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Technology and Cost Containment

Technology and Cost Containment

In response to continually rising health care costs, the Health Information Technology for Economic and Clinical Health (HITECH) provision was created to promote the meaningful use of health care information technology through numerous incentive programs for health care providers. By enhancing data collection, streamlining electronic medical records, and increasing transparency, it is believed that significant cost savings can be realized as well as other positive outcomes. What are some of the tradeoffs involved in this type of policy?

To prepare:

  • Reflect      on the challenges of containing health care costs in the U.S. presented in      the Learning Resources and discussed by Dr. Kominski and Dr. Zelman in the      media.
  • Consider      how information technology may be used to address health care issues      related to cost.
  • Examine      the Health Information Technology for Economic and Clinical Health      (HITECH) provision and its goals.

By tomorrow 03/272018 12 pm, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”

Post a cohesive response that addresses the following:

1) Briefly summarize a significant challenge to containing health care costs.

2) How do policy makers envision technology could be utilized to address this challenge (above)? Provide at least one example to support your response.

3) Do you agree or disagree with the policy makers? Describe why you agree or disagree and include one or more insights from this analysis that relate to the question of how information technology could, or could not, help contain costs while supporting health care reform initiatives.

Required Readings

Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Medical.

  • Chapter      8, “Painful Versus Painless Cost Control”

    Chapter 8 focuses on the relationship between health care costs and health      outcomes and its importance on the health policy agenda. This chapter also      presents strategies for effectively utilizing resources as opposed to      rationing health care services.

  • Chapter      9, “Mechanisms for Controlling Costs”

    Chapter 9 examines an array of policies aimed at controlling health care      costs and reviews specific financial and reimbursement cost containment      methods to health outcomes.

Buntin, M., Jain, S., & Blumenthal, D. (2010). Health information technology: Laying the infrastructure for national health reform. Health Affairs, 29(6), 1214–1219. doi: 10.1377/hlthaff.2010.0503

In this article, the authors examine the role of health information technology as a major component in the restructuring of health care. They suggest it will improve quality, reduce costs, and allow for seamless access to data across providers.

Margolius, D., & Bodenheimer, T. (2010). Transforming primary care: From past practice to the practice of the future. Health Affairs, 29(5).

The authors propose a primary care practice of the future in which physicians act as leaders of a team of health care professionals. Reimbursement would shift from a pay-per-service model to a comprehensive model that incorporates both a standardized payment per patient and performance pay based on improved patient health outcomes.

Maxson, E., Jain, S., McKethan, A., Brammer, C., Buntin, M., Cronin, K., … Blumenthal, D. (2010). Beacon communities aim to use health information technology to transform the delivery of care. Health Affairs, 29(9), 1671–1677. doi: 10.1377/hlthaff.2010.0577

Monheit, A., Cantor, J., DeLia, D., & Belloff, D. (2011). How have state policies to expand dependent coverage affected the health insurance status of young adults? Health Services Research, 46(1), 251- 267.

Young adults (19-29 years of age) are one of the highest uninsured segments of U.S. population. Some states have mandated extended dependent coverage; however, the study presented in this article depicts little effect on uninsured rates. The authors suggest that the PPACA 2010 provision mandating expanded dependent coverage will have better success because more health plans will be involved in the mandate.

Rosenthal, M., Beckman, H., Forrest, D., Huang, E., Landon, B., & Lewis, S. (2010). Will the patient-centered medical home improve efficiency and reduce costs for care? A measurement and research agenda. Medical Care Research & Review, 67(4), 476–484.

This article discusses the use of Patient-Centered Medical Homes (PCMHs) as a cost containment strategy. The authors maintain that credible research needs to be conducted to evaluate the actual results.

Steuerle, C. E., & Bovbjerg, R. R. (2008). Health and budget reform as handmaidens. Health Affairs, 27(3), 633–644.

Wilensky, G. (2010). Health economics. Information Knowledge Systems Management, 8, 179–193.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy: Cost containment. Baltimore: Author.

In this media presentation, Dr. Gerald Kominski and Dr. Walter Zelman discuss the challenges policy makers face in containing health care expenditures and costs.

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collaborative environments

Advanced registered nurses work in highly collaborative environments and must collaborate with interdisciplinary teams in order to provide excellent patient care. Besides knowing the role and scope of one’s own practice, it is essential to understand the role and scope of other nurse specialties to ensure effective collaboration among nurses, the organization, and other professionals with whom advanced registered nurses regularly interact.

Use the “Nursing Roles Graphic Organizer Template” to differentiate how advanced registered nurse roles relate to and collaborate with different areas of nursing practice. Compare your future role with one of the following: nurse educator; nurse leader; family nurse practitioner; acute care nurse practitioner; graduate nurse with an emphasis/specialty in public health, health care administration, business, or informatics; clinical nurse specialist; doctor of nursing practice. Indicate in the appropriate columns on the template which roles you are comparing.

