phase of business. Not having donation calculations in her budget provides Debbie with the ability to design real calculations, balancing every unfavorable variance that might arise in the next business phase.
Financial operations have changed over time. In the past, financial developers were allowed to use donor information to design a budget for the next business phase. With most non-profit organizations still wishing to retain this factor, it has proven difficult for non-profit organizations to transit to the new financial demands. With all the uncertainties of the present, what happens when we have full donor representation and information on the budget and fail to receive the full amount? Wong-Hammond and Damon (2013) report that business targets and plans should be trimmed to help in planning in the event investors fail to remit the whole amount.

 

Explain the 7 Pillars of Bachelors Nursing.

Explain the 7 Pillars of Bachelors Nursing.PLEASE, PLEASE. THIS IS A POSTER. In the guidelines there is website that shows what it should have.
Please See attached files:1- Poster guidelines (there is no minimum word count)2- 7 Pillars of Bachelors Nursing3- Is the actual essay (Capstoneessay) that is based on the 7 Pillars
Also, please write a footnote as I will be using that to do the voice.

 

Discuss conceptual theorists in Nursing.

After reading the assigned chapters, please post two discussion questions based on the readings along with your answers. Do not summarize the chapters. Provide your thoughts and discussion questions that makes your classmates think. Chapters 6, 7, 10, 11, 12, 13, 14, & 15 Conceptual models help us visualize and understand complex issues. Conceptual theorists in Nursing include: Dorothea OremImogene KingSister Callista RoyDorothy JohnsonMyra LevineBetty NeumanMartha Rogers As you read through the assigned chapters, you will get a good understanding of the conceptual model, what makes a conceptual model, and what is concept mapping.
Book: Nursing Theories. The Base for Professional Nursing Practice Julia B. George. 6th edition Instructions: Nursing Theories-Chapter 3,5, 9, 18, and 19. Please add these chapters After reading the assigned chapters, please post two discussion questions based on the readings along with your answers to the following questions: If these chapters influenced your philosophy? Why or why not? Did anything surprise you? What?