The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 600-700-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:

1. Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.
2. Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.
3. Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.

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.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Discuss characteristic findings of immune dysfunction for either hypersensitivity reactions or AIDS. Explain what symptomology the patient would exhibit and how these symptoms may complicate daily living and relationships.

Assessment 1

• Proposing a New Initiative

Research an economic opportunity that might be available within your health care setting that will provide ethical and culturally equitable improvements to the quality of care. Then, write a 2–4-page proposal for an initiative to take advantage of that opportunity, supported with economic data and an analysis of the prospective benefits.

Note: Each assessment in this course builds upon the work you have completed in previous assessments. Therefore, you must complete the assessments in the order in which they are presented.

Master’s-level health care practitioners are charged with the responsibility of constantly scanning the external environment for shifts in the supply of, and demand for, services. Concurrently, leaders must examine their organization’s strategic direction and determine whether adjustments must be made to current service offerings, whether equipment updates are needed, whether staffing models should be changed, and whether other decisions must be made. Each decision that is proposed must be evaluated in terms of the organization as a system, alignment with the organization’s mission and strategy, available internal resources, potential contract and payer source implications, and the short- and long-term economic effects at both the micro and macro levels.

Health Care Supply and Demand

The following multimedia animation illustrates elastic and inelastic demand curves, with changes in price.

Medical Care Demand Elasticities.

The following multimedia simulation presents the many concerns of stakeholders about the potential effects on an existing hospital system of a proposed mobile clinic for veterans with PTSD.

Vila Health: A New Mobile Clinic.

The following multimedia self-check activities will aid you in defining terms commonly used in discussions of health care economics.

The Demand for Health.

U.S. Health Care System Issues.

Understanding supply and demand in health care can be crucial to effective cost management and fiscal responsibility. This author explains the concept well by the use of examples and strategies for success.

Indresano, R. (2016). How to rebalance the supply-demand scales in healthcare. Retrieved from https://www.beckershospitalreview.com/patient-engagement/how-to-rebalance-the-supply-demand-scales-in-healthcare.html

The following article addresses the how and why behind the concept of spending efficiently in health care organizations. Examining the costs and benefits of economic opportunities is the key to success for leaders that know how to do more with less.

Doi, S., Ide, H., & Takeuchi, K., Fujita, S., & Takabayashi, K. (2017). Estimation and evaluation of future demand and supply of healthcare services based on a patient access area model. International Journal of Environmental Research and Public Health, 14(11), 1367–1381.

Health Care Costs

The following article provides a good example of the impact that the current health care environment has had on the practice of nurse practitioners. Many of these restrictions are similar toother disciplines, while others are unique to health care providers. This is important from the perspective of both the care giver and patients.

Chattopadhyay, S., & Zangaro, G. (2019). The economic cost and impacts of scope of practice restrictions on nurse practitioners. Nursing Economics, 37(6), 273–283.

The following article addresses the financial impact of health care and why health care executives and leaders play such a fiduciary role between the organization and environment. What is revealed is why the application of research and best practices becomes paramount for successful fiscal management for health care organization’s viability and sustainability.

Lyford, S., & Lash, T. A. (2019). America’s healthcare cost crisis: As the costs of U.S. healthcare continue to escalate, three commonsense reforms could reverse this unsustainable trend. Generations, 7–12.

Economic Initiatives

The following articles address the critical importance of aligning the quality of patient care initiatives with cost-effectiveness. The creation of service lines and the improvement of current practices must be sustainable and realistic to meet the challenges of ongoing performance improvement from the perspective of productivity standards.

Bennett, L. E., Jewell, V. D., Scheirton, L., McCarthy, M., & Muir, B. C. (2019). Productivity standards and the impact on quality of care: A national survey of inpatient rehabilitation professionals. Open Journal of Occupational Therapy, 7(4), 1–11.

Lin, C., Romley, J. A., & Carlin, C. (2018). The relationship between the patient-centered medical homes, healthcare expenditures, and quality of care among children with special health care needs. Maternal & Child Health Journal, 22(12), 1751–1760.

The following article addresses the provision of free health care services and the evaluation of the program’s impacts.

Edoka, I., Ensor, T., McPake, B., Amara, R., Tseng, F.-M., & Edem-Hotah, J. (2016). Free health care for under-fives, expectant and recent mothers? Evaluating the impact of Sierra Leone’s free health care initiative. Health Economics Review, 6(19), 1–15. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4877339/

The following interesting article provides the perspective of the cost evaluation process with use of a trial for a new initiative. It can be identified why a trial run can be benefit when exploring the opportunities for management of the costs from before and after the plan is implemented.

Panagioti, M., Reeves, D., Meacock, R., Parkinson, B., Lovell, K., Hann, M., . . . Bower, P. (2018). Is telephone health coaching a useful population health strategy for supporting older people with multimorbidity? An evaluation of reach, effectiveness and cost-effectiveness using a ‘trial within a cohort’. BMC Medicine, 16(1), 1–15.

The following article addresses the impact of an economic initiative on cost, utilization, and outcomes.

Rhodes, K. V., Basseyn, S., Gallop, R., Noll, E., Rothbard, A., & Crits-Christoph, P. (2016). Pennsylvania’s medical home initiative: Reductions in healthcare utilization and cost among Medicaid patients with medical and psychiatric comorbidities. Journal of General Internal Medicine, 31(11), 1373–1381. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5071276/

Ethical and Cultural Issues

The systemic review findings in the following article include evidence that interventions to improve cultural competency can improve patient or client health outcomes.

Truong, M., Paradies, Y., & Priest, N. (2014). Interventions to improve cultural competency in healthcare: A systematic review of reviews. BMC Health Services Research, 14, 99. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946184/

Library Research Guides

You may choose other resources to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The following library guides can help direct your research.