Make sure to compare the following areas of practice in your graphic organizer:

  1. Ethics
  2. Education
  3. Leadership
  4. Public Health
  5. Health Care Administration
  6. Informatics
  7. Business/Finance
  8. Specialty (e.g., Family, Acute Care)

Include any regulatory bodies or certification agencies that provide guidance or parameters on how these roles incorporate concepts into practice.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

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rings true

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

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

To Prepare:

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

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

Change Implementation and Management Plan

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

Your presentation should be 5–6 minutes in length and should include a video with you as presenter.

Your Change Implementation and Management Plan should include the following:

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

4 references not more than 5 years

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Professional Identity and Image

Case Study, Chapter 23, Professional Identity and Image

Nursing care is frequently perceived by the public as simple and unskilled. Many male nurses live in fear of how their caring actions might be interpreted. Many nurses hold that stereotypes about the profession are true, just as the general public does. Public identity and image has been a struggle for nurses for a long time. The greater public clearly does not understand what professional nursing is all about, and the nursing profession has done a poor job of correcting long-standing, historically inaccurate stereotypes.

1. What are the common nursing stereotypes?

2. What was the role of the Center for Nursing Advocacy? Discuss the role of Truth about Nursing in addressing inaccurate or negative portrayals of nursing in the media and the process they use to raise public and professional awareness of the issues surrounding nursing public image?

3. What are some of the ways of changing nursing’s image in the public eye?

4. One of the most important strategies needed to change nursing’s image is to change the image of nursing in the mind of the image makers. What are some of the key ways for nurses to interact with the media?

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appropriate decision making

Question

Question 1. Xi, a fifty-four-year-old female, has a history of migraine that does not respond well to OTC migraine medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend. Which of the following actions would you take for appropriate decision making?

Prescribe Maxalt, but to monitor the use, only give her four tablets with no refills.

Prescribe Maxalt and arrange to have her observed in the clinic or urgent care with the first dose.

Explain that rizatriptan is not used for postmenopausal migraines and recommend Fiorinal (aspirin and butalbital).

Prescribe sumatriptan (Imitrex) with the explanation that it is the most effective triptan.

Question 2. Chronic pain is a complex problem. Some specific strategies to deal with it include ________.

telling the patient to “let pain be your guide” to using treatment therapies

prescribing pain medication on a pro re nata (PRN) basis to keep down the amount used

scheduling return visits on a regular basis rather than waiting for poor pain control to drive the need for an appointment

All the given options

Question 3. Phil is starting treatment with febuxostat (Uloric). Education of patients starting febuxostat includes which one of the following instructions?

Gout may worsen with therapy.

Febuxostat may cause severe diarrhea.

The patients should consume a high-calcium diet.

The patients will need frequent CBC monitoring.

Question 4. The Pain Management Contract is most appropriate for:

Patients with a history of chemical dependency or possible inappropriate use of pain medications

All patients with chronic pain who will require long-term use of opiates

Patients who have a complex drug regimen

Patients who see multiple providers for pain control

Question 5. Patients whose total dose of prednisone exceed 1 gram will most likely need a second prescription for _________.

metformin, a biguanide to prevent diabetes

omeprazole, a proton pump inhibitor to prevent peptic ulcer disease

naproxen, an NSAID to treat joint pain

furosemide, a diuretic to treat fluid retention

Question 6. Sallie has been taking 10 mg of prednisone per day for the past six months. She should be assessed for ________.

gout

iron deficiency anemia

osteoporosis

renal dysfunction

Question 7. All NSAIDs have an FDA black box warning regarding __________.

potential for causing life-threatening GI bleeds

increased risk of developing systemic arthritis with prolonged use

risk of life-threatening rashes, including Stevens-Johnson

potential for transient changes in serum glucose

Question 8. Which of the following statements is true about age and pain?

Use of drugs that depend heavily on the renal system for excretion may require dosage adjustments in very young children.

Among the NSAIDs, indomethacin is the preferred drug because of lower adverse effects profiles than other NSAIDs.

Older adults who have dementia probably do not experience much pain due to loss of pain receptors in the brain.

Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs.

Question 9. Kirk sprained his ankle and is asking for pain medication for his mild-to-moderate pain. The appropriate first-line medication would be __________.

ibuprofen (Advil)

acetaminophen with hydrocodone (Vicodin)

oxycodone (OxyContin)

oral morphine (Roxanol)

Question 10. Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of __________.

serum glucose

stool culture

folate levels

vitamin B12

Question 11. Jamie has fractured his ankle and has received a prescription for acetaminophen and hydrocodone (Vicodin). Education when prescribing Vicodin includes which one of the following instructions?

