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Technology Trends and Risk

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

 

Main Post

I am currently a home telehealth nurse for a  large VA hospital. I worked bedside for 17 years prior my current  position. Unlike the inpatient setting, the technology and advancement  made for the telehealth programs within the VA are impressive and  evolving rapidly.

Technology Trends and Risk

An obvious trend within the VA system is the  expansion of technology within the telehealth program. A large  percentage of the veterans live in rural areas.  At the time, home  telehealth technology is limited to monitoring patients with chronic  diseases through platforms via PC, a device to manually enter readings  daily, mobile apps, and manually entering readings through a phone  number.  The VA is now trending toward video assisted monitoring with  home telehealth.   There are physician’s offices and community-based  clinics are already using this technology. The primary challenge with  this technology is the accessibility of reliable signal strength to  patients in rural areas.  An additional struggle is difficulty with  these veterans working with this technology.

Data Safety

The VA medical system has an adequate privacy and  security protection as it relates to data safety and information sent  through telemedicine modalities.   The VA has a dedicated department  that strictly monitors all data activity. Despite the security in place  there are risk, specifically with telehealth transmission of personal  health information. These risks include accidental transmission of  household information and activities including personal interactions  with family members or indicators when the patient may not be home (Hall  & McGraw, 2014).

Patient Care

Patient care benefits of telemedicine are  endless. These benefits include less travel time, real time monitoring  of medication changes, monitors patients with chronic condition like  COPD and CHF closely to prevent or address acute episode (McGonigle  & Mastrian, 2018).  This cuts down on office visits and travel time.  More importantly, healthcare management is achieved sooner improving  overall patient outcomes.  Patient’s rely heavily on monitoring from  home creating a potential risk.  Often these patients with chronic care  management are not compliant with transmitting information or  information is sent inconsistently making it difficult to assist with  achieving overall goals.

Legislation

Telehealth  technology allows providers to treat remotely defined by state-by-state  licensure (Milstead & Short, 2019).  The benefit of state  regulation is the ability to closely monitor practice and outcomes on a  state level. The federal government is considering nationalizing the  regulations for telehealth. This presents a dilemma as physicians  practicing telehealth will require multi state licenses.

I believe the most promising healthcare trends  impacting healthcare technology and nursing practice is the advancement  of telemedicine.  The ability to remotely monitor patients and maintain a  consistent record provide information for time sensitive diagnosis and  treatment.  The impact this has on nursing is profound. Nurses will be  responsible not only for monitoring but for teaching these patients how  to manage these problems themselves. The nurse’s consistent  communication allows for education not only with medication but with  diet, exercise, weight loss and overall prevention.  Telehealth is a  promising tool to the new culture of preventative healthcare. While  patients are in the program, they can interact and learn about their  disease process and exacerbation prevention. Telehealth is a win win.

References

Hall, J. L., & McGraw, D. (2014). For  Telehealth to Succeed, Privacy and Security risks must be Identified and  Addressed []. Health Affairs, 33(2).                        https://doi.org/https://doi.org/10.1377/hlthaff.2013.0997

McGonigle, D., & Mastrian, K. G. (2018). Nursing Informatics and the Foundation of Knowledge (4 ed.). Burlington, MA: Jones & Bartlett Learning.

Milstead, J. A., & Short, N. M. (2019). Health Policy & Politics A Nurse’s Guide. Burlington, MA: Jones & Bartlett Learning Books.

The Case Study Assignment

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Assigned CASE STUDY: Forgetfulness -A 70-year-old female comes to your clinic with complaints of forgetfulness. She noticed it about a year ago and it has progressively gotten worse. She sometimes forgets what she is going to do when she gets to another room. Her family has noticed the problem with her forgetfulness but she is still able to manage her finances and drive, per her report.

Your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

With regard to the case study you were assigned:

Review this week’s Learning Resources, and consider the insights they provide about the case study.

Consider what history would be necessary to collect from the patient in the case study you were assigned.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. 

Health care organizations

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Assignment Details

Health care organizations are currently tasked with providing value-based health care. The concept of value-based health care is best illustrated in the Triple Aim Initiative outlined by the Institute for Healthcare Improvement (IHI), which emphasizes the need for health care organizations to optimize their performance by simultaneously addressing the following three aims (2018):

  • Improve the experience of care
  • Improve the health of populations
  • Reduce the per capita costs of health care

Task

Identify a health care organization, and answer the following questions:

  • Do you think this organization meets these criteria? If yes, how? If no, why not?
  • What recommendations would you advance to hospital administrators to enhance their health care delivery with these goals in mind?

Do not forget to cite concepts and personal experiences in your response.

leadership and inquiry

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Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.

