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Systems Development Life Cycle

To Prepare:

Review the steps of the  (SDLC) as presented in the Resources.
Reflect on your own healthcare organization and consider any steps your healthcare organization goes through when purchasing and implementing a new health information technology system.
Consider what a nurse might contribute to decisions made at each stage of the SDLC when planning for new health information technology.

Assignment: Write a description of what you believe to be the consequences of a healthcare organization not involving nurses in each stage of the SDLC when purchasing and implementing a new health information technology system. Provide specific examples of potential issues at each stage of the SDLC and explain how the inclusion of nurses may help address these issues. Then, explain whether you had any input in the selection and planning of new health information technology systems in your nursing practice or healthcare organization and explain potential impacts of being included or not in the decision-making process. Be specific and provide examples.

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Case Study

Case Study 3 & 4 (10 Points) Due 06/29/2019

Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.

Case Study 3 & 4 S Inflammatory Bowel Disease and Urinary Obstruction

Case Studies will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)

Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

Late Assignment Policy

Assignments turned in late will have 1 point taken off for every day assignment is late, after 7 days assignment will get grade of 0. No exceptions

Urinary Obstruction

Case Studies

The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary stream for several months. Both had progressively become worse. His physical examination was essentially negative except for an enlarged prostate, which was bulky and soft.

Studies

Results

Routine laboratory studies

Within normal limits (WNL)

Intravenous pyelogram (IVP)

Mild indentation of the interior aspect of the bladder, indicating an enlarged prostate

Uroflowmetry with total voided flow of 225 mL

8 mL/sec (normal: >12 mL/sec)

Cystometry

Resting bladder pressure: 35 cm H2O (normal: <40 cm H2O)

Peak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O)

Electromyography of the pelvic sphincter muscle

Normal resting bladder with a positive tonus limb

Cystoscopy

Benign prostatic hypertrophy (BPH)

Prostatic acid phosphatase (PAP)

0.5 units/L (normal: 0.11-0.60 units/L)

Prostate specific antigen (PSA)

1.0 ng/mL (normal: <4 ng/mL)

Prostate ultrasound

Diffusely enlarged prostate; no localized tumor

Diagnostic Analysis

Because of the patient’s symptoms, bladder outlet obstruction was highly suspected. Physical examination indicated an enlarged prostate. IVP studies corroborated that finding. The reduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the patient was found to have a normal total voided volume, one could not say that the reduced flow rate was the result of an inadequately distended bladder. Rather, the bladder was appropriately distended, yet the flow rate was decreased. This indicated outlet obstruction. The cystogram indicated that the bladder was capable of mounting an effective pressure and was not an atonic bladder compatible with neurologic disease. The tonus limb again indicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was normal, again indicating appropriate muscular function of the bladder. Based on these studies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA indicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis. Cystoscopy documented that finding, and the patient was appropriately treated by transurethral resection of the prostate (TURP). This patient did well postoperatively and had no major problems.

Critical Thinking Questions

1. Does BPH predispose this patient to cancer?

2. Why are patients with BPH at increased risk for urinary tract infections?

3. What would you expect the patient’s PSA level to be after surgery?

4. What is the recommended screening guidelines and treatment for BPH?

5. What are some alternative treatments / natural homeopathic options for treatmen

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Ethics Handout

Assignment Details

Unit 6 assignment: Ethics Handout

Purpose: The Purpose of this assignment is for you to learn the principles of ethical conduct in research as defined in the Belmont Report, the role of the IRB, and the role of the RN in protecting human subjects in research.

Outcomes addressed:

NU310-4: Determine the ethical principles necessary to protect human subjects and avoid scientific misconduct in research.

PC 2.3: Demonstrate integrity through the application of relevant codes of conduct and social responsibility within one’s profession.

Ethics Handout Project:

For this assignment you will create a colorful handout that you will post on a bulletin board in your staff lounge or disseminate to work colleagues to inform them of ethical conduct in human research and protection of participants.

Be creative with the handout using color and make it interesting.