It is OK to double the dose of Vicodin if the pain is severe.

Vicodin is not habit forming.

He should not take any other acetaminophen-containing medications.

Vicodin may cause diarrhea; therefore, he should increase his fluid intake.

Question 12. Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is _____.

black, tarry stools

vomiting

tremors

tinnitus

Question 13. Henry is eighty-two years old and takes two aspirin every morning to treat the arthritis pain in his back. He states that the aspirin helps him to “get going” each day. Lately, he has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for Henry?

Add an H2 blocker such as ranitidine to his therapy.

Discontinue the aspirin and switch him to Vicodin for the pain.

Decrease the aspirin dose to one tablet daily.

Have Henry take an antacid fifteen minutes before taking the aspirin each day.

Question 14. Patients with RA who are on chronic low-dose prednisone will need co-treatment with which medications to prevent further adverse effects?

A bisphosphonate

Calcium supplementation

Vitamin D

All of the above

Question 15. One of the main drug classes used to treat acute pain is NSAIDs. They are used due to which of the following reasons?

They have less risk for liver damage than acetaminophen.

Inflammation is a common cause of acute pain.

They have minimal GI irritation.

Regulation of blood flow to the kidney is not affected by these drugs.

Question 16. Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a “red flag” about potential chemical dependency?

Use of more than one drug to treat the pain

Multiple times when prescriptions are lost with requests to refill

Preferences for treatments that include alternative medicines

Presence of a family member who has abused drugs

Question 17. Jayla is a nine-year-old who has been diagnosed with migraines for almost two years. She is missing up to a week of school each month. Her headache diary confirms she averages four or five migraines per month. Which of the following would be appropriate?

Prescribe amitriptyline (Elavil) daily, start at a low dose and increase the dose slowly every two weeks until effective in eliminating migraines.

Encourage her mother to give her Excedrin Migraine (aspirin, acetaminophen, and caffeine) at the first sign of a headache to abort the headache.

Prescribe propranolol (Inderal) to be taken daily for at least three months.

Explain that it is rare for a nine-year-old to get migraines and that she needs an MRI to rule out a brain tumor.

Question 18. Narcotics are exogenous opiates. They act by ______.

inhibiting pain transmission in the spinal cord

attaching to receptors in the afferent neuron to inhibit the release of substance P

blocking neurotransmitters in the midbrain

increasing beta-lipoprotein excretion from the pituitary

Question 19. Pathological similarities and differences between acute pain and chronic pain include which of the following options?

Both have decreased levels of endorphins.

Chronic pain has a predominance of C-neuron stimulation.

Acute pain is most commonly associated with irritation of peripheral nerves.

Acute pain is diffuse and hard to localize.

Question 20. Different areas of the brain are involved in specific aspects of pain. The reticular and limbic systems in the brain influence ______.

the sensory aspects of pain

the discriminative aspects of pain

the motivational aspects of pain

the cognitive aspects of pain

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right to manual therapy.

  1. Use the Internet to further explore manual therapy, and answer the following questions:
    1. Identify the actions you can take to safe-guard a patient’s right to manual therapy.
    2. Describe the role of educators, counselors, advocates, and change agents in manual therapy.
    3. List several cases of EBP (evidence-based practice) that support the use of manual therapy.

Please start the paper off with an introduction of manual therapy and then make sure to answer all 3 of those questions

use proper apa 6th edition. include 4 references. each references must include the doi

the paper must be at least 4 pages, include a title page and a reference page

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Theory Overview

Signature Assignment Title: Theory Overview

This week, you will develop a PowerPoint presentation reviewing the theories from each module. Please select one theory from each module (1-8) and answer the following questions. You should have two slides per theory:

Describe the theory
Provide 3 examples of how the theory applies to current practice
Provide 3 positive patient outcomes resulting from utilizing the theory
Explain 3 benefits to nursing satisfaction when utilizing the theory
Describe two barriers to using the theory in practice and at least one method for overcoming each barrier (support methods with sources)
Support from literature clearly noted throughout
The PowerPoint presentation should include at least two outside references and the textbook. The presentation should contain 2 to 4 slides per theory, for a total of 16 to 32 slides.

Learning Materials

Smith, M. C., & Parker, M. E. (2015). Nursing theories and nursing practice (4th ed.). Philadelphia, PA: F.A. Davis. Chapters 19 – 22

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Understand the human experience across the health-illness continuum.

The benchmark assesses the following competency:

Benchmark: 5.1. Understand the human experience across the health-illness continuum.

Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:

  1. Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.
  2. Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.
  3. Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

RUBRIC IN ATTACHED FILE. USE SCHOLARLY ARTICLES ONLY!!!!!!

