Musculoskeletal and Neurologic System

Using the South University Online Library or the Internet, research the conditions affecting the musculoskeletal and the neurologic systems. Based on your research and understanding, respond to one of the following scenarios:

1. A 58-year-old female is admitted for a work up for a complaint of neck and low back pain. During admission, you discover that she underwent a renal transplant six years ago. The patient also had blood work collected. When you review the findings, you notice that her serum calcium is elevated at 13.9 (Normal values range from 8.5 to 10.2 mg/dl), her CBC shows a hematocrit of 33%, and hemoglobin of 11.1 g/dl (normal adult female hematocrit Range: 37-47%, normal adult female hemoglobin range: 12-16 g/dl).
   • What does this mean and what could be the underlying cause of her pain and her abnormal lab values?
   • What other assessments would be helpful?

Describe the processes that take place during a typical hospitalization, or emergency department visit for a consumer under the ACA. From admission to discharge, including aftercare, rehab, and acquisition of medications; address the differences, with the same experience from before the ACA was passed into law?

Assignment Expectations: How will students be successful?

• Length:
  • 1500-2000 words (6-8 pages); answers must thoroughly address the questions in a clear, concise manner
• Structure:
  • Include a title page and reference page in APA style
• References:
  • Two scholarly references are required; you should include the appropriate APA style in-text citations and references for all resources utilized to answer the questions

Policy and State Boards of Nursing

Within the far-reaching and multi-layered realm of policy and reform, government at the state level plays an essential role. Consider the federally enacted PPACA’s individual mandate which sought to increase the number of consumers who receive insurance coverage and, therefore, greater access to care. In a system that is already stretched beyond capacity and confronting a nursing shortage, how can the health care system meet this increased demand? Since state boards of nursing determine scope of practice, it is important to stay up to date and current with the policies and regulations that are created by the state board of nursing.

To prepare:

Review the Thomas, Benbow, and Ayars article and the Watson and Hillman article focusing on how states regulate advanced nursing practice and how legislative changes are impacting scope of practice.
Visit your state board of nursing website and/or contact the board to determine how the state board controls advanced practice through regulations (google mbon.org for my state board of nursing)
Determine if your state board has created any new policies or regulations that address changes to scope of practice in response to legislative changes.
By tomorrow 04/25/2018 10am, 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) What are the most recent regulations promulgated through your state board of nursing for advanced practice?

2) How are the state regulations supported within your place of employment? (google mbon.org for my state board of nursing)

3) How do the states differ in terms of scope of practice? What impact does this have on professional nurses across the United States?

Required Readings

Chen, A. S., & Weir, M. (2009). The long shadow of the past: Risk pooling and the political development of health care reform in the States. Journal of Health Politics, Policy & Law, 34(5), 679–716.

The authors provide an analysis of varying state health care policies, with a basic premise that health care risk is either “pooled”—shared, or “actuarial”—segmented by risk level. Most states have taken a segmented approach to health care, and therefore, have not solved health care issues such as rising costs and access to care. The authors maintain that federal action is needed to create a uniformed approach to health care.

Junghee, L. (2009). Cultural, social, and political influences on state-level indigent health care policy formation. Journal of Policy Practice, 8(2), 129–146.

This article provides details on a 50-state study of Medicaid spending. The authors concluded that political and economic factors can positively predict individual state Medicaid spending, and that actual need has a negative impact on spending. In conclusion, a uniform, federal structure may be the only method to ensure equal access to Medicaid.

Mills, A., Engelhard, C. L., & Tereskerz, P. M. (2010). Truth and consequences—Insurance-premium rate regulation and the ACA. New England Journal of Medicine 363(10), 899–901.

O’Connor, J. C., MacNeil, A., Chriqui, J. F., Tynan, M., Bates, H., & Eidson, S. K. (2008). Preemption of local smoke-free air ordinances: The implications of judicial opinions for meeting national health objectives. Journal of Law, Medicine & Ethics, 36(2), 403– 412.