In your journal, you will reflect on the personal knowledge and skills gained throughout this course. The journal should address a variable combination of the following, depending on your specific practice immersion clinical experiences:

1. New practice approaches

2. Intraprofessional collaboration

3. Health care delivery and clinical systems

4. Ethical considerations in health care

5. Population health concerns

6. The role of technology in improving health care outcomes

7. Health policy

8. Leadership and economic models

9. Health disparities

Students will outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how the student met the competencies aligned to this course.

While APA style is required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines.

process measures

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Field of study:  Nursing

 

In a 1,000-1,250 word paper, consider the outcome and process measures that can be used for CQI. Include the following in your essay:

  1. At least two process measures that can be used for CQI.
  2. At least one outcome measure that can be used for CQI.
  3. A description of why each measure was chosen.
  4. An explanation of how data would be collected for each (how each will be measured).
  5. An explanation of how success would be determined.
  6. One or two data-driven, cost-effective solutions to this challenge.

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.

Head-to-Toe Assessment

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Head-to-Toe Assessment

For this assignment, perform a complete head-to-toe assessment on one of your chosen participants. Your analysis should include the following:

  • Topical headings to delineate systems.
  • For any system for which you do not have equipment, explain how you would do the assessment.
  • Detailed review of each system with normal and abnormal findings, along with normal laboratory findings for client age.
  • An analysis of age-specific risk reduction, health screen, and immunizations.
  • Your expectation of normal findings and what might indicate abnormal findings in your review of systems.
  • The differential diagnosis (disease) associated with possible abnormal findings.
  • A plan of care (including nursing diagnosis, interventions, evaluation).
  • Client and age-appropriate evidenced based practice strategies for health promotion.
  • Pharmacological treatments that can be used to address health issues for this client.

Provide your answers in a 6- to 7-page Microsoft Word document.

Support your responses with examples.

On a separate references page, cite all sources u

excessive resorption

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Question

1. Which disorder is characterized by the formation of abnormal new bone at an accelerated rate beginning with excessive resorption of spongy bone?

Osteomalacia

Paget disease

Osteoporosis

Osteosarcoma

Question 2. Considering the pathophysiology of osteoporosis, what are the effects of extracellular signal regulated kinases (ERKs) and receptor activator of RANKL on osteoblasts and osteoclasts?

ERKs increase the life span of osteoclasts and RANKL decreases the life span of osteoblasts.

ERKs and RANKL increase the life span of osteoclasts and decrease the life span of osteoblasts.

ERKs and RANKL increase the life span of osteoblasts and decrease the life span of osteoclasts.

ERKs increase the life span of osteoblasts and RANKL decreases the life span of osteoclasts.

Question 3. _____ is the temporary displacement of two bones in which the bone surfaces partially lose contact.

Dislocation

Subluxation

Malunion

Nonunion

Question 4. What is the diagnosis of a person who has tennis elbow characterized by tissue degeneration or irritation of the extensor carpi brevis tendon?

Lateral epicondylitis

Medial tendinitis

Bursitis

Lateral tendinitis

Question 5. Which type of osteoporosis would a person develop after having the left leg in a cast for 8 weeks to treat a compound displaced fracture of the tibia and fibula?

Iatrogenic

Regional

Idiopathic

Osteoblastic

Question 6. Bone death as a result of osteomyelitis is because of

formation of immune complexes at the site of infection.

localized ischemia.

TNF-? and IL-1.

impaired nerve innervation at the site of infection.

Question 7. By the time osteoporosis is visible on x-ray, up to ____% of bone has been lost.

30

40

50

60

Question 8. Osteochondrosis is caused by a(n)

imbalance between calcitonin and parathyroid hormone.

nutritional deficiency of calcium and phosphorus.

bacterial infection of the bone.

vascular impairment and trauma to bone.

Question 9. Ewing sarcoma arises from

bone marrow.

bone-producing mesenchymal cells.

metadiaphysis of long bones.

embryonal osteocytes.

Question 10. An insufficient dietary intake of vitamin _____ can lead to rickets in children.

C

B12

B6

D

Question 11. Which protein, absent in muscle cells of Duchenne muscular dystrophy, mediates the anchoring of skeletal muscles fibers to the basement membrane?

Syntrophin

Laminin

Dystrophin

Troponin

Question 12. Which serum laboratory test is elevated in all forms of osteogenesis imperfecta?

Phosphorus

Calcium

Alkaline phosphatase

Total protein

Question 13. Cerebral palsy is usually a result of

brain ischemia during birth.

prematurity.

congenital defects.

genetic defect.

Question 14. What diagnosis is given when the infant’s hip maintains contact with the acetabulum, but is not well seated within the hip joint?

Dislocatable hip

Subluxated hip

Dislocated hip

Subluxable hip

Question 15. The total mass of muscle in the body can be estimated from which serum laboratory test value?