I. Content of the Handout:

  1. Include a brief historical overview of ethics and the need for human protection

(for example the Belmont Report and how it came about).

  1. Include legal and ethical issues relevant to nursing research.
  2. Briefly state the role of the Institutional Review Board (IRB).
  3. Procedures for protecting individuals:
    1. Informed consent.
    2. Identify vulnerable or at risk participants and explain special considerations.
    3. Privacy and confidentiality issues.
    4. Justice and fair treatment of research participants.
    5. The RN’s role in protecting human subjects.
  4. Section containing frequently asked questions concerning protection of human subjects with answers provided.

II. Presentation of Handout

  1. Name and credentials at the bottom.
  2. The handout should have attractive formatting that is legible and well-organized and is presented with a mix of interesting graphics along with text.
  3. Handout should be colorful and interesting and well organized.
  4. Spelling, grammar, and punctuation should be correct throughout the document.
  5. Provide at least 5 scholarly references and list them in APA format on a separate document.

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issue facing healthcare today

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

  • Review the Resources and select one current national healthcare issue/stressor to focus on.
  • Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

By Day 3 of Week 1

Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

requires citations of at least three current references.

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create a meal plan. 

Step 1: Using the following Case Study, create a meal plan.

Jackie is a healthy women.  She is 45 years old and 5’7″ tall.  Jackie’s current weight is 160 lbs.  She exercises 4-5 times per week but is struggling to meet her goal weight.  Jackie is seeking your clinical advice to lose 15 lbs in 3 months.  Her target weight goal is 145 lbs.

Write a basic meal plan for your client. Include how many calories each day she will need to consume to lose 1-2 lbs each week Calculate her complete macronutrient breakdown including; total carb consumption, total fat consumption, total protein consumption and explain the rationale for all of your choices.

Jackie is a healthy women.  She is 45 years old and 5’7″ tall.  Jackie’s current weight is 160 lbs.  She exercises 4-5 times per week but is struggling to meet her goal weight.  Jackie is seeking your clinical advice to lose 15 lbs in 3 months.  Her target weight goal is 145 lbs. Write a basic meal plan for your client. Include how many calories each day she will need to consume to lose 1-2 lbs each week Calculate her complete macronutrient breakdown including; total carb consumption, total fat consumption, total protein consumptionExplain the rationale for all of your choicesStep 1: Using the following Case Study, create a meal plan. Jackie is a healthy women.  She is 45 years old and 5’7″ tall.  Jackie’s current weight is 160 lbs.  She exercises 4-5 times per week but is struggling to meet her goal weight.  Jackie is seeking your clinical advice to lose 15 lbs in 3 months.  Her target weight goal is 145

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alternative ideas regarding opportunities and risks related to the observations shared. 

Respond to the post bellow, offering additional/alternative ideas regarding opportunities and risks related to the observations shared. 

 

Initial Post

There  is no doubt that the use of technology is increasing all around us. The  health care field is no different. Technology now plays a major role in  the health care profession. It is almost guaranteed to continue to  develop at a rapid rate (Horn, 2017). From electronic heath records to  patient portals, I have utilized technology since becoming a nurse,  increasing significantly over the last decade. However, at my most  current place of employment, we do not use much technology at all. In  fact, much of technology is prohibited as I work in a prison. After  relying on technology so heavily, it has been a major adjustment to  return to the era of very limited technology use. In fact, the only  technology we utilize is telehealth.

Telehealth is the “delivery of  health care services, where distance is  a critical factor, by all healthcare professionals using information  and communication technologies for the exchange of valid information for  diagnosis, treatment and prevention of disease and injuries, research  and evaluation, and for the continuing education of health care  providers, all in the interest of advancing the health of individuals  and their communities” (Koivunen, & Saranto, 2018). This method of  health care delivery is seen as a means in which to improve  communication and enhance patient-centered care (Cipriano, 2011; Virji,  Yarnall, Krause, Pollak, Scannell, Gradison, & Ostbye, 2006). As  with all technology, there are both facilitators and barriers present  with the use of telehealth.