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professional responsibilities

I need 1 page paper, this is instruction:

Overview

This week’s assignment is also related to the ANA Code of Ethics – Provision 9. You might want to review provision 9 again. Advocating for the profession is important. Writing a letter is one of the ways a nurse can positively promote nursing and its causes. The purpose of this assignment is to write a professional letter to address the image of nursing or to promote a cause for nursing.

This assignment is worth 20 points.

Learning Objectives

· Distinguish the professional responsibilities that accompany the nursing profession.

· Define pressing issues that may arise as a nurse.

Directions

Read the letter writing handout. Then construct a professional letter using one of the two options below. Your letter will consist of proper address, correct salutation/greeting, body of the letter, proper closing, and contact information.

Option A: Write a letter on a current economic or political topic related directly to nursing. Address your letter to the appropriate person – You need to write to a person who is in a position to do something about the problem. For example, you should not write to the President to address a healthcare issue that needs to be passed in congress. You would want to address the correct Senator or representative from your state who will be voting on the issue. This is a professional letter, so letter form, grammar and punctuation is graded, too. This could be to a congressman or woman or to other legislators, to big business or corporations. Remember, there must be a close nursing link to write this letter. You might want to look at a professional organization website in order to look for options.

Option B: Write a letter to defend the image of nursing. Most often nursing is portrayed as less than professional in popular media, TV, advertising, greeting cards, etc.  Choose an example and write a professional letter to the appropriate person to tell them why you think they have portrayed nursing unprofessionally. Tell them how this affects the image of nursing and provide suggestions to change the situation. Look at popular TV shows, e-greetings, traditional cards advertising etc. to find an example. You can even “Google” to find some ideas.

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neurological system

The neurological system affects all parts and functions of the body through nerve stimulation. Nerves also control the sensation and perception of pain. While pain can be described in a variety of ways, it is essentially labeled according to its duration and source. As an advanced practice nurse evaluating a patient, you need to consider the following questions: Does the pain quickly come and go, or is it persistent and ongoing? Does the pain arise at the source of injury or in another location? In this Discussion, you compare three common types of pain—acute, chronic, and referred.

To Prepare

· Review this week’s media presentation on the neurological system, as well as Chapter 14 in the Huether and McCance text.

· Identify the pathophysiology of acute, chronic, and referred pain. Consider the similarities and differences between these three types of pain.

· Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain.

Discussion Post: 

Post a description of the pathophysiology of acute, chronic, and referred pain, including similarities and differences between them. Then, explain how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain.

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

  • Chapter 13, “Structure and      Function of the Neurologic System”

This chapter begins with an overview of the structure and function of the nervous system. It also explains the importance of the central, peripheral, and autonomic nervous systems.

  • Chapter 14, “Pain,      Temperature, Sleep, and Sensory Function”

This chapter covers the role of pain, sleep, stress, and the senses on body functions. It also explores alterations involving pain, sleep, stress, and the senses.

  • Chapter 15, “Alterations in      Cognitive Systems, Cerebral Hemodynamics, and Motor Function”

This chapter explores disorders of cognitive systems, neuromotor function, tone, movement, and motor performance. It also examines factors that impact these disorders as well as clinical manifestations.

  • Chapter 16, “Disorders of      the Central and Peripheral Nervous Systems and Neuromuscular Junction”

This chapter examines the pathophysiology, clinical manifestations, and evaluation and treatment of central and peripheral nervous system disorders. Tumors of the central nervous system are also covered.

  • Chapter 17, “Alterations of      Neurologic Function in Children”

This chapter focuses on the pathophysiology, clinical manifestations, evaluation, and treatment of neurologic disorders and brain tumors in children. Normal growth and development is also examined.

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.

  • Chapter 7, “Nervous System      Disorders”

This chapter begins with an overview of the structure and function of the nervous system to lay a foundation for exploring nervous system disorders. It then examines several nervous system disorders such as Parkinson’s disease, epilepsy, dementia, Alzheimer’s disease, and stroke.

  • Chapter 12, “Disorders of      the Adrenal Medulla”

This chapter examines disorders relating to alterations of the adrenal medulla. It classifies disorders by the organ or tissue that is most impacted by the disorder. The pathophysiology, clinical manifestations, symptoms, and signs of the disorders are also covered.

  • Chapter 19, “Disorders of      the Hypothalamus & Pituitary Gland”

This chapter covers the structure and function of the hypothalamus and pituitary glands. It also explores disorders of the hypothalamus and pituitary glands.

  • Chapter 21, “Disorders of      the Adrenal Cortex”

This chapter begins by exploring the structure and function of the adrenal cortex. It then explores disorders relating to alterations of the adrenal cortex.

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