Sommers, B. (2010). Enrolling eligible children in Medicaid and CHIP: A research update. Health Affairs, 29(7), 1350.

The enrollment and retention of eligible children in Medicaid and Children’s Health Insurance Program (CHIP) is a health care concern. The article concludes that some state processes have mitigated this issue but other requirements, such as providing citizenship documentation, may have a detrimental effect. Therefore, these concerns should be incorporated into the implementation on PPACA of 2010.

Thomas, M. B., Benbow, D. A., & Ayars, V. D. (2010). Continued competency and board regulation: One state expands options. Journal of Continuing Education in Nursing, 41(11), 524-528.

The authors use the changes instituted by the state of Texas in regard to the licensing of nurses to illustrate the need to adapt state licensing requirements to the changing diversity and scopes of practice among nurses.

Watson, E., & Hillman, H. (2010). Advanced practice registered nursing: Licensure, education, scope of practice, and liability issues. Journal of Legal Nurse Consulting, 21(3), 25–29.

The expanded role of the advanced practice nurse has led to changes in licensure, education, certification, and scope of practice definitions. The author points out that this expanded role has led to increased liability and accountability concerns as well.

Yue, L., Harrington, C., Spector, W. D., & Mukamel, D. B. (2010). State regulatory enforcement and nursing home termination from the Medicare and Medicaid programs. Health Services Research, 45(6p1), 1796-1814. doi:10.1111/j.1475-6773.2010.01164.x

Those nursing homes receiving Medicare and Medicaid funding are subject to strict quality and safety regulations. This article examines the consequences of enforcing those federal quality standards.

Optional Resources

Wieck, K. L., Oehler, T., Green, A., & Jordan, C. (2004). Safe nurse staffing: A win-win collaboration model for influencing health policy. Nursing Education Perspectives, 31(3), 160-166.

Part B. For this assignment, you will research and prepare a community-level strategic plan that addresses a key public health issue.

Potential topics may include:

• Using prenatal and infancy home visits to prevent child abuse and neglect

• Preventing falls in the elderly

• Reducing population salt intake

• Reducing tobacco use among adults

• Preventing risky sexual behavior among youth and young adults

• Reducing drug experimentation among young adults

Include the following in your paper:

Introduction:

Provide an overview of the community health issue as described in Part A (attached is three documents that are Part A from last week done by you for each assignment) with identified causes and influences, including knowledge gaps.

Detail the prevalence of the issue inside and outside the United States.

Describe potential monetary costs associated with the issue in the United States.

You must include data as part of your introduction (images, charts, graphs, etc., may be included as well as written data).

Describe advance practice roles and management strategies that affect change at the community level.

Identify key community and social resources that negatively and positivelyaffect the selected issue.

Identify changes or enhancements in community-related services for your selected topic.

Develop a strategic plan that could decrease the prevalence of your selected topic.The goals for this plan needs to be specific, measurable, attainable, realistic, and time-bound. Include how your plan takes into consideration health literacy, socioeconomic factors, and cultural differences.

Conclusion:

A summary of the goals and challenges

An assessment of the outlook for action/progress

Appendix A: Include your community assessment from Week 3 as Appendix A.

Your paper should be 5 pages in length (not including the cover or reference pages). Use APA throughout.

Include 2–3 scholarly sources that are carefully selected and appropriate to the topic. References should be current—no more than four years old.

Rubrics:

The writer clearly and effectively responds to the assignment.

There is one clear, well-focused topic. Main ideas are clear and are well supported by detailed and accurate information.

The introduction is inviting, states the main topic, and provides an overview of the paper. Information is relevant and presented in a logical order. The conclusion is strong.

The assignment consistently follows current APA format and is free from errors in formatting, citation, and references. No grammatical, spelling, or punctuation errors. All sources are cited and referenced correctly.