According  to the study conducted by Koivunen & Saranto (2018), nurses’ skills  in telehealth application were seen as a facilitator to telehealth  utilization. However, the same study identified some barriers present.  Some of those barriers included nursing’s discomfort with the equipment  utilized with telehealth as well as lack of basic computer skills  present amongst nurses (Koivunen, & Saranto, 2018). In addition,  negative attitudes along with lack of support and training were  identified barriers (Koivunen, & Saranto, 2018). It is obvious that  the change from traditional face-to-face nursing practice to telehealth  requires much support for its users. There is certainly a learning curve  with any new technology with experience and attitudes playing a major  role in the successful implementation. However, if the proper steps are  taken, telehealth can be a  cost-effective way to address health care needs and has been shown to  improve clinical indicators (Shulver, Killington, & Crotty, 2016).

In addition to the barriers present, there is also negative attitudes  by some clinicians in regards to telehealth. While some health care  providers believe that telehealth could offer enhanced and expanded  services to many, other clinicians voiced reservations about the  potential safety and suitability of this service (Shulver et al., 2016).  However, in the case of rural patients, many can agree that a service  is better than no service. According to Shulver et al. (2016),  clinicians agreed that any perceived risks associated with telehealth  could be alleviated by having a person “on the ground” with the patient  during telehealth conferences. This is exactly how telehealth is  utilized at my current place of employment. The inmates are seen by a  distance provider as the nurse remains in the room with the patient to  perform any assessments requested and provide information from records  as needed.

Telehealth  is only one of many promising trends in health care that offer many  benefits. Other up-and-coming health technology trends include  artificial intelligence, Internet of Medical Things (IoMT),  blockchains, and virtual/augmented reality. These trends have many  benefits to offer. For example, artificial intelligence is now capable  of diagnosing skin cancer more accurately and more efficiently than a  board-certified dermatologist (Rigby, 2019). But, as previously  mentioned, all technology can bring added risks. Such use of technology  has the potential to threaten patient safety, preference, and privacy  (Rigby, 2019). Informed consent remains of utmost importance, as with  any medical procedure, when utilizing technology in providing health  care to patients. All the risks associated with the technology must  remain transparent to the patient.

Technology has already advanced quickly all around us and its use in  health care is no exception. By utilizing technology, the practice of  medicine is revolutionized, transforming the patients’ experiences and  the providers’ daily routines. These up-and-coming health care trends  are aimed at preventative care while enhancing patient experiences,  lowered expenses, and big data processing. Cutting-edge technology is  being utilized by many providers to assist their patients. We can only  expect the current trend to continue with more amazing discoveries to  come.

References

Cipriano P. (2011). The future of nursing and health IT: the quality elixir. Nursing Economics, 29(5), 286–90. Retrieved from https://www.researchgate.net/publication/221868226_The_Future_of_Nursing_and_Health_IT_The_Quality_Elixir

Horn, H. (2017). Predicting the Future of Healthcare Technology. Biomedical Instrumentation & Technology51(3), 203. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.2345/0899-8205-51.3.203

Koivunen,  M., & Saranto, K. (2018). Nursing professionals’ experiences of the  facilitators and barriers to the use of telehealth applications: a  systematic review of qualitative studies. Scandinavian Journal of Caring Sciences32(1), 24–44. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.1111/scs.12445

Rigby, M.J. (2019). Ethical Dimensions of Using Artificial Intelligence in Health Care. AMA Journal of Ethics21(2), 121–124. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.1001/amajethics.2019.121

Shulver,  W., Killington, M., & Crotty, M. (2016). “Massive potential” or  “safety risk”? Health worker views on telehealth in the care of older  people and implications for successful normalization. BMC Medical Informatics And Decision Making16(1),  131. Retrieved from  https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=27733195&site=eds-live&scope=site

Virji,  A., Yarnall, K., Krause, K., Pollak, K., Scannell, M., Gradison, M.,  & Ostbye ,T. (2006). Use of email in a family practice setting:  opportunities and challenges in patient- and physician-initiated  communication. BMC Med, 4(18), 1-7. Retrieved from https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-4-18

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Change Implementation and Management Plan

Assignment: Change Implementation and Management Plan

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.

o  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.