MHA Program Library Guide.

MSN Program Library Research Guide.

Public Health Masters Program Library Guide.

Additional Resources for Further Exploration

Review the following:

Centers for Disease Control and Prevention. (n.d.). National Center for Health Statistics. Retrieved from http://www.cdc.gov/nchs/

Centers for Medicare & Medicaid Services. (n.d.). Retrieved from http://cms.gov/

National Institutes of Health. (n.d.). Retrieved from http://www.nih.gov/

Assessment Instructions

Research an economic opportunity that might be available within your health care setting—at both micro (departmental, neighborhood) and macro (organizational, community) levels—that you believe will provide ethical and culturally equitable improvements to the quality of care. Then, propose an initiative to take advantage of that opportunity. Support your proposal with economic data (sector growth, supply versus demand, cost versus reimbursement, et cetera) and an analysis of the prospective benefits for your department and for the organization overall.

Such economic opportunities might include offering a new service line, working to improve a service line already offered, retiring an outdated or unprofitable service line, or any other initiative you believe will be of benefit to your organization in the short and long term. One example is a recently launched partnership with a local bicycle sharing company. Your organization partners with them to host healthy community events that offer free screenings for early detection of various health issues. Free screenings help fulfill some of your organization’s preventive and healthy lifestyle initiatives, while also potentially driving referrals to other services provided by your organization.

Note: Your proposal will serve as the basis for subsequent assessments in this course.

Note: Remember that you can submit all, or a portion of, your draft proposal to Smarthinking for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

Requirements

The requirements for your proposal, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format, length, and supporting evidence.

Explain why your proposed initiative presents a viable and beneficial economic opportunity for your organization.

Describe your proposed service line or economic initiative.

Explain why your proposal presents an economic opportunity at the micro level and macro level.

Explain how your proposed initiative will provide ethical and culturally equitable improvements to the quality of care.

Analyze the economic factors of supply and demand associated with your proposed initiative, within a context relevant to your organization or care setting.

What do economic and demographic data suggest is the supply and demand?

What additional information would improve your analysis?

Explain how relevant economic and environmental data support your proposed initiative.

How does the data illustrate a potential opportunity and the economic viability of your proposal?

Write concisely and directly, using active voice.

Proofread your proposal before you submit it to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your proposal.

Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Assessment 1 Example [PDF].

Additional Requirements

Your assessment should also meet the following requirements:

Format: Format your proposal using current APA style. Use the APA Style Paper Template [DOCX]. An APA Style Paper Tutorial [DOCX] is also provided to help you in writing and formatting your proposal. Be sure to include:

A title page and references page. An abstract is not required.

A running head on all pages.

Appropriate section headings.

Length: Your proposal should be 2–4 pages in length, not including the title page and references page.

Supporting evidence: Cite 3–5 authoritative and scholarly resources to support your proposal. Be sure that your sources include specific economic data.

Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, after your work has been evaluated.

Portfolio Prompt: You may choose to save your proposal to your ePortfolio.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment scoring guide criteria:

Competency 1: Analyze the effects of financial and economic factors (such as cost-benefit, supply and demand, return on investment, and risks) in a health care system on patient care, services offered, and organizational structures and operation.

Analyze the economic factors of supply and demand associated with a proposed initiative, within a context relevant to a particular organization or care setting.

Competency 2: Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and services offered.

Explain why a proposed initiative presents a viable and beneficial economic opportunity for an organization.

Competency 3: Justify the qualitative and quantitative information used to guide economic decision making to stakeholders and colleagues.

Explain how relevant economic and environmental data support a proposed initiative.

Competency 5: Produce clear, coherent, and professional written work, in accordance with Capella writing standards.

Write concisely and directly using active voice.

Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.

Case Study:

Middle-Aged White Male With Anxiety

BACKGROUND INFORMATION:

The client is a 46-year-old white male who works as a welder at a local steel fabrication factory. He presents today after being referred by his PCP after a trip to the emergency room in which he felt he was having a heart attack. He stated that he felt chest tightness, shortness of breath, and feeling of impending doom. He does have some mild hypertension (which is treated with low sodium diet) and is about 15 lbs. overweight. He had his tonsils removed when he was 8 years old, but his medical history since that time has been unremarkable. Myocardial infarction was ruled out in the ER and his EKG was normal. Remainder of physical exam was WNL.

He admits that he still has problems with tightness in the chest and episodes of shortness of breath- he now terms these “anxiety attacks.” He will also report occasional feelings of impending doom, and the need to “run” or “escape” from wherever he is at.

In your office, he confesses to occasional use of ETOH to combat worries about work. He admits to consuming about 3-4 beers/night. Although he is single, he is attempting to care for aging parents in his home. He reports that the management at his place of employment is harsh, and he fears for his job. You administer the HAM-A, which yields a score of 26.

Client has never been on any type of psychotropic medication.

MENTAL STATUS EXAM:

The client is alert, oriented to person, place, time, and event. He is appropriately dressed. Speech is clear, coherent, and goal directed. Client’s self-reported mood is “bleh” and he does endorse feeling “nervous”. Affect is somewhat blunted but does brighten several times throughout the clinical interview. Affect broad. Client denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment is grossly intact, as is insight. He denies suicidal or homicidal ideation.

The PMHNP administers the Hamilton Anxiety Rating Scale (HAM-A) which yields a score of 26.

Diagnosis: Generalized anxiety disorder

To prepare for this Assignment:

· Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.

·

The Assignment:

Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

· Decision #1:

o Which decision did you select?

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

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:

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

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?

· Decision #3:

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

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.

Note: Support your rationale with a minimum of three to five academic resources no more than five years in APA Format.