Albumin

Blood urea nitrogen

Creatinine

Creatine

Question 16. Which malignancy is characterized by slow-growing lesions that usually have depressed centers and rolled borders and are frequently located on the face and neck?

Squamous cell carcinoma

Kaposi sarcoma

Malignant melanoma

Basal cell carcinoma

Question 17. Which cell is thought to be the progenitor cell of Kaposi sarcoma?

Endothelial

Keratinocyte

Melanocyte

Exothelial

Question 18. Cutaneous vasculitis develops from the deposit of _____ in small blood vessels as a toxic response allergen.

immune complexes

IgE

complement

T lymphocytes

Question 19. Which type of psoriasis is characterized by lesions on the elbows and knees that are well demarcated, thick, silvery, scaly, and erythematous?

Plaque

Inverse

Guttate

Erythrodermic

Question 20. An older adult man states he has a sore above his lip that has not healed and is getting bigger. The nurse observes a red scaly patch with an ulcerated center and sharp margins. The nurse recognizes these features as commonly associated with Bowen disease, a form of

Kaposi sarcoma.

malignant melanoma.

basal cell carcinoma.

squamous cell carcinoma.

Question 21. What is a common source of tinea corporis?

Mites

Kittens

Fleas

Ticks

Question 22. Which skin disorder has as its hallmark clinical manifestation skin lesions that rupture, creating a thin, flat, honey-colored crust?

Rubella

Tinea capitis

Atopic dermatitis

Vesicular impetigo

Question 23. Bullous impetigo is caused by a strain of _____ that produces an exfoliative toxin, resulting in a disruption in cellular adhesion.

Staphylococcus aureus

Streptococcus pyogenes

Escherichia coli

Candida albicans

Question 24. Which immunoglobulin is elevated in atopic dermatitis?

IgA

IgM

IgE

IgG

Question 25. Which clinical manifestation is considered the hallmark of atopic dermatitis?

Papular rash

High fever

Vesicles that burst and form crusts

Itching

 

environmental assessment

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Develop a proposed evidence-based change-project plan specific to the environment you are using to implement your change project. Your environmental assessment will include a work breakdown structure, a budget plan, and a measurement tool.

This week, you will design a plan that is at least four pages in length and includes all the information listed in the instructions below to discuss the elements of your proposed plan.

  • Develop an environmental assessment of your change project area and its readiness for the specific change project you are going to implement.
    • Include a work breakdown structure. For example, you could create a (timeline/task list/Gantt chart)—a hierarchical definition of the planned tasks and activities of a project that normally begins with the highest-level activities and works downward into the individual tasks.
    • Include a proposed project budget (table or spreadsheet) for the project that addresses the needed personnel, equipment, and supplies that may have associated costs. Click this link for a sample budget template Click for more options .
    • Include your measurable evaluation methods (indicators/metrics). Include the actual measurement tool you will use and describe any of the following that are applicable to your project: cost savings, improved efficiencies, access to care (visits/procedures/admissions), patient/family satisfaction, associate satisfaction, associate engagement, retention, clinical outcomes, injury prevention, and risk reduction.
  • attachment

    BudgetTemplate.docx

politics in associations and interest groups

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Complete this week’s assigned readings, chapters 86 & 87 of your book . After completing the readings, post a reflection discussing your thoughts and opinions about one or several of the specific topics covered in the textbook readings. pertaining to politics in associations and interest groups. Identify which one MSN Essential most relates to your selected topic in your discussion.

As a reminder, no scholarly sources are required only your text book :

Mason, D. J., Leavitt, J.K., Chaffee, M.W. (2016). Policy and Politics: In Nursing and Health Care. (7th• Ed) St. Louis, Missouri: Elsevier, Saunders. ISBN-13: 9780323299886

policy issues

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Reflect on the role that the electoral process and government plays in one’s daily work and family life. As nurses, health policy can influence both arenas of our lives.

1-What policy issues might drive

Reflect on the role that the electoral process and government plays in one’s daily work and family life. As nurses, health policy can influence both arenas of our lives.

1-What policy issues might drive nurses to lobby Congress and/or get involved in campaign politics?

2-What strategies might nurses use to have their voices heard?

You can use this reference:

The American Nurse: http://www.theamericannurse.org/2014/10/22/time-for-nurses-to-get-out-the-vote/ 

As a reminder, all questions must be answered by separated to receive full credit for this discussion. Make sure to use scholarly sources to support your discussion. Original posts must be  a minimum of 250 words.

and/or get involved in campaign politics?

2-What strategies might nurses use to have their voices heard?

You can use this reference:

The American Nurse: http://www.theamericannurse.org/2014/10/22/time-for-nurses-to-get-out-the-vote/

As a reminder, all questions must be answered by separated to receive full credit for this discussion. Make sure to use scholarly sources to support your discussion. Original posts must be a minimum of 250 words.