MODULE 4 ASSIGNMENT ATTACHED.  WILL DO ASSIGNMENT ON WORKPLACE INCIVILITY.

WORKPLACE ENVIRONMENT ASSESSMENT ATTACHED

· Reflect on how you might implement this change and how you might communicate this change to organizational leadership.

The Assignment (6-7 PowerPoint SLIDE presentation):

Change Implementation and Management Plan

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—ATTACHED BELOW)

· 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

ADDITIONAL RESOURCES FOR REFERENCES:

http://www.ijhpm.com/article_3183_5015382bcf9183a74ef7e79b0a941f65.pdf

https://medcom.uiowa.edu/annsblog/wp-content/uploads/2012/10/JONA-FINAL-Cullen-2012.pdf

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(Chamberlain)

NR 439 EVIDENCE-BASED PRACTICE

(Chamberlain)

 

NR 439 Week 1 Discussion 1 Searchable Clinical Questions

NR 439 Week 1 Discussion 2 Role of Research

NR 439 Week 2 Discussion 1 Describe a Significant Nursing Clinical Issue

NR 439 Week 2 Discussion 2 Share a Research Database Description

NR 439 Week 3 Discussion 1 Research Problems and Design

NR 439 Week 3 Discussion 2 Share a Research Design for Your Significant Nursing Clinical Issue

NR 439 Week 4 Discussion 1 Sampling

NR 439 Week 4 Discussion 2 Ethical and Legal Issues

NR 439 Week 5 Discussion 1 Measurement Strategies

NR 439 Week 5 Discussion 2 Data Collection

NR 439 Week 6 Discussion 1 Significance of Results

NR 439 Week 6 Discussion 2 Collection Methods

NR 439 Week 7 Discussion 1 Applying Evidence to Practice

NR 439 Week 7 Discussion 2 Sharing Evidence

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nuclear weapons

WRITE A PARAGRAPH ON EACH QUESTION.

1.  Discuss the example of Harry Truman dropping nuclear weapons on  Hiroshima and Nagasaki in the context of the Utilitarian and Kantian  principles. Also include a discussion of Elizabeth Anscombe’s critic of  Truman.

2.  Describe the Categorical Imperative. Be sure to include a description  of how Kant derives the principle from an understanding that Morality is  a matter of reason not emotion.

3.  What is Kant’s argument against lying? What is problematic about it,  and what happens when it comes into conflict with other absolute rules?

4. How do Kant’s core values cause him to embrace retribution, and reject rehabilitation?

5. What are the Utilitarian arguments for the implementation of retribution?

6.  Discuss Kolberg’s six stages of moral development. Include in your  discussion the examples of Amy and Jake, and how their different  approaches to a moral dilemma would be understood in the context of  Kohlberg’s theory.

7.  Discuss Giligan’s Objection to Kolberg’s labeling of Amy and Jake. What  are the differences between the way men and women approach moral  dilemma’s according to Giligan?

8.  Discuss the ethics of care. How does it differ from the pre-dominantly  male oriented approaches to morality that have been discussed?

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Health Care Fraud

Read the news report “Maryland Health Care Provider Sentenced to 10 Years in Federal Prison for Health Care Fraud Resulting in Patient Deaths.”

Use the FiveWhys to conduct a root cause analysis to determine why the Medicare fraud occurred and Timothy Emeigh’s participation in the case.

Write a 525- to 700-word paper that identifies and evaluates the root cause for Medicare fraud in this case.

Include the following:

  1. List each of the Five Whys and your response.
  2. Speculate as to why Mr. Emeigh participated in the scheme.
  3. Explain what you might have done to prevent this from happening.

This is the link to the web site for this assignment

https://www.justice.gov/usao-md/pr/maryland-health-care-provider-sentenced-10-years-federal-prison-health-care-fraud

Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